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Everlong Tablet - Dapoxetine for Premature Ejaculation

Delayed ejaculation is a side effect of selective serotonin reuptake inhibitors (SSRIs) in men. Dapoxetine, a short-acting SSRI, is the first drug marketed for premature ejaculation.

After oral administration, peak plasma concentrations of dapoxetine are achieved within one hour. The elimination is relatively rapid and the terminal half-life is about 19 hours.

Ever long tablet randomized controlled trials have been performed for premature ejaculation.1-6 The primary outcome of most studies was the "intravaginal ejaculation phase" that the partner measures by using the stopwatch.

In two studies (1) in which 2614 men (18-77 years of age) were randomized to dapoxetine (30 mg or 60 mg) or placebo (all 1-3 hours before intercourse), it was found that dapoxetine significantly increased the intravaginal ejaculation time than the placebo. The starting point for men was at least 2 minutes or less than 75% intravaginal ejaculation latency. After 12 weeks, 29% of the 30 mg dose taking men and 34% of the 60 mg dose had a latency of 3 minutes or more. This was compared with only 14% of placebo-treated men. Men who took dapoxetine saw that they had better ejaculation and were more satisfied with sexual performance than placebo.

In another study, Everlong tablet (60 mg) was compared with paroxetine (20 mg), another SSRI, 340 men (22-48 years) with premature ejaculation. Treatments were taken each day divided into two doses. After 12 weeks, the intravaginal ejaculation latency period had increased for 38 to 179 seconds with dapoxetine, 31 seconds to 370 seconds for paroxetine and for a 34 to 55-second placebo. More men reported sexual satisfaction with dapoxetine and paroxetine than the placebo (66% vs 78% vs. 16%). A similar kind of sexual satisfaction trend was seen with partners who were interviewed independently of their husbands. Eleven men resigned due to lack of efficacy - 3/104 dapoxetine, 2/105 paroxetine, and 6/100 placebo. The time of administration with regard to sexual intercourse was not described in this study.6

During the studies, dapoxetine over 30 mg was most commonly reported with nausea (11%), headache (5.6%), diarrhea (3.5%), drowsiness (3.1%) and dizziness (5.8%) than placebo. These events were dose-dependent - all of them were more common at 60 mg dapoxetine. Nausea and dizziness were the most common causes of cessation with 30 mg dapoxetine. Due to the increased risk of adverse reactions, patients should be warned to take up to one tablet for 24 hours.

Sexual adverse reactions, including erectile dysfunction, abnormal ejaculation and decreased libido, were more common than dapoxetine than placebo. They appeared in 2.9% of patients receiving dapoxetine 30 mg and 3.8% dapoxetine 60 mg versus 1.5% in placebo-treated patients.

Some patients had postural hypotension and cautiousness was advised at the same time using vasodilators, such as alpha-blockers, nitrates and phosphodiesterase-5 inhibitors. Syncopes have been reported with Everlong tablet price in Pakistan and appeared to be dose-dependent (0.05% with placebo, 0.06% with 30 mg and 0.23% for 60 mg). Possible prodromal symptoms such as nausea, dizziness and light were also more common with dapoxetine than with placebo. Patients should be warned of this risk and advised to maintain adequate fluidization and avoid alcohol.

Dapoxetine is metabolised by the effects of enzymes in the liver and kidneys, particularly cytochrome P450 (CYP) 2D6 and 3A4. It also moderately weakens CYP 2D6 and causes poor CYP 3A4, so many interactions are expected. Poor CYP 2D6 metabolites may have a higher risk of side effects. Concomitant treatment with potent CYP 3A4 inhibitors such as ketoconazole and ritonavir is contraindicated. Dapoxetine is also contraindicated with antidepressants, including monoamine oxidase inhibitors, serotonin reuptake inhibitors, tricyclic drugs and other drugs with serotonergic effects (tramadol, St John's Wort and lithium).

Everlong tablets timing should not be used as a composite of recreational drugs such as ketamine, methylenedioxymethamphetamine (MDMA) and lysergic acid diethylamide (LSD) as potential risk of serious adverse events including arrhythmias, hyperthermia and serotonin syndrome. Concurrent sedatives can increase sleepiness and dizziness.

Dapoxetine is contraindicated in patients with impaired heart failure such as heart failure, abnormalities of conduction or significant ischemic or hypertensive effects. It is also contraindicated in moderate to severe liver problems. Please see the following Everlong tablet link for more information on everlong tablet. // https://caremedic.weebly.com/home/everlong-tablet-timing-ever-long-is-safe-and-effective

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