Caverject and pain

James C. said...
In some reading about injection therepy, I came across the following quote by an ED specialist.  I'm wondering how many men here used Caverject and wheter they had pain, or if the pain lessened.  If they had pain at 3 months, did anyone go back and try again at 6 mt, a year, or 2 years to see if it had lessened?  Id like to hear of your experience with it, pain or no pain, especially if you tried it again later.

"Patients in my clinic who were post radical prostatectomy frequently reported pain in the penis as the injected Edex or Caverject Impulse began to work (about 10 to 20 minutes after injection). This complaint of pain in these patients fits with the hypothesis that pain is caused by activation of pain receptors via the prostaglandin in the time frame following prostatectomy when surgical incisions are still vulnerable to activation of local pain receptors. "

http://www.medscape.com/viewarticle/551563_5  - require free registration to view

James--Yes, I had pain with Caverject--post-injection and for several hours after using it!  The high cost and the pain prompted me to switch to a mix formulated by a compounding pharmacy.  It works without the painful side effects and it's much less expensive. 

I only used it a few times before switching, so I can't report on any longterm changes.  Take care and hang in there...Tim

I am happy to respond to this one. I can say that when I met with my doctor 2 weeks ago to start injection therapy, he used Caverject the first time. The pain was not pleasant, and if I would have been able to have intercourse, it would not have been pleasant either. Before I left the office he wrote a prescription for the Caverject. I also insisted that he write one for bimix as well. I was sure that I would probably never use the Caverject again, but filled the prescription anyway, since insurance covered it after a co-pay. The only time I would use the Caverject is when I am traveling, as the bimix has to be refrigerated. I started with the bimix at .5ml. That gave me everything I needed, but lasted at least 2 hours. I went to .25ml the next time. The effect was still great, and the complete erection process was over in less than 2 hours. The bimix has no pain for me except the initial prick of the needle. If you have an Apothecary near you that can mix it for you, I would really recommend that. I can also say the the cost od 5ml of the bimix was $45. At .5ml per injection that's 10 injections at $4.50 each. At the .25 where I am right now that drops the cost to $2.25 each. The Caverject still cost about $35.00 per injection.

Seems to me like a no-brainer.....bimix for me....with no pain.

Good luck.

From what I have read here of others experience, it seems at least as many men go on to bimix as uses trimix.  Bimix doesn't have the same medicine that Caverject and Trimix has, whihc usually is the one that causes the pain or aching.  If you can get it without lots of expense or such, I'd personally try it to see if it works better.

I'll be discussing the use of injection with my Surgeon next Tuesday. Going in for my 3 year checkup at that point. Cialis and Viagra have not done much for me except give me a back ache or head ache. The pump helps but is really not what I'd like for the future. I'm hoping an injection would give me the erection like the good or days. My girlfriend has been very patient and we have had unassisted intercourse on two or three occasions. But, overall, I still need help.

I'll let you guys know what I find out on Tuesday.

Axe

Axeman, Just remember if he wants you to use the Caverject, try it, but I can't believe the bimix won't work for you. My wife had a smile that lasted 2 days after our ist use of the bimix.

My first injection was done by my urologist's PA in the office. It was Caverjet at what he called a low dosage. Within a couple of minutes after the injection I began getting an ache. It got worse and when he came back in I asked him about it. He said that it did happen to some men but after a few injections it was not so bad. I had to drive home two hours with an erection and a lot of discomfort. He had given me a prescription for Caverjet but I called him the next day and told him that I could not handle the Caverjet. He then called me in a prescription for Bimix which has work well and no pain. It took me a month after the Caverjet experience to try the Bimix. I was three months post op when I had the Caverjet injection. The PA told me that they prefer to try Caverjet first because it has a lower complication rate for priapism and Peyronies then Bimix or Trimix.

Tamu

Hey Axe,

I use Trimix with excellent results. No pain and it is dependable once you get the dose right.

A plus for Trimix is that with the very small dose I use (.02 - .04 cc) and syringes costing 25 cents apiece, my total cost per shot is about 65 cents.

Good luck...

Jim

Urologists who insist on Caverject (including mine) are trying simplify the injection procedure by prescribing the Caverject kit.  The 20mcg kit comes as an already filled syringe that makes it easier to start injections. However for most people the pain is a negative. 

Your doctor either lied to you or showed his ignorance when he said only 1% experienced pain. Tell him to try it himself. The 37% pain figure is probably on the low side.  I have never spoken to a Caverject user who did not have pain at least during the early injections.

My doctor gave me a bunch of free samples of Caverject 20mcg, but when they are gone I will be getting a Rx for bimix. I hope it works. I feel that the maker of Caverject has overpriced their product. With the help of ignorant physicians, they can sell it at about $35 per injection.  The bimix is less than $5 each. 

The prostaglandin appers to be the cause of pain.  When it is eliminated in the bimix, users report far fewer problems.  The Caverject is a pre mixed prostaglandin. The trimix includes prostaglandin E1,papaverine hyrochloride and phentolamine.  The bimix leaves out the prostaglandin.  It is necessary to go to a compounding pharmacist to get the tri or bi mix prescription filled. 

I am 10 months post radical P. Caverject is very painful for me; however, I have not tried it in over 4 months and the trimix just doesn't give me strong enough erection for penetration.  I have considered mixing the trimix with levitra.  What do you think.  This is getting very frustrating.

Axeman, not trying to start an argument, but about the % of patients experiencing pain from Caverject.  I just got my first prescription filled for 40mcg Caverject.  The Patient Instructions for Caverject, packaged inside the box, straight from the manufacturer, therefore a manufacturer printed insert states - quote:

"The most common side effect of CAVERJECT is mild to moderate pain after injection.  about one-third of patients report this effect."

Straight from the horse's mouth.  This statement, combined with the number of members here who report pain from Caverject makes the % well above less than 1% of patients your doctor states.  Of course, the main thing is if it hurts when you take it, so if your Doc. prescribes it, then you will find out if you are a fortunate individual or one of the unlucky ones..lol  I know of only one person here, out of several, who stated they didn't get pain or aching from Caverject.  I hope your experience will be that also. 

The rest of the guys:

One a side note, sometimes you get smiled on, sometimes frowned on.  Today, I got smiled on.  I had talked to a pharmacist over the phone, trying to find one with experience prescribing the powder form of Caverject.  Seems the new guys aren't familiar, so I found a guy who had been practicing since the 50's who knew what I was talking about, as far as powder, reconstituting from dilutent and such.  He ordered a vial of the 40 mcg powder for me, expected cost of $51.00.  I picked it up today, and the vial order was actually 6 vials, cost $331.00.  We ran my insurance just in case, and it accepted payment, less a $30 co-pay.  Plus the dilutent Bacteriostatic water and a pack of 12 1/2 inch, 30 ga, 1cc syringes were included.  Talk about being smiled on.....lol  The Caverject still aches, but I am trying to tough it out, hoping my body will adjust to it.  I keep reminding myself that it's for therepy now, not for pleasure, until I get back to the Doc. the end of March.  I hope I can stay on this until then, then switch to a Bimix. 

I had a bad result from my first attempt, resulting in aching and a 4 hr. erection that required Sudafed to reduce, using 10 mcg/.25 cc alprostadil.  The next time, I tried 5 mcg/.125 cc and got a almost total failure.  I got a little swelling and redness just behind the head, but no erection.  The aching was still there, but reduced and it lasted about 1 1/2 hr. total.  The difference from first to second time was a reduction of 50% strength and a 5/16 inch neeedle rather than a 1/2 inch needle. 

I had RP in 2014. It was non nerve sparing so for me, living in the UK, its Caverject, vacuum pump, non penetrative sex or abstinence!

I started Caverject after 6.5 months. Trial of 2.5mcg produced soft erection and some unpleasant but bearable aching. Nurse said "you will learn to tolerate that", happens to between 1/3 and 1/2 of the men we see here.

I was also prescribed Cialis 5mg per day which was said to possibly be helpful in maintaining penile health / blood supply. I do experience very soft erections especially at night since taking this. I don't know whether the Cialis has any part to play in the Caverject pain but suspect it does not.

Increased dose by 2.5mcg each time. At 10mcg - 12.5mcg the not quite useable erection and increasingly painful aching was lasting about 1hr to 1.5hr.

At 15mcg erection was just useable, ache was really not good and lasting around 2hrs.

At 20mcg erection was great, pain was awful - both lasted 3 hours. predominant pain is aching around the base of penis with some aching in the shaft.

Have backed off to 15mcg but ache and erection now still lasting 3 hours though not so intense.

Sadly for me I live in UK where it's Caverject or nothing. We don't have compounding pharmacies as you do in the States and bimix / trimix is simply not available. Apparently no drug company here is prepared to consider marketing a version - in fact that is also true in the States but you have a way around that.

Vacuum pumps are simply awful to my mind so for the moment I plan to try to continue with the Caverject and hope and pray that the aching does reduce over time, at the moment 1 x pw is about the max I can contemplate the experience which is handy as that is all the NHS will prescribe for me anyway!

Post Edited (Prevail SV10) : 4/6/2015 4:32:11 PM (GMT-6)