Injections/ trimix, bimix, caverject,needles, injectors, and cost of all of the above.

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lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 573
   Posted 8/22/2007 4:31 PM (GMT -6)   
As some of us move down the road to recovery, we find that we must deal with things that are new and confusing. I hope to to gather information from those who have tried and succeeded or not and what they have learned.
 
I am in my third week of injections.  As it turns out, my urologist is reluctant to do anything but Caverject (by the book).  That means  I go to his office and he or his PA do the injection, increasing 5cc every week. 5 then 10 then 15 then 20 until the ideal amount is found.  After hearing horror stories from some who are sent home with a needle and mix and no help, I am grateful for the energy my doctor is spending to make sure I am monitored and carefully supervised.
 
I think we have found the right dosage and now I will be sent home to inject on my own. I have some aching, but no severe pain as others have described. Things are looking up...so to speak.
 
Now my questions.
 
Do you (have you) used Caverject?  At what dose?  How much do you pay and where? ( I found drugstore.com at slightly less than $20 per injection.) Others were higher
 
Do you use trimix/bimix?  How much do you pay per injection? including needles
 
Do you use an injector?  Why?    Any other helpful information?

 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
Back on the golf course...
90 day PSA  less than 0.01 (undetectable)
Six Month PSA still undetectable
Beginning injection therapy for ed (08/07/07)
 


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1720
   Posted 8/22/2007 4:39 PM (GMT -6)   
Caverject cost us 66 dollars for a 2 dose, prefill box. Everything was included. Insurance paid for 6 doses of any of the meds with a 20 dollar co-pay every 34 days. The month must be gettin longer these days :>)
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1453
   Posted 8/22/2007 7:56 PM (GMT -6)   
Hey Life,

Welcome to medically assisted love making! Yeah, this disease does lead us down some paths that we would never have considered otherwise.

I use TriMix and my uro gave a lesson on how to use it. He started me on .10 ml which was way too much. It caused a lot of pain and stayed up way too long. I since have cut it to .02 ml and take 50 mg of Viagra about 2 - 3 hours before the injection. It stays up for about an hour and there is no pain. Works great. The cost is $75 for a 5 ml vial which at my doseage would give me 250 shots!!! Needless to say we would never use a full vial before the expiration date. (We aren't teenagers anymore.) I will ask my uro for a smaller prescription at my next visit.

These things do take some experimentation in order to find what works best. The important thing is that they do work very well. I had ED problems before cancer and was on Levitra which was a mediocre solution compared to the shots. Things are better than ever in the sex department these days.

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2C. Gleason 3+4. Cancer confined to prostate.
PSAs from  1/3/07 - 7/18/07 0.00. 
T level on 4/2/07 - 48     On 7/16/07 - 613
Started .10 ml Tri-Mix on 8/7/07.  It works!!!
Next PSA and T tests on 10/17/07
 
"Patience is essential, attitude is everything."
 


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 8/22/2007 8:58 PM (GMT -6)   

Hi There Life,

I am pleased to see you learning as much as you can and taking control.  Here is my experience and the information that you requested.

I had a lot of aching with the Caverjet and could not used it.  If you are not having any significant discomfort with Caverjet then it is good to use as it has a lower level of incidences of Peyronies and priapism.

I am using Bimix.  My cost including two packages of 10 syringes each is about $59.  I have been using Bimix since April and at first went up to a dosage level of .35 cc's.  At this level my cost was about $3.00 an injection.  I started combining the Bimix with Viagra at the end of June as directed by my urologist.  Since then I have been able to reduce the dosage down to .15 cc's.  Since the combination of the injection and Viagra I have been able to get about a 50% erection unassisted.  I may be reading something into the response but it appears that the combination has helped with the nerve rehab or enough time has passed that it is coming back on it's own.  It has been about nine months since my surgery and this is when many men report the beginning of natural erections coming back. 

I only had the initial injection of Caverjet in the surgeon's office.  Once I got the Bimix I began injecting myself.  I have probably injected myself 20 to 30 times and have only had two misses.  One was when I injected myself too close to the base of the penis and apparently missed the spongy tissue.  It caused a spectacular bruise but no pain.  The second was just recently when I think that I was too low and again missed the tissue.  That was when I was doing it left handed(being right handed).  I have found that slowly inserting the needle is better then sort of stabbing it.  There is no bleeding when I do it that way and no bruising. 

Good Luck!

Tamu


Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07
Began injections in April '07
Undetectable PSA on 6/25/07


jerryg
Regular Member


Date Joined Feb 2007
Total Posts : 30
   Posted 8/24/2007 7:32 AM (GMT -6)   

Hello Lifeguyd,

I was shown once in the my Doctors office how to inject.  After that, I was on my own.  No problems after about 20 injections.  Tried PGE1 with no effect, but alot of pain.  Then tried Trimix, worked, but very painful for a couple of hours.  Switched to Bimix, no pain or problems.  I inject .5ml with a 30 gauge needle with about a 45 min erection. I asked on this forum about where people have found injectable drugs reasonably.  I was told about Franck's Compounding Lab located in Ocala, Fl.  A 5ml vile cost $50.00 and 10-30 gauge needles cost $4.00.  I live 25 mile south of Ocala most of the year, so a trip up to Ocala to see this Lab was easily done.  I have been there and can speak for the cleanliness and professionism of the lab.  They will overnight ship to you in a cold pack box out of state at no charge.  I was previously paying $15.50 per injection at a local pharmacy in the midwest.  Hope this helps you.  I am not connected to or affilated with Franck's Compouding Lab in any way. 

                           1210 SW 33Rd Ave.

                           Ocala, Fl. 34474

                           800 622-4510

Jerry



Prostate Cancer diagnosed Dec. 18, 2006
Biopsy 12/13/2006 Gleason score = 3+5=8
RRP Jan. 5, 2007
Pathology - negative margins from succesful surgery
10 mg Cilias M_W_F for 8 weeks
Almost no leakage after 5 weeks
Used Vacurect pump for 4 weeks before useable erection.
Presently using injections - PGE and Trimix caused really bad pain.
Now using Bimix - Bingo, good times are back.

Post Edited (jerryg) : 8/24/2007 4:55:32 PM (GMT-6)


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 8/24/2007 9:42 AM (GMT -6)   
I also get my Bimix from Franck's compounding pharmacy. They are the ones my urologist uses for all of his patients for Bimix or Trimix. My urologist's PA told me they were the lowest cost with the best reputation. When I order the 5 ml vial it is delivered overnight in a cold pack. The first vial I used was good for about a month past the expiration date of six months.

Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07
Began injections in April '07
Undetectable PSA on 6/25/07


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 3/23/2008 3:22 PM (GMT -6)   
Thanks for the excellent information.

Danman Bob
Age 57
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Possible post-surgery radiation therapy...decision likely in late April 2008, depending upon PSA at that time
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of March 2008)
Began using Viagra 3 times a week December 2007 to stimulate blood flow
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Will probably begin using bimix injections in addition to Viagra and pump in May 2008


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 573
   Posted 3/23/2008 5:39 PM (GMT -6)   

Hi Friends

As you can see by my recent posts, this one from last August (8/2007) tells of a work in progress.  As I have posted recently, I am now using a Bi-Mix that causes no pain, but does not work quite as good as the straight Caverject.  The freedom from pain is worth the change. 

Unlike some people here, I still do not get any erection without help. I had no problems before surgery. Now However,I use various combinations of pills, pumps, and shots.  I am past 60 but still very motivated to return to a fulfilling sex life.

I am fortunate to have a wife who is as motivated as me.  We work together well.


biopsy 10/16/06
T2A,  PSA 4.7
Gleason  4+4=8  right side
DaVinci Surgery  1/16/07
Post op confirms gleason 4+4=8
no extension or invasion found
no continence problems
PSA 90 day -.01  , 6 month -.01 , 9 month +.02 , 1 year +.02
Ed problems continue
Caverject/viagra /discomfort
02/28/08  start Bi-Mix Rx
 


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 3/23/2008 5:58 PM (GMT -6)   
lifeguy,
 
did you wait from august until late february to switch to bimix?  how much do you use and have you tried more/less with any difference in results?
 
did you use caverject during the period from august through february?
Danman Bob
Age 57
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Possible post-surgery radiation therapy...decision likely in late April 2008, depending upon PSA at that time
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of March 2008)
Began using Viagra 3 times a week December 2007 to stimulate blood flow
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Will probably begin using bimix injections in addition to Viagra and pump in May 2008


ernestnolan
New Member


Date Joined May 2008
Total Posts : 3
   Posted 5/30/2008 7:05 PM (GMT -6)   
In 1991 I began TRT via testosterone hormone pellets inserted under the skin below the belt and thought I had cured my severe ED as no pills were available then. Several weeks of easy erections were wonderful but after my new higher level of T stabilized my ED returned as severe as before.

I found a book by Dr. Irwin Goldstein, Boston Univ. 1992 and began TRIMIX therapy which he pioneered. Initially he would not give me a prescription and I had to pay several hundred dollars for each 10 ml vial. Later that changed so I could buy it from Franck's Pharmacy, Ocala, FL. Next he told me I had to travel to Boston yearly for him to continue receiving prescriptions.

I contacted Franck's Pharmacy who asked me to have my GP call to verify his credentials and he would tutor him on how to write the prescription for mixture #5. Since then I have paid about $110 for 10 ml vial which lasts me for about 100 injections.

I had unreliable injections until I figured out what the problem was. I could not find the inside of the cavity while the penis was flaccid. One wall of the cavity was against the other wall with no space between so I could stop the needle in the right place. I would get lumps in the cavity wall and no erection or a poor erection. I finally developed a new method which works very well.

Tease the penis till some blood flows into the cavity and squeeze it toward the end and hold tight. This enlarges the injection site to nearly erect diameter and bury the syringe all the way in to be sure you are thru the wall of the cavity before unloading the syringe.

Still works for me at 76. I continue to receive TRT via pellets as my PSA tests still show I have no prostate problems.

DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 5/31/2008 3:19 PM (GMT -6)   

ernestnolan,

How did you figure out that the inner wall was pressed against the outer wall?  Is there a "scan" of some sort that would show this?

Thanks in advance.


Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 6/11/2008 1:03 PM (GMT -6)   
ernestnolan,
 
did you leave us already?
Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008


ernestnolan
New Member


Date Joined May 2008
Total Posts : 3
   Posted 3/14/2009 9:19 PM (GMT -6)   
A flacid penis laying across your thigh is like a toy balloon with no air and the sides of the cavity are for sure very close to each other unless there is blood in the cavity. IT is tough to stop the needle in the exact location between the touching walls of the cavity. Tease the penis to get some blood in it and squeeze it toward the head to enlarge the cavity at the injection site. BINGO no problem with unreliable injections.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4438
   Posted 3/15/2009 11:55 AM (GMT -6)   
You discovered at an earlier time what I did last year... tongue I use a penis pump and pump a little, then apply a ring to hold the blood in, and inject. The needle passes thru the other wall and into the cavity easily, painlessly, and noticably, so I don't have to worry any more about hitting the spot. Very gently massage the drug around for a couplel minutes, remove the ring and I'm ready to go. I call it pre-plumping... tongue Several guys here have adapted the technique to them with success. It would have been easier for me if I had read of your method a couple years ago... turn Thanks for returning to share with us...
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- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


justus1292
Regular Member


Date Joined Feb 2009
Total Posts : 63
   Posted 3/25/2009 8:46 AM (GMT -6)   
Don't remember what CaverJect is, but I've been on bimix and trimix and back to bimix.  This erection thing has been a roller coaster for me.  Now, to the point.  Bimix didn't do much except tumance.  Trimix made for painful erections for up to three hours.  Back on bimix now and erection is usable, just not all that hard until I orgasm.  Good tumance for two to three hours though....without the pain.

justus1292
Regular Member


Date Joined Feb 2009
Total Posts : 63
   Posted 3/25/2009 8:49 AM (GMT -6)   

Oh yea, the cost?  Under my GI insurance bimix or trimix cost me only $9.00 copay.  Getting it from the VA now at no cost to me.  Either of these, without insurance to help would cost upwards of $200.00 plus for a 10 ml bottle.  Then add in needles and alachol pads.

Good luck.


ernestnolan
New Member


Date Joined May 2008
Total Posts : 3
   Posted 5/18/2009 10:33 AM (GMT -6)   
I was of the opinion that painful injections with trimix were very rare.

I was told bimix was invented for that purpose but was not nearly as effective.

I use mixture #5 which has a very low PGE ingredient. I do know there are several mixtures for various purposes I imagine.

More and more trimix is being used. It is finally catching on.

hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 295
   Posted 5/18/2009 4:43 PM (GMT -6)   

Trimix still has Alpostadil in it, which is what causes the pain. Every guy seems to be different in response to Alpostadil. I couldn't take the aching pain from either Caverject or Edex which is almost pure Alpostadil. It did give me 4 hour, really hard erections though.

Currently I'm on Trimix with a low mix of Alpostadil and it is working great.  The pharmacy I use, will either fill the syringes or give me a vial and extra syringes.

 


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


RES946
New Member


Date Joined Dec 2009
Total Posts : 2
   Posted 12/17/2009 5:21 PM (GMT -6)   
biker90 said...
Hey Life,

Welcome to medically assisted love making! Yeah, this disease does lead us down some paths that we would never have considered otherwise.

I use TriMix and my uro gave a lesson on how to use it. He started me on .10 ml which was way too much. It caused a lot of pain and stayed up way too long. I since have cut it to .02 ml and take 50 mg of Viagra about 2 - 3 hours before the injection. It stays up for about an hour and there is no pain. Works great. The cost is $75 for a 5 ml vial which at my doseage would give me 250 shots!!! Needless to say we would never use a full vial before the expiration date. (We aren't teenagers anymore.) I will ask my uro for a smaller prescription at my next visit.

These things do take some experimentation in order to find what works best. The important thing is that they do work very well. I had ED problems before cancer and was on Levitra which was a mediocre solution compared to the shots. Things are better than ever in the sex department these days.

Jim

RES946
New Member


Date Joined Dec 2009
Total Posts : 2
   Posted 12/17/2009 5:26 PM (GMT -6)   
Had my first injection of Tri-Mix at the urologists today. Way too large
a dose, and now have an erection that won't go away. Followed his
advice, and took two (2) Sudafed, and now have an ice pack on. Guess
this is a drug that will take some getting used to. Next stop, the emergency
room, I guess.

MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 12/18/2009 1:54 AM (GMT -6)   
Your Urologist allowed you to leave his office with a full erection ?
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


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1453
   Posted 12/19/2009 12:27 AM (GMT -6)   
Hey RES,

My uro did the same thing, it stayed up for about 5 hours and hurt like the dickens. You just have to start small (.05ml or less on a diabetic syringe) and work up. I take some Viagra an hour or so before and stimulate (manually or foreplay) then inject and it stays up for an hour or so with no pain at alll. You have to experiment to find your comfort level with it.

Docs only have the book to go by unless they are in the boat with us and after all, they are "practicing" medicine.

Jim
Age 75. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06. Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + .03 cc Trimix = Excellent Results
PSAs from 1/3/07 - 7/17/09 zero.
Next PSA - July/2010
Lung cancer dxed on 5/16/08. Surgery on 6/25/08 T1N1M0 - Stage IIA Finished 4 cycles of chemo on 11/7/08.
CT scans on 12/2/08 - 9/22/09 - in remission!!!
Next scan in December 09.
Biker90's Journey
http://www.caringbridge.org/visit/jimrobinson
"Patience is essential, attitude is everything."


bearfield
New Member


Date Joined Jan 2010
Total Posts : 1
   Posted 1/17/2010 12:38 PM (GMT -6)   
Hi:
 
I am on Trimix myself.  I pay $60.00 for a vial.  My problem is that with being over 50 it gets wasted due to the short shelf life of only 30 days.  I understand that Bimix has a lot longer shelf life.  Any ideas on this?
 
Thanks
 
Ted
 

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4438
   Posted 1/17/2010 1:18 PM (GMT -6)   
Ted, Welcome to the forum. You might want to read this thread dealing with shelf life of the mixes. 30 days in your case is really short, compared to the experiences of others with it.

www.healingwell.com/community/default.aspx?f=35&m=1690136&p=1&ord=d
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

Post Edited (James C.) : 1/17/2010 5:55:12 PM (GMT-7)


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 1/17/2010 3:13 PM (GMT -6)   
Hi Ted,

My Trimix says to refrigerate, after 90 days it begins to lose its effectiveness. Never a problem for me, a 5ml vial lasts 5-6 weeks
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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