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High everyone, im a new member to the forum. A couple years ago I got prescription for Tri mix from a Urologist at Mayo Clinc. I was there for an annual physical. it kinda worked, but after reading posts here, I realize that I mostly likely was under dosing. I never got above 20 units. So for me I was thinking it didn't work that good. I see now that many of you dose a lot higher. Id like to try it again. The original prescribing urologist has moved on, Mayo wont renew the prescription without an office visit, that's a days drive away and 4 months wait. my local doc will prescribe it, but doesn't know anything about it. Do I go with that, or is there a good doc or company on line that that I can work with. it seems like there can be a lot to know and try, so I would prefer a doc who is very familiar with all this. thanks in advance for the help.

Hey friend
I doubt that your going to anyone that will prescribe Trimix without an office visit. This is something that really requires following closely. I would recommend trying to find a urologist that can follow you while your using the Trimix. I have had to have mine prescription changed twice. When you get the new script if it doesn't work well for you call them and most likely they can advise you further over the phone. I have had to get my prescription changed twice. I got up to almost a full 1cc and I wasn't getting the good hard erection desire so they changed my script and now it works much better and I use a lot less medicine. My new script is twice the strength of the old script. I wish you the best! This is a great forum with guys that are willing to help you in anyway they can. Feel free to use this forum and the guys on here. Most experience ED or have had it in the past and have implants. I am scheduled for an implant in January of the coming year.

Welcome to the forum Ben!

I'm not a medical professional of any kind. Anything I post is based on my own experiences, at best and is, at worst, based on hallucinations or delusions. Any advice found on an interned forum is likely worth what you paid for it, or worse. Always ask your doctor and follow his/her advice.

I have no experience with the online doctors and would be leery of using one but I suppose they have their place and fill a need.

I will disagree with notaes somewhat. There is no doubt that being under the care of a urologist that specializes in men's sexuality health is probably the best option, if practical. I've had to struggle along mostly on my own and it can be done, especially if your General Practitioner or Primary Care Provider is willing to help and is interested. That's what I've done.

My case was simplified somewhat in that I've had great success with mono-mix which is straight alprostadil (PGE-1) and saline or bacteriostatic water. This equates to Edex or Caverject. It's a more simple mix than tri-mix but surprisingly it's harder to find a compounding pharmacy that makes it.

It would be helpful if you knew your previous script so you and your doctor would have a better idea of a starting off point. It may be easier to retrieve that information from the pharmacy that produced it. You can then compare your old script to some of the standard scripts offered by some online compounding pharmacies. You can find examples of the standard offerings from 3 online pharmacies listed on this site in the "General" sub-forum in the "Documents Worth Reading List" sticky thread: https://www.franktalk.org/phpBB3/viewtopic.php?f=3&t=9266 This is not an endorsement of those pharmacies. They are just examples of some standard mixes. Others are different. For example, the pharmacy I use doesn't have standard mixes and just mixes to order whatever the doctor prescribes. Here's a link to a PDF put out by another compounding pharmacy that contains a pretty good description on how the different components of the different mixes work. This is also not an endorsement of the pharmacy: http://www.wedgewoodpharmacy.com/uploads/ED%20Switching%20Guide.pdf

So, you're going to want a bump up from what you already tried. You can compare that to some standard mixes and the descriptions of effects of the various ingredients. The offerings of the compounding pharmacy you intend to use may simplify this process if they have just a few standard mixes. You'd obviously just try the next stronger mix.

Don't try to guess exactly what your dose would be when you get a stronger mix. PLEASE
error on the side of caution and deliberately underdose to start with and then work your way up cautiously. You don't want an ER visit. Bring some of the results of your research with you to see your local doctor, hopefully with a copy of your old script. Having a local doctor (PCP or GP) that will work with you is a wonderful thing.

There are a number of guys on this forum that will try to help you along your way. Just remember that few if any of us are qualified to give medical advice. Work together with that local doctor you are so lucky to have.

Good luck. You can do this.

the previous script was PAP30, PTA1, PGE10, I believe that is a fairly common one. My GP will write the script, he just doesn't know a lot about this type of therapy. That's why I thought an online urologist or specialist might be a better choice for a prescriber.

If you didn't have any major issues with PGE-1 pain then I'd up that component to 20mcg. Remember I'm not a doctor but that's what I'd suggest to yours.

I did my doctor visit and pharmacy order 100% online through Defy Medical out of Florida (I live in CA) and their first prescription was for 150/5/50 which only requires 5-6 units to get the job done compared to 20-60 others have to do for the same effect (also means faster injections and less pain). I will say I paid like $500+ before my first prescription was in my hands so it’s NOT the cheapest route but was pretty easy. Now $90 gets me 180 injections and that’s as a cash patient. Anyways not to be a sales pitch for them, but I did have a positive experience

Anon,
What he was taking is exactly the same as your script, it's just written a different way. His is written as per 1ml. Yours is written as per 5ml.

If it's only online, run in the opposite direction. If there's a reasonable level of info verification/exchange then go ahead with it. All totalled, I dealt with four different people to make contact and set up my " treatment plan" using the phone, fax, and internet.

I just finished the "intake" process with Defy Medical in Florida and have my 1st order for Trimix and syringes coming from Empower Pharmacy. Initial impression is 90% positive. Defy's staff were all professional and courteous. I was able to have my GP's group practice fax my records/last periodic exam to them (must be within approx 6 months or less then every 12 months thereafter), they scheduled a phone consult (mine 1/2 hr. long - 1 hr. allowed) with the staff PA or Dr. (based on availability/your preference) within 2 days of record acceptance. The PA I dealt with was great and within an hour, I had a follow-up call to order the Trimix prescribed (30/1/10 actually 150/5/50 5ml freeze dried) and 2 10ct bags of syringes with a 5 unit starting dose to be used. Empower you sends Trimix, biostatic water, mixing syringe, and instructions.

Defy gives a 10% veteran discount which I had to request. Standard shipping from Empower is 8-10 business days, any faster is not cheap. The initial intake Dr's consult is normally $249, but in recent months (probably Covid related) there's a $100 discount making it only $149.

The 10% negative is that Defy is cash only (Your CC# kept on file) and does not participate in any insurance plans. They will give you necessary paper work so you can file a reimbursement claim. AND, Defy is embedded with Empower. YOU CANNOT TAKE YOUR SCRIPT ELSEWHERE!!! Right now, 5ml of 30/1/10 is $120 before $12 vet discount, syringes, which they said were 1st class are $3/10 pc bag. Discount does not apply to supplies, only meds. There are two other Compounders Defy is linked to, but investigation online made me stay with their favored pharmacy which is Empower.

I do not know which states Defy/Empower can do business in. You need to check. I went the Defy route after seeing their name here on this site, and:
1. I didn't want want to try to find a Urologist I liked, that was taking new patients, and that didn't have a hellacious wait for an appointment.
2. I didn't want to become a "profit center" with Medicare and supplimental insurances being subjected to endless tests, visits, etc.
3. And I figured that I'm smart enough to successfully inject myself after oral ED medications stopped working for me.

That's it in a nut shell. Stay Healthy Y'all!!!

My GP declined to work with me on this and insisted I go the Urologist route so I was left with no choice.

My opinion - if you have already tried injections, you do NOT need to go to Mayo...besides, you are proof that they did not do a good job. 20 units is very small. We have patients using 100. But Mayo is not known for sexual medicine anyway. Sounds like you got a novice urologist when it comes to sex med.
Telemedicine is where health care is going. I would never recommend telemedicine for guys who have not learned injections - you do need to be taught and you do need monitoring. But eventually, you graduate to being on your own. Defy Medical is perfectly fine. Or your local urologist is fine.

I would only increase by 5 units at a time however. I have seen too many men have nothing at 10 and a 4 hour erection at 20. Everyone is different.

Good for you for being open to trying it again. There are also stronger combinations of trimix if needed.
Paul

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