Which should you choose, DirectMax or Quad by MEDVi, and what does each cost? DirectMax is a per-dose tablet at $8.78 to $10.78 a dose, and Quad is a monthly liquid plan starting at $114, so the choice comes down to how you want to buy. The published data worth reading is on the single ingredients: the Viagra label reports side-effect data from placebo-controlled phase II and III studies, with 734 men on Viagra and 725 on placebo. DirectMax is a rapid-dissolve tablet that combines sildenafil, tadalafil and apomorphine, and Quad is a sublingual liquid with four ingredients.
Disclosure: For clarity, several links on this page are affiliate links. If you buy through them, this publication may earn a commission. Your price is the same either way.
DirectMax vs Quad by MEDVi side by side
Each column uses the seller’s own page or paid release as its source. Where a figure comes from a third-party site, the price section says so.
| Feature | DirectMax (Direct Meds) | Quad by MEDVi |
|---|---|---|
| Who runs it | Direct Meds runs the online platform. Its paid press release says licensed providers make prescribing decisions and licensed third-party pharmacies verify and fill. | MEDVi. Its page says it is “partnered with multiple USA certified pharmacies.” |
| Format | Rapid-dissolve tablet that dissolves under the tongue | A “rapid-absorb liquid” that “goes under your tongue” |
| Ingredients named | Sildenafil, tadalafil, apomorphine | Apomorphine, L-citrulline, tadalafil, sildenafil. Its comparison graphic also shows vardenafil. |
| Price | $8.78 to $10.78 per dose, by strength; standard 6-dose pack | From $114 a month, “Starting at” |
| Doses per purchase | Standard 6-dose pack; larger quantities up to 20 doses | |
| Renewal | Recurring plans may charge every 30 days, with notice about 5 to 7 days before | “Cancel Anytime” |
| Cancellation | Membership plans can be canceled anytime in the Patient Portal. A new order can be canceled within 24 hours if it has not reached the provider network. | “Cancel Anytime” |
| Refunds | Received medication is generally not refundable. Exceptions cover incorrect, damaged, unsafe, unshipped or denied medication. | A Refund Policy is linked in the page footer |
| Availability | Eligible adults in states where the provider network, telehealth and pharmacy fulfilment are supported | |
| Online visit and prescription | A secure online medical questionnaire. Intake or payment does not guarantee a prescription. | A 3-minute intake form. A US-licensed doctor reviews the case within 24 hours, and if approved, “your script is issued instantly.” |
| Onset (seller’s claim) | “typically within 15 minutes or less” | “hits your system in 10 minutes” |
| Duration (seller’s claim) | “Most patients experience effects lasting 24–36 hours” | Tadalafil “Stays active in your system for up to 36 hours” |
| Support | help@directmeds.com, (888) 696-7176, 9 a.m. to 9 p.m. Eastern daily | hello@medvi.org, (585) 312-4226 |
What each one is, and who it may fit
Direct Meds describes DirectMax as “a physician-designed, multi-mechanism formula that combines sildenafil, tadalafil, and apomorphine.” Its sales page says the goal is “More consistent response. More reliability. More control.” DirectMax may suit you if you want a tablet that dissolves under the tongue, a per-dose price, and the three-ingredient combination. For how it compares with a three-ingredient rival, see our directmax vs rugiet page.
MEDVi calls Quad “the world’s first 4-in-1 formula that activates your desire and your body.” Its page leads with “Harder & Faster” and “Boosts your desire,” and it says the formula is “Engineered for your body.” Quad may suit you if you want a liquid, a monthly starting price, and a formula the page describes for desire as well as erection strength. A third-party review site, quadedreviews.us.com, says Quad is best suited to men 30 and older and is not meant for anyone under 18.
Ingredients: what each formula names
DirectMax names three ingredients. MEDVi’s page lists four in its text, and its comparison graphic adds vardenafil.
| Ingredient | DirectMax | Quad by MEDVi |
|---|---|---|
| Sildenafil | Named. The sales page image says “Maintains blood flow.” | Named. The page pairs it with L-citrulline as “A potent dual-strike of nitric oxide amplification.” |
| Tadalafil | Named. The image says “Extends effectiveness.” | Named. The page says it “Stays active in your system for up to 36 hours.” |
| Apomorphine | Named. The image says “Primes for arousal.” | Named. The page says it “Acts centrally via the nervous system to heighten sexual desire and arousal.” |
| L-citrulline | Not named | Named. The page gives it the label “Rapid Flow.” |
| Vardenafil | Not named | Shown in MEDVi’s comparison graphic next to Levitra. It is not in the page’s written list of four. |
Because MEDVi’s two lists do not match, ask MEDVi for the exact ingredient list on your prescription. Neither seller’s page gives milligram amounts, so ask each one for the amount of each ingredient in writing.
What does the research show for each?
The best published information is on the single ingredients both products share. The Viagra prescribing information on DailyMed reports adverse reactions from flexible-dose phase II and III studies, comparing 734 men on Viagra with 725 on placebo. Among the reactions more frequent than placebo was abnormal vision, described as “Mild and transient, predominantly color tinge to vision.” The Cialis prescribing information from FDA covers tadalafil for erectile dysfunction.
The combination is where the published data ends. DirectMax’s paid press release says it is “not an FDA-approved finished drug product” and that approvals of the single ingredients do not extend to the combination.
Each seller makes its own claims about speed and duration. DirectMax’s sales page says effects typically start within 15 minutes and that most patients have effects lasting 24 to 36 hours. MEDVi says Quad “hits your system in 10 minutes” and lists “Peak rigidity guaranteed.”
Side effects and who should avoid them
Each seller lists its own side effects, so the table puts them beside the FDA label or MedlinePlus entry for the same ingredient.
| Source | Effects listed |
|---|---|
| DirectMax sales page | Headache, flushing, nasal congestion, mild indigestion, dizziness, back or muscle discomfort, nausea, temporary vision changes (such as a blue tint or mild blurring), mild irritation under the tongue |
| Quad by MEDVi (third-party review site, quadedreviews.us.com) | Nausea, dizziness, headache |
| Viagra prescribing information (sildenafil) | Abnormal vision, mild and transient; increased sensitivity to light or blurred vision; nasal congestion |
| MedlinePlus sildenafil drug information | Headache, heartburn, diarrhea, nausea, flushing, nosebleeds, numbness or tingling in the arms, hands, feet or legs, muscle or back pain, changes in color vision, sensitivity to light, nasal congestion. MedlinePlus notes that some side effects can be serious. |
| Cialis prescribing information (tadalafil) | Back pain and myalgia, generally mild or moderate, with discontinuation under 1%. Changes in color vision were rare, under 0.1% of patients. |
Warnings and emergency signs
DirectMax’s sales page says not to use these medicines if you take nitrates for chest pain, or guanylate cyclase stimulators such as riociguat, because this “can cause a dangerous drop in blood pressure.” It asks you to tell your provider about heart problems, low blood pressure, a recent heart attack or stroke, kidney or liver disease, eye conditions, and all medications and supplements you take.
The DirectMax sales page lists these emergency signs: an erection lasting more than 4 hours (priapism), sudden vision loss, sudden hearing loss, chest pain, or severe dizziness. The Cialis label says to “seek emergency treatment if an erection lasts >4 hours” and to stop and seek medical care for a sudden loss of vision in one or both eyes.
The DirectMax release says packages are “NOT shipped in child-resistant packaging.” If children or teens live in the home, plan storage around that.
Ask MEDVi for its full safety information, including the nitrate and riociguat warnings, before you pay.
What does each cost, and what do you pay in total?
Prices as of November 2, 2026, from each seller’s page. DirectMax’s sales page lists low strength at $8.78 per dose, medium at $9.28 and high at $10.78. It says introductory pricing “may start as low as $7.45 per dose” from time to time, and it shows a banner that says “Get 33% OFF your prescription instantly!” Your exact total appears after the online questionnaire, and the release says totals may include pharmacy, medical-group and platform fees.
MEDVi’s page shows $114 per month, “Starting at,” beside $179 with “36% Off Retail” and the line “Or Bundle & Save More.” Two third-party sites show other figures. quadedreviews.us.com lists $114 a month for a 5-pack and $179 for a 10-pack, and it also describes 40% off retail with $199. edpillscomparisons.com lists $99 to $149 a month. Both conflict with MEDVi’s own page, so check the checkout total.
| Option | Price as stated | Arithmetic total |
|---|---|---|
| DirectMax, low strength, one 6-dose pack | $8.78 per dose | $52.68 per pack |
| DirectMax, medium strength, one 6-dose pack | $9.28 per dose | $55.68 per pack |
| DirectMax, high strength, one 6-dose pack | $10.78 per dose | $64.68 per pack |
| Quad by MEDVi, monthly plan | $114 per month, “Starting at” | 3 months: $342. 12 months: $1,368. |
These totals are arithmetic only and are not like-for-like. MEDVi’s dose count is not stated, and each figure is before any fees.
Renewal, cancellation and refunds
The two sellers handle billing differently, so read each row before you enter payment details.
| Term | DirectMax (Direct Meds) | Quad by MEDVi |
|---|---|---|
| Renewal | The release says recurring plans may charge every 30 days, with notice about 5 to 7 days before. Auto-refill can be turned off in the portal up to 48 hours before processing. | “Cancel Anytime” on the MEDVi page. |
| Cancellation | Membership plans can be canceled anytime in the Patient Portal. A new prescription order can be canceled within 24 hours if it has not reached the provider network. | “Cancel Anytime” on the MEDVi page. A third-party review says users can cancel by contacting customer service. |
| Refunds | Received medication is generally not refundable. Exceptions cover incorrect, damaged, unsafe, unshipped or denied medication. Report problems within 48 hours. | The MEDVi page links a Refund Policy in its footer. Read it before you pay. |
| Fees | A $35 disposal fee applies to the medication disposal described in the release | “No hidden fees” on the MEDVi page. The page also says “Risk-Free: If you don’t qualify, you don’t pay.” |
The DirectMax terms send disputes to binding individual arbitration under AAA rules in Salt Lake City, Utah, and waive class actions. Read that section before you accept the terms.
Where to buy each, and how the online visit works
You buy DirectMax from its Product Page. You complete the online medical questionnaire and see your personalized pricing before checkout. The sales page says the product is “delivered discreetly in 1-2 days,” but the release says delivery timing varies and intake or payment does not create a guaranteed shipment date.
You buy Quad from its Product Page. MEDVi’s page describes three steps: a 3-minute intake, a review by a US-licensed doctor within 24 hours, and delivery in “a plain, unmarked package” with free rush shipping. A third-party review says Quad is not sold on Amazon or other third-party sites.
Are DirectMax and Quad legitimate?
Both pages describe an online visit in which a clinician decides whether to prescribe. These are seller statements, and the checks below let you verify them yourself. Here is what to check for each.
DirectMax: how to check Direct Meds
- The release says completing intake or paying does not guarantee a prescription, and a provider may decline, ask for more information or require an in-person evaluation.
- The Direct Meds contact page displays “LegitScript Certified” and “HIPAA Compliant” badges and says “US licensed pharmacies.” Look up the LegitScript listing yourself.
- The contact page displays a 4.6 Trustpilot rating. Check Trustpilot directly for the reviews.
- Ask which pharmacy will fill your order. The release says pharmacy names vary by location.
- The seller lists a mailing address on its contact page.
Quad by MEDVi: how to check MEDVi
- MEDVi says it is “partnered with multiple USA certified pharmacies.” Ask which one fills your order.
- MEDVi’s page says: “MEDVi does not produce compounded medications, and individuals may receive medication that looks different than what is portrayed on the website.”
- The page displays a 4.5 out of 5 Trustpilot rating. Check Trustpilot directly.
- Contact is hello@medvi.org or (585) 312-4226. The seller lists a mailing address in its footer.
Why “compounded” matters for both
DirectMax is described as a compounded tablet in its release, which says it is “not an FDA-approved finished drug product.” The DirectMax sales page footer says, “Compounded medications are not FDA-approved.” MEDVi’s page tells prospective users of compounded medications to speak with their provider about the risks and benefits. Ask MEDVi in writing whether your Quad prescription is compounded and who makes it. The FDA page on compounding inspections, recalls and other actions is where to check recall news for a compounding pharmacy.
FDA-approved sildenafil and tadalafil, and in-person care
If the combination is the part you are unsure about, the single-ingredient route is the other option. The Viagra prescribing information and the Cialis prescribing information are the FDA labels for sildenafil and tadalafil. An in-person clinician can talk through which medicine fits your health history and medication list. A pharmacist can quote the total price of an approved prescription, so you can set that number beside the checkout totals above.
Which one may fit you
- DirectMax may suit you if you want the three-ingredient tablet, per-dose pricing, and you accept that received medication is generally not refundable.
- Quad may suit you if you prefer a liquid and a monthly starting price, and you read MEDVi’s Refund Policy before you pay.
- An FDA-approved single-ingredient prescription may suit you if the combination is the part you are unsure about.
My husband takes Viagra and doesn’t tell me. What should I do?
Start with a calm conversation, not an order. Both DirectMax and Quad combine sildenafil and tadalafil, the same active ingredients as Viagra and Cialis, so it is worth reading those labels together. DirectMax’s sales page tells buyers to “Tell your provider about all medications and supplements you take,” and that applies to him too. If he already takes Viagra or Cialis, any added medicine is a question for his prescriber. The emergency signs above apply to him as well.
Lifestyle, exercise, symptoms and whether ED goes away
Neither product page describes a natural method for a harder erection. Both are prescription medicines, so the route they describe runs through a clinician. For lifestyle changes, the right exercise, the symptoms to watch for, and whether erectile dysfunction can go away on its own, your next step is an in-person visit with a primary care clinician or a urologist, who can look at your health history.
Frequently asked questions
Do I need a prescription for either one?
Yes. Both sellers describe a clinician who decides after an online visit. MEDVi’s page says the script is “issued instantly” once approved.
What happens if I don’t qualify?
MEDVi’s page says “Risk-Free: If you don’t qualify, you don’t pay.” Direct Meds’ release says a provider may decline an order, so ask what you would pay if that happens.
Can I buy Quad on Amazon?
A third-party review says Quad is not available on Amazon or any third-party website, and that it is sold only through the seller’s own website.
How to proceed
- Pick the one whose form and billing terms you can accept.
- Ask the seller in writing for the exact ingredient list and the amount of each ingredient on your prescription.
- Read the refund and cancellation terms before you enter payment details.
- Tell the clinician about every medicine and supplement you take, and any heart, blood pressure, kidney, liver or eye condition.
- Compare the checkout total with the price of an approved single-ingredient prescription from a pharmacist.
Before you order
- Ask which pharmacy fills your order and whether it is licensed in your state.
- Ask MEDVi to confirm in writing whether Quad is compounded.
- Ask MEDVi what one package contains and how many doses it holds.
- Ask Direct Meds which dosing interval applies, because its images show both “Maximum 1 dose per 36 hours” and “Maximum 1 dose per 24 hours.”
- Confirm today’s price and renewal schedule at checkout.
The decision and the main uncertainty
If you want a three-ingredient tablet with per-dose pricing, DirectMax fits that picture. If you want a liquid with a monthly starting price and a four-ingredient list, Quad fits that picture. The main uncertainty for both is the combination itself: neither seller’s page shows a clinical study of its exact formula, and the FDA labels cover the single ingredients. Before you pay, get the ingredient amounts, the refund rules and the study question answered in writing, and compare the total with an FDA-approved single-ingredient prescription.
For a fuller look at DirectMax alone, read our DirectMax review.
By Sense and Evidence Health Research Team
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.