Rugiet Reviews: Is Rugiet a solution for ED and more?

Erectile dysfunction (ED) afflicts enough men in the world that none should feel any shame around it — no matter their age.1 2 And ED medications like Viagra, Cialis, and their much less expensive generics (sildenafil and tadalafil) can make an enormous difference. While most companies provide these medications in pill form, a few providers have alternative delivery methods that are more convenient.

Rugiet’s flagship product, Rugiet Ready, contains both sildenafil and tadalafil, as well as a third ED medication called apomorphine, delivered in a sublingual lozenge you can take without needing water. But the company has also expanded to offer a handful of other novel treatment combinations, as well as TRT for men who qualify.

In this review, we’ll break down the evolution of Rugiet’s offerings and help you decide which of them may be right for you.

Rugiet has expanded in recent years to offer compelling combination treatments for various men’s health concerns, with sexual health forming the cornerstone of its catalog. One or two combination pills are available at competitive prices, but alternatives from Hims and BlueChew consistently match or beat the majority of Rugiet’s lineup. That said, if the price difference is slim and Rugiet’s specific doses align better with your needs for safety and efficacy, this could be a good place to turn.

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions involving staying healthy and living healthier lifestyles. We extensively test each health service or product we review, including ED medication services like Rugiet.

Our team has spent countless hours researching and writing about erectile dysfunction, compiling a database of over 100 clinical studies, speaking with men who use ED medications and their partners, and conferring with urologists and other clinicians about the latest and best treatment options. We’ve ordered medication through Rugiet to test the company’s customer service and discretion, and we put the lozenges to the test with rigorous experiments designed to assess their convenience and reliability. For medical reasons, no members of the testing team consumed the medication themselves.

Additionally, like all health-related content on this website, this review was thoroughly vetted by one or more members of our Medical Review Board for accuracy. As research continues, we will continuously revisit and update this content.

Our evaluation of Rugiet required us to pit it head-to-head with a handful of comparable services providing prescriptions and delivery of medications to treat ED, hair loss, low testosterone, sleep issues, and anything else Rugiet could treat. We focused on competitors that also used streamlined online platforms, instead of comparing what treatments and prices you could find if you saw a urologist or endocrinologist through your insurance.

Comparing available medications became extremely important, especially because Rugiet deals exclusively in combination therapies. These have become more popular in recent years, but specific combinations and doses vary between companies, making this a critical lens through which to view the landscape. We also focused on key variables like safety, cost, and convenience.

Let’s gain a deeper understanding by looking more closely at each major factor.

Available treatments

Most of Rugiet’s competitors also offer sildenafil and tadalafil, and some go further with medications like avanafil or vardenafil. And since you can’t easily get sildenafil or tadalafil on their own from Rugiet, it’d be easier — and likely less expensive — to look for them as monotherapies elsewhere. But Rugiet offers apomorphine as part of its flagship combination therapy, Rugiet Ready, which includes it alongside both sildenafil and tadalafil. At this time, only BlueChew offers a similar combination.

Rugiet’s also recently expanded its lineup to include a handful of new therapies. Currently, its catalog can treat the following:

• Erectile dysfunction: tadalafil, sildenafil, and apomorphine
• Premature ejaculation (PE): tadalafil and paroxetine
• Low testosterone: DHEA (with tadalafil), TRT injections or creams, and oral enclomiphene citrate
• Hair loss: biotin and minoxidil (only available combined with tadalafil)
• Poor sleep: ramelteon, doxylamine, and valerian root
• Overweight and obesity: metformin, bupropion, and naltrexone

You’ll find some of these treatment offerings in one form or another from competitors, but the variety here is impressive. Of course, with tadalafil forming the basis of two-thirds of these treatment options, that variety quickly becomes less useful; for example, you couldn’t take the company’s ED and hair loss combinations concurrently without potentially taking an unreasonably high dose of tadalafil.

Still, if you’re not sure the best way to tackle a suite of symptoms, this variety means you can go through a consultation at Rugiet and confer with the medical pro on the other side to determine the best course of treatment.

Here’s a quick chart to compare this variety to treatment options from competitors BlueChew, Hims, and Rocket Rx:

Safety

Because all of the medications in Rugiet’s lineup require you to have a prescription to access them, there’s a baseline of safety provided by the medical consultation at the outset. You’ll answer a pretty basic questionnaire and message back and forth with a doctor, nurse practitioner, or physician’s assistant before having your medication shipped. And if there are specific contraindications that arise from this process, that medical professional can guide you to alternatives if the company offers anything relevant.

This is the standard of treatment through most telehealth outfits, and Rugiet does fine. Because that standard is so similar among telemed companies, we wanted to look more deeply at the available doses and specific combinations of medications, compare them to those available from competitors, and hold them up to scrutiny in the scientific literature to ensure the products Rugiet’s designing are as safe as they can be.

Looking at this example, you can see that Rugiet doesn’t deviate too far from acceptably safe dose ranges, but its base doses for both sildenafil and tadalafil are higher than its competitors. That can limit who makes good candidates for treatment, especially if they’re new to ED treatment and even more so considering Rugiet’s commitment to providing only combination therapies. All three other companies on the chart offer these two drugs on their own, without other medications mixed in.

Cost

Rugiet eventually lays its costs out very plainly for you to see, but you’ll have to work your way through a consultation first. This is a step in the right direction compared to some certain competitors, however. Hims, for example, doesn’t have its full pricing possibilities baked into the purchasing process. Instead, your consulting doctor or customer service can tell you what certain options cost once you’ve qualified for them.

Rugiet makes it far easier to let price be a factor in where and how you start treatment. If you were stuck between two formulas or doses and unsure where to start, with your doctor saying either could work, you’d have another useful set of data points to consider.

Unfortunately, once you see those prices, you’ll find that they’re higher than comparable medication combinations from competitors in just about every instance.

Let’s take a look at cost possibilities for Rugiet Ready, the company’s flagship product, to see how it compares at each dose level to a comparable product from BlueChew:

Rugiet’s low dose is a bit of an outlier here, with its doses significantly lower than BlueChew Gold's base dose. And, since Rugiet has four dosing tiers to BlueChew’s three, it makes more sense to elide Ready’s low dose entirely from the comparison to see how more similar pairings from the two companies stack up.

That base dose from BlueChew is a better match for Rugiet Ready’s medium dose, but Rugiet charges around $2 more per lozenge. The next two doses up reveal identical best prices, but BlueChew gives you slightly higher doses of either sildenafil or apomorphine while adding oxytocin.

This pattern repeats itself throughout Rugiet’s lineup: strong medications delivered at higher prices than you could get from other companies offering similar, sometimes more flexible dosing options.

Convenience

As a telemed provider of men’s health solutions, Rugiet offers some undeniable convenience. A short intake questionnaire is often all it takes to get a prescription for medications that still carry some stigma, should you seek them in person. Medication is delivered straight to your door, to boot. But that’s largely the bare minimum most similar platforms meet in satisfying customer convenience. It’s not enough on its own for Rugiet to stand out.

So, we turn to the lineup itself. In theory, a product like Rugiet Ready should be extremely convenient. It’s a lozenge that dissolves under your tongue and kicks in faster than other ED medications delivered in pill form. It was a novelty upon its arrival, but BlueChew’s chewable tablets have recently been reformulated to dissolve under the tongue, as well. Ready is no longer unique.

Then, there’s the sensitivity of the lozenges to temperature. If you live in a cold climate, this might not be as much of an issue. But above 70 degrees Fahrenheit, those lozenges start to soften. Rugiet advises you to keep them in a fridge or freezer, and they’re shipped along with ice packs to keep them cool. If you pop the pack of lozenges in your pants pocket at the beginning of a hot summer’s night out, they might be too soft to get them out of the package by the time you need them. And exposure to significant temperatures, such as those seen in a hot car, can completely liquify the lozenges within an hour. If there were a safe and effective way to stabilize them against higher temperatures, we’d be able to recommend them much more strongly.

Privacy

Rugiet mostly conforms to the same privacy standards set across the industry, with discreet shipping boxes and billing practices. And all of your medical data is protected by HIPAA, so there’s no concern about your private health information getting shared with others. That legal restriction forms the bulk of our rating here.

As far as your digital footprint is concerned, Rugiet does what just about every other website does by using cookies and web beacons to track the way your IP address uses its site. This information is more closely tied to your WiFi connection than it is to you as a person, but there are features of the data collected that can be used to identify, or at least close in on, the user in question. Most people are comfortable with this level of data collection, but companies often give people the option to opt out and explicitly not have their data shared or sold to third parties.

If you dig into Rugiet’s privacy policy, you’ll find out how to opt out of that kind of data use. We appreciate this option, but other companies — notably, Hims and Roman — provide you with buttons at the bottom of their web pages that take you directly to an interface that lets you opt out. If Rugiet added such a feature, it could increase our regard for its privacy practices.

Rugiet Health is an online telehealth service that offers several men’s health solutions for things like ED, hair loss, and low testosterone. It delivers its cornerstone ED medication combo as a sublingual troche — also known as a lozenge — that dissolves under your tongue. This allows the drugs to absorb much more efficiently than in pill form.

While it started with that ED combination, Rugiet Ready, the company has expanded in recent years to cover far more than just ED. Currently, its catalog includes:

• Ready: tadalafil, sildenafil, and apomorphine to treat ED
• Go Long: tadalafil and paroxetine to treat ED and premature ejaculation (PE)
• Daily Boost: tadalafil and DHEA to treat ED and low testosterone
• Grower: tadalafil and minoxidil to treat ED and hair loss
• Recharge: ramelteon, doxylamine, and valerian root to improve sleep
• TRT: various therapies to improve testosterone, including testosterone injections and oral meds
• Weigh In: Various meds for weight control, including metformin and bupropion

You’ll notice that the majority of medications Rugiet offers start with tadalafil among their ingredients. That’s because most of these are concerned with men’s sexual health, specifically ED and PE, and tadalafil has been shown to be safe and effective at treating these disorders when taken daily. Since other medications included in these combinations, like paroxetine or minoxidil, are also prescribed for daily use, tadalafil makes the most sense as an adjunct ED medication alongside them.

Next, we’ll take a closer look at each of the products in Rugiet’s lineup, so you can get a sense of where you might want to start your journey. We’ll begin with a deep dive into the company’s original offering, the combination ED therapy lozenges called Rugiet Ready.

Rugiet Ready was the first product Rugiet brought to market — a relatively novel lozenge delivery method and a customizable combination of well-researched drugs that is likely a safe and effective option for many users.

Ready’s sublingual absorption means the medications can start working in around 15 minutes, compared to the average 30-60 minutes seen in pills. That’s because the medication can pass through oral membranes directly into the bloodstream, rather than having to be metabolized in the liver first. The time you save can make a big difference if you’re taking it for immediate use not long before intimacy. For people new to ED treatments, this added convenience is a considerable selling point. But if you’re already accustomed to taking your ED meds an hour or so before intercourse begins and can pick up on subtle signals from your partner, it might not have as much of an impact.

Rugiet Ready remains more expensive than traditional pills, and the lozenges melt a bit too easily at high temperatures. But we find Rugiet Ready to be an excellent choice for two groups of men in particular:

1. Those who have unsuccessfully tried one or more ED medications in isolation and want to combine them
2. Those who have yet to try a medication but are more than willing to spend more in order to ensure immediate success, avoiding trial and error

Other men — particularly budget-conscious men — seem like less obvious candidates. There are more affordable, single-medication options that would be equally effective for many men with ED.

For the men whose erectile performance gets a big boost from apomorphine, they’ll undeniably benefit from Rugiet’s offering. It’s generally well-tolerated, but it can induce some nausea. That makes Rugiet a less desirable choice if you’ve been drinking heavily while out on a date or looking to meet someone.3 There’s a small chance that added nausea could put you over the edge if you’re already close to feeling sick.

At the end of the day, we appreciate Rugiet’s use of a relatively uncommon drug in the fight against ED, but if it were easier to customize each user’s formula, picking and choosing drugs and doses, we’d be able to rate them a little higher. Currently, you have to make that request to your consulting physician, but there’s no mention of that path as an option on the website, and there’s no guarantee the company can accommodate you.

How the ingredients in Rugiet Ready fight ED?

There are many potential causes of erectile dysfunction, including both psychogenic and organic causes. Psychogenic causes can be things like depression, anxiety, stress, or even the belief that you can’t perform without assistance (as seen in men who’ve used PDE-5 inhibitors recreationally).

Organic causes for erectile dysfunction are broken down further into vasculogenic, neurogenic, and hormonal causes:

• Vasculogenic: Generally arising from cardiovascular issues affecting blood flow
• Neurogenic: Rooted in brain chemistry as it relates to erectile performance
• Hormonal: Imbalances in hormones that drive sexual health

Cardiovascular issues are the top organic cause of ED, so much so that the dysfunction itself can serve as an early warning for men susceptible to serious cardiovascular complications either from genetic predisposition or a poor diet and lack of exercise.4

It’s essential to address any of these underlying issues along with any ED medication you might seek. Not only could treating these issues alleviate the majority of your ED symptoms, but it could, in turn, eliminate the need for ED meds in the first place. That would cut down on your risk of complications or adverse effects and remove any prescription medications’ practical and financial burden on you. While you attempt to remedy those underlying issues, however, there’s no shame in reaching for a little prescription assistance in your sex life.

Whatever the cause of erectile dysfunction, the physical processes remain constant: the body either fails to deliver adequate blood to the corpora cavernosa (the spongy tissue that makes up the bulk of your penis) or the blood that arrives there leaves too quickly.5 Without enough blood in this tissue, the penis will not expand and harden.

Most ED medications — prescription and non-prescription — seek to relax the blood vessels in this area of the body and increase blood flow in general. That creates an environment where physical and psychological arousal can result in a healthy erection that sustains long enough for satisfactory sex.

The three ED medications available to combine in Rugiet Ready treatments are:

• Sildenafil
• Tadalafil
• Apomorphine

If you become a member, you and the doctors at Rugiet Health will determine your optimal combination of these three. The doctors can prescribe one, two, or all three to be included in your dissolvable treatment.

Let’s look at each of these ingredients to paint a clear picture of how Rugiet Ready fights ED.

Sildenafil

Sildenafil is the key ingredient in Viagra.6 It’s a prescription PDE-5 inhibitor, which reduces the activity of the enzyme phosphodiesterase type 5. Blocking the activities of this enzyme means that the blood vessels running through the penis relax and stay relaxed, allowing for improved blood flow in response to arousal.

Typically, sildenafil starts working within 30 minutes, and its effect can last 4-6 hours.7 If you take traditional sildenafil after a heavy meal, though, it may take longer to feel the full effects (and some men may not feel them at all, depending on metabolism and dose). Rugiet Ready is generally less affected by meal type or size thanks to its sublingual absorption.

Sildenafil has been studied extensively and prescribed widely, but it can be dangerous if you have cardiovascular issues, especially if you’re taking medication for conditions like high blood pressure (such as those with nitrates). During your doctor’s consultation, you’ll need to provide a recent blood pressure reading, and you’ll want to divulge any cardiovascular diagnoses you’ve received and discuss whether PDE-5 inhibitors would be safe for you.

Other potential side effects of sildenafil include:

• Headache
• Nausea
• Vomiting
• Nosebleeds
• Sore throat
• Runny nose
• Fever
• Respiratory infection
• Flushing
• Trouble sleeping
• Abnormally long-lasting erections
• Visual color processing issues

Typical sildenafil doses range from 25mg to 100mg. Rugiet Ready is available with 40mg, 65mg, 80mg, and 110mg doses.

Tadalafil

Like sildenafil, tadalafil — the key ingredient in Cialis — is a PDE-5 inhibitor, but it works a little differently than sildenafil.8 Though it has a similar side effect profile, its primary effects last longer. So, while sildenafil is active in your system for about 4-6 hours, tadalafil remains effective for 24-36 hours. That makes it a more convenient choice for a lot of users.9 It also takes just a little more time to activate than sildenafil, but it isn’t affected by meals.

Like sildenafil, tadalafil comes with cardiovascular implications. Make sure your consulting doctor is aware of any medications you take for blood pressure or any heart conditions you may have before you take tadalafil. Beyond cardiovascular complications, one of the most frequently reported side effects of tadalafil is muscle pain, often located in the lower back.10

Tadalafil is sometimes prescribed for daily use, often starting at a lower dose. This is because 5mg daily can be as effective as 20mg taken as needed, and the lowest effective dose is generally best. Daily use is extremely convenient compared to making sure you have a pill on you just before sex, but some men might not want to take a daily pill if their sex lives don’t justify it.

Rugiet Ready provides tadalafil in combination with its other two medications at 14mg and 22mg doses. Both of these doses are on the high side for tadalafil, which is usually prescribed somewhere between 2.5mg and 20mg, with side effect risks increasing in lock-step with dose.27 Also, Rugiet Ready is not intended for daily use the way that lower doses of tadalafil sometimes are. Even if you had Rugiet make specialized lozenges of just tadalafil, its doses and prices are too high for it to make financial sense. Men interested in daily tadalafil should look to a service like Hims or Roman.

That said, you’ll see lower tadalafil doses of around 5-8mg in certain daily Rugiet products we’ll describe below.

Apomorphine

Apomorphine is a less common ED medication than tadalafil or sildenafil. It’s not a PDE-5 inhibitor like those two are. Instead, apomorphine is a dopamine agonist, which means it helps stimulate dopamine activity in the brain. Specifically, the apomorphine in Rugiet Ready stimulates the D2 dopamine receptor (among others), which studies have concluded is directly involved with erectile function.11 Collaterally stimulated dopamine activity may help with psychological issues that can contribute to erectile dysfunction, as dopamine reuptake inhibitors such as Wellbutrin are sometimes prescribed for mild depression.

This is one of the most compelling aspects of Rugiet Ready, as none of its major competitors offer apomorphine either as a standalone treatment or in combination with other drugs.

That said, apomorphine is more commonly used as a treatment for Parkinson’s disease. Those patients receive the drug via intramuscular injection in an average dose of 3mg. They often experience significant nausea as a side effect — so much so that most of them also consume an antiemetic to fight it off.

Interestingly, the oral dose of apomorphine that shows the most promise with relatively low side effects is also 3mg.12 Rugiet Health provides a 3mg dose of apomorphine in its standard dosing configurations, though it’s possible to have a lower 2mg dose as part of your ideal combination. While these doses are close to what Parkinson’s patients receive, it’s important to remember that they take their medication as an injection, which enters the bloodstream much more quickly than a lozenge. As a result, the nausea side effect for Rugiet Ready users is largely curtailed.

Potential side effects of apomorphine include:

• Nausea
• Vomiting
• Constipation
• Dizziness
• Diarrhea
• Headache
• Runny nose
• Weakness
• Yawning

Hypoactivity is also common in rat models, but often at doses well above the minimum at which successful erectile performance is achieved. Still, if you notice signs of a depressed nervous system, such as fatigue or lack of motivation, it might be worth mentioning to your doctor.

ED and PE often go hand-in-hand, so it might not come as a surprise to learn that ED treatments have become common therapies for men with PE.29 To be clear, more traditional treatments like topical numbing products or prescription SSRIs remain front-line options for men with PE, but ED meds have entered the picture as useful adjunct therapies when indicated.

That is why Rugeit and a few other companies have begun offering combination therapies that include a daily PDE5 inhibitor — typically, and in Rugiet’s case, tadalafil — alongside an SSRI to manage ED and PE concurrently.

Different companies use different SSRIs, with Rugiet opting for the well-studied paroxetine. A systematic review and meta-analysis from 2019 found that paroxetine performed better than placebo at reducing PE, but it also outperformed other SSRIs in included studies.28 And, while PDE5 inhibitors have plenty of research support for their ability to treat ED, they can also support men’s efforts to last longer in bed. What’s more, because they work on different parts of the physiology, their synergistic effects for PE are greater than either PDE5 inhibitors or SSRIs on their own.30

Neither Go Long nor any of Rugiet’s other non-Ready products come in novel forms like lozenges. These are traditional tablets you take with water on a daily basis.

For men concerned with both ED and hair loss, Rugiet offers Grower, a combination of tadalafil for ED and oral minoxidil for hair loss. The concept of combining an oral ED medication with an oral hair loss medication gained traction with the hair loss drug finasteride (generic for Propecia) after that treatment became known for its relatively high incidence of sexual side effects.31 But rather than proactively treating ED caused by finasteride, Grower includes oral minoxidil, which doesn’t suffer from the same sexual side effects that plague finasteride.32

You might be more familiar with minoxidil as a topical medication, as it originally hit the market as a solution called Rogaine, which you applied directly to your scalp. But minoxidil was originally investigated as an oral medication to lower blood pressure, and it was only repurposed topically after patients in those early blood pressure trials developed extra hair growth.33 Now, the oral version is considered a top choice for men seeking oral hair loss medication with a more favorable side effect profile.34

Oral minoxidil doses typically run in 1.25mg increments, but Rugiet and some others in the combination therapy sector have begun offering a 3mg version, which is the dose employed in Grower. That, alongside a 6mg tadalafil dose and 3mg of biotin, should be sufficient for most men to see immediate improvements in erectile performance and gradual improvements in hair growth, with regrowth possible after a few months of use.

Like many medications from Rugiet, Grower is available in 1- or 3-month increments, with the 3-month supply offering the best deal. However, you can get a similar product from Hims that contains a stronger tadalafil dose of 8.5mg for either the same price at three months or an even lower per-dose price through a 5-month subscription.

Erectile dysfunction is often associated with hypogonadism, or clinically low levels of the sex hormone testosterone.35 In many cases, resolving a clinical hypogonadism diagnosis can potentially reverse ED. But that can take time, especially if you choose certain medication options or supplements over something like direct testosterone replacement injections.

So, for men who want to restore erectile function now and let their testosterone levels catch up over time, Rugiet combined a common over-the-counter testosterone treatment with prescription tadalafil. That ingredient is dehydroepiandrosterone (DHEA), a prohormone produced in the adrenal glands that spurs testosterone production.36 Taken as a supplement, results are mixed, with doses above 50mg performing best, and women seeing better results for testosterone increases than men.37

Compared to various other supplemental ingredients on the market, DHEA seems like an odd choice here. There’s more compelling data behind things like ashwagandha or fenugreek, for example.38 39 And Rugiet only includes 50mg of DHEA per dose — the apparent bare minimum.37

Men interested in supplemental support for testosterone levels and a tadalafil prescription for ED would do better to seek out medication separately and consult our guide to the best testosterone boosters.

One of the few formulas in Rugiet’s lineup that’s not strictly for men, Recharge is aimed at improving sleep. It contains a trio of ingredients that can help its users fall asleep faster and sleep more deeply. That’s pretty useful in a society where sleep is hard to come by.19 But, as with the decision to include DHEA as a testosterone booster in Daily Boost, the ingredients selected for Recharge, while potent, might not be the best choice for most people.

Specifically, Recharge contains:

• Ramelteon: a prescription medication for insomnia
• Doxylamine: an OTC antihistamine
• Valerian root: a botanical sleep aid

Individually, these ingredients have shown promise for helping people sleep. Ramelteon helped insomnia patients get to sleep faster without any withdrawal symptoms.20 Doxlamine is recommended for similar uses, including in healthy populations without clinical insomnia.21 And a systematic review of valerian root studies supports its potential efficacy for getting people to sleep.22

But each path also presents a problem. A 20-year real-world ramelteon safety study revealed “a broad spectrum of AEs…including unique sensory experiences (e.g., hangover, derealisation, feeling drunk), reproductive system effects (e.g., decreased libido, priapism), hallucination-related AEs (e.g., visual hallucinations), and rare but clinically significant reactions.”23 That’s a lot of potential adverse effects.

Doxylamine is considered a bit safer, but AEs there also include:21

• Constipation
• Dysuria
• Blurred vision and diplopia
• Flushing of the skin
• Anhidrosis
• Hyperthermia
• Hallucinations
• Mydriasis
• Delirium
• Urinary retention

Finally, while a widely available botanical might seem very safe, valerian root hasn’t been widely studied for periods longer than six weeks.24 Even within those studies, things like headache, GI distress, brain fog, and vivid dreams were seen.

When other products exist that are designed for safe long-term use, like Innerbody Labs Sleep Support, for example, it’s hard to justify this as a starting point for anyone having trouble with their sleep.

Whether you’re discouraged by DHEA as a potential OTC testosterone treatment (as seen above in Daily Boost) or you’re simply more interested in treating low testosterone without needing to address erectile issues, Rugiet’s TRT options may be of interest to you. And TRT in the modern era isn’t just injections, either. There are oral medications, patches, creams, and other means to either directly introduce new testosterone to your body or get your body to produce more of its own.

Currently, Rugiet offers four TRT options:

• Enclomiphene citrate: an oral medication that indirectly spurs testosterone production. Takes longer than other methods, but it’s arguably the safest of the bunch.
• Oral TRT: testosterone administered as an oral tablet. Works faster than enclomiphene but not as fast as gels or injections, even though it has a similar side effect profile.
• Topical testosterone roll-on gel: Faster than oral TRT and more convenient than injectables. However, this introduces the risk of testosterone exposure to women and children in the household.
• Injectable TRT: The fastest and most traditional method. Worst side effect profile, however, and you have to bother with needles.

Rugiet simplifies its pricing for the TRT program, with a single price structure applied to whichever treatment you prefer. Unfortunately, none of those prices can compete with bigger, better players in the TRT space, like Maximus Tribe or even Hims.

To learn more about alternatives to Rugiet for TRT, check out our guide to the best online TRT clinics.

Similar to Rugiet’s expansion into TRT, its weight loss catalog aims to provide a wide array of prescription treatments for tackling overweight and obesity. However, as of this writing, the catalog is stuck in a previous generation of weight loss drugs. While Rugiet’s competitors like Hims and Roman offer traditional weight loss drugs alongside modern medicines like Ozempic, Zepbound, and their generic equivalents, Rugiet only offers those traditional, previous-generation therapies.

Now, to be clear, those therapies can be effective for many people. They include things like bupropion, naltrexone, and metformin. But until Rugiet can find a way to offer GLP-1 medications like its competitors do, it’ll be stuck in the past.

Rugeit’s expanding catalog makes it an interesting place for men to go who are seeking combination therapies to tackle more than one issue at once, especially if one of those issues is ED. Ultimately, we consider Rugiet Ready to be a possible option if you fit into a small subset of ED sufferers who have tried monotherapies in the past (e.g., sildenafil or tadalafil on their own) and found those to be insufficient even at high doses. For these men, a combination of drugs might be more effective, especially with the inclusion of apomorphine, which most ED patients will not have tried yet.

We typically don’t recommend that men start with drug combinations if they haven’t previously sought treatment for ED. But some men, especially those interested in the lozenge delivery format, will still want to start here first. Rugiet’s ability to tailor the medication to meet your needs and wants — including making lozenges that only contain one of the three drugs available through its system — could give you access to lozenges that make more sense for some first-time patients, but that’s often a much more expensive route than traditional pills.

Who might want to look elsewhere?

If you’ve never taken medication for ED, you should probably start somewhere else in your search for treatment; the increased risk from combining medications is less justifiable, considering the positive track records that sildenafil and tadalafil offer. Not only that, but you will be paying more for the combination than for a single medication alone. With companies like BlueChew and Hims offering effective medications with lower side effect profiles and lower prices, it’s hard to argue in favor of Rugiet Ready unless you want to use a kitchen-sink approach or you’ve exhausted those options.

And, of course, if you do not have erectile dysfunction, you shouldn’t try to take ED medications. Taking these medications recreationally is highly inadvisable; using ED medications when you don’t need them has been shown to result in psychogenic erectile dysfunction.25

Rugiet company reputation

While Rugiet has an A+ rating from the Better Business Bureau, the customer ratings there leave a lot to be desired. Out of a possible five stars, Rugiet currently holds a 1.86-star rating. However, that’s only from 14 reviews, so not quite statistically significant. A bigger picture might be coming from Trustpilot, where the company holds a 4.2-star rating out of a possible five.

Most of the complaints on the BBB site revolve around issues canceling subscriptions or medication not working well enough. Some also bring up the melting lozenge issue we discussed above under our convenience criterion. We’ve experienced those lozenge consistency issues in testing, but our experiences canceling Rugiet subscription in recent years have been pretty seamless, so we can’t corroborate those accounts.

As you can see from our overall rating above, we don't rate Rugiet quite as highly as its Trustpilot page does, but we think it’s a far better company than the picture painted by its BBB reviews.

We went through the same ordering process any customer would when we decided to perform hands-on testing of Rugiet’s products. It’s a pretty straightforward process involving a short questionnaire and photos of your face, as well as the front and back of your driver’s license.

Rugiet Ready temperature stability tests

After hearing from so many users who had their shipments arrive liquified, we decided to take it upon ourselves to determine at what temperatures and in what situations a Rugiet Ready lozenge might begin to soften and melt. The most important part of our findings was that the lozenges are somewhat soft at room temperature (clocked at 71 degrees Fahrenheit in our testing space).

Like some other medications or cough drops, the lozenges come in punch-out packages, often called blister packs. But those products are completely solid at room temperature, and when you push against them, they easily tear through the thin aluminum backing. Softened Rugiet Ready lozenges absorb the pressure from your fingers, deforming in their packaging and requiring a little more finesse to get them out. If you keep them in the fridge or keep your thermostat lower than we do, you might not have this problem.

So, how are packages arriving to customers with melted lozenges? Well, Rugiet packs its lozenges with a small ice pack in a thermally resistant envelope. But that ice pack is pretty small, and if the package is on a hot delivery truck, it might not be enough to prevent melting. In our testing, lozenges began to soften significantly at about 100 degrees Fahrenheit, and they liquified completely at around 120 degrees.

According to the CDC, a car parked in the sun on an 80-degree day can reach an internal temperature of 123 degrees within 60 minutes.26 That’s three degrees over our tested melting point. When liquified, the lozenges won’t pierce their blister packs. You’ll have to bring them back to a stable temperature first.

Our testing team found it took about 10 minutes in a 37-degree refrigerator and about 20 minutes at our 71-degree room temperature for the lozenges to return to their normal state. But once they’ve melted, the lozenges are deformed in their packaging. Typically, the lozenges are slightly smaller than their blister pack sections, and that difference in size helps you punch them through the aluminum backing easily. But once they’ve melted and reformed, they take on the full width of the blister section, making them more difficult to remove. Our testers had to peel away the blister pack backing and pry out lozenges that had previously melted, often getting loose lozenge material stuck under their fingernails.

The safety profile of each Rugiet product varies, but the buffer of a telemedical consult with a physician should serve as a good first line of defense against the most severe risks. These medications all have side effect profiles worth considering, however, which can affect even the best candidates for an intervention.

It’s hard to say whether Rugiet Ready’s specific combination of ED medications is as safe as each individual medication by itself. Studies into combination therapies are lacking and often include participants on a daily dose of tadalafil who take sildenafil as needed.13

ED medications like sildenafil and tadalafil are quite safe for most men as long as they don’t have an underlying cardiovascular condition. In practice, the lowest effective dose of any medicine is the safest — that’s how you minimize adverse effects, and it’s why Rugiet Health doctors advise people to start by taking half of a sublingual dose at the outset to see how it affects them.

But if sildenafil or tadalafil work well enough on their own, there’s no need to combine them. You’re not going to get extended performance out of either, and you certainly won’t get any kind of special erection from the combination.

The biggest risks associated with sildenafil or tadalafil come from cardiovascular complications.14 PDE-5 inhibitors widen blood vessels, which lowers blood pressure. Men on nitrates or other medications that affect blood pressure could experience dangerous drops. Though it’s not a PDE-5 inhibitor, apomorphine has shown similar side effects, including fainting from low blood pressure in several studies. Your doctor will extensively review your medical history and require you to submit a recent blood pressure reading before providing you with a prescription.

Apomorphine has similar blood pressure implications to those of PDE-5 inhibitors, but it is also associated with a high incidence of nausea. In oral doses, this nausea is far less intense than what we see in Parkinson’s trials using subcutaneously injected doses that enter the bloodstream faster than Rugiet Ready. Thankfully, any nausea you might feel from oral administration appears to fade with continued use.15

In cases of severe ED in which a high dose of sildenafil or tadalafil barely works or stops working, it’s worth exploring the combination. Some men with diabetes, PTSD, or a history of prostatectomy may find that traditional ED prescriptions become less effective. For these people, a combination often succeeds where the prior prescription has failed. Despite the fact that there haven’t been a lot of studies on the combination of PDE-5 inhibitors, the few studies that exist typically showed greater reported satisfaction levels among participants with no noticeable uptick in side effects compared to PDE-5 inhibitors taken in isolation.16

Ultimately, more studies on the combination of these medications would be helpful.

Is Rugiet Ready suitable for daily use?

Rugiet Ready isn’t intended for daily use, and the doctors at Rugiet Health will never advise you to take these treatments as a daily routine.

Doctors do prescribe tadalafil for daily consumption, but these situations typically involve much lower doses than what is present in Rugiet Ready. If a daily routine is what you’re seeking, then Rugiet Ready isn’t for you. Even before considering the presence of sildenafil and apomorphine, it may be unsafe (and expensive) to consume Rugiet Ready’s tadalafil dose daily.

Other Rugiet products, like its testosterone booster and hair loss medication, come combined with daily tadalafil, so they’re certainly more suitable for daily use.

Hims is likely the best place to acquire tadalafil for daily use, particularly if you know your way around its somewhat complex pricing structure. Our review of its ED services goes into more detail.

Rugiet offers most of its treatments on 30- and 90-day billing and shipping cycles, with the 90-day option always reducing your cost per dose. Rugiet Ready is the only product with a price that varies by dose and quantity, as well. Ready is available in packages of 6, 12, 18, and 24 doses per month.

Here’s a simple chart to show you how much you’ll pay for 12 doses of each Rugiet Ready formula:

Here’s a simplified look at pricing for the company’s other treatments:

In just about every instance here, Rugiet is more expensive than the competition. For example, you can get a stronger version of Rugiet’s Grower from Hims for as little as $1.17/dose, while Grower itself only comes down to $1.63/dose at best.

Rugiet’s TRT offerings are the only ones not offered on a monthly basis, but offered on an optional 6- or 12-month cycle, which you won’t see with its other products. There’s also a $69 charge for initial bloodwork, but Rugiet provides follow-up testing for free.

No matter which TRT intervention you choose, the prices are the same:

Rugiet Health accepts payments via credit cards only. Shipping from Rugiet used to cost $10, but the company has since waived that fee, providing free shipping on all orders. It’s also worth considering that Rugiet Ready has to ship cold. Fortunately, shipping has been reliably fast in our testing. Your package will contain reusable ice packs to keep the doses cool in transit, but don’t freeze the doses when they arrive. Rugiet advises that you keep them in the refrigerator if the temperature in your home regularly exceeds 74 degrees, as high temperatures can melt the treatments. After all, they’re designed to melt at body temperature.

If you live in a warm climate, Hims Hard Mints or BlueChew might be better as the individually packed doses offer similar portability but without the concern for temperature.

The company is upfront about the fact that it doesn't work directly with insurers and that customers would have to put in claims for out-of-network reimbursement. It also clearly states that you’re welcome to try an HSA or FSA card to make your purchase but that most such attempts are declined. We encourage you not to get your hopes up about insurance reimbursement. More insurance companies have begun covering Viagra, Cialis, and their authorized generics, but Rugiet Ready’s components are not authorized generics, and its combination makes them even less likely to be covered for reimbursement.

Rugiet will provide you with any necessary receipts that could expedite a reimbursement claim through an HSA or FSA program.

Most telehealth platforms offering generic ED medications are in the same boat. Hims is one of the few to offer an authorized generic — for Viagra’s sildenafil — but even then, there’s no guarantee you’ll get coverage.

Privacy is vital when it comes to sexual health, both online and in person. You can rest assured that Rugiet Health takes your privacy and security seriously. While the company will track your activity on its site using cookies, beacons, and other trackers, it protects all significant personal data. You can opt out of data sharing, but Rugiet doesn’t make this process as easy as some of its competitors do.

Rugiet Health is a HIPAA-compliant “covered entity,” and it defines the pharmacies and medical groups it uses as “business associates” under HIPAA guidelines. That ensures your medical information is protected under the strictest standards, as we’d expect.

Your shipment also provides added privacy. The medication comes in a box whose only identifying markers are your address and the return address of the issuing pharmacy. Nothing about the shipment would inform anyone, from parcel carriers to neighbors, about what’s inside. This is commendable but not unusual for services like these. The top telehealth providers of ED medications ship and bill discreetly.

Rugiet is a somewhat unusual player in the ED telehealth space, specifically for its use of multiple combined therapies. As a result, Rugiet Ready is comparably much more expensive than other standalone treatments.

If you’re just starting out on your ED treatment journey, you might be tempted to reach for Rugiet first because its combination of ingredients could increase the chances that it will help you. But that also increases the odds of adverse reactions. We often recommend men start out with a monotherapy approach before reaching for a combination.

Fortunately, there are a lot of excellent places to get these single therapies, and some of them offer convenience and portability comparable to Rugiet’s lozenges.

BlueChew

BlueChew happens to be one of the most comparable to Rugiet, not just in terms of cost or drug combination, but in terms of how it delivers medication. BlueChew originally only provided chewable tablets, but those tablets have had their formulas adjusted in recent months so that, at least in the case of its combined therapies like BlueChew Gold, they can dissolve under your tongue like a lozenge.

Given the higher cost of Rugiet’s combination of drugs, we recommend starting with BlueChew to see if it’s a better fit.

BlueChew has also expanded its offering in recent years to include vardenafil. Essentially, sildenafil and vardenafil have the same effect, but vardenafil is a little more selective in its targeting of PDE-5, whereas sildenafil has a greater impact on PDE-6.17 That impact leads to a visual disturbance in some men that prevents them from differentiating between blue and green colors. There are also some men who simply respond better to vardenafil in general, though there isn’t a sufficient clinical explanation for this difference.

For more information, check out our comprehensive BlueChew review.

Hims

Hims is a more expansive telehealth provider than either Rugiet or BlueChew. It has an entire section of its business dedicated to treating ED, but it also offers treatments for hair loss, premature ejaculation, mental health, and even skincare.

For most combination therapies, Hims has inferior prices to BlueChew, but its prices still beat out Rugiet’s if you’re open to trying monotherapies instead. It’s also a great place to go if you’re looking for a single platform that can handle multiple health-related issues.

We also recommend Hims to men interested in daily tadalafil. Rugiet Ready is not intended for daily use, but doctors often prescribe a once-daily regimen of a low tadalafil dose for men who are consistently sexually active enough to engage with daily medication. This is one place where you can take advantage of Hims’ overly complicated pricing structure.

Hims charges the same for daily tadalafil subscriptions (30 pills per month) whether you take it at the 2.5mg or 5mg level. And that cost is significantly less than the same pill prescribed for as-needed use. You stand to save even more when billing quarterly.

Hims is also one of the few telehealth providers of Stendra 100mg. Stendra is a fast-acting alternative to sildenafil that studies suggest has a slightly different side effect profile, causing less nasal congestion and headache but more myalgia.18 Stendra is a brand-name medication, so it isn’t cheap, but it is a lot less expensive than branded Viagra or Cialis.