Dual-Action Troche (sildenafil + tadalafil)
What is the Dual-Action Troche?
Sildenafil and tadalafil are each FDA-approved PDE5 inhibitors used to treat erectile dysfunction (ED). Your ReformedRx provider may prescribe the Dual-Action Troche, which combines sildenafil 60 mg and tadalafil 12 mg in one dissolving troche. This is a compounded medication. Compounded medications may be prescribed under federal law, but they are not FDA-approved, and the FDA does not review them for safety, effectiveness or manufacturing quality.
Who should not use it?
Do not use the Dual-Action Troche if you:
- Take any nitrate medicine, such as nitroglycerin, isosorbide mononitrate, isosorbide dinitrate or amyl nitrite. Combining them can cause a dangerous drop in blood pressure.
- Take riociguat or another guanylate cyclase stimulator. This combination can also cause a dangerous drop in blood pressure.
- Already take sildenafil or tadalafil for pulmonary arterial hypertension.
- Are allergic to sildenafil, tadalafil or any inactive ingredient in the troche.
- Have been told by a healthcare provider that sexual activity isn’t safe for your heart.
How should I use it?
- Use it exactly as prescribed. Place the troche under your tongue and allow it to dissolve completely, before sexual activity as directed by your provider. Do not chew it or swallow it whole.
- You still need sexual arousal for it to work. It doesn’t cause an automatic erection.
- Do not use it more than once in 24 hours, or within 24 hours of any other medicine that contains sildenafil or tadalafil, unless your provider tells you otherwise.
- Because it combines two ED medicines, consider taking your first dose at a time when you can rest afterward and see how your body responds.
- Avoid heavy drinking while using it.
What should I tell my provider first?
Tell your provider about every medicine you take, including over-the-counter supplements, including over-the-counter medicines, vitamins and supplements. Be especially sure to mention:
- Alpha-blockers (often used for prostate symptoms or blood pressure) or other blood pressure medicines
- Medicines such as ritonavir, ketoconazole, itraconazole, clarithromycin or erythromycin, which can raise the amount of sildenafil and tadalafil in your body
- Any other ED treatment
Also tell your provider if you have or have had: heart problems (including heart attack, irregular heartbeat, heart failure or chest pain), a stroke, low or uncontrolled high blood pressure, a narrowing of the heart valve or outflow (such as aortic stenosis), sudden vision loss or an eye condition called retinitis pigmentosa, kidney or liver problems, a bleeding disorder or stomach ulcers, a curved or scarred penis (Peyronie’s disease), or a condition that raises the risk of prolonged erections, such as sickle cell anemia, multiple myeloma or leukemia. Leaving out or giving inaccurate health information can lead to serious harm.
What are the most serious side effects?
If you have a medical emergency, call 911. Stop using the Dual-Action Troche and get medical help right away if you have:
- An erection that lasts more than 4 hours
- Sudden loss of vision in one or both eyes
- Sudden decrease or loss of hearing, sometimes with ringing in the ears or dizziness
- Chest pain, dizziness or nausea during sex
- Signs of very low blood pressure, such as fainting, severe dizziness or lightheadedness
- Signs of an allergic reaction, such as swelling of the face, lips or throat, or trouble breathing
Because this medicine combines two PDE5 inhibitors, watch closely for low blood pressure and prolonged erections, especially when you first start.
What are the most common side effects?
Headache, flushing, upset stomach or indigestion, stuffy nose, back pain, muscle aches, dizziness, nausea, and changes in vision such as a blue tint or sensitivity to light.
Other important information
The Dual-Action Troche does not protect against sexually transmitted infections. You’re encouraged to report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088. This summary doesn’t include everything about this medicine. Read the information that comes with each prescription, and ask your ReformedRx care team if you have questions.
As-Needed Tablet (sildenafil)
What is the As-Needed Tablet?
The As-Needed Tablet contains sildenafil, an FDA-approved PDE5 inhibitor used to treat erectile dysfunction (ED). Your ReformedRx provider chooses the strength, 50 mg or 100 mg.
Who should not use it?
Do not use sildenafil if you:
- Take any nitrate medicine, such as nitroglycerin, isosorbide mononitrate, isosorbide dinitrate or amyl nitrite. Combining them can cause a dangerous drop in blood pressure.
- Take riociguat or another guanylate cyclase stimulator. This combination can also cause a dangerous drop in blood pressure.
- Already take sildenafil for pulmonary arterial hypertension.
- Are allergic to sildenafil or any inactive ingredient in the tablet.
- Have been told by a healthcare provider that sexual activity isn’t safe for your heart.
How should I use it?
- Take one tablet about an hour before sexual activity, or as your provider directs. It can be taken from 30 minutes to 4 hours before.
- You still need sexual arousal for it to work. It doesn’t cause an automatic erection.
- Do not take it more than once a day, or within 24 hours of any other medicine that contains sildenafil or tadalafil.
- A heavy or high-fat meal can delay how quickly it works.
- Avoid heavy drinking while using it.
What should I tell my provider first?
Tell your provider about every medicine you take, including over-the-counter supplements, including over-the-counter medicines, vitamins and supplements. Be especially sure to mention:
- Alpha-blockers (often used for prostate symptoms or blood pressure) or other blood pressure medicines
- Medicines such as ritonavir, ketoconazole, itraconazole, clarithromycin or erythromycin, which can raise the amount of sildenafil in your body
- Any other ED treatment
Also tell your provider if you have or have had: heart problems (including heart attack, irregular heartbeat, heart failure or chest pain), a stroke, low or uncontrolled high blood pressure, a narrowing of the heart valve or outflow (such as aortic stenosis), sudden vision loss or an eye condition called retinitis pigmentosa, kidney or liver problems, a bleeding disorder or stomach ulcers, a curved or scarred penis (Peyronie’s disease), or a condition that raises the risk of prolonged erections, such as sickle cell anemia, multiple myeloma or leukemia. Leaving out or giving inaccurate health information can lead to serious harm.
What are the most serious side effects?
If you have a medical emergency, call 911. Stop taking sildenafil and get medical help right away if you have:
- An erection that lasts more than 4 hours
- Sudden loss of vision in one or both eyes
- Sudden decrease or loss of hearing, sometimes with ringing in the ears or dizziness
- Chest pain, dizziness or nausea during sex
- Signs of very low blood pressure, such as fainting, severe dizziness or lightheadedness
- Signs of an allergic reaction, such as swelling of the face, lips or throat, or trouble breathing
What are the most common side effects?
Headache, flushing, upset stomach or indigestion, stuffy nose, back pain, muscle aches, nausea, dizziness, rash, and changes in vision such as a blue tint, blurred vision or sensitivity to light.
Other important information
Sildenafil does not protect against sexually transmitted infections. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
This summary provides basic information about the As-Needed Tablet but does not include everything known about this medicine. Your ReformedRx provider can answer any questions about side effects before you start treatment. Please also read the information that comes with your prescription each time it’s filled.
Tadalafil (Daily Tablet, Long-Lasting As-Needed Tablet)
What is tadalafil?
Tadalafil is an FDA-approved PDE5 inhibitor used to treat erectile dysfunction (ED). The Daily Tablet (5 mg) is taken every day. The Long-Lasting As-Needed Tablet (20 mg) is taken before sexual activity.
Who should not use it?
Do not use tadalafil if you:
- Take any nitrate medicine, such as nitroglycerin, isosorbide mononitrate, isosorbide dinitrate or amyl nitrite. Combining them can cause a dangerous drop in blood pressure.
- Take riociguat or another guanylate cyclase stimulator.
- Already take tadalafil for pulmonary arterial hypertension or prostate symptoms.
- Are allergic to tadalafil or any inactive ingredient in the tablet.
- Have been told by a healthcare provider that sexual activity isn’t safe for your heart.
How should I use it?
- Daily Tablet: take one tablet at about the same time every day.
- Long-Lasting As-Needed Tablet: take one tablet before sexual activity, as your provider directs. Don’t take it more than once a day.
- Don’t take both, and don’t take any other ED medicine while using tadalafil.
- You still need sexual arousal for it to work.
- It can be taken with or without food. Avoid heavy drinking.
What should I tell my provider first?
Tell your provider about every medicine you take, including over-the-counter supplements, including over-the-counter medicines, vitamins and supplements. Be especially sure to mention alpha-blockers or other blood pressure medicines, medicines such as ritonavir, ketoconazole, itraconazole, clarithromycin or erythromycin, and any other ED treatment.
Also tell your provider if you have or have had: heart problems (including heart attack, irregular heartbeat, heart failure or chest pain), a stroke, low or uncontrolled high blood pressure, a narrowing of the heart valve or outflow (such as aortic stenosis), sudden vision loss or retinitis pigmentosa, kidney or liver problems, a bleeding disorder or stomach ulcers, Peyronie’s disease, or a condition that raises the risk of prolonged erections, such as sickle cell anemia, multiple myeloma or leukemia. Leaving out or giving inaccurate health information can lead to serious harm.
What are the most serious side effects?
If you have a medical emergency, call 911. Stop taking tadalafil and get medical help right away if you have:
- An erection that lasts more than 4 hours
- Sudden loss of vision in one or both eyes
- Sudden decrease or loss of hearing, sometimes with ringing in the ears or dizziness
- Chest pain, dizziness or nausea during sex
- Signs of very low blood pressure, such as fainting or severe dizziness
- Signs of an allergic reaction, such as swelling of the face, lips or throat, or trouble breathing
What are the most common side effects?
Headache, indigestion, back pain, muscle aches, flushing, stuffy nose and pain in the arms or legs.
Other important information
Tadalafil does not protect against sexually transmitted infections. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
This summary provides basic information about tadalafil but does not include everything known about this medicine. Your ReformedRx provider can answer any questions about side effects before you start treatment. Please also read the information that comes with your prescription each time it’s filled.
3-in-1 Performance Film and Desire + Performance Tablet
What are these products?
The 3-in-1 Performance Film contains sildenafil 40 mg, tadalafil 10 mg and oxytocin 50 IU. The Desire + Performance Tablet contains tadalafil 22 mg, oxytocin 50 IU and PT-141 (bremelanotide) 100 mcg. Sildenafil and tadalafil are FDA-approved PDE5 inhibitors for erectile dysfunction (ED). Both products are compounded medications. Compounded medications may be prescribed under federal law, but they are not FDA-approved, and the FDA does not review them for safety, effectiveness or manufacturing quality.
Who should not use them?
Do not use either product if you:
- Take any nitrate medicine, such as nitroglycerin, isosorbide mononitrate, isosorbide dinitrate or amyl nitrite. Combining them can cause a dangerous drop in blood pressure.
- Take riociguat or another guanylate cyclase stimulator.
- Already take sildenafil or tadalafil for pulmonary arterial hypertension.
- Are allergic to any active or inactive ingredient in the product.
- Have been told by a healthcare provider that sexual activity isn’t safe for your heart.
Do not use the Desire + Performance Tablet if you have high blood pressure that isn’t controlled or heart disease, because PT-141 can briefly raise blood pressure.
How should I use them?
- Use exactly as prescribed. Allow the film or tablet to dissolve completely in your mouth, before sexual activity as directed by your provider. Do not chew it or swallow it whole.
- Do not use more than once in 24 hours, or within 24 hours of any other medicine containing sildenafil or tadalafil.
- You still need sexual arousal for them to work.
- Avoid heavy drinking.
What should I tell my provider first?
Tell your provider about every medicine you take, including over-the-counter supplements, especially alpha-blockers or other blood pressure medicines, medicines such as ritonavir, ketoconazole, itraconazole, clarithromycin or erythromycin, naltrexone (for the Desire + Performance Tablet), and any other ED treatment. Also tell your provider about any heart, blood pressure, vision, hearing, kidney, liver or bleeding problems, Peyronie’s disease, or conditions that raise the risk of prolonged erections. Leaving out or giving inaccurate health information can lead to serious harm.
What are the most serious side effects?
If you have a medical emergency, call 911. Stop using the product and get medical help right away if you have:
- An erection that lasts more than 4 hours
- Sudden loss of vision or hearing
- Chest pain, dizziness or nausea during sex
- Signs of very low blood pressure, such as fainting or severe dizziness
- A severe headache or a pounding heartbeat
- Signs of an allergic reaction, such as swelling of the face, lips or throat, or trouble breathing
What are the most common side effects?
Headache, flushing, upset stomach, stuffy nose, back pain, muscle aches, dizziness and changes in vision. With PT-141, nausea is common, especially with the first doses.
Other important information
These products do not protect against sexually transmitted infections. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
This summary provides basic information about these products but does not include everything known about them. Your ReformedRx provider can answer any questions about side effects before you start treatment. Please also read the information that comes with your prescription each time it’s filled.
Desire Strip (PT-141)
What is the Desire Strip?
The Desire Strip contains PT-141 (bremelanotide) 2 mg in a dissolving strip, for low sexual desire in men and women. An injectable form of bremelanotide is FDA-approved for premenopausal women with low desire; the Desire Strip is a compounded medication. Compounded medications may be prescribed under federal law, but they are not FDA-approved, and the FDA does not review them for safety, effectiveness or manufacturing quality.
Who should not use it?
Do not use the Desire Strip if you:
- Have high blood pressure that isn’t controlled, or heart disease
- Are pregnant
- Are allergic to bremelanotide or any inactive ingredient in the strip
How should I use it?
- Use it as needed before sexual activity, following your provider’s directions on timing.
- Let the strip dissolve fully. Don’t chew or swallow it whole.
- Don’t use it more than once in 24 hours.
What should I tell my provider first?
Tell your provider about every medicine you take, including over-the-counter supplements, especially naltrexone, since PT-141 can affect how it works, and any blood pressure medicines. Also tell your provider if you have heart problems, high blood pressure, or are pregnant or planning a pregnancy.
What are the most serious side effects?
If you have a medical emergency, call 911. Stop using the Desire Strip and get medical help right away if you have chest pain, a severe headache, fainting, or a very fast or pounding heartbeat. PT-141 can briefly raise blood pressure after each dose.
What are the most common side effects?
Nausea (most common, often easing with later doses), flushing, headache and vomiting. Frequent use can cause darkening of patches of skin, such as on the face or gums.
Other important information
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
This summary provides basic information about the Desire Strip but does not include everything known about this medicine. Your ReformedRx provider can answer any questions about side effects before you start treatment. Please also read the information that comes with your prescription each time it’s filled.
Oxytocin (Arousal Spray, Intimacy Strip)
What are these products?
The Arousal Spray (oxytocin 100 IU/mL nasal spray) and the Intimacy Strip (oxytocin 50 IU dissolving strip) are compounded medications prescribed off-label for sexual wellness support. Compounded medications may be prescribed under federal law, but they are not FDA-approved, and the FDA does not review them for safety, effectiveness or manufacturing quality.
Who should not use them?
Do not use either product if you:
- Are pregnant or could be pregnant, since oxytocin can cause the uterus to contract
- Are allergic to oxytocin or any inactive ingredient in the product
How should I use them?
- Use exactly as your provider directs, typically shortly before intimacy.
- Arousal Spray: spray into the nose as directed. Intimacy Strip: let the strip dissolve fully in your mouth.
What should I tell my provider first?
Tell your provider about every medicine you take, including over-the-counter supplements, and if you are pregnant, planning a pregnancy, breastfeeding, or have heart problems, seizures or a history of low sodium levels.
What are the most serious side effects?
If you have a medical emergency, call 911. Stop using the product and get medical help right away if you have signs of an allergic reaction, such as swelling of the face, lips or throat, or trouble breathing, or if you have a fast or irregular heartbeat or confusion.
What are the most common side effects?
Headache, nausea, and, with the spray, nasal irritation or a runny nose.
Other important information
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
This summary provides basic information about these products but does not include everything known about them. Your ReformedRx provider can answer any questions about side effects before you start treatment. Please also read the information that comes with your prescription each time it’s filled.
Licensed providers make all consultation and prescribing decisions. Purchasing does not guarantee a prescription. Prescriptions are issued only after a licensed provider reviews your information and determines that treatment is appropriate.
We serve patients in 46 states. We do not currently provide services in Alaska, Mississippi, New Jersey or Texas. Availability can vary by product, depending on whether the dispensing pharmacy is licensed to ship to your state.
