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Enhancing Men’s Sexual Wellness with PDE5 Inhibitors 

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Much attention is paid to erectile dysfunction, but did you know there are other aspects of the male sexual response cycle that need attention as well? Specifically, rapid or premature ejaculation, delayed ejaculation and arousal deficiency. One in three men experiences rapid ejaculation and an estimated 1-4% of men experience delayed ejaculation.12 These conditions are underserved and undertreated but that can change. Many providers who are experts in male reproductive health specialize in combination therapies that are designed to take treatment beyond ED and address co-conditions like premature and delayed ejaculation.12 Integrative solutions are key in helping men’s overall vitality. 


PDE5 Inhibitors Explained

PDE5, or phosphodiesterase type 5, is an enzyme in the body that affects smooth muscle contraction. So, when PDE5 is inhibited, muscles may remain contracted.  

Options for Sexual Dysfunction 

Though FDA-approved treatments for erectile dysfunction exist, there are no commercially available options for rapid ejaculation or delayed ejaculation. For patient-specific options, providers may combine a unique variety of ingredients with some PDE5 inhibitors when they formulate treatments for conditions related to sexual health and overall quality of life. Urologists and men’s health practitioners have long used compounding pharmacies to source these options.  

Combination Ingredients for Men’s Sexual Wellness

Prescribers using emerging therapies for male sexual wellness may often combine one or more of the following ingredients with PDE5 inhibitors: 

Apomorphine Bremelanotide Cabergoline
Dapoxetine Dextromethorphan Oxytocin
Phentolamine mesylate Testosterone Tramadol

Prescribers may seek compounded PDE5 inhibitor medications because they are offered in a range of strengths, combinations and alternative dosage forms.

Empower Pharmacy offers 22 different PDE5 inhibitor options ranging from capsules and oral disintegrating tablets (ODTs) to troches, many of which are listed below. Providers who already work with Empower may talk to their Clinic Liaison if they are interested in these or other options. Providers who are interested in partnering with Empower may contact us about these products and anything else we can offer their practices and patients. 

Compounded Oral PDE5 Inhibitor Combinations

Expert providers may turn to custom combination therapies to potentially address patients' multiple issues, including ED.  

Sildenafil Combination Products 

Sildenafil 100 mg / Apomorphine HCl 6 mg Troche

Sildenafil 55 mg / Tadalafil 12.5 mg Capsule 

Sildenafil 100 mg / Testosterone 100 mg Troche 

Tadalafil Combination Products 

Bremelanotide 1 mg / Oxytocin 100 IU / Tadalafil 10 mg Troche

Bremelanotide 1 mg / Oxytocin 100 IU / Tadalafil 20 mg Troche 

Bremelanotide 2 mg / Oxytocin 100 IU / Tadalafil 20 mg Troche 

Sildenafil 55 mg / Tadalafil 12.5 mg Capsule 

Tadalafil 40 mg / Apomorphine HCl 6 mg Troche 

Tadalafil 25 mg / Phentolamine Mesylate 3 mg Capsule 

Tadalafil 20 mg / Tramadol HCl 30 mg Troche 

Vardenafil Combination Products 

Vardenafil 40 mg / Apomorphine HCl 8 mg Troche


The Empower Difference

Our solutions extend beyond these combinations. Explore our full men’s sexual wellness catalog and find out how Empower Pharmacy is different.

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  • 1. a. b. Premature ejaculation. Cleveland Clinic. Accessed July 27, 2022.
  • 2. a. b. Chen J. The pathophysiology of delayed ejaculation. Transl Androl Urol. 2016;5(4):549-562. doi:10.21037/tau.2016.05.03