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for educational and safety purposes
sci-wiki~$open stack blood-flow
vessel calibre, oxygen release, and red cell count; the third one is the serious one
3 items; 3 structures drawn from pubchem.
⚠️ ONE PDE5 INHIBITOR, NOT THREE. Tadalafil or aminotadalafil or mirodenafil, and they are not equivalent choices. Tadalafil is the one with the real evidence base and the long half-life of roughly seventeen and a half hours, which is why it is the daily-dosing option. Aminotadalafil is an unapproved analogue found as an adulterant in supplements, with no safety record whatsoever. Mirodenafil is approved in South Korea. Those are three very different levels of evidence and levelling them would be the error.
⚠️ PDE5 INHIBITORS ARE ABSOLUTELY CONTRAINDICATED WITH NITRATES, and it is the textbook named mechanism: both act on the nitric oxide and cyclic GMP pathway, both lower blood pressure, and together they can drop it fatally. Caution with alpha-blockers applies for the same reason.
ITPP is the unloading lever, and it also appears in the endurance stack. ⚠️ It is prohibited in competitive sport.
Roxadustat is the capacity lever and by far the most serious compound here. It is a hypoxia-inducible factor prolyl-hydroxylase inhibitor, approved for anaemia of chronic kidney disease in several countries. ⚠️ ITS REGULATORY HISTORY IS THE POINT RATHER THAN A FOOTNOTE: an FDA advisory committee voted against approval over thrombotic and cardiovascular safety signals, which is why it is not approved in the United States.
⚠️ RAISING HAEMATOCRIT RAISES THROMBOSIS RISK. That is the named mechanism, it is not theoretical, and it is the specific reason the drug was rejected. Stacking it with two other things that alter oxygen transport, in a person who is not anaemic, is the highest-risk combination in this entire roster.
Three genuinely different levers on oxygen delivery, and describing them separately is the point: vessel calibre, haemoglobin's willingness to let go, and how many red cells there are to begin with.
PDE5 inhibition raises cyclic GMP and relaxes vascular smooth muscle, which widens the pipe. ITPP shifts haemoglobin's oxygen dissociation curve so that oxygen unloads into tissue more readily rather than being held too tightly, which changes extraction rather than delivery. Roxadustat stabilises hypoxia-inducible factor, which raises endogenous erythropoietin and therefore haemoglobin, which changes carrying capacity.
⚠️ THAT STACKING IS ALSO EXACTLY WHY THIS IS THE HIGHEST-RISK COMBINATION ON THIS PAGE. Each lever independently increases oxygen availability, and the third one does it by making the blood thicker. Raising haematocrit in someone who is not anaemic, while simultaneously widening vessels and altering oxygen release, is a combination nobody has studied and whose components each carry a thrombotic or haemodynamic signal on their own.
The PDE5 arm is felt within an hour or two and its side effect profile is the familiar one: headache, flushing, nasal congestion.
Roxadustat is not felt at all in the short term, and that is precisely the problem. Haematocrit rises over weeks with no sensation attached, so the only way to know where it has got to is a full blood count.
ITPP has no clear reported subjective signature in humans.
⚠️ PDE5 INHIBITORS WITH NITRATES CAN BE FATAL; both lower blood pressure through the same nitric oxide and cGMP pathway. Caution also with alpha-blockers. ⚠️ ROXADUSTAT RAISES HAEMATOCRIT AND THEREFORE THROMBOSIS RISK, which is why an FDA advisory committee voted against its approval; in a person who is not anaemic there is no therapeutic target being corrected, only a risk being taken. ITPP is WADA-prohibited. Aminotadalafil is an unapproved supplement adulterant with no safety record. Anyone running the third item without periodic full blood counts has no way of knowing where their haematocrit has gone.
nothing flaggedcurated roster
every pair here reads as compatible on the mechanisms the site holds. that is the absence of a known conflict, not a clearance.
2 of 3 in one basketKimera Chems; Code Sean
3 of 3 priced
no overlap found
no two of these share a primary class or a listed receptor. every item is pulling a different lever.
interested in protocols? join the discord; that is where dosing, timing and the practical side get discussed.
the sci-wiki publishes this as a description of what these compounds do together, not as a recommendation to take them. Nothing here is medical advice.