Trimix Injections For ED: A Guide

Katelyn Hagerty

Medically reviewed by Katelyn Hagerty, FNP

Written by Our Editorial Team

Last updated 11/29/2022

Erectile dysfunction is a frustrating problem with frustrating solutions. Can’t get it up? Maybe you should be exercising more, eating better, taking medication and reducing stress. You’ve probably heard of those methods. But one you may not have heard of is the Trimix injection.

Injection-based solutions for the management of erectile dysfunction aren’t the craziest solutions we’ve ever heard of — that honor goes to buying pills from a gas station to treat your ED, because nothing good for your body comes from the same counter as scratch-off lotery tickets and 5-hour ENERGY® shots. 

But are injection-based solutions to ED actually a solution? We’re sure you have questions — we had a few ourselves. 

How are Trimix injections supposed to work? What does the science have to say? Should you consider using Trimix injections for your ED?

But before we get into the details and the results, it’s probably a good idea to walk you through what’s in that needle, why it’s there and what you’re actually putting into your body when you start taking Trimix injections for erectile dysfunction.

So what’s in this syringe destined for your shaft? Well, medications — plural.

What are Trimix Injections?

Trimix is an injectable medication for erectile dysfunction. It contains three compounds thought to work in synergy to help people with ED function better: alprostadil, papaverine and phentolamine. 

Alprostadil is a vasodilator, which increases blood flow to your penis (it’s also available in a cream). 

Papaverine is a phosphodiesterase inhibitor that keeps your erection from going soft by inhibiting a compound that reduces blood flow. 

As for phentolamine, it’s an alpha blocker, which works to increase blood flow, which can have both positive and negative effects on your erectile function depending on circumstances unique to your body.

Together, these medications are believed to apply a sort of triple threat to erectile dysfunction. The idea is that the sum of the parts is greater when combined. 

How Do Trimix Injections For ED Work?

Trimix is essentially designed to take the proven track record of the vasodilator alprostadil and enhance its performance with two other medications for ED. The medication is injected directly into the penis, where within minutes it provides a strong, supported erection for you to enjoy.

It’s difficult to find FDA-quality documentation on how Trimix is supposed to be administered (probably because it’s not approved by the FDA). Still, because it contains alprostadil and is administered via an injection, it likely functions the way other alprostadil medications do. 

With other alprostadil injections, you inject the solution into the corpora cavernosa (two chambers of spongy muscle tissue in the penis that fill with blood to create an erection) before it’s time for intimacy, and apply pressure to the injection site for a few minutes. 

Your erection will typically occur within five to 20 minutes and peak in function around half an hour after the injection.

Most erections in this case disappear after an hour. If yours sustains for longer than four hours, you should seek immediate medical attention.

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Are Trimix Injections Effective?

It’s hard to judge the efficacy of Trimix injections at the moment because we don’t have as much info to go on as we do with other ED treatments. 

Part of the reason we don’t have much in the way of supporting information for Trimix is that it isn’t approved by the FDA for the treatment of ED.

What we do know is that Trimix contains alprostadil, and that alprostadil has been proven safe and effective for the treatment of erectile dysfunction. 

That said, Trimix has been seen as effective in the treatment of ED, and the combination is considered “particularly” effective in some cases. 

Therein lies another limit though: because Trimix is not produced at a commercial level, the compounding pharmacies responsible for its production are typically more expensive and, to the extent that they add another opportunity for human error, could be considered less safe than commercial pharmacies.

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The Side Effects of Trimix Injections: Are They Safe?

Aside from the safety concerns we noted above, the reality is that there’s simply a lot we don’t know about Trimix — things long-term studies would tell us, and things the FDA is probably still sorting out themselves.

Alprostadil can cause a variety of side effects, including:

  • Rash or swelling of the penis

  • Penile infections and Injuries to the penis

  • Hypotension or hypertension

  • Dizziness and headache

Alprostadil can cause penile function issues like priapism, too, which is an erection lasting longer than four hours. It can also cause hypotension and can increase your risk of heart attack and other cardiovascular risks, not to mention penile fibrosis.

Trimix’s other two active ingredients — papaverine and phentolamine — present some problems of their own. 

Papaverine is also a vasodilator that, like alprostadil, can cause penile fibrosis — a type of scarring that can reduce the penis’s elasticity. This could potentially cause anatomical deformation, which is a complicated way of saying it could cause your penis to curve

A penile needle injury from penile injection therapy could make your erection never quite right (or left) again.

As for phentolamine, current study data doesn’t actually display much at all about this compound, which in an alpha blocker. 

It’s rarely used in injections by itself, and so our picture of its side effects is blurry at best. 

When you consider all of this with the risks of hypodermic needle injuries, priapism or the horror show that would emerge from a defective needle, pills sound pretty good.

And that’s kind of the point (to take another easy needle pun): Trimix and other penile injections generally aren’t supposed to be a first-line treatment option for erectile dysfunction. 

First-line treatments look like changes in diet, increased exercise, weight loss, quitting smoking or drinking, discontinuing illicit drug use and, most often, medications like pills.

Two of the most commonly prescribed ED pills are tadalafil and sildenafil, though you probably know them as Cialis® and Viagra®, respectively. These two medications are called phosphodiesterase-5 inhibitors (PDE5 inhibitors) work by increasing blood flow to your penis, and they’re proven safe and effective, with mostly mild side effects.

Both medications are available in an as-needed dose to be taken before sex, and Cialis is available as a once-daily medication, too.

Cialis also has the benefit of being able to be effective for up to 36 hours after you take it, which is why some folks have deemed it “the weekend pill.” 

Other PDE5 inhibitors include avanafil (Stendra®) and vardenafil (Levitra®).

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Trimix Injections and ED: The Final Word

Sexual activity is important, but it’s not a reason to cause a medical emergency. If we can tell you one thing with certainty, it’s that even if you are prescribed Trimix or another one of the intrapenile injections on the market, it’s definitely not a decision you should explore lightly. 

Whether a penile injection is the right choice as a treatment for erectile dysfunction in your life is ultimately going to be determined by your conversations with a healthcare provider. 

Injection therapy is not the safest and easiest treatment option for patients with erectile dysfunction out there, and many erectile dysfunction medications can be taken orally. However, that’s not to say that Trimix doesn’t have a place as an erectile dysfunction treatment.

Either way, talking to a professional is crucial. If you’re not sure where to start, it may be time to start a consultation with a healthcare professional.

6 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Sooriyamoorthy T, Leslie SW. Erectile Dysfunction. Updated 2022 May 27. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
  2. Jain A, Iqbal OA. Alprostadil. Updated 2022 Jul 18. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
  3. Parker A, Bruha M, Akinola O, Welliver C. A summary of the controversy surrounding off-label medications in men's health. Transl Androl Urol. 2016 Apr;5(2):201-6. doi: 10.21037/tau.2016.03.07. PMID: 27141447; PMCID: PMC4837311.
  4. Reference ID: 4198338 - Food and Drug Administration. (n.d.). Retrieved October 18, 2022, from
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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.