Trimix

Trimix is an injectable medication commonly prescribed for erectile dysfunction (ED) and penile rehabilitation, particularly after prostate surgery. It contains three active ingredients—alprostadil, phentolamine, and papaverine—that each help increase blood flow to the penis, resulting in an erection.

Unlike U.S. Food and Drug Administration (FDA)-approved ED treatments like Caverject^®, Trimix is a compounded medication, which means it’s custom-made to be tailored to each individual patient’s needs at sterile compounding pharmacies. 

Trimix is typically injected into the penis shortly before intercourse, with effects beginning within 5 to 20 minutes and lasting 30 to 60 minutes. 

While Trimix is effective for many people who do not respond to oral ED medications, the injectable carries some risks and side effects, such as pain, bruising, scarring, and priapism, which is a painful erection that lasts more than four hours and requires immediate medical attention to avoid permanent damage.

Trimix (alprostadil, papaverine, and phentolamine) is not an FDA-approved medication. It is sometimes prescribed for:

• Erectile dysfunction

Alprostadil: prostaglandin E1 agonist

Papaverine: vasodilator

Phentolamine: nonselective alpha-adrenergic antagonist

Common side effects of Trimix include:

• Pain

• Bleeding

• Infection

• Priapism

The cost of Trimix injections for ED varies depending on factors such as your insurance plan, the dosage, the quantity, and the pharmacy you use. There are no good estimates available when it comes to the exact price of Trimix.

Keep in mind that Trimix may not be covered by some insurance plans because it’s compounded, and these types of medications are not FDA-approved. Also, some compounding pharmacies may not take insurance, which would require you to pay for the medication out-of-pocket.

You can get a prescription for Trimix after being evaluated by your primary care provider or another specialist who can determine if the medicine is right for you based on factors like your symptoms and medical history.

Trimix injections should not be used by patients with:

• Allergies to any components of Trimix

• Sickle cell anemia

• Blood clotting disorders

• Conditions predisposing to priapism

• Leukemia

• Anatomical deformations of the penis

• Penile implants

• Direct instructions from a physician to abstain from sexual activity

• Drug interactions: Some chemicals within Trimix penile injections can interact with other medications, causing ineffectiveness or adverse effects.

• Be aware that the first few administrations of Trimix may not deliver a satisfactory result

• Always contact your provider before increasing your dosage

• If you experience swelling, numbness, tenderness, redness or lumps on your penis or surrounding areas, contact your provider immediately

There are other prescription medication options for treating ED. Some of these drugs may be better suited to you than others. If you’re interested in finding an alternative to Trimix, talk with your provider to learn more about other medications that may work well for you.

Other penile injection medications for ED include:

• Caverject^® and Edex^® (alprostadil)

• Papaverine on its own

• Phentolamine on its own

• Other combination medications such as Bimix and Quadmix

Oral medications that can treat ED include:

• Viagra^® (sildenafil)

• Cialis^® (tadalafil)

• Stendra^® (avanafil)

• Vardenafil

• Chewable ED meds available through Hims that contain one or more of the active ingredients in Cialis and Viagra

As an alternative or in addition to taking ED medications, your healthcare provider may suggest therapy for mental health issues that may be contributing to your ED symptoms. They may also suggest you make certain lifestyle changes that support sexual health, like following a healthy diet, exercising, and cutting back on alcohol.

Other treatments for ED include a topical gel, a penis pump with or without a constriction ring, penile implant surgery, and testosterone therapy (if you have low testosterone).

*Information about Trimix^® is limited. This information was taken, in part, from Olympia Pharmaceuticals' website.