Sildenafil + Tadalafil + Vardenafil + Apomorphine

Sildenafil 40mg, tadalafil 4mg, vardenafil 7.5mg, and apomorphine 2mg — every PDE5 ingredient plus a dopamine-pathway ingredient, at moderate doses.

• Every PDE5 ingredient
• Plus apomorphine
• Moderate doses throughout
• Dissolves in seconds

Rapid-dissolve tablet · as needed. Your clinician writes your schedule after reviewing your assessment.

• Take about 30–60 minutes before activity, dissolved under the tongue or on it.
• No more than one dose in 24 hours unless your provider says otherwise.
• A heavy, high-fat meal can slow how quickly it starts working.

• Never take with nitrates (nitroglycerin, isosorbide) or riociguat — the combination can cause a dangerous drop in blood pressure.
• Use caution with alpha-blockers and other blood-pressure medications; tell your provider everything you take.
• Common effects include headache, flushing, nasal congestion, indigestion, and dizziness.
• Seek care immediately for an erection lasting more than 4 hours, or any sudden loss of vision or hearing.
• Apomorphine can cause nausea, dizziness, and fainting. Do not combine with anti-nausea drugs in the 5-HT3 class (such as ondansetron) — together they can cause severe low blood pressure.
• Compounded medications are prepared by state-licensed pharmacies for individual patients. They are not FDA-approved, and the FDA does not verify their safety, effectiveness, or quality.