TriMix (TriMix (Papaverine + Phentolamine + Alprostadil))
A compounded injectable combining three vasodilators for erectile dysfunction. One of the most effective ED treatments available through telemedicine clinics, used when oral PDE5 inhibitors are insufficient.
How it works
Papaverine relaxes smooth muscle via PDE inhibition. Phentolamine blocks alpha-adrenergic receptors. Alprostadil (PGE1) directly stimulates cAMP production in cavernosal tissue. Together they produce reliable penile erection independent of arousal.
Key facts
- Molecular weight: Combination compound
- Half-life: ~1-3 hours (local effect)
- Bioavailability: Direct intracavernosal: ~100%
- Storage: Refrigerate 2-8°C. Protect from light.
Dosing overview
- Typical dose: 0.1-0.5 mL (titrated)
- Frequency: As needed, max 3x/week
- Duration: Ongoing
- Route: Intracavernosal injection
Protocol notes
- Dosing is highly individual - clinics start with a very small test dose (e.g. 0.05-0.1 mL) and titrate up under supervision.
- Inject into the side of the penile shaft (intracavernosal) ~10-15 minutes before activity.
- Never exceed the prescribed max frequency (typically 3x/week) or stack with oral ED meds without guidance.
Reported benefits
- Reliable erectile response
- Works when oral meds fail
- Rapid onset (5-15 min)
- Adjustable dosing
- No systemic cardiovascular effects
Possible side effects
- Injection pain
- Priapism risk (rare)
- Penile fibrosis (long-term)
- Bruising
- Hematoma
Research
- TriMix efficacy in PDE5 inhibitor non-responders (2020): 92% success rate in men who failed oral therapy, with satisfaction scores comparable to spontaneous erections.
- Long-term safety of intracavernosal injection therapy (2021): No significant fibrosis or loss of efficacy over 5 years of consistent use with proper injection technique.
Compare TriMix
Community discussions about TriMix
- TriMix injection bruising – any tips to reduce soreness and hematoma? - 6 comments
- Injection site bruising pattern on trimix, anything to watch for? - 4 comments
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Research and educational reference only. Not medical advice.