Dapoxetine (International)

Pryor et al9 thought that the PGIC condition as a study endpoint

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Thus, it is important to treat patients with PE in order to improve quality of life. At present, treatment of PE includes mainly psychotherapy, drug therapy and surgical treatment6. Drug therapy is not only likely to be the most receptive approach for patients, but it is also the most commonly used method. Selective serotonin reuptake inhibitors (SSRIs) have become the most widely used medicine in the world7. Dapoxetine hydrochloride, belonging to the class of SSRIs, was the first drug originally approved for the on-demand treatment of men with PE by seven European countries in 20088.

Better Timing Control

Unfortunately, the efficacy and safety of dapoxetine (30 mg and 60 mg on-demand) has never been comprehensively studied in men with PE. Most data derived from clinical studies in men with PE are available. The objective of this study was to not only evaluate the efficacy and safety of dapoxetine when used at either 30 mg or 60 mg as compared with the placebo as an oral on-demand treatment in men with PE in routine clinical practice by performing a meta-analytic synthesis of studies, but also to assess whether there are differences in efficacy and safety for PE treatment using either 30 mg or 60 mg dapoxetine. The electronic and manual searches of PubMed, EMBASE and Cochrane Central Register of Controlled Trials (Cochrane Library) databases resulted in 106 references, of which 88 were clearly not relevant to our study. Of the remaining 18 references, 11 were excluded after reading the full text. is informative with respect to men's

• Clinical guidelines from urology associations mention dapoxetine.
• It is a first-line pharmacological option.
• Behavioral techniques remain first-line non-pharmacological options.
• The "stop-start" and "squeeze" techniques are examples.
• Topical anesthetics are another treatment class.
• Combining topical anesthetics with dapoxetine is not standard.
• Patients should not crush or split the 30mg tablet.
• Doing so could alter the absorption profile.
• Sublingual or buccal use is not studied or approved.
• It is incompatible with monoamine oxidase inhibitors.
• A washout period is needed after MAOI use.
• The half-life allows for rapid clearance.

perception to minor detectable changes in IELT.

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In other words, there is a positive relationship between

• Storage temperature is usually below 25°C or 77°F.
• The bottle should be kept tightly closed.
• Moisture protection is important for stability.
• It should be kept out of sight and reach of children.
• Accidental ingestion by a child requires immediate medical help.
• In case of overdose, symptoms may be severe.
• Overdose symptoms include serotonin syndrome, vertigo, and vomiting.
• There is no specific antidote; treatment is supportive.
• Contact a poison control center immediately.
• The prescriber should be informed of any overdose.
• The prescribed quantity is often limited to reduce overdose risk.
• Doctors may prescribe only a few tablets at first.

the participants' PGIC ratings and mean change in IELT values.

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However, no valid conclusions from these studies comparing 60 mg versus 30 mg dapoxetine could be obtained since these lacked strong statistical evidence. In this meta-analysis, in order to obtain a reliable and scientifically sound comparison of dapoxetine (30 and 60 mg) versus placebo and dapoxetine 60 mg versus dapoxetine 30 mg as on-demand oral treatment for PE, a precise search strategy was performed to include all relevant RCTs. Therefore, studies of patients with erectile dysfunction18, non-RCTs19 and studies including patients with chronic, daily oral treatment with dapoxetine20,21 were excluded from the analysis of patients with PE. Ultimately, seven RCTs met the inclusion criteria for the present meta-analysis. To our knowledge, this is the most recent systematic review and meta-analysis comparing oral dapoxetine on-demand with placebo and comparing dapoxetine dosages (60 mg versus 30 mg) for the treatment of patients with PE. The present findings agree with the results

Tip	Explanation	Additional Advice
Take as prescribed	Do not exceed 30 mg per dose	Follow healthcare provider directions
Avoid alcohol	Can increase side effects, impair judgment	Stay sober during activity
Inform about other meds	Especially antidepressants, antifungals, or liver drugs	Always disclose current medications

of previous clinical trials that reported a similar

Final Thoughts

The present meta-analysis for IELT demonstrated that on-demand oral treatment with dapoxetine had an advantage over placebo despite the different dosages (30 mg and 60 mg) used. It demonstrated dapoxetine sex that on-demand oral dapoxetine was an effective treatment for PE. In addition, our meta-analysis comparing dapoxetine 60 mg with 30 mg on-demand orally proved that there was a statistically significant difference in IELT between the both groups; thus, 60 mg dapoxetine had a longer IELT than 30 mg on-demand for PE. The present findings are in agreement with the results of previous clinical trials that have reported significant improvement in the IELT with the use of dapoxetine9,10,11,12,13,14,15,16,17,18,19,20,21. Mean IELT was also significantly increased in all the studies not included in this meta-analysis. improvement in PGIC with dapoxetine versus placebo

Frequently Questions & Answers

Mirone et al22 performed non-RCT trials in 2014 that compared dapoxetine 30–60 mg with alternative care/nondapoxetine, the results revealed that dapoxetine for treatment of PE had a longer mean IELT. The integrated analysis from five trials by McMahon et al19 also showed dapoxetine 30 and 60 mg on-demand significantly increased mean IELT compared with placebo (1.9 minutes for placebo, 3.1 and 3.6 minutes for dapoxetine 30 mg and 60 mg, respectively). Our statistical results and subgroup analysis of PGIC demonstrated that dapoxetine was associated with a major improvement in PGIC. As shown in Figure 5, the overall RR was 2.14 (95% CI = 1.90–2.24) between dapoxetine and placebo, 2.01(95% CI = 1.69–2.38) between the dapoxetine 30 mg subgroup and placebo and 2.26 (95% CI = 1.91–2.67) between the dapoxetine 60 mg subgroup and placebo, respectively. Additionally, the present meta-analysis also demonstrated significant improvement in PGIC with 60 mg over 30 mg dapoxetine on-demand alone. or comparing 60 mg versus 30 mg dapoxetine9,10,11,12,13,16,17,18,19,20,21.

7. Product details

After a quality validation, only seven studies9,10,11,12,13,14,15 were selected from the literature search. The flow chart of the evidence acquisition process is summarized in Figure 1 and the methodological quality of the included dapoxetine 60 mg tablets studies is reported in Figure 2. Seven randomized controlled trials (RCTs) involving 8039 PE patients met the inclusion criteria. Of these, 2478, 2932 and 2629 patients received 30 mg dapoxetine, 60 mg dapoxetine, or the placebo, respectively. The study included patients aged 18 years or older and the patients were randomized for dapoxetine 30 mg or dapoxetine 60 mg or placebo administration on-demand (1–3 hours prior to anticipated sexual activity).

Therapeutic Categories

The basic characteristics of the included studies are summarized in Table 1. Three of the RCTs selected9,12,13 evaluating dapoxetine versus placebo for PE reported IELT as the primary outcome. Our pooled analysis showed that PE in patients in the dapoxetine group showed a significant improvement in IELT when compared to patients in the placebo group (mean difference [MD] = 1.39; 95% confidence interval [95% CI] = 1.24–1.55; P < 0.00001). Among these studies, we carried out a subgroup analysis based on PE patients treated with dapoxetine 30 mg and 60 mg on-demand oral administration. A statistically significant difference was found in the subgroup treated with 30 mg dapoxetine compared with the placebo-treated group (MD = 1.16; 95% CI = 0.94–1.38; P < 0.00001). This analysis revealed the incidence of total AEs was more frequent with dapoxetine

• Availability: dapoxetine 30mg tablets are available from licensed pharmacies worldwide.
• Do not take with recreational drugs such as MDMA or cocaine due to dangerous interactions.
• The medication should be prescribed after thorough patient evaluation.
• Emphasize the importance of correct timing to maximize drug effectiveness.
• Patients should avoid driving if experiencing side effects like dizziness.
• Partner communication about medication can improve treatment outcomes.
• Awareness of psychological factors contributing to premature ejaculation is beneficial.
• Dapoxetine 30mg should be part of a comprehensive treatment plan, not standalone.

than with placebo and more common with dapoxetine 60 mg than 30 mg. However, from a review of all the studies reported

Possible Side Effects

Data from four9,11,12,13 and five9,10,11,12,13 studies reported AEs with sufficient data to generate a subgroup forest plot for dapoxetine 30 mg versus placebo and dapoxetine 60 mg versus placebo, respectively. Our pooled result of the meta-analysis showed that the number of AEs of patients in the dapoxetine (30 mg and 60 mg) group were significantly higher than those reported by patients in the placebo group (RR = 2.23; 95% CI = 1.66–3.01; P < 0.00001). The subgroup analysis indicated a statistically significant difference between treatment, with regards to 30 mg or 60 mg dapoxetine versus the placebo group in number of AEs reported (RR = 1.91, 95% CI = 1.36–2.70, P = 0.0002; and RR = 2.52, 95% CI = 1.58–4.02, P = 0.0001, respectively; Figure 7). Furthermore, AEs were assessed in six tadalafil with dapoxetine tablets studies9,11,12,13,14,15 comparing two dapoxetine dosages (60 mg vs. 30 mg).

Check with your doctor if:

This present plot demonstrated that a statistically significant difference existed between the 60 mg and 30 mg group in terms of the incidence of AEs (RR = 1.57; 95% CI = 1.31–1.89; P < 0.00001; Figure 8). Dapoxetine hydrochloride was the first drug originally approved for the on-demand treatment of patients with PE in 2008. Since then, it has received marketing authorization in 59 countries worldwide7,8. In 2011, McMahon et al.16 published an integrated analysis of results from five phase 3 trials attempting to explore the efficacy and safety of dapoxetine for treatment of PE and they proposed that dapoxetine significantly improved all aspects of PE and was generally well tolerated. In 2012, McCarty et al17 published a systematic descriptive review and analyzed whether dapoxetine could be considered an efficacious and tolerable treatment for PE. in the literature, AEs of dapoxetine are generally tolerable.

Usage Instructions

The subgroup analysis of the dapoxetine group treated with 60 mg compared with placebo also reporting IELT also revealed a statistically significant difference in patient response (MD = 1.63; 95% CI = 1.41–1.84; P < 0.00001). In addition, five studies9,12,13,14,15 including a total of 3346 patients, we pooled to compare IELT; patients were divided into two groups treated with either 60 mg or 30 mg dapoxetine. In the fixed-effect model meta-analysis of the five studies, the pooled estimates were statistically significantly different between the dapoxetine 60 mg and 30 mg groups (MD = 0.39; 95% CI = 0.23–0.56; P < 0.00001; Figure 4). This pooled analysis indicated that the dapoxetine 60 mg group was associated with a markedly longer IELT than the dapoxetine 30 mg group. Three studies9,12,13 including 2950 patients compared the PGIC in dapoxetine 30 mg and placebo subgroups and four studies9,10,12,13 including 3567 patients compared PGIC in dapoxetine 60 mg and a placebo subgroup.

Less Stress and Worry

Pooled analysis indicated that when compared to the placebo group, there was a significantly higher proportion of PGIC in the dapoxetine group. The overall risk ratio (RR) was 2.14 (95% CI = 1.90–2.42; P < 0.00001). The subgroup analysis indicated a statistically significant difference between the dapoxetine (for both 30 mg and 60 mg groups) and the placebo group in PGIC (RR = 2.01, 95% CI = 1.69–2.38, P < 0.00001; and RR = 2.26, 95% CI = 1.91–2.67, P < 0.00001, respectively; Figure 5). In addition, data from three9,12,13 studies reporting PGIC compared dapoxetine dosages (60 mg versus 30 mg). These count data were extracted to perform a forest plot analysis, which showed that the use of dapoxetine 60 mg was associated with a significantly greater improvement in PGIC than when dapoxetine 30 mg was used (RR = 1.17, 95% CI = 1.09–1.25; P < 0.00001, Figure 6).