4-in-1 oral liquid
4th Gear
Four active ingredients in one prescription liquid, taken by mouth.
Sildenafil · Tadalafil · Vardenafil · Apomorphine
Vials per pack · price per refill
Start my evaluationLearn about 4th GearVital Step Men · Sexual health
Make room for
better sex.
Your sex life is worth making time for. Explore prescription ED treatments with private online care, a licensed clinician’s review and discreet delivery, if prescribed.
for pleasure.
ED options from $59 per refill
Single-ingredient tablets · 6-pack
Start my evaluationPrescription required. Subscription renews monthly.
Your next step, made easy
Private care. Made simple.
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Start online
Share your health history and goals in a private online evaluation.
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Get expert guidance
A licensed clinician reviews your health and prescribes if appropriate.
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Delivered discreetly
Medication ships discreetly to your door, if prescribed.
LegitScript certificationVerify vitalstep.com
Our featured treatments
Your next chapter.
Your treatment options.
Start with the format that feels right for you. Compare oral liquid, daily tablets and as-needed options, then let your clinician review the fit.
3-in-1 tablet
Ignite
Three active ingredients combined in one prescription tablet.
Tadalafil · Sildenafil · Apomorphine
Tablets per pack · price per refill
Start my evaluation
Daily dissolving tablet
Boost
A daily prescription tablet option with tadalafil, caffeine and L-citrulline.
Tadalafil · Caffeine · L-citrulline
Tablets per pack · price per refill
Start my evaluationPrices are per refill. Subscription renews monthly. Pack size is supply quantity, not a prescribed dose or a promise of how long it will last. Your clinician determines the formulation, strength and instructions.
Find your starting point
Not sure which
treatment to choose?
Tell us what matters to you, what you’ve tried and what you’d like to change. You can explore your options before choosing a preference for your clinician to review.
Start my private evaluationThe full ED range
Find your fit.
Compare single-ingredient and compounded tablet formulations. You can share a preference; your clinician makes the prescribing decision.
Single-ingredient tablet
Sildenafil
An orally dissolving sildenafil tablet. Your clinician determines whether 50 mg or 100 mg is appropriate.
Tablets per pack · price per refill
Start my evaluation
Single-ingredient tablet
Tadalafil
A 20 mg orally dissolving tadalafil tablet option for as-needed use, according to your prescription.
Tablets per pack · price per refill
Start my evaluation
Combination dissolving tablet
Drive
Sildenafil and Pycnogenol combined in an orally dissolving prescription tablet.
Tablets per pack · price per refill
Start my evaluation
Combination dissolving tablet
Overdrive
Tadalafil and Pycnogenol combined in an orally dissolving prescription tablet.
Tablets per pack · price per refill
Start my evaluation
3-ingredient dissolving tablet
Drive Plus
Sildenafil, bremelanotide and Pycnogenol in one compounded prescription tablet.
Tablets per pack · price per refill
Start my evaluation
3-ingredient dissolving tablet
Overdrive Plus
Tadalafil, bremelanotide and Pycnogenol in one compounded prescription tablet.
Tablets per pack · price per refill
Start my evaluation
2-in-1 dissolving tablet
Mach 1
Tadalafil and sildenafil combined in one orally dissolving prescription tablet.
Tablets per pack · price per refill
Start my evaluation
Daily dissolving tablet
Cruise Control
A daily prescription tablet option combining tadalafil and NMN.
Tablets per pack · price per refill
Start my evaluationThese options require a prescription. Do not assume that a combination is stronger, faster or more effective for you. Follow the amount, frequency and method on your pharmacy label. Compounded medications are not FDA-approved. Read important safety information.
The people behind your care
A team in your corner.
A plan built around you.
Bring your goals, your questions and your health history. A licensed provider reviews your information and helps you understand which treatment is right for you.
- Medical review before prescribing
- Medication and dose chosen for your needs
- A care team for treatment questions
How Vital Step Men works
Private care.
A clear next step.
- 01
Tell us about you.
Complete your online health form with your symptoms, medications and previous ED treatments.
- 02
Choose your preferred treatment.
Compare your options and select a plan. Review the full charge and subscription terms at checkout, then submit your request for clinical review.
- 03
Your clinician takes it from here.
A licensed clinician reviews your information and decides whether treatment is right for you. Follow any requests for more information or consultation steps before a prescribing decision.
- 04
Start care with clear instructions.
If prescribed, the pharmacy prepares and ships your medication. Follow your pharmacy label, and contact your care team with treatment or refill questions.
After you submit, check your patient portal for review and delivery updates. Your treatment choice is a preference for your clinician to review, not a confirmed prescription.
Start my private evaluationBefore you start
Clear answers.
Better decisions.
Understand the treatment and the process before taking your next step.
What happens after I submit my request?
Your request moves to clinical review. Check your patient portal for updates and follow any requests for more information or consultation steps. Your clinician confirms whether treatment is appropriate. If prescribed, the pharmacy prepares your medication, with tracking available in your portal when it ships.
Does choosing a treatment mean I have a prescription?
Your selection tells the clinician what you would like to explore. The clinical review is a separate step: your clinician considers your health history, medicines and any follow-up information before making the prescribing decision.
How does the online consultation work?
Start by completing the health questions online. A licensed clinician reviews the information you submit. If further information or consultation is needed, follow your care team’s instructions; submitting the form does not mean the review is complete.
When is my first payment taken?
Checkout authorizes your payment method; you are charged only if a clinician prescribes treatment. A temporary authorization hold may appear on your card. Review the full charge, renewal schedule and cancellation terms at checkout.
Which ED treatment should I choose?
You do not need to decide before starting. Tell your clinician about your symptoms, previous treatments, side effects and preferences. They review your health and medications before recommending whether treatment is appropriate.
What is the difference between the treatments?
The options differ in ingredients, formulation and format. 4th Gear is an oral liquid. Sildenafil and tadalafil are single-ingredient tablets. Other products combine multiple ingredients in prescription tablets. Some are intended for daily use and others for as-needed use. Your prescription and pharmacy label determine how you take any medication.
Does a larger pack mean a stronger treatment?
No. Pack size describes the number of vials or tablets supplied. Your medication strength, dose and instructions are separate. The pack quantity does not tell you how much or how often to take medication.
How do subscriptions and refills work?
Choose a pack quantity that fits your prescription. The subscription renews monthly, with refills subject to your prescription and continued clinical suitability. Prices are shown per refill. Review renewal, cancellation and refund terms at checkout.
Can I combine these with another ED medication?
Do not add other ED medication. Tell your clinician about every medication, supplement and recreational substance you use so they can check for interactions. ED medications must not be used with nitrates or recreational nitrites such as poppers. Read the important safety information below.
Are the compounded products FDA-approved?
Compounded medications are not FDA-approved. The FDA does not review compounded medications for safety, effectiveness or quality before marketing. A licensed clinician should discuss the potential benefits, risks and alternatives for the specific treatment they prescribe.
Vital Step Men
Make your
next move.
Make time for your sexual health.
Start a private online evaluation and explore your treatment options.
Read before considering treatment
Important safety
information.
This overview does not replace your prescription information or a clinician’s advice.
Review your health and medications.
Do not use with nitrates, recreational nitrites (poppers) or riociguat. Do not add other ED medication. Share all medications and health conditions with your clinician so they can check interactions and whether sexual activity is appropriate for you.
Know when to seek help.
ED medicines can cause side effects such as headache, flushing and upset stomach. Seek urgent medical care for an erection lasting more than four hours or sudden vision or hearing loss. This is not a complete list of possible effects or interactions.
General medicine information: sildenafil, tadalafil, vardenafil and apomorphine (injection reference). These references do not establish the safety or effectiveness of the 4th Gear combination.