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What is the difference between the Trimix and just mono alprostadil?

Trimix has three drug mixed together and many different formulas. Usually some combination of prostaglandin, papervine, and phentolamine.

Adoprostadil is just prostaglandin, which is a name brand medicine, cost more, is generally more painful.

Prostaglandin E1 (PGE1), is also known as alprostadil. I don't believe any of those are brand names. There is more than one type of prostaglandin. Prostaglandin E1 is the one used for erections which is often shortened to just prostaglandin and commonly PGE1. Alprostadil is just another name for the PGE1.

Alprostadil as an injection is commonly sold very expensively under the brand names of Edex and Caverject. Those come in kits pre-loaded with saline and dried alprostadil in a tube that serves as a syringe and includes a fine needle that attaches to the tube. The alprostadil powder and the saline are separated by a rubber stopper. For use you partially depress the plunger which allows the saline and powder to mix. After it's mixed you inject. It has an amazingly long practical shelf life.

I get my alprostadil from a compounding pharmacy. It comes pre-mixed in vials and I use small insulin syringes to draw and inject it. It has to stay frozen between uses or it will have an extremely short shelf life. My pharmacy charges me the same as it does for tri-mix. $125 for ten 1ml vials.

Alprostadil is not generally more painful. I don't remember the exact number but it is painful and poorly tolerated by 10 to 15% of men. Fortunately I'm not one of them.

Not all compounding pharmacies will sell the mono-mix. I believe many of the compounding pharmacies are reselling pre-made tri-mix formulations. At least pre-mixed in the dry form. That is what probably limits the options and why mono-mix is not as commonly found. My pharmacy does it all in house and it's all the same price. I think most of the cost is actually in the time and labor involved.

I agree with the description of tri-mix given by Namirrah.

Thank you!

so how is the best way to start?

Well, by far the best method is to see a good urologist that is familiar with and hopefully specializes in ED issues.

If you're specifically interested in injections I'd call and find out if he/she prescribes them and more specifically does he prescribe other than the name brands like Edex and Caverject. Unless your insurer pays for them in which case Edex or Caverject may be just fine. Mine paid very limited for Edex initially and then quit paying for them completely. That's why I moved on to the generic from the compounding pharmacy.

Not all urologists will prescribe tri-mix or for that matter generic compounded alprostadil and will only prescribe the standard name brands stuff. My current urologist will only prescribe tri-mix from one pharmacy in Tampa that I don't use and won't prescribe straight mono-mix at all. I get my regular GP to prescribe it. Of course I'm experienced with the stuff. My GP only knows what I've taught him about it. He's the second GP I've had to train. Oh well!

Try posting you city. There's a remote chance someone on here will be from your area and have a recommendation for a good uro in your area if you don't have one already. If you do it's time to have a chat.

I live in Honolulu Hawaii

Ah, the 808 part. I'm kinda slow sometimes.

I think I'd recommend googling Hawaii or Honolulu compounding pharmacy. Start calling the compounding pharmacies and asking them if they do tri-mix or mono-mix and if they do how much does it cost. They may not give you a price without a script. When or if you find one or more that supply it ask them for a list of doctors that write scripts for it. They'll probably give you a list but won't likely recommend a specific doctor but that should give you start. It might be worth calling your insurance to see if they cover Edex or Caverject or even try-mix or mono-mix, etc.

Surferdad,

Others have answered your question, so I won't repeat what they have said. I will express some concerns that I have based on what you have not shared with us. I will assume that you have had some issues with erectile dysfunction.

That being said, asking about penile injections is certainly legit, but may be premature. The first step in dealing with ED is to recognize that ED is a symptom; therefore, your first step in relieving the symptom is to identify the problem correctly. The first step in that process is to have a complete medical work-up: blood chemistry profile (including Free Testosterone levels, sugar levels, including A1C, etc.), blood pressure, heart function, other circulatory stuff, prostate health, etc. etc. Find the problem, fix the problem, and the symptom may simply go away. Even if not, you can treat the ED (symptom) all day long but if you do not deal with the underlying problem, you're simply, as we say down South, pissing in the wind.

Start with your internist/GP/whatever she may be called in Hawaii. From there you may be promoted to Urology; you may, in fact, be promoted to Cardiology or even Oncology. Once you do get to Urology, that is the time to talk about relieving your ED symptoms.

Perhaps you've done all this; it's just not clear from your post.

All the best. Hoping for hard times.

Thank you all. To answer a few questions, I recently received brachytherapy for prostate cancer. The PDE5's are not as effective as they once were. How do you find a pharmacy that mixes?