What Is BlueChew MAX? Sildenafil + Tadalafil, Explained

BlueChew MAX is a compounded sublingual ED medication that combines 45 mg of sildenafil and 18 mg of tadalafil, the active ingredients in Viagra and Cialis, in one tablet. 

Sildenafil helps you get going quickly, and tadalafil keeps working for up to 36 hours, so you get a fast start and a long window from a single dose.

Here's how MAX works, why combining two PDE5 inhibitors can help, how to take it, and who it's best for.

• BlueChew MAX combines sildenafil and tadalafil, two PDE5 inhibitors, in one sublingual tablet.
• It typically starts working within 15–30 minutes, and its effects can last up to 36 hours.
• Research has found that combining sildenafil and tadalafil improved erection quality and satisfaction compared with tadalafil alone, without increasing side effects.
• MAX may be a good fit for men who didn't get the results they wanted from a single ingredient.
• Don't take MAX with nitrates or riociguat.
• MAX is a compounded medication. Compounded medications aren't FDA-approved, and the FDA doesn't verify their safety or effectiveness.

Sildenafil: The Fast Start

Sildenafil, the active ingredient in Viagra, is a PDE5 inhibitor. During arousal, it keeps blood vessels in the penis relaxed so more blood can flow in. On its own, sildenafil lasts about 4–6 hours, and in sublingual form it may start working faster than a swallowed pill.

Tadalafil: The Long Window

Tadalafil, the active ingredient in Cialis, works the same way but stays active much longer, up to 36 hours. That long window means you don't have to time sex around a pill, which may help ease performance anxiety.

In MAX, the two work together: sildenafil supports a quick response, and tadalafil keeps you covered for up to 36 hours. Neither causes an erection without sexual stimulation.

Some men find that a single PDE5 inhibitor doesn't give them the firmness or consistency they want. Research suggests combining a short-acting and a long-acting PDE5 inhibitor may help:

• Better results: in a 2014 study, men taking daily tadalafil plus as-needed sildenafil had greater improvements in erection quality, penetration, and satisfaction than men taking tadalafil alone.
• Help for non-responders: a 2024 study found men who hadn't responded to one PDE5 inhibitor saw significant gains in rigidity and function after switching to a tadalafil and sildenafil combination.
• No increase in side effects: in the 2014 study, men on the combination didn't have more side effects than men on a single medication.

If one ingredient alone hasn't worked well for you, here's more on why some men don't respond to Viagra or Cialis alone.

1. Place the tablet under your tongue and let it dissolve completely.
2. Take it 15–30 minutes before sexual activity.
3. Remember that MAX still needs sexual stimulation to work.

Take MAX as needed, not more than once in 24 hours. Taking it on a relatively empty stomach may help the sildenafil kick in faster, and limit alcohol, which can increase dizziness. Here are more tips for the best results with MAX.

MAX may be a good fit if you:

• Got partial or inconsistent results from sildenafil or tadalafil alone
• Want a fast start and a long window in one tablet
• Prefer more spontaneity than a short-acting medication allows

If you're new to ED medication, a provider may suggest starting with a single ingredient like SIL or TAD. Here's how tadalafil and sildenafil compare.

Because MAX contains sildenafil and tadalafil, its side effects are the same as those of PDE5 inhibitors in general. Most are mild and temporary.

Common side effects:

• Headache
• Facial flushing or warmth
• Nasal congestion
• Indigestion or upset stomach
• Back or muscle aches
• Dizziness or lightheadedness

Get medical help right away for: chest pain or fainting, sudden changes in vision or hearing, or an erection lasting more than 4 hours.

Safety considerations:

• Don't take MAX with nitrates (such as nitroglycerin) or riociguat, because the combination can cause a dangerous drop in blood pressure.
• Tell your provider if you take alpha-blockers or other blood pressure medications.
• Avoid heavy drinking, which can make erections harder to get and increase dizziness.

For the full list, see our guide to BlueChew side effects.

VMAX swaps sildenafil for vardenafil, which some men respond to better. GOLD adds apomorphine and oxytocin to support arousal. See how all three compare in GOLD vs. MAX and VMAX.

Interested in getting your hands on an erectile dysfunction prescription? BlueChew has got you covered.

Select a plan, complete an online intake, and you're done. A medical provider will review your information and, if appropriate, prescribe your plan, which will be shipped directly to your door.

No doctor appointments or patient support charges make it a stress-free experience.

Plus, there's no commitment—you can easily cancel or switch plans anytime. Click here to explore all plan options for treatments at BlueChew.

What is BlueChew MAX?

BlueChew MAX is a compounded sublingual ED medication that combines 45 mg of sildenafil and 18 mg of tadalafil, the active ingredients in Viagra and Cialis, in one tablet.

How quickly does BlueChew MAX work?

MAX typically starts working within 15–30 minutes. Take it 15–30 minutes before sexual activity. Sexual stimulation is still needed.

How long does BlueChew MAX last?

The sildenafil in MAX works for about 4–6 hours, and the tadalafil extends the window to up to 36 hours.

Is it safe to take sildenafil and tadalafil together?

Research has found the combination can be effective without increasing side effects, but it should only be taken as a single prescribed formula like MAX. Never combine separate ED medications on your own.

Can I drink alcohol with MAX?

Light to moderate drinking is usually fine, but heavy drinking can make erections harder to get and increase dizziness.

Do I need a prescription for MAX?

Yes. BlueChew MAX requires an online consultation with a licensed provider, who decides whether it's right for you.

Who shouldn't take MAX?

Don't take MAX if you use nitrates or riociguat. Tell your provider if you take alpha-blockers or other blood pressure medications, or if you have a serious heart condition.

What's the difference between MAX and GOLD?

MAX contains sildenafil and tadalafil. GOLD contains those two plus apomorphine and oxytocin, which support arousal, and it comes in three strengths.