BIMIX QUESTION

My uro has decided it would be a good idea for me to try some BIMIX.  They require a minimum of two office visits to confirm how well it works, make sure the dosage is right and teach you how to give yourself the shots. I have already had the first visit.  I was very pleased with the results. 

My question is, how much does BIMIX normally cost. I can't seem to be able to nail down that piece of information.  Any information about cost or anything else to do with the BIMIX would be appreciated.

Hi Wood,

It varies greatly by region and compounding pharmacy

I get a 5ml vial delivered packed in ice packs of Trimix for $64, 90 day expiration if kept refrigerated

Bimix is a relatively cheap option, so three times a week will not break the bank. Of course a lot depends on what dose you need, and you don't know that until you have done some trials.

My bimix had a nominal life of three months, but I found that my last batch kept refrigerated was still going well at nine months. To avoid contamination as much as possible, I would prepare 10 syringes at a time, and so avoid diving into the vial for every jab.

If you get erratic results, I strongly recommend some constriction at the time of injection and a few minutes after. I used a few office rubber bands doubled over and wrapped around the base -- there are equivalents.

Others in this forum have recommended a little pump-up beforehand, but I found that did nothing for me.

The vial is sealed with a metal ring that contains a rubber disk in the center, which is self sealing when inserting a needle into it. You just have to make sure that you clean the rubber disk properly with alcohol before each needle insertion, along with wiping the needles, even brand new one, with the alcohol. The rubber seal wil continue to reseal each puncture.

Corvetteman:
I found difficulty in exactly measuring the 0.2ml dose I was on, so preferred to do a bunch when I was wide awake and had good light. And I figured, (without any proof whatsoever!) that up to 10 vial insertions in sequence was cleaner than 10 insertions on separate occasions.

I used a special draw-up needle which is extra long and much coarser -- don't know if this is general practise. I did the draw, pulled the needle with syringe out of the vial, then replaced the draw-up needle on the syringe with the the real needle. I wanted the real needle to stay as sharp as possible, so avoided using it to puncture the seal on the vial. Then fitted the same draw-up needle to a fresh syringe and repeated.

And no, I never did screw up and use the draw-up needle for an actual injection

Mr Gimpy:
My syringes were of the type that had a screw-in needle. It would have been possible to leave the draw-up needle inserted in the vial and just screw in each new syringe, but again I found it easier to remove the syringe completely from the vial to unscrew the needle, using the needle's protective cap.

Piano, the thing that pops into my mind when reading your description of using screw off needles is the idea of the end of the needle, hence the inside of the vial and it's contents being exposed to room air and any 'unsterile' conditions while you are drawing up the drug , then making the transfer from big needle to putting on the smaller needle. It may well be a sterile fieled throughout, but I can't picture it. I imagine these little micro-bugs diving into the open end of the draw up syringe and into the vial, or into the to be used syringe.

James:
I agree that leaving the large needle poked into the vial without a syringe body attached is a potential source of contamination, which is another reason not to do it. As I mentioned above, I didn't do it because of the difficulty of unscrewing the syringe body from draw-up needle, which being in the vial, could not have its cap/wrench attached.

And as you say, there is the exposure to air of syringe and contents while you are changing needles.

Even with a one-piece syringe I can still image those little buggies diving into the end of the needle after you have withdrawn it from the vial

We will never have completely sterile conditions, so all we can do is our best, and not leave things uncapped or open for any longer than necessary. I survived!

Hi Piano,

Thanks for the detailed how to. Do you notice any diff when a needle did not lose its sharpness by being inserted into the vial ?

Mr Gimpy:

The tops on my vials were quite tough, and on the one or two occasions I used a fine needle for the draw, it was a struggle, and the needle bent somewhat. I never did use that needle for the injection, so can't comment on the sharpness.

There must be a scientific way of measuring needle sharpness without sticking it you know where. E.g., measure the force necessary to poke it through a vial top.