MEDVi's 4-in-1 sublingual liquid now combines apomorphine, L-citrulline, tadalafil, and sildenafil, with a consultation included, 24/7 medical support, and a don't-qualify-don't-pay policy.
Quick answerIs QUAD by MEDVi worth it?
For men who want the most support, yes. QUAD is MEDVi's 4-in-1 sublingual liquid (sildenafil, tadalafil, apomorphine, and L-citrulline), from $114 to $179 a month with a doctor consultation, free rush shipping, 24/7 medical support, and a don't-qualify-don't-pay policy. It's LegitScript certified. We rate it 4.8 out of 5, second in our rankings behind QMAX.
Key facts
Our rating4.8/5
Last reviewedOctober 2026
Treatment4-in-1 compounded sublingual liquid
ActivesSildenafil, tadalafil, apomorphine, plus L-citrulline
Published pricingFrom $114 to $179/month*
BundledDoctor consultation, free rush shipping, 24/7 medical support
PolicyDon't qualify, don't pay; cancel anytime
Provider reviewUS-licensed doctor, reported within 24 hours
CertificationLegitScript certified,
verify ↗ How we rate: editorial ratings reflect our review of each program's formula, format, bundled services, transparency, policies, and certification status, not clinical outcomes, which we cannot measure. Facts below were re-checked against the program's own site in October 2026; the program's site is authoritative and details can change. We may earn a commission through our links; commissions never change an assessment (
methodology ·
disclosure).
On this page
- What changed in our October review
- The formula, in plain terms
- How it works
- Pricing
- Who QUAD fits best
- Pros and cons
- Common questions
- Our verdict
QUAD is MEDVi's 4-in-1 ED program: a rapid-absorb liquid that dissolves under the tongue, prescribed only after a US-licensed doctor reviews a short private intake. MEDVi is an established telehealth operator with a listed phone line, a Delaware business address, and LegitScript certification linked in its footer.
What changed in our October review
MEDVi has updated the QUAD formula. It previously listed vardenafil as one of its four ingredients; the current formula is apomorphine, L-citrulline, tadalafil, and sildenafil. L-citrulline is an amino acid the body converts into nitric oxide, which supports blood flow; it isn't a prescription drug like the other three. In practice QUAD now pairs the two PDE5 inhibitors behind Viagra and Cialis with apomorphine for the arousal side and L-citrulline as a blood-flow support ingredient. Pricing and policies are unchanged.
Sildenafil supports a strong response, tadalafil provides a long window (MEDVi reports up to 36 hours), apomorphine works on dopamine pathways involved in desire rather than on blood flow, and L-citrulline supports nitric oxide production. MEDVi reports onset in as little as 10 to 15 minutes because the liquid absorbs under the tongue instead of through digestion, which also means a heavy meal is less likely to blunt it. These are the program's reported characteristics; individual response varies and a provider decides whether the formula suits you.
How it works
A 3-minute private intake online, review by a US-licensed doctor (MEDVi reports within 24 hours), then free rush shipping in plain packaging if prescribed. MEDVi's don't-qualify-don't-pay policy means you aren't charged if the doctor decides treatment isn't right for you, which removes the main risk of trying a telehealth program.
Pricing
QUAD starts at $114 per month on a bundled plan, from a $179 list price, and the price includes the doctor consultation, free rush shipping, and 24/7 medical support. You can cancel anytime. It sits in the premium tier, well above generic tablets, in exchange for the multi-ingredient formula and the most complete support package we track.
Who QUAD fits best
Men whose single-ingredient tablets gave inconsistent results and who want a multi-ingredient sublingual, men who want to be able to reach medical support at any hour, and men who'd like the reassurance of paying nothing if they don't qualify. Men who want every milligram published before enrolling may prefer QMAX, which discloses its exact doses.
Pros and cons
What we like
- 4-in-1 sublingual combining sildenafil, tadalafil, apomorphine, and L-citrulline
- Don't-qualify-don't-pay policy removes evaluation risk
- Consultation, free rush shipping, and 24/7 medical support included in the price
- Cancel anytime, LegitScript-certified operator
What to weigh
- Premium tier versus generic tablets, best value for men ready to move past single-ingredient options
- Exact per-ingredient doses are set by your provider rather than published
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.
Common questions
What's in QUAD now?
As of our October 2026 review, QUAD combines apomorphine, L-citrulline, tadalafil, and sildenafil in a sublingual liquid. Earlier versions listed vardenafil instead of L-citrulline.
What does L-citrulline do?
L-citrulline is an amino acid the body converts into nitric oxide, a molecule involved in blood flow. In QUAD it's a supporting ingredient alongside sildenafil and tadalafil, which are the prescription blood-flow medications.
How much does QUAD cost?
MEDVi lists QUAD from $114 per month on a bundled plan, from a $179 list price, including the doctor consultation, free rush shipping, and 24/7 medical support.
What if I don't qualify?
MEDVi publishes a don't-qualify-don't-pay policy: if the doctor determines treatment isn't appropriate, you aren't charged for it.
How fast can I get started?
The online intake takes about 3 minutes, a US-licensed doctor reviews it (MEDVi reports within 24 hours), and treatment ships free with rush delivery if prescribed.
Our verdict
MEDVi earns its 4.8 on the most complete support package we track: consultation, free rush shipping, and 24/7 medical support included, cancel anytime, and a don't-qualify-don't-pay policy that removes the risk of trying. The updated formula keeps both PDE5 inhibitors and apomorphine, now with L-citrulline in place of vardenafil. For men who want a multi-ingredient sublingual with maximum support, it's an excellent choice.
Safety first: ED medications 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.
