commercial vs custom-made trimix

[newbie1]

My previous pharmacy stopped making trimix and I have to change to another compounding pharmacy recently.
I was told by the new pharmacy that the previous pharmacy used commercially available trimix ingredients (phentolamine, papaverine and PGE1) and this new pharmacy custom-made each ingredient itself in house.
Can anyone tell me if there could be any difference between commercially available ingredients vs pharmacy own-made ingredients (such as effectiveness, side-effects, etc, etc)?
The solution of this new pharmacy looks a bit thicker and a bit more opaque than my previous solutions.
I tried one dose (same number of units) and it seemed not lasting as long as the previous supplies. Don't know if it is just coincidence or real or psychological.

[rahod1]

No way of knowing in this case. I would think commercial source would be more consistent. BTW, my trimix is crystal clear. I don't think it should be anything other than that either.

[JimStars]

I wonder if by Commercially Available maybe meant that they used premixed solutions one for each of the three ingredients -- whereas the new place is using actual powder that has to be measured and dissolved etc... that's the only thing I can think of. Using powders give complete control over the amount per ml ... with solutions it is a crazy ever changing calculation as each solution contributes the ingredient and also some solution.

J

[rahod1]

I wonder if by Commercially Available maybe meant that they used premixed solutions one for each of the three ingredients -- whereas the new place is using actual powder that has to be measured and dissolved etc... that's the only thing I can think of. Using powders give complete control over the amount per ml ... with solutions it is a crazy ever changing calculation as each solution contributes the ingredient and also some solution.

J

I assume they have computer programs to do *the math*?

[Cigar56]

I wonder if by Commercially Available maybe meant that they used premixed solutions one for each of the three ingredients -- whereas the new place is using actual powder that has to be measured and dissolved etc... that's the only thing I can think of. Using powders give complete control over the amount per ml ... with solutions it is a crazy ever changing calculation as each solution contributes the ingredient and also some solution.

J

Here's what I think: Some trimix is mixed in bulk and then sold to pharmacies in volume containers. Many of these pharmacies sell through mail order. In my opinion, Trimix blended that way is the so-called "commercially available" Trimix.

I think Edgewood Pharmacy, in New Jersey -- a noted mailorder shop -- gets its Trimix this way. On the other hand, Olympia Pharmacy, in Orlando, does a lot of mail order too but mixes every order in-house.

I think the best stuff comes from pharmacies who custom mix each order on the premises.

[JimStars]

Cigar,

yeah, I like your theory ... that's got to be it. Do you think it is sold already in solution form .. or dry ?

J

[Cigar56]

Cigar,

yeah, I like your theory ... that's got to be it. Do you think it is sold already in solution form .. or dry ?

J

I think the pharmacies receive the bulk shipments in liquid form. When I was using Edgewood I'd call them for refills and sometimes they would have my formula in stock, and sometimes they would not. That was a clear tip off that they were not custom blending on the premises. On the other hand, Olympia could always fill an order and get it out the next day. The tradeoff is that Olympia is very expensive compared to some of the other mail order places.

I talked to the pharmacist at Olympia once and asked him about his prices. He told me personally mixed every solution that his Trimix was stronger than the so-called "commercially available" mixes. I used Olympia a few times with good results, but the high cost eventually led me to search elsewhere.

[ohohiakane]

I think that Trimix can be made with too many variables. I doubt that any company that wants to make it will find it nearly impossible. Consider this, even if only the 3 usual ingredients are use, there would be thousands of variable quantities of each ingredient.