Buy Dapoxetine Online – Fight premature ejaculation

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Dapoxetine is a drug used to treat premature ejaculation. You can buy Dapoxetine online simply and safely using our confidential pharmacy service.

Buy Dapoxetine Online

When buying Dapoxetine on the internet, make sure that you are asked to answer several questions in the form of a reliable health form and that a qualified doctor checks your order.

What is Dapoxetine

The official chemical name is “dapoxetine hydrochloride” and the chemical structural formula is (S)-N,N-dimethyl-3-(1-naphthyloxy)-1-phenylpropylamine hydrochloride, or (S)-N, It is written as N-dimethyl-α-[2-(1-naphthyloxy)ethyl]benzylamine hydrochloride.

Its molecular formula is C21H23NO. HCl, resulting in a compound with a molecular weight of 341.88. Currently, it is used as an active ingredient in premature ejaculation prevention drugs and is a notable ingredient that is used all over the world.

This time, we will discuss how dapoxetine was born, its history, how it works in the body and what effects it exhibits, its mechanism of action and effects, and how to purchase and use products containing dapoxetine. Let’s thoroughly explain everything about dapoxetine, including how to use it.

History of Dapoxetine

Dapoxetine is classified as a drug called SSRI (selective serotonin reuptake inhibitor) that inhibits the uptake of serotonin, one of the three major neurotransmitters.

SSRIs were originally used for depression and panic disorder, and dapoxetine was originally used as an antidepressant.

However, when SSRIs were administered to patients with depression as a treatment, the so-called side effect of prolonging the ejaculation time appeared in many patients. There is a history that has been advanced.

Among antidepressants, SSRIs have few side effects and are highly safe, so they are often used to improve premature ejaculation, which is not indicated.

Methods to improve premature ejaculation before using SSRIs include training methods to prevent premature ejaculation such as the Semans method and squeeze method, masturbation before sexual activity, coping methods such as using multiple condoms to reduce sensitivity, and surgical operations such as phimosis. was common.

However, the appearance of dapoxetine, which is said to be the most effective treatment for premature ejaculation among SSRIs, has changed the concept of treatment, and the use of dapoxetine is currently the first choice as a standard treatment for premature ejaculation due to its high effectiveness. increase.

Specific SSRI

Antidepressants such as paroxetine (trade name Paxil) and fluvoxamine (trade name Luvox) are well-known SSRI drugs in addition to dapoxetine.

Paroxetine is also used as an SSRI to improve premature ejaculation. There is also a report that it has been improved to 34 to 90 seconds.

However, paroxetine did not gain much attention as an anti-premature ejaculation drug because it was inconvenient, such as the effect not appearing immediately after taking paroxetine, and the improvement rate of premature ejaculation in clinical trials was not high at 10-30%. There was not.

SSRIs other than paroxetine were also used, but although some IELT prolongation effect was observed, the effect was limited and the evaluation was low.

On the other hand, dapoxetine has been shown to have a specific effect of prolonging IELT and is highly evaluated for its ease of use as it is a short-acting drug that can be taken before sexual activity.

Development of Priligy

According to documents from the US National Center for Biotechnology Information, the main ingredient dapoxetine was originally developed by the US company Eli Lilly, and then tested with the US company Pharmaceutical Product Development (PPD). was

PPD acquired the patent for dapoxetine, but the rights were transferred by transferring the license to Johnson & Johnson. In 2009, Janssen Silag, the pharmaceutical division of Johnson & Johnson, developed Priligy, the world’s first oral anti-premature ejaculation drug.

2012 Menarini is granted the right to commercialize Priligy. After that, in 2014 Actavis acquired the patent and rights, and now Priligy is manufactured by Janssen Silag on consignment and is managed, distributed, and sold by Menarini.

Johnson & Johnson is a company headquartered in New Planswick, New Jersey, United States, which handles pharmaceuticals and medical devices.

Janssen Cirag Pharmaceutical is a pharmaceutical company specializing in ethical pharmaceuticals headquartered in Belgium, with more than 250 group companies in 60 countries around the world.

Menarini S.p.A. is an Italian pharmaceutical company founded in 1886 and has long been the leader in pharmaceutical sales in Italy. The sales area extends to 110 countries around the world. Actavis is a company that manufactures and sells generic drugs, headquartered in Iceland.

Approval in European countries

Immediately after its introduction in 2009, dapoxetine (trade name Priligy) attracted attention as a revolutionary drug and has been sold worldwide, mainly in European countries such as Sweden, Germany, Belgium, the United Kingdom, France, Spain, Italy, Portugal, Finland, and Austria. It was approved and approved and sold one after another as the first oral premature ejaculation drug.

Approval of pharmaceuticals is necessary for public use of pharmaceuticals for appropriate purposes. Proof of efficacy and safety in actual use in the country by clinical trial data etc. is a condition.

In European countries, there is a European Union (EU) body called the European Medicines Agency (EMA), which is the European Union (EU)’s dedicated body for the evaluation and control of human and veterinary medicines. ) are grouped together.

By sharing information such as clinical trial data and unifying the review system, it is said that the approval and approval of pharmaceuticals will spread rapidly in European countries.

Approval in Japan

Large-scale clinical trials have been conducted around the world to date, and dapoxetine has been proven to be safe and effective, but unfortunately, it is an unapproved drug that has not yet been approved in Japan. .

Approval of pharmaceuticals in Japan is conducted in accordance with the Pharmaceuticals and Medical Devices Act, and even if a drug is officially approved for use outside Japan, it is necessary to target Japanese people in Japan in order to obtain approval in Japan. clinical trials are also needed.

We have established a system that allows approval if there is clinical data from some Asians, but at present, there are very few drugs that have been approved under that condition. Since unapproved drugs are not covered by public medical insurance, the patient will be responsible for their own use.

In Japan, it is often pointed out that it takes a long time to approve new drugs and overseas drugs. It will be given to the cause of

The time lag between a drug that has already been approved overseas and being approved in Japan is called a drug lag. In Japan, premature ejaculation is not yet recognized as a disease or disease, and there is no information that it will be approved in the future, and it is said that it will take a long time.

Sold in over 50 countries around the world

After being approved and marketed in European countries, dapoxetine will be approved and marketed one after another in countries around the world, including Australia, New Zealand, Singapore, South Korea, Malaysia, Mexico, Argentina, and Uruguay.

In the United States, an application for approval is currently being submitted to the US Food and Drug Administration (FDA), and approval is expected to be granted in the near future. As of 2018, it has been approved and sold in more than 50 countries around the world, and has been used by more than millions of people.

The European Medicines Agency (EMA) has been actively disclosing information on approved drugs since 2015 and permits the downloading, saving, and printing of clinical trial data and other research data submitted when applying for drug marketing approval. increase.

It is an epoch-making policy that allows the sharing of drug information and data, and it has also made it possible for third parties to re-analyze the data. Information on dapoxetine is naturally applicable, and it is expected that it will be shared and used in many countries.

In addition, dapoxetine is currently the only oral anti-premature ejaculation ingredient, and it is expected that the number of countries where it will be approved and marketed will steadily increase in the future.

Mechanism of Action of Dapoxetine

Until now, premature ejaculation was mainly thought to be caused by hypersensitivity of the skin of the penis and weakness to stimulation of the glans. I’m here.

In sexual activity, the parasympathetic nervous system dominates in a relaxed state at the beginning. However, as the act progresses, sexual arousal occurs, and when it accumulates, the neurotransmitter noradrenaline is secreted, and the sympathetic nerves work predominantly.

Ejaculation occurs when the brain sends an ejaculation signal when sexual arousal reaches its limit. Excessive noradrenaline secretion is considered to be the mechanism of premature ejaculation that occurs when ejaculation cannot be controlled.

Serotonin has the effect of suppressing the secretion of noradrenaline, and if serotonin is working normally, the amount of noradrenaline is regulated. Increasing serotonin and decreasing noradrenaline is the key to improving premature ejaculation.

Ejaculation control

Dapoxetine is an ingredient classified as an SSRI (selective serotonin reuptake inhibitor). Between nerve cells, there are cells called synapses that release and receive neurotransmitters and transmit information. Cells that release neurotransmitters are called presynaptic cells, and cells that receive them are called postsynaptic cells.

In brain neurons, the neurotransmitter serotonin released from presynaptic cells acts on serotonin receptors in postsynaptic cells to transmit information.

The synaptic cleft stores serotonin that is released and not accepted, and this serotonin is reuptake and recycled by the serotonin transporter in presynaptic cells. By reuptake, the concentration of serotonin in the synapse decreases, making it difficult to act on serotonin receptors.

SSRIs selectively act on serotonin transporters in presynaptic cells and inhibit serotonin reuptake, thereby increasing the amount of serotonin acting. An increase in serotonin concentration leads to the control of noradrenaline secretion, suppressing excessive excitement in the brain and controlling ejaculation.

Penetrates quickly into the body

The administered drug follows the route of absorption, distribution, metabolism, and excretion. The movement of these drugs in the body is called pharmacokinetics, and by looking at pharmacokinetic values ​​such as the time to reach maximum blood concentration and half-life of blood concentration, we can know the characteristics of the drug in the body. increase.

Time to peak blood concentration is the time it takes for the blood concentration of the drug component to reach its maximum when the time of taking the drug is set to 0 hours and is the time until the maximum effect appears. . The half-life is the time from the peak blood concentration of a drug component to the time when the blood concentration halves.

In clinical trials, dapoxetine was found to reach its peak blood concentration about 1 hour after administration, and this is a result with little error depending on the dose taken. It is a short-acting drug with a short half-life of 1.4 hours and is excreted from the body in about 5 hours.

Safety and acceptability

SSRIs (selective serotonin reuptake inhibitors) are among the few antidepressants with the least side effects.

Tricyclic antidepressants and tetracyclic antidepressants, which had been used until the advent of SSRIs, are highly effective but have side effects caused by anticholinergic and antiadrenergic effects such as dry mouth, tremors, and tachycardia. Since there are many drugs that are contraindicated for concomitant use, there are many restrictions on their use.

On the other hand, since SSRIs act only on serotonin, they are used as first-choice drugs for depression treatment as a class of drugs with few side effects and high safety.

Among such highly safe SSRIs, dapoxetine is particularly well absorbed and metabolized, as mentioned above, and is quickly excreted, so it has an immediate effect. Therefore, even if a side effect occurs, the time to speak is very short, and it has become widely accepted as an anti-premature ejaculation drug.

Conversely, it can be said that it was unsuitable for depression treatment, which requires gentle action and a long-lasting effect.

Effects of dapoxetine

Dapoxetine is a drug that is expected to be effective in improving premature ejaculation. Premature ejaculation, also known as premature ejaculation, is ejaculation early during intercourse or before a woman reaches orgasm.

It is a condition in which ejaculation cannot be controlled by one’s own will, and is considered one of the sexual dysfunctions such as ED.

Irritable premature ejaculation is caused by the weakness of the penis to stimulation, psychogenic premature ejaculation is caused by excessive tension and excitement, and debilitating premature ejaculation is caused by a decrease in muscle strength of the obturator muscle that holds sperm in place due to aging. It is said that more than 1 million people in Japan are suffering from this problem.

The criteria for premature ejaculation are when the following three items are met at a medical institution that specializes in premature ejaculation treatment.

  • Ejaculation always occurs before or within 1 minute of vaginal penetration.
  • No or little delay in ejaculation after vaginal penetration.
  • Passive behavior such as sexual pain, distress, frustration, or avoidance of sexual activity

However, from a medical point of view, it is only a condition or guideline for diagnosing premature ejaculation, and it does not mean that it is not premature ejaculation even if it does not correspond to the item.

In addition to prolonging the ejaculation time by the action of the drug, it can be said that the basis of premature ejaculation treatment is to bring it closer to the desired insertion time of the female partner, that is, to increase the satisfaction of the female partner.

Efficacy

Dapoxetine improves the state of excess neurotransmitter noradrenaline caused by an insufficient amount of neurotransmitter serotonin in the brain, which is thought to be the cause of premature ejaculation.

By selectively acting on the serotonin transporter of presynaptic cells, by putting on a so-called lid, it is once released from the presynaptic cells and does not act on the serotonin receptors of the post-synaptic cells. By selectively inhibiting, the amount of serotonin released is increased, creating a state in which a large amount of serotonin can easily act on the receptor.

Serotonin, also known as the “happiness hormone,” produces mental stability, exhilaration, comfort, and a sense of well-being. From work, it is possible to suppress excessive sexual arousal. By being able to control sexual arousal, you will be able to control the timing of ejaculation at your own will.

Effect

The efficacy of dapoxetine has been proven in clinical trial facilities conducted in various countries, and a clear improvement in premature ejaculation has been shown numerically. First, in a clinical trial conducted overseas with 6081 premature ejaculation patients, subjects whose IELT average before administration of dapoxetine was 54 seconds, the effect of the first dose was 2.1 in the dapoxetine 30 mg group. minutes, and 2.5 minutes in the dapoxetine 60mg group, both of which more than doubled.

In addition, when used continuously during sexual activity for 12 weeks and 24 weeks, the average IELT was 3.5 minutes and 3.3 minutes in the dapoxetine 30 mg group, and 3.8 minutes and 3.9 minutes in the dapoxetine 60 mg group, both of which were 3 compared to before administration. There was also a result that the effect was enhanced by extending it more than twice and using it continuously.

After 24 weeks of timely use, the overall rate of improvement in premature ejaculation was 72%, proving that treatment effects can be expected.

In addition, in a clinical trial of 2,600 premature ejaculation patients conducted by Dr. John Primer in the United States, subjects whose IELT average before administration of dapoxetine was 54 seconds took timely for 12 weeks. 2 minutes and 47 seconds, and 3 minutes and 19 seconds in the dapoxetine 60mg group.

Furthermore, 52% of the dapoxetine 30mg group and 58 % of the dapoxetine 60mg group said that taking anti-premature ejaculation drugs using dapoxetine was effective in controlling ejaculation. the degree has increased.

Effective time

Dapoxetine begins to take effect within 30 minutes of taking it and reaches its maximum effect within 1 hour. Although there may be slight differences depending on the presence or absence of meals and individual differences, no significant difference was observed in clinical trials.

In addition, there is no significant difference in the time to onset of effect or the time to reach maximum effect due to the difference in dosage, so there is no need to change the timing of administration depending on the dosage.

It is said that the duration of the effect is about 4 to 5 hours, but the guideline that the effect lasts is very vague. Since there are almost no ingredients in the body, it seems to be an opinion only from a pharmacokinetic point of view, and it is said that the duration for which the effect can be felt is 2 to 3 hours at the longest.

Of course, the higher the dose, the higher the maximum blood concentration reached in about 1 hour, so the amount of components remaining in the blood increases to some extent over time. When compared under the same conditions, it is thought that the higher the dose, the longer the duration for which the effect can be felt.

Products containing dapoxetine

There are many products with dapoxetine as the main ingredient and active ingredient. Currently, generic drugs are also sold, and in countries where medical expenses are high, the penetration rate is extremely high.

Generic drugs, also known as generic drugs, are drugs that are manufactured and sold by other manufacturers after the patent term of the original drug expires, as they contain the same active ingredients and have the same uses and efficacy.

Since there is no cost for research and development or large-scale clinical trials, the most important feature is that it can be sold at a lower price than the original drug. In today’s world where the declining birthrate and aging population are seen as a problem, it is important to reduce medical expenses, and in the United States, the penetration rate exceeds 90%.

The patent term is 20 years from the filing date, and generic drugs cannot be manufactured or sold until this period has passed. Generic drugs may be manufactured and sold even for drugs with patents.

In particular, India is famous as a generic medicine superpower, and many generic medicines are manufactured and sold during the patent period. There are many voices of concern about quality, but there are many pharmaceutical companies in India that have thorough hygiene and quality control, and they are focusing on sales for use in developing countries. Generic drugs manufactured in Japan are in high demand around the world and are highly evaluated.

Priligy

Priligy, developed by Janssen Silag, the pharmaceutical division of Johnson & Johnson, is the world’s first oral premature ejaculation drug currently marketed by Italian pharmaceutical company Menarini. It is a drug that has been approved and sold mainly in Europe, has expanded its market share to Asia and South America, and has been used by more than several million people.

It is a short-acting SSRI that selectively inhibits the reuptake of the neurotransmitter serotonin and increases the amount of serotonin in the brain. It can be expected to have effects such as prolongation of IELT (time from vaginal insertion to ejaculation) and control of ejaculation.

The standard has 30 mg and 60 mg of dapoxetine content, and each box contains 3 tablets, 6 tablets, 18 tablets, and 30 tablets.

However, the 18-tablet and 30-tablet packages are expensive and there is not much demand for them, so most private importers of overseas pharmaceuticals mainly handle 3-tablet or 6-tablet packages. As of 2018, the price per tablet of Priligy is 2,300 yen for 30 mg and 3,000 yen for 60 mg.

Posette

Pozzet is an oral anti-premature ejaculation drug manufactured and sold by Sunrise Remedies, an Indian pharmaceutical company that is famous for expanding into various countries with a focus on generic drugs for premature ejaculation and ED treatment. It is one of the best Priligy generics.

Sunrise Remedies products are developed, manufactured, and sold in accordance with the WHO (World Health Organization) manufacturing quality control standards for pharmaceuticals, etc., and are highly evaluated for their efficacy, safety, and reliability. A pharmaceutical company.

Pozzet’s active ingredient is dapoxetine, which selectively inhibits the reuptake of serotonin, just like the original product Priligy. However, due to differences in manufacturing processes, dosage forms, additives, etc., there may be slight differences in the effects depending on the individual.

The standard is 30 mg, 60 mg, and 90 mg of dapoxetine content, and it is sold with 10 tablets and 30 tablets per box, respectively. As of 2018, the price per tablet of Pozzet 30mg is 250 yen, 60mg is 300 yen, and 90mg is 350 yen, which is about 1/10 the price of the original product Priligy.

It is a premature ejaculation prevention drug whose sales volume is growing at a rate that surpasses that of Priligy due to its low price and popularization of generic drugs.

Ingredients that improve premature ejaculation other than dapoxetine

Currently, dapoxetine is the mainstream drug for preventing premature ejaculation, but before dapoxetine was released, other ingredients were used that were expected to have other effects.

In the old days, premature ejaculation, like ED, was seen as a lack of masculinity, and many measures have been taken to prevent premature ejaculation. In addition, the interpretation of the mechanism of premature ejaculation has changed, and effective improvement methods have changed accordingly.

Even now, some ingredients are used in cases where dapoxetine cannot be used, in cases of organic premature ejaculation unrelated to serotonin deficiency, and when used in combination to further enhance the effect, and it is necessary to use them properly depending on the cause and symptoms.

As an improvement ingredient for the same premature ejaculation, let’s understand the effects and risks.

local anesthesia

Until a decade ago, it was generally believed that premature ejaculation was caused by hypersensitivity of the penis, and the main method of improvement was to apply a local anesthetic to the penis to reduce the sensation of stimulation.

With this method, the effect appears 10 to 15 minutes after application, and the effect lasts for about an hour. Since it acts locally, it does not act on areas other than the applied area, and it is possible to adjust the effect by adjusting the amount of application.

There are rare side effects such as itching and rashes, but there are almost no serious side effects if used appropriately. There are various projects such as coating agents, spray agents, and condoms with ingredients applied.

Lidocaine

This is the most widely used local anesthetic in the world. It inactivates action potentials and blocks neurotransmission by binding to sodium channels and blocking sodium ion permeation. Because of its mechanism of action related to the myocardium, it is also used as an ingredient in the treatment of arrhythmia. The product names include ” Xylocaine “, ” Lidospray ” and “Feminina Ointment”.

Benzocaine

This medicine is a local anesthetic, also known as ethyl aminobenzoate, which blocks nerve transmission by paralyzing sensory nerves. It also has the effect of suppressing stomach pain and nausea, so it is sometimes added to gastrointestinal medicines and motion sickness medicines. There are product names such as “Tonos” and ” Kama Sutra Long Last (premature ejaculation prevention condom)”.

Ingredients of Antidepressants

There are various types of SSRIs (selective serotonin reuptake inhibitors) to which dapoxetine is classified. Fluvoxamine (product name Luvox), paroxetine (product name Paxil ), sertraline (product name Zoloft), escitalopram (product name Lexapro), and fluoxetine (product name Prozac ) are currently mainly used as antidepressants. You will be an SSRI that is

Since it has the same mechanism of action that increases the amount of serotonin in the brain, pharmacologically equivalent effects can be expected. In fact, before dapoxetine, paroxetine and fluoxetine were used to prevent premature ejaculation.

However, in clinical trials for improving premature ejaculation of these drugs, the effect on IELT (time from vaginal insertion to ejaculation) was not as good as dapoxetine, and the incidence of side effects was high, so opportunities for use gradually decreased. is coming.

Since dapoxetine is an unapproved drug in Japan and permission is required to prescribe it, these SSRIs are sometimes used, but there are restrictions on their use from the viewpoint of side effects.

Others

cabergoline

This medicine stimulates dopamine receptors and is used to treat Parkinson’s disease caused by a lack of dopamine. In addition, this action also has the effect of suppressing the excessive secretion of a hormone called prolactin, and it is also used as a treatment for ovulatory disorders due to hyperprolactinemia, pituitary gland, and galactorrhea.

This prolactin works to eliminate libido, and it is also effective in treating premature ejaculation, suppressing weakness after ejaculation, and restoring libido. It has a long half-life of 65 hours and a highly sustained effect and is said to be more immediate than dapoxetine.

However, since it is originally a drug for treating Parkinson’s disease, side effects such as nausea, nausea, and loss of appetite may be seen, and there is also a risk of serious side effects such as hallucinations and delusions. The product names include ” cabergoline “, “cavassal”, and “cudrulin”.

high perforin

It is one of the ingredients contained in the extract of St. John’s Want and is attracting attention as an ingredient with antidepressant action.

This component works as an activator of ion channels that control the sprouting of nerve axons, and by inhibiting the uptake of neurotransmitters such as serotonin, dopamine, noradrenaline, and GABA, it has been confirmed to have the effect of increasing the amount of these neurotransmitters. It has been.

By increasing the amount of serotonin, it has the effect of improving premature ejaculation by an action similar to that of dapoxetine, but since the amount of noradrenaline is also increased at the same time, it is expected that the effect will not be so strong. Although it is used as a medicine in Germany, it is generally an ingredient contained in supplements.

ED drug combined with dapoxetine effect

Studies have shown that about 30% of people with ED (erectile dysfunction) also have premature ejaculation. This is likely due to the hardness and sensitivity of the penis, not due to a lack of serotonin.

The main reasons for premature ejaculation are

It is believed that ED causes the inability to maintain an erection with conventional stimulation, requiring stronger stimulation, which shortens the time to ejaculation. It is also said that the impatience of having to ejaculate while maintaining an erection is also a factor.

Therefore, in the case of a merger, in some cases, combination with ED drugs such as sildenafil (trade name Viagra ), vardenafil (trade name Levitra ), tadalafil (trade name Cialis ), and avanafil (trade name Stendra ) may be promoted. A combination drug that combines dapoxetine and ED treatment ingredients is also on sale.

By maintaining the hardness of the erection with ED treatment drugs and taking measures against premature ejaculation with dapoxetine, anxiety and worries during sexual activity will be eliminated and it will be effective. In addition, you can expect the effect of increasing the satisfaction of not only yourself but also the other party.

How to take Dapoxetine

Since dapoxetine is a short-acting type, it is effective when taken only when necessary, and it is a convenient drug that has almost no effect other than that.

However, since the duration of action is short, if the dosage method or timing is incorrect, the maximum effect may not be felt and side effects may occur if the dosage is incorrect.

In addition, it is often used in combination with other premature ejaculation prevention drugs, ED treatment drugs, and aphrodisiacs, and sexual activity is often performed after drinking. I have.

Dapoxetine is purchased in many ways other than prescriptions from specialized medical institutions, so be sure to check the proper dosage method for yourself.

How to take

Take dapoxetine with water or lukewarm water 1-3 hours before sexual activity. Although there are individual differences, the effect is maximized about 1 hour after taking it, and the effect lasts for 3 to 5 hours.

When taking it for the first time, start with 30 mg at a time. If there is no effect and no side effects, increase the dose to 60 mg at a time.

Also, if the effect is too strong, it is possible to divide the tablet with a pill cutter and take it, and there is no problem with the medicinal effect. In some countries, the dose of dapoxetine is 90 mg, but in principle, the upper limit for Japanese people is 60 mg per day.

If you don’t really feel the effect after taking one dose, it is possible to add an additional dose that does not exceed 60 mg in total if the interval between doses is several hours. However, if you take 60mg daily, you will need at least a 24-hour interval. Since it is not affected by food, it can be taken before meals, between meals, after meals, and before bedtime.

In addition, the method of continuing to take once a week is also being promoted. It is said that taking it continuously regardless of whether or not you have sex will make it more effective.

Concomitant therapeutic agents

There is no problem in combination with anti-premature ejaculation drugs containing lidocaine or benzocaine, which are local anesthetics. Although there are no clinical trials or papers on interactions due to co-administration, there is no clear data, but since the mechanism of action is completely different and does not affect metabolic pathways, co-administration is possible assuming that it can be used safely.

There is also statistical data showing that IELT (time from vaginal insertion to ejaculation) was improved when dapoxetine was used in combination, rather than using dapoxetine alone. It seems that there are many places that do.

It is also sold as a combination drug, so it can be used in combination with ED drugs, which tend to occur concurrently, without any problems. However, since dapoxetine and various ED treatment drugs differ slightly in terms of maximum blood concentration reaching time and half-life when taken at the same time, the maximum effect may not be obtained at the same time.

In the case of a combination drug, the dissolution rate has been adjusted, but when taking a single drug, it is necessary to follow the dosing instructions for each drug.

Proper intake

The marketed specifications of Priligy, the original product, and other generic products differ, and the upper limit of dapoxetine intake differs accordingly. The upper limit for dapoxetine is 90 mg per day, but this is an amount that can be increased if the effect is not felt, and is not currently recommended for Japanese people.

Most people start with 30 mg a day, and then increase or decrease the dosage while considering the actual effect and side effects, and the maximum dosage is generally 60 mg a day. Since it is also a drug with few side effects, it may be started at 60 mg, but it is a starting dose that is not promoted unless prescribed by a specialized medical institution.

Although it varies depending on the drug, SSRIs are said to be particularly prone to side effects, and it is necessary to give priority to the presence or absence of side effects when taking them. Since the safe and effective amount required varies from person to person and from person to person, it is necessary to increase or decrease by small amounts to find your own dosage.

Effects of diet and alcohol

Dapoxetine can be taken before meals, after meals, and before bedtime, so there is no food effect. However, it is only for general meals, and it cannot be denied that the effect may be affected if the digestive function is weakened, such as when eating and drinking excessively or on a diet.

Alcohol should be avoided with any drug, not just dapoxetine. Alcohol is broken down and metabolized in the liver, so it puts a burden on the liver. While the metabolic function of the liver is affected, taking drugs that are also metabolized by the liver can increase the blood concentration of the drug, increasing the risk of enhancing its action and developing side effects.

In addition, drugs may affect the metabolism of alcohol, and acetaldehyde, which is produced in the middle of alcohol metabolism, accumulates, and disulfiram effects such as headache, vomiting, and flushing of the face can be seen, and the so-called hangover may worsen. It is quite possible to have sex after drinking, so be careful.

Side effects of dapoxetine

Dapoxetine is a short-acting SSRI (selective serotonin reuptake inhibitor), which makes it a drug that is well absorbed, metabolized, and excreted quickly. The maximum effect appears 1 hour after taking it, and after 5 to 6 hours the effect is exerted, more than 90% of the ingredients are excreted from the body after 24 hours at the maximum.

Therefore, even if side effects appear, they will disappear within 24 hours from a pharmacological point of view. Based on clinical trial data from the development stage and market research from the launch stage, dapoxetine alone is said to have basically few severe side effects.

However, since drugs are basically foreign substances for the body, there is no drug without side effects. In fact, it has been confirmed that the incidence of side effects caused by taking dapoxetine is less than 10%. Let’s summarize the side effects seen with dapoxetine taking, referring to past reports.

Major side effects

The following side effects have been confirmed in clinical trials in patients with premature ejaculation in each country and in post-marketing reports.

mental disorder

Symptoms such as anxiety and insomnia may occur. The anxiety and insomnia in the case of dapoxetine may well be the original anxiety about premature ejaculation or insomnia due to sexual excitement, so it cannot be determined whether it is due to the drug.

However, this is not limited to SSRIs but is a possible risk for drugs related to neurotransmitters, and in most cases, it will subside after getting used to it.

Digestive disorders (nausea, vomiting, constipation, diarrhea, etc.)

Symptoms such as nausea, nausea, constipation, and diarrhea may occur. It is a common symptom at the beginning of drinking and is thought to occur when serotonin stimulates the organ in the brain that controls nausea and bowel movements. In most cases, it will subside with repeated use.

neuropathy

Symptoms such as headache and dizziness may occur. Since neurotransmitters act on the constriction and dilation of blood vessels, it is thought that headaches and blood pressure are not a little affected by their action on the cerebral blood vessels, and symptoms such as dizziness appear.

Rare Side Effects

serotonin syndrome

It is a side effect caused by excessive serotonin levels in the brain. Symptoms such as elevated body temperature, hyperhidrosis, high blood pressure, increased heart rate, tremor, excitement, and coma may be observed.

Since symptoms such as nausea and headache are also seen, it is necessary to suspect serotonin syndrome if the symptoms are mild. Most of them are due to overdose or combined use with caution/contraindicated drugs, and they are rarely seen in the case of proper use alone.

malignant syndrome

It is a side effect caused by too much dopamine in the brain. High fever (38°C or higher), disturbance of consciousness, extrapyramidal symptoms (muscle stiffness, tremors, and convulsions of the limbs, etc.), autonomic symptoms (high blood pressure, palpitations, etc.), rhabdomyolysis (due to muscle destruction) muscle pain) may occur.

Since SSRIs originally have the effect of suppressing dopamine secretion, their expression is rare and the mechanism is not clear.

anaphylactic shock

A short time after taking the medicine, the side effect is that allergic symptoms occur all over the body. It may cause skin symptoms such as hives, respiratory symptoms such as coughing and shortness of breath, lower blood pressure, and disturbance of consciousness.

It is caused by the human immune function, and it can be expressed in anything you eat or touch.

If you feel that the effects and side effects are strong

The maximum effect appears about 1 hour after taking dapoxetine. After that, the effect gradually weakens, so the effects and side effects will decrease with the passage of time.

Even if the effect is too strong and you may experience delayed ejaculation, you can solve it by leaving an interval. Since it is not a drug-related to health maintenance, there is no problem even if you take measures such as reducing the dose the next time you use it.

Even if side effects occur, they can be resolved by spacing them out. If the symptoms are severe, consult a specialist doctor and take measures such as prescribing medicine to alleviate the symptoms.

In principle, it is desirable to avoid taking the drug after the occurrence of side effects, but if it is absolutely necessary, consult your doctor and reduce the dose if possible.

It is said that the frequency of occurrence is very low because it is a drug used when necessary. However, discontinuation or excessive dose reduction when taken at high frequency or in high doses may cause withdrawal symptoms or discontinuation symptoms, so caution is required.

Precautions for co-administration of dapoxetine

Drug interactions, not just dapoxetine, almost always exist. It means that a drug can increase or decrease the action of the drug or cause the worsening of the disease under the influence of another drug, food, or disease.

Therefore, when using drugs, there are precautions when using them in combination with other drugs, supplements, foods, etc., or when you have a chronic disease, based on their mechanisms of action, metabolic pathways, clinical data, etc.

Concomitant use caution literally means that caution is required for concomitant use. Although it is not serious, please be aware that there is a possibility that side effects may occur.

Most of the side effects have been confirmed by reports, etc., although there is no chemical basis. Concomitant use is not prohibited, so it is not uncommon for them to be used together depending on the situation when the effect should be prioritized in consideration of side effects.

Those who need to use it carefully

Since there is no clinical data for people under the age of 18 and elderly people over the age of 65, there is no evidence of safety, and there is a risk that the effects and side effects may be too strong, so use caution. need to do it.

Premature ejaculation is a drug that is indicated for men, so in principle, women cannot take it, but taking it does not mean that it is dangerous.

Consideration for chronic illness and physical condition is also necessary. Increases and decreases in serotonin and norepinephrine levels may affect the circulation and hormone secretion, so people with diseases such as high blood pressure, heart disease, prostatic hyperplasia, and glaucoma may experience worsening symptoms of chronic diseases. so be careful.

In addition, people who are not feeling well due to colds, etc., and people who have had some kind of allergic symptoms to medicines are not recommended to take them because they are prone to side effects.

However, taking into consideration the degree of premature ejaculation and chronic diseases, the dose of dapoxetine, etc., it is possible to take dapoxetine by conducting a thorough monitoring, so if you fall under the above and wish to take dapoxetine, consult with your doctor. let’s do it.

Precautions for concomitant use

There are some drugs that need to be used with caution, since taking them together with dapoxetine may affect the effects of this drug, or may make you feel unwell.

Concomitant use with antipyretic analgesics significantly increases the incidence of gastrointestinal symptoms such as stomachache and stomach rash. Since they do not affect each other’s actions, the risk can be reduced by using them together.

Antithrombotic drugs (warfarin, etc.), antiarrhythmic drugs (quinidine, cimetidine), and antiepileptic drugs (phenytoin, phenobarbital, etc.) affect the blood concentration of dapoxetine through their mechanisms of action and metabolic pathways. It becomes a dangerous drug.

In addition, macrolide antibiotics erythromycin (brand name Erythrosin) and clarithromycin (brand name Claris/Claricid), antifungal drug fluconazole (brand name Diflucan), tamsulosin (product name Harnal), anti-HIV drug Amprenavir (brand name Plose), Hosaamprenavir (brand name Lexiva), antiemetic drug aprepitant (brand name Imendo), calcium channel blocker antiarrhythmic agent verapamil (brand name Visolan)・Diltiazem (trade name: Herbesser) is a drug that has actually been reported as a drug to be used with caution.

Contraindications for co-administration of dapoxetine

A medical or pharmacological contraindication, also known as a contraindication, is something that must not be applied. Contraindications for co-administration literally mean that co-administration is prohibited, and there are serious side effects or adverse effects on efficacy due to the combination of two or more of the drugs being taken, the situation of the subject taking the drug, the environment, etc. To do.

Drugs that have chemical grounds for interactions due to concomitant use and drugs that have serious cases such as death or disturbance of consciousness even without grounds are adopted.

For example, drugs with parasympathetic effects such as aspirin, and drugs with anticholinergic effects such as psychotropic drugs are prohibited for glaucoma patients because they exacerbate or induce symptoms. Narcotic analgesics, narcotic antitussives, and some antihypertensives can exacerbate or induce symptoms in patients with asthma attacks, so it is extremely dangerous to use them together. Another reason is that safety for children, the elderly, and pregnant women have not been established.

As with precautions, even if it is contraindicated, it may be used in combination only when there is a special reason and with the consent and approval of the patient or his/her family, but sufficient caution and follow-up monitoring are required. .

Those who should not take

Since dapoxetine is originally an antidepressant, it should not be used by people with a history of depression or mania or who are being treated for it. When administering antidepressants, it is necessary to increase or decrease the dose or adjust the drug while considering the symptoms and side effects.

In principle, this medicine cannot be used by people who have a history of ischemic heart disease or angina pectoris, or who are undergoing treatment. Increases and decreases in serotonin and noradrenaline levels may affect the cardiovascular system, increasing the risk of side effects, and there is a risk that accurate treatment data for the disease being treated may not be obtained.

In principle, it cannot be used by people with a history of epilepsy. SSRIs have been reported to induce epileptic seizures and convulsions. This is especially likely to occur when taking it for the first time.

In principle, it cannot be used by people with liver dysfunction (moderate to severe). This is because dapoxetine is a drug that is decomposed and metabolized in the liver, which puts a heavy burden on the patient and may cause serious diseases such as liver cirrhosis. In addition, the effect of dapoxetine may be too strong in patients with impaired liver function.

Contraindicated drugs

MAO inhibitors (monoamine oxidase inhibitors) such as isoniagid (trade name iscotin) and selegiline (trade name FP), which are a type of antiparkinsonian drug, have the effect of preventing the breakdown of neurotransmitters such as serotonin and noradrenaline. Therefore, concomitant use with SSRIs may cause serotonin syndrome and is contraindicated.

SSRIs (selective serotonin reuptake inhibitors) such as paroxetine (brand name Paxil), sertraline (brand name Zoloft), escitalopram (brand name Lexapro), milnacipran (brand name Toledomin), duloxetine (brand name Cymbalta) SNRIs (serotonin/norepinephrine reuptake inhibitors) such as dapoxetine have the same or similar mechanism of action as dapoxetine.

In addition, the antifungal drugs ketoconazole (brand name Nizoral) and itraconazole (brand name Itrizol), the anti-HIV drugs ritonavir (brand name Novia), saquinavir (brand name Invirase), and atazanavir (brand name Reyataz), and the antibiotic Terisro Mycin (trade name Ketec) is actually reported as a drug contraindicated for concomitant use.

Summary of Dapoxetine

What did you think?

Due to an unexpected turn of events, dapoxetine is now useful to many people as an anti-premature ejaculation drug. The effect is clear when looking at clinical data, mechanism of action, and efficacy.

There are many highly rated reviews, such as the effect was felt even with a small amount, side effects were not particularly observed, and it was safe to take, and there are many people around the world who use it continuously. Premature ejaculation boasts a high repeat rate. You could call it an antidote.

If you are suffering from premature ejaculation, are not satisfied with sexual activity, or have concerns, why not try Priligy or Pozzet, which contain dapoxetine?

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Tom Perry, M.D., attended Tulane University and graduated Magna Cum Laude with a B.S. degree in Parasitology. He received his M.D. degree in 1983 from the University of Virginia School of Medicine, where he gained extensive research experience, including studies conducted through the National Institutes of Health.