Pick a point in your day you will not have to think about, and keep it there. As directed by your clinician.
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What it is
A simple, daily plan that pairs low-dose tadalafil with NMN—a precursor that raises NAD⁺ in humans—to support cellular and vascular health alongside everyday sexual readiness.
Who it’s for
U.S.-Licensed Providers
503A Pharmacy Approved
HIPAA Compliant
Free Discreet Shipping
From $99.9/mo
As low as with 6-month plan
4.9
from 2,400+ patients
LegitScript-certified
Licensed in all 50 states
Progesterone is often considered when sleep and cycle-related symptoms are part of the picture. A provider reviews your history to determine whether it may be appropriate for you.
Tadalafil 5 mg supports steady readiness without timing pressure.
NMN helps raise NAD⁺ levels in human trials; NAD⁺ relates to endothelial and metabolic health.
We’ll adjust your plan based on your goals and response.
Sildenafil is for the man who wants a focused, same-night answer instead of a longer, looser runway.
5mg
Daily PDE5 support for spontaneity.
50mg
Adjunct to support NAD+ biology.
Compounded to this ratio. One dose contains both.
Tadalafil does the erectile work. NMN is an adjunct to your daily dose, not a second ED medication.
Tadalafil
Maintains background PDE5 inhibition to enhance erectile response with stimulation.
NMN
Nicotinamide mononucleotide helps increase NAD+.
NAD+
A cofactor central to cellular energy and endothelial function.
Tadalafil is the treatment. NMN is the adjunct.
PDE5 inhibition with a well-understood mechanism.
An adjunct layered onto your daily tadalafil.
ED-specific RCTs for NMN are not established. Human trials consistently show NAD+ increases and good short-term tolerability.
Never combine
Do not use with nitrates or riociguat
Tell your clinician
Tell your clinician about alpha-blockers, strong CYP3A inhibitors, and any significant heart/liver/kidney issues.
Get care immediately
Seek care for chest pain, fainting, sudden vision/hearing loss, or erection > 4 hours
Compounded prescription; not an FDA-approved finished drug.
A steady baseline
Rather than “on-demand” timing.
Check-ins with your care team
For dose refinements.
Fast, discreet monthly delivery
A clinician reviews your history and sets the plan before anything ships.
Individual results vary. Patients commonly report changes in energy, mood, focus, libido, strength and overall quality of life across the first several weeks and months of treatment.
AV Rejuvenate is a daily protocol, not an as-needed dose.
1×
every day
Pick a point in your day you will not have to think about, and keep it there. As directed by your clinician.
Do not add other ED medicines unless your clinician instructs you to.
Your clinician will fine-tune the plan based on response.
Straight answers on how Ascend Vitality works, what’s included, and what to expect after checkout.
Ascend Vitality is a telehealth company that provides personalized medical care directly to your door. Our licensed providers work with you to help you reach your health and body goals, offering tailored treatments and ongoing support.
Your path to treatment at Ascend Vitality begins with a simple online process. First, you’ll complete our comprehensive intake form where you’ll share information about your symptoms, medical history, and current health status. This information helps us understand your needs and ensures safe, appropriate care.
After submitting your intake form, a licensed healthcare provider will carefully review your information and develop a personalized treatment plan. Depending on your state’s requirements, your care will proceed in one of two ways:
For residents in states requiring face-to-face consultation, you’ll be prompted to schedule a video or audio visit with your provider. You’ll see available appointment times and can choose one that best fits your schedule. During this consultation, you’ll discuss your symptoms and treatment options directly with your provider.
For residents in states without video or audio visit requirements, your provider will review your information and send a detailed treatment recommendation directly to your secure message inbox through the Ascend Vitality platform. You can then review their recommendations and ask any questions you may have.
Ascend Vitality works partner pharmacies and a private doctor network to write prescriptions and fulfill orders. You can find more information about our partner pharmacies by scrolling to our footer and visiting the ‘Partner Pharmacies’ link under the Contact section.
Not at all! Ascend Vitality doesn’t require insurance. We offer transparent pricing on treatments and your medical visit, ongoing shipments, and provider messaging are all included in one low price.
Ascend Vitality is available in all U.S. states and Washington, D.C., excluding Louisiana, Mississippi, Kansas, New Mexico, and West Virginia.