Trimix while on blood thinners like Apixaban?

Melody68 · Mar 19, 2025

Hey guys - I'm 69 and have been on TE for about a year, love it.

I had a TIA in December and was recently put on a blood thinner / anti-coagulant being 5 mg Apixaban (Eliquis) twice a day, permanently.

I saw a urologist a few days ago about beginning Trimix. There's a $300 fee payable before undergoing tests to see if I qualify. He said there is no contraindication with Apixaban and Trimix.

Some past posts suggest, however, that caution is in order. The consensus is that it should be "okay", but of course I don't want to risk $300 if suddenly it's not. The fear is that a patient might bleed (from the injection I guess) and end up with a penile hematoma or increased risk of scarring leading to Peyronie's disease.

Is that concern irrational? You would think that with a tiny 30 gauge needle, it would be pretty tough to create a bleed. Would it make sense to only inject after the Apixaban has been in your system at least 8-10 hours and is thus getting weaker?

I'd love to hear from others in a similar situation, and how things have worked out ...

Nelson Vergel · Mar 19, 2025

Melody68 said:
Is that concern irrational? You would think that with a tiny 30 gauge needle, it would be pretty tough to create a bleed. Would it make sense to only inject after the Apixaban has been in your system at least 8-10 hours and is thus getting weaker?

You may get bruises. Make sure that you massage the injection site hard with your thumb.

Penis bruises take around 3 weeks to disappear. If you get one, massage the area with your thumb while you are showering. Some guys use arnica oil with success.

"Arnica oil is a popular homeopathic and herbal preparation traditionally used to help reduce the appearance of bruises and soothe minor aches or muscle discomfort. It is derived from the yellow-orange flowers of the Arnica montana plant, which contain active compounds (such as sesquiterpene lactones) believed to have anti-inflammatory properties."

Nelson Vergel · Mar 19, 2025

By the way, Apixaban has an average half-life of about 12 hours in individuals with normal kidney function. As a rule of thumb, most medications are considered effectively eliminated from the body after about five half-lives. Here’s how that applies to Apixaban:

Half-life in healthy adults: ~12 hours
Time to near-complete elimination: 5 × 12 hours = ~60 hours (about 2.5 days)

Nelson Vergel · Mar 19, 2025

N

Thread 'Blood Thinner and TriMix?'

Oct 12, 2017

Just wondering if it's possible to get a script for TriMix while being on a blood thinner? Unfortunately I have to take Xarelto. I'm not a bleeder despite being on Xarelto, I shave my face with a blade and if I get a small cut on my face or finger, etc, it does stop pretty quickly. I ask because I have completed the paperwork for Defy for a Trimix consult, and was just going to schedule a local physical, but paused here to ask you all...I don't want to spend more money if Defy is going to say "no way!". Thanks

Melody68 · Mar 20, 2025

Nelson Vergel said:
By the way, Apixaban has an average half-life of about 12 hours in individuals with normal kidney function. As a rule of thumb, most medications are considered effectively eliminated from the body after about five half-lives. Here’s how that applies to Apixaban:

Half-life in healthy adults: ~12 hours
Time to near-complete elimination: 5 × 12 hours = ~60 hours (about 2.5 days)

Nelson, thanks for the responses above.

When you say I could be prone to bruising, are you referring to discolorization the size of a nickel or dime . . . or the kind of darkening effect that I saw on images when I input "penile hematoma" - which is truly shocking. Some of the pics are of penises that are completely black, looking as if the whole thing could just fall off at any time. Really disturbing. Is the bruising dangerous?

I take the Apixaban every 12 hours. To clarify, when you say that Apixaban has a half life of about 12 hours, are you saying that the blood thinning is at half of it's full effectiveness after 12 hours? Seems to me that it would make sense then to inject shortly before the next Apixaban dose is taken to minimize the chances of a bleed . . .

Nelson Vergel · Mar 20, 2025

You won't bleed. You may get a small dark bruise if you do not press the injection site well while making circular motions. I know this because a friend is on blood thinners and bruising would happen once in a while.