Dissolvable combination troches
A compounded dissolvable troche, such as sildenafil with tadalafil or a daily tadalafil option, that melts in the mouth and is prescribed through Medlly when a licensed provider decides it is clinically appropriate.
Oral troche / ODT (6 or 12 pack) · A compounded dissolvable troche or orally disintegrating tablet combining ingredients selected by your provider: typically sildenafil with tadalafil, with or without apomorphine; or silodosin with tadalafil; or low-dose tadalafil alone for daily use. This is a compounded preparation made by a licensed compounding pharmacy; it is not a brand-name product, and compounded drugs are not FDA-approved or evaluated by the FDA for safety, efficacy, or quality.
Compounded and prescribed only if appropriate. Provider review and discreet shipping included.
Compounded dissolvable troche or orally disintegrating formulation prepared by a licensed compounding pharmacy; compounded drugs are not FDA-approved or evaluated by the FDA for safety, efficacy, or quality, and this is not a brand-name product.
A licensed provider decides if it’s appropriate. A consultation doesn’t guarantee a prescription.
More than a prescription
Care, not just a refill
- Visits with a U.S.-licensed provider
- Your compounded medication, if prescribed
- Lab orders and review when clinically needed
- Unlimited messaging with your care team
- Free, discreet shipping
- Pause or cancel anytime
How it works
What it is and how it works
The science
Each troche dissolves slowly in the mouth, and some of the active ingredient may be absorbed across the lining of the mouth while the rest is swallowed. How much is absorbed this way, and whether it offers any advantage over a swallowed pill, has not been established or evaluated by the FDA for these compounded formulations. The PDE5 inhibitors in the formula, sildenafil and tadalafil, block the PDE5 enzyme. During arousal, nitric oxide raises a signaling molecule called cGMP that relaxes smooth muscle and supports blood flow into the penis; PDE5 normally breaks cGMP down, so blocking it helps cGMP build up. Pairing a shorter-acting molecule with a longer-acting one is meant to balance onset and duration. Some troches add apomorphine, which works centrally in the brain on dopamine pathways involved in arousal, or silodosin, which relaxes smooth muscle in the prostate and urethra. A low-dose daily tadalafil troche is taken every day rather than before activity. Sexual stimulation is still needed, and individual results vary.
Taking it
Oral troche / ODT (6 or 12 pack)
Place one troche in your mouth, typically between the cheek and gum or under the tongue, and let it dissolve fully rather than chewing or swallowing it whole; avoid eating or drinking while it dissolves. As-needed troches are generally used before sexual activity and not more than once in 24 hours, while a daily tadalafil troche is taken at about the same time each day. Follow your provider's exact timing and dosing instructions, as these vary by formula.
Common side effects
Most side effects are mild and tend to ease as your body adjusts. This isn’t a complete list. Your provider reviews the full picture with you and what to watch for.
- Headache
- Flushing
- Nasal congestion
- Back pain or muscle aches
- Indigestion or dizziness
- Mouth or throat irritation where the troche dissolves; nausea or changes in ejaculation may occur depending on the formula
- Erection lasting more than 4 hours (priapism); seek emergency care
Important safety information
This compounded dissolvable troche is prescription-only and is not right for everyone; it is prepared by a licensed compounding pharmacy, and compounded drugs are not FDA-approved or evaluated by the FDA for safety, efficacy, or quality. It is not a brand-name product. A licensed provider decides whether it is clinically appropriate for you, and a consultation does not guarantee a prescription. Do NOT use this medication if you take any nitrate medication (such as nitroglycerin or isosorbide) or the drug riociguat, because the combination can cause a sudden, dangerous, and potentially life-threatening drop in blood pressure. Tell your provider about all medications and conditions, especially alpha-blockers and other blood-pressure drugs, heart disease, recent heart attack or stroke, uncontrolled high or very low blood pressure, irregular heartbeat, liver or kidney problems, a history of priapism, sickle cell or other blood-cell disorders, bleeding disorders, stomach ulcers, retinitis pigmentosa, or prior sudden vision loss. Sexual activity can strain the heart; seek emergency care for chest pain, fainting, or severe shortness of breath. Seek immediate medical help for an erection lasting more than 4 hours (priapism), which can cause permanent damage, or for sudden vision loss or sudden decrease or loss of hearing, which may come with ringing in the ears or dizziness. If the formulation contains apomorphine, it can cause nausea, vomiting, dizziness, drowsiness, low blood pressure, and fainting or vasovagal syncope; use caution when standing up or before driving. If it contains silodosin, it can cause lightheadedness when standing (orthostatic hypotension) and commonly changes ejaculation. The troche may cause mild mouth or throat irritation where it dissolves. Limit grapefruit and use alcohol cautiously, as both can increase dizziness and low blood pressure. This medication does not protect against sexually transmitted infections. This information is educational and is not a substitute for advice from a licensed healthcare provider. Individual results vary.
Dissolvable combination troches is available by prescription only and only where a licensed provider determines it’s clinically appropriate. This information is educational and not a substitute for advice from your provider. Individual results vary. If you experience a serious reaction, seek medical care; for emergencies call 911.
Questions
Dissolvable combination troches FAQ
Sexual health
