Medication safety, made easier to understand.

What these treatments are

Sildenafil and tadalafil are PDE5 inhibitors — the same active ingredients in Viagra and Cialis. They improve blood flow so the body can respond to sexual stimulation. They do not create desire and do not work without arousal.

Maro Reserve is a compounded dual-active formula that combines sildenafil 90 mg and tadalafil 5 mg in one pill. It is prepared by a US-licensed pharmacy when prescribed.

How to take them

Sildenafil

One tablet, taken about 30 to 60 minutes before sex. No more than once per day. Works best on an empty stomach — heavy or fatty meals can delay onset.

Tadalafil

Taken as needed before sex, or as a lower daily dose if your clinician recommends it. Food affects tadalafil less than sildenafil. Onset is around 30 minutes, with effects extending up to 36 hours.

Maro Reserve

One tablet taken before sex, as directed by your prescribing clinician. Not intended for daily use. Combines a faster onset with a longer window than sildenafil alone.

Who should not take these medications

• You take any nitrate medication, including nitroglycerin for chest pain or recreational poppers — the combination can cause a dangerous drop in blood pressure.
• You take guanylate cyclase stimulators such as riociguat (Adempas).
• A clinician has told you that sex is unsafe for your heart.
• You have had a recent heart attack, stroke, life-threatening arrhythmia, or unstable angina.
• You have severe liver impairment, severe low or uncontrolled high blood pressure, or known hereditary degenerative retinal disorders.

Tell your clinician about all medications you take, including alpha-blockers, certain antifungals, HIV protease inhibitors, and other heart or blood pressure medications. These can interact with PDE5 inhibitors.

Common side effects

Most men tolerate PDE5 inhibitors well. The most commonly reported effects are:

• Headache
• Facial flushing
• Nasal congestion
• Indigestion or stomach upset
• Back or muscle aches (more common with tadalafil and Reserve)
• Mild visual changes (rare)

Side effects are usually short-lived and dose-related. They often improve with continued use or with a dose adjustment.

When to seek immediate medical attention

Stop the medication and get medical help right away if you experience:

• Chest pain or symptoms of a heart attack during or after sex.
• An erection lasting more than 4 hours (priapism). Untreated, this can permanently damage erectile function.
• Sudden vision loss in one or both eyes, or sudden hearing loss.
• Signs of a serious allergic reaction, including swelling, trouble breathing, or rash.

Compounded medication notice

Maro Reserve is a compounded medication prepared by a US-licensed pharmacy. The individual active ingredients (sildenafil and tadalafil) are FDA-approved. The combination as a finished product is not separately FDA-evaluated for safety, efficacy, or quality. Compounded medications are intended for patients whose clinical needs cannot be met by an FDA-approved product alone.

Have questions

If you experience side effects, have questions about your prescription, or notice anything that feels wrong, message your Maro clinician through the patient portal anytime. For medical emergencies, call 911.

What these treatments are

Maro Density Pill and Density Pill+ are daily oral formulas that combine multiple hair-loss actives in one pill, prepared by a US-licensed compounding pharmacy.

Density Pill (3-in-1)

Finasteride 1.1 mg, minoxidil 5.0 mg, biotin 1.0 mg.

Density Pill+ (4-in-1)

Finasteride 1.1 mg, minoxidil 5.0 mg, biotin 1.0 mg, dutasteride 0.1 mg.

Finasteride and dutasteride lower DHT, the hormone that drives male pattern hair loss. Minoxidil supports the growth phase of the hair cycle. Biotin is included as a supportive nutrient. Dutasteride provides stronger DHT suppression than finasteride alone.

How to take them

One tablet daily, with or without food. Consistency matters more than timing. Most men take it at the same point in their morning or evening routine.

This is a long-term treatment. Visible changes typically appear over months 3 to 6, with continued improvement up to and beyond month 12. Stopping treatment will gradually reverse the gains.

Who should not take these medications

You should not take these medications if:

• You are female, pregnant, breastfeeding, or could become pregnant.
• You have a history of hypersensitivity to finasteride, dutasteride, or minoxidil.
• You have certain heart, kidney, or liver conditions your clinician identifies as a contraindication.
• You have low blood pressure or take blood pressure medications that could interact with oral minoxidil.

Tell your clinician about your full medical history, all medications and supplements you take, and any plans to donate blood (men taking finasteride or dutasteride should not donate blood during treatment or for a period after stopping).

Common side effects

Most men tolerate the formula well. Possible side effects include:

• Temporary shedding in the first weeks. Often a sign that the hair cycle is shifting, not a sign the medication is failing.
• Sexual side effects from finasteride or dutasteride — reduced libido, erectile changes, or ejaculation changes. Reported in a small percentage of men. Most resolve with discontinuation; rare cases of persistent symptoms have been reported.
• Lightheadedness, swelling, or fluid retention from oral minoxidil. Usually mild but can be more pronounced in some men.
• Body or facial hair changes from minoxidil — increased growth in unintended areas is possible.
• Mood changes have been reported in postmarketing data for finasteride. Tell your clinician if you notice depression, anxiety, or changes in mood.
• Breast tenderness or enlargement is uncommon but possible with finasteride or dutasteride.

When to contact your clinician

Reach out through the patient portal if you experience:

• Any persistent sexual side effects.
• New or worsening mood symptoms, including depression or suicidal thoughts.
• Lightheadedness, chest discomfort, or significant swelling.
• Unusual breast changes — tenderness, enlargement, lumps, or discharge.
• Severe shedding or scalp irritation.

For medical emergencies, call 911.

Compounded medication notice

Maro Density Pill and Density Pill+ are compounded medications prepared by a US-licensed pharmacy. The individual active ingredients (finasteride, minoxidil, dutasteride) are FDA-approved for various indications — finasteride 1 mg is FDA-approved for male pattern hair loss, dutasteride is FDA-approved for BPH and used off-label for hair loss, and oral minoxidil is FDA-approved for hypertension and used off-label for hair loss at lower doses. The combined oral formula is not separately FDA-evaluated.

Compounded medications are intended for patients whose clinical needs cannot be met by an FDA-approved product alone.

What these treatments are

Semaglutide is a GLP-1 receptor agonist. Tirzepatide is a dual GIP and GLP-1 receptor agonist. Both work on appetite and metabolism pathways — slowing gastric emptying, reducing hunger signals, and improving how the body responds to food.

Both are prepared by US-licensed compounding pharmacies and prescribed only when a clinician determines you are an appropriate candidate.

How to take them

Both medications are taken as a small subcutaneous injection once a week, on the same day each week. The dose is titrated up gradually over weeks to months so your body has time to adjust.

Common injection sites include the abdomen, upper thigh, or upper arm. Rotate sites week to week. Your clinician and the included instructions will walk you through technique.

These are long-term treatments paired with food and movement habits. Stopping the medication often leads to weight regain unless lifestyle changes are sustained.

Who should not take these medications

You should not take semaglutide or tirzepatide if:

• You or a family member has medullary thyroid cancer or MEN2.
• You have had pancreatitis.
• You have severe gastrointestinal disease, including severe gastroparesis.
• You have active gallbladder disease.
• You are pregnant, planning to become pregnant, or breastfeeding.
• You have type 1 diabetes or a history of diabetic ketoacidosis.
• You have severe kidney disease.
• You have a history of hypersensitivity to GLP-1 medications.

Tell your clinician about all medications you take, including insulin, sulfonylureas, oral medications that depend on stomach absorption, and any history of eating disorders, diabetic retinopathy, or mental health concerns.

Common side effects

Most side effects are gastrointestinal and are most common in the first weeks of treatment and during dose increases. They usually improve as your body adjusts.

• Nausea
• Constipation or diarrhea
• Reflux or indigestion
• Reduced appetite (this is part of how it works, but can become uncomfortable)
• Fatigue
• Headache
• Injection site reactions — redness, mild pain, or itching

Eating smaller, lower-fat meals, staying hydrated, and avoiding alcohol typically reduces GI symptoms during titration.

When to seek immediate medical attention

Stop the medication and get medical help right away if you experience:

• Severe, persistent abdominal pain that may radiate to your back — possible pancreatitis.
• Signs of gallbladder disease — pain in the upper right abdomen, fever, yellowing of the skin or eyes.
• A lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath — possible thyroid concern.
• Symptoms of severe allergic reaction — swelling, trouble breathing, severe rash.
• Severe dehydration from prolonged vomiting or diarrhea.
• Symptoms of low blood sugar (especially if you also take insulin or sulfonylureas) — shakiness, sweating, confusion.
• Vision changes, particularly if you have a history of diabetic retinopathy.
• Significant mood changes or thoughts of self-harm.

Compounded medication notice

Maro's GLP-1 treatments are compounded medications prepared by US-licensed pharmacies. The active ingredients (semaglutide and tirzepatide) are FDA-approved as branded products. Compounded versions are not separately FDA-evaluated for safety, efficacy, or quality. Compounded medications are intended for patients whose clinical needs cannot be met by an FDA-approved product alone.

FDA shortage status and compounding regulations evolve. Your clinician will discuss what this means for your treatment.

Have questions

Message your Maro clinician through the patient portal anytime — for side effects, dose questions, or anything that feels off. For medical emergencies, call 911.

What sermorelin is

Sermorelin is a growth hormone-releasing hormone (GHRH) analogue. Instead of replacing growth hormone directly, it prompts your pituitary gland to release your own growth hormone in its natural, pulsatile rhythm.

This is an important distinction: sermorelin is not HGH replacement therapy. It works upstream, supporting your body's own signaling. Individual response varies, and clinical evidence in healthy adults is more limited than for FDA-approved indications.

How to take it

Sermorelin is administered as a small subcutaneous injection, typically in the evening before bed to align with the body's natural growth hormone pulse. Your clinician will provide a specific protocol — including dose, schedule, and length of cycle.

Sermorelin is generally cycled rather than taken indefinitely. Continuous long-term use without breaks is not the standard approach.

Who should not take sermorelin

• You have any active or suspected cancer. GHRH stimulation may not be appropriate when malignancy is present.
• You have a pituitary disorder, pituitary tumor, or have had pituitary surgery or radiation.
• You are pregnant, planning to become pregnant, or breastfeeding.
• You have severe systemic illness or are critically ill.
• You have a known hypersensitivity to sermorelin or related peptides.
• You are seeking direct HGH replacement — sermorelin is not a substitute for prescription growth hormone therapy.

Tell your clinician about your full medical history, all medications and supplements, and any prior or current hormone-related concerns. Sermorelin should not be combined with growth hormone or with medications that significantly alter pituitary function without clinician guidance.

Common side effects

Sermorelin is generally well tolerated when used as directed. Possible side effects include:

• Mild redness, swelling, or irritation at the injection site
• Flushing
• Headache
• Occasional nausea or stomach upset
• Dizziness or lightheadedness
• Trouble sleeping if dosed too late or too high
• Joint or muscle aches in some cases

Side effects are usually mild and short-lived. Tell your clinician if anything persists or worsens.

When to contact your clinician or seek care

Reach out through the patient portal for:

• Persistent injection site reactions or signs of infection.
• Significant swelling in the hands or feet.
• New or worsening joint pain.
• Tingling or numbness in the hands (possible carpal tunnel-type symptoms).
• Vision changes, severe headaches, or other unusual symptoms.

Seek immediate care for signs of a serious allergic reaction — swelling of the face or throat, trouble breathing, or severe rash. For medical emergencies, call 911.

Compounded medication notice

Sermorelin is a compounded medication prepared by a US-licensed pharmacy. It is not FDA-approved as a finished product. Sermorelin is not approved for anti-aging, athletic performance enhancement, or bodybuilding. It is prescribed only when a clinician determines it is clinically appropriate based on your individual evaluation.

What sermorelin is not

To be direct: sermorelin is not a guarantee of results, not a shortcut, and not the same as HGH. It is a clinician-guided peptide protocol with a specific mechanism. People respond differently. Lifestyle factors — sleep, nutrition, training, and recovery — matter as much as the peptide itself.