TRIMIX

Trimix is an injectable medication comprised of papaverine, phentolamine, and alprostadil used as a treatment for erectile dysfunction (ED).  Trimix injections can trigger an erection within 15 minutes and result in longer and firmer erections that last longer through climax.

Erectile dysfunction (ED), a sexual health condition characterized by the inability to achieve or maintain an erection, affects an estimated 15-30 million men in the U.S., with over 600,000 new cases arising each year.  While ED can occur in younger men, it becomes more prevalent after age 40.  Additionally, large multinational studies have estimated the prevalence of ED in young men to be as high as 30%.  It’s predicted that by 2025, 322 million men worldwide will have ED. 

Trimix aims to provide a reliable, easy, safe way for men to achieve and sustain erections firm enough for sex.  Its main benefits include:

• Effectiveness
• Simple storage
• Long duration
• Easy self-administration

Trimix was developed in 1983 when scientists discovered that adding phentolamine and alprostadil to papaverine, at the time a standalone ED treatment, created a more effective compound.  Trimix injections are an accepted second-line ED medication when oral PDE5 inhibitors, like Viagra, Levitra, or Cialis, are ineffective or create side effects.  Since Trimix works locally where it is injected, rather than circulating throughout the bloodstream like oral drugs, it tends to have a lower risk of side effects.

WHAT ARE TRIMIX COMPONENTS?

Trimix medication contains papaverine, phentolamine, and alprostadil.  These three drugs are compounded into a customized formula tailored to each patient’s requirements.

Papaverine

Papaverine aids men with ED by enhancing blood flow to the penis, allowing patients to achieve and sustain a firm erection for sexual intercourse.  When used alone, papaverine is often prescribed for patients with circulatory disorders to improve blood flow.  As a blood vessel dilator, papaverine relaxes and widens blood vessels, facilitating blood circulation to the heart and body. Furthermore, papaverine relaxes smooth muscles inside large blood vessels, particularly the heart, systemic peripheral, and lung arteries, with minimal effects on the central nervous system.

Phentolamine

Phentolamine is a long-acting adrenergic alpha-receptor blocker that increases blood flow to the skin, mucous membranes, abdominal organs, and reduces blood pressure. Phentolamine works by obstructing alpha receptors in the body, which are present in the smooth muscle lining blood vessel walls. When these alpha receptors are blocked by phentolamine, the muscles relax and blood vessels dilate, producing a significant boost in circulation.

Alprostadil

As a vasodilator, alprostadil relaxes the muscles and widens the blood vessels in the penis, enabling continuous blood flow to achieve and sustain an erection.

REVERSAL

Phenylephrine (Erection Reversal)

In cases of prolonged erections, phenylephrine offers a solution.  It should be injected using the same method as Trimix, but only after about 3-4 hours of sustained erection to prevent negative outcomes. Dosing with .05 ml and repeating until the erection subsides is advised, but frequent use for erection “knock down” is not recommended due to potential risks.

HOW DOES TRIMIX WORK?

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 erection.

Trimix can work quickly, triggering an erection within 15 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. 

WHO SHOULD USE TRIMIX?

Trimix may be suggested for men with erectile dysfunction as an alternative to PDE5 inhibitors if they 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.

POTENTIAL SIDE EFFECTS OF TRIMIX

While Trimix injections tend to cause fewer side effects that 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 a potential risk with other ED drugs like Viagra, Levitra, and Cialis. An erection persisting longer than 4 hours requires prompt medical care.

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

FREQUENTLY ASKED QUESTIONS

IS TRIMIX SAFE?

According to the American Urological Association, intra-cavernous injections like Trimix are the most potent non-surgical ED treatment currently available. Trimix injections themselves have been an accepted ED treatment since the 1980s.. As localized ED therapy, Trimix has few to no systemic side effects and is usually unaffected by alcohol when used responsibly.

HOW EFFECTIVE IS TRIMIX COMPARED TO ORAL ED DRUGS?

Trimix is an accepted second-line drug for ED treatment when oral PDE5 inhibitors aren’t effective or cause side effects.  Compared to PDE5 inhibitors like Viagra, Cialis or Levitra, studies show Trimix is often more effective for patients with diabetes or those unresponsive to oral meds.  Clinical trial results indicate patients using Trimix achieved erections firm enough for sex 82-90% of the time, versus 62-72% with PDE5 inhibitors alone.  Trimix may also work faster since it is injected directly into the penis.

Multiple studies demonstrate Trimix outperforms PDE5 inhibitors in efficacy and safety.  A 2016 Baylor College study found Trimix yielded 61% greater improvement in penile rigidity compared to 18% with PDE5 inhibitors in men with mild to severe ED.  Another trial in the Canadian Urological Association Journal showed significantly fewer adverse events with Trimix versus sildenafil or vardenafil.

Because Trimix is injected locally into the penis, there are typically few to no systemic side effects, unlike oral medications that circulate through the bloodstream and can sometimes cause headaches, nausea, or vomiting.