Trimix injection good or bad idea?

Well worth it; thank you.

So far since starting 11 days ago I'm 2 and 2. At 25 units and 30 units on the right side, I only experienced about 40% erect which was insufficient for sex. At 35 units and 35 units on the left side I had a full erection and it was great. The first time on 35, I was still fully erect at 3 hours so took 30mg of Sudafed and a hot shower, which worked. The second time on 35 I took a hot shower at 90 minutes and still standing firm.
SO my questions to the group are:
1. Do you find that small increments in your dosing have dramatic results? In other words, can bumping up to 30 be effective without the 3 hours of discomfort?
2. Any other strategies for reversing the effect? I have tried the hot shower but not exercise yet. I'm reluctant to push too much Sudafed because of the adverse effect on BP -- with pure autonomic failure I typically have orthostatic hypotension (low BP when standing) and supine hypertension (high BP when lying down) so I have to be careful about taking it at bedtime.
3. Have you noticed any difference in effectiveness when injecting the left side versus right side?
I'm really early into this therapy and testing what works and does not.

@kcarmack99
Good morning,
I have taken Trimix since I believe 2018. It is more effective on my right side. Not sure if you’re aware there is an injectable antidote if the sudafed isn't effective. When I got Trimix near San Francisco they always included 2 prefilled antidote syringes and some Sudafed. I always let the erection go down at its own pace except when the erection lasted 4 hours. I had to take 2 doses of Sudafed and use both antidotes before it went down.
I don't find that small increases make any difference for me. I have found there is a difference in how it's formulated. When I got it from a San Francisco based clinic it was more effective. My new doctor supposedly ordered a stronger strength and wants me to use 10 cc instead of my previous 40 cc but that isn't working so I went up to 20cc then 30cc then 40cc. I used to pay $35.00 per injection which and used 40 cc to work. Now I pay about $140 instead of $350. The new place doesn't send antidotes. Maybe they have to be ordered separately and cost heaven knows what. But since I switched suppliers and now get it from somewhere in Florida, it doesn't seem to work as effectively so I guess you get what you pay for. If I am paying less but using more, is it really any cheaper? Has anyone else paid less and had a less-than-effective reaction? They say to use a smaller dose to avoid a prolonged erection but you have to take enough to get an effective erection. If the erection is prolonged so be it as long as it doesn't exceed 4 hours. You mentioned “discomfort.” I haven't noticed any discomfort. Do you mean discomfort as in pain or inconvenience?
Good luck,
Jake

@jasonfarmer
May I ask where you get your Trimix filled?
Thanks,
Jake

My answers to your questions:
1) Effect of small increments in dosing? Yes, dosing matters. That's why I track it closely. My MD started me on 20 units, but by tapering that I got erections that last more appropriately (I keep it in the 45-90 minute range.)
2) Strategies for reversal? The sudafed has worked for me. I note in my chart when I've used it and usually make a dosage adjustment for the next time based on that. I also remain at rest for a period of time, usually one to two hours, less if I am comfortable moving sooner.
3) Difference between sides? I probably have too much OCD, but I use my chart to alternate sides and locations. I have 12 guidepoints--1,2,3, and 9, 10, 11 where 12 is vertical on a virtual clockface, at 2 or 3 finger widths above the base. I do notice some difference between locations and there have been a few occasions where I have "missed the mark". Missing the mark probably means it did not go into the "Corpus cavernosum smooth muscle (CCSM)", perhaps do to a bent needle, diverted insertion, or even a fibroid mass. When the mark is missed I sometimes note a longer but much more mild effect, so perhaps the drugs are arriving but not in the timing and dosage required for effective erectile function. Because of the small number of misses and the variety of positions for insertion, I have not noted a particular pattern.
4) Bonus question: Indicators dose is high? In addition to duration (which I measure to 50% decline, not total deflation,) I notice that higher doses are associated with more pain and sensitivity at the tip. I have not noted discussion of this anywhere or by anyone. Erectile Hardness Scale: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475665/ https://www.drlove.com.au/wp-content/uploads/2020/12/erection-hardness-score-new.pdf [I actually use a 1-10 scale where 10 is max and 0 is nada, with 6 being the minimum required for penetration. I aim for 7-9 combined med + stimulation. Initially stimulation contributed nothing but over time that has increased but still not enough for penetration in my case.]

KCar I do have discomfort after injection but gets better after sex is started. After sex discomfort again but cold shower then recline in recliner helps with discomfort and helps errection go down a little faster and usually 60 to 90 minute errection. Have had 2 hour sometimes. 32 units is my favorite not 30 and not 35. A few units does make a difference to me. Injection on right side is usually less discomfort but I alternate anyway.

Leonard it is Dothan Al.
Doctors Center Pharmacy

I just found an interview (and transcript) that discusses erectile dysfunction after PC, and specifically vacuum devices and shots. It also includes a link to a site where a free book is downloadable. (I got it off the site @kujhawk1978 directed me to a while back.) I found it helpful and I intend to download and read the book as well. https://www.urotoday.com/video-lectures/asco-2023/video/mediaitem/3501-understanding-erectile-dysfunction-patient-education-and-personalized-treatment-jeffrey-albaugh.html
One takeaway: I had earlier noted that a research study in NZ required massage of the penis after the shot. I've been doing this since and finding it helpful. I also do some muscle tensioning (in my case planks and leg lifts) immediately after. Jeffrey Albaugh suggests this is helpful to keep the injection in the penis--I thought it was to distribute the injection more evenly through the corpus cavernousa (penile smooth tissue.)
Another: He suggests using the vacuum erection device like I used the RestoreX for penile rehabilitation after surgery. I think the vacuum erection devices are cheaper and more available, and I wish I had been aware of that option. They work slightly differently than the RestoreX--the RestoreX is focused on muscle tensioning while the vacuum erection devices focus on increasing blood flow (as described by Albaugh). I may still try it, even though I'm two years out from RALP--today!

Hi Spino,
It’s always great to communicate with and share valuable, helpful information with men who truly find some kind of assistance and value from it.
It sounds like you are having a successful, consistent and satisfying sex life with your wife averaging sexual intercourse about 2.5 times per week. That’s great my friend. Frankly, that’s about where my wife at both 69 years of age each currently find ourselves, Admittedly, when.we’re on vacation and she doesn’t have near the amount of regular amount of stress and work we are ever more playful than that. The most important thing thing is to
always pay attention to the overall importance a healthy sexual attitude and participation is in any successful, happy and prospering relationship is.
Additionally, I certainly realize that both the desire to have and enjoy sexual intercourse with one’s spouse can vary over time from week to week and month to month. Speaking from my own personal experience, If I have a strong erection than I automatically “rise” to the occasion to have a strong, powerful, penetrative sexual desire to make love with my wife. No doubt about it. My wife prefers a really strong, erect and durable erection for some vigorous sexual pleasure and enjoyment. We also enjoy some slow, intimate, romantic and sensual sexual intercourse as well with a mixture of everything in between. The nicest thing is to let the overall mood, quality and consistency of the moment and erection determine whatever you want to do, play and equally meet you mood and desires with. “NO LIMITATIONS!”
Keep enjoying and growing your intimacy with your wife. More than ever, it’s something I will never take for granted and appreciate forever.
Best wishes and enjoy the “RIDE!”
Phil

Hello to all of my fellow “TRIMIX” users. The dosage definitely makes a difference in terms of the strength and rigidity of the erection and the length of time your penis remains erect. I find that it also makes as difference if you experience an orgasm or not. My erections always go away more quickly after having an orgasm. However, if my wife and I are in the mood, I can still maintain a strong erection to continue on to “Round Two” should we both desire. If she has already experienced her orgasm or multiple orgasms and I haven’t done so………….and my erection is still very hard and definitely needs a “release” as they say. Fortunately, my wife is very understanding and willing to assist me at my time of “need!” We have some more fun together and I go for obtaining and enjoying my orgasm and then my erection will start to dissipate more quickly, If my erection still persists longer than I like than I simply chew a few Sudafed tablets and my erection is usually totally gone after about 10-15 minutes! I find that the length of time my Compounded TRIMIX has been in and out of freezer storage for use and reuse definitely has an effect on its overall strength and potency. Additionally, if I’ve been traveling with it or has it just been at home in my freezer during most of its usage etc, can also affect its efficacy. After starting TRIMIX about 7 months ago I find that a average dosage of between 40-60 unit works best for me. Using 35-40 units doesn’t always work or provide the strength and rigidity of the erection I am seeking. I have never gone above 60 units. Again, if the TRIMIX is nearing its expiration date then the overall potency is certainly less effective and weaker than when it was first compounded by my pharmacist. Like most therapies, medications and treatments etc, things can change over time requiring appropriate changes in dosages and usage to always get the the optimum results you are striving for. Personally, I am very thankful that TRIMIX is available and is so effective and consistent.
Best wishes to all of my fellow Prostate Cancer Brothers out there and may all of you seek and discover the most effective therapies available while pursuing your total recovery.
Kindest regards,
Philip Snowdon