Trimix (drug)

Trimix is a prescription combination drug containing alprostadil, papaverine, and phentolamine. It is used to treat erectile dysfunction.^[1][2][3]

Trimix

Combination of
Alprostadil	prostaglandin
Papaverine	vasodilator
Phentolamine	alpha blocker
Clinical data
Routes of administration	injection, intraurethral, topical
Legal status
Legal status	US: ℞-only
Identifiers
ChemSpider	none
(verify)

Medical use

Available forms

Trimix is available in several different formulations, including a gel that can be used topically, a gel that can be administered into the urethra, and an injectable form that is administered via intracavernosal injection (an injection at either side, not the base, of the penis).^[2][4][5][6]

Adverse effects

Adverse effects from injecting Trimix may include pain, fibrosis, hematoma, and priapism (a prolonged erection of the penis).^[3]

Pharmacology

Trimix is a combination of three drugs: alprostadil, papaverine, and phentolamine. These medications work in combination to increase blood flow to the penis, resulting in an erection.^[1][2][3] Alprostadil is a prostaglandin vasodilator that allows more blood to flow into the area by relaxing the smooth muscle in the blood vessels of the penis.^[3][7] Papaverine is a smooth muscle relaxant that acts by increasing blood flow to the penis.^[3][8] Phentolamine is an alpha blocker that relaxes blood vessel muscles, allowing more blood to flow to the penis.^[3][9]

Society and culture

Availability

While the active drugs in Trimix have all been individually approved by the U.S. Food and Drug Administration (FDA), Trimix as a combination drug has not been approved by the FDA and is only available from compounding pharmacies.^[1][3][10] Trimix is typically prepared by the compounding pharmacy in a sterile environment and then frozen.^[11] The compound is stable for up to six months while stored frozen and for one month if stored refrigerated beginning at the time of manufacture.^[12]