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Apomorphine Sildenafil Tadalafil Compounded
Sublingual apomorphine stimulates dopamine receptors used as an alternative or combination with sildenafil and/or tadalafil for patients with erectile dysfunction. You may have Apomorphine and Sildenafil and/or Tadalafil combination compounded by CareFirst Specialty Pharmacy with a valid prescription from your prescriber.
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Price: as low as $54.95
Please Note: Due to market volatility, prices are subject to change. Please contact us for the most current pricing.
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This medication requires a prescription.
To process your order we will require a prescription from you or your Prescriber. We will only compound and dispense upon receipt of a valid patient specific prescription.
- Your prescriber can mail or fax in the prescription
- You can mail in the original prescription
- We can contact your prescriber for you
- You can transfer your prescription from another pharmacy
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Call our pharmacists at (844) 822-7379 with prescription details.
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Pharmacy Info
We are a nationally accredited PCAB compounding pharmacy and a .Pharmacy verified website. A verified .Pharmacy website designation ensures our patients and prescribing partners that our website is verified and safe.
https://safe.pharmacy/buy-safely/?url=cfspharmacy.pharmacy
Drug Description
Actual product image may vary.
Product Info
Apomorphine, Sildenafil & Tadalafil Compounded
Sublingual apomorphine stimulates dopamine receptors and can be used as an alternative to, or in combination with, sildenafil and/or tadalafil for patients with erectile dysfunction (ED).
CareFirst Specialty Pharmacy can compound this combination as a fast-dissolving troche, capsule, or gummy with a valid prescription from your prescriber — allowing multiple ED medications to be combined into a single, customized dose.
✨ A Combination Approach to ED Therapy
Combining a dopamine agonist with a PDE-5 inhibitor may offer patients who don't respond fully to a single therapy an additional option, tailored to their prescriber's guidance.
Mechanism of Action
1
Apomorphine
Stimulates postsynaptic dopamine-type receptors in the brain.
Stimulates postsynaptic dopamine-type receptors in the brain.
2
Sildenafil & Tadalafil
Phosphodiesterase type 5 (PDE-5) inhibitors that enhance the response to sexual stimulation by boosting the effect of nitric oxide.
Phosphodiesterase type 5 (PDE-5) inhibitors that enhance the response to sexual stimulation by boosting the effect of nitric oxide.
3
Combined Effect
Increased cyclic guanosine monophosphate (cGMP) levels lead to smooth muscle relaxation and increased blood inflow.
Increased cyclic guanosine monophosphate (cGMP) levels lead to smooth muscle relaxation and increased blood inflow.
Why a Compounded Troche?
⚡
Fast, Direct Absorption
Troches dissolve slowly under the tongue, against the cheek, or between the gums and cheek, allowing direct absorption through the oral mucosa — bypassing the digestive system and first-pass metabolism for faster onset and enhanced bioavailability.
Troches dissolve slowly under the tongue, against the cheek, or between the gums and cheek, allowing direct absorption through the oral mucosa — bypassing the digestive system and first-pass metabolism for faster onset and enhanced bioavailability.
💊
Ease of Administration
Ideal for patients who have difficulty swallowing or want a quicker onset of action than a traditional tablet.
Ideal for patients who have difficulty swallowing or want a quicker onset of action than a traditional tablet.
🧪
Customization
Dosage, strength, flavor (such as peppermint or bubblegum), and combination therapy can be tailored to your specific requirements — options not commercially available.
Dosage, strength, flavor (such as peppermint or bubblegum), and combination therapy can be tailored to your specific requirements — options not commercially available.
📄
Fewer Pills to Take
Multiple medications can be compounded into a single formulation, simplifying medication regimens and reducing pill burden.
Multiple medications can be compounded into a single formulation, simplifying medication regimens and reducing pill burden.
Administration & Handling
✅
Use this medication as ordered and directed by your prescriber, and contact them for specific dosing instructions.
⚠️
Use with caution in patients with chronic kidney disease and/or liver disease.
Drug Interactions
Do not use alongside: selective 5-HT3 receptor antagonists (e.g., ondansetron, granisetron, alosetron), nitrates (e.g., nitroglycerin, isosorbide dinitrate), or riociguat (a guanylate cyclase stimulator).
Warnings, Precautions & Adverse Effects
Experiences may vary per patient and are not all the same. Patients may experience gastrointestinal upset (nausea, diarrhea, vomiting), hypotension, increased risk of falls, headaches, visual disturbances, hallucinations/psychosis, impulse control disorders, dizziness, and somnolence while on this medication.
⚠️ Use caution with anatomical penis deformation, bleeding disorders, cardiovascular disease, conditions predisposing to priapism, peptic ulcer disease, pulmonary arterial hypertension, or sickle cell anemia
⚠️ Use caution in patients with risk factors for torsades de pointes (hypokalemia, hypomagnesemia, bradycardia, concurrent QTc-prolonging drugs, or genetic predisposition)
⚠️ Confusion and hallucinations are reported more frequently in patients ≥65 years of age; use with caution
Pregnancy & Lactation
Adverse events have been observed in animal reproduction studies. It is not known if apomorphine is excreted in breast milk. According to the manufacturer, the decision to continue or discontinue breastfeeding during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.
⚠️ Disclaimer: This information is general and not intended to cover all possible uses, directions, precautions, or adverse effects, nor is it a substitute for medical advice. Talk with your prescriber about whether this combination is right for you.
References
- Apomorphine [Lexi-Drugs]. Lexi-Comp. Wolters Kluwer Health, Inc. Updated on 2026 April 21. Accessed on 2026 April 22.
- Sildenafil [Lexi-Drugs]. Lexi-Comp. Wolters Kluwer Health, Inc. Updated on 2026 April 22. Accessed on 2026 April 22.
- Tadalafil [Lexi-Drugs]. Lexi-Comp. Wolters Kluwer Health, Inc. Updated on 2026 April 22. Accessed on 2026 April 22.
- Dhir RR, Lin HC, Canfield SE, Wang R. Combination therapy for erectile dysfunction: an update review. Asian J Androl. 2011 May;13(3):382-90. doi: 10.1038/aja.2011.2. PMID: 21423198; PMCID: PMC3739353.
- Guillén, V., José-Ramón, R., Lopez-Argumedo, M., Solà Ivan, & Ballesteros, J. (2020). Apomorphine for the Treatment of Erectile Dysfunction: Systematic Review and Meta-Analysis. Archives of Sexual Behavior, 49(8), 2963-2979. https://doi.org/10.1007/s10508-020-01817-5.
- Safety Data Sheet. Apomorphine Hydrochloride. Cayman Chemical. Revised 2019 January 9. Accessed 2026 April 22. Available from: https://content.labscoop.com/products/01e764e5-04d3-479d-a7a6-41f43dba02b1/uOMaX16094m.pdf.
- A Comprehensive Guide to Understanding Troches and Compounding Medicine. Gaspar’s Best. Accessed on 2026 April 22. Available from: https://gasparsbest.com/a-comprehensive-guide-to-understanding-troches-and-compounding-medicine/.
- APHA Pharmacy Library. The Art, Science, and Technology of Pharmaceutical Compounding, 6th Edition. Chapter 14: Lozenges, Troches, and Films. Updated on 2020 Oct. Accessed on 2026 April 22. Available from: https://doi.org/10.21019/9781582123578.ch14.
Active Ingredients
Apomorphine, Sildenafil, and Tadalafil
Directions
Consult your prescriber.
Instructions
Use the medication as prescribed by your doctor. The information provided is not intended to cover all possible uses. This information is generalized and not intended as specific medical advice. If you have questions about the use of your prescription, please contact your prescriber.
Shipping
Troches and suppositories require refrigeration (ice packs) and will incur an extra charge of $19.95 per order.
Reviews
Customer Reviews
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Leave a Review
We are a nationally accredited PCAB compounding pharmacy and a .Pharmacy verified website. A verified .Pharmacy website designation ensures our patients and prescribing partners that our website is verified and safe.
https://safe.pharmacy/buy-safely/?url=cfspharmacy.pharmacy
Actual product image may vary.
Apomorphine, Sildenafil & Tadalafil Compounded
Sublingual apomorphine stimulates dopamine receptors and can be used as an alternative to, or in combination with, sildenafil and/or tadalafil for patients with erectile dysfunction (ED).
CareFirst Specialty Pharmacy can compound this combination as a fast-dissolving troche, capsule, or gummy with a valid prescription from your prescriber — allowing multiple ED medications to be combined into a single, customized dose.
✨ A Combination Approach to ED Therapy
Combining a dopamine agonist with a PDE-5 inhibitor may offer patients who don't respond fully to a single therapy an additional option, tailored to their prescriber's guidance.
Mechanism of Action
1
Apomorphine
Stimulates postsynaptic dopamine-type receptors in the brain.
Stimulates postsynaptic dopamine-type receptors in the brain.
2
Sildenafil & Tadalafil
Phosphodiesterase type 5 (PDE-5) inhibitors that enhance the response to sexual stimulation by boosting the effect of nitric oxide.
Phosphodiesterase type 5 (PDE-5) inhibitors that enhance the response to sexual stimulation by boosting the effect of nitric oxide.
3
Combined Effect
Increased cyclic guanosine monophosphate (cGMP) levels lead to smooth muscle relaxation and increased blood inflow.
Increased cyclic guanosine monophosphate (cGMP) levels lead to smooth muscle relaxation and increased blood inflow.
Why a Compounded Troche?
⚡
Fast, Direct Absorption
Troches dissolve slowly under the tongue, against the cheek, or between the gums and cheek, allowing direct absorption through the oral mucosa — bypassing the digestive system and first-pass metabolism for faster onset and enhanced bioavailability.
Troches dissolve slowly under the tongue, against the cheek, or between the gums and cheek, allowing direct absorption through the oral mucosa — bypassing the digestive system and first-pass metabolism for faster onset and enhanced bioavailability.
💊
Ease of Administration
Ideal for patients who have difficulty swallowing or want a quicker onset of action than a traditional tablet.
Ideal for patients who have difficulty swallowing or want a quicker onset of action than a traditional tablet.
🧪
Customization
Dosage, strength, flavor (such as peppermint or bubblegum), and combination therapy can be tailored to your specific requirements — options not commercially available.
Dosage, strength, flavor (such as peppermint or bubblegum), and combination therapy can be tailored to your specific requirements — options not commercially available.
📄
Fewer Pills to Take
Multiple medications can be compounded into a single formulation, simplifying medication regimens and reducing pill burden.
Multiple medications can be compounded into a single formulation, simplifying medication regimens and reducing pill burden.
Administration & Handling
✅
Use this medication as ordered and directed by your prescriber, and contact them for specific dosing instructions.
⚠️
Use with caution in patients with chronic kidney disease and/or liver disease.
Drug Interactions
Do not use alongside: selective 5-HT3 receptor antagonists (e.g., ondansetron, granisetron, alosetron), nitrates (e.g., nitroglycerin, isosorbide dinitrate), or riociguat (a guanylate cyclase stimulator).
Warnings, Precautions & Adverse Effects
Experiences may vary per patient and are not all the same. Patients may experience gastrointestinal upset (nausea, diarrhea, vomiting), hypotension, increased risk of falls, headaches, visual disturbances, hallucinations/psychosis, impulse control disorders, dizziness, and somnolence while on this medication.
⚠️ Use caution with anatomical penis deformation, bleeding disorders, cardiovascular disease, conditions predisposing to priapism, peptic ulcer disease, pulmonary arterial hypertension, or sickle cell anemia
⚠️ Use caution in patients with risk factors for torsades de pointes (hypokalemia, hypomagnesemia, bradycardia, concurrent QTc-prolonging drugs, or genetic predisposition)
⚠️ Confusion and hallucinations are reported more frequently in patients ≥65 years of age; use with caution
Pregnancy & Lactation
Adverse events have been observed in animal reproduction studies. It is not known if apomorphine is excreted in breast milk. According to the manufacturer, the decision to continue or discontinue breastfeeding during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.
⚠️ Disclaimer: This information is general and not intended to cover all possible uses, directions, precautions, or adverse effects, nor is it a substitute for medical advice. Talk with your prescriber about whether this combination is right for you.
References
- Apomorphine [Lexi-Drugs]. Lexi-Comp. Wolters Kluwer Health, Inc. Updated on 2026 April 21. Accessed on 2026 April 22.
- Sildenafil [Lexi-Drugs]. Lexi-Comp. Wolters Kluwer Health, Inc. Updated on 2026 April 22. Accessed on 2026 April 22.
- Tadalafil [Lexi-Drugs]. Lexi-Comp. Wolters Kluwer Health, Inc. Updated on 2026 April 22. Accessed on 2026 April 22.
- Dhir RR, Lin HC, Canfield SE, Wang R. Combination therapy for erectile dysfunction: an update review. Asian J Androl. 2011 May;13(3):382-90. doi: 10.1038/aja.2011.2. PMID: 21423198; PMCID: PMC3739353.
- Guillén, V., José-Ramón, R., Lopez-Argumedo, M., Solà Ivan, & Ballesteros, J. (2020). Apomorphine for the Treatment of Erectile Dysfunction: Systematic Review and Meta-Analysis. Archives of Sexual Behavior, 49(8), 2963-2979. https://doi.org/10.1007/s10508-020-01817-5.
- Safety Data Sheet. Apomorphine Hydrochloride. Cayman Chemical. Revised 2019 January 9. Accessed 2026 April 22. Available from: https://content.labscoop.com/products/01e764e5-04d3-479d-a7a6-41f43dba02b1/uOMaX16094m.pdf.
- A Comprehensive Guide to Understanding Troches and Compounding Medicine. Gaspar’s Best. Accessed on 2026 April 22. Available from: https://gasparsbest.com/a-comprehensive-guide-to-understanding-troches-and-compounding-medicine/.
- APHA Pharmacy Library. The Art, Science, and Technology of Pharmaceutical Compounding, 6th Edition. Chapter 14: Lozenges, Troches, and Films. Updated on 2020 Oct. Accessed on 2026 April 22. Available from: https://doi.org/10.21019/9781582123578.ch14.
Apomorphine, Sildenafil, and Tadalafil
Consult your prescriber.
Use the medication as prescribed by your doctor. The information provided is not intended to cover all possible uses. This information is generalized and not intended as specific medical advice. If you have questions about the use of your prescription, please contact your prescriber.
Troches and suppositories require refrigeration (ice packs) and will incur an extra charge of $19.95 per order.
Customer Reviews
No reviews yet
Leave a Review
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