Compounded ED formulations
Compounding as it is supposed to work: a prescriber decides, a pharmacy prepares.
An FDA-approved medicine, used at an approved dose, on an approved schedule. The benchmark everything else is measured against.
- Price
- Not published
- Verdict
- Reasonable option
- Sourcing
- Read at source
- Last checked
- 2 August 2026
Read this first
We are a competitor of the companies reviewed on this page. That is a conflict of interest and you should read everything here with it in mind. What we can offer against it: every factual claim is drawn from the company's own published material and linked, every clinical criticism applies equally to us where it applies, and no assessment on this page is for sale — the one company we carry advertising for, CoreAge Rx, is graded at our lowest tier in its own review, and those placements are labelled wherever they appear.
A compounding pharmacy that will not prescribe to you — it fills what your own physician writes. Included here deliberately, because it shows what compounding looks like when it is done the way it was designed to be done.
What the company states
- What it is
- Compounded capsules “containing the exact dosage needed”, troches, and injections including Bimix, Trimix and Quadmix
- Active ingredients
- Tadalafil and sildenafil, among others
- Prescribing
- They do not prescribe. ClearSpring states “your doctor will provide a prescription tailored to your needs”
- Model
- Collaborates with your prescriber; describes relationships with local physicians
- Side effects noted
- Headaches, flushing, dizziness, vision changes and others
Our assessment
This page has been hard on compounded ED products, so it is worth being precise about what the objection actually is — because this entry is compounding too, and we rate it well.
Compounding exists so a pharmacist can prepare a formulation a particular patient needs and no manufacturer makes: a capsule at a dose between the licensed strengths, a troche for a man who cannot swallow tablets, or the intracavernosal mixtures — Bimix, Trimix, Quadmix — that are the second-line therapy for men in whom oral medication has genuinely failed. Those mixtures have no approved commercial equivalent. Compounding is the only way they exist at all, and they work.
The difference is who decides. Here, a physician who has examined you writes a prescription specifying the agents and the doses, and the pharmacy prepares exactly that. The compounded products reviewed further down this page invert it: a fixed formulation is designed by a company, marketed direct to consumers, and dispensed after a questionnaire. The pharmacy is the same technology; the clinical governance is not.
So the honest position is not that compounding is bad. It is that a compounded medicine is only as good as the prescriber behind it, and a twenty-minute form is not a prescriber in any sense that matters. Where our own clinic uses compounded injectable therapy, it is on this model — measured, prescribed, and titrated in person.
No pricing is published, which for a service routed through your own physician is less of a problem than it would be elsewhere; your prescriber and the pharmacy will settle it between them.
Reasonable for
- Men whose physician has prescribed a compounded formulation, particularly injectable therapy
- Men who need a dose or a format no manufactured product provides
- Men who have genuinely failed oral therapy and are moving to second-line treatment
Not for
- Men looking to obtain ED medication without seeing a prescriber — that is not what this is
- Men who want published prices before involving their doctor
Considering a combination product?
CoreAge Rx 4PLAY combines sildenafil, tadalafil, vardenafil and apomorphine in a single sublingual dose, from $114 / mo, prescribed online.
This is a featured placement, not a result of our assessment — it appears because we placed it, and it is an advertisement for the purposes of how you should read it. 4PLAY is a compounded product, which the FDA does not review for safety, effectiveness or quality, and it contains apomorphine, which is not approved in the United States for erectile dysfunction.
4PLAY by CoreAge Rx
A compounded sublingual combining four active ingredients, prescribed online after a consultation and shipped to your door.
- Sildenafil, tadalafil, vardenafil and apomorphine in one sublingual dose
- ~10 minute typical activation, up to a 36-hour window
- Compounded in the USA, prescribed after an online consultation
- Auto-refill is opt-in; price locks at checkout
This is a featured placement, not a result of our assessment — it appears because we placed it, and it is an advertisement for the purposes of how you should read it. 4PLAY is a compounded product, which the FDA does not review for safety, effectiveness or quality, and it contains apomorphine, which is not approved in the United States for erectile dysfunction.
$114 / mo
4PLAY — four actives, one sublingual dose.
This is a featured placement, not a result of our assessment — it appears because we placed it, and it is an advertisement for the purposes of how you should read it. 4PLAY is a compounded product, which the FDA does not review for safety, effectiveness or quality, and it contains apomorphine, which is not approved in the United States for erectile dysfunction.
Important
The information on this website is provided for general education and does not constitute medical advice, diagnosis, or treatment. Erectile dysfunction can be the first sign of cardiovascular disease, diabetes, or hormonal disorders. Always consult a licensed physician about your individual circumstances, and never start, stop, or change a prescription based on what you read here.
If you want the other thing
A diagnosis, rather than a subscription.
If you have already been assessed and just need a refill, this may serve you well. If nobody has taken your blood pressure in years, that is the appointment to make.