Dapoxetine
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| Clinical data | |
|---|---|
| Trade names | Priligy, others (see below) |
| AHFS/Drugs.com | International Drug Names |
| Routes of administration |
Oral (tablets) |
| ATC code | G04BX14 (WHO) |
| Legal status | |
| Legal status |
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| Pharmacokinetic data | |
| Bioavailability | 15–76% (mean 42%), Tmax = 1–1.3 hours |
| Protein binding | >99% |
| Metabolism | Liver (CYP2D6, CYP3A4), kidney (FMO1) |
| Metabolites | Dapoxetine-N-oxide, desmethyldapoxetine, didesmethyldapoxetine |
| Biological half-life | 1.5–1.6 h |
| Excretion | Kidneys |
| Identifiers | |
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| CAS Number |
119356-77-3 129938-20-1 (HCl salt) |
| PubChem (CID) | 71353 |
| IUPHAR/BPS | 7901 |
| ChemSpider | 64453 |
| UNII |
GB2433A4M3 
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| KEGG | D03649 |
| ChEMBL | CHEMBL2106574 |
| Chemical and physical data | |
| Formula | C21H23NO |
| Molar mass | 305.413 g/mol |
| 3D model (Jmol) | Interactive image |
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Dapoxetine, marketed as Priligy and Westoxetin, among and other brands, is the first compound developed specially for the treatment of premature ejaculation (PE) in men 18–64 years old. Dapoxetine works by inhibiting the serotonin transporter, increasing serotonin's action at the post synaptic cleft, and as a consequence promoting ejaculatory delay. As a member of selective serotonin reuptake inhibitor (SSRI) family, dapoxetine was initially created as an antidepressant. However, unlike other SSRIs, dapoxetine is absorbed and eliminated rapidly in the body. Its fast acting property makes it suitable for the treatment of PE but not as an antidepressant.
Originally created by Eli Lilly pharmaceutical company, dapoxetine was sold to Johnson & Johnson in 2003 and submitted as a New Drug Application to the Food and Drug Administration (FDA) for the treatment of PE in 2004. Dapoxetine is sold in several European and Asian countries, and in Mexico. In the US, dapoxetine has been in phase III development since 2003. However, it is expected to be marketed soon. In 2012, Menarini acquired the rights to commercialise Dapoxetine in Europe, most of Asia, Africa, Latin America and the Middle East.
Randomized, double blind, placebo-controlled trials have confirmed the efficacy of dapoxetine for the treatment of PE. Different dosage has different impacts on different type of PE. Dapoxetine 60 mg significantly improves the mean intravaginal ejaculation latency time (IELT) compared to that of dapoxetine 30 mg in men with lifelong PE, but there is no difference in men with acquired PE. Dapoxetine, given 1–3 hours before sexual episode, prolongs IELT, increases the sense of control and sexual satisfaction in men of 18 to 64 years of age with PE. Since PE is associated with personal distress, interrelationship difficulty, dapoxetine provides help for men with PE to overcome this condition. Because lack of specific approval treatment for PE in the US and some other countries, other SSRIs such as fluoxetine, paroxetine, sertraline, fluvoxamine, and citalopram have been used as off label drugs to treat PE. Waldinger's meta analysis shows that the use of these conventional antidepressants increasing IELT from two to ninefold above base line in comparison of three to eightfold when dapoxetine is used. However, these SSRIs must be taken daily in order to achieve meaningful efficacy, and the long half-life increases the risk of the drug accumulation and as a consequence increased of adverse effects such as decreasing sexual libido and causing erectile dysfunction. Dapoxetine, on the other hand, is a fast-acting SSRI. It is rapidly absorbed and eliminated from the body within a few hours. This favorable pharmacokinetics minimizes the risk of the drug's accumulation in the body, and therefore reducing side effects.
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