Question: i suffer from ed. i had been taking viagra regularly and had--until March--no difficulty in getting results. Suddenly viagra ceased to work. My PCP prescribed cialis, and it worked for two weeks. He then gave me a prescription for levitra. Same thing. After that, he referred my to a urologist. The urologist whom I saw Thursday put me back on cialis, and said my problem was not waiting long enough. An hour minimum. Well and good. I tried that today. Nothing. In the meantime, I--on my own--had decided to increase intervals between masturbation. I have done nothing since Friday. I have had no ejaculations now for two weeks now. The urologist told me to return to him in a month. I can't believe he expected me to go that long. My thought is to next try levitra, wait a week, and if nothing happens, contact the urologist. What do you think? (The urologist is aware of all the medications I take, ambien, ativan (occasionally) and said they posed no problem. I even cut down on them).

I wrote these words several weeks ago to a prominent urologist. For some reason( unknown) to me our dialogue ended.

Since then I have been able (once Friday) with the aid of Viagra to get a firm erection and ejaculate.

I do not have hypertension, nor have I ever had diabetes.

Thanks. I see my urologist today. I will (as promised many times) let you know the outcome of our discussion. In the meantime, let me once again express my appreciation for your assistance.

Reply and follow-up q to Dr XXXXXXX

Sorry I didn't write sooner. I saw the doctor late Monday. Tuesday was commencement at XXXXXXX where I teach. I see him again tomorrow.

In brief, I suppressed Friday's success story. I wanted to present the circumstances as exigent ones.

I got the caverject 20 mcg, though not over his objections. He (or rather is colleague) first recommended some medication--I'm sure you know the name--that is inserted in the ureatha. But it had drawbacks. What they recommended was something called (I have the prescription in front of me) trimix, but said a pharmacy probably could not fill it. (Every time the XXXXXXX doctor prescribed it, it had to be sent from the manufacturer directly to the office). For some reason, I mistakenly thought that trimix was Caverject, and went to the pharmacy with it. The pharmacist on duty was the one with whom I had spoken. She said: "No this isn't what we discussed. And called the doctor who happened by that time to have left the office. But she gave his assistant all the details.

The doctor called me at nine the next morning. "I'll prescribe this," he said, but I want you to know that it is not nearly as strong as what we had recommended.He was, of course, correct. Caverject is what? the generic name for Alprostadil. But that made no difference to me.

So I went to the pharmacy after commencement and picked up the medication. Two boxes with 2 syringes in each. The directions (given over the phone by the doctor): "Use one injection intracavecrnosally every other day as needed for ED."

But the strength of the drug is 20 mcg/s. Enough, in other words, for one injection a week. Then why do the directions say "every other day?" Because, from what the pharmacist told me, the doctor intends to start off with 2.5 mags. If this doesn't result in an erection, inject again.

Do understand what that means? Remember I am giving this to you second hand.

It seems to me to mean multiple injections. The hope, I take it, is to begin with the lowest possible dosage, and then increase it, if this proves unsucessful.

The internet has a comprehensive video, on how to use Caverject, but the doctor wants to see me tomorrow for a personal demonstration.

Questions; Have you heard of trimix ( I have not misspelled it; I'm looking at the original prescription)?

2.5 mgs.--possible multiple injections for a single erection? There may be something here I have not understood.

I see the doctor tomorrow.

My hope (and belief) is that this will not be necessary. I have not masturbated since Friday. I know...if this is vascular related, that won't make a difference. I feel a need, though.... I just haven't had the time. I'm scrambling to leave for Prague, and then Berlin, next week.


Thanks for your help and please forgive any grammatical or stylistic imperfections due to haste in composition.

Saw the Urologist today and injected 5 mg of Caverject into my penis. I had a firm erection within minutes. I went home and masturbated.
I hope my first injection will be my last. Can Caverject and Viagra (or Cialis) be
combined?

They (my Urologist and his XXXXXXX partner) mentioned the PDS--if things don't improve. But--worst case!--I can use C. and always have the option of increasing the dosage. Five to twenty mis is quite a distance.

You would prefer your patients NOT use C if Viagra works? My problem is (or was)
that sometimes it did, and sometimes it didn't

Once more, thanks for holding my hand during this difficult time.

Thank you. My instructions (admittedly written in haste) say Caverject should be refrigerated. This I believe was meant to apply to Trimixd. Is it true with Caverject?
Will refrigerating it (as I am doing) damage the drug?

Why is Caverject to be used only as a last resort? It's expensive I know. If injected properly it cannot harm the penis.