The HESHE ED Pack is a clinically-formulated combination therapy designed to address moderate to severe erectile dysfunction through synergistic pharmacological action. This pack includes two distinct PDE5 inhibitors—sildenafil citrate and tadalafil—providing both immediate and prolonged therapeutic options tailored to individual needs and timing. Developed under stringent pharmaceutical standards, it offers a flexible, patient-centered approach to restoring sexual function, with dosing flexibility that accommodates both planned and spontaneous intimacy. Backed by robust clinical evidence, this dual-agent system ensures optimized efficacy while minimizing potential side effects through appropriate compound selection.

Features

• Contains 10 tablets of sildenafil citrate 100mg and 10 tablets of tadalafil 20mg
• Dual-mechanism PDE5 inhibition for immediate and sustained effect windows
• Manufactured in FDA-approved facilities following cGMP standards
• Blister-packed for stability, portability, and discretion
• Includes detailed patient information leaflet and dosage guide

Benefits

• Enables reliable achievement and maintenance of erections sufficient for sexual activity
• Provides both short-acting (4–6 hour) and long-acting (up to 36-hour) treatment options
• Reduces performance anxiety through predictable pharmacological response
• Improves sexual confidence and relationship satisfaction
• Allows dosing flexibility based on timing of anticipated sexual activity
• Minimizes need for repeated dosing decisions through pre-planned regimen

Common use

The HESHE ED Pack is prescribed for adult males experiencing erectile dysfunction of various etiologies, including vasculogenic, neurogenic, and psychogenic origins. It is particularly suitable for patients who require different therapeutic windows—sildenafil for planned intimacy with rapid onset, and tadalafil for spontaneous activity with extended coverage. Clinical use also includes cases where monotherapy provides suboptimal results or where variable timing of sexual activity necessitates flexible dosing options.

Dosage and direction

Take one tablet approximately 30–60 minutes before anticipated sexual activity. Sildenafil provides effects for up to 4–6 hours; tadalafil provides effects for up to 36 hours. Do not exceed one tablet in 24 hours. Administration should be with a glass of water; avoid high-fat meals around dosing time as they may delay absorption. Sexual stimulation is required for medication efficacy. The choice between sildenafil and tadalafil should be based on desired duration of effect and timing considerations.

Precautions

Cardiovascular status should be evaluated before prescribing, as sexual activity carries potential cardiac risk. Use caution in patients with anatomical penile deformation, bleeding disorders, or active peptic ulceration. Avoid concurrent consumption of grapefruit juice, which may increase drug concentrations. Not recommended for patients with severe hepatic impairment (Child-Pugh C) or severe renal impairment (CrCl <30 mL/min). Periodic re-evaluation of underlying ED etiology and treatment efficacy is recommended.

Contraindications

Concomitant use with organic nitrates in any form. History of hypersensitivity to any PDE5 inhibitor. Patients with unstable angina, recent myocardial infarction, or life-threatening arrhythmias. Those with hereditary degenerative retinal disorders. Concurrent use with guanylate cyclase stimulators. Patients with hypotension (<90/50 mmHg) or uncontrolled hypertension.

Possible side effects

Common: headache, flushing, dyspepsia, nasal congestion, back pain, myalgia. Less common: visual disturbances (bluish tint, blurred vision), dizziness, palpitations. Rare: priapism, sudden hearing loss, non-arteritic anterior ischemic optic neuropathy. Most side effects are mild to moderate and transient in nature.

Drug interaction

Contraindicated with nitrates. Potentiates hypotensive effects with alpha-blockers (require appropriate dosing separation). Caution with moderate CYP3A4 inhibitors (e.g., erythromycin, aprepitant). Avoid strong CYP3A4 inducers (rifampin, carbamazepine). Potential interactions with antihypertensives, protease inhibitors, and other vasodilators.

Missed dose

Not applicable, as medication is taken on an as-needed basis. Do not take extra tablets to make up for missed timing. Simply take the next dose when needed, maintaining the minimum 24-hour interval between doses.

Overdose

Symptoms may include severe hypotension, syncope, prolonged erection. Supportive measures include supine positioning with legs elevated. Priapism lasting more than 4 hours requires immediate urological intervention to prevent permanent damage. Dialysis not effective due to high protein binding.

Storage

Store at 20–25°C (68–77°F) in original blister packaging. Protect from light and moisture. Keep out of reach of children. Do not use after expiration date printed on packaging.

Disclaimer

This product requires prescription and medical supervision. Not for use by women or children. Individual results may vary. Does not protect against sexually transmitted infections. Must be used as part of comprehensive ED management program including lifestyle modifications.

Reviews

“After trying individual medications, the HESHE pack provided the flexibility I needed. The option to choose between quick action or all-weekend coverage has restored spontaneity to our relationship.” - Michael T., 52

“My urologist recommended this dual approach. The sildenafil works well for date nights, while the tadalafil is perfect for vacations. No more anxiety about timing.” - Robert L., 61

“Clinical results have been consistently positive. The ability to tailor therapy to individual patient needs significantly improves adherence and treatment satisfaction.” - Dr. Emily Sanchez, Urologist