new to injections - likely next step - what to expect?

[Implant_Curious]

moving on to injections, Cialis has become unreliable and sildenafil doesn't work any more.

Urologist suggested moving to injections, specifically to start with Alprostadil.

I was wondering about its efficacy vs. cialis - does it give an erection independent of arousal?

Also, how long does the erection from it tend to last? I know it differs from person to person, but just want an estimate - it seems one hour is what most report?

do you just inject on one side? how does it then spread to both cavernosal chambers?

will be starting just on alprostadil - is it necessarily "worse" than e.g. bimix or trimix?

[Flounder]

I’m Assuming you reside in the USA with my response.

Alprostadil is the only FDA approved injection and the reason most urologist will start you off with it. It’s available through regular drug stores like CVS or Walgreens and covered by some better prescription plans. It’s also the most pricey option if you don’t have good prescription coverage. I personally experienced a burning sensation with straight Alprostadil and switched to Trimix early on.

Trimix, Bimini quadmix are not FDA approved. They all come from compounding pharmacies and are not covered by insurance that I know of.although you can us HSA dollars if that’s available to you.

Your urologist should provide you with full instructions on usage and ultimately you will need to do some experimental work to find the right product and dosage for you.

[Old Guy]

Never used Alprostadil, but I used Trimix and Quadmix for several years until they failed. If you get a good injection in the right spot an erection can last 1-3 hours. And regardless of your state of arousal an injection will give you an erection. After orgasm my erections tended to go down when I was using injections to a semi-hard state. Even the next morning it would still be a bit chubby. It's best to change sides each time you inject. How it gets to both sides I'm not sure, but it does. Hope the injections work out for you.
For me the Trimix just started to fail even with a very high dose. The high doses caused a lot of soreness. Quadmix only worked for me for a short time before failures started.

[bldoink]

Urologist suggested moving to injections, specifically to start with Alprostadil.

Alprostadil mono-mix (A single drug mix) can be had in proprietary prepared cartridges under the brand names of Caverject and Edex. They come with the active ingredient in a dry form with included sterile saline that is mixed with it in proprietary cartrideges prior to use. The cartridges will contain the needle for injection. They are very expensive if not covered by insurance and even if covered will often be rationed due to the expense. It does not have to be refrigerated prior to use and any leftovers are to be discarded and not kept for further use. It only comes in a few predetermined strength doses.

Some compounding pharmacies will also custom mix an alprostadil mono-mix. It will generally come already mixed with the sterile saline in a vial and must be kept frozen prior to use. It has a very short shelf life if just refrigerated and even much shorter if at room temperature. You draw dose out of a vial and return the vial to the freezer. The injection is done with a standard insulin syringe. The strength of the mix is custom ordered by your doctor. It tends to be very reasonably priced even if not covered by insurance. It's not as easy to find a compounding pharmacy that will prepare it as it is with tri-mix, etc.

I was wondering about its efficacy vs. cialis - does it give an erection independent of arousal?

The injection should work much more reliably than the pills. It will give an erection regardless of arousal although arousal can enhance it.

Also, how long does the erection from it tend to last? I know it differs from person to person, but just want an estimate - it seems one hour is what most report?

As you said, it varies from person to person. It also varies by alprostadil dose. At my current dose I get a couple of hours.

do you just inject on one side? how does it then spread to both cavernosal chambers?

Yes, you inject on only one side. They are connected so it works for both sides. I alternate sides.

will be starting just on alprostadil - is it necessarily "worse" than e.g. bimix or trimix?

There can be a pain or ache reaction to alprostadil. The extent of this reaction varies widely. Some men can't ever tolerate straight alprostadil and some men can't even tolerate it as an ingredient of tri=mix or quad-mix. If they are to continue with injections they must us a mix not containing alprostadil.

Many men experience some pain or ache from alprostadil. With many of those men they find that with continued use the pain/ache moderates or disappears completely with continued use and the perfecting of one's dose. I'm one of those guys, but if I use a substantially stronger dose than necessary some ache can still be present. Some guys always get some ache but find it tolerable.

It's a crap shoot. You won't know if it's for you without trying. So good luck. Don't give up too quickly.