Men's Health
Before the treatment, geometric mean IELT of the patients was 22.72±15.16 seconds, mean PEDT score was 16.85±2.42, mean PEP score was 3.36±1.12and IIEF-EF score was 13.17±3.33. At the end of the 4-week treatment period, statistically significant improvements were observed in the mean IELTs, PEP and IIEF-EF scores compared to the patients' pre-treatment values (69.47±103.34;p<0.001, 9.92±2.36;p<0.001, The dapoxetine/ sildenafil combination therapy significantly improves the IELT values and patient reported outcome measures of PE patients who also suffer from ED.
A balanced verdict from a pharmacy perspective
Lifelong PE is present from the first sexual experience onwards, occurs in almost all attempts at intercourse, and is considered to have a neurobiological etiology. Secondary PE occurs later in life after a period of perceived normal ejaculatory control, and may have a psychological and neurobiological etiology. This type of PE may be triggered by stress or linked to adverse events associated with medications.19,20 Waldinger et al suggested that, in addition to these well known types of PE, there are two other subtypes, ie, natural variable PE and premature-like ejaculatory dysfunction.21 Natural variable PE refers to those men reporting occasional early ejaculation in the course of normal events, whilst with the latter, men experience or complain of PE while having normal or prolonged IELT.22,23 Despite the above classifications, features common to all PE are an inability to control ejaculation, ejaculation prior to/soon after vaginal penetration, embarrassment, low self-esteem, personal distress, and often interpersonal difficulty and relationship problems as a result of the lack of sexual satisfaction for both the man and his partner.6,7 The first evidence-based definition of lifelong PE has recently been published by the International Society for Sexual Medicine, and includes the criterion of “ejaculation which always or nearly always occurs prior to or within about 1 minute of vaginal penetration”, ie, an IELT of 1 minute or less. Other specified criteria are “… the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy”.8 Prior to this, researchers recruiting patients for clinical studies of PE tended to use the definition given in the DSM-IV-TR, which is similar to that of the International Society for Sexual Medicine, but does not specify an IELT threshold.6 The etiology of PE is multifactorial, and associations with psychological, environmental, endocrine, and neurobiological factors have been made. Control of ejaculation is under neuronal control from the supraspinal level and involves various neurotransmitters, the most widely studied of which is serotonin (5-hydroxytryptamine, 5-HT).
Increase in IELT
The role of 5-HT in the pathophysiology of PE is complex, with at least three receptor subtypes (5-HT1a, 5-HT1b, 5-HT2c) being known to play a role.24 Recently, there has been interest in investigating a potential genetic basis for PE.25 It is postulated that a polymorphism of the serotonin transporter gene (5-HTT) may be associated with the response to treatment with SSRIs.26 Due to a perceived psychosomatic aspect of PE, psychotherapy, such as sex therapy or cognitive therapy, has been widely used historically to treat PE.12 The aim of such treatment is to encourage self-confidence and improve communication and intimacy between PE patients and their partners, in the hope of improving performance and reducing the anxiety associated with intercourse. Behavioral methods are also used to reduce the urgency to ejaculate, including squeezing the glans of the penis or intermittent penetration, although the latter may actually lead to prolonged sexual frustration rather than greater penetrative time.27 Despite some reported short-term efficacy, there is little evidence of any long-term benefit associated with these treatment methods.1,9,28,29 The use of topical anesthetic creams was first described by Schapiro in 1943, the rationale being that reduced penile sensitivity would result in prolongation of sexual intercourse without adversely affecting the sensation of ejaculation.30,31 Prilocaine/lidocaine cream (EMLA®) has commonly been used off-license in the first-line management of PE. A novel metered-dose aerosol spray of lidocaine/prilocaine (TEMPE®) was found to increase IELT significantly compared with placebo (up to an eight-fold increase in one study) but is awaiting licensing.30,32–34 On face value, these topical treatments may appear ideal for on-demand use in PE, but they have several disadvantages, including genital numbness for both the patient and partner, reduced ability to maintain an erection, and messy application.12 As a result, these topical therapies have never achieved widespread acceptability. Although several side effects were reported, these were mild and reversible. Premature ejaculation (PE) is a major issue in male sexual health. The global prevalence of PE is estimated to be between 20% and 40%, making it the most common sexual dysfunction in men. PE causes distress and reduced quality of life for patients and has a negative impact on interpersonal relationships. Historically, it has been treated with cognitive therapy, behavioral methods, and off-label use of selective serotonin reuptake inhibitors usually used to treat depression and other psychological disorders. Dapoxetine is a selective serotonin reuptake viagra packaging inhibitor specifically designed to treat PE.
| Product | Dosage | Quantity + Bonus | Price | |
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| Viagra Professional | 100mg | 120 + 4 Pills | 262.83€ 250.31€ | |
| Viagra Professional | 100mg | 60 + 2 Pills | 146.74€ 139.75€ | |
| Viagra Soft Tabs | 100mg | 30 + 4 Pills | 83.06€ 79.10€ | |
| Viagra Original | 100mg | 76 + 4 Pills | 306.59€ 291.99€ | |
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| Viagra Generic | 25mg | 30 + 4 Pills | 47.97€ 45.69€ | |
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| Viagra Soft Tabs | 100mg | 180 + 10 Pills | 314.95€ 299.95€ | |
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| Viagra Generic | 150mg | 20 Pills | 55.02€ 52.40€ |
This paper reviews the current evidence for use of dapoxetine in the treatment of PE in adult men. There is substantial evidence that dapoxetine 30 mg or 60 mg taken “on-demand” results in a significant increase in intravaginal ejaculatory latency time when compared with placebo. Patient-reported outcomes are clearly improved relative to placebo following dapoxetine therapy, indicating greater control over ejaculation, more satisfaction with intercourse, less ejaculation-related distress, and, importantly, significantly reduced interpersonal difficulty. These data were supported by consistent reports of improvement in Clinical Global Impression of change in PE following treatment with dapoxetine. Further studies are needed to evaluate long-term efficacy and health economics.
| Medication | Main Active Ingredient | Uses | Typical Dose | Side Effects | Price Range (per pill) |
|---|---|---|---|---|---|
| Viagra + Dapoxetine | Sildenafil + Dapoxetine | ED + PE combined | 50-100mg + 30-60mg | Headache, dizziness, nausea | $2 - $10 |
| Cialis + Dapoxetine | Tadalafil + Dapoxetine | Long-term ED and PE support | 10-20mg + 30-60mg | Muscle pain, flushing | $3 - $12 |
| Levitra + Dapoxetine | Vardenafil + Dapoxetine | Similar to Viagra | 5-20mg + 30-60mg | Vision disturbances | $3 - $11 |
The unique pharmacology of dapoxetine makes it ideal for on-demand dosing, and the clinical evidence shows dapoxetine to be an efficacious and tolerable treatment for lifelong and acquired PE.
| Benefit | Description | Common Platforms | Additional Notes |
|---|---|---|---|
| Convenience | Purchase from home without doctor's visit | Online pharmacies | Discreet packaging |
| Cost-effectiveness | Lower prices compared to local pharmacies | Licensed online stores | Check for authenticity |
| Privacy | Confidential transaction | International sellers | Reduces social stigma |
| Discreet Delivery | Products shipped in plain packaging | Various online vendors | Ensures privacy |
| Accessibility | Available 24/7 without location constraints | E-pharmacies | Can bypass local restrictions |
Keywords: dapoxetine, intravaginal ejaculatory latency time, patient-reported outcomes, premature ejaculation Dapoxetine (PriligyTM, Johnson and Johnson, Raritan, NJ) is the first and only product licensed for the treatment of premature ejaculation (PE) in men aged 18–64 years. At present, dapoxetine is licensed in ten countries, including several countries in Europe, and Mexico, South Korea, and New Zealand.1,2 PE is the most common sexual dysfunction in men, with a global prevalence estimated to be between 20% and 40%.3–5 The uncertainty about prevalence figures is due to the intimate nature of the condition and, until recently, the lack of a universal evidence-based definition. It is probable that many men do not admit to having the condition and do not seek medical advice.
- Viagra with Dapoxetine is not recommended for women or children.
- Men with severe kidney or liver issues should avoid this drug.
- Those with retinitis pigmentosa may face increased vision risks.
- Heart patients must get clearance before starting treatment.
- Diabetic men may require lower doses due to health complications.
- High blood pressure patients should monitor cardiovascular response.
- Consult specialist if you have a history of stroke or seizures.
- Prostate surgery patients may have altered drug sensitivity.
- Age over 65 may require reduced dosage for safety reasons.
PE is characterized by ejaculation prior to, or soon after, vaginal penetration with minimal stimulation, with the male having no control over ejaculation.
This article is cited by
Patient-reported outcomes are clearly improved relative to placebo following dapoxetine therapy, indicating greater control over ejaculation, more satisfaction with intercourse, less ejaculation-related distress, and, importantly, significantly reduced interpersonal difficulty. These data were supported by consistent reports of improvement in Clinical Global Impression of change in PE following treatment with dapoxetine. Further studies are needed to evaluate long-term efficacy and health economics. The unique pharmacology of dapoxetine makes it ideal for on-demand dosing, and the clinical evidence shows dapoxetine to be an efficacious and tolerable treatment for lifelong and acquired PE. Keywords: dapoxetine, intravaginal ejaculatory latency time, patient-reported outcomes, premature ejaculation Dapoxetine (PriligyTM, Johnson and Johnson, Raritan, NJ) is the first and only product licensed for the treatment of premature ejaculation (PE) in men aged 18–64 years.
Levitra Brand
At present, dapoxetine is licensed in ten countries, including several countries in Europe, and Mexico, South Korea, and New Zealand.1,2 PE is the most common sexual dysfunction in men, with a global prevalence estimated to be between 20% and 40%.3–5 The uncertainty about prevalence figures is due to the intimate nature of the condition and, until recently, the lack of a universal evidence-based definition. It is probable that many men do not admit to having the condition and do not seek medical advice. PE is characterized by ejaculation prior to, or soon after, vaginal penetration with minimal stimulation, with the male having no control over ejaculation. Definitions have been published by the International Society for Sexual Medicine and in the Diagnostic Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), with the key point being the uncontrolled brevity of sexual intercourse.6–8 The negative consequences of PE are significant, and affect both the male and female partner. As well as obvious sexual dissatisfaction, the condition can cause personal distress, low self-esteem, and interpersonal difficulty.5,9–11 Dapoxetine belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs) which are frequently used to treat depression. Definitions have been published by the International Society for Sexual Medicine and in the Diagnostic Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), with the key point being the uncontrolled brevity of sexual intercourse.6–8 The negative consequences of PE are significant, and affect both the male and female partner.
| Risk | Description | How to Avoid | Signs of Fake Medication |
|---|---|---|---|
| Ineffective Treatment | Fake drugs may not treat ED or PE | Purchase from reputable sources | Unusual packaging |
| Adverse Reactions | Unexpected side effects from contaminated substances | Check for proper certification | Poor packaging |
| Legal Consequences | Buying illegal drugs can lead to legal action | Verify legality in your country | Unlicensed vendors |
| Financial Loss | Money lost on counterfeit products | Use secure payment methods | Lower prices than usual |
| Health Risks | Potential toxicity or allergenic reactions | Read ingredient labels | Unusual taste or appearance |
As well as obvious sexual dissatisfaction, the condition can cause personal distress, low self-esteem, and interpersonal difficulty.5,9–11 Dapoxetine belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs) which are frequently used to treat depression. Prior to the availability of dapoxetine, psychotherapy (eg, cognitive behavior therapy) was widely used to weekend viagra treat PE. More recently, several SSRIs (other than dapoxetine) have been used off-label to treat PE.12,13 These SSRIs were not developed to treat PE,12 in contrast with dapoxetine which was specifically developed for this purpose and has a different pharmacological profile to the other SSRIs,14–17 with properties making it suitable for on-demand dosing.1 The aims of this article are to review the current evidence for use of dapoxetine in the treatment of PE, including the ability of the drug to not only increase time to ejaculation post-penetration, termed intravaginal ejaculatory latency time (IELT), but also to improve patient self-esteem, satisfaction with sexual intercourse, and perceived control over ejaculation. Literature searches were carried out in August 2011 using PubMed ( the Cochrane Database of Systematic Reviews ( NHS Evidence ( and the National Institute for Health and Clinical Excellence (NICE, These databases were searched using the terms “dapoxetine” or “dapoxetine AND premature ejaculation”.
Medical Supervision & Regulatory Status
Articles involving dapoxetine for the treatment of PE were identified, with priority given to systematic reviews, meta-analyses and integrated analyses, double-blind, randomized, placebo-controlled clinical trials (RCTs), and nonrandomized observational studies. Only articles published in English were selected for inclusion. The references listed in identified articles were used as a further source of relevant studies. PE is highly prevalent and, due to the nature of the disorder, is likely to be under-reported and undertreated.5,18 Reported prevalence has also been variable due to the previous lack of an evidence-based definition. In the past, physicians generally considered PE to have a psychological element, hence the historical use of psychotherapy to treat the condition. However, in recent years, the biological component has become more widely understood, and pharmacotherapy is the new focus cialis or viagra for women for the treatment of PE. Two types of PE have been widely recognized, ie, lifelong (primary) and acquired (secondary) PE. Lifelong PE is present from the first sexual experience onwards, occurs in almost all attempts at intercourse, and is considered to have a neurobiological etiology.
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Prior to the availability of dapoxetine, psychotherapy (eg, cognitive behavior therapy) was widely used to weekend viagra treat PE. More recently, several SSRIs (other than dapoxetine) have been used off-label to treat PE.12,13 These SSRIs were not developed to treat PE,12 in contrast with dapoxetine which was specifically developed for this purpose and has a different pharmacological profile to the other SSRIs,14–17 with properties making it suitable for on-demand dosing.1 The aims of this article are to review the current evidence for use of dapoxetine in the treatment of PE, including the ability of the drug to not only increase time to ejaculation post-penetration, termed intravaginal ejaculatory latency time (IELT), but also to improve patient self-esteem, satisfaction with sexual intercourse, and perceived control over ejaculation. Literature searches were carried out in August 2011 using PubMed ( the Cochrane Database of Systematic Reviews ( NHS Evidence ( and the National Institute for Health and Clinical Excellence (NICE, These databases were searched using the terms “dapoxetine” or “dapoxetine AND premature ejaculation”. Articles involving dapoxetine for the treatment of PE were identified, with priority given to systematic reviews, meta-analyses and integrated analyses, double-blind, randomized, placebo-controlled clinical trials (RCTs), and nonrandomized observational studies. Only articles published in English were selected for inclusion.
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The references listed in identified articles were used as a further source of relevant studies. PE is highly prevalent and, due to the nature of the disorder, is likely to be under-reported and undertreated.5,18 Reported prevalence has also been variable due to the previous lack of an evidence-based definition. In the past, physicians generally considered PE to have a psychological element, hence the historical use of psychotherapy to treat the condition. However, in recent years, the biological component has become more widely understood, and pharmacotherapy is the new focus cialis or viagra for women for the treatment of PE. Two types of PE have been widely recognized, ie, lifelong (primary) and acquired (secondary) PE. Secondary PE occurs later in life after a period of perceived normal ejaculatory control, and may have a psychological and neurobiological etiology. This type of PE may be triggered by stress or linked to adverse events associated with medications.19,20 Waldinger et al suggested that, in addition to these well known types of PE, there are two other subtypes, ie, natural variable PE and premature-like ejaculatory dysfunction.21 Natural variable PE refers to those men reporting occasional early ejaculation in the course of normal events, whilst with the latter, men experience or complain of PE while having normal or prolonged IELT.22,23 Despite the above classifications, features common to all PE are an inability to control ejaculation, ejaculation prior to/soon after vaginal penetration, embarrassment, low self-esteem, personal distress, and often interpersonal difficulty and relationship problems as a result of the lack of sexual satisfaction for both the man and his partner.6,7 The first evidence-based definition of lifelong PE has recently been published by the International Society for Sexual Medicine, and includes the criterion of “ejaculation which always or nearly always occurs prior to or within about 1 minute of vaginal penetration”, ie, an IELT of 1 minute or less. Other specified criteria are “… the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy”.8 Prior to this, researchers recruiting patients for clinical studies of PE tended to use the definition given in the DSM-IV-TR, which is similar to that of the International Society for Sexual Medicine, but does not specify an IELT threshold.6 The etiology of PE is multifactorial, and associations with psychological, environmental, endocrine, and neurobiological factors have been made.
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Before the treatment, geometric mean IELT of the patients was 22.72±15.16 seconds, mean PEDT score was 16.85±2.42, mean PEP score was 3.36±1.12and IIEF-EF score was 13.17±3.33. At the end of the 4-week treatment period, statistically significant improvements were observed in the mean IELTs, PEP and IIEF-EF scores compared to the patients' pre-treatment values (69.47±103.34;p<0.001, 9.92±2.36;p<0.001, The dapoxetine/ sildenafil combination therapy significantly improves the IELT values and patient reported outcome measures of PE patients who also suffer from ED. Although several side effects were reported, these were mild and reversible. Premature ejaculation (PE) is a major issue in male sexual health. The global prevalence of PE is estimated to be between 20% and 40%, making it the most common sexual dysfunction in men.
Licensed Provider Review
PE causes distress and reduced quality of life for patients and has a negative impact on interpersonal relationships. Historically, it has been treated with cognitive therapy, behavioral methods, and off-label use of selective serotonin reuptake inhibitors usually used to treat depression and other psychological disorders. Dapoxetine is a selective serotonin reuptake viagra packaging inhibitor specifically designed to treat PE. This paper reviews the current evidence for use of dapoxetine in the treatment of PE in adult men. There is substantial evidence that dapoxetine 30 mg or 60 mg taken “on-demand” results in a significant increase in intravaginal ejaculatory latency time when compared with placebo. Control of ejaculation is under neuronal control from the supraspinal level and involves various neurotransmitters, the most widely studied of which is serotonin (5-hydroxytryptamine, 5-HT).
Why do men choose Sildenafil with Dapoxetine?
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The role of 5-HT in the pathophysiology of PE is complex, with at least three receptor subtypes (5-HT1a, 5-HT1b, 5-HT2c) being known to play a role.24 Recently, there has been interest in investigating a potential genetic basis for PE.25 It is postulated that a polymorphism of the serotonin transporter gene (5-HTT) may be associated with the response to treatment with SSRIs.26 Due to a perceived psychosomatic aspect of PE, psychotherapy, such as sex therapy or cognitive therapy, has been widely used historically to treat PE.12 The aim of such treatment is to encourage self-confidence and improve communication and intimacy between PE patients and their partners, in the hope of improving performance and reducing the anxiety associated with intercourse. Behavioral methods are also used to reduce the urgency to ejaculate, including squeezing the glans of the penis or intermittent penetration, although the latter may actually lead to prolonged sexual frustration rather than greater penetrative time.27 Despite some reported short-term efficacy, there is little evidence of any long-term benefit associated with these treatment methods.1,9,28,29 The use of topical anesthetic creams was first described by Schapiro in 1943, the rationale being that reduced penile sensitivity would result in prolongation of sexual intercourse without adversely affecting the sensation of ejaculation.30,31 Prilocaine/lidocaine cream (EMLA®) has commonly been used off-license in the first-line management of PE. A novel metered-dose aerosol spray of lidocaine/prilocaine (TEMPE®) was found to increase IELT significantly compared with placebo (up to an eight-fold increase in one study) but is awaiting licensing.30,32–34 On face value, these topical treatments may appear ideal for on-demand use in PE, but they have several disadvantages, including genital numbness for both the patient and partner, reduced ability to maintain an erection, and messy application.12 As a result, these topical therapies have never achieved widespread acceptability.
- Using Viagra with Dapoxetine does not prevent sexually transmitted infections.
- Combining these drugs may improve confidence and reduce performance anxiety.
- The pills should be taken about an hour before sexual activity.
- Do not take more than the prescribed dose to avoid overdose risks.
- Be aware of potential interactions with blood pressure or heart medications.
- Consult your doctor if you experience prolonged or painful erections.
- Alcohol can diminish the effectiveness and increase side effects.
- These medications are not suitable for men with certain health conditions.
- Combining these medicines can sometimes cause dizziness or fainting.
- They should be used only when needed; do not take daily without medical advice.
- Always check for allergies to sildenafil or dapoxetine before use.
- Keep a record of any side effects experienced and inform your doctor.