TriMix Is a Solid Option for Treating ED, But Overdoing It Can Cause This Scary Consequence

A four-hour erection may sound fun, but it’s not.

By Austin Letorney
Medically reviewed by Lanna Cheuck, D.O.
January 23, 2024

For men with erectile dysfunction, PDE5 inhibitors—including Viagra and Cialis—are often prescribed to improve erections. But they’re not for everyone. Side effects like flushing and headaches can leave you searching for other ED treatments.

In a recent Hone Community AMA, board-certified urologic surgeon and sexual health expert Lanna Cheuck, D.O., spoke in depth about alternative ED treatments—including TriMix injections.

So, how do TriMix injections work, and what happens—as one community member asked—if you inject too much?

How TriMix Injections Work

Three ingredients make up TriMix injections: alprostadil, phentolamine, and papaverin. Together these drugs open your blood vessels and allow blood to flow to your penis, says Cheuck.

Your doctor may administer the first injection at the office to show you how it’s done, but TriMix is a medication you self-administer. Once you’re on your own, TriMix should not be injected more than once a day, she says.

TriMix acts within seconds or minutes after injecting and shouldn’t be used with PDE5’s. That increases your risk of priapism (more on this below), Cheuck says.

As for pain level, Dr. Cheuck says these injections are virtually painless—to you or your member. The needles are very thin and you can use a numbing cream before the injection, says Cheuck.

How Long Do TriMix Injections Last?

TriMix injections only last as long as there is continued stimulation, says Cheuck. And the effect wears off when you ejaculate or climax.

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What Are the Side Effects of TriMix Injections?

Pain and bruising are the most common. While there is virtually no swelling or bleeding, you may experience a small amount of each at the injection site.

Injecting too much TriMix can also cause priapism—a prolonged erection (we’re talking four hours or more after sex), says Cheuck. Priapism happens when blood doesn’t flow out of your penis. Your shaft may become rigid—although your tip stays soft—and pain will slowly progress.

Priapism is uncommon, but it can happen if you get the dose wrong, as happened to one Redditor.

“In reality, any amount of TriMix has the ability to cause priapism,” Cheuck says. “However, it is dose dependent. The higher the dose administered, the higher the risk of priapism to occur.”

You should always take this medication under a doctor’s supervision, she says.

How to Treat Priapism

Go to the ER, Cheuck says.

There, a doctor may use a small needle and syringe to drain excess blood from your penis or inject a medication called phenylephrine, which helps open blood vessels that carry blood out of your penis.

Moral of this TriMix story—don’t overdo it on dose.

You can watch the full AMA with Dr. Lanna Cheuck—which covers more on erectile dysfunction medication, semen volume, ashwagandha, and emerging treatments for ED—by joining our Hone Community today. It’s easy, free, and full of great information around treatment and how to live a healthier, longer life.