Diabetes-induced erectile dysfunction: Epidemiology, pathophysiology dapoxetin sildenafil and management J Diabetes Complications. Hicks CW, Wang D, Windham BG, Selvin E. Association of peripheral neuropathy with erectile dysfunction in US men Am J Med. Redrow GP, Thompson CM, Wang R. Treatment strategies for diabetic patients suffering from erectile dysfunction: An update Expert Opin Pharmacother.
Side Effects of Tadalafil and Dapoxetine
The study investigated the frequency of IIEF scores in 216 men suffering from T2DM. Approximately 41% of the subjects included in this study reported lower than normal SD scores which is a clear indication of ED. This finding resonated with reports published in several previous studies. Two studies, one from the Netherlands and another from the United States indicated that 41.3% and more than 50% of the subjects respectively reported prevalence of ED. [,] Thus, low SD is a clear indicator of ED in individuals with DM.
Q2: Can Dapoxetine + Tadalafil be taken daily?
The findings of the current study showed that age is significantly associated with ED in individuals with T2DM which is known from the fact that the prevalence of severe ED increases with age. [] Secondly, obesity is also one of the risk factors for developing ED. [] Among all subjects enrolled in the current study, 187 (86.6%) had a BMI of more than cut-off of 23 kg/m2 and these subjects showed significantly lower SD values as compared to the individuals with cut-off or lower than cut-off BMI. A similar observation was also made for other clinical parameters except cholesterol. Reported SD values are significantly lower in subjects who also exhibit imbalanced metabolic profile with high HbA1c, low testosterone, low VitB12, high triglyceride, low HDL, and high LDL.
Who should not use tadalafil?
The lipid profile is also a pressing cause of concern in aggravating ED. Findings in this study demonstrate that an imbalance in triglycerides, HDL, and LDL affect the OS scores significantly. Interesting to note is the fact that a raised cholesterol level does not by itself have a direct adverse effect on any of the five domains of the IIEF scores. Next, the investigation demonstrates that the prevalence of ED using the IIEF is (more than 50%) higher in men with DM as observed from the HbA1c results. Among 216 participants with sexual dysfunction enrolled in this study, 136 (62.9%) had a higher HbA1c level (7.6–16%). Hatzimouratidis K, Hatzichristou D.
| Parameter | Tadalafil | Dapoxetine |
|---|---|---|
| Absorption | Rapid, peak in 2 hours | Rapid, peak in 1-3 hours |
| Bioavailability | ~80% | ~99% |
| Half-life | 17.5 hours | 15 hours |
| Metabolism | Liver (CYP3A4 enzyme) | Liver (CYP2D6, CYP3A4) |
| Excretion | Feces (61%), urine (36%) | Urine (~95%) |
How to treat erectile dysfunction in men with diabetes: From pathophysiology to treatment Curr Diab Rep. 2014;14:545.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Cialis Professional | 20mg | 120 + 4 Pills | 291.68€ 277.79€ | |
| Priligy Generic Dapoxetine | 60mg | 20 + 4 Pills | 77.31€ 73.63€ | |
| Levitra Professional | 20mg | 20 Pills | 101.00€ 96.19€ | |
| Cialis Professional | 40mg | 180 + 4 Pills | 618.23€ 588.79€ | |
| Kamagra 100 mg | 100 mg | 12 Pills | 55.64€ 52.99€ | |
| Priligy Generic Dapoxetine | 60mg | 10 Pills | 47.63€ 45.36€ | |
| Priligy Generic Dapoxetine | 60mg | 60 + 8 Pills | 183.06€ 174.34€ | |
| Priligy Generic Dapoxetine | 60mg | 120 + 10 Pills | 341.26€ 325.01€ | |
| Priligy Generic Dapoxetine | 60mg | 90 + 10 Pills | 265.64€ 252.99€ | |
| Super Kamagra | 160 mg | 152 + 8 Pills | 729.11€ 694.39€ | |
| Priligy Generic Dapoxetine | 60mg | 180 + 10 Pills | 494.76€ 471.20€ | |
| Priligy Generic Dapoxetine | 60mg | 30 + 6 Pills | 106.65€ 101.57€ | |
| Viagra Generic | 100mg | 90 + 6 Pills | 129.02€ 122.88€ |
Phosphodiesterase-5 (PDE5) inhibitors in the management of erectile dysfunction P T. 2013;38:407–19 Tadalafil in the treatment of erectile dysfunction Ther Clin Risk Manag.
Conflict of interest statement
Dr. Amol Chaudhari and Dr. Dhruvi Hasnani performed statistical analysis on the collected data, wrote and reviewed the manuscript. Vibhuti Jain Rana, Nishtha Singh, and Pusala Lakshmi Prasanna from Neovation Consultancy Services Pte. Ltd., Singapore, for assisting with statistical analysis and manuscript revision.
Basic questions to ask your doctor
Sexual dysfunction in men with type II diabetes Caspian J Intern Med. Definition, classification and diagnosis of diabetes mellitus Exp Clin Endocrinol Diabetes. Al-Saeed AH, Constantino MI, Molyneaux L, D’Souza M, Limacher-Gisler F, Luo C, et al An inverse relationship between age of type 2 diabetes onset and complication risk and mortality: The impact of youth-onset type 2 diabetes Diabetes Care. Colson M, Cuzin B, Faix A, Grellet L, Huyghes E. Current epidemiology of erectile dysfunction, an update Sexologies. Recent advances in the understanding and management of erectile dysfunction F1000Res. Treatment options for erectile dysfunction Endocrinol Metab Clin North Am. The effectiveness of psychological interventions for the treatment of erectile dysfunction: Systematic review and meta-analysis, including comparisons to sildenafil treatment, intracavernosal injection, and vacuum devices J Sex Med. Current diagnosis and management of erectile dysfunction Med J Aust. Etiology of erectile dysfunction and duration of symptoms in patients undergoing penile prosthesis: A systematic review Sex Med Rev. Dapoxetine: A new option in the medical management of premature ejaculation Ther Adv Urol.
- Always consult a healthcare provider before starting these medications.
- Do not drink alcohol when taking tadalafil or dapoxetine, to reduce risks.
- Tadalafil can be used by men with diabetes or prostate issues.
- Dapoxetine is intended for men aged 18-64 with premature ejaculation.
- Patients should report any prolonged erections exceeding 4 hours.
- These drugs are not suitable for women or children.
Efficacy and safety of dapoxetine/sildenafil combination tablets in the treatment of men with premature ejaculation and concomitant erectile dysfunction-DAP-SPEED study Int J Impot Res. Dresser M, Desai D, Gidwani S, Seftel A, Modi N. Dapoxetine, a novel treatment for premature ejaculation, does not have pharmacokinetic interactions with phosphodiesterase-5 inhibitors Int J Impot Res. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction Int J Impot Res.
- Tadalafil is effective for up to 36 hours, offering flexibility.
- Dapoxetine provides quick relief from pre-ejaculation symptoms.
- Both medications may be part of a comprehensive sexual health plan.
- Regular dosing of tadalafil can help in managing chronic erectile issues.
- Dapoxetine should be used exactly as prescribed, not more frequently.
- Patients should monitor their response and report adverse effects.
Evidence-based multiple action points for public awareness, screening, and treatment: An extension of Asian-Pacific recommendations Asia Pac J Clin Nutr. Obesity and erectile dysfunction: From bench to clinical implication World J Mens Health.
- Tadalafil's effects are influenced by age, health, and other medications.
- Dapoxetine's effectiveness depends on proper timing and adherence.
- Tadalafil can be used in men with stable cardiovascular health.
- Dapoxetine may require dose adjustments for elderly patients.
- Combining tadalafil with dapoxetine increases careful monitoring is needed.
- Always report any unusual symptoms or side effects to healthcare providers.
Nehra A.
Regulatory history
The treatment of individuals with T2DM with Tadalafil and Tadalafil + Dapoxetine drug combination shows promising results in improving ED, as analyzed using the IIEF questionnaires. However, no clear advantage of combination of the two drugs was observed. This study lays the foundation of long-term prospective clinical studies to validate the efficacy of using Tadalafil + Dapoxetine drug combination in managing ED in individuals with T2DM. The findings of this study also outline the pressing need of careful examination of sexual dysfunction in healthcare clinics for diabetic individuals. Increased awareness through routine screening for ED can contribute to the timely diagnosis and effective treatment of ED especially in elderly population.
Adverse Drug Reactions (ADR)
The authors of this study do not have any conflicts of interest with publication of the manuscript or an institution or product that is mentioned in the manuscript and/or is important to the outcome of the study presented. Dr. Amol Chaudhari is also a part of the scientific department at Neovation Consultancy Services Pte. Dr. Vipul Chavda conceived the idea and design for the study and overlooked the entire study until completion.
Full Text Sources
Dr. Santosh Jha made major contributions in drafting the manuscript and statistical analysis. Dr. Tejal Gandhi and Anjali Patel conducted manuscript editing and reviewing. Literature search and clinical data collection was done by Hiren Raninga. Erectile dysfunction and cardiovascular disease: Efficacy and safety of phosphodiesterase type 5 inhibitors in men with both conditions Mayo Clin Proc.
| Contraindication | Tadalafil | Dapoxetine | Notes |
|---|---|---|---|
| Nitrate use | Absolutely contraindicated | Not recommended | Risk of severe hypotension |
| Severe Liver Impairment | Caution | Caution | Dose adjustments may be needed |
| Concurrent use of other SSRIs | Not recommended | Contraindicated | Risk of serotonin syndrome |
| Heart Disease | Caution | No specific contraindications | Consult doctor before use |
The association between erectile dysfunction and cardiovascular risk in men with Type 2 diabetes in primary care: It is a matter of age J Diabetes Complications. Seftel AD, Sun P, Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction J Urol. Nakanishi S, Yamane K, Kamei N, Okubo M, Kohno N. Erectile dysfunction is strongly linked with decreased libido in diabetic men Aging Male. Fedele D, Coscelli C, Santeusanio F, Bortolotti A, Chatenoud L, Colli E, et al Erectile dysfunction in diabetic subjects in Italy.
Article Type
Higher HbA1c levels are associated with ED which was also observed in another study. [] In addition, testosterone hormone is responsible for normal sexual functioning such as erection and for sexual desire or libido. Among all study participants, 61.9% were found to have a low level of testosterone. Furthermore, the effect of hypogonadism on reduced libido and DM is supported by several studies. [,] Besides, conditions such as metabolic syndrome and atherogenic dyslipidemia are also associated with ED among diabetic men.
Q4: Who should not take Dapoxetine + Tadalafil?
[] Among the study participants, 57.8% had high triglyceride levels and 25.4% of subjects had low levels of HDL. This study also presents noteworthy findings when the participants were subjected to Tadalafil or the combination of Tadalafil + Dapoxetine. There was no indication of superiority of either. Both Tadalafil and Tadalafil + Dapoxetine improved most of the IIEF parameters. Thus, there appears to be no masking effect on the efficacy of Tadalafil when it is used in combination with Dapoxetine.
Generic Names
Moreover, the Tadalafil + Dapoxetine combination improved all the IIEF parameters for subjects with high BMI except for SD. In subjects with co-morbidities, the use of either Tadalafil or Tadalafil + Dapoxetine drug combination was shown to significantly enhance all the IIEF scores, suggesting a strong correlation between comorbidities and ED. The findings of the present study highlight the high prevalence of ED in men suffering from T2DM. An imbalanced physiological profile, such as higher BMI, higher HbA1c, lower testosterone, disturbed lipid profile, and a lower VitB12 level is reported to be major contributors to ED. In addition to this, the presence of comorbidities such as hypertension, dyslipidemia, and coronary artery disease further elevates the odds of developing ED. Tadalafil and Dapoxetine are found to be the two active ingredients that are responsible for giving men a break from sexual weakness. Yes, they are proven to be the best oral medicine for overcoming erectile dysfunction. But alongside that, premature ejaculation is also controlled by its consumption.
| Medication | Indications | Approved by FDA | Common off-label use |
|---|---|---|---|
| Tadalafil | Erectile Dysfunction, BPH | Yes | Pulmonary Hypertension |
| Dapoxetine | Premature Ejaculation | Yes | Off-label for sexual therapy |
| Combined Therapy | ED + PE | No | Enhancement in sexual activity |
As Tadalafil is found to belong to the class of drugs PDE-5 inhibitors, which mainly help to improve the flow of blood in the penis. Whereas the role of Dapoxetine is a selective serotonin reuptake inhibitor that helps to delay the ejaculation process. No doubt, the combination of the medicines allows men to overcome and balance their sexual lives quickly and without getting stressed or delayed.
- Tadalafil is a medication used to treat erectile dysfunction and BPH.
- Dapoxetine is prescribed for premature ejaculation in men.
- Tadalafil has a long duration, up to 36 hours of efficacy.
- Dapoxetine acts as a selective serotonin reuptake inhibitor (SSRI).
- Both drugs may have side effects like headaches and dizziness.
- Combining these medications should be done under medical supervision.
The use of Tadalafil and Dapoxetine is found to be helpful for men only, and this makes them withstand (during intercourse) and obtain complete pleasure. Tadalafil is a medicine that helps to fight and control erectile dysfunction. Men, at the time of obtaining pleasure, do not have to think twice. But one dose before making love will help overcome weakness.