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 dysfunctionCompounded
Vardenafil Capsules
RxPrescription onlyTaken by mouth · As needed, 30–60 min before · 20 mg · Sexual health · Erectile dysfunction · Compounded
Starting at $59/mo
Compounded vardenafil 20 mg capsules taken 30 to 60 minutes before sex. An alternative for men who do not respond well to sildenafil or tadalafil.
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.
- Different PDE5 inhibitor, sometimes works when others did not
- Onset in 30 to 60 minutes
- Effect lasts 4 to 5 hours
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 vardenafil?
(var-DEN-a-fil)
Vardenafil is the active ingredient of Levitra. It works like the other PDE5 inhibitors, with a potency and profile that suit some men better.
- How it is taken
- Taken by mouth
- How often
- As needed, 30–60 min before
- Dose range
- 20 mg
- Form
- Sexual health · Erectile dysfunction · Compounded
4-5 h
typical duration of effect
High-fat meals slow absorption.
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
vardenafil.
Vardenafil is a PDE5 inhibitor. Its evidence is a set of placebo-controlled trials in men with erectile dysfunction, starting with an at-home trial in 2001.
- Intercourse71% to 75%
In 601 men with mild to severe erectile dysfunction, 12 weeks of 5, 10 or 20 mg vardenafil gave 71% to 75% successful intercourse attempts across the three doses, in a placebo-controlled trial.
Porst et al., International Journal of Impotence Research 2001 - Keeping an erection1.4 to 1.7 points
On IIEF question 4 (keeping an erection), the change from baseline was 1.4, 1.5 and 1.7 points at 5, 10 and 20 mg, against 0.5 points on placebo; both differences were significant (P below 0.001).
Porst et al., International Journal of Impotence Research 2001 - Better erections80% vs 30%
At 20 mg, 80% of men reported improved erections on the global assessment question, against 30% on placebo.
Porst et al., International Journal of Impotence Research 2001
What the studies found
- Intercourse succeeded in 71% to 75% of attempts across 5, 10 and 20 mg in 601 men (Porst et al., International Journal of Impotence Research 2001)
- Keeping an erection (IIEF question 4) improved by 1.4 to 1.7 points vs 0.5 on placebo (Porst et al., International Journal of Impotence Research 2001)
- At 20 mg, 80% of men reported better erections vs 30% on placebo (Porst et al., International Journal of Impotence Research 2001)
Trial results are for vardenafil tablets at 5 to 20 mg, averaged across the men in each group. They are not predictions for you. The capsules sold here are not the approved tablets studied in these trials. Your physician sets your dose.
What this does not say
- The key trial abstract reports a 12-week period; longer-term results come from other publications.
- The global figures rest on the men's own ratings of their erections, not on a device measurement.
- Vardenafil is contraindicated with nitrate medicines; the prescriber checks for this.
The research
behind it.
Randomized trials show vardenafil improves erections, including in men with diabetes and after prostate surgery.
Vardenafil can slightly prolong the QT interval; tell your physician about heart rhythm problems and antiarrhythmic drugs.
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 Vardenafil Capsules?
Taken by mouth, as needed, 30–60 min before. The starting prescription is 1 capsule (20 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 switch to vardenafil?
Response to PDE5 inhibitors varies. If one did not work well or caused side effects, another may suit you better.
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.
Vardenafil 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.
More options
in this area.
Injection
Bi-Mix Injection
Combination of papaverine and phentolamine for intracavernosal injection. Vasodilator mix for erectile dysfunction. Priapism risk and rescue requirements.
Starting at $171/mo
Cream
Climax Cream
Topical cream for female sexual enhancement and orgasm support. Combination of arginine, ergoloid, pentoxifylline, sildenafil, and theophylline.
Starting at $116/mo
Cream
Ecstasy Cream for Her
Topical cream for female sexual arousal and pleasure. Contains oxytocin, theophylline, arginine, and sildenafil for enhanced sensation and response.
Starting at $138/mo
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.