DirectMax vs Keeps Powerhouse vs MEDVI QUAD: Formula and Safety Comparison

Commercial disclosure: Partner-network links helped prompt this comparison. This page may earn compensation if you use a marked link. Payment did not control the facts, safety notes, or questions below.

By TotalCareMedical.com Health Team | August 2026

DirectMax, Keeps Powerhouse, and MEDVI QUAD all combine several ingredients in one prescription offer. They are not the same formula. The clearest differences are the listed ingredients, dose details, form, and price disclosure.

Before choosing any telehealth offer, use this provider and price verification checklist. You can also see how this site handles compounded program comparisons and its prior review of Direct Meds.

DirectMax vs Keeps Powerhouse vs MEDVI QUAD at a glance

Prices and page details can change. Confirm the current checkout total, refill terms, formula, and dose before you pay.

What each seller currently discloses

DirectMax lists sildenafil, tadalafil, and apomorphine in rapid dissolve tablets. Its public page does not list the amount of each ingredient.

DirectMax says it is prescription only and doctor reviewed. Direct Meds also says prescriptions are filled by licensed third-party compounding pharmacies.

The DirectMax page shows three per-dose prices: $8.78, $9.28, and $10.78. Those figures do not answer every cost question, so ask about dose count, refill timing, shipping, and cancellation.

Keeps lists Powerhouse as tadalafil 5 mg, vardenafil 10 mg, and apomorphine 2 mg. The page calls it an Rx-only compounded medication that is not FDA approved as a finished drug product.

MEDVI lists PT-141, L-citrulline, tadalafil, and sildenafil. It calls QUAD a rapid-absorb liquid that dissolves under the tongue.

The MEDVI page shows $114 beside a struck $179 per month figure and uses the words “starting at.” Treat that as a page display, not a promised final bill.

The MEDVI page calls QUAD a prescription and includes a notice about risks and benefits of compounded medication. It does not list the amount of each ingredient in the captured formula block.

Why the missing amounts matter

An ingredient name tells you what is present. It does not tell you how much you may receive. That matters when two drugs work in the same broad pathway or when you use other medicine.

Ask for the full prescription label before paying. It should show each active amount, the form, directions, prescriber, dispensing pharmacy, refill quantity, and expiration or beyond-use date.

Keeps gives the clearest public amount list of these three offers. That does not make it the right choice for every person. It only removes one question from the first review.

Safety checks that should come before price

Drug labels say sildenafil, tadalafil, and vardenafil should not be combined with nitrates. This can cause a dangerous drop in blood pressure. We also cover this in Keeps Powerhouse: What to Check Before You Refill.

Apomorphine labels say it should not be used with 5-HT3 blockers, including ondansetron and similar nausea drugs. DirectMax and Keeps both list apomorphine.

Get urgent medical help for an erection that lasts more than four hours. Sildenafil and tadalafil labels both give this warning.

For a focused follow-up on formula details, label warnings, and questions for a prescriber, see the DirectMax-only safety checklist.

MEDVI lists PT-141. The approved Vyleesi label says that product is not indicated for men and is not the same proof for a compounded male ED formula.

The Vyleesi label also bars use in people with uncontrolled high blood pressure or known heart and blood-vessel disease. MEDVI’s L-citrulline listing raises another question because long-term supplement safety has not been well assessed.

FDA says compounded drugs are not FDA approved. The agency does not check their safety, effectiveness, or quality before marketing in the same way it reviews approved drugs.

A simple decision path

1. Start with your medication list. Include nitrates, nausea drugs, blood-pressure drugs, and nonprescription products.
2. Ask for the exact formula. Do not stop at a three-in-one or four-in-one name.
3. Verify the care team. Get the prescriber name, medical group, and dispensing pharmacy.
4. Calculate the real cost. Add consultation, medication, shipping, refills, and cancellation terms.
5. Review the follow-up plan. Know who answers questions and what happens after a side effect.

Questions you can save and use

Do not rush this step. Ask each question and save the reply.

• What is in my dose?
• How much of each drug is in it?
• Who writes the prescription?
• Which pharmacy fills it?
• What will I pay now?
• What will each refill cost?
• Is shipping part of the price?
• How do I pause or cancel?
• Who do I call if I feel ill?
• Will you check all the drugs I use?
• What should I do if a dose fails?
• What could make this unsafe for me?

A clear care team should be able to give clear replies. Save the label, bill, and care plan in one place.

Five signs to stop and ask more

• The page hides the full dose.
• No one checks the drugs you take.
• The site will not name the pharmacy.
• The price grows late in checkout.
• You cannot get a clear care plan.

One red flag may have a fair answer. More than one should slow you down. Take your time. Read each line. Ask first. Keep the facts that you get.

Who should pause before ordering

Pause if the site will not show the full active amounts or identify the prescriber and pharmacy before treatment. You should also pause if no one reviews your full medication list.

Do not use a price table as a medical green light. A licensed prescriber should decide whether any option fits your health history.

Common questions

Which offer has the most complete public dose list?

Keeps Powerhouse lists amounts for all three named ingredients. The captured DirectMax and MEDVI formula blocks list ingredient names without each amount.

Which one is cheapest?

The public pages do not support a fair all-in winner. DirectMax lists per-dose figures, MEDVI shows a starting figure, and the captured Keeps page does not provide a reliable full checkout total.

Does more active ingredients mean better results?

No. A longer formula can add questions and interaction risks. It does not prove a better result for you.

Are these standard FDA-approved combination drugs?

The pages use compounded or compounding-pharmacy language. FDA says compounded drugs are not FDA approved and are not reviewed before marketing in the same way as approved drugs.

This article gives general education, not personal medical advice. It does not diagnose or treat a condition. Talk with a licensed clinician who has your full health and medication history.