Dapoxetine for treatment of premature ejaculation – Authors' reply
Try it free for 7 days—no obligation. New release: The first edition of the Urology Textbook as an e-book—ideal for offline reading and quick reference.
Generic vs Brand
The maximum dosing frequency is once per day. If the response is inadequate and tolerability is good, the dose may be increased to 60 mg. If there is no meaningful improvement or if adverse effects are unacceptable, clinicians should discontinue treatment. & Giuliano, F. Dapoxetine for the Treatment of Premature Ejaculation: Results from a Randomized, Double-Blind, Placebo-Controlled Phase 3 Trial in 22 Countries. With over 1300 pages and hundreds of illustrations, it’s the perfect companion for residents and medical students. After your 7-day trial has ended, you will receive a download link for your exclusive e-book. To compare the efficacy of tadalafil alone, dapoxetine alone, and tadalafil with dapoxetine as a combination therapy for the treatment of premature ejaculation. Eligible patients attended our andrology clinic with premature ejaculation were randomly allocated into three groups: group A (92 participants) received on-demand tadalafil, 5 mg; group B (91 participants) were given on-demand dapoxetine, 30 mg; and group C (89 participants) received on-demand combination of tadalafil, 5 mg, and dapoxetine, 30 mg. We assessed the changes in the intravaginal ejaculatory latency time (IELT) and the satisfaction scores 1, 2, and 3 months after treatment.
- Dapoxetine 30 mg has a rapid onset, with effects usually felt within 1-3 hours.
- Do not exceed the prescribed dose to reduce the risk of severe side effects.
- Combining dapoxetine with certain medications may cause interactions; always inform your doctor.
- It’s important to follow the prescribed timing for maximum effectiveness.
Highly statistically significant improvements were found in the mean IELT and satisfaction scores 1, 2, and 3 months post-treatment in all groups (P = <0.001).
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Professional | 20mg | 10 Pills | 48.29€ 45.99€ | |
| Priligy Generic Dapoxetine | 60mg | 30 + 6 Pills | 106.65€ 101.57€ | |
| Cialis Generic | 60mg | 30 + 2 Pills | 85.33€ 81.27€ | |
| Priligy Generic Dapoxetine | 60mg | 180 + 10 Pills | 494.76€ 471.20€ | |
| Priligy Generic Dapoxetine | 60mg | 60 + 8 Pills | 183.06€ 174.34€ | |
| Priligy Generic Dapoxetine | 60mg | 10 Pills | 47.63€ 45.36€ | |
| Priligy Generic Dapoxetine | 60mg | 20 + 4 Pills | 77.31€ 73.63€ | |
| Priligy Generic Dapoxetine | 60mg | 90 + 10 Pills | 265.64€ 252.99€ | |
| Kamagra Polo | 100 mg | 60 + 4 Pills | 189.39€ 180.37€ | |
| Viagra Original | 100mg | 92 + 4 Pills | 362.88€ 345.60€ | |
| Cialis Super Active | 20mg | 10 Pills | 55.64€ 52.99€ | |
| Cialis Generic | 10mg | 90 + 6 Pills | 146.17€ 139.21€ | |
| Viagra Original | 100mg | 76 + 4 Pills | 306.59€ 291.99€ | |
| Priligy Generic Dapoxetine | 60mg | 120 + 10 Pills | 341.26€ 325.01€ | |
| Cialis Professional | 40mg | 180 + 4 Pills | 618.23€ 588.79€ |
Post hoc analysis suggested this improvement was more pronounced in group C (P < 0.001).
Adverse Effects of Dapoxetine
The initial elimination half-life is approximately 1.5 hours, whereas the terminal half-life of active and inactive metabolites ranges from 18 to 22 hours. Nausea (2.2% of patients) and dizziness (1.2% of patients) are the most frequent adverse effects leading to discontinuation of dapoxetine treatment. Anxiety, restlessness, somnolence, headache, tremor, and dizziness occur commonly. Depressed mood, mood changes, disturbances in thinking, syncope, and other orthostatic reactions have been reported occasionally. Occurrence of depressive symptoms and suicidality is a general concern with SSRIs, there is no specific data for dapoxetine available.
If you forget to take PRILIGY
Visual disturbances, tinnitus, and dizziness have been reported occasionally. Bradycardia, tachycardia, blood pressure fluctuations with hypotension or hypertension, as well as orthostatic hypotension and syncope may occur. Nausea occurs very frequently (in more than 10% of patients). Diarrhea, vomiting, abdominal pain, and flatulence occur frequently. Dapoxetine must not be coadministered with monoamine oxidase inhibitors (MAO inhibitors), selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, or other serotonergic agents (such as St. Both tadalafil and dapoxetine are effective in the treatment of patients with premature ejaculation, but the combination of both drugs gives better results. Premature ejaculation (PE) is a male sexual disorder characterized by a brief intra-vaginal ejaculatory latency time (IELT) and lack of ability to properly control ejaculation which has detrimental personal effects [Citation1]. There is no global definition for PE.
| Condition | Contraindicated? | Notes |
|---|---|---|
| Heart failure | Yes | Risk of worsening symptoms |
| Liver impairment | Yes | Metabolized in the liver, caution advised |
| Use with MAO inhibitors | Yes | Causes severe interactions |
| History of syncope | Yes | Due to risk of fainting |
| Allergic reactions to SSRIs | Yes | Allergic response possible |
PE is defined according to the International Society for Sexual Medicine (ISSM) guidelines as ejaculation that always happens in fewer than 1 minute following vaginal penetrating from the initial sexual encounter (lifelong PE), or a decrease in IELT, less than 3 min (acquired PE) with inability to delay ejaculation on all or nearly all vaginal penetrations and negative personal consequences, such as distress, frustration, bother and/or avoidance of sexual intimacy [Citation2].
| Country | Average Price (per tablet) | Availability | Purchase Options |
|---|---|---|---|
| USA | $1.50 - $3.00 | Widely available | Online pharmacies, local pharmacies |
| UK | £1.20 - £2.50 | Prescription required | Prescribed by doctor, online options |
| India | ₹50 - ₹150 | Over the counter possible | Online marketplaces, pharmacies |
| Australia | AUD 2.00 - AUD 4.00 | Prescription needed | Through healthcare providers |
Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) define PE as a persistent or recurrent ejaculation that occurs within approximately 1 minute after vaginal penetration and before the individual wishes it.
Buy Dapoxetine Tablets
60 mg dapoxetine) showed no change or worsening in 68% vs. 42% vs. 28%, “a little better” or “better” in 28% vs. 48% vs. 60%, and “much better” in 4% vs.
Things you should do
10% vs. 12%, respectively. Dapoxetine is rapidly absorbed from the gastrointestinal tract, with a maximum plasma concentration reached after 1 to 2 hours. Its bioavailability is approximately 42%, with considerable interindividual variability (15–76%), and food has only a minor effect on absorption. Dapoxetine undergoes extensive metabolism in the liver and kidneys, primarily via the cytochrome P450 (CYP) isoenzymes CYP2D6 and CYP3A4 as well as monooxygenases, and its metabolites are eliminated predominantly via the kidneys. The problem must present for at least 6 months and present on almost all (approximately 75–100%) or on all occasions of sexual attempts with clinically significant distress and cannot be explained by a nonsexual mental disorder or as a result of severe relationship distress and is not attributable to the effects of a substance/medication or other medical condition [Citation3,Citation4]. A recent comprehensive novel classification of PE was reported by Raveendran A.
Medical uses
John’s wort, tramadol, triptans, linezolid, lithium, or thioridazine) because of the risk of serotonin syndrome. Dapoxetine must not be combined with potent CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, or similar agents, because these drugs can markedly increase dapoxetine plasma concentrations. Concomitant use of anticoagulants or antiplatelet agents may increase the risk of bleeding. Exercise caution when dapoxetine is used with other centrally acting depressants (such as alcohol, sedatives, or opioids) because of the potential for additive sedative effects. Moderate and severe hepatic impairment (Child–Pugh B and C).
Phosphodiesterase 5 inhibitors
Severe renal impairment with an estimated glomerular filtration rate of less than 30 mL/min. Significant structural heart disease (such as heart failure New York Heart Association class II–IV, clinically relevant conduction disorders, significant coronary artery disease, or severe valvular heart disease). Mania, major depression, or ongoing dapoxetine 30mg tablet psychiatric pharmacotherapy (see above). Dapoxetine is not approved for women, children, or adolescents. The recommended starting dose for on-demand use is 30 mg taken orally 1 to 3 hours before anticipated sexual activity. In this classification, the grading of the severity of reduction of IELT was reported as mild or grade 1 (IELT of 2 to 3 minutes), moderate or grade 2 (IELT of 1 to less than 2 minutes), severe or grade 3 (IELT less than 1 minute), and extreme or grade 4 (ejaculation occurring prior to vaginal penetration) [Citation5]. Premature ejaculation is a frequent male sexual dysfunction, although the real incidence is unclear, 24% to 30% of males may be affected [Citation6,Citation7]. Several drugs as tricyclic antidepressants (e.g.
| Side Effect | Frequency | Severity | Recommendations |
|---|---|---|---|
| Nausea | Common | Mild | Take with food |
| Dizziness | Common | Mild | Avoid driving |
| Headache | Uncommon | Mild | Hydrate adequately |
| Dry Mouth | Uncommon | Mild | Use sugar-free gum |
| Insomnia | Rare | Mild | Take earlier in the day |
clomipramine) and tramadol could be used for treatment of PE.
Satisfaction scores
It presents diseases of the genital organs through detailed text and images. Some content may not be suitable for children or sensitive readers. Many illustrations are available exclusively to Steady members. Are you a physician and interested in supporting this project? Join Steady to unlock full access to all images and enjoy an ad-free experience. Selective serotonin-reuptake-inhibitors (SSRIs), like escitalopram, fluoxetine, serteralin, paroxetine and dapoxetine are the most common medications used for management of PE [Citation8–10]. As SSRI, dapoxetine was the first licenced drug with FDA approval used for on-demand management of PE.
How to Order
Moreover, his inspiration and motivation has assisted us in completing all our tasks in a hassle free manner thus earning a top stature in the market. Since we have incepted in this industry, we are working under the leadership and quality management of our mentor Mr. Shankar Viththalarav Chakole. You are here: Urology Textbook > Drugs in Urology > Dapoxetin Dapoxetine is a selective serotonin reuptake inhibitor (SSRI) with a short duration of action. By inhibiting the serotonin transporter, it increases serotonin concentrations in the synaptic cleft, which delays the ejaculatory reflex and prolongs the intravaginal ejaculatory latency time (IELT).
Depression and anxiety
On-demand medication for the treatment of premature ejaculation in men 18 to 64 years of age (typically characterized by an IELT of less than two minutes, lack of control over ejaculation, marked distress, and interpersonal difficulties) in whom sexual counseling alone has not resulted in a satisfactory improvement. The largest randomized, placebo-controlled trial included 1,162 patients (Buvat 2009). Starting from a mean IELT of approximately one minute at baseline, mean IELT values after 24 weeks were 1.9 minutes with placebo, 3.2 minutes with dapoxetine 30 mg, and 3.5 minutes with dapoxetine 60 mg. Patients’ global assessment of treatment response after 24 weeks (placebo vs. 30 mg vs. Dapoxetin acts by neglecting the effect for the different G protein coupled and ligand gated channels for all 5-hydroxytryptamin (5-HT) receptor subtypes, it inhibits the 5-HT transporter and activate the 5-HT 2C receptor, an action which diminishes the operation of 5-HT 1A receptor, thus reattaining equilibrium between the actions of 5-HT 1A and 5-HT 2C receptors and this leads to increased 5-HT levels in the synaptic clefts which results in delayed ejaculation [Citation11].
- The medication’s effectiveness varies based on individual health and response.
- Dapoxetine does not increase libido or sexual desire directly.
- Maintain a healthy lifestyle to support the benefits of dapoxetine therapy.
- Always complete the prescribed course unless advised otherwise by a healthcare provider.
Nitric oxide (NO) activates guanylate cyclase which increases the intracellular cGMP in the corpus cavernosum causing smooth muscle relaxation.
- Monitor for any allergic reactions such as rash, swelling, or difficulty breathing.
- Pregnant women or those planning pregnancy should discuss alternatives with their doctor.
- Dapoxetine should be used cautiously in older adults or those with prior medical conditions.
- Always follow the guidance given by a healthcare professional regarding dosage.
PDE-5 inhibitors act through increasing nitric oxide which causes relaxation of the smooth muscles of corpus cavernosum and the vas deferens and seminal-vesicles, also they reduce anxiety from sexual performance which is commonly associated with PE [Citation12]. According to several researches, using SSRIs and PDE-5 inhibitors together enhances sexual pleasure and boosts IELT when compared with taking SSRIs alone.