Dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSI) specifically developed and approved for the on-demand treatment of premature ejaculation (PE) in adult men. It represents the first pharmacologic agent designed exclusively for this condition, offering a targeted approach to a common male sexual health concern. Unlike daily-dosed antidepressants sometimes used off-label, dapoxetine’s rapid absorption and elimination profile allows for intake approximately 1–3 hours before anticipated sexual activity, providing control precisely when needed. Its mechanism works centrally by increasing serotonin activity in the synaptic cleft, which is believed to help modulate the ejaculatory reflex and improve latency time.

Features

• Active Ingredient: Dapoxetine hydrochloride.
• Pharmacologic Class: Selective Serotonin Reuptake Inhibitor (SSRI).
• Dosage Forms: Film-coated tablets available in 30 mg and 60 mg strengths.
• Rapid Onset: Designed for absorption within approximately 1–2 hours post-ingestion.
• Short Half-Life: Elimination half-life of several hours, suitable for on-demand, non-daily use.
• Prescription Requirement: Available only under medical supervision and prescription.

Benefits

• Significantly increases intravaginal ejaculatory latency time (IELT), allowing for improved sexual control and satisfaction.
• Provides on-demand flexibility, taken only when sexual activity is anticipated, avoiding the need for daily medication.
• Enhances perceived control over ejaculation and reduces personal distress related to premature ejaculation.
• Improves sexual satisfaction for both the patient and their partner, contributing to better relationship quality.
• Offers a clinically studied, approved treatment option with a defined safety and efficacy profile.
• Reduces anxiety and concern associated with timing of ejaculation during sexual encounters.

Common use

Dapoxetine is indicated for the treatment of premature ejaculation (PE) in adult men aged 18–64 years. PE is defined clinically as persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it, which causes marked distress or interpersonal difficulty. It is intended for men who meet these diagnostic criteria and seek pharmacologic intervention to improve control over ejaculation. The medication is not intended for use in men with other forms of erectile or sexual dysfunction unless comorbid and properly evaluated. It should be used as part of a broader management approach, which may include psychological or behavioral techniques.

Dosage and direction

The recommended starting dose is 30 mg, taken orally as a single dose approximately 1–3 hours before anticipated sexual activity. It must be swallowed whole with at least one full glass of water; tablets should not be divided, crushed, or chewed. Based on efficacy and tolerability, the dose may be increased to 60 mg. Dosing should not exceed one tablet in a 24-hour period. It can be taken with or without food, although a high-fat meal may delay absorption. Patients should be advised that sexual activity is necessary for the effect of the medication to be assessed—it does not cause automatic delay without sexual stimulation.

Precautions

Prior to initiation, a thorough medical and psychiatric history should be obtained. Use with caution in patients with a history of syncope, hypotension, or orthostatic hypotension. Caution is advised in those with bleeding tendencies or on concomitant anticoagulant therapy, given SSRI-associated bleeding risk. Monitor for signs of activation of mania/hypomania in patients with bipolar disorder. Avoid use in patients with moderate or severe hepatic impairment. Patients should be advised not to drive or operate machinery until they know how dapoxetine affects them, due to potential dizziness or syncope. Alcohol should be avoided due to increased risk of adverse events such as dizziness, hypotension, or syncope.

Contraindications

Dapoxetine is contraindicated in patients with known hypersensitivity to dapoxetine or any excipient in the formulation. It must not be used in combination with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to risk of serotonin syndrome. Concomitant use with thioridazine or other potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir, clarithromycin) is contraindicated. It is also contraindicated in patients with significant cardiac conditions such as heart failure, conduction abnormalities, or significant ischemic heart disease. Not recommended in patients with severe renal or hepatic impairment.

Possible side effect

Common adverse reactions include nausea, dizziness, headache, diarrhea, insomnia, and fatigue. Less frequently, patients may experience orthostatic hypotension, syncope, vomiting, anxiety, blurred vision, and tinnitus. SSRI-class effects may include serotonin syndrome (though rare with on-demand dosing), increased sweating, and decreased libido. Some men may experience sexual side effects such as erectile dysfunction or anorgasmia. Most side effects are mild to moderate and tend to decrease with continued use. Patients should be advised to report persistent or severe symptoms.

Drug interaction

Dapoxetine is primarily metabolized by CYP enzymes including CYP3A4, CYP2D6, and others. Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole) is contraindicated. Use with moderate CYP3A4 inhibitors or CYP2D6 inhibitors may increase dapoxetine exposure—caution and potential dose adjustment are advised. Concurrent use with other serotonergic drugs (e.g., SSRIs, SNRIs, triptans, tramadol) may increase the risk of serotonin syndrome. Avoid use with alcohol or recreational drugs due to CNS depressant effects. Concomitant use with alpha-blockers or other antihypertensives may increase risk of orthostatic hypotension and syncope.

Missed dose

As dapoxetine is taken on an as-needed basis prior to anticipated sexual activity, the concept of a “missed dose” does not apply in the traditional sense. If a dose is not taken within the recommended window before sexual activity, it should be omitted. Patients should not take a double dose to make up for a missed opportunity. The next dose may be taken when再次 needed, adhering to the minimum 24-hour interval between doses.

Overdose

Symptoms of overdose may include serotonergic effects such as agitation, confusion, rapid heart rate, dizziness, nausea, vomiting, and in severe cases, seizures or serotonin syndrome. There is no specific antidote for dapoxetine overdose. Management is supportive and symptomatic, including monitoring of vital signs and ECG, ensuring adequate hydration, and providing appropriate symptomatic care. Gastric lavage or activated charcoal may be considered if ingestion was recent. In cases of serotonin syndrome, cyproheptadine or other supportive measures may be utilized under medical supervision.

Storage

Store at room temperature (15–30°C or 59–86°F) in the original container, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Do not transfer tablets to other containers, as the original packaging helps protect against moisture and light degradation.

Disclaimer

This information is intended for educational purposes only and does not constitute medical advice. Dapoxetine is a prescription medication and should only be used under the guidance of a qualified healthcare professional. Individual response to treatment may vary. Always follow the dosage and precautions advised by your prescribing physician. Do not start, stop, or change the dosage of any medicine without your doctor’s advice.

Reviews

Clinical trials and post-marketing studies have demonstrated that dapoxetine significantly improves IELT and patient-reported outcomes related to control and satisfaction. In randomized controlled trials, men taking dapoxetine reported approximately 3-4 fold increases in IELT compared to placebo. Many users report improved confidence and reduced anxiety surrounding sexual performance. Some note side effects such as mild nausea or dizziness, particularly when initiating treatment or increasing the dose, though these often diminish over time. Overall, it is regarded as a valuable option for men meeting diagnostic criteria for PE who seek a pharmacologic aid. Long-term satisfaction often depends on appropriate patient selection, dosing, and integration with other therapeutic strategies.