Trimix Injections

Trimix is ideal for men who haven't had success with oral ED medications or need a more reliable solution. It's particularly effective for those with diabetes, prostate surgery history, or other conditions affecting blood flow.

Trimix is considered the most effective ED treatment available, with success rates over 90%. Because it's injected directly, it works independently of arousal and provides very reliable results.

RespondWell uses the T-105 formulation: • Papaverine 30mg • Phentolamine Mesylate 1mg • Prostaglandin E1 10mcg. Compounded by Hallandale or Olympia Pharmacy. A 1-month supply is 5 mL; a 3-month supply is 15 mL (three 5 mL vials). Some patients may alternatively be prescribed  Papaverine 30mg • Phentolamine Mesylate 2mg • Prostaglandin E1 40mcg.

Standard dosing protocol — your prescriber may adjust this: Inject 0.05–0.10 mL at the base of the penis before sexual activity. Increase by 0.025–0.05 mL based on response. Wait at least 48 hours before repeating or increasing the dose. Maximum 0.50 mL per dose; no more than 3 doses per week.

→ Instructions: Penile Injection Instructions (PDF) →

One 5mL vial holds up to 10 injections at the maximum dose (0.50mL). Dosed every 3 days — the most frequent schedule your provider will approve — that works out to right around 30 days.

Here's the part that actually matters: the vial has a four week life after the first puncture, and that clock is what governs, not how much is left. Even if you're dosing below 0.50mL and have solution to spare, discard the vial after four weeks. The potency and sterility of your vial cannot be assured after that point, regardless of the remaining volume. A half-full vial on day 30 isn't a bonus — it's a vial you shouldn't be drawing from.

Bottom line: Order your refill with enough lead time that you're not stretching a vial past its date to bridge a gap.

No — RespondWell offers only the T-105 TriMix formulation. T-105 is a well-established, balanced formulation that works for the vast majority of men, and standardizing on a single formula lets our prescribers fine-tune your results through dosing adjustments rather than switching formulas. Focusing on one formulation also means our pharmacy compounds it at higher volume, which keeps quality consistent and pricing lower than we could offer across multiple formulas.

Fast. Our goal is to have your medication at your door by this time next week, at the latest—and we meet that goal about 94% of the time.

Here's what that usually looks like:

Provider review: Most intakes are reviewed within 4 business hours. More complex medical histories may require additional review by our Medical Director or care team.

Pharmacy processing: Once approved, our partner pharmacy typically prepares and ships your medication within 1–3 business days.

Shipping: UPS 2nd Day Air is included at no additional cost.

Keep in mind that pharmacy volume, holidays, severe weather, and other carrier delays can occasionally extend these timelines. We'll keep you updated every step of the way.

Common side effects include mild pain at the injection site, prolonged erection, and minor bruising. The most serious risk is priapism (erection lasting more than 4 hours), which requires immediate medical attention. Proper dosing and technique may reduce these risks.

Penile Injection Instructions (PDF) →

No. RespondWell providers don't prescribe phenylephrine injections, and we don't offer or advertise phenylephrine as part of our services.

Why not? Because this treatment needs real-time monitoring. Phenylephrine is sometimes used off-label for priapism or prolonged erections, but clinical guidelines call for blood pressure and heart rate monitoring during and after each dose because of a real, if uncommon, risk of cardiovascular side effects. That kind of monitoring belongs in a medical setting — not at home through telehealth.

Can I take Sudafed if an erection is lasting too long?
For some patients, yes. Pseudoephedrine HCl — the ingredient in original Sudafed — may be considered before an erection reaches the 4-hour mark, as long as you don't have contraindications.

Important: this does not mean Sudafed PE. Sudafed PE contains phenylephrine and is not the same medication. Pseudoephedrine can raise blood pressure and heart rate, so patients with heart conditions, uncontrolled blood pressure, or other risk factors should ask a clinician before using it.

Learn more here: Penile Injection Instructions (PDF) →

What should I do if I have a prolonged erection?
Don't wait and hope it goes away. If your erection is lasting longer than expected, follow the instructions provided with your medication. Prior to the 4-hour mark, consider Sudafed. If you have an erection lasting 4 hours or more, seek emergency medical care right away or call 911.

No guessing. No toughing it out. Get checked.

Why does RespondWell take this approach?
Your safety comes first. RespondWell is built for convenient care, but not at the expense of clinical judgment. Some treatments just aren't appropriate for an at-home telehealth model, and our medical team has made the call not to offer phenylephrine injections for that reason.

Yes. TriMix is available to eligible patients in California following a review by a licensed clinician. If you're approved for treatment, your prescription will be sent to one of our partner pharmacies for fulfillment and discreet delivery.

TriMix is available to eligible patients in all 50 states and Washington, D.C.

Every prescription is reviewed by a licensed clinician in your state. If treatment is appropriate, your medication is prepared by one of our partner pharmacies and shipped directly to your door in discreet packaging.