got priapism! Went to ER

[jayjayc]

I'm very new w Trimix: using for psychogenic ED; physically all systems ok.
The clinic I got Trimix from recommended start at 10 units. (The clinic said their concentration was not super high (It is 40mcg PGE1, 2mgPhentolamine + 30papaverine) but it IS high right? What concentration are you guys using?)

1st time: 8 units R side: 20 minutes to work; full erection for 3.5 hrs, got scared, took benadryl, iced, and squats, went down somewhat so I knew I'm out of danger. It was still up and down for another hour or so.
2nd time few days later: 6 units L side: total dud. At the time I assumed I missed bc hard to inject left side or maybe dose was too low.
3rd time a few days later: 8 units R side just like 1st time: would not go down at 3.5 hrs but I figure its same as 1st time so should be OK to give it a little more time. Took increasing amounts of benadryl and ice and squats starting about 3.5 hrs mark without effect. Went to pharmacy and took 10,20,30,40,50,60 mg of phenylephrine at 10 minute intervals...no effect. At 5 hrs finally checked into ER. Doctors drained and gave injection of phenylephrine at around 7 hrs mark for it to go away. NOT FUN! and super embarrassing. Follow up with urologist the next day he didnt seem to worry at all.
Couple days later, little sore but able to get natural erection so hopefully no permanent damage. Been a few days more now everything does seem normal again.

I am super super scared to ever try again due to priapism...few hours more and could have been bad! How come the effects varied so much from injection to injection? I did not do anything different between 1st try (worked fine ~3.5 hours) and 3rd try (total priapism+ER trip); only thing I can think of is having a couple drinks on 3rd try and taking benadryl a little later vs 1st time bc I thought I knew what to expect. Boy was I unpleasantly surprised.

Very discouraging and scary experience. Angry at the clinic I got it from: had I did 10 units as they recommended could have been a LOT worse. Thinking I might try again but with 4 units only and will definitely taking antidotes (benadryl, phenylephrine, pseudoephdrine) ready at 2 hour mark. Urologist said don't touch Trimix again; he's upset I went to clinic and not proper MD urologist but funny thing is I had actually tried to make appts with urologists but they were all booked out for 3-4 months in advance lol

[RJ_in_Pa]

JJ,

Sorry you had a bad experience, but glad things weren’t worse.

Couple days later, little sore but able to get natural erection so hopefully no permanent damage. Been a few days more now everything does seem normal again.

If I may ask, if you are able to get a natural erection, why did you do an injection. Venous leak?

RJ

[bldoink]

...The clinic said their concentration was not super high (It is 40mcg PGE1, 2mgPhentolamine + 30papaverine) but it IS high right? What concentration are you guys using?)

That is not a starter mix! I would think something like 10/1/20 (same order of ingredients you used) would be more appropriate, or try even weaker.

You obviously missed on your 2nd try. If you experience plunger resistance try adjusting the depth deeper or more shallow. Never force the plunger.

I use a mono-mix of 80mcg/ml of PGE1. That is meaningless to you. Our ED causes are not even remotely similar.

Listen to your doctor!

3 months is not at all a long wait for a specialist. You sound like a very young guy. Learn patience!

[jayjayc]

JJ,

Sorry you had a bad experience, but glad things weren’t worse.

Couple days later, little sore but able to get natural erection so hopefully no permanent damage. Been a few days more now everything does seem normal again.

If I may ask, if you are able to get a natural erection, why did you do an injection. Venous leak?

RJ

Just psychogenic ED / performance anxiety. Physically OK more or less. Pills work too but thought Trimix would be 100% for sure...wasn't planning on using it often; just for special occasions etc.

[jayjayc]

...The clinic said their concentration was not super high (It is 40mcg PGE1, 2mgPhentolamine + 30papaverine) but it IS high right? What concentration are you guys using?)

That is not a starter mix! I would think something like 10/1/20 (same order of ingredients you used) would be more appropriate, or try even weaker.

You obviously missed on your 2nd try. If you experience plunger resistance try adjusting the depth deeper or more shallow. Never force the plunger.

I use a mono-mix of 80mcg/ml of PGE1. That is meaningless to you. Our ED causes are not even remotely similar.

Listen to your doctor!

3 months is not at all a long wait for a specialist. You sound like a very young guy. Learn patience!

Yea I should have done the research on the specific Trimix ingredient concentrations: the clinic just told me this is where they start people off at...10 units of 40/2/30. Ugghhhhh could have been a disaster, esp since first time worked more or less as advertised, the 3rd time I held off on ER past the 4 hour mark till the 5th hour whilst waiting for OTC antidotes to kick in. Lesson learned but not sure if should even try again at like 3-4 units only.

[RG3p013]

I also use trimix for psychogenic issues. If there's no actual physical damage to your penis, my doctor explained that less is more when using trimix for psychogenic erection issues. Even injecting .01 ml more than you have to could be the difference between a suitable and enjoyable 90 minute to 2 hour erection versus a painful 4 to 5 hour one. I use a VERY low dose (10/30/1 at .09 ml, as I found that 1 ml was too much) that is tremendously effective and not painful/uncomfortable (a painful erection can be a sign that you've injected too much). There is definitely a learning curve, but what helped me is using an auto injector with a partial erection to avoid any misfires. All the best to you.

[Bambino09]

The unit they gave you is too high, your doctor doesn't know anything, change it.
Generally, you start with 10 mcg of Caverject. And if it doesn't work, increase the dose.

[CanGetItUpButNotOff]

I've started on PT-141 and my doc was worried about priapism so he gave me an Rx for injected phenylephrine. I filled it at MenMD for about $60. Seems like a high price for insurance but whenever I take the PT-141, I keep the phenylephrine handy. Before I had the Rx, I did experience one case of a prolonged (2-3 hours) erection, but an ice pack resolved it.

[Shootanoogah]

Went to pharmacy and took 10,20,30,40,50,60 mg of phenylephrine at 10 minute intervals...no effect.

Apologies if I’m mistaken, but it seems like you took several 10mg doses of phenylephrine. Next time you’re at Walmart, ask the pharmacist for a 30mg dose (it’s not available on the shelves). They’ll check your ID before giving it to you.

Good luck with Trimix. It can be intimidating at first. After my first two shots, I wanted to quit, but trust me, once you find the right dosage, you’ll appreciate it. Also, make sure to read what @bldoink writes. He’s been a huge help for me. I follow his advice closely—his posts are even more insightful than what my urologist tells me.

[jayjayc]

Went to pharmacy and took 10,20,30,40,50,60 mg of phenylephrine at 10 minute intervals...no effect.

Apologies if I’m mistaken, but it seems like you took several 10mg doses of phenylephrine. Next time you’re at Walmart, ask the pharmacist for a 30mg dose (it’s not available on the shelves). They’ll check your ID before giving it to you.

Good luck with Trimix. It can be intimidating at first. After my first two shots, I wanted to quit, but trust me, once you find the right dosage, you’ll appreciate it. Also, make sure to read what @bldoink writes. He’s been a huge help for me. I follow his advice closely—his posts are even more insightful than what my urologist tells me.

So upon doing more research, if my understanding is correct, need oral Sudafed with the pseudoephedrine fast acting...that's the oral antidote. The phenylephrine oral tablets don't do much...it has to be injected phenylephrine antidote. Since priapism ER episode I still haven't tried Trimix yet. Though also pleasantly surprised erections are pretty much normal and if anything maybe I'm just happy I survived priapism wo any apparent damage; ED was just psychogenic anyway. IDK I still think would be nice to have Trimix as an absolute backup for special occasions but definitely gonna keep doing my homework. Also, the different Trimix mixtures vary sooooo much in terms of strength / concentration, any discussion of how many "units" do inject makes no sense unless the type of Trimix concentration is also known. My clinic started me off with 40/2/30 which is wayyyy to strong...esp aprostadil 40!