Always review the safety information before you take this medication. PEAK Fusion is a compounded sublingual liquid containing three active ingredients — sildenafil, tadalafil, and apomorphine. Take PEAK Fusion only as prescribed by your healthcare provider.
01 STOP! You Cannot Take This Medication If
- You take medications containing nitrates, use "poppers" (amyl nitrate or butyl nitrate), or take a class of medications called guanylate cyclase stimulators (Riociguat, Adempas).
- You are allergic to any of the active ingredients in PEAK Fusion (sildenafil, tadalafil, or apomorphine).
- You are a woman or a child.
02 STOP Taking This Medication and Seek Immediate Medical Attention If
- You have had an erection that is painful or lasts more than 4 hours.
- You have a sudden loss of vision in both or either eye, as this can be a sign of an eyesight-losing condition known as non-arteritic anterior ischemic optic neuropathy (NAION).
- You have sudden loss of hearing, ringing in your ears, or dizziness.
- You develop a change in the ability to distinguish the colors blue and green, or develop an inability to see color.
- You feel faint, lightheaded, or lose consciousness when standing up (severe orthostatic symptoms).
- You develop an allergic reaction. Symptoms may include but are not limited to: swelling of the mouth, lips, tongue, or throat; difficulty swallowing; chest pain; shortness of breath; rash; or hives.
03 You NEED to Tell Your Doctor BEFORE Taking This Medication If
- You are allergic to sildenafil, tadalafil, apomorphine, or any part of this drug.
- You have pulmonary veno-occlusive disease (PVOD).
- You have retinitis pigmentosa.
- You have sickle cell disease.
- You use "poppers" that contain nitrites.
- You are taking any of these drugs: Cobicistat, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, riociguat, ritonavir, vericiguat, itraconazole, or ketoconazole.
- You are taking another drug that contains sildenafil, tadalafil, or apomorphine.
- You are taking another drug for erectile dysfunction.
- You are taking a 5-HT3 receptor antagonist (such as ondansetron, granisetron, palonosetron, or dolasetron). These are contraindicated with apomorphine.
- You take medications for Parkinson's disease or other dopamine-related conditions.
- You have been told that you are not healthy enough to have sex, or you have had a heart attack in the last 90 days, chest pain during sex, heart failure, abnormal heartbeat, blood pressure problems, or a stroke in the last 6 months.
- You are prone to low blood pressure or lightheadedness when standing.
- You are of female gender or a child.
- You have a history of a misshapen penis (Peyronie's disease).
- You have ever had an erection that was painful or lasted more than 4 hours.
- You have a history of any of the following medical problems: gastrointestinal ulcers, liver conditions, kidney problems or dialysis, bleeding, anemia, blood cancers such as leukemia or myeloma, vision loss, or NAION.
04 Tell Your Healthcare Provider If You Are Taking Any of These Drugs
Any medications, prescription and over-the-counter, including any supplements, vitamins, or herbals. It is especially important to let your provider know if you are taking any of the following:
- Nitrates.
- Guanylate cyclase stimulators (examples: Riociguat, Adempas).
- Alpha blockers (examples: Hytrin/terazosin, Flomax/tamsulosin, Cardura/doxazosin mesylate, Minipress/prazosin, Uroxatral/alfuzosin, Jalyn/dutasteride and tamsulosin, Rapaflo/silodosin).
- Protease inhibitors used for HIV treatment (examples: Norvir/ritonavir, Crixivan/indinavir sulfate, Fortovase or Invirase/saquinavir, Reyataz/atazanavir sulfate).
- Antifungals (examples: Nizoral/ketoconazole, Sporanox/itraconazole).
- Antibiotics or antibacterials.
- 5-HT3 receptor antagonists (examples: ondansetron/Zofran, granisetron, palonosetron, dolasetron) — contraindicated with apomorphine.
- Dopamine antagonists (some antipsychotics and antiemetics), which may interfere with apomorphine's mechanism.
- Any medications to treat blood pressure, erectile dysfunction, or pulmonary artery hypertension (such as Adcirca or Revatio, which contain the same main ingredients found in PEAK Fusion).
05 Other Things You Should Know About This Medication
- Talk with your doctor before you drink alcohol while on this medication. Alcohol can amplify low blood pressure and dizziness.
- This drug does not protect you against sexually transmitted diseases (including HIV) or pregnancy.
- This medicine is not a cure for erectile dysfunction and does not have an effect on libido.
- Rise slowly from sitting or lying positions during your first doses — apomorphine can cause lightheadedness when standing.
06 Possible Side Effects When Taking This Medication
- Rash, hives, itching; red, swollen, blistered, or peeling skin; flushing.
- Pressure or pain in the chest, chest tightness, wheezing, trouble breathing.
- Fast or abnormal heartbeat.
- Low blood pressure, lightheadedness or faintness on standing (orthostatic hypotension).
- Headache, dizziness, imbalance, or passing out.
- Nausea, vomiting, reflux, upset stomach.
- Yawning or drowsiness.
- Stroke-like symptoms such as weakness, trouble speaking or thinking, face drooping.
- Change or loss of eyesight or blurriness.
- Throat, mouth, face, lips, or tongue swelling; hoarseness; difficulty swallowing; nasal congestion.
- Ringing in the ears, hearing loss, changes in hearing.
- Swelling of extremities.
- Muscle aches or pains, back pain.
- Fever.
- Bleeding, bruising.
- Painful erection or an erection that lasts longer than 4 hours.
Not an Exhaustive List
There are other potential side effects of this medication, and this is not an all-inclusive list. For additional information, you can ask your pharmacist or healthcare provider.
Call 911 for any medical emergencies. For any side effects, you can contact the pharmacy and/or the FDA at 1-800-FDA-1088.