Affiliate Disclosure & Editorial Note: TutelaMedical.com is an independent health research publication. Some links in this article may be affiliate links; this does not affect our analysis or policy citations. Our mission is to help readers understand publicly stated telehealth ED treatment policies and pricing by examining official source pages.
By TutelaMedical.com Health Research Team
At a Glance: DirectMax vs. Keeps Powerhouse
| Factor | DirectMax | Keeps Powerhouse |
|---|---|---|
| Price Model | Per-dose pricing listed publicly | Plan-specific pricing shown after intake |
| Auto-Refill Terms | Subscription products charge every 30 days | Elective; notifications sent per refill |
| Cancellation Window | Turn off 48 hours before charge; within 24 hours of placement | Anytime in account; call if within 24 hours of refill |
| Returns Policy | No refunds for medication received; returns have listed exceptions; $35 fee on returned medication | Treatment purchases final; damaged/defective items may be replaced within 48 hours |
| Guarantee | None found in public terms (as of Aug 5, 2026) | 60-night guarantee for new patients* |
| Official Links | DirectMax Product Page | Keeps ED Program Page |
*Specific conditions apply. See FAQ section for details.
What This Comparison Covers
If you're choosing between DirectMax and Keeps Powerhouse, pricing, refill frequency, and cancellation terms are primary decision points. Both are prescription-only telehealth ED treatments, but their stated policies differ significantly. This guide compares publicly disclosed policies as of August 5, 2026, so you can understand what each service publishes before enrollment.
Critical fact: Both DirectMax and Keeps Powerhouse are compounded prescription products. The finished combinations are not FDA-approved. According to FDA guidance on compounded drugs, compounded medications do not undergo pre-market FDA review for safety, effectiveness, or quality in the same way as FDA-approved medications.
DirectMax Pricing and Dose Options
DirectMax publishes a transparent, dose-tiered price structure. As of August 5, 2026, DirectMax lists three strength levels on its product page:
- Low-strength dose: $8.78 per dose
- Medium-strength dose: $9.28 per dose
- High-strength dose: $10.78 per dose
DirectMax is sold in standard six-dose packs, with larger quantities up to 20 doses available. A six-dose pack of medium-strength totals $55.68 before any promotions or applicable fees. Promotions can change, so verify current pricing on the official product page before consultation.
According to Direct Meds' terms, prescription products are fulfilled by licensed third-party compounding pharmacies, and the pharmacy serving your order may vary by location and availability.
Keeps Powerhouse Pricing: What's Public and What Isn't
Keeps advertises ED treatments “start from $1/day,” but this is an umbrella rate across four different Keeps ED programs—not a Powerhouse-specific price. The Keeps ED program page does not disclose a plan-specific price for the Powerhouse combination publicly.
You cannot see the Powerhouse cost until you complete an intake consultation and reach checkout. This is a significant difference from DirectMax, where per-dose pricing is visible upfront. If per-dose or monthly cost is a primary factor in your decision, you'll need to complete a Keeps consultation to compare actual pricing.
Automatic Refill Policies
Both services offer recurring delivery, but their structures differ.
DirectMax Auto-Refill: Direct Meds' terms state that certain subscription products charge every 30 days with notice 5 to 7 days before the charge. This provides a window to cancel before the charge is applied.
Keeps Auto-Refill: Keeps describes an elective automatic prescription-refill program where enrolled prescriptions are refilled when available, with notification for each refill, and preferences can be changed per product in your account.
Cancellation Windows: When You Can Stop Charges
Cancellation timing is critical—missing a deadline can result in an unexpected charge.
DirectMax Cancellation: Direct Meds' terms state that auto-refill must be turned off up to 48 hours before the next processing date. A prescription order may be canceled within 24 hours of placement if the provider network has not received it; after 24 hours cancellation is generally unavailable.
Keeps Cancellation: Keeps states a subscription can be canceled in the account at any time. If the next refill is within 24 hours, the customer should call to try to ensure cancellation before processing.
Returns and Refund Policies
DirectMax Returns: Direct Meds' terms specify that no refunds are issued for medication already received. Returns or exchanges are limited to listed exceptions. A $35 disposal fee applies to returned medication, and there is a 48-hour contact window for receipt problems.
Keeps Returns: Keeps' policy states treatment purchases are final and prescription treatments cannot be returned for a refund, including unused medication. However, defective or damaged items may be replaced if Keeps is contacted within 48 hours.
Guarantees and Risk Reversal
The two services differ significantly in guarantee offerings.
DirectMax Guarantee: Based on the DirectMax product and terms pages verified on August 5, 2026, no independently sealed outcome guarantee is stated in the public terms. Do not assume any guarantee exists beyond what is published on the official site.
Keeps Powerhouse Guarantee: Keeps advertises a 60-night guarantee for eligible ED medications and new patients only. To claim it, you must take medication as directed, request a refund within 30 days of your most recent billing date, and the guarantee covers only the most recent billing cycle.
Compounding and Drug Status
Both DirectMax and Keeps Powerhouse are compounded prescription combinations. The finished multi-active combination in each case is compounded and is not FDA-approved. FDA guidance emphasizes that compounded drugs undergo a different regulatory pathway than FDA-approved medications.
Important Medical Disclosure Requirements
Before starting either treatment, disclose all medications to your clinician, particularly any nitrates (used for chest pain) or riociguat (used for pulmonary hypertension). These medications interact dangerously with the PDE5-inhibitor active ingredients in both DirectMax and Keeps Powerhouse and are absolute contraindications. Do not skip this disclosure during your consultation. Consult your doctor or pharmacist to review all your medications before proceeding.
Frequently Asked Questions
What is the Keeps Powerhouse 60-night guarantee, and what does it cover?
The guarantee applies to new patients only and requires that you take medication as directed, request a refund within 30 days of your most recent billing date, and understand that only your most recent billing cycle is covered. The guarantee is conditional and does not cover all circumstances.
Can I cancel a DirectMax order after 24 hours?
Generally not. DirectMax orders may be canceled only within 24 hours of placement if the provider network has not yet received it. After 24 hours, cancellation is generally unavailable according to Direct Meds' terms.
Is the “$1 per day” Keeps pricing accurate for Powerhouse?
That is not established for Powerhouse from the public page. The “$1/day” rate is an umbrella starting price across four Keeps ED treatments, not a Powerhouse-specific quote. Plan-specific pricing for Powerhouse appears only after you complete an intake and reach checkout.
Where can I find my Keeps order history and refill date?
Keeps's refill policy. Check your account regularly to stay informed about upcoming refills and charges.
What should I do before starting either treatment?
Disclose all medications, especially nitrates and any heart medications, to your clinician during consultation. Both services require clinician review and prescription. If you have any doubt about whether a compounded ED treatment is appropriate for your health profile, consult your primary care doctor first.
For a detailed examination of DirectMax's formula and safety claims, Tutela's full DirectMax formula and safety review covers the active ingredients and clinical research. We also document how Tutela evaluates another compounded telehealth ED offer, which demonstrates our evaluation approach for this product category.
This article is for educational purposes and is not medical advice. DirectMax and Keeps Powerhouse are prescription medications requiring a licensed clinician's evaluation. All prices, policies, and terms stated here are based on official pages verified on August 5, 2026, and are subject to change without notice. Before enrolling, review current terms on the official sites (directmeds.com and keeps.com) and consult your healthcare provider about whether a compounded ED treatment is appropriate for you. Compounded drugs are not FDA-approved and are not pre-reviewed by the FDA for safety, effectiveness, or quality. This article was written by the TutelaMedical.com Health Research Team and is intended for informational purposes only.