Priligy contains an active substance called Dapoxetine. It belongs to a group of urological preparations and is used to treat premature ejaculation in men aged 18-64 years.
Premature ejaculation is defined as an inability to delay ejaculation until it is desirable for both partners. It is believed that a man has premature ejaculation if ejaculation occurs ≤ 1 minute of penetration.
This is one of the most common sexual problems affecting men of all ages. Since premature ejaculation affects self-confidence and can even lead to psychological problems (anxiety and depression), it is recommended to treat this problem in a timely manner. In fact, research has shown that 29% of men are dealing with premature ejaculation at some point.
Mechanism of Action
Priligy is a potent selective serotonin reuptake inhibitor, and it is believed that this mechanism is responsible for its beneficial effect in the treatment of premature ejaculation. Ejaculation is primarily regulated by a sympathetic nervous system and nerve impulses for ejaculation come from a reflex center in the spinal cord, which is under the control of the brainstem and serotonin.
Efficacy of Priligy
The efficacy of Priligy was demonstrated in five double-blind, randomized clinical studies that included a total of 6081 men who suffered from premature ejaculation for at least 6 months. One group of men was taking Dapoxetine and the other group was taking a placebo for three months. The results of all five clinical studies have shown that Priligy on average extends the time needed to ejaculate in 6-7 minutes if administered at a dose of 30 mg or 12-13 minutes if administered at a dose of 60 mg.
The recommended starting dose for men aged 18-64 years is 30 mg, 1-3 hours prior to the planned sexual activity. Treatment should never start with a dose of 60 mg daily, as this increases the risk of side effects.
If a 30 mg dose does not deliver the appropriate effect, then it may be increased to 60 mg. However, bear in mind that the incidence of side effects is higher with a 60 mg dose. If the patient experiences side effects with a 30 mg dose, then the dosage should not be increased to 60mg.
Keep in mind that dapoxetine it is not intended for every day and continuous use, but should only be used when sexual activity is expected. Long-term use of this drug has not been studied.
The use of Priligy dapoxetine in patients below age 18 is not medically justified and must be avoided. Also, there is no data on the safety of Priligy use in patients above the age of 64.
Priligy is contraindicated in patients with heart failure (NYHA grade II, III or IV), ischemic heart disease (e.g. heart attack), valvular heart disease, or atrioventricular block. Cases of neurocardiogenic (vasovagal-mediated) syncope have been reported. Syncope can aggravate the condition in patients with heart disease. However, clinical studies have revealed that Priligy exerts no other cardiotoxic effects – it does not affect QT interval and heart rate.
Since Dapoxetine is, by its pharmacological action, classified to selective serotonin reuptake inhibitors (which are most commonly used in the treatment of depression), it can interact with other antidepressants, such as monoamine oxidase inhibitors (Moclobemide, Isocarboxazid, Phenelzine, and Tranylcypromine). The simultaneous administration with these medicines can lead to accumulation of serotonin in the blood which may cause a condition called serotonin syndrome. Serotonin syndrome is characterized by hypertensive crises and arrhythmias which may have a fatal outcome!
The concomitant use with drugs that inhibit the enzyme through which Priligy is metabolized is also contraindicated as they can significantly increase the concentration of the Dapoxetine the blood and increase the risk of adverse effects. Such drugs include:
- Antifungal drugs, such as Ketoconazole, Itraconazole, and Fluconazole.
- Macrolide antibiotics, such as erythromycin, Clarithromycin, and Azithromycin.
- HIV protease inhibitors, such as Darunavir, Fosempranavir, Lopinavir, Ritonavir, Atazanavir, Nelfinavir, and Saquinavir.
- Nefazodone – a drug used in the treatment of major depressive episodes.
Clinical studies have shown that Priligy can cause orthostatic hypotension (a sudden drop in blood pressure accompanied by fainting when suddenly getting up from a sitting or lying position). It is recommended to determine the blood pressure in the standing/sitting/lying position before the initiation of therapy. The therapy should not be started if the patient has low blood pressure.
Except for orthostatic hypotension, cases of syncope (loss of consciousness due to low blood pressure) have been reported. That’s why patients are advised to avoid operating/handling hazardous machines because they could be harmed if they faint while operating/handling these machines.
The risk of orthostatic hypotension and syncope can be reduced by taking sufficient amounts of water during the day (at least 2 liters). The simultaneous use with alcohol increases the risk of these side effects and therefore the use of alcoholic beverages must be avoided.
Although very rarely, Priligy can provoke suicidal ideas. If you notice this side effect, stop using the medicine immediately and contact your doctor.
Priligy Dapoxetine may cause the following side effects:
- Orthostatic hypotension
- Decreased libido
- Prolonged and painful erections
- Pain in the eye
- Clogged sinuses
- Increased sweating
- Erectile dysfunction
- Serotonin syndrome