Active ingredients: Tadalafil and Dapoxetine

Typical strength: 20 mg tadalafil + 60 mg dapoxetine per tablet

Intended use: on-demand management for men with erectile dysfunction (ED) and premature ejaculation (PE). Not for women or for individuals under 18 years old.

Related topics: Erectile dysfunction, premature ejaculation, sexual health. Not designed for athletic performance; see the sport note under Alternatives.

How it works

Tadapox combines two established pharmacologic approaches in one tablet:

  • Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor. By enhancing nitric-oxide mediated vasodilation in penile tissue, it supports a firm erection in response to sexual stimulation. Tadalafil has a longer duration of action, often up to about 36 hours after a dose.
  • Dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSRI) indicated in many countries for premature ejaculation. By modulating serotonin signaling, it helps delay ejaculation and can lengthen time to climax.

Because these mechanisms address different concerns, the combination is aimed at men who need support for both erection firmness and ejaculation control. For safety cautions, jump to Safety information.

Directions for use

Always use as directed by your prescriber. General guidance for on-demand use:

  • Swallow the tablet whole with a full glass of water.
  • You may take it with no food or after a light meal; heavy or high-fat meals may delay effect.
  • Avoid alcohol and grapefruit or grapefruit juice, which can increase side effects or alter drug levels.
  • Plan ahead. Allow time for onset before sexual activity: tadalafil commonly starts to act within about 20 to 60 minutes, and dapoxetine typically begins to help within about 30 to 90 minutes.
  • Do not combine with other erectile dysfunction medicines unless your healthcare provider specifically tells you to.

For dosing and missed dose advice, see Dosage. If you experience dizziness or fainting, lie down and seek medical advice; also review Safety information.

Dosage and missed dose

Follow your clinician's instructions. The combination commonly contains 20 mg tadalafil plus 60 mg dapoxetine in a single tablet taken as needed before sexual activity. Some patients require lower strengths because of age, kidney or liver considerations, or interacting medicines.

Missed dose: Because Tadapox is generally used on an as-needed basis rather than on a fixed schedule, you normally would not "make up" a dose. If you are on a scheduled regimen and a dose is missed, take it when you remember unless it is close to your next planned dose; do not take two doses at once.

Storage

Keep in a dry, dark place at 68 to 77 degrees F (20 to 25 degrees C). Protect from moisture and heat. Store out of reach of children and pets.

More facts

Active ingredients: tadalafil and dapoxetine. Duration of erectile effect from the tadalafil component can be up to around 36 hours. Not everyone should or can use the full-strength combination; your healthcare professional may recommend a different dose or an alternative therapy.

Safety information

Do not use Tadapox if any of the following apply:

  • You take any form of nitrates for chest pain, or use recreational "poppers" such as amyl nitrite or butyl nitrite.
  • You have had a heart attack in the last 90 days, a stroke or severe heart failure in the past 6 months, or you have serious arrhythmias.
  • You have severe liver disease or severe kidney impairment.
  • You are allergic to tadalafil, dapoxetine, or any tablet ingredient.
  • You have uncontrolled low or high blood pressure or other significant, unstable cardiac conditions.

Tell your doctor before use if you have or have had:

  • Any prescription or nonprescription medicines, vitamins, herbal products, or supplements you take regularly.
  • Allergies to medicines, foods, dyes, or preservatives.
  • Blood disorders such as sickle cell anemia.
  • History of kidney or liver problems, stomach or intestinal ulcers, bleeding disorders, or blood vessel disease.
  • Heart disease, prior heart attack or stroke, angina, aortic stenosis, irregular heartbeat, or low blood pressure episodes.
  • Eye problems such as retinitis pigmentosa or a history of sudden vision loss, or ear problems including sudden hearing loss.
  • Mood disorders or a history of mania, as SSRIs can precipitate such symptoms in susceptible individuals.

Important medicine interactions

Serious blood pressure drops and other reactions may occur if you combine Tadapox with certain drugs. Contact your prescriber if you use any of the following:

  • Nitrates such as nitroglycerin or isosorbide, or nitroprusside.
  • Alpha-blockers for prostate or blood pressure (for example, doxazosin, tamsulosin) or other antihypertensives.
  • Strong CYP3A4 inhibitors or inducers that can affect tadalafil or dapoxetine levels; always check before starting or stopping any medicine.

Additional precautions

  • May cause dizziness, drowsiness, or blurred vision. Until you know your response, avoid driving or operating machinery.
  • Alcohol, hot environments, exertion, or fever can worsen lightheadedness or fainting. Stand up slowly; sit or lie down if you feel unwell.
  • Heavy alcohol use while taking Tadapox can increase risks of headache, rapid heartbeat, low blood pressure, and fainting.
  • Chest pain, jaw or shoulder pain, severe dizziness, nausea, numbness, trouble speaking, vision changes, or one-sided weakness may signal a heart attack or stroke. Call emergency services immediately.
  • An erection lasting more than 4 hours (priapism) requires urgent medical attention to prevent long-term injury.
  • Tadapox does not prevent sexually transmitted infections. Use barrier protection (for example, condoms) to reduce STI risk.
  • It does not prevent pregnancy. If pregnancy prevention is desired, use reliable birth control.
  • Do not take other ED treatments at the same time unless directed by your clinician.
  • Older adults may be more sensitive to side effects.
  • Not recommended for women, teenagers, or children under 18.

Possible side effects

Most people tolerate the medicine, but side effects can occur.

Common, often mild effects include:

Headache, flushing, dizziness or lightheadedness, nasal congestion or runny nose, drowsiness, mild back or muscle pain.

Uncommon but serious reactions can include prolonged or painful erection, severe allergic reactions (rash, swelling, trouble breathing), fainting, severe drop in blood pressure, vision or hearing changes, or signs of serotonin-related problems such as agitation, sweating, rapid heart rate, or tremor. Seek medical help right away for severe symptoms.

Alternatives and similar medicines

If a combination tablet is not suitable, clinicians in the USA often consider the following options. Your prescriber will select based on your health status, interactions, and goals:

  • PDE5 inhibitors for ED only: tadalafil (Cialis), sildenafil (Viagra), vardenafil (Levitra), or avanafil (Stendra). These do not treat PE directly but address erection firmness.
  • For PE: daily SSRIs such as paroxetine, sertraline, or fluoxetine may be used off-label in the USA; clomipramine is another option. Dapoxetine itself is not FDA-approved in the USA.
  • Topical anesthetics for PE: lidocaine-prilocaine sprays or creams (for example, OTC lidocaine sprays) can reduce penile sensitivity when used as directed.
  • Behavioral strategies: the pause-squeeze method, start-stop technique, pelvic floor training, and counseling can complement medicines.

Sports note: PDE5 inhibitors are not on the World Anti-Doping Agency prohibited list, but athletes should consult their team doctor for individual guidance and to avoid prohibited combinations. See pricing for these options under Approximate prices in USD.

Approximate prices in the USA (USD)

Prices vary by pharmacy, insurance, coupons, and telehealth programs. The combination product Tadapox is not FDA-approved and is not stocked by licensed U.S. pharmacies; quotes below are for context only.

  • Tadapox (20 mg tadalafil + 60 mg dapoxetine, unapproved in the USA): typically advertised by overseas or international online sellers at about 1 to 6 USD per tablet depending on quantity. Quality and legality are uncertain; see Legal status.
  • Generic tadalafil 20 mg: roughly 1 to 8 USD per tablet cash price with discounts; brand Cialis can exceed 50 to 80 USD per tablet.
  • Generic sildenafil 100 mg: about 0.30 to 3 USD per tablet; brand Viagra often 60 to 90 USD per tablet.
  • Avanafil (Stendra): commonly 20 to 70 USD per tablet depending on strength and program.
  • Vardenafil (generic): often 2 to 10 USD per tablet; brand Levitra can be significantly higher.
  • SSRIs for PE (generic sertraline, paroxetine, fluoxetine): frequently 4 to 15 USD per month with discount plans.
  • Topical anesthetic sprays/creams: approximately 20 to 60 USD per bottle OTC.

These ballpark figures are for information only and may change over time.

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