Efficacy and safety of dapoxetine/sildenafil combination tablets in the treatment of men with premature ejaculation and concomitant erectile dysfunction-DAP-SPEED Study

What to do if you miss a dose: For ED: Take your dose 30 minutes to 4 hours before your next sexual activity. For PAH: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once.

12.1 Mechanism of Action

In one study, children with PAH who took this drug had an increased chance for death. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on: how you react to the first dose Strengths: 25 mg, 50 mg, 100 mg Strengths: 25 mg, 50 mg, 100 mg Typical dosage: 50 mg, taken as needed about 1 hour before sexual activity. It can be taken 30 minutes to 4 hours before sexual activity. Maximum dosage: 100 mg once per day.

Mechanism of action

This drug has not been confirmed to be safe or effective in children younger than 18 years. Senior dosage (ages 65 years and older) The kidneys, liver, or heart of older adults may not work as well as they used to. This raises your risk of side effects. Your doctor may start you on a lowered dosage of sildenafil. This can help prevent levels of this drug from building up in your body. This could result in dangerous side effects. How to tell if the drug is working: For ED: You should be able to get and maintain an erection when sexually aroused. For PAH: You should be able to exercise more easily.

• Sildenafil is marketed globally under the brand Viagra.
• Dapoxetine is marketed as Priligy in many regions.
• Common side effects of sildenafil include headaches and flushing.
• Dapoxetine may cause nausea, dizziness, or insomnia.
• Taking sildenafil with nitrates can cause severe hypotension.
• Dapoxetine should not be used with other antidepressants without doctor approval.
• Both medications may cause dizziness, so caution is advised when driving.
• Alcohol can reduce the effectiveness of sildenafil and dapoxetine.

Your doctor will also check you to determine if this drug is working. Keep these considerations in mind if your doctor prescribes sildenafil for you. You can take this drug with or without food. You can cut or crush the tablet. When you take the drug depends on the condition being treated:For ED: You can take this drug at any time of day.For PAH: Take this drug three times per day about 4–6 hours apart. Take it at the same time every day. For ED: You can take this drug at any time of day. For PAH: Take this drug three times per day about 4–6 hours apart. Store sildenafil tablets at room temperature between 59°F and 86°F (15°C and 30°C). Don’t store this medication in moist or damp areas, such as bathrooms. A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription. When flying, never put it into a checked bag. Keep it sildenafil and dapoxetine in your carry-on bag. Don’t worry about airport X-ray machines. You may need to show airport staff the pharmacy label for your medication.

Product	Dosage	Quantity + Bonus	Price
Priligy Generic Dapoxetine	60mg	120 + 10 Pills	341.26€ 325.01€	Buy
Priligy Generic Dapoxetine	60mg	10 Pills	47.63€ 45.36€	Buy
Kamagra 100 mg	100 mg	60 + 4 Pills	201.34€ 191.75€	Buy
Viagra Professional	100mg	30 Pills	88.92€ 84.69€	Buy
Kamagra 100 mg	100 mg	32 Pills	121.24€ 115.47€	Buy
Viagra Original	100mg	120 + 8 Pills	470.39€ 447.99€	Buy
Kamagra Gold	50 mg	360 + 6 Pills	713.95€ 679.95€	Buy
Priligy Generic Dapoxetine	60mg	20 + 4 Pills	77.31€ 73.63€	Buy
Priligy Generic Dapoxetine	60mg	90 + 10 Pills	265.64€ 252.99€	Buy
Priligy Generic Dapoxetine	60mg	30 + 6 Pills	106.65€ 101.57€	Buy
Priligy Generic Dapoxetine	60mg	180 + 10 Pills	494.76€ 471.20€	Buy
Cialis Black	80mg	90 + 6 Pills	207.88€ 197.98€	Buy
Cialis Super Active	20mg	30 + 6 Pills	128.09€ 121.99€	Buy
Priligy Generic Dapoxetine	60mg	60 + 8 Pills	183.06€ 174.34€	Buy
Viagra Generic	200mg	270 + 10 Pills	379.76€ 361.68€	Buy

Always carry the original prescription-labeled container with you. Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Adverse effects

Typical dosage: 5 or 20 mg, taken three times per day about 4 to 6 hours apart Maximum dosage: 20 mg, taken three times per day about 4 to 6 hours apart This drug shouldn’t be used in children younger than 18 years of age. Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. Always speak with your doctor or pharmacist about dosages that are right for you. Sildenafil oral tablet is used for short-term treatment of ED and long-term treatment of PAH.

Warnings for people with certain health conditions

It comes with serious risks if you don’t take it as prescribed. If you stop taking the drug suddenly or don’t dapoxetine order online take it at all: For ED: Your ED symptoms won’t improve. For PAH: Your condition won’t improve and may get worse. Also, you won’t be able to exercise. If you miss doses or don’t take the drug on schedule: For ED: Your ED symptoms won’t improve. If you’re taking this drug for PAH, your doctor may monitor your blood pressure and pulse regularly. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it. Many insurance companies require prior authorization for this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

• Sildenafil's patent expiration has increased availability of generics.
• Dapoxetine is relatively newer, approved in the early 2000s.
• Lifestyle factors like smoking can impact medication effectiveness.
• Both medications have different mechanisms of action.
• Dapoxetine's efficacy is confirmed through multiple clinical trials.
• Sildenafil may cause temporary visual disturbances.
• Proper dosage timing enhances effectiveness and safety.
• Always discard expired medications safely to avoid misuse.

Sildenafil under the brand name Viagra is prescribed to treat erectile dysfunction by increasing blood flow to the penis during arousal.

Formulation	Strengths	Advantages	Notes
Tablets	50 mg, 100 mg sildenafil	Easy to dose, portable	Available by prescription
Dapoxetine Tablets	30 mg, 60 mg	Fast absorption, on-demand use	Prescription required
Combination Tablets	Fixed doses (e.g., 100/60 mg)	Simplifies treatment regimens	Under medical supervision

Sildenafil under the brand name Revatio is often prescribed to help adults with PAH get more exercise by treating their condition. What if I forget to take it? If you are taking Revatio and you forget to take your scheduled dose, take it as soon as possible. However, you should never double your dosage. If you completely miss a dose and it’s time for the next dose, skip the one you missed.

Medication Class	Interaction Effect	Recommendation
Nitrates	Severe hypotension	Avoid concomitant use
CYP3A4 inhibitors	Increased levels of sildenafil, dapoxetine	Dose reduction or avoid
Antihypertensives	Additive blood pressure lowering	Monitor blood pressure closely
Other PDE5 inhibitors	Increased risk of side effects	Use caution, dose adjustment

Are there any safety measures I should take before using this drug? Like most medications, there are precautions you should take before using this drug. Make sure you talk with your doctor about: any other drugs, medications, herbs, or supplements you take or plan to take any medical conditions or surgeries you have or plan to have if you are pregnant or plan to become pregnant There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you. Sildenafil and tadalafil are alike because they both can treat ED and PAH. However, tadalafil has a few distinctions from sildenafil.

• Consistent use of sildenafil can help maintain erectile function.
• Dapoxetine provides a pharmacological solution for PE.
• Both products should be stored in a cool, dry place away from children.
• Side effects may diminish with continued use or dose adjustment.
• Some patients may require alternative therapies if side effects occur.
• Clinical guidelines recommend consultation before combining treatments.
• Dapoxetine's short half-life minimizes residual effects.
• Patients should inform healthcare providers about all current medications.

Tadalafil is the generic name for the erectile dysfunction drug Cialis. There are two versions of the drug: a version that can be taken as needed Cialis 5-mg daily dosing is the only PDE5 inhibitor dose approved for treating an enlarged prostate; improving ED symptoms is an added benefit of the daily dose. Because of the “as needed” version of tadalafil, some users may find this option more convenient. The downside, however, is that side effects tend to last longer too. The main difference between generic sildenafil and Viagra is marketing.

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For people with problems with the shape of their penis: If you have a problem with the shape of your penis, such as Peyronie’s disease, this drug raises your risk for having an erection that lasts more than 4 hours. For people with a history of stomach ulcers or bleeding: This drug raises your risk for stomach bleeding, ulcers, or small holes in the lining of your digestive system. These events can be fatal (cause death). They can happen at any time, with or without symptoms. For people with sickle cell anemia: This drug may cause a common painful complication of sickle cell anemia called vaso-occlusive crisis.

Dosage for pulmonary arterial hypertension (PAH)

If you have sickle cell anemia, ask your doctor whether this drug is safe for you. For pregnant women: Research in animals has not shown a risk to the fetus when the mother takes the drug. However, there aren’t enough studies done in humans using the drug for PAH to show if the drug poses a risk to the fetus. Talk with your doctor if you’re pregnant or planning to become pregnant. It appears unlikely that this drug will harm a pregnancy. The main ingredient in Viagra is sildenafil, meaning that the drugs are essentially the same.

Parameter	Value	Description
Absorption Rate	Rapid	Peak plasma levels in about 30-120 min
Peak Concentration	90 minutes	Time to maximum plasma concentration
Half-Life	Approx. 4 hours	Duration in system for elimination
Metabolism	Liver (CYP3A4 enzyme)	Primary metabolic pathway
Excretion	Feces and urine	Removal route

However, Viagra is marketed and prescribed strictly for erectile dysfunction, while generic sildenafil can be prescribed for PAH as well. Viagra is also known as “the little blue pill” because of its blue color, while generic sildenafil tends to be a white color. Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

Additional information

However, this drug should only be used during pregnancy if clearly needed. Viagra or generic sildenafil for ED should not be used in women. For women who are breastfeeding: When used for PAH, sildenafil may pass into breast milk and may cause side effects in a child who is breastfed. Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

Chemical Names

For seniors: The kidneys, liver, or heart of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk for side effects. For children: This drug isn’t recommended in children younger than 18 years. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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For PAH: This medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times. If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include: If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away. Premature ejaculation (PE) and erectile dysfunction (ED) are the most prevalent sexual disorders in men. ED is commonly reported among patients with PE. Although recent guidelines recommend to treat ED first in men with both PE and ED, this recommendation is not based on evidence and there are limited data about the efficacy and safety of dapoxetine/sildenafil combination therapy for these patients.

• Sildenafil can be combined with lifestyle changes for better results.
• Dapoxetine helps subjects gain better control during sexual activity.
• Use caution in hot weather as both drugs can cause dehydration.
• Patients should avoid grapefruit or high-fat foods around intake time.
• Sildenafil has been studied extensively for safety and efficacy.
• Dapoxetine's rapid onset makes it convenient for planned activity.
• These medications are not substitutes for safe sexual practices.
• Always follow the prescribed dosage and timing instructions.

The aim of this study is to evaluate the clinical efficacy and safety of the dapoxetine/sildenafil combination (Dapoxil® 30/50 mg film-coated tablet) in the treatment of patients with PE and concomitant ED. In a single-center, single-arm, open-label clinical study conducted between October 2016 and September 2017, 74 patients with lifelong or acquired PE and ED were included.