Tadalafil / Citrulline / B6 / B12 / Zinc Picolinate / Apomorphine

(EDaily Plus+) Chewable Tablet

6 mg / 50 mg / 2 mg / 1 mg / 25 mg / 2 mg

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Product Overview

Tadalafil Description1-3

Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor with a mean terminal half-life of more than 17 hours, significantly longer than other medications in this class. This extended half-life allows for either once-daily use or on-demand dosing. Tadalafil is indicated for pulmonary arterial hypertension (PAH), erectile dysfunction (ED), benign prostatic hypertrophy (BPH), and for patients who require treatment for both ED and BPH.

Citrulline Description4

Citrulline, commonly associated with watermelon, is an amino acid that is converted in the body to argininosuccinate and subsequently to arginine. The kidneys transform citrulline into arginine and nitric oxide. Nitric oxide plays multiple roles in the body, including supporting vasodilation, immune function, and the regulation of glucose and fatty acid metabolism. Because citrulline can be converted into nitric oxide, it has been studied for its potential role related to erectile dysfunction.

Vitamin B65

Vitamin B6 is a water-soluble vitamin essential for neurotransmitter function, brain health, immune activity, and metabolic processes throughout the body.

Vitamin B126

Cyanocobalamin, the synthetic form of vitamin B12, participates in several methylation reactions in the body. Vitamin B12 is essential for growth, cell reproduction, hematopoiesis, and the synthesis of nucleoproteins and myelin. It also plays an important role in red blood cell formation and in supporting rapidly dividing cells such as those in epithelial tissue, bone marrow, and myeloid cells.

Zinc7

Zinc is an essential trace mineral involved in numerous biological processes, including appetite regulation, testicular development, immune function, and wound healing.

Apomorphine8,9

Apomorphine is a central dopamine agonist that has been evaluated in randomized controlled trials for its use in erectile dysfunction. The sublingual form is the most commonly studied. It has a half-life of approximately 2 to 3 hours, and administration is generally recommended about 20 minutes before sexual activity.

Tadalafil1-3

Phosphodiesterase (PDE) has many isoforms and is an enzyme that has many functions in the body including degrading the effect of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). PDE5 is an enzyme that is found in many parts of the body including in the smooth muscle of the corpus cavernosum, prostate, bladder, the vascular and visceral smooth muscle, skeletal muscle, urethra, platelets, kidney, lung, cerebellum, heart, liver, testis, seminal vesicle, and pancreas. Tadalafil is a selective inhibitor of PDE5, the enzyme responsible for the degradation of cGMP. The drug has selective activity on PDE5 than other phosphodiesterase isoforms. Tadalafil activity on PDE5 is more than 10,000-fold more than for PDE1, PDE2, PDE4, and PDE7 enzymes. Increased cGMP leads to smooth muscle relaxation in the corpus cavernosum which can help in maintaining a penile erection.

Citrulline4

Citrulline may inhibit the activity of PDE5 in the body by increasing arginine availability, stimulating production of nitric oxide and preventing degradation of cGMP. This activity may increase the ability to gain and maintain a penile erection through muscle relaxation.

Vitamin B65

Vitamin B6 is made up of at least three main compounds: pyridoxine, pyridoxal, and pyridoxamine. Pyridoxine works in the red blood cells to be activated. Pyridoxamine acts as a coenzyme while pyridoxamine is converted into pyridoxamine phosphate. These active forms act as coenzymes for at least 60 metabolic processes including the metabolism of fat, protein, and carbohydrate.

Vitamin B126

Vitamin B12 is important for division and growth of the cell. It is converted to coenzyme B12 in the body and in this form facilitates the conversion of homocysteine to methionine (methylcobalamin) and plays an important role in converting methylmalonyl-coenzyme A to succinyl-Co-A (fatty acid and amino acid metabolism). Without coenzyme B12, tetrahydrofolate cannot be produced from 5-methyl tetrahydrofolate leading to folate deficiency. In addition, vitamin B12 is needed to produce myelin and is important for axon and nerve development. Gastrointestinal absorption of vitamin B12 depends on the presence of sufficient intrinsic factor and calcium ions.

Zinc7

Zinc is important for enzymatic activity in the body involving carbohydrates, lipids, proteins, and nucleic acids. It may provide support for immune function, wound healing and development of testicular activity.

Apomorphine8,9

Apomorphine works on D2 receptors in central dopaminergic areas of the brain (paraventricular nucleus and the medial preoptic of the hypothalamus) to stimulate an erection. It may also target dopamine D1-like receptors and increase nitric oxide in the corpus cavernosum.

Tadalafil1

Common 

  • Headache
  • Dyspepsia
  • Flushing
  • Back pain and myalgia (typically delayed onset, resolving within 48 hours)
  • Nasal congestion
  • Pain in limbs

 

Vitamin B65

Common

  • Nausea/vomiting, headache

 

Vitamin B126

Common

  • Dyspepsia, glossitis, nausea, vomiting, and mild transient diarrhea

 

Zinc salts7

Common

  • Metallic taste, nausea, vomiting, diarrhea, dyspepsia, and abdominal pain.

 

 Apomorphine8,9

Common

  • Nausea, vomiting, vagal syncope, dizziness and headache

Contraindications1,2,8,9  

  • Known hypersensitivity to tadalafil, vitamin B6, vitamin B12, zinc, apomorphine or tablet excipients
  • Use of nitrates and guanylate cyclase (GC) stimulators therapy, such as riociguat due to risk of life-threatening hypotension
  • Apomorphine should be avoided in patients with a major psychotic disorder

Precautions1,2,8,9

  • Use with caution in patients with:
  • Severe hepatic impairment (Child-Pugh Class C)
  • Severe renal impairment (creatinine clearance <30 mL/min)
  • Retinitis pigmentosa (rare inherited retinal disorder)
  • History of NAION (non-arteritic anterior ischemic optic neuropathy)
  • Recent history of myocardial infarction, stroke, or unstable angina
  • Use in caution with pre-existing hypotension
  • Store at controlled room temperature (20°C to 25°C / 68°F to 77°F)
  • Protect from moisture and light
  • Keep in a tightly closed container
  1. Tadalafil Prescribing Information – Eli Lilly. www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf Revised October 2011. Accessed May 31, 2025
  2. Clinical Pharmacology Tadalafil clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  3. Padda IS, Tripp J. Phosphodiesterase Inhibitors. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559276/
  4. Sulyman, Abdulhakeem Olarewaju, et al. “Mechanisms of L-citrulline on phosphodiesterase 5 in erectile dysfunction intervention.” Scientific African, vol. 27, Mar. 2025, https://doi.org/10.1016/j.sciaf.2025.e02572.  
  5. Clinical Pharmacology Vitamin B6 clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  6. Clinical Pharmacology Vitamin B12 clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  7. Clinical Pharmacology Zinc salts clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
  8. Guillén V, Rueda JR, Lopez-Argumedo M, Solà I, Ballesteros J. Apomorphine for the Treatment of Erectile Dysfunction: Systematic Review and Meta-Analysis. Arch Sex Behav. 2020 Nov;49(8):2963-2979.
  9. Clinical Pharmacology Apomorphine clinical monograph 2025 https://www.clinicalkey.com/pharmacology/

WPPL operates as a 503A compounding pharmacy and prepares individualized prescription medications pursuant to provider direction. Compounded preparations are not reviewed, tested, or approved by the FDA.

This listing also includes commercially manufactured products for convenience; these items are not compounded by our pharmacy and are sold as provided by their manufacturers. Any statements regarding non-compounded products are manufacturer-supplied, have not been evaluated by the FDA, and are not intended to diagnose, treat, cure, or prevent any disease. WPPL does not verify or endorse any therapeutic claims made by manufacturers. Please refer to original labeling for complete product information.

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