Tadalafil + Vardenafil.

Tadalafil has a long half-life, which suits daily dosing. Vardenafil is among the faster-acting PDE5 inhibitors. Combining them at low doses puts both properties in one daily tablet. Your provider decides whether a dual tablet or a single-active tablet is the better fit for you.

One tablet at the same time each day, with or without food. Do not take more than one in 24 hours. Your provider confirms whether daily dosing is appropriate for you.

No. This is a compounded medication prepared by a licensed 503A pharmacy under a provider's prescription. The two active ingredients, tadalafil and vardenafil, each have FDA-approved single-ingredient products; the combination tablet itself is compounded and not FDA-approved.

Anyone taking nitrates (such as nitroglycerin) or riociguat, since the combination can cause a dangerous drop in blood pressure. Recent heart attack or stroke, severe liver or kidney disease, certain heart rhythm conditions, and certain eye conditions also require provider review. Tell your provider about every medication you take.

The most common are headache, flushing, indigestion, back or muscle aches, and nasal congestion. These are usually mild. Seek emergency care for an erection lasting more than four hours, sudden vision or hearing loss, or chest pain.

No. One payment covers your supply, the provider consultation, and shipping. Nothing renews. When you are running low, you can reorder.

Yes. Plain, unmarked packaging with no pharmacy name or product description on the outside. Your name is on the pharmacy label inside.