Alprostadil, Papaverine, and Phentolamine (TriMix) for Erectile Dysfunction (ED)

The statements below have not been evaluated by the FDA.

What is Alprostadil, Papaverine, and Phentolamine?

For intracavernous injection therapy, many physicians recommend alprostadil, papaverine, and phentolamine. A combination of these drugs, known as TriMix, often elicits erection in humans by increasing blood flow to the penis, benefiting those that are suffering from erectile dysfunction (ED).

Alprodastil is a vasodilator that relaxes the muscles and blood vessels. Papaverine is another vasodilator that does the same and widens muscles and blood vessels to allow blood to flow easily and phentolamine is an alpha-adrenoceptor antagonist that also eases blood flow.

With their capabilities to relax muscles and stimulate blood flow, TriMix is often used in treating erectile dysfunction in men who have not had any success with commercially available options.

TriMix is administered via injection at the base of the penis, and although it may seem intimidating- desired results make up for any initial discomfort.

Frequently Asked Questions

A prescription is required for TriMix. Talk to your provider on whether it is a good fit for you, and expert pharmacists at Eastern States Compounding can work with them to develop the dosage that is suitable for your needs.

TriMix has long been considered to be a safe and effective non-surgical option for men suffering from erectile dysfunction and there are little known side effects.

TriMix formulation requires a complex process that can only be made by a specialty compounding pharmacy. Whether you’re a physician or a patient who’s interested in TriMix for erectile dysfunction, you can get in touch with your nearest compounding pharmacy to learn more.

If there is cause for concern, or you want a clear picture assessing your overall health, your practitioner can prescribe a hormone profile saliva test, where different kits test different hormone levels. Hormone abnormalities can cause ED, so it is important to check your levels.

Step-by-Step Guide for At-Home Saliva Testing »

Please contact Eastern States Compounding Pharmacy and our experts will be happy to guide you through the journey to optimal health. We work with providers and their patients to educate and provide customized treatments for erectile dysfunction (ED), hormonal imbalances and health conditions. 

Ask a Pharmacist »

Shipping available for OTC products nationwide, and prescription products for New Hampshire, Maine, Vermont, and Massachusetts.  

TriMix Requires a Prescription from your Doctor. 

Related Readings

Meinhardt W, Lycklama à Nijeholt AA, Kropman RF, et al. Comparison of a mixture of papaverine, phentolamine and prostaglandin E1 with other intracavernous injections.

Eur Urol
. 1994;26(4):319-21.
Accessed February 2, 2022.


Objective: evaluation of a self-injection program with a mixture of papaverine, phentolamine and prostaglandin E1 (PGE1).

Method: a self-injection program for erectile dysfunction was started by 48 patients, using a 1-ml mixture of 4.5 mg papaverine, 0.2 mg phentolamine and 1.5 micrograms PGE1. Patients completed a questionnaire at 6 weeks and at 3 months and were followed at the Outpatients Department for an average of 1 year.

Shenfeld O, Hanani J, Shalhav A, et al. Papaverine-phentolamine and prostaglandin E1 versus papaverine-phentolamine alone for intracorporeal injection therapy: a clinical double-blind study.

J Urol. 1995;154(3):1017-9.
Accessed February 2, 2022.


Purpose: A study was designed to compare intracorporeal injections of papaverine plus phentolamine (2-drug solution) and papaverine plus phentolamine and prostaglandin E1 (3-drug solution) for the treatment for impotence.

Materials and methods: A total of 20 impotent patients received intracorporeal injections of the 2-drug or 3-drug solution alternately during 2 sessions, and the quality and duration of erections were assessed.

Paick, J. S., Lee, K. C., Kim, S. W., et al. Trimix intracavernosal self-injection therapy: long-term follow-up results in the patients with erectile dysfunction.

Korean Journal of Urology. 1998:39(9), 911-915.
Accessed February 2, 2022.


PURPOSE: Trimix, the mixture of papaverine, phentolamine and PGE1 , has been widely used in intracavernosal therapy for patients with erectile dysfunction. Although several results have been reported in Korean patients using the Trimix, no long-term follow-up studies have been carried out. Therefore, we analysed our long-term follow-up results of Trimix therapy

Khera M, Goldstein I. Erectile dysfunction.

BMJ Clin Evid. 2011;2011:1803.
Accessed February 2, 2022.


Erectile dysfunction may affect 30% to 50% of men aged 40 to 70 years, with age, smoking, and obesity being the main risk factors, although 20% of cases have psychological causes.

Methods and outcomes
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of phosphodiesterase inhibitors in men with erectile dysfunction of any cause? What are the effects of phosphodiesterase inhibitors on erectile dysfunction in men with diabetes, with cardiovascular disease, with spinal cord injury, and with prostate cancer or undergoing prostatectomy?

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