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Trimix combines three vasoactive agents: alprostadil (PGE1), papaverine, and phentolamine. Injected directly into the corpus cavernosum, they relax smooth muscle and dilate blood vessels through complementary mechanisms — producing erections that don't require sexual stimulation or an intact neurological axis.
No commercial Trimix product exists. Alprostadil alone (Caverject, Edex) costs $50–$100 per injection. Compounded Trimix costs $3–10 per injection and is more effective than alprostadil monotherapy due to the synergistic 3-drug combination. Compounding is the only way to obtain Trimix.
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Trimix is a compounded injectable medication containing three vasoactive drugs — alprostadil (prostaglandin E1), papaverine, and phentolamine — administered by self-injection into the penis to produce an erection. It is the standard of care for men with erectile dysfunction who do not respond to oral PDE5 inhibitors.
Unlike Viagra, Cialis, or Levitra which require intact nitric oxide signaling and sexual stimulation, Trimix works directly on penile smooth muscle through multiple pathways simultaneously — making it effective for men with diabetic neuropathy, post-prostatectomy ED, vascular disease, spinal cord injury, and severe psychogenic ED.
Erectile dysfunction unresponsive to PDE5 inhibitors, post-prostatectomy ED, diabetic neuropathy-related ED, spinal cord injury, vascular ED, severe psychogenic ED
Starting dose: 0.05–0.1mL injected into the lateral corpus cavernosum
Target: Smallest dose producing a 30–60 minute erection
Priapism (erection >4 hours — seek emergency care immediately), injection site pain, penile bruising, fibrosis with long-term use.
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