Mixing Injections and pde5 Inhibitor Pills

[Sean762]

So, I had my first 0.1 ml Trimix #5 injection for the doppler ultrasound of my penis to assess the potential cause of my ED back in April. At the doc's office, i never got fully erect...maybe 60% in the 25 minutes I was there. I'm guessing that was due to nerves b/c when I got in my car to drive the hour plus home, I relaxed and became fully erect in 5 to 10 minutes and stayed that way for the next 5 hours until I had to have the priapism drained at the local ER.

I had abstained from using any generic Cialis or Viagra (the two I normally use....but are only effective maybe 50% of the time and sporadically at best) for over a week (I think about 10 days). The urologist didn't tell me to stop using it...I just assumed it was a bad idea to mix the injections with the pills.

My question is this (knowing I'd really like to avoid another priapism).....can the two be mixed?

Obviously, I'd like to have sex with my partner w/o using anything, but pills are relatively easy to take and sometimes do work. The problem is: what if I take a pill hoping to have sex with her, and I can't get a full erection? Can I then not inject Trimix for fear of causing another priapism?

JFYI....My urologist said he's going to stick with Trimix #5 and give me the lowest dose (0.03 ml) to see what my reaction is but I'm nervous to start down the road of injection therapy and want to ask a bunch of questions of more veteran users like, "Does tolerance increase over time to a point where the drug stops working?". Is Peyronie's an issue with injecting or is the concern overblown? If you had it to do over, would you still choose injections to solve your ED issues? ...things of that nature.

Any answers are most welcome.

Thanks in advance,
Sean

[BenjaminButton]

In my experience I get some nocturnal semi erections from PDE 5 drugs and none without. But since I could not get any daytime erections I turned to injections. I felt some nocturnal erection ability was healthy so I wanted to continue with the pills. I did need to reduce my injection dose due to the effect of the pills.

If that’s your case it can be beneficial to use both, but approached with caution.

[Benjohn]

I'm the same as BenjaminButton. I use Sildenafil at night so wouldn't inject in the mornings, wait around 18 hours for it to completely leave my system. Came close to priapism a few weeks ago so taking a half dose of Invicorp moving forward.
I guess it's a bit trial and error - just try and take the lowest dose of trimix that works.

[Ozbloke]

Deleted

[Sean762]

Thanks!

[bldoink]

The common medical advice, to my layman understanding, is to NOT mix the two drugs due to priapism risk. For example see the question and answers near the end of this pamphlet in PDF format produced by UCSF:

https://urology.ucsf.edu/sites/urology.ucsf.edu/files/uploaded-files/attachments/successful_self_penile_injection_2.pdf

It seems to be a pretty good pamphlet although I certainly don't follow all of their advice. I've mixed Viagra with injections numerous times and I use 31 gauge needles both practices they clearly tell you not to do. They also proscribe using a VED after injecting which some guys seem to do successfully. I get a hematoma if I do it so I guess I follow them on that one.

I have used generic Viagra with injections on a number of occasions without issue. It does give my injection a noticeable extra bump. I haven't had any priapism issues with it. But bear in mind Viagra alone does pretty much nothing for me. Since having a supposedly nerve sparing RRP I've had NO erections of any amount without injections or VED with rings. The Viagra does make pumping with a VED very noticeably easier. The point being, don't take my ability to use Viagra with injections as any indication that it is safe for you to do it. I'm fairly certain I would reach a fatal dose of Viagra before it gave me any erection on it's own. I don't mix injections with Viagra too much anymore as I can do well with the injections alone and just avoid the extreme nasal stuffiness that results when I use it. I use the 100mg pills.

With many things related to ED and it's treatments there is much variation between individuals. Guys like me that have ED so severe that they can safely mix the drugs without any issue are hopefully rare. Until you are able confirm that you can mix Viagra with injections please be extremely cautious if you proceed with it. There appears to be good reason most medical professionals tell you not to do it.

Good luck.

[Sean762]

The common medical advice, to my layman understanding, is to NOT mix the two drugs due to priapism risk. For example see the question and answers near the end of this pamphlet in PDF format produced by UCSF:

https://urology.ucsf.edu/sites/urology.ucsf.edu/files/uploaded-files/attachments/successful_self_penile_injection_2.pdf

It seems to be a pretty good pamphlet although I certainly don't follow all of their advice. I've mixed Viagra with injections numerous times and I use 31 gauge needles both practices they clearly tell you not to do. They also proscribe using a VED after injecting which some guys seem to do successfully. I get a hematoma if I do it so I guess I follow them on that one.

I have used generic Viagra with injections on a number of occasions without issue. It does give my injection a noticeable extra bump. I haven't had any priapism issues with it. But bear in mind Viagra alone does pretty much nothing for me. Since having a supposedly nerve sparing RRP I've had NO erections of any amount without injections or VED with rings. The Viagra does make pumping with a VED very noticeably easier. The point being, don't take my ability to use Viagra with injections as any indication that it is safe for you to do it. I'm fairly certain I would reach a fatal dose of Viagra before it gave me any erection on it's own. I don't mix injections with Viagra too much anymore as I can do well with the injections alone and just avoid the extreme nasal stuffiness that results when I use it. I use the 100mg pills.

With many things related to ED and it's treatments there is much variation between individuals. Guys like me that have ED so severe that they can safely mix the drugs without any issue are hopefully rare. Until you are able confirm that you can mix Viagra with injections please be extremely cautious if you proceed with it. There appears to be good reason most medical professionals tell you not to do it.

Good luck.

Once again, great info. Thanks for sharing.

I will admit this is disappointing news in that in the scenario I laid out....trying to have sex using the pills, finding it's not working.....means I will have to risk the injection (at perhaps a lower dose than I'd normally take...which I haven't even figured out yet) or accept that for that day or so anyway, we'll need to forego PIV or deal with suboptimized PIV I guess.

Regardless, thanks for the comment. Very much appreciated.

Oh, and what is RRP...I am not well versed at all in the causes of ED other than all my tests pretty much came back as 'normal' so one of my urologists thinks it's all mental.

[bldoink]

Radical Robotic Prostatectomy.

[Flounder]

I take 5mg Cialis daily to support nocturnal erections and use trimix for for sex. Been doing this for 5 years with my uro’s blessings and no ill effects. That said, I’m reaching the end of the line with that combination as injections are starting to fail so an implant is in my near future.

I never injected following a failed “on-demand” dosage of pde5’s. It sounds risky to me. My advise is discuss this with your doctor first. Besides priapism there are other factors to consider such as heart health and blood pressure history which nobody here is capable of assessment.

[Sean762]

I take 5mg Cialis daily to support nocturnal erections and use trimix for for sex. Been doing this for 5 years with my uro’s blessings and no ill effects. That said, I’m reaching the end of the line with that combination as injections are starting to fail so an implant is in my near future.

I never injected following a failed “on-demand” dosage of pde5’s. It sounds risky to me. My advise is discuss this with your doctor first. Besides priapism there are other factors to consider such as heart health and blood pressure history which nobody here is capable of assessment.

Thanks for the information.

My heart health is excellent (run 3/4 mile in 4:30 several times a week) and was recently checked out by my cardiologist to rule out ED issues from something there. Blood pressure is a little on the low side at times though I think 98/56 or so is the lowest I've clocked recently.

I was planning more Cialis 20mg maybe the day of (approximately 8 hours prior to sex)....

Considering I won't know how well it works until I try it...I don't see much choice if we still decide we want to have sex after taking the pill and not being able to get hard. I guess I'll have to decide if it's worth rolling the dice.