Sildenafil + Tadalafil + Apomorphine Film

Three ED medicines, in one film. Sildenafil 35 mg and tadalafil 10 mg help blood flow into the penis; apomorphine 2.5 mg works on the brain’s side of arousal. All three come in one compounded film that dissolves under your tongue, taken as needed. The combination hasn’t been tested in trials, so a provider decides whether it’s right for you.

Sildenafil 35 mg, tadalafil 10 mg and apomorphine 2.5 mg in one film
Dissolves under your tongue, with no water
Individually sealed, discreet sachets

Under-the-tongue film · from $60/mo, as a 2-month supply. Prices are preliminary.

How to use it

Tear open a sachet with dry hands.
Place the film under your tongue and let it dissolve completely. No water needed. If you feel sick, sweaty or light-headed, sit or lie down until it passes.
Take it before sex as your provider directs; it only works when you’re aroused. Take no more than one film a day, and no other ED medicine alongside it.

Form: Film you place under your tongue
Strength: Sildenafil 35 mg, tadalafil 10 mg and apomorphine 2.5 mg per film
Typical use: As needed, before sex, as your provider directs; one film a day at most
Pack: 20 individually sealed films, a 2-month supply
Who it’s for: Adult men with erectile dysfunction

Three actives, two ways of working.

Sildenafil (35 mg): A PDE5 inhibitor. When you’re aroused, it helps the arteries in the penis relax and fill with blood. Its level in the blood peaks about an hour after a dose, with a half-life of about 4 hours. 35 mg sits between the approved 25 and 50 mg doses of sildenafil on its own.
Tadalafil (10 mg): The same kind of medicine, but it stays in the body much longer, with a half-life of about 17.5 hours: in trials of the approved 10 and 20 mg doses, it still improved erections 36 hours after a dose. 10 mg is the usual starting dose of tadalafil taken as needed.
Apomorphine (2.5 mg): A different kind of medicine. It acts like dopamine on the part of the brain that sends the signals that start an erection, rather than on blood vessels. Despite its name, it isn’t an opioid. Tablets of 2 and 3 mg under the tongue were approved for erectile dysfunction in Europe in 2001 and later taken off the market; in the US it’s approved only for Parkinson’s disease, at much higher doses.

What the research does and doesn’t show

What it shows: sildenafil and tadalafil each work on their own. In trials of sildenafil, 63 to 82% of men on 25 to 100 mg said their erections improved, against 24% on a placebo. Tadalafil taken as needed was tested in 12-week, placebo-controlled trials of more than 1,500 men: on 10 or 20 mg, 50 to 78% of attempts at sex succeeded, against 23 to 43% on a placebo. Apomorphine under the tongue helped less: in trials of 2 and 3 mg tablets, men had erections firm enough for sex in about half of attempts, against about a third on a placebo, and in studies that compared the two, sildenafil worked better.

What it doesn’t show: no trial has tested sildenafil, tadalafil and apomorphine together, these doses, or this compounded film. The labels for sildenafil and tadalafil say combining them with another ED medicine hasn’t been studied and isn’t recommended. A film under the tongue hasn’t been shown to make any of them work faster.

So the evidence is for each medicine on its own, not for this film.

Studies: Viagra (sildenafil citrate) prescribing information, DailyMed: improved erections in 63%, 74% and 82% on 25, 50 and 100 mg vs 24% on placebo; doses 25 to 100 mg; peak at a median of 60 minutes; half-life about 4 hours; with ritonavir, no more than 25 mg in 48 hours; combinations with other PDE5 inhibitors or ED treatments “have not been studied… the use of such combinations is not recommended.” Cialis (tadalafil) prescribing information, Lilly, DailyMed 2026: as-needed use, 7 placebo-controlled 12-week trials (402 men in the US, 1,112 outside); successful intercourse in 50 to 78% of attempts on 10 or 20 mg vs 23 to 43% on placebo; 36-hour timing study; half-life 17.5 hours; 10 mg the recommended starting dose for as-needed use. Apomorphine SL for erectile dysfunction: Heaton 2001 and Dula 2001, Urology (fixed-dose and dose-optimised 2 to 3 mg vs placebo; erections firm enough for intercourse in about 45 to 50% of attempts vs about 33%); Uprima and Ixense (apomorphine hydrochloride 2 and 3 mg sublingual) authorised in the EU in 2001 and later withdrawn; TAP Pharmaceutical Products withdrew its US application in 2000 after FDA questions about syncope; head-to-head studies favouring sildenafil (Eardley 2004, Perimenis 2004). Apokyn (apomorphine hydrochloride injection) prescribing information, DailyMed: contraindicated with 5-HT3 antagonists (ondansetron, granisetron, dolasetron, palonosetron, alosetron) because of profound hypotension and loss of consciousness; nausea and vomiting, orthostatic hypotension and syncope, falling asleep during daily activities, QT prolongation; dopamine antagonists may reduce its effect. No study found of sildenafil, tadalafil and apomorphine combined, or of a compounded combined film (PubMed and ClinicalTrials.gov, Oct 7, 2026).

What to expect

The first time: Take it at home, well ahead, and sit down for a while afterwards in case it makes you dizzy or queasy. It only works with arousal. Don’t take a second film the same day, even if the first didn’t seem to work.
The first few weeks: It can take a few tries to find the timing that works for you. Headache, flushing, a stuffy nose, nausea and dizziness are the most common side effects, and they usually pass.
Ongoing: Your provider checks how it’s working and whether you still need all three medicines, or whether fewer would do. Refills ship in plain packaging.

Important safety information

Before you start

Your provider reviews your health history, medicines and allergies before prescribing, and prescribes only if it’s right for you. Tell your care team about any side effect, and get emergency care for chest pain, trouble breathing, or swelling of the face, lips or throat.

Side effects, and when to get help

The most common are headache, flushing, indigestion, a stuffy nose, back or muscle aches, nausea, dizziness and yawning. Sildenafil can briefly cause a blue tinge, blurred vision or more sensitivity to light. Apomorphine can lower blood pressure and, rarely, cause fainting, usually after nausea, sweating or light-headedness; sit or lie down if you feel that way. Most side effects pass on their own. Stop and get care right away for an erection that lasts more than 4 hours, fainting, chest pain, sudden loss of vision in one or both eyes, sudden hearing loss or ringing in the ears, or swelling of the lips, face or throat.

Rules that keep it safe

Never take this film with nitrate heart medicines, such as nitroglycerin or isosorbide, with poppers, or with riociguat or vericiguat: the drop in blood pressure can be dangerous. Tadalafil lasts, so at least 48 hours should pass after a film before a nitrate is given, and only under medical supervision; if you need emergency care for chest pain, tell the staff what you’ve taken, and when. Never take it with ondansetron (Zofran), granisetron, dolasetron, palonosetron or alosetron: with apomorphine they can cause a severe drop in blood pressure and loss of consciousness. Take no more than one film a day, and don’t add any other ED medicine, including Sildenafil Film, Tadalafil + Sildenafil Chewable, daily tadalafil, vardenafil, avanafil, Revatio or Adcirca. With ritonavir (including Paxlovid for COVID), ketoconazole or itraconazole, this film isn’t used. Alpha-blockers, blood pressure medicines and alcohol add to the drop in blood pressure; medicines that block dopamine, such as antipsychotics or metoclopramide, can cancel out apomorphine. Don’t use it if a doctor has told you your heart isn’t healthy enough for sex.

Is it FDA-approved?

No. This film is compounded: prepared by a licensed pharmacy for you, and not reviewed by the FDA for safety, effectiveness or quality. Sildenafil and tadalafil are each FDA-approved for erectile dysfunction, but no FDA-approved product combines them, and apomorphine isn’t approved for erectile dysfunction in the US. This film hasn’t been compared with them in a trial. If one approved medicine suits you better, your provider can talk it through.

About Sildenafil + Tadalafil + Apomorphine Film

Why three medicines in one film?

Sildenafil and tadalafil act on blood flow in the penis; apomorphine acts in the brain, on the signals that start an erection. Some providers combine them for men who didn’t get enough from one medicine. But no trial has tested the three together, or these doses, so it isn’t known whether the combination works better than one or two of them.

What is apomorphine?

A medicine that acts like dopamine, a brain messenger involved in arousal. Despite its name, it isn’t an opioid. Tablets of 2 and 3 mg under the tongue were approved for erectile dysfunction in Europe in 2001 and later taken off the market. In the US, its maker withdrew its application for erectile dysfunction in 2000 after the FDA raised concerns about fainting; it’s approved only for Parkinson’s disease, at much higher doses.

Is it safe to take these medicines together?

It hasn’t been well studied. The labels for sildenafil and tadalafil say combining them with another ED medicine hasn’t been studied and isn’t recommended, because together they may lower blood pressure further. Apomorphine can lower blood pressure too. Your provider weighs this against your health history, and may suggest fewer medicines instead.

What are the side effects?

Headache, flushing, indigestion, a stuffy nose, back or muscle aches, nausea, dizziness and yawning are the most common. Apomorphine can, rarely, cause fainting, usually after nausea, sweating or light-headedness: sit or lie down if you feel that way. Get medical help right away for an erection that lasts more than 4 hours, fainting, chest pain, or sudden loss of vision or hearing.

How is it different from Tadalafil + Sildenafil Chewable?

The chewable has two medicines, tadalafil 18 mg and sildenafil 10 mg, and you chew it. This film has less tadalafil (10 mg) and more sildenafil (35 mg), adds apomorphine, which works in a different way, and dissolves under your tongue. Your provider helps you choose.

Is there an FDA-approved version?

No FDA-approved product combines any of these medicines. Sildenafil and tadalafil are each FDA-approved for erectile dysfunction; apomorphine isn’t approved for erectile dysfunction in the US. If an approved medicine suits you better, your provider can talk it through.

Does it protect against STIs?

No. These medicines don’t protect against sexually transmitted infections, including HIV.

Is it FDA-approved?

No. Compounded medications are prepared by a licensed pharmacy for an individual patient and are not reviewed by the FDA for safety, effectiveness or quality.

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