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Trimix Injection For ED: The Risks And Benefits

Last Updated: August 29, 2025
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Trimix

In Stock
As low as $249/Mo
  • Improved erectile function
  • Rapid onset
  • High efficacy (89%-95%)
NAD+ Vial

Trimix injections are a combination of three medications that are used to treat erectile dysfunction. Injecting medications into the penis may sound extreme and more than a little painful. As you learn more about a Trimix injection for ED, you may find this option may be a better one than you might think at first glance, especially if you are in the 22-35% of men who have not been helped by oral ED treatment or have a medical contraindication to using medications such as Viagra (Guay et al., 2001).

In one study of 116 men in whom both oral ED and penile injectables were successful, one-third of the men preferred the penile injectables over the oral medications (Bennarchik et al., 2010). Trimix has proven to be 80% effective for helping men with ED maintain an erection long enough to have sex (Coombs et al., 2012). 

Trimix shots require a prescription. After consulting with a physician such as the specialists at Invigor Medical, a telehealth clinic, if you are a suitable candidate, a prescription will be sent to a U.S. licensed compounding pharmacy allowing you to buy Trimix injections online safely.

What Are Penile Injections?

Men who do not get the expected results from oral ED medications may be candidates for penile injections. After being trained, men can draw up the medication in a syringe attached to a tiny insulin needle. Men inject the medication into the side of the penis, and they hold pressure for up to five minutes to prevent a bruise from forming. An erection usually results within a few minutes. There are several forms of penile injectables:

  • Alprostadil (Caverject, Edex): Insurance sometimes covers alprostadil, but it is expensive. Approximately 15 to 50 percent of men complain of pain with injections. Approved and comes in a kit.
  • Trimix (alprostadil, papaverine, and phentolamine combination): Trimix injections are stronger and there are fewer reports of pain compared with alprostadil alone. The efficacy and side-effects of Trimix vary depending on the dosage of each of the three ingredients.
  • Bimix (papaverine and phentolamine): Bimix is very effective but has a higher incidence of priapism and fibrosis than alprostadil alone.
  • Quadmix: (alprostadil, papaverine, phentolamine, atropine): Rarely used (Köhler, 2020)

Trimix, Bimix, and Quadmix are not F.D.A approved. The benefit is that they are cheaper than alprostadil, but they require a compounding pharmacy to prepare the prescription. Because of the higher incidence of side effects from Bimix and Quadmix, alprostadil alone and Trimix are usually the initial treatment choices. Alprostadil has a lower risk for priapism and fibrosis, while Trimix is lower cost and less likely to cause pain with injection (Bennarchik et al., 2010).

Trimix Infographic

Benefits Of A Trimix Injection For ED

Multiple studies have found intercavernous injections to be effective, reasonably priced, and easy to administer. A long-term predictor of successful treatment is men who persist with using intercavernous injections for longer than two months. Men who stopped using penile injections and chose alternative treatment within the first two months of use were the least likely to benefit from their use (Gupta et al., 1997).

In a study of 65 men, on a score of one to ten, men rated the pain from injection a 0.8/10 with a range of 0-3 and 40 percent of men reporting no pain at all. Study participants rated the pain from the medication being injected as 1/10 with a range of zero to five, with 64.6 percent reporting no pain (Albaugh & Ferrans, 2009). In another study, 12-15% of men reported pain with injection. Most men reported that pain decreased over the course of treatment (Bennarchik et al., 2010).

Drawbacks Of A Trimix Injection For ED

The biggest drawback is that men must inject the medication. If you are squeamish about self-injecting, then any other factor, no matter how positive, is not likely to change your mind. Men should not use intercavernous injections if they have conditions that increase their risk for priapism such as sickle cell disease, multiple myeloma, and leukemia. They should also not use intra-cavernous injections if they have Peyronie’s disease (abnormal curvature of the penis), cavernosal fibrosis, or a health condition in which sexual activity is not advisable (Bennarchik et al., 2010).

In one study on the effectiveness of injectables for ED, in the vast majority of cases, ED was secondary to decreased blood flow or other vascular causes, followed by neurogenic and psychogenic causes. Men in the study received either alprostadil, Trimix, Bimix, or alprostadil with papaverine. Men who left the study gave the following reasons:

  • Ineffectiveness: Mostly within the first month, but persisted throughout
  • Penile scarring or nodules: After the first six months of treatment
  • Inconvenience or lack of spontaneity
  • Pain or fear of injectables (Gupta et al., 1997).
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Priapism

Priapism is an unwanted erection lasting over four hours. The number one cause of priapism is medications used to treat ED. Priapism is considered a medical emergency because a sustained erection can cause damage to the structure of the penis. Do not inject yourself with these medications without a prescription and after a discussion with your physician. Men who borrow the medication from others, or buy Trimix online without a prescription, with no established safe dosage based on their medical history, are the most likely to run into trouble (Köhler, 2020). The incidence of priapism with Trimix ranges from 0% to 3.7% of users (Seyam et al., 2005). 

Drugs that stimulate the sympathetic nervous system, such as pseudoephedrine and terbutaline, are frequently prescribed to constrict blood vessels and speed the drainage of blood from the penis. If men do not find relief within 15 minutes, they should call their physician for further instructions or go to the emergency room for treatment (Bennarchik et al., 2010). 

Fibrosis

Cavernous fibrosis is another potential side-effect of an intra-cavernous injection. It occurs most commonly with injectables containing papaverine. Cavernous fibrosis occurs in less than one percent of men using alprostadil and approximately four percent with Trimix. The risk of fibrosis depends on the dosage and frequency of injection. Temporarily discontinuing treatment will resolve fibrosis most times (Bennarchik et al., 2010). 

Trimix should not be used by men who are allergic to any of its components, have a condition that predisposes to priapism (prolonged erection), have an anatomical deformity of the penis, or are taking any medications that interfere with blood clotting (McVary, 2010). To minimize the side effects of Trimix, it is essential to start slow and use a low dose. It is also important that you follow up every six months and that you report all complications or concerns.

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Side Effects From A Trimix Injection For ED

All medications have side effects. The most common side effects from Trimix use include:

  • Stinging, pain, or soreness at the injection site, which usually is temporary and goes away after a few minutes. In one extensive study conducted by Mulhall et al. (1999), only 4.9% of men discontinued treatment due to pain from injections.
  • Slight bleeding at the injection site immediately after the injection. Applying pressure after injection can mitigate this issue.
  • Bruising that can occur at the injection site (though proper injection technique will minimize or prevent this from happening)
  • Infection due to poor hygiene or failure to follow proper injection protocols.

Less common side effects include:

  • Diarrhea, nausea, stomach cramps, or vomiting
  • Allergic reactions (hives, swelling, itching, etc.)
  • A sudden drop in blood pressure
  • Increased heart rate
  • Abnormal heart rhythm
  • Fibrosis or scarring at the injection site

The most serious Trimix injection side effects result from too high a dose or overuse—injecting Trimix more frequently than the prescribing instructions state or injecting more Trimix than prescribed by your physician. Follow the directions carefully and ask questions if anything is unclear.

Learn more about the pros and cons of each option and also learn why buying Trimix from a website that does not require a prescription can be a dangerous choice in terms of costs, security, and health risks.

Finally, there are additional factors to consider, such as credentialing, licensure, reputation, and safety protocols. Before choosing a compounding pharmacy to fill your prescription, verify that it is licensed through the State Board of Pharmacy.

Conclusion

When looking to buy Trimix for erectile dysfunction treatment, it’s important to understand both the risks and benefits outlined by Invigor Medical. Trimix injections are acknowledged for their effectiveness in producing an erection, deemed a viable option especially for those who haven’t found success with oral ED treatments. Before purchasing, ensure a consultation with a physician to discuss the suitability based on your medical history and to manage the proper dosage to minimize any risks.

Trimix

In Stock
As low as $249/Mo
  • Improved erectile function
  • Rapid onset
  • High efficacy (89%-95%)
NAD+ Vial

Frequently Asked Questions

What is the downside of a Trimix injection for ED?

The downside of Trimix includes potential discomfort from self-injection and risks of side effects like pain, bruising, or priapism. It’s important to discuss these risks with a healthcare provider.

How much does a Trimix injection for ED cost?

The cost of a Trimix injection can vary depending on factors such as dosage, pharmacy, and insurance coverage. It’s advisable to check with a healthcare provider and pharmacy for specific pricing information.

How long does Trimix last after injection?

A Trimix injection for ED typically induces an erection that can last for 30 minutes to several hours after injection, depending on factors such as dosage and individual response.

How much Trimix should I inject the first time?

The initial dosage of Trimix for injection should be determined by a healthcare provider based on factors such as the severity of erectile dysfunction, individual response, and any underlying health conditions. It’s essential to follow healthcare provider instructions carefully for safe and effective usage.

Written by

Leann Poston M.D.
Leann Poston M.D.
Licensed Physician and Medical Content Reviewer
Dr. Leann Poston is a licensed physician in the state of Ohio who holds an M.B.A. and an M. Ed. She is a full-time medical communications writer and educator who writes and researches for Invigor Medical. Dr. Poston lives in the Midwest with her family. She enjoys traveling and hiking. She is an avid technology aficionado and loves trying new things.

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Every article on Invigor Medical is reviewed by licensed medical professionals to ensure accuracy, clarity, and clinical relevance. Our editorial team works closely with practitioners to verify that content reflects current research, guidelines, and best practices.
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The content provided in this article is for informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a licensed healthcare provider regarding any medical concerns, conditions, or treatments. Do not disregard medical advice or delay seeking it because of something you have read on InvigorMedical.com.

Invigor Medical does not offer emergency medical care. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately.

Medical treatments discussed on this site may not be appropriate for everyone. All medications require a prescription from a licensed healthcare provider following an appropriate telehealth consultation, and treatment decisions should be made on an individual basis.
Leann Poston M.D.
Leann Poston M.D.
Licensed Physician and Medical Content Reviewer
Dr. Leann Poston is a licensed physician in the state of Ohio who holds an M.B.A. and an M. Ed. She is a full-time medical communications writer and educator who writes and researches for Invigor Medical. Dr. Poston lives in the Midwest with her family. She enjoys traveling and hiking. She is an avid technology aficionado and loves trying new things.

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