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After not getting enough response from 20mcg of Edex (100 units). I went to a Quadmix compound of 1.8MG Papaverine, 0.2MG Phentelomine, 30MCG Alprostadil, 0.02MG Atropine.
I tried this with Increasing dosages from 25 units to 47 units, without seeing much difference to Edex.
Several people on this forum thought that it was both weird and weak Quadmix formula I had been given (advice greatly appreciated!!) .
I tried to talk to Pharmacist but he was never available for several days, so I went elsewhere.
This new Pharmacist put me on Trimix of 30/1.5/20.
As recommended, I tried 20 units today and while still not as strong as I'd like/want, it was definitely the best so far. So I will try 25 units next time, but that got me thinking...
The Pharmacist said I could try increasing quantity over several successive injections, but he also said he could raise formula levels if needed.
Having read on this forum several really scary stories of (4+ hour)visits to ER, they always seemed to be related to using too many units.
So my question here is, when do you decide to increase the dosage strength versus just increasing the size of the dosage?

I have been on Trimix (5.88mcg PGE1) for over three years. During the first year, I was able to reduce the dosage to 12 units. However, over the past six months I have had to increase the dosage to 45-50 units. I went to the Uro last week and asked him to double the ingredients which he agreed to do. Based on my experience, I would say when you reach 50 units, it may be time to increase the ingredients.

Palace,

Great that you got that Trimix straightened out -- That is an excellent formula you have now.

That said, it is a little puzzling that you are not getting any joy out of it yet.

But, you had already tried EDEX system which DELIVERED 20mcg of PGE-1.

Your Trimix shot at 20units (1/5th of a ml) is only delivering 20mcg/5= 4mcg PGE-1 (plus the PAP and PHENT .. which help but not as much as PGE-1 which is the heavy lifter of the three -- so to speak).
Just as an example my current shots are delivering about 15mcg PGE-1 (plus Pap and Phent at about 25% of 1ml levels). And for me that is good for an hour of 90% or so hardness. (That's more delivered amts than a year ago or two ago -- like DT my units needed are going up some over time).

The EDEX 20mcg shots that do not do enough for you tell us that you are unfortunately not a good responder to PGE-1. If you were you would only need a fraction of 20mcg.

Why you are not responding well could be a lot of reasons -- Venous Leakage, poor arterial circulation (due to being out of cardio shape or hypertension or Diabetes poor circulation etc), or too much adrenaline due to too much worry on the shot?? Who knows exactly ...

But you still have some additional runway left on your Trimix shots til you hit 50u. 25 units might even do it .. or 30 or 35. Yes it could really put yourself way over the top with each 5u increase but I kind of doubt it based on your EDEX trial.

So proceed with caution .. make sure you are really hitting the spot each time and see how it goes.

J