How it works
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Sildenafil boosts penile blood flow during sexual stimulation by inhibiting PDE-5 (cGMP pathway).
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Dapoxetine delays ejaculation by enhancing serotonergic control of the ejaculatory reflex.
How to take
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Swallow 1 tablet with water 1–3 hours before sex.
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With or without food, but avoid heavy/high-fat meals near dosing (slows sildenafil).
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No more than one dose per 24 h. Do not stack with other ED/PE meds.
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If this strength is too strong, discuss alternatives; fixed combos cannot be split-titrated. Many men do better starting with sildenafil 25–100 mg or dapoxetine 30 mg as single agents.
Do not use if you
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Take nitrates or riociguat
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Had recent MI/stroke, have unstable angina, severe hypotension/uncontrolled hypertension
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Have significant liver disease, severe renal impairment, or marked QT prolongation
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Take MAOIs (past 14 days), thioridazine, or strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir)
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Have history of syncope, bipolar disorder/mania, seizures, or certain retinal disorders (e.g., retinitis pigmentosa)
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Are women or under 18
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Are allergic to sildenafil, dapoxetine, or excipients
Interactions to watch
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Absolutely avoid: Nitrates (“poppers”), riociguat.
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Serotonergic add-ons ↑ serotonin-syndrome risk: SSRIs/SNRIs, TCAs, triptans, tramadol, linezolid, St. John’s wort.
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CYP3A4/2D6 inhibitors ↑ dapoxetine/sildenafil levels: azoles, macrolides, protease inhibitors; paroxetine/fluoxetine.
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Alpha-blockers/antihypertensives: hypotension/syncope risk—medical supervision needed.
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Grapefruit may raise levels; alcohol worsens dizziness and ejaculation control—limit.
Possible side effects
Common: Headache, flushing, nasal congestion, dyspepsia, nausea/diarrhea, dizziness, insomnia, anxiety.
Serious—stop and seek care: Chest pain, fainting, priapism (>4 h), sudden vision/hearing loss, severe palpitations, serotonin syndrome (agitation, sweating, tremor, fever, diarrhea), severe allergic reaction.
Practical tips
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Stand up slowly; dapoxetine can cause orthostatic syncope.
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Give treatment 4–8 properly timed attempts before judging response.
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Optimize basics: light meal, low alcohol, adequate arousal, sleep, cardio fitness.
Storage
Room temperature, protected from heat and light. Keep in original blister. Keep out of reach of children and pets.
FAQs
Does it work without arousal? No. Sexual stimulation is required.
Can I take it daily? No—as needed only, max once per 24 h.
Can I add another ED pill? Do not combine PDE-5 inhibitors the same day unless your clinician directs.
Why not just use 100/60 for everyone? Safety and efficacy vary. Many patients need lower doses or single-agent titration.