Alex. He is thorough, professional, knowledgeable, helpful and friendly.
Where to Get Treatment for ED in NYC?
Sildenafil typically requires 30-60 minutes before sexual activity and lasts 4-6 hours. Tadalafil offers a longer duration of up to 36 hours but also takes time to reach peak effectiveness. Managing both medications means tracking different timing windows and potentially dealing with overlapping or conflicting dosing schedules. BlueChew MAX (sublingual): May begin working in as little as 15–30 minutes with effects lasting up to 36 hours Oral Sildenafil (Viagra): Typically takes 30-60 minutes to begin working with effects lasting 4-6 hours Oral Tadalafil (Cialis): Typically takes 30-60 minutes to begin working with effects lasting up to 36 hours Separate pills together: Limited by oral absorption requiring 30-60 minutes with variable duration The sublingual delivery of MAX may provide a meaningful advantage in spontaneous situations. According to clinical data on PDE5 inhibitors, oral tablets must pass through the digestive system before reaching the bloodstream—a process that high-fat meals can further delay for sildenafil specifically.
Duration of action
MAX's tadalafil component provides what many call the "weekend coverage" effect. Rather than planning intimacy around a narrow 4-6 hour window, the extended duration allows for natural spontaneity over a much longer period. This mirrors one of tadalafil's key advantages over sildenafil alone, but MAX adds the rapid-onset benefit that tadalafil tablets don't typically offer. The combination means there's no forced choice between "fast but short" (sildenafil) or "slow but long" (tadalafil)—MAX is designed to deliver both characteristics simultaneously. The rationale for combining sildenafil and tadalafil isn't simply about convenience—it's supported by clinical evidence suggesting combination therapy may outperform single-agent approaches, particularly for men who haven't achieved satisfactory results with one medication alone.
Muscular Dystrophy (Orphan)
A 2014 randomized controlled trial published in Andrologia examined 180 patients over 12 weeks, comparing daily tadalafil plus on-demand sildenafil (taken as separate medications) against tadalafil monotherapy. The results showed that the combination group experienced: Importantly, the study found no increase in side effects compared to single-medication therapy—addressing a common concern about combining PDE5 inhibitors. While this study used separate daily and as-needed pills rather than a single combination tablet, the positive findings support the therapeutic rationale for combination products like MAX. Research presented at a 2024 conference reported in the Journal of Sexual Medicine further reinforced these findings, specifically examining men who had not responded adequately to single PDE5 inhibitors. The combination approach produced significant improvements in erectile function and rigidity among these previous non-responders. I have seen him for ED and prostate issues, and he has explained all my options clearly, and found solutions that have been a great help. I highly recommend both Dr. Alex and his staff, which I find to be helpful, friendly, knowledgeable and very professional. They are a pleasure to deal with and all have been a great help. by Clarence Brown on Sep 14, 2017 I am very much thankful for meeting Dr Alex .I had a very serious medical problem I visited many doctors but none could not help me it was very difficult for me until I visited Dr Alex after a couple visits my medical problem is no more I feel very great also I felt almost 20 years younger Dr Alex is second to none fantastic doctor. Thanks again Dr Alex from my family. I am feeling better now after visiting clinic New York urology specialists. by George & Sally R on Jan 07, 2013 Dear Dr. Alex: We want to thank you for the excellent care you provided for George during his emergency operation and the follow up treatment. Your quiet, confident manner was reassuring to us during a very scary time for us. by Joyce T on Feb 16, 2012 Dr.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Black | 80mg | 360 + 20 Pills | 639.78€ 609.31€ | |
| Cialis Generic | 60mg | 60 + 4 Pills | 145.06€ 138.15€ | |
| Cialis Super Active | 20mg | 60 + 8 Pills | 230.32€ 219.35€ | |
| Cialis Professional | 20mg | 360 + 6 Pills | 807.03€ 768.60€ | |
| Cialis Generic | 20mg | 20 Pills | 54.72€ 52.11€ | |
| Cialis Soft Tabs | 20mg | 30 + 4 Pills | 87.43€ 83.27€ | |
| Cialis Generic | 2.5mg | 90 + 6 Pills | 112.43€ 107.08€ | |
| Cialis Soft Tabs | 20mg | 270 + 10 Pills | 471.40€ 448.95€ | |
| Cialis Original | 20mg | 34 + 2 Pills | 183.99€ 175.23€ | |
| Cialis Soft Tabs | 20mg | 90 + 6 Pills | 216.71€ 206.39€ | |
| Cialis Professional | 20mg | 30 Pills | 104.57€ 99.59€ | |
| Cialis Generic | 2.5mg | 270 + 10 Pills | 199.64€ 190.13€ | |
| Cialis Generic | 10mg | 360 + 10 Pills | 388.49€ 369.99€ | |
| Cialis Professional | 20mg | 270 + 6 Pills | 623.07€ 593.40€ | |
| Cialis Super Active | 20mg | 180 + 20 Pills | 521.59€ 496.75€ | |
| Cialis Professional | 40mg | 20 Pills | 110.24€ 104.99€ |
Alex Shteynshlyuger and Staff – Thank you so much for taking care of my husband Bob.
- Avoid high-fat meals before taking, as they can delay absorption.
- Sublingual route may reduce this food interaction slightly.
- Taking on an empty stomach may provide most consistent results.
Dr. Alex: I thank God everyday for you. At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction. We understand the challenges that ED creates for our patients, their relationships, and their self-esteem. We help you find a treatment for erectile dysfunction that fits your needs, lifestyle, and your preferences. Urologists are doctors specializing in the treatment of men with erectile dysfunction. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED. We offer medical and surgical treatment for erectile dysfunction. Erectile dysfunction in men with prostate cancer after radical prostatectomy Erectile dysfunction in men with Peyronie’s disease Erectile dysfunction in men for whom Viagra and Cialis do not work. Erection problems in men with low testosterone. This post is also available in: Spanish Russian Arabic Chinese (Simplified) Japanese Cialis Professional is a prescription medication for erectile dysfunction (ED) that contains the active ingredient tadalafil.
Designed for You: Discretion and Convenience with BlueChew
It is important to note that Cialis Professional is a generic medication, not the original brand Cialis by Eli Lilly. For information on the safety and efficacy of generic options, you can refer to our article on generic medicines. Form: Often a sublingual or orally disintegrating tablet. Key Claim: Designed for faster onset and potentially greater intensity of effect compared to standard oral tablets. Managing erectile dysfunction often means choosing between multiple medications with different timing requirements, onset windows, and duration profiles.
Dosing Modifications
For many men, the question becomes: should you coordinate separate sildenafil and tadalafil prescriptions, or could a single combination approach deliver better results? BlueChew MAX offers a compelling answer—combining both active ingredients in one sublingual tablet designed for rapid onset and extended duration. This comprehensive guide examines how MAX compares buy cialis lilly to the traditional approach of taking Viagra and Cialis separately, covering everything from clinical evidence to practical convenience factors. BlueChew MAX combines 45mg sildenafil and 18mg tadalafil in a single sublingual tablet, eliminating the need to manage two separate medications with different timing protocols Sublingual delivery may support a faster onset than traditional oral tablets, with some men noticing effects in as little as 15–30 minutes compared to the typical 30-60 minute wait time associated with traditional oral tablets Clinical research supports combination therapy: A 2014 study in Andrologia examined patients using daily tadalafil combined with as-needed sildenafil (taken as separate pills) and found that men using this combination approach experienced superior improvements in erection quality, confidence, and satisfaction compared to single-agent therapy—supporting the rationale for combination products like MAX The tadalafil component provides up to 36 hours of duration, offering extended flexibility without the timing pressure of shorter-acting medications alone Cost efficiency improves significantly: MAX starts at $5.63 per tablet versus the combined cost of separate brand-name prescriptions, which can exceed $95-180 per combined use Sublingual delivery may reduce some digestive delay, though a high-fat meal may still slow how quickly MAX works BlueChew MAX represents the most comprehensive single-dose ED solution in the BlueChew lineup, combining the rapid-acting properties of sildenafil with the extended duration of tadalafil in one sublingual tablet. This dual-action formulation delivers 45mg of sildenafil alongside 18mg of tadalafil—strategically dosed to provide both immediate readiness and lasting confidence.
Key Characteristics
The sublingual delivery method distinguishes MAX from traditional oral tablets. Rather than swallowing a pill and waiting for it to move through the digestive process, the tablet is placed under the tongue where the active ingredients can begin absorbing through the oral mucosa. This approach may enable faster onset compared to conventional pills. Combined active ingredients: Both sildenafil (the active ingredient in Viagra) and tadalafil (the active ingredient in Cialis) work together in a single dose Sublingual format: Designed for rapid absorption through tissues under the tongue Extended coverage: The tadalafil component may provide effects lasting up to 36 hours Single-dose simplicity: One tablet replaces the complexity of coordinating two separate medications For men who want to understand BlueChew products more broadly, MAX sits at the premium end of the product lineup—designed for those seeking maximum flexibility and comprehensive coverage from a single dose. The fundamental challenge with taking Viagra and Cialis separately lies in timing coordination. It is marketed as an enhanced or “professional” formulation of standard tadalafil, which is also found in the brand-name drug Cialis. Unlike the original film-coated tablets, Cialis Professional is often produced as a sublingual (under-the-tongue) or chewable tablet, which may allow for faster absorption into the bloodstream. The primary purpose of Cialis Professional is to treat erectile dysfunction. It belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors.
- Legal status varies by country; prescription required in most.
- Traveling with medication: keep in original labeled container.
- Declare medications when crossing international borders.
By inhibiting this enzyme, it helps relax the blood vessels in the penis, increasing blood flow to facilitate an erection when combined with sexual stimulation. It is important to note that Cialis Professional is a generic medication, not the original brand Cialis by Eli Lilly. For information on the safety and efficacy of generic options, you can refer to our article on generic medicines. Form: Often a sublingual or orally disintegrating tablet. Key Claim: Designed for faster onset and potentially greater intensity of effect compared to standard oral tablets.
Additional Benefits
Alex: I thank God everyday for you. At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction. We understand the challenges that ED creates for our patients, their relationships, and their self-esteem. We help you find a treatment for erectile dysfunction that fits your needs, lifestyle, and your preferences. Urologists are doctors specializing in the treatment of men with erectile dysfunction.
The Telehealth Advantage
By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED. We offer medical and surgical treatment for erectile dysfunction. Erectile dysfunction in men with prostate cancer after radical prostatectomy Erectile dysfunction in men with Peyronie’s disease Erectile dysfunction in men for whom Viagra and Cialis do not work. Erection problems in men with low testosterone. This post is also available in: Spanish Russian Arabic Chinese (Simplified) Japanese Cialis Professional is a prescription medication for erectile dysfunction (ED) that contains the active ingredient tadalafil.
Comparison with actions of other PDE5 inhibitors
It is marketed as an enhanced or “professional” formulation of standard tadalafil, which is also found in the brand-name drug Cialis. Unlike the original film-coated tablets, Cialis Professional is often produced as a sublingual (under-the-tongue) or chewable tablet, which may allow for faster absorption into the bloodstream. The primary purpose of Cialis Professional is to treat erectile dysfunction. It belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. By inhibiting this enzyme, it helps relax the blood vessels in the penis, increasing blood flow to facilitate an erection when combined with sexual stimulation. Managing erectile dysfunction often means choosing between multiple medications with different timing requirements, onset windows, and duration profiles. For many men, the question becomes: should you coordinate separate sildenafil and tadalafil prescriptions, or could a single combination approach deliver better results?
Side Effects
BlueChew MAX offers a compelling answer—combining both active ingredients in one sublingual tablet designed for rapid onset and extended duration.
Side Effects of Medications for Impotence
This comprehensive guide examines how MAX compares buy cialis lilly to the traditional approach of taking Viagra and Cialis separately, covering everything from clinical evidence to practical convenience factors. BlueChew MAX combines 45mg sildenafil and 18mg tadalafil in a single sublingual tablet, eliminating the need to manage two separate medications with different timing protocols Sublingual delivery may support a faster onset than traditional oral tablets, with some men noticing effects in as little as 15–30 minutes compared to the typical 30-60 minute wait time associated with traditional oral tablets Clinical research supports combination therapy: A 2014 study in Andrologia examined patients using daily tadalafil combined with as-needed sildenafil (taken as separate pills) and found that men using this combination approach experienced superior improvements in erection quality, confidence, and satisfaction compared to single-agent therapy—supporting the rationale for combination products like MAX The tadalafil component provides up to 36 hours of duration, offering extended flexibility without the timing pressure of shorter-acting medications alone Cost efficiency improves significantly: MAX starts at $5.63 per tablet versus the combined cost of separate brand-name prescriptions, which can exceed $95-180 per combined use Sublingual delivery may reduce some digestive delay, though a high-fat meal may still slow how quickly MAX works BlueChew MAX represents the most comprehensive single-dose ED solution in the BlueChew lineup, combining the rapid-acting properties of sildenafil with the extended duration of tadalafil in one sublingual tablet.
| Feature | Sublingual Cialis | Oral Cialis |
|---|---|---|
| Absorption site | Sublingual mucosa | Gastrointestinal tract |
| Time to peak plasma levels | 15-30 minutes | 2 hours |
| Convenience | Very high | Moderate |
| Duration of Action | Up to 36 hours | Up to 36 hours |
This dual-action formulation delivers 45mg of sildenafil alongside 18mg of tadalafil—strategically dosed to provide both immediate readiness and lasting confidence. The sublingual delivery method distinguishes MAX from traditional oral tablets. Rather than swallowing a pill and waiting for it to move through the digestive process, the tablet is placed under the tongue where the active ingredients can begin absorbing through the oral mucosa. This approach may enable faster onset compared to conventional pills. Combined active ingredients: Both sildenafil (the active ingredient in Viagra) and tadalafil (the active ingredient in Cialis) work together in a single dose Sublingual format: Designed for rapid absorption through tissues under the tongue Extended coverage: The tadalafil component may provide effects lasting up to 36 hours Single-dose simplicity: One tablet replaces the complexity of coordinating two separate medications For men who want to understand BlueChew products more broadly, MAX sits at the premium end of the product lineup—designed for those seeking maximum flexibility and comprehensive coverage from a single dose. The fundamental challenge with taking Viagra and Cialis separately lies in timing coordination. Sildenafil typically requires 30-60 minutes before sexual activity and lasts 4-6 hours. Tadalafil offers a longer duration of up to 36 hours but also takes time to reach peak effectiveness. Managing both medications means tracking different timing windows and potentially dealing with overlapping or conflicting dosing schedules. BlueChew MAX (sublingual): May begin working in as little as 15–30 minutes with effects lasting up to 36 hours Oral Sildenafil (Viagra): Typically takes 30-60 minutes to begin working with effects lasting 4-6 hours Oral Tadalafil (Cialis): Typically takes 30-60 minutes to begin working with effects lasting up to 36 hours Separate pills together: Limited by oral absorption requiring 30-60 minutes with variable duration The sublingual delivery of MAX may provide a meaningful advantage in spontaneous situations. According to clinical data on PDE5 inhibitors, oral tablets must pass through the digestive system before reaching the bloodstream—a process that high-fat meals can further delay for sildenafil specifically. MAX's tadalafil component provides what many call the "weekend coverage" effect. Rather than planning intimacy around a narrow 4-6 hour window, the extended duration allows for natural spontaneity over a much longer period. This mirrors one of tadalafil's key advantages over sildenafil alone, but MAX adds the rapid-onset benefit that tadalafil tablets don't typically offer. The combination means there's no forced choice between "fast but short" (sildenafil) or "slow but long" (tadalafil)—MAX is designed to deliver both characteristics simultaneously. The rationale for combining sildenafil and tadalafil isn't simply about convenience—it's supported by clinical evidence suggesting combination therapy may outperform single-agent approaches, particularly for men who haven't achieved satisfactory results with one medication alone. A 2014 randomized controlled trial published in Andrologia examined 180 patients over 12 weeks, comparing daily tadalafil plus on-demand sildenafil (taken as separate medications) against tadalafil monotherapy. The results showed that the combination group experienced: Importantly, the study found no increase in side effects compared to single-medication therapy—addressing a common concern about combining PDE5 inhibitors.
Effectiveness of Medications for ED
Both sildenafil and tadalafil belong to the PDE5 inhibitor class, working by blocking the phosphodiesterase-5 enzyme and helping preserve cyclic GMP levels. This enhances the natural nitric oxide signaling involved in relaxing blood vessels and improving blood flow necessary for erections. While both medications share this mechanism, they have different pharmacokinetic profiles: Sildenafil: Faster onset, shorter duration, more affected by food Tadalafil: Longer half-life, extended duration, less food interaction A 2021 meta-analysis in PMC found that certain combination approaches for ED were associated with improved outcomes without a clear increase in adverse events, though the evidence was not limited to sildenafil-tadalafil combination therapy alone. While this study used separate daily and as-needed pills rather than a single combination tablet, the positive findings support the therapeutic rationale for combination products like MAX. Research presented at a 2024 conference reported in the Journal of Sexual Medicine further reinforced these findings, specifically examining men who had not responded adequately to single PDE5 inhibitors. The combination approach produced significant improvements in erectile function and rigidity among these previous non-responders. Both sildenafil and tadalafil belong to the PDE5 inhibitor class, working by blocking the phosphodiesterase-5 enzyme and helping preserve cyclic GMP levels.
Why Choose a Combination: The Science Behind BlueChew MAX's Effectiveness
Alex. He is thorough, professional, knowledgeable, helpful and friendly. I have seen him for ED and prostate issues, and he has explained all my options clearly, and found solutions that have been a great help. I highly recommend both Dr. Alex and his staff, which I find to be helpful, friendly, knowledgeable and very professional.
How quickly does BlueChew MAX work compared to standard Viagra or Cialis?
They are a pleasure to deal with and all have been a great help. by Clarence Brown on Sep 14, 2017 I am very much thankful for meeting Dr Alex .I had a very serious medical problem I visited many doctors but none could not help me it was very difficult for me until I visited Dr Alex after a couple visits my medical problem is no more I feel very great also I felt almost 20 years younger Dr Alex is second to none fantastic doctor. Thanks again Dr Alex from my family. I am feeling better now after visiting clinic New York urology specialists. by George & Sally R on Jan 07, 2013 Dear Dr.
Mechanism of Action
Alex: We want to thank you for the excellent care you provided for George during his emergency operation and the follow up treatment. Your quiet, confident manner was reassuring to us during a very scary time for us. by Joyce T on Feb 16, 2012 Dr. Alex Shteynshlyuger and Staff – Thank you so much for taking care of my husband Bob. Dr. This enhances the natural nitric oxide signaling involved in relaxing blood vessels and improving blood flow necessary for erections. While both medications share this mechanism, they have different pharmacokinetic profiles: Sildenafil: Faster onset, shorter duration, more affected by food Tadalafil: Longer half-life, extended duration, less food interaction A 2021 meta-analysis in PMC found that certain combination approaches for ED were associated with improved outcomes without a clear increase in adverse events, though the evidence was not limited to sildenafil-tadalafil combination therapy alone.
- Cialis sublingual is available by prescription in many countries.
- Store the medication in a cool, dry place away from children.
- Avoid alcohol consumption when taking Cialis sublingual for safety.
- Combining Cialis with nitrates can cause dangerous blood pressure drops.
- It offers an alternative for those who have difficulty swallowing pills.