{"id":305,"date":"2014-12-27T03:07:39","date_gmt":"2014-12-27T03:07:39","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/ed\/?page_id=305"},"modified":"2020-04-04T19:06:54","modified_gmt":"2020-04-04T19:06:54","slug":"need-know-penile-injections","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/ed\/ici\/need-know-penile-injections\/","title":{"rendered":"What You Need to Know About Penile Injections – Trimix, Bimix, Quadmix, Edex and Caverject"},"content":{"rendered":"

What You Need to Know about Using Injectable Medications for Erectile Dysfunction (Trimix, Bimix, PGE or Prostaglandin, Caverject, Edex)<\/strong><\/h1>\n

by Alex Shteynshlyuger MD<\/a><\/strong><\/p>\n

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If you have any questions, to schedule a consultation<\/a>, please <\/a>contact us<\/a> or call\/text: <\/strong>1-646-663-5211<\/span><\/a>.<\/strong><\/p>\n

We have excellent reviews from patients <\/a><\/strong>and their partners.  Information for out-of-state and international patients<\/a>.  Find out our office hours or directions to our office<\/a>. <\/strong><\/span><\/p>\n

We offer affordable appointment prices<\/a> with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.<\/strong><\/span><\/p>\n

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Penile Injection Therapy for ED<\/h1>\n

There are a few issues to consider in terms of logistics and timing related to using injectable medications for the treatment of erectile dysfunction (when we mention Trimix it applies to other medications as well (Bimix, Quadmix, PGE, and other combinations):<\/strong><\/p>\n

Facts about Trimix, Bimix and other Penile Injections<\/h2>\n

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  1. Trimix<\/a> needs to be frozen or refrigerated<\/strong> – if you travel you will need to carry it in an ice pack.  <\/span><\/strong><\/strong><\/strong><\/li>\n
  2. Trimix that does not require refrigeration<\/strong> is available but is more expensive<\/strong>.<\/li>\n
  3. Trimix has a ‘shelf-life’.<\/strong> The pharmacy we use prepares Trimix that can be frozen for up to 3 months.  Often, if frozen and properly stored, it may stay potent for as long as 6 months.<\/li>\n
  4. You need to have a consultation and full evaluation for ED, including lab work.<\/strong> If you have recent labs (past 2-3 months), we can accept them (cholesterol, kidney function testing \u2013 creatinine or CMP, thyroid hormone levels, testosterone levels).<\/li>\n
  5. We can’t simply prescribe you Trimix or any other injectable medications<\/a>. We need first to inject you with a test dose that will then be increased\/decreased “titrated” until we find out the correct dosing.<\/strong> Sometimes it takes a few injections which must be separated by at least 2 days.  The goal is to obtain an erection that does not last longer than 1 hour.  Once we determine the dose you require we need to order Trimix which can take about a week to be prepared\/shipped to us.<\/li>\n
  6. Typically, custom compounded medications (Trimix, Bimix, etc) are not covered by insurance<\/a><\/strong>.<\/li>\n
  7. The prostaglandin can be obtained that does not require refrigeration but it is fairly costly<\/strong> (Caverject<\/a>, Edex). The advantage is that it is covered by insurances for some men depending on the insurance plan.  Less expensive prostaglandin is available which has the same potency but requires refrigeration and is not covered by insurance.<\/li>\n
  8. If your erection lasts more than 1.5-2 hours, go to the nearest Emergency Room<\/strong>; it often takes a few hours to get to the emergency room, get registered and get a doctor to see you. We typically advise our patients to have phenylephrine for self-injection to reverse a prolonged erection; this may avoid the need to go to an emergency room if the erection goes away after self-treatment with phenylephrine.  A prolonged erection (priapism<\/a>) can cause severe erectile dysfunction to the point that injections such as Trimix may not work and lead to scar formation in the penis.<\/strong><\/li>\n
  9. Trimix may not work well in patients with low testosterone<\/a>. Testosterone replacement therapy may be helpful for many men.<\/li>\n
  10. Venous leak<\/a> <\/strong>is the most common cause of why Trimix injections do not work.<\/li>\n<\/ol>\n

    Common Reasons Trimix, Bimix, Quadmix, and Prostaglandin E1 (Caverject) May Not Work<\/h2>\n

    We take pride in teaching our patients how to properly self-inject penile medications<\/strong> such as Trimix, Bimix, and Quadmix.  The most common cause that these medications do not work reliably when injected at home is that they are not injected correctly.  Often, if medication is not injected correctly it goes in the skin or just below the skin and will not produce a good erection.  <\/p>\n

    It is important that the needle is held perpendicularly at a 90-degree angle<\/strong> to the penis. A 0.5 ml or 1 ml diabetic syringe<\/strong> should be used and the needle should be inserted all the way<\/strong> in the penis, perpendicular to the surface, with the penis stretched.  The needle should be inserted on the side of the penis, away from the urethra that runs in the bottom half of the penis.<\/p>\n

    The second most common cause of penile injections with Trimix not working<\/a> is that the medications lost their potency<\/strong>.  This usually results from improper storage; a medication that should be refrigerated or frozen, if left unrefrigerated overnight, can lose a significant amount of potency.<\/p>\n

    Learn more about penile injection therapy for ED<\/a> and other treatment options.<\/a><\/p>\n

    Where to Get Treatment for ED in NYC?<\/h2>\n

    At New York Urology Specialists, we offer specialized treatment for ED for men<\/strong>. Same-day appointments are available.<\/p>\n

    Call\/text today: 1-646-663-5211<\/span><\/a><\/span> <\/span><\/strong>or <\/span>make an appointment<\/span><\/a> online.  <\/span><\/span><\/strong><\/p>\n

    We treat sexual and erection problems<\/a><\/strong> and offer comprehensive STD testing<\/a><\/strong> for infections.  We treat penile problems in men<\/a><\/strong>, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy<\/strong>, vasectomy reversal, cosmetic circumcision<\/strong><\/a>, circumcision revision<\/a><\/strong>, penile frenuloplasty. We offer confidential<\/strong> appointments.<\/p>\n

    Our prices are ED treatment prices<\/a> are affordable with or without insurance<\/strong>.  Low-cost<\/strong> Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.  We offer free insurance verification<\/strong>.<\/p>\n

    Read Real Stories of Men who Underwent Treatment for ED at New York Urology Specialists.<\/h2>\n

    We offer ED treatment to patients within driving distance to our offices as well as from other states and countries.  Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.<\/p>\n