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I noticed this morning when I used the next to last of the remaining 10 unit injections that it was not as effective as the injections from the beginning of the vial. My erection only lasted 45 minutes instead of my usual 90 minutes. The vial has always been refrigerated. I was wondering if the fact that it is now over 60 days old or perhaps the ineffectiveness is due to not properly shaking the vial before each use. If I recall correctly, this also occurred at the end of one of my earlier vials.

Any one else experienced this loss of effectiveness at the end of the vial or have any other ideas?

Yes, the mixture does age even with refrigeration and is not as effective the further you get from the formulation date. My compounding pharmacy puts a 90 day expiry date on their mixes and I too notice a diminished effect as I near the end. You can increase your dosage when you get further out from the formulation date but you'll have to decide just how much of an increase as every one responds a little bit differently to the meds.

You can use it after the expiry date ONLY if the liquid is crystal clear. Never inject if the mixture is cloudy or you see small precipitates floating in the mixture, time to toss it then.

The instructions that I received from the pharmacy and doctor is to keep the trimix frozen. They give an expiration of 6 months frozen and 30 days refrigerated. They also say no more than three thaws and the thawed days need to be subtracted from the 30 days. I would assume that these are general guidelines and not precise red lines. There seems to be a variety of opinions on this issue here on the board.

I draw out enough syringes to last me 4 weeks to store in the refrigerator -- they are then ready to go and I'm only 10-15 minutes away from a good erection. The remainder of the trimix in the vial goes into the freezer until I've used up my prepared syringes.

The filled syringes go in this hand case http://www.relion.com/diabetes/carrying-case to discreetly store in the refrigerator. The case comes with a freezable ice pack, so it's handy to take for travel.

SPARTAN,
Could you leave the full syringes in the freezer and just pull one to the fridge when you might need it??...Tom..

My doc and my compounding pharmacist + instructions on the vial told me to keep Trimix refrigerated. Nobody said anything about keeping it frozen. My current vial of Trimix is 10 months old and is as potent as ever.

G
BR

I have PROSTAGLANDIN (I believe it is the same as ALPROSTADIL) in the freezer, a 4ML vial. I won't see the PA until 4/20 to learn how to start the injections. The script says 20 MCG/ML so I assume that will be the first dose. The mixologist said to keep it in the freezer and it will thaw in about 5 minutes. and the vial should be potent for 4 months. I will ask to PA if loading multiple doses and keeping them in freeze will work.
I have learned much from all of you and hope to participate regularly...Tom..

I have PROSTAGLANDIN (I believe it is the same as ALPROSTADIL) in the freezer, a 4ML vial. I won't see the PA until 4/20 to learn how to start the injections. The script says 20 MCG/ML so I assume that will be the first dose. The mixologist said to keep it in the freezer and it will thaw in about 5 minutes. and the vial should be potent for 4 months. I will ask to PA if loading multiple doses and keeping them in freeze will work.
I have learned much from all of you and hope to participate regularly...Tom..

katsboytoy wrote:SPARTAN,
Could you leave the full syringes in the freezer and just pull one to the fridge when you might need it??...Tom..

I've been doing that and has worked fine. When I get my prescription I go ahead and prepare the syringes with the dose that is generally successful and then put them in the freezer. Then when I need one I just pull it out of the freezer and let it thaw. And I have also tried dropping the syringe in warm water to speed up the thawing process and did not notice any less results.

Kats:

The script says 20 MCG/ML so I assume that will be the first dose. I have learned much from all of you and hope to participate regularly...Tom..

The prescription strength (20MCG/ML) is not a dose. The dose will be .1ml or .2ml or some such amount. The dose is related to prescription strength tho .. and often they charge the same price for even double or triple strength. So if you don't get 5 or 10 shots per ml you might ask for a double strength perscription at some point in the future so you can use half the amount per shot. But that is jumping way ahead .. you have to see how your dose settles in at the current strength. Also see how you tolerate plain Alprostadil as far as achiness goes.

So, you just learned even more stuff from us!

katsboytoy wrote:SPARTAN,
Could you leave the full syringes in the freezer and just pull one to the fridge when you might need it??...Tom..

I suppose that you could, as someone else indicated. Currently, I'm preparing 15 syringes for the refrigerator.