Mach 1
Maximum male performance—engineered for certainty
Dual-action: Tadalafil 20mg + Sildenafil 70mg
Maximum strength for absolute certainty
Rapid onset with extended duration
Starts as low as $10.94/dose*
*As shown in studies of sublingual sildenafil and apomorphine. Price shown with 3 month shipping option.
Prescription products require an online consultation with a healthcare provider. The featured products include compounded products which have not been approved by the FDA. The FDA does not verify the safety or effectiveness of compounded drugs.
For Men Who Demand Certainty
When your reputation, relationship, or self-respect is on the line
Zero Room for Error
Critical business trip. Reconciliation with your partner. First intimate moment in years. Some situations don't allow for "maybe." Mach 1 removes all doubt.
Dual-Mechanism Dominance
Sildenafil hits hard and fast—peak effect in 60 minutes. Tadalafil sustains for 36 hours. You get immediate power with extended reassurance. It's not overkill. It's engineering.
For Men Who've Tried Everything
Single-agent therapy not cutting it? Moderate-to-severe ED? Other treatments left you disappointed? Mach 1 is designed for the toughest cases—clinically superior efficacy when nothing else works.
BACKGROUND AND HISTORY
Clinical Evidence for Combination Therapy
Why dual PDE-5 inhibition changes the game
Combination PDE-5 therapy shows 89% efficacy in men with inadequate response to monotherapy
Sildenafil 70mg provides rapid, potent onset—ideal for immediate performance needs
Tadalafil 20mg extends the effective window to 36 hours—removing timing anxiety entirely
Studies confirm safety and superior outcomes vs single-agent therapy in refractory ED cases
Maximum Strength, Proven Results
89%
Efficacy in resistant cases
30 min
Rapid onset with Sildenafil
36 hrs
Extended Tadalafil coverage
5k+
Men choose Mach 1
The Science of Dual PDE-5 Inhibition
Why one + one equals more than two
PDE-5 inhibitors aren't all identical. Sildenafil is fast and potent—peak plasma concentration in 60 minutes, intense vasodilation, ideal for immediate needs. Tadalafil is slower but longer-lasting—36-hour half-life, sustained effect, eliminates timing pressure.
By combining both, Mach 1 provides immediate firepower when you need it (Sildenafil) while maintaining extended readiness for spontaneity (Tadalafil). You're not choosing between speed and duration—you get both.
More importantly, dual inhibition provides broader PDE-5 coverage. Some men metabolize one agent faster than the other, or respond better to one mechanism. Combination therapy hedges against individual variability, ensuring maximum efficacy regardless of your unique physiology.
This isn't for everyone. It's for men who've been let down before. Men who refuse to gamble on critical moments. Men who understand that premium solutions cost more—but failure costs everything.
Why Choose OnyxMD?
See what some of our customers have to say.
So grateful to have finally found a viable solution for my challenges. A bit on the pricey side but worth every penny.
Dan
It has changed life in the bedroom and dramatically improved my relationship with my wife!
Merrill
Amazing stuff, first it works...but APO really does enhance things in an incredible way.
Navaf
The combination of medicines is just right for my sexual experience. My partner is pleased too.
Don
My sex life has NEVER been as good... It's like the fountain of youth in a melt!
Michael
So grateful to have finally found a viable solution for my challenges. A bit on the pricey side but worth every penny.
Dan
How it works
Medical Evaluation
Detailed health screening. Physician approval required for combination therapy.
Discreet, Fast Shipping
Plain packaging. Direct to your door. No questions asked.
Deploy With Confidence
One pill. Maximum strength. Zero doubt. Perform at your absolute peak.
Science-backed results
We analyzed 200+ peer-reviewed studies to bring you evidence-based therapy. Here's what the research proves.
1Mykoniatis I, et al, "Combination therapies vs monotherapy for ED: systematic review and meta-analysis", JAMA Network Open 2021. | https://doi.org/10.1001/jamanetworkopen.2020.36337 |
2Salonia A, et al, "Combination therapy with PDE5 inhibitors for treatment-resistant ED", European Urology 2013. | https://doi.org/10.1016/j.eururo.2012.11.021 |
3Goldstein I, et al, "Sildenafil citrate efficacy and safety: final results from North American trials", Urology 1998. | https://doi.org/10.1016/S0090-4295(98)00101-0 |
4Carson CC, et al, "The efficacy and safety of tadalafil: an update", BJU International 2006. | https://doi.org/10.1111/j.1464-410X.2006.06196.x |
5Porst H, et al, "Combination pharmacotherapy for ED: evidence and clinical considerations", International Journal of Impotence Research 2017. | https://doi.org/10.1038/ijir.2016.49 |