Tri-Mix Injection Therapy: When PDE5 Pills Aren't Enough
For men who don't respond to sildenafil or tadalafil, Tri-Mix bypasses the entire upstream pathway and produces a reliable erection.
What it is
Tri-Mix is a compounded blend of three vasoactive medications. Papaverine, phentolamine, and prostaglandin E1 (alprostadil). Injected directly into the corpus cavernosum of the penis with a small insulin needle.
How it works
Bypasses the cGMP pathway entirely. The three agents relax penile smooth muscle directly. An erection follows within 5–15 minutes and lasts 30–90 minutes depending on dose.
Response rates
In the literature, response rates exceed 90% in men with non-anatomic ED, including men who failed all oral therapy.
Side effects to know
Penile pain at injection (manageable with technique). Prolonged erection (>4 hours), rare but a medical issue requiring care. Selvara's practitioner titrates the dose carefully.
Cost
$149 per vial at Selvara, typically lasting 4–8 weeks depending on use frequency.
Frequently asked questions
Does it hurt?
The needle is small. Most men report mild discomfort that improves with practice.
Can I overdose?
Practitioner-guided titration prevents this. Always start at the lowest test dose.
Free intake. Practitioner review in 24 hours.
No card on file until a licensed Selvara practitioner has approved a protocol, and you have approved it.
Begin intake, free