Super Strut ED vs MEDVi QUAD: The Comparison Where One Side Actually Publishes Its Doses

Strut Health's Super Strut and MEDVi QUAD are both compounded four-ingredient ED treatments taken under the tongue. They differ in ingredients, in price, and — most usefully for anyone trying to make an informed decision — in how much each company is willing to tell you about what is actually in the product.

Super Strut's Three Tiers — With Published Milligrams

Strut Health sells Super Strut in three strength tiers, and it publishes the exact amount of every ingredient in each one. That is unusual enough in compounded telehealth that it deserves to lead the page.

Each price covers 10 tablets for the month, with a maximum of one dose daily. Working that through, you are paying $7.90, $8.90, or $9.90 per tablet depending on tier. Strut includes free shipping, the online physician visit, and follow-up in the price, and the plan auto-refills with cancellation available at any time.

Look at what the tiers actually escalate. Vardenafil triples across the range, 5mg to 15mg. Tadalafil moves from 15mg to 22mg — a real jump between Low and Medium, then almost nothing between Medium and High. Oxytocin doubles only at the top tier. Apomorphine barely moves. Whatever you think of the formula, you can see its shape, which is exactly the point of publishing the numbers.

Super Strut vs QUAD, Side by Side

MEDVi reformulated QUAD on July 16, 2026. It now contains sildenafil, tadalafil, L-citrulline, and PT-141 (bremelanotide); vardenafil and apomorphine were removed. That reformulation moved the two products further apart than they used to be — before July, both contained apomorphine.

Dose Transparency: Strut Wins This One

We are not going to soften this, because it is the clearest finding on the page. Strut Health publishes the exact strength of every ingredient at every tier. MEDVi publishes nothing for QUAD — the doses are described as being set by the prescribing clinician during the consultation, and no milligram figure appears anywhere on the product page.

The usual defence is that compounded products are personalised and therefore cannot carry fixed strengths. Super Strut is the counterexample sitting right there: it is also compounded, it is also prescriber-gated, and it still publishes three defined tiers with numbers attached. So the difference is a decision about disclosure, not a regulatory constraint.

QUAD is not opaque about what is in it — all four ingredients are named — and that puts it ahead of some competitors, including Hims, which does not publish strengths for any of its Hard Mints variants either (we cover that comparison here). But naming ingredients is the lower bar. Strut clears the higher one.

Mechanisms: Two Non-PDE5 Routes vs One

Both products stack two PDE5 inhibitors, which is where any similarity ends. The interesting comparison is what sits alongside them.

Apomorphine — Super Strut's dopaminergic route

Apomorphine is a dopamine agonist, also used in Parkinson's disease. It has genuine clinical evidence in erectile dysfunction and a real history of clinical use — this is not a fringe ingredient, and anyone dismissing it as one is not being straight with you. Its best-known drawback is a strong association with nausea. MEDVi removed apomorphine from QUAD in July 2026, and the only public reason the company has given is that the change improves taste, which it says improves approval rates. We are not going to read anything further into it, and we would not suggest that a product containing apomorphine is unsafe for containing it. BlueChew Gold and Rugiet Ready also still include it.

Oxytocin — the ingredient we have reservations about

Oxytocin is Super Strut's fourth ingredient and the one where we would push back hardest. Sublingual oxytocin has a bioavailability of roughly 4.5%, with about tenfold variation between individuals — and the researchers who measured it concluded that the sublingual route did not look reliable. Intranasal delivery reaches roughly 11%. On top of that, there are no published randomised controlled trials of oxytocin for erectile dysfunction at all.

So counting mechanisms, Super Strut has two non-PDE5 routes to QUAD's one. But a mechanism you cannot reliably absorb and that has never been tested in an ED trial is not worth as much as the count implies. This is the same position we have taken on BlueChew Gold, which also uses oxytocin, and it is not a point we invented for this page.

PT-141 — QUAD's genuine differentiator

PT-141 (bremelanotide) is a melanocortin MC4R receptor agonist that acts centrally on desire and arousal rather than on blood flow. It is the one thing on this page that neither Super Strut nor any other four-ingredient competitor uses — a different receptor system entirely.

Its status needs stating carefully. PT-141 is FDA-approved as Vyleesi (2019), a 1.75 mg subcutaneous injection, for hypoactive sexual desire disorder in premenopausal women. It is not approved for ED and not approved in men. Early-phase trials of intranasal bremelanotide in men did show erectogenic effects, including in some men who did not respond to sildenafil, but ED development was halted, partly over blood-pressure concerns. In QUAD it is compounded, off-label, and prescriber-supervised.

The side effect worth planning for is nausea. In the pooled phase 3 trials for Vyleesi, nausea was reported by 40% of patients versus 1% on placebo, concentrated in the first dose (21%, dropping to around 3% on later doses), typically lasting about two hours; 13% used an anti-emetic and 8% discontinued. Those figures come from a 1.75 mg subcutaneous injection given to women with HSDD, not from sublingual PT-141 in a men's compounded formula at a dose MEDVi does not publish. Read them as an upper bound from the best-documented version of the drug, not a prediction for QUAD. Our full PT-141 explainer goes through the evidence, the dosing range, and the blood-pressure contraindication in detail.

Onset: Both Claims Come From the Companies

Neither of the numbers below is trial data, and nobody has run a head-to-head study. Strut says Super Strut can work in as little as 15 minutes and remains active up to 36 hours; its FAQ gives a 15–30 minute range, which is the more realistic framing of the two. MEDVi states roughly 10–15 minutes for QUAD.

Put honestly: the claims overlap almost completely, and the gap between them is smaller than the uncertainty inside either one. Both are sublingual, both bypass first-pass digestion, and both companies have an incentive to quote the low end of whatever range they observed. Treat onset as a tie. If you are choosing between these two products on the basis of five claimed minutes, you are choosing on noise.

Format and the 70°F Storage Problem

Super Strut is a mint-flavoured rapid-dissolve sublingual tablet. QUAD is a sublingual liquid taken with a dropper and held under the tongue for 60–90 seconds. Both skip the digestive tract; both work regardless of whether you have eaten.

The tablet has one practical weakness that Strut discloses itself: the company's FAQ says the tablets can soften or melt above roughly 70°F and recommends refrigeration. Seventy degrees is not an extreme temperature. It is a warm room, a glovebox in spring, a suitcase, a jacket pocket on a summer evening. If you travel or live somewhere hot, this is a genuine logistics problem rather than a footnote.

We flag it because we have flagged the same thing with Rugiet Ready's rapid-dissolve tablets, and it would be inconsistent to raise it there and stay quiet here. It is a characteristic of fast-dissolving sublingual tablets generally, not a defect specific to Strut, and Strut deserves some credit for saying so on its own site rather than letting customers discover it. QUAD, being already liquid, does not have this particular problem.

Price and What You Actually Get

Super Strut runs $79 to $99 per month for 10 tablets, one dose maximum per day, with shipping, the online medical visit, and follow-up included. QUAD is $119 per month.

Strut is cheaper on the headline number, and it is also the only one of the two where you can calculate a per-dose cost, because you know how many tablets you get: $7.90 to $9.90 each. MEDVi does not publish a dose count for QUAD's bottle, so a like-for-like per-use figure cannot be calculated. That is a second, quieter transparency gap on top of the milligram one.

If you want to see how both of these stack up against the wider field, including FDA-approved generics that cost a fraction of either, our best ED medication guide covers the whole landscape.

Both Are Compounded — Applied Evenly

Neither product is FDA-approved. Strut states on its own site that the compound is not FDA tested or approved and that the use is off-label. The same is true of QUAD. Both companies deserve credit for saying so; both readers deserve to have the standard applied identically.

The useful detail: compounded drugs are not reviewed by the FDA for safety, effectiveness, or quality before they reach patients. A 503A compounder is a licensed pharmacy or physician, state-regulated, dispensing against a patient-specific prescription and exempt from CGMP manufacturing rules. A 503B outsourcing facility registers with the FDA and is subject to CGMP. The FDA also recognises that compounding meets legitimate needs — allergies to inactive ingredients, dosage forms that do not exist commercially, combinations no manufacturer produces.

So this is a disclosure, not a verdict. The individual actives — tadalafil, vardenafil, sildenafil — are approved drugs with long safety records. The combinations are not, in either product, and you are relying on the compounding pharmacy's standards and your prescriber's judgement in both cases.

Who Each One Is For

Choose Super Strut if you want to know exactly what you are taking before you pay. That is the strongest argument for it and it is a good one. It is also cheaper, it lets you compare three defined strengths, and apomorphine has real published ED evidence behind it. Accept in return that oxytocin is the weakest ingredient in either formula on the evidence, and that you will need somewhere below 70°F to keep the tablets.

Choose MEDVi QUAD if PT-141 is specifically what you are after — a melanocortin pathway that Super Strut does not use, with human trial data in men and an FDA approval in a different indication. It is also the answer if the refrigeration requirement is impractical for your life, since a liquid does not melt. You pay $119 rather than $79–$99 for that, and you accept that MEDVi will not tell you your dose until a clinician has set it. Our full MEDVi QUAD review goes deeper on the formula, pricing, and cancellation terms.

What neither of us can tell you is which one works better, because no one has compared them and neither company has published outcome data on its own product. Everything above is composition, published pricing, disclosed storage requirements, and each company's own claims. That is the honest limit of what is knowable right now.

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