Two PDE5 Inhibitors In One Sublingual Troche

The Tadalafil & Sildenafil troche combines two widely used PDE5 inhibitors into a single dose — 22mg Tadalafil and 110mg Sildenafil, delivered sublingually (under the tongue). Both are FDA-approved active ingredients with decades of clinical use. Sildenafil is associated with a faster onset; Tadalafil is associated with a longer active window. Whether this medication is appropriate for you is determined by a licensed provider.

About Tadalafil

Tadalafil has been FDA-approved since 2003 under the brand name Cialis and is used in prescriptions worldwide. It is described in the medical literature as having an active window of up to about 36 hours — among the longest of the approved PDE5 inhibitors. As a PDE5 inhibitor, Tadalafil is understood to relax smooth muscle and support blood flow in response to sexual stimulation. Whether it is appropriate for you, and any expected effect, is determined by a licensed provider.

About Sildenafil

Sildenafil was the first FDA-approved PDE5 inhibitor, cleared in 1998 and widely known by its brand name, Viagra. It is among the most studied and prescribed medications in its class. It is associated with an onset that is typically described as within 30 to 60 minutes. Its role in this troche relates to that earlier onset, which is part of the reasoning behind pairing the two ingredients.

Why The Two Are Combined

Each ingredient has a different described profile: Sildenafil is associated with faster onset but a shorter active window, while Tadalafil is associated with a longer window. Combining two PDE5 inhibitors in one sublingual troche is intended to draw on both profiles. This is a compounded formulation, prepared for you rather than pulled off a shelf, which is why it can pair the two in a single dose. Whether this combination is appropriate for you is determined by a licensed provider.

How To Take A Troche

A troche is a small medicated lozenge designed to dissolve under the tongue, so the medicine is absorbed sublingually. General handling instructions:

• For sublingual use only.
• Take one troche 30–60 minutes before activity, if directed.
• Let it fully dissolve under your tongue — do not chew or swallow it whole.
• Use only as prescribed by your provider.

Your prescribing provider sets the exact dose and frequency based on your health history.

How Often Is Safe?

General guidance for these ingredients is to take no more than one dose in any 24-hour period and to wait at least 24 hours between doses. Do not combine this troche with other ED medications, including oral pills or other compounds. Your prescribing provider sets the exact frequency that is appropriate for you based on your history.

Safety: Read This Before You Order

The safety rules here are not optional. Do not take it if you use nitrate medications (for chest pain or heart conditions), if you take alpha-blockers without medical guidance, or if you have had a recent heart attack, stroke, or severe arrhythmia — Tadalafil and Sildenafil can cause significant drops in blood pressure when combined with these medications. Consult a medical provider if you have liver impairment, severe kidney disease, low or uncontrolled high blood pressure, a history of vision or hearing loss, or sickle cell conditions.

Some users may experience headache, flushing, indigestion or heartburn, nasal congestion, back or muscle pain, dizziness, or temporary changes in vision such as blurred sight or a blue tint. Seek immediate medical attention if you experience chest pain, sudden vision or hearing loss, or an erection lasting more than 4 hours (priapism). This is why treatment is only dispensed after a licensed provider reviews your history — the consultation is a safety step, not a formality.

Compounded, Prescribed For You

Tadalafil + Sildenafil as a single 22mg / 110mg sublingual troche isn't stocked on retail pharmacy shelves — it's compounded for you, one prescription at a time, by Pharmacy Hub LLC, a U.S. compounding pharmacy licensed in all 50 states. The combination troche is not FDA-approved as a single product, though both active ingredients individually are. Compounding means a prescribed-for-you medication rather than a one-size-fits-all pill.

The Bottom Line

The Tadalafil & Sildenafil troche combines two FDA-approved PDE5 inhibitors in a single sublingual dose, compounded by Pharmacy Hub LLC, a U.S. compounding pharmacy licensed in all 50 states. It is a compounded prescription medication, dispensed only after a licensed provider decides it is appropriate for you. Whether it is appropriate for you is determined by a licensed provider; the next step is a consultation.