Limitations Of Priligy

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What is premature ejaculation?

Premature ejaculation is the most common condition affecting male sexual function.
In 2008, experts appointed by the International Society for Sexual Medicine agreed that three factors are involved in the definition of premature ejaculation: timing, a sense that the man does not have control over ejaculation, and distress for the couple.
Experts concluded that is no set time when a man should ejaculate during sex. But it is probably too soon if you have an orgasm before intercourse or less than a minute after you start.

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It is a problem because when you ejaculate, you lose your erection and cannot continue having sex.
Premature ejaculation causes a big impact in a man’s sex life which results in discontentment of a man’s partner during sexual intercourse and could lead to relationship breakups. Also, premature ejaculation causes mental health conditions like anxiety and distress to a man after coming too quickly or reaching orgasm easily with no control during a sexual intercourse. The specific cause of this condition is not known yet. Some studies show that the cause of premature ejaculation is very complex and involve biological, physical and psychological factors.

 

Clinical characteristics of premature ejaculation

The diagnosis of premature ejaculation is made considering the sexual history of the patient.
Most of the men with premature ejaculation are reluctant and unlikely to request treatment out of embarrassment or shame and when they seek medical attention, many of them have waited years before doing so.
Another roadblock to diagnosis is that clinicians may not be able to rely on the accuracy or completeness of a man’s testimony of his ejaculatory behaviour.
Discrepancies also exist between the man and his partner’s reports of the man’s ejaculatory behaviour. For instance, women have been found to report shorter ejaculatory latency times than their male partner reported.
Thus, the partner’s report of the man’s ejaculatory behaviour might serve as an informative tool for clinicians.

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Prevalence of premature ejaculation

The prevalence of premature ejaculation (PE) varies according to the definition and is difficult to assess in view of many men not wanting to seek help or even discuss the problem.
The aetiology of, and risk factors for premature ejaculation are unknown but it is important to distinguish premature ejaculation from erectile dysfunction (ED); if ED exists, it should be treated before or at the same time as premature ejaculation.
The prevalence of premature ejaculation is not related to age and ranges from 3-30%.
Results of studies that assessed the prevalence of premature ejaculation and erectile dysfunction in a single population support the view that premature ejaculation is more common than erectile dysfunction. An approximately 30% prevalence of premature ejaculation vs a 10% prevalence of erectile dysfunction was reported. However, awareness of erectile dysfunction is greater due to its more precise definition, standard diagnostic criteria, and established and vigorously promoted medical therapy.

Premature ejaculation effect on culture and ethnicity

Results of an automated telephone self-interview survey of 1,320 men 40 years or older suggest that different racial/ethnic groups may define premature ejaculation differently and/or differ in the self-reported prevalence of premature ejaculation. The percent of white, black and Hispanic men who reported „always/almost always” or „usually” experiencing premature ejaculation in the previous 3 months was 16%, 21% and 29%, respectively. The corresponding percent of men who „always/almost always” or „usually” ejaculated before penetration were 3%, 9% and 16%.

 

What is Priligy?

Priligy contains an active substance called „dapoxetine”. This belongs to a group of medicines called „selective serotonin reuptake inhibitors” (SSRIs). Priligy may also be known as a „urological” medicine.
Priligy was introduced first as an antidepressant drug, but because of its fast acting effect in delaying the ejaculation, it was used as a good treatment for premature ejaculation. There are several drugs used as antidepressants but most people are very much excited and interested about the wonderful effects provided by Priligy.
In fact, it is the best selling drugs in the market for premature ejaculation.
Priligy is available as 30 mg and 60 mg tablets.
Priligy increases the time it takes to ejaculate and can improve the control over the ejaculation. This may reduce the frustration or worry about fast ejaculation.
The legal category for Priligy is POM. This means it is a prescription only medicine and supply can only be made according to the instructions in a prescription issued by a qualified doctor or non-medical prescriber.

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How do I know if I need Priligy?

A man suffering from premature ejaculation usually ejaculates within 2 minutes of his penis entering his partner. Priligy should be used only if you are incapable of expanding this length of time and it is causing serious problems for your sexual relationship.
A study published in Wiley Online Library also provides results of a recent survey that was conducted among sex therapists. Results linked the amount of time it takes for ejaculation to occur to the satisfaction level of the partner.

  1. Ejaculating within two minutes were found to be „too short”;
  2. Ejaculating within three to seven minutes were found to be „adequate”;
  3. Ejaculating within seven to thirteen minutes were found to be „desirable”;
  4. Ejaculating within ten to thirty minutes were found to be „too long”.

Also, Priligy is the appropriate medication for you if you have a history of premature ejaculation over the past 6 months in the majority of intercourse attempts and marked personal distress or interpersonal difficulty because of premature ejaculation.

 

How does it work?

Dapoxetine works by increasing the activity of serotonin in the nervous system. Serotonin is a neurotransmitter that is involved in passing messages between nerve cells. It has various functions in the body and is involved in sending the nerve messages that result in ejaculation.
Increasing the activity of serotonin in the nervous system helps to increase the time it takes to ejaculate and improve control over the ejaculation.

 

How should I take Priligy?

The recommended dose is 30 mg. If the effect of 30 mg is insufficient and the side effects are acceptable, the dose may be increased to the maximum recommended dose of 60 mg;
You should take Priligy 1 to 3 hours before sexual activity. It is important to know that you should not take it more than once every 24 hours or every day;
Swallow the tablets whole to avoid a bitter taste, with at least one full glass of water. This may help lower your chance of fainting. Priligy can be taken with or without food;
Discuss your treatment with your doctor after the first 4 weeks or after 6 doses to see whether you should continue treatment.

How much longer will I be able to last during sex?

This will vary considerably, depending on the severity of your premature ejaculation. Some men may last only 2-3 minutes longer than before (although this makes a big difference to men who ejaculate in 1-2 minutes), while some men may find they last 10-20 minutes longer than before. It will depend on what methods you choose and how long you stick with them.

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Duration of action

Priligy, among the all selective serotonin reuptake inhibitors, has a unique pharmacokinetic profile, which means that is rapidly absorbed and extensively metabolized to inactive compounds. Priligy is almost completely eliminated from the body within 24h, showing minimal accumulation after daily dosing.

Are there any limitations of Priligy?

Many men suffering from premature ejaculation find treatment with Priligy to be of a huge benefit to them in effectively helping them to manage their condition. But, Priligy is not for everybody. There are some limitations to its use like certain medical conditions which mean Priligy is not a suitable treatment for them or certain medications that Priligy should not be taken with. You should not take Priligy if:

  • You are allergic to dapoxetine or any other ingredients of Priligy;
  • You can hold back ejaculation for around 7 minutes;
  • You are under 18 years or over 65 years;
  • You cannot easily get or maintain erections;
  • You are taking medication to treat depression, or have a history of mental illness such as bipolar disorder, depression or anxiety;
  • You are taking certain medicines for fungal infection, including ketoconazole and itraconazole;
  • You are taking certain medicines for HIV (Human Immunodeficiency Virus), including ritonavir, saquinavir, nelfinavir and atazanavir;
  • You are taking certain antibiotics for treating infection, including telithromycin;
  • You suffer from low blood pressure and bouts of fainting.

It is important to speak to your doctor before taking Priligy. Your doctor will be able to take in considering your whole medical history, symptoms and current medication to give you the most appropriate and safe advice regarding the best course of action in treating premature ejaculation.

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Effectiveness of Priligy

The main evidence for the effectiveness of Priligy can be found in a large research review conducted by Dr Chris G McMahon in 2012. He reviewed 5 different major studies which involved over 6000 men in total. His main findings were:

For men who last an average of 0.9 minutes, a 30 mg dose increased that to 3.1 minutes;
A 60 mg dose increased it to 3.6 minutes.

So it appears that on average Priligy does increase the lasting time by a couple of minutes on average.
It’s important to note that it can’t permanently cure premature ejaculation – you have to take it every time you have sex.

 

Side effects of PriligySIDE EFFECTS

Like all medicines, Priligy can cause side effects, although not everybody gets them. The following side effects may occur with this medicine:

  • fits (seizures)
  • fainting when standing up
  • mood changes
  • suicidal thoughts

If any of these potentially serious adverse reactions occur, you should stop taking Priligy.
Priligy is not recommended when you are dehydrated (you do not have enough water in your body).
This can happen if:

  • You have not had anything to drink in the past 4 to 6 hours
  • You have been sweating for a long time
  • You have an illness where you have a high temperature, diarrhoea or being sick.

Very common side effects (affects more than 1 user in 10):

  • Feeling dizzy;
  • Headache;
  • Feeling sick.

Common side effects (affecting 1 to 10 users in 100) include:

  • Feeling irritable, anxious, agitated or restless;
  • Feeling numb or having „pins and needles”;
  • Difficulty getting or keeping an erection;
  • Sweating more than normal or flushing;
  • Diarrhoea, constipation or having wind;
  • Stomach pain, bloating or being sick;
  • Problems sleeping or strange dreams;
  • Feeling tired or sleepy, yawning;
  • Blocked nose (nasal congestion);
  • A rise in blood pressure;
  • Difficulty concentrating;
  • Shaking or trembling;
  • Lower interest in sex;
  • Ringing in the ears;
  • Blurred vision;
  • Indigestion;
  • Dry mouth.

Uncommon side effects (affecting1 to 10 users in 1,000) include:

  • Fainting or feeling dizzy upon standing (see advice above);
  • Change in mood, feeling overly excited or feelings of paranoia;
  • Feeling confused, disoriented or unable to think clearly;
  • Slow or irregular heartbeat or increase in heart rate;
  • Loss of sex drive, problems reaching orgasm;
  • Feeling weak, sedated, lethargic or fatigued;
  • Feeling depressed, nervous or indifferent;
  • Feeling hot, jittery, abnormal or drunk;
  • Vision problems or dilated pupils;
  • Low or high blood pressure;
  • Feeling itchy or cold sweat;
  • Spinning sensation;
  • Abnormal taste;
  • Teeth grinding.

Rare side effects (affecting 1 to 10 users in 10,000) include:

  • Feeling dizzy following exertion;
  • Sudden onset of sleep;
    Urgency of bowel action.
    Even though these events are usually mild to moderate in severity, they frequently result in discontinuation from treatment, especially among patients who were treated with dapoxetine 60 mg (the highest dose).
    If you have any questions related to PE or the use of Priligy, please contact us at [email protected].

Overdose

In clinical tests, cases of overdose are not described.
Priligy dosage up to 240 mg (2 doses of 120 mg every 3 h) caused no unexpected adverse events. Generally, symptoms of SSRI (selective serotonin reuptake inhibitor) overdose include serotonergic reactions, including drowsiness, gastrointestinal disorders (nausea, vomiting), tachycardia, tremor, excitement and dizziness.
In case of overdose, it is necessary to carry out standard maintenance therapy. Due to significant drug binding to plasma proteins and a large volume of dapoxetine hydrochloride distribution, forced diuresis, dialysis, hemoperfusion and blood transfusion are unlikely to be effective. The specific antidote is not known.

 

Does Priligy affect the driving ability?

Dizziness, disturbance in attention, blurred vision and somnolence have been reported in subjects receiving Priligy in clinical trials. Therefore, you should avoid situations where injury could result, including driving or operating hazardous machinery.
Also combining alcohol with Priligy may increase alcohol-related neurocognitive effects and may enhance neurocardiogenic adverse events such as syncope, thereby increasing the risk of accidental injury. Syncope, also known as fainting, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery.
You should avoid alcohol while taking Priligy.

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Key Messages:

Premature ejaculation is not a sickness or disease and even the most sexually active of men can suffer from it;
Substances such as wine, beer and certain pills and drugs can lower inhibitions and heighten sexual pleasure-but abuse of them can lead to erectile dysfunction, the inability to orgasm and premature ejaculation itself;
Lack of sleep leads to low serotonin levels in the brain, which triggers your body to ejaculate more rapidly;
Approximately 1 in 3 men suffer from premature ejaculation at some time in their lives.8
Dapoxetine (Priligy) significantly improved all aspects of premature ejaculation and was generally well tolerated in a broad population.
Dose-related effects including nausea, diarrhoea, dizziness, headache, insomnia, and fatigue, which are typical of drug class, can appear when using Priligy.
Considering that premature ejaculation is not a life-threatening disease, the added benefit of 60 mg compared to 30 mg (5-10% more responders) was considered too modest to outweigh the potentially increased risk for severe events of syncope.
For clinicians treating premature ejaculation, it is very important to know that due to its particularly short half-life, dapoxetine has a risk-benefit ratio definitively in favour of the benefits and is usually well tolerated.12

If you are intending to use Priligy, or if you have questions related to side-effects, please address directly to our pharmacy. You can start a consultation to establish if Priligy is the right medicine for you.

 

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References:

  1. http://www.issm.info/sexual-health-conditions/premature-ejaculation1/;
  2. https://www.webmd.com/men/what-is-premature-ejaculation#1;
  3. Godpodinoff ML. Premature ejaculation: clinical subgroups and etiology. J Sex Marital Ther 1989; 15: 130–134. DOI: 10.1080/00926238908403817;
  4. Rowland DL, Strassberg DS, de Gouveia Brazao CA, Slob AK. Ejaculatory latency and control in men with premature ejaculation: an analysis across sexual activities using multiple sources of information. J Psychosom Res 2000; 48: 69–77. PubMed PMID: 10750632;
  5. Byers ES, Grenier G. Premature or rapid ejaculation. Arch Sex Behav 2003; 32: 261–270;
  6. Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, Vardi Y, Wespes E; European Association of Urology. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol 2010; PubMed PMID: 20189712; DOI:
  7. 10.1016/j.eururo.2010.02.020;
  8. Althof SE. Prevalence, Characteristics and Implications of Premature Ejaculation/Rapid Ejaculation. J Urol. 2006 Mar;175(3 Pt 1):842-8; PubMed PMID: 16469562; DOI: 10.1016/S0022-5347(05)00341-1;
  9. http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Priligy_29/WC500124577.pdf;
  10. http://www.issm.info/sexual-health-conditions/premature-ejaculation1/;
  11. Chris G. McMahon. Efficacy of Dapoxetine in the Treatment of Premature Ejaculation. Clin Med Insights Reprod Health. 2011; 5: 25–39; PMCID: PMC3888071; PubMed PMID: 24453509; DOI: 10.4137/CMRH.S7337;
  12. Abdlekawy KS, Donia AM, Elbarbry F. Effects of Grapefruit and Pomegranate Juices on the Pharmacokinetic Properties of Dapoxetine and Midazolam in Healthy Subjects.
  13. Eur J Drug Metab Pharmacokinet. 2017 Jun;42(3):397-405; PubMed PMID: 27294349; DOI: 10.1007/s13318-016-0352-3.
  14. Jannini EA, Lenzi A. Ejaculatory disorders: epidemiology and current approaches to definition, classification and subtyping. World J Urol 2005;23:68–75.

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