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Trimix Injections: A Well-Tested Solution For ED

Dec 14, 2020
Trimix Injections: A Well-Tested Solution For ED

Penile injection therapy is a well-tested treatment for erectile dysfunction. Injectable medications have been used since 1983 and are considered by the American Urologic Association to be one of the most effective non-surgical solutions for ED (American Urological Association, 2018). Trimix injections are compounded medications that require a prescription.

Men can buy Trimix injections online after consulting with a physician and receiving a prescription. Trimix is an alternative treatment option for men who have not had satisfactory results with PDE5 inhibitors such as Viagra®, Levitra®, Cialis®, or men who prefer an injectable to treat ED. The American Urological Association evaluates treatment options and makes recommendations that are followed by healthcare providers around the country. In this article, we present some of these recommendations.

The Importance Of Treating ED

Men who have ED should start with a consultation with a healthcare provider. Their primary care provider is usually most men’s first choice. Other men may feel more comfortable seeing a specialist in ED treatment. Their reasoning may be a desire to learn about all available treatment options and consult with someone who has a depth of experience in treating men and their health issues. Invigor Medical is a clinic focused on men’s health. It can evaluate men for treatment options such as Trimix injections and if it is an appropriate option. Invigor Medical partners with a licensed, U.S.-based pharmacy to ensure that pharmaceutical-grade components are used to produce Trimix.

Trimix Injections

An Evaluation Starts With A History And Physical Exam

The American Urological Association recommends that men with symptoms of ED should undergo a thorough medical, sexual, and psychosocial history, a physical exam, and a select panel of lab tests to begin the evaluation process. Several well-validated questionnaires are available to aid in this process. These questionnaires include questions on the following topics:

  • When was the onset of ED?
  • Was the onset gradual or more abrupt?
  • How often are you able to have erections?
  • Are your erections firm enough for sexual relations?
  • Are you able to penetrate and maintain an erection?
  • How would you rate your level of sexual desire?
  • Past sexual history.
  • Previous treatments for ED and their success.
  • Risk factors for ED.
  • Past medical history.
  • Findings on a physical exam.
  • Lab testing.

The panel from the American Urological Association stressed that ED is a risk marker for many treatable underlying medical conditions. Ignoring ED symptoms can cause delayed identification and treatment of disorders such as diabetes and cardiovascular disease, which can adversely affect both the quality and length of life. Symptoms of ED may precede symptoms of cardiovascular disease by up to five years. Younger men with ED have a 50-fold increase in cardiovascular events when compared with men without ED.

Recommendation: Make an appointment with a healthcare provider to undergo an evaluation and to treat ED.

Treatment Options

The American Urological Association panel advocates for shared decision-making and states that men should not need to progress through ED treatment options based on invasiveness or reversibility. Men may choose to start with oral treatments first, but any option is a valid starting point as long as men are aware of the risks and benefits associated with that treatment option. Some men may prefer injectable medications because they act locally, not systemically, and may have fewer unwanted side effects for that reason.

Recommendation: Explore treatment options for ED and have a discussion with your healthcare provider regarding the risks and benefits of each option.

How To Use Trimix

Trimix and other ICI (intracavernosal injections) medications are injected into the corpus cavernosa of the penis to produce an erection. The four common substances used for ICI injections are alprostadil, papaverine, phentolamine, and atropine. Trimix injections are a combination of the first three. Men who choose ICI may be among the 40 percent who find that oral ED medications do not provide adequate treatment or just prefer ICI. The American Urological Association panel reported that 53.7 to 100 percent of men achieved a satisfactory erection with Trimix, and 46.3 to 98.8 percent of men were happy with their choice to use intracavernosal injections as a treatment option.

Trimix Injections: A Well-Tested Solution For ED

Adverse Effects Of Trimix

The most serious adverse effect of any ICI treatment option is the risk of priapism. Using only the prescribed dose of Trimix and at the recommended interval and never combining ED medications unless instructed by your physician can help decrease the risk of priapism.

Pain as an adverse effect is more common when papaverine or alprostadil are used as single agents for treatment.

The panel reported that there was a wide range of the incidence of penile fibrosis across studies. The panel could find no association of penile fibrosis with any particular medication. They recommend that penile fibrosis be noted before treatment and followed closely throughout treatment.

The panel recommends that men have an in-office injection test to determine dosage and to minimize the risk of adverse effects. An in-office injection test can help verify that a man is comfortable with the injection method. Besides injection techniques, men and their partners should learn how to titrate the dose, the importance of alternating injection sites, and how to proceed if an adverse event, such as priapism, should occur.

The American Urological Association panel members point out that ICIs, such as Trimix injections, were developed to improve efficacy by taking advantage of the drugs’ synergistic effects and to reduce side effects because lower doses of each medication are used when they are combined.

Recommendation: Know how to decrease the risk of priapism and the actions you should take if it occurs.

Trimix Dosage

Dosage titration is essential to ensure that your prescribed dosage of Trimix is the minimum effective dose. Do not make dosage adjustments on your own. Priapism, or a prolonged, painful erection, can cause damage to the structure of the penis if it is not treated quickly and appropriately. The incidence of priapism with Trimix ranges from 0% to 3.7% of users (Seyam et al., 2005).

Recommendation: Use Trimix injections in the recommended dosage and interval prescribed by your physician.

How To Get Trimix Injections Online

Men can buy Trimix injections online from any compounding pharmacy. A prescription is required for all compounded medications, as the amount of each component may vary. We recommend that men choose U.S. based, national compounding pharmacies that are licensed and follow all guidelines on compounding medications.

Trimix Injections: A Well-Tested Solution For ED

Invigor Medical’s platform has proven successful for thousands of patients. You select the medication desired, fill out the intake form, arrange a call from a doctor to evaluate whether you are a good candidate for Trimix shots, and get a prescription. The doctor sends the script to the pharmacy. The pharmacy mails the medication to you. These steps can be done using your smartphone on the Invigor Medical website.

Frequently Asked Questions

What is the downside of Trimix?

While Trimix injections can be effective for treating erectile dysfunction (ED), there are potential downsides to consider. One downside is the need for self-injection, which can be intimidating or uncomfortable for some individuals. Additionally, there is a risk of side effects such as pain at the injection site, bruising, or scarring of penile tissue. Priapism, a prolonged and painful erection lasting more than four hours, is a rare but serious complication associated with Trimix injections. It’s essential to discuss the potential risks and benefits of Trimix with a healthcare provider to determine if it’s the right treatment option for you.

How long does a Trimix injection last?

The duration of a Trimix injection’s effectiveness can vary from person to person and depends on factors such as dosage, individual response, and level of sexual stimulation. Typically, an erection induced by Trimix can last for 30 minutes to several hours. It’s important to follow your healthcare provider’s instructions regarding dosage and timing to optimize the duration of the erection and minimize the risk of complications such as priapism.

Where do you inject Trimix?

Trimix injections are typically administered directly into the corpus cavernosum, which are the erectile chambers of the penis. The injection is usually given along the side of the penis, avoiding the central area where the urethra is located. Healthcare providers often provide guidance on proper injection technique, and it’s important to follow their instructions closely to ensure safety and effectiveness.

Does Trimix come in a pill?

Trimix is not available in pill form. It is a compounded medication that consists of a combination of three drugs: papaverine, phentolamine, and alprostadil. These drugs are typically mixed together in a solution and administered as an injection directly into the penis to induce an erection. Trimix injections are prescribed by healthcare providers for individuals with erectile dysfunction who have not responded to other treatments such as oral medications.

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

Trimix Injections: A Well-Tested Solution For ED

Leann Poston, M.D.

Dr. Leann Poston is a licensed physician in the state of Ohio who holds an M.B.A. and an M. Ed. She is a full-time medical communications writer and educator who writes and researches for Invigor Medical. Dr. Poston lives in the Midwest with her family. She enjoys traveling and hiking. She is an avid technology aficionado and loves trying new things.


  • American Urological Association. (2018). Erectile Dysfunction: AUA Guidelines. https://www.auanet.org/guidelines/erectile-dysfunction-(ed)-guideline#x8050
  • Seyam, R., Mohamed, K., Akhras, A. et al. A prospective randomized study to optimize the dosage of Trimix ingredients and compare its efficacy and safety with prostaglandin E1. Int J Impot Res 17, 346–353 (2005). https://doi.org/10.1038/sj.ijir.3901313


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