Super Tadapox

Uses

1.Erectile Dysfunction (ED)

ED is defined as the persistent inability of an adult male to achieve or sustain an erection for a minimum required amount of time. It is caused by impaired biochemical pathways to the penis, which leads to insufficient blood flow and relaxation of the penile tissues. Super Tadapox 20 mg improves the blood flow to the region and facilitates smooth muscle relaxation. It targets the enzyme responsible for controlling an erectile reaction, thus enhancing the body’s natural reaction.

2.Premature Ejaculation (PE)

PE manifests as a result of an impaired neurological signal pathway, which leads to an accelerated ejection, with no voluntary control over the process. Super Tadapox 20 mg (specifically, the Dapoxetine component) increases the availability of serotonin in the nervous system, which delays the ejaculatory pathway. The Tadalafil component helps maintain the erection for a sufficient amount of time, for the treatment of delayed ejaculation.

3.Off-Label Indications

• Benign Prostatic Hyperplasia (BPH) (prostatic smooth muscle relaxation)
• Pulmonary Arterial Hypertension (PAH) (pulmonary vasodilation)
• Major Depressive Disorder (increased central serotonin)
• Generalized Anxiety Disorder (serotonergic anxiolytic effect)
• Social Anxiety Disorder (performance anxiety reduction)
• Panic Disorder (panic modulation)
• Obsessive-Compulsive Disorder (serotonin enhancement)
• SSRI-induced Sexual Dysfunction (improves erection quality)
• Delayed Ejaculation (further latency increase)
• Male Orgasmic Disorder (erectile support only)
• Raynaud’s Phenomenon (peripheral vasodilation)
• Chronic Anal Fissure (anal sphincter relaxation)
• High-Altitude Pulmonary Edema (HAPE) (reduces pulmonary pressure)
• Lower Urinary Tract Symptoms (LUTS) (bladder neck relaxation)
• Female Sexual Arousal Disorder (increased genital blood flow)
• Systemic Sclerosis–Related Digital Ulcers (improves microvascular circulation)

Dosage Information

1.Erectile Dysfunction (On-Demand)

• Recommended dose: Tadalafil 10–20 mg taken at least 30–60 minutes before sexual activity (in this combination: 20 mg).
• Maximum limit: Tadalafil 20 mg per 24 hours.
• Other clinical information: Not to be repeated within 24 hours. Super Tadapox 20 mg is not intended for regular dosing when used in this fixed combination.

2.Premature Ejaculation (On-Demand)

• Recommended dose: Dapoxetine 30 mg taken 1–3 hours before sexual activity (in this combination: 60 mg).
• Maximum limit: Dapoxetine 60 mg per 24 hours.
• Other clinical information: If starting therapy, 30 mg is usually the initial dose. 60 mg is used if 30 mg is ineffective and well tolerated. No more than one dose should be taken in 24 hours.

3.Concomitant Erectile Dysfunction + Premature Ejaculation (Fixed Combination Use)

• Recommended dose: Tadalafil 20 mg + Dapoxetine 60 mg taken 1–3 hours before sexual activity.
• Maximum limit: Tadalafil 20 mg and Dapoxetine 60 mg in 24 hours.
• Other clinical information: Dose adjustment is not possible due to fixed-dose formulation. This dosage combination is not recommended for daily continuous use. Individuals must not consume repeat dosing within the same day.

How Super Tadapox Works

Super Tadapox 20 mg is made up of two constituent drugs- Tadalafil and Dapoxetine. These drugs act on two different pathways- NO-cGMP pathway and the serotonin 5-HT pathways respectively. In this formulation, Tadalafil is used in the treatment of ED, whereas Dapoxetine is used for PE.

Tadalafil activates the Nitric Oxide (NO)-cGMP pathway. Under normal conditions, after a sexual stimulation, the nerve endings in the penile tissues release a chemical known as nitric oxide (NO). NO stimulates the enzyme guanylate cyclase. This enzyme promotes the formation of cyclic guanosine monophosphate (cGMP) by converting guanosine triphosphate (GTP) molecules to cGMP. The increased cGMP concentration relaxes smooth muscle tissues in the corpus cavernosum (penile erectile tissue). This causes vasodilation (dilation of blood vessels), which promotes greater blood flow in the tissue. These reactions are responsible for the formation of an erection.

After some time, the enzyme phosphodiesterase-5 (PDE-5) is released, and it is responsible for the breakdown of cGMP molecules. As a result, the effects of cGMP are diminished, and the erection weakens further before returning to its usual form.

Super Tadapox 20 mg contains Tadalafil, which selectively inhibits the PDE-5 enzyme. This improves blood flow in the corpus cavernosum and allows the effects of cGMPs to last for an appropriate amount of time. Thus, the individual can maintain an erection for a longer period of time.

The dapoxetine in Super Tadapox 20 mg is used to treat premature ejaculation. Ejaculation is normally mediated by serotonin (5-HT) pathways intertwined by the parasympathetic nervous system. Normally, the brain, spinal cord, and peripheral nerve system control ejaculation. The decision is made based on the competitive actions between excitatory and inhibitory molecules, with serotonin acting as an inhibitor. 

The nerve cells emit serotonin as part of their baseline inhibitory regulation, which binds to the receptors on postsynaptic nerve cells, known as serotonin receptors (5-HT receptors). This maintains the ejaculation in the "WAIT" state. The neuron synapses include serotonin transporters (SERT), which transfer serotonin back into their parent nerve cells. This action of SERT interferes with the "WAIT" signal. 

This procedure is necessary to propel the body toward ejaculation, but only once the excitatory impulses reach the appropriate thresholds. Premature ejaculation occurs when serotonin binding to 5-HTs is prevented before the threshold is crossed. 

Dapoxetine selectively targets this SERT, allowing serotonin molecules to attach to their 5-HT receptors. As a result, the body remains situated in the "WAIT" mode for an appropriate period of time. As the excitatory signals naturally cross the required threshold, the pathway favours ejaculation.

Possible Side Effects

Common Side Effects

• Headache
• Dizziness
• Flushing
• Nausea
• Vomiting
• Indigestion
• Dyspepsia
• Diarrhea
• Dry mouth
• Nasal congestion
• Runny nose
• Back pain
• Muscle pain
• Limb pain
• Fatigue
• Insomnia
• Somnolence

Cardiovascular Effects

• Palpitations
• Tachycardia
• Bradycardia
• Hypotension
• Orthostatic hypotension
• Hypertension
• Chest pain
• Syncope
• Arrhythmia

Neurological Effects

• Tremor
• Paresthesia
• Hypoesthesia
• Vertigo
• Migraine
• Seizures
• Confusion
• Agitation
• Anxiety
• Restlessness

Psychiatric Effects

• Mood swings
• Irritability
• Depression
• Panic attack
• Emotional instability
• Suicidal ideation
• Mania
• Hallucinations

Gastrointestinal Effects

• Abdominal pain
• Gastroesophageal reflux
• Flatulence
• Constipation
• Gastrointestinal bleeding
• Dry throat

Ophthalmic Effects

• Blurred vision
• Visual disturbance
• Photophobia
• Conjunctival hyperemia
• Increased intraocular pressure
• Non-arteritic anterior ischemic optic neuropathy
• Sudden vision loss

Auditory Effects

• Tinnitus
• Sudden hearing loss
• Hearing impairment

Genitourinary Effects

• Priapism
• Prolonged erection
• Hematuria
• Urinary retention
• Erectile dysfunction (paradoxical)
• Ejaculatory disorder

Dermatological Effects

• Rash
• Urticaria
• Pruritus
• Hyperhidrosis
• Angioedema
• Stevens-Johnson syndrome

Respiratory Effects

• Dyspnea
• Epistaxis
• Pharyngitis

Hematological Effects

• Anemia
• Thrombocytopenia
• Leukopenia

Metabolic & Systemic Effects

• Hyperglycemia
• Weight changes
• Fever
• Peripheral edema

Severe / Life-Threatening Reactions

• Anaphylaxis
• Serotonin syndrome
• Severe hypotension
• Myocardial infarction
• Stroke
• Sudden cardiac death

Precautions and Considerations

• Super Tadapox 20 mg should only be taken as prescribed by a licensed healthcare expert. Super Tadapox 20 mg contains a strong dose for both tadalafil and Dapoxetine. Do not self-medicate.
• Individuals must follow the dose concentration and timings as prescribed by their healthcare provider.
• Super Tadapox 20 mg is intended to be an on-demand medication used in the treatment of erectile dysfunction. This dosage should not be used on a daily-basis.
• Maintain adequate hydration to decrease the chances of any side effects.
• If any serious adverse effects (such as priapism or sudden loss of vision) occur, immediately seek medical intervention.
• Super Tadapox 20 mg cannot be taken with certain consumables such as alcohol or grapefruit.
• Its use should be carefully examined in patients suffering from cardiovascular diseases, particularly those who have had unstable angina, myocardial infarction, or stroke. In such cases, routine examination of cardiovascular markers is essential.
• Apart from these, Super Tadapox 20 mg should be administered with caution in individuals with hematological, hepatic, renal, neurological, ophthalmic, and auditory problems.
• Super Tadapox 20 mg should not be taken with nitrates, CYP3A4 inducers and inhibitors, alpha-blockers, or other PDE-5 and SSRI  inhibitors. Individuals should avoid using Super Tadapox 20 mg with these medications.
• The safety of Super Tadapox 20 mg is not scientifically established in females. Hence, this medication must not be consumed by women, unless prescribed by a licensed healthcare provider, in very rare cases.
• Similarly, Super Tadapox 20 mg must not be administered in children except for medically necessary cases determined by medical professionals.

Other Information

1.What happens if I miss a dose of Super Tadapox 20 mg?

Super Tadapox 20 mg is intended for on-demand consumption. Hence, there are no effects for a missed dose, in absence of a routine.

2.Can Super Tadapox 20 mg affect the blood pressure?

Yes. Super Tadapox 20 mg has vasodilatory properties, which can decrease the blood pressure. 

3.Can Super Tadapox 20 mg cause me to faint?

On its own, Super Tadapox 20 mg is not likely to cause fainting. However, if this medication is taken along with alcohol, there are chances of dizziness and fainting.

4.Is Super Tadapox 20 mg safe for diabetic patients?

Yes, Super Tadapox 20 mg is safe for diabetic ED. However, it must be consumed under medical supervision.

5.Does Super Tadapox 20 mg interact with antidepressants?

Yes. Combining this drug with antidepressants can lead to increased serotonin syndrome risk.