Quad Rx Cost Per Month vs Buying Sildenafil and Tadalafil Separately
Quad Rx starts at $99 a month for a four-drug ED combo, but generic sildenafil and tadalafil can cost as little as $7–$22 each. Here’s the full math so you know which option actually saves you money in the long run.
Quad Rx costs $99 per month and combines apomorphine, sildenafil, tadalafil and vardenafil in one prescription written online by a licensed U.S. provider. By contrast, filling separate prescriptions for generic sildenafil (Viagra) and tadalafil (Cialis) can run anywhere from about $17 to $41 per 30-day supply at 2026 cash-pay prices. The best value for you depends on how often you need medication, the dose that works and whether you want four ingredients in a single capsule or prefer to dose each pill on its own.
- Quad Rx is a custom-compounded mix of apomorphine, sildenafil, tadalafil and vardenafil that starts at $99 per month through Rx.com.
- Generic sildenafil 50 mg costs from $6.64 – $21.19 for 30 tablets, while tadalafil 5 mg costs from $9.70 – $19.49 for 30 tablets at U.S. pharmacies. (drugs.com)
- Buying both generics separately therefore ranges from $16.34 to $40.68 per month before coupons or insurance. (drugs.com)
- Quad Rx may appeal to men who need multiple PDE-5 drugs or a central agent (apomorphine) because on-demand stacking of generics can require managing four separate prescriptions.
- Quad Rx is not FDA-approved as a combination product; each ingredient carries its own side-effect profile and nitrate warning.
What Quad Rx Is - a four-ingredient ED capsule
Quad Rx is a pharmacist-compounded capsule that mixes four erectile dysfunction ingredients: apomorphine, sildenafil, tadalafil and vardenafil. The formula provides both a centrally acting dopamine agonist (apomorphine) and three phosphodiesterase-5 (PDE-5) inhibitors. It is prescribed after an online visit with a licensed U.S. clinician through Rx.com and shipped monthly.
Regulatory status: The combination capsule itself is not FDA-approved, because the agency does not review 503A compounded formulas. Each PDE-5 ingredient is FDA-approved individually for ED, while apomorphine is FDA-approved for Parkinson’s “off” episodes but not for ED. Providers prescribe Quad Rx when they believe a patient needs a customized dosage form that is not commercially available.
Learn more about the individual ingredients on the Quad Rx drug page or compare single-ingredient pills in our sildenafil vs tadalafil guide.
How Much Does Quad Rx Cost?
Quad Rx costs $99 for a 30-day supply at the starter dose, and that price includes the online visit, prescription and shipping. The flat rate stays the same even if your provider later adjusts the strength of one or more ingredients.
No insurance billing: Because the capsule is compounded, it is typically not covered by commercial insurance or Medicare Part D. You pay the $99 out of pocket each month through Rx.com.
What the fee covers:
- Licensed-provider visit via telehealth
- Customized compounding of all four ingredients
- FedEx shipping in discreet packaging
If the prescriber decides Quad Rx is not medically appropriate, you are not charged for the medication.
What Generic Sildenafil and Tadalafil Cost in 2026
Cash-pay prices for generics are at historic lows, especially when you buy 30 tablets at once. The latest Drugs.com price guide lists:
- Sildenafil 50 mg oral tablets: from $6.64 to $21.19 for 30 tablets (drugs.com)
- Tadalafil 5 mg oral tablets: from $9.70 to $19.49 for 30 tablets (drugs.com)
The wide range reflects different wholesalers and pharmacies. Prices can fluctuate week to week, so always compare before you fill. You can run a real-time check with the free Rx.com discount card at more than 60,000 U.S. pharmacies.
Want one capsule instead of four bottles?
See if a licensed provider thinks Quad Rx makes sense for your situation in a quick online visit.
Why Some Men Combine ED Drugs
Stacking PDE-5 inhibitors or adding apomorphine can rescue erections when a single agent underperforms, but it is strictly off-label and requires medical supervision. Urologists sometimes rotate or combine drugs for patients who:
Night-and-day flexibility: Tadalafil’s 36-hour window (half-life 17.5 h) lets couples keep spontaneity, while sildenafil offers a strong but shorter 4-to-5-hour boost. (dailymed.nlm.nih.gov)
Central stimulation: Apomorphine can trigger erections within about 20 minutes by activating dopamine receptors in the hypothalamus. (pubmed.ncbi.nlm.nih.gov)
Different onset needs: Vardenafil kicks in fast (≈45 min) and may work better after a meal than sildenafil. (mayoclinic.org)
Caution: More drugs mean more chances for side effects like flushing, nasal congestion or drops in blood pressure. Never mix or double-dose without clinician approval.
Cost Calculator: Generic Pills vs Quad Rx
| Monthly Strategy | Pills Supplied | 2026 Cash Price Range | What You Get |
|---|---|---|---|
| Sildenafil only (50 mg) | 30 tabs | $6.64 – $21.19 | On-demand, 4-to-5-hour window |
| Tadalafil only (5 mg daily) | 30 tabs | $9.70 – $19.49 | All-day readiness up to 36 h |
| Sildenafil + Tadalafil | 60 tabs total | $16.34 – $40.68 | Choice of daily or on-demand |
| Quad Rx | 30 compounded capsules | $99 flat | Apomorphine + three PDE-5s in one |
Pros and Cons That Matter Besides Price
Convenience vs flexibility: Quad Rx means one capsule, one refill and one predictable bill. Separate pills let you fine-tune doses or skip medication on days you do not need it.
Tolerance and side effects: If nasal congestion or flushing hits you hard with sildenafil, you can switch to tadalafil without wasting vardenafil or apomorphine. Quad Rx blends all four, so if you cannot tolerate one ingredient you likely need a new prescription.
FDA coverage: Commercial insurance sometimes reimburses generic sildenafil or tadalafil with prior authorization, but rarely covers compounded combinations.
Drug interactions: All four ingredients carry nitrate warnings. Apomorphine also interacts with serotonin agonists and dopamine antagonists. Always review your full medication list with your provider.
Should you pay $99 for Quad Rx?
Check the column that fits your situation:
✅ Quad Rx makes sense if…
- You tried sildenafil or tadalafil alone and still struggled
- You want one flat, predictable monthly bill
- You prefer an online visit and home delivery
- You are comfortable with a non-FDA-approved compounded capsule
🏥 Stick with generics if…
- A single PDE-5 already works well for you
- You only need a few tablets per month
- Cost under $25 is your top priority
- You can easily pick up refills at a local pharmacy
Insurance, HSAs and Discount Cards
Insurance coverage: Most commercial plans limit ED coverage to a handful of pills per month or require step therapy. Generic sildenafil and tadalafil are often tier-1 generics costing just a few dollars with insurance, but compounded products like Quad Rx are almost never covered.
HSA/FSA eligibility: Out-of-pocket ED prescriptions are generally reimbursable with HSA or FSA dollars as long as you keep the Rx.com invoice.
How to lower retail prices: Compare cash prices at local pharmacies with the free Rx.com discount card before you decide. Even insured patients sometimes pay less with cash if their plan has a high deductible.
| Ingredient | Typical Onset* | Effect Duration* | Key Warning |
|---|---|---|---|
| Sildenafil | 30–60 min | 4–5 h | Nitrates contraindicated (mayoclinic.org) |
| Tadalafil | 30 min–6 h | Up to 36 h (dailymed.nlm.nih.gov) | |
| Vardenafil | ≈45 min | 4–5 h (mayoclinic.org) | |
| Apomorphine (SL data) | ≈20 min | ~1 h (pubmed.ncbi.nlm.nih.gov) |
*Median values from FDA labels or Mayo Clinic patient information; individual response varies.
🚨 When to Contact Your Healthcare Provider
Contact your doctor immediately if you experience any of the following:
- Erection lasting > 4 hours (priapism) - can cause permanent damage
- Sudden vision or hearing loss - rare PDE-5 adverse effect
- Chest pain or severe dizziness - may signal unsafe drop in blood pressure
- Severe nausea or vomiting after apomorphine use
- Fainting or feeling light-headed when standing
- Allergic reaction: rash, swelling of lips, tongue or throat
- Shortness of breath or rapid heartbeat
- Worsening kidney, liver or heart disease symptoms
Scientific References
- Drugs.com. Sildenafil Prices, Coupons & Patient Assistance. Updated 2026.
- Drugs.com. Tadalafil Prices, Coupons & Patient Assistance. Updated 2026.
- Mayo Clinic. Erectile dysfunction: Viagra and other oral medications. 2026.
- Dean RC, et al. Sublingual apomorphine for the treatment of erectile dysfunction. Int J Impot Res. 2002.
- DailyMed. Tadalafil Tablets Prescribing Information. Last updated 2026.
- DailyMed. Sildenafil Tablets Prescribing Information. Last updated 2026.
Frequently Asked Questions
Is Quad Rx covered by insurance?
No. Because Quad Rx is a 503A compounded medication rather than an FDA-approved drug, commercial insurers and Medicare generally do not reimburse its $99 monthly fee. You can, however, pay with HSA/FSA funds.
Can I split Quad Rx capsules to save money?
No. The pharmacy custom-fills each capsule with a precise ratio of four ingredients. Splitting or opening the capsule can change dosing accuracy and is not recommended.
How many doses come in a month of Quad Rx?
The standard starter plan dispenses 30 capsules, typically one per day or as your provider instructs. Your dosing schedule will be customized during your telehealth visit.
Does Quad Rx work faster than sildenafil alone?
Apomorphine can start working in about 20 minutes, while sildenafil generally peaks around 60 minutes, so some men notice a quicker response with Quad Rx. Individual results vary.
What happens if Quad Rx causes side effects?
Contact your prescribing clinician through your Rx.com dashboard. They can adjust the formula or switch you back to a single-ingredient pill if needed.
Can I keep taking tadalafil daily and add Quad Rx on top?
Using multiple PDE-5 inhibitors concurrently can dramatically lower blood pressure. Never layer them without explicit medical guidance.
Are there cheaper ways to combine four ED drugs?
You could theoretically fill four separate generic prescriptions, but the total cost plus multiple copays and the inconvenience usually exceed Quad Rx’s flat $99 fee.
Ready to explore a four-in-one ED option?
Start an online visit today to learn whether Quad Rx is appropriate for you. A licensed provider will review your health history, and you’ll only be charged if treatment is approved.
