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Just picked up my latest Tri-Mix from pharmacist. When I did, the pharmacist had a consult with me. He advised that new compounding requirements to assure product sterility had been implemented. The compound is now to be kept frozen and has been provided to me in four vials. One vial at a time is to be defrosted and kept in the refrigerator for up to 14 days. The Tri-Mix cannot be refrozen. If the refrigerated mixture turns cloudy, throw it out as that is a possible sign of bacterial action. Use of Tri-Mix after expiration date is not an issue of effectiveness but of an increased risk of bacterial infection from the compound.

What's the size of the vials? Did the pharmacist take the amount you were previously getting and split it into four vials? Or does four vials mean you're being issued more of the medication than previously?

My compounding pharmacy sends me five 2 ml vials with each reorder with the only instructions to keep it frozen until ready to use, then refrigerate.

The pharmacist provided four vials each with 2.5ml. Previously he provided two 5.0ml vials. As I use .5ml for each shot I should be able to get five shots from each vial. I say should, as it is difficult to get the full amount out for the fifth syringe pull. He said to keep all vials frozen until ready to use. Then remove one to the refrigerator to defrost. I can use that vial for up to fourteen days.

FWIW: I got a vial of Trimix in March 2013; it has never been frozen, always in fridge. I went back to my uro this June for a checkup and asked if I should throw it out and she said there was no need to. She said that it wouldn't spoil, it just might get weaker over time. But it still works as well as it did in the beginning as far as I can tell.

Chas,

It does sound a little like something from an Anal Retentive Pharmacist sketch from SNL...

I would not worry about that 14 day limit. Freezing the stuff can't hurt.

On the other hand you oughta be able to blow thru 5 shots in 14 days easy ...

J

I am not worried about the 14 day time limit as previously I had used refrigerated Trim-Mix months after expiration. However, the Pharmacist did stress that if the liquid is cloudy then do not use it as that can be an indication of bacterial action.

Chas,

Yes always good to check for cloudy and for 'floaters' if you hold it up to the light.

But this is not hamburger juices here .. the vial was sterile .. the bacteriostatic water is sterile .. the needles are pretty sterile ... About the only thing that is not sterile is the AIR in the syringe that you blow into the vial to keep the pressure even.

So, maybe some small chance but I don't think anyone here has ever reported a vial contents going cloudy.

( I was told by my BiMix supplier that it IS possible for the ingredients of BiMix to sometimes precipitate out as tiny crystals -- especially if you keep it at too cold temps). Bimix is fine stored even at 50 degrees F -- Trimix better at lower temps of a real fridge course since PGE-1 is sensitive to temperature over time -- reducing strength by a few percent every week.. but nothing to worry about.

Of course bacteria don't like it COLD so there's for keeping things pretty chilly...

J

My pharmacist AND my uro mentioned to me the same thing. I was given 4 vials and told to keep one in the frig and the others in the freezer.
So I am doing so. Because of some illness on my wife's part we didn't use any for awhile. When we did resume the Tri-mix was like the first
shot. No deterioration at all.
My uro did tell me that there had been some government oversight issues with a few labs.

Charlie