Dapoxetine works by inhibiting the reuptake of serotonin (5-HT) in the central nervous system. According to the Lippincott Textbook of Pharmacology, serotonin plays a crucial role in modulating ejaculation. By increasing serotonin levels in the synaptic cleft, Dapoxetine enhances the activity of 5-HT receptors, particularly the 5-HT2C and 5-HT1A receptors. This action delays the ejaculatory reflex, thereby improving control over ejaculation.

The Lange Basic & Clinical Pharmacology further explains that Dapoxetine's rapid onset of action (1-2 hours) and short half-life (approximately 1.5 hours) make it ideal for use on an as-needed basis, unlike traditional SSRIs that require daily dosing

Dapoxetine is specifically indicated for the treatment of premature ejaculation in men aged 18-64 years. It is not intended for use in women or children. The British National Formulary (BNF) emphasizes that Dapoxetine should only be prescribed after a thorough medical evaluation to rule out other underlying causes of PE, such as psychological factors or hormonal imbalances.

The recommended dose of Dapoxetine is 30 mg, taken orally 1-3 hours before anticipated sexual activity. Depending on the individual's response and tolerability, the dose may be increased to 60 mg. However, the maximum dosing frequency is once daily.

Key points from the BNF:

• Dapoxetine should be taken with a full glass of water.
• It can be taken with or without food, but high-fat meals may delay its absorption.
• The medication should not be used more than once in 24 hours.

Like all medications, Dapoxetine may cause side effects. Common side effects, as listed in the Lippincott Textbook of Pharmacology, include:

• Nausea
• Headache
• Dizziness
• Diarrhea
• Insomnia
• Fatigue

Less common but serious side effects may include:

• Syncope (fainting)
• Orthostatic hypotension (a sudden drop in blood pressure upon standing)
• Suicidal thoughts (rare, but important to monitor in patients with a history of depression)

Patients experiencing severe side effects should seek medical attention immediately.

Before starting Dapoxetine, certain precautions should be taken:

1. Medical History: Inform your healthcare provider if you have a history of cardiovascular disease, liver or kidney impairment, or psychiatric disorders.
2. Alcohol: Avoid alcohol while taking Dapoxetine, as it may increase the risk of side effects such as dizziness and fainting.
3. Driving and Operating Machinery: Dapoxetine may cause dizziness or drowsiness, so patients should avoid activities requiring mental alertness until they know how the medication affects them.

Pregnancy and Breastfeeding: Dapoxetine is not indicated for use in women, but men should consult their doctor if their partner is pregnant or breastfeeding

Dapoxetine has the potential to interact with other medications, which may increase the risk of adverse effects or reduce its efficacy. Key interactions highlighted in the BNF and Lange Basic & Clinical Pharmacology include:

• Other SSRIs or SNRIs: Concurrent use may increase serotonin levels, leading to serotonin syndrome (a potentially life-threatening condition).
• MAO Inhibitors: Contraindicated due to the risk of severe serotonin syndrome.
• Thioridazine: Increased risk of QT prolongation and arrhythmias.
• Strong CYP3A4 Inhibitors (e.g., ketoconazole, ritonavir): These drugs can increase Dapoxetine levels, necessitating a dose reduction.
• Nitrates: May cause severe hypotension.

Always inform your healthcare provider about all medications, supplements, and herbal products you are taking before starting Dapoxetine.

Dapoxetine is the active ingredient in the brand-name medication Priligy. In pharmacies, it may also be available under various generic names, depending on the region and manufacturer. Some common generic names include:

• Dapoxetine Hydrochloride
• Dapoxetin (in some European countries)