FrankTalk.org

Tried contacting Kevin at Olympia for about 2 weeks. Took off work so I could actually have a private conversation with him about my ED and injections. Long story short, he doesn't follow through on his statement on his voicemail that he returns calls same day. Basically, after repeated messages and attempts to contact him at the recommendation from some users here, I contacted a different sales rep through Olympia's website. I mentioned his name and number in that contact request so he'd get credit in case that's how the referral system worked and low and behold he answered the phone when I called after he reached out that next morning and I missed his call.

The bigger issue was that I had read here and corroborated the claims via researching online that papaverine caused more scarring than a mono-mix of PGE-1, Alprostadil, Prostaglandin would which is why I requested a mono-mix from Kevin at Olympia. He and the telemed Doc both assured me that I was incorrect (it had been over a year since I'd done the research and was unable to verify this info until after I'd already set up the order for their recommended Bi-mix). However, I found, after doing the research again, that neither the Doc nor Kevin were correct and there's plenty of evidence stating that if you're worried about scar tissue (and increased chance of priapism with papaverine vs. alprostadil) then one shouldn't use papaverine.

Kind of appalling that they were both ignorant of this information.

Once I told them I wasn't comfortable using any compound with papaverine in it, he agreed to refund my money for both the script and the telemed appointment, which is why I'd give them 1 star instead of zero.

I'm sure they do a great job for a lot of folks, I just wasn't one of them.

Also, there's the price difference. The Telemed was reasonable at $59. The 10ml of Bi-mix was going to run $312. Just as a point of reference, my urologist prescribed Tri-mix T-105 (that I filled but never used b/c of the papaverine component) and it was $85 for 5ml overnighted from a local compounding pharmacy. Granted, I'm sure a lot of the price is the overnight shipping from Florida to AZ, but still....probably wiser for most of us to find a local compounding company if cost is an issue.

2 cents.

Try MenMD in st. pete fl. I do think they ship out of state .. I was paying 85.00 for bimix and I think 125.00 for trimix last year ..

easymoney wrote:Try MenMD in st. pete fl. I do think they ship out of state .. I was paying 85.00 for bimix and I think 125.00 for trimix last year ..

Thanks....I'm going to try a local compounding pharmacy and doc first, but I appreciate the suggestion and may have to take you up on it.

Updating the thread with the email to Kevin to document the research I found on Bimix....and Papaverine in particular.

Hi Kevin,

I appreciate you setting up my telemed appointment with Dr. Clements and getting my prescription out so quickly.

However, when I got home where I could do a very cursory Google search of the risk of scarring and fibrosis associated with the use of Bi-Mix (generally Papaverine and Phentolamine), I found several research papers discussing the issue.

Here are some of the links with quotes from the articles below each:


https://www.sciencedirect.com/topics/me ... -injection


"Papaverine is a nonselective PDE inhibitor and was the first described agent for intracavernosal injection. It is less effective as a single agent than alprostadil and carries a higher rate (emphasis added) of priapism and penile fibrosis."


"Phentolamine is an alpha-adrenergic antagonist that acts by inhibiting the postsynaptic alpha-1 receptor leading to relaxation of the penile vasculature. Unlike the other intracavernous agents, phentolamine has significant systemic side effects, including hypotension, tachycardia, gastrointestinal upset, and nasal congestion."


https://pubmed.ncbi.nlm.nih.gov/2724447 ... e%20reason. And the linked article this references: https://www.sciencedirect.com/science/a ... 4717413450

The pH analysis of papaverine-phentolamine and prostaglandin E1 for pharmacologic erection - PubMed
Although papaverine-phentolamine preparations are being employed for pharmacologic erection programs across the nation, their chemical properties have not been described in the literature. We found that the pH of papaverine-phentolamine solution in all concentrations tested remained less than 4.0. A …
pubmed.ncbi.nlm.nih.gov

"Abstract

Although papaverine-phentolamine preparations are being employed for pharmacologic erection programs across the nation, their chemical properties have not been described in the literature. We found that the pH of papaverine-phentolamine solution in all concentrations tested remained <4.0. Attempts to buffer the solution resulted in a precipitate at a pH greater than or equal to 5.0. The pH of prostaglandin E1 was <5.0 but could be easily buffered to pH 7.4 or even 10.75 and remained stable. The effect of an acidic solution on corporal connective tissue and smooth muscle meshwork is unknown. We believe that buffering by blood will lead to the precipitation of papaverine-phentolamine and may cause primary intracorporal scarring. Extravasation or improper injection into the subcutaneous tissue exposes the mixture to blood and may secondarily result in additional scarring for the same reason. Therefore, prostaglandin E1 may be a more appropriate agent for penile injection."


https://www.auajournals.org/doi/10.1016 ... %2940585-4 mentions that after a year of use of Bi-mix, 57% of men had nodules in their penises from the injections. Granted, the injection frequency played a part, but the article fails to divulge just how often the injections were used per week in the first place.


https://urology.ucsf.edu/sites/urology. ... nswers.pdf


"Injection Medications And Mechanism

Q7. It seems that there are several different medications suitable for injections. What are they and what

are the differences?

A7. Each of these medications will work to help you achieve an erection. You should always consult

your physician to discuss which is best for you. Some of the medicines currently in use include the

following:

1. Papaverine is available at a relatively low cost and is stable at room temperature but is less

effective than the other medications and may have a higher tendency to cause scarring (fibrosis).

2. Papaverine plus phentolamine (Bimix) is more potent than papaverine alone, but with the same

potential side effects such as priapism (see Q19 for definition) and scar tissue formation.

3. Alprostadil rarely causes priapism, but with its use, pain is more common. (Alprostadil is also

known as prostaglandin E-1 or PGE-1. In powdered form it may be called Caverject or Edex."



Kevin, I am simply not comfortable using anything other than Alprostadil, PGE-1 or Prostaglandin as a mono-mix. Can you give me an idea why this isn't an option for me considering that last quote in item 3 says it rarely causes priapism (and yes, I'm aware that it can me be more painful when used alone) and the first linked article confirmed Alprostadil is less likely to cause priapism than Papaverine.


I've sent a similar email to Dr. Clements through the patient portal.


Please let me know how to proceed.


Thanks,

Sean

Good finds. I'll have to add them to the reading list.

I guess it really depends on the rep you get. I just tried Olympia because the last online provider was very unresponsive. The rep I got was very knowledge as far as I could tell (what he said corresponded with research I've done), and he also answered emails within a half hour, and got me setup with my first shipment overnight the first day. So far so good, but we shall see with future interactions. So far at least much better than last provider.

I've had nothing but top notch service from Olympia so I guess its to each their own..Rich has always been awesome and gave me his direct line.

Just made my second purchase from Olympia. I would recommend their service. I phone on Tuesday from AZ to Orlando and the Trimix was delivered still frozen to my door exactly 24 hours later. Impressed.
I am new to this and .2 is giving me a two hour complete erection window.
Also bought the autoinject 2 off them and I am very happy with it.

And as I said...the reviews here for Olympia have been excellent. My experience was very much the opposite. I will say that any of our local compounding pharmacies have lower pricing.