Trimix is a prescribed, injectable medication
consisting of three active ingredients- alprostadil, papaverine, and
phentolamine. Together, these three medications help to relax, expand, and fill
the corpus cavernosum (erectile tissue) with blood resulting in an erection
shortly after administration. Unlike oral medications, Trimix is localized to
the intended area rather than having to flow through the bloodstream into other
areas of the body. Trimix is self-administered and easy to perform in the
comfort of your own home.
Indications:
Trimix
is indicated in the treatment of males with erectile dysfunction. This injectable
medication is for patients unsuitable for the oral medication prostaglandin E1.
What are the 3 medications that are combined to form this sterile
injection?
Papaverine: This is a vasodilator which helps to expand
the blood vessels. When injected into the penile tissue, this medication causes
the smooth muscles to relax. In turn, this allows blood to flow through the
corpus cavernosum resulting in an erection.
Alprostadil: Also known as prostaglandin E1 (PGE1),
alprostadil is a naturally occurring prostaglandin used as a medication. This
medication is also within the vasodilator class. It, too, is used to help open
the blood vessels by relaxing the smooth muscles within the penis. Alprostadil is
listed on the World Health Organization’s List of Essential Medicines and was
isolated in 1957 and approved for medical use in the United States in 1981.
Phentolamine: This medication is a reversible nonselective
a-adrenergic antagonist. Its primary action is vasodilation. Because it is a
nonselective a-blocker, this medication also increases cardiac output.
Trimix injection is a medication that is very
customizable to the patient’s needs. In order to receive the most effective
results, it is imperative that the patient, provider, and pharmacy work together
in determining the correct formula. Be aware that it is possible that the first
few administrations may not deliver the individual’s satisfactory result.
Increasing the dosage little by little will help reach the individual patient’s
goal. To do this, the initial dose should be 0.05cc (mL) to 0.2cc (mL)
depending on the level of the patient’s ED. Max dose is 0.50cc (mL). Always contact your provider before
increasing your dosage.
Contraindications: The use of Trimix
injection is contraindicated in patients with allergies to any components in
this medication, sickle cell anemia, blood clotting disorders, any condition
that can predispose you to priapism (a painful erection lasting more than 4
hours), leukemia, anatomical deformations of the penis, penile implants, and if
you have direct instructions from your physician to abstain from sexual
activity.
It is important to provide your healthcare
provider with a list of all drugs that you are currently using. This includes
all non-prescription drugs, illegal drugs, herbal, and dietary supplements.
Some chemicals within Trimix can interact with your medication causing them to
become ineffective or leave you with adverse effects.
Common side effects:
Pain- This is very minimal though as there
are not many nerve endings in the area of injection.
Bleeding- This could be due to the angle
administered or possible may result from hitting a tiny blood vessel. If this
occurs, apply pressure until bleeding has stopped. Do not engage in sexual
activity until bleeding has ceased.
Infection- Good hygiene always prevents this.
Make sure the area is clean and use alcohol swabs just prior to administering
the injection. Always be sure to wash your hands before and after
administration.
Priapism- This can be a painful erection
lasting longer than 4 hours. This is a medical emergency. If unseen, the tissue
can become damaged and the effects may be irreversible. If your erection lasts
for more than 2 hours, take 2 – 4 pseudoephedrine tablets only once. You should
then apply an ice pack. If this erection still persists after another hour,
seek immediate medical attention.
While using Trimix, if you experience any
swelling, numbness, tenderness, redness, and lumps on your penis or its
surrounding areas, make sure to contact your provider immediately.
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