Alprostadil - Perfect result?

[WestLad]

This post is aimed at UK users, where straight Alprostadil (Caverject / Viridal /generic Alprostadi)l is one of the two available prescribed options.
I am Interested to hear what others think are their ideas of ideal responses to Alprostadil.

I have been tracking Dose, Reliability, Rigidity, Duration, Response Time, Pain and Consistency since I reverted to Alprostadil after several years on Invicorp (when it started to become less reliable / effective).

Dose - the optimal dose for me is 5mcg/ml.
Reliability - this dose gives very consistent and predictable results.
Rigidity - 10 out of 10. (Back to my youth….!)
Duration - between 75- 90 minutes
Response Time - full rigidity in about 4 minutes
Pain - A trade-off with dose / duration for me. At these parameters, residual pain is minimal.
Consistencency - Very reliable, and repeatable.

I can achieve a much longer duration with a higher dose, but this brings residual pain, so not worth it for me.

When I started on Invicorp, I would say that it was never painful, but over time it became less reliable, and ‘rigidity’ started to fade - hence my request to go back to Alprostadil.

What are your thoughts?

[Unhappy60]

I have try all the UK available injections and it's not been great a 60 to 70% erection about an hour duration increasing the dose only seems to increase the ache afterwards currently I use 40mcg which is 2 injections every time I have sex so for me I generally use a ved

[HeavyMetalFan]

You guys getting this on the NHS?

I’m concerned because I don’t meet the “SLS” criteria for NHS prescribing. I found one internal NHS prescribing guideline document that details that severe psychological distress is a criterion, which I do have. But I’m expecting a struggle to get a prescription anyway.

Even if I do get a prescription, I think I would struggle to get a prescription for more than one dose per week. I can imagine this would cause me a lot of frustration. At the moment I fail to have satisfactory sex maybe 99% of the time, but at least I can attempt it whenever I want. If I start using injections, I would never attempt sex without injections. This would mean I would spend 6 days of the week sexually frustrated.

I could buy the injections myself, at a cost of around £25 a go, but that would lead to one of these results:
1: I enjoy the injections a lot and buy enough to satiate my sexual appetite, causing me financial difficulties
2: I enjoy the injections, dislike the cost, then buy underground alprostadil from China at half the cost and take a chance on big infections
3: I don’t enjoy the injections enough to warrant the cost, and suffer being without sex

It was much more simple buying tadalafil at £0.90 per 20mg

[WestLad]

You guys getting this on the NHS?

I’m concerned because I don’t meet the “SLS” criteria for NHS prescribing. I found one internal NHS prescribing guideline document that details that severe psychological distress is a criterion, which I do have. But I’m expecting a struggle to get a prescription anyway.

Even if I do get a prescription, I think I would struggle to get a prescription for more than one dose per week. I can imagine this would cause me a lot of frustration. At the moment I fail to have satisfactory sex maybe 99% of the time, but at least I can attempt it whenever I want. If I start using injections, I would never attempt sex without injections. This would mean I would spend 6 days of the week sexually frustrated.

I could buy the injections myself, at a cost of around £25 a go, but that would lead to one of these results:
1: I enjoy the injections a lot and buy enough to satiate my sexual appetite, causing me financial difficulties
2: I enjoy the injections, dislike the cost, then buy underground alprostadil from China at half the cost and take a chance on big infections
3: I don’t enjoy the injections enough to warrant the cost, and suffer being without sex

It was much more simple buying tadalafil at £0.90 per 20mg

Why are you expecting a problem meeting the “SLS” criteria for NHS prescribing?

Are you currently taking ED tablets, and with what results?

If you are failing to have “satisfactory sex maybe 99% of the time”, what has your Urologist said?

[HeavyMetalFan]

Why are you expecting a problem meeting the “SLS” criteria for NHS prescribing?

Are you currently taking ED tablets, and with what results?

If you are failing to have “satisfactory sex maybe 99% of the time”, what has your Urologist said?

I have since been prescribed alprostadil. The doctor who prescribed it said I don’t meet the SLS criteria, but that he will put the prescription through to my GP and hopefully my GP won’t notice that I don’t meet the SLS criteria.

So far, I’ve had 8 doses from my GP and I’m not paying anything beyond my prepayment prescription of like £10 per month.

The alprostadil alone doesn’t work well enough to get a rigid erection. I am currently pairing it with 60mg tadalafil, 100mg sildenafil, 150-1000mcg pt141, 0.25mg cabergoline every 4 days, and 800mcg intraurethral misoprostol tablets. With that cocktail of drugs, I can just about get a mostly-rigid erection. But I also feel so sick, and my penis burns so much from the alprostadil that I don’t even want to have sex.

I would go for an implant, but what happens when I’ve had my 10th revision and further revisions are not possible? I, like everyone else, already have a death sentence. I don’t need an additional one.

I think the next step for me is to acquire raw misoprostol powder and use that intraurethrally. It’s fairly cheap, and unlike the misoprostol tablets I can dose it as high as 2000000mcg due to a lack of excipients.

Of all of the drugs I’ve ever taken to combat my ED, misoprostol is one of the better ones, and unlike alprostadil it doesn’t cause a burning sensation. Or any side effects at all, for that matter.

My only concern is the legality of importing it. It would certainly raise some flags for HMRC to detect an import of misoprostol equivalent to 500000 usual doses. They will probably suspect me of being a drug manufacturer lol. I have been studying the law on drug importation, and I think it would be legal to import. I suppose the law may have to be tested in court!

[WestLad]

Why are you expecting a problem meeting the “SLS” criteria for NHS prescribing?

Are you currently taking ED tablets, and with what results?

If you are failing to have “satisfactory sex maybe 99% of the time”, what has your Urologist said?

I have since been prescribed alprostadil. The doctor who prescribed it said I don’t meet the SLS criteria, but that he will put the prescription through to my GP and hopefully my GP won’t notice that I don’t meet the SLS criteria.

So far, I’ve had 8 doses from my GP and I’m not paying anything beyond my prepayment prescription of like £10 per month.

The alprostadil alone doesn’t work well enough to get a rigid erection. I am currently pairing it with 60mg tadalafil, 100mg sildenafil, 150-1000mcg pt141, 0.25mg cabergoline every 4 days, and 800mcg intraurethral misoprostol tablets. With that cocktail of drugs, I can just about get a mostly-rigid erection. But I also feel so sick, and my penis burns so much from the alprostadil that I don’t even want to have sex.

I would go for an implant, but what happens when I’ve had my 10th revision and further revisions are not possible? I, like everyone else, already have a death sentence. I don’t need an additional one.

I think the next step for me is to acquire raw misoprostol powder and use that intraurethrally. It’s fairly cheap, and unlike the misoprostol tablets I can dose it as high as 2000000mcg due to a lack of excipients.

Of all of the drugs I’ve ever taken to combat my ED, misoprostol is one of the better ones, and unlike alprostadil it doesn’t cause a burning sensation. Or any side effects at all, for that matter.

My only concern is the legality of importing it. It would certainly raise some flags for HMRC to detect an import of misoprostol equivalent to 500000 usual doses. They will probably suspect me of being a drug manufacturer lol. I have been studying the law on drug importation, and I think it would be legal to import. I suppose the law may have to be tested in court!

Good luck!