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The mechanism of action is thought to be related to inhibition of neuronal reuptake of serotonin and subsequent potentiation of serotonin activity. The central ejaculatory neural circuit comprises spinal and cerebral areas that form a highly interconnected network. The sympathetic, parasympathetic, and somatic spinal centers, under the influence of sensory genital and cerebral stimuli integrated and processed at the spinal cord level, act in synergy to command physiologic events occurring during ejaculation. Experimental evidence indicates that serotonin (5-HT), throughout brain descending pathways, exerts an inhibitory role on ejaculation. To date, three 5-HT receptor subtypes 5-HT(1A), 5-HT(1B), and 5-HT(2C) have been postulated to mediate 5-HT's modulating activity on ejaculation. Dosage & Administration Adult (18 to 64 years of age): The recommended starting dose for all patients is 30 mg, taken as needed approximately 1 to 3 hours prior to sexual activity. 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. The maximum recommended dosing frequency is one dose every 24 hours. Interaction CNS active medicinal products: The use of Dapoxetine in combination with CNS active medicinal products has not been systematically evaluated in patients with premature ejaculation. Consequently, caution is advised if the concomitant administration of Dapoxetine and such medicinal products is required. PDE5 inhibitors: Tadalafil did not affect the pharmacokinetics of Dapoxetine. Sildenafil caused slight changes in Dapoxetine pharmacokinetics, which are not expected to be clinically significant. However, Dapoxetine should be prescribed with caution in patients who use PDE5 inhibitors due to possible reduced orthostatic tolerance. Tamsulosin: Concomitant administration of single or multiple doses of 30 mg or 60 mg Dapoxetine to patients receiving daily doses of Tamsulosin did not result in changes in the pharmacokinetics of Tamsulosin. However, Dapoxetine should be prescribed with caution in patients who use alpha adrenergic receptor antagonists due to possible reduced orthostatic tolerance. Warfarin: There are no data evaluating the effect of chronic use of Warfarin with Dapoxetine; therefore, caution is advised when Dapoxetine is used in patients taking Warfarin chronically. Ethanol: Concomitant use of alcohol and Dapoxetine could increase the chance or severity of adverse reactions such as dizziness, drowsiness, slow reflexes, or altered judgment. Combining alcohol with Dapoxetine may increase these alcohol-related effects and may also enhance neurocardiogenic adverse events such as syncope, thereby increasing the risk of accidental injury; therefore, patients should be advised to avoid alcohol while taking Dapoxetine. Contraindications Patients with known hypersensitivity to Dapoxetine Hydrochloride. Patients with significant pathological cardiac conditions such as heart failure (NYHA class II-IV), conduction abnormalities (second or third degree AV block or sick sinus syndrome) not treated with a permanent pacemaker, significant ischemic heart disease of significant valvular disease. Concomitant treatment with monoamine oxidase inhibitors (MAOIs), thioridazine. Similarly, MAOIs or thioridazine should not be administered within 7 days after Dapoxetine has been discontinued. Concomitant treatment with serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs) or other medicinal/herbal products with serotonergic effects or within 14 days of discontinuing treatment with these medicinal/herbal products. Side Effects Dizziness, Headache, Somnolence, Tremor, Blurred vision, Tinnitus, Sinus congestion, Nausea, Diarrhea, Abdominal pain, Dry mouth, Fatigue, Insomnia, Hypertension. Pregnancy & Lactation Dapoxetine is not indicated for use by women. It is not known either dapoxetine or its metabolites are excreted through human breast milk. Precautions & Warnings Patient with bleeding disorders, epilepsy, susceptibility to angle-closure glaucoma or raised intraocular pressure. Not intended for use in women. Known CYP2D6 poor metabolisers. Overdose Effects There were no unexpected adverse events in a clinical pharmacology study of Dapoxetine with daily doses up to 240 mg. In general, symptoms of overdose with SSRIs include serotonin-mediated adverse reactions such as somnolence, gastrointestinal disturbances such as nausea and vomiting, tachycardia, tremor, agitation and dizziness. In cases #longlastingsexmedicine#bddrug24 #bestsexmedicineinbd#
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Erectile dysfunction (ED) can have various causes, including underlying health conditions, medications, psychological factors, and lifestyle habits. While diet and supplements may play a role in supporting sexual health, it's important to note that they are not a guaranteed solution and may not be effective for everyone. Consulting with a healthcare professional is crucial to address the root causes of ED and determine the most appropriate treatment options. That being said, here are some dietary and lifestyle factors that may positively impact erectile function: Mediterranean Diet: Research suggests that following a Mediterranean-style eating pattern, rich in fruits, vegetables, whole grains, lean proteins (such as fish and poultry), healthy fats (such as olive oil), and limited processed foods, may promote cardiovascular health and potentially improve erectile function. A study published in the Journal of Sexual Medicine (https://pubmed.ncbi.nlm.nih.gov/19796047/) found that adherence to the Mediterranean diet was associated with a reduced risk of ED. L-arginine: L-arginine is an amino acid that acts as a precursor to nitric oxide, a compound involved in blood vessel dilation. Some studies indicate that L-arginine supplementation may enhance erectile function, particularly in individuals with impaired nitric oxide metabolism. However, the evidence is not conclusive. Consult with a healthcare professional before considering L-arginine supplements, as they may interact with certain medications. Pomegranate Juice: Pomegranate juice is rich in antioxidants and has been studied for its potential effects on erectile function. A small pilot study published in the International Journal of Impotence Research (https://pubmed.ncbi.nlm.nih.gov/17568759/) suggested that daily consumption of pomegranate juice over a period of two weeks resulted in improved erectile function. Further research is needed to confirm these findings. DHEA: Dehydroepiandrosterone (DHEA) is a hormone that naturally occurs in the body and plays a role in the production of testosterone. Some studies have explored the use of DHEA supplementation in individuals with ED and low levels of DHEA. However, more research is needed, and it's important to consult with a healthcare professional before considering DHEA supplementation due to potential side effects and interactions. For online training WhatsApp 8899143037
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