ED treatment

In stock

CompoundedApexFast and long-lasting, dissolvable

From$85/mo^*

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* Troche, in 3, 6 or 12 month plans. Prices may vary.

Compounded in the USAFSA and HSA eligiblePay over time with Klarna

Tadalafil and sildenafil in one dissolvable troche
Same-day doctor visits and prescriptions
Free expedited shipping, all 50 states
No hidden fees, no surprise charges

A dissolvable troche that combines tadalafil and sildenafil, pairing fast onset with long duration. It melts under the tongue, so there is no pill to swallow.

Who it's for: Men who want both quick and long-lasting effects and prefer a dissolvable to a tablet.

Tadalafil 22 mg, long-lasting blood flow, up to 36 hours
Sildenafil 120 mg, kicks in fast, within the hour

A 24/7 care team, day or night
Physician visits and follow-ups
Dose adjusted as you progress
Help with side effects
Medication from a US pharmacy
Free expedited shipping, all 50 states

Cancel anytime, online in your account. No call, no form, no fee.

Canceling does not stop an order already sent to the pharmacy. If one is on its way, write to [email protected] and we will help.

The statements on this page have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. The FDA does not review or approve any compounded medications for safety or effectiveness.

Important Safety Information (opens in a new tab)

Explore men's treatments

Men's treatments and targeted add-ons, prescribed and monitored by licensed physicians.

Daily TadalafilLow daily dose for everyday readinessFrom $65/mo

Sexual wellness Important Safety Information (opens in a new tab)

SildenafilFast-acting, taken as neededFrom $65/mo

Sexual wellness Important Safety Information (opens in a new tab)

PT-141Boosts desire and arousalFrom $175/mo

Sexual wellness Important Safety Information (opens in a new tab)

ApexFast and long-lasting, dissolvableFrom $85/mo

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VardenafilOn-demand support for erectile functionFrom $55/mo

Sexual wellness Important Safety Information (opens in a new tab)

Five ways, one visit

As needed or every day, fast or long lasting. Find the one that fits your life, and switch anytime.

Prescription

SildenafilFrom $65/mo

Best for: Planned moments.

FormTablet

TakenAs needed, 30 to 60 min before

Works onBlood flow

Get started

Prescription

Daily tadalafilFrom $65/mo

Best for: Spontaneity, no planning.

FormTablet

TakenOnce a day, every day

Works onBlood flow

Get started

Prescription

VardenafilFrom $55/mo

Best for: An alternative to sildenafil.

FormTablet

TakenAs needed, about an hour before

Works onBlood flow

Get started

Compounded

ApexFrom $85/mo

Best for: A fast start and a long window.

FormTroche, melts under the tongue

TakenAs needed

Works onBlood flow

Get started

Compounded

PT-141From $175/mo

Best for: Low desire, not blood flow.

FormInjection

TakenAbout 45 min before

Works onDesire, in the brain

Get started

Personalized medicine,
in three simple steps

Get started See treatments

Submit your application
and meet with a doctor

Step1

Complete a quick form and meet a licensed provider 100% online. They'll see if a treatment plan is right for you.

Choosing what you are interested in on the Sipra intake

Get your medication
delivered at home

Step2

Once approved, your prescription ships directly to your door, fast and free.

Receive 24/7 support
and ongoing care

Step3

Regular check-ins and on-demand medical support to keep you on track.

Sexual wellness

You do not have to bring this up out loud. Start in your account.

Create your account, choose what fits in the Sexual Wellness section, and check out. The health questions come at checkout.

See sexual wellness treatments

More than a prescription

Most online programs ship a box. Sipra stays with you.

Sipra compared with a typical online program
		Typical online programs
No membership fee	No fee	Often a monthly fee
The Sipra PromisePay only if a physician approves.	$0 today	Often charged at checkout
Leave anytimeCancel online. No call, no form.	Anytime	Steps may vary
One price, shipping includedVisits and support too.	Included	Fees may vary
US-licensed pharmaciesURAC, ACHC and LegitScript accredited	Accredited	May vary
Tested before it shipsPotency, plus sterility for injections	Yes	Testing may vary
Dosing set by your physician	Included	Follow-up may be limited
Side effect support	Included	May vary
Care team messaging, day or night	Anytime	Hours may be limited

Start my visit

Nothing is charged until a physician approvesFSA and HSA eligible

How it works

An erection is blood flow. These medicines keep the signal on longer.

ArousalA signal starts in the brain

Nitric oxideReleased in the tissue

cGMPRelaxes the vessel walls

Blood flowFills and holds

PDE5 is the off switchSildenafil, tadalafil and vardenafil pause it, so the signal lasts.

PT-141 works upstreamOn desire, in the brain. Useful when wanting it is the issue, not blood flow.

When it works

See how long each option keeps you ready, from the moment you take it.

Take it1 hr4 hrs12 hrs24 hrs36 hrs

SildenafilTablet

about 4 hours

about 4 hours

Daily tadalafilDaily tablet

every day, steady

every day, steady

VardenafilTablet

4 to 5 hours

4 to 5 hours

ApexTroche

up to 36 hours

up to 36 hours

PT-141Injection

desire, several hours

desire, several hours

Blood flow, as neededDaily, always onDesire

Heard from our members

Real members, in their own words, on what changed after their first visit.

Filling in the form was my big step.

I’d put off getting help for a long time. Even filling out the form felt like a big step. But the questions were straightforward, and the doctor put me at ease. We talked through the options and what to expect. That was what I needed: a clear conversation about something I’d spent months avoiding.

Daniel R. · TexasTreated with Sildenafil

Verified member

I had room to ask.

I thought an online appointment would be pretty quick, and I worried I’d forget something important. I had a few questions written down, including ones that probably sounded basic. The doctor went through them with me without making me feel like I was holding things up. I left knowing what we’d discussed and what I still needed to think about.

Anthony J. · OhioTreated with Daily tadalafil

Verified member

We started with what mattered to me.

I wasn’t sure how to explain what I wanted to be different. It wasn’t as simple as wanting more desire, and I didn’t want someone assuming it was. The doctor gave me room to explain it in my own words. We talked about what mattered to me before getting into the options.

Marcus D. · North CarolinaTreated with PT-141

Verified member

It wasn’t awkward the way I feared.

I rehearsed what I’d say for days. The questions did most of the work, and the doctor picked up from there in a matter of fact way. By the end it felt like any other health conversation.

Kevin L. · NevadaTreated with Sildenafil

Verified member

Daily made more sense for us.

I didn’t like planning around a pill. The doctor asked how our weeks actually go and explained the difference between an as needed dose and a daily one. Choosing together made it simple.

Luis R. · CaliforniaTreated with Daily tadalafil

Verified member

He asked about my heart medication.

I take a blood pressure pill and assumed that ruled me out. The doctor went through my medications one by one and explained what was safe together and why.

Steve B. · PennsylvaniaTreated with Vardenafil

Verified member

The box gave nothing away.

My roommate gets the mail. It came in a plain box with nothing on the outside, and the label inside was just for me. That was half my worry, gone.

Derek F. · OregonTreated with Sildenafil

Verified member

I could ask the follow up questions.

After my first try I had questions I hadn’t thought of before. I messaged from my account and the answer came back clear and kind, with a small change to try.

Nate H. · MichiganTreated with Apex

Verified member

Nobody rushed me to decide.

I wanted to understand the options before committing to one. The doctor laid them out side by side and let me take a day to think. No pressure at all.

Carlos V. · TexasTreated with Daily tadalafil

Verified member

Talking about it got easier.

I was more stressed about the conversation than the problem. Being asked plainly, by someone who clearly hears it every day, took the weight off.

Will J. · ColoradoTreated with Sildenafil

Verified member

The pharmacy behind your treatment

Get started See treatments

Licensed 503A pharmacy

Your treatment ships to all 50 states

Compounded in the USA

Made for you, never mass-produced

Tested before it ships

Sterility, endotoxin, and potency, under USP 795 and 797

Independently accredited

URAC, ACHC, and LegitScript

From your visit to your door

Exactly what happens after your visit, who handles it, and when you pay. Nothing is charged until a physician approves.

Start my visit

01Online visit
A few questions, no charge
02Physician review
A licensed US physician
03Approval
Charged only if approved
04Pharmacy
Prepared in the US
05Delivery
Expedited shipping included
06Ongoing care
Check-ins and dose changes

Start my visit

Care between visits

Message your physician from your account. Refills arrive before you run out.

Your care team9:52 AM

Thanks. Your physician checks it against this treatment and messages you before anything ships.

Today 9:41 AM Can I take it with my blood pressure pill?9:41 AM · Delivered Good question. Which one do you take?Thanks. Your physician checks it against this treatment and messages you before anything ships.9:52 AM

Message your care team ...

Refills, on their own

Scheduled for youYour next box is set before your supply runs out.
A heads-up emailIt says a shipment is coming, never what is in it.
Ships in a plain boxNothing outside says what is inside.
Yours to changeSkip it, or move it up to 7 days. Pause up to three months.

Your prescription covers a full year, so a refill needs no new visit. Cancel online, anytime. No call needed.

Sipra Medical Reviewer

“ED is common, and it is often a sign worth listening to. What matters is a careful review of your heart health and medications, then the option that fits how you live.”

Dr. Jillian Foglesong StabileMD, FAAFP, DABOM

Board-certified family physician and Diplomate of the American Board of Obesity Medicine.

American Board of Family Medicine

American Board of Obesity Medicine

Wake Forest University School of Medicine

ED questions, answered

Sildenafil, tadalafil, and vardenafil relax blood vessels in the penis so blood can flow in more easily when you are aroused. They do not cause an erection on their own, and they do not raise desire. Your physician picks the one that fits your health and routine.

Some medications are taken before sex, and their effect lasts for a set window. Daily tadalafil is taken at a regular time, so you do not have to plan around the moment. Your physician helps you choose based on how often you want to be ready.

A troche is a small dissolving tablet that sits under the tongue or in the cheek rather than being swallowed. It is made by a licensed pharmacy and combines tadalafil and sildenafil in one dose. Your physician decides whether it makes sense for you.

PT-141, also called bremelanotide, works on pathways in the brain tied to sexual desire, rather than on blood flow. It is sometimes considered when the usual ED pills are not a good fit. It is compounded, which means it is not FDA-approved, and your physician decides if it is appropriate.

Common ones include headache, flushing, stuffy nose, upset stomach, and dizziness. PT-141 can also cause nausea and a short rise in blood pressure. A very long erection, sudden vision loss, or sudden hearing loss needs emergency care right away.

Anyone taking nitrate medicines, including some chest pain medications, should not take these drugs, because the combination can drop blood pressure dangerously. Heart disease, low blood pressure, and some other medications also need careful review. Be complete on your intake, and your physician decides what is safe.

No office visit is needed. A licensed US physician reviews your online intake, including your health history and medications. If they want blood work or a blood pressure reading, they will tell you.

A compounded medication is prepared by a licensed pharmacy for a specific patient, which allows different formats or ingredient combinations. Compounded medications are not FDA-approved, and they are not the same as any brand-name product. Your plan shows exactly what you receive, and it ships from a licensed US 503A pharmacy that tests it first.

Plans are billed per plan term, and the price does not change with your dose. Shipping is included, and you pay nothing unless a physician approves your treatment. It is cash pay with no insurance needed, and FSA and HSA funds can be used.

Yes. You can cancel online at any time, with no phone call and no form. If something is not working, message your care team first, since a change in medication or timing can help.