Quattro™ Sublingual: what sublingual delivery means.
Surfbound Health offers Quattro™ Sublingual, a compounded sublingual ED option that combines three PDE5 inhibitors with apomorphine in one liquid shot held in the mouth, at $69 for a 5-pack, with medication included if prescribed and no membership fee. Packs are billed in full upfront, and nothing is charged unless your medication is approved. Automatic renewal is optional and chosen at checkout. A licensed provider reviews your history and decides whether it's right for you, so you don't self-prescribe.
Prepared by a licensed compounding pharmacy for individual patients. Apomorphine is used off-label in this formulation at the provider's discretion.
Direct answer
What is Quattro™ Sublingual?
Quattro™ Sublingual is a compounded prescription treatment for erectile dysfunction. It is a liquid shot held in the mouth that combines three PDE5 inhibitors — sildenafil, tadalafil, and vardenafil — with apomorphine, a dopamine agonist used off-label for ED in this formulation. Because it is a compounded prescription, a licensed provider decides whether it is appropriate for you.
- What it is
- A compounded prescription ED option in a sublingual liquid shot
- Active ingredients
- Sildenafil, tadalafil, vardenafil, and apomorphine
- Route
- Held in the mouth and absorbed through the mouth lining
- Who decides
- A licensed provider, based on your health history
Quick answer
Quattro™ Sublingual at a glance
Quattro™ Sublingual is a compounded liquid — combining sildenafil, tadalafil, vardenafil, and apomorphine — placed under the tongue rather than swallowed. A 5-pack starts at $69 through Surfbound Health. It is prescribed only when an independent licensed provider determines it is medically appropriate.
Who it’s for
- Men seeking a compounded sublingual option for ED
- Those who prefer a liquid under the tongue to swallowing a tablet
- People who want flat, all-inclusive pricing with no membership fee
- Anyone who would rather avoid insurance or a pharmacy visit
Common questions before choosing Surfbound
- How much does Quattro™ Sublingual cost per pack, and is there a membership fee?
- Quattro™ Sublingual is priced per pack, starting with a 5-pack, with larger packs available and no membership fee. Medication is included when prescribed, packs are billed in full upfront, and nothing is charged unless a licensed provider approves your medication.
- How soon does Quattro™ Sublingual ship once it is prescribed?
- After a licensed provider approves Quattro™ Sublingual and the pharmacy processes the order, it typically ships within about 1-2 business days, with delivery usually 2-5 business days later. Timing can vary by pharmacy and location, tracking is provided, and it arrives in plain, discreet packaging.
- Can I be treated with Quattro™ Sublingual without an office visit?
- Yes. Treatment starts with a private online intake, and a licensed provider reviews your history remotely before deciding whether Quattro™ Sublingual is appropriate. There is no in-person exam and no pharmacy-counter pickup.
- What should I tell my provider about other medications before starting Quattro™ Sublingual?
- List every medication and supplement you take, especially nitrates such as nitroglycerin, which must not be combined with PDE5 inhibitors. A licensed provider reviews your full history and current medications to decide whether Quattro™ Sublingual is safe and appropriate for you.
- I have never used a sublingual ED treatment before. Is Quattro™ Sublingual suitable for a first-timer?
- It can be. A first-time patient completes the same private online intake, and a licensed provider decides whether Quattro™ Sublingual, a single-ingredient tablet, or no treatment is medically appropriate. Wanting to try a compounded sublingual option is a preference the provider weighs, not a guarantee of approval.
Verified ingredients
The four ingredients in Quattro™ Sublingual.
Three PDE5 inhibitors (for blood flow) plus apomorphine (for the brain signal). Each works a different way.
Sildenafil
PDE5 inhibitor
Relaxes the blood vessels in the penis so more blood can flow in. Generally active for about 4–6 hours.
Tadalafil
PDE5 inhibitor
Works the same blood-flow route but stays in the body longer, effects can last up to 36 hours.
Vardenafil
PDE5 inhibitor
A third PDE5 inhibitor that also relaxes blood vessels to support blood flow.
Apomorphine
Dopamine agonist
Acts in the brain, not the blood vessels, by activating dopamine receptors involved in the signal that initiates an erection. FDA-approved for Parkinson’s disease; its use in this compounded ED formulation is off-label.
Ingredient list reflects Surfbound's current Quattro™ Sublingual formulation. Apomorphine is FDA-approved for Parkinson's disease; its use in this compounded ED formulation is off-label and decided by a licensed provider.
The sublingual route
What "sublingual" actually means.
Sublingual refers to how the medication is taken, absorbed through the mouth rather than swallowed.
Hold it in your mouth
Quattro™ Sublingual is a liquid shot you hold under your tongue or in the mouth rather than swallowing as a pill.
Absorbs through the mouth lining
The medication absorbs through the lining of the mouth and enters circulation without first passing through the digestive system.
Response varies by person
How well sublingual absorption works, and how it feels, varies from person to person. Your licensed provider determines which option fits your situation.
ED medication without swallowing a pill is a route-of-administration difference, not an established performance advantage.
The difference
How Quattro™ differs from single-ingredient options.
The difference is formulation and route.
Quattro™ Sublingual targets two routes at once, blood flow and the brain signal, because it pairs PDE5 inhibitors with a dopamine agonist. A provider decides which option, if any, fits you.
Pricing & options
Quattro™ pack options, plain and simple.
Surfbound Health offers Quattro™ Sublingual starting at $69 for a 5-pack, with medication included if prescribed and no membership fee. Packs are billed in full upfront, and nothing is charged unless your medication is approved. Automatic renewal is optional and chosen at checkout. Pick your pack size (5, 10, 15, or 20 shots) and purchase term; a licensed provider decides whether treatment is appropriate.
Quattro™ Sublingual
Compounded sublingual liquid shot
Before you pay, confirm
- Pack size (5, 10, 15, or 20 shots)
- Selected supply term (1, 3, or 12 months)
- Total charged after provider approval
- Product specification (compounded sublingual shot)
- That a licensed provider has reviewed your case
You are only charged once your medication is approved. Multi-month supplies are charged once after provider approval. Shipment timing follows the selected plan details shown at checkout. Orders are nonrefundable once the pharmacy has processed the item.
See all Quattro™ plan pricesSafety & contraindications
Who should not take Quattro™ Sublingual
Quattro™ Sublingual isn't for everyone. Always tell your provider about every medication you take.
Nitrates (any form)
PDE5 inhibitors are contraindicated with nitrates, including nitroglycerin and other nitrate medications, because the combination can cause a serious, sometimes life-threatening drop in blood pressure. This includes regular and intermittent nitrate use.
Guanylate cyclase stimulators
PDE5 inhibitors should not be used with riociguat (a guanylate cyclase stimulator) due to the risk of dangerously low blood pressure.
Certain heart conditions
Men with certain cardiovascular conditions may not be candidates. A licensed provider reviews your cardiac history before deciding whether this treatment is appropriate.
Priapism & vision/hearing changes
An erection lasting more than four hours (priapism) or sudden vision or hearing changes require immediate medical attention. These are rare but serious.
Apomorphine side effects
Apomorphine can cause nausea, dizziness, and yawning, and rarely fainting or a meaningful drop in blood pressure. Because it is used off-label in this formulation, this is discussed with your provider.
This is not a complete list of contraindications. A licensed provider reviews your full health history, including all prescriptions, over-the-counter products, and supplements, before deciding whether Quattro™ Sublingual is medically appropriate.
Provider review
You don't self-prescribe. A provider does.
Quattro™ Sublingual is a prescription medication. Here's how the review works.
Complete a short intake
Answer a few private questions about your health history and what you're experiencing. It takes only a few minutes, all online.
A licensed provider reviews it
A licensed provider reviews your intake and decides whether Quattro™ Sublingual is medically appropriate for you, and the pack size and schedule.
Treatment ships discreetly
If prescribed, your medication is prepared by a licensed compounding pharmacy and shipped in plain, discreet packaging. You pay only if treatment is approved.
FAQ
Questions about Quattro™ Sublingual.
Quattro™ Sublingual is a compounded sublingual ED option from Surfbound Health. It is a liquid shot you hold in your mouth. It combines several ingredients in one formulation, prepared by a licensed compounding pharmacy for an individual patient when a provider determines it is medically appropriate.
Quattro™ Sublingual combines three PDE5 inhibitors, sildenafil, tadalafil, and vardenafil, with apomorphine, a dopamine agonist. The PDE5 inhibitors act on blood flow in the penis, while apomorphine acts on the brain signal involved in initiating an erection. Apomorphine is FDA-approved for Parkinson’s disease; its use in a compounded ED formulation is off-label and decided by a licensed provider.
No. Quattro™ Sublingual is a compounded medication and is not an FDA-approved finished drug product. It is prepared by a licensed compounding pharmacy for an individual patient when a licensed provider determines treatment is appropriate. The individual active ingredients have FDA-approved commercial forms, but this specific compounded combination does not.
Sublingual means the liquid shot is held in the mouth and absorbed through the lining of the mouth, so it enters circulation without first passing through the digestive system. How well this works varies from person to person.
Quattro Sublingual is a compounded liquid ED treatment that combines sildenafil, tadalafil, vardenafil and apomorphine. It is a different formulation from tadalafil alone. Explore the available pack options, then complete a short online intake so a licensed provider can decide whether Quattro is right for you.
Response and timing vary from person to person. The relevant difference is the formulation and route, a multi-ingredient sublingual shot versus a single-ingredient oral tablet, and your licensed provider determines which option fits your situation.
Apomorphine is FDA-approved for Parkinson’s disease. Its use in a compounded erectile dysfunction formulation is off-label, meaning the FDA has not approved apomorphine for this specific use, and is a decision made by a licensed provider. Apomorphine can cause nausea, dizziness, yawning, and, rarely, fainting or a meaningful drop in blood pressure.
PDE5 inhibitors can cause headache, flushing, nasal congestion, indigestion, and back pain, and rarely vision changes, hearing loss, or priapism (an erection lasting more than four hours, which requires emergency care). Apomorphine can cause nausea, dizziness, yawning, and rarely fainting or a drop in blood pressure. These medications are not safe for people taking nitrates or with certain heart conditions.
Anyone taking nitrates (including nitroglycerin) or riociguat should not take PDE5 inhibitors because of the risk of a serious drop in blood pressure. Men with certain cardiovascular conditions may not be candidates. A licensed provider reviews your full health history and current medications before deciding whether treatment is appropriate.
No. You do not self-prescribe. A licensed provider reviews your health history and decides whether Quattro™ Sublingual is medically appropriate for you, and the appropriate pack size and schedule. The pack options simply describe what Surfbound offers.
Next step
Ready to get started?
Fill out a short online intake. A licensed provider reviews it and decides whether Quattro™ Sublingual, and which pack size, is right for you.
No waiting room. No awkward small talk.
Get startedQuattro™ Sublingual is a compounded prescription medication and is not FDA-approved. Prescription requires review by a clinician, who determines whether treatment is medically appropriate for you.