From Invicorp back to Alprostadil.

[WestLad]

To cut a long story short, after many years on Invicorp, I was finding the injections less and less effective. I hadn’t had a really good erection for a long time.
I thought it was down to age, but I felt it was worth getting an Urology referral from my GP.
It took a while to get the specialist appointment, but eventually I got to sit down and go through my history with him.
He obviously asked about my history leading up to Invicorp.
I explained that I had tried Alprostadil (Caverject / Viridal), and that, although the erections were very good, I did experience some pain, so the consultant at that time was quite keen for me to try Invicorp - a new treatment at the time in the UK.
The result was good (not outstanding) erections but no pain - I did, however, feel that they weren’t always reliable.

The new Consultant asked I had considered trying Alprostadil again, and I agreed it was worth a try before starting down the implant route (he said that there was no guarantee it would an option for me).
He said that there was no need for me to attend “how to” appointments at the Hospital, as I was clearly well-informed, and used to self-injecting.
He issued me a prescription for 20mcg cartridges, said that he would write to my GP to tell her he was happy for me try Alprostadil with her support, and he would contact me in a few months to see how I was getting on.

The result has been amazing - absolutely rigid and reliable erections.
I did experience some pain while trying to find the right dose (in my case ‘less is more’), and I overestimated the required dose (ouch….).

One side-effect has been the re-appearance of morning erections - I thought they were long gone. It is as if my penis is recovering some natural erectile function.

My supportive GP has issued me with 6 injections per month on repeat, and by ‘splitting’ each 20mcg dose into 4, I can get more injections than I can possible use in a week.

The only issue was getting the wording on the Prescription right, with the help of my friendly local pharmacist.
Caverject cartridges are no more apparently, and Viridal supply is still hit and miss.
Fortunately the Pfizer generic powder and solution is now readily available.
It has a long shelf life, so I will be able to build stocks though splitting doses and ‘harvesting’ my surplus prescriptions. Hopefully, I can avoid being out of stock if there are any future supply issues.

So, there we are.

[Irish Lad 34]

Glad to hear you're getting a good result with the alprostadil shots.

I had a private urologist's consultation in London a few weeks ago. He has advised me to try Viridal Duo. If that doesn't work we will do the implant.

He prescribed me Viridal Duo 40mcg. He advised me to try starting at appx 30mcg and titrating up to 40mcg if I need to do. If 40 doesn't work well enough we will do the implant.

You say "less is more." Do you find if you take too much it is ineffective?

[WestLad]

Glad to hear you're getting a good result with the alprostadil shots.

I had a private urologist's consultation in London a few weeks ago. He has advised me to try Viridal Duo. If that doesn't work we will do the implant.

He prescribed me Viridal Duo 40mcg. He advised me to try starting at appx 30mcg and titrating up to 40mcg if I need to do. If 40 doesn't work well enough we will do the implant.

You say "less is more." Do you find if you take too much it is ineffective?

The effective dose “zone” for me is quite narrow - between 4mcg and 6mcg.
Below 4mcg not rigid / short time span
Above 6mcg rigid, but painful

Out of interest I have been keeping a detailed log,
So far, it’s been very consistent
A 5mcg dose :-

- 5 minutes response
- Full rigidity
- Average of 90 minutes

The good news is that I can get 4 injections from one 20mcg dose, by mixing a dose and then splitting it into 1ml syringes.

Happy to answer any questions

[Irish Lad 34]

I see - so less alprostadil doesn't necessarily mean a stronger better erection for you, it just means less pain?

If you took 30mcg do you think you'd get a very long lasting erection?

I've started keeping a log too. My last 5 injections have been like:

- 30/35mcg of Viridal OK erection but not great. Kept going soft at the base. Needed to tense my kegels to squeeze full capacity into it. Lost some capacity every time I let my kegels drop. Used for masturbating.

- 20mcg Caverject taken about 3 weeks ago I got an excellent erection from it although I did a good bit of kegle tensing. Rolled around the bed masturbating in all sorts of positions at full mast for about 1 hour. 2 hours after ejaculating I was able to stimulate a bit of an erection again.

- 40mcg Viridal used for masturbating. Somewhat erect but not great. Penis went soft at the base when I was lying flat. Lost potency in 40 minutes.

- 20mcg Caverject used for masturbating. Had to tense kegels to go full blown mega erect. After shifting from lying down to standing up then doing a good strong squeeze of the kegles the penis started going flaccid. Total time from injection to drop off in potency was a disappointing 16 minutes.

- 40mcg Viridal used with an escort a few days ago. Injected 10 - 15 minutes before appointment. Managed to get a good erection with the escort. Oral sex lying flat was good. Then sex missionary and doggy for 5 minutes it was fine. Unfortunately I then ejaculated so didn't get to really test if it would have worked for sex lying flat or for a longer bout of intercourse but I was then able to get a chubby again about 2 hours later. I was very horny that day though.

I'll try another 5 injections to see how consistent the results are then decide from there if I want the implant.

[WestLad]

I see - so less alprostadil doesn't necessarily mean a stronger better erection for you, it just means less pain?

If you took 30mcg do you think you'd get a very long lasting erection?

I've started keeping a log too. My last 5 injections have been like:

- 30/35mcg of Viridal OK erection but not great. Kept going soft at the base. Needed to tense my kegels to squeeze full capacity into it. Lost some capacity every time I let my kegels drop. Used for masturbating.

- 20mcg Caverject taken about 3 weeks ago I got an excellent erection from it although I did a good bit of kegle tensing. Rolled around the bed masturbating in all sorts of positions at full mast for about 1 hour. 2 hours after ejaculating I was able to stimulate a bit of an erection again.

- 40mcg Viridal used for masturbating. Somewhat erect but not great. Penis went soft at the base when I was lying flat. Lost potency in 40 minutes.

- 20mcg Caverject used for masturbating. Had to tense kegels to go full blown mega erect. After shifting from lying down to standing up then doing a good strong squeeze of the kegles the penis started going flaccid. Total time from injection to drop off in potency was a disappointing 16 minutes.

- 40mcg Viridal used with an escort a few days ago. Injected 10 - 15 minutes before appointment. Managed to get a good erection with the escort. Oral sex lying flat was good. Then sex missionary and doggy for 5 minutes it was fine. Unfortunately I then ejaculated so didn't get to really test if it would have worked for sex lying flat or for a longer bout of intercourse but I was then able to get a chubby again about 2 hours later. I was very horny that day though.

I'll try another 5 injections to see how consistent the results are then decide from there if I want the implant.

As is I said in my post “The effective dose “zone” for me is quite narrow - between 4mcg and 6mcg.”
Below 4mcg, either rigidity or duration will be affected.
Above 6mcg, I won’t get any harder, and duration will increase, so it’s not really beneficial.

Maybe I am lucky in that:-

I am responsive to a relatively small dose
The optimal dose range for me is very narrow (between 4mcg and 6mcg)
My response (rigidity and duration) is very predictable at that dose.