Dapoxetine 60mg is a short-acting selective serotonin reuptake inhibitor (SSRI) approved for the treatment of premature ejaculation (PE) in men aged 18 to 64. Marketed under brand names like Priligy, it is well-known for its quick onset of action and effectiveness in extending the time to ejaculation. While Dapoxetine has transformed the way PE is managed, it is not suitable for everyone.
This article provides a comprehensive overview of who should avoid taking Dapoxetine, including medical conditions, drug interactions, age considerations, and other risk factors.
Understanding Dapoxetine
Dapoxetine is unique among SSRIs due to its fast absorption and elimination, making it ideal for on-demand use rather than long-term antidepressant therapy. It is typically taken 1 to 3 hours before anticipated sexual activity, and its effects can last up to 3–4 hours. You can also visit dosepharmacy to get more information about ED and PE treatment.
While effective for many, patient safety is a top priority, and Dapoxetine is contraindicated in certain populations. Let’s explore those groups.
1. Men with Heart Conditions
Dapoxetine can affect heart rhythm, especially in people with underlying cardiovascular issues. It is particularly unsafe for those with:
- Congenital long QT syndrome
- A history of syncope (fainting)
- Unstable heart failure
- Significant bradycardia (slow heart rate)
- Cardiac arrhythmias (abnormal heart rhythms)
These individuals are at increased risk of serious heart rhythm disturbances, especially when taking drugs that prolong the QT interval.
✅ Recommendation:
Before starting Dapoxetine, patients with any history of heart disease should undergo electrocardiogram (ECG) testing and consult a cardiologist.
2. People Taking Certain Medications
Dapoxetine is metabolized primarily through the CYP3A4 enzyme in the liver. Therefore, drugs that strongly affect this enzyme can interact dangerously with Dapoxetine.
🚫 Medications to Avoid:
Strong CYP3A4 Inhibitors:
- Ketoconazole
- Ritonavir
- Itraconazole
- Clarithromycin
- Nefazodone
These can increase blood levels of Dapoxetine, potentially leading to toxicity.
MAO Inhibitors:
- Phenelzine
- Tranylcypromine
- Isocarboxazid
These increase the risk of serotonin syndrome, a potentially life-threatening condition.
Other SSRIs or SNRIs:
Combining Dapoxetine with other antidepressants can increase the risk of side effects, including seizures, mood changes, and serotonin syndrome.
Thioridazine:
Avoid coadministration due to risk of heart rhythm disturbances.
✅ Recommendation:
Always inform your healthcare provider about all medications and supplements you’re taking before using Dapoxetine.
3. Men with Liver Impairment
Dapoxetine is primarily metabolized in the liver, so those with moderate to severe liver impairment should avoid taking it.
Why?
- Impaired liver function can cause accumulation of the drug, increasing the risk of side effects such as dizziness, nausea, and even fainting.
- The body may not clear the drug efficiently, leading to toxicity.
✅ Recommendation:
Men with liver disease should undergo liver function testing (LFTs) before starting treatment. Mild liver impairment may be manageable, but moderate or severe cases are contraindications.
4. Men with a History of Depression or Bipolar Disorder
Since Dapoxetine affects serotonin levels in the brain, it may worsen psychiatric conditions in men with:
- Major depressive disorder
- Bipolar disorder
- Mania or hypomania
- Schizophrenia
- History of suicidal ideation
In such individuals, Dapoxetine may trigger mood swings, anxiety, or suicidal thoughts.
✅ Recommendation:
A full mental health evaluation should be performed before initiating treatment. If a patient has a current or past psychiatric illness, Dapoxetine is generally not recommended.
5. Underage and Elderly Patients
Dapoxetine is approved only for men aged 18 to 64. It is not recommended for:
- Boys under 18: Safety and efficacy in minors have not been established.
- Men over 65: Older adults are more likely to experience dizziness, falls, and fainting, especially due to blood pressure fluctuations and drug interactions.
✅ Recommendation:
Only use Dapoxetine within the approved age range unless under close medical supervision.
6. Men with Seizure Disorders
Like other SSRIs, Dapoxetine lowers the seizure threshold, making it unsafe for men with:
- Epilepsy
- History of seizures
- Neurological disorders that predispose to seizures
✅ Recommendation:
Avoid use or proceed with extreme caution if seizure risk is present. An alternative PE treatment should be considered.
7. Men Prone to Fainting (Orthostatic Hypotension)
Dapoxetine is known to cause:
- Dizziness
- Orthostatic hypotension (drop in blood pressure upon standing)
- Syncope (fainting)
This effect is especially dangerous for men with a history of fainting, low blood pressure, or autonomic nervous system dysfunction.
✅ Recommendation:
Monitor blood pressure regularly during treatment. Start at the lowest effective dose (30 mg) and assess tolerance.
8. Men with Kidney Impairment
Mild to moderate kidney disease may not significantly affect Dapoxetine clearance, but in severe renal impairment, caution is warranted.
✅ Recommendation:
Use only if benefits outweigh risks, and under medical supervision with close monitoring.
9. Men Using Recreational Drugs or Alcohol
Dapoxetine should not be combined with alcohol or recreational drugs, such as:
- Cannabis
- Cocaine
- Ecstasy (MDMA)
- LSD
- Amphetamines
These substances can amplify side effects like confusion, dizziness, and serotonin syndrome. Alcohol, in particular, increases the risk of fainting and impaired coordination.
✅ Recommendation:
Avoid alcohol and illicit substances during Dapoxetine use.
Conclusion: Who Should Avoid Dapoxetine?
Dapoxetine is a well-researched, effective treatment for premature ejaculation—but not everyone is a suitable candidate. You should avoid Dapoxetine if you:
- Have heart problems (especially rhythm disorders)
- Take MAOIs, SSRIs, or CYP3A4 inhibitors
- Suffer from liver disease or seizure disorders
- Are under 18 or over 65
- Have psychiatric conditions like depression or bipolar disorder
- Are prone to fainting or low blood pressure
- Use alcohol or recreational drugs
Always consult your doctor before starting Dapoxetine to determine if it’s safe and appropriate for you. A personalized approach to treatment ensures not only effectiveness but also your long-term safety and well-being.