Apomorphine / Sildenafil / Tadalafil / Vardenafil Troches
Quad-mix troche combining three PDE5 inhibitors with apomorphine dopamine agonist for maximum potency and comprehensive mechanism.
Troche
from $79/mo
Dissolved under the tongue · Once a day
Sexual healthErectile dysfunctionDissolving tablet
Orally disintegrating tadalafil tablets: low strengths taken once daily for steady readiness, or higher strengths as needed before sex.
Disclaimer: Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.
(ta-DA-la-fil)
At 6.5 mg once daily, tadalafil keeps a steady level so you can respond whenever the moment comes. At 11.5 to 22.5 mg it is taken as needed before sex.
Daily
low-dose tadalafil removes the need to plan
Daily 5 mg is also FDA-approved for enlarged prostate symptoms (as the brand product).
Men who want tadalafil's long window without swallowing a pill.
Dissolving tablets in several strengths, including a daily one.
The as-needed and the daily strengths are different plans. Follow your label.
when aroused, with a reliable response
you know when it starts and how long it lasts
less performance worry, more presence
dose and form adjusted to you
Day 1
A US-licensed physician reviews your health, medications (especially nitrates and blood pressure drugs) and goals, and chooses the dose and form.
1First doses
Take it 30 minutes to 2 hours before intimacy, on a light stomach. Arousal is still needed; the medicine helps the response, it does not create it.
2Week 2
You know how your body responds. Timing, dose and food effects are clear, and confidence builds.
3Month 1
Check-in with your physician: the dose is adjusted up or down, or the form is changed, based on your response and side effects.
4Beyond
It works for as long as you use it. Your physician reviews your health at least yearly, including blood pressure and heart health.
5Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
A sample week
Once a day
Trials of once-daily tadalafil show improved erectile function and spontaneity, and relief of lower urinary tract symptoms in men with an enlarged prostate.
The ODT is a compounded delivery form; your physician chooses the strength and schedule.
Learn morePDE5 inhibitors are generally well tolerated. Common effects are flushing, headache, nasal congestion, indigestion and, with sildenafil, a temporary blue tint to vision. CRITICAL: never combine with nitrates or poppers (dangerous drop in blood pressure). Use with care alongside alpha-blockers. Seek emergency care for an erection lasting more than 4 hours, sudden vision or hearing loss, or chest pain. Tell your physician about heart disease, low blood pressure, liver or kidney problems and retinal disease before starting.

1.Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.

2.Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.

3.Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.

Tadalafil ODT educational content reviewed by our physician
Scott Nass, MDDoctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Dissolved under the tongue, once a day. The starting prescription is one tablet (6.5 mg) each time. Your physician sets your own dose and it is printed on your label.
The pharmacy carries 5: 6.5 mg Dissolving Tablet, 11.5 mg Dissolving Tablet, 20 mg Dissolving Tablet, 20.5 mg Dissolving Tablet, 22.5 mg Dissolving Tablet. Your physician chooses which one you get.
30 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
Daily suits men who are intimate often or want spontaneity; as needed suits occasional use. Both are safe with a physician's review.
Never with nitrates (nitroglycerin, isosorbide) or recreational poppers: the combination can drop blood pressure dangerously. Tell your physician about alpha-blockers, blood pressure medicines, antifungals and HIV medicines, which change how the drug is processed.
Arousal is still required, and a heavy or fatty meal can delay absorption. Most men need two or three attempts at a given dose before judging it. If it still falls short, your physician adjusts the dose or the formulation.
An erection lasting more than 4 hours, sudden loss of vision or hearing, chest pain or fainting need immediate care. Stop the medication and go to the emergency room.
Compounded troches, capsules and ODTs contain the same active ingredient, prepared by a US-licensed pharmacy, but they have not gone through FDA review as a finished product. Your physician chooses the form that fits how you want to use it.
Quad-mix troche combining three PDE5 inhibitors with apomorphine dopamine agonist for maximum potency and comprehensive mechanism.
Troche
from $79/mo
Combination of papaverine and phentolamine for intracavernosal injection. Vasodilator mix for erectile dysfunction. Priapism risk and rescue requirements.
Injection
from $171/mo
Topical cream for female sexual enhancement and orgasm support. Combination of arginine, ergoloid, pentoxifylline, sildenafil, and theophylline.
Cream
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Topical cream for female sexual arousal and pleasure. Contains oxytocin, theophylline, arginine, and sildenafil for enhanced sensation and response.
Cream
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The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Individual results vary.
Sildenafil citrate for erectile dysfunction: a systematic review of randomized controlled trials.
Arch Intern Med, 2002Tadalafil 5 mg once daily for erectile dysfunction: pooled analysis of randomized trials.
Transl Androl Urol, 2020Tadalafil ODTfrom $89/mo