Description

(Intracavernosal Injection Therapies for Erectile Dysfunction and Penile Rehabilitation)

Customized, Physician-Guided Injection Therapy for Reliable and Immediate Erectile Function

TRIMIX, BIMIX, and QUADMIX are compounded, intracavernosal injection (ICI) therapies designed for men experiencing moderate to severe erectile dysfunction (ED) who do not respond to—or prefer alternatives to—oral PDE5 inhibitors. These formulations provide a fast-acting, targeted vascular response that results in a firm, lasting erection, typically within 5–15 minutes of administration.

Each formulation is prepared in various strengths and combinations to suit patient-specific needs and tolerability, and is delivered directly into the corpus cavernosum of the penis using a fine-gauge needle.

Product Variants & Composition

1. TRIMIX (most commonly prescribed)
   • Papaverine – smooth muscle relaxant

   • Phentolamine – alpha-adrenergic antagonist

   • Prostaglandin E1 (Alprostadil) – vasodilator that increases blood flow

2. BIMIX
   • Papaverine

   • Phentolamine

   • (Used when patient is sensitive to prostaglandins or Alprostadil-related side effects)

3. QUADMIX
   • TRIMIX base + Atropine or Forskolin (4th agent varies by compounding protocol)

   • May be used for refractory ED or advanced penile rehabilitation

Each blend can be compounded in low, moderate, or high strengths, depending on:

• Baseline erectile function

• Severity of ED

• Tolerance to side effects

• Treatment goals (e.g., intercourse, penile rehabilitation post-prostatectomy)

Product Overview

• Form: Sterile injection

• Volume: Supplied in 1–5 mL vials or pre-filled syringes

• Strengths: Multiple custom concentrations available

• Route: Intracavernosal injection (penile shaft)

• Use: Erectile dysfunction, penile rehabilitation, Peyronie’s disease (investigational)

• Storage: Requires refrigeration (2–8°C); some versions are stable frozen

• Availability: Prescription only; compounded by licensed sterile pharmacies

Mechanism of Action

Each agent works synergistically to promote a powerful local vasodilatory effect that increases arterial inflow and restricts venous outflow, producing a firm erection:

• Papaverine: Relaxes smooth muscle in penile arteries and corpora cavernosa

• Phentolamine: Blocks alpha-adrenergic receptors, preventing vasoconstriction

• Prostaglandin E1 (Alprostadil): Induces local vasodilation and enhances blood trapping

• Atropine (Quadmix): Inhibits cholinergic activity, further relaxing smooth muscle (in select formulations)

These effects do not require sexual stimulation, making these formulations particularly effective in severe organic or neurogenic ED.

Clinical Applications

TRIMIX, BIMIX, and QUADMIX are used in:

• Erectile dysfunction unresponsive to oral medications

• Post-prostatectomy penile rehabilitation (to preserve tissue and prevent fibrosis)

• Neurological ED (e.g., post-spinal cord injury or diabetes)

• Psychogenic ED where rapid, predictable results help overcome performance anxiety

• Clinical management of Peyronie’s disease (off-label)

Dosing and Administration

• Initial dose: Typically 0.05 to 0.2 mL

• Titration: Gradual increase until desired rigidity achieved without priapism

• Injection frequency: No more than 3 times per week; minimum 24 hours between doses

• Max dose: 1 mL (varies by strength and protocol)

• Administration site: Lateral penile shaft (10 or 2 o’clock position); never the base, top, or underside

• Needle: 29–31 gauge insulin syringe (0.5″ to 1″ length)

Patients should receive hands-on injection training before self-administering.

Onset & Duration

• Onset: Within 5–15 minutes

• Duration: Typically 30–90 minutes, depending on dose

• Does not require arousal to initiate or maintain erection

Safety and Tolerability

These formulations are highly effective but require strict adherence to administration protocols.

Common, manageable side effects include:

• Mild penile ache or bruising

• Injection site redness

• Erection >2 hours (prolonged, but not emergency)

• Penile fibrosis or scarring (with excessive or incorrect use)

Serious risks (require urgent care):

• Priapism: Erection lasting longer than 4 hours

• Penile hematoma or curvature (with repeated improper injections)

Contraindications

Do not use in:

• Men with bleeding disorders or on anticoagulants

• Anatomical penile deformities (e.g., Peyronie’s unless supervised)

• Known allergy to prostaglandins or any formulation components

• Men with predisposition to priapism (e.g., sickle cell disease)

• Severe psychiatric illness or inability to self-administer correctly

Storage & Handling

• Refrigeration required (some formulations may be frozen for long-term storage)

• Protect from light and contamination

• Do not reuse syringes; use aseptic technique

• Dispose of needles and vials properly (sharps container recommended)

Why Choose TRIMIX/BIMIX/QUADMIX?

• Highly effective even when oral medications fail

• Customized to individual response and tolerance

• Fast onset with predictable duration

• Enhances confidence, spontaneity, and intimacy quality

• Supports penile health and tissue integrity post-surgery

Summary

TRIMIX / BIMIX / QUADMIX Injections are potent, customizable erectile dysfunction therapies designed for men who require reliable, immediate, and powerful erections. Whether used as a first-line therapy for severe ED, a penile rehabilitation protocol post-surgery, or a performance enhancer in select cases, these compounds are tailored for precision results and improved sexual function. Under physician guidance, they offer an unmatched level of control and effectiveness.