T Nation

Alprostadil Penile iIjections (Tri Mix) Any Experience?


#1

Dr is recommending Tri mix penile injections after 13 + years using oral ED meds, that approach no longer working. Good blood flow testing says, great nocturnal erections, can get erection with Viagra, but cant maintain for 1-5 min. Dr says Tri mix should work. Any body here willing to share experience pros cons etc? On TRT for 8 months no change on ED issue (was not the reason for starting TRT), Thanks


#2

I would like to see you first get your TRT labs resolved and other issues in your other thread.

There has not been much discussion about tri-mix in this forum.

Because your mechanics are good, its also time to consider whats going in inside your skull and other general health and vitality issues.


#3

That is a real sound approach. I’m very hesitant to introduce new drugs into the mix and making it more complicated to figure out. But after 15 years I still have a wife, that is interested in improving the ED issues too. Like playing pool with a rope. The Dr.'s know so little about the complexities and inter relationship of all this male hormone replacements protocol. Thanks


#4

[quote]jimp4155 wrote:
Dr is recommending Tri mix penile injections after 13 + years using oral ED meds, that approach no longer working. Good blood flow testing says, great nocturnal erections, can get erection with Viagra, but cant maintain for 1-5 min. Dr says Tri mix should work. Any body here willing to share experience pros cons etc? On TRT for 8 months no change on ED issue (was not the reason for starting TRT), Thanks[/quote]

I use trimix and it is incredible. Rock hard for a couple of hours very single time - no exceptions. The injections sound scary, but they don’t hurt (if done right).


#5

Expensive?


#6

[quote]KSman wrote:
Expensive?[/quote]

No. I don’t need much. Works out to about $1.50/shot without insurance. Used to be cheaper before insurance stopped covering it.


#7

yea Dr told me about $5 a shot. Viagra has gone up to $30 each and now oral meds have quit working


#8

Bikeguy, I had the test dose at Dr office of .1 ml and although the Dr was happy with a little fullness I did not get an erection. He said I could go up in amount and try an additional .1 more each time till I get desired results. But he said try the .1 test dose next time because from what he saw that might work combined with stimulation? what are your thoughts, does stimulation matter or do I go up the dose to ensure erection. don’t want a trip to hospital with 4 hr hard on either


#9

[quote]jimp4155 wrote:
Bikeguy, I had the test dose at Dr office of .1 ml and although the Dr was happy with a little fullness I did not get an erection. He said I could go up in amount and try an additional .1 more each time till I get desired results. But he said try the .1 test dose next time because from what he saw that might work combined with stimulation? what are your thoughts, does stimulation matter or do I go up the dose to ensure erection. don’t want a trip to hospital with 4 hr hard on either[/quote]

I use 0.07 ml. That will get me hard in about 15 minutes with stimulation or 30 minutes without stimulation. So stimulation helps. I remain very hard for 2 to 3 hours. I am fairly sure that 0.08 or 0.09 would keep me hard for more than 4 hours.

I would increase dose slowly. I did overdose several times when I first started. 6 to 7 hours is uncomfortable, but not unmanageable. I did have to go to the emergency room once after 12 hours of erection. I was looked after by 3 young female interns who thought it was pretty funny. They agreed - definitely priapism. Embarrassing and uncomfortable, but no residual problems.

It was a pretty classy hospital. My doctor called ahead. When I walked in, they asked it I was Mr. xxxxx. I said yes. They said, let me show you to a bed and we can handle the paperwork later.


#10

thanks for input, do you mean .7 ml or .07 as stated? my test dose was .1ml so your dose would be .03 lower than my test dose. That is super low dose from what I’ve read, but that would be awesome. with .1ml I never got an erection just full feeling for about 40min, so I planned on an increase of between .05 - .1ml. I should prob try test dose .1ml with stimulation first? what is one more disappointment after 12 years of many previous, if it doesn’t work. 4hr hard on doesn’t sound possible after that long but I’m prob wrong with this Trimix drug.


#11

When discussing doses, its important to know whats been injected. Are all tri-mix preparations the same strength? If not, someone could have a nasty surprise.

So I have to wonder what one does with a boner that lasts past orgasm? Multiple adventures?


#12

[quote]jimp4155 wrote:
thanks for input, do you mean .7 ml or .07 as stated? my test dose was .1ml so your dose would be .03 lower than my test dose. That is super low dose from what I’ve read, but that would be awesome. with .1ml I never got an erection just full feeling for about 40min, so I planned on an increase of between .05 - .1ml. I should prob try test dose .1ml with stimulation first? what is one more disappointment after 12 years of many previous, if it doesn’t work. 4hr hard on doesn’t sound possible after that long but I’m prob wrong with this Trimix drug.[/quote]

I really meant 0.07 ml. So out of a 5 ml vial I get about 70 shots. Since I don’t need much, that keeps the price/shot low.

From my experience the dose between not enough and way too much is not a lot.

Still, if 0.1 ml didn’t do much for you, 0.15 + stimulation might be a good next step.


#13

[quote]KSman wrote:
When discussing doses, its important to know whats been injected. Are all tri-mix preparations the same strength? If not, someone could have a nasty surprise.

So I have to wonder what one does with a boner that lasts past orgasm? Multiple adventures?[/quote]

You are right, there are different preparations. However, there is also a standard mix that is normally used.

And yes, multiple adventures are easy if you want them. I’ve done it, but at age 72 I am usually satisfied to just roll over and go to sleep.


#14

I called the dr, he did not spend much time in the office and even less on the phone (imagine that) but he suggested .2 ml since .1 never produced a Bonner. sounds like most guys feel the same way, hard on lasting longer than mutual orgasm is just an inconvenience. Thanks Ksman you do come up with the correct questions no matter what the compound. There are many variations of the mix. This mix my dr gave me by his trial and error is the best blend of effectiveness and least pain or chance of priapism. I’ve been shooting pool with a rope for a while so a couple more conservative trial runs would be better that trip to ER


#15

A few things to consider from someone who has dealt with hundreds of men using such injections:

(1) Start with a dose that your doctor suggested based on an office injection and increase by increments of .02-.04mL until you reach the desired effect (not more than 1 injections per 2-3 days).

(2) Priapism can result in permanent scarring and should be dealt with one way or another. Docs recommend Sudafed as a first line treatment, but it doesn’t have much effect. You can get a RX for a Phenylephrine Kit (1mg/cc 5ML Sig: Inject 0.25ml every 15 minutes until erection comes down), which might save you a trip to the hospital if it comes to that.

(3) Some men experience nodules on the shaft at injection sites. These will eventually go away but it may take on the order of years. Best to vary injection site, both right and left side of penis and up and down the shaft.

(4) There are many possible formulations of injections and you should feel encouraged to try different formulations if you feel you are having to inject too much or it is ineffective. The injection mix with the least pain is usually papaverine+phentolamine, and that can be done in various ratios, too.

(5) You might try adding a vasoconstriction device (basically a ring) to prevent venous flow if erection duration is insufficient.

(6) Your doctor is probably too busy to optimize the injection process for you, so contact the compounding pharmacy and ask their opinion when you feel a change is needed.

Good luck!


#16

That was extremely useful information and very well written!

Regarding the different formulations. Do any have any greater or lesser impact on nodules?


#17

Thanks so much for the info, I’ve used 1 time so far. Very apprehensive so tried .1ml more than the office trial 0f .1ml (which in office did not produce an erection). .2ml gave ma an erection sufficient to have intercourse but barely. Erection gone pretty much immed after ejac. still better than in years. Dr. said go up another .1ml increase next run. It’s promising but want to avoid the priapism trip.


#18

Any idea as to what caused this problem? Was it medication related or just something that happened over time?


#19

over time, no significant trauma, no disease, not on any meds, not really sure why. over 15 years of progression to the point I’m at now.


#20

[quote]KSman wrote:
That was extremely useful information and very well written!

Regarding the different formulations. Do any have any greater or lesser impact on nodules?[/quote]

Thank you. I am not aware of any difference in formation rates due to the injection’s formulation. I believe the current thinking is that it is the repetitive trauma of injecting that incites inflammation leading to nodules, which is why it is important to vary the injection site. I will ask around and let you know if anyone I know has seen otherwise.