Trimix (drug)
{{Short description|Treatment for erectile dysfunction}}
{{about|the erectile dysfunction drug|the oxygen-nitrogen-helium gas mixture|Trimix (breathing gas)}}
{{Drugbox
| drug_name = Trimix
| verifiedrevid = 470616043
| type = combo
| component1 = Alprostadil
| class1 = prostaglandin
| component2 = Papaverine
| class2 = vasodilator
| component3 = Phentolamine
| class3 = alpha blocker
| tradename =
| pregnancy_AU =
| pregnancy_US = D
| pregnancy_category =
| legal_AU =
| legal_CA =
| legal_UK =
| legal_US = Rx-only
| legal_status =
| routes_of_administration = injection, intraurethral, topical
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = none
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number =
| ATCvet =
| ATC_prefix =
| ATC_suffix =
| PubChem =
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank =
}}
Trimix is a prescription combination drug containing alprostadil, papaverine, and phentolamine. It is used to treat erectile dysfunction.{{cite journal | vauthors = Elena BW, Zachary M, Haritha P, Graham BA, Wayne HJ | title = Current status of intracavernosal injection therapy in erectile dysfunction | journal = Expert Opinion on Pharmacotherapy | volume = 24 | issue = 8 | pages = 925–933 | date = June 2023 | pmid = 37078428 | doi = 10.1080/14656566.2023.2204189 | s2cid = 258238107 }}{{cite journal |vauthors= Marmar JL, Harkins TJ, Riordan J |title=Studies with Trimix gel in men who failed phosphodiesterase inhibitors |journal=Journal of Urology |volume=179 |issue=4S |date=May 2008 |issn=0022-5347 |doi=10.1016/s0022-5347(08)61264-1 |page=431 |url=https://www.auajournals.org/doi/pdf/10.1016/S0022-5347%2808%2961264-1|url-access=subscription }}{{cite journal | vauthors = Duncan C, Omran GJ, Teh J, Davis NF, Bolton DM, Lawrentschuk N | title = Erectile dysfunction: a global review of intracavernosal injectables | journal = World Journal of Urology | volume = 37 | issue = 6 | pages = 1007–1014 | date = June 2019 | pmid = 30895359 | doi = 10.1007/s00345-019-02727-5 | s2cid = 84185652 }}
Medical use
=Available forms=
Trimix is available in several different formulations, including a gel that can be used topically, a gel that can be administered into the urethra, and an injectable form that is administered via intracavernosal injection (an injection at either side, not the base, of the penis).{{cite journal | vauthors = Seyam R, Mohamed K, Akhras AA, Rashwan H | title = A prospective randomized study to optimize the dosage of trimix ingredients and compare its efficacy and safety with prostaglandin E1 | journal = International Journal of Impotence Research | volume = 17 | issue = 4 | pages = 346–353 | year = 2005 | pmid = 15772683 | doi = 10.1038/sj.ijir.3901313 | doi-access = free }}{{cite journal | vauthors = Kim SC, Chang IH, Jeon HJ | title = Preference for oral sildenafil or intracavernosal injection in patients with erectile dysfunction already using intracavernosal injection for > 1 year | journal = BJU International | volume = 92 | issue = 3 | pages = 277–280 | date = August 2003 | pmid = 12887483 | doi = 10.1046/j.1464-410X.2003.04324.x | s2cid = 41078747 }}{{cite journal | vauthors = Israilov S, Baniel J, Shmueli J, Niv E, Engelstein D, Segenreich E, Livne PM | title = Treatment program for erectile dysfunction in patients with cardiovascular diseases | journal = The American Journal of Cardiology | volume = 93 | issue = 6 | pages = 689–693 | date = March 2004 | pmid = 15019870 | doi = 10.1016/j.amjcard.2003.11.049 }}
Adverse effects
Pharmacology
Trimix is a combination of three drugs: alprostadil, papaverine, and phentolamine. These medications work in combination to increase blood flow to the penis, resulting in an erection. Alprostadil is a prostaglandin vasodilator that allows more blood to flow into the area by relaxing the smooth muscle in the blood vessels of the penis.{{cite book | vauthors = Jain A, Iqbal O | chapter = Alprostadil | title = StatPearls | location = Treasure Island (FL) |publisher=StatPearls Publishing |date=18 July 2022 |pmid=31194374 | chapter-url = https://www.ncbi.nlm.nih.gov/books/NBK542217/ |access-date=24 April 2023}} Papaverine is a smooth muscle relaxant that acts by increasing blood flow to the penis.{{cite journal | vauthors = Kim ED, el-Rashidy R, McVary KT | title = Papaverine topical gel for treatment of erectile dysfunction | journal = The Journal of Urology | volume = 153 | issue = 2 | pages = 361–365 | date = February 1995 | pmid = 7815584 | doi = 10.1097/00005392-199502000-00019 }} Phentolamine is an alpha blocker that relaxes blood vessel muscles, allowing more blood to flow to the penis.{{cite journal | vauthors = Bella AJ, Brock GB | title = Intracavernous pharmacotherapy for erectile dysfunction | journal = Endocrine | volume = 23 | issue = 2–3 | pages = 149–155 | date = 2004 | pmid = 15146094 | doi = 10.1385/ENDO:23:2-3:149 | quote = The vasoactive potential of phentolamine was discovered in 1978, with early animal studies suggesting effective blockade of the epinephrine pressor response and a smaller sympatholytic effect (63). An alpha-adrenergic antagonist with equal affinity for α1 and α2 receptors, monotherapy with phentolamine has been disappointing. It is hypothesized that although intracavernous injection of phentolamine increases corporal blood flow, a concurrent increase in norepinephrine prevent sinusoidal relaxation. | s2cid = 13056029 }}
Society and culture
=Availability=
While the active drugs in Trimix have all been individually approved by the U.S. Food and Drug Administration (FDA), Trimix as a combination drug has not been approved by the FDA and is only available from compounding pharmacies.{{cite web | vauthors = Billingsley A |title=What to Know About Trimix Injections for Erectile Dysfunction |url=https://www.goodrx.com/conditions/erectile-dysfunction/trimix-injections-erectile-dysfunction |website=GoodRx Health |access-date=26 April 2023 |date=28 January 2022}} Trimix is typically prepared by the compounding pharmacy in a sterile environment and then frozen.{{Cite web |title=Alprostadil / Papaverine / Phentolamine 20mcg-30mg-1mg/ml Injection Solution (Tri-Mix) {{!}} Formulas {{!}} My Dashboard | work = Bayview Pharmacy |url=https://www.bayviewrx.com/formulas/rec7COK9TaoQTRYU4 |access-date=2023-01-11 }} The compound is stable for up to six months while stored frozen and for one month if stored refrigerated beginning at the time of manufacture.{{cite journal | vauthors = Trissel LA, Zhang Y | title = Long-term stability of trimix: a three-drug injection used to treat erectile dysfunction | journal = International Journal of Pharmaceutical Compounding | volume = 8 | issue = 3 | pages = 231–235 | date = 2004 | pmid = 23924676 }}
References
{{reflist}}
External links
- {{cite web |title=Erectile Dysfunction: Trimix Injections |date=6 April 2021 |url=https://healthcare.utah.edu/menshealth/conditions/erectile-dysfunction/trimix-injection |publisher=University of Utah}}
{{DEFAULTSORT:Trimix (Injection)}}