Priligy is an agent for the treatment of premature ejaculation. It belongs to a serotonin reuptake inhibitor. The mechanism of action of dapoxetine in premature ejaculation is associated with inhibition of serotonin reuptake by neurons. It is followed by an increase in the action of a neurotransmitter on pre- and postsynaptic receptors.
Treatment of premature ejaculation in men aged 18 to 64.
The recommended starting dose for all men is 30 mg. This Priligy dose is taken 1-3 hours before the planned sexual intercourse. If the effect is insufficient and the dose of 30 mg is well tolerated, it can be increased to 60 mg. The maximum recommended dose frequency is 1 time per 24 hours.
The doctor prescribing a drug for the treatment of premature ejaculation should evaluate the risks and benefits of using the drug after the first 4 weeks of treatment or after taking 6 doses to decide whether to continue treatment with a drug containing dapoxetine.
- Mental disorders: often – anxiety, agitation, restlessness, unusual dreams, decreased libido; infrequently – depression, depressed mood, euphoria, mood swings, nervousness, indifference, apathy, confusion, disorientation, pathological thinking, somatosensory amplification, sleep disturbances, initial insomnia, intrasomal disorder, nightmares, bruxism, loss of libido, anorgasmus.
- The central nervous system: very often – dizziness, headache; often – drowsiness, impaired concentration, tremor, paresthesia; infrequently – fainting, incl. vasovagal syncope, postural dizziness, akathisia, taste perversion, hypersomnia, lethargy, sedation, depression of consciousness; rarely – dizziness during physical exertion, sudden falling asleep.
- The organ of vision: often – blurred vision; infrequently – mydriasis, pain in the eye area, visual impairment.
- The organ of hearing and labyrinth disorders: often – ringing in the ears; infrequently – vertigo.
- The cardiovascular system: often – hot flashes; infrequently – cessation of sinus node activity, sinus bradycardia, tachycardia, lowering blood pressure, systolic hypertension.
- The respiratory system: often – nasal congestion, yawning.
- The digestive system: often – diarrhea, vomiting, constipation, abdominal pain, dyspepsia, flatulence, stomach discomfort, bloating, dry mouth.
- Skin and subcutaneous tissue disorders: often – hyperhidrosis; infrequently – itching, cold sweat.
- The reproductive system: often – erectile dysfunction; infrequently – lack of ejaculation, violation of orgasm, incl. anorgasmia in men, paresthesia of the male genitals.
- General reactions: often – weakness, irritability; infrequently – asthenia, a feeling of heat, anxiety, a feeling of malaise, a feeling of intoxication.
- Changes in laboratory parameters: often – increased blood pressure; infrequently – an increase in heart rate, an increase in diastolic blood pressure, an increase in orthostatic blood pressure.
- Severe heart disease (for example, NYHA class II-IV heart failure, cardiac conduction disorders (AV-conduction block 2-3 degrees or SSS) in the absence of a permanent pacemaker, severe coronary artery disease or valvular disease); simultaneous reception of MAO inhibitors and reception within 14 days after the termination of their use; likewise, MAO should not be taken within 7 days of discontinuing dapoxetine;
- Moderate to severe liver dysfunction;
- Severe renal dysfunction;
- A history of diagnosed or suspected orthostatic hypotension;
- A history of mania/hypomania or bipolar disorder;
- Children and adolescents under 18 years of age;
- Increased sensitive to dapoxetine.
In clinical studies, cases of overdose have not been described. Dapoxetine up to 240 mg (2 doses of 120 mg every 3 hours) did not cause unforeseen adverse events. In general, symptoms of an overdose include serotonergic reactions, incl. drowsiness, gastrointestinal disturbances (nausea, vomiting), tachycardia, tremors, agitation and dizziness.
In case of overdose, standard supportive therapy should be carried out, if necessary. Due to the significant binding of dapoxetine to blood plasma proteins, forced diuresis, dialysis, hemoperfusion, and blood transfusion are unlikely to be effective. The specific antidote is unknown.
- Taking the drug concurrently with serotonergic drugs (including monoamine oxidase inhibitors, L-tryptophan, triptans, tramadol, linezolid, selective serotonin reuptake inhibitors, inhibitors of serotonin and norepinephrine uptake, lithium) may cause serotonine-like side effects.
- Alcohol enhances the effect of the drug on the nervous system (dizziness, drowsiness, slow reflexes, changes in judgment).
- Taking the drug with CYP2D6 inhibitors increases the systemic drug effect.
- Thioridazine prolongs the QTc interval, which is accompanied by ventricular arrhythmia. Dapoxetine inhibits the CYP2D6 enzyme and appears to inhibit the metabolism of thioridazine. The increase in thioridazine levels caused by this is expected to increase the prolongation of the QTc interval.
- Do not allow simultaneous administration with monoamine oxidase inhibitors.
- Dapoxetine should not be taken in combination with active CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, saquinavir, telithromycin, nefazodone, nelfinavir and atazanavir, as they increase the plasma concentration of dapoxetine.