Telehealth Companies Face Scrutiny Over Combination Erectile Dysfunction and Hair Loss Pills

Telehealth companies such as Hims & Hers, Ro, and BlueChew are increasingly offering compounded medications that combine treatments for erectile dysfunction (ED) and hair loss, a practice that is drawing criticism from medical professionals who question the safety and efficacy of these “Franken-Pills.” These medications, which frequently enough include multiple drugs and supplements in a single pill, have not been rigorously studied or approved by the Food and Drug Management (FDA), raising concerns about potential health risks for consumers.

Concerns Over Safety and Efficacy

These telehealth platforms are differentiating themselves by offering customized versions of FDA-approved medications. This practice, known as compounding, is particularly prevalent in the realm of ED and hair loss treatments. These companies combine multiple drugs into one pill, add supplements, and sometimes even flavor the medications to taste like candy. This allows them to sell unique, branded pills that are more profitable and better for customer retention than simply dispensing generic drugs readily available at any pharmacy.

Though, these combination pills, such as Hims’ “5-in-1” pill that mixes hair loss and ED medications with B vitamins and L-theanine, have not undergone official safety or efficacy studies and lack FDA review or approval. In some instances,these combinations even pair medications that FDA labeling specifically advises against taking together. This has made some doctors uneasy.

Did You Know? The global erectile dysfunction drugs market is projected to reach $5.7 billion by 2030, growing at a CAGR of 5.3% from 2023, according to a report by Allied Market Research.

In a traditional healthcare setting, a patient with ED might receive a prescription for generic cialis or Viagra from a manufacturer like Teva Pharmaceuticals. However, on telehealth platforms, it is becoming increasingly common for patients to be enticed by combinations of the two ED treatments.

Hims, Ro, BlueChew, and others offer products that combine sildenafil (the active ingredient in Viagra) and tadalafil (the active ingredient in Cialis). Taking full doses of both sildenafil and tadalafil is generally not recommended, as indicated in informational blogs by Hims and Ro. The FDA labeling for both drugs explicitly states that combining them with other ED treatments has not been studied and is not advised.

Dr. Jessica Yih, a urology professor at the University of California, Irvine, notes that doctors outside of direct-to-consumer platforms typically would not prescribe such combinations due to the increased risk of negative side effects. while some patients may have prescriptions for both generic Viagra and Cialis, they are usually prescribed as separate pills at lower dosages rather than a combined version.

“There’s also risk of overprescribing without assessing for contraindications or potential side effects, especially in patients with complex medical histories,” Yih said.

The Combination Conundrum: Hair Loss and ED Treatments

Some urologists find the combination of hair loss and ED treatments particularly puzzling.Hims has offered this combination since August of last year, and some smaller providers have followed suit.

“These pills do very different things,” said Alan Shindel, a urologist at the University of California, San Francisco. “I understand the marketing of it, but it doesn’t make a lot of sense medically.”

Pro Tip: Always consult with a healthcare professional before starting any new medication, especially compounded drugs, to ensure they are safe and appropriate for your individual health needs.

While it is unclear how often these companies prescribe these combination pills,a source familiar with Hims’ prescribing practices told