Poxet (Dapoxetine) – Comprehensive Guide for Patients in Australia
Basic Product Information
| International Nonproprietary Name (INN) | Dapoxetine hydrochloride |
|---|---|
| Australian Brand Names | PoxetTM (commonly used), PriligyTM (original brand) |
| ATC Code | G04BX14 |
| Available Forms & Strengths | Film-coated tablets: 30 mg, 60 mg |
| Manufacturers | Menarini, Sunrise Remedies, Sun Pharma (varies by brand/generic) |
| Prescription Status | Prescription-only medicine in Australia (Schedule 4/S4, Rx) |
Mechanism of Action
Dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSRI), specifically developed to treat premature ejaculation (PE) in adult men aged 18–64 years. It works by increasing the levels of serotonin in the brain—serotonin helps control ejaculation reflexes. For patients, this means that dapoxetine can help delay ejaculation and improve satisfaction with sexual intercourse.
For Specialists
- Inhibits presynaptic serotonin (5-HT) reuptake, elevating synaptic 5-HT concentrations.
- Acts within the lateral paragigantocellular nucleus (LPGi), strengthening descending serotoninergic inhibition of the ejaculatory reflex arc.
- Pharmacodynamics distinguished by rapid absorption and elimination, specifically suited for “on-demand” use rather than chronic therapy as with other SSRIs.
Pharmacokinetics
- Absorption: Rapidly absorbed; peak plasma levels reached within 1–2 hours after oral administration.
- Metabolism: Extensively metabolised in the liver (CYP3A4, CYP2D6, CYP2C19 pathways); primarily produces inactive metabolites.
- Elimination: Elimination half-life ~1.3–1.5 hours (initial), ~21 hours (terminal); excreted mainly in urine.
- Duration of Action: Clinical effect persists for up to 4–6 hours post-dose—ideal for “as-needed” use before anticipated sexual activity.
Use in Everyday Life and Best Practices
Dapoxetine is designed for men struggling with premature ejaculation, typically defined as ejaculation that always or nearly always occurs within one minute of vaginal penetration, inability to delay ejaculation, and negative personal consequences such as distress or frustration in sexual relationships.
- Typical Use: “On-demand”—take 1–3 hours before anticipated sexual activity, no more than once daily.
- Initial Dose: 30 mg per occasion; may be increased to 60 mg if lower dose is ineffective and side effects are tolerated.
- Not for Everyday Use: Dapoxetine is not intended for continuous daily use, but rather when needed, based on sexual activity frequency.
Prescriptions are required; your Australian GP or urologist will advise on whether dapoxetine is suitable for you, factoring in your health history, other medications, and sexual health needs.
Dosing in the Morning vs Evening
- Dose timing is flexible—morning or evening—depending on when sexual activity is planned.
- Effects begin within 1–2 hours; aim to take the tablet at least 1 hour before sex for optimal results.
- Evening Use: Check for drowsiness; do not drive or operate heavy machinery after taking dapoxetine until you know how it affects you.
- Do not take more than one dose in 24 hours regardless of timing.
Taking With Food or On an Empty Stomach
- Dapoxetine can be taken with or without food—the presence of food does not significantly affect its absorption or action.
- For best tolerability, especially if you experience dizziness or nausea, consider taking with a small meal: this is compatible with typical English diet habits (e.g. light breakfast, sandwich, or main meal).
- Avoid large, fatty meals directly before dosing, as this may slightly delay absorption.
Interaction Warnings
| Substance/Group | Potential Interaction / Precaution |
|---|---|
| Alcohol | Increases risk of drowsiness, dizziness, fainting; increased risk of injury or falls—avoid combination. |
| SSRIs, SNRIs, MAOIs, other antidepressants | Risk of serotonin syndrome—do not combine unless directed by a specialist. |
| St John’s Wort | Can increase side effects—avoid. |
| CYP3A4 Inhibitors (e.g. ketoconazole, ritonavir) | May increase dapoxetine levels—risk of toxicity. |
| CYP2D6 Inhibitors (e.g. fluoxetine, paroxetine) | May increase side effect risk—dose adjustment may be necessary. |
| Nitrates (angina medication) | Risk of severe hypotension—avoid combination. |
| Other Sexual Dysfunction Drugs (e.g. sildenafil, tadalafil, vardenafil) | Use caution; increased risk of hypotension or side effects—seek medical advice before combining. |
Indications
| Type | Details |
|---|---|
| Official Indication (TGA-approved) | Treatment of premature ejaculation (PE) in adult men (18–64 years) with all of the following:
|
| Off-Label Uses | None well-established or routinely approved in Australia. Not recommended for other ejaculation disorders, sexual performance issues without PE, or in women/children. |
Dosing According to Clinical Indications
| Population | Starting Dose | Max Dose | Notes |
|---|---|---|---|
| Adult males (18–64 years) | 30 mg “on demand” | 60 mg (if 30 mg insufficient and tolerated) | Take 1–3 hours prior to sexual activity. Not more than once in 24 hours. |
| Paediatric (under 18) | Not approved / not recommended | — | Safety/efficacy not established |
| Elderly (65+ years) | Not routinely recommended | — | Limited data; consult specialist |
Safety Profile / Side Effects
Most side effects are mild to moderate and dose-dependent. Let your pharmacist or GP know if you experience strong or persistent symptoms.
| Frequency | Possible Side Effects |
|---|---|
| Common (≥1/10) | Nausea, dizziness or lightheadedness, headache, diarrhoea, insomnia, dry mouth, feeling restless or anxious |
| Uncommon (≥1/100 to <1/10) | Blurred vision, sweating, increased blood pressure, fatigue, yawning, indigestion, vomiting, sexual dysfunction |
| Rare (<1/1000) | Seizures, fainting (syncope), mood changes, allergic reactions, thoughts of self-harm—seek urgent help |
| Warnings | May cause sudden drop in blood pressure—rise slowly from sitting/lying position to avoid falls. Not for use in patients with underlying heart conditions, significant psychiatric disorders, or history of fainting. |
Guidelines for Proper Use
- Always take the medicine as prescribed—do not exceed one dose per day.
- If you miss a dose, do not double up; only take if needed, as per your doctor's advice.
- Speak to a doctor before using if you take any regular medication for depression, angina, or blood pressure, or if you have a history of seizures or fainting.
- If you experience blackouts, severe dizziness, or chest pain, seek urgent medical help.
- Store dapoxetine at room temperature, away from moisture and direct sunlight—do not use out-of-date tablets.
- Not suitable for use by women or boys/men under 18.
- Discuss confidential sexual health concerns with your regular pharmacist, GP, or specialist—many clinics in Australia offer discreet sexual health counselling.
Alternative Treatment Options
- Non-drug approaches: Pelvic floor rehabilitation, cognitive behavioural therapy (CBT), the “stop-start” or “squeeze” techniques—often benefit from professional supervision.
- Other medicines:
- SSRIs (off-label): Paroxetine, sertraline, fluoxetine—effective but less convenient (daily use, more side effects, not TGA-approved for PE).
- Topical anaesthetics: Lidocaine/prilocaine sprays, creams—reduce penile sensitivity; effective, but can numb partner or reduce sensation.
- Clomipramine: Occasional use “as needed”; not first-line in Australia due to side effects, limited approval.
Dapoxetine is the only medicine licensed by the TGA specifically for premature ejaculation in adult men in Australia.
Legal, Registration, and Reimbursement Status in Australia
- Regulatory: Registered with the Therapeutic Goods Administration (TGA). Schedule 4 (S4) – Prescription required.
- Not included in: Pharmaceutical Benefits Scheme (PBS)—not reimbursed by Medicare (patients pay full price).
- Prescription: Available by private script through GPs, urologists, or select sexual health clinics. Not available over the counter.
- Importation: Online ordering from overseas suppliers is regulated and should be done through TGA-approved channels.
Latest Research / Clinical Guidance (2022–2025)
Recent peer-reviewed studies and Australian expert consensus (Clinical Urology 2023, Sexual Medicine Reviews 2024) confirm dapoxetine remains first-line pharmacological treatment for premature ejaculation with a moderate-to-large effect size and a robust safety profile when used as directed. Combination therapy (medication plus behavioural therapy) offers the best overall result for many patients. Systematic reviews (see: Syrjanen et al., 2022; Waldinger, 2024) underscore dapoxetine’s unique pharmacokinetics favouring on-demand use, with over 50% of men achieving meaningful improvement. Current guidance (Urological Society of Australia and New Zealand, 2024) continues to recommend dapoxetine where psychological/ behavioural interventions alone are insufficient. No new major safety alerts in recent years.
Availability and Delivery
| Pack Size | Average Price (2024, AUD) | Delivery to Sydney | Delivery to Melbourne | Delivery to Brisbane | Delivery to Perth |
|---|---|---|---|---|---|
| 3 tablets (30 mg) | $28–$38 | 1–2 days | 1–2 days | 2–3 days | 3–4 days |
| 6 tablets (30 mg) | $48–$62 | 1–2 days | 1–2 days | 2–3 days | 3–4 days |
| 12 tablets (30 mg) | $85–$120 | 1–2 days | 1–2 days | 2–3 days | 3–4 days |
| 3 tablets (60 mg) | $45–$55 | 1–2 days | 1–2 days | 2–3 days | 3–4 days |
| 6 tablets (60 mg) | $81–$99 | 1–2 days | 1–2 days | 2–3 days | 3–4 days |
Note: Stock levels and delivery times may vary between pharmacies. Always use a TGA-licensed pharmacy for safety and fast delivery. Some telehealth platforms offer discrete home delivery and video consultation options.
FAQ – Answers to Common Patient Questions
- Can I take Poxet (dapoxetine) with alcohol?
Avoid alcohol while using dapoxetine. Combining the two increases your risk of fainting, dizziness, or accidental injury. - Is dapoxetine safe for daily use?
Dapoxetine is meant for “as needed” use, not daily—take only before planned sexual activity. Do not exceed one dose in 24 hours. - Will dapoxetine affect my fertility or testosterone?
There is no evidence that dapoxetine affects sperm quality or male hormone (testosterone) levels. - What if I miss the timing before sex?
Take dapoxetine one to three hours before intended sexual activity for best results. If you miss the window, wait for your next opportunity. Do not “double up.” - Can I use dapoxetine with erectile dysfunction treatments like Viagra?
Combination is possible but should be supervised by a doctor due to increased risk of side effects (e.g. low blood pressure). Always check with your GP or pharmacist first.
For personalised advice or if you have further questions, speak confidentially with your local Australian pharmacist, GP, or sexual health clinic.
