Tadalafil + Sildenafil ODT
A compounded dissolving tablet containing two PDE5 inhibitors: tadalafil + sildenafil.
Active ingredients: Tadalafil + Sildenafil
From $89 for 6 doses
- 6 doses $89
- 12 doses $139
- 18 doses $179
No membership fee · No clinician fee · Free shipping
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Tadalafil and sildenafil are each established ED medications. This compounded dual-drug product is not FDA-approved.
What it does
Both ingredients work through the same PDE5 pathway. Tadalafil lasts longer; sildenafil has a shorter treatment window. Combining them increases total PDE5-inhibitor exposure rather than creating a new mechanism.
What's in it
Tadalafil
- What it is
- Longer-acting PDE5 inhibitor.
- Hormone?
- Not a hormone.
- Why it's here
- Supports erectile response during sexual stimulation and can provide a longer timing window.
Sildenafil
- What it is
- PDE5 inhibitor.
- Hormone?
- Not a hormone.
- Why it's here
- Improves blood-flow signaling during sexual stimulation.
Why choose this one?
Why choose this one
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.
Why choose another option?
A single-ingredient sildenafil or tadalafil product is simpler and has a clearer standard evidence and safety framework.
Compare your options
Sildenafil vs tadalafil
| Sildenafil (and vardenafil) | Tadalafil | |
|---|---|---|
| Treatment type | PDE5 inhibitor, shorter-acting | PDE5 inhibitor, longer-acting |
| Who it's for | Men | Men |
| Typical use | Taken about an hour before sex | Taken before sex, with a much longer window |
| How long it can work | Several hours | Still effective at 36 hours in a clinical study |
| Food | A large, high-fat meal can delay standard tablets | Absorption not meaningfully affected by food |
| Common side effects | Headache, flushing, indigestion, stuffy nose, vision tint | Headache, indigestion, back pain, muscle aches, flushing |
| Never combine with | Nitrate medicines | Nitrate medicines |
| Price at Avono | From $60 for 6 doses | From $60 for 6 doses |
Duration and food findings come from standard FDA-approved tablets. Compounded dissolving formats were not studied in those trials.
Benefits and evidence
Sildenafil placebo-controlled study
- What the study found
- 74% vs 16%
- Who was studied
- 329 men with erectile dysfunction
- What it means
- In a placebo-controlled sildenafil study, 74% of participants reported improved erections compared with 16% receiving placebo.
- Important context
- Oral sildenafil · Flexible oral dosing · 12 weeks
- Source
- Efficacy and safety of oral sildenafil in the treatment of erectile dysfunction: a double-blind, placebo-controlled study of 329 patients. Sildenafil Study Group International Journal of Clinical Practice, 1998, PMID 9894373
Tadalafil at 24 and 36 hours
- What the study found
- 36 hours
- Who was studied
- 348 men with erectile dysfunction
- What it means
- In a tadalafil 20 mg clinical study, treatment remained effective through the 36-hour assessment period.
- Important context
- Studied tadalafil 20 mg. These results do not automatically apply to compounded combination ODTs. Oral tadalafil · 20 mg · Assessed at about 24 and 36 hours after dosing
- Source
- Efficacy of tadalafil for the treatment of erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial Urology, 2003, PMID 12837435
Sources
- Cialis (tadalafil) prescribing information, DailyMed
- Viagra (sildenafil) prescribing information, DailyMed
- Efficacy of tadalafil for erectile dysfunction at 24 and 36 hours after dosing: a randomized controlled trial. Urology. 2003
- Efficacy and safety of oral sildenafil in erectile dysfunction: a double-blind, placebo-controlled study of 329 patients. Int J Clin Pract. 1998
Common side effects
Headache, flushing, dizziness, indigestion, congestion and blood-pressure lowering. Using two PDE5 inhibitors can increase total exposure and may increase side-effect risk.
What may help
Headache, flushing and a stuffy nose are the most common side effects and are usually mild and short-lived. General measures that may help:
- Stay hydrated, and keep alcohol moderate; heavy drinking makes dizziness and low blood pressure more likely and can itself worsen erections.
- With standard sildenafil tablets, a large or high-fat meal can delay the effect.
- Do not take more than prescribed, and do not combine with other erection medicines.
If side effects bother you, your clinician can review the plan.
Important safety information
Do not add another sildenafil, tadalafil or vardenafil product on your own. Never use with nitrates.
Do not use a PDE5 inhibitor with nitrate medications. The combination can cause a dangerous drop in blood pressure.
PDE5 inhibitors must not be used with nitrate medications because the combination can cause dangerous blood-pressure lowering. Other cardiovascular history, alpha blockers and interacting drugs matter.
Never use with nitrates. Do not independently add other sildenafil/tadalafil/vardenafil products. Compounded dual-drug product, not FDA-approved.
This is a compounded medication. Compounded medications are prepared by licensed pharmacies and are not FDA-approved.
Prescription treatments require evaluation by a licensed clinician and are not appropriate for everyone. Some of these medications can interact with other medications, including nitrates. Compounded formulas are not FDA-approved. Not available in all states.
When to contact your clinician
Contact your clinician about fainting or significant dizziness, especially if you take blood-pressure medicines or alpha-blockers.
When to seek urgent care
Seek emergency care for an erection lasting more than 4 hours, sudden loss of vision in one or both eyes, sudden hearing loss (sometimes with ringing or dizziness), or chest pain during or after sex. Tell responders you took an erection medicine, because nitrates must not be given soon afterwards.
Questions people ask
Can I take two ED medications together?
Do not independently add other sildenafil/tadalafil/vardenafil products. Combination therapy exists only as a specific prescribed product, and it increases total PDE5-inhibitor exposure.
How is tadalafil different from sildenafil?
Duration is the clearest practical difference. Tadalafil usually requires less precise timing because of its longer half-life/duration. Sildenafil is generally used closer to planned sexual activity and has a shorter duration.
Does it increase libido?
No. PDE5 inhibitors are not aphrodisiacs. They do not create sexual desire on their own; they support erectile response during sexual stimulation.
What happens if I use nitrates?
PDE5 inhibitors must not be used with nitrate medications because the combination can cause dangerous blood-pressure lowering. Other cardiovascular history, alpha blockers and interacting drugs matter.
Does tadalafil really last 36 hours?
It can. In a study of tadalafil 20 mg, treatment was still effective at the 36-hour assessment: about 59% of attempts were successful versus 28% with placebo. "Lasting" means the window in which sexual stimulation can lead to an erection. It does not mean an erection lasts 36 hours.
Why does sildenafil sometimes take longer to work?
With standard sildenafil tablets, a large or high-fat meal can slow absorption and delay the effect. How food affects compounded dissolving formats has been studied less. Sexual stimulation is still needed.
Discuss Tadalafil + Sildenafil ODT with a licensed clinician
Your clinician reviews your health history and decides whether this option, or another, is appropriate.
From $89 for 6 doses
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Tadalafil + Sildenafil ODT From $89 for 6 doses