TriMix FAQs

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Trimix "Causes" erections to happen,

Oral ED medications "Help" erections happen

Trimix is an injectable ED medication

When Viagra or Cialis doesn't work  ( PDE5 inhibitors) Trimix has been the go to medication

History: Created and in use since 1983.

How does Trimix work to produce an erection?

These drugs create an erection by relaxing the smooth muscles and widening the blood vessels in the penis. They are not dependent on nerve stimulation.

Does the medication continue to work indefinitely or is a tolerance created requiring increasing dosage?  Both have been experienced.

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Trimix Storage

Keep Refridgerated. It begins to lose it's potency after 6-8 weeks. .

Storing frozen, it is considered stable for up to 6-9 months months . Afterwhich it begins  to lose potency. 

Thawing & Freezing repeatedly is not recommended. Cycling often between frozen and liquid form can degrade it's stability and potency.

Thawing in water in Not Recommended

Rubbing between your palms and shaking to break up the ice will thaw a vial in about 3-5 minutes without risking excess heat exposure

Additionally others have approached this by:

1) Putting some pre-measured syringes in the refrigerator and freezing the difference
2) Buying sterile vials online and putting some in them and freezing the difference.     
(Also  purchasing in larger 10ml vials and then storing, provides for significant qty discount & shipping savings)

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Trimix Usage

Trimix produces erections generally  lasting  2-4 hours

Trimix produces erections generally regardless of your circumstance, including too much alcohol, too much caffeine , too much etc...  

Extended erections can be quite hazardous and dangerous to penis health. Penises need fresh blood flow after a while and TriMix inhibits this. 

****  Please see  "Trimix Reversal" below

Trimix Video Reference

YouTube has TriMix Information and TriMix Injection Techniques

Click Here for Trimix Videos | Opens New Window

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What is Trimix:

Papaverine, Phentolamine and (PGE)Alprostadil

Papaverine: is a Vasodilator: produces an erection by allowing for increased blood flow to the penis, a vasodilator. (Brings blood into the penis)

Phentolamine: is an Alpha Blocker: induces an erection by relaxing and dilating the blood vessels of the penis, as well as by elevating cardiac output (Makes more room to store more blood )

PGE: (Alprostadil): known as Prostaglandin in the body:  allows for more blood into the penis and lets less blood out by relaxing the penis's blood vessels and dilating cavernosal arteries (Retains blood in the penis )

The ratio of the mixtures of the the three come in many varieties to suit patient needs.  

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10 ml Vials 

$169.75 each

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What is Quadmix:

Papaverine, Phentolamine and (PGE)Alprostadil, Atropine

QuadMix uses the same ingredients as TriMix , plus the addition of Atropine

Atropine:  Atropine sulfate works by inhibiting the nervous system receptors that control smooth muscle relaxation. Keeps the erection muscles stiff by not letting them relax. 

QuadMix is usually prescribed for patients for whom Trimix does not work sufficiently well

What is Bimix:

Papaverine, Phentolamine 

BiMix uses the same ingredients as TriMix , minus the PGE (Alprostadil)

BiMix is often prescribed for patients for whom  find Trimix, in particular Alprostadil, painful

What is Forskolin:

A Vasodialator

Forskolin is sometimes used in lieu of Alprostadil (PGE)

Patients experiencing Extreme Forms of pain ( severe ache) from Trimix/Quadmix  sometimes find satisfaction with Forskolin substituting for PGE.

What is VIP:

A Vaso-Intestinal Peptide

The combination of VIP and Phentolamine is another safe and effective means of treating ED.

VIP has a potent effect on the veno-occlusive mechanism, but little effect on arterial inflow, whereas phentolamine increases arterial blood flow with no effect on the veno-occlusive mechanism

Trimix Injections FAQs

Do the injections hurt?

Not really - the skin on the shaft of your penis is similar to the skin on your elbow in terms of sensitivity.


Could I even learn how to inject myself?      Yes.

The vast majority of men report that watching video and live demonstrations of the injection process

reveals how simple it really is.

YouTube has TriMix Injection Techniques

Click Here for Trimix Videos | Opens New Window

Does the medication lose potency over time even if stored correctly? Yes

  • After 60-90 days in a refrigerator  it will Begin to lose it's strength

  • Frozen it lasts for six months (or more) 

  • Also cycling between freezing and thawing also degrades it's strength

Will I develop a tolerance over time?
This can happen and may require you to adjust the dosage amount and/or the formula

Trimix Injection Best Practices

  1. Alternate sides of injection to avoid scaring tissue

  2. Lay your penis flat out and fully extended (but soft)

  3. Point needle to the center, not up or down

  4. Avoid veins

  5. Target the area 1 inch up from the base between 1 to 3 o'clock ( or 9 to 11)

  6. Use a 1/2 inch length needle - it's needed to reach into the cavernosum

  7. Push needle completely flush to the skin

  8. Work the plunger a few times before filling syringe to insure it is not sticky

  9. Don't force the plunger. If it is really difficult to push, then you should start over making sure the needle is in properly

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Trimix Injection Techniques ( How To )

Compliments of the Department of Urology, University of California, San Francisco

Filling the syringe, I have heard that that the plunger should be pulled down to the 1.0 cc mark before pushing the needle through the rubber stopper. Once the needle is pushed through the rubber stopper, the plunger should be pressed on, pushing the air into the ampoule before withdrawing the medication. Is there an advantage to this

Yes, It makes withdrawing the medication easier

Where to Inject. Where do I want the medication to go? What structures am I aiming for and which do I want to avoid? 

Aim for the Corpora Cavernosa (shown here)

Q) Am I'm injecting the right place? Are there any cues you can give me? Sometimes I feel more resistance to the plunger than other times; when that happens, the injection usually fails. Why? What should I do?

Where to Inject Trimix

Inject one inch up from the base - between   1 - 3  or  9 -11 o'clock

Needle MUST be angled to the center of the penis as shown

Use a 1/2 inch long needle to reach all the way into the Corpora Cavernosa

A) The amount of resistance to pushing the plunger is one of the best indicators of good needle placement. If a lot of resistance is felt then the needle may be in too far or not far enough. Pull the needle back a little or push it in further. If that does not work withdraw the needle and reinsert it in another suggested place. The plunger should depress quite easily. Your doctor can demonstrate. Do not inject if the resistance is strong.

Q) What should I feel when I inject? Will it hurt? Should I feel resistance? Can I feel if the needle is in too deep or too shallow?

A) As there are few nerve endings for pain in this area, there will probably be just a slight momentary discomfort. The needle should be pushed firmly until it is fully in the penis, slight resistance may be felt.
An autoinjector may reduce even further this momentary pain. (See Below)

Q) If I don't get any response to an injection can I follow up with another injection maybe to a different side of the penis and perhaps using a smaller dose? 

A) No, the first injection may have punctured the urethra or other tissue. A second injection may cause more bleeding in the wrong area. The next time you inject (on another day) do it on the other side of the penis.

Q) What's the best way to hold the penis for the injections? 

A) Ideally you need a flat surface to inject (minimal wrinkles) you may wish to pull the penis to full length and let it relax and then inject.

Q) Does the medication lose potency over time even if stored correctly?
A) Yes, it "begins" to lose effectiveness after about 60-90 days in your refrigerator. Freezing Trimix will extend efficacy for months.  Cycling between freezing and thawing may cause Trimix to lose effectiveness each time.

Q) Will I develop a tolerance over time requiring an increasing dose?
A) This can occur and your physician may have to readjust the formula.

Trimix Auto-Injectors

Also available are injectors that allow a user to press a pen-like device up to their skin,

press a button and it will automatically insert needle and medication for you.

Some like this, some do not as one loses active control of pressure of the needle and to a degree the depth of the injection. Auto-injectors are used for a large variety of medications and injection sites (tummy, thigh, etc...)

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How well does Trimix work? 

Will it work for you?      Yes

Caveat:   There is an apparent concensus of around 90% efficacy.

ie: It works for around 90% of the people who tried it

Research white paper summary:

Combination therapy first was introduced in 1991 by Bennett and coworkers[2] with a reported success rate of 92%


Efficacy for this treatment option is as high as 87% to 93% (Linet &. Ogring, 1996
by JA Albaugh - ‎2006 - ‎Cited by 11 - ‎Related articles

(KSSMA) Guideline on Erectile Dysfunction - :: WJMH :: The World ...
by JK Ryu - ‎2013 - ‎Cited by 18 - ‎Related articles

Aug 31, 2013 - Trimix was shown to have a better efficacy rate (92%) and less pain, but a higher risk of prolonged erection and cavernous fibrosis compared to ...

Extended Erections & Erection Reversal

Trimix Reversal

Phenylephrine: Erection Reversal

  • Use only when needed (@ about 4 hours of sustained erection)

  • Waiting longer than this time range may negatively affect your results with Phenylephrine

  • Dose yourself with .5 ml (50 units on the syringe),  keep repeating every 5-10 minutes until the erection is lost

  • Using Phenylephrine everytime just to "knock down" your erection is not recommended and can result in other issues

  • Inject into your penis in the same method as Trimix

Liquid Phenylephrine is especially recommended for those with any blood pressure or heart issues

Phenylephrine Reversal

Phenylephrine is a potent vasoconstrictor.  Inject 100-500 mcg <micrograms> (0.1 ml - 0.5 ml) into the penis cavernosa. Repeat every 5-10 minutes and/or up to  1,000 mcg (1 ml) until your erection is gone.


After injection, massage the penis (the corpora cavernosa) to facilitate drug distribution.

Lower volumes should be used in patients with severe cardiovascular disease

Trimix and Sudafed for Erection Reversal

Sudafed and Benadryl  can be used reduce a prolonged erection. Yes, however

NOT Recommended for those with any blood pressure or heart issues (use Liquid Phenylephrine)

Memorial Sloan hospital instructs:  take 4 (30 mg) tablets of pseudoephedrine HCl (Sudafed) of the "Fast Acting" variety Only, not the  "Time Release":  via Memorial Sloan

How many Doses are in a 5ml Vial of Trimix

20 -25 doses typically depending on dose size (which means your mileage will vary)

A small vial = 5ml

A full syringe  equals 1.0 ml  (A vial = 5 Full syringes)

A typical syringe is marked with 100 units (0.01ml x 100)  

A typical Dose (for example)  is 0.20ml. (ie: 20 units on the syringe)

That means there are around 25 doses in a vial using  0.20ml as a dose
 0.20ml dose
x 25 uses = 5ml

Trimix  Purchase Caution

Be advised, a black market for the prescription treatment has developed, and Trimix is being sold, dispensed, and administered without the supervision of a physician. You can guess the consequences: Men are being given excessive doses of Trimix, and are needlessly suffering the complications of priapism, landing in emergency rooms across the country. Bottom line: Using Trimix outside of medical supervision is a very high risk strategy.


Additionally less than sterile development can lead to poor quality and obvious risks of dangerous injections and infections. Buy quality from a USA accredited pharmacy. Look for FDA accreditation or ACHC (Accreditation Commission for Health Care).

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Trimix Risks

There is always risk to whatever medication you take. ALWAYS.

The big ones for Trimix you may already know:

Extended erections:  Penises need blood, erections inhibit blood flow. Cut blood flow long enough
and it becomes an issue.  THE reason to have reversal medication available (phenylephrine)

Peyronies disease:   tissue hardening, especially at injection sites, can cause curvature over time. Making it a really good idea to alternate injection sites.

Which Trimix is right for you?

There is no test that can be given to determine the perfect formula for anyone. 
Looking at your medical profile and using past experience provides the best guidance.

Of paramount importance, is getting the formula right without it being too strong as the risk of having an erection for too long and having to go to the ER  is absolutely real and must be considered by the user.

When a persons profile is outside the the "typical" it can be really difficult to say with any certainty what will be right with any percentage attached to it.

For those reasons there may be some trial and error before the formula is  appropriately "dialed in" for the individual.

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