Dapoxetine
Dapoxetine is a short-acting selective serotonin reuptake inhibitor developed specifically for on-demand treatment of premature ejaculation rather than for erectile dysfunction. Its rapid absorption and short half-life make it suitable for as-needed dosing. It is approved in many countries (not the US) and is frequently combined with a PDE5 inhibitor in grey-market 'super' tablets.
01 Overview
Unlike chronic-use SSRIs, dapoxetine is absorbed and eliminated quickly, so it can be taken 1-3 hours before intercourse to delay ejaculation via increased synaptic serotonin at the ejaculatory reflex. It reliably increases intravaginal ejaculatory latency time in men with premature ejaculation.
It is often co-formulated or co-administered with a PDE5 inhibitor to address both premature ejaculation and erectile function; such combination products are common on the grey market. Because it is a serotonergic drug, it carries typical SSRI cautions — nausea, dizziness, orthostatic effects and a serotonin-syndrome risk if combined with MAOIs or other serotonergic agents.
02 Mechanism
Short-acting selective serotonin reuptake inhibitor that raises synaptic serotonin, delaying the ejaculatory reflex.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Starting dose | 30 mg | Oral | Taken 1-3 hours before intercourse, as needed; max one dose per 24 h. |
| Higher dose | 60 mg | Oral | If 30 mg is insufficient and tolerated. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Delayed ejaculationIncreases intravaginal ejaculatory latency time in men with premature ejaculation. | 2-3x increase in IELT | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Nausea and dizzinessNausea, dizziness and headache are the most common complaints and the main reason for discontinuation. | Mild | Very common | Clinical | |
| Orthostatic hypotension / syncopeDizziness on standing and rare fainting, especially at first dose or when combined with vasodilators. | Moderate | Uncommon | Clinical | |
| Serotonin syndrome (with other serotonergics)Agitation, hyperthermia, tremor and autonomic instability if combined with MAOIs or other serotonergic drugs. | Severe | Rare | Clinical |