Michael Stewart, MRPharmS

Like most medications, tadalafil can cause side effects. The most common are usually mild and will go away if you stop taking the tablets. Imagine the dilemma: ejaculate too soon, or risk losing your erection. Premature ejaculation (PE) and erectile dysfunction (ED) can go hand in hand. And when it comes to sex, you don’t want to miss your shot.

How do I take Priligy, and how often?

If you suffer from both erectile dysfunction (ED) and premature ejaculation (PE) try treatment for ED first and if you still have PE problems discuss this with your regular doctor who may be able to prescribe these together following a more in depth review. Priligy (dapoxetine) was developed after it was realised that a side effect of taking SSRI antidepressants was to prolong erections. It was specifically designed as a short acting medication rather than an antidepressant but acts in the same way to increase serotonin levels in the brain, which delays ejaculation. It is washed out of the system within around 20 hours (half-life approximately 1.5 hours) and has no antidepressant effect. There are two strengths of dapoxetine (Priligy) tablets: 30mg and 60mg.

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You should start with the lower 30mg strength, taking the tablet 1-3 hours before sexual intercourse. Swallow the tablet whole, with a full glass of water. It can be taken with or viagra tablet for sex without food. The strength of tablet can be increased the next time, if the lower dose does not have the desired response and you had no significant side effects. You should not take a dose more than once every 24 hours and do not take it every day. Let’s see which treatments can be combined to tackle the issue on both fronts.

Aspect	Priligy (Dapoxetine)	Viagra (Sildenafil)	Combined Use Effectiveness
Effectiveness in delaying ejaculation	High (80-90%)	Not relevant	Variable, depends on individual response
Improvement in erectile function	No	Yes	Yes, when used with ED indication
Satisfaction rate in users	70-80%	75-85%	Enhanced with proper management
Onset of noticeable effects	1-3 hours	30-60 mins	Typically within 30 minutes to 2 hours

They’re the two most common male sexual problems and the root causes are often the same.

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Viagra Generic	50mg	270 + 8 Pills	198.48€ 189.03€	Buy

High-stress levels, performance anxiety, and relationship problems are just a few examples that can cause both problems in the bedroom. ED can even lead to the development of PE.

Article history

Most men reported an improvement in premature ejaculation symptoms and a reduction in personal distress related to ejaculation. How do I know if I have premature ejaculation? What treatment is available for premature ejaculation? Can I take erectile dysfunction drugs with dapoxetine (Priligy)? What are the side effects of dapoxetine (Priligy)?

Corresponding author

How can I reduce the risk of side effects of dapoxetine (Priligy)? Premature ejaculation (PE) is actually quite common. Up to 30% of men suffer with PE problems at some time in their life. It is usually related to stress and psychological factors rather than a physical problem. There are a variety of ways to help. You’re getting intimate, all the while focusing on staying hard. Arousal is high, but that leads to the point of no return faster than you’d like. Or, to avoid going soft, you try to cool off. It’s a tightrope walk where enjoyment takes a back seat.

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One must be careful when it comes to combining dapoxetine with other medicines. Dapoxetine and certain recreational drugs, tricyclic antidepressants, or other selective serotonin reuptake inhibitors can interact. Consultation with a healthcare professional is crucial before initiating therapy with multiple drugs. Yes, dapoxetine can be taken alongside erectile dysfunction treatments such as sildenafil (Viagra). However, it's vital to be cautious of potential blood pressure fluctuations, as both medications can influence blood pressure.

Redefining a sexual medicine paradigm: subclinical premature ejaculation as a new taxonomic entity

Common adverse reactions include dizziness, headaches, and nausea. To lower these effects, it's advised to: Avoid alcohol, as it can increase specific side effects. Be cautious when standing up from sitting or lying to prevent dizziness. Grapefruit juice is one of the drinks that might increase the level of dapoxetine in the blood, heightening the risk of side effects. Men with significant ischemic heart disease, sick sinus syndrome, a history of mania or severe depression (major depressive disorder), if already on tricyclic antidepressants, or those with severe renal impairment should avoid taking Priligy. It can lead to disappointment, frustration, or embarrassment.

• Priligy is taken 1-3 hours before sexual activity.
• Viagra's effects typically last 4-6 hours.
• Combining the drugs may increase the risk of side effects.

Not exactly feelings associated with enjoyable sex.

• Priligy and Viagra are not directly interchangeable.
• Use of one does not substitute for the other.
• Monitor for adverse reactions when using both medications.

There are many medications to treat both ED and PE.

What treatment is available for premature ejaculation?

Adverse effects associated with dapoxetine range from nausea, dizziness, and headaches to increased blood pressure. While most of these adverse reactions are mild, it's essential to recognize and report any severe adverse reactions immediately. Clinical trials have not conclusively linked dapoxetine to alterations in testosterone levels. However, always consult with a specialist in sexual medicine for comprehensive insights. Dapoxetine, under the brand name Priligy, has been patented in the UK, allowing only certain distributors access.

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However, more affordable generics are expected to surface post-patent expiry (2024), providing a more cost-effective solution. Certain NHS areas do indeed offer Priligy prescriptions. Connecting with a local GP for details on NHS and private prescription options is always advised. Dapoxetine increases the intravaginal ejaculatory latency time, though exact times can vary based on individual responses. Dapoxetine has undergone placebo-controlled clinical trials, with results indicating a high satisfaction rate. Sometimes they can even be used together - a double team to fight on both flanks. Delay Wipes and Delay Spray contain numbing agents such as lidocaine, which numbs your penis before sex, making you last longer. There is no interaction between topical anaesthetics and ED treatments like Sildenafil or Tadalafil, so they’re safe to use together. Paroxetine can be combined with either ED treatment. In fact, studies have shown that a combination of paroxetine and sildenafil can achieve better results for PE than paroxetine alone. Together, these drugs can cause low blood pressure, which could bring it to dangerous levels if combined, resulting in severe dizziness, feeling faint, or even collapse.

What is the satisfaction rate with dapoxetine?

Doctors define premature ejaculation as ejaculation in less than 2 minutes from penetration. However, if you ejaculate with very little stimulation, or before you want, and it is leading to relationship difficulties, you may benefit from treatment. There is medication available - dapoxetine (Priligy) - but there are also physical treatments such as extra thick condoms or anaesthetic (numbing) creams and sprays, and condoms pre-coated with numbing gel, which reduce penile sensitivity. These can be bought in many pharmacies without the need for a prescription. As premature ejaculation is often linked to stress and psychological factors, psychological therapies can help.

Can You Buy Priligy and Viagra as a Combination Pill?

See NHS - Ejaculation problems or the book Coping with Premature Ejaculation: How to Overcome PE, Please Your Partner, and Have Great Sex (2004) by Michael E. Metz. There are a few medical conditions where it would be unsafe to take Priligy. Checks are carried out within the Priligy online consultation. The license for dapoxetine states that Viagra (sildenafil), Cialis (tadalafil), and other erectile dysfunction drugs should not be used together with Priligy as there is a risk of very low blood pressure. Alcohol is often thought of as a solution to PE - but it can have the opposite effect.

Side Effect	Priligy (Dapoxetine)	Viagra (Sildenafil)
Headache	Yes	Yes
Dizziness	Yes	Yes
Flushing	Rare	Common
Nasal Congestion	Rare	Rare
Gastrointestinal upset	Possible	Possible

Drinking large amounts can make it hard to get or keep an erection, or make it hard to have an orgasm at all.

Medicine Leaflet Review Manager – Contractor, Pharmacist

Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency, or glucose-galactose malabsorption should not take dapoxetine (Priligy). Most men benefit from dapoxetine (Priligy), but psychological therapies and direct physical treatments can be used at the same time and may increase the benefit. Priligy was first launched in the UK in 2013 and remained under patent until October 2025, so only the drug company Menarini could produce and sell the medicine. When the patent expired, lower cost generic/unbranded versions became available and Menarini decided to no longer market Priligy. Dapoxetine is available on prescription in some NHS health authority areas, usually after specialist referral and advice - please check with your local GP surgery.

Relevance to NICE guidance programmes

NHS doctors will also usually be able to write private prescriptions for dapoxetine (charges will apply). Authored 28 July 2020 by Dr A. Reviewed by Dr C. Pugh, Dr B. Babor Last reviewed 19 June 2023 Last updated 3 December 2025 Editorial policy Tadalafil side effects: how common are they? It also causes low blood pressure so should be avoided when taking Priligy, sildenafil, or tadalafil.

• Priligy works by delaying ejaculation reflex.
• Viagra increases nitric oxide levels to expand blood vessels.
• Both medications require medical consultation prior to use.

Our clinicians can talk you through the options when you make a purchase. If you relax, you’re more likely to stay hard and you’re also less likely to come fast.

I am lactose intolerant - can I take dapoxetine (Priligy)?

It is possible that grapefruit juice will cause the dapoxetine (Priligy) to stay in your system longer, so you should wait 24 hours after drinking grapefruit juice before taking dapoxetine. Grapefruit juice is a weak inhibitor of CYP3A4 gut wall metabolism, which can lead to a rise in levels of many drugs in your blood. Men usually get on well with dapoxetine (Priligy). The most common side effects are dizziness due to lower blood pressure, nausea, and headache. The full list of side effects is in the patient information leaflet.

Clinical Study Supporting the Priligy Viagra Combination

You are more likely to have side effects if taking alcohol, recreational drugs (such as LSD, heroin, methadone), or sleeping tablets at the same time as Priligy. There are some interactions with other drugs and some herbal remedies. The online consultation questionnaire checks if your medication is unsuitable to take with Priligy. Priligy is only licensed for use by men aged between 18 and 64 years. The effectiveness and safety of Priligy has not been established in patients aged 65 years and over. Incorporating relaxation techniques, or discussing it with your partner are steps towards better sex. Try methods like the stop-and-start technique for PE or practise losing and gaining an erection for ED. It’s better to realise they come and go. Squeezing the muscles you use to hold in urine or gas a few times a day, in quick and long bursts, can help you control erections and ejaculations.

Interaction Type	Priligy (Dapoxetine)	Viagra (Sildenafil)
Other serotonergic drugs	Increased risk of serotonin syndrome	Not relevant
CYP3A4 inhibitors	Increased dapoxetine levels	May increase sildenafil levels
Nitrates	Contraindicated	Contraindicated
Alcohol	Can increase side effects	Can cause hypotension, dizziness