Active ingredient: Dapoxetine hydrochloride

Common strengths in markets where available: 30 mg, 60 mg, and in some regions 90 mg tablets

Main therapeutic area: Premature ejaculation (PE) in adult men

For a deeper dive into how it is taken, jump to Dosage guidance. For its U.S. legal status, see Legal status in the USA.

What Dapoxetine is and who may benefit

Dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSRI) specifically studied for premature ejaculation. By increasing synaptic serotonin, it can delay ejaculation and help improve control and sexual satisfaction for some men. It is not a treatment for erectile dysfunction, though it may be used alongside an erectile dysfunction medicine when both conditions occur together. If you are unsure whether Dapoxetine is appropriate, speak with a clinician and also review the Safety checklist.

How to take Dapoxetine

Use only as directed by a licensed health care provider. General administration advice includes:

  • Do not exceed one dose in a 24 hour period.
  • Swallow the tablet with a full glass of water.
  • Take approximately 1 to 3 hours before anticipated sexual activity.

If you have questions about your schedule or any missed dose, ask your prescriber. For suggested starting doses, see Dosage guidance.

Dosage guidance

Most adults begin at 30 mg taken as needed, about 1 to 3 hours before intercourse. If the response is inadequate and the medicine is well tolerated, a clinician may adjust to 60 mg. Some regions list 90 mg tablets, but higher doses raise the likelihood of side effects and should only be used if explicitly directed by a specialist. Never take more than one dose per day.

Always follow your prescriber's instructions. If side effects occur, consider returning to a lower dose or discontinuing after medical advice. For long-term strategies and alternatives, see Alternatives and similar options.

Storage

Keep the medication at room temperature, protected from moisture, excessive heat, and direct light. Store in a secure location away from children and pets. Do not use past the expiration date on the package.

Safety checklist

Do not use Dapoxetine if any of the following applies:

  • You use nitrates in any form (for example, nitroglycerin, isosorbide) or nitroprusside.
  • You are taking or recently took monoamine oxidase inhibitors (MAOIs), linezolid, or have taken other serotonergic agents that could raise the risk of serotonin syndrome without medical supervision.
  • You use recreational nitrite products known as poppers (amyl or butyl nitrite).
  • You have a known allergy to Dapoxetine or any tablet component.
  • Your clinician has told you to avoid sexual activity due to significant cardiovascular disease.

Tell your doctor before use if you have or have had:

  • Kidney or liver impairment; high or low blood pressure; a history of fainting or dizziness.
  • Heart conditions including failure, arrhythmias, prior heart attack, prior stroke, or major rhythm problems within the past 6 months.
  • Bleeding disorders, peptic ulcers, or if you take anticoagulants or antiplatelets.
  • Blood disorders such as sickle cell disease or leukemia.
  • Psychiatric conditions including depression, bipolar disorder, mania, anxiety disorders, or a history of suicidal thoughts.

Important cautions:

  • Dapoxetine can cause dizziness, drowsiness, or fainting. Alcohol and certain medicines may intensify these effects. Do not drive or operate machinery until you know your response.
  • Standing up slowly can reduce lightheadedness. Sit or lie down at the first sign of faintness.
  • Rarely, a prolonged or painful erection lasting more than 4 hours can occur. Seek urgent care if this happens.
  • Dapoxetine does not protect against sexually transmitted infections or HIV. Use barrier protection if needed.
  • This medicine does not prevent pregnancy. Use effective contraception if pregnancy is possible.
  • Vision changes such as blurred vision or color tinge may rarely occur. Contact a clinician if persistent or severe.
  • Older adults may be more sensitive to adverse effects; use with caution.
  • Not recommended under 18 years of age.

For interactions that can increase side effects or reduce benefit, see Drug interactions.

Drug interactions

Always give your clinician and pharmacist an up-to-date list of all prescription drugs, OTC medicines, and supplements.

  • Strong CYP3A4 or CYP2D6 inhibitors such as ketoconazole, itraconazole, ritonavir, saquinavir, cimetidine, erythromycin, or telithromycin can raise Dapoxetine levels and side effect risk.
  • Blood pressure medicines, alpha blockers like doxazosin, nitrates, or nitroprusside may trigger significant hypotension with dizziness or fainting.
  • Serotonergic drugs including SSRIs, SNRIs, TCAs, tramadol, St. John's wort, linezolid, triptans, or MAOIs can increase the risk of serotonin syndrome when combined.
  • Enzyme inducers such as rifampin or bosentan may reduce Dapoxetine effectiveness.
  • Opioids and certain sedatives can increase drowsiness and fall risk.

This list is not exhaustive. Consult your prescriber before starting, stopping, or changing any medicine.

Possible side effects

Many people tolerate Dapoxetine well, but side effects can occur.

Common or mild effects:

  • Dizziness, lightheadedness, or drowsiness; difficulty sleeping or unusual fatigue.
  • Nausea, dry mouth or, less commonly, excessive saliva; diarrhea; decreased appetite.
  • Tremor, agitation, anxiety; rare mood swings or mania in predisposed individuals.
  • Skin reactions such as rash or hives.

Serious effects - seek medical help immediately:

  • Severe nausea or vomiting, confusion, seizures, or muscle rigidity.
  • Fainting, chest pain, severe headache, vision changes, or signs of stroke.
  • Priapism - an erection lasting more than 4 hours.

If side effects persist or interfere with daily life, contact your health care provider. For dose adjustments, review Dosage guidance.

Alternatives and similar medications

If Dapoxetine is not accessible or appropriate, options to discuss with a clinician include:

  • Other SSRIs used off-label for PE: paroxetine, sertraline, or fluoxetine. These are often taken daily and may reduce ejaculatory sensitivity over several weeks.
  • Clomipramine (a tricyclic antidepressant), used off-label for PE either daily or as needed, with anticholinergic side effects in some users.
  • Topical anesthetics: lidocaine-prilocaine creams or metered sprays applied to the glans before intercourse to reduce penile sensitivity. Wipe excess before penetration to limit partner numbness.
  • PDE5 inhibitors for coexisting erectile dysfunction: sildenafil, tadalafil, vardenafil. They do not directly treat PE but may improve sexual confidence and performance when ED is present.
  • Tramadol off-label as needed for PE in selected cases; however, it is an opioid analgesic (Schedule IV in the USA) with dependence and interaction risks, so it is generally considered when other options fail.
  • Non-pharmacologic methods: behavioral techniques (stop-start, squeeze), pelvic floor therapy, condom use to decrease sensitivity, and counseling for performance anxiety.

For cost comparisons among these options, see Price comparison in USD. Always consult a clinician to individualize therapy and check for interactions noted in Drug interactions.

Price comparison in USD

Dapoxetine in the USA: There is currently no FDA-approved Dapoxetine product in the United States, so it is not legally sold at U.S. pharmacies. Prices quoted online by foreign sellers vary widely, but informal ranges are often about USD 2 to 6 per 30 mg tablet and USD 3 to 8 per 60 mg tablet. Purchases from unregulated sources carry quality and legal risks. See Legal status in the USA.

Approximate U.S. retail or discount-club prices for alternatives: Actual out-of-pocket costs depend on dose, pharmacy, coupons, and insurance.

  • Paroxetine, sertraline, or fluoxetine (generic SSRIs): about USD 4 to 15 per month at common doses via discount programs.
  • Clomipramine (generic): roughly USD 15 to 40 per month depending on dose and pharmacy.
  • Topical lidocaine-prilocaine sprays or creams: about USD 20 to 60 per bottle or tube; usage frequency affects monthly cost.
  • Sildenafil (generic): approximately USD 1 to 5 per 100 mg tablet through cash-discount pharmacies; monthly total varies by frequency.
  • Tramadol (Schedule IV): low-cost generics exist, but use for PE is off-label and requires careful risk assessment.

These figures are rough estimates to aid discussion with your prescriber and pharmacist.

More information and reminders

Ask your health care provider any questions you have about how to use Dapoxetine or alternatives. To reduce adverse effects such as dizziness or fainting, hydrate, rise slowly from sitting or lying positions, and avoid alcohol. If chest pain, severe headache, confusion, or visual changes occur, seek urgent care.

This page is informational and does not replace advice from your own clinician. For navigation back to key areas, visit top of page or review Safety checklist and Drug interactions.