Troche
Apomorphine / Sildenafil / Tadalafil / Vardenafil Troches
Quad-mix troche combining three PDE5 inhibitors with apomorphine dopamine agonist for maximum potency and comprehensive mechanism.
4, 8 or 12 troches per month
Starting at $69/mo
Sexual healthErectile dysfunctionLong-acting
Tadalafil 25 mg Capsules
RxPrescription onlyTaken by mouth · As needed, 30–60 min before · 25 mg · Sexual health · Erectile dysfunction · Long-acting
Starting at $59/mo
Compounded tadalafil 25 mg capsules taken as needed about 30 to 60 minutes before sex, with an effect window of up to 36 hours.
How many capsules per month?
MonthlyEvery 3 months
4 capsulesper month
8 capsulesper month
12 capsulesper month
You'll receive 8 capsules per month. $89 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Effect window of up to 36 hours
- Less need to plan around timing
- Food has little effect on absorption
Every plan includes
- Personalized, physician-guided plan
- 4, 8 or 12 capsules per month, monthly and 3-month
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is tadalafil?
(ta-DA-la-fil)
Tadalafil is a long-acting PDE5 inhibitor, the active ingredient of Cialis. With arousal it keeps blood flowing into the penis; its long half-life gives a wide window of effect.
- How it is taken
- Taken by mouth
- How often
- As needed, 30–60 min before
- Dose range
- 25 mg
- Form
- Sexual health · Erectile dysfunction · Long-acting
~36 h
how long a single dose can keep working
It does not cause a continuous erection; arousal is still needed.
How it works,
week by week.
Day 1
A US-licensed physician reviews your health, medications (especially nitrates and blood pressure drugs) and goals, and chooses the dose and form.
First doses
Take it 30 minutes to 2 hours before intimacy, on a light stomach. Arousal is still needed; the medicine helps the response, it does not create it.
Week 2
You know how your body responds. Timing, dose and food effects are clear, and confidence builds.
Month 1
Check-in with your physician: the dose is adjusted up or down, or the form is changed, based on your response and side effects.
Beyond
It works for as long as you use it. Your physician reviews your health at least yearly, including blood pressure and heart health.
What you may notice,
and when.
Firmer erections
when aroused, with a reliable response
Predictable timing
you know when it starts and how long it lasts
Confidence
less performance worry, more presence
Physician oversight
dose and form adjusted to you
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
PDE5 inhibitors are generally well tolerated. Common effects are flushing, headache, nasal congestion, indigestion and, with sildenafil, a temporary blue tint to vision. CRITICAL: never combine with nitrates or poppers (dangerous drop in blood pressure). Use with care alongside alpha-blockers. Seek emergency care for an erection lasting more than 4 hours, sudden vision or hearing loss, or chest pain. Tell your physician about heart disease, low blood pressure, liver or kidney problems and retinal disease before starting.
The research behind
tadalafil.
Tadalafil is a long-acting PDE5 inhibitor, active for up to about 36 hours. It has been tested in many placebo-controlled trials for erectile dysfunction, both as needed and once daily, and it is also labeled for prostate-related urinary symptoms.
- Up to 36 hours59.2% vs 28.3%
In 348 men, 20 mg tadalafil was tested about 24 and 36 hours after dosing. At 36 hours, 59.2% of intercourse attempts succeeded on tadalafil and 28.3% on placebo (P below 0.001); at about 24 hours, 52.9% and 29.1%.
Porst et al., Urology 2003 - Once daily17.8% and 23.6%
Pooled data from six placebo-controlled trials of 1,913 men, 12 weeks at 2.5 mg or 5 mg once daily. Both doses improved intercourse success over placebo, with least-squares gains of 17.8% and 23.6%.
Porst et al., European Urology 2014 - Stopping, daily2.1% to 6.3%
In a 24-week placebo-controlled US trial of once-daily tadalafil, 2.1% of placebo patients, 6.3% on 2.5 mg and 4.1% on 5 mg stopped because of adverse events.
Rajfer et al., International Journal of Impotence Research 2007
What the studies found
- Works for up to 36 hours: 59.2% of attempts succeeded at 36 hours vs 28.3% on placebo in 348 men (Porst et al., Urology 2003)
- Once-daily 2.5 or 5 mg raised intercourse success by 17.8% and 23.6% over placebo in 1,913 men (Porst et al., European Urology 2014)
- On once-daily dosing, IIEF erectile function rose by 4.2 and 5.4 points in the same pooled trials (Porst et al., European Urology 2014)
- Once-daily erectile function improved significantly over placebo on all co-primary endpoints at 24 weeks (Rajfer et al., International Journal of Impotence Research 2007)
- Prostate symptoms: 5 mg once daily significantly improved urinary symptom scores at 12 weeks in 1,058 men with BPH (Roehrborn et al., Journal of Urology 2008), and it is labeled for BPH (CIALIS prescribing information)
Trial results are for tadalafil tablets, averaged across the men in each group. They are not predictions for you. The capsules, troches, dissolving tablets and the 5.5 mg product sold here are not the tablets studied in these trials, and they have not been tested on their own. Your physician sets your dose.
What this does not say
- The as-needed trial used 20 mg; the 36-hour effect is an average over the men in the trial, not a guarantee.
- The once-daily pooled analysis ran for 12 weeks; the longest placebo-controlled data are for 24 weeks.
- Tadalafil is contraindicated with any form of organic nitrate; the prescriber checks for this.
The research
behind it.
Large randomized trials show tadalafil improves erectile function across all severities, with benefit lasting up to 36 hours after a dose.
The 25 mg capsule is slightly above the 20 mg label maximum; your physician uses it only after checking your heart health and medications.
Erections as a vital sign:
what the cohorts showWhy a change in erections is worth a heart check, what the numbers say, and what they do not.Read the researchPDE5 inhibitors:
what the trials showSildenafil, tadalafil and vardenafil compared, daily and as-needed use, and the rule on nitrates.Read the research
what the cohorts showWhy a change in erections is worth a heart check, what the numbers say, and what they do not.Read the researchPDE5 inhibitors:
what the trials showSildenafil, tadalafil and vardenafil compared, daily and as-needed use, and the rule on nitrates.Read the research
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I take Tadalafil Capsules 25 mg?
Taken by mouth, as needed, 30–60 min before. The starting prescription is 1 capsule (25 mg) each time. Your physician sets your own dose and it is printed on your label.
How much arrives in each shipment?
8 capsules at the starting strength, shipped to your door from a licensed US pharmacy.
Why 25 mg instead of 20 mg?
Some men need a little more than the standard maximum. Your physician weighs the benefit against side effects like headache and back pain.
Can I take it with other medications?
Never with nitrates (nitroglycerin, isosorbide) or recreational poppers: the combination can drop blood pressure dangerously. Tell your physician about alpha-blockers, blood pressure medicines, antifungals and HIV medicines, which change how the drug is processed.
What if it does not work the first time?
Arousal is still required, and a heavy or fatty meal can delay absorption. Most men need two or three attempts at a given dose before judging it. If it still falls short, your physician adjusts the dose or the formulation.
What are the warning signs?
An erection lasting more than 4 hours, sudden loss of vision or hearing, chest pain or fainting need immediate care. Stop the medication and go to the emergency room.
Is a compounded version as reliable as the brand?
Compounded troches, capsules and ODTs contain the same active ingredient, prepared by a US-licensed pharmacy, but they have not gone through FDA review as a finished product. Your physician chooses the form that fits how you want to use it.
Tadalafil educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
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Topical cream for female sexual enhancement and orgasm support. Combination of arginine, ergoloid, pentoxifylline, sildenafil, and theophylline.
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References
- 1.Sildenafil citrate for erectile dysfunction: a systematic review of randomized controlled trials. Arch Intern Med, 2002
- 2.Tadalafil 5 mg once daily for erectile dysfunction: pooled analysis of randomized trials. Transl Androl Urol, 2020
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.