Premature ejaculation is one of the most common sexual health concerns in men, and one of the most treatable. If you're looking for a clinically proven premature ejaculation treatment in the UK, or you've been prescribed Priligy tablets (dapoxetine) and want to understand how they work, this guide covers the mechanism, dosage, side effects, and who the treatment is suitable for.
What Is Premature Ejaculation?
Premature ejaculation (PE) is defined clinically as persistent or recurrent ejaculation that occurs before, on, or shortly after penetration, and sooner than the man or his partner would wish. The condition is also associated with a lack of control over ejaculation and personal distress as a result.
PE is the most common ejaculation problem in men. European guidelines on male sexual dysfunction report prevalence rates of between 20% and 30%, though most estimates in clinical practice suggest the figure is lower when strict diagnostic criteria are applied.1 Despite how common it is, very few men seek treatment.
There are two recognised types: lifelong (primary) PE, which occurs from the first sexual experience onwards, and acquired (secondary) PE, which develops after a period of normal ejaculatory function. The causes of PE are not fully understood, but both psychological and neurobiological factors are thought to play a role.
What Is Priligy and What Does It Contain?
Priligy is a prescription-only tablet containing dapoxetine hydrochloride. It is the only medicine currently licensed in the UK specifically for the treatment of premature ejaculation in adult men aged 18 to 64.3
Dapoxetine belongs to a class of medicines called selective serotonin reuptake inhibitors (SSRIs), the same family used in antidepressants. However, dapoxetine differs from conventional antidepressant SSRIs in one important way: it is very rapidly absorbed and then eliminated from the body within a few hours. This fast-in, fast-out profile is what makes Priligy tablets suitable for on-demand use rather than daily dosing.2
Priligy is available in two strengths: 30mg (the standard starting dose) and 60mg (used if the 30mg dose proves insufficient and has been well tolerated).
How Does Priligy (Dapoxetine) Work?
Dapoxetine works by inhibiting the serotonin transporter, which is the protein responsible for removing serotonin from the spaces between nerve cells. By blocking this reuptake process, it increases serotonin availability at nerve synapses, which appears to delay the ejaculatory reflex.2
Ejaculation is regulated by a complex pathway involving the brain, spinal cord, and sympathetic nervous system. Serotonin plays a key role in this process, and lower serotonin activity in certain brain regions is associated with faster ejaculation. Unlike daily antidepressant SSRIs, which require weeks to build therapeutic levels, dapoxetine reaches peak concentration within one to two hours of taking a tablet and is largely cleared within a few hours. This is why Priligy tablets are taken on demand, shortly before anticipated sexual activity, rather than every day.
Who Is Priligy Suitable For?
Priligy is not suitable for every man who experiences premature ejaculation. If you are considering premature ejaculation treatment in the UK, a clinical assessment is required before prescribing. The prescribing information states that Priligy should only be used by men who meet all of the following criteria:2
- An intravaginal ejaculatory latency time (IELT) of less than two minutes, meaning ejaculation consistently occurring within two minutes of penetration
- Persistent or recurrent PE with minimal stimulation before or shortly after penetration
- Marked personal distress or interpersonal difficulty as a result
- A history of PE in the majority of sexual encounters over the prior six months
Priligy is licensed for men aged 18 to 64 only, and should not be used as a daily preventive measure.
There are also important contraindications. Priligy should not be taken by men with significant heart conditions, moderate to severe liver impairment, or a history of mania or schizophrenia. It should not be used alongside other SSRIs, SNRIs, tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), or thioridazine. Combining Priligy with PDE5 inhibitors (such as sildenafil or tadalafil) requires caution due to an increased risk of low blood pressure on standing.2 Your prescriber will assess your suitability before issuing a prescription.
Priligy Dosage: 30mg or 60mg?
The recommended starting dose is Priligy 30mg, taken one to three hours before anticipated sexual activity. Always take it with at least one full glass of water, as this helps reduce the risk of dizziness and fainting, which are among the most commonly reported side effects.5
If Priligy 30mg does not provide sufficient improvement after a reasonable trial and has been well tolerated without significant side effects, your prescriber may increase the dose to 60mg. You should never take more than one tablet within any 24-hour period.
Priligy tablets are designed for on-demand use only. They should not be taken daily as a preventive measure, and there is no clinical benefit to taking them on days when sexual activity is not anticipated.
Do not drink alcohol when taking Priligy. Alcohol can intensify the sedative effects and significantly increase the risk of fainting. Similarly, avoid grapefruit juice for at least 24 hours before taking a tablet. Compounds in grapefruit can raise the amount of dapoxetine in your bloodstream and increase the risk of side effects.2
Does Priligy Work the First Time?
For many men, yes. Dapoxetine reaches peak concentration within one to two hours of taking a tablet, and its effect on delaying ejaculation can be noticeable from the first dose. However, individual response varies, and some men find the experience improves as they become more comfortable with the treatment and less anxious about performance.
The clinical trial data shows that men taking dapoxetine 30mg on demand increased their mean time to ejaculation from approximately 0.9 minutes at baseline to approximately 1.9 minutes at 12 weeks. NICE's evidence summary confirms statistically significant improvements versus placebo across multiple outcomes, including perceived control and sexual satisfaction.3
Bear in mind that Priligy works best when performance anxiety is not overriding the pharmacological effect. If you find the first experience disappointing, discuss this with your prescriber rather than stopping treatment abruptly.
How Effective Is Priligy for Premature Ejaculation?
The evidence for dapoxetine comes from a pooled analysis of five large, randomised, double-blind, placebo-controlled trials covering more than 6,000 men. At 12 weeks, men taking dapoxetine 30mg on demand increased their mean intravaginal ejaculatory latency time (IELT) from approximately 0.9 minutes to approximately 1.9 minutes. Those on 60mg increased to approximately 3.6 minutes. Both doses produced statistically significant improvements compared to placebo across IELT, perceived control over ejaculation, satisfaction with sexual intercourse, and ejaculation-related personal distress.4
Men in the placebo group also improved, from around 0.9 to approximately 1.9 minutes at 12 weeks. This underlines the role that psychological factors can play in PE management. Dapoxetine’s effect is additive to this baseline improvement.
Priligy Side Effects: What to Expect
The most commonly reported Priligy side effects in clinical trials were dose-related and typically mild to moderate in severity. For the 30mg dose:2
- Nausea – reported in around 11% of men in trials
- Dizziness – reported in around 5.8% of men in trials
- Headache – reported in around 5.6% of men in trials
- Diarrhoea – reported in around 3.5% of men in trials
- Insomnia – reported in around 2.1% of men in trials
Side effects were generally more frequent at the 60mg dose. The most common reasons men stopped taking Priligy tablets in trials were nausea (2.2%) and dizziness (1.2%).
Dizziness and fainting (syncope) are of particular clinical concern. Before prescribing, your clinician should check your blood pressure both lying down and standing. Be aware of warning signs such as light-headedness when standing, and sit or lie down if you feel faint after taking a tablet. Do not drive or operate machinery if you experience these symptoms.2
Priligy and Behavioural Techniques: Using Both Together
Priligy is a prescription treatment for PE, not a permanent cure. The underlying causes, including psychological factors such as anxiety, performance pressure, or relationship difficulties, are not addressed by dapoxetine alone.
Clinical guidance generally recommends that men explore behavioural and psychological approaches alongside, or instead of, medication where appropriate. Established techniques include the stop-start method, the squeeze technique, and psychosexual counselling. Some men find that using Priligy to reduce performance anxiety gives them the confidence to gradually reduce their reliance on medication over time.
Speak to your GP or a psychosexual therapist if you feel psychological factors are contributing to your PE.
When to Seek Further Advice
Contact your prescribing clinician or GP if:
- You experience fainting, significant dizziness, or a drop in blood pressure after taking Priligy
- Side effects persist or significantly affect your day-to-day wellbeing
- Priligy tablets do not provide sufficient improvement after a reasonable number of attempts on the 30mg dose
- You start taking any new prescription medication that may interact with dapoxetine, including antidepressants, antifungals, or HIV treatments
- You experience mood changes or mental health symptoms you were not experiencing before starting treatment
A full list of side effects, contraindications, and drug interactions is available in the patient information leaflet supplied with your medication.
References
- Hatzimouratidis K, et al. EAU Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. European Association of Urology. 2014.
- Electronic Medicines Compendium (eMC). Priligy 30mg and 60mg film-coated tablets: Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/1269/smpc
- National Institute for Health and Care Excellence (NICE). ESNM40: Premature ejaculation: dapoxetine. May 2014. Available at: https://www.nice.org.uk/advice/esnm40
- McMahon CG, et al. Efficacy of dapoxetine in the treatment of premature ejaculation: a pooled analysis of phase III randomised controlled trials. Journal of Sexual Medicine. 2011;8(4).
- British National Formulary (BNF). Dapoxetine. Available at: https://bnf.nice.org.uk/drugs/dapoxetine/
This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.
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