If you've been prescribed Priligy tablets, or you're weighing up premature ejaculation treatment in the UK, it helps to know what's actually going on. So, how does Priligy work? It uses a fast-acting medicine called dapoxetine to slow down the reflex that triggers ejaculation. And you only take it when you're planning to have sex.
This guide covers how Priligy works, how long it lasts, which dose you're likely to start on and what the trials really showed. We'll also go through the side effects worth knowing about, and who it isn't suitable for.
Premature ejaculation is common, and there are proven treatments that can help. Getting it checked out is a sensible step, not something to feel awkward about.
What is premature ejaculation?
Premature ejaculation (PE) is when you ejaculate sooner than you or your partner would like during sex. It's a common ejaculation problem in men.1
The occasional quick finish is normal and nothing to worry about. It's when it keeps happening and starts to bother you that treatment can help.1
Some men have had PE since they first became sexually active. For others, it starts later on.
Physical factors, such as prostate or thyroid problems, can play a part. So can psychological ones, like stress, relationship worries or anxiety about performance.1
If PE is new for you, mention any recent changes in your health at your consultation. It's worth ruling out a physical cause.
What is Priligy?
Priligy is a prescription-only tablet that contains dapoxetine. It's licensed in the UK to treat PE in men aged 18 to 64.2
Dapoxetine is a selective serotonin reuptake inhibitor (SSRI). That's the same family of medicines as some antidepressants. But unlike other SSRIs, dapoxetine was designed specifically to treat PE.1
Here's what sets it apart. Dapoxetine gets into your bloodstream quickly and clears quickly. That fast-in, fast-out profile is why you take it on demand, rather than every day.2
Priligy comes in two strengths: 30mg and 60mg. Everyone starts on 30mg.2 Which brings us to the main question: how does Priligy work once you've taken it?
How does Priligy work?
Ejaculation is a reflex. It's controlled by your sympathetic nervous system, with signals passing between your brain and a reflex centre in your spinal cord.2
Serotonin is one of the chemical messengers involved. After a nerve cell releases serotonin, a transporter protein normally pulls it back in. Dapoxetine blocks that transporter, so more serotonin stays active between your nerve cells.2
That extra serotonin activity is thought to delay the ejaculation reflex. The result? More time before you ejaculate, and more of a sense of control.
The big difference from antidepressant SSRIs is speed. When those are used for PE, they're taken daily, and it usually takes one to two weeks to notice the full effect.1
Dapoxetine reaches its peak level in your blood about one to two hours after you take it.2
Priligy is designed to be taken for the occasion. You don't need to keep a steady level in your system, as you would with a daily medicine.
How long does Priligy last?
Dapoxetine peaks one to two hours after you take a tablet, then levels fall quickly. Its initial half-life is around one and a half hours.
By 24 hours, less than 5% of the peak level is left in your blood.2
That's why timing matters. You take Priligy one to three hours before you expect to have sex, so the medicine is working when you need it.2
A small amount lingers for longer, with a terminal half-life of around 19 hours.2
Get the timing right and you'll give Priligy its best chance. Aim for that one to three hour window, rather than taking it at the last minute.
Who can take Priligy?
Priligy isn't right for every man with PE, which is why you'll need a consultation first. It's licensed for men who meet all of the following criteria:2
- You usually ejaculate in less than two minutes after penetration
- It happens with minimal stimulation, before, on or shortly after penetration, and before you want it to
- You have poor control over when you ejaculate
- It causes you marked distress or problems in your relationship
- It's happened in most of your attempts at sex over the past six months
You should not take Priligy if you have certain heart problems, such as heart failure, heart rhythm problems, or significant heart valve or coronary heart disease. It's also not suitable if you have a history of fainting, mania or severe depression, or moderate to severe liver problems.2
Other medicines matter too. Priligy must not be taken with other SSRIs, SNRIs, tricyclic antidepressants, MAOIs or thioridazine.
The same goes for other medicines with serotonin effects, such as triptans for migraine, tramadol, lithium, linezolid and St John's wort. It also must not be taken within 14 days of stopping any of them.2
The gap works the other way too. If you stop Priligy, wait at least 7 days before starting any of these medicines.2 Do not stop or change a prescribed medicine to fit around Priligy without speaking to your prescriber first.
Priligy must not be combined with strong CYP3A4 inhibitors either. That group includes the antifungals ketoconazole and itraconazole and some HIV medicines.2
And it should not be used alongside erectile dysfunction tablets such as sildenafil (Viagra) or tadalafil (Cialis). The combination can make your blood pressure drop when you stand up.2
Before you start, your prescriber should check your blood pressure and pulse both lying down and standing up.2
Be completely open about every medicine you take, including herbal remedies and anything bought over the counter. Several common ones rule Priligy out.
Priligy 30mg or 60mg: which dose is right?
Everyone starts on Priligy 30mg. You take one tablet one to three hours before you expect to have sex. Swallow it whole with at least one full glass of water, as it tastes bitter if you chew it.2
If 30mg isn't doing enough, and you haven't had moderate or severe side effects or signs of fainting, your prescriber may move you up to Priligy 60mg. Side effects are more common and can be more severe at the higher dose.2
Pharmica's consultation asks whether you have already used Priligy 30mg at least four times without side effects but with too little benefit. That is a screening question, not a promise of 60mg. A prescriber must still review your safety and how you responded.
A few rules apply whatever your dose:2
- Do not take more than one tablet in 24 hours
- Do not take it every day, only when you're expecting to have sex
- Do not drink alcohol with it, as the combination makes drowsiness, dizziness and fainting more likely
- Do not have grapefruit juice in the 24 hours before a dose, as it can raise the level of dapoxetine in your blood
Do not take a second tablet if the first one does not seem to have worked. Wait at least 24 hours, and speak to your prescriber if it keeps happening.
Does Priligy work the first time?
It can. Because dapoxetine peaks within one to two hours, it's active from your very first dose.2
But results vary from man to man. That's why the licence builds in a review after your first four weeks or six doses, to check Priligy is helping and is still the right choice. After that, it's reviewed at least every six months.2
Nerves play a part as well. Anxiety about performance is a common cause of PE, so a tense or rushed first try might not show you what Priligy can really do.1
Disappointing first go? Do not change your dose yourself. Speak to your prescriber, who can review how you're getting on.
Give Priligy a fair trial over several occasions. One evening rarely tells you the whole story.
How effective is Priligy?
The main evidence comes from five large, randomised, placebo-controlled trials involving more than 6,000 men.3
Researchers timed ejaculation with a stopwatch. At the start, men in every group ejaculated after about 0.9 minutes on average. After 12 weeks, the average times had risen to these figures:3
- Placebo - about 1.9 minutes
- Priligy 30mg - about 3.1 minutes
- Priligy 60mg - about 3.6 minutes
Both doses also improved men's sense of control, satisfaction with sex and distress about PE more than placebo did.3
You'll notice the placebo group improved too. That's a reminder of how much reduced anxiety and growing confidence can help. Priligy's effect comes on top of that.
Keep your expectations realistic, though. Averages hide a lot of variation, and how much extra time you gain depends partly on your starting point.2
A 2021 Cochrane review of SSRIs for PE, including dapoxetine, found they may delay ejaculation compared with placebo, but they also cause more side effects.4
What are the side effects of Priligy?
Like all medicines, Priligy can cause side effects, and they're more likely at 60mg. Here's how often the main ones were reported at 30mg in trials:2
- Nausea - very common, reported by around 11% of men
- Dizziness - common, around 5.8%
- Headache - common, around 5.6%
- Diarrhoea - common, around 3.5%
- Insomnia - common, around 2.1%
- Fatigue - common, around 2.0%
Nausea and dizziness were the side effects most likely to make men stop treatment.2
Fainting is the one to take seriously. It's uncommon, but it has happened, usually in the first three hours after a dose. Warning signs include feeling sick, dizzy or light-headed, sweating, palpitations or confusion.2
If you notice these, lie down with your head lower than the rest of your body, or sit with your head between your knees until they pass. Do not drive or use machinery if you feel dizzy or faint. Staying well hydrated is important too.2
Fainting on Priligy can happen with little or no warning. Take it somewhere you can sit or lie down quickly if you need to.
If you notice low mood or other signs of depression while taking Priligy, stop taking it and speak to your prescriber.2
Using Priligy with behavioural techniques
Priligy treats PE, but it doesn't cure it. It won't tackle the things that can sit behind PE, such as anxiety, stress or relationship worries.
That's where behavioural techniques come in. The NHS describes two well-known ones:1
- Stop-go technique - you stop stimulation just before the point of ejaculation, wait, then start again
- Squeeze technique - the same idea, but you squeeze the head of your penis for 10 to 20 seconds before carrying on
They take plenty of practice. A psychosexual therapist can guide you through them and help with any relationship issues.
If you're seeking treatment, it's usually recommended that you involve your partner as much as you can.1
There's no reason you can't do both. Priligy can help in the moment while you practise techniques that don't depend on a tablet.
Talking to your partner about PE can really help. It's something you can tackle together, rather than on your own.
When should you seek medical advice?
Speak to your prescriber or GP if:
- You faint, or feel very dizzy or light-headed, after taking Priligy
- Side effects don't settle or are affecting your daily life
- Priligy isn't helping enough after several tries on 30mg
- You're starting any new medicine, including antidepressants, antifungals, HIV treatments or herbal remedies
- You notice low mood, mood swings or other changes in your mental health
New medicines and Priligy do not always mix. Check with a pharmacist before starting anything new, even something you've picked up over the counter.
You'll find the full list of side effects, warnings and interactions in the patient information leaflet that comes with your tablets.
Frequently asked questions
Can you take Priligy with Viagra?
No, Priligy should not be used alongside erectile dysfunction tablets such as sildenafil (Viagra) or tadalafil (Cialis). Taken together, they can make it harder for your body to keep your blood pressure steady when you stand up, which raises the risk of dizziness and fainting. If you have erectile dysfunction as well as PE, speak to your prescriber about the right treatment for you.
Can you drink alcohol with Priligy?
No, you should avoid alcohol while taking Priligy. Alcohol doesn't change how much dapoxetine gets into your blood, but the two together make you drowsier, slow your reactions and increase the chance of dizziness and fainting. That raises your risk of falling and hurting yourself. If you're planning to drink, do not take Priligy that day.
Is Priligy available over the counter?
No. Priligy is a prescription-only medicine in the UK, so you can't buy it off the shelf. You'll need a consultation with a prescriber first, through your GP or a regulated online pharmacy. Some local NHS areas do prescribe it. The consultation matters, because your prescriber needs to check your health, your other medicines and whether you meet the criteria for treatment.
Can you take Priligy every day?
No. Priligy is designed for on-demand use only, so you take it one to three hours before you expect to have sex, not as a daily tablet. You should never take more than one tablet in 24 hours. If you feel you need treatment more often than this, speak to your prescriber, who can review whether Priligy is still the best option for you.
Does Priligy cure premature ejaculation?
No, Priligy treats premature ejaculation rather than curing it. It helps delay ejaculation on the occasions you take it, but the effect wears off as the medicine leaves your system. You can combine it with behavioural techniques, such as the stop-go or squeeze technique, or with psychosexual counselling, which can help with the underlying causes over time.
Is Priligy an antidepressant?
Not exactly. Dapoxetine belongs to the same family as some antidepressants, called SSRIs, but it isn't used to treat depression. It was developed specifically for premature ejaculation and works much faster than antidepressant SSRIs. Because of this overlap, Priligy must not be taken alongside other SSRIs or certain other antidepressants, and it isn't suitable if you have a history of severe depression or mania.
References
- NHS. Ejaculation problems. NHS website; 2023. nhs.uk
- A. Menarini Farmaceutica Internazionale SRL. Priligy 60 mg film-coated tablets: Summary of Product Characteristics. Medicines and Healthcare products Regulatory Agency; 2021. products.mhra.gov.uk
- McMahon CG, Althof SE, Kaufman JM, et al. Efficacy and Safety of Dapoxetine for the Treatment of Premature Ejaculation: Integrated Analysis of Results from Five Phase 3 Trials. The Journal of Sexual Medicine. 2011;8(2):524-539. doi:10.1111/j.1743-6109.2010.02097.x
- Sathianathen NJ, Hwang EC, Mian R, et al. Selective serotonin re-uptake inhibitors for premature ejaculation in adult men. Cochrane Database of Systematic Reviews. 2021;(3):CD012799. doi:10.1002/14651858.CD012799.pub2
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.