Tri-Mix is a compounded intracavernosal injection used to treat erectile dysfunction. It combines three vasoactive agents — papaverine, phentolamine, and alprostadil (prostaglandin E₁) — that work synergistically to relax penile smooth muscle and increase blood flow, producing an erection. It is used primarily for men who have not responded adequately to oral ED medications like sildenafil or tadalafil.

Both formulations contain the same three active ingredients, but Super Tri-Mix contains double the concentration of phentolamine (2 mg/mL vs. 1 mg/mL) and double the prostaglandin E1 (20 mcg/mL vs. 10 mcg/mL). Super Tri-Mix is intended for men who require a stronger vascular response, as determined by their prescribing provider. Your provider will recommend the appropriate strength based on your individual response and medical history.

Tri-Mix is administered as an intracavernosal injection — meaning it is injected directly into the corpus cavernosum (the erectile tissue) of the penis, typically on the side of the shaft. Your provider will instruct you on proper injection technique during onboarding. It is important to alternate injection sites with each use and to follow aseptic (sterile) technique to minimize the risk of fibrosis or infection.

Tri-Mix typically produces an erection within 5–20 minutes of injection. The duration of the erection is dose-dependent and varies by individual — most men experience an erection lasting 30 minutes to 2 hours. If an erection persists beyond 2 hours, patients are advised to take an oral decongestant (such as pseudoephedrine). If an erection has not subsided after 4 hours, seek emergency medical care immediately, as priapism is a medical emergency.

Priapism is a prolonged erection that lasts longer than desired and does not subside on its own. If left untreated beyond 4 hours, it can cause permanent damage to erectile tissue. To reduce risk, always use the lowest effective dose as prescribed by your provider, and never exceed your prescribed amount. If an erection lasts beyond 2 hours, take an oral decongestant as directed. If it persists to 4 hours, go to an emergency room immediately.

Tri-Mix is contraindicated for men with sickle cell anemia, leukemia, or other conditions predisposing them to priapism; men with significant Peyronie's disease or other penile anatomical abnormalities; men for whom sexual activity is contraindicated due to cardiovascular conditions; men with active infections or open wounds on the penis; and anyone with a known allergy to papaverine, phentolamine, or alprostadil. Always disclose your full medical history to your provider.

The most common side effects are local and mild — pain, aching, or a burning sensation at the injection site, and occasional minor bruising or bleeding. Some men experience brief dizziness or flushing after injection, which typically resolves quickly. Serious side effects are rare when Tri-Mix is used as directed, but include priapism and, with long-term use, penile fibrosis (scar tissue formation). Rotating injection sites and following your provider's frequency guidelines significantly reduces fibrosis risk.

Tri-Mix should not be used more than once in a 24-hour period, and most providers recommend no more than 3 injections per week. Overuse increases the risk of penile fibrosis (scar tissue) over time. Your provider will give you specific frequency guidelines tailored to your needs. Always follow those instructions and do not self-escalate your dose or frequency without medical guidance.

Tri-Mix vials should be stored in the refrigerator. Do not freeze. Keep the vials protected from light. Once reconstituted, use as directed by your pharmacy's labeling. Discard any unused medication after the period specified by your compounding pharmacy. Do not use if the solution appears cloudy or contains visible particles.

Tri-Mix as a combined compounded formulation is not FDA-approved. It is prepared by licensed compounding pharmacies under Section 503A of the U.S. Food, Drug, and Cosmetic Act as a patient-specific prescription. Alprostadil, one of its three components, has been FDA-approved in injectable form for ED since 1995. Compounded products are not evaluated by the FDA for safety, efficacy, or quality, and their use is reserved for patients under medical supervision.

Yes. Tri-Mix is a prescription-only compounded medication. At Testosteroneshots.com, the full process — medical intake, provider evaluation, and prescription — is handled online via telemedicine. No clinic visits are required. You must be 18 or older to order. Services are provided by licensed physicians and nurse practitioners in served states. Check your state's telemedicine laws for eligibility.