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Indications & Uses
Prolong (dapoxetine hydrochloride) is used to treat premature ejaculation (PE) in men aged 18 to 64 years who have one or all of the following. Ejaculation that keeps happening, or comes back again and again, with very little sexual stimulation before, during or shortly after penetration, and sooner than the man wishes. Marked personal distress or difficulty with his partner because of PE. Poor control over ejaculation.
Pharmacology
Dapoxetine is thought to work in premature ejaculation by blocking the reuptake of serotonin into nerve cells. This increases the action of serotonin at receptors on both sides of the nerve junction (pre- and post-synaptic). Ejaculation in humans is mainly controlled by the sympathetic nervous system. The pathway starts from a spinal reflex centre, which is mediated by the brain stem. This centre is first influenced by a number of nuclei in the brain (the medial preoptic and paraventricular nuclei).
Dapoxetine is absorbed quickly. The maximum plasma concentration (Cmax) is reached about 1 to 2 hours after taking the tablet. The absolute bioavailability is 42%. In vitro, more than 99% of dapoxetine binds to human serum proteins, and its active metabolite, desmethyl dapoxetine (DED), is 98.5% protein bound. Dapoxetine seems to distribute rapidly, with a mean steady state volume of distribution of 162 L.
The body metabolises dapoxetine extensively into multiple metabolites. The main pathways are N-oxidation, N-demethylation, naphthyl hydroxylation, glucuronidation and sulfation. There was evidence of presystemic first-pass metabolism after oral administration. The metabolites were mainly eliminated in urine as conjugates. Dapoxetine is cleared rapidly, and the terminal half life is about 19 hours.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
For premature ejaculation in adult men aged 18 to 64 years, the recommended starting dose of Dapoxetine is 30 mg. Take it as needed, about 1 to 3 hours before sexual activity. Don't take it more than once every 24 hours. If 30 mg doesn't work well enough and the side effects are acceptable, the dose may be raised to the maximum recommended dose of 60 mg. Dapoxetine can be taken with or without food.
Children and adolescents: Dapoxetine should not be used by anyone below 18 years of age.
Elderly (65 years and over): Safety and efficacy of Dapoxetine have not been established in patients aged 65 years and over, because only limited data are available for this group.
Patients with renal impairment: Take care in patients with mild or moderate renal impairment. Dapoxetine is not recommended for patients with severe renal impairment.
Patients with hepatic impairment: Dapoxetine is contraindicated in patients with moderate and severe hepatic impairment.
Side Effects
Prolong most often causes nausea, dizziness, dry mouth, headache, diarrhea and insomnia. How many people stop taking it because of side effects depends on the dose. Among the 1067 subjects studied, 0.3% stopped on placebo, 1.7% on Prolong 30 mg and 5.3% on Prolong 60 mg. Other SSRIs used for depression are linked with high rates of sexual dysfunction, but Prolong is linked with low rates. When it's taken as needed, its effect on loss of libido (<1%) and ED (<4%) is very mild.
Cautions & Contraindications
Warnings & Precautions
Use with recreational drugs: Patients should be told not to take Prolong together with recreational drugs. Those with serotonergic activity, such as ketamine, methylenedioxymethamphetamine (MDMA) and lysergic acid diethylamide (LSD), may cause potentially serious reactions when combined with it. These reactions include arrhythmia, hyperthermia and serotonin syndrome, but are not limited to them. Recreational drugs with sedative properties, such as narcotics and benzodiazepines, may further increase somnolence and dizziness. Ethanol: Alcohol taken with Prolong may increase alcohol-related neurocognitive effects. It may also worsen neurocardiogenic adverse events such as syncope, which raises the risk of accidental injury. So patients should be advised to avoid alcohol while on treatment. Syncope: Possibly prodromal symptoms such as nausea, dizziness, lightheadedness, palpitations, asthenia, confusion and diaphoresis generally occurred within the first 3 hours after dosing, and they often came before the syncope. Patients need to know that syncope can happen at any time during treatment, with or without prodromal symptoms. Orthostatic hypotension: An orthostatic test should be done before therapy is started. If a patient has a history of documented or suspected orthostatic reaction, treatment with Prolong should be avoided. Haemorrhage: Bleeding abnormalities have been reported with SSRIs. Caution is advised in patients taking Prolong, particularly if they also use medicinal products known to affect platelet function (e.g., atypical antipsychotics and phenothiazines, acetylsalicylic acid, nonsteroidal anti-inflammatory drugs [NSAIDs], anti-platelet agents) or anticoagulants (e.g., warfarin). The same caution applies to patients with a history of bleeding or coagulation disorders. PDE5 inhibitors: A single dose crossover study looked at the pharmacokinetics of Prolong (60 mg) in combination with Tadalafil (20 mg) and Sildenafil (100 mg). Neither Tadalafil nor Sildenafil affected the pharmacokinetics of Prolong. Tamsulosin: Prolong should be prescribed with caution in patients who use alpha adrenergic receptor antagonists, because their orthostatic tolerance may be reduced.
Contraindications
Dapoxetine Hydrochloride must not be given to anyone with a known hypersensitivity to it. It is also not for patients with significant pathological cardiac conditions. These include heart failure (NYHA class ll-IV), conduction abnormalities (second- or third-degree AV block or sick sinus syndrome) that are not treated with a permanent pacemaker, significant ischemic heart disease, or significant valvular disease. Don't use Dapoxetine together with monoamine oxidase inhibitors (MAOIs) or thioridazine, or within 14 days of stopping treatment with MAOIs or thioridazine. The same applies the other way round, so MAOIs and thioridazine should not be given within 7 days after Dapoxetine has been stopped. It is also contraindicated with serotonin reuptake inhibitors [selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs)] and with other medicinal or herbal products that have serotonergic effects. It should not be used within 14 days of stopping treatment with these medicinal or herbal products either.
Pregnancy & Breastfeeding
Dapoxetine Hydrochloride is not meant for use by women. Nobody knows yet whether dapoxetine or its metabolites pass into human breast milk.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
No case of overdose with Dapoxetine Hydrochloride has been reported. In a clinical pharmacology study, daily doses up to 240 mg (two 120 mg doses given 3 hours apart) caused no unexpected adverse events. In general, an overdose of SSRIs produces serotonin-mediated adverse reactions such as somnolence, gastrointestinal disturbances (nausea and vomiting, for example), tachycardia, tremor, agitation and dizziness.
Withdrawal effects
A clinical trial in subjects with PE looked at withdrawal effects after 62 days of daily or as needed dosing with 60 mg Dapoxetine Hydrochloride. It found no evidence of a withdrawal syndrome.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Dapoxetine Hydrochloride tablets below 30°C. Protect them from light and moisture, and keep them out of reach of children.
Drug Interactions
Common questions about X-Ride 60 mg
What is X-Ride 60 mg Tablet?
X-Ride 60 mg Tablet is a medicine that contains Dapoxetine Hydrochloride. It is made by Somatec Pharmaceuticals Ltd. It belongs to the Drugs for Erectile Dysfunction group of medicines.
What is X-Ride used for?
Prolong (dapoxetine hydrochloride) is used to treat premature ejaculation (PE) in men aged 18 to 64 years who have one or all of the following. Ejaculation that keeps happening, or comes back again and again, with very little sexual stimulation before, during or shortly after penetration, and sooner than the man wishes.
What are the side effects of X-Ride?
Prolong most often causes nausea, dizziness, dry mouth, headache, diarrhea and insomnia. How many people stop taking it because of side effects depends on the dose.
Can I take X-Ride during pregnancy or while breastfeeding?
Dapoxetine Hydrochloride is not meant for use by women. Nobody knows yet whether dapoxetine or its metabolites pass into human breast milk. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much X-Ride?
No case of overdose with Dapoxetine Hydrochloride has been reported. In a clinical pharmacology study, daily doses up to 240 mg (two 120 mg doses given 3 hours apart) caused no unexpected adverse events. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store X-Ride?
Keep Dapoxetine Hydrochloride tablets below 30°C. Protect them from light and moisture, and keep them out of reach of children.
Can I take other medicines with X-Ride?
Some medicines can interact with Dapoxetine Hydrochloride, for example: Tamsulosin Hydrochloride, Ethanol 70%, Warfarin Sodium, Premature ejaculation. Tell your doctor or pharmacist about every medicine you take.
Is there a cheaper medicine with the same ingredient?
X-Ride is already among the lowest-priced brands of Dapoxetine Hydrochloride at this strength.
Do I need a prescription for X-Ride?
X-Ride is a prescription (Rx) medicine. Take it as your doctor advises.