New bimix formula

[Rocky3000]

This is my first time in this site.
I went to a urologist and he prescribed a bimix formula but different from most in that it was a combo of PGE1 (Alprostadil)/phentolamine 100mcg/5mg. Per 10ml

This is my first attempt with injection. A few months ago I suddenly was unable to get a full erection. I had been using Viagra to extend time of erection although i could get erection without it. Suddenly nothing just pretty flacid and unable to have intercourse.

I started out with 20 units (.2 ml) of bimix and now up to 40 units (.4ml) but still no better than at start.

Has anyone else used this combination? If so, is it working and how much do you use ? How high should I go before I axk for something else like a trimix ?

Thanks for ANY advice !

[cincinnatus1951]

Rocky: Injection therapy is a trial and error proposition relative to both formulation and dosage. I would give your bimix another couple of tries, then I'd start increasing the dosage in increments of 0.01cc. If you get to 0.25 and it is still not working, I'd make another appointment with the urologist and see what he/she recommends. Read up in the injections forum and you'll find lots of helpful information. Also, you might want to look for a doc who specializes in sexual medicine or reproductive medicine, Many garden variety urologists do not know that much about ED therapies.
Good luck.
Cincinnatus

[cincinnatus1951]

Rocky: Sorry I had not caught that you are up to 4 units. That's plenty. You should see the doc before pushing the dosage up any more.
C

[rahod1]

This is my first time in this site.
I went to a urologist and he prescribed a bimix formula but different from most in that it was a combo of PGE1 (Alprostadil)/phentolamine 100mcg/5mg. Per 10ml

This is my first attempt with injection. A few months ago I suddenly was unable to get a full erection. I had been using Viagra to extend time of erection although i could get erection without it. Suddenly nothing just pretty flacid and unable to have intercourse.

I started out with 20 units (.2 ml) of bimix and now up to 40 units (.4ml) but still no better than at start.

Has anyone else used this combination? If so, is it working and how much do you use ? How high should I go before I axk for something else like a trimix ?

Thanks for ANY advice !

OK...so they left out the PAP. That's a standard dose of PGE (10mcg per 1ML) and HALF standard for Phent (.5mg per 1ML). Seems to defeat the reason for BIMIX in the first place, which is to eliminate PGE to prevent *aching*/pain it is associated with! I would go straight to TRIMIX, don't waste your time with BIMIX...adding the PAP (30mg). I would also go to standard 1mg/ml for the Phent...so you would have standard TRIMIX formula of
>>>10mcg PGE/1MG Phent/30MG PAP per 1 ML<<< I would start off at 30 units, given failure stated.

[Rocky3000]

OK...so they left out the PAP. That's a standard dose of PGE (10mcg per 1ML) and HALF standard for Phent (.5mg per 1ML). Seems to defeat the reason for BIMIX in the first place, which is to eliminate PGE to prevent *aching*/pain it is associated with! I would go straight to TRIMIX, don't waste your time with BIMIX...adding the PAP (30mg). I would also go to standard 1mg/ml for the Phent...so you would have standard TRIMIX formula of
>>>10mcg PGE/1MG Phent/30MG PAP per 1 ML<<< I would start off at 30 units, given failure stated.

The urologist I went to has 4 options he uses in conjunction with his preferred pharmacy.
1) standard double p (which is one I 'm currently using)
2)standard triple p which is PGE1/Phentolamine/paparerine 50mcg/2.5mg/75mg per 4.5ml. This is the next step up if #1 doesn't work
3)intermediate triple p which is PGE1/Phentolamine/Papaverine at 100mcg/2.5mg/75mg per 4.5ml
4)high dose triple p PGE1/Phentolamine/Papaverine at 200mcg/2.5mg/75mg per 4.5ml This is the last combo to be used if the other 3 are ineffective

So does step 2 sound appropiate. I called the pharmacist and she said I should try up to 80 units (.8ml) of step 1 before I go to step 2

Does this make sense ?

[rahod1]

So does step 2 sound appropiate. I called the pharmacist and she said I should try up to 80 units (.8ml) of step 1 before I go to step 2

I would not want to inject 80 units...you'll also go through your supply very quickly with that.
Step 2 is only SLIGHTLY more potent than what you have now..same amount PGE1 and Phent (per Ml) plus adding about HALF the standard dose of PAP at 16 MG/ml (vs 30 standard).
Step 3 would be a meaningful change because it DOUBLES the PGE concentration you now have and PGE is the most potent component of the three.

[Rocky3000]

Thanks for the info. I'll probably continue to increase my current amount a bit more just out of curiosity to see if anything happens, which so far is nothing then see if doctor will go to step 3.

He was surprised on my first and only visit when I told him how suddenly my symptoms occured. Within just days I went from being able to get an erection to just a partial. I'm otherwise in great health and have no chronic medical problems or take meds. I'm beginning to worry that something else is going on that no type of injections will help. Will have to wait and see.

[rahod1]

Dr should have done Doppler test for venous leakage. Any sudden change could indicate that.

[Rocky3000]

[quote]Dr should have done Doppler test for venous leakage. Any sudden change could indicate that.
/quote]

I've read conflicting reports and studies about whether the Doppler test is reliable and even if leakage is shown, whether surgery or other treatments are advisable. I've also read it's expensive and I 'm not sure if it would be covered by medicare.

I'm 72 and on SS so limited in income and surgery options.

The doctor did recommend a stress EKG test but haven't done it yet (I 've just had a regular EKG)

I was hoping the injections would be a simple solution and still have that hope, even if it means switching to a trimix formula.

[rahod1]

Yes Doppler is limited, but they should do it.
If you aren't getting ANY response with injections....that's a clue. In the test, they actually give you an injection.
I would try an adjustable constriction band (I use one for enhanced performance..no leak) to see if it helps. For *minor* leaks it may. You place it on right after injecting (or before). Make sure it's adjustable or has *handles* for easy removal when erect. BTW, if you have a significant leak, get an IMPLANT...not venous surgery. Covered by Medicare.