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You can usually tell if a topical product has oxidized if it turns a dark orange or brown color

Consistently, a different RCT including 59 patients with mildmoderate ED of mixed etiology demonstrated that a daily treatment with 3 g l-ARG plus 50 mg of the PDE5i sildenafil, administered for 8 weeks, induced a more significant improvement in IIEF-5, compared to sildenafil as single compound [17]

Dosage form Capsules Directions Adults: Take 1 x 1 capsule daily with liquid

They don't compete for the same receptors or pathways, so there's no downside to combining them

Vitamin D injections can also complement the protocol, though theyre administered separately

In a large placebo-controlled trial, sildenafil was linked with better erection firmness and higher intercourse success versus placebo