Adult: 18-64 yr Initially, 30 mg approx 1-3 hr before sexual activity, subsequent doses adjusted according to response. Max: 60 mg. Dose should not be taken more than once in 24 hr. Review treatment after 4 wk (6 doses) and at least 6 mthly thereafter.
Moderate to severe: Contraindicated.
May be taken with or without food. Swallow tab whole & take w/ a full glass of water.
Significant cardiac disease, history of syncope or mania, bipolar disorder, severe depression. Severe renal and moderate to severe hepatic impairment. Concomitant use w/ potent CYP3A4 inhibitors. Not to be used w/ or w/in 14 days of discontinuing treatment w/ antidepressants including other SSRIs and serotonin norepinephrine reuptake inhibitors (SNRIs) or MAOIs.
Patient w/ bleeding disorders, epilepsy, susceptibility to angle-closure glaucoma or raised intraocular pressure. Not intended for use in women. Known CYP2D6 poor metabolisers.
May impair ability to drive and operate machinery.
Symptoms: Somnolence, GI disturbances (e.g. nausea, vomiting), tachycardia, tremor, agitation and dizziness. Management: Symptomatic and supportive treatment.
Concomitant use w/ PDE-5 inhibitors may result in orthostatic hypotension. Significant increase in exposure w/ moderate CYP3A4 inhibitors (e.g. fluconazole, verapamil) or potent CYP2D6 inhibitors (e.g. fluoxetine).
Potentially Fatal: Increased exposure w/ potent CYP3A4 inhibitors (e.g. ketoconazole, ritonavir, telithromycin). Concurrent use w/ SSRIs, SNRIs or MAOIs may increase the risk of serotonin associated effects. Prolonged QT interval w/ thioridazine.
Avoid alcohol as it may increase neurocognitive and neurocardiogenic (e.g. syncope) adverse events, thereby increasing the risk of accidental injury. Increased risk of serotonin syndrome w/ St John’s wort.
Description: Dapoxetine is a potent short-acting SSRI. Its action is assumed to be due to the inhibition of neuronal reuptake of serotonin and the subsequent potentiation of the neurotransmitter's action at pre- and postsynaptic receptors. Pharmacokinetics: Absorption: Rapidly absorbed. Absolute bioavailability: 42%. Time to peak plasma concentration: Approx 1-2 hr. Distribution: Volume of distribution: 162 L. Plasma protein binding: <99%. Metabolism: Extensively metabolised to multiple metabolites primarily through N-oxidation, N-demethylation, naphthyl hydroxylation, glucuronidation and sulfation. Excretion: Via urine as conjugates. Terminal half-life: Approx 19 hr.
Buckingham R (ed). Dapoxetine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/08/2014.Joint Formulary Committee. Dapoxetine. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/08/2014.