Compounded ED treatment,
reviewed by real providers.
Two pathways. A few solid options.
Quattro™ Sublingual works on both blood flow and the brain signal behind an erection. Sildenafil and tadalafil handle the blood-flow side as straightforward oral tablets.
Compounded medications are not FDA-approved. Prescribed only when a licensed provider determines it’s medically appropriate.
Why Surfbound for men's health?
See the full pricing grid, what is included, and why people choose Surfbound — from $39/mo, no membership fee.
Compare starting packs and total prices
Check the strength, quantity and supply term before choosing a plan. These are starting options; a licensed provider determines whether treatment is appropriate.
| Product and form | Starting strength and pack | Total for starting option |
|---|---|---|
| SildenafilStandard oral tablet | 50 mg · 6 tablets/mo | $391-month supply |
| TadalafilStandard oral tablet | 20 mg · 6 tablets/mo | $391-month supply |
| Quattro™ SublingualCompounded sublingual liquid shot | 5-pack | $69Starting pack; see full pack and supply terms |
Looking for liquid tadalafil online?
Surfbound’s liquid option is Quattro™ Sublingual, a compounded combination of sildenafil, tadalafil, vardenafil and apomorphine. It is not tadalafil-only liquid. Quattro starts at $69 for a 5-pack; tadalafil tablets start at $39 for 6 tablets per month. A licensed provider decides whether treatment is appropriate. Nothing is charged unless your medication is approved.
See all strengths, pack sizes and supply totals. Read sildenafil vs tadalafil or Quattro vs oral tablets before your provider review. Compounded Quattro is not FDA-approved.
The Options
Your treatment options, explained plainly.
Three different approaches. A provider decides which fits you.
Sildenafil
Standard oral tablet
- One ingredient, focused on blood flow
- Available in 50 mg and 100 mg strengths
- A tablet you take when you need it
How it works
Relaxes the blood vessels in the penis so more blood can flow in. Usually active for about 4–6 hours, taken as needed.
Who it may be for
If you want the simplest route — one ingredient, no fuss. A provider picks the strength (50 mg or 100 mg) and the schedule.
Active ingredient is FDA-approved in its commercial form (compounded formulation is not). Not for anyone taking nitrates or with certain heart conditions.
Tadalafil
Standard oral tablet
- One ingredient, focused on blood flow
- 20 mg standard oral tablet
- Can stay effective for up to 36 hours
How it works
A longer-acting PDE5 inhibitor that works the same blood-flow route. Because it stays in your system longer, timing gets a lot more forgiving.
Who it may be for
If you’d rather not watch the clock before the moment.
Active ingredient is FDA-approved in its commercial form (compounded formulation is not). Not for anyone taking nitrates or with certain heart conditions.
Quattro™ Sublingual
Compounded sublingual liquid shot
- A few ingredients together: PDE5 inhibitors plus a dopamine-acting one
- A drinkable sublingual shot absorbed through the mouth, without first passing through the digestive system
- Covers both blood flow and the brain signal
How it works
Puts PDE5 inhibitors (for blood flow) together with a dopamine agonist (for the brain signal). It’s a drinkable sublingual shot you hold in your mouth, where it absorbs through the lining of the mouth, so some of the medication enters circulation without first passing through the digestive system.
What it actually feels like: it’s built to support both the signal that initiates an erection and the blood flow that keeps it going — but it won’t cause one on its own. Sexual stimulation is still required. Timing and response vary from person to person. And tadalafil, one of the ingredients, stays in the body longer than sildenafil or vardenafil.
Who it may be for
When a provider thinks a two-part approach makes sense — for example, if a single-ingredient option hasn’t done the job.
Compounded medication: not FDA-approved. Apomorphine may cause nausea or dizziness. Prescription required. A provider reviews your health profile first.
You won’t have to choose — which is good, because nobody wants to self-prescribe. A licensed provider reviews your history and decides what’s actually right for you, if anything.
Pricing
How much does it cost? No surprises.
Nothing is charged unless your medication is approved. Once treatment is approved, payment becomes nonrefundable.
See how sildenafil, tadalafil, and compounded combinations are priced across telehealth providers in our ED telehealth price index.
Sildenafil
Standard oral tablet
The classic, in two strengths. One ingredient, focused on blood flow.
Tadalafil
Standard oral tablet
Same idea, longer runway. Works for up to 36 hours.
Quattro™ Sublingual
Compounded sublingual liquid shot
One drinkable sublingual shot absorbed through the mouth that covers blood flow and the brain signal.
The Process
How it works, step by step.
Three steps. Zero waiting rooms.
The Biology
How ED medications actually work
Two separate routes. Most pills only cover one.
The Blood Flow Pathway
PDE5 inhibitors ( sildenafil, tadalafil, vardenafil) relax the blood vessels in the penis so more blood can flow in. Think of this as the hardware : the part you can actually feel working.
Combining three PDE5 inhibitors in one formulation is intended to offer both a faster start and longer coverage, but this specific combination has not been established in clinical trials. Quattro™ is compounded, not FDA-approved, and is prescribed at a licensed provider's discretion.
The Brain Signal Pathway
A dopamine agonist called apomorphine works upstream in the brain, helping fire the signal that starts an erection. Think of this as the software : the “go” signal that kicks everything off.
This matters when anxiety or headspace is part of the problem, not just circulation.
Quattro™ Sublingual covers both — blood flow and brain signal — in one drinkable sublingual shot absorbed through the mouth.
erectile dysfunction.*
*Prevalence estimates vary by study. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates 30–50 million U.S. men have erectile dysfunction; the Massachusetts Male Aging Study is a commonly cited source. Individual experiences vary.
Compounded medications are not FDA-approved. Treatment decisions are made by a licensed provider after reviewing your individual health profile. See FAQ for more detailed information about how these compounds work.
Route & onset
How each medication gets in
How a medication gets in changes how quickly it starts working. A sublingual shot absorbs through the mouth straight into the bloodstream — the most direct route. Oral tablets take a longer path through the stomach and liver first.
Fuller bar = more direct route to the bloodstream
Onset windows from FDA-approved prescribing information for sildenafil and tadalafil. Quattro™ is a compounded formulation with no published onset data.
What this visual shows
Each bar shows how direct the route is — not how well the medication works. Quattro™ is sublingual, so it absorbs through the mouth and enters the bloodstream directly, the most direct path. Sildenafil and tadalafil are oral tablets that travel through the stomach and liver first, a longer route. Their onset windows (where established) are noted on the right.
Onset times are approximate and vary by person. Food intake, metabolism, and health status all influence how quickly and completely any medication takes effect. A more direct route does not guarantee faster or better results — it describes how the medication enters the bloodstream, not clinical efficacy.
*Quattro™ Sublingual is a compounded medication and is not FDA-approved. Its specific onset time has not been established in clinical studies — the "most direct route" label describes the sublingual delivery mechanism, not a measured onset speed or guaranteed result.
Safety
Is ED Treatment Safe?
- Not for everyone. PDE5 inhibitors are contraindicated for men taking nitrates or with certain heart conditions. Apomorphine may cause nausea, dizziness, or, rarely, fainting. Side effects include headache, flushing, and nasal congestion.
- Compounded medications, including Quattro™ Sublingual, are not FDA-approved finished drug products. They are prepared by licensed compounding pharmacies for individual patients when a provider determines treatment is appropriate. Apomorphine is FDA-approved for Parkinson’s disease; its use in compounded ED treatment is at the provider’s discretion.
What's Included
What's included
Everything you need. Nothing you don't.
- 1Private online intake
- 2Licensed provider review
- 3Sildenafil, tadalafil, and Quattro™ sublingual options when appropriate
- 4Clear pricing before checkout
- 5Discreet shipping if prescribed
FAQ
Questions about
men’s health treatment.
About the treatments
Quattro™ Sublingual is a compounded sublingual liquid shot you hold in your mouth. It combines several PDE5 inhibitors with a dopamine-acting ingredient, so it touches both the blood-flow side and the brain-signal side in one go. Viagra (sildenafil) and Cialis (tadalafil) each do one thing: blood flow. Compounded medications are not FDA-approved.
Apomorphine works in the brain, not the blood vessels. It nudges dopamine receptors in the hypothalamus — the part that starts the whole erection cascade. That’s a different job from PDE5 inhibitors, which work locally in the blood vessels. Side effects can include nausea, dizziness, and, rarely, a drop in blood pressure. Apomorphine is FDA-approved for Parkinson’s disease; using it in a compounded ED treatment is a decision made by a licensed provider.
Quattro™ Sublingual targets two routes at once. PDE5 inhibitors handle blood flow (relaxing the blood vessels), while apomorphine works on the brain signal that sets things off. Combining more than one PDE5 inhibitor also gives both shorter and longer-acting blood-flow coverage. Single-ingredient treatments only cover the blood-flow half.
Sublingual means the liquid shot is held in your mouth and absorbs straight into the bloodstream through the lining of your mouth. It skips the stomach and the liver’s first pass, so more of the ingredient can reach circulation compared to a swallowed pill. How well this works varies from person to person.
Both are single-ingredient PDE5 inhibitors that work on blood flow. Sildenafil is usually active for about 4–6 hours and is taken as needed. Tadalafil can stay effective for up to 36 hours, so you don’t have to time it as precisely. Both are standard oral tablets. The compounded versions aren’t FDA-approved, though the active ingredients are FDA-approved in their brand-name form.
Quattro™ Sublingual may come up when a provider thinks a dual-pathway approach makes sense. Sildenafil suits simple, as-needed use. Tadalafil suits anyone who wants a longer window. You don’t pick — the provider reviews your profile and decides which, if any, fits.
PDE5 inhibitors can cause headache, flushing, nasal congestion, indigestion, and back pain. Rarely: vision changes, hearing loss, or priapism (an erection lasting more than four hours — that needs emergency care right away). Apomorphine can cause nausea, dizziness, yawning, and rarely fainting or a meaningful drop in blood pressure. These medications aren’t safe for people taking nitrates or with certain heart conditions.
About the process
Yes. Everything happens online — no waiting room, no pharmacy counter. If you’re prescribed treatment, it ships in plain packaging with nothing on the outside that says what it is.
Nope. A licensed provider reviews your health history and figures out which option — sildenafil, tadalafil, or Quattro™ Sublingual — makes sense for you, if any. You don’t have to decide before you start.
Still have questions? View pricing details or explore weight loss treatment options.
Next step
Ready to get started?
Fill out a short online intake. A licensed provider reviews it and decides which treatment (Sildenafil, Tadalafil, or Quattro™ Sublingual) — if any — is right for you.
No waiting room. No awkward small talk.
Get started