Medvi Quad Review: Does a 4-Drug ED Liquid Work?

Disclosure: PrescribedRX sells its own treatments, so we compete with some of the companies covered here, and we may earn affiliate commissions.

Short answer: Quad by MEDVi is a compounded under-the-tongue liquid that combines sildenafil, tadalafil, apomorphine and L-citrulline, as listed on MEDVi’s site in October 2026. Sildenafil and tadalafil are prescription ED drugs whose prescribing information reports trial results for each drug taken alone (Viagra prescribing information; Cialis prescribing information). No published trial has tested whether the four-ingredient MEDVi Quad mix works (PubMed), and MEDVi does not publish the dose of each ingredient. Without a trial of the mix, there is no published data on how it compares with a standard prescription.

What is Medvi Quad?

Quad is a prescription erectile dysfunction (ED) product sold online by MEDVi, a Delaware-based telehealth storefront. MEDVi calls it a “4-in-1” and describes it as a “rapid-absorb liquid” that goes under your tongue (Quad by MEDVi page). The Quad page footer says MEDVi “does not produce compounded medications” and encourages users to talk with their provider about compounded medication. Quad is a compounded product, and so is the PrescribedRX product compared further down. Compounded medications are prepared by licensed pharmacies and are not FDA-approved.

What is in Quad by MEDVi?

MEDVi’s Quad page lists four ingredients (quad.medvi.org):

• Sildenafil, the active ingredient in Viagra.
• Tadalafil, the active ingredient in Cialis.
• Apomorphine, which MEDVi labels “Ignites Desire.”
• L-citrulline, an amino acid sold as a supplement.

MEDVi’s page does not list how many milligrams of each ingredient are in a dose. Several other websites that write about Quad list vardenafil as a Quad ingredient. MEDVi’s own page, as of October 16, 2026, lists L-citrulline, not vardenafil.

If you are considering Quad, you can ask MEDVi for the exact strength of each ingredient in writing before you pay. The same question applies to any compounded combination product, including ours. PrescribedRX does not list per-dose strengths for Prime Time either, because your provider sets the dose.

Does each ingredient work for ED? What does the evidence say?

Ingredient	What it is	What the cited source reports for ED	Source
Sildenafil	Prescription ED drug (Viagra; generics exist)	Randomized trials described in the prescribing information	Viagra prescribing information
Tadalafil	Prescription ED drug (Cialis; generics exist)	Improved erectile function vs placebo up to 36 hours after a dose	Cialis prescribing information
Apomorphine	Not sold as an ED drug in the U.S.; an EU ED product’s authorization lapsed in 2006	Two head-to-head trials report lower success rates than sildenafil	Pavone, Eardley, EMA
L-citrulline	A supplement, not a drug	One small single-blind study of 24 men with mild ED	Cormio 2011
The 4-ingredient mix	Compounded	No published trial	PubMed search

Sildenafil

Sildenafil is the active ingredient in Viagra. Its prescribing information lists a usual starting dose of 50 mg taken about an hour before sex, with a range of 25 to 100 mg, no more than once a day, taken anywhere from 30 minutes to 4 hours beforehand (Viagra prescribing information). Those figures describe the brand-name tablet. Your provider sets the dose for any product you are prescribed.

Tadalafil

Tadalafil is the active ingredient in Cialis. Its prescribing information says that, taken as needed, it improved erectile function compared with placebo for up to 36 hours after a dose (Cialis prescribing information).

Apomorphine

Apomorphine is not sold as an ED drug in the United States. In the EU, an under-the-tongue apomorphine product for ED called Uprima was authorized in May 2001. The company did not renew it “for commercial reasons,” and the authorization lapsed in May 2006 (EMA Uprima page).

Two trials compared apomorphine directly with sildenafil:

• In a randomized crossover trial (Pavone and colleagues, Journal of Urology), sublingual apomorphine 3 mg was compared with sildenafil 50 mg in 34 evaluable men. Erections firm enough for intercourse came in 85% of attempts on sildenafil vs 44% on apomorphine (PubMed).
• In an open-label crossover trial of 139 men new to treatment (Eardley and colleagues, BJU International, 2004), the successful intercourse rate was 75% on sildenafil vs 35% on apomorphine, and 96% of the men preferred sildenafil (PubMed).

L-citrulline

L-citrulline is an amino acid. In one small single-blind study, 24 men with mild ED took a placebo for a month, then L-citrulline 1.5 g a day for a month. Erection hardness improved to normal in 50% of men on L-citrulline vs 8.3% on placebo. The authors wrote that it is less effective than PDE5 inhibitors, at least in the short term (Cormio et al., Urology, 2011).

Does combining four ingredients make it work better?

No published study has answered that. PubMed lists no study of all four ingredients together (apomorphine, sildenafil, tadalafil and citrulline) (PubMed search). The trials summarized above each tested one ingredient, or compared apomorphine with sildenafil, so how the mix’s results and side effects compare with a single ED drug has not been reported.

Whether any combination of ED medicines is appropriate for you is decided by a licensed provider who reviews your health history and current medications.

Does sublingual mean faster?

MEDVi says Quad “hits your system in 10 minutes” and, elsewhere on the same page, “Works in as little as 15 minutes” (Quad page). No published study has measured how fast Quad is absorbed, so these are statements from MEDVi’s page, not study results.

Is Medvi Quad safe? What is known about side effects

There is no published safety study of Quad itself. The prescribing information for sildenafil and tadalafil describes side effects and drug interactions for each drug taken alone (Viagra, Cialis), and the apomorphine trials above report the side effects seen in their own participants. None of these sources tested the four ingredients together.

Whether Quad, any other combination product, or any ED medication taken alongside blood pressure medicines is appropriate is decided by a licensed provider who reviews your health history and current medications. For general background, read our ED safety information and our guide to tadalafil side effects.

How much does Medvi Quad cost?

On October 16, 2026, MEDVi’s Quad page showed “$114” a month labeled “Starting at,” next to “$179” and a “36% Off Retail” tag, plus “Or Bundle & Save More” without details (Quad page). The page does not say how many doses you get each month, so a per-dose cost can’t be worked out from it.

The page also says “If you don’t qualify, you don’t pay.” MEDVi’s Cancellation and Refund Policy says you get a refund if a provider finds you medically ineligible, that monthly plans are not refunded for the month you cancel, and that you need to cancel at least 72 hours before your next billing date (MEDVi refund policy).

How does the Quad process work?

According to MEDVi’s Quad page (quad.medvi.org):

1. You fill out an intake form that MEDVi says takes 3 minutes.
2. MEDVi says “A US-licensed doctor reviews your case within 24 hours.”
3. If approved, the treatment ships in “a plain, unmarked package” with “Free rush shipping.”

The Quad page does not name the prescriber or the pharmacy. MEDVi’s main site names OpenLoop Health and CareGLP Affiliated P.C.s as prescribers and three partner pharmacies, but those statements are made for its GLP-1 program (MEDVi home page), so it is reasonable to ask which partners handle Quad.

What do Medvi Quad reviews say?

Many pages about Quad are sponsored placements, press releases or affiliate sites that mainly repeat MEDVi’s own descriptions, and some list ingredients that differ from MEDVi’s own page. This review does not quote testimonials or report star ratings. It sticks to what MEDVi’s site lists and what published studies report.

Medvi Quad vs PrescribedRX Prime Time: how do they compare?

We sell Prime Time, so we compete with Quad. The table lists facts only: Quad details as listed on MEDVi’s site, Prime Time details as shown on our Prime Time product page. Checked October 16, 2026.

	Medvi Quad (as listed on MEDVi’s site, Oct 2026)	PrescribedRX Prime Time
What it is	Sildenafil, tadalafil, apomorphine, L-citrulline	Tadalafil + sildenafil in one tablet
Form	Liquid under the tongue	Tablet, as needed
Compounded?	Yes	Yes
Price shown	“Starting at” $114/month, next to $179; doses per month not stated	6 pills a month: 3 month plan $201 · $67/mo · Billed every 3 months. Cancel anytime. A 12-pills-a-month plan is also listed: 36 pills, $386, every 3 months.

For Prime Time, a licensed provider decides whether it is appropriate for you. There is also Prime Time Max, a separate compounded product. To compare the two main ingredients on their own, see sildenafil vs tadalafil compared.

Questions to ask before any combination ED prescription, from us or anyone else:

• What is the exact strength of each ingredient in one dose?
• Which pharmacy compounds it, and is it licensed in my state?
• Will the provider review my health history and every medication I take, including blood pressure medicines?
• What happens if it doesn’t work for me?
• What is the renewal price, and when is the next charge?

What should you discuss with a provider before Quad?

Bring a full list of your medicines, including any heart or blood pressure medicines, and mention that the exact mix has no published trial. Whether a combination product like Quad is appropriate is decided by a licensed provider who reviews your health history and current medications. The American Urological Association’s ED guideline recommends shared decision-making, where you and your clinician weigh every treatment that is not ruled out for you (AUA ED guideline).

For a broader look at providers, see our roundup of online ED treatment services and our Rugiet review, another multi-drug sublingual.

Medvi Quad FAQ

Does Medvi Quad actually work?

The evidence is limited: no published trial has tested Quad’s four-ingredient mix (PubMed search). Sildenafil and tadalafil each have trial results reported in their prescribing information. In two head-to-head trials, apomorphine had lower success rates than sildenafil (Pavone; Eardley). MEDVi does not publish the dose of each ingredient.

What are the ingredients in Medvi Quad?

As listed on MEDVi’s Quad page on October 16, 2026: sildenafil, tadalafil, apomorphine and L-citrulline, in a liquid taken under the tongue. MEDVi does not list the milligrams of each. Some other sites list vardenafil instead of L-citrulline; MEDVi’s own page does not list vardenafil.

Is Medvi Quad a compounded medication?

Yes. The Quad page footer refers to compounded medication (Quad page). Sildenafil and tadalafil are also sold as separate brand-name and generic drugs. Apomorphine is not sold as an ED drug in the U.S.

How fast does Medvi Quad work?

MEDVi says Quad “hits your system in 10 minutes” and works “in as little as 15 minutes.” No published study has measured how fast Quad is absorbed.

Is Medvi Quad safe? What are the side effects?

No study has tested Quad’s safety directly. The sildenafil and tadalafil prescribing information covers each drug on its own (Viagra; Cialis). Whether Quad is appropriate for you is decided by a licensed provider who reviews your health history and current medications.

How much does Medvi Quad cost?

On October 16, 2026, MEDVi’s Quad page showed “Starting at” $114 a month, next to $179 and a “36% Off Retail” tag. It did not say how many doses come each month. MEDVi’s refund policy does not refund the month you cancel on monthly plans and asks for 72 hours’ notice before billing.

Can you take sildenafil and tadalafil together?

Whether any combination of ED medicines, including Quad or our Prime Time, is appropriate is decided by a licensed provider who reviews your health history and current medications. Our page on sildenafil vs tadalafil compares the two drugs on their own.

The bottom line

Quad pairs two prescription ED drugs with two extras, apomorphine (not sold as an ED drug in the U.S.) and L-citrulline (a supplement tested in one small study), in a compounded liquid with no published trial and no published doses. MEDVi’s speed figures come from its own page, not from study results. Before any prescription, ask for the strengths and pharmacy name in writing and go over your medication list with a licensed provider.

Want to see a combination product with prices on the page? Prime Time contains sildenafil and tadalafil in one tablet. It is compounded, and 6 pills a month are shown as “3 month plan $201 · $67/mo · Billed every 3 months. Cancel anytime.” A licensed provider decides whether it is appropriate for you. Check your eligibility, compare what every PrescribedRX treatment costs, or browse our online ED treatment options.

Sources

1. MEDVi. Quad by MEDVi landing page. quad.medvi.org. Accessed Oct 2026.
2. MEDVi. Cancellation and Refund Policy. home.medvi.org/cancellation-and-refund-policy. Accessed Oct 2026.
3. MEDVi. Home page (prescribers, pharmacies). home.medvi.org. Accessed Oct 2026.
4. VIAGRA (sildenafil) prescribing information. DailyMed, National Library of Medicine. dailymed.nlm.nih.gov. Accessed Oct 2026.
5. CIALIS (tadalafil) prescribing information. DailyMed, National Library of Medicine. dailymed.nlm.nih.gov. Accessed Oct 2026.
6. Pavone C, et al. Prospective, randomized, crossover comparison of sublingual apomorphine (3 mg) with oral sildenafil (50 mg) for male erectile dysfunction. J Urol, 2008. PubMed. pubmed.ncbi.nlm.nih.gov/18405767. Accessed Oct 2026.
7. Eardley I, et al. An open-label, randomized, flexible-dose, crossover study to assess the comparative efficacy and safety of sildenafil citrate and apomorphine hydrochloride in men with erectile dysfunction. BJU Int, 2004. PubMed. pubmed.ncbi.nlm.nih.gov/15180621. Accessed Oct 2026.
8. Cormio L, et al. Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction. Urology, 2011. PubMed. pubmed.ncbi.nlm.nih.gov/21195829. Accessed Oct 2026.
9. European Medicines Agency. Uprima: EPAR. ema.europa.eu. Accessed Oct 2026.
10. American Urological Association. Erectile Dysfunction Guideline. auanet.org. Accessed Oct 2026.
11. National Library of Medicine. PubMed search results: apomorphine AND sildenafil AND tadalafil AND citrulline. pubmed.ncbi.nlm.nih.gov. Accessed Oct 2026.
12. PrescribedRX. Prime Time – 6 Monthly Pills product page (ingredients, pill counts, prices). prescribedrx.com/plans/prime-time/. Accessed Oct 2026.

This article is for general information. It is not medical advice and it is not a recommendation for any particular treatment. Whether a treatment is appropriate for you is a decision for a licensed clinician who has reviewed your health history and current medications.