Tri mix ?

[2010FLHK]

Hi, I am a new user of tri mix, just a cpl of times so far. Starting out with a small dose and was wondering does increasing the dosage help with your erection being more firm or does it make it last longer ? I could use more firmness but not anymore time as it already lasts a cpl of hours.

[SanDiegoChris]

What is your current prescription?
It will have a breakdown on each of the 3 ingredients and the amount of each.

[BigEyes]

Hi, I am a new user of tri mix, just a cpl of times so far. Starting out with a small dose and was wondering does increasing the dosage help with your erection being more firm or does it make it last longer ? I could use more firmness but not anymore time as it already lasts a cpl of hours.

Hi 2010

Hard question to answer. The PGE-1 in Trimix mostly effects rigidity and is broken down relatively quickly by the body. The other two chemicals, papaverine and phentolamine last longer. The papa is typically held at around 30 mg/ml and the phento varied from 0.5 as high as 4-6mg/ml. Both have to do with duration, especially pheno. Increasing the dosage may help, but if you are already lasting a couple hours, might increase the time even more.

When you say you're lasting a couple hours, is this just engorgement but not really hard? The phento tends to last a long time, but does not really cause a rigid erection. If you can bend it easily, the danger of priapism is very low. But, if you are getting pretty hard for a couple hours, then increasing your script for more PGE-1 and holding pheno where it is should do a better job for you.

Big

[cumstein]

For me the dose has to be just right to get real firm AND avoid a 4 hour hard on.
I would increase the dose very slightly to see the point where the erection lasts longer. At that point you have to make a decision between a super hard on that last way longer than you want and less firmness but an easier and faster return to flaccid. I have said screw it sometime, i want it all and have used a larger dose but I know afterwards I am going to have a hard on for a while. So, I take 120 mg sudafed and a hot bath and usually another 60mg sudafed after. Its worth it sometimes to have the super hard engorged member, but your going to pay the price later. Don't over do it or you will end up in the emergency room with priapism. Good luck. I went back to PGE 1 only because of scarring from tri mix, so keep an eye on that. I forget which ingredient caused more scarring but PGE1 causes the least.

[morgan5a]

I went back to PGE 1 only because of scarring from tri mix, so keep an eye on that. I forget which ingredient caused more scarring but PGE1 causes the least.

I'd like to know more about this. I thought scarring and fibrosis were a result of the needle, not the contents of the injection. But I went Googling and found this:

https://www.ncbi.nlm.nih.gov/books/NBK38722/

"Fibrosis in Men Treated With Injection Treatments

"Penile fibrosis, scarring, and indurated nodularity have
been reported to be associated with long-term use of ICI
with papaverine. There is less data regarding the effect of
PGE1 on the incidence of penile fibrosis. Penile fibrosis
and scarring can lead to abnormal penile curvature with
erections and subsequent discontinuation of therapy.
Since RCTs are of insufficient duration to adequately
assess the risk of penile fibrosis, this review evaluated
the evidence from 20 retrospective observational studies
and clinical trials that reported the incidence of penile
fibrosis. The incidence of fibrosis varied widely and was
not consistent across studies of treatments with
papaverine, triple therapy (Trimix) and PGE1. The design of
the identified studies and many confounding factors
precluded a comparison of the rates of fibrosis between
patients receiving injections of PGE1 versus papaverine
alone or in combination. The rates of fibrosis may depend
on the type and dose of medication, frequency of
injections, at home versus office injections, and presence
of priapism. Evidence regarding the relative incidence of
penile fibrosis amongst patients treated with different
types of injection therapies is inconclusive. The conduct
of well-designed trials is needed to determine the
incidence, severity, and health impact of penile fibrosis
in long-term ICI users. Moreover, it is important to
determine whether there is a medication-, dose- or
frequency-response effect of injections. Further evidence
is required on whether different injection strategies (e.g.
alternating sites) would help to further reduce risk of
fibrosis. Penile fibrosis is a complication of ICI and all
ED patients receiving this treatment need to be warned of
the risk of fibrosis and be examined periodically for
fibrotic changes in the penis."

Do you have a good source that says that PGE alone causes less scarring than trimix?

[rahod1]

Hi, I am a new user of tri mix, just a cpl of times so far. Starting out with a small dose and was wondering does increasing the dosage help with your erection being more firm or does it make it last longer ? I could use more firmness but not anymore time as it already lasts a cpl of hours.

I have found moving up to the OPTIMAL dosage will increase firmness and lower onset time without too much effect on longevity. I would UP your dose in 5 unit increments to see if you can get a better response with minimal increase in longevity. Personally, I can't get maximum firmness with less than 4 hrs duration. It's not uncomfortable for me either. Also, you may want to add a cock ring after injecting , which can be left on for 1/2 hr or so during sex. It enhances firmness. Just make sure it can be removed when fully erect.

[2010FLHK]

My script is Prost 8.3mcg ML-Phen 0.83mg ML-Pap 22.5MG/ML
When I say it lasts a cpl hrs I mean that my erection is not hard as I would like but chubby. It doesn't ever get real firm/hard.
I am injecting 0.15ml
Thanks

[BigEyes]

Hi 2010

First things first. Although priapism is a serious medical issue, docs often tend to overblow it and scare the daylights out of anyone using injections. It is pretty rare and guys wind up in the ER due mostly from fear of losing their penis, and of course, once in the ER, treatment is the typical course of action -- needed or not!

Priapism typically results in a rigid, rock hard, cold, uncomfortable and painful erection. A three or four hour "chubby" does not qualify.

As Rahod1 says "up your dosage in 5ml increments" (or whatever increment you feel comfortable with). If you get to a point where you're using more than 50-60 ml or so and still not getting a useful erection, you probably need to get a more powerful script.

The script you posted is pretty weak. Typical starter is 10, 1, 30 (same order as your post). More common is 20, 2, 30. (The papaverine is rarely changed due to difficulty of keeping higher values in solution). Many docs are very conservative and first scripts are often too weak.

Big

[cumstein]

"Do you have a good source that says that PGE alone causes less scarring than trimix?[/quote]"

HI Morgan5a, one source is the NCBI article you posted and others I don't recall over the last 20 years, as well as the language you point out in the study suggesting Papaverine potentially causing more scarring than the other drugs. BUT, More than that is 1) my own experience 17+- years ( I don't remember exact dates and this by itself is weak evidence) of using PGE1 without problems because N=1.( My own experience is not definitive. But my Urologist at the time who specialized in ED said PGE1 was the safest from a scar tissue standpoint but caused more pain during erection and some priapisim problems. He had been giving injections off label for years before seeing me and noticed the scarring issue in a clinical setting. Note EDEX and Caverject are FDA approved for the treatment of ED but I don't believe they contain any Papaverine. I used bimix and trimix for only about 2 years and noticed penile shrinkage, and the band of scar tissue presented within a year of start up. The scar tissue was also confirmed by ultra sound as well as not being able to inject in the scarred area and I could feel it and see it. So thats the way it was for me with 2 decades of experience, But more important is, 2) Dr. Francois Eid of NYC one of the leading implant surgeons stating that injecting Tri mix and Bi mix can cause a lot more scarring than just the PGE1 and the actual damage from the needle. He has seen a lot of it in his practice where he also does injection therapy before considering an implant. 3) discontinuing the tri mix for around 3 months produced noticibly less scarring in the area. It didn't resolve, its still there but is seems more pliable and flexible but I have not tried to inject there. I do not have Perone's disease but some plaques FWIW.
If it was just me saying this, I would blow it off, but when I saw Dr Eid he confirmed it. In summary its was my own experience i.e 17 years no scarring with Pge1 VS 2 years and scarring with trimix/bimix and finally two Doc's telling me about tri mix/bi mix and scarring. That was enough evidence for me.
A number of URO docs have stated injections are intended for shorter term use and not a long term solution due to possible scarring. I don't know if thats a conflict of interest to move us on to implants, but based on my own experience I believe it true. How many guys have 20 years of experience with this stuff? Anyone try Trimix for 20 years without an scarring? It may be the case, I don't know.My case and comments may not apply to shorter term use using smaller needles. 20 years ago we used 28/29 gauge needles VS 30/31 now and I am sure that has some impact on scarring i.e the smaller needles cause less damage. But with the trimix I used 30 gauge needles and it didn't take long to notice something had changed. I used the larger gauge needles and PGE1 for over a decade with no problem.
Like I said, just keep an eye on it, palpate the area of injection to make sure you don't see signs of scarring over time and keep it in mind. I think the average guy stays on injections for about 5? years or less? I stayed on it for so long because I didn't think an implant was a good option for me in the 90's. With advances from the high volume guys, those on injections have a good option if injections cause problems.If you go over to the Implant section I recall this being discussed and a number of guys had some bad scarring from injections. Hope this helps. best to you
.

[rahod1]

Hi 2010

First things first. Although priapism is a serious medical issue, docs often tend to overblow it and scare the daylights out of anyone using injections. It is pretty rare and guys wind up in the ER due mostly from fear of losing their penis, and of course, once in the ER, treatment is the typical course of action -- needed or not!

Priapism typically results in a rigid, rock hard, cold, uncomfortable and painful erection. A three or four hour "chubby" does not qualify.

Big

Agree...very important point. I have had many 5 hr erections with ZERO after effects. The *4 Hr* line in the sand is simply a *cover your ass* for drug co. After extensive research on my part>>>>8hrs is the time to be concerned. NO research has demonstrated permanent erectile dysfunction under 12 hrs. BTW>>> SIX Hrs is the definition for priapism according to drug co.