Dapoxetine
Dapoxetine is a short-acting selective serotonin reuptake inhibitor designed specifically for on-demand treatment of premature ejaculation in adult men. Unlike other SSRIs, it has rapid onset and short duration suitable for as-needed use.
- Chemical formula
- C21H23NO
- CAS number
- 129938-20-1
- ATC code
- G04BX14
- Molecular weight
- 305.4 g/mol
- Drug class
- Short-acting SSRI (premature ejaculation)
- Also known as
- LY-210448, Priligy
What is it?
Dapoxetine is a selective serotonin reuptake inhibitor (SSRI) specifically developed for the on-demand treatment of premature ejaculation in adult men. Unlike other SSRIs intended for chronic daily use in depression, dapoxetine has been engineered for rapid absorption and short duration of action, allowing it to be taken 1 to 3 hours before anticipated sexual activity. It was first approved in Europe in 2009 under the brand name Priligy. Dapoxetine is not approved in the United States for this indication.
Mechanism of action
Dapoxetine selectively blocks the serotonin transporter on the presynaptic neuron, increasing serotonin concentration in the synaptic cleft. In the context of ejaculation, increased serotonin signalling delays the ejaculatory reflex by acting on supraspinal and spinal control centres. The pharmacological mechanism is shared with other SSRIs, but dapoxetine's distinguishing feature is its kinetics: rapid absorption, short half-life, and limited accumulation, which together support on-demand rather than continuous dosing.
Pharmacokinetics
After oral administration, dapoxetine reaches peak plasma concentrations in approximately one hour. Bioavailability is approximately 42%. The molecule is rapidly metabolised in the liver, primarily via CYP3A4 and CYP2D6, to active and inactive metabolites. The terminal half-life is approximately 1.5 hours for the parent compound, with longer half-lives for some metabolites. This rapid kinetic profile allows on-demand dosing with minimal accumulation between doses, distinguishing it from chronic-use SSRIs like sertraline or fluoxetine.
Indications
Dapoxetine is approved in many European, Asian and Latin American countries for the on-demand treatment of premature ejaculation in adult men aged 18 to 64 years with a confirmed diagnosis. The diagnosis typically requires a personal history of consistently rapid ejaculation, distress or interpersonal difficulty associated with it, and ejaculation occurring within approximately one minute of vaginal penetration in most encounters. The molecule is not approved for general anxiety, depression or any female indication.
Safety profile
Common adverse effects include nausea, dizziness, headache, diarrhoea, insomnia and fatigue, particularly during the first doses. Vasovagal episodes (presyncope or syncope) have been reported, prompting recommendations to take dapoxetine with at least one full glass of water and to remain seated or lying down if dizziness occurs. Dapoxetine is contraindicated with monoamine oxidase inhibitors, thioridazine and certain serotonergic agents. According to the prescribing information, the molecule should not be combined with alcohol or recreational drugs.
Products containing this ingredient
Frequently asked questions
How is dapoxetine different from other SSRIs? ▾
Although dapoxetine is chemically an SSRI, its pharmacokinetic profile is fundamentally different from chronic-use SSRIs like sertraline, fluoxetine or paroxetine. Dapoxetine has a much shorter half-life (about 1.5 hours versus 26 hours for sertraline and longer for others), allowing it to be taken as needed before sexual activity rather than every day. This kinetic difference is what makes dapoxetine the only SSRI specifically approved for on-demand use in premature ejaculation.
Is dapoxetine approved in the United States? ▾
No. Despite its approval in many other regulated markets (Europe, Asia, Latin America, Australia), dapoxetine has not received FDA approval for the treatment of premature ejaculation. In the US, treatment of premature ejaculation typically uses off-label SSRIs (such as sertraline or paroxetine) or topical anaesthetics. According to clinical guidelines, off-label use of chronic SSRIs requires daily dosing rather than on-demand use, with a different side effect profile.
How long does dapoxetine take to work? ▾
Dapoxetine is taken approximately 1 to 3 hours before anticipated sexual activity. Peak plasma concentrations are reached in about one hour, which corresponds to the optimal window for the ejaculation-delaying effect. The effect wears off within several hours due to the molecule's short half-life. According to clinical trials, dapoxetine increases intravaginal ejaculatory latency time by 2 to 3 fold compared with placebo, with response varying by individual.
What dose of dapoxetine should I take? ▾
According to the prescribing information, the recommended starting dose is 30mg, taken approximately 1 to 3 hours before anticipated sexual activity. If insufficient response is observed and side effects are tolerable, the prescribing physician may increase the dose to 60mg. The maximum dosing frequency is once every 24 hours. Dapoxetine should be taken with at least one full glass of water to reduce the risk of vasovagal episodes.
Can dapoxetine be combined with PDE5 inhibitors? ▾
Combining dapoxetine with PDE5 inhibitors (sildenafil, tadalafil, vardenafil) is sometimes used in men with both premature ejaculation and erectile dysfunction, after specialist evaluation. The combination is not formally approved everywhere and may increase the risk of orthostatic hypotension, dizziness and syncope. According to clinical guidelines, this combination should only be initiated under medical supervision, with attention to cardiovascular status, and not as a self-medication strategy.
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