⚡ Quick Answer — What is ED Combo Pack?
ED Combo Pack is een 3-drug PDE5 inhibitor sampler pack die sildenafil 100 mg, tadalafil 20 mg, and vardenafil 20 mg — the three most widely-prescribed oral erectile dysfunction medicines in one pack. Designed for patients starting ED treatment who want to compare the three PDE5 inhibitor molecules head-to-head (rather than committing to a single drug up-front) and for established ED patients who want flexibility to match the drug to the occasion (sildenafil for quick on-demand, tadalafil for long-duration or weekend coverage, vardenafil for diabetic ED). Belangrijk: this is a sampler — take only ONE drug on any given day, never combine PDE5 inhibitors. All three share the same absolute contraindications (nitrates, severe cardiovascular disease) and broadly the same side-effect profile.
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What Is the ED Combo Pack?
The ED Combo Pack is a curated pack that brings together the three oral phosphodiesterase type 5 (PDE5) inhibitors approved worldwide for the treatment of erectile dysfunction: sildenafil (generic Viagra), tadalafil (generic Cialis), and vardenafil (generic Levitra). Each drug is supplied in equal quantity at the standard on-demand dose — sildenafil 100 mg, tadalafil 20 mg, vardenafil 20 mg.
The pack is intended for two patient profiles:
- New ED patients who have not yet tried PDE5 treatment — rather than committing to a monthly supply of one drug you may not tolerate, the combo pack lets you try all three and identify the one that fits your onset/duration/side-effect profile best.
- Established ED patients whose lifestyle benefits from having all three drugs on hand — sildenafil for a quick on-demand response, tadalafil for a 36-hour window covering an entire weekend, and vardenafil as an alternative in diabetic ED or if sildenafil/tadalafil lose effect.
What’s in the Pack?
| Geneesmiddel | Dosering | Werkingsbegin | Duur | Food effect |
|---|---|---|---|---|
| Sildenafil (generic Viagra) | 100 mg | 30-60 min | 4-6 hours | Fatty meal slows onset by up to 1 hour |
| Tadalafil (generic Cialis) | 20 mg | 30-45 min | Up to 36 hours | Minimal — can take with food |
| Vardenafil (generic Levitra) | 20 mg | 25-60 min | 4-5 hours | Fatty meal slows onset |
How Do PDE5 Inhibitors Work?
All three drugs share the same mechanism — they are selective PDE5 inhibitors that work on the natural erectile physiology:
- Sexual stimulation triggers stikstofmonoxide (NO) vrijgave in het corpus cavernosum
- NO activeert guanylaatcyclase, waardoor lokaal cGMP toeneemt
- cGMP relaxes arterial smooth muscle, increasing blood flow into erectile tissue
- The enzyme PDE5 normally breaks cGMP down, ending the erection
- Sildenafil, tadalafil and vardenafil all block PDE5, prolonging the body’s natural erectile response
None of these drugs cause an erection without sexual stimulation — they amplify the natural response rather than triggering one pharmacologically. This is the fundamental difference between PDE5 inhibitors and older, more-invasive ED treatments (intracavernosal injection, intra-urethral pellets).
Which PDE5 Inhibitor Should I Use First?
Most urology guidelines (AUA 2018, EAU 2023) do not specifically recommend one PDE5 inhibitor over another — choice is individualised based on the patient’s profile, lifestyle, comorbidities, and response. Starting points that usually work well:
- If your encounters are planned and occasional: start with sildenafil 100 mg — the most studied PDE5 inhibitor, rapid onset, predictable 4-6 hour window, widest clinical experience.
- If you want flexibility across a weekend or multi-day period: tadalafil 20 mg — the 36-hour window removes the pressure of timing dose-to-intercourse precisely. Also well-tolerated with food.
- If you have diabetes or have not responded well to sildenafil: vardenafil 20 mg — some evidence of better response rates in diabetic ED, and a different PDE11 selectivity profile that may reduce side effects in some patients.
- If you are prone to PDE-related side effects (headache, flushing, nasal congestion, back pain, muscle aches): each drug has a slightly different side-effect profile; the combo pack lets you test which one you personally tolerate best.
Never take two PDE5 inhibitors on the same day. They are all additive for cardiovascular side effects, and combined dosing gives no additional benefit over a single optimal drug. Wait at least 48-72 hours between doses if switching between drugs during a trial period.
How to Take the ED Combo Pack
- Choose ONE drug per day. Never combine PDE5 inhibitors in the same 24-hour window.
- Take on an empty stomach or with a light meal for fastest onset (particularly for sildenafil and vardenafil). Tadalafil is less affected by food.
- Swallow whole with a glass of water. Do not crush, split or chew (unless you specifically have the chewable or jelly form of a PDE5 inhibitor, which is different).
- Wait for the onset window indicated for the drug you chose (see table above) before anticipated sexual activity.
- Seksuele stimulatie is vereist — no drug in this class produces an erection without arousal.
- Log your response. For the first 3-6 doses of each drug, note onset time, duration of effect, and side effects. This record helps you identify the drug that fits you best.
- Maximum one dose per 24 hours for sildenafil / vardenafil; maximum one 20 mg dose per 24 hours for tadalafil (or 2.5-5 mg daily if taking daily-dose tadalafil, which is a different regimen not in this pack).
Side Effects — Common to All Three
- Hoofdpijn (most common — 10-16%)
- Facial flushing (5-12%)
- Dyspepsia, mild stomach upset (5-10%)
- Nasal congestion (4-9%)
- Back pain, muscle aches — more common with tadalafil than sildenafil/vardenafil (3-6% tadalafil; <2% sildenafil/vardenafil)
- Visual disturbances (blue-tinted vision) — more common with sildenafil than tadalafil/vardenafil
- Dizziness, mild palpitation
Serious side effects requiring urgent medical attention: priapism (erection lasting >4 hours), sudden vision loss (NAION), sudden hearing loss, severe chest pain, syncope, severe allergic reaction.
Contraindications — Apply to All Three
- Nitrates (nitroglycerin, isosorbide mononitrate/dinitrate) in any form — ABSOLUTE contraindication. Severe hypotension and death have occurred.
- Guanylaatcyclase-stimulatoren (riociguat) for pulmonary hypertension — ABSOLUTE contraindication.
- Recent myocardinfarct, instabiele angina, ernstig hartfalen (NYHA III-IV) — sexual activity itself is the concern; any ED treatment is contraindicated until cardiology clearance.
- Severe hepatic impairment, severe renal impairment — dose reduction or specialist advice required.
- Alpha-blockers (doxazosin, tamsulosin) — risk of symptomatic hypotension; separate dosing by 4+ hours or use with cardiology advice.
- Sterke CYP3A4-remmers (ketoconazol, ritonavir, clarithromycine) — reduce PDE5 dose by 50-75%.
- History of NAION (non-arteritic ischaemic optic neuropathy) — relative contraindication.
Veelgestelde vragen
Can I take two different ED medications on the same day?
No. PDE5 inhibitors are additive for cardiovascular side effects, and combined dosing does not produce additional benefit over a single optimal drug. Take one drug per day. If you are trialling the pack to find the one that fits you best, separate each test by at least 48-72 hours.
Which is strongest — sildenafil, tadalafil or vardenafil?
At their standard doses (sildenafil 100 mg, tadalafil 20 mg, vardenafil 20 mg), all three have similar overall efficacy for most ED patients. Head-to-head trials show roughly equivalent response rates (60-80% of patients achieving a satisfactory erection). Individual response varies — some patients respond best to one and less well to another. The combo pack lets you identify your personal best responder.
Which one should I try first?
Most urologists recommend sildenafil 100 mg as the starter because it has the widest clinical experience and the most predictable 4-6 hour window. If the onset is too slow, sildenafil gives unacceptable side effects, or you want a longer window for a weekend, try tadalafil 20 mg next. Vardenafil 20 mg is the third option, particularly valuable in diabetic ED.
Can I take PDE5 inhibitors with alcohol?
Small amounts of alcohol (1-2 drinks) are generally tolerated with any of these three. Heavy alcohol amplifies the hypotensive side effects of all three drugs and independently impairs erection — avoid heavy drinking when taking a PDE5 inhibitor.
What if none of the three work for me?
If all three PDE5 inhibitors fail at full dose over multiple attempts, the diagnosis needs revisiting. Possibilities include: vascular ED requiring intracavernosal injection, peripheral nerve damage, significant testosterone deficiency, psychogenic ED needing behavioural treatment, or drug-interaction issues. See a urologist for full evaluation.
Are the drugs in this pack the same as brand-name Viagra, Cialis and Levitra?
Yes — they contain the same active pharmaceutical ingredients at the same strengths. Sildenafil is the active in Viagra, tadalafil is the active in Cialis, vardenafil is the active in Levitra. Generic PDE5 inhibitors are the standard worldwide now that the originator patents have expired.
Can I take any of these with nitrates for heart conditions?
No — absolute contraindication. The combination of any PDE5 inhibitor with nitrates (nitroglycerin, isosorbide mononitrate/dinitrate, amyl nitrite “poppers”) can cause severe hypotension, cardiovascular collapse, and death. If you use nitrates for angina or take them intermittently for chest pain, do NOT use PDE5 inhibitors. Discuss with your cardiologist about alternative angina treatment.
How long between trying the three drugs?
Allow at least 48-72 hours between each trial dose so that you are evaluating each drug with no residual effect from the previous one. Sildenafil and vardenafil clear in 12-24 hours; tadalafil’s 17.5-hour half-life means effects can linger 36 hours or more. Wait a full 3 days after tadalafil before trying the next drug.
Where can I order the ED Combo Pack online?
You can order the ED Combo Pack from MedsBase in pack sizes that suit your intended trial or long-term use. Orders ship worldwide with discreet packaging. All three drugs in the pack are specialist-supervised in most jurisdictions.
Related Individual Products on MedsBase
- Cenforce — sildenafil 25-200 mg (widest strength range)
- Caverta — sildenafil 50/100 mg (Sun Pharma)
- Vidalista — tadalafil 2.5-60 mg (full ladder)
- Tadacip — tadalafil 20 mg (Cipla)
- Vilitra — vardenafil 10-60 mg (widest vardenafil range)
- Tadasiva — sildenafil 100 + tadalafil 20 mg combination tablet
Helpful reading: browse the full Erectile Dysfunction category en onze klantbeoordelingen.
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