Erection + Arousal

Sildenafil

Apomorphine

One troche. Two mechanisms. Arousal starts in the brain, and the window stays open for 36 hours — no timing, no pressure, no compromise.

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Overview

Sildenafil / Apomorphine HCl Sublingual Troche

This compounded troche combines apomorphine's central dopaminergic activation with sildenafil's peripheral PDE5 inhibition in one sublingual dose. Apomorphine initiates arousal at the hypothalamic level independently of sexual stimulus, while sildenafil sustains the vascular response once arousal is established. Sublingual delivery accelerates absorption of both actives relative to oral tablet formulations, reducing time to clinical effect.

Mechanism of Action

Apomorphine is a non-selective dopamine D1 and D2 receptor agonist that activates the paraventricular nucleus (PVN) of the hypothalamus, initiating the central component of erection through oxytocinergic and nitrergic projections to the spinal cord. This central pathway operates independently of peripheral vascular tone, making apomorphine effective in patients with psychogenic or CNS-mediated erectile dysfunction. Sildenafil selectively inhibits phosphodiesterase type 5 in corporal smooth muscle, preventing the degradation of cyclic GMP and sustaining nitric oxide-mediated relaxation of trabecular smooth muscle. Together, apomorphine primes the CNS arousal cascade while sildenafil amplifies and sustains the resulting peripheral vascular response.

Oral

Sublingual · Dissolves under the tongue.

Information presented here is for educational purposes only and not intended to replace or substitute guidance from a healthcare provider. Compounded medications are not FDA-approved nor evaluated by the FDA for safety, efficacy, or quality.

Benefits

Central Activation

Apomorphine activates hypothalamic dopamine receptors to initiate the CNS arousal component that PDE5 inhibitors alone cannot address.

Peripheral Vasodilation

Sildenafil sustains nitric oxide-mediated corporal smooth muscle relaxation for reliable vascular erectile response.

Rapid Onset

Sublingual mucosal absorption bypasses hepatic first-pass metabolism, reducing time to therapeutic plasma concentration for both actives.

Dual Coverage

Central plus peripheral mechanism addresses both psychogenic and vasculogenic contributing factors in the same dose.

Individual results may vary. Benefits described are based on clinical and pharmacological evidence and do not constitute a guarantee of treatment outcomes. All treatment requires evaluation and approval by a licensed provider.

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Medical intake

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Provider evaluation

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Personalized plan

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Ongoing support

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FAQs

What is Sildenafil / Apomorphine?

Sildenafil Apomorphine is a prescription therapy used for male sexual wellness support.

Who should use Sildenafil / Apomorphine?

Patients seeking support for male sexual wellness support may qualify after evaluation by a licensed provider.

Does Sildenafil / Apomorphine HCl Troche require a prescription?

Yes. Both sildenafil and apomorphine require a valid prescription from a licensed provider.

What are the possible side effects?

Apomorphine may cause nausea, dizziness, drowsiness, or yawning, particularly at initiation. Sildenafil may cause headache, flushing, nasal congestion, dyspepsia, and visual color tinge. Hypotension may occur if combined with antihypertensives or alpha-blockers.

Who should not use Sildenafil / Apomorphine HCl Troche?

Absolutely contraindicated in patients taking nitrates in any form. Not for patients with severe cardiovascular disease, uncontrolled hypotension, recent stroke or myocardial infarction within 90 days, or known hypersensitivity to either active. Patients with a history of syncope or severe nausea with apomorphine require provider evaluation.

Are there any drug interactions?

Nitrates are an absolute contraindication with sildenafil. CYP3A4 inhibitors including ritonavir, ketoconazole, and clarithromycin significantly increase sildenafil exposure and require dose reduction or avoidance. Alpha-blockers and antihypertensives increase hypotension risk and require provider management. Apomorphine combined with 5-HT3 antagonists such as ondansetron is contraindicated due to risk of profound hypotension.

Is Sildenafil / Apomorphine HCl Troche safe if I have a pre-existing medical condition?

Patients with cardiovascular disease require fitness-for-sexual-activity evaluation before use. Patients with hepatic impairment require sildenafil dose adjustment. Not recommended in patients with hereditary degenerative retinal disorders. Patients with Parkinson's disease or other dopaminergic conditions require specialist evaluation given the apomorphine component.

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The information and clinical services described on this website are for educational and informational purposes only and are not intended to diagnose, treat, cure, or prevent any disease. All treatments require evaluation and approval by a licensed healthcare provider through a telemedicine consultation. Treatment approval is not guaranteed. Individual results may vary, and treatments may carry risks and side effects. Certain compounded medications, wellness treatments, or off-label uses may not be evaluated by the U.S. Food and Drug Administration (FDA) for safety, effectiveness, or quality unless explicitly stated. Testosterone Shots provides telehealth consultations, clinical review, care coordination, lab-related services, membership services, and ongoing treatment management. Testosterone Shots is not a pharmacy and does not manufacture, compound, dispense, sell, handle, warehouse, ship, or collect payment for prescription medication. Testosterone Shots collects payment only for consultations, clinical review, care coordination, lab-related services, membership services, and other non-pharmacy services. If treatment is approved, your prescription may be sent to a licensed pharmacy partner. The pharmacy contacts you directly to complete medication payment and shipping. Services are provided by licensed physicians, nurse practitioners, and/or other licensed healthcare providers in states where they are authorized to practice. This service is not intended for medical emergencies. If you are experiencing an emergency, call 911 or seek immediate medical care. We take reasonable measures to protect personal health information in accordance with applicable privacy laws, including HIPAA. By using this website or its services, you agree to our Terms of Service, Privacy Policy, Notice of Privacy Practices, Telehealth Consent, and Important Safety Information. You must be 18 years of age or older to use this service.