Tri-Mix

Erectile Dysfunction, What is It?

The recurrent inability to attain or retain an erection adequate for sexual intercourse is known as Erectile Dysfunction (ED). Approximately 15 to 30 million men across the United States suffer from ED. The prevalence of this problem increases as men age. However, ED can be treated effectively. Learn more about our Erectile dysfunction diagnosis.

What Causes an Erection?

The erection process is quite intricate. First, a physical or mental stimulus is received by the brain. A signal is then transmitted through a series of nerves from the brain to the penis. This signal causes the blood vessels in the penis to relax. Upon relaxation of these penile blood vessels, blood flows more freely into the penis. The high pressure causes the blood in the penis to be trapped in the corpus cavernosum. This leads to a sustained erection. The corpus cavernosum consists of two columns of erectile tissue that run parallel to one another and form the shape of the penis.

Promescent® and Premature Ejaculation

Promescent is a topical spray from Absorption Pharmaceuticals for the treatment of premature ejaculation. Its unique absorption technology, in conjunction with the metered-dose spray bottle, enables men to deliver a specific and reproducible amount of anesthetic through the stratum corneum (outer layer) of the penile skin to the nerves that control ejaculation. Promescent allows men to gain ejaculatory control while maintaining good sensation to achieve complete sexual satisfaction.

Promescent takes effect in 10 minutes or less, and the use of a condom is not required. It absorbs and dries in just a few minutes and can be easily washed off before intercourse so that transmission is not an issue. Ejaculatory control typically lasts at least 30 minutes to more than one hour, depending upon the dose and penile sensitivity.

For a wealth of information about PE, visit the Promescent web pages: About Premature Ejaculation.

Helping All Men Last Longer

For men looking to last longer regardless of penis sensitivity and for couples who simply want to have longer, more satisfying sex, Promescent is the solution.

  • FDA Approved via OTC monograph (21 CFR Part 348)

  • Unique absorption technology enables superior ejaculatory control

  • Metered-dose spray bottle provides repeatable and adjustable dosing

  • The light formula spreads easily and absorbs quickly – no transference to partner

  • Low cost per use – approximately $1.33 per spray

Purchase at Mark Drugs Pharmacies.

What Are the Causes of Erectile Dysfunction?

Several factors can cause ED. These factors can be classified as physical, psychological, or both. The majority of cases are due to physical problems. ED can be caused by any condition that leads to the disruption in the process of events that occur during a normal erection (explained above). Common conditions that lead to ED include neurological disease, malignancies, diabetes, vascular disease, and kidney disease. Diabetes hinders the conduction from peripheral nerves to the penis. Nerve conduction to the brain may be impaired by stroke or spinal cord injuries. Hypertension (increased blood pressure), peripheral vascular disease, and atherosclerosis (hardening and thickening of arterial walls) can decrease the flow of blood to the penis. Ten to twenty percent of all ED cases can be attributed to psychological problems. These consist of depression, indifference, stress, low self-esteem, guilt, and anxiety. Patients with psychological problems frequently fail to react to psychogenic stimuli.

Medication-induced ED occurs when the condition is elicited by medications that the patient is taking. Listed in the tables below are over 200 possible medications that can cause ED. Any medication listed should not be discontinued before consulting your physician.

Drug Class

Anti-Anxiety, Anti-Epileptic, and Antidepressant Drugs

  • Generic (Brand)

  • Amitriptyline (Elavil)

  • Amoxipine (Asendin)

  • Buspirone (Buspar)

  • Chlordiazepoxide (Librium)

  • Clorazepate (Tranxene)

  • Clomipramine (Anafranil)

  • Desipramine (Norpramin)

  • Diazepam (Valium)

  • Doxepin (Sinequan)

  • Fluoxetine (Prozac)

  • Imipramine (Tofranil)

  • Isocarboxazid (Marplan)

  • Lorazepam (Ativan)

  • Nortriptyline (Pamelor)

  • Oxazepam (Serax)

  • Phenelzine (Nardil)

  • Phenytoin (Dilantin)

  • Sertraline (Zoloft)

  • Tranylcypromine (Parnate)

Anti-Arrhythmic Drugs

  • Generic (Brand)

  • Disopyramide (Norpace)

  • Anti-Histamines

  • Generic (Brand)

  • Dimenhydrinate (Dramamine)

  • Diphenhydramine (Benadryl)

  • Hydroxyzine (Vistaril)

  • Meclizine (Antivert)

  • Promethazine (Phenergan)

Anti-Hypertensive and Diuretic Drugs

  • Generic (Brand)

  • Atenolol (Tenormin)

  • Bumetanide (Bumex)

  • Captopril (Capoten)

  • Chlorothalidone (Hygrotone)

  • Clonidine (Catapres)

  • Enalapril (Vasotec)

  • Furosemide (Lasix)

  • Guanfacine (Tenex)

  • Hydralazine (Apresoline)

  • Hydrochlorothiazide (Esidrix, Hydrodiuril,

  • Inderide, Moduretic, Oretic, Lotensin)

  • Labetalol (Normodyne)

  • Methyldopa (Aldomet)

  • Metoprolol (Lopressor)

  • Nifedipine (Adalat, Procardia)

  • Phenoxybenzamine (Dibenzyline)

  • Propranolol (Inderal)

  • Spironolactone (Aldactone)

  • Triamterine (Maxide, Dyazide)

  • Verapamil (Calan, Isoptin, Verelan)

Chemotherapy Medications

  • Generic (Brand)

  • Busulfan (Myleran)

  • Cyclophosphamide (Cytoxan)

Histamine H2-Receptor Antagonists

  • Generic (Brand)

  • Cimetidine (Tagamet)

  • Nizatidine (Axid)

  • Ranitidine (Zantac)

Muscle Relaxants

  • Generic (Brand)

  • Cyclobenzaprine (Flexeril)

  • Orphenadrine (Norflex)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

  • Generic (Brand)

  • Naproxen (Anaprox, Naprelan, Naprosyn)

  • Indomethacin (Indocin)

Parkinson's Disease Medications

  • Generic (Brand)

  • Benztropine (Cogentin)

  • Biperiden (Akineton)

  • Bromocriptine (Parlodel)

  • Levodopa (Sinemet)

  • Procyclidine (Kemadrin)

  • Trihexyphenidyl (Artane)

Prostate Cancer Medications

  • Generic (Brand)

  • Flutamide (Eulexin)

  • Leuprolide (Lupron)

Diagnosing ED

A physician will perform a detailed examination in order to attain an accurate diagnosis. Your doctor will perform a physical exam as well as obtain a surgical history, blood work, medical history, sexual history, and medication history. Lastly, you will be asked to complete a questionnaire known as the "International Index of ED," which will help to evaluate the quality of sexual intercourse and erectile function.

The information on this website should not be used to diagnose or treat patients without the specific direction and supervision of a physician. You should consult with a physician who knows your medical history and current medical conditions before using Tri-Mix or any erectile dysfunction treatments. Your treatment should be individualized for you by a prescribing physician. Tri-Mix is for the treatment of Erectile Dysfunction and is not approved by the FDA. Tri-Mix requires a prescription and can only be filled at a compounding pharmacy.

Tri-Mix: What is it?

Physicians often prescribe Tri-Mix injections to help patients with erectile dysfunction (ED). Around 15-30 million male patients in the United States are affected by ED. This site is for educational and informational purposes. Any information provided on this site should not be used to self-diagnose or treat erectile dysfunction. Your physician should be consulted regarding any treatment options, internet information, or for any recommendations to make sure that they are safe for you and your situation. Tri-Mix has not been approved by the FDA.

The information regarding dosing listed on this site is based on commonly dispensed strengths at pharmacies or from various studies enlisted under the studies linked on this site. Prior to the administration of any medication, doses, and strengths should be individualized for each patient. Your physician must write a prescription for Tri-Mix injection, and it should be filled at a pharmacy with experience in sterile compounding.

The information on this website should not be used to diagnose or treat patients without the specific direction and supervision of a physician. You should consult with a physician who knows your medical history and current medical conditions before using Tri-Mix or any erectile dysfunction treatments. Your treatment should be individualized for you by a prescribing physician. Tri-Mix is for the treatment of Erectile Dysfunction and is not approved by the FDA. Tri-Mix requires a prescription and can only be filled at a compounding pharmacy.

Copyright 2011

Tri-Mix Instructions

Injecting yourself with Bi-Mix, Tri-Mix, or Quad-Mix

This serves solely as a recommendation for administering Bi-Mix, Tri-Mix, or Quad-Mix. Before administering any of the injectable treatments, patients should carefully review the appropriate administration methods with their doctor.

Initial Steps

  • Start by washing your hands and ensuring that the penis is clean.

  • Have the following ready to go: a syringe, an alcohol swab, and an injectable solution bottle.

Using the syringe

  • Using alcohol or an alcohol swab, clean the rubber top of the vial that contains the tri-mix.

  • Take off the needle cap, and allow the syringe to fill with air by setting the plunger to the required dosage.

  • Put the needle into the rubber top of the vial and inject the air. Next, flip the vial upside down ensuring the needle tip is below the surface of the medication.

  • Gradually draw the syringe back to the required dosage.

  • Using your fingers, gently tap the sides of the syringe so that the air bubbles float to the top. Then, make sure to inject the air bubbles out of the syringe prior to using it.

  • Take the needle out of the bottle and place the cap back on it.

Preparation of the Site

  • The site of the injection is located between the base of the penis and the mid-portion, specifically at the upper right or upper left sides. Make sure to NOT inject at the midline since it can damage the urethra and arteries/nerves of the penis. Also, make sure to keep away from any arteries or veins that are showing.

  • This is typically within one (1) inch of the base of the penis, near the scrotum.

  • Place the head of the penis near the side of the leg and choose an injection site.

  • Wipe the site using alcohol.

Injecting the Penis

  • Gradually go through the skin with the needle at a right angle. Ensure that the needle is pushed to the end.

  • Inject the tri-mix over a period of several seconds and take out the needle.

  • Compress the site of the injection for a couple of minutes. To stop any possible bleeding, additional time may be necessary.

  • Properly dispose of the syringe and needle in the appropriate container.

Basic Rules for Injection

  • Use the smallest dose that works. Higher doses may result in more side effects.

  • Injections should be administered no more than three times a week or once every couple of days.

  • If an erection lasts longer than 4 hours, find medical help.

  • Sexual stimulation should happen after the injection is administered.

Causes of Insufficient Response

  • Injected into an incorrect site

  • Agent leaks before injection

  • Stimulation causes premature ejaculation

  • Stress before, during, or after injection

  • Pain – localized – during and/or after the injection procedure

  • Insufficient dose

Steps to Resolve Insufficient Response

  • Re-assess the injection method

  • Re-assess the timing of the injection with regard to sexual activity

  • Have a partner present and involved and inject in a relaxed atmosphere

  • Attempt combo therapy with lower PGE-1 doses

  • Re-examine the dose with your doctor and if accepted by the doctor, raise doses in two to three days or change to a higher dose for optimal results.

The information on this website should not be used to diagnose or treat patients without the specific direction and supervision of a physician. You should consult with a physician who knows your medical history and current medical conditions before using Tri-Mix or any erectile dysfunction treatments. Your treatment should be individualized for you by a prescribing physician. Tri-Mix is for the treatment of Erectile Dysfunction and is not approved by the FDA. Tri-Mix requires a prescription and can only be filled at a compounding pharmacy.