Erectile Dysfunction (ED) Support
TrocheOralNon sterile Rx only

Sildenafil Oral Troche (Dissolving)

Troche Formulation

A compounded dissolving sildenafil troche, prepared in Chino, CA to a prescriber's order. Not an FDA approved product.

Reviewed by Linda Pungpravat, Compounding Pharmacist, RPh Mixwell Compounding Pharmacy, Chino, CA

  • USP <795> compliant
  • USP <800> hazardous drug lab
  • PCCA member

Clinical Advantages

  • Custom strength available
  • Alternative to swallowing pills
  • Flavored for palatability
  • Non sterile preparation

How It Works

What is sildenafil?

Sildenafil is a prescription medicine called a PDE5 inhibitor. The FDA approved sildenafil tablet, sold as Viagra, is labeled for the treatment of erectile dysfunction [1]. Sildenafil is also sold as Revatio for pulmonary arterial hypertension, which is a different use [1].

What is a troche, and what does compounding into one provide?

A troche, also called a lozenge, is a solid dose that dissolves slowly in the mouth instead of being swallowed whole. Sildenafil Oral Troche is made by a compounding pharmacy to a prescriber's order. Compounding sildenafil into a troche allows:

  • A dose that dissolves in the mouth, for patients who prefer not to swallow a tablet or have trouble swallowing one
  • No water needed to take a dose
  • A strength set by the prescriber, instead of the fixed strengths of tablets
  • Flavoring chosen to the patient's preference

How a troche is absorbed, and how it compares with a swallowed tablet, is not described in FDA labeling.

When prescribers choose it

  • Urologists, primary care providers, and men's health clinics treating erectile dysfunction in patients who prefer a dissolving form
  • Prescribers whose patients have trouble swallowing tablets
  • Prescribers who want a strength the approved tablets do not offer

Clinical Details

What does the evidence show?
  • FDA approved sildenafil is a tablet (Viagra) labeled for the treatment of erectile dysfunction [1].
  • Sildenafil is also sold as Revatio, which is labeled for pulmonary arterial hypertension, a different use [1].
  • Sildenafil is not FDA approved as a troche, and the FDA has not reviewed this preparation.
  • The Viagra label states that the safety and efficacy of combining it with other PDE5 inhibitors have not been studied [1].

Findings come from the cited studies and do not promise any individual outcome.

Why is it compounded, and how is it typically used?

Why it is compounded

Sildenafil is FDA approved as a tablet in fixed strengths, and no approved product is a troche [1]. A prescriber who wants a dissolving form or a strength the tablets do not offer orders it compounded.

Dosage forms and strengths

  • Strength set by the prescriber
  • Troche base, with flavoring on request
  • Quantities matched to the prescription

Dosing is the prescriber's decision.

How Mixwell prepares it

Mixwell compounds these troches in Chino, California under USP 795 standards for non sterile preparations [2]. Our pharmacist confirms the strength and flavor with the prescriber before compounding. Batch records document every preparation, and finished troches ship across California.

Safety information

Viagra labeling contraindicates use with nitrates in any form, because sildenafil can increase the blood pressure lowering effect of nitrates, and with guanylate cyclase stimulators such as riociguat [1].

The label advises patients to seek medical care for an erection that will not go away, to stop and seek care for sudden vision loss in one or both eyes, or sudden decrease or loss of hearing, and to use caution with alpha blockers and blood pressure medicines [1]. It also tells patients not to take Viagra with other PDE5 inhibitors [1].

No FDA labeling describes how much medicine is absorbed from a troche. Patient selection, dosing, and monitoring are the prescriber's responsibility.

References
  1. VIAGRA (sildenafil citrate) tablets. Prescribing information. DailyMed
  2. United States Pharmacopeia. General Chapter 795, Pharmaceutical Compounding: Nonsterile Preparations. USP NF. Official November 1, 2023.

What to include on the prescription

  • APIs and strengths
  • Base or vehicle
  • Quantity
  • Directions for use
  • Refills
  • Allergies or dye free needs
Call (909) 378-7301 Fax (909) 378-7071

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Compounded in Chino, CA. Delivered across California.

  • Chino
  • Chino Hills
  • Ontario
  • Pomona
  • Diamond Bar
  • Rancho Cucamonga
  • Eastvale
Mixwell Compounding Pharmacy 13788 Roswell Ave, Ste 158, Chino, CA 91710
(909) 378-7301

Compounded medications are not reviewed or approved by the FDA. Dispensed only with a valid prescription. Mixwell is a non sterile pharmacy and does not prepare sterile products or injectables. Compounded preparations are not presented as superior to commercially available products, and nothing here promises a specific result. Mixwell does not accept insurance. Call for pricing.

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Want to learn more about Sildenafil Oral Troche (Dissolving)

Are you a healthcare provider or patient in Chino, Chino Hills, Ontario, Eastvale, Rancho Cucamonga, or Upland? Mixwell Pharmacy provides specialized pharmaceutical support throughout San Bernardino, Los Angeles, and Orange Counties. Contact our Chino laboratory to learn how we facilitate customized Sildenafil Oral Troche (Dissolving)for practitioners across Southern California.

(909) 378-7301

Serving Los Angeles County, Orange County, San Bernardino County, Riverside County, Ventura County, and the Inland Empire