When Pills Aren't Enough — There's Tri-Mix
Tri-Mix is the gold standard injection therapy for erectile dysfunction — with a 90–95% success rate even when Viagra and Cialis fail. Physician-prescribed and custom-compounded, available at our San Antonio clinic or via telehealth with home delivery.
Tri-Mix is a compounded medication that requires physician prescription and monitoring. Not FDA-approved as a combination product. Individual results vary. Must be trained in proper injection technique.
What Is Tri-Mix Injection Therapy?
Tri-Mix is a custom-compounded combination of three vasodilators — Alprostadil (prostaglandin E1), Papaverine, and Phentolamine — injected directly into the penis (intracavernosal injection or ICI) to produce a firm, reliable erection.
Considered the gold standard for ED that doesn't respond to oral medications, Tri-Mix works by relaxing smooth muscle and increasing blood flow directly at the site. With a 90–95% success rate, it's the most effective ED treatment available — even for men with diabetes, post-prostatectomy patients, and those with severe vascular ED.
- Alprostadil (PGE1): Directly dilates penile arteries and relaxes smooth muscle
- Papaverine: Relaxes vascular smooth muscle for sustained blood flow
- Phentolamine: Alpha-blocker that prevents vasoconstriction
- Onset in 5–15 minutes, duration 30–60+ minutes
⚕️ Physician-Prescribed & Custom-Compounded
Every Tri-Mix prescription is individually compounded based on your response. Requires in-office injection training before home use. Available in San Antonio and via telehealth with medication shipped to your door.
"An Injection… Down There?" — Let's Address That
We get it. The idea of a penile injection makes most men wince. It's the #1 concern we hear — and it's completely normal. But here's what patients consistently tell us after their first time:
"It was nothing like I expected. I barely felt it."
- Ultra-fine 30-gauge needle — thinner than a human hair. Most patients compare it to a tiny pinch, less painful than a blood draw.
- In-office training with Dr. Goel — you'll practice with guidance until you're fully comfortable. Nobody goes home unprepared.
- Injection takes 5 seconds — the entire process from prep to done is under a minute. Onset within 5–15 minutes.
- 95% of anxious patients continue therapy — once they experience how easy the injection is and how effective the results are, the initial nervousness disappears completely.
The 30 seconds of mild discomfort is worth the 30–60+ minutes of reliable confidence that follows.
Who Benefits from Tri-Mix Therapy?
Tri-Mix is the next step for men who need more than oral ED medications can provide. If any of these describe you, Tri-Mix may be the answer.
The Oral Med Non-Responder
Viagra, Cialis, and other PDE5 inhibitors haven't worked — or stopped working. Tri-Mix bypasses the oral pathway entirely for direct, reliable results.
Post-Surgery Patients
Men who've had prostatectomy, pelvic surgery, or radiation therapy often benefit from Tri-Mix as nerve-sparing approaches recover over time.
Diabetes & Vascular ED
Diabetic neuropathy and vascular disease cause severe ED that pills rarely fix. Tri-Mix works directly on penile tissue regardless of underlying vascular conditions.
The Out-of-State Patient
You live in Texas, California, or Florida and want physician-prescribed Tri-Mix via telehealth — with custom-compounded medication shipped directly to your door.
Two Paths to Getting Started
Whether you visit our San Antonio clinic or connect via telehealth, Dr. Goel guides you through every step of Tri-Mix therapy.
In-Office · San Antonio
Comprehensive Evaluation
Visit our San Antonio clinic for a full ED workup — medical history, labs, current medications, and treatment goals with Dr. Goel.
In-Office Test Dose
Your first Tri-Mix injection is administered in-clinic under medical supervision. Dr. Goel calibrates the dose to your individual response.
Injection Training
Hands-on training in self-injection technique — you'll practice until fully confident. Most patients master it in one session.
Take Home & Follow-Up
Leave with your custom-compounded Tri-Mix prescription and supplies. Scheduled follow-ups to fine-tune dosing for optimal results.
Telehealth · Nationwide
Schedule Video Visit
Book a secure telehealth consultation from home — available in TX, CA, and FL. Discuss your ED history and treatment goals.
Lab Work Ordered Locally
We order bloodwork at a lab near you. Results reviewed by Dr. Goel to ensure Tri-Mix is safe and appropriate.
Virtual Injection Training
Detailed video instruction on self-injection technique. Dr. Goel walks you through the process step-by-step over video.
Medication Shipped to You
Custom-compounded Tri-Mix shipped cold-chain to your door with syringes, supplies, and detailed instructions. Virtual follow-ups for dose optimization.
Why Patients Choose Prime Vitality for Tri-Mix
Tri-Mix requires precision prescribing and proper training. Here's what separates physician-guided therapy from shortcuts.
Physician-Prescribed
Every Tri-Mix formulation is custom-compounded after physician evaluation — not a one-size-fits-all dose from an online questionnaire.
Triple Board-Certified
Dr. Shiv Goel holds certifications in Internal Medicine, Functional Medicine, and Aesthetic Medicine — America's Best Doctor 2025.
Custom-Compounded Dosing
Your Tri-Mix ratio is individually titrated based on your response. We adjust the Alprostadil, Papaverine, and Phentolamine proportions for optimal effect with minimal side effects.
In-Office + Telehealth
Visit our San Antonio clinic for hands-on injection training, or get treated from anywhere in TX, CA, or FL with medication delivered cold-chain to your door.
What to Expect with Tri-Mix
Tri-Mix provides fast, reliable results from the very first use. Here's what most patients experience.
First Dose — In-Office (5–15 Minutes)
Your initial Tri-Mix injection is performed under medical supervision. Erection typically begins within 5–15 minutes and lasts 30–60+ minutes. Dr. Goel adjusts the dose based on your response to find the optimal formulation.
First Home Use (Week 1–2)
After mastering self-injection technique, you use Tri-Mix at home. Patients consistently report reliable, firm erections and a significant boost in confidence and spontaneity.
Dose Optimization (Weeks 2–4)
Dr. Goel fine-tunes the compounding ratio based on your feedback — adjusting duration, firmness, and onset time. Most patients find their ideal dose within 2–4 uses.
Long-Term Success
Tri-Mix can be used on an ongoing basis with consistent results. Many patients combine it with PDE5 inhibitors or PT-141 for even more comprehensive sexual health. Regular check-ins ensure safety and efficacy.
Results may vary. Individual outcomes depend on health status, underlying ED causes, and adherence to physician recommendations.
"I was terrified of the needle — I put off Tri-Mix for months. After my first injection with Dr. Goel, I couldn't believe how easy it was. And the results? Night and day. Viagra never came close. My only regret is not starting sooner."
Robert L., Age 55
Tri-Mix Injection Therapy · In-Office Patient (San Antonio, TX)
*Patient name changed for privacy. Individual results vary.
Tri-Mix Pricing & Membership
Transparent pricing with flexible options. All programs include physician oversight, custom compounding, and ongoing dose optimization.
Tri-Mix Therapy
Pricing depends on custom formulation, dosing, and supply quantity. Discussed during consultation.
- Physician consultation & ED evaluation
- In-office test dose & calibration
- Self-injection training session
- Custom-compounded Tri-Mix supply
- Injection supplies (syringes, swabs)
ED Membership
Comprehensive erectile dysfunction program with Tri-Mix and additional therapies as needed.
- Monthly physician check-ins
- Tri-Mix + oral ED meds included
- Custom compounding & dose optimization
- Lab monitoring included
- Telehealth or in-office flexibility
- Priority scheduling & support
Tri-Mix Injection FAQ
Answers to the most common questions about Tri-Mix injection therapy for ED.
Yes. Tri-Mix is available via telehealth for patients in Texas, California, and Florida. After a video consultation with Dr. Goel and lab review, your custom-compounded medication is shipped cold-chain directly to your home with injection supplies and video training instructions.
The injection uses an ultra-fine 30-gauge needle — thinner than what's used for insulin. Most patients describe it as a tiny pinch or barely noticeable. The initial anxiety is almost always far worse than the actual experience. Over 95% of patients who try Tri-Mix continue using it because the results far outweigh the minimal discomfort.
Tri-Mix must be stored refrigerated (36–46°F). For telehealth patients, it's shipped in cold-chain packaging. Once opened, a vial typically lasts 30 days when properly refrigerated. Never freeze Tri-Mix and protect it from light. Detailed storage instructions are included with every shipment.
The most common side effect is mild aching at the injection site. Prolonged erection (priapism) lasting more than 4 hours is the most serious risk — this is a medical emergency requiring immediate treatment. Bruising at the injection site may occur. Dr. Goel carefully calibrates your dose to minimize risks and provides emergency protocols with every prescription.
Not necessarily. While in-office patients benefit from hands-on injection training at our San Antonio clinic (10007 Huebner Rd, Bldg 3, Suite 302), telehealth patients receive detailed video training and can begin therapy from home. Many physicians recommend an initial in-office visit for the test dose, but Dr. Goel offers fully remote protocols for patients in TX, CA, and FL.
We currently prescribe and ship Tri-Mix to patients in Texas, California, and Florida. Dr. Goel is licensed in these states for telehealth prescribing. All shipments use cold-chain packaging to maintain medication potency. Contact us for the latest state availability.
Tri-Mix is typically limited to no more than 3 times per week, with at least 24 hours between injections. Only one injection per session. Overuse can increase the risk of priapism and fibrotic tissue formation. Dr. Goel establishes a safe usage frequency as part of your treatment protocol.
Yes, Tri-Mix is often part of a comprehensive ED protocol. It can be combined with PT-141 for desire enhancement, PDE5 inhibitors for additional support, or TRT for underlying hormonal optimization. However, never combine Tri-Mix with other injectable ED medications or use with nitrates. Dr. Goel designs multi-modal protocols tailored to your needs.
