Starting Dose: Bimix or Trimix?

[chametzoo]

Hi All.

I'm going to be taking my first "shot" at an injectable. I've dabbled in Cialis, but found it not very effective and full of side effects. I'm working with Defy Medical, an on line "clinic" who approved prescription for either Bimix or Trimix. I've had moderate ED for 10 years. I'm 62, of normal weight and fit. No diabetes, heart disease or other common metabolic illnesses. The consultant at Defy immediately recommended Trimix, but like many advise here, I want to start more modestly; I'm not in a hurry. They mostly use Empower Pharmacy. Empower offers the following potencies in Bimix:

1] Bimix: 150/5 (per 5ml vial)
2] Super Bimix: 150/10 (per 5ml vial)

Dosing advice from Defy is, start with 5 units. Add up to 3 units at a time, until you achieve good results.

QUESTION: Given my health background, would 5 units of Super Bimix [150/10] sound like a reasonable starting point?

[Budward]

Yes for sure, 5 would be a good starting point.

[sogwap]

Penile injections are powerful meds.
I've read reports of guys getting Pripasm with 5 units. While others need 40 or more units.

Why do you want to start with Super Bimix?
Given that you've had "moderate" ED.

Please follow the prescriber's recommended dosing.
You do NOT want to end up in ER, with an extended erection, which is both dangerous and can be embarrassing.
If you do end up needing 40 or more units of the "regular" bimix. You can always get the "super" bimix.

[chametzoo]

Thank you both for your comments.

sogwap: 5 or 40 units? It seems from my exhaustive reading of this "injection" forum, it starts out as a guess and we learn what our optimal dosage is by trial and error. "Super" Bimix is simply a name that Empower Pharmacy gave to differentiate from their own Bimix product. They themselves actually make up what the potencies are; there are no standardized concentrations unless you go with non compounded pharmaceutical. From my reading as well, 5 units of a 30/2 concentration is not an unreasonable starting point. My level of ED (what I called "moderate") is enough to bring me to this moment with injection therapy, so the terminology is subjective. The pharmacy is also providing premixed Phenylephrine injections as an antidote should priapism present.

But thanks for sharing your caution.

budward: Is your agreement with a 5 unit starting dose based on the 30/2 concentration I will be using?

Thanks!

[Budward]

Sorry, don't know squat about BiMix as I started on Trimix.

[Reggieman]

Shortly after a radical prostatectomy, I started using bimix at 30/.5 concentration and a dose of .15 cc twice a week. I later moved up to 30/1 at .15 per dose. Hope this helps.

[sogwap]

Thank you both for your comments.

sogwap: 5 or 40 units?

You missed my point. There is no such thing as a starting dose.

For some guys 5 units will give them a 4+ hour erection.
Someone else may have more severe ED and require 40 units or more for an erection that last an hour.

If I told you I use 10 units that gives me a 1-3 hour erection.
And you try 10 units and it barely gives you a chubby. All you would know is you need more than I do. Next time try 15 units.

On the other hand, if you inject 40 units because that's what someone else uses and 4.5 hours later your dick is still raging. You will likely need to go to ER and have the blood pumped out. Which from what I've heard is no fun, embarrassing, and dangerous.

That is why you start with a low dose and titrate up to the desired dosage that works for you.

[chametzoo]

Thank you both for your comments.

sogwap: 5 or 40 units?

You missed my point. There is no such thing as a starting dose.

For some guys 5 units will give them a 4+ hour erection.
Someone else may have more severe ED and require 40 units or more for an erection that last an hour.

If I told you I use 10 units that gives me a 1-3 hour erection.
And you try 10 units and it barely gives you a chubby. All you would know is you need more than I do. Next time try 15 units.

On the other hand, if you inject 40 units because that's what someone else uses and 4.5 hours later your dick is still raging. You will likely need to go to ER and have the blood pumped out. Which from what I've heard is no fun, embarrassing, and dangerous.

That is why you start with a low dose and titrate up to the desired dosage that works for you.

Sogwap. I do get your point and I apologize for not making my statement more clearly. Start low and work your way up in increments. But are you also commenting that 5 units of a 30/2 bimix concentration is too high of a starting dose for anyone? I could walk into 3 different urologist's offices, give my case history and get 3 different dosing recommendations. That is for sure evident from this "injections forum" user experiences. Also, I am observing that trimix (which is considered to be the more potent drug), is overwhelmingly the starting drug for many, many clinics and doctor's.... even at low concentrations. So I made a modest choice in the range of available potencies. Could I have chosen a weaker potency; absolutely. My bimix comes with an injectable antidote if things go awry. I'll let you know how my experience goes. Hopefully, it will look something like this:

[Donkeykong]

My starting dose was 5 units. It was too much.

I injected the “antidote.” It didn't work and I had to go to the hospital.

I have some scarring from the hospital procedure. But I have far more internal scarring where I injected the antidote. I was told by the hospital urologist that the antidote is potentially very destructive to penile tissue and it unfortunately turned out to be true.

Bimix is usually not prescribed as a first line injectable because it requires higher doses of papaverine, which is known to cause fibrosis because of its acidity.

Your prescriber sounds as fly-by-night as mine was. It may be best to go to a proper urologist. It will be safer and also be a lot cheaper.

[chametzoo]

My starting dose was 5 units. It was too much.

I injected the “antidote.” It didn't work and I had to go to the hospital.

I have some scarring from the hospital procedure. But I have far more internal scarring where I injected the antidote. I was told by the hospital urologist that the antidote is potentially very destructive to penile tissue and it unfortunately turned out to be true.

Bimix is usually not prescribed as a first line injectable because it requires higher doses of papaverine, which is known to cause fibrosis because of its acidity.

Your prescriber sounds as fly-by-night as mine was. It may be best to go to a proper urologist. It will be safer and also be a lot cheaper.

Thank you Donkey... that is clear actionable advice. I can easily switch to trimix and I really appreciate the heads up regarding the acidity issue with Papaverine and potential for fibrosis. This did come up once in my searches through this forum. I'm authorized for trimix as well with my provider.