Prescription
Prescription RequiredCompoundedBi-mix Injection
Bi-Mix is a sterile intracavernosal injection used to treat erectile dysfunction in adult men. Together, these medicines relax smooth muscle and widen blood vessels in the penis, helping men achieve and keep an erection when sexual stimulation occurs.
Requires a valid prescription from your provider. Not sure if it's right for you? Ask a pharmacist.
These statements have not been evaluated by the Food and Drug Administration. Compounded products are not FDA-approved and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. This information is for educational purposes only and is not medical advice — always consult your healthcare provider before starting any new treatment.
Clinical information
Medication information for patients and providers.
Use exactly as instructed by your healthcare provider. Inject the prescribed amount into the side of the penis shaft using a new, sterile needle each time. Do not inject more than once in 24 hours or more than 3 times a week. If you forget a scheduled dose, skip it and wait until your next planned dosing day. Never double your dose.
Papaverine blocks certain enzymes that normally tighten blood vessel walls, while phentolamine blocks alpha-adrenergic receptors that cause the vessels to narrow. Together they relax smooth muscle in the penile arteries and spongy tissue, letting more blood flow in and stay trapped during sexual stimulation. Most men notice an erection within 5–15 minutes after injection, and the effect usually lasts 30–60 minutes. The medicine leaves the body within a few hours.
Do not use if you are allergic to papaverine, phentolamine, or any ingredients in this medication. Do not use if you have sickle cell anemia, leukemia, multiple myeloma, or any condition that raises the risk of prolonged erections (priapism). Do not use if you have a penile implant, severe penile curvature, scar tissue, or Peyronie’s disease. Avoid use if you have low blood pressure, uncontrolled heart disease, recent stroke, or are taking nitrates for chest pain. Not for use in women, children, or adolescents.
Using this injection with nitrate medicines (such as nitroglycerin), PDE5 inhibitors (Viagra, Cialis, Levitra), or other blood pressure–lowering drugs can cause dangerous drops in blood pressure. Alpha-blockers for prostate problems (tamsulosin, doxazosin) or high blood pressure may increase dizziness. Blood thinners like warfarin may raise bleeding risk at the injection site. Limit alcohol because it can worsen light-headedness. Always tell your provider about all prescription drugs, over-the-counter medicines, and herbal supplements before starting therapy.
Very common (more than 1 in 10 men): mild pain, burning, or small bruise at the injection site. Common (1–10 in 100 men): redness, swelling, dizziness, flushing, rapid heartbeat. Uncommon (1–10 in 1,000 men): prolonged erection lasting longer than 4 hours (priapism), penile fibrosis (lumps or curvature), fainting, low blood pressure. Rare but serious: severe bleeding, infection at injection site, allergic reaction (rash, swelling, trouble breathing). Seek immediate medical help if an erection lasts over 4 hours or if you notice severe pain, swelling, or signs of infection.
Store in a refrigerator between 36–46 °F (2–8 °C). Keep the vial in its original box to protect from light. Do not freeze. After first puncture, write the date on the vial and discard any unused solution 28 days later. Keep out of reach of children. Do not use if the solution is cloudy, colored, or contains particles. Dispose of unused or expired medication through a pharmacy take-back program or follow local regulations; do not flush down the toilet.
Frequently asked questions.
Most men notice an erection within 5 to 15 minutes after injecting, but timing can vary. Inject only when you are ready for sexual activity.
If your erection lasts longer than 4 hours, go to the nearest emergency room right away. A prolonged erection can permanently damage the penis if not treated quickly.
Inject into the side of the mid-shaft of the penis, avoiding visible veins and never the top, bottom, or head. Alternate sides with each dose to reduce bruising or scar tissue.
Do not combine this injection with oral ED medicines unless your doctor specifically tells you to. Using them together can cause low blood pressure and fainting.
Keep the vial in a small insulated cooler with an ice pack to stay between 36–46 °F (2–8 °C). Do not freeze the medicine and protect it from direct sunlight.
You will need a new small-gauge insulin syringe and needle, alcohol swabs to clean the vial top and injection site, and a sharps container for used needles.
Limit alcohol to one or two drinks. Alcohol can increase dizziness and make it harder to achieve a firm erection.
Most men should not inject more than three times a week and never more than once in a 24-hour period. Follow your doctor’s exact plan.
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