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Active Ingredients
Important Disclaimer
These statements have not been evaluated by the Food and Drug Administration (FDA). Compounded products are not FDA-approved and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. The information provided is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before starting any new treatment.
Clinical Information
Evidence-based details for healthcare providers
Use this medication exactly as shown by your healthcare provider. Inject the prescribed amount into the side of the penis as directed. Do not use more than one dose in 24 hours and do not use more than 3 doses in a week unless told otherwise. If you miss a dose on a planned day, skip it and wait for your next scheduled injection. Never double your dose.
Each ingredient widens blood vessels in a slightly different way. Papaverine blocks an enzyme that normally causes the muscles around blood vessels to tighten. Phentolamine blocks alpha-adrenergic receptors, preventing signals that narrow the vessels. Alprostadil raises a natural chemical called cAMP inside the smooth muscle, causing quick relaxation. Together, they let more blood enter and stay inside the erectile tissue, producing a firm erection. Most men feel an effect within 5–15 minutes after injection, and it usually lasts 30–90 minutes depending on dose and individual response.
Do not use if you:
• Have sickle cell anemia, leukemia, or another condition that raises the risk of prolonged erections (priapism) because the drug can worsen this problem.
• Have an implant or scar tissue in the penis that blocks injection or blood flow.
• Are allergic to papaverine, phentolamine, alprostadil, or any component of the product.
• Have severe heart or lung disease that makes sexual activity unsafe.
• Take certain blood-thinning medicines in high doses (like warfarin with an INR above goal) unless your prescriber approves.
• Are under 18. Safety in women or children has not been established.
• Blood thinners (warfarin, apixaban, clopidogrel) may increase bruising or bleeding at the injection site.
• Antihypertensive drugs, especially alpha-blockers for prostate problems (tamsulosin, doxazosin), can add to low blood-pressure effects such as dizziness or fainting.
• Nitrates or nitric-oxide donors (nitroglycerin, isosorbide) may lead to sudden low blood pressure if erections last long and the drugs enter the bloodstream.
• PDE-5 inhibitors (sildenafil, tadalafil, vardenafil) should not be used on the same day without medical guidance; combining them can lead to priapism.
• Alcohol can increase dizziness and reduce the ability to get a satisfactory erection. Limit intake.
Always tell your doctor and pharmacist about all prescription drugs, over-the-counter medicines, and herbal supplements you use.
Very common (affects more than 1 in 10 men): mild pain, burning, or pressure at the injection site; small bruise on the penis.
Common (affects 1–10 in 100): prolonged erection lasting 2–4 hours, slight curvature during erection, redness where injected.
Uncommon (1–10 in 1,000): dizziness, flushing, rapid heartbeat, swelling or nodules in the penis caused by scar tissue.
Rare but serious: priapism (erection longer than 4 hours), severe penile pain, significant bleeding, infection at injection site. Seek immediate medical care if an erection lasts over 4 hours or if severe pain, swelling, or fever occurs.
Most local reactions improve within a few hours. Scar tissue can be reduced by rotating injection sites as trained.
Keep refrigerated at 36–46°F (2–8°C). Do not freeze. Store in the original amber vial to protect from light. Brief room-temperature exposure (up to 6 hours) during travel or use is acceptable, but return to the fridge as soon as possible. Check the solution before each use; do not use if cloudy, colored, or if particles are seen. Keep out of reach of children. Dispose of unused or expired vials through a pharmacy take-back program or in a sharps container following local regulations.
Frequently Asked Questions
How do I give myself the Tri-Mix shot?
Your healthcare provider will show you step-by-step in the office. You will use a very small insulin-type needle. Clean the skin with alcohol, insert at a slight angle into the side of the shaft, and inject slowly. Rotate sides and spots each time to avoid scar tissue.
When will the erection start and how long will it last?
Most men feel results within 5–15 minutes. The erection usually lasts 30–90 minutes, but this can vary. If it lasts longer than 2 hours, walk around, apply a cold pack, or take a warm shower. Call your doctor or go to the ER if it lasts over 4 hours.
What should I do if the medication burns or hurts when injecting?
A mild sting is normal and goes away quickly. If pain is sharp, stop and withdraw the needle, then apply gentle pressure with gauze. Make sure the medicine is not cold; let the vial sit at room temperature for 5 minutes before use. If pain continues with future injections, tell your provider.
Can I still take Viagra, Cialis, or Levitra on the same day?
Using a pill and Tri-Mix on the same day can raise the chance of priapism and dizziness. Do so only if your doctor approves and gives clear instructions. Never take a PDE-5 pill within 4 hours after a Tri-Mix dose unless told it is safe for you.
How do I travel with Tri-Mix?
Keep the vial in a small insulated bag with a cold pack. Security checkpoints allow injectable medicines; keep it with your name-labeled prescription. Limit warm exposure to less than 6 hours and refrigerate again as soon as you arrive.
What if I see bumps or curvature forming in my penis?
These may be early signs of scar tissue from injecting the same spot. Rotate sites each time and never inject into a lump. If bumps grow or the curve worsens, stop using the medication and contact your urologist for evaluation.
Related Products
Sildenafil Citrate Rapid Dissolve Tablet
Sildenafil Citrate rapid dissolve tablets are custom-made tablets that melt on your tongue. They are used to treat erectile dysfunction by helping blood flow into the penis so you can get and keep an erection when sexually aroused. The fast-dissolve form starts working quicker than regular tablets, giving many men more flexibility.
Quad-Mix
This compounded injectable medication (often called “Quad-Mix”) contains four active drugs that work together to improve erectile function in adult men. When injected into the side of the penis before sexual activity, the medicine relaxes smooth muscle, widens blood vessels, and reduces outflow so more blood stays in the erectile tissue. A very small volume is used, and the effect starts within about 5–20 minutes and can last 30–90 minutes. Because it is a sterile compound prepared for each patient, strength ratios and vial size may vary based on your prescriber’s order.
Bi-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. This compounded medication is prepared in a controlled pharmacy environment to ensure sterility and accurate concentration.
Climax Cream
This compounded cream combines four blood-flow–enhancing agents—Theophylline 3%, Arginine 6%, Ergoloid Mesylate 0.05%, and Pentoxifylline 5%—to increase circulation when applied to intimate skin. It is dispensed in a 30-gram metered pump for easy, accurate dosing. The formula is designed for adults who want faster, stronger genital arousal. Use only as directed by your prescriber.