Sildenafil/Clomipramine Combo Boosts Outcomes in Premature Ejaculation

The price for benzocaine wipes varies widely – averaging approximately $2 to $6 per wipe.5 Selective serotonin reuptake inhibitors (SSRIs) are medications generally prescribed for mental health conditions like depression and anxiety. One of the side effects of SSRIs is delayed ejaculation and studies6 show this can help with PE symptoms. Because of this, medical providers often prescribe SSRIs for PE. Sertraline (generic Zoloft) is part of the classification of drugs called SSRIs.

Further information

It affects as many as 30% to 40% of all men at some point in their life. It can have a wide range of causes, from hypersensitivity to medical conditions to psychological factors.The critical thing to remember when treating PE is that you are not alone. The condition is very common, even if it is not openly discussed, and is easily treatable. Premature ejaculation (PE) treatments include prescription pills, numbing creams and desensitizing wipes. Each works differently to help delay climax.

Premature ejaculation prognosis

Numbing creams and wipes contain local anesthetics such as lidocaine, which reduce sensation on the skin. Prescription pills – like SRIs (sertraline, paroxetine) and PDE5 inhibitors (sildenafil, tadalafil, vardenafil) – are often also used to treat PE by adjusting serotonin levels in the brain, which can help prolong intimacy. The best PE treatment depends on your symptoms, preferences and any other health concerns. A licensed provider can help you choose the right option for safe and effective results. Premature ejaculation treatments are available in two main types: topical and oral medications.

Citalopram (Celexa)

Topical treatments are applied directly to the genitals to reduce sensation and help delay ejaculation. Common options include desensitizing creams or sprays and benzocaine wipes. Oral medications can help men maintain an erection or delay climax. Two main categories used for premature ejaculation are selective serotonin reuptake inhibitors (SSRIs), which are a type of antidepressant, and PDE5 inhibitors, which are typically prescribed for erectile dysfunction. Topical treatments are applied directly to the genitals anywhere from five to 20 minutes before intercourse to reduce sensation and have been shown to delay orgasm in men by three to six minutes.2 However, for some users, topical treatments can cause loss of sexual desire or erectile disruption due to numbness.3 One risk of using topical treatments for PE is that the numbing ingredients can transfer to your partner, reducing sensation for them as well. It is used for the treatment of a wide range of conditions, including depression, anxiety, OCD, PTSD and PMS.7 Although it’s not known exactly how it works, studies8 have shown that sertraline does work for PE. The retail price for sertraline (without insurance) is around $37 for a one-month supply.9 At Redbox Rx it starts at $25 per month. Paroxetine (generic Paxil) is another SSRI that has shown promising study results for treating PE.10 Although it is difficult to prove, some researchers believe that SSRIs ability to reduce depression and anxiety could be the foundation for treating PE.

• Dapoxetine is specifically designed for on-demand use in PE.
• Topical anesthetics require minimal use to avoid excessive numbness.
• SSRIs impact neurotransmitters involved in ejaculation control.
• Tramadol's side effects limit its routine use for PE.
• Non-drug approaches include psychological counseling and exercises.
• Pelvic strengthening exercises aid in delay of ejaculation.
• Partner education enhances understanding and support.
• Managing stress and anxiety can significantly improve PE.
• Some therapies combine medication with sex therapy sessions.
• Medical evaluation is essential before initiating treatment.
• Lifestyle factors like smoking can influence sexual performance.
• Patient adherence to treatment plans improves outcomes.

PE is a condition that can be wholly psychological rather than fully biological. Paroxetine for PE is available by prescription only and can cost upward of $28 per month without insurance coverage. A RedBox Rx paroxetine prescription starts at $25 per month. All RedBox Rx PE prescription medication options are FDA-approved, competitively priced, and customized to your health needs by a licensed U.S.

Medication Name	Type	Typical Dosage	Onset Time	Duration of Effect	Common Side Effects	Approval Status	Available By Prescription	Estimated Cost (USD)
Dapoxetine	SSRI	30 mg	1-3 hours	12-24 hours	Nausea, dizziness, headache	Approved	Yes	2-5
Paroxetine	SSRI	20 mg/day	1-2 hours	24 hours	Fatigue, dry mouth	Approved	Yes	1-4
Sertraline	SSRI	50 mg/day	2-4 hours	24 hours	Diarrhea, insomnia	Approved	Yes	2-4
Topical Anesthetics	Local anesthetic	Varies	Immediate	30-60 minutes	Loss of sensation in area	Approved	Yes	3-7

medical professional. PDE5 inhibitors are a classification of medications traditionally prescribed for erectile dysfunction. Additionally, research has shown that PDE5 inhibitors can have positive cenforce 100 soft results when prescribed for premature ejaculation.

• Dapoxetine is contraindicated with certain medications and health conditions.
• Topical creams should be used sparingly to prevent partner numbness.
• SSRI treatment may cause emotional blunting or decreased libido.
• Tramadol's risk of dependency requires careful medical supervision.
• Mechanical devices can provide temporary ejaculation delay.
• Behavioral training involves specific sex exercises for control.
• Mindfulness and relaxation techniques benefit PE management.
• Proper diagnosis is essential to rule out underlying disorders.
• Incorporate partner feedback to improve treatment results.
• Avoid abrupt discontinuation of prescribed medication.
• Lifestyle modifications can include weight management.
• Ongoing research aims to develop more effective PE treatments.

The best result for treating premature ejaculation is a combination of a PDE5 inhibitor and an SSRI, according to research.11 Sildenafil (generic Viagra) is a commonly prescribed medication to treat erectile dysfunction. Studies12 have shown that sildenafil also benefits men that experience PE. In addition to helping delay ejaculation during vaginal intercourse, study participants reported an increase in sexual confidence, satisfaction and a decrease in recovery time to achieve a second erection after ejaculation.13 A prescription is required to purchase sildenafil for PE.

Strategy	Description	Expected Outcome	Time Frame	Additional Notes
Mindfulness Meditation	Practice focusing on the present moment to reduce anxiety	Reduced performance anxiety	Weeks to months	Complements other treatments
Sensate Focus Exercises	Partner-based touching exercises to build comfort	Increased control and intimacy	Several weeks	Requires partner cooperation
Cognitive Behavioral Therapy	Therapy addressing thoughts and anxiety related to sex	Better sexual confidence	Several sessions	Often part of a comprehensive plan

Retail price for sildenafil can be upward of $45 per dose.14 With RedBox Rx, sildenafil starts as low as $1 per dose.

Product	Dosage	Quantity + Bonus	Price
Cialis Generic	2.5mg	270 + 10 Pills	199.64€ 190.13€	Buy
Levitra Generic	10mg	180 + 10 Pills	246.74€ 234.99€	Buy
Cialis Professional	20mg	180 + 4 Pills	423.11€ 402.96€	Buy
Levitra Generic	20mg	30 + 4 Pills	70.59€ 67.23€	Buy
Viagra Generic	200mg	30 + 2 Pills	83.07€ 79.11€	Buy
Kamagra 100 mg	100 mg	20 Pills	86.09€ 81.99€	Buy
Viagra Generic	150mg	270 + 10 Pills	326.61€ 311.06€	Buy
Tadalista Super Active	20mg	10 Pills	55.64€ 52.99€	Buy
Cialis Original	20mg	48 + 4 Pills	224.69€ 213.99€	Buy
Kamagra 100 mg	100 mg	180 + 6 Pills	436.79€ 415.99€	Buy
Kamagra Soft Tabs	100mg	12 Pills	57.55€ 54.81€	Buy
Cialis Generic	60mg	360 + 10 Pills	570.52€ 543.35€	Buy
Levitra Generic	40mg	120 + 8 Pills	302.37€ 287.97€	Buy
Viagra Oral Jelly	100mg	63 + 7 Sachets	190.54€ 181.47€	Buy
Levitra Generic	20mg	90 + 8 Pills	180.78€ 172.17€	Buy
Viagra Generic	25mg	120 + 6 Pills	125.56€ 119.58€	Buy
Viagra Generic	50mg	60 + 4 Pills	83.93€ 79.93€	Buy

Tadalafil (generic Cialis) is also commonly prescribed for erectile dysfunction. Tadalafil can help treat PE, especially if symptoms for PE and ED are both present. Studies show that taking tadalafil for PE can help men last longer before finishing.15 A prescription is required to purchase tadalafil for PE – with the cost per tablet (without insurance) averaging around $12 per tablet.16 Tadalafil is available for as low as $1 per dose with RedBox Rx. Vardenafil (generic Levitra) is commonly prescribed for ED and has shown promise as a PE treatment as well. In studies, men improved their lasting time, recovery period, control and satisfaction during sexual activity.17 A prescription is required for vardenafil, and without insurance it can cost more than $50 per tablet.18 Vardenafil starts at $3 per tablet with RedBox Rx.

• Dapoxetine is effective when taken 1-3 hours before intercourse.
• Topical anesthetics can reduce sensation but risk partner numbness.
• SSRIs may take several weeks to reach full efficacy for PE.
• Tramadol's use for PE is off-label; consult a doctor before use.
• Combining medication with therapy can optimize outcomes.
• Avoiding excessive alcohol and stress can improve sexual performance.
• Pelvic exercises increase muscle strength and ejaculatory control.
• Psychological support can address anxiety-related PE.
• Devices like constriction rings may be used as mechanical aids.
• Open communication with partner improves treatment success.
• Regular follow-up with healthcare provider is recommended.
• Natural remedies lack solid clinical proof but are popular.

RedBox Rx makes receiving treatment for premature ejaculation easy and affordable. Transparent, affordable, flat rates for PE medications with SSRIs for $25 per month (with purchase of three-month supply). $25 online consultations with a U.S. licensed medical professional.

Medication Summary

Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation by Abdel-Hamid et al. Intracavernous medication for treatment of premature ejaculation. Chen J, Mabjeesh NJ, Matzkin H, Greenstein A. Efficacy of sildenafil as adjuvant therapy to selective serotonin reuptake inhibitor in alleviating premature ejaculation. A new combination treatment for premature ejaculation: A sex therapist’s perspective.

Stop-start technique

Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K, Abraham L, Crossland A, Morris M. Development and validation of a premature ejaculation diagnostic tool. Azam U. Late-stage clinical development in lower urogenital targets: flibanserin Sexual dysfunction. Taber MT, Wright RN, Molski TF, Clarke WJ, Brassil PJ, Denhart DJ, Mattson RJ, Lodge NJ.

Tadalafil (Cialis)

Neurochemical, pharmacokinetic, and behavioral effects of the novel selective serotonin reuptake inhibitor BMS-505130. Pharmacol Biochem Behav 2005;80:521–8. Aloosh M, Hassani M, Nikoobakht M. Seminal plasma magnesium and premature ejaculation: A case-control study. Premature ejaculation (PE)1 is the most common type of sexual dysfunction in men. No office wait times or scheduling issues typical with physical medical practices. Start your PE treatment today with our quick and easy online assessment. Please be advised there are two sections on this topic, one by Dr. Stanley Ducharme, a sex therapist, and one by Dr.

Drug Name	Approval Year	Primary Use	Recommended Dosage	Prescription Needed	Monitor Required	Typical Side Effects
Dapoxetine	2009	Premature ejaculation	30 mg before sex	Yes	Yes	Nausea, dizziness
Paroxetine	Approved for other uses, off-label for PE	20 mg/day	Yes	Yes	Yes	Fatigue, sexual dysfunction
Sertraline	Approved for depression, off-label for PE	50 mg/day	Yes	Yes	Yes	Insomnia, digestive issues

Ricardo Munarriz, a sexual medicine physician. For men, erectile dysfunction and ejaculatory problems are the most common sexual difficulties. With the introduction of Viagra however, problems of erectile dysfunction are much less frequent and more easily treated. In contrast, ejaculatory problems continue to be commonplace among men and often create feelings of shame and embarrassment for those men who struggle with this difficulty. When does an ejaculation problem become a disorder? This is a subjective question and is based on the level of distress that is experienced by the man or his partner.

Why trust our experts?

Using a condom can mitigate the transfer of topical treatment to your partner during sexual contact. Lidocaine cream is a topical PE medication that numbs the application area with local anesthetics. When applied to male genitals, desensitization helps prolong an erection and prevent premature ejaculation. Lidocaine is available via a prescription or over the counter. RedBox Rx offers prescription-strength 4% lidocaine cream in a 15 gm tube for $30.

Medications for premature ejaculation

Benzocaine is a mild anesthetic that is widely available in over-the-counter pain relief products. When used topically on the skin, it can create numbness and desensitizes the area. Benzocaine wipes4 have been developed specifically for PE as a convenient method to apply anesthetic to the genitals. Its ability to help men with PE last longer during intercourse has shown promise in small studies. Benzocaine wipes for PE are available over the counter. The time from initiating sexual activity to ejaculation varies from one individual to another. This time period is called the ejaculatory latency.

Author information

Maier U, Koinig G. Andrological findings in young patients under long-term antidepressive therapy with clomipramine. Mousavizadeh K, Ghafourifar P, Sadeghi-Nejad H. Calcium channel blocking activity of thioridazine, clomipramine and fluoxetine in isolated rat vas deferens: A relative potency measurement study. Tramadol HCL has promise in on-demand use to treat premature ejaculation.

Topical Treatments for Premature Ejaculation

J Sex Med 2008;5:188–93. Safety and efficacy of tramadol in the treatment of premature ejaculation: A double-blind, placebo-controlled, fixed-dose, randomized study. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T. Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Efficacy of type-5 phosphodiesterase inhibitors in the drug treatment of premature ejaculation: A systematic review.

Information to gather in advance

Ejaculatory abnormalities in mice lacking the gene for endothelial nitric oxide synthase (eNOS-/-). Abdel-Hamid IA ENE, El Gilani A-H. Assessment of as needed use of pharmacotherapy and the pausesqueeze technique in premature ejaculation. Efficacy of sildenafil citrate in treatment of erectile dysfunction: Impact of associated premature ejaculation and low desire. Goldmeier D, Lamba H. What may be a problem for one man may be acceptable to another. Typically, ejaculatory disorders fall into two categories.