Rapid-onset combination vials
A compounded single-dose vial combining familiar molecules, such as sildenafil and tadalafil with or without vardenafil or apomorphine, prescribed through Medlly when a licensed provider decides it is clinically appropriate.
Single-dose vials (10-pack) · A compounded combination of two or more active ingredients selected by your provider, drawn from PDE5 inhibitors (sildenafil, tadalafil, vardenafil), the central dopamine agonist apomorphine, and the selective alpha-blocker silodosin. 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 multi-ingredient PDE5-based 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
These vials combine more than one active molecule chosen by your provider. The PDE5 inhibitors in the formula, such as sildenafil, tadalafil, and sometimes vardenafil, work by blocking the PDE5 enzyme. During sexual arousal, nitric oxide raises a signaling molecule called cGMP that relaxes smooth muscle and lets blood flow into the penis; PDE5 normally breaks cGMP down, and blocking it helps cGMP build up so blood flow is supported. When apomorphine is included, it acts centrally in the brain on dopamine pathways involved in arousal. When silodosin is included, it relaxes smooth muscle in the prostate and urethra. Combining a faster-acting and a longer-acting PDE5 inhibitor is intended to balance onset and duration. Sexual stimulation is still needed, and individual results vary.
Taking it
Single-dose vials (10-pack)
Each vial is a single pre-measured dose. Use one vial as directed by your provider before sexual activity, and do not use more than one dose in a 24-hour period unless your provider tells you otherwise. Because these formulations combine multiple molecules with different onset and duration profiles, follow your provider's timing and dosing instructions exactly. Alcohol and high-fat meals can affect how the medication feels and how quickly it works.
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
- Facial flushing
- Nasal congestion
- Indigestion or heartburn
- Dizziness or lightheadedness
- Temporary vision changes, such as a blue tint or light sensitivity; 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 single-dose vial 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, isosorbide, or amyl nitrite "poppers") 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, an irregular heartbeat or a heart-rhythm condition such as congenital prolonged QT (a concern with vardenafil-containing formulas), 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. 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. 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.
Rapid-onset combination vials 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
Rapid-onset combination vials FAQ
Sexual health
