Uses

Premature Ejaculation (PE)

PE refers to a male sexual condition where the ejaculatory process occurs earlier than required, either before or immediately after penetration. A shorter ejaculatory time is not the only defining factor of PE. The diagnosis of PE requires three main conditions:

1. Shorter ejaculatory time (~less than 1 minute)
2. Inability to delay ejaculation
3. Negative psychological conditions 

PE can occur due to psychological issues (stress, depression, performance anxiety, etc) or biological factors (impaired neurotransmitter function, hormonal imbalance, genetic predisposition, prostatis, or urogenital infections). 

Dosage Information

Recommended Dose:

• Generally, the starting dose of Dapoxetine is 30 mg. 
• Based on the effectiveness of the drug and individual tolerability, the dapoxetine dose can be increased to 60 mg (Prejac 60 mg).
• Take a single tablet of Prejac 60 mg at least 1- 3 hours before intended sexual activity.

Maximum Dose Limit:

• 1 tablet of Projec 60 mg (60 mg of dapoxetine) in 24 hours.

Missed Dose Instructions:

• Prejac 60 mg is prescribed only for on-demand use. Hence, there are no missed dose instructions for this medication.

Overdose Instructions:

• In case of Prejac 60 mg overdose, individuals must immediately report to their healthcare providers.
• If symptoms like Nausea, vomiting, dizziness, or agitation occur, they must immediately seek medical attention.

How Prejac 60mg (Depoxetine HCI Tab) Works

The ejaculatory process works by a series of coordinated neurological reactions involving the brain, spinal cord, and the peripheral nervous system. When there is a trigger (sexual stimulation), the Spinal Ejaculation Center (that can control the ejaculatory process) is activated. The ejaculatory process occurs in two phases- emission and expulsion. 

For these processes, two main neurotransmitters- serotonin and dopamine- work in tandem. These neurotransmitters have opposing effects, but are required in optimum concentration for an efficient process. Serotonin is the inhibitory, i.e., “WAIT” signal in the ejaculatory process, whereas dopamine promotes (“GO” signal) ejaculation. Any imbalance between these signals can result in impaired ejaculatory function.

In the case of Premature Ejaculation (PE), the interaction between these two neurotransmitters is disturbed. The most accepted cause of PE includes low concentrations of serotonin in certain areas of the brain involved in this process. As a result, there is inadequate inhibitory signalling, which causes the ejaculatory reflex to be initiated even if the sexual stimulation is low, and/or the time is too short. Additionally, psychological conditions increase the chances of PE as they can increase the activity of the sympathetic nervous system and further accelerate the ejaculatory reaction.

Prejac 60 mg (Dapoxetine) belongs to the class of short-acting selective serotonin reuptake inhibitors (SSRI). It enhances the activity of serotonin in the nervous system by inhibiting its reuptake into the nerve cells and allowing the serotonin to persist in the synaptic clefts for a sufficient amount of time. This increases the availability of serotonin in the brain, which provides the “WAIT” signal, thus delaying ejaculation. Unlike traditional SSRIs, dapoxetine can rapidly enter the blood and can also be cleared just as quickly, making it an ideal medication to use on an on-demand basis.

Possible Side Effects

Very Common Side Effects

• Nausea

Common Side Effects

Nervous System

• Dizziness
• Headache
• Somnolence (drowsiness)
• Tremor

Gastrointestinal

• Diarrhea
• Vomiting
• Dyspepsia (indigestion)

Psychiatric

• Insomnia
• Anxiety
• Agitation
• Restlessness

General

• Fatigue

Cardiovascular

• Flushing

Uncommon Side Effects

Nervous System

• Syncope (fainting)
• Orthostatic hypotension
• Disturbance in attention
• Paraesthesia (tingling sensation)
• Sedation

Cardiac

• Palpitations
• Tachycardia

Psychiatric

• Depression
• Mood changes
• Irritability
• Nervousness
• Abnormal dreams
• Decreased libido

Gastrointestinal

• Abdominal pain
• Constipation
• Flatulence

Eye Disorders

• Blurred vision

Ear and Labyrinth

• Tinnitus (ringing in the ears)
• Vertigo

Skin

• Hyperhidrosis (excess sweating)
• Rash

Reproductive System

• Erectile dysfunction

Rare / Serious (Clinically Important)

Neurological

• Loss of consciousness
• Seizures (very rare)

Cardiovascular

• Significant hypotension

Psychiatric

• Suicidal ideation (very rare but serious)
• Severe mood alterations

Serotonergic Effects

• Serotonin syndrome (especially with interacting drugs)

Key High-Risk Adverse Effects 

• Syncope (fainting) → hallmark concern
• Orthostatic hypotension
• Dizziness leading to falls
• Nausea (most frequent)

Precautions and Considerations

General Precautions

• Prejac 60 mg must only be consumed if prescribed by a licensed healthcare professional.
• This drug must be prescribed only to those individuals with a confirmed diagnosis of PE.
• Prejac 60 mg is intended to be used on an on-demand basis. Individuals must not consume it daily as it has a comparatively higher concentration of dapoxetine.
• Maintain a minimum gap of 24 hours between two consecutive doses. 
• Do not crush, chew, or split the Prejac 60 mg tablet before consuming it.

Monitoring and Follow-Up:

• It is important to have regular reassessment of the treatment every 4-6 weeks to evaluate the benefit of the treatment and tolerance to the drug.

Use in Special Populations:

• This drug must be administered cautiously in patients with renal, hepatic, and those with psychiatric conditions.
• It is important to assess the cardiovascular health of individuals before administering Prejac 60 mg. Such patients must maintain adequate hydration and avoid sudden movements.
• This medication must not be consumed by women or children under any circumstances.

Drug Interactions:

• Do not combine Prejac 60 mg with other SSRIs, as it can lead to excessive serotonergic activity and serotonin syndrome.
• This drug must not be combined with CYP3A4 inhibitors as it can increase the levels of dapoxetine in the blood.
• Avoid combining Prejac 60 mg with other antihypertensive drugs and PDE-5 inhibitors, which promote vasodilation, which can further lead to an excessive drop in blood pressure.

Side Effects

• Individuals must report any adverse symptoms to the medical care providers if they suspect they might be due to Prejac 60 mg use.
• Symptoms like loss of consciousness, severe hypotension, seizures, or suicidal thoughts require immediate medical attention.

Other Information

Frequently Asked Questions

1. Is Prejac 60 mg safe for daily use?

The dapoxetine levels in Prejac 60 mg are comparatively high. Hence, individuals must consume this drug on an on-demand basis and not consume it daily.

1. Does Prejac 60 mg cure premature ejaculation permanently?

No. Prejac 60 mg can temporarily treat the symptoms of PE, but cannot completely cure the disease.

1. Can Prejac 60 mg be consumed with alcohol?

Individuals must avoid alcohol use with Prejac 60 mg, as it can increase the risk of dizziness, fainting, and can also impair judgment.

1. How long do the effects of Prejac 60 mg last?

The half-life of Prejac 60 mg is comparatively short (~1.5 hours), which is the duration of time its effects last. Dapoxetine (active component of Prejac 60 mg) can remain in the body for up to 24 hours.

1. Can Prejac 60 mg be combined with medications for erectile dysfunction (ED)?

Before combining Prejac 60 mg with ED medications like Sildenafil, Tadalafil, or Vardenafil, individuals must consult appropriate medical specialists to avoid any adverse reactions.