Is trimix made differently among pharmacies?

[CanGetItUpButNotOff]

To properly assess whether different compounding pharmacies compare with one another, it's important to differentiate between the branding "TriMix #X" vs "TriMix Y/Y/Y", where "X" is an arbitrary naming designation that will vary between pharmacies and "Y" refers to specific formulations of Papaverine, Phentolamine and PGE1. There is no reason to expect that one pharmacy's "X" is comparable to another. But there should be an expectation that any reputable compounding pharmacy will be close, probably very close, to the same "Y/Y/Y" mix.

[GoodWood]

To properly assess whether different compounding pharmacies compare with one another, it's important to differentiate between the branding "TriMix #X" vs "TriMix Y/Y/Y", where "X" is an arbitrary naming designation that will vary between pharmacies and "Y" refers to specific formulations of Papaverine, Phentolamine and PGE1. There is no reason to expect that one pharmacy's "X" is comparable to another. But there should be an expectation that any reputable compounding pharmacy will be close, probably very close, to the same "Y/Y/Y" mix.

Great answer. CanGetItUpButNotOff and BDOINK have it right.

Pharmacies ARE regulated and you can safely expect that switching from one compounding pharmacy to another will be fine when the prescription is listed as Y mcg/cc PGE1, Y mg/cc Papaverine. and Y mg/cc Phentolomine.
Thinking TriMix #1 or TriMix #3 means the same thing everywhere is like thinking “ExtraStrength” or “Super” will mean the same thing everywhere. It’s not the case. But not a sign that the system is broken and needs further regulation.

[GoodWood]

Education about the components of TriMix and their role will help with understanding how this works. Having a provider who can tweak the script for the best effect for YOU as well as a compounding pharmacy that can make custom mixes can help you get the best erection possible.

These screenshots are taken from a brochure Wedgewood Pharmacy provided. (Wedgewood no longer makes Trimix but the information is still valid.)

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[ElbowRoom]

This is why the government MUST intervene to regulate this market else men will only get seriously hurt not knowing the make up and proportions of their trimix. This market must be standardized only to prevent incredible harm in the form of unnecessary priapism, loss of nerves, tissue damage, peyronies, agony, mental anguish and suicide.

I'd philosophically disagree with this point. IMO we don't need government to intervene on our behalf. We need patients to take responsibility for their own health, do their research and act rationally and not just trust what some Urologist says because he's wearing a white coat.

Just my opinion, others can certainly disagree. I would just rather be in charge of my health and medications than Big Daddy Government.

[ElbowRoom]

Education about the components of TriMix and their role will help with understanding how this works.

This is the key! Patients need to read up on *any* drug they are prescribed, understand how it works, and what the pitfalls and side effects are.

Too many just do whatever their doctor says or make assumptions and come to grief over it. If Covid taught us anything, it should be that we need to think long and hard about what people tell us and how we react to that information.

(I'm not getting political here -- just saying there were tons of conflicting opinions and recommendations -- ultimately the patient had to decide who to believe.)

[CanGetItUpButNotOff]

This is why the government MUST intervene to regulate this market else men will only get seriously hurt not knowing the make up and proportions of their trimix. This market must be standardized only to prevent incredible harm in the form of unnecessary priapism, loss of nerves, tissue damage, peyronies, agony, mental anguish and suicide.

I'd philosophically disagree with this point. IMO we don't need government to intervene on our behalf. We need patients to take responsibility for their own health, do their research and act rationally and not just trust what some Urologist says because he's wearing a white coat.

Just my opinion, others can certainly disagree. I would just rather be in charge of my health and medications than Big Daddy Government.

Agree with ElbowRoom. If the regulators get aggressive the most likely outcome is that we won't have an option for compounded Tri-Mix.

[Donkeykong]

In my experience, even supposedly equal mixes are not the same between pharmacies. I think the raw ingredients are not necessarily equally fresh, or maybe some pharmacies underdose or overdose their mixes on purpose or by accident.

[bldoink]

...

[GoodWood]

Pharmacies ARE regulated .

Bad answer You're completely wrong and it's complete bullshit. Everyone knows compound pharmacies are not regulated. There's no standardization in the industry.

Compounding pharmacies in the United States are regulated by a mix of federal and state laws, as well as professional guidelines. Here’s a breakdown of the main regulations they must follow:

⸻

1. Federal Regulations

FDA (Food and Drug Administration)
• Traditional Compounding (503A):
• Regulated by state boards of pharmacy.
• Must follow USP standards (e.g., <795>, <797>, <800>).
• Cannot compound drugs that are essentially copies of commercially available drugs.
• Cannot compound for resale.
• Outsourcing Facilities (503B):
• Registered with the FDA.
• Held to current Good Manufacturing Practices (cGMP).
• Can produce larger batches without prescriptions.
• Subject to FDA inspections.

DEA (Drug Enforcement Administration)
• If the pharmacy handles controlled substances, it must comply with DEA regulations regarding security, recordkeeping, and prescribing.

⸻

2. United States Pharmacopeia (USP) Standards

Compounding pharmacies must follow:
• USP <795> – Non-sterile compounding
• USP <797> – Sterile compounding
• USP <800> – Handling hazardous drugs

These outline facility requirements, personnel training, documentation, and quality assurance.

⸻

3. State Boards of Pharmacy
• Each state has its own board that licenses and inspects pharmacies.
• States may have stricter standards than federal ones.
• Must follow state-specific rules regarding labeling, recordkeeping, and licensing.

⸻

4. NABP & PCAB Accreditation
• NABP: National Association of Boards of Pharmacy may set standards or conduct inspections.
• PCAB: Pharmacy Compounding Accreditation Board offers accreditation that shows compliance with high-quality standards.

[CanGetItUpButNotOff]

I have a different, but similar question that I'll post here rather than start a new thread. I'm going to be traveling extensively and my strategy is to get a vial of lyophilized trimix that I will then reconstitute while on the road. (The idea is to not have to worry about refrigerating it and I want to have a backup in any case.)

I think we've established on this thread (macoza's dissent notwithstanding ) that mixtures of trimix from different pharmacies will be similar in efficacy. I've only used one vial of trimix in my life, so I don't have experience going from vendor to vendor. I'll be in the position of injecting a new vial of trimix while in a foreign country and not in complete control of my circumstances. This raises a concern that I may misjudge the correct mix and induce priapism. My question is whether I can start up where I left off with the same dose or if I need to be super careful about starting low and titrating up? Put another way, do those of you who have gone through many vials over the course of your trimix journey find that each vial is similar to the previous one?