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Newbie with some injection questions.....

Posted: Tue Jul 09, 2019 11:28 am
by Beachdude
I"ve been reading a lot of the posts here about Trimix and I don't understand some of the terminology that you guys use. So pardon my ignorance as I ask what are probably stupid questions. I"m not new to injections. I've used Caverject for years and currently have a supply of EDEX. But my insurance no longer covers either and the cost to me for 6 cartridges is about $500 !!
So no way I can afford that as my wife and I have sex about 4-6 times a month on average. So I'm looking for a cost effective alternative. The Caverject and EDEX are just Alprostatil and that alone is working great for me in conjunction with a blue pill.

So my questions are:
Would you recommend that I try Trimix, or can you just get a prescription for Alprostatil ?
Which is the most cost effective?
My EDEX dosage is 20mcg. I don't understand how to translate that into mix that is listed in ml. For example, if I see vial of 5ml of a mix, how many 20mcg doses will that provide?
In general, do the mail order pharmacies beat the prices of local ones?

That's my initial list of questions. I would greatly appreciate any feedback and advise that could be given.

Re: Newbie with some injection questions.....

Posted: Tue Jul 09, 2019 3:28 pm
by bldoink
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 very likely worth what you paid for it, or worse. Always ask your doctor and follow his/her advice.
Additional warning: My post includes some math calculations. I suck at math. My calculations are likely wrong.

Beachdude wrote:I"ve been reading a lot of the posts here about Trimix and I don't understand some of the terminology that you guys use. So pardon my ignorance as I ask what are probably stupid questions. I"m not new to injections. I've used Caverject for years and currently have a supply of EDEX. But my insurance no longer covers either and the cost to me for 6 cartridges is about $500 !!
So no way I can afford that as my wife and I have sex about 4-6 times a month on average. So I'm looking for a cost effective alternative. The Caverject and EDEX are just Alprostatil and that alone is working great for me in conjunction with a blue pill.

So my questions are:
Would you recommend that I try Trimix, or can you just get a prescription for Alprostatil ?

I recommend you try Trimix if you can't get Monomix (Alprostadil) but otherwise, if the Edex works, I'd stick with the monomix if possible. I see no reason to take more different drugs than necessary. Plus, some research indicates that Alprostadil poses less risk of scaring, etc, than the other two ingredients of trimix. All appear to have some risk.
Beachdude wrote:Which is the most cost effective?

That seems to vary between pharmacies and it seems there is little consistency. My pharmacy charges the same for all mixes. The pharmacist told me the major cost was in the labor and not the ingredients.
Beachdude wrote:My EDEX dosage is 20mcg. I don't understand how to translate that into mix that is listed in ml. For example, if I see vial of 5ml of a mix, how many 20mcg doses will that provide?

I'm going to assume you use the whole Edex cartridge per injection. The Edex 20 is 20mcg of alprostadil that you dissolve in the cartridge into 1ml of sterile saline water.

So, if you were to get a script of 10ml of monomix at 20mcg per ml (like your Edex), then you would get 10 doses.

I was also using Edex 20s but I later found that it appears I don't actually need 20mcg of alprostadil. I got my doctor to write a script for 10ml of monomix at 80mcg per ml of alprostadil. But assuming I continue at 20mcg per dose (like the Edex), I would now get 4 doses per ml of mix and with 10 ml per order I would get 40 injections per order. At, in my case, $125 per order of 10ml in 10 iml vials. That would work out to what? $3.12 a dose. Not bad, huh!
Beachdude wrote:In general, do the mail order pharmacies beat the prices of local ones?
Probably, in general. My pharmacy is fairly local to me at 30 miles but they also do mail order but last I checked only within FL.

That's my initial list of questions. I would greatly appreciate any feedback and advise that could be given.

---------------------------------------
I responded to your post in "Introductions" as well so I'll paste some of my response to that thread here:

"I started on Edex injections but my insurance quit covering them and they weren't otherwise affordable.

I then switched to compounded Alprostadil (mono-mix) from a compounding pharmacy at 80mcg per ml allowing me to reduce the injection volume. The compounder I use is way cheaper than Edex and I don't even worry about the insurance coverage.

You should also be able to find a compounding pharmacy that will supply you too. I don't believe mine is licensed for SC so no point in sharing mine. The prices charged by pharmacies vary pretty dramatically so shop around.

Another complication for me is that most compounders only do tri-mix with only a few doing the mono-mix I use. I'm not sure why. I'm sure tri-mix would work for me too but since the mono-mix works great why mess with success?

I'm using 14 units per injection now which has increased some but my juice is starting to get some age on it (months) and even if kept frozen mono-mix looses a bit of potency over time. But even at 15 units per shot, at $125 for 10 ml it works out to be pretty cheap."
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I hope all of that made at least some sense.

Edit to add: Just called my pharmacy. It's $120 for 10ml for all mixes except quadmix which is more but I didn't ask how much more. Also, the stuff I'm using I apparently bought as a double order as my renewal was running out. I bought it last March, as in 2018. It still works well. It's lost a little potency but not much. I keep it frozen solid in the back of my freezer. Oh yeah, they still only ship within Florida. Sorry!

Re: Newbie with some injection questions.....

Posted: Tue Jul 09, 2019 9:30 pm
by Beachdude
Thanks once again bldoink. You have enlightened me significantly. $3 a dose sure beats the $90 a dose I would be charged for Edex without ins.

Re: Newbie with some injection questions.....

Posted: Tue Jul 09, 2019 10:40 pm
by Beachdude
Oh, another question I forgot to ask. Where do you purchase the syringes for something like Trimix and what size would I get?

Re: Newbie with some injection questions.....

Posted: Thu Jul 11, 2019 12:02 am
by Bigdog4all
Here is what I use.......I am not a Doctor.....just what I use.

SureComfort U-100 Insulin Syringes 29G 1cc 1/2 inch 100/bx
https://***.adwdiabetes.com/product/130 ... -2in-100ct

Re: Newbie with some injection questions.....

Posted: Thu Jul 11, 2019 2:22 pm
by Beachdude
Bigdog4all wrote:Here is what I use.......I am not a Doctor.....just what I use.

SureComfort U-100 Insulin Syringes 29G 1cc 1/2 inch 100/bx
https://***.adwdiabetes.com/product/130 ... -2in-100ct





Thanks, Bigdog4all. I appreciate the link. I'll check those out.

Re: Newbie with some injection questions.....

Posted: Thu Jul 11, 2019 4:29 pm
by bldoink
As for needle purchasing, your State or local laws can have an effect. Some jurisdictions require a script. But your doctor should be able to give you one anyhow. I use the U-100 31G 5/16". I've ordered online before but lately I've just bought them at the pharmacy in the local Publix Supermarket. Even when legal to purchase without script some stores will give you grief without one. I've also ordered online from a diabetes supply such as suggested by Bigdog. The only issue with that is my order is never big enough to justify the shipping cost.

Re: Newbie with some injection questions.....

Posted: Thu Jul 11, 2019 7:20 pm
by midwest guy
Beachdude wrote:Oh, another question I forgot to ask. Where do you purchase the syringes for something like Trimix and what size would I get?


I receive 20 syringes at no cost with purchase of Trimix from Wedgewood. I use 28ga 1/2 inch.

Re: Newbie with some injection questions.....

Posted: Thu Jul 11, 2019 9:21 pm
by once a writer
I started with 27ga 1/2" four years ago and gradually evolved to 30ga 1/2".

The pain, which was never significant, is definitely less with the smaller needle.

(For newbies: Larger number means smaller gauge.)

Some guys on FT post about using 31ga. I have not seen any posts about using 32ga or smaller.

Re: Newbie with some injection questions.....

Posted: Thu Jul 11, 2019 11:49 pm
by DP5689
I share your concerns and I'm about your age too. The injections work great, and don't worry me too much most of the time, but when I miss and I get a little bruising they worry me.
Like right now... I missed the injection over the weekend and had a few drops of blood followed by some bruising. 5 days later I still have a bruise the size of a pea with some white dots in the middle. I had a bruise after a failed injection a year ago and it turned out okay, but it's still distressing.