What You Need to Know about Using Injectable Medications for Erectile Dysfunction (Trimix, Bimix, PGE or Prostaglandin, Caverject, Edex)

by Alex Shteynshlyuger MD


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.


Penile Injection Therapy for ED

There are a few issues to consider in terms of logistics and timing related to using injectable medications for the treatment of erectile dysfunction (when we mention Trimix it applies to other medications as well (Bimix, Quadmix, PGE, and other combinations):

Facts about Trimix, Bimix and other Penile Injections

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  1. Trimix needs to be frozen or refrigerated – if you travel you will need to carry it in an ice pack.  
  2. Trimix that does not require refrigeration is available but is more expensive.
  3. Trimix has a ‘shelf-life’. The pharmacy we use prepares Trimix that can be frozen for up to 3 months.  Often, if frozen and properly stored, it may stay potent for as long as 6 months.
  4. You need to have a consultation and full evaluation for ED, including lab work. If you have recent labs (past 2-3 months), we can accept them (cholesterol, kidney function testing – creatinine or CMP, thyroid hormone levels, testosterone levels).
  5. We can’t simply prescribe you Trimix or any other injectable medications. We need first to inject you with a test dose that will then be increased/decreased “titrated” until we find out the correct dosing. Sometimes it takes a few injections which must be separated by at least 2 days.  The goal is to obtain an erection that does not last longer than 1 hour.  Once we determine the dose you require we need to order Trimix which can take about a week to be prepared/shipped to us.
  6. Typically, custom compounded medications (Trimix, Bimix, etc) are not covered by insurance.
  7. The prostaglandin can be obtained that does not require refrigeration but it is fairly costly (Caverject, Edex). The advantage is that it is covered by insurances for some men depending on the insurance plan.  Less expensive prostaglandin is available which has the same potency but requires refrigeration and is not covered by insurance.
  8. If your erection lasts more than 1.5-2 hours, go to the nearest Emergency Room; it often takes a few hours to get to the emergency room, get registered and get a doctor to see you. We typically advise our patients to have phenylephrine for self-injection to reverse a prolonged erection; this may avoid the need to go to an emergency room if the erection goes away after self-treatment with phenylephrine.  A prolonged erection (priapism) can cause severe erectile dysfunction to the point that injections such as Trimix may not work and lead to scar formation in the penis.
  9. Trimix may not work well in patients with low testosterone. Testosterone replacement therapy may be helpful for many men.
  10. Venous leak is the most common cause of why Trimix injections do not work.

Common Reasons Trimix, Bimix, Quadmix, and Prostaglandin E1 (Caverject) May Not Work

We take pride in teaching our patients how to properly self-inject penile medications such as Trimix, Bimix, and Quadmix.  The most common cause that these medications do not work reliably when injected at home is that they are not injected correctly.  Often, if medication is not injected correctly it goes in the skin or just below the skin and will not produce a good erection.  

It is important that the needle is held perpendicularly at a 90-degree angle to the penis. A 0.5 ml or 1 ml diabetic syringe should be used and the needle should be inserted all the way in the penis, perpendicular to the surface, with the penis stretched.  The needle should be inserted on the side of the penis, away from the urethra that runs in the bottom half of the penis.

The second most common cause of penile injections with Trimix not working is that the medications lost their potency.  This usually results from improper storage; a medication that should be refrigerated or frozen, if left unrefrigerated overnight, can lose a significant amount of potency.

Learn more about penile injection therapy for ED and other treatment options.

Where to Get Treatment for ED in NYC?

At New York Urology Specialists, we offer specialized treatment for ED for men. Same-day appointments are available.

Call/text today: 1-646-663-5211 or make an appointment online.  

We treat sexual and erection problems and offer comprehensive STD testing for infections.  We treat penile problems in men, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy, vasectomy reversal, cosmetic circumcision, circumcision revision, penile frenuloplasty. We offer confidential appointments.

Our prices are ED treatment prices are affordable with or without insuranceLow-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.  We offer free insurance verification.

Read Real Stories of Men who Underwent Treatment for ED at New York Urology Specialists.

We offer ED treatment to patients within driving distance to our offices as well as from other states and countries.  Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.

What do Penile Problems Look Like?

You can find pictures of penile problems including before and after treatment images in our image gallery.

What You Need to Know:

Why Choose New York Urology Specialists for Treatment of Erectile Dysfunction?

  • All treatment is performed by a board-certified urologist experienced in treating men with symptoms of ED, premature ejaculation, and other sexual problems using medical therapy, minimally invasive therapies, lasers, and surgery.
  • We are one of the few practices in the region to offer a full range of options for the treatment of sexual, and erection problems in men.
  • We offer diagnostic testing in our office which avoids hospital costs.
  • Extensive Experience: Thousands of men have treated successfully using medical therapy, shockwave therapy for ED, penile injections with Trimix, and penile implant surgery.
  • Confidential and Understanding Care. We understand that most of our patients desire privacy.  We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
  • We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
  • We are conveniently located within 30-60 minute commute to men who are seeking ED treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

Scheduling Appointments for ED Treatment at New York Urology Specialists


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.

Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation, and other sexual concerns.  He has successfully treated hundreds of men with sexual problems including ED and poor libido.


Patients Reviews

Overall Rating:

5

Total Ratings

5

Total Reviews

19

Ratings

Ease of Appointment: Bedside Manner:
Promptness: Spends Time with Me:
Courteous Staff: Follows Up After Visit:
Accurate Diagnosis:

Patient review
by on Jan 24, 2020

Peronis Disease
by on Aug 04, 2019

Dr Alex was both knowledgeable and concise with his diagnosis and advice which was well received. Dr was her knowledgeable in the subject and provided good advice.

3P Removal
by on Jul 24, 2019

Went to get my penile papule remove. Got done same day, it was fast, great staff, and most importantly, pleased with the result.

Recommendation
by on Jul 18, 2019

Therefore I would like to recommend you to anyone who need your services.

Urology Visit
by on Jul 18, 2019

Staff were all very welcoming. Dr. Alex Shteynshlyuger was very knowledgeable and attentive during my time spent with him.

Outstanding
by on Jul 09, 2019

Went in for a procedure with Dr. Alex and he was very calm and thorough about the the operation and the recovery. From the front desk to his assistants, everyone was very courteous, professional and polite. I highly recommend NY Urologist Specialist. They are outstanding!!!

Friendly , courteous, effiecient and professional
by on Sep 15, 2018

Wyts Wyts recommends New York Urology Specialists via Facebook. September 15, 2018 · Friendly , courteous, effiecient and professional staff members. This office i highly recommend for any and all Urology matters. Dr Alex Shteynshlyuger is very professional and knowledgable easy to communicate with. Thanks Dr Alex

Satisfied Patient
by on Sep 15, 2018

I am very please and satisfied with everything that has been offorded to me by New York Urology Specialist Office.....Dr Alex

Surgical Procedure
by on Sep 01, 2018

Dr Alex and his staff are through professionals in every sense of the word. From initial diagnosis to a period of evaluating and ruling out options, we decided upon a surgical solution, which appears for the most part to have corrected the issue. Thanks to Ana, and the staff, especially Dr. Alex for treating me so well. Best regards, Lee

Review
by on Aug 16, 2018

Outstanding service

A very good doctor
by on Aug 15, 2018

Dr. Alex Shteynshlyugerand is careful, patient, experienced. Uses innovative approaches, that actually yield results. He is indeed a good doctor, in every sense

urology services
by on Apr 11, 2018

I am very satisfied with the treatment I received at new york urology specialist and would recommend them to other patients.they are the very best.

My wife was elated
by on Jan 15, 2018

Well I put it to use last night and man, good job. My wife was elated. u made it much better somehow, so thank u for fixing my penis

Thankful
by on Dec 05, 2017

"Cannot express how thankful I am I found Dr. Shtetnshlyuger. After undergoing surgery to correct a penile torsion I couldn't be happier with the results. A great doctor who is clearly good at what he does. With something as important as your private area, It's nice to be able to rest easy and know you are in good hands.." via HealthGrades.com 12/5/2017

Review
by on Nov 19, 2017

I am writing to thank dr. Alex. He is thorough, professional, knowledgeable, helpful and friendly. I have seen him for ED and prostate issues, and he has explained all my options clearly, and found solutions that have been a great help. thank you! I highly recommend both Dr. Alex and his staff, which I find to be helpful, friendly, knowledgeable and very professional. They are a pleasure to deal with and all have been a great help.

Dr visit
by on Sep 14, 2017

I am very much thankful for meeting Dr Alex .I had a very serious medical problem I visited many doctors but none could not help me it was very difficult for me until I visited Dr Alex after a couple visits my medical problem is no more I feel very great also I felt almost 20 years younger Dr Alex is second to none fantastic doctor. Thanks again Dr Alex from my family.

Excellent doctor
by on Jul 03, 2014

I am feeling better now after visiting clinic New York urology specialists. Excellent staff and appointment on time.

Thank you for excellent care
by on Jan 07, 2013

Dear Dr. Alex: We want to thank you for the excellent care you provided for George during his emergency operation and the follow up treatment. Your quiet, confident manner was reassuring to us during a very scary time for us. We will never forget you. George Sally R. Date: 2013

We love you!
by on Feb 16, 2012

Dr. Alex Shteynshlyuger and Staff – Thank you so much for taking care of my husband Bob. Dr. Alex: I thank God everyday for you. You were an answer to prayer.

ED is Treatable in Nearly Every Man

Excellence-Urology_Care-banner2At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction.  We understand the challenges that ED creates for our patients, their relationships, and their self-esteem.  We help you find a treatment for erectile dysfunction that fits your needs, lifestyle, and your preferences.

Urologists are doctors specializing in the treatment of men with erectile dysfunction. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED.  We offer medical and surgical treatment for erectile dysfunction.

We Treat Some of the Most Complex ED Problems Including:

dr alex about banner large Copy 300x176 - What You Need to Know About Penile Injections - Trimix, Bimix, Quadmix, Edex and CaverjectSchedule an Appointment with Dr. Shteynshlyuger:

Call/text today: 1-646-663-5211 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship-trained board-certified urologist with expertise in the evaluation and treatment of sexual and erection problems in men using modern effective and proven treatment methods.  We offer inflatable penile implant, shockwave therapy for ED, and treatment for Peyronie’s disease.

He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.

 

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