The drugs, in order of chance of painful side effects are:
1. Caverject or 100% Alprostadil
2. Trimix- a 3 part mixture of alprostadil, phentolamine and papaverine.
3. Bimix- a mixture of phentolamine and papaverine.
4. A category by itself is Muse, a pellet inserted into the mouth of the penis. Most guys who use it here report a noticed lack of successful erections, with a high dose cost.
Caverject is usually 20mcg or 40mcg strength dose. Thais is what most ED treatments want to start out with. It is very expensive (maybe in the $40 a shot range) and the most likely to produce pain and aching, usally described as severe. Also the most likely to produce erections over 4 hours.
Trimix contains (usually) alprostadil 20mcg/phentolamine 1mg/papaverine 30mg. Alprostadil in this formula is much reduced than when straight, and results in no or very little pain and/or aching when the dose is adjusted to the maximum effect to the least amount. There may still be some small amount of aching invloved, but nothing that can't be tolerated well, plus most guys report that it mostly goes away with repeated use. Trimix costs around $90 to $100 per 5ml vial, and depending one individual doseage, will give maybe 50 does. That's at .10 cc or ml, or 10 units on an insulin syringe. Cheap and effective.
Bimix contains the phentolamine and papaverine drug in the same strength, and usually is effective and well tolerated by most users. It may not be strong enough for satisfactory results with some guys who have severe damage to the veinous valves in the penis, but does eliminate the aching and/or pain. It is easy to adjust the strength to find a dose that is effective. Effective for all three types is a firm erection lasting an hour or so. Bimix costs around $55 a 5ml vial and usually the user will be using twice the amount (.2cc/ml or 20 units)as the trimix, so the cost is about
As I said, most places want to start with the strongest and go down. I don't necessarily agreew ith that, as a bad first experience, with aching, pain or over 4 hour erection is a poor way to begin the injection process and will put lots of guys off. If it were me, I would try to get them to try the bimix first, then progress up from that, but that's something you and the doctors will need to discuss.
One thing to note, some insurance plans will pay for the CAverject, but won't pay for the bimix or trimix.
I hope this little primer is helpful. Good luck and let us know how it goes.edited to correct type of Edex to Muse, thanks Jeff
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing
open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 01/11-.09
Post Edited (James C.) : 1/19/2011 10:03:27 AM (GMT-7)