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Dapoxetine: A clinical overview of the drug for Premature Ejaculation (PE)

Dapoxetine (often sold under brand names Priligy, Poxet, Vriligy, Stop Ejac) is the only active ingredient specifically designed and clinically approved for the treatment of premature ejaculation (PE) in men aged 18 to 64. It is important to understand that Dapoxetine does not treat erectile dysfunction (ED) and does not affect erection hardness.

What is Dapoxetine and its indication?

Dapoxetine is a medication for "on-demand" use. Unlike traditional antidepressants, it belongs to the Selective Serotonin Reuptake Inhibitor (SSRI) class, but it has an ultra-short half-life (about 1.5–2 hours).

1. Indication and dosages

The drug is indicated exclusively for the treatment of PE.

  • Dapoxetine 30 mg: The recommended starting dose. It provides a good balance between efficacy and a low risk of side effects.

  • Dapoxetine 60 mg: The maximum daily dose. It is used if 30 mg was insufficient for control, provided the drug was well-tolerated.

Detailed mechanism of action of Dapoxetine

The mechanism of action of Dapoxetine is centered on the neurochemical processes in the central nervous system that regulate the ejaculation reflex.

  1. Serotonin: Ejaculation is controlled by a complex chain of reflexes where serotonin (5-HT) plays a key inhibitory role. Low serotonin activity is associated with rapid ejaculation.

  2. Action of Dapoxetine: Dapoxetine blocks the transporter proteins that carry out the reuptake of serotonin in neurons. This leads to a temporary and rapid increase in serotonin concentration in the synaptic cleft.

  3. Result: The enhanced serotonergic transmission exerts an inhibitory effect on the brain and spinal cord centers that control ejaculation. This slows down nerve impulses and allows the man to significantly prolong sexual intercourse (by 3-4 times).

Key takeaway: The ultra-short action of Dapoxetine allows it to be taken "on-demand," without the drug accumulating in the body, which is typical of conventional SSRIs.

Instructions for using Dapoxetine (30/60 mg)

Strict adherence to the rules for taking Dapoxetine is critical to minimizing side effects, especially the risk of fainting (syncope).

1. Dosage and timing of intake

  • Dosage: Start with 30 mg. If the effect is insufficient, the dose can be increased to 60 mg (the maximum daily dose). It is strictly prohibited to take more than 60 mg within 24 hours.

  • Method: Swallow the tablet whole with a full glass (at least 250 ml) of water. Do not chew.

  • Timing: Take 1–3 hours before planned sexual activity.

2. Influence of alcohol

  • Alcohol: Absolute prohibition. The combination of Dapoxetine with alcohol manifold increases the risk of neurocognitive side effects (dizziness, drowsiness, sluggishness) and can lead to fainting (syncope).

Critical contraindications

The list of contraindications related to the drug's neurochemical action is very strict.

  • Cardiovascular Disorders: Cardiac rhythm disturbances (blocks, bradycardia), severe heart failure, IHD (Ischemic Heart Disease).

  • Hepatic Impairment: Severe and moderate severity.

  • Psychiatric Disorders: History of mania, severe depression, uncontrolled bipolar disorder.

  • Drug Interactions: Absolutely forbidden to take with:

    • MAO Inhibitors (MAOIs): Risk of serotonin syndrome.

    • Potent CYP3A4 Inhibitors: (Ketoconazole, Erythromycin, Grapefruit juice). Increases Dapoxetine concentration and the risk of fainting.

    • Other SSRIs: (Antidepressants).

Side effects of Dapoxetine

  • Very Common: Nausea (the most common side effect), dizziness, headache.

  • Common: Drowsiness, insomnia, anxiety, diarrhea, dry mouth.

Special Warning: To avoid fainting (syncope), always wash the tablet down with a full glass of water and avoid dehydration.

Professional advice on using

  1. Take with water, while sitting: To minimize the risk of fainting (orthostatic hypotension), always take Dapoxetinewhile standing or sitting, washing it down with a full glass of water, and avoid standing up abruptly.

  2. Not for daily use: Dapoxetine is an "on-demand" drug. It should not be taken daily or as a course.

  3. Combination Therapy: If you have both PE and ED, Dapoxetine can be safely combined with PDE5 inhibitors (Sildenafil, Tadalafil) for a dual effect, provided contraindications are strictly excluded.

Dapoxetine: Extended Q&A section

  • How much does Dapoxetine prolong intercourse? On average, IELT (latency time) increases by 3–4 times.

  • How soon does Dapoxetine start working? The effect begins after 60 minutes, with the peak effect occurring 1–2 hours after intake.

  • How long does the prolongation effect last? The ejaculation control effect lasts for 3–4 hours after the peak concentration, which is optimal for "on-demand" use.

  • How does VRILIGY differ from POXET? They are direct generics containing Dapoxetine. The difference is only in the trade name.

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