Priligy (Dapoxetine): Uses, dosage, side effects, warnings & patient reviews

What is Priligy (Dapoxetine)?

Priligy is the brand name for dapoxetine, a medication approved for the treatment of premature ejaculation in men. Unlike daily-use antidepressants, dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSRI) taken only as needed, 1 to 3 hours before anticipated sexual activity.

Its mechanism involves increasing serotonin activity in the central nervous system, which is believed to help delay the ejaculatory reflex. For more on how medications in this class work, you can read about antidepressants and sexual function.

Priligy is available by prescription only, typically in 30 mg and 60 mg tablet strengths. A proper diagnosis from a healthcare provider is essential before use.

How to Take Priligy

Following the prescribed dosing instructions is crucial for the safety and effectiveness of Priligy.

Standard Dosage and Administration

The recommended starting dose is 30 mg, taken orally with water, 1 to 3 hours before planned sexual activity. Do not take more than one dose in a 24-hour period.

Based on efficacy and tolerance, your doctor may increase the dose to the maximum recommended dose of 60 mg. The tablet should be swallowed whole and can be taken with or without food.

Important Usage Notes

• As-Needed Use: Priligy is not intended for daily use. It should only be taken when sexual activity is anticipated.
• Missed Dose: If you miss taking the tablet at the planned time, skip the dose. Do not take a double dose.
• Medical Assessment: A doctor should confirm the diagnosis of premature ejaculation and rule out other underlying medical or psychological causes before prescribing Priligy.

Side Effects of Priligy

As with all medications, Priligy can cause side effects, which are often most noticeable when starting treatment or increasing the dose.

What is Priligy Used For?

Priligy has one primary, approved medical use.

Treatment of Premature Ejaculation (PE)

Priligy is indicated for the treatment of premature ejaculation in men aged 18 to 64 years. Premature ejaculation is defined as a persistent or recurrent pattern of ejaculation occurring within approximately one minute of vaginal penetration and before the individual wishes it, causing significant distress.

It is important to understand that Priligy is a symptomatic treatment that helps delay ejaculation. It does not cure the underlying biological or psychological factors that may contribute to PE. A comprehensive approach that may include behavioral techniques or counseling is often recommended alongside medication.

Important Limitations

• Not for Erectile Dysfunction (ED): Priligy does not treat erectile dysfunction. It is specifically for ejaculatory control.
• Not for Daily Use: It is designed for on-demand use, not continuous daily administration like some other SSRIs used off-label for PE.
• Not for Women or Adolescents: Priligy is not indicated for use by women, men under 18, or men over 64.

Important Safety Concerns and Considerations

Risk of Syncope (Fainting)

A significant concern with Priligy is orthostatic hypotension, a sudden drop in blood pressure upon standing, which can lead to dizziness, lightheadedness, and fainting (syncope). This risk is highest within the first 3 hours after taking the tablet. Patients should be advised to rise slowly from a lying or sitting position. Activities requiring alertness should be avoided during this period.

Mood Changes and Suicidal Ideation

As an SSRI, dapoxetine carries a warning about the potential for mood changes, including the emergence of anxiety, agitation, panic attacks, and, in rare cases, suicidal thoughts or behavior. Patients and their partners should be alert to any unusual changes in mood or behavior, especially when starting treatment or changing the dose, and report them immediately to a doctor.

Serotonin Syndrome

This is a rare but potentially life-threatening condition caused by excessive serotonin activity. The risk increases if Priligy is taken with other serotonergic drugs. Symptoms include agitation, hallucinations, rapid heart rate, fever, muscle stiffness, and loss of coordination. This is a medical emergency.

Underlying Medical Conditions

Priligy is contraindicated in men with significant heart problems (including heart failure, conduction abnormalities), moderate to severe liver impairment, or a history of mania or bipolar disorder. A thorough medical history and examination are necessary before prescription.

Critical Warnings for Priligy Use

Contraindication with Alcohol and Recreational Drugs

Priligy must not be used with alcohol or recreational drugs (e.g., “poppers” containing amyl nitrite). These combinations dramatically increase the risk of serious adverse events like fainting, hypotension, and cardiovascular complications.

Contraindication with Monoamine Oxidase Inhibitors (MAOIs) and Other Serotonergic Drugs

Concurrent use with MAOIs is prohibited due to the high risk of serotonin syndrome. A washout period of at least 14 days is required between stopping an MAOI and starting Priligy, and vice versa. Use with other SSRIs, SNRIs, tricyclics, or triptans is also contraindicated or requires extreme caution.

Cardiovascular and Hepatic Warnings

Priligy should not be used in patients with known cardiovascular conditions such as heart failure, heart block, or significant ischemic heart disease. It is also contraindicated in patients with moderate or severe liver impairment, as this can lead to increased drug exposure and higher risk of side effects.

Bleeding Risk

SSRIs, including dapoxetine, may increase the risk of bleeding, especially if taken with other drugs that affect bleeding (e.g., NSAIDs like ibuprofen, aspirin, warfarin). Patients should be cautious and report any unusual bruising or bleeding.

Priligy Dosage Information

The dosage must be individualized by a healthcare provider based on efficacy and tolerability.

Important Administration Notes

• Maximum Frequency: One dose per 24 hours.
• Timing: Efficacy is time-dependent. Taking it too early or too late may reduce its effect.
• Duration of Treatment: The need for ongoing treatment should be reassessed by a doctor periodically (e.g., every 6 months).
• Missed Dose: Do not take a double dose. Skip the missed dose and take the next one as planned before future sexual activity.

Drug Interactions with Priligy

Priligy has numerous potentially serious drug interactions. A complete and honest medication history must be provided to the prescribing doctor.

Additional Information

Storage and Handling

Store Priligy tablets at room temperature (below 30°C or 86°F), in a tightly closed container, away from light, excess heat, and moisture. Keep all medications out of the reach of children and pets.

Related Formulations

The active ingredient dapoxetine is also available in combination with medications for erectile dysfunction (ED) in single tablets. These are intended for men who experience both premature ejaculation and ED. They are available as generic formulations but require a prescription and medical supervision. Examples include:

• Viagra Super Force (Sildenafil + Dapoxetine)
• Kamagra Super (Sildenafil + Dapoxetine)
• Tadapox (Tadalafil + Dapoxetine)
• Super Avana (Avanafil + Dapoxetine)

A healthcare provider can determine if a combination therapy is appropriate for your specific situation.

Reporting Side Effects

If you experience a side effect, report it to your doctor. You can also report adverse drug events directly to your national drug safety authority (e.g., the FDA’s MedWatch program in the United States). This helps improve overall drug safety knowledge.

References and Medical Sources

1. European Medicines Agency (EMA). Priligy (dapoxetine) Summary of Product Characteristics. [Updated 2023]. https://www.ema.europa.eu/en/documents/referral/questions-and-answers-referral-priligy_en.pdf
2. International Society for Sexual Medicine (ISSM). Guidelines for the Diagnosis and Treatment of Premature Ejaculation. [2014]. https://www.issm.info/sexual-health-headlines/dapoxetine-for-premature-ejaculation-has-high-discontinuation-rate
3. MedlinePlus. Dapoxetine. U.S. National Library of Medicine; [Updated 2022]. https://medlineplus.gov/druginfo/meds/a616035.html
4. Drugs.com. Dapoxetine Professional Monograph. Drugs.com; [Updated 2024]. https://www.drugs.com/international/dapoxetine.html

Disclaimer: The information on this site is provided for informational purposes only and is not medical advice. It does not replace professional medical consultation, diagnosis, or treatment. Do not self-medicate based on the information presented on this site. Always consult with a doctor or other qualified healthcare professional before making any decisions about your health.