TriMix Injections

  • RTriMix is safe for people who take nitrates.
  • RTriMix is safe, reliable, and affordable.
  • RQuadMix adds a 4th ingredient, which is usually atropine.
  • RTriMix is a mixture of papaverine, phentolamine, and alprostadil.
  • RInjection therapy is accepted by the AUA as a viable alternative to surgery when oral medications can not be used or do not produce satisfactory results.


Trimix & Trimix Injections

TriMix Definition: TriMix is a common term used to describe a mixture of Papaverine, Phentolamine, and Alprostadil (PGE). These drugs produce a vasodilating effect when injected into the penis, relaxing and dilating the blood vessels. The American Urological Society recognizes TriMix injection therapy as a viable treatment for erectile dysfunction.

The TriMix injection is administered using a very small needle inserted into the proper area along the shaft of the penis, so the drug mixture is delivered into the corpus cavernosum. The mix of drugs causes the corpus cavernosum to relax, dilate, and become filled with blood, producing an erection.

TriMix is generally an effective, low-cost treatment for ED, especially for those patients who have not had good results or experience moderate to severe side effects from PDE5 inhibitors (Viagra®, Levitra®, Cialis®).

TriMix injections offer a solution for ED that is:

– Safe

– Reliable

– Fast-acting

– Long-lasting

–More affordable than oral medications

– Not affected by alcohol consumption

According to the American Urologic Association, an intracavernous injection is the most effective non-surgical treatment for ED. Penile injections, unlike most oral medications, can trigger an automatic erection in less than 5 minutes. In addition, triMix medication can provide longer and fuller erections that may last through climax, allowing you to maintain and improve your sexual health.

What Is Erectile Dysfunction?

So, what is erectile dysfunction, exactly? Erectile dysfunction is sexual dysfunction characterized by the inability to develop or maintain an erection sufficient for intercourse. While erectile dysfunction can affect men of any age, it is most common in men over the age of 40. Studies have estimated that the number of men with erectile dysfunction in the United States is more than 30 million. Learn more about erectile dysfunction and penile injection medications today.

Symptoms and Causes

The inability to achieve or maintain an erection can affect a man at any time. It can happen once in a while or more frequently, and there can be many different causes. Some common causes include:

– Low testosterone
– Cardiovascular disease
– Diabetes
– Prostate issues
– Depression
– Anxiety
– Nerve/spinal cord damage
– Effects of taking medications

Treatment Options
Topline Pharmacy offers various forms of popular oral medications for erectile dysfunction, such as:

– Sildenafil (compare to Viagra): Available in capsules or rapid dissolve tablets (dissolve under tongue)

– Vardenafil (compare to Levitra): Available in capsules or rapid dissolve tablets (dissolve under tongue)

– Tadalafil (compare to Cialis): Available in capsules or rapid dissolve tablets (dissolve under tongue)


Topline Pharmacy also offers more than 40 combinations of TriMix, a popular penile injection therapy medication. Our TriMix medications are backed by a full stability study and cGMP testing of every batch.


Want answers to your TriMix injection questions? View our FAQs now:

TriMix Injection Benefits

Goals of TriMix Injection Treatment

TriMix injection treatment plans aim to provide men with a reliable, easy-to-use, safe method of achieving and maintaining an erection suitable for sexual relations. There are many benefits to using TriMix injections for ED: they’re safe, effective, easy to store, long-lasting, easy to administer and more. Once you receive a prescription, or if you have additional questions, Contact Us.

Alternative to Tablets
TriMix injections are an alternative to PDE5 Inhibitor tablets (Viagra®, Levitra®, Cialis®) and are most commonly comprised of a mixture of three drugs; phentolamine, papaverine and alprostadil. These penile injections can be especially useful when patients are unable to take PDE5 Inhibitors because they are taking nitrates, certain beta-blockers, or if they experience severe side effects from the oral medications.


7 Things to Know About TriMix Injections:


TriMix injections are a common and well-tolerated method of obtaining an erection used by men with symptoms of ED for more than 30 years. It’s especially useful for men with severe ED caused by high blood pressure, high cholesterol, smoking, diabetes and obesity.



TriMix ED injections are incredibly effective. According to the American Urologic Association, intracavernous injections like TriMix are currently the most effective option for non-surgical ED treatment.



Unlike oral ED medications, TriMix injections trigger an automatic erection — most in 10 minutes or less. Some men may not begin to see the effect until after sexual foreplay has begun. In the beginning, we recommend using a lower dose to prevent prolonged erections. Your doctor may recommend adjusting your dosage after the initial exposure.


TriMix injections provide longer and fuller erections than most oral alternatives that can last through the climax, helping men achieve improved sexual health and performance. Erections should last between one and two hours.

When using TriMix or any other ED medication, an erection should never last four or more hours. Erections that last more than four hours are considered a medical emergency. Please immediately contact your local emergency room to be treated if you are experiencing this symptom.


For some, penile injections may seem too painful to self-administer. However, for many who’ve tried TriMix, the process couldn’t be easier and more painless! Check out these simple self-injection instructions to see how easy it can be to do it yourself:

— Wash your hands with soap and water and keep the penis clean.
— Keep the TriMix cold and the syringe sterilized.
— Administer the injection at the 9-11 and 1-3 o’clock positions, between the base and mid-portion of the penis.
— Dispose of your needle properly after injection.


Unlike some medications, the effectiveness of TriMix injections is not usually altered by consuming alcohol. While using this medication, patients can drink responsibly and still have the same results as they would have without it.


TriMix injections are best stored in the refrigerator (between 32 – 39°F) and should be kept away from light. If your prescription is for more than one vial of medication, please store your medication as follows:

— Store the TriMix vial being actively used at normal refrigeration temperature. For convenience, the TriMix can be stored at room temperature for short periods while in use. However, every effort should be made to keep the medication refrigerated or frozen. When traveling, TriMix can be transported with an ice pack.

— The remaining TriMix vials should be placed in a freezer and kept frozen. Frozen vials (between 0-31°F) have a beyond-use date of up to one year.

TriMix is shipped with ice packs. It is normal for the ice packs to melt and the medication to arrive unfrozen or even slightly warm. The effectiveness of the medication is not compromised. TriMix is shipped overnight to ensure stability and optimum results.

TriMix Injection Dosage

The initial Trimix Injection dose should be .05cc to .2cc, depending on the patient’s level of ED. Wait 48 hours before increasing dosage. Then, increase by 0.025 cc to 0.050 cc until a satisfactory dose is reached. The maximum dose is 0.50 cc. Do not be discouraged by a poor result with the first few injections, as the initial dose should be kept low to avoid a prolonged erection.

TriMix injections are a medication that is very customized to the patient’s needs.

How to Get TriMix

Trimix requires a prescription from a licensed physician

TriMix’s 3 Main Ingredients: Papaverine, Phentolamine and Alprostadil

TriMix is composed of three ingredients that act synergetically when combined into a sterile injection. These ingredients include Papaverine, Phentolamine and Alprostadil. Each of these ingredients can be indicated for several conditions independently, but they can have highly effective results in treating ED when combined. This combination has become one of the go-to treatment options for men who do not have effective results from conventional PDE5 inhibitors.

Papaverine as a standalone medication is typically prescribed to patients with circulation problems to increase blood flow. As a vasodilator, papaverine relaxes and dilates blood vessels to help blood flow more easily to the heart and throughout the body. In addition, papaverine relaxes smooth muscle within large blood vessels, especially coronary, systemic peripheral and pulmonary arteries, and is almost completely devoid of effects on the central nervous system.

This ingredient is helpful for men struggling with ED because it helps to provide improved circulation to the penis, enabling patients to obtain and maintain a full erection for intercourse.

Phentolamine is a lasting, adrenergic, alpha-receptor blocking agent that enhances blood flow to the skin, mucosa and abdominal viscera and lower blood pressure. Phentolamine works by blocking alpha receptors in the body, which can be found in the muscle that lines the walls of blood vessels. When these alpha receptors are blocked by phentolamine, muscles relax and blood vessels widen, resulting in a substantial increase in blood flow.

Alprostadil can be used to address symptoms of erectile dysfunction in men. Alprostadil, also a vasodilator, is used to relax the muscles and blood vessels in the penis to allow a steady flow of blood to the penis so the user can achieve and maintain an erection. In three different studies conducted on the efficacy and safety of this ingredient used for intracavernosal treatment, it was found that alprostadil is an effective therapy with tolerable side effects.

TriMix Injection Studies

For detailed information about TriMix injections and their results, read this TriMix study conducted by the International Journal of Impotence Research below.

Introduction and Objective:

Intracavernous injection of Trimix (Tx) is indicated for patients unsuitable for prostaglandin E1 (PgE1) injection due to lack of response, pain or cost. We believe that the ideal ratio of ingredient doses in Tx is yet to be found. We postulated that increasing the doses of individual drug components in an orderly manner would convey important data on penile hemodynamic response. Such information is needed to choose an effective and less costly alternative to PgE1 with least side effects. We set out to evaluate the impact of varying the ingredient dosage on response and short-term safety of Tx compared with PgE1. We prospectively randomized 180 consecutive patients with erectile dysfunction into nine equal groups and each group received a different dose of Tx, namely phentolamine (1 mg) plus one dose of PgE1 (2.5, 5 or 10 μg) and one dose of papaverine (5, 10 or 20 mg). Each patient was injected with 20 μg PgE1 and one dose of Tx in two clinic visits 1 week apart. Following injection, duplex ultrasound of cavernous arteries and axial rigidometry were carried out. Patients ranked the quality of erection, estimated overall satisfaction and reported time to detumescence and side effects. Patients’ mean age was 50.5±11.7 y with underlying organic condition in 91.1%. We set out to evaluate, by means of an acute, prospective, randomized, single blind study, the various dose combinations of Tx versus PgE1 20 μg using both subjective and objective end points.


We think that the ideal ratio of ingredient doses in Tx is yet to be found. The effect of increasing individual drug components on penile response is not known. Such information is needed to choose an effective and less costly alternative to PgE1 with least side effects.


In spite of oral drug therapy for ED, there is a considerable number of candidates for self-injection therapy. These include patients who do not respond to or have a contraindication for PDE-5 inhibitor treatment. In addition, some patients prefer the rigidity provided by injections. In patients undergoing ICI therapy and given the option to try sildenafil, 36.2% decided to use injections most of the time or at least sporadically. The association of multiple vasoactive drugs produces a full erectile response in more than 90% of patients. In nonresponders to doses as high as 40 μg PGE1, Tx combination produced a response in 31%. The cost of the medication is another important issue where Tx has an advantage. Learn more in the study here