All About Dapoxetine

All About Dapoxetine

Premature ejaculation (PE) is a frustrating sexual disorder in males that may appear during first sexual intercourse or develop later in life. It affects any age group, and it is more common than erectile dysfunction (ED). Dapoxetine is a popular and efficient drug for overcoming this disorder. It also helps prolong sexual intercourse. In this article, you will learn how science explains the of dapoxetine in PE treatment. Is it a unique drug, or does it have its competitors? Let’s find out.

Furiex Pharmaceuticals, Inc. introduced dapoxetine into the US market in May 2010. The drug became a revolutionary solution for PE in males. It was designed by Furiex in cooperation with Alza Corporation and correlated partners.

US license includes recommendations related to using dapoxetine and shows its benefits compared to other drugs with similar ingredients in the identical drug family. The patent is active till 2022. More than 45 countries in the world, including leading and emerging markets, have been sending grants to Furiex for equal patent claims.

Janssen-Cilag (Alza’s partner) presently produces dapoxetine under the brand name Priligy ™ and sells it in numerous markets outside America. The preparation has been distributed among leading members of European Union (Germany, Sweden, Austria, Spain, Italy, Finland, Portugal), South Korea, New Zealand, and Mexico.

Scientific research clearly showed that serotonin played a central role in the timing of ejaculation. Thusly, the method represented in the dapoxetine patent is valuable. Unlike other drugs, which dapoxetine belongs to, its effect on PE is evident even after the first use, allowing to take it on an as-needed basis.

What Is Dapoxetine HCL?

Dapoxetine hydrochloride is a fast-acting serotonin reuptake inhibitor, which is widely used to cure PE and ED in males. This active ingredient can be used by males of 18 to 64 years of age. Inhibitors of this class of drugs are usually used to treat depressive states and multiple psychiatric illnesses.

Dapoxetine is the active ingredient of the Priligy (the brand name of the drug). It is used for chronic and sudden cases of PE. It belongs to SSRI (Selective Serotonin Reuptake Inhibitor) drug class, which has mainly been used for depressive conditions treatment. The tests showed that this medical preparation is highly effective for curing PE in males. Over 50 countries have approved Dapoxetine HCL for sale.

The table represents the trade names by which dapoxetine is known in the following countries of manufacture.

Brand name

CountryForeign name

Generic name

Priligy (dapoxetine)

Latvia, Romania, Poland, Lebanon, Lithuania, Slovakia, Singapore, Bosnia and Herzegovina, Croatia, SwitzerlandDapoxetinum (Latin)Dapoxetine
Priligy (dapoxetine hydrochloride)Belgium, Denmark, Finland, Germany, Austria, Bulgaria, Estonia, France, Hong Kong, Ireland, Malaysia, Mexico, Hungary, Italy, Malta, Netherlands, Portugal, Spain, Switzerland, United Kingdom, New Zealand, South Korea, ThailandDapoxétine (French)

Dapoxetine hydrochloride

Dasutra, Kutub, Xydap, Sustinex

IndiaDapoxetin (German)LY-210448
JoypoxEgypt

LY 210448 HCl

Lagose, Extensil, Prolongal, Precoce

ArgentinaDapoxetina (Spanish)UNII-GB2433A4M3
TD-Pill (dapoxetine and tadalafil combination)India

UNII-U4OHT63MRI

Due to its revolutionary action, an international society does not have a unanimous opinion about it. That is why dapoxetine is not approved for sale in every country. In the countries where it is not certified patients have to buy it overseas.
All About Dapoxetine

Is It Approved by FDA?

The drug was submitted for the Food and Drug Administration (FDA) approval in the USA in December 2004, but it has not been approved yet. It has been in phase III development.e.

DapoxetineIn October 2005 FDA rejected the medicine. Two more clinical tests were done over the next two years. Nevertheless, dapoxetine has not appeared on the US market to date. Complicating issues of approving the procedure are still incomprehensible. The most obvious ones are adverse symptoms and a lack of long-term human testing.

The third phase is a groundbreaking one: the clinical analyses are usually gathered into a big document, which contains extensive information about the approaches and outcomes of all studies, production process and stages, formulation data and expiration date. Passing this stage successfully gives rights to the sponsor to market the drug.

The trials in this phase are the most expensive ones. They demand a lot of time for implementation, especially for chronic illnesses. If the drug is lifesaving, it can be prescribed to some patients on an individual basis until it is approved for public purchasing.

The question, how soon dapoxetine may appear on the US market, is open It is very likely that dapoxetine will not be available in the US in the coming years. It may never receive FDA approval for sale. It should be noted that in most European countries this drug has been successfully selling as of today. Its approval depends on the government politics, especially if the supervisors find more advantages than potential health risks.

Dapoxetine can be the first drug specifically targeted for PE in patients in the USA, where it should be distributed by Ortho-McNeil Pharmaceutical, Inc. Alza press release says that the producers plan to work on the problem mentioned in the FDA document regarding dapoxetine. The process of introducing dapoxetine onto the US Pharmaceutical Market is underway.

Its generic versions have already been successfully produced and are selling today. Those who do not want to wait for the FDA approval may order generic dapoxetine from foreign producers in the countries where dapoxetine has already been certificated.

Dosages

Premature ejaculationDapoxetine tablets come in doses of 30 mg, 60 mg and 90 mg.

30 mg is the most suitable dose for beginners. Minimal dose helps estimate the effectiveness of the remedy in each individual and the influence of side effects on a patient. It may be increased up to 60 mg depending on response and tolerability.

60 mg is the optimal dose. Trials showed that administering the drug in these doses showed the best results in PE treatment with moderate adverse events. It is the most common and successful dosage among patients, and they can tolerate the drug well.

90 mg includes the highest concentration of dapoxetine available at the pharmaceutical market. It can be taken for more powerful effect in PE cure, if the lower doses showed weak effect. Adverse symptoms should be considered as well. If, despite the dapoxetine effectiveness, a patient suffered from severe side effects, he should consult the doctor to seek other solutions.

To get sufficient efficacy from the drug and avoid adverse symptoms, a patient should discuss with his physician the schedule of treatment.

In males with PE concurrent with ED problems dapoxetine can be combined with PDE5 inhibitors. Combination of dapoxetine with such active ingredients as sildenafil, vardenafil, tadalafil show excellent therapeutic effect. Multiple clinical tests proved the feasibility of these substances with dapoxetine. Different ratio of the two active ingredients are designed for better problem solving in a patient. Individual medical consultation before the start of the treatment course is highly recommended.

What Forms Does Dapoxetine Come In?

Dapoxetine is widely available in firm tablet drug form. The rigid tablet contains dapoxetine as a single ingredient. This is a classic tablet form which should be used with water without chewing.

Liquid one is sold for laboratory research only. The bottle of liquid dapoxetine contains 30 mg of the active ingredient. Consumption of this product by human may be harmful if ingested.

Generic dapoxetine is available in other drug forms in combination with different active ingredients, for example Super P Force oral jelly (sildenafil 100mg and dapoxetine 60mg).

For curing ED problems accompanied with PE dapoxetine is highly used as a compound. A few popular drug names and their ratio with dapoxetine are represented in the table.

Dapoxetine and sildenafil

Dapoxetine and Vardenafil

Dapoxetine and tadalafil

Sildigra Super power

(60 mg / 100 mg)

Snovitra Power

(60 mg / 40 mg)

Tada Plus

(30 mg / 20 mg)

Dapoxile

(30 mg / 50 mg)

Snovitra Super Power

(60 mg / 20 mg)

Tadapox

(60 mg / 20 mg)

Super P Force

(60 mg / 100 mg)

Super Valetra
(20 mg / 60 mg)

Tadapox Super

(60 mg / 40 mg)

Suhagra Force

(30 mg / 50 mg)

Super Zhewitra

(60mg / 20 mg)

Extra Super Tadarise

(60 mg / 40 mg)

Patients should receive a proper medical consultation before using any other drugs listed above. They may cause unwanted reactions and side effects. Individual schedule of treatment is highly suggested.

How to Use Dapoxetine Tablets?

Fat foodDapoxetine tablets are very easy to use. The pills can be taken at any time on an as-needed basis. Fat food may delay the absorption of the tablet, but it does not affect its efficacy. Here are a few simple steps how to use dapoxetine:

  1. It is necessary to have a complete medical examination before starting dapoxetine treatment course. A healthcare provider should estimate the patient’s health condition, prescribe the correct dosage of the drug, explain in detail what is dapoxetine, and give detailed instructions on how to take it.
  2. Be sure to inform the healthcare provider about other drugs or other treatments you have been using. Dapoxetine highly interacts with several drug groups, therefore detailed medical consultation is highly recommended. Several medical conditions demand special medical attention. Be sure to inform the medical representative if you experience one of these conditions:
    • fainting tendency;
    • heart diseases;
    • bleeding or clotting problems;
    • epilepsy;
    • psychological disorders (mood swings, dismal mood, obsessiveness, bipolar illness);
    • eye pressure (glaucoma);
    • liver problems;
    • kidney illnesses;
    • dermatological reactions on medical preparations.
  1. Read carefully the medical annotation inside the package. It contains complete information about dapoxetine with the list of possible negative symptoms which might occur during the treatment.
  2. Strictly follow the scheme prescribed by the doctor. The correct dosage should be used 1-3 hours before sexual intercourse. Wash down the tablet with 250 ml of water.
  3. If the prescribed dose appeared weak and ineffective during several days of consumption, a patient should come for medical consultation. Increasing a dose on one’s own initiative is not recommended because bigger dose also increases the risks of side effects.
  4. Dapoxetine should be taken only once in a 24-hour period. The drug should be used on an as-needed basis before planned sex.
  5. Dapoxetine has a bitter taste. There is no need to chew it. It can be taken regardless of the meal time.

Failure to follow medication direction can ruin the drug effect, cause a negative reaction, or even have serious health consequences. In case of any unwanted reaction a patient must see his health care provider immediately.

How and When to Take Dapoxetine for the Best Results?

DoctorDapoxetine is an effective remedy. However, to get the best results from the treatment course, remember the important tips:

  1. After beginning of the treatment course continue seeing your physician to inform him about your health condition, progress, and to monitor side effects if any. Alcohol increases the risk of adverse symptoms like fainting, therefore its consumption with dapoxetine is not recommended.
  2. Recreational drugs may cause serious side effects in combination with dapoxetine. Never use them together!
  3. Due to risk of fainting symptoms after taking dapoxetine, driving and other activities, which demand high concentration, should be postponed for patient’s safety.
  4. Make sure to get a detailed consultation before mixing dapoxetine with other medical preparations.
  5. In case of overdosing call an ambulance or local hospital department immediately. Bring the pack with you, even if the box is empty.
  6. Before your surgery (including dental surgery), inform the specialist that you consume dapoxetine.
  7. Taking expired dapoxetine is not recommended. Contact local pharmacy for utilization of the expired drug.
  8. Never share dapoxetine with other people. The drug should be used individually, even if someone has approximately the same condition.
  9. Keep the tablets out of reach and sight of children in cool dry place away from direct sun rays.
  10. Contact your physician to discuss any problem which occurred during dapoxetine treatment course.
  11. There are many ways how to avoid mild side effects of the drug. Get detailed instructions at the medical center. Stay in touch with your doctor during the whole therapy for successful treatment.

These simple rules will help you receive maximum effect from the tablet and prolong sexual intercourse.

Can Dapoxetine and Sildenafil Be Taken Together?

Priligy and ViagraSometimes ED and PE are concomitant conditions. The question is whether dapoxetine and sildenafil can be taken together. It can not be answered simply because PE may be caused by various reasons: relationship issues or erectile problems.

Some scientific works claim that sildenafil and dapoxetine can not be used together. It is explained by the combined effect, which reduces blood pressure to a low level enough to cause dizziness, fainting and lightheadedness. Medical scientists suggest treating ED first, assuming that during that time PE will be treated by itself as well.

If sildenafil improves erectile function but PE problem still exists, health professionals recommend using non-drug practices for overcoming it. These are preferably relaxation, squeezing techniques, and psychological methods, which include avoiding stressful situations and overcoming lack of communication between partners.

Exercising can be effective but does not always help. A patient may use sildenafil with dapoxetine under a strict doctor’s control only. Both ingredients have a lot of common features. Working with natural mechanisms, they make impact only on the selective brain areas. The latest clinical researches showed a perfect compatibility that can create a new medication. As a result, pharmaceutical market can offer the drug, which contains two active substances: sildenafil and dapoxetine.

Today this combination is manufactured under various names with different ratio of both ingredients. While sildenafil works to achieve and maintain erection, dapoxetine releases tension. A male becomes more comfortable and can have sexual intercourse without unnecessary anxiety.

Preceding concerns were not without a reason, the new drug does have side effects. Though, as tests showed, the conflict of contraindications and damages to the man’s health were not life threatening. Taking two drugs may lessen the combined effect of the substances.

The treatment scheme may include separate drugs with sildenafil (like Viagra) and dapoxetine (like Priligy) or their mix in one tablet (like Viagra Super Force). Regardless of the brand names a patient may use, the combination of sildenafil and dapoxetine shows excellent results in treating ED and PE. Nevertheless, preliminary medical consultation and health care provider’s assistance during the whole treatment course are necessary.

If PE problem is connected with ED problem, then sildenafil should possibly become one and the best remedy for this particular clinical case. The decision about mixing the preparations should be made by doctors based on patient’s medical history.

Is It Safe?

Central nervous systemEffectiveness and safeness of dapoxetine in PE therapy has been investigated by such reputable institutions as EMBASE (world’s most comprehensive biomedical literature database), MEDLINE, Web of Science, and PICA. Primary scientific community represented by international and local foundations confirmed that dapoxetine is indeed a strong and safe medical preparation. The approbations showed that dapoxetine in doses of 30 and 60 mg were positively sustained with minimal possibility of severe side effects manifestations. More than half males reported mild forms of gastrointestinal and central nervous system problems.

A careful attention over the whole period of dapoxetine course was given to cardiovascular changes in patients, since the syncope case had been recited. Throughout all five tests, loss of consciousness happened in 0.06% and 0.23% of cases after using dapoxetine 30 mg and dapoxetine 60 mg respectively. With high probability this adverse event may occur after taking the first dose of the drug. The tests showed 0.19% cases which happened after the first dose, and 0.08% after subsequent ones. Findings of dapoxetine developmental program demonstrate that the ingredient is related to vasovagal-mediated (neurocardiogenic) syncope. Other crucial vascular cardiac negative reactions were not diagnosticated.

Most drugs of SSRI class may cause neurocognitive unwanted changes in patients with psychosocial disabilities. Clinical tests showed that dapoxetine does not affect the mood, and it does not cause anxiety and self-destructive streaks. Dapoxetine on-demand doses for PE may minimize the risk of withdrawal symptoms.

Thusly, all this evidence shows safeness of dapoxetine. But the final word on that is given to FDA, which has not approved this preparation yet. Only due to this reason the medics of the USA, Canada and United Kingdom (the countries where dapoxetine is not approved for sale yet) may disapprove it to patients.

The quality of generic versions depends on how reputable the producer is and if its product was certificated by the local government. It is highly suggested to buy generic versions of dapoxetine only from trusted sources who sell high quality medications. Using mislabeled drugs may be dangerous for your health.

Is It Used for Depression?

Created in 2003, dapoxetine was initially aimed for depression and mental disorders treatment. The preparation did not show positive results in depression therapy and was shelved until its PE effect was discovered. During clinical trials the results in ejaculation problems treatment were awesome.

Depression

Dapoxetine may potentially cause side effects peculiar to SSRI drugs as far as it belongs to this class. But this preparation is mostly obtained for treating PE only.

Even more, dapoxetine is contraindicated for people who suffer from such psychological disorders as:

  • bipolar and related disorders;
  • mania and hypomania;
  • major depressive episode;
  • schizophrenia and other psychiatric illnesses.

Dapoxetine is a specific remedy created for solving PE problem in males. Using it for other purposes is not recommended.

How Does Dapoxetine Work?

The clear biochemical mechanism of dapoxetine action is still ill-defined. With a high probability in PE case it is attributed to the breakage of the serotonin reuptake by the neuronal cells with the forthcoming neurotransmitter enhancing on pre- and postsynaptic receptors.

The ejaculation mechanism is mostly manipulated by the excitatory system or, more precisely, by the part of the nervous system that accelerates the heart rate, constricts blood vessels, and raises blood pressure (sympathetic nervous system). The ejaculatory trajectory sets in from a spinal reflex center, mediated by the cerebral trunk, which is influenced initially by a number of nuclei in the brain. Postganglionic sympathetic nervous fibers innervate gone cysts, deferent duct, prostate gland, urethra muscles and neck of urinary bladder, calling their synchronized cutdown for ejaculation achievement.

Dapoxetine definitely impacts ejaculation reflex, prolonging the latency period and reducing the duration of the reflector impulse. The stimulation pulse, which activates ejaculation, is generated in cerebrospinal nerve center, which is controlled by a few niduses of the brain cord through the cerebral trunk.

The function of dapoxetine consists in preventing the reuptake of serotonin and the subsequent action enhancement of the neurotransmitter receptors. Dapoxetine inhibits the ejaculatory expulsion reflex by acting at a supra spinal level with the lateral paragigantocellular nucleus as a necessary brain structure for the effect. Postganglionic sympathetic fibres that innervate the seminal vesicles, prostate, bulbourethral muscles, and bladder neck cause them to contract in a coordinated fashion to achieve ejaculation. Dapoxetine modulates this ejaculatory reflex, causing an increase in pudendal motoneuron reflex discharge (PMRD) latency and a reduction in PMRD duration.

It relieves tension and improves patient’s general mood. It works only with the brain cells which are responsible for PE, without affecting the whole brain.

This unique formula distinguishes dapoxetine from other drugs of SSRI family group, which are used for mental disorders. Working precisely on ejaculation mechanism it prolongs the time of emission of seminal fluid, which is the main purpose of dapoxetine.

How Long Does It Stay in Your System?

Renal impairmentDapoxetine is quickly absorbed. Maximal concentration is achieved within 1-2 hours after consumption. Absolute bioavailability is 42% raging from 15% to 76%.

Fattening food may affect dapoxetine concentration depending on how long it stays in your system. High fat meals frugally reduce dapoxetine concentration without affecting the total absorption level. Dapoxetine can be used regardless of the meal time.

Dapoxetine is metabolized by the multiple ferments of liver and kidneys. The metabolites of dapoxetine are moved out with urine. Unconverted substance in urine has not been discovered. The low concentration of dapoxetine in blood (5%) within 24-hours period testifies that it is egested quickly out of the body. Every usage allows minimal accumulation of dapoxetine, the terminal half-life is about 19 hours.

Single usage of dapoxetine 60 mg has not showed any statistically authentic distinction between Caucasian, Black, Hispanic and Asian races. Although, Japanese race is characterized by higher plasma levels (20%) comparing to Caucasian (10%) due to lower body weight. This fact is not expected to have a meaningful clinical effect.

There is no significant difference between using dapoxetine by different age groups. Patients with severe renal impairment were not thoroughly tested, doses should be used carefully.

Side Effects of Dapoxetine

Medical preparations may cause side effects, and dapoxetine is not an exception. The most frequent adverse events known after taking dapoxetine is dizziness, headache and sickness. Adverse effects is the main reason why this preparation has not been approved in the USA, so let’s examine this point more carefully. The table represents the names and statistics of side effects in patients.

Very common (1 in 10 people)

Common (1 in 10 and 1 in 100 people)Uncommon (1 in 100 and 1 in 1000 people)

Rare (1 in 1000 and 1 in 10 000 people)

Vertigo

DisturbanceLightheadedness

Sleep attacks

Nervousness

Excitation

Unrest

Faint

Concentration troubles

Sleeplessness

Mood swings

Parasomnia

Low libido

Depressive states

Migraine

Erectile problems

Dizzy feeling after physical overwork

Tiredness

Anxiety

Drowsy feeling

Oscitation

Disconcerted feeling

Shaking

Pricky sensation

Weakness

Ear ringing or buzzing

Blurred vision

Panic

Sick feeling

Nasal congestion

Urgent need for toilet
Stomach upsets

Tumultuous dreams

Emesis

Costiveness

Irregular heartbeat

Abdominal discomfort

Flatulence

Enlarged pupils

Thirst

Hyperhidrosis

Bruxism

Blushing

Hypertension

The list of adverse events is incomplete. To avoid adverse symptoms manifestations it is important to follow the treatment schedule and abide by the following rules:

  1. Reduce driving and operating hazardous machinery, especially in case of dizzy feeling after taking dapoxetine. Check out first how the body reacts to the new preparation.
  2. Avoid alcoholic beverages because they increase the risks of the side effects.
  3. Always drink a full glass of water along with the tablet and stand up slowly if you have been sitting or lying for a long time.
  4. If dizziness becomes annoying, a patient should lie down or sit down, put his head between his legs until the symptoms pass.
  5. Do not take dapoxetine with recreational drugs (ecstasy, LSD, amyl nitrate, narcotics or benzodiazepines).

Always consult with a healthcare provider regarding any abnormal conditions during the treatment. If the risks overweigh the benefits, a healthcare provider will suggest giving up the medicine or switching to a different drug.

Side effects of dapoxetineImportant note: in case of sudden reducing SSRI drugs they may cause the following symptoms:

  • dysphoria;
  • irritation;
  • agitation;
  • dizziness;
  • sensory impairment (for example, paraesthesia);
  • anxiety;
  • confusion of consciousness;
  • migraine;
  • lethargy;
  • emotional lability;
  • insomnia;
  • hypomania.

Dapoxetine belongs to an SSRI class group, and its reaction to sudden reducing was clinically tested. Researches showed that after 62 days of taking the preparation (or longer) the most frequent symptoms were sleeplessness and dizziness in mild and moderate form. Therefore, sudden reducing should go smoothly.

What If I Take Dapoxetine with …

The medical annotation for dapoxetine includes strict admonitions against consuming it with herbal remedies that prevent the activity of the Cytochrome P450 (CYP) 3A4 ferment.

The effect of the daily intake of grapefruit and pomegranate juice on the work of dapoxetine was tested during a 3-way crossover study. It appeared that grapefruit increases the dapoxetine plasma concentration and prolonged its elimination half-life. Slight, but not statistically significant changes were discovered after pomegranate juice intake.

The impact of juices is mild. Many more concerns call their parallel usage with dapoxetine into question. Therefore, grapefruit and pomegranate are not recommended due to the accumulation of the active ingredient and difficult elimination of it from the organism. Such processes may become a reason for overdose and provoke side effect manifestations.

Consult with medics in private regarding the usage of caffeine, herbal supplements, and nutraceuticals.

Alcohol

AlcoholThe combination of dapoxetine with alcohol may intensify the ethanol activity on the central nervous system and increase neurocardiogenic side effects, like syncope which, in turn, increases the risk of sudden traumatic accidents. Thus, patients should avoid using alcohol during the dapoxetine curing course.

One-time consumption of ethanol (0.5 g/kg which is about 2 units) did not affect the pharmacokinetics of dapoxetine 60 mg. Simultaneous consuming of dapoxetine and alcohol caused drowsy feelings, reduced the vigil level, delayed reflexes, and changed judgment.

Food

High fat meals make a modest impact on an organism in conjunction with dapoxetine which actually consist in a delay of the working time. It is explained by the complicated digestion process which takes more time. Trials showed that the tablet started working within 30 minutes after the patient ate the food which slowed absorption. However, the general work of dapoxetine goes without significant changes.

A few examples of high fat food which delay the digestion process are below:

  • fried chicken;
  • bacon cheeseburger;
  • french fries;
  • fried cheese sticks;
  • pizza;
  • Caesar salad;
  • nachos;
  • cheesecake;
  • hot dogs;
  • beef burrito;
  • chicken nuggets;
  • taco.

Other Medications

Interaction with alcohol, tablets and grapefruit

Dapoxetine drastically interacts with a few medication groups. The list below shows the largest drug families and the outcome of their cooperation with dapoxetine. It is far from complete. For the detailed info regarding every particular drug and how does it work in combination with dapoxetine, a patient should refer to a healthcare provider:

  1. Monoamine oxidase inhibitors (MAOIs). Patients who received SSRI and MAOIs simultaneously had serious and sometimes lethal reactions, for example hyperthermia, rigidity, myoclonus, mental health changes including distraction which leads to delirium and coma. These reactions may appear in those who reduced the SSRI course and started an MAOI cure recently. In some cases the symptoms were similar to neuroleptic malignant syndrome. These two drugs increase blood pressure and caused agitated behavior. Dapoxetine is strictly forbidden for usage during the 14-day period after stopping the MAOI course. MAO inhibitors are forbidden for 7 days after stopping dapoxetine.
  2. Thioridazine. SSRI inhibit CYP2D6 ferment and delay thioridazine metabolism. Dapoxetine is forbidden for parallel consumption with dapoxetine and within 14 days after stopping a thioridazine course. Thioridazine is forbidden for a week after dapoxetine rejection.
  3. Drugs with serotoninergic activity: L-tryptophan, triptan, tramadol, linezolid, lithium, preparations on the base of hypericum perforatum (St John’s wort). Their combination with dapoxetine increases the frequency of serotonergic side effects. Dapoxetine can be used 2 weeks after reducing these family drugs. Serotoninergic remedies should be taken not earlier than 1 week after dapoxetine rejection.
  4. CYP3A4 inhibitors: ketoconazole, itraconazole, ritonavir, saquinavir, telithromycin, nefazodone, nelfinavir, atazanavir. Simultaneous treatment of dapoxetine with these drugs is forbidden. Moderate inhibitors of CYP3A4 (erythromycin, clarithromycin, fluconazole, amprenavir, fosamprenavir, aprepitant, verapamil, diltiazem) increase the level of dapoxetine systemic exposure. Maximal dose of dapoxetine should be bordered to 30 mg.
  5. CYP2D6 inhibitors. Dapoxetine 60 mg should be cautiously used in people with low CYP2D6 activity level.
  6. A-adrenergic receptors (tamsulosin) should be used carefully in combination with dapoxetine due to low tolerance of patients to orthostatic hypotension.

Dapoxetine Alternatives

Alternative of dapoxetine should be considered any drug from the SSRI drug group. However, it must be noted that similar is only their mechanism of action, while they are different in strength, duration, working start, and side effects.

SSRI drug groupThe most famous analogues of dapoxetine are:

  • sertraline;
  • fluvoxamine;
  • fluoxetine (Prozac);
  • paroxetine;
  • escitalopram;
  • citalopram;
  • indalpine;
  • zimelidine;
  • panuramine;
  • cericlamine;
  • femoxetine.

A remarkable place take PDE5 inhibitors which can be a decent alternative of dapoxetine, too. They are:

They have similar pharmacological properties and therapeutic effects. Along with PE, they treat ED problems, normalizing the potency and genital abnormalities in men.

Remember that dapoxetine is an active ingredient which is produced under multiple brand names. All drugs with the same active ingredient may be considered as alternatives, as well.

Dapoxetine Vs Viagra (Sildenafil)

Erectile dysfunctionViagra (sildenafil) is a brand drug for treating ED problems. While dapoxetine belongs to the SSRI family of drugs, sildenafil belongs to PDE5 inhibitors. The data about successful treatment of PE by sildenafil is very limited.

Some users inform that after taking Viagra, PE problems stopped bothering them. But this information needs more research. Doctors say that delayed ejaculation may be an adverse reaction of sildenafil which is not far enough to say that Viagra treats PE. Dapoxetine is a drug designed especially for PE recovery, and its action is directed to solve this particular problem.

Across one clinical trial, it was found that 50 mg of sildenafil is more effective for curing PE as compared to 20 mg of paroxetine. During half a year, 180 healthy males divided into 3 groups took sildenafil, dapoxetine, and used squeezing techniques, respectively. Sildenafil showed significantly different results, proving its efficacy comparing to paroxetine and squeezing methods. This curious fact demands more research and scientific proof regarding effectiveness of Viagra for PE treatment.

Being preparations for different purposes, dapoxetine and sildenafil perfectly complete each other. Across another clinical test, dapoxetine, sildenafil, and their combination were all thoroughly checked. 150 males without ED were tested from March 2015 to May 2016. The groups of men received 30 mg of dapoxetine, 50 mg of sildenafil citrate, and a combo of dapoxetine (30 mg) with sildenafil citrate (50 mg) for 6 weeks.

All groups significantly improved their satisfaction score after treatment. The combo group showed the best result. This means that combining sildenafil with dapoxetine therapy can perfectly improve patients with PE without ED problems, comparing to a single usage of dapoхetine alone or sildenafil with tolerated adverse events.

Cialis (Tadalafil)

Cialis tabsCialis is a brand drug with the active ingredient tadalafil which is used for ED, pulmonary hypertension, and benign prostatic hyperplasia treatment. Its action is similar to such PDE5 inhibitors as Viagra and Levitra. This drug was approved by the FDA in the USA in 2003 as an ED cure. It can be used daily or on an on-demand basis. The approval for the treatment of pulmonary arterial hypertension was given by the FDA in 2009.

This drug has received the name «weekend pill» for its prolonged activity time: up to 36 hours while other medical preparations of this drug family work only 5 hours.

The main condition for drug work is preliminary the sexual stimulation of the phallus. This condition makes brain cells pass signals to blood vessels in the penis area and enlarge them. Massive bloodflow provides a perfect erection. The dosage should be taken once in a 24-hour period. It also may cause side effects (fainting, sickness, long-lasting erection, and many more). It also interacts with several drug groups. Therefore, this is a prescription drug which should be used under strict doctor’s control.

Cialis generic tabs are available, too. They contain the same active ingredient, tadalafil. The price for generics is very cheap which allows regular usage without significant expenses.

The effectiveness of this drug has been checked for many years of practice. It is not weird as the remedy has been known in the USA for more than 10 years. It is the third pill after Viagra and Levitra represented for ED cure. This preparation is awesomely popular among ED patients and has gathered a lot of positive reviews.

This preparation is available in our drug store ViagraBit in different dosages: 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg, and 60 mg. Different amounts of tabs inside the package helps to choose the best option for individual cure. Visit our catalogue for more information.

Dapoxetine Vs Paroxetine

ParoxetineParoxetine, manufactured under the brands Brisdelle, Paxil, Paxil CR, and Pexeva, is an antidepressant drug used for the treatment of various depressive conditions, panic states, social anxiety problems, and many other psychological deviations. Like dapoxetine, it belongs to the SSRI class. During FDA checking, this paroxetine has received the black box warning which means that side effects may be dangerous for patients’ health and increase suicidal thoughts and behavior.

Unlike dapoxetine, paroxetine was initially created for the treatment of physiological disorders. Delayed ejaculation is a side effect of this antidepressant which is used in therapeutic purposes for PE sufferers. There is much scientific data regarding the comparison of the two preparations. During the first one, 150 married males from 30-36 y.o. with stable relations and constant PE were divided into 3 groups. The first one received 30 mg dapoxetine, the second one got 60 mg of dapoxetine, and the third one had 20 mg paroxetine once a day 1-3 hours before planned sexual intercourse for a month.

Within 30 days, the IELT index (intravaginal ejaculatory latency time) increased in all groups: 117% after dapoxetine 30 mg, 170% after dapoxetine 60 mg, and 117% after paroxetine 20 mg. This means that the low doses of dapoxetine and paroxetine work approximately equally, but the best results were achieved after using dapoxetine 60 mg.

During another clinical research, aimed to estimate the efficiency and safeness of dapoxetine and paroxetine, 40 males with PE were involved. The groups of men received 30 mg of dapoxetine, 60 mg of dapoxetine, and 20 mg of paroxetine for 12 weeks, and the results were checked every 2 weeks.

The tests showed increased IELT index (see the table):

Dapoxetine 30 mg

Dapoxetine 60 mg

Paroxetine 20 mg

Before trial

After trialBefore trialAfter trialBefore trial

After trial

IELT (seconds)

46.1±23.2100.2±24.543.5±20.6118.2±40.8

45.2±31.6

It proved higher efficiency of paroxetine, though not without adverse effects (see the diagram).

Fluoxetine Versus Dapoxetine

Fluoxetine capsulesFluoxetine is an antidepressant which belongs to the SSRI drug family and is used for the treatment of depressive states and obsessive-compulsive problems in adults.

During clinical trials, fluoxetine in dose 20 mg was compared to 20 mg of paroxetine and 30 mg of dapoxetine in usage by 170 men of 36 y.o. who suffer from PE. Within 1 month, the tests showed global improvement in all groups, although, the dapoxetine and paroxetine results were better than in the fluoxetine test group. Adverse effects were estimated, too:

  • paroxetine: 8 patients;
  • fluoxetine: 9 patients;
  • dapoxetine: 0 patients.

Across a single test of fluoxetine, 17 patients with PE were examined. The dosage of 20 mg of fluoxetine daily for 1 week and 40 mg afterward showed a good IELT index with such side effects as sickness, migraines, and sleeplessness. Generally this drug was assumed as a safe and effective remedy for the cure of PE. But in the battle of dapoxetine vs fluoxetine the last one fails.

The use of SSRI drugs which control and regulate ejaculation processes may cause negative reactions in other sexual functions in males such as suppressing the libido. In order to smooth both effects, fluoxetine is often used in combination with PDE5 inhibitors. This helps to eliminate unwanted reactions of SSRI antidepressants on males sexual functioning and prolong sexual intercourse. Mixing therapy provides significantly more powerful effects than a single usage of an SSRI drug.

Dapoxetine Reviews & User’s Experience

SexThere are plenty of controversial dapoxetine reviews on the Internet. They include a lot of positive feedback. The perfect effect of the drug makes people order it even from overseas.

Negative reviews take place, too. Ethan Green from the UK writes that the preparation is not easily available in his country. 30 mg of Dapoxetine appeared effective for him, even the small dose taken for several weeks 2 hours before planned intercourse increased the time of sex by 2-8 minutes. Constant headaches were quite bothersome during the treatment course and that was the reason why he did not desire to increase the dose for a more powerful effect. His conclusion is a big concern about the future dapoxetine purchase. Firstly, because of trouble buying the drug, and secondly because of its weak effect and adverse symptoms.

Other patients shared different kinds of problem. After long-lasting tortures with PE, he chose dapoxetine for a cure. The drug helped to prolong the sexual act up to 90 minutes, though he could not ejaculate at all afterward.

One patient who tried to increase intake to 60 mg had nausea afterwards. He enjoyed the powerful effect but continued the cure in standard dose.

The curious thing is that female partners find the dapoxetine effect excellent and often insist on their men using it or place it surreptitiously in their man’s meal. Females often buy dapoxetine as a present for their partners and enjoy extra sensations during sex. Males without severe forms of PE also use it to bring more pleasure to their female partners.

Dapoxetine appeared very effective for people who suffer from lifelong PE, ending sexual acts in 5-7 seconds. While other preparations appeared absolutely ineffective, dapoxetine has prolonged sexual acts by up to 20 minutes.

PE may affect a man at any age. Dapoxetine is the first chemical substance that was designed to specifically target this problem in men. It is assumed to be an effective and safe remedy if a patient follows the recommended dose. Most patients are satisfied with the achieved results. With this medicine, they have overcome PE problems which accompanied them for many years.

Where Can I Buy Dapoxetine in USA?

Dapoxetine has many pros and cons, but nevertheless it stays awesomely popular among users. Due to an absence of FDA approval, it is not allowed to be listed for sale in local USA pharmacies, therefore online orders are the only way to get it. Those who want to buy this preparation should order it from foreign countries where it is licensed and authorized for sale.

Cheap prices for Indian dapoxetine makes it convenient for regular treatment. The table represents the costs for the most popular brands of the generic drug.

Indian trade mark

ProducerAmount of tabs in the packagePrice in India for the package in USD (converted from rupee)

The value of 1 tab in USD (converted from rupee)

Dasutra (30 mg)

Hetero Healthcare Ltd41.230.3
Dapox (30 mg)Ranbaxy Laboratories Ltd62.25

0.38

Prilyxet (30 mg)

Sun Pharmaceutical Industries Ltd41.50.38
Ejalong (30 mg)Emcure Pharmaceuticals Ltd62.27

0.38

Sustinex (30 mg)

Emcure Pharmaceuticals Ltd62.270.38
Xydap (30 mg)Cilpa Limited41.63

0.41

Duralast (30 mg)

Sun Pharmaceutical Industries Ltd41.720.43
Kutub (30 mg)Hetero Healthcare Ltd43.13

0.78

Sustinex (60 mg)

Emcure Pharmaceuticals Ltd63.210.54
Dasutra (60 mg)Hetero Healthcare Ltd42.33

0.58

Kutub (60 mg)

Hetero Healthcare Ltd42.330.58
Duralast (60 mg)Sun Pharmaceutical Industries Ltd42.38

0.59

The prices listed above are submitted for information purposes only and may not match the factual price at which they are sold. The tabs value may vary depending on many factors, such as manufacturer, local taxes, and the rupee / dollar exchange rate.

Those, who want to purchase dapoxetine abroad should ask Google «where can I buy dapoxetine». For most chemists, prescribing information is not needed. A purchaser should be sure that the drug store is reputable and sells qualitative product. Always check the legitimacy of the drug store and the drug certificate.

How to Get Dapoxetine Without Prescription?

Online storeOur online pharmacy ViagraBit offers a simple way out for those who rack their brains about how to get dapoxetine. It is available in our drugstore under different brand names without prescription at a fair price. Quick shipment and big discounts make the purchase easy, safe, and comfortable. Forget about bank payment reducing, choose anonymous, which is a quick and safe way of payment and get benefits: -35% off your order for bitcoin paying!

The most optimal dosage of Priligy 60 mg is available in various amounts in the package: from a trial pack (10 tabs) which is convenient for beginners and drug effect testers, to wholesale package (500 tabs) for regular patients.

In our wide assortment there are drugs for PE and ED cure: Cialis, Stendra, and many others. A wide choice of the active ingredients will help to select the most effective preparation for the best curing effect.

Our prices are the cheapest because we contact Indian laboratories directly and sell the Indian generic drugs in the US. This way is maximally comfortable for customers.

Ordering the drugs from our chemists, you avoid possible problems which may occur with customs control. Our packages go through customs without difficulties. The general time of shipment may take 7-18 days.

Choosing the best preparation for the treatment of such delicate problems demands a lot of time. By choosing our chemistry, you save both your money and time! Our constant purchasers are satisfied with our services and our community grows!

We guarantee that our products are top quality and completely risk-free. Try for yourself how the modern PE and ED drugs increase libido, prolong sexual intercourse, and fill up life with bright emotions. Cure PE and ED with our chemists!

Buy Viagra Online – The Cheaper Solution to Enhanced Libido

Although Viagra online is safe to use, it may present some mild side effects such as flushed skin, heartburn, and headaches. Patients who are using other prescription medication ought to seek medical consultation because the combination can lead to severe side effects. Bonus: You can order free Viagra samples & get it delivered by mail.

The launch of Viagra in 1998 marked the beginning of an era in the pharmaceuticals industry.

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The Justin Bieber Gay Debate Finally Answered: He Likes It Both Ways

The heated Justin Bieber gay debate is hotter than we thought. Our favorite boy toy accidentally attended a gay mixer recently – where he insisted on being the center of attention. To his surprise, what Justin thought was a birthday party was really a boy-on-boy coming out party. His initial surprise faded when he requested a table in the middle. Although the event was held at one of LA’s hottest gay bars, he seemed surprised when he learned the true nature of the event.

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Cost of Buying Viagra Online at CVS, Walgreens & Walmart

Of course, the biggest pro of buying generic Viagra online is the price. You simply cannot find Viagra at such a low price in any store, even if your insurance offers copays. The price on name brand Viagra and similar medications in stores is not going down, and likely won’t anytime soon. That is why browsing online is becoming a popular method for purchasing generic erectile dysfunction medications. Tip: Order our free generic Viagra samples.

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Buy Viagra for Cheap and Change Your Life

Have you ever wondered how you can buy Viagra for cheap? It’s a lot easier than you might think! There’s no need to jump through hoops waiting for an appointment, getting a prescription or paying high prices. We can have your Viagra or generic Cialis in your hands tomorrow! Our online shopping experience is easy and painless, and we offer incredible prices and immediate, overnight shipping. Tip: Get our free generic Viagra trial pack.

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The Best Viagra Price – Cost of Generic vs. Non-Generic

Generic Viagra is currently available for $0.79 per pill, which is a huge reduction in price compared to the huge $25 Viagra price tag of the branded version. Tip: Before you buy generic Viagra, order our free generic Viagra samples.

Have you ever wondered why doctors demand such a high Viagra price for a drug that is so popular? Although Viagra is a brilliant drug that can help men to completely transform their love lives and confidence in the bedroom, for many it is simply too expensive to rely on regularly. However, it is possible to find an affordable Viagra price if you look for generic alternatives such as Sildenafil.

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Kamagra Uses, Effects and Benefits

Kamagra Uses, Effects and Benefits

A lot of men share your feeling of being broke after buying several packages of original Viagra. Don’t worry: this is not the only way out. Nowadays, many reputable manufacturers produce sildenafil under other brand names at more affordable prices. Kamagra is among the proven and safe generics which aim to recover your normal erectile function.

ED (here and below – erectile dysfunction) treatment is on the agenda of modern medicine. Men are no longer putting up with this disorder and don’t want to “retire” from their sexual lives.

Even though many methods are annually offered by various healthcare organizations, drugs for impotence remain the safest and the most convenient method to fight it off.

What Is Kamagra?

Kamagra is a generic of Viagra produced by an Indian company called Ajanta Pharma. This means that this medication contains the same active ingredient as the Pfizer’s creation – sildenafil. That’s why Kamagra has identical effects on the male body. Moreover, the drug is a great alternative for those who don’t want to overpay when purchasing original Viagra. It has another use: some doctors prescribe it for people who suffer from pulmonary arterial hypertension and prostate cancer.

The generic is manufactured in two forms: tablets and oral jelly. The first one is represented in good old pills for swallowing, while the second requires a little close-up overview.

What is Kamagra oral jelly? It is a chewable tablet which comes in different flavors including strawberry, vanilla, cherry, pineapple, orange, banana, and so on. The other benefits of this form are as follows:

  • it is suitable for those who can’t swallow pills or don’t want to do this (elderly men, people who have some specific diseases, those who don’t like swallowing pills, etc.);
  • it kicks in twice as fast as a pill because of the higher absorbing ability of the gel inside the jellies;
  • you don’t need a large amount of water to wash it down: simply chew it in your mouth.

Here in ViagraBit, you can buy Kamagra 100 mg. The number of tablets in the package may vary from 10 to 500. Each of them will provide you with the guaranteed erection and unforgettable sexual experience.
Kamagra Uses, Effects and Benefits

Kamagra Effects

Sildenafil, an active ingredient in Kamagra, belongs to the class of PDE5 (phosphodiesterase type 5) inhibitors and is used for ED treatment. Those medicines are able to maintain the mechanism of the erection through activating this process on any of its stages. On average, it kicks in 30 minutes after intake, releasing a substance called nitric oxide, which is crucial for an erection. When a man is aroused, it relaxes the smooth muscles tissues and increases the bloodflow to the penis.

Men with ED need such drugs because PDE5 enzymes interfere with the nitric oxide release in their bodies. PDE inhibitors block their activity and ensure enough blood supply to the penile tissues, so the erection is achieved.

Kamagra tablets

The other effect of Kamagra is its ability to prolong sexual intercourse. On the one hand, it prevents blood outflow from the penis, on the other – it shortens the window between acts making you more durable in bed. It works for 4-6 hours – after their expiry sildenafil starts to excrete from the body.

How to Use Kamagra?

The recommended dosage for men with a moderate form of ED varies from 50 to 100 mg. 50 mg is good for a start, while 100 mg provide the more pronounced effect. Consult your doctor if you are not sure that this dosage fits you well. He or she will tell you precisely how many milligrams you require.

Tablets we sell contain 100 mg of sildenafil, so you can split it into two parts and take 1 or ½ of the pill daily. Swallow the pill by washing it down with a glass of water. Do not exceed the dosage of 100 mg due to a high risk of overdose. The use of oral jelly doesn’t require water. It absorbs in the mouth while you are chewing it. There are also a few tips to enhance the action of Kamagra:

  • avoid fatty food before the tablet’s intake – it slows down an absorption;
  • get aroused or ask your partner for stimulation: Kamagra will not work if you’re not in a right mood;
  • don’t get drunk before or during the drug’s action. Alcohol causes or enhances such side effects as dizziness, nausea, blurred vision and fainting;
  • do not eat grapefruit or drink grapefruit juice. This product contains specific substances which increase the sildenafil’s content in blood and, therefore, lead to an overdose.

Kamagra is not intended for men under 18 and women. If you belong to one of these categories, do not use Kamagra – it will give you no benefits.

Is Kamagra Safe?

Sildenafil is an FDA approved medication considered safe for healthy people. Still, it doesn’t change the necessity of its proper usage and some special recommendations for people who are suffering from certain diseases. Also, it should be avoided by those who are allergic to the substance.

Contraindications of KamagraThe list of conditions and disorders having which you should discuss the treatment with the healthcare provider:

  • kidney and liver malfunctions (hepatitis, cirrhosis);
  • vision impairments (glaucoma, eye injuries and infections, severe myopia);
  • blood cell disorders (anemia, leukemia, hemophilia);
  • cardiovascular illnesses (rheumatic heart disease, congestive heart failure, arrhythmias, etc.);
  • penis injuries or birth defects;
  • low or high blood pressure;
  • recent heart attack or surgery.

It doesn’t mean that you can’t use Kamagra at all. Your doctor will simply adjust your dosage (likely decrease) for the purpose of safety and avoidance of serious side effects.

To go into greater detail, Kamagra may cause mild side effects even in healthy people. Don’t worry, it is a normal reaction if you experience 2-3 symptoms of the mentioned below at the early stages of your treatment:

  • nasal stuffiness;
  • blushing;
  • blurred vision;
  • reduction of light sensitivity;
  • changed color perception;
  • headache;
  • muscle and back pain;
  • tinnitus;
  • increased heart rate;
  • stomachache.

These effects are not dangerous and quickly go away as far as you continue to take a medicine. However, improper usage or overdoses result in health-threatening effects like:

  • difficulty breathing;
  • arrhythmia;
  • loss of consciousness;
  • critically low blood pressure;
  • sudden cardiac death;
  • anxiety;
  • seizures;
  • severe nausea and vomiting.

Even though these reactions are very rare, immediately seek medical help if you notice at least one of them after Kamagra’s intake.

When to Use It for the Best Results?

How to use the medicine to achieve the maximum effectiveness? Take one dose of Kamagra 30-60 minutes before intercourse. Consider the fact that oral jelly kicks in twice as fast, so you don’t need to wait an hour, 30 minutes are enough.

Kamagra lasts up to 6 hours, so you can take one tablet before an important date or romantic supper with your partner. Do not use the drug if you are not going to have sex: it should be taken only if you plan to have a sexual encounter.

Can I Use Kamagra with Other Drugs?

Nitrates pillsAs well as a lot of other medications, Kamagra interacts with some groups of substances. Three types of medicines may be identified:

  1. Drugs incompatible with sildenafil.
  2. Avoid medications based on nitrates to avoid dire consequences. Drugs containing nitroglycerin, isosorbide mononitrate, and isosorbide dinitrate should not be combined with any of PDE5 inhibitors including Kamagra. You may see them in the pharmacies under the following brand names:

    • Imdur, Monoket, ISMO (isosorbide mononitrate);
    • Nitromist, GoNitro, Nitro-Time, Nitrolingual, Nitrostat (nitroglycerin);
    • Isordil, Dilatrate-SR, Isochron, Isordil Titradose, Sorbitrate, Isordil Tembids, ISDN (isosorbide dinitrate).

    There are some more similar products on the market, so always check the list of ingredients on the back of the medicine’s package after the purchase. Their danger lies in the ability to lower blood pressure to a critical level, especially in combination with Kamagra (sildenafil slightly decreases blood pressure, too). A very low level of blood pressure is quite a risky condition for the patient and can lead to the heart attack or death in severe cases.

    Also, it is not safe to take recreational drugs called “poppers” together with Kamagra. Nothing foretells troubles, but there is alkyl nitrites concealed behind the funny slang name, which are other chemical compounds totally incompatible with ED remedies. So wipe out of your head the idea to enhance your sexual experience by taking two drugs at a time. It’s not worth it.

    Blood pressureSafety tip: if you can’t do without nitrates (for instance, you have the serious cardiovascular disorder), wait at least 24 hours after the last Kamagra’s intake. This time is enough for sildenafil to go away from your body.

  1. Medicines with major interaction with sildenafil.
  2. The class of medications and the popular examples which belong to this category:

    • alpha-blockers or high blood pressure medications (doxazosin, terazosin, prazosin or others);
    • azole antifungals (clotrimazole, econazole, ketoconazole, etc.);
    • bronchodilators (albuterol, metaproterenol, levalbuterol or others);
    • the other CYP3A4 (cytochrome P450 3A4) and PDE5 inhibitors (sildenafil, vardenafil, avanafil etc.);
    • antibiotics (Zithromax, Biaxin etc.);
    • HIV protease and hepatitis C virus protease inhibitors (tipranavir, atazanavir, indinavir, and others);
    • some anxiety medicines (Xanax, and so on);
    • herbal supplements which have the same properties as synthetic PDE5 inhibitors (yohimbine, ginkgo, ginseng, maca, etc.).

The major interaction means they can be barely mixed with the medicine, but you can ask your doctor to comprise the individual recommendations on their joint use. In the majority of cases, the dose of sildenafil will be decreased.

The main risk of such a combination remains the same –critically low blood pressure. The other threats are pronounced side effects such as breathing problems, loss of libido, pain during urination, severe drowsiness, and lightheadedness.

  1. Drugs with minor-to-moderate interaction with sildenafil.
  2. It is a wide range of different medicines, including pain relievers (oxycodone, hydrocodone) and some other groups of drugs. This list of their names is quite extensive, so we will not provide it here. The main characteristic of this category – they don’t interfere with Kamagra’s effects and do not cause life-threatening conditions.

How to Get Cheap Kamagra Pills?

DeliveryYou can buy Kamagra in both oral jelly and tablet form in our ViagraBit online pharmacy. Apart from this remedy, we offer the other generics of Viagra and Cialis at an affordable price: for instance, Cialis 20 mg is our bestseller, so if Kamagra doesn’t suit you, order the free sample of this ED medicine.

The main benefits of the pharmacy:

Last and most importantly, a prescription is not required to purchase medicines on our website. We sell all the products over the counter.

Avanafil: Dosages, Side Effects, Interaction

Avanafil: Dosages, Side Effects, Interaction

Less known analog of popular drugs against erectile dysfunction Stendra is just as good as them. The remedy contains the active ingredient avanafil which helps men get a stable erection whenever they want and feel more confident in bed with their partner. The main benefit: it works even quicker than Cialis, kicking in during 15 minutes from intake.

Even though the majority of men are uncomfortable with their sex lives from time to time, the first symptoms of erectile dysfunction (further referred to as ED) are not a prison sentence. Still, with due care and attention to your men’s health and with the support of specially designed tablets, you can keep such issues to a minimum.

There are a number of distinguished ED medications on the market: Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil) are the most popular and used ones. Avanafil is not as well-known as them, but it isn’t less effective. In some cases, it works even better than those drugs and that’s why may be more suitable for a particular person.

What Is Avanafil?

Avanafil is a PDE5 inhibitor (here and below – phosphodiesterase type 5 inhibitor) widely used for erectile dysfunction treatment. It is a relatively new remedy, the production of which was started only in 2013 by the American pharmaceutical company Vivus Inc.

It has a pretty similar mechanism of action to other PDE5 inhibitors: blood flow to the penile chambers is increasing due to the nitric oxide release and smooth muscles of cavernous bodies’ relaxation. Those substances maintain an erection and help men to improve their performance during intercourse. Avanafil works only in the case of sexual arousal, so it will not cause an erection in everyday life without any reason.
Avanafil: Dosages, Side Effects, Interaction

Available Avanafil Brands

This ingredient is an integral part of Stendra and Spedra medications manufactured by Vivus. Stendra is common in the American market, while Spedra is promoted by the company’s partner, Menarini Group, in 40 European countries, Australia and New Zealand.

Apart from Vivus, there is more than one manufacturer in India which produces so-called generic Stendra. At first sight, such products compare favorably with brand ones because of their lower price. Here you have no guarantee of the high-grade quality – unoriginal drugs may be useless or even harmful to human health. The customer indeed pays a bit more for the well-established brands, but he will be sure of the 100% remedy’s efficiency.

Dosages and Forms

AvanafilAvanafil is available in both online and land-based pharmacies in three forms:

  • 50 mg tablets;
  • 100 mg tablets;
  • 200 mg tablets.

The average starting dose is 100 mg. It may be adjusted in accordance with the individual differences of each man. If you don’t feel much effect or your tolerability has risen, you may increase the dosage up to 200 mg.

Decrease the drug serving to 50 mg if you are taking alpha-blockers or other medications which don’t interact very well with avanafil. Also, it may be reduced due to particular health conditions. The dosage below 50 mg doesn’t provide a benefit, so there is no sense to take less.

Can I Take Avanafil?

Now that you figured out what is avanafil, you should ensure that this component is safe for your body. The one crucial restriction is as follows: Stendra is prohibited for people who are allergic to its components. A man should also consult a doctor before using if he has:

  • heart malfunctions or recent surgery, stroke or another serious problem with the cardiovascular system;
  • fluctuations of blood pressure or permanently high or low pressure;
  • angina and breathing issues;
  • liver and kidney diseases;
  • various blood disorders;
  • serious vision impairment;
  • a stomach ulcer;
  • penis deformity.

Usually, avanafil is well-tolerated, so people without serious health problems may take it safely. It is worth noting that Stendra and Spedra are not intended for women and their impact on pregnant hasn’t been studied yet.

How to Take Avanafil Pills?

ErectionIf you discussed the feasibility of the drug’s usage with your doctor and he or she has approved this solution, go ahead and follow your prescription. Take the serving specified there and don’t change your dose drastically without contacting a doctor.

Avanafil pills are usually taken with a small amount of liquid; the number of tablets depends on the medicine’s form and dosage. The manufacturer states that the time of the last meal doesn’t matter but experts recommend using the drug on an empty stomach. This way, the substance has better solubility, and the body absorbs it quicker. The erection will be forthcoming.

It is preferable to take avanafil in advance: at least 30-60 minutes before sex. You will achieve an erection when you feel sexual arousal – an indispensable condition for a success. At the end of intercourse, your penis will return to its regular state.

Do not take drugs containing avanafil more than once a day. Let 24 hours pass between the usages.

Side Effects

Even though Stendra is safe for a healthy person, some side effects may occur, especially at the initial stages of the treatment. The majority of them don’t require medical care and disappear after the body gets used to the medicine. However, they bring sort of discomfort, so you should be aware of what may happen after your first use and be ready for that.

The other group of possible negative reactions may be dangerous for your body; in this case, you should stop the treatment and contact your doctor.

Common

The most widely spread unwanted effects affecting the patients are:

Those which need medical attention

Those which do not need medical attention

Blurred vision
Dizziness
TinnitusFlushing
Heart rhythm disruptionsFever
HeadacheSore throat
Muscle painStuffy nose
Feeling of warmth

Rare

These effects are very seldom, so you should worry less about them. Some men reported about such issues, so they also have to be listed:

Those which need medical attention

Those which do not need medical attention

Back, bladder, arm, jaw, genitals, chest or other body parts’ pain

Indigestion or diarrhea
Blood in the urine, pain or discomfort during urination, enuresis

Cough

Breathing difficulties or chest tightness

Sweating or shivering
Vomiting and nausea

Anxiety

Fatigue and weakness

Unusual drowsiness
Unexpected weight gain or loss

Muscle spasms

Increased appetite

Overdose

PoisoningDo not take serving more than 200 mg per day. It may cause an overdose and you will require medical help. If you noticed symptoms of poisoning of yourself or another person, call the local Poison Control Center or an ambulance to receive emergency care.

Before the ambulance arrives, try to remove the drug surplus from the body through stomach pumping and providing the injured with a safe environment.

Interactions

You may notice the enhancement of particular side effects if it is taken in combination with some food, medications, or beverages. To minimize risks, avoid the products listed above and fully enjoy your sexual experience without backfire.

Interaction of Avanafil with Food

Alcohol and grapefruit juiceDrugs containing avanafil may be used before, during, or after a meal according to the official instructions. The only product affecting the person in a negative way together with Spedra or Stendra is grapefruit. So, avoid drinking grapefruit juice or eating salads, desserts, or the other dishes containing it, as it can cause an adverse effect.

All other products are acceptable while taking avanafil medication. However, the drug takes effect quicker if you refrain from food a couple hours before using it.

Avanafil and Alcohol Drinks

It is not recommended to mix alcohol and avanafil. As you may know, alcohol in high dosages prevents erection even in young men. Another threat of this combination is an increase of common side effect probability. Stendra + alcohol is not dangerous, though. Therefore, it is your choice whether to drink such beverages before or after taking avanafil, but limit consumption to a couple glasses of beer or wine and no more.

Other Drugs and Avanafil

Avanafil is prohibited to use with riociguat (Adempas) and nitrates like nitroglycerin (Nitromist, Nitro-Dur, Minitran), isosorbide dinitrate (Dilatrate-SR, Isordil), isosorbide mononitrate (Monoket) etc. Such medications are often taken for cardiovascular diseases treatment. Also, they may be supplied in various forms including pills, sprays, pastes, and so on. If you don’t know whether your medicines contain nitrates, ask your doctor. Do not take Spedra together with these drugs, as it is unsafe for your health.

Some recreational drugs also contain nitrates. Such substances as amyl nitrate and butyl nitrate are known better for their street name “poppers” and are not compatible with avanafil.

Do not combine avanafil with other PDE5 inhibitors such as sildenafil, tadalafil, or vardenafil. The most widespread brand names for them are Viagra, Cialis, Levitra, Staxyn, Revatio, and Adcirca.

Before starting the treatment, inform your doctor about all medicines you take.

Here is the list of those which require special attention:

  • antibiotics (clarithromycin, erythromycin, telithromycin);
  • immune supportive medicines used in case of HIV or AIDS (atazanavir, indinavir, saquinavir);
  • antifungal drugs (ketoconazole, itraconazole);
  • remedies against hepatitis C (boceprevir, telaprevir);
  • alpha blockers (alfuzosin, prazosin, terazosin);
  • medications for high blood pressure (nefazodone, verapamil).

Take into account that even some dietary supplements, minerals, and vitamins may influence avanafil’s effect, so be careful while using those together with the remedy.

Other Avanafil Alternatives

The list of similar substances to avanafil includes sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and dapoxetine (Priligy). The first established brand name among those is Viagra by the Pfizer company. The other two emerged later and are slightly different from it. Let’s compare those medicines with avanafil.

Avanafil Versus Viagra Sildenafil

Many people make their choice based on the question “How long does it last” applicable to each of the ED drugs. To compare avanafil vs sildenafil, the first one has indisputable advantages: it lasts 1-2 hours longer (6 hours of Stendra’s duration against of 4-5 Viagra’s) and kicks in quicker (15-20 minutes vs 30 minutes respectively). Food doesn’t influence avanafil’s effect, so it can be taken with the meal, while sildenafil’s effect may be delayed if used together with food.

The side effects inherent to these drugs are pretty similar. However, Stendra commonly causes nasal congestion and runny nose, while Viagra more often becomes a reason for indigestion.

Avanafil vs Cialis

CialisCialis is famous for its super durability due to its longer half-life. In comparison of avanafil vs Cialis Stendra is losing in effect’s lasting: it works for 6 hours on the average while Cialis lasts up to 36 hours. As for kicking in, the drugs are almost equal and both are resistant to food.

The most typical side effects for Stendra are facial flushing, headache, and stuffy nose. For Cialis – headache and indigestion. Both drugs are cheaper than Viagra, which could be a major cause for purchasing it.

Users’ Reviews

Apart from scientific studies proving the efficiency of the drug, it is important to know what real people say about avanafil’s action. The best way to express your impressions is to write a customer review.

The majority of users are satisfied with both Stendra and Spedra and confirm its efficiency. They say the drug helped them to return their virility back by maintaining stable and durable erection within intercourse. Some customers notice avanafil suits them even better than similar medicines. There are few reports about minor side effects, but most men feel good after taking Stendra.

Buy Avanafil OTC Online

Online pharmacyIf you stumble upon an ED issue for the first time, you may wonder where to buy such remedies over the counter. Stendra, Spedra, and other drugs such as Viagra, Cialis, and Levitra are available in online pharmacies without a prescription. ViagraBit is one of them and has some benefits over the others.

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