Patient Drug Information & Medication Resource Guide
Epiq Quad Quad Formula
Quad Formula contains Sildenafil 40mg, Tadalafil 4mg, Vardenafil 2.5mg, and Apomorphine 2mg in a 12mm, light orange, tangerine-flavored tablet.
Formulation
Product Description
Individual response varies based on vascular health, neurological function, hormonal status, and underlying medical conditions.
Tangerine Flavor, Light Orange
Quad Formula
What Is Quad Formula
- Sildenafil is a PDE5 inhibitor that supports erectile function via the same nitric oxide-cGMP pathway, generally with a faster onset profile in some patients (30 to 60 minutes). It is intended to enhance penile blood flow during sexual stimulation.
- Vardenafil is a PDE5 inhibitor that enhances the nitric oxide-cGMP pathway, supporting increased blood flow to erectile tissue during sexual stimulation. It is often associated with a relatively faster onset of action in some patients (15 to 30 minutes).
- Tadalafil is a PDE5 inhibitor that elevates cGMP, promoting smooth muscle relaxation and increasing blood flow to erectile tissue. Tadalafil is known for its long duration of action (up to 36 hours).
- Apomorphine is a dopaminergic agonist that acts centrally to support pathways involved in sexual response and arousal. Historically studied for erectile dysfunction via central nervous system mechanisms. It may complement peripheral vascular support in select patients.
Potential Clinical Benefits
- Supports erectile function through triple PDE5 inhibition and enhanced nitric oxide-mediated vasodilation across the cavernosal vascular bed.
- Provides complementary central (dopaminergic) and peripheral (cGMP-mediated) pro-erectile mechanisms, potentially benefiting patients with both psychogenic and organic contributors.
- Rapid buccal absorption may facilitate faster onset compared to conventional oral tablet formulations of the individual components.
- Low dose tadalafil contributes sustained background PDE5 inhibitory effect compatible with a semi-daily-use pharmacokinetic profile.
- May support improved erectile rigidity and overall sexual performance satisfaction in appropriately selected individuals.
Directions for Use
Use only as prescribed by your healthcare provider. Dosing should be individualized based on clinical response and tolerability:
- Chew slowly and allow buccal absorption per clinical instructions; do not swallow rapidly.
- Take approximately 15-30 minutes before anticipated sexual activity, or as directed by your provider.
- Do not exceed the prescribed dose or frequency.
- Avoid concurrent use with additional PDE5 inhibitors or dopamine agonists unless specifically directed by a clinician.
Potential Side Effects
- Possible side effects related to vardenafil, tadalafil, and sildenafil:
- Headache, flushing, nasal congestion
- Dyspepsia (heartburn), nausea
- Dizziness or lightheadedness (blood pressure lowering)
- Visual changes (sildenafil more commonly)
- Back pain or myalgias (tadalafil more commonly)
- Rare: priapism (prolonged erection), hearing changes, cardiovascular symptoms.
- Possible effects related to apomorphine:
- Nausea/vomiting
- Dizziness, hypotension, syncope
- Fatigue, headache
- Rare: palpitations or clinically significant blood pressure effects
- Patients should seek urgent care for chest pain, fainting, severe dizziness, or an erection lasting >4 hours.
Who Should Not Use This Product
- Individuals taking organic nitrates in any form (sublingual, transdermal, oral) – ABSOLUTE CONTRAINDICATION: risk of severe, life-threatening hypotension.
- Patients using soluble guanylate cyclase stimulators (e.g., riociguat).
- Individuals with significant cardiovascular disease in whom sexual activity is not medically advisable.
- Patients with a history of non-arteritic anterior ischemic optic neuropathy (NAION).
- Individuals with hereditary degenerative retinal disorders.
- Patients with severe hepatic impairment.
- Patients with hypersensitivity to any component of this formulation.
- Patients concurrently using strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) without clinician dose adjustment.
How do I store and/or dispose of this drug?
Store at room temperature. Protect from light. Avoid exposure to high humidity (keep container tightly closed). Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain. Check with your pharmacist if you have questions about how to throw out drugs. Do not share your drugs with others and do not take anyone else’s drugs. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-888-463-6332 or at https://www.fda.gov/medwatch.
Exclusively Made By EPIQ SCRIPTS
Epiq Scripts is a URAC- and ACHC/PCAB-accredited compounding pharmacy, committed to the highest standards of safety, quality, and regulatory compliance. All ingredients are sourced exclusively from FDA-registered and inspected wholesalers to ensure pharmaceutical-grade purity and efficacy. Our compounds are crafted with precision in a state-of-the-art facility adhering to strict USP guidelines.
Compounded Medication Disclaimer
This is a custom-compounded medication prepared by a licensed pharmacy for individual patient use. It has not been reviewed by the FDA for safety or efficacy, and is prescribed based on the clinical judgment of a qualified healthcare provider.
Compounded medications are made in accordance with Section 503A of the Federal Food, Drug, and Cosmetic Act, and are intended to address unique patient needs when FDA-approved options are not appropriate or available.
