Premature Ejaculation Treatment Selector
Recommended Treatment Option
Why This Matches Your Needs:
Treatment Overview
| Treatment | Administration | Onset | Duration | Side Effects | Cost (USD/month) |
|---|---|---|---|---|---|
| Poxet (Dapoxetine) | On-demand | 30-60 min | 4-6 hours | Nausea, headache, dizziness | $70-$120 |
| Paroxetine | Daily oral | 2-3 weeks | 24 hours | Nausea, sexual dysfunction, weight gain | $30-$50 |
| Sertraline | Daily oral | 2-3 weeks | 24 hours | Diarrhea, insomnia, sexual dysfunction | $35-$55 |
| Clomipramine | Daily oral | 2-3 weeks | 24 hours | Dry mouth, constipation, drowsiness | $25-$45 |
| Lidocaine-Prilocaine Spray | Topical | 5-10 min | 30-60 minutes | Temporary numbness, skin irritation | $15-$25 |
| Behavioral Techniques | No medication | Immediate | Variable | None (may cause performance anxiety) | $0 |
Quick Take
- Poxet (dapoxetine) is a short‑acting SSRI specifically approved for premature ejaculation (PE).
- Alternative oral SSRIs (paroxetine, sertraline, clomipramine) work but need daily dosing.
- Topical anesthetics (lidocaine‑prilocaine spray) act locally and avoid systemic side‑effects.
- Behavioral techniques (start‑stop, squeeze) cost nothing but require practice.
- Choosing the right option depends on timing, side‑effects, cost, and whether you prefer on‑demand or daily use.
When it comes to managing premature ejaculation, Dapoxetine often tops the list because it’s the only drug officially labeled for on‑demand use. But it’s not the only game in town. Below we break down how dapoxetine stacks up against the most common alternatives, so you can decide which route matches your lifestyle and health profile.
What Is Poxet (dapoxetine) and How Does It Work?
Dapoxetine is a selective serotonin reuptake inhibitor (SSRI) engineered for rapid onset and short half‑life, typically 1-2hours. It boosts serotonin levels in the central nervous system just long enough to delay ejaculation without the lingering mood‑changing effects of traditional SSRIs. The drug is taken 1‑3hours before sexual activity, and its effect lasts about 4-6hours, matching most intimate encounters. Because it clears the body quickly, withdrawal symptoms are minimal compared with daily SSRIs.
Key attributes of dapoxetine:
- Dosage: 30mg or 60mg tablets, on‑demand.
- Approval: European Medicines Agency (EMA) and several Asian regulators; not FDA‑approved in the U.S. yet.
- Common side‑effects: nausea, headache, dizziness, rarely insomnia.
Common Alternatives to Dapoxetine
Below are the main contenders you’ll encounter when researching PE treatments.
Paroxetine is a classic SSRI used off‑label for PE. It requires a daily dose of 20mg, and steady‑state levels build up over 2-3weeks.
Sertraline works similarly, with daily dosing of 50‑100mg. It’s often favored for men who also need anxiety relief.
Clomipramine is a tricyclic antidepressant that doubles as a PE therapy; doses range from 25‑50mg per day.
Lidocaine‑prilocaine spray (often sold under brand names like TEMPE) provides local desensitization. Apply 5-10minutes before sex; effect lasts 30‑60minutes.
Start‑stop technique is a behavioral method where stimulation stops before the point of inevitability, waits, then resumes. No medication required.
Squeeze technique involves applying pressure to the penis shaft just before climax to reduce arousal. Like the start‑stop, it’s free but may feel awkward.
Side‑Effect Profile Comparison
| Attribute | Dapoxetine (Poxet) | Paroxetine (daily SSRI) | Sertraline (daily SSRI) | Clomipramine (daily TCA) | Lidocaine‑prilocaine spray | Behavioral technique |
|---|---|---|---|---|---|---|
| Administration | On‑demand, 1‑3h before | Daily oral | Daily oral | Daily oral | Topical, 5‑10min before | No medication |
| Onset of effect | 30‑60min | 2‑3weeks | 2‑3weeks | 2‑3weeks | 5‑10min | Immediate (practice‑dependent) |
| Duration | 4‑6h | 24h (continuous) | 24h (continuous) | 24h (continuous) | 30‑60min | Variable |
| Common side‑effects | Nausea, headache, dizziness | Nausea, sexual dysfunction, weight gain | Diarrhea, insomnia, sexual dysfunction | Dry mouth, constipation, drowsiness | Temporary numbness, skin irritation | None (may cause performance anxiety) |
| Cost (2025 USD per month) | $70‑$120 | $30‑$50 | $35‑$55 | $25‑$45 | $15‑$25 | $0 |
| Regulatory status (US) | Not FDA‑approved (off‑label) | Approved for depression, off‑label for PE | Approved for depression, off‑label for PE | Approved for OCD, off‑label for PE | FDA‑approved for topical anesthesia | None |
Decision Criteria: Which Option Fits You?
When you line up the numbers, the choice boils down to three personal factors:
- Timing needs - If spontaneity is key, on‑demand dapoxetine or spray wins. If you’re comfortable planning, a daily SSRI may be cheaper long‑term.
- Tolerance for side‑effects - Systemic drugs can affect mood, appetite, or sleep. Topicals stay local; techniques have no pharmacologic risk.
- Budget and access - In 2025, dapoxetine is still pricier and may need import. Generic paroxetine or sertraline are widely covered by insurance.
For many men, a hybrid approach works: a daily low‑dose SSRI to set a baseline, plus an on‑demand spray for extra control. Always discuss with a physician, especially if you’re on other meds (e.g., nitrates, antidepressants) that could interact.
Practical Tips and Common Pitfalls
- Start low, go slow - If trying dapoxetine, begin with 30mg. Upsize only if tolerated.
- Don’t combine multiple oral SSRIs - Overlap can cause serotonin syndrome.
- Timing the spray - Apply 5‑10minutes before intimacy and wipe off excess to avoid partner numbness.
- Practice makes perfect - Behavioral methods need at least a few weeks of consistent practice before noticeable improvement.
- Watch for contraindications - Dapoxetine isn’t for men with severe heart disease or taking monoamine oxidase inhibitors.
Frequently Asked Questions
Is dapoxetine safe for men with hypertension?
In most studies, dapoxetine didn’t raise blood pressure significantly. However, if you’re on beta‑blockers or other cardiac meds, talk to your doctor first.
Can I use both dapoxetine and a topical spray together?
Yes, many clinicians recommend a low dose of dapoxetine plus a spray for extra buffering. Just keep the spray amount modest to avoid over‑numbing.
How long does it take for daily SSRIs to improve PE?
Typically 2‑4weeks of consistent dosing are needed for noticeable delay. Some men report improvement as early as 1week.
Are there any natural supplements that work as well as dapoxetine?
Herbal extracts like yohimbine or horny goat weed have modest anecdotal support, but robust clinical data are lacking. They’re not a reliable replacement for FDA‑ or EMA‑approved treatments.
What should I do if I experience severe nausea with dapoxetine?
Take the tablet with food, reduce the dose to 30mg, or switch to a daily low‑dose SSRI. If nausea persists, stop the medication and seek medical advice.
Bottom line: dapoxetine offers the convenience of on‑demand use and a pharmacologic profile tuned for PE, but it isn’t the only path. By weighing timing, side‑effect tolerance, and cost, you can pick the strategy that feels right for your body and your bedroom life.
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