Do Hard Chews Now and Rugiet have the same ingredients?

Yes. Both combine sildenafil, tadalafil, and apomorphine. The differences are format, support, and terms.

Which is better, Hard Chews Now or Rugiet?

With the same active ingredients, it depends on what you value. Hard Chews Now offers a chew format, human phone support, and a pause-anytime membership, which is why it ranks in our top three. Rugiet offers a troche and publishes pack pricing up front.

Is a chew or a troche better?

Neither is medically superior in general; both avoid swallowing a pill. A chew is quicker to take and more familiar for most men, while a troche dissolves slowly under the tongue.

Rugiet publishes pack pricing; Hard Chews Now shows pricing at checkout, often with promotions. Compare the total for the plan you'd actually use.

Do both need a prescription?

Yes. Both require a licensed provider to review your health information before prescribing.

QMAX vs DirectMax

The most transparent 4-in-1 we track against the lowest-cost multi-ingredient option. Here is what the price difference actually buys you.

Last reviewed: October 2026 · Michael Hayes, editor · standards

See if I qualify for QMAX

On this page

Side by side
What the price difference buys
Cost per month
Payment, refunds, and billing
Which should you pick?
Frequently asked questions
The certified programs we track
Bottom line

Quick answer

Should I choose QMAX or DirectMax?

Choose QMAX (4.9 out of 5, our editor's pick) if you want four actives with every dose published and month-to-month plans. Choose DirectMax (4.6 out of 5) if price comes first: a standard 6-dose pack runs $52.68 to $64.68, about $8.78 to $10.78 per dose before promotions, with HSA/FSA accepted.

How to read this: we may earn a commission if you enroll in a program through our links; commissions never change what we write or how we rank. This is editorial information, not medical advice; a licensed provider makes treatment decisions.

Side by side

	QMAX by BetterMe Rx	DirectMax by Direct Meds
Our rating	4.9/5, editor's pick (#1)	4.6/5
Actives	4: sildenafil 40mg, tadalafil 4mg, vardenafil 7.5mg, apomorphine 2mg	3: apomorphine, sildenafil, tadalafil
Dosages published	Yes, before you enroll	Set by your clinician
Format	Sublingual drop	Rapid-dissolve tablet
Price	About $124 (5 doses) to $449 by plan*	$52.68 to $64.68 per 6 doses*
Per dose	About $16.50 on a 10-dose pack, lower on larger plans*	About $8.78 to $10.78*
Payment and policy	Month-to-month, no lock-in	HSA/FSA accepted, 100% refundable per Direct Meds
Certification	LegitScript certified	LegitScript certified

*As published or publicly reported at review time, October 2026, before promotions. The price on each program's own checkout screen is authoritative.

What the price difference buys

DirectMax is cheaper per dose, and that is a real advantage. What QMAX adds for the extra cost is a fourth active (vardenafil) and published doses for all four ingredients, so you know exactly what you are taking before you pay. DirectMax combines three actives and your clinician sets the dose. Only a licensed provider can decide which formula is appropriate for you.

Cost per month

With DirectMax, one 6-dose pack covers six uses, so a typical month runs about $53 to $65 at standard prices. With QMAX, a 5-dose starter pack is about $124 and a 10-dose pack about $165, with lower per-dose pricing on larger plans. If you use treatment a few times a month and price is the deciding factor, DirectMax costs less. See the full QMAX cost and DirectMax cost breakdowns.

Payment, refunds, and billing

DirectMax accepts HSA and FSA payments and describes its orders as 100% refundable, which lowers the risk of trying it. QMAX runs month-to-month with no lock-in, so you can stop after a month. Both require review by a licensed provider, and neither guarantees approval.

Which should you pick?

Pick QMAX if you want the most transparent multi-ingredient formula and are comfortable paying more per dose for it. That is why it is our #1.

Pick DirectMax if keeping cost low matters most, or you want to pay with HSA or FSA funds.

Start with QMAX Check DirectMax pricing

Frequently asked questions

Is DirectMax cheaper than QMAX?

Yes, per dose. DirectMax runs about $8.78 to $10.78 per dose before promotions, while QMAX plans work out to about $16.50 per dose on a 10-dose pack and less on larger plans.

What is the difference between QMAX and DirectMax?

QMAX is a 4-in-1 sublingual drop with published doses (sildenafil, tadalafil, vardenafil, apomorphine). DirectMax is a triple-ingredient rapid-dissolve tablet (apomorphine, sildenafil, tadalafil) with HSA/FSA accepted.

Can I use HSA or FSA for QMAX or DirectMax?

Direct Meds states that HSA and FSA payments are accepted for DirectMax. Check with BetterMe Rx and your plan administrator for QMAX.

Are QMAX and DirectMax FDA approved?

No. Both are compounded medications, and the FDA does not approve or verify compounded drugs for safety or effectiveness. Their individual active ingredients are used in FDA-approved medicines, and a licensed provider must prescribe them.

The certified programs we track

★ Editor's pick

QMAX™ · 4-in-1 sublingual, every dosage published, month-to-month, no lock-in. 4.9/5

QUAD™ · 4-in-1 sublingual, 24/7 support, don't-qualify-don't-pay. 4.8/5

Hard Chews Now · 3-in-1 chew, human phone support, pause or cancel anytime. 4.8/5

DirectMax · triple-ingredient, HSA/FSA accepted, 100% refundable. 4.6/5

Surge MAX · 3-in-1 compounded sublingual, free consult. 4.4/5

See if QMAX is right for you

Our editor's pick. A licensed provider reviews your health first, and plans are month-to-month with no lock-in.

See if I qualify

Bottom line

QMAX is the better product for most men, which is why it ranks first: four actives, every dose published, no lock-in. DirectMax is the better value: a genuine multi-ingredient option at roughly half the per-dose price, with HSA/FSA and a refund policy. Decide on what matters more to you, transparency or price.

About compounded medications: compounded drugs are not FDA-approved, and the FDA does not verify their safety or effectiveness. A licensed provider decides whether any treatment is appropriate for you.

Safety first: ED medications, including sildenafil, tadalafil, and vardenafil, can interact with nitrates and certain heart and blood pressure medications, and ED can signal an underlying condition such as cardiovascular disease. Every program we list requires review by a licensed provider, and talking to your own doctor is always a good idea.

More on QMAX

QMAX review QMAX cost Is QMAX legit?How QMAX works QMAX vs QUAD QMAX vs Hard Chews Now QMAX vs DirectMax QMAX alternatives