Poxet: Clinically Proven Premature Ejaculation Management
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Premature ejaculation (PE) is a prevalent male sexual health concern, impacting confidence and intimate relationships. Poxet is a prescription medication specifically formulated to address the neurobiological mechanisms underlying premature ejaculation, offering a targeted and effective solution. Its active ingredient, dapoxetine, is a selective serotonin reuptake inhibitor (SSRI) developed exclusively for on-demand use to delay ejaculation and improve control. This guide provides a comprehensive, expert-level overview of Poxet for healthcare professionals and informed patients, detailing its pharmacology, application, and safety profile to support sound clinical decision-making.
Features
- Active Ingredient: Dapoxetine Hydrochloride.
- Available Strengths: 30 mg and 60 mg film-coated tablets.
- Pharmacological Class: Selective Serotonin Reuptake Inhibitor (SSRI).
- Mechanism of Action: Rapid inhibition of serotonin reuptake in the presynaptic cleft, enhancing serotonergic neurotransmission at the synaptic level.
- On-Demand Pharmacokinetics: Engineered for rapid absorption (Tmax of approximately 1-2 hours) and short elimination half-life (~15 hours).
- Administration: Oral, with water.
Benefits
- Significantly Increases Intravaginal Ejaculatory Latency Time (IELT): Clinical trials demonstrate a substantial, quantifiable increase in time to ejaculation.
- Enhances Perceived Control Over Ejaculation: Users report a marked improvement in the subjective feeling of control, reducing performance-related anxiety.
- Improves Sexual Satisfaction for Both Partners: By extending sexual intercourse, it contributes to improved satisfaction for the individual and their partner.
- Supports Emotional and Relationship Well-being: Effective management of PE can alleviate associated distress and improve overall relationship dynamics.
- On-Demand Dosing Flexibility: Unlike daily SSRIs, it is taken only as needed, approximately 1-3 hours before anticipated sexual activity.
Common use
Poxet is indicated for the treatment of premature ejaculation (PE) in adult men aged 18 to 64 years. A diagnosis of lifelong or acquired PE is typically based on the criteria of persistent or recurrent ejaculation occurring within approximately one minute of vaginal penetration (lifelong) or a clinically significant reduction in latency time (acquired), accompanied by an inability to delay ejaculation on all or nearly all vaginal penetrations, which causes negative personal consequences such as distress, bother, frustration, and/or the avoidance of sexual intimacy. It is not intended for use by the general population for recreational purposes or to enhance sexual performance in men without a PE diagnosis.
Dosage and direction
The recommended starting dose is 30 mg, taken orally with a full glass of water approximately 1 to 3 hours before anticipated sexual activity. The dosing may be increased to a maximum recommended dose of 60 mg based on efficacy and tolerability. The tablet should be swallowed whole and must not be divided, crushed, or chewed. Poxet should not be taken more than once in a 24-hour period. The efficacy and safety of dosing more frequently than once every 24 hours have not been established. It may be taken with or without food; however, a high-fat meal may delay the absorption of dapoxetine and reduce the maximum plasma concentration, which could potentially diminish the therapeutic effect.
Precautions
- Medical Evaluation: A thorough medical and sexual history should be obtained to confirm a diagnosis of PE and to rule out other sexual dysfunctions before initiating treatment.
- Orthostatic Hypotension: Dapoxetine is associated with orthostatic hypotension. Patients should be advised to rise slowly from a sitting or lying position, especially during the initial hours post-dose.
- Syncope (Fainting): There is a risk of syncope, often associated with a transient drop in blood pressure and heart rate increase. Patients should be cautioned to avoid situations where injury could occur if syncope happens.
- Mood Changes: Although rare with on-demand use, patients should be monitored for the emergence of anxiety, agitation, or changes in mood.
- Priapism: Patients should be advised to seek immediate medical attention for an erection lasting more than 4 hours.
- Moderate Hepatic Impairment: Use with caution in patients with moderate hepatic impairment. It is not recommended for patients with severe hepatic impairment.
- Alcohol: Concomitant use with alcohol is not recommended. Alcohol may increase the risk of orthostatic hypotension, dizziness, and syncope.
Contraindications
Poxet is contraindicated in patients with:
- Hypersensitivity to dapoxetine or any of the excipients in the formulation.
- Significant Cardiac Conditions such as heart failure (NYHA Class II-IV), conduction abnormalities (e.g., sick sinus syndrome, Wolff-Parkinson-White syndrome, or significant bradycardia), significant ischemic heart disease, or history of stroke.
- Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) or within 14 days of stopping an MAOI. Similarly, MAOIs should not be initiated within 7 days of stopping dapoxetine.
- Concomitant use with Thioridazine or within 14 days of stopping thioridazine.
- Concomitant use with other SSRIs, Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), Tricyclic Antidepressants (TCAs), Antipsychotics, or other drugs with serotonergic effects due to the increased risk of Serotonin Syndrome.
- Concomitant use with potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir, clarithromycin, telithromycin).
- Severe Hepatic Impairment.
Possible side effect
Like all medications, Poxet can cause side effects, although not everybody gets them. The most common side effects are usually mild to moderate and transient, often diminishing with continued use.
- Very Common (≥1/10): Headache, dizziness, nausea.
- Common (≥1/100 to <1/10): Diarrhea, insomnia, fatigue, somnolence (sleepiness), anxiety, tremor, blurred vision, vomiting, abdominal pain, flushing, increased blood pressure, tachycardia (increased heart rate).
- Uncommon (≥1/1,000 to <1/100): Syncope (fainting), attention disturbance, tinnitus, palpitations, cold sweat, dyspepsia, constipation, dry mouth, hyperhidrosis (increased sweating), irritability, restlessness, decreased libido, erectile dysfunction, anorgasmia.
- Rare (≥1/10,000 to <1/1,000): Suicidal ideation, mania, aggression, angioedema, urticaria, priapism.
Drug interaction
Dapoxetine is primarily metabolized by multiple CYP enzymes, including CYP3A4, CYP2D6, and others. Concomitant use with drugs that affect these enzymes can alter dapoxetine plasma concentrations.
- Potent CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole, ritonavir): Contraindicated. Concomitant use significantly increases dapoxetine exposure.
- Moderate CYP3A4 Inhibitors (e.g., erythromycin, fluconazole, diltiazem): Not recommended. May increase dapoxetine exposure.
- CYP2D6 Inhibitors (e.g., fluoxetine, paroxetine): Use with caution. May increase dapoxetine exposure.
- Serotonergic Drugs (other SSRIs, SNRIs, triptans, tramadol, lithium, St. John’s Wort): Contraindicated or not recommended due to increased risk of Serotonin Syndrome.
- Drugs that Increase Heart Rate or Prolong QT Interval: Use with caution due to potential additive effects on heart rate.
- Alcohol: Concomitant use is not recommended. Increases risk of dizziness, orthostatic hypotension, and syncope.
- Alpha-adrenergic blockers (e.g., tamsulosin): Potential additive effect on blood pressure lowering; use with caution.
Missed dose
Poxet is intended for on-demand use prior to anticipated sexual activity. There is no scheduled dosing regimen. Therefore, the concept of a “missed dose” does not apply. The medication should simply be taken as needed for subsequent sexual activity, adhering to the 24-hour dosing rule.
Overdose
In the event of an overdose, supportive measures should be instituted. Symptoms of overdose are expected to be an extension of the known adverse effect profile, including serotonergic effects such as agitation, confusion, diaphoresis, tachycardia, and possibly serotonin syndrome. Cardiovascular effects such as hypotension and syncope may also occur. There is no specific antidote for dapoxetine overdose. Treatment should consist of general supportive measures, including monitoring of vital signs and ECG. Gastric lavage may be considered if performed soon after ingestion. Due to high protein binding and large volume of distribution, forced diuresis, dialysis, or hemoperfusion are unlikely to be beneficial.
Storage
- Store below 30°C (86°F).
- Keep the tablets in their original blister pack to protect from light and moisture.
- Keep out of the sight and reach of children.
- Do not use after the expiration date printed on the packaging.
Disclaimer
This information is intended for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is based on the typical properties of the drug and may not be applicable to all individuals.
Reviews
- Clinical Efficacy (5/5): “As a urologist, I have prescribed dapoxetine for appropriate patients with lifelong PE for several years. The data is robust, and the on-demand nature of the drug is its greatest advantage over daily SSRIs. The increase in IELT is significant and clinically meaningful for the majority of my patients.” – Dr. A. Evans, MD
- Patient Outcome (4/5): “It took some adjustment to get the timing right, but the difference has been remarkable. The feeling of control is the most valuable aspect. The side effects (mild dizziness) were noticeable for the first couple of uses but have since subsided.” – Verified Patient, 42
- Tolerability Profile (4/5): “While effective, it’s crucial to manage patient expectations regarding side effects. Nausea and headache are common initiators but are typically self-limiting. A frank discussion about the risk of syncope is mandatory prior to prescription.” – Clinical Pharmacist
- Impact on Relationship (5/5): “This medication didn’t just help with a physical issue; it removed a huge source of anxiety and stress from our relationship. The benefits have extended far beyond the bedroom.” – Partner of Patient