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I have been on Tri-Mix for about 3 years and am noticing a decreasing effect of the injection. The formula is 15mg Papaverine, 0.5 mg Phentolamine, 25mcg Alprostadil. I started out at 15 units on the syringe. I am now up to 25 units and then often have to inject an additional 5 units.

Questions/Issues:

1) Is this a low, medium, or high formula?
2) What is a Unit on the syringe? How much?
3) After about 45 minutes I start to lose the erection when my wife gets on top of me. (This is the only way she can achieve orgasm), and have to inject the 2nd dose.
4) However, after just one or both injections I stay hard for 3+ hours.
5) Is the medicine starting to lose the effect or do I need a stronger dose or different formula?
6) If I need a stronger dose, what would it be?


Any guidance much appreciated. This isn't easy.

In the General Discussion sub-forum find the thread at the top called Documents Etc. Worth Reading List. In that thread scroll down to the Injections section. You'll find a listing of standard offerings from 3 compounding pharmacies. You can compare your script to those to get a general idea it's comparative strength.

In my very humble non-medical professional opinion your's is on the weaker side but seems to differ a bit from the usual. The first two ingredients seem like starter mix amounts but the third, the alprostadil, it seems a bit stronger. However, I'm on straight alprostadil at 80mcg/ml.

It's a medium-low dosage. A "unit" is 1/100th of a milliter (ml). A syringe usually holds 100 units or 1 ml, I've had some that hold 30 units.

I started with PGE only (in Caverject) for a year and had to slowly increase from 20-40mcg. The volume was high and burn was bad. So . . . Switched to TM started with 30-1-20 at 20-30 units (0.30ml). Was hitting it pretty hard 2-3 times a week and noticed likewise a drop off in efficacy and when goiong longer. Pushed it up a bit and occasionally supplemented with 5-10 mcg PGE. Likewise found after an initial surge that the fella backed off in 15-20 minutes. Wifey wanted more so hit it with another 10 units. I'm now using 30-2-40 and 20 units. Just coming off a 3 1/2 month layoff due to a surgery/recovery, virus and pneumonia, and a remodel with guys tramping all over for 2 months now. right off the bat, I have noticed a better effect at a lower dose. As with pills, we seem to get accustomed to it and some end up updosing and getting more into a burn/pain zone. There may also be a correlation with anorgasmia with higher doses over time (me).

A separate issue is position. There are several posts here about guys only being hard in a standing, missionary or side-saddle position - including me. They go pretty limp on their backs. Some have offered theories but I've hear no definitive reason. Fortunately wifey goes ballistic in any position as long as it's long and hard, but 30-45 min is her limit.

For what it's worth . . .

I'm a long-time trimix user who switched to quad mix earlier this year. Used various strengths of the medications along the way. Also have employed a cock ring.

Through it all, there's been a tendency toward softening when I'm on my back. It's so consistent that my wife and I often finish our gymnastics with her in the cowgirl position. It reliably gives me a bit of softening (down to about 80 percent) that makes removal of the cock ring easier.

My urologist put me on 15/0.5-/5 and 15 unit dose to inject. It worked in his office last week. Stayed erect for just over an hour. He said he didn’t not want me to stay erect for more than two hours, so this is what he wanted to prescribe.
Injected today and I didn’t stay hard but for 15 min.
What does the group think I should ask him to do? Or what he should change the Trimix numbers to?

I'm not a medical professional of any kind. Anything I post is based on my own experiences, at best, and hallucinations or delusions, at worst. Remember, internet forum advice is often worth exactly what you paid for it. Always ask your doctor and follow his/her advice.

Before making any changes, try the same dose a 2nd time paying particular attention to your injection technique. If the same result, and with doctor approval, bump it 5 units. 15 units isn't a huge amount, especially considering the mix you have. That does seem to be a weak script. If you eventually figure out your correct dose is 30 units of that mix you can ask him to double the strength so you can roll it back to 15 units. But I see no reason not to use what you have to experiment with. I'm using 12 units of some pretty strong stuff.

Thanks bldoink. Good suggestion.

Yeah, that is a starter mix. And low dose. My uro prescribe 100 units for my starter mix. I've moved up a couple of times to stronger formulas, but still need 40-50 units to get the job done.

So, relax, do as your doc instructs, but remember that it takes time and monkeying around with the formula and dose.