Needle and antibiotics


Trimix is an injectable medication used for the treatment of ED. This medication varies in active ingredients and concentrations and is also known as BiMix, Trimix, or SuperMix. This sterile compounded medication is specially made in a compounding pharmacy which requires a prescription. TriMix is a self-administered penile injection designed for use immediately prior to sexual activity.


Phentolamine, Papaverine, and Prostaglandin (PGE1) are all known to increase blood flow to the penis, ultimately resulting in an erection. TriMix and other compounded penile injection therapies are fast-acting and long-lasting making it a notable option for patients suffering from ED.


Prescription required from your physician.

How to use:

1. Remove vial from freezer and allow entire contents of vial to thaw
2. Wipe rubber stopper with alcohol swab and allow to dry
3. Remove safety cap from syringe and insert into vial
4. Draw up designated dose and remove any air bubbles
5. Clean injection site with alcohol swab
6. Inject Trimix solution into the cavernosal muscle slowly until syringe is empty and safely discard syringe
7. Apply pressure to injection site for up to 5 minutes to stop any bleeding and prevent scar tissue from forming

What it does

The combination of 3 different medications in Trimix work together to amplify and enhance erectile function as compared to a single medication. Once injected, Trimix may result in relaxation and expansion of the penis, resulting in a satisfactory erection lasting throughout the duration of sexual intercourse.

Reasons for use

Trimix begins working quickly in about 5-20 minutes and is expected to last up to 1 hour. Trimix is generally regarded as safe and effective while also providing an alternative to surgery when oral medications are not satisfactory. The injection is relatively painless and easy to administer.


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Troubleshooting Guide

Trimix must be stored in the freezer, between -13°F to 14°F, whenever it is not being used. Each time Trimix is thawed and refroze, potency is lost which is important to keep in mind when adjusting your dose.

Due to state law restrictions, shipping is available in Iowa and Texas via UPS Ground for delivery on Friday’s. Trimix is shipped with dry ice to keep it frozen. It is important to properly dispose of dry ice by not touching, flushing down the toilet or drain, or dumping dry ice into the garbage. Once the medication is retrieved from the shipping container, leave the ends open in a low-frequented location to allow the dry ice to dissolve. Once all the dry ice is gone, dispose of the container in the garbage. A pamphlet is provided with thorough instructions when shipped.

Trimix should be injected into the penis at either the 2 o’clock or 10 o’clock position and at a 90° angle to avoid the urethra. It is also important to avoid any visible arteries or veins when injecting.
Your prescriber will usually start you off on a lower dose with the ability to adjust as needed based on responsiveness. Trimix is commonly adjusted at 5 to10-unit intervals until an effective dose is reached. There may need to be more dose adjustments made with the thawing and refreezing cycle since a small reduction in potency may occur.
There are several available strengths. Most patients start off with the lowest concentration and are able to increase as needed. If you do not believe the current concentration you are using is effective or are using maximum recommended dose, talk with you prescriber or pharmacist for other available concentration options.
Trimix is compounded weekly on Wednesdays. It is available for pick-up on Thursdays in the pharmacy or will be shipped out on Thursday to be received on Friday.

Needles should be disposed of in a designated sharps container. A sharps container may be provided by your pharmacist or a hard, plastic container with a screw on lid may be used. This includes laundry detergent bottles, coffee cans, etc. It is important to never reuse or share needles.

Trimix should be discarded 28 days after first use or 45 days after it was compounded, whichever date comes first.
Penile pain lasting longer than 10 minutes after injection with Trimix may indicate a reaction to one of the drugs, alprostadil. If this occurs, talk to your prescriber or pharmacist about switching to Bimix. Bimix does not contain alprostadil and is a suitable option to prevent further reactions.
Trimix begins working in 5-20 minutes and is expected to last up to 1 hour
Mild to moderate pain, burning, or stinging at the injection site. If you experience an erection lasting longer than 2 hours, apply an ice pack and take 1-3 Sudafed (generic pseudoephedrine) IR 30mg once. If this does not help, seek medical attention immediately for any erection lasting longer than 4 hours.

Trimix can be used up to three times weekly, waiting at least 24 hours between injections.

◦ Phentolamine blocks alpha receptors in the penis causing blood vessels to expand, resulting in increased blood flow to the penis
◦ Papaverine causes blood vessels to expand and muscles to relax leading to an increase in blood flow to the penis

◦ Prostaglandin-E1, also known as alprostadil, is a naturally-occurring lipid that causes blood vessels to expand and muscles to relax, increasingblood flow to the penis

Do’s and Don’ts


  • Keep vial frozen at all times; use a clean needle before each use; dispose of needles in a designated sharps container; alternate injection sites; allow vial to completely thaw before use; use an alcohol swab on vial and injection site before each use; inject at a 10 o’clock or 2 o’clock position.


  • Leave vial out on counter for extended periods of time; allow others to use/try your medication; use for longer than 28 days once opened; reuse needles; draw up and inject medication from a partially thawed vial; inject into a visible artery or vein; inject at 12 o’clock position to avoid urethra.