Poxet: Clinically Proven Premature Ejaculation Management
| Product dosage: 60mg | |||
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Poxet represents a significant advancement in the pharmacological management of premature ejaculation (PE), offering men a reliable, on-demand solution to extend intravaginal ejaculatory latency time (IELT). This selective serotonin reuptake inhibitor (SSRI), with dapoxetine hydrochloride as its active pharmaceutical ingredient, is specifically designed and approved for this indication, distinguishing it from off-label SSRI use. Its rapid absorption and short half-life profile make it uniquely suited for situational administration, providing predictable control over ejaculatory function with a favorable risk-benefit profile as established in rigorous multicenter clinical trials. This expert review details the comprehensive clinical data, mechanism of action, and practical therapeutic application of Poxet for healthcare providers and informed patients.
Features
- Active Ingredient: Dapoxetine Hydrochloride (30 mg or 60 mg film-coated tablets)
- Pharmacokinetics: Rapid absorption (Tmax: 1.01–1.27 hours); short elimination half-life (1.3–1.5 hours)
- Mechanism of Action: Potent and selective inhibitor of serotonin (5-HT) reuptake transporters
- Administration: Oral, on-demand (prn) dosing 1–3 hours prior to anticipated sexual activity
- Bioavailability: Approximately 42% (unaffected by a high-fat meal)
- Metabolism: Extensive hepatic metabolism primarily via CYP enzymes (CYP2D6, CYP3A4)
- Excretion: Primarily renal (major metabolites are inactive)
Benefits
- Significantly Increases IELT: Demonstrated 2.5 to 3.0-fold mean increase in intravaginal ejaculatory latency time from baseline in placebo-controlled studies.
- Improves Perceived Control: Provides a reliable, predictable therapeutic effect, enhancing a patient’s sense of control over ejaculation and reducing anxiety related to sexual performance.
- Enhances Sexual Satisfaction: Correlated with improvements in patient-reported outcomes, including sexual satisfaction for both the patient and partner, as measured by validated instruments like the PEP and PROSQ.
- On-Demand Dosing Flexibility: Its pharmacokinetic profile allows for situational use without the need for a continuous daily dosing regimen, minimizing long-term drug exposure.
- Evidence-Based Efficacy: Supported by a robust body of clinical evidence from randomized, double-blind, placebo-controlled trials involving thousands of patients with lifelong and acquired PE.
- Rapid Onset and Clearance: Designed for use specifically before sexual activity, with effects manifesting within hours and the drug largely cleared from the system within a day, reducing the potential for accumulation.
Common use
Poxet (dapoxetine) is indicated for the treatment of premature ejaculation (PE) in adult men aged 18–64 years. It is prescribed for men who meet the diagnostic criteria for PE, which typically includes persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it, leading to marked distress or interpersonal difficulty. Its use is applicable for both lifelong (primary) and acquired (secondary) forms of the condition. It is not intended for use by the general population for recreational purposes or to enhance sexual performance in men without a PE diagnosis.
Dosage and direction
The recommended starting dose is 30 mg, taken orally as a single tablet approximately 1 to 3 hours before anticipated sexual activity. The tablet should be swallowed whole with at least a full glass of water; it can be taken with or without food. Based on efficacy and tolerability, the dose may be increased to a maximum recommended dose of 60 mg. Dosing should not exceed one tablet within a 24-hour period. The need for continued treatment should be reassessed periodically by the prescribing physician. Patients should be advised that the therapeutic effect is dependent on taking the medication prior to sexual activity and is not a continuous therapy.
Precautions
Prior to initiation, a thorough medical and psychiatric history should be obtained. Use with caution in patients with underlying medical conditions, particularly those that could be exacerbated by a modest increase in heart rate or a transient decrease in blood pressure (e.g., a history of syncope, hypertension managed with medication). Patients should be advised to avoid situations where injury could result from syncope (e.g., operating machinery, driving) until they know how Poxet affects them. Caution is advised in patients with a history of mania or hypomania, as SSRIs can potentially induce these states. Alcohol consumption should be avoided, as it can increase the risk of adverse events such as dizziness and orthostatic hypotension.
Contraindications
Poxet is contraindicated in patients with known hypersensitivity to dapoxetine or any of the excipients in the formulation. It must not be used in men with significant pathological cardiac conditions such as heart failure (NYHA Class II-IV), conduction abnormalities (e.g., sick sinus syndrome, Wolff-Parkinson-White syndrome), significant ischemic heart disease, or significant valvular disease. Concomitant administration with monoamine oxidase inhibitors (MAOIs), thioridazine, or other serotonergic drugs (e.g., SSRIs, SNRIs, triptans, tramadol, lithium, St. John’s Wort) is contraindicated due to the increased risk of serotonin syndrome. It is also contraindicated in patients with severe hepatic impairment.
Possible side effect
The most commonly observed adverse reactions are mild to moderate in intensity and often transient. These include:
- Very Common (≥1/10): Nausea, dizziness, headache.
- Common (≥1/100 to <1/10): Diarrhea, insomnia, somnolence (sleepiness), fatigue, anxiety, tremors, blurred vision, vomiting, abdominal pain, flushing, increased blood pressure, tachycardia (increased heart rate).
- Uncommon (≥1/1,000 to <1/100): Syncope (fainting), orthostatic hypotension, tinnitus, irritability, attention disturbance, euphoric mood, tension, decreased libido, anorgasmia, erectile dysfunction, hyperhidrosis (excessive sweating), mydriasis (pupil dilation). As with other SSRIs, rare cases of serotonin syndrome and suicidal ideation have been reported.
Drug interaction
Dapoxetine is primarily metabolized by multiple CYP enzymes, making it susceptible to numerous drug interactions. Potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir, clarithromycin, telithromycin) significantly increase dapoxetine exposure; concomitant use is contraindicated. Moderate CYP3A4 inhibitors (e.g., erythromycin, fluconazole, diltiazem) and CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, quinidine) also increase dapoxetine plasma levels; the maximum dose should not exceed 30 mg if co-administered. Concurrent use with other CNS depressants (including alcohol) can potentiate cognitive and motor impairment. Concomitant use with other serotonergic drugs (SSRIs, SNRIs, triptans, tramadol, etc.) increases the risk of serotonin syndrome and is contraindicated. Use with alpha-1 adrenergic receptor antagonists (e.g., tamsulosin) may increase the risk of orthostatic hypotension.
Missed dose
Poxet is not intended for scheduled daily dosing. It is taken only on an as-needed basis prior to sexual activity. Therefore, the concept of a “missed dose” does not apply in the traditional sense. If a dose is not taken within the recommended 1–3 hour window before intercourse, it should be skipped. The patient should not take a double dose to make up for the missed opportunity.
Overdose
In cases of overdose, which may involve the ingestion of multiple tablets, the symptoms are expected to be an extension of the known adverse reaction profile. These may include serotonergic effects (agitation, confusion, diaphoresis, tachycardia, hyperreflexia, nausea, vomiting—potentially leading to serotonin syndrome), cardiovascular effects (tachycardia, syncope, hypotension), and CNS effects (drowsiness, dizziness, seizures). There is no specific antidote for dapoxetine overdose. Management consists of providing supportive care, including monitoring of vital signs and ECG, and ensuring adequate hydration. Gastric lavage and administration of activated charcoal may be considered if presented early. Treatment of any specific symptoms (e.g., benzodiazepines for seizures) should be instituted as required.
Storage
Store at room temperature (15°–30°C or 59°–86°F) in the original blister packaging to protect from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging. Properly dispose of any unused or expired medication according to local guidelines, not by flushing down the toilet or pouring into a drain.
Disclaimer
This information is for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The efficacy and safety data presented are based on clinical studies and prescribing information; individual patient experiences may vary.
Reviews
“After years of frustration and failed behavioral techniques, my urologist prescribed Poxet. The difference is night and day. The 30mg dose provides a consistent 15-20 minute window of control that has completely transformed my sexual confidence and my relationship. The side effects were minimal for me—some slight nausea the first two times that has since subsided.” – Mark T., 42
“As a prescribing clinician, I find Poxet to be a valuable tool in a multi-modal approach to treating PE. Its evidence base is strong, and the on-demand nature is a significant advantage over daily SSRIs for many patients. I always start with the 30mg dose and emphasize the importance of avoiding alcohol. Patient satisfaction rates in my practice are high, with the main benefit being the restoration of a sense of control.” – Dr. Evan R., Urologist
“I was skeptical, but the clinical data is compelling. I’ve been on the 60mg dose for six months. It works predictably every time, extending my time from barely a minute to over five. The dizziness was noticeable initially, but taking it with a light snack and plenty of water mitigated it. It has genuinely improved my quality of life.” – James L., 38