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SEXUAL HEALTH
Compare sildenafil, tadalafil and vardenafil by how long they work, how you take them, what is in each formula and the side effects worth knowing. These medications do not create sexual desire on their own. They help support an erection when sexual stimulation is present.
A shorter-window PDE5 inhibitor commonly used when sex is planned. High-fat meals can delay absorption of standard sildenafil tablets.
A longer-acting PDE5 inhibitor. Standard tadalafil can remain effective for up to 36 hours, giving more flexibility around timing.
Another shorter-window PDE5 inhibitor. It works through the same basic mechanism but has its own dosing, interaction and heart-rhythm considerations.
Some compounded products add another ingredient or combine two PDE5 inhibitors. More ingredients does not automatically mean better. The reason for the combination and the added risks should be clear.
Active ingredients: Sildenafil + Pycnogenol
A dissolving compounded tablet pairing sildenafil with Pycnogenol, a pine-bark extract.
Why choose it
For men who want a shorter, planned ED treatment window and prefer a dissolving format.
From $60 for 6 doses
No membership fee · No clinician fee · Free shipping
Active ingredients: Tadalafil + Pycnogenol
A dissolving compounded tablet pairing longer-acting tadalafil with Pycnogenol.
Why choose it
For men who want a wider timing window and prefer a dissolving format.
From $60 for 6 doses
No membership fee · No clinician fee · Free shipping
Active ingredients: Tadalafil + Sildenafil
A compounded dissolving tablet containing two PDE5 inhibitors: tadalafil + sildenafil.
Why choose it
This is a more complex option that may be discussed when a clinician believes a single PDE5 inhibitor has not provided the desired response. It should not be presented as the default starting choice.
From $89 for 6 doses
No membership fee · No clinician fee · Free shipping
Active ingredients: Tadalafil
A single-ingredient, longer-acting ED tablet with a treatment window of up to 36 hours in standard clinical use.
Why choose it
For men who want more flexibility around timing and a simple single-ingredient tablet.
$99
No membership fee · No clinician fee · Free shipping
Active ingredients: Vardenafil
A compounded dissolving form of vardenafil, another shorter-window PDE5 inhibitor.
Why choose it
For men who want an alternative to sildenafil or tadalafil or prefer a dissolving troche.
$149
No membership fee · No clinician fee · Free shipping
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HOW TO CHOOSE
Sildenafil and vardenafil are usually taken about an hour before sex and work for several hours. A good fit if you prefer to plan.
Tadalafil was still effective 36 hours after a dose in a clinical study, so timing matters less. A good fit if you prefer flexibility.
Sildenafil or tadalafil? Both are PDE5 inhibitors that support erections during sexual stimulation. The practical difference is duration. In one study of tadalafil 20 mg, about 59% of attempts were successful at 36 hours versus 28% with placebo. In a placebo-controlled sildenafil study, 74% of men reported improved erections versus 16% with placebo.
Tablet or dissolving? Standard tablets are swallowed. Dissolving tablets (ODT) and troches dissolve in the mouth, which some people find easier. How they perform has been studied less than standard tablets.
One medicine or a combination? Single medicines are the usual starting point and make side effects easier to attribute. Combination products add a second ingredient, such as Pycnogenol or a second PDE5 inhibitor, and are sometimes discussed after an incomplete response.
What is established. The effects of sildenafil, tadalafil and vardenafil are well established in trials of standard products. Compounded combinations and dissolving formats were not themselves studied in those trials.
Safety for all options. None of these can be used with nitrate medicines. Seek emergency care for an erection lasting more than 4 hours or sudden vision or hearing loss.
Sources: Tadalafil 36-hour study (Urology 2003); Sildenafil study (Int J Clin Pract 1998).
Typically used for a shorter planned window around sexual activity. Food can affect onset for standard oral sildenafil.
Longer duration gives more scheduling flexibility and can remain effective for up to roughly 36 hours in FDA-approved tablet use.
Another PDE5 inhibitor with a shorter planned window, broadly similar to sildenafil but with its own dosing and interaction profile.
Compounded formulas may combine a PDE5 inhibitor with Pycnogenol or combine tadalafil + sildenafil. These are not FDA-approved combinations and may increase side-effect complexity.
HOW IT WORKS
THE RESEARCH
Research on the medicines behind these treatments, including exactly what was studied. Study results describe the products and doses tested. They are not a prediction for any one person or for a compounded formulation.
PDE5 inhibitors can cause headache, flushing, nasal congestion, indigestion, dizziness and visual symptoms. They must not be used with nitrates because of dangerous blood-pressure lowering. Serious but uncommon risks include priapism and sudden vision or hearing changes.
FIND YOUR OPTIONS
Answer three quick questions and we'll narrow the options by timing, format and formula. A clinician decides what is medically appropriate.
These results are based on the preferences you selected, not a diagnosis or prescription.
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Active ingredients: Sildenafil + Pycnogenol
A dissolving compounded tablet pairing sildenafil with Pycnogenol, a pine-bark extract.
Why choose it
For men who want a shorter, planned ED treatment window and prefer a dissolving format.
From $60 for 6 doses
No membership fee · No clinician fee · Free shipping
Active ingredients: Tadalafil + Pycnogenol
A dissolving compounded tablet pairing longer-acting tadalafil with Pycnogenol.
Why choose it
For men who want a wider timing window and prefer a dissolving format.
From $60 for 6 doses
No membership fee · No clinician fee · Free shipping
Active ingredients: Tadalafil + Sildenafil
A compounded dissolving tablet containing two PDE5 inhibitors: tadalafil + sildenafil.
Why choose it
This is a more complex option that may be discussed when a clinician believes a single PDE5 inhibitor has not provided the desired response. It should not be presented as the default starting choice.
From $89 for 6 doses
No membership fee · No clinician fee · Free shipping
Active ingredients: Tadalafil
A single-ingredient, longer-acting ED tablet with a treatment window of up to 36 hours in standard clinical use.
Why choose it
For men who want more flexibility around timing and a simple single-ingredient tablet.
$99
No membership fee · No clinician fee · Free shipping
Active ingredients: Vardenafil
A compounded dissolving form of vardenafil, another shorter-window PDE5 inhibitor.
Why choose it
For men who want an alternative to sildenafil or tadalafil or prefer a dissolving troche.
$149
No membership fee · No clinician fee · Free shipping
Care & Safety
Some peptides and weight loss compounds are sold online with a “research use only” label. Here is what that label means, and how prescription care is different.
Care & Safety
Compounded medications are prepared by licensed pharmacies for individual prescriptions. They are not FDA-approved. Here is what that means in practice.
Weight Management
Both are used in clinician-guided weight management. One acts on one receptor, the other on two. A plain-language overview.
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