PVital PoleMedical

Medications

Every medication,
fully explained.

Indications, mechanisms, side effects, contraindications. We cite our sources — MedlinePlus (NIH/NLM), FDA labeling, Cleveland Clinic, peer-reviewed trials.

Weight loss

GLP-1 therapy, fully explained

Paraphrased from MedlinePlus (NIH/NLM) and FDA labeling.

Semaglutide

aka Wegovy®, Ozempic®

Once-weekly GLP-1 that helps curb appetite and slow gastric emptying.

From $199/month

See if Semaglutide fits you

How it works

Semaglutide is an incretin mimetic that activates GLP-1 receptors. It signals the pancreas to release insulin when blood sugar rises, slows how quickly the stomach empties, and reduces appetite — which together support gradual weight loss.

Onset

Appetite changes in 1–2 weeks; meaningful weight loss over 3–6 months.

Duration

Once-weekly subcutaneous injection; rotate sites (abdomen, thigh, upper arm).

Typical titration

Typical plan: start at 0.25 mg weekly × 4 weeks, then step up every 4 weeks (0.5 → 1.0 → 1.7 → 2.4 mg) as tolerated.

Common side effects

  • Nausea, vomiting, diarrhea
  • Constipation
  • Stomach pain, heartburn, burping
  • Headache or fatigue

Don't use if…

  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • Pregnancy or active plans to become pregnant (stop ≥2 months before)
  • Prior severe allergic reaction to semaglutide

Tell your provider about…

  • History of pancreatitis
  • Severe gastroparesis or GI motility disorders
  • Gallbladder disease
  • Kidney disease
  • Depression or prior suicidal ideation

Seek urgent care if you notice

Persistent upper-abdominal pain radiating to the back (possible pancreatitis)
Gallbladder problems — fever, jaundice, clay-colored stools
Severe allergic reaction: rash, swelling, trouble breathing
New or worsening depression or suicidal thoughts
Kidney problems from dehydration due to vomiting/diarrhea
Vision changes in people with diabetic retinopathy

FDA boxed warning

FDA boxed warning: in rodent studies, semaglutide caused thyroid C-cell tumors. Human relevance is unknown. Patients with a personal or family history of MTC or MEN 2 should not use it.

Source: MedlinePlus — Semaglutide Injection

Tirzepatide

aka Zepbound®, Mounjaro®

Dual GIP + GLP-1 receptor agonist with the largest average weight loss in trials.

From $249/month

See if Tirzepatide fits you

How it works

Tirzepatide is the first-in-class dual agonist that activates both GIP and GLP-1 receptors. The combined signal improves glucose control, delays gastric emptying, and lowers food intake more strongly than GLP-1 alone.

Onset

Appetite changes in 1–2 weeks; substantial weight loss over 6–18 months.

Duration

Once-weekly subcutaneous injection.

Typical titration

Typical plan: start 2.5 mg weekly × 4 weeks, then step up every 4 weeks (5 → 7.5 → 10 → 12.5 → 15 mg) as tolerated.

Common side effects

  • Nausea, vomiting, diarrhea
  • Decreased appetite
  • Constipation
  • Injection-site reactions

Don't use if…

  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • Pregnancy
  • Prior serious allergic reaction to tirzepatide

Tell your provider about…

  • Type 2 diabetes with other glucose-lowering drugs
  • History of pancreatitis or gallstones
  • Severe GI disease
  • Kidney disease

Seek urgent care if you notice

Pancreatitis (severe persistent abdominal pain)
Gallbladder disease
Severe hypoglycemia (especially with sulfonylureas or insulin)
Severe allergic reaction
Kidney injury from dehydration

FDA boxed warning

FDA boxed warning shared with GLP-1 class: rodent thyroid C-cell tumors. Avoid in MTC/MEN 2.

Source: FDA — Zepbound/Mounjaro prescribing info (SURMOUNT-1 data)

Oral semaglutide

aka Rybelsus®

Same GLP-1 molecule in a once-daily tablet — no needles required.

From $169/month

See if Oral fits you

How it works

Oral semaglutide is the same GLP-1 receptor agonist as the injectable, formulated with an absorption enhancer (SNAC) so enough can cross the stomach lining. It curbs appetite, slows gastric emptying, and improves blood-sugar control.

Onset

Appetite changes within 1–2 weeks; meaningful weight loss over 3–6 months.

Duration

Once daily, first thing in the morning with ≤4 oz of water, then nothing by mouth for 30 minutes.

Typical titration

Typical plan: start 3 mg daily × 30 days, step up to 7 mg × 30 days, then 14 mg daily as tolerated.

Common side effects

  • Nausea, vomiting, diarrhea
  • Abdominal pain and decreased appetite
  • Constipation
  • Fatigue, headache

Don't use if…

  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • Pregnancy or planning pregnancy (stop ≥2 months before)
  • Prior serious allergic reaction to semaglutide

Tell your provider about…

  • Conditions affecting oral absorption (severe gastroparesis, prior bariatric surgery)
  • History of pancreatitis or gallstones
  • Kidney disease
  • Medications needing careful stomach timing (e.g., levothyroxine)

Seek urgent care if you notice

Pancreatitis — persistent severe upper-abdominal pain
Gallbladder disease
Severe allergic reaction
Kidney problems from dehydration
Vision changes in people with diabetic retinopathy

FDA boxed warning

FDA boxed warning shared with the GLP-1 class: rodent thyroid C-cell tumors. Avoid in MTC/MEN 2.

Source: MedlinePlus — Semaglutide Oral

Liraglutide

aka Saxenda®, Victoza®

Once-daily GLP-1 injection — a flexible option for people who prefer daily titration.

From $229/month

See if Liraglutide fits you

How it works

Liraglutide is a GLP-1 receptor agonist that slows gastric emptying, increases satiety signals in the brain, and improves post-meal glucose control. It's dosed daily, which can help some patients manage GI side effects more gradually.

Onset

Reduced appetite within 1–2 weeks; clinically meaningful weight loss over 3–6 months.

Duration

Once-daily subcutaneous injection at any time of day; rotate sites each injection.

Typical titration

Typical plan: start 0.6 mg daily × 1 week, then step up by 0.6 mg each week (1.2 → 1.8 → 2.4 → 3.0 mg) as tolerated.

Common side effects

  • Nausea, vomiting, diarrhea, or constipation
  • Decreased appetite
  • Injection-site reactions
  • Headache or fatigue
  • Low blood sugar when combined with insulin or sulfonylureas

Don't use if…

  • Personal or family history of medullary thyroid carcinoma (MTC)
  • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • Pregnancy
  • Prior serious allergic reaction to liraglutide

Tell your provider about…

  • History of pancreatitis or gallstones
  • Severe GI disease or gastroparesis
  • Kidney disease
  • Other glucose-lowering medications
  • Depression or prior suicidal ideation

Seek urgent care if you notice

Pancreatitis — severe persistent abdominal pain
Gallbladder disease (stones, inflammation)
Kidney injury from dehydration
Severe allergic reaction
Suicidal thoughts or new depression (rare — report immediately)

FDA boxed warning

FDA boxed warning shared with the GLP-1 class: rodent thyroid C-cell tumors. Avoid in MTC/MEN 2.

Source: MedlinePlus — Liraglutide Injection

Compare

Side-by-side comparison

Feature
Semaglutide
Tirzepatide★ Best
Oral Sema.
Efficacy (avg weight loss)
~15%
~22%
~10%
Injection frequency
Weekly
Weekly
Daily pill
FDA approval (weight loss)
Off-label
Insurance coverage likelihood
High
Medium
Low
Dual receptor (GLP-1 + GIP)
Oral option available
Cardiovascular benefit proven
Emerging
Available in US
Individual results vary. Your physician selects the right medication based on your specific medical history and goals.

Sexual wellness

PDE5 inhibitors & PE care, fully explained

Paraphrased from MedlinePlus and Cleveland Clinic.

Sildenafil

aka Viagra®

As-needed PDE5 inhibitor — the classic generic option for ED.

From $36/month

See if Sildenafil fits you

How it works

Sildenafil blocks phosphodiesterase type 5 (PDE5), the enzyme that breaks down cGMP in penile tissue. With sexual stimulation, more cGMP means more blood flow and a firmer erection. It does not increase desire on its own.

Onset

Take 30–60 minutes before intimacy (up to 4 hours before).

Duration

Effective for roughly 4–6 hours. No more than one dose per 24 hours.

Common side effects

  • Headache
  • Facial flushing
  • Nasal congestion
  • Indigestion or heartburn
  • Blue-green color vision tint or light sensitivity

Don't use if…

  • Any nitrate medication (isosorbide, nitroglycerin) or nitrate-based recreational drugs (poppers)
  • Riociguat (Adempas)
  • Severe cardiovascular disease where sexual activity is inadvisable
  • Recent heart attack, stroke, or life-threatening arrhythmia

Tell your provider about…

  • Low or unstable blood pressure
  • Severe liver or kidney disease
  • Retinitis pigmentosa or prior NAION (sudden vision loss)
  • Bleeding disorders or active peptic ulcer
  • Peyronie's disease or penile deformity

Seek urgent care if you notice

Erection lasting longer than 4 hours (priapism) — seek care immediately
Sudden loss of vision or hearing
Chest pain, fainting, or irregular heartbeat during activity

Source: MedlinePlus — Sildenafil

Tadalafil

aka Cialis®

Long-acting PDE5 inhibitor — ideal for daily dosing and spontaneity.

From $42/month

See if Tadalafil fits you

How it works

Tadalafil is a PDE5 inhibitor like sildenafil but with a much longer half-life, enabling either low-dose daily use or higher as-needed dosing. With arousal, it increases blood flow to support a firm erection.

Onset

As-needed: at least 30 minutes before activity. Daily: steady state after about a week.

Duration

Up to 24–36 hours of responsiveness per dose, hence the 'weekend pill' nickname.

Common side effects

  • Headache
  • Indigestion, back or muscle pain (often delayed)
  • Facial flushing
  • Nasal congestion

Don't use if…

  • Nitrates in any form or recreational nitrates
  • Riociguat (Adempas)
  • Severe cardiovascular disease contraindicating sexual activity

Tell your provider about…

  • Alpha blockers for prostate or blood pressure (dose adjustments needed)
  • Severe liver or kidney disease
  • Benign prostatic hyperplasia (may also benefit)
  • Retinitis pigmentosa or prior NAION

Seek urgent care if you notice

Priapism (erection > 4 hours)
Sudden vision or hearing loss
Severe hypotension when combined with alpha blockers
Serious allergic reaction or skin blistering

Source: MedlinePlus — Tadalafil

Lidocaine 4% topical

Topical anesthetic that reduces penile sensitivity to help delay climax.

From $29/month

See if Lidocaine fits you

How it works

Lidocaine temporarily blocks sodium channels in surface nerves, dulling stimulation of the glans and shaft. Applied before intercourse, it can extend time-to-ejaculation without affecting erection quality.

Onset

Apply 10–30 minutes before intimacy.

Duration

Effect lasts roughly 30–60 minutes. Wash the area before intercourse to avoid transferring numbness to your partner.

Common side effects

  • Mild numbness or tingling at the site
  • Temporary reduced sensation
  • Occasional skin irritation

Don't use if…

  • Known allergy to amide-type local anesthetics
  • Broken or inflamed skin at the application site

Tell your provider about…

  • Use the smallest effective amount
  • Partner numbness — wash before intercourse or use a condom
  • Avoid contact with eyes and mouth

Seek urgent care if you notice

Severe allergic reaction (rash, swelling, trouble breathing)
Systemic absorption with large overuse — dizziness, irregular heartbeat

Source: Cleveland Clinic — Premature Ejaculation

Sertraline (off-label for PE)

aka Zoloft®

Daily SSRI used off-label to delay ejaculation in lifelong or distressing PE.

From $39/month

See if Sertraline fits you

How it works

SSRIs raise synaptic serotonin, which — as a side effect — delays the ejaculatory reflex. Sertraline is one of several SSRIs (paroxetine, fluoxetine, escitalopram, citalopram) used off-label for PE, usually daily, sometimes 'on-demand' a few hours before sex.

Onset

Meaningful improvement usually after 1–2 weeks of daily dosing.

Duration

Taken once daily. Do not stop abruptly — taper under medical guidance.

Common side effects

  • Nausea or loose stools (first 1–2 weeks)
  • Headache
  • Decreased libido
  • Drowsiness or mild insomnia
  • Sweating

Don't use if…

  • Current MAO inhibitor use (within 14 days)
  • Pimozide use
  • Known hypersensitivity to sertraline

Tell your provider about…

  • Bipolar disorder or mania history
  • Seizure disorder
  • Bleeding disorders or anticoagulant use
  • Liver disease
  • Pregnancy or breastfeeding

Seek urgent care if you notice

Suicidal thoughts — especially in adults under 25
Serotonin syndrome when combined with other serotonergic drugs
Abnormal bleeding
Hyponatremia (low sodium)

FDA boxed warning

FDA boxed warning for all antidepressants: increased risk of suicidal thinking in children, adolescents, and young adults. Monitor closely for mood changes.

Source: Cleveland Clinic — Premature Ejaculation (SSRI off-label)

Viagra®

aka Viagra®

The original name-brand sildenafil — same molecule, branded manufacturing and blister packaging.

From $89/month

See if Viagra® fits you

How it works

Viagra® is the brand name for sildenafil, a PDE5 inhibitor that increases cGMP in penile tissue so blood flow improves with arousal. Clinically equivalent to the generic; the difference is manufacturing, packaging, and price.

Onset

Take 30–60 minutes before intimacy (effective up to about 4 hours before).

Duration

Roughly 4–6 hours of responsiveness. One dose per 24 hours maximum.

Common side effects

  • Headache
  • Facial flushing
  • Nasal congestion
  • Indigestion or heartburn
  • Blue-green color vision tint

Don't use if…

  • Any nitrate medication or recreational nitrates (poppers)
  • Riociguat (Adempas)
  • Severe cardiovascular disease where sex is inadvisable
  • Recent heart attack, stroke, or life-threatening arrhythmia

Tell your provider about…

  • Low or unstable blood pressure
  • Severe liver or kidney disease
  • Retinitis pigmentosa or prior NAION (sudden vision loss)
  • Peyronie's disease or penile deformity

Seek urgent care if you notice

Erection lasting more than 4 hours (priapism) — seek care immediately
Sudden loss of vision or hearing
Chest pain, fainting, or irregular heartbeat during activity

Source: MedlinePlus — Sildenafil

Arousal cream (compounded)

Compounded topical applied before intimacy to boost clitoral blood flow and sensitivity.

From $79/month

See if Arousal fits you

How it works

A compounding pharmacy prepares the cream using vasodilators (commonly L-arginine and low-dose sildenafil) that relax local blood vessels. Applied to the clitoral area, it may increase blood flow, warmth, and responsiveness in about 15–30 minutes. It does not raise desire on its own.

Onset

Apply 15–30 minutes before intimacy.

Duration

Localized effect lasts roughly 30–60 minutes. Wash before intercourse to avoid partner transfer.

Common side effects

  • Mild warmth, tingling, or redness at the application site
  • Temporary increased sensitivity
  • Possible mild irritation

Don't use if…

  • Pregnancy or breastfeeding
  • Known allergy to any compounded ingredient
  • Broken, infected, or inflamed skin at the application site
  • Concurrent nitrate therapy (because the cream may contain sildenafil)

Tell your provider about…

  • Cardiovascular disease — discuss with your clinician
  • Use only the amount prescribed
  • Partner sensitivity — wash before intercourse or use a barrier

Seek urgent care if you notice

Allergic reaction — rash, swelling, trouble breathing
Systemic effects if overused or applied to broken skin

FDA boxed warning

This is a compounded preparation — not an FDA-approved combination product. Quality depends on the compounding pharmacy, and individual ingredients have their own warnings.

Source: FDA — Compounding and the FDA

Oxytocin nasal (compounded)

Compounded intranasal oxytocin used off-label to support connection and arousal.

From $99/month

See if Oxytocin fits you

How it works

Oxytocin is the bonding hormone released during intimacy and breastfeeding. As a compounded nasal spray it is absorbed through the nasal mucosa; some patients report a short-lived sense of connection, relaxation, and arousal when used before intimacy. Evidence is limited and use is off-label.

Onset

Typically 10–30 minutes after a spray in each nostril.

Duration

Short-acting — effects usually fade within 30–60 minutes.

Common side effects

  • Nasal irritation or runny nose
  • Mild headache
  • Facial flushing
  • Occasional nausea

Don't use if…

  • Pregnancy or actively trying to conceive
  • Known hypersensitivity to oxytocin
  • Severe cardiovascular disease

Tell your provider about…

  • Breastfeeding — discuss with your clinician
  • History of low sodium or kidney disease
  • Use only as directed — avoid dose stacking

Seek urgent care if you notice

Allergic reaction — hives, swelling, trouble breathing
Uterine contractions in pregnancy
Very low blood sodium (hyponatremia) with excessive use

FDA boxed warning

Compounded intranasal oxytocin is not FDA-approved for sexual wellness and is prescribed off-label. Evidence is early and individual response varies.

Source: NIH — Oxytocin overview

Now accepting new members

Get started in 3 minutes.
No card needed.

Physician-led care for metabolic weight loss and sexual wellness — same care team, one platform.

See if I qualify

~3 minutes · No card needed · HSA/FSA eligible · Cancel anytime

FDA-approved

Medications only

US-licensed

Clinicians + pharmacies

1-click

Cancel anytime