Knockout Rx
Daily dual PDE5 dosing, and vardenafil has no approved daily regimen.
Something sits outside an approved envelope — a dose above the ceiling, an ingredient with no approval for this use, or a dosing schedule the drug has never been licensed for. Not a claim that the product is unsafe; a claim that the decision needs someone who can see your blood pressure.
- Price
- $49 / bottle
- Verdict
- Not without a physician
- Sourcing
- Not verified at source
- Last checked
- 1 August 2026
Read this first
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A compounded daily capsule pairing vardenafil with tadalafil and a small amount of citrulline. The doses are modest — it is the word 'daily' that changes the analysis, because one of these two drugs has no daily regimen at all.
Not verified at source
MaleMD blocks automated access to its pages — four separate paths were tried. This entry is drawn from third-party reporting and search indexing of MaleMD's own published material, corroborated across more than one search. In particular we could not read what compounding or FDA disclosure appears on their own site; the absence of a quoted disclosure below means we could not verify it, not that none is made. Treat this entry as less reliable than the primary-sourced ones and check against MaleMD directly.
Reported specifications
- Reported composition
- Vardenafil 6mg, tadalafil 6mg and L-citrulline 100mg, in a capsule
- Dosing
- Reported as taken daily rather than as needed
- Preparation
- Reported as compounded by a partner pharmacy shortly before shipping, described as ensuring maximum potency
- FDA status
- Compounded. We could not verify the wording of any FDA disclosure on MaleMD's own pages.
- Claims
- Reported marketing states the active ingredient has been shown in studies to help men last 7–10 times longer
- Labs or examination
- None described
Our assessment
The individual doses here are the most modest on this page — 6mg of each PDE5 inhibitor, well under what any of the on-demand products contain. On strength alone this would be the least concerning combination we have looked at. The regimen is what moves it.
Daily tadalafil is a real, approved thing. It is licensed at 2.5mg and 5mg once daily and it is genuinely useful, particularly for men who want spontaneity or who also have benign prostatic hyperplasia. At 6mg this sits just above that approved daily ceiling, which on its own would be a minor observation.
Vardenafil is the problem. Vardenafil is an on-demand medication. It is approved at 5mg, 10mg and 20mg taken before activity, and there is no approved daily-dosing regimen for it — no licensed low dose, and no established evidence base for taking it every day indefinitely. A daily capsule containing vardenafil is therefore not a lower-dose version of an approved therapy; it is a chronic exposure to a drug that was never studied for chronic use.
Put the two together and the distinction from the rest of this page becomes clear. The on-demand combination products expose a man to two PDE5 inhibitors episodically, on the evenings he chooses. This one does it continuously. Both drugs lower blood pressure through the same pathway, and a daily regimen means that additive effect is present every day rather than occasionally — including on the days he is unwell, dehydrated, drinking, or starting a new blood-pressure medication.
The citrulline is the third of the three and, as with the vitamin elsewhere on this page, it is doing very little. Trials of L-citrulline in erectile dysfunction have used doses around 1.5 grams a day. 100mg is roughly a fifteenth of that. It is a reasonable ingredient at a token quantity.
Two pieces of the marketing deserve a closer look. Being compounded fresh for maximum potency sounds like a quality control assurance and is not one — freshness is not what verifies a drug's content, and the point of an approved product is that its potency has been tested rather than asserted. Similarly, a pharmacy operating in an FDA-registered facility is an administrative fact about the building; registration is not approval, and the phrase reads as an endorsement it is not.
The efficacy claim is the weakest part. Lasting 7 to 10 times longer is a comparative statement with no stated comparator and no cited study, and it is describing the wrong thing: PDE5 inhibitors act on erectile rigidity, not on ejaculatory latency. Multipliers of that order are the sort of figure associated with SSRIs used for premature ejaculation, which is a different drug class treating a different problem.
In fairness: the per-dose price is competitive, a 60-day money-back guarantee is more than most of this category offers, and daily low-dose PDE5 therapy is a legitimate clinical strategy when it is the approved drug at the approved dose. The objection is specific — it is to the vardenafil, and to deciding on chronic dual therapy without anyone taking a blood pressure first.
Reasonable for
- Nobody we can identify from a website — daily dual PDE5 therapy is a regimen to set up with a physician who can monitor it, not one to start from a questionnaire
- If daily dosing appeals, ask a prescriber about tadalafil alone at its approved daily dose, which is the evidenced version of this idea
Not for
- Anyone taking nitrates in any form, including recreational 'poppers'
- Men on alpha-blockers, antihypertensives, or anyone whose blood pressure runs low
- Men with cardiovascular disease or a history of dizziness or fainting
- Men who would take a daily medication without a baseline blood pressure and blood work
- Men who read a 7-to-10-times claim as a clinical finding
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.