Description
Tadapox (tadalafil + dapoxetine)
Tadapox combines tadalafil 20 mg with dapoxetine 60 mg in a single tablet, addressing erectile dysfunction and premature ejaculation simultaneously. The two components have different durations: tadalafil’s effects last up to 36 hours; dapoxetine is a short-acting SSRI specifically developed for on-demand use in premature ejaculation, with a much shorter half-life. This pharmacokinetic mismatch is intentional — tadalafil provides the extended window for ED, while dapoxetine acts acutely at the time of dosing to delay ejaculation.
Dosing
One tablet taken 15 to 30 minutes before sexual activity. Maximum one dose per 24-hour period. Tadalafil doesn’t require precise timing beyond “before activity” — the 36-hour window is wide. Dapoxetine’s peak effect is closer to the dose time, so the combination works best when timed for the actual encounter rather than taken many hours ahead.
Tadalafil absorption is not significantly affected by food. Alcohol is contraindicated — the combination of vasodilation from tadalafil and CNS effects from dapoxetine with alcohol increases risk of orthostatic hypotension, dizziness, and syncope.
Nitrates
Tadalafil in this combination is absolutely contraindicated with nitrates in any form — nitroglycerin, isosorbide preparations, amyl nitrate. The resulting blood pressure drop can be severe and fatal. This is not dose-dependent and cannot be made safe by timing adjustment.
Contraindications
All nitrates. Unstable angina or recent cardiac events. Severe hepatic or renal disease. Retinitis pigmentosa. Uncontrolled cardiac rhythm disorders. Under 18 years of age. Dapoxetine is an SSRI — combinations with other serotonergic medications, particularly MAO inhibitors, carry serious interaction risk. A washout period from MAOIs is required before using dapoxetine-containing products.
Side effects
Headache occurs in approximately 11% of users, dyspepsia in around 7%. Muscle pain, nasal congestion, and dizziness are also commonly reported. These are consistent with the individual profiles of each drug. Side effects are typically transient and diminish with continued use.
Sudden vision loss, chest pain, and syncope require immediate evaluation and cessation of the drug.
Priapism — erection lasting more than 4 hours — is a medical emergency. Permanent damage to erectile tissue occurs without prompt treatment.
