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    • Treatment for Priaprism Caused by Trimix: PHENYLEPHRINE HCL INJECTION

      Priapism is a medical condition in which the erect penis does not return to its flaccid state, despite the absence of both physical and psychological stimulation, within four hours. Improper dosing of Trimix can cause priapism. Phenylephrine injections can be an antidote to an erection that would not come down after 4 hours. Prolonged erections can cause fibrosis and long term erectile dysfunction.


      Indications/Dosage:
      For treatment of ischaemic priapism: Phenylephrine is currently the drug of choice due to its high selectivity for the alpha-1-adrenergic receptor, without concomitant beta-mediated inotropic and chronotropic cardiac effects.

      Phenylephrine use has potential cardiovascular side-effects and it is recommended that blood pressure and pulse are monitored every 15 minutes for an hour after the injection. This is particularly important in older men with existing cardiovascular diseases.
      Administration:
      Intracavernosal Route:

      Inject 1mg (1mL) of Phenylephrine HCl 0.1% into the penis every 3-5 minutes until detumescence occurs for up to one hour. After injection, the puncture site should be compressed and the corpora cavernosa massaged to facilitate drug distribution. Smaller volumes should be used in children and patient with severe cardiovascular disease.

      Where to buy it by prescription: https://www.empowerpharmacy.com/drug...injection.html

      Priapism: Current Updates in Clinical Management

      This article was originally published in forum thread: Treatment for Priaprism Caused by Trimix: PHENYLEPHRINE HCL INJECTION
      Comments 24 Comments
      1. DaveK22's Avatar
        DaveK22 -
        On a few occasions I have taken Sudafed when using my Trimix. Mainly its been preventative when I'm down to 1/2 to 3/4 erections after 3 hrs or so.However, I've noticed a few times that it disrupts my sleep. Last night I fell asleep for 2 hrs after taking sudafed, then woke up & couldn't fall back asleep. I took 4 x 30mg pills which may have been too much?

        Question...is there an alternative to Sudafed which may have little or lesser effect on sleep?

        Thanks in advance.

        PS I know I can lower my dose but I have Super Trimix and a difference of only .01 ml can have a big swing. For me, .03 is a ~ 2 hr erection but sometimes hard to tell exactly where the plunger is. .04 ml is closer to 3-3.5 hr.
      1. Nelson Vergel's Avatar
        Nelson Vergel -
        The post above is an alternative to Sudafed.

        Also, poppers can kill an erection pretty well (in certain cases)

        https://en.wikipedia.org/wiki/Poppers
      1. nuna ya's Avatar
        nuna ya -
        Trimx is scary stuff Attachment 3073
      1. KennyT's Avatar
        KennyT -
        I will NEVER recommend Trimix to Anyone. I'm living proof that it can destroy your manhood. AND I did use the recommended dose my doctor prescribed. It was horrible.
      1. Gamnc's Avatar
        Gamnc -
        From what I read on "poppers" they are a Nitrite compound. What does the use of this for priapism have on blood pressure? I bought Sudafed and have not had to use it yet. For me after ejaculation I seem to relax within 15 mins. not sure if this is normal, or if I am just on the edge of the right dose.
      1. riverside's Avatar
        riverside -
        Has anyone self administered with Phelylephrine as mentioned here? I haven't found any threads where someone says that they have. The question I have is needle size - I am hoping that I could use my 30 gauge 1ml insulin syringe to inject into my erect penis with 1ml every 5 mins?

        120mg of Sudanese does nothing for me. Running, squatting, ice, cold showers..etc all do nothing too. I am hoping this helps.
      1. Mark92's Avatar
        Mark92 -
        wow this is scary
      1. wizmike's Avatar
        wizmike -
        I have, I actually save my Insulin pin used for TriMix injection, just in case I have to inject Phelylephrine. I keep Phelylephrine on hand because my first Trimix inject landed me in the ER with a 6 hour erection. I don't want to go through that again, but triMix has been a life saver. I have adjusted the dose and don't normaly have an issue
        Quote Originally Posted by riverside View Post
        Has anyone self administered with Phelylephrine as mentioned here? I haven't found any threads where someone says that they have. The question I have is needle size - I am hoping that I could use my 30 gauge 1ml insulin syringe to inject into my erect penis with 1ml every 5 mins?

        120mg of Sudanese does nothing for me. Running, squatting, ice, cold showers..etc all do nothing too. I am hoping this helps.
      1. rhino5169's Avatar
        rhino5169 -
        Any more info on the Phenylephrine injection and if it definitely works and how long until it takes effect? Also how does it compare with a phenylephrine spray?
        The spray would be a much easier way to use, but is it as effective?
      1. looyvillelarry's Avatar
        looyvillelarry -
        I can tell you this, this is what the urologist administered when I had a priapism. I can't tell the dosage, but it was this injection.
      1. Neil's Avatar
        Neil -
        Hi Larry, am I understand that they have to inject 1ml? That's a pretty huge shot for a penis! Did you see that sort of volume in the shot the urologist game you? How quickly did it work?
      1. looyvillelarry's Avatar
        looyvillelarry -
        Quote Originally Posted by Neil View Post
        Hi Larry, am I understand that they have to inject 1ml? That's a pretty huge shot for a penis! Did you see that sort of volume in the shot the urologist game you? How quickly did it work?
        Ok, I'm just going to give some fair warning here. The following is for mature audiences lol
        This was not a fun thing. Sure, I used to laugh at the V commercials "..if you have an erection that lasts more than 4 hours".

        The treatment was brutal, as it was an irrigation. In this case, a butterfly ( think 27g or perhaps larger) was inserted on BOTH sides, and a diluted mixture of phenylephrine and saline, 1ml at a time. He would fill it up, massage it (I mentioned that he had a career in non-anesthetic dentistry if this didn't work out) , and drain it out the opposite side.

        This process took an hour. Keep in mind, this was around the 7 hour mark, so he was wanting to get that blood out at that point.

        Surprisingly, once detumescence occurred, there wasn't a lot of pain afterwards.

        I don't know how those volumes could be handled. 1ml every 5 min ? That is a LOT in vessel that is already swollen to maximum capacity.

        I tried sudafed, and plan on having poppers on hand. I will also be speaking with my physician on this on Monday.

        Trimix isn't a "first line" approach. But for guys that have had ED for a long time, without other things working, I will tell you, this is amazing. I don't know that I've had an erection THAT hard in decades.

        https://www.excelmale.com/showthread.php?13378-First-Trimix-Injection-Met-my-Deductible-for-the-year&p=96674&viewfull=1#post96674
      1. EAH's Avatar
        EAH -
        A little more Phenylephrine info.

        I spoke to Dr. Caulkin @ Defy & he recommended starting with
        @ .5ml of Phenylephrine instead of a full ml for priapism in people with certain heart conditions.
        In my case a heart murmur. (Mitral valve regurgitation)

        I have not needed to use trimix yet as my N.O. Stack
        with daily cialis is usually effective, but I am prepared just in case.
      1. Neil's Avatar
        Neil -
        Thank you Larry, this is all info we need to hear. Very sorry you had to go through that, it sounds like a very bad dream. That .125 dose sounds like a triple or quadruple overdose for you, as your new starting dose would probably be .04 or .03?? That it took a full hour to resolve in the ER with all that stuff he was doing to you is incredible.

        EAH, solid info. I also have a heart history as well, no doubt this would be what I would also have to follow. Thank you.
      1. Nelson Vergel's Avatar
        Nelson Vergel -
        Quote Originally Posted by rhino5169 View Post
        Any more info on the Phenylephrine injection and if it definitely works and how long until it takes effect? Also how does it compare with a phenylephrine spray?
        The spray would be a much easier way to use, but is it as effective?
        Spray does not provide enough dose. Please, guys, I suggest that you read this long post. It concerns me that most of you do not know the basics even on this site that is the main Trimix info on the internet.

        Penis Injections for Hard Erections: TRIMIX

      1. EAH's Avatar
        EAH -
        Quote Originally Posted by Nelson Vergel View Post
        0.5 cc is too much for many men. Start at 0.1 cc and do not inject again for at least 8 hours if that dose is not enough.
        half cc of Phenylpherine
        I should have bolded this line.

        Originally Posted by EAH
        A little more Phenylephrine info.
        I spoke to Dr. Caulkin @ Defy & he recommended starting
        @ .5ml instead of a full ml for people with certain heart conditions.
        In my case a heart murmur. (Mitral valve regurgitation)

        I have not needed to use trimix yet as my N.O. Stack
        with daily cialis is usually effective, but I am prepared just in case.

        I have edited the original post to make it more clear.
      1. Neil's Avatar
        Neil -
        EAH, I understood you perfectly.
      1. EAH's Avatar
        EAH -
        Quote Originally Posted by Neil View Post
        EAH, I understood you perfectly.
        Thanks man that is a relief. Wouldnt want to steer anyone wrong.
        Good luck!
      1. TH's Avatar
        TH -
        63 yo here. Previous usage of Cialis resulted in moderate anaphylactic reaction. Four days ago, urologist had me try Tri-Mix 20 units (0.2 ml) with instructions to call if still tumescent after 3 hours. 120 mg. (real) Sudafed did nothing. Went to ER at a different medical facility. Ten consecutive injections of Pheneylepherine (5 min apart-all on right side) did nothing. Urologist resident then inserted 18 gauge needle with big blue plastic tab on right side. Four times he aspirated/irrigated/aspirated. Between each of these he injected another 3 doses of Pheneylepherine. After each aspiration, I fully tumesced again. He finally decided to go get the senior urologist to insert a shunt. I was left waiting on the gurney for 75 min., as the senior urologist was with other patients. Being alone and able to relax apparently allowed my stress level and heart rate to drop and after an hour I detumesced. When the senior urologist finally arrived, he stated that was a good thing as the shunt he was going to install would have caused permanent and irreversible ED. I am caucasian, but entire penis and scrotum (sans glans) are solid black from hematoma. Surprisingly, there is no pain or tenderness.

        I do plan to try again, but will insist urologist begin with far smaller dose and have treatments for priapism on hand. I will post updates.
      1. looyvillelarry's Avatar
        looyvillelarry -
        Quote Originally Posted by TH View Post
        63 yo here. Previous usage of Cialis resulted in moderate anaphylactic reaction. Four days ago, urologist had me try Tri-Mix 20 units (0.2 ml) with instructions to call if still tumescent after 3 hours. 120 mg. (real) Sudafed did nothing. Went to ER at a different medical facility. Ten consecutive injections of Pheneylepherine (5 min apart-all on right side) did nothing. Urologist resident then inserted 18 gauge needle with big blue plastic tab on right side. Four times he aspirated/irrigated/aspirated. Between each of these he injected another 3 doses of Pheneylepherine. After each aspiration, I fully tumesced again. He finally decided to go get the senior urologist to insert a shunt. I was left waiting on the gurney for 75 min., as the senior urologist was with other patients. Being alone and able to relax apparently allowed my stress level and heart rate to drop and after an hour I detumesced. When the senior urologist finally arrived, he stated that was a good thing as the shunt he was going to install would have caused permanent and irreversible ED. I am caucasian, but entire penis and scrotum (sans glans) are solid black from hematoma. Surprisingly, there is no pain or tenderness.

        I do plan to try again, but will insist urologist begin with far smaller dose and have treatments for priapism on hand. I will post updates.
        So sorry to hear your experience, it sounds much like mine. 20 units ( I suppose it depends on the strength ) is an awful lot to start with. I know what you went through, and it is even less fun that it sounds.

        Just take charge is what I've learned. If he balks, ask him if there is a medical reason for not starting lower ( 5 units ) ? If not, lets do that. If he disagrees, maybe time for a second opinion.
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