Trimix is a combination of three vasoactive ingredients: Papaverine, Phentolamine, and Alprostadil used for the treatment of erectile dysfunction.

The components of Trimix include Papaverine, Phentolamine, and Alprostadil. The three components together are commonly called combination therapy. Together Trimix utilizes several different mechanisms to achieve an erection, such as:

  • increasing corporal smooth muscle relaxation;
  • decreasing smooth muscle and blood vessel contraction;
  • increasing blood vessel dilation.


A vasodilating agent that promotes the widening of the blood vessels and influx of blood volume into the penis. The mechanism of action is by relaxing the smooth muscle contained within the walls of blood vessels.


An alpha-blocker that prevents the excitatory signals to blood vessels that normally keeps blood vessel constricted, thereby leading to muscle relaxation.


Alprostadil is an FDA approved monotherapy penile injection for the treatment of ED. It acts by stimulating the production of cAMP (Cyclic adenosine monophosphate) in both penile smooth muscle and blood vessels. A cascade of events leads to muscle relaxation, penile hardness, and a rigid erection.

Combining Trimix and Oral ED Meds

There are several studies that report a high satisfaction rate in men who utilized a combination of both ED meds with penile injection therapy. In an effort to improve penile function and penile rehabilitation, men post radical prostatectomy, have performed the following: Intracavernosal injection of alprostadil 2-3x times per week in addition to using of Viagra during sexual activity.

It is important to note that Alprostadil was injected 2-3x per week on a scheduled basis and not during sexual activity. Satisfaction scores by men who use this therapy were high, especially in men who had failed oral ED meds and did not want to perform penile injection just before activity.

How to improve spontaneity with penile injection therapy?

Trimix has to be refrigerated at all times and it has to be injected, so this makes it difficult to be spontaneous with a partner. One easy way patients have improved their spontaneity is by pre-fill the syringes with the prescribed dosage of Trimix.

Keep the pre-filled syringes in the refrigerator as opposed to the Trimix bottle. This will provide the individual with a quick and easy opportunity to excuse himself, inject with pre-filled syringes, and enjoy the moment.

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