Tri-Mix is a compounded prescription erectile injection containing three vasoactive agents — alprostadil, papaverine, and phentolamine — that work together to directly relax penile smooth muscle and produce a firm, reliable erection. Unlike oral medications that depend on arousal, nerve signaling, and cardiovascular function to work, Tri-Mix acts locally inside the erectile tissue and bypasses all of those requirements. It is the most effective treatment available for erectile dysfunction and works in men for whom every oral option has failed.

Tri-Mix is for men with erectile dysfunction who have not responded adequately to oral medications like sildenafil or tadalafil, or who cannot take them due to nitrate use or cardiovascular contraindications. It is particularly effective for men with vascular ED, post-prostatectomy nerve damage, diabetic neuropathy, spinal cord injury, or severe arterial insufficiency. If pills have stopped working or never worked to begin with, Tri-Mix is the next step. A licensed provider will review your medical history during your consultation to confirm candidacy and determine the appropriate starting dose.

Yes. Tri-Mix is a compounded prescription medication that requires evaluation and approval by a licensed medical provider. Upon approval, your prescription is sent to our partner pharmacy, which compounds and ships it directly to your home under USP 797 sterile standards.

The most common side effect is mild pain or bruising at the injection site. Priapism — a prolonged erection lasting more than 4 hours — is a rare but serious risk and requires immediate medical attention. Mild penile aching during the erection is reported by some users, typically resolving as the medication wears off. Fibrosis or scarring at injection sites is possible with frequent, improper use, which is why your provider will establish a proper dosing protocol. Systemic side effects are uncommon due to the local mechanism of action.

Not recommended for patients with sickle cell disease, multiple myeloma, leukemia, anatomical penile deformity, or those taking MAO inhibitors.

Do not combine with oral PDE5 inhibitors on the same occasion. Interactions with antihypertensives and anticoagulants are possible. Full medication review is required.

Patients with bleeding disorders, cardiovascular disease, or penile anatomical conditions require provider evaluation and dose individualization before starting Tri-Mix.

Tri-Mix is indicated for men with erectile dysfunction who have not responded adequately to oral PDE5 inhibitors (sildenafil, tadalafil, vardenafil), or who cannot use them due to nitrate use or cardiovascular contraindications. It is also commonly used in men with post-prostatectomy ED, diabetic neuropathy, vascular insufficiency, or spinal cord injury. A licensed provider will review your medical history and determine appropriate candidacy during your consultation.

Tri-Mix is administered via intracavernosal injection — a small-gauge needle is inserted into the side of the penile shaft, into the erectile tissue. The injection site is rotated with each use. Your care team will walk you through the technique during onboarding, and most patients become comfortable with self-injection within one to two sessions. The needle used is very fine (27–30 gauge), and most men report minimal to no discomfort.

This is a medical emergency called priapism. Go to the nearest emergency room immediately. Prolonged erections can cause permanent damage to erectile tissue if not treated promptly. Do not wait to see if it resolves on its own. Your provider will give you guidance on initial management steps as part of your onboarding protocol.

Do not combine Tri-Mix with other erectile agents (oral PDE5 inhibitors, vacuum devices, or other injectables) without explicit provider guidance. Combination use significantly increases the risk of priapism. Tri-Mix is generally safe with most other medications, but inform your provider of all current medications, including blood thinners, antihypertensives, and any supplements.