Priligy (dapoxetine) is a potent, selective and fast-acting serotonin reuptake inhibitor. It is also responsible for inhibiting the reuptake of norepinephrine and dopamine. Researchers of this organic chemical compound assume that the action of dapoxetine is based on the inhibition of neuronal reuptake of serotonin, with subsequent enhancement of its action on the receptors of the sympathetic nervous system. It is the sympathetic nervous system that is responsible for male ejaculation. The highest concentration of Priligy in plasma is achieved two hours after dosing.
Pharmacological modulation of ejaculation is a novel concept, radically going beyond the psychosexual model of PE etiopathogenesis. The introduction of serotonin reuptake inhibitors (SSRIs) has revolutionized the approach to the treatment of this disorder. Lots of research concerning the EP were designed incorrectly or errors were made methodological, which makes them not reliable enough.
In a meta-analysis of studies on all drugs used in PE only 14.4% were found to be sufficiently confirmed effectiveness in reliable studies, and dapoxetine was by far the most effective medications. Unfortunately, drug treatment is also limited effectiveness: after its termination, the disorder frequently recurs.
Some authors believe that medications should be taken whole period of sexual activity. Currently, the best results are achieved when taking medications for a limited period (60 days) in combination with couple sexual therapy; the man gains control over his ejaculation and strengthens himself in overcoming PE.
The mechanism of action
Priligy is the only drug approved for the treatment of PE in men aged 18–64 years. It belongs to the fast and short-acting SSRIs. The mechanism of action of dapoxetin is to block the reabsorption of serotonin at synapses, and additionally, the drug stimulates dopaminergic and noradrenergic transmission. It is usually used 1-3 hours before sexual intercourse once a day as an “on-demand” drug. It is rapidly absorbed from the gastrointestinal tract, reaching the maximum plasma concentration approximately 1 hour after ingestion, and it is quickly eliminated, so it does not accumulate in the body.
The pharmacokinetics of the drug depends on the dose, however, it does not depend on the consumption of food and alcohol. Priligy is metabolised in the liver to, inter alia, desmethyl dipoxetine and didemethyl dipoxetine. The metabolites are eliminated by the kidneys. It is not recommended for use in patients with liver and kidney damage, as well as in patients taking drugs that affect cytochrome P450 (e.g. ketoconazole, ritonavir) and taking other serotonin reuptake inhibitors.
Caution should be exercised in patients with diseases of the cardiovascular system. From the point of view of clinical practice, it is also important that no interactions with phosphodiesterase 5 inhibitors were observed. The above pharmacological features distinguish Priligy from other selective serotonin reuptake inhibitors.
Indications for use
Priligy is a drug dedicated to men who struggle with premature ejaculation.
The indications for the use of Priligy are:
- premature ejaculation in men aged 18 to 64;
- intravaginal ejaculation delay time is less than two minutes;
- chronic or recurrent ejaculation with minimal sexual stimulation;
- personal and interpersonal anxiety resulting from premature ejaculation;
- poor control or complete lack of control over ejaculation;
- premature ejaculation in sexual contact within the last six months.
Contraindications to use
Priligy is an effective drug for premature ejaculation, but it cannot be used by every man struggling with this ailment.
Contraindications to the use of Priligy are:
- hypersensitivity to any of the ingredients of the preparation;
- moderate or severe liver disorders;
- mania, hypomania, severe depression or bipolar disorder;
- heart problems, such as: heart failure, atrioventricular block, coronary heart disease, valvular disease;
- use of other serotonergic preparations.
Priligy is taken with or without food. At the beginning of using this preparation, it is taken 30 mg / d one to three hours before the planned sexual intercourse. Depending on the effect of the drug, its dose may be increased to 60 mg / day. Priligy is not a drug that can be used continuously every day. After using at least 6 doses, the benefits of using this preparation should be weighed against the risks associated with its frequent use.
Priligy, like any other drug, may cause various side effects.
They are divided according to the frequency of occurrence:
- dizziness, headaches and nausea;
- the use of the drug may cause anxiety, agitation, anxiety, insomnia, decreased libido, sleepiness, blurred vision, tinnitus, diarrhea, vomiting, excessive sweating, erectile dysfunction or irritability;
- depressive mood, euphoria, nightmares, grinding of the teeth, fainting, taste disturbance, increased heart rate, increased blood pressure may uncommonly occur.
Before use, read the leaflet, which contains indications, contraindications, data on side effects and dosage as well as information on the use of the medicinal product, or consult your doctor or pharmacist, as each drug used improperly is a threat to your life or health.
Priligy is an effective drug in the treatment of PE. The above-mentioned studies have shown that the drug is well tolerated and has a high safety profile. It increases the average duration of intercourse by 3-4 minutes. It is noteworthy that dapoxetine can be treated as a “pill on demand” for emergency use. The lack of significant side effects and effectiveness rank this drug high among other treatments for PE. In addition to dapoxetine, there are other treatments that are less effective or have a large number of side effects.
Psychotherapy can be an alternative as well as a method supporting the treatment of PE. The choice of therapy should be discussed with the patient and, if possible, with the partner. The therapy of sexual dysfunctions is currently an increasingly common problem not only in the offices of psychologists, psychiatrists or sexologists, but also a problem faced by internists and cardiologists in their daily medical practice. To sum up, it should be emphasized that the treatment of PE with dapoxetine is possible and should be undertaken by doctors of various specialties, who treat patients with this problem.
This patient information is published for educational purposes only. The instructions and product properties quoted on this page follow the guidelines outlines by the drug manufacturer, but do not replicate it in all fullness. We strongly advise against using this information as a call to action of any kind, be it purchasing or using the drug without a proper medical consultation carried out first. Trademarks, names of companies and eventual studies are inserted for informational purposes and as a legal reference and respect for the copyright law and ethics.