Before and After Trimix Injection Results: What to Expect 

What is Trimix—and who is it for? 

Trimix is a compounded (custom-mixed) injectable medication that combines three vasodilators—alprostadil (PGE1), papaverine, and phentolamine—to increase blood flow inside the penis and create an erection. Alprostadil is an FDA-approved ED drug on its own (e.g., Caverject/Edex), while Trimix as a mixture is prepared by compounding pharmacies for on-demand use when PDE5 pills (like sildenafil or tadalafil) don’t work well or aren’t tolerated. Cleveland Clinic Memorial Sloan Kettering Cancer Center 

Major urology guidelines include intracavernosal injection (ICI) therapy as a standard treatment option—often discussed after lifestyle changes and oral PDE5 inhibitors—using shared decision-making to match the therapy to the patient’s goals and medical history. American Urological Association 

The “before” phase: evaluation, training, and dose finding 

Before your first self-injection at home, you’ll typically have: 

• Clinical screening (heart health, priapism risk, medications). 

• In-office teaching and test dosing, so you learn sterile technique, where to inject, how to rotate sites, and how to respond if an erection lasts too long. Many centers explicitly train patients over 1–2 visits. Memorial Sloan Kettering Cancer Center 

Two trusted patient guides emphasise practical technique: inject into the outer third of the shaft, avoiding visible veins; positions like 3 and 9 o’clock are standard; some services allow 2/4/8/10 o’clock but note a slightly higher chance of missing the erectile tissue. UCSF Health 

Safety planning is part of “before.” You’ll be told how to recognise priapism (an erection that doesn’t go down) and to keep oral decongestants (pseudoephedrine) on hand as a first step while arranging urgent care if instructions don’t resolve it. Memorial Sloan Kettering Cancer Center 

The “after” phase: what happens right after an injection? 

Most men notice effects within 5–15 minutes. Erection duration varies with dose and individual factors, but many programs aim for ~30–60 minutes, with some patients lasting longer. An erection that is still rigid at 2 hours warrants following your clinic’s “de-escalation” plan; ≥4 hours is an emergency. 

If the needle doesn’t enter the erectile bodies correctly, you might feel burning without an erection—a sign to review technique with your team. 

Results you can realistically expect 

1) Erection quality and reliability 

Across modern studies, ICI therapy (the class that includes Trimix) produces functional erections in roughly two-thirds to three-quarters of men—even in difficult-to-treat groups. In one long-term series, 68% achieved and maintained erections sufficient for intercourse; other cohorts report ~68–74% functional response rates independent of ED cause. 

2) Patient satisfaction (and why some stop) 

Among men who continue using injections, satisfaction tends to be high on validated tools (e.g., IIEF), particularly when erections reach full rigidity. However, drop-out rates can be substantial (often 46–80% in the first year), commonly due to cost, inconvenience, loss of partner, or a preference for less invasive options—not necessarily because the medicine “fails.” Education, right-sizing the dose, and expectation setting improve adherence. 

3) Special situations: after prostate surgery 

Post-prostatectomy patients often use injections for penile rehabilitation and sexual function while nerves recover. With proper titration, long-term series show safe, effective use and similar questionnaire outcomes to other ED populations. PubMed 

A simple “before vs. after” snapshot 

(Your exact plan may differ—always follow your clinic’s protocol.) Memorial Sloan Kettering Cancer Center

Side effects and risks: know them, manage them 

• Penile pain or burning, bruising, and small hematomas can occur, especially early on. 

• Priapism (an erection that won’t go away) is an uncommon but urgent risk with ICI; education and clear action steps reduce harm. Large datasets and modern reviews continue to flag ICI components as priapism-linked agents, reinforcing the importance of training and follow-up. 

• Fibrosis/curvature can develop with long-term use in a minority of men (e.g., ~10% mild curvature in one series); rotating sites and proper dosing help mitigate risk. 

Trimix vs. tablets vs. other options 

Guidelines emphasise that ED care is not one-size-fits-all. Many start with PDE5 inhibitors (sildenafil, tadalafil, etc.). If pills don’t work or aren’t tolerated, ICIs (like Trimix), vacuum erection devices, intraurethral alprostadil, and penile prosthesis surgery are valid options. Your clinician should discuss benefits, burdens, and reversibility for each, so you can choose what matters most (spontaneity, reliability, invasiveness, cost).

How to make your results better (and safer) 

• Get technique right. Use the exact syringe/needle size prescribed, choose approved clock-face positions, avoid veins, rotate sides, and keep things sterile. UCSF Health 

• Respect timing with PDE5 pills. Many centers advise spacing injections from PDE5 inhibitors (especially tadalafil) to reduce interaction risks—follow your clinic’s exact windows.

• Keep decongestants handy (per your clinic) and follow the two-hour/three-hour/four-hour action plan for prolonged erections. Memorial Sloan Kettering Cancer Center 

• Track doses and responses. Share your injection log with the clinic so they can fine-tune dosing and reduce side effects.

• Mind overall health. Cardio-metabolic health, sleep, and alcohol intake can influence erectile response; address modifiable risks alongside ED treatment. 

Real-world outcomes: what the studies say 

• Efficacy: Functional erections in ~68–74%; many responders are men who didn’t improve enough with pills.

• Satisfaction: High among ongoing users; full rigidity predicts better satisfaction. 

• Complications: In a long-term series, priapism 7.1%, bruising 7.6%, mild curvature 10%, pain 12.4%—reinforcing the value of dosing and education.

• Adherence: Despite initial success, many discontinue within a year due to convenience/cost preferences rather than pure medical failure—plan for follow-ups and troubleshooting. World Journal of Men's Health 

Storage, sourcing, and quality 

Because Trimix contains alprostadil, many clinics recommend refrigeration and light protection to maintain potency; supplies usually come from a licensed compounding pharmacy after your dosing is set. Work only with reputable pharmacies arranged by your urologist. Memorial Sloan Kettering Cancer Center 

The bottom line 

Before Trimix, you and your clinician should agree on goals, review risks, and practice the technique. After Trimix, most men who respond see predictable, on-demand erections within 5–15 minutes, typically lasting 30–60 minutes, with high satisfaction among those who continue use. Clear safety steps for prolonged erections and regular follow-up are essential for good outcomes. If pills haven’t delivered, injection therapy is a guideline-supported option that can restore reliable sexual function when used correctly.

References (selected) 

• American Urological Association (AUA) Erectile Dysfunction Guideline (2018). 

• UCSF Health. Patient Guide to Penile Injections (onset/duration, technique). 

• Memorial Sloan Kettering Cancer Center. Penile Injection Therapy (timing, safety and priapism plan). Memorial Sloan Kettering Cancer Center 

• Bearelly P, et al. Long-term ICI therapy: safety, complications, and outcomes.  

• Prabhu V, et al. Functional erection rates with ICI (multiple etiologies). 

• Hsiao W, et al. Satisfaction profiles among ICI users (IIEF-based). 

• Reviews on adherence/drop-out and reasons for discontinuation. 

FAQs 

1) What is Trimix?

Trimix is a compounded mix of alprostadil, papaverine, and phentolamine injected into the penis to improve blood flow and create an erection, usually when pills aren’t enough. 

2) How fast does Trimix work?

Most men see an effect in 5–10 minutes after a correctly placed injection. Onset can vary based on dose, technique, and arousal. 

3) How long should a Trimix erection last?

Clinics typically aim for about 30–60 minutes. Your duration depends on dose and individual response. Follow your prescriber’s plan. 

4) How often can I inject Trimix?

Many urology programs limit use to no more than three injections per week with at least 24 hours between doses, alternating sides each time. Follow your clinic’s exact limits. 

5) What counts as an emergency after an injection?

A rigid erection lasting 4 hours or more is a medical emergency (priapism). Seek urgent care as directed by your clinician. 

6) Is there anything I can try at home if an erection lasts too long?

Many programs advise an initial step with pseudoephedrine (Sudafed) while arranging urgent evaluation. Use only as your clinic instructs. 

 Quick note: This article is educational and not a substitute for medical advice. Always follow your urologist’s instructions and get your first doses and dose-titration under clinical supervision.