The Caverject "Impulse" System and use together with Viagra/Cialis

[AL SMITH]

After visiting my Uro earlier this week, he prescribed Caverject
Impulse System for me in the 20mcg max dose size.

I had complained to him that my past use of Caverject was halted due,
in part, to the complexity of the mixing process and the need to keep
the solution refrigerated after mixing.

I am seeing prostitutes and need to be able to carry in a syringe that
I can mix easily on the spot for instant use...like in a bathroom of a
motel room etc...or do it in a nearby restroom or in my car (depending
on privacy considerations)

He suggested the relatively new Caverject "Impulse" system that he
showed me in his office. It consists of a prefilled syringe containing
BOTH the freeze dried Caverject (Alprostadil) and a sterile solution.
Twisting the plunger mixes the 2 inside the syringe and it is then
ready for injection! The syringe, prior to being mixed need only be
kept at room temperature range.

My first question to the group is: Has anyone used this method of
preparing and injecting Caverject..I couldn't find much on it here ?

How has it worked for you...is it a major improvement over the old way
of mixing the drug with solution? Or is it really no big deal? I guess
that it would depend on the specific circumstances of use..If it is
at home with your SO, then you just go and get it out of the fridge
and mix it and inject it..if you are "on the road" so to speak..then
this wouldn't be so convenient. I recall having to carry around a
large Thermos with ice in it to keep the drug at the right temperature
until I was ready to inject it.

Sometimes, I had the syringe in my pocket for an extended period of
time, due to some delay in starting the session, and that could have
been why it was less effective..the Caverject got too warm and lost
its efficacy?

My other question is one that I DID find some info on by using the
"search" function..that is the use of BOTH Caverject and Viagra. One
of the points made had to do with the sequence...V first or Caverject
first? The poster said that it was not a good idea to take the V first
and then inject as your dick would be hard and force the blood out the
injection hole or cause a hematoma under the skin...well, with most of
us, I don't think that would be the case!

I don't get a hard erection, or much of one at all, with just Viagra,
without some direct physical stimulation. That wouldn't have taken
place at the point where I would be injecting...my penis would still
be flaccid so I can't see how the "pressurized" penis effect would
happen re blood being forced out the injection hole..maybe I am
missing something here?

To me...I need to take V (and with Cialis this would be a shorter
period) about 45 mins prior to sex to get the right effect..If I did
the Caverject injection even before that, it may run out of its
usefull effective period before I am ready for intercourse!

Lastly, there is the question of dosage? I know EVERYONE IS
DIFFERENT!!!

However, some general guidelines would be useful to me. My first
thought would be to start with lower dosages when using both at the
same time...I have been taking a full 100mg of V alone to minimal
effect on my Performance Anxiety caused ED.

I plan on starting with a 25mg dose of V and a 7.5mcg shot of
Caverject and then going up from there as necessary.

Do those of you with experience in using both simultaneously have any
better suggestions for me?

When I get my Cialis from China, I will substitute perhaps a 10mg dose
of that for the Viagra and see how that combo works.. Has anyone tried
"C+Cav"? If so, any noticable difference than the "V+Cav..." pair?

Al

PS: I recall very well the nut pain caused by Caverject....I was able
to dampen it by taking an Asperin at the time I injected...that seemed
to reduce the discomfort to a very tolerable level. I know "bi-mix" or
"tri-mix" are better in that this side effect is reduced..but those
meds are NOT covered by my Rx insurance plan where Caverject is.

[avocet]

Of all ED therapies/drugs the injectibles carry the most risk of priapism -
an erection that won't go down. By mixing Viagra or Cialis with the
injectible drugs you increase the risk of an event of priapism.

What you might do - since your insurer covers Caverject - is try the Impulse
system on your own and see what kind of reaction you get in terms of
duration. It may be totally adequate and you won't need to add Viagra or
Cialis to the mix.

I've never tried Viagra and TriMix together but I have taken Cialis one day
and injected the next while the Cialis was still active. But I have the
luxury of determining how much TriMix I use for any event and so can lower
the TriMix amount if Cialis is still working in my system. Since the
Caverject Impulse is pre-loaded with a set dosage, you don't have the option
of altering your dose. So learn first how it will work on you, then
consider how you might augment its effect, if necessary.

Jim

Post by AL SMITH
After visiting my Uro earlier this week, he prescribed Caverject
Impulse System for me in the 20mcg max dose size.
I had complained to him that my past use of Caverject was halted due,
in part, to the complexity of the mixing process and the need to keep
the solution refrigerated after mixing.

[AL SMITH]

Avocet:

I wish to correct you on one point..Caverject Impulse does indeed
allow you to alter the exact dosage per your Doctor's recommendation
or to experiment yourself to find the optimum amount. This is done by
turning the plunger until the desired # shows up in the dosage window
on the side of the syringe.

Another misconception re Caverject Impulse, that I noted in another
thread, had to do with the size of the needle prepackaged with
Impulse. The poster just assumed that Pharmacia would utilize a larger
gauge needle than necessary in order to reduce potential litigation
arising out of needle breakage while in the penis. Apparently, this
isn't the case...It is true,however, that you MUST use only this
special needle as it fits the syringe that comes with the kit.

It IS a "Superfine" 29 gauge needle, even smaller than the often used
30 gauge "insulin" needles most users of the Standard Caverject use.

I will be getting my Caverject Impulse Kits from my "mail order"
(actually I use the I'net) Rx insurance company thru Merck-Medco Rx
Drug Services in about 10 days and am looking forward to trying this
new way of injecting this med.

I will take Avocet's advise and try the C'ject on its own first to see
if that is enough to obtain and maintain a satisfactory erection
during intercourse.

If not, THEN, I will try a Viagra or Cialis "Booster"!!

Al

PS: Again, it seems that the ONLY real medical advantage of "Bi-Mix"
or "Tri-Mix" over Caverject is the reduced groin pain that results? If
I wasn't fortunate enough to only have to pay a $20 co-pay for every
3 kits (or a total of 6 syringes = $3.34 per use), then the cost, of
course, would be the other MAJOR advantage of the "MIXES".

Al

Post by avocet
Of all ED therapies/drugs the injectibles carry the most risk of priapism -
an erection that won't go down. By mixing Viagra or Cialis with the
injectible drugs you increase the risk of an event of priapism.
What you might do - since your insurer covers Caverject - is try the Impulse
system on your own and see what kind of reaction you get in terms of
duration. It may be totally adequate and you won't need to add Viagra or
Cialis to the mix.
I've never tried Viagra and TriMix together but I have taken Cialis one day
and injected the next while the Cialis was still active. But I have the
luxury of determining how much TriMix I use for any event and so can lower
the TriMix amount if Cialis is still working in my system. Since the
Caverject Impulse is pre-loaded with a set dosage, you don't have the option
of altering your dose. So learn first how it will work on you, then
consider how you might augment its effect, if necessary.
Jim

Post by AL SMITH
After visiting my Uro earlier this week, he prescribed Caverject
Impulse System for me in the 20mcg max dose size.
I had complained to him that my past use of Caverject was halted due,
in part, to the complexity of the mixing process and the need to keep
the solution refrigerated after mixing.

[avocet]

Al;

Thanks for the correction. I have never seen the system and did not know
that dosage adjustment was a possibility.

Jim

Post by AL SMITH
I wish to correct you on one point..Caverject Impulse does indeed
allow you to alter the exact dosage per your Doctor's recommendation
or to experiment yourself to find the optimum amount. This is done by
turning the plunger until the desired # shows up in the dosage window
on the side of the syringe...

[cliver6]

Post by AL SMITH
After visiting my Uro earlier this week, he prescribed Caverject
Impulse System for me in the 20mcg max dose size.
I had complained to him that my past use of Caverject was halted due,
in part, to the complexity of the mixing process and the need to keep
the solution refrigerated after mixing.
I am seeing prostitutes and need to be able to carry in a syringe that
I can mix easily on the spot for instant use...like in a bathroom of a
motel room etc...or do it in a nearby restroom or in my car (depending
on privacy considerations)
He suggested the relatively new Caverject "Impulse" system that he
showed me in his office. It consists of a prefilled syringe containing
BOTH the freeze dried Caverject (Alprostadil) and a sterile solution.
Twisting the plunger mixes the 2 inside the syringe and it is then
ready for injection! The syringe, prior to being mixed need only be
kept at room temperature range.
My first question to the group is: Has anyone used this method of
preparing and injecting Caverject..I couldn't find much on it here ?
How has it worked for you...is it a major improvement over the old way
of mixing the drug with solution? Or is it really no big deal? I guess
that it would depend on the specific circumstances of use..If it is
at home with your SO, then you just go and get it out of the fridge
and mix it and inject it..if you are "on the road" so to speak..then
this wouldn't be so convenient. I recall having to carry around a
large Thermos with ice in it to keep the drug at the right temperature
until I was ready to inject it.
Sometimes, I had the syringe in my pocket for an extended period of
time, due to some delay in starting the session, and that could have
been why it was less effective..the Caverject got too warm and lost
its efficacy?
My other question is one that I DID find some info on by using the
"search" function..that is the use of BOTH Caverject and Viagra. One
of the points made had to do with the sequence...V first or Caverject
first? The poster said that it was not a good idea to take the V first
and then inject as your dick would be hard and force the blood out the
injection hole or cause a hematoma under the skin...well, with most of
us, I don't think that would be the case!
I don't get a hard erection, or much of one at all, with just Viagra,
without some direct physical stimulation. That wouldn't have taken
place at the point where I would be injecting...my penis would still
be flaccid so I can't see how the "pressurized" penis effect would
happen re blood being forced out the injection hole..maybe I am
missing something here?
To me...I need to take V (and with Cialis this would be a shorter
period) about 45 mins prior to sex to get the right effect..If I did
the Caverject injection even before that, it may run out of its
usefull effective period before I am ready for intercourse!
Lastly, there is the question of dosage? I know EVERYONE IS
DIFFERENT!!!
However, some general guidelines would be useful to me. My first
thought would be to start with lower dosages when using both at the
same time...I have been taking a full 100mg of V alone to minimal
effect on my Performance Anxiety caused ED.
I plan on starting with a 25mg dose of V and a 7.5mcg shot of
Caverject and then going up from there as necessary.
Do those of you with experience in using both simultaneously have any
better suggestions for me?
When I get my Cialis from China, I will substitute perhaps a 10mg dose
of that for the Viagra and see how that combo works.. Has anyone tried
"C+Cav"? If so, any noticable difference than the "V+Cav..." pair?
Al
PS: I recall very well the nut pain caused by Caverject....I was able
to dampen it by taking an Asperin at the time I injected...that seemed
to reduce the discomfort to a very tolerable level. I know "bi-mix" or
"tri-mix" are better in that this side effect is reduced..but those
meds are NOT covered by my Rx insurance plan where Caverject is.

I start out with 100 mg sildenafil (generic V), and if my erection begins to
weaken, use the alprostadil (generic Caverject). I have not had any
problems.

Incidentally, Caverject and alprostadil both consist of prostaglandin E1
(the active ingredient) mixed with biostatic water.

Cliver6