Trimix Injections for Erectile Dysfunction: A Guide

Trimix may be prescribed for men with symptoms of erectile dysfunction, especially if PDE5 inhibitors have proven ineffective or resulted in side effects.

Some common risk factors and conditions associated with ED include:

• • Low testosterone
• • Cardiovascular disease
• • Diabetes
• • Prostate issues
• • Depression
• • Anxiety
• • Neurological/spinal cord injury

Trimix may also be appropriate for patients with medical conditions that preclude taking oral ED drugs, such as men who’ve had prostate surgery or certain cardiovascular diseases, or for patients who cannot take PDE5 inhibitors due to concurrent nitrate therapy or certain beta-blockers.

While Trimix injections tend to cause fewer side effects than systemic ED medications, some adverse reactions may still occur. Trimix side effects can vary significantly between individuals.

A serious but rare side effect of Trimix is priapism, an erection lasting over 4 hours. This is also a potential risk with other ED drugs like Viagra, Levitra, and Cialis. An erection persisting longer than 4 hours requires prompt medical care.

Other possible Trimix side effects include:

• • Mild to moderate penile pain
• • Priapism (prolonged erections)
• • Penile scarring
• • Bruising or hematoma
• • Low blood pressure or dizziness
• • Allergic reactions

Note that this list is not comprehensive, and patients may experience other uncommon or individual-specific side effects. It’s vital to discuss treatment with a healthcare provider who can monitor response, address concerns, and manage any side effects from Trimix injections.

Trimix is not recommended for men with:

• • Known allergies to Trimix ingredients
• • Sickle cell anemia
• • Bleeding disorders
• • Conditions increasing priapism risk
• • Leukemia
• • Penile abnormalities
• • Penile implants
• • Explicit medical advice to refrain from sexual activity

It’s important to inform your provider of all medications, over-the-counter drugs, herbal products, and other substances you take. Trimix components can interact with some medications, potentially making them less effective or causing adverse reactions.

After receiving a physician’s instructions, Trimix injections are typically self-administered at home. While this may sound daunting, it’s actually an easy procedure that many patients find painless with practice. (See our injection instructions below.) However, it’s important to use proper injection technique with a 29-30 gauge x 1/2″ needle inserted fully into the shaft of the penis for intracavernosal administration.

Below are the general step-by-step instructions for self-administering Trimix. Be sure to follow the specific instructions of your medical provider. Always consult a healthcare provider before starting any new medication.

• • Proper hygiene is important. Wash your hands and keep the penis clean to prevent infection.
• • Assemble the following: bottle of Trimix, alcohol pad, syringe.
• • Keep the Trimix cold by returning the bottle to the refrigerator or placing the bottle in a cup of ice.

• • Wipe the rubber top of the vial with an alcohol pad to sanitize it.
• • After removing the cap of the needle, pull the plunger back to the desired dosage, filling this volume with air. Use a new needle
  and syringe each time.
• • Insert the needle through the rubber top and inject the air into the vial.
• • Turn the vial with the needle and syringe inserted upside down. Pull back on the syringe plunger in a slow and steady motion until the desired dosage is achieved.
• • Tap the side of the syringe (1cc tuberculin syringe with a 29 gauge needle) to allow any air bubbles to float towards the needle.
  Avoid having these air bubbles in the syringe when self-injecting by first injecting out the collected bubbles that may form.
• • Remove the needle from the bottle and replace the protective cap on the needle.

• • The proper location for injection is at the 9-11 and 1-3 o’clock positions, between the base and mid-portion of the penis. (See the diagram in Step 3 of our Trimix Self-Injection Instructions PDF.) Avoid the midline because of the potential for injury to the urethra (6 o’clock for urinary passage) and the penile arteries and nerves (near 12 o’clock). Avoid any visible veins or arteries on the surface.
• • Grasp and pull the head of the penis toward the side of your leg with the index finger and thumb (use the left hand, if right handed). While maintaining light tension, select a site for injection.
• • Clean the site with an alcohol pad.

• • With a steady and continuous motion, penetrate the skin with the needle at a 90-degree angle. The needle should then be advanced to the hub. Slight resistance is encountered as the needle passes into the proper position within the erectile tissue (corporeal body).
• • Inject the Trimix over approximately 4 seconds. Withdraw the needle from the penis and apply compression to the injection site
  for approximately 1 minute. Several minutes of compression may be required to avoid bleeding, especially if you are an aspirin
  user.
• • Replace the cap on the needle and dispose of it properly.

Once Trimix is injected directly into the shaft of the penis, the compounded mixture of papaverine, phentolamine, and alprostadil triggers a vasodilation effect that causes the relaxation and expansion of blood vessels, allowing for the increased blood flow needed to achieve and sustain an erection.

Trimix can work quickly, triggering an erection within 5-10 minutes or less. Some men respond after foreplay begins. Erections typically last 1-2 hours with Trimix, often persisting through climax. Trimix is not designed to enlarge the size of the penis. However, it can help men with ED obtain and maintain a firm erection for longer periods.

With appropriate administration, Trimix can assist men in regaining their lost sexual function due to ED, enhancing their overall quality of life. Remember, erections lasting over 4 hours are a medical emergency requiring immediate care.