Alprostadil in trimix

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Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 1/31/2010 9:49 AM (GMT -6)   
Is this what causes the aching pain, and if so, what are the recommended prescription adjustments that have gotten rid of the pain. I have gone from .1 ml to 3.3 ml, which now does the trick, but there was quite a bit of that aching pain.

Thx
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable
Continance: Night and morning fine; mid day onward still not there yet.
Trying Trimix


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4450
   Posted 1/31/2010 10:15 AM (GMT -6)   
Yes, that's what causes the aching. I have tried prescriptions of 30mg papaverine/1mg phentolmine/2.5mcg alprostadil, then 30/1/5.0, and 30/1/10, and finally 30/1/20mcg. Each one presents a little more aching, but at the same time produces a stronger erection as the alropstadil dosing increases, so it's still a trade off- for me. However, each one also requires les drug, so the usage is reduced, also. It seems that each man reacts differently, so what works for one may not work for you.

Do you really mean you have gone to 3.3ml, rather than .33ml? 3.3ml is a monster dose. .33ml on an insulin syringe is 33 units or .33cc. Thats a much more normal amount. But, in answer to your question, increasing the dose will normally increase the discomfort, while also increasing the quality of the erection.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 1/31/2010 10:44 AM (GMT -6)   
Thanks JamesC. No, it's .33 ml as I didn't connect that 1 ml = 1 cc...not a math major! Thanks I'll re-read your post per dosages. I'm hoping the aching is from getting to a decent erection. Things subsided in an hour so no issue there.
Age 54
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable at < .05
Continance: Night and morning fine and improving
Doing 3 P's and now using trimix


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 1/31/2010 10:49 AM (GMT -6)   
Getting the lingo down per units -ml-cc. Im at 33 units.
Age 54
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable at < .05
Continance: Night and morning fine and improving
Doing 3 P's and now using trimix


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 1/31/2010 10:50 AM (GMT -6)   
Forgot to ask...what are the number for a standard mix of trimix...I assume that is 20 of the Alprostadil.
Age 54
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable at < .05
Continance: Night and morning fine and improving
Doing 3 P's and now using trimix


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4450
   Posted 1/31/2010 10:51 AM (GMT -6)   
Your theory about aching from non-use has some backing here, as several in the past has said the aching has reduced or disappeared with continued use. I can't say for certain in my case, but the 20mcg. shots now don't ache as much as they did a year ago. So don't give up yet, if you can tolerate it, give it a chance to get the tissues swollen and stretched again and see how it goes 3 or 6 months from now.

Oh, by the way, if you can produce consistent usable erections with .33ml of trimix, you fall in the normal curve of guys experiences here. You may also find that you can reduce the amount, in time, as you become accustomed to it. I'd suggest finding a dose that works and stick with it for some time, maybe a couple months, then try a little less to see how it goes.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


T40
Regular Member


Date Joined Oct 2009
Total Posts : 103
   Posted 1/31/2010 10:56 AM (GMT -6)   
I used .17 on Saturday and it lasted over 2 1/2 hours so I took a sudafed. This caused it to slowly go down after another 45 minutes. I will be reducing my next dosage to .13 and see if that allows for a 1 hour time point. I was told as I improved that the dosage would decrease so I will take that as a good sign. Just wasn't expecting it to happen so quickly. On a side note, I started using the manly sildenafil and it works as well if not possibly a little better then the normal stuff. And NO, I do not use the trimix and any other drug on the same day.

T41
Age 40
Pre-op PSA was 5.8 from wellness test on May 19, 09
Follow up test from uro was 4.6 with a 9.3% free psa
Gleason 3+3 in one core, 3+4 in second core of 12 samples taken
Surgery performed August 19th, 09.
One side nerves spared. Nerve graft on other side.
Six weeks incontinence almost over. ED a work in progress but seeing some response.
4 months no longer using pads. ED using trimix with positive response.
Post op October 2nd, 2009 All margins were negative. PSA results in a few days.
Post op pathology 3+4 PT2A NOMO
6 wk PSA .004
4 month PSA .003 12-18-09


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4450
   Posted 1/31/2010 10:56 AM (GMT -6)   
I think the majority of guys here would say their standard mix is 30mg papaverine per ml/1mg phentolmine per ml/20mcg alprostadil per ml, expressed usually as 30/1/20. . The next would be 30/1/10mcg. A couple guys also get a small amount of novacaine type drug added, maybe one or 2 guys, I think.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 297
   Posted 1/31/2010 10:58 AM (GMT -6)   
.20 ml of Trimix works fine for me. No pain and it lasts about 90 minutes. I take a Levitra tab from ADC about an hour before as some of the other guys on here do. I have been on Trimix for over a year now.
Age 60, PSA 2007 4.1, PSA 2008 10.0
Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared, Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 1/31/2010 12:15 PM (GMT -6)   
Awesome feedback guys...thanks!
Age 54
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable at < .05
Continance: Night and morning fine and improving
Doing 3 P's and now using trimix


JStars
Regular Member


Date Joined Oct 2005
Total Posts : 450
   Posted 1/31/2010 1:50 PM (GMT -6)   
Redman,
I have used Trimix-Gel and regular MUSE (no shots yet for Trimix) in search of less ache from the Alprostadil. The theory is that the Alpro stimulates nerves and that is the cause of the pain. But almost by accident, when trying to make sure the Gel or MUSE did not escape during intercourse ( it irritates the Missus delicate parts) I employed a not-too-restrictive penis ring-with-beads (which you can get at Adam&Eve or millions of other websites) and it not only kept the fluids at bay but also seemed to reduce the Alpro ache for me to negligible levels.

(you might try one of those clear Super Stretchy rings too -- they come in three-packs).

The key to success was to fit the ring just below the GLANS -- not at the base. For me having the Alpro Ache at the head of the penis is probably the most annoying and that seemed to prevent that completely. And the bonus was no ache really at the base or at the pelvic floor area either. And unlike a really restrictive ring this one does not need to be removed after 30 minutes -- can go for however long it takes. I just leave it on til everything has gone down hours later (although actual penile usableness does not last that long -- maybe an hour at most). (But keep an eye on any discoloration that may indicate too much contriction as your mileage may vary).

So add that to your bag of tricks and see if it makes a difference. Be sure to report back!
Age 58, 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
11/2008 Biopsy: 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery , Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
02/18/09 Cath out, passed a 1cm oblong STONE within hours.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- no real effect (thru 01/2010).
04/01/09, 07/07/09, 10/01/09, 01/15/10 PSA <0.1
08/09 MUSE@1000mcg +pump&plump - (80-90%) (alpro ache).
09/09 MUSE@500mcg +pump&plump + 2 advil - (80-90%) - (less Alpro ache).
10/09 TrimixGel@(500/300/100mcg): 1st:60%, 2nd:(pump&plump) 60%, 3rd(added 500mcg muse):70-80% --
12/09 MUSE@500mcg+Cialis@20 working well (>90%) and useful erection.
01/2010 TrimixGel@1000/300/100mcg ordered for one more try:


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 1/31/2010 1:59 PM (GMT -6)   
My trimix dosage is what my Dr called standard and is 30/2/20

Each Dr must have their own baseline mixture that they wish to work from

My dosage is .22 and lasts 1.5 to 2 hrs, never had aches, been using it for approx 5 months now 3-4x a week
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0

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