Keeps Review: 3-in-1 ED Med with Apomorphine - What to Know Before Buying

Keeps (keeps.com) is a men's telehealth platform offering prescription ED medications through an online consultation model. Its ED lineup includes four products: Powerhouse, a sublingual troche combining tadalafil, vardenafil, and apomorphine; Quicky, a sildenafil-based formulation; Weekend, a tadalafil-only option; and Combo, a sildenafil + tadalafil combination. Keeps markets itself around the idea that different men need different formulations and positions Powerhouse as a multi-mechanism product that targets both blood flow and the brain's arousal signal.

Keeps advertises pricing starting at $1/day, though actual cost varies by product and plan. All four products are compounded formulations and are not FDA-approved as finished drug products. The individual active ingredients, sildenafil, tadalafil, vardenafil, and apomorphine, are each FDA-approved when prescribed individually for their respective indications.

This article reviews Keeps' ED products, how they work, what they contain, their cost, and their pros and cons.

This article is for informational purposes only and should not be taken as medical advice. If you have questions or concerns about your condition or treatment, please consult a healthcare provider.

What Is Keeps?

What it is: Keeps is a US-based telehealth platform connecting men with clinicians who specialize in men's health. After completing an online health questionnaire, a clinician reviews your information and, if appropriate, issues a prescription that is filled and shipped directly to you. Keeps offers auto-refills, cancel anytime, and 24/7 care access. The company reports serving over 2,000,000 men and offers a 60-day money-back guarantee if you do not see results.

What it offers for ED: Four compounded ED formulations: Powerhouse (tadalafil + vardenafil + apomorphine, sublingual), Quicky (sildenafil), Weekend (tadalafil), and Combo (sildenafil + tadalafil).

How much it costs: Keeps advertises pricing starting at $1/day. Because this is a per-day figure applied to subscription plans, actual per-dose cost and monthly spend will vary depending on which product you select and how frequently you use it. Full pricing details are presented during the online consultation process.

Pros: Four distinct formulations for different use cases; Powerhouse includes apomorphine for arousal support alongside blood flow; sublingual option available; 60-day money-back guarantee; auto-refill with no long-term commitment; clinicians who specialize in men's health.

Cons: All products are compounded and not FDA-approved as finished drugs; "starting at $1/day" pricing is vague and total monthly cost depends on product and plan; no standard FDA-approved pill option.

Good for: Men who want a formulation tailored to their specific ED profile, particularly those who want to address arousal and desire alongside physical blood flow.

Not ideal for: Men who want only FDA-approved finished drug products; those who prefer a transparent flat-rate pricing model.

Keeps' ED Products

Powerhouse

Powerhouse is Keeps' flagship product and the most complex of its four formulations. It combines tadalafil, vardenafil, and apomorphine in a single sublingual troche.

Active ingredients: Tadalafil + Vardenafil + Apomorphine

How it works: Tadalafil and vardenafil are both PDE5 inhibitors that address blood flow to the penis during sexual stimulation. Tadalafil provides extended duration up to 36 hours; vardenafil adds a second angle of PDE5 inhibition with high enzyme selectivity. Apomorphine is a dopamine agonist that works through the central nervous system to support the brain's arousal signal, addressing the desire component of sexual function that blood-flow medications do not directly target.

Format: Sublingual troche; dissolves under the tongue

What it does: Apomorphine restarts the arousal signal in the brain. Tadalafil and vardenafil handle blood flow from two angles.

Best for:

• Men who feel they don't have the drive
• Men who want desire and performance working together

Keeps' positioning: Keeps describes Powerhouse as "the only ED treatment that targets desire, not just erection and blood flow like others."

Quicky

Quicky is Keeps' sildenafil-based formulation, positioned as the entry point for men who have never tried ED medication or who want the fastest-onset single-ingredient option.

Active ingredient: Sildenafil (the active ingredient in Viagra®)

How it works: Sildenafil is a PDE5 inhibitor that increases blood flow to the penis during sexual stimulation. It is the most widely prescribed ED compound and has over 25 years of clinical data.

What it does: Opens blood flow to the penis. Hard in approximately 15 minutes. Lasts 4 to 6 hours.

Best for:

• Men who have never tried ED medication before
• Men who get partially erect but lose it during activity

Weekend

Weekend is Keeps' tadalafil-based formulation, available as an as-needed dose or as a daily low-dose for continuous readiness.

Active ingredient: Tadalafil (the active ingredient in Cialis®)

How it works: Tadalafil is a PDE5 inhibitor with a significantly longer half-life than sildenafil. A single as-needed dose stays active for up to 36 hours. Daily low-dose use maintains a steady concentration in the bloodstream so timing around sexual activity is not required.

What it does: One dose active up to 36 hours. Also available as a daily low-dose for always-on readiness.

Best for:

• Men who don't want to plan sex around a pill
• Men who want steady, continuous coverage

Combo

Combo is Keeps' two-ingredient formulation combining sildenafil and tadalafil in a single dose.

Active ingredients: Sildenafil + Tadalafil

How it works: Sildenafil provides faster onset. Tadalafil provides extended duration. The combination addresses the gap that single-ingredient formulations leave for men who need both speed and staying power.

What it does: Sildenafil gets you hard fast. Tadalafil keeps you covered for hours. Clinician-balanced dosing.

Best for:

• Men for whom one compound alone was not enough
• Men who need both fast onset and lasting duration

Keeps' positioning: Keeps notes that single compounds work for 60 to 70% of men. The Combo is designed for those who fall outside that range.

How Do Keeps' ED Products Work?

All four of Keeps' products use one or more PDE5 inhibitors as the primary mechanism. PDE5 inhibitors work by blocking phosphodiesterase type 5, the enzyme that normally breaks down cyclic GMP (cGMP) in penile blood vessels. When PDE5 is blocked, cGMP accumulates, smooth muscle relaxes, and blood flows into the penis during sexual stimulation. PDE5 inhibitors do not cause erections without arousal. They enhance the body's natural response.

Powerhouse adds apomorphine, a dopamine agonist that acts through the brain's dopaminergic pathways. Rather than working on blood vessels, apomorphine supports the neurological component of sexual desire and arousal. Keeps positions this as addressing the arousal signal itself rather than only the physical mechanics of erection.

Side Effects

Common side effects of PDE5 inhibitors (sildenafil, tadalafil, vardenafil):

• Headache
• Flushing
• Nasal congestion
• Dizziness
• Upset stomach or indigestion
• Muscle or back pain
• Temporary vision changes

Apomorphine (Powerhouse only):

• Nausea (most common)
• Dizziness
• Low blood pressure
• Yawning

Rare but serious side effects:

• Sudden hearing or vision loss
• Severely low blood pressure
• Priapism (an erection lasting more than four hours) requires immediate medical attention

PDE5 inhibitors should not be taken with nitrate medications, other ED drugs, or certain blood pressure medications. Men with cardiovascular conditions should discuss their full medical history with a provider before starting any ED medication.

How to Get a Keeps Prescription

The process is fully online. You answer an intake questionnaire about your health, a clinician who specializes in men's health reviews your information, and if appropriate, a prescription is issued and shipped to you. Keeps offers auto-refills with the option to cancel at any time. 24/7 care access is available for ongoing questions.

How Much Does Keeps Cost?

Keeps advertises pricing starting at $1/day. Because products vary in how frequently they are taken (as-needed vs. daily) and because plans are structured as monthly subscriptions, the actual per-dose cost and total monthly spend will differ meaningfully by product and usage frequency. Actual pricing is presented during the online consultation flow on keeps.com.

For context, sildenafil-only formulations from telehealth providers typically start in the range of a few dollars per dose. Multi-ingredient compounded products like Powerhouse typically run higher. Keeps' $1/day starting figure likely reflects the most basic daily tadalafil option rather than multi-ingredient products.

Keeps Reviews and Company Reputation

Keeps has served over 2 million men and has received editorial coverage from Forbes, GQ, Business Insider, and NBC. The company offers a 60-day money-back guarantee, which is less common among telehealth ED providers. Customer feedback frequently references the Powerhouse formulation and the concept of targeting arousal alongside blood flow.

Who Is Keeps For?

Keeps may be worth considering for men who:

• Have tried sildenafil or tadalafil alone and found results inconsistent
• Are specifically looking for an ED treatment that also addresses low desire or arousal
• Want a sublingual dissolve-under-the-tongue format (Powerhouse)
• Want a range of formulations to match their specific ED pattern

Who May Not Want to Choose Keeps?

• Men who want only FDA-approved finished drug products
• Men who prefer fully transparent, published per-dose pricing before starting the consultation
• Men new to ED treatment who want to start with a simple, low-dose single-ingredient option at the lowest possible cost

Is Keeps FDA-Approved?

Keeps' ED products are compounded medications. They are not FDA-approved as finished drug products. The individual active ingredients, sildenafil, tadalafil, vardenafil, and apomorphine, are each FDA-approved when prescribed individually for their respective indications. The FDA does not independently evaluate compounded formulations for safety, efficacy, or quality.

Keeps Pros and Cons

Pros

• Four distinct formulations matched to different ED profiles and needs
• Powerhouse targets arousal and blood flow through apomorphine alongside two PDE5 inhibitors
• Sublingual troche available (Powerhouse) for faster absorption than swallowed tablets
• 60-day money-back guarantee if results are not seen
• Auto-refill, cancel anytime with no long-term commitment

Cons

• All products are compounded and not FDA-approved as finished drug products
• Pricing is opaque upfront. "Starting at $1/day" is a broad range; actual monthly cost varies significantly by product
• No standard FDA-approved pill option for men who specifically want a non-compounded formulation

Keeps vs. Rugiet Ready for ED

For men comparing Keeps' Powerhouse to other sublingual combination treatments, Rugiet Ready is worth considering alongside it.

Both Powerhouse and Rugiet Ready are sublingual troches that combine PDE5 inhibitors with apomorphine to address both blood flow and the brain's arousal pathway. The key differences:

• Ingredients: Powerhouse uses tadalafil + vardenafil + apomorphine. Rugiet Ready uses sildenafil + tadalafil + apomorphine.
• Dose tiers: Rugiet Ready is available in four strength tiers (low, medium, high, and max), allowing men to start conservatively and adjust upward. Keeps does not publish a tiered dosing structure for Powerhouse.
• Pricing transparency: Rugiet Ready pricing is published by plan. Keeps' $1/day starting figure requires completing the consultation to determine what Powerhouse actually costs.
• Platform scope: Keeps offers four distinct ED formulations. Rugiet also covers ED, PE, and TRT.

Both are compounded sublingual products with apomorphine. The right choice depends on which PDE5 inhibitors your prescribing physician determines are appropriate for you and whether dose flexibility is a priority.

Bottom Line

Keeps offers a well-differentiated ED lineup with four formulations matched to different use cases. A few things worth knowing before you start:

• Powerhouse is the most distinctive product in the lineup. Combining tadalafil, vardenafil, and apomorphine in a sublingual troche sets it apart from most telehealth ED options.
• "Starting at $1/day" is a vague pricing anchor. Get the full picture on what your specific product will cost before committing.
• All products are compounded. If you want only FDA-approved finished drug products, Keeps does not currently offer those.
• The 60-day money-back guarantee reduces some of the risk of trying a new formulation.

If you are interested in a sublingual troche combining sildenafil, tadalafil, and apomorphine with four dose tiers and published pricing, Rugiet Ready is worth considering. Start your free online visit at rugiet.com.