Sexual Health Q&A

Can dapoxetine and tramadol be used to treat premature ejaculation (PE)?

Premature ejaculation (PE) occurs when a man ejaculates more quickly than he wants to, usually within one minute of penetration. Men with PE find that they cannot delay their climax and often feel great distress about it. PE may affect their partner’s satisfaction as well.

Two medications – dapoxetine and tramadol – are sometimes used to treat PE.  Where available, these medications may be obtained by prescription and should only be used under a doctor’s care.

Dapoxetine (Priligy)

Dapoxetine is a fast-acting selective serotonin-reuptake inhibitor (SSRI) and was originally developed as an antidepressant. It can be used as an on-demand treatment for PE and is generally taken between one and three hours before sexual activity.

Common side effects of dapoxetine are nausea, dizziness, and headache.

While dapoxetine is available in many parts of the world, it has not been approved for use in the United States.

In June 2015, Italian scientists reported that adding behavioral sex therapy to dapoxetine treatment could be even more effective than dapoxetine alone; however, more research is still needed.

Tramadol

Tramadol is typically prescribed for pain, but some doctors use it “off-label” to treat PE. (“Off label” is a term used when medicine is used for an unapproved purpose.)

While clinical trials have found tramadol to be effective for PE, scientists are concerned about side effects, such as erectile dysfunction (ED), nausea and vomiting, constipation, headache, itching, and drowsiness. Experts are also concerned whether men can become addicted to tramadol or develop breathing problems.

In January 2015, researchers from the United Kingdom published a study analyzing the results of eight tramadol trials. They reported that the trials were of varying quality. There are still questions on the safest and most effective dose as well as the long-term effects of tramadol.

PE can be troublesome for men and for couples. Men who are concerned about ejaculatory problems are encouraged to see their doctor in order to discuss possible treatment alternatives such psychotherapy, topical anesthetic creams and daily or on-demand anti-depressants along with dapoxetine and tramadol.