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Trimix for Erectile Dysfunction

Trimix is an injectable three-drug compound prescribed for the treatment of impotence, also known as erectile dysfunction (ED), a condition impacting over 18 million men in the United States.

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Trimix for Erectile Dysfunction
Alprostadil 30mcg/Papaverine HCI 30mg/Phentolamine 2mg/mL Injection Solution

Trimix is an injectable three-drug compound prescribed for the treatment of impotence, also known as erectile dysfunction (ED), a condition impacting over 18 million men in the United States.

Erectile dysfunction is defined as the consistent inability to obtain and maintain an erection for satisfactory sexual relations. There are many potential causes for ED including disease of the blood vessels, low testosterone, hormonal imbalance or problems with relationships or mental health¹.

First line ED treatment is typically a PDE5 inhibitor such as Sildenafil (Viagra®), Tadalafil (Cialis) or Vardenafil (Levitra), all of which are generally effective in 60-70% of men who use them.

However, for patients struggling with erectile dysfunction who have tried everything else to produce and maintain an erection, Trimix offers new hope.  Administered as an intracavernosal self-injection containing alprostadil, papaverine and phentolamine, Trimix is most often prescribed when conventional therapies, such as PDE5 inhibitors, fail.

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How Trimix Works

Trimix is a vasoactive drug with many dosing iterations available to the prescriber, yielding a high satisfaction rate. The erectile tissue is a muscle and like any muscle, going long periods of time without use is unhealthy. As a result, erectile tissue that does not experience engorgement may be damaged over time.² The combination of alprostadil, phentolamine and papaverine work synergistically by relaxing the smooth muscle and opening the blood vessels in the penis, resulting in an erection.

Frequent Dose

Alprostadil 30µg/Papaverine HCl 30mg/Phentolamine Mesylate 2 mg/mL

Trimix Ingredient Highlights:

Alprostadil is a prostaglandin (a hormone-like compound) that induces erection by relaxing the blood vessels in the penis and dilating the cavernosal arteries by inhibiting the release of noradrenaline from sympathetic nerve terminals. The increased blood flow allows more blood to move into the penis, causing engorgement (erection). Alprostadil is FDA approved to treat ED however, data suggests 40-70% of patients will respond, which is why it is often compounded with papaverine and phentolamine.

Papaverine is also a vasodilator and smooth muscle relaxer with multiple mechanisms of action – some of which are complex. Most succinctly, papaverine is an inhibitor of PDE enzyme leading to an increase in cGMP in penile tissue. It causes direct smooth muscle relaxation and consequent filling of the corpus cavernosum with blood resulting in erection.

Phentolamine offers therapeutic action by blocking alpha-adrenergic receptors which, in turn, lead to muscle relaxation and a widening of the blood vessels.

Timing and Use:

  • Test doses of Trimix are recommended for all patients to make sure that dosing is accurate.
  • Injections have an average 15-20 minute onset and should be timed accordingly with intercourse. Erections can last up to 60 minutes.
  • Trimix may be used twice weekly or as often as every other day, to be determined by the prescriber.
  • Using penile injections with oral Viagra, Cialis or other PDE5 inhibitors or vacuum erection devices is not recommended.
  • If properly dosed, 80% of men should be able to experience an erection when using Trimix.

Beyond-use Date of Trimix:

A Reproducible Stability Study Using Bracketing Design

Patel Gopesh, Davis Countaney, Liu Yi, Ip Kendice, Debideen Krystal E, Anderson Stephanie, Byrne Robert, Herr Dylan, Rhoads Melissa Merrell, Caputo Ross, Banov Daniel, Bassani August S

What Sets Us Apart

  • VLS Pharmacy operates under the auspices of The New York State Board of Pharmacy, the strictest pharmacy board in the United States. 
  • VLS Pharmacy voluntarily undergoes third-party lab testing to ensure strict quality control of all sterile compounding. This testing assesses compounding accuracy, potency and sterility against bacteria, fungus and pyrogens.


Disclaimer: The content of this post is not intended to a be a substitute for medical advice, diagnosis or treatment. Patients should always seek the advice of a medical professional for any questions about a medical condition. We try to ensure that all information is accurate and correct but cannot be held responsible for typos or grammatical errors.

Please note: all compounds require a valid, patient-specific prescription


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