WOW Just received SUPER TRIMIX BY ACCIDENT

[StanWest]

Hello the Forum, I just got delivered this morning my trimix, this on a new renewed prescription from my uro's office. I was expecting and only been using as shown below.

My Regular: 20 mcg / 2 mg / 30 mg / 2.5 ml vial PGE-1, Phentolamine, Papaverine
Super trimix: 100 mcg / 10 mg / 150 mg / 5 ml vial PGE-1, Phentolamine, Papaverine
(Super trimix label states "reconstitute with 5 ml of bacteriostatic water". Saline water???

Empower stated they usually ship trimix as a powder, I asked for it to be as liquid ready to inject. So, I guess they deliver the actual vial dry, with powder already in it. There is 5 ml in same size vial as other compounding pharmacy who only filled to 2.5 ml. This vial has twice as much liquid, makes sense, 2.5 vs 5 ml! OK.

From reading the labels I can now see that the amount by weight declared on the label is the total amount of drug contained in the vial. So I am thinking I have 5x the drug dissolved in 2x the volume, meaning the concentration is 2.5 times stronger than
what I was getting previously.

So, if I had previously inject 12 (12.5) units on insulin syringe, now I should use 5 units.
Sort of confusing at first, but writing this out helps it make sense. Do I have this correct??

It was shipped yesterday, arrived this morning. The trimix was not still frozen. Will this super trimix vial freeze without having the drug come out of suspension??

Any advice would be appreciated,
Stan

[bldoink]

This has come up before. I've called Empower and here's the scoop: As in your case, if your doctor ordered 20mcg/2mg/30mg, that script is written as ingredients per ml (millilitre) or cc. Empower, and some others, label their vials as per the whole volume of the vial. So for a 5 ml vial of 20/2/30 per ml, it is written out as 100/10/150 per 5 ml. It's the same concentration but the different labeling routines can cause confusion. I'm assuming your original script came labeled in the more common method of ingredients per ml and not a total per 2.5 ml. What did your script from the doctor actually say?

The order of the ingredients listed can also cause confusion. I believe the more common way of writing your script would be 30/2/20. It seems that the ingredients are usually written in reverse order compared to your script with alprostadil usually listed last.

The bottom line is you got the script you originally expected to get.

[StanWest]

Hello bldoink, thanks for the response. I also noticed the ingredients are listed in opposite order than the trimix I have received from University Compounding.
The vial is specifically labeled "150 mg / 10 mg / 100 mcg / vial". The mcg on the third number clued me in to the reverse order, but thanks for mentioning it.

"The bottom line is you got the script you originally expected to get." Actually that did not happen at all. The prescription I received at my last uro visit was very broad, trimix & bimix, and allowing me to choose strengths when I order it. This last time, Rx expired and the pharmacy called the urologist, and evidently he wrote it for super trimix only. I had that Rx transferred to Empower. They told me it read super trimix. Only. I have asked Empower for a copy of the Rx but the phone guy did not seem to know how to send me a copy. I will have to ask the pharmacy dept within Empower to send it. If they can.

Rephrase: Empower said over the phone that it was "super trimix". Whether he wrote that or he wrote 20mcg/2mg/30mg per ml I do not I know, yet.

Indeed, I was using 20mcg/2mg/30mg from University Compounding, that's what it says on their vial. It makes no reference whether that is per ml or vial contents. But on Empowers web site I see the SUPER TRIMIX and TRIMIX vials. In the text the super trimix is stated 20mcg/2mg/30mg per ml. Thanks for clearing this up. They are the same.