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 · As needed, 20–30 min before
Sexual healthCombinationCompounded
Vardenafil with apomorphine 6 mg, as a capsule or a strawberry troche, taken 20 to 30 minutes 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.
(vardenafil + apomorphine)
Vardenafil improves blood flow; apomorphine adds a signal from the brain. Apomorphine acts on dopamine receptors in the brain that help start an erection, so it adds a central push to the local effect of the PDE5 inhibitor. It commonly causes nausea, yawning, dizziness or drowsiness; do not drive until you know how it affects you.
20-30 min
typical time to take it before sex
Compounded combination; no trials of this exact product.
Men who respond to vardenafil and want help with arousal.
Vardenafil with apomorphine, in three strengths.
Never with ondansetron.
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 20 to 30 minutes 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.
Both ingredients have trial evidence alone for erectile dysfunction; together they act at two levels.
Expect possible nausea, headache and flushing; never combine with nitrates.
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. Apomorphine adds nausea, yawning, dizziness and drowsiness; avoid driving until you know how you react.

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.

Vardenafil and apomorphine 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, as needed, 20–30 min before. The starting prescription is one troche (17.5 mg / 3 mg) each time. Your physician sets your own dose and it is printed on your label.
The pharmacy carries 3: 17.5 mg / 3 mg Troche, 25 mg / 6 mg Capsule, 40 mg / 6 mg Troche. Your physician chooses which one you get.
Vardenafil, Apomorphine.
8 troches at the starting strength, shipped to your door from a licensed US pharmacy.
Keep it light. Alcohol adds to the dizziness from apomorphine and the blood pressure drop from vardenafil.
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.
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
from $159/mo
Topical cream for female sexual arousal and pleasure. Contains oxytocin, theophylline, arginine, and sildenafil for enhanced sensation and response.
Cream
from $189/mo
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, 2002Apomorphine SL for erectile dysfunction: randomized, placebo-controlled trials.
Urology, 2000Vardenafil + Apomorphinefrom $79/mo