What you are actually buying
One compounded dissolving tablet containing sildenafil 50 mg, tadalafil 20 mg and oxytocin 125 IU. A written intake goes to a US-licensed physician, and if approved a state-licensed compounding pharmacy prepares it.
Publishing the doses matters more than it sounds. Most of this market does not, and without them you cannot tell whether you are getting a starting dose or a maximum one — or whether you would be doubling up if you already keep sildenafil at home.
The stacking problem, now that we can quantify it
Because the doses are public, the concern stops being theoretical. Tadalafil 20 mg is the maximum as-needed dose. Adding sildenafil 50 mg on top means total PDE5 inhibition above what either drug is approved to deliver on its own.
No guideline supports combining two PDE5 inhibitors, and no FDA-approved product does it. The predictable consequences of overshooting are lower blood pressure and a higher chance of a prolonged erection — not exotic risks, just the known dose-related effects of the class.
The third ingredient
Oxytocin is a nine-amino-acid peptide. Swallowed, it is broken down by digestive enzymes; absorbed through the mouth, uptake is poor and inconsistent. There is no good evidence that oral or sublingual oxytocin improves desire or erectile function.
The page describes it as supporting “arousal, intimacy, and connection” — careful, unfalsifiable wording rather than a clinical claim. Our read is that at this dose and by this route it is probably doing very little.
Where it genuinely leads the field
Both prices are on the page — $59 month-to-month, $41 on the quarterly plan — with free shipping and FSA/HSA eligibility. There is no asterisked “free month” that turns out to require a longer commitment.
Cancellation terms are stated before you buy. Of the five services we audited, this is the only one that does. Billing complaints, not safety, are the most common grievance in this category, so this is not a small thing.
There are also no testimonials, which removes an entire class of problem — no paid endorsements presented as spontaneous enthusiasm.
What we would want fixed
The nitrate warning needs teeth. “Should not be taken with nitrates” is technically present and practically useless. A man carrying a nitroglycerin spray for angina may not know that is a nitrate. Name the drugs and say what happens.
There is no cardiac screening language at all. For a product containing two vasodilators, sold largely to men over 50, that is the most conspicuous omission on the page.
We could not find a pharmacy licence number or a physical address. The page says “state-licensed compounding pharmacy” without naming it, so there is nothing to check with a state board.
The bottom line
If you have decided you want a combination product, this is the one that treats you most like an adult about price and terms. We would still rather see a man try one drug at a proper dose first — cheaper, better evidenced, and far easier to work out what is actually helping. How the single drugs compare.