Dapoxetine (Priligy) for Premature Ejaculation: Using It Safely

Dapoxetine, best known by the brand name Priligy, was the first medicine developed specifically to treat premature ejaculation. It is approved in many countries in Europe and Asia. Many patients ask me, "How long will I last if I take it?" and "Is it dangerous?" This article answers both.

How dapoxetine works

Dapoxetine is a short-acting SSRI (selective serotonin reuptake inhibitor). It raises serotonin levels for a short time, which slows the ejaculation reflex controlled by the spinal cord and brain. Unlike ordinary SSRI antidepressants, dapoxetine is absorbed quickly and cleared quickly, so it can be taken only when needed rather than every day.

What results to expect

In phase 3 trials, dapoxetine lengthened the time from penetration to ejaculation by around 2.5–3 times on average, and men felt more in control and more satisfied.

In plain terms, the medicine helps, but it won't turn 1 minute into 30 minutes, and the results are much better when it is combined with training techniques. Read how to practise them in Premature ejaculation (PE): causes, exercises and treatment.

How it is generally used (as assessed and prescribed by a doctor)

• Taken about 1–3 hours before sexual activity with a full glass of water
• The usual starting dose is 30 mg; a doctor may increase it to 60 mg if the effect isn't enough and there are no worrying side effects
• No more than once a day (every 24 hours)
• Licensed for men aged 18–64
• Doctors usually review the results after about 4 weeks or around 6 doses to decide whether to continue

Before starting, the doctor should measure your blood pressure lying down and standing up, to see whether it drops when you change position, because that increases the risk of fainting.

Possible side effects

• Nausea (the most common)
• Dizziness, headache
• Diarrhoea, insomnia, tiredness
• Fainting (syncope), which is uncommon but important

To reduce the risk, drink enough water, don't take it when you are sleep-deprived or dehydrated, and don't drive or operate machinery if you feel light-headed.

Who should not use it, or needs extra caution

• Men with significant heart disease, such as heart failure, heart rhythm problems, severe heart valve disease or coronary artery disease
• Men who have fainted frequently in the past
• Men with bipolar disorder or severe depression
• Men with moderate to severe liver problems

Medicines that must not be combined with it

• SSRI, SNRI and tricyclic antidepressants, and MAOIs
• St John's wort and tramadol, because of the risk of serotonin syndrome
• Strong CYP3A4 inhibitors, such as ketoconazole, itraconazole, clarithromycin and HIV medicines containing ritonavir or cobicistat
• Thioridazine

If you already take an antidepressant, do not use dapoxetine with it. Read about the sexual effects of antidepressants in When antidepressants affect your sex life.

Alcohol and other substances to be careful with

• Avoid alcohol, especially in large amounts, because it increases light-headedness and fainting
• It can be used with PDE5 inhibitor erection medicines in some men, as assessed by a doctor, but low blood pressure is a risk. See Tadalafil vs sildenafil
• Never combine it with recreational drugs such as methamphetamine (ya ba or ice) or ecstasy. Read about the risks in crystal meth, yaba, ketamine and G in chemsex

Why you shouldn't buy it and use it yourself

Dapoxetine needs to be assessed and prescribed by a doctor. Much of what is sold online is fake or of unknown origin, and some products combine several drugs in one tablet, making the risks impossible to judge. Some cases of premature ejaculation also have causes that need specific treatment, such as prostatitis, an overactive thyroid or coexisting ED.

Get advice at Dr. Kris Clinic

We assess your premature ejaculation, check your blood pressure, review your current medicines and consider whether dapoxetine or another option suits you, while teaching training techniques alongside and arranging follow-up. You can consult at the clinic in Surat Thani or online, and consultations in English are available. There's no judgement here.