How to use your medication
A Guide to Bi-Mix, Tri-Mix, and Quad-Mix Therapy
These injectable medications may be prescribed as part of a treatment plan to support blood flow. They are administered as intracavernosal injections and may contain one or more ingredients that work together to potentially relax smooth muscle and promote circulation, as directed by your healthcare provider.
Role in Therapy
BiMix contains two medications, typically papaverine and phentolamine, which may help support smooth muscle relaxation and blood flow.
TriMix includes three medications, papaverine, phentolamine, and alprostadil also known as prostaglandin E1. The addition of alprostadil introduces a third component to the formulation as prescribed by your provider.
QuadMix contains the same three ingredients as TriMix, papaverine, phentolamine, and alprostadil, along with a fourth medication, atropine. This formulation includes an additional component and is prepared based on your provider’s prescription.
Preparing the Injection
Prepare a clean, flat surface and remove the vial from the freezer if applicable.
Gather your supplies: one vial, two alcohol swabs, one insulin syringe, and a sharps container.
Wash your hands thoroughly with soap and water.
Remove the vial’s cap and clean the rubber stopper with an alcohol swab.
Open the insulin syringe, remove the cap, and avoid touching the needle.
Hold the syringe upright with the needle pointing up. Pull the plunger back to draw in air equal to your prescribed dose.
Turn the syringe so the needle is pointing downward and hold it like a dart. Place the vial on a stable surface.
Insert the needle into the center of the rubber stopper and push the plunger to inject the air into the vial.
Turn the vial and syringe upside down together, keeping the needle tip in the liquid to help prevent air from entering.
Pull the plunger back slightly past your prescribed dose, then push forward to remove any air bubbles and align with the correct dose. Double-check your measurement.
Remove the needle from the vial and carefully recap it while maintaining sterility.
Did you know?
Some individuals may experience side effects such as dizziness, headache, or a prolonged erection.
A mild, dull ache in the penis may occur, particularly with formulations that include alprostadil (prostaglandin E1). This sensation is typically temporary and may improve with rest.
Injection Technique
Proper injection technique and site selection are important to help reduce the risk of irritation or injury.
The injection is typically administered into the middle portion of the shaft, on either the left or right side.
Rotate injection sites with each use to help minimize tissue irritation.
Avoid areas with visible veins.
Do not inject along the top or bottom of the shaft.
Gently grasp the head of the penis to stretch it before injection.
Clean the injection site with an alcohol swab and allow it to fully dry.
Hold the syringe like a pen using your thumb and fingers, keeping the penis gently stretched.
Place the needle against the skin and insert it at a 90 degree angle using a quick, controlled motion. Depress the plunger steadily until the full dose is administered.
Remove the needle smoothly once the injection is complete, avoiding twisting or sudden movements.
Apply gentle pressure to the injection site for 2 to 3 minutes. If you take blood thinners or aspirin, apply pressure for about 5 minutes to help reduce bleeding or bruising.
Do not use this medication if you have a known allergy or sensitivity to any of its components. It should also be avoided in individuals with conditions that may increase the risk of prolonged erections, such as sickle cell anemia, multiple myeloma, or leukemia. This medication may not be appropriate for those with certain anatomical conditions of the penis or penile implants, or for individuals who have been advised by their healthcare provider to avoid sexual activity. Always consult your provider to determine if this treatment is appropriate for you.
Storage and Disposal Guidelines
- Allow the medication to fully thaw before use.
- Once thawed, store the medication in the refrigerator as directed.
- Do not use the medication if it appears cloudy or has changed in appearance.
- Opened vials should be discarded according to the instructions provided with your prescription.
- Keep the medication out of reach of children and store it away from air and light when possible.
- Storage requirements and expiration timelines may vary based on the specific formulation and strength. Always follow the directions on your prescription label.
- Used syringes should be placed in an appropriate sharps container or a sturdy, clearly labeled household container such as an empty laundry detergent bottle marked “Home Sharps – Not for Recycling.” Dispose of the sealed container according to local guidelines.
Tips for Minimizing Injection Pain
- Make sure the medication has reached room temperature before injecting.
- Remove any air bubbles from the syringe prior to injection.
- Allow the alcohol to fully dry on both the vial stopper and the skin before inserting the needle.
- Keep the muscles in the injection area relaxed to help minimize discomfort.
- Insert the needle using a quick, steady motion.
- Avoid changing the direction of the needle during insertion or withdrawal.
- Do not reuse needles. Always use a new, sterile needle for each injection.
BiMix contains two medications, typically papaverine and phentolamine, which may help support smooth muscle relaxation and blood flow.
TriMix includes three medications, papaverine, phentolamine, and alprostadil also known as prostaglandin E1. The addition of alprostadil introduces a third component to the formulation as prescribed by your provider.
QuadMix contains the same three ingredients as TriMix, papaverine, phentolamine, and alprostadil, along with a fourth medication, atropine. This formulation includes an additional component and is prepared based on your provider’s prescription.
The information contained in this monograph is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. The information is generalized and is not intended as specific medical advice. If there are questions about the medications being taken, check with a pharmacist, provider, or healthcare professional.
Turning Problems Into
Solutions
Email: pharmacists@mixwithintegrity.com
