Tri-Mix for Erectile Dysfunction

Erectile Dysfunction (ED; formerly referred to as “impotence”) is estimated to affect 40% of men at age 40, and almost 70% of men at age 70. However, ED has many treatable causes, and does not need to be an inevitable consequence of aging. While treatment with oral medications known as PDE-5 inhibitors (Viagra™, Cialis™, and Levitra™) is very popular, some patients are unable to take these medications because of drug interactions (ie, sildenafil and nitroglycerin) or a lack of response. In addition, these agents can be associated with adverse effects and are not as effective in patients who have undergone radical prostatectomy (removal of prostate) or who have severe vascular disease, which is a common complication of advanced diabetes. Consequently, PDE-5 inhibitor therapy is associated with a high rate of discontinuation.

   Self-injection (intracavernosal injection; ICI) is a well-accepted and popular therapy for ED from many causes, and is considered “the most effective medical therapy for diabetic erectile dysfunction.” 1 Tri-mix is a combination of medications (papaverine/phentolamine/prostaglandin) that work in various ways to produce an erection. Men with ED who used tri-mix by self-injection and who changed to oral sildenafil (Viagra™) found they had a greater preference than expected for triple therapy and the erection quality was better with trimix than with sildenafil in 89%.2 Fear of pain with self-injection therapy may discourage some men. Yet, in the majority of ED patients, findings from a Cleveland Clinic study show that discomfort is minimal, which may help to alleviate the fear of injection in those who may benefit from this therapy.3

   Early intracavernosal injections following radical prostatectomy facilitated early sexual intercourse, patient satisfaction and potentially earlier return of natural erections, according to a study from the Glickman Urological Institute, Cleveland Clinic Foundation.4

    While studies have shown that the highest percentage of positive response in men with erectile dysfunction is achieved with tri-mix5, the professional compounders at Key Pharmacy will work together with each man and his physician to customize doses and combinations of medications to meet specific needs.

Tri-Mix injection requires a prescription from your physician and should be filled only by an accredited pharmacy experienced in sterile compounding, such as Key Pharmacy.

1 Expert Opin Pharmacother. 2008 Feb;9(2):257-66.
2 BJU Int. 2003 Aug;92(3):277-80
3 J Sex Med. 2005 May;2(3):428-31
4 Int J Impot Res. 2006 Sep-Oct;18(5):446-51. Epub 2006 Feb 16
5 Arch Esp Urol. 2001 May;54(4):355-9

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