My experience with oral drugs and Caverject

[Bluewhippet]

I am a new member of this site but have been watching the posts for about 9 months. I thought it might be worth setting out my background and experience with ED. I am a retired 68 year old Type 2 diabetic and diagnosed some 15 years ago and I live near the town of Banbury in the UK.

I started suffering from mild ED about 12 years ago. Initially, my Doctor prescribed Viagra (50mg) and this worked very well with only mild side effects (the usual stuffy nose). After about 8 years, the Diabetic Nurse at my Doctor's practice suggested that I try Levitra because she said there is some evidence that it works well on patients with diabetes that have ED. My experience was that it certainly worked faster and had less side effects. However, after about 12 months I began to suffer from bad indigestion lasting up to 24 hours and starting about 2 hours after using Levitra. This may be an interaction with the drugs I take for my Diabetes. My Doctor suggested I try the relatively new Cialis treatment but this did not seem to work for me so I reverted back to using Viagra. About 18 months ago, I noticed that the Viagra was becoming less effective both in the firmness of erection and duration. I tried an increased dose of Viagra (100mg) which gave some improvement but was still not always effective enough and I sometimes lost my erection part way through lovemaking with my wife. Finally in March this year I discussed this with my Doctor. initially he suggested that I try daily Cialis but, as with the individual dose, this did not work. My Doctor then referred me to the Erectile dysfunction Clinic at my local hospital.

My first appointment with the Specialist Nurse Practitioner was in early April and we discussed my history and problems in detail. Although he mentioned Muse intraurethral therapy I told him that I had heard that it was not very effective with a high percentage of patients. He agreed that this was his experience but had recommended it to patients who could not face the thought of injecting their penis. I told him that I did not expect this to be a problem for me and he made an appointment to see me two weeks later for a trial with Caverject.

At the next session he showed me how the Caverject (Alprostadil) dual chamber injection syringe works and exactly where he recommends that the injection is made (about 1 inch from the base of the penis either side between 2 o'clock and 3 o'clock or 9 o'clock to 10 o'clock). He suggested that we start with a dose of 5mcg. He was happy for me to do the injection under his supervision. The Caverject syringe has a 29g needle and I was surprised how little I felt when the needle went in - less than I feel when pricking my finger for a blood glucose test. Although the 5 mcg dose had some effect (I estimated about a30% to 40% erection) certainly not enough for penetration. On a second visit a week later we tried 10mcg which was better but still only 50 to 60%. He then agreed that I could continue to try increasing doses at home to determine exactly how much I need. In the end it seems I need 25 or 30 mcg which is more than I expected. Both give good firm erections but whereas 25 mcg lasts about 40 minutes before beginning to soften 30 mcg gives about 1 hour. I understand that in clinical trials the average dosage was 21.7 mcg so I need more than the average. I am one of the lucky ones and Alprostadil (Caverject) does not give me the pain that about 30% of men experience.

The good news is that living in the UK I have the benefit of our wonderful National Health Service (NHS). This means that all the doctor appointments and drugs for my diabetes over the years have been free and patients who suffer ED as a result of conditions such as diabetes, cancer treatment or injury also get free treatment and drugs for ED. The NHS limits the free ED drugs either oral or injection therapy to 4 per month but patients can, of course, pay for more if they wish. In the UK, a 20 mcg Caverject dual chamber syringe costs about £12 ($18 at current exchange rates) so it is quite expensive.

If I had the choice I would be very keen to try Trimix. It could well be that I would need a much smaller dose. However, it is not available in the UK or in most of Europe so this is not an option. I usually have a holiday once or twice a year in the USA but I am not sure how I could get a prescription and I assume that a consultation with a Urologist would be expensive with no insurance. I see that Trimix cost is relatively low in comparison with Caverject (or its equivalent Edex) and that at least one compounding pharmacy now supplies freeze dried Trimix which does not need to be kept cold until it is reconstituted. At least that is not a problem with Caverject which is freeze dried and mixed in the syringe just before use.

I hope my experience will be of help to anyone thinking of injections to help with ED. I am delighted that at the age of 68 I can still perform as I did as a 20 year old!

[dtwarren1942]

I read your post with great interest because I followed a similar ED path as you since being diagnosed with diabetes 18 years ago. I have had great success with Trimix and my private insurance covers all but $7.95 for a three month supply which provides a little more than 2 injections a week. However, I do have to pay monthly premiums for my insurance.

I am also on daily Cialis (10 mg) which allows me to also generate and maintain erections with the aid of constriction. I am using an Osbon tension band. This procedure allows me to have good penetrative sex on days I am not using injections. The downside of this procedure is that insensitivity starts to set in after 10 minutes and the constriction needs to be removed every 20 minutes in order to avoid problems. If you have a desire to have sex more than four times a month, you should look into it.

Feel free to send me a pm if you would prefer to discuss it one on one.

[newly1]

What is the advantage of the osborn ring over a regular co ck ring? Thanks newly1

[dtwarren1942]

An Osbon tension band lasts forever. It is designed with nitches at the top and bottom to allow blood to move through the dorsal vein and ejaculate to flow through the urethra, though not easily. It is also designed with "ears" to help pull it down as close to the base as possible. For me it works better than any cock ring I have tried over the past 15 years. Other than that I can't come up with any other advantages at this time.

[shipper222001]

I been injecting Trimix twice a week and love it. If you need any info email me.

[shipper222001]

I been injecting Trimix twice a week and love it. If you need any info email me.

[lexmc1945]

If you're using Caverject Impulse you may be interested in a solution I came up with to reduce the cost.

This procedure assumes you are wasting a significant amount of the mixed solution after using your normal dose.

Mix the solution in the syringe in the normal way then fit the snap on needle to allow pressure in the syringe to dissipate, after this remove the needle and use a standard diabetic syringe (I use BD Ultrafine with a 29g needle) The needle can be inserted into the Caverject syringe where the needle normally fits and will allow you to withdraw whatever dose you require. You can then refrigerate the leftover solution for next time. In my experience the mixed solution keeps refrigerated for at least a few weeks and probably longer.