Patient Instructions

Trimix Gel Information and Patient Instructions

This therapy is used to increase blood flow to the penis for rehabilitation purposes and for the treatment of erectile dysfunction. These instructions are intended to help you use prescribed Trimix gel safely.

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Trimix gel and Trimix injections are not interchangeable

Trimix gel and Trimix injections are not the same therapy. Trimix injectable comes in a syringe with a needle for injection only. These medications are not the same strength and must never be interchanged or mixed together. For injection instructions, see Trimix injection information.

Warning illustration showing the wrong medication route with an injection syringe near penile tissue.
Wrong product or wrong route: do not switch, mix, or transfer Trimix medications.

Medication route warning

NEVER switch Trimix gel and Trimix injectable

Trimix gel and Trimix injectable are different prescriptions with different formulations, strengths, routes, and supplies. They must not be interchanged, mixed together, transferred between syringes, or used with the other product’s instructions.

  • Use Trimix gel only as directed for urethral insertion.
  • Use Trimix injectable only as directed for injection.
  • Do not transfer either medication into another syringe or applicator.
  • If you have prescriptions for both products, keep them separate and confirm which one you are using before each dose.

When to use

  • You can insert the gel a maximum of once every 24 hours, or as recommended by your physician, either for sexual intercourse or for rehabilitation purposes.
  • Use of the gel does not need to be associated with sexual intercourse.
  • If the gel is being used for rehabilitation purposes, it may be advisable to use it the maximum number of times each week recommended by your physician, even in the absence of sex.
  • Most men experience blood flow effects within 5 to 15 minutes following insertion.
  • Your dose should be based on your physician’s order. These instructions are printed on the pharmacy label and may be expressed as a range.
  • Start with a low dose and titrate upward on subsequent uses to get the desired effect. This approach helps minimize unpleasant effects while searching for an effective dose.
  • If you do not experience results from the gel, do not reinsert more gel and do not use an injection of Bimix or Trimix. Wait 24 hours before reattempting.
Figure 1: The Syringe
Needleless syringe used for intraurethral gel.
Reusable cap
Stopper
Syringe
Plunger
Figure 2: Syringe Preparation

Remove the reusable
cap and insert the
syringe tip into the
urethra.

Needleless syringe tip placed at the urethral opening.
Figure 3: Gel Insertion
Needleless syringe delivering gel into the urethra.
Slowly depress the plunger to insert your prescribed dose.

Instructions for urethral gel

  1. 1Remove the reusable cap from the syringe and line up the opening of the syringe with the urethral opening of the penis.
  2. 2Insert the small tapered tip of the syringe gently into the urethra.See Figure 2.
  3. 3Slowly depress the plunger to insert the gel into the urethra.Note: It may be necessary to squeeze the tip of the penis with your thumb and finger to create a tight seal around the penis and the syringe. This helps avoid gel flowing out while you are depressing the plunger.
  4. 4Depress the plunger to insert your indicated dose.See Figure 3.
  5. 5Remove the syringe from the urethral opening and squeeze the tip of the penis closed to stop the gel from coming out. While the urethral opening is closed off, use your other hand to squeeze the whole penis like you are making and relaxing a fist. This spreads the medicine around the inside of the urethra and encourages absorption of the medication into the erectile chamber. Continue for 2 to 3 minutes while keeping the urethral opening closed.
  6. 6If there is medication left in the syringe, recap the syringe and store it in the refrigerator for your next insertion.

Rigidity scale

You may not experience success with your first insertion. Record the response after each use. A satisfactory response in the source chart is rated between 2 and 9, with 5 to 6 marked as just firm enough for penetration.

Rigidity Scale

Tracking chart

Use the chart to record the date, volume inserted, duration, and rigidity score. Bring a printout or your notes to your doctor’s office if you have follow-up questions.

Record your response for follow-up discussion with your doctor

Date
Volume Inserted (mL)
Duration of Erection
Rigidity Scale

Warnings

  • If you experience burning or aching, this is a known adverse reaction that is fairly common and may resolve on its own. Follow up with your physician.
  • Do not use Trimix gel for sexual intercourse with a pregnant woman, or a woman of childbearing potential, unless using a condom barrier to prevent the partner from exposure to the medication.
  • Do not exceed the prescribed dose of medication since it may cause a painful erection known as priapism. Prolonged erections may cause penile damage and permanent, irreversible erectile dysfunction. If you experience a prolonged erection, return to the clinic or go to the emergency room.
  • Do not take Viagra, Levitra, Staxyn, or Cialis the same day that you are planning to use Trimix gel unless instructed to do so by your physician. Prescription erectile dysfunction medications are available by prescription only.
  • If you experience persistent pain, swelling, or fever, you may have an infection. Please contact your doctor as soon as possible.