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Rex MD® IgniteRx combines the active ingredient in
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Important safety information
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Rex MD 2-in-1 ED treatment combines the best
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Important safety information
IgniteRx is a compounded drug. Although compounded drugs are permitted to be prescribed under federal law, they are not FDA-approved and do not undergo FDA review for safety, effectiveness, or manufacturing quality.

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  • ED meds from a U.S. State-Licensed pharmacy
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Have questions?
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  • How does Rex MD work?

    Rex MD is a completely virtual telemedicine platform that provides convenient and reliable prescriptions for various health concerns. It starts with an online health consultation that allows a licensed medical provider to evaluate your symptoms and prescribe medication, when clinically appropriate.

    If you are prescribed medication, you can choose to have it filled by our partnering pharmacy and shipped directly to your door, quickly and discreetly. We offer monthly refills, or you can reorder your medication as needed. If you have any new or ongoing issues, you can always connect with a Rex MD team member through our patient portal.

  • What is the Rex MD Ignite 2-In-1 ED Treatment?

    Rex MD Ignite is a new 2-in-1 prescription ED treatment containing the active ingredients in Viagra® and Cialis® for a powerful treatment that may take effect quickly with sildenafil (40mg) and may keep men active longer with tadalafil (8.5mg). Rex MD Ignite is custom formulated by a U.S. State-Licensed pharmacy, exclusive for Rex MD patients and can be prescribed online and delivered to your door.

  • What is sildenafil and tadalafil?

    Both sildenafil and tadalafil are ingredients used in popular ED medications. Sildenafil is the generic version of Viagra®, and tadalafil is the generic version of Cialis®.

  • How quickly does Rex MD Ignite take effect?

    Rex MD Ignite typically starts working in as little as 30 minutes on average.

  • When is the best time to take Rex MD Ignite?

    Take Rex MD Ignite about 30 minutes before anticipated activity, allowing enough time for it to take effect.

  • Do I need a prescription to purchase Rex MD Ignite?

    A Rex MD-affiliated healthcare provider will handle your consultation and prescribe you a treatment if it’s an effective and medically appropriate option for your diagnosis. Even if you already have a prescription for a condition that Rex MD treats, you’ll still need to have a consultation through a Rex MD-affiliated clinician to confirm your diagnosis.

  • How many Rex MD Ignite gummies come in a package?

    Package sizes may vary depending on your prescription.

  • How does Rex MD work?

    Rex MD starts with an online visit. Our U.S. licensed affiliated physicians can assess your symptoms and make a diagnosis, writing you a prescription if that’s the best course of action. Your medication is then delivered to you quickly and in discreet packaging. You can continue with a monthly subscription (the simplest way to stay up to date) and, if needed, you can ask your Rex MD affiliated physician about new or ongoing issues after your initial diagnosis.

  • Which medications does Rex MD prescribe and ship?

    With Rex MD, you can indicate a preference for Viagra® (sildenafil), Cialis® (tadalafil), generic Viagra®, generic Cialis®, sildenafil (generic Revatio) or the New Rex MD Ignite 2-in-1 (sildenafil + tadalafil). Prices vary, and your Rex MD-affiliated doctor or nurse practitioner may recommend one medication over another based on your medical history and symptoms.

  • Do I need insurance to use Rex MD?

    With Rex MD, you don’t need insurance to access quality care and ED medications. Instead, we strive to make the treatment you need accessible 100% online and much more affordable.

  • Do I physically have to talk to a doctor in person?

    No, Rex MD offers all medications 100% online. Your free consultation is completely online and oftentimes, if there’s no issues based on your medical intake form, you get the shipment right away. There's no in-person office visits. It’s easy and discreet.

  • Is telehealth safe?

    As long as you answer our health questionnaire fully and accurately, absolutely. Be sure to read the information we provide on the risks and benefits of treatment and direction to ensure safe treatment.

    ED medication should only be used by men who are healthy enough for sexual activity. We acknowledge that ED medication is not safe for everyone. Our affiliated licensed physicians will provide a treatment plan only after carefully determining the patient’s suitability for ED treatment.

  • Who are the healthcare professionals associated with Rex MD?

    All Rex MD’s affiliate doctors and nurse practitioners are U.S. State-Licensed. All doctors are board-certified and – per applicable law – licensed in the states where they practice.

  • Is Rex MD available where I live?

    Rex MD serves patients in all 50 states and ships medications for most prescriptions throughout the U.S. Plus, any appointment you may have with a healthcare provider will be virtual, so you won’t have to make the trip to a doctor’s office.

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Important Safety Information

Erectile Dysfunction
Last Updated: Aug 15, 2024
Table of Contents
  1. Sildenafil
  2. Tadalafil
 

What Should You Know Before Taking Sildenafil?

Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

Contraindications

Do not take Sildenafil if you:

  • take medicines called "nitrates" (such as nitroglycerin)

  • use street drugs called "poppers" such as amyl nitrate or amyl nitrite, and butyl nitrate

  • take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)

  • are allergic to sildenafil, as contained in Sildenafil and Revatio, or any of the ingredients in Sildenafil. See the end of this leaflet for a complete list of ingredients in Sildenafil.

What should I tell my healthcare provider before taking Sildenafil?

To make sure Sildenafil is safe for you, tell your healthcare provider if you have any of the following before you take Sildenafil:

  • Have or have had heart problems such as a heart attack,irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure

  • Have had heart surgery within the last 6 months

  • Have pulmonary hypertension

  • Have had a stroke

  • Have low blood pressure, or high blood pressure that is not controlled

  • Have a deformed penis shape

  • Have had an erection that lasted for more than 4 hours

  • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia

  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease

  • Have ever had severe vision loss, including an eye problem called NAION

  • Have bleeding problems

  • Have or have had stomach or intestinal ulcers

  • Have liver problems

  • Have kidney problems or are having kidney dialysis

  • Have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Sildenafil may affect the way other medicines work, and other medicines may affect the way Sildenafil works, causing side effects.

Drug Interactions

Tell your healthcare provider if you take any of the following because these drugs interact with Sildenafil:

  • Medicines called "nitrates"

  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)

  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Sildenafil with alpha-blockers can lead to a drop in blood pressure or to fainting

  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)

  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)

  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin

  • Other medicines that treat high blood pressure

  • Other medicines or treatments for ED

  • Sildenafil contain sildenafil, which is the same medicine found in another drug called Revatio®. Revatio® is used to treat a rare disease called pulmonary arterial hypertension (PAH). Sildenafil should not be used with Revatio® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

Sildenafil Side Effects

What are the possible side effects of Sildenafil?

Sildenafil can cause serious side effects. Rarely reported side effects include:

  • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.

  • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). It is uncertain whether PDE5 inhibitors directly cause the vision loss. Stop taking Sildenafil and call your healthcare provider right away if you have sudden vision loss in one or both eyes.

  • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Sildenafil and contact a doctor right away.

The most common side effects of Sildenafil are:

  • headache

  • flushing

  • upset stomach

  • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision

  • stuffy or runny nose

  • back pain

  • muscle pain

  • nausea

  • dizziness

  • Rash

In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking Sildenafil. Most, but not all, of these men had heart problems before taking Sildenafil. It is not known if Sildenafil caused these problems.

Tell your healthcare provider if you have any side effect that bothers you or does not go away.

These are not all the possible side effects of Sildenafil. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

 

What Should You Know Before Taking Tadalafil

Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

Contraindications

Who should not take Tadalafil? Do not take Tadalafil if you:

  • take medicines called nitrates (such as nitroglycerin)

  • use street drugs called "poppers" such as amyl nitrate or amyl nitrite, and butyl nitrate

  • take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)

  • are allergic to Tadalafil or any of the ingredients in Tadalafil. See the end of this section for a complete list of ingredients in Tadalafil.

What should I tell my healthcare provider before taking Tadalafil?

To make sure Tadalafil is safe for you, tell your healthcare provider if you have any of the following before you take Tadalafil?:

  • Have or have had heart problems such as a heart attack,irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure

  • Have had heart surgery within the last 6 months

  • Have pulmonary hypertension

  • Have had a stroke

  • Have low blood pressure, or high blood pressure that is not controlled

  • Have a deformed penis shape

  • Have had an erection that lasted for more than 4 hours

  • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia

  • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease

  • Have ever had severe vision loss, including an eye problem called NAION

  • Have bleeding problems

  • Have or have had stomach or intestinal ulcers

  • Have liver problems

  • Have kidney problems or are having kidney dialysis

  • Have any other medical conditions

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Tadalafil may affect the way other medicines work, and other medicines may affect the way Tadalafil works, causing side effects.

Drug Interactions

Tell your healthcare provider if you take any of the following because these drugs interact with Tadalafil:

  • Medicines called nitrates

  • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)

  • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Tadalafil with alpha-blockers can lead to a drop in blood pressure or to fainting

  • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)

  • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)

  • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin

  • Other medicines that treat high blood pressure

  • Other medicines or treatments for ED

  • Adcirca® (tadalafil) is used to treat a rare disease called pulmonary arterial hypertension (PAH) and has the same active ingredient as Tadalafil. Tadalafil should not be used with Adcirca® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Revatio® [sildenafil citrate])

Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

Tadalafil Side Effects

What are the possible side effects of Tadalafil?

Tadalafil can cause serious side effects. Rarely reported side effects include:

  • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.

  • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). It is uncertain whether PDE5 inhibitors directly cause the vision loss. Stop taking Tadalafil and call your healthcare provider right away if you have sudden vision loss in one or both eyes.

  • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Tadalafil and contact a doctor right away.

The most common side effects of Tadalafil are:

  • headache

  • flushing

  • upset stomach

  • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision

  • stuffy or runny nose

  • back pain

  • muscle pain

  • nausea

  • dizziness

  • Rash

In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking Tadalafil. Most, but not all, of these men had heart problems before taking Tadalafil. It is not known if Tadalafil caused these problems.

Tell your healthcare provider if you have any side effect that bothers you or does not go away.

These are not all the possible side effects of Tadalafil. For more information, ask your healthcare provider or pharmacist.

Talk to your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What Happens if I Overdose?

Taking more than the recommended amount of Tadalafil greatly increases your risk of side effects, including severe ones that can be dangerous, such as severe low blood pressure or an erection that won’t go away even after 4 or more hours (priapism). Never take more than the amount prescribed to you by your doctor. If you have any severe side effects after taking more than the recommended amount, or even after taking the amount of medicine prescribed to you, seek out emergency medical attention immediately.