What is actually in a "4-in-1"?
The custom blends are the fastest-growing product in this market and the hardest to compare, because "3-in-1" describes a count rather than a composition. Here is every formula we track, what each contains, and how much of it you are told before you pay.
Naming a molecule is not the same as telling you how much of it you are taking — and dose is what determines both whether it works and how it interacts with everything else you take.
Every ED blend, by composition#
| Channel | Formula | What's in it | Composition disclosed | Price |
|---|---|---|---|---|
| BlueChew chew | MAX 2-in-1 | sildenafil + tadalafil | molecules named, no doses | from $5.63/dose |
| BlueChew chew | VMAX 2-in-1 | vardenafil + tadalafil | molecules named, no doses | from $5.63/dose |
| BlueChew sublingual | GOLD 4-in-1 | sildenafil 70–110 mg + tadalafil 18–22 mg + apomorphine + oxytocin | incomplete | $7.30–18.28/dose (~$75–269/mo by count) |
| Hims mint | Hard Mints 3-in-1 3-in-1 | tadalafil + sildenafil + third ingredient unpublished | incomplete | ~$8/dose monthly ("from $2" on annual prepay) |
| Lemonaid sublingual | Bliss unpublished | ingredients not published pre-intake | nothing published | $8/dose |
| Ro sublingual tab | Sparks 2-in-1 | sildenafil 55 mg + tadalafil 22 mg | every active, with dose | $12/dose flat ($48–120/mo by count) |
| Rugiet Ready troche | Rugiet 3-in-1 | sildenafil + tadalafil + apomorphine | molecules named, no doses | $12.42–22.42/dose monthly ($149–269/mo tiers; promo floor ~$7.29) |
Disclosure level is scored from the published ingredient string, not from our impression: "full" means every named active carries a dose. Vitamin bundles are not counted as dosed actives.
Daily products, for completeness#
These sit in the same part of the market but are single-active daily products rather than blends, so they are not counted in the disclosure figures above.
| Channel | Product | Composition | Price |
|---|---|---|---|
| BlueChew | DailyTAD daily chew | tadalafil 9 mg + 7 vitamins | $100/mo monthly · $66.67/mo quarterly |
| Ro | Daily Rise daily gummy | tadalafil 7 mg (gummy) | $89/mo · $69/mo on 3-month |
The ingredients beyond the familiar two#
Almost every blend starts from the same base — sildenafil and tadalafil, the molecules in Viagra and Cialis. What distinguishes a "3-in-1" or "4-in-1" is what gets added:
| Ingredient | What it is | Worth knowing |
|---|---|---|
| Sildenafil | PDE5 inhibitor — the molecule in Viagra | FDA-approved on its own. Available generically for cents a tablet — see the cost page. |
| Tadalafil | PDE5 inhibitor — the molecule in Cialis, longer-acting | FDA-approved on its own. Combining two PDE5 inhibitors is not an approved use. |
| Vardenafil | A third PDE5 inhibitor — the molecule in Levitra | Appears in one blend we track. |
| Apomorphine | A dopamine agonist, not a PDE5 inhibitor | A genuinely different mechanism. It is approved in the US for a different condition entirely, and its ED use here is compounded, not approved. |
| Oxytocin | A peptide hormone | Appears in the highest-count formula we track. Not an approved ED treatment. |
The chewable premium, quantified#
Format is the other half of what you are paying for. Sildenafil as a plain tablet runs $0.22 to $0.57 a dose at cash pharmacies. The same molecule as a chewable runs $3.53 to $5.00 a dose — a premium of roughly 16x to 23x against the cheapest tablet, or 6x to 9x against the pricier one.
What the per-dose figure does support: at eight doses a month, tablets cost about $1.76 and chews $28 to $40. That gap is real whatever the milligrams say.
Whether the format is worth it is a genuine question rather than a rhetorical one — discretion, onset and not swallowing a tablet are real reasons people choose it. It is worth knowing the size of what you are paying for. The frequency arithmetic is on the daily-versus-as-needed page.
The hair equivalent#
The same pattern runs through topical hair combinations, where the ingredient count is also the marketing:
| Channel | Combination | Price | Billing |
|---|---|---|---|
| Maximus (Tribe) | 4-in-1 gel (dutasteride + minox + tretinoin + fexofenadine) | ~$18–22/mo reported (~$55–65 per 90 days) | official page price not rendering |
| Hims | Rx spray / serum (fin + minox; +keto $39) | starting at $35/mo | billing unit behind checkout |
| Ro | Ro Mane spray (minox 6% + fin 0.3% + tretinoin) | $50/mo quarterly, $43/mo on 6-month | quarterly shipments |
| Ulo | Topical finasteride 0.2% + minoxidil 7% | from $69/mo | headline rates tied to 12-month plans; add-on and tretinoin variants also from $69; 180-day money-back |
| Keeps | Topical fin + minox gel | $60/mo reported | quarterly billing |
| Happy Head | Topical fin 0.25% + minox 8% | $63/mo subscribe ($79 one-time); $49 first order | Derm consult included. The 'true monthly billing' we previously claimed here does not hold across the brand — Happy Head's oral plans bill up front on longer terms. On this product the page states the 1.7oz bottle is a 25-day supply at twice daily, so a subscription sold as monthly runs out before the month does; we have not yet confirmed the refill interval at checkout. |
| XYON | Topical finasteride (SiloxysSystem gel, no minox) | $109 per 30 days ($119 one-time) | $20 consult on first one-time order (credited on subscription) |
| XYON | Topical dutasteride gel | $139 per 30 days ($149 one-time) | premium vehicle; true 30-day billing |
Note the spread: the widest-ingredient combination is also among the cheapest, and the two most expensive rows are single-ingredient gels. Ingredient count and price are close to uncorrelated here, which is a useful thing to know when a fourth ingredient is being sold as an upgrade.
How to compare blends without being led#
- Ask for the full composition with doses, in writing, before you pay. 1 of 7 blends provides it upfront. The rest can be asked, and the answer is worth having in writing whatever they say.
- Price per dose, not per month. These are priced per dose against a monthly count you choose, so a "$149/mo" tier and a "$269/mo" tier can be the same per-dose price at different volumes.
- Count the PDE5 inhibitors. A "2-in-1" that is two PDE5 inhibitors is a different proposition from one that adds a separate mechanism.
- Check what the generic costs. If a blend is mostly sildenafil and tadalafil, the comparison is against $0.22 a tablet, and the difference is what you are paying for the formulation and the convenience.
- Tell any prescriber the full composition. Which requires knowing it — the practical reason unpublished ingredients matter beyond the principle.
Common questions#
What is actually in a 3-in-1 or 4-in-1 ED formula?#
Typically two PDE5 inhibitors — sildenafil and tadalafil — plus one or two additions, most often apomorphine and sometimes oxytocin. These are compounded preparations, not FDA-approved products, and the combination itself has not been through approval even where the individual molecules have.
Do ED telehealth companies tell you the doses in their blends?#
Mostly not. Of the 7 multi-ingredient blends we track, 1 publishes every active ingredient with its dose before you buy. 3 name the molecules without any milligram figures, and 3 leave at least one ingredient without a dose or unpublished entirely.
Pricing and composition journalism, not medical advice, and not a recommendation of any formula. Compounded blends are not FDA-approved products. Combining erectile-dysfunction medications carries interaction risks — particularly with nitrates and some blood-pressure medicines — that belong in a conversation with a prescriber who knows everything else you take. Listed compositions and prices on the researched date; the checkout is the final word. No link on this page earns us a commission; ordering is by cost, never compensation — disclosure.