Impact-Site-Verification: 2721d812-1059-4270-b9fa-5c1654788cd1

Get weight loss treatment From $99/mo LegitScript certified Licensed U.S. pharmacy Providers licensed in all 50 states

Quad Mix: 4 ED Medications in One Dose

Quad Rx from Rx.com combines apomorphine, sildenafil, tadalafil and vardenafil in liquid drops that absorb under your tongue. Prescribed online by independent U.S.-licensed providers and shipped to your door.

Get Quad Rx From $114/month
  • Free provider consultation
  • Free express shipping
  • Billed only if prescribed
Quad Rx sublingual bottle: apomorphine, sildenafil, tadalafil and vardenafil
4 in 1ED medications
Under the tongueNo pill to swallow
Independent U.S.-licensed providers U.S.-licensed pharmacies Free express shipping, 1 to 5 days Same price every renewal
QUAD Rx4-in-1 performance
Quad Rx sublingual bottle: apomorphine, sildenafil, tadalafil and vardenafil
SildenafilPeak strength
TadalafilLasts up to 36 hours
VardenafilReliable response
ApomorphineIgnites desire

Complete Stack

1 solution, 4 powerful ingredients. Three trusted ED medicines plus one that works on arousal, in a single sublingual dose.

4ED medications
1sublingual dose
36 hrtadalafil can stay active

Engineered for your body.

Absorbs under the tongue

Quad Rx is a liquid you hold under your tongue, where it absorbs through the tissue there instead of being swallowed like a pill.

  • No pill to swallow
  • Discreet, easy to carry
  • Dosed by your provider

Up to 36 hours of coverage

Tadalafil, the long-acting ingredient in Cialis, can stay active for up to 36 hours, while sildenafil and vardenafil cover the shorter window.

  • Short- and long-acting ingredients together
  • Less planning around timing
  • One dose instead of several pills

Desire and blood flow

Most ED pills only improve blood flow. Quad Rx adds apomorphine, which works in the brain on the pathways involved in arousal.

  • Three PDE5 inhibitors for blood flow
  • Apomorphine for arousal
  • Two mechanisms in one dose
Prescribed online, shipped to your door

Your best performance. Delivered.

Choose your plan, complete a short online visit, and if an independent provider approves treatment, Quad Rx ships free by express delivery in plain packaging.

Get Started

What is Quad Mix?

Quad Mix is an erectile dysfunction treatment built on a simple idea: instead of relying on a single active ingredient, combine four that work in different ways.

You may also see it called Quad Rx, Quad ED drops, Quad liquid, Quad for men or 4-in-1 ED medicine. They all describe the same idea: several ED medications combined in one fast-absorbing sublingual dose instead of a single pill.

Rx.com's Quad Rx delivers that 4-in-1 formula as a compounded prescription liquid that dissolves under your tongue. Three of its ingredients are the PDE5 inhibitors behind Viagra, Cialis and Levitra, which improve blood flow. The fourth, apomorphine, works in the brain on the pathways involved in arousal.

Because it is prescription only, every order includes an online health evaluation reviewed by an independent U.S.-licensed provider. If treatment is clinically appropriate, a U.S.-licensed pharmacy fills the prescription and ships it to you.

Why settle for an incomplete formula?

A single ED pill covers one window. Quad Rx layers short- and long-acting ingredients, so the formula covers more of the weekend than any one of them alone.

Apomorphinearousal, acts centrally
VardenafilLevitra
4-5 hr
SildenafilViagra
4-6 hr
TadalafilCialis
Up to 36 hours
0 hr12 hr24 hr36 hr
Typical duration of each ingredient taken on its own, from FDA labeling and clinical literature. How Quad Rx works for you depends on your prescribed strength; your provider will explain what to expect.

Four ingredients, four jobs

Each active ingredient in Quad Rx plays a specific role.

1

Apomorphine

The arousal ingredient

Unlike the other three, apomorphine works in the brain on dopamine pathways that help start an erection, rather than on blood flow alone.

2

Sildenafil

The active ingredient in Viagra

The most widely prescribed ED medication in the world, a PDE5 inhibitor that typically lasts about 4 to 6 hours.

3

Tadalafil

The active ingredient in Cialis

The long-lasting one. Tadalafil can stay active for up to 36 hours.

4

Vardenafil

The active ingredient in Levitra

A PDE5 inhibitor closely related to sildenafil that is effective at a low dose and typically lasts about 4 to 5 hours.

The power of 4 meds. In 1 dose.

Quad Rx sublingual bottle: apomorphine, sildenafil, tadalafil and vardenafil
Free provider visitFree express shipping

Quad Rx by Rx.com

$114/ month
Billed monthlyNo commitment
Same priceEvery renewal
Free shipping1 to 5 days
  • Billed monthly, no commitment
  • Same price on every renewal
  • Only billed if a prescription is approved
  • No insurance needed, Klarna available
Choose Your Plan

3 steps to total confidence

Step 1

Choose your plan

Pick your pack size, billed monthly. You're only billed if a prescription is approved.

Step 2

Provider approval

Answer a short online health questionnaire. An independent U.S.-licensed provider reviews it and prescribes only if treatment is right for you.

Step 3

Fast, discreet delivery

A U.S.-licensed pharmacy fills your prescription and it ships free by express delivery, usually in 1 to 5 business days.

MEDVi Quad vs. Quad Rx

Both are compounded 4-in-1 sublingual ED treatments sold online with the name "Quad", so they are easy to confuse. They are separate products from separate companies, and their formulas are not the same.

Quad Rx (Rx.com)MEDVi Quad
FormSublingual liquid dropsSublingual liquid drops
IngredientsApomorphine, sildenafil, tadalafil, vardenafilSildenafil, tadalafil, apomorphine, L-citrulline*
Prescription ED drugs43, plus L-citrulline (an amino acid)*
Vardenafil (Levitra)YesNo*
Online provider visitYes, includedYes
Compounded, not FDA-approvedYesYes
Ordered throughRx.comMEDVi

The key difference is the fourth ingredient. Quad Rx uses vardenafil, the prescription PDE5 inhibitor in Levitra, where MEDVi's formula uses L-citrulline, an amino acid also sold as a supplement. Quad Rx also includes free express shipping, the same price on every renewal, and you are only billed if a prescription is approved.

*MEDVi details are from MEDVi's published materials as of September 2026; MEDVi has changed its Quad formula more than once in 2026, so check its site for the current version. MEDVi is a trademark of its owner. Rx.com is not affiliated with MEDVi.

Get Quad Rx from Rx.com

Quad Mix FAQs

What is Quad Mix?
Quad Mix refers to an erectile dysfunction treatment that combines four active medications in a single dose. Rx.com's Quad Rx is a compounded sublingual (under the tongue) liquid that combines apomorphine, sildenafil, tadalafil and vardenafil. It is prescription only and is prescribed after an online evaluation by an independent U.S.-licensed provider.
What is in Quad Rx?
Four active ingredients: sildenafil (the active ingredient in Viagra), tadalafil (Cialis) and vardenafil (Levitra), which are three PDE5 inhibitors that improve blood flow, plus apomorphine, which acts on dopamine pathways in the brain involved in arousal.
Are Quad ED drops the same thing?
Yes. "Quad drops" and "Quad liquid" are common names for this kind of 4-in-1 sublingual ED treatment. Rx.com's Quad Rx is a liquid taken under the tongue, as drops, rather than a pill you swallow.
What is the Quad Rx dosage and how do I take it?
Quad Rx is held under the tongue so it absorbs there instead of being swallowed. Your provider sets your strength and gives you dosing instructions with your prescription, so follow those exactly and do not take more than prescribed.
Does Quad Rx work?
Each of Quad Rx's three PDE5 ingredients (sildenafil, tadalafil and vardenafil) is FDA-approved for erectile dysfunction on its own and backed by large clinical trials, and apomorphine has been studied for ED as a sublingual tablet. The four-ingredient combination itself has not been tested in large trials and is not FDA-approved, so a provider reviews your health history to decide whether it is right for you.
Is Quad Rx legit?
Yes. Quad Rx is a real prescription medication. It is ordered through Rx.com, prescribed only after an independent U.S.-licensed provider reviews your health information, and filled by a U.S.-licensed pharmacy. It is a compounded medication and is not FDA-approved, and you are only billed if a prescription is approved.
Is this the same as MEDVi Quad?
No. MEDVi sells its own product called Quad, and its formula has changed over time. Rx.com's Quad Rx is a separate product: a compounded sublingual liquid of apomorphine, sildenafil, tadalafil and vardenafil, prescribed by independent U.S.-licensed providers and ordered through Rx.com. Rx.com is not affiliated with MEDVi.
How long does it last?
It depends on the ingredient. Sildenafil and vardenafil typically last about 4 to 6 hours, while tadalafil can stay active for up to 36 hours. Your provider will explain what to expect from your prescribed strength.
How much does Quad Rx cost?
Quad Rx starts at $114 per month. Choose your pack size at checkout, billed monthly with no commitment. The provider consultation and express shipping are included, the price stays the same on every renewal, and you are only billed if a prescription is approved.
Do I need a prescription?
Yes. Quad Rx is a prescription medication. You complete an online health questionnaire, an independent U.S.-licensed provider reviews it, and if treatment is clinically appropriate the prescription is filled by a U.S.-licensed pharmacy and shipped to you.
Is Quad Rx FDA-approved?
No. Quad Rx is a compounded medication, which means it is prepared by a licensed pharmacy for an individual prescription and is not FDA-approved as a finished product. Sildenafil, tadalafil and vardenafil are each FDA-approved for erectile dysfunction on their own; apomorphine is not FDA-approved for ED in the United States.
Is Quad Rx safe? Who should not take it?
Men who take nitrates for chest pain (such as nitroglycerin) or riociguat should never take sildenafil, tadalafil or vardenafil, because the combination can cause a dangerous drop in blood pressure. Men with serious heart conditions, uncontrolled blood pressure or a history of priapism need a provider's guidance first. The online evaluation screens for these issues, so answer it honestly.
Does insurance cover it?
No insurance is needed and none is billed. Quad Rx is a cash-pay prescription with one flat price, and buy now, pay later is available through Klarna.

Your best performance is one click away.

Choose your plan, complete a short online visit, and an independent provider will decide whether Quad Rx is right for you. If no prescription is approved, you aren't billed.

Get Started From $114/month, consultation and shipping included

Important safety information

Quad Rx contains sildenafil, tadalafil and vardenafil, which must never be combined with nitrates (such as nitroglycerin) used for chest pain, or with riociguat. The combination can cause a life-threatening drop in blood pressure.

Tell the provider about any heart conditions, blood pressure problems, or medications you take during the online visit. Common side effects include headache, flushing, nasal congestion, dizziness and nausea. Seek immediate medical care for an erection lasting more than 4 hours.

ED & Men's Health Guides

MedVi Quad Review: Do the 4-in-1 ED Drops Actually Work? Quad for Men promises prescription-like erection support without a doctor visit. Our clinicians dissect the fo... Can I Take 40 mg of Tadalafil? Dose Limits and Stronger Options Considering 40 mg of tadalafil for erectile dysfunction? This guide explains why the FDA caps the as-needed do... Viagra vs Generic Sildenafil: Is There Any Difference? Is Viagra really different from its generic, sildenafil? This deep-dive explains how the two compare in ingred... Is Viagra Over the Counter? How to Get Sildenafil Legally Online Wondering if you can walk into a U.S. pharmacy and buy Viagra without a prescription? You can’t-at least not y... Sildenafil Dosage Guide: 25mg vs 50mg vs 100mg Not sure whether to start with 25 mg, 50 mg, or 100 mg of sildenafil? This evidence-based guide explains how e... Tadalafil 20 mg Price Without Insurance: What You’ll Pay in 2026 Paying cash for tadalafil 20 mg? Learn the current generic and brand-name prices, where the biggest savings hi... Quad Rx for Erectile Dysfunction: What It Is, Cost, and How to Qualify Pills not working? Quad Rx combines four ED medications in one compounded sublingual liquid that dissolves und... Quad Rx Cost Per Month vs Buying Sildenafil and Tadalafil Separately Quad Rx is Rx.com’s four-in-one compounded sublingual ED liquid starting at $114 a month. This guide breaks do... Tadalafil 5 mg Price Without Insurance (2026) Paying cash? In 2026 a 30-day supply of generic tadalafil 5 mg can run as little as $10 at some pharmacies but... Can You Take Sildenafil and Tadalafil Together? Mixing ED drugs is risky. This guide explains why doctors rarely recommend taking sildenafil (Viagra) and tada... Generic Cialis Cost in 2026: Cash Price by Dose and Where to Buy Online Curious what you’ll pay for generic Cialis in 2026? This deep-dive breaks down cash prices for every tadalafil... Is Cialis Over the Counter? How to Get Tadalafil Legally Online Wondering if you can buy Cialis without a prescription? We explain why tadalafil remains prescription-only in... Combination ED Troches vs Chewable Tablets: Which Format Starts Working Faster? Combination ED medications now come in fast-dissolving troches and convenient chewables. We compare how quickl... Sildenafil 100 mg Price Without Insurance in 2026 Generic sildenafil 100 mg tablets can cost as little as $2.20 for two pills or more than $8,500 for brand-name... GLP-1 Weight Loss and Erectile Dysfunction: Will Losing Weight Improve ED? Excess weight strains the blood vessels and hormones that enable an erection. Clinical trials show that sheddi... ED Medication and Alcohol: How Much Can You Safely Drink? Wondering if it is safe to have a drink before taking your ED pill? This evidence-based guide explains how alc... Sublingual ED Medication vs Pills: Which Works Faster and Costs Less? Wondering if a fast-dissolving sublingual ED strip can really beat a classic Viagra-style pill? This evidence-... Is Online ED Treatment Legit? How to Spot a Safe Provider Millions of men now get erectile-dysfunction prescriptions online. This guide shows exactly how to verify that... ED Treatment for Men Over 50: Best Options and Cost in 2026 Men over 50 have more ED choices than ever. This guide compares pills, pumps, injections, implants and their 2... Daily ED Medication vs As-Needed: Cost and Convenience Compared Wondering if a low-dose daily ED pill is worth the cost compared with taking a stronger tablet only when you n... Rhino Pills: What’s Actually Inside and Safer Alternatives for Erectile Dysfunction Rhino-brand “male enhancement” pills are frequently adulterated with undeclared prescription ED drugs that can... Quad Rx vs Tadalafil Daily: Which ED Treatment Fits Your Routine? A side-by-side guide that breaks down how Quad Rx and daily tadalafil work, how fast they act, what they cost,... ED Medication for Men With High Blood Pressure: Safe Options Taking blood-pressure pills does not mean you must live with erectile dysfunction. This guide walks through th... How to Get an ED Prescription Online Without Seeing a Doctor in Person Need Viagra, Cialis or another ED pill? This guide explains how U.S. men can legally get an erectile-dysfuncti... Quad Rx for ED: Sildenafil, Tadalafil, Apomorphine & Vardenafil Explained Quad Rx is Rx.com’s 4-ingredient compounded sublingual liquid that combines three FDA-approved PDE-5 inhibitor... Performance Anxiety Erectile Dysfunction: Prescription Options That Work Performance anxiety can shut down erections even when everything is physically healthy. This guide reviews the... How to Take Sildenafil for Best Results: Timing, Food and Dose Taking sildenafil at the right time and dose is the difference between a frustrating night and reliable perfor... Cialis vs Generic Tadalafil: Is There Any Difference? Should you pay more for brand-name Cialis or switch to generic tadalafil? This evidence-based guide compares h... Does Insurance Cover Viagra or Cialis in 2026? Wondering whether your 2026 health plan will pay for Viagra, Cialis or their generics? This guide breaks down... What to Do When Viagra Doesn’t Work: Combination ED Treatment Options About one-third of men do not respond to Viagra (sildenafil) alone. This in-depth guide explains why the pill... Apomorphine for ED: How It Works and How to Get It Prescribed Apomorphine works differently from Viagra-type pills because it activates dopamine pathways in the brain. This... L-Citrulline for Erectile Dysfunction: Does It Boost Sildenafil or Tadalafil? L-citrulline is a nitric-oxide–boosting amino acid that some men add to prescription ED pills. This guide revi... Sildenafil vs Tadalafil in 2026: Which ED Pill Works Faster, Lasts Longer, and Costs Less? Trying to choose between sildenafil (generic Viagra) and tadalafil (generic Cialis)? This head-to-head guide l... Eroxon Gel vs Viagra: Does the New OTC ED Treatment Work—and Is It Cheaper? Eroxon is the first FDA-cleared over-the-counter erectile-dysfunction gel in the United States. Learn how its... Tadalafil Daily vs As-Needed: Which Dose Is Right for You? Should you take tadalafil (Cialis) every day or only when you plan to have sex? This in-depth guide compares d... Does Tirzepatide Affect Libido? Wondering if tirzepatide will boost, sink or leave your sex drive unchanged? We unpack the data on GLP-1 weigh... How Long Should Sex Last? Average Times, Expectations & Proven Ways to Last Longer Wondering if you finish too quickly-or take too long? This evidence-packed guide explains the average length o... Will Cialis (Tadalafil) Appear on a Drug Test? Does tadalafil show up on a drug test? This in-depth guide explains how workplace and athletics panels work, w... Tadalafil 5 mg Daily Cost: 2026 Monthly Price Breakdown Wondering what a month of daily tadalafil really costs in 2026? This guide compares pharmacy acquisition (NADA... Sildenafil 20 mg vs 100 mg Tablets: Dose and Price Explained Wondering why sildenafil comes in both tiny 20 mg tablets and much stronger 100 mg pills? This evidence-based... Does Food Slow Down Viagra (Sildenafil)? How Meals Change Onset, Duration and Results Wondering if steak dinner is killing your Viagra buzz? This guide shows how fat and meal size cut sildenafil’s... How Fast Does Quad Rx Work and How Long Does It Last? Quad Rx contains apomorphine, sildenafil, tadalafil, and vardenafil in one sublingual liquid that dissolves un... Quad Rx vs Sildenafil: When a Combination ED Treatment Makes Sense Wondering if a single-ingredient ED pill is enough? Learn how Rx.com’s Quad Rx stacks up against sildenafil al... Can Sildenafil Treat Premature Ejaculation and Erectile Dysfunction at the Same Time? About one-third of men with erection problems also climax sooner than they want. This evidence-based guide exp... How to Get Quad Rx Online: Visit, Prescription and Delivery Explained Quad Rx combines four proven erectile-dysfunction ingredients into one compounded sublingual liquid. This guid... Natural Viagra Alternatives vs Prescription ED Drugs: What Actually Works? Can herbs or supplements really replace Viagra? This doctor-reviewed guide compares the evidence for popular n... How to Get the Maximum Effect From Tadalafil (Cialis) Want stronger, longer-lasting results from tadalafil? This in-depth guide covers the exact timing, dosing stra... Gas Station Sex Pills vs Prescription ED Medication: Risks and Real Options Gas-station “male enhancers” can seem like a cheap quick-fix for erectile dysfunction, but many are illegally... Generic Viagra Cost in 2026: Cash Price by Pharmacy and Online A 100-mg generic Viagra tablet can cost as little as $0.22 at the pharmacy counter in 2026-about 400× less tha... What to Do When Cialis Doesn’t Work: Next-Step ED Options Cialis helps millions of men, but as many as 4 in 10 still cannot get or keep an erection strong enough for se...
Browse all guides →

Compounded medication: Quad Rx is a compounded medication. It is not FDA-approved. Medications are only issued when clinically appropriate after provider evaluation. Rx.com does not manufacture compounded medications.

Medical services: All medical services, including clinical evaluations, treatment planning and prescribing decisions, are provided exclusively by licensed independent medical providers. Rx.com provides the technology platform and administrative coordination services, does not employ healthcare providers, and does not practice medicine. This page is for informational purposes and is not a substitute for professional medical advice.

Don't Miss Out On Savings!