VAST
When you need everything to fire at once
Central + peripheral dual-mechanism action
Fast-dissolving sublingual for rapid absorption
Supports libido, arousal, and erection quality
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.
Why VAST Is Different
The only OnyxMD formula that works from the brain down
Brain-Triggered Response
Apomorphine activates dopamine pathways in the hypothalamus — the same region responsible for initiating sexual arousal — before peripheral mechanisms even need to fire.
Dual PDE5 Coverage
Tadalafil's 36-hour window combined with vardenafil's high receptor affinity delivers comprehensive peripheral vascular support that single-agent PDE5 therapy can't match.
Sublingual Precision
Mint-flavored sublingual tablet absorbs directly into the bloodstream — bypassing first-pass liver metabolism for faster, more predictable onset than standard oral tablets.
BACKGROUND AND HISTORY
The Science of Triple-Mechanism Therapy
Why brain + body is the most complete approach to ED
Up to 40% of men have an incomplete response to PDE5 inhibitor monotherapy — apomorphine addresses the central arousal deficit they miss
Apomorphine acts on hypothalamic dopamine D1/D2 receptors within 20–30 minutes — initiating the arousal–erection cascade before peripheral mechanisms even engage
Sublingual absorption bypasses first-pass liver metabolism, delivering active drug directly to the bloodstream with more predictable onset than oral tablets
Dual PDE5 coverage (tadalafil's 36-hour window + vardenafil's high receptor affinity) ensures peripheral vascular response is fully supported
VAST by the Numbers
3
Active mechanisms in one tablet
20 min
Central arousal onset
36 hrs
Tadalafil coverage window
40%
Men who don't fully respond to PDE5 alone
Why VAST Goes Further
Three pathways. One sublingual tablet.
Most ED treatments work at one level: the blood vessels. PDE5 inhibitors like tadalafil and vardenafil increase blood flow by preventing the breakdown of cGMP — and they work well. But for men whose ED has a psychogenic or neurogenic component, the problem isn't just plumbing. It's the signal that starts the process.
Apomorphine works upstream. By stimulating dopamine D1/D2 receptors in the hypothalamus and limbic system — the brain regions responsible for sexual motivation and arousal — apomorphine activates the central erectile pathway that pure PDE5 inhibitors don't touch. The result is a more complete, coordinated response: brain signals the body, body responds.
VAST's sublingual delivery format is deliberate. Dissolving under the tongue bypasses the digestive tract and first-pass metabolism in the liver, delivering active ingredients directly into the bloodstream. Onset is faster and more consistent than equivalent oral doses — which matters when timing is 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
Dissolve under your tongue
Place ½–1 tablet sublingually 30–60 minutes before activity. Best on an empty stomach for faster onset.
Central arousal activates
Apomorphine triggers dopaminergic signaling in the hypothalamus — enhancing libido and initiating the arousal–erection sequence.
Peripheral blood flow follows
Tadalafil and vardenafil block PDE5, allowing cGMP to accumulate and penile smooth muscle to relax for increased blood flow.
Extended coverage
Tadalafil's 36-hour half-life provides a wide window — no rushed timing, no second-guessing.
Physician-prescribed safety
Every prescription is reviewed by a US-licensed physician. Contraindications screened, dosing personalised — half or full tablet based on your response.
Discreet delivery
Plain packaging, no indication of contents. Fulfilled by an FDA-registered compounding pharmacy and delivered directly to your door.
Science-backed results
We analyzed 200+ peer-reviewed studies to bring you evidence-based therapy. Here's what the research proves.
1Melis MR, Sanna F, Argiolas A, "Dopamine, Erectile Function and Male Sexual Behavior from the Past to the Present: A Review", Brain Sci. 2022;12(7):826. | https://doi.org/10.3390/brainsci12070826 |
2Fahmy G, Hess J, "Tadalafil. In: StatPearls", StatPearls Publishing 2025. | https://www.ncbi.nlm.nih.gov/books/NBK603743/ |
3Montorsi F, et al., "Vardenafil provides reliable efficacy over time in men with erectile dysfunction", Urology. 2004;64(6):1187-95. | https://doi.org/10.1016/j.urology.2004.07.032 |
4Dhaliwal A, Gupta M, "PDE5 Inhibitors. In: StatPearls", StatPearls Publishing 2025. | https://www.ncbi.nlm.nih.gov/books/NBK549843/ |