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Important Safety Information
Trimix (Alprostadil / Papaverine / Phentolamine) Injection
Prescription Intracavernosal InjectionTrimix is a compounded intracavernosal (penile) injection combining alprostadil, papaverine, and phentolamine for the treatment of erectile dysfunction. It requires a prescription, provider training on injection technique, and strict adherence to prescribed dosing.
Emergency: If you experience chest pain, severe shortness of breath, a prolonged painful erection (over 4 hours), or sudden vision/hearing loss — call 911 or go to your nearest emergency room immediately.
Who Should Not Use Trimix (Alprostadil / Papaverine / Phentolamine) Injection
- Men with a history of priapism or conditions predisposing to priapism (e.g., sickle cell disease/trait, leukemia, multiple myeloma)
- Men with bleeding disorders or on anticoagulant therapy without provider clearance
- Men with penile deformity, implants, or Peyronie's disease without provider evaluation
- Men for whom sexual activity is medically inadvisable due to cardiovascular status
Warnings & Precautions
Priapism — Medical Emergency
An erection lasting more than 4 hours is a medical emergency requiring immediate evaluation to prevent permanent tissue damage. Never exceed your prescribed dose.
Strict Dose Titration
Dosing must be carefully individualized and titrated by your provider. Do not adjust your dose without medical guidance.
PDE5 Inhibitor Combination
Combining Trimix with sildenafil, tadalafil, or other PDE5 inhibitors increases priapism risk — inform your provider of all ED medications you use.
Injection Technique
Improper injection technique increases risk of bruising, scarring (fibrosis), and infection. Use only as trained by your provider.
Common Side Effects
This is not a complete list. Contact your provider if you experience any concerning symptoms.
- Penile pain or burning at injection site
- Bruising or bleeding at injection site
- Swelling or hematoma
- Fibrosis/scarring with repeated long-term use
- Lightheadedness (rare)
Drug Interactions
Always inform your provider of all medications, supplements, and substances you are currently taking.
- PDE5 inhibitors (sildenafil, tadalafil, vardenafil) — increased priapism risk, avoid combining without provider guidance
- Anticoagulant/antiplatelet medications — increased bruising/bleeding risk
When to Contact Your Provider
- An erection lasting more than 4 hours — seek emergency care immediately
- Significant pain, swelling, or signs of infection at the injection site
- Any lump, curvature, or scarring developing in the penis
- Lightheadedness or fainting after injection
This safety information is provided for general educational purposes only and does not constitute medical advice. It is not a substitute for the full prescribing information, package insert, or guidance from your licensed healthcare provider. Individual responses to medications and supplements vary. MEDVera providers review your complete health profile before recommending or prescribing any treatment.