Dapoxetine (Priligy): Medical Guide for Premature Ejaculation

Known as original brand(s)

Priligy

Dapoxetine is a fast-acting selective serotonin reuptake inhibitor (SSRI) originally marketed under the brand name Priligy, specifically developed for the treatment of premature ejaculation in men aged 18 to 64 years. Unlike other SSRIs, dapoxetine is rapidly absorbed and eliminated from the body, making it ideal for on-demand use shortly before anticipated sexual activity.

The mechanism of action of dapoxetine is related to the inhibition of neuronal reuptake of serotonin and the subsequent potentiation of the neurotransmitter's action at pre- and postsynaptic receptors. The drug increases intravascular latency time and delays ejaculation, enhancing control over ejaculation and reducing distress.

Clinical use of dapoxetine significantly extends the duration of intercourse, improves ejaculatory control, and enhances overall sexual satisfaction for the patient and their partner.

Wikipedia page
Dapoxetine

Indications

Dapoxetine is indicated in urology and sexual medicine for the following conditions:

  • Premature Ejaculation: Treatment of premature ejaculation in adult men aged 18 to 64 years with persistent or recurrent ejaculation with minimal sexual stimulation.
  • Ejaculatory Control: Improvement of poor control over ejaculation and reduction of personal distress or interpersonal difficulty as a consequence of premature ejaculation.

Dosage and administration

Dapoxetine is intended strictly for oral administration on an as-needed basis:

  • Recommended Starting Dose: The standard initial dose is 30 mg, taken 1 to 3 hours prior to anticipated sexual activity.
  • Maximum Dosage: If the response to 30 mg is insufficient and side effects are acceptable, the dose may be increased to a maximum of 60 mg.
  • Frequency: Designed for on-demand use only. Do not take more frequently than once every 24 hours.
  • Administration Method: Tablets should be swallowed whole with a full glass of water, with or without food. Alcohol consumption should be avoided.

Dapoxetine is contraindicated in the following cases:

  • Cardiovascular Conditions: Significant heart failure, conduction abnormalities (AV block grade II-III), ischemic heart disease, or pacemaker presence.
  • Hepatic Impairment: Moderate to severe hepatic impairment.
  • Drug Interactions: Concomitant use with MAO inhibitors, thioridazine, other SSRIs/SNRIs, tricyclic antidepressants, and potent CYP3A4 inhibitors (e.g., ketoconazole, ritonavir).
  • Age and Gender: Females, and male patients under 18 or aged 65 years and older.

Dapoxetine is generally well tolerated, but the following adverse reactions may occur:

  • Central Nervous System: Dizziness, headache, insomnia, somnolence, anxiety, and vivid dreams.
  • Gastrointestinal System: Nausea (most common effect), diarrhea, dry mouth, and dyspepsia.
  • Cardiovascular System: Flushing, increased blood pressure, orthostatic hypotension, and syncope (fainting).
  • Other Reactions: Hyperhidrosis, tinnitus, nasal congestion, and fatigue.

Frequently Asked Questions

Dapoxetine is an oral short-acting selective serotonin reuptake inhibitor (SSRI) specifically developed for on-demand treatment of premature ejaculation. Unlike standard antidepressants in this class that require continuous daily administration, dapoxetine features a rapid pharmacokinetic profile with a short half-life, meaning it is absorbed and eliminated quickly. By increasing serotonin neurotransmission at the synaptic cleft, dapoxetine delays the ejaculatory reflex at the spinal cord level, enabling men to significantly improve control over ejaculation and prolong intercourse duration.
The standard starting dose of dapoxetine is 30 mg, which can be increased by a physician up to 60 mg depending on individual efficacy and tolerability. The medication should be taken orally 1 to 3 hours prior to anticipated sexual activity, accompanied by a full glass of water. A critical safety rule is that dapoxetine must not be taken more frequently than once every 24 hours. The tablet should be swallowed whole with or without food, as food intake has minimal clinical impact on its absorption rate.
Dapoxetine is generally well-tolerated, but like other short-acting SSRIs, it can cause transient adverse effects. The most frequent reactions include mild nausea, headache, dizziness, diarrhea, insomnia, and fatigue. A specific safety consideration is orthostatic hypotension—a sudden drop in blood pressure when rising quickly from a seated or lying position—which can occasionally result in lightheadedness, dizziness, or a brief fainting episode (vasovagal syncope).
Dapoxetine carries strict contraindications regarding drug-drug interactions. It must never be combined with monoamine oxidase inhibitors (MAOIs), other antidepressants, lithium, tryptophan, or strong analgesics like tramadol, as concurrent use can trigger a life-threatening serotonin syndrome. Furthermore, co-administration with potent CYP3A4 enzyme inhibitors (such as certain antifungals and antivirals) is contraindicated. Patients are also strongly advised to completely avoid alcohol while taking dapoxetine, as alcohol increases the risk of adverse neuro-cardiovascular effects, sedation, and syncope.
Dapoxetine is intended exclusively for adult men experiencing premature ejaculation. The medication is contraindicated in individuals with hypersensitivity to its active ingredients, severe heart failure, significant conduction abnormalities (arrhythmias), or a history of myocardial infarction or stroke. It is also contraindicated in patients with severe hepatic impairment, moderate-to-severe renal impairment, or pre-existing psychiatric conditions such as severe major depression, bipolar disorder, or poorly controlled epilepsy.

List of medicines by active substance

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