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Erectile Dysfunction & Sexual Health Safety Information

Erectile Dysfunction & Sexual Health Treatments

Important Safety Information

Your licensed healthcare provider may prescribe compounded medications for erectile dysfunction (such as custom formulations of Tadalafil, Sildenafil, or Apomorphine, including Prime Time, Prime Time Max, and The Epiq Chew) following an online medical consultation. Compounded medications are customized by state-licensed pharmacies based on individual prescriptions. They are permitted under federal law but are not approved by the FDA and are not reviewed by the FDA for safety, effectiveness, or manufacturing quality.

This summary does not contain all possible safety information or side effects. Always consult your healthcare provider with any medical questions.

CRITICAL CONTRAINDICATION: NITRATES

DO NOT TAKE Tadalafil, Sildenafil, or any ED medication if you take any medications containing nitrates (often prescribed for chest pain or heart conditions), such as:

  • Nitroglycerin (sublingual tablets, sprays, transdermal patches)
  • Isosorbide mononitrate or isosorbide dinitrate
  • Recreational nitrates known as “poppers” (such as amyl nitrate, butyl nitrate, or alkyl nitrite)

Combining PDE5 inhibitors (tadalafil, sildenafil) with nitrates can cause a severe, sudden, and potentially life-threatening drop in blood pressure.

Indications and Use

Prescription treatments for erectile dysfunction are indicated for adult men diagnosed with erectile dysfunction (the consistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance).

  • Not indicated for use in women or patients under 18 years of age.
  • Not intended to treat lack of sexual desire or underlying psychological trauma without clinical evaluation.

Who Should Not Use ED Treatments

Do not use these medications if you:

  • Take nitrates in any form or use recreational nitrate “poppers”.
  • Take guanylate cyclase stimulators, such as riociguat (Adempas) for pulmonary hypertension.
  • Have a known allergy or hypersensitivity to tadalafil, sildenafil, apomorphine, or any inactive ingredients.
  • Have been advised by a physician to avoid sexual activity due to cardiovascular disease.
  • Have severe unstable angina, severe heart failure, or experienced a heart attack, stroke, or life-threatening arrhythmia within the last 6 months.
  • Have severe hepatic (liver) impairment or end-stage renal disease requiring dialysis.
  • Have resting blood pressure below 90/50 mmHg or uncontrolled resting blood pressure above 170/100 mmHg.

Before Using ED Medications

Tell your licensed healthcare provider about your complete medical history, including if you:

  • Take alpha-blockers (such as tamsulosin, Flomax, doxazosin) or blood pressure medications.
  • Have a history of priapism (erections lasting longer than 4 hours) or conditions predisposing to priapism (sickle cell anemia, multiple myeloma, leukemia).
  • Have anatomical deformation of the penis (such as Peyronie’s disease).
  • Have a history of non-arteritic anterior ischemic optic neuropathy (NAION) or sudden vision/hearing changes.
  • Have stomach ulcers, bleeding disorders, or retinitis pigmentosa.

Possible Side Effects

Common side effects may include: Headache, facial flushing, nasal congestion, indigestion (upset stomach), back pain, muscle aches, and dizziness.

Seek emergency medical attention immediately if you experience:

  • Priapism: An erection that lasts longer than 4 hours. Without immediate medical treatment, permanent tissue damage can occur.
  • Sudden loss of vision in one or both eyes.
  • Sudden decrease or loss of hearing, ringing in the ears, or dizziness.
  • Chest pain, shortness of breath, or severe dizziness during sexual activity.

Key Tips & Administration

  • Onset and Duration: Sildenafil typically takes effect within 30 to 60 minutes and lasts 4 to 6 hours. Tadalafil can remain active in the body for up to 36 hours.
  • Food Interactions: High-fat meals can delay the absorption and onset of action of oral sildenafil tablets.
  • Alcohol: Excessive alcohol consumption can increase the risk of dizziness, headache, and low blood pressure.
  • Maximum Dosing: Do not take more than one dose in a 24-hour period. Never double your dose without clinical approval.