Tadapox (Tadalafil/Depoxetine)

Medically reviewed by Sanjay Gangani, B.Pharm, CMO & Pharmacist

Active Ingredient	Tadalafil/Depoxetine
Indication	Erectile dysfunction and Premature Ejaculation
Manufacturer	Centurion Laboratories Pvt. Ltd.
Packaging	10 tablets in 1 strip

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Tadapox (Tadalafil/Depoxetine)
Pack Size	Price	Price/unit	Quantity	Add To Cart
90 Tablet/s	$100	$1.11/Pill
120 Tablet/s	$130	$1.08/Pill
150 Tablet/s	$156	$1.04/Pill
300 Tablet/s	$265	$0.88/Pill

What is Tadapox?

Tadapox is a prescription medicine with two active ingredients.
It contains tadalafil 20 mg and dapoxetine 60 mg.
Some listings call it Tadapox 80 mg.
That figure is simply the two doses added together.
It is not an 80 mg dose of any single drug.
It targets two separate conditions with one dose.
Tadalafil is a PDE-5 inhibitor. It treats erectile dysfunction (ED).
Tadalafil helps a man get and keep an erection during sexual stimulation.
The same molecule is sold worldwide as Cialis.
Dapoxetine is a short-acting SSRI. It treats premature ejaculation (PE).
Super Tadapox lengthens the time from penetration to ejaculation.
SSRI stands for selective serotonin reuptake inhibitor.
Dapoxetine is chemically an antidepressant, used at low on-demand doses.
It is sold in some countries under the brand name Priligy.

Important limits

Neither drug works without sexual arousal.
This is an on-demand medicine. It is not taken every day.
It is for men aged 18 to 64 only.
Dapoxetine has not been shown safe or effective at 65 and over.
It is not for women or for anyone under 18.
It does not increase sexual desire or libido.
It does not improve emotional connection or relationship satisfaction.
It gives no protection against HIV or other sexually transmitted infections.

How It Works (Mechanism of Action)

Sexual stimulation releases nitric oxide in the penile tissue.
Nitric oxide raises levels of cyclic guanosine monophosphate (cGMP).
cGMP relaxes the smooth muscle of the penile arteries.
Relaxed muscle allows more blood to flow in.
The enzyme PDE-5 is what breaks cGMP down.
Tadalafil blocks PDE-5. The medicine is the inhibitor.
Blocking PDE-5 means cGMP stays higher for longer.
The erection becomes firmer and lasts longer during arousal.
Ejaculation is controlled mainly by the sympathetic nervous system.
Serotonin is a key signalling chemical in this reflex.
Dapoxetine blocks nerve cells from reabsorbing serotonin.
Serotonin therefore stays active longer at the nerve junction.
This raises the threshold needed to trigger ejaculation.
The result is a longer time before ejaculation occurs.

Why the two are combined, and why that needs care

Many men with ED also have PE. The two conditions often occur together.
One tablet treating both is convenient for those men.
But both drugs can lower blood pressure on standing.
Tadalafil is a mild vasodilator, meaning it widens blood vessels.
Dapoxetine can cause orthostatic hypotension and fainting.
Together the effects on standing blood pressure may add up.
This is the reason the dapoxetine label warns against the pairing.

Absorption and clearance

Property	Tadalafil	Dapoxetine
Time to peak level	30 minutes to 6 hours (median 2 hours)	About 1 to 2 hours
Protein binding	About 94 percent	Over 99 percent
Half-life	About 17.5 hours	Initial 1.5 hours; terminal about 19 hours
Main liver enzymes	CYP3A4	CYP2D6, CYP3A4 and FMO1
Effect of food	No effect	No clinically significant effect
Duration of effect	Up to 36 hours	Short-acting

Interaction note: in a crossover study, tadalafil 20 mg did not change dapoxetine blood levels. The two do not interfere chemically. The concern is their combined effect on blood pressure.

Dosage Guide

A doctor must set the dose. This table shows approved dosing for each component.

Patient group or situation	Tadalafil	Dapoxetine	Frequency	Key note
Adult men 18–64, new to dapoxetine	10 mg start	30 mg start	Once in 24 hours	This fixed product does not fit here
Adult men 18–64, tolerating 30 mg dapoxetine	10–20 mg	60 mg	Once in 24 hours	This is the group this product suits
Had faintness on 30 mg dapoxetine	Doctor decides	Do not increase	Not applicable	No step-up to 60 mg is allowed
Men aged 65 and over	No change for age	Not established	Not applicable	Dapoxetine is unproven in this age group
Liver: mild impairment	Max 10 mg	Caution	Once in 24 hours	Specialist judgement needed
Liver: moderate or severe	Caution or avoid	Contraindicated	Do not use	Dapoxetine is banned in Child-Pugh B and C
Kidney: severe	Max 5 mg per 72 hours	Not recommended	Do not use	Neither component fits this group
On moderate CYP3A4 inhibitors	Caution	Max 30 mg	Once in 24 hours	60 mg exceeds the allowed dapoxetine dose
On potent CYP3A4 inhibitors	Max 10 mg per 72 hours	Contraindicated	Do not use	See the interaction table in Section 7
Women, children, under-18s	Not indicated	Not indicated	Not applicable	Not for use in these groups

How to Take It

Step-by-step:

Confirm your dose and suitability with a registered doctor.
Ask your doctor for a standing blood pressure check first.
Check the strip seal and the printed expiry date.
Swallow the tablet whole with a full glass of water.
Do not split, crush or chew it. Dapoxetine tastes bitter.
Take it 1 to 3 hours before planned sexual activity.
Take it with or without food. Food makes little difference.
Drink enough water. Dehydration raises the fainting risk.
Do not drink alcohol before or after the dose.
Allow sexual stimulation to occur. Arousal is essential.
Never take a second dose within 24 hours.
Most fainting episodes occurred in the first 3 hours after a dose.
Many occurred after the very first dose a man took.
Do not drive during this window.
Do not operate machinery or work at height.
Rise slowly after lying down or sitting for a while.

If you feel faint

Warning signs include lightheadedness, nausea, sweating and palpitations.
Other signs are weakness, confusion and dizziness on standing.
Lie down at once, with your head lower than the rest of your body.
If you cannot lie down, sit with your head between your knees.
Stay there until the feeling passes fully.
Fainting can also happen with no warning signs at all.
Take it 1 to 3 hours before activity. This is set by the dapoxetine.
The tadalafil component then remains active for up to 36 hours.
Any claim of a 4 to 5 hour total duration is wrong.
The dosing limit is one tablet in 24 hours. It is not a 24 to 36 hour range.
This is an on-demand medicine, so there is no missed dose.
Never take two doses to make up for one.
Do not stop a long course abruptly without medical advice.

Precautions

Absolute contraindications (never use)

Any organic nitrate, in any form, regular or occasional.
Examples: nitroglycerin, isosorbide mononitrate, isosorbide dinitrate.
Nitrate sprays and patches count too, not just tablets.
Recreational nitrite ‘poppers’.
Guanylate cyclase stimulators such as riociguat.
Known serious allergy to tadalafil.
Men for whom sexual activity is unsafe due to heart disease.

From the dapoxetine component:

Known allergy to dapoxetine or any excipient.
Heart failure of NYHA class II to IV.
Conduction problems such as AV block or sick sinus syndrome.
Significant ischaemic heart disease or significant valve disease.
Any history of fainting.
Any history of mania or severe depression.
MAOI antidepressants, now or within the last 14 days.
Thioridazine, now or within the last 14 days.
Any SSRI, SNRI or tricyclic antidepressant.
Lithium, tramadol, triptans, linezolid or L-tryptophan.
St John’s Wort and other serotonergic herbal products.
Potent CYP3A4 inhibitors: ketoconazole, itraconazole, ritonavir.
Also saquinavir, telithromycin, nefazodone, nelfinavir, atazanavir.
Moderate or severe liver impairment (Child-Pugh B or C).

Conditions to disclose to your doctor

Any past episode of fainting or near-fainting, at any age.
Heart attack within the last 90 days, or stroke within 6 months.
Angina, especially angina occurring during sexual intercourse.
Uncontrolled irregular heartbeat, or uncontrolled blood pressure.
Low blood pressure below 90/50 mmHg.
Depression, anxiety, bipolar disorder or schizophrenia.
Any epilepsy or seizure history. SSRIs can lower the seizure threshold.
Raised eye pressure, or risk of angle closure glaucoma.
Bleeding or clotting disorders, or use of blood thinners.
Regular use of aspirin or anti-inflammatory painkillers.
Liver disease or kidney disease of any degree.
A curved or deformed penis, such as Peyronie’s disease.
Any past erection lasting more than 4 hours.
Sickle cell anaemia, multiple myeloma or leukaemia.
Retinitis pigmentosa, or any past severe vision loss.
All current medicines, including herbal and over-the-counter products.

Food and drink precautions

Avoid alcohol completely on any day you take this medicine.
Alcohol with dapoxetine increases drowsiness and lowers alertness.
It also raises the chance of fainting and of accidental injury.
Tadalafil with five or more alcohol units can drop standing blood pressure.
The two effects point the same way. The risk adds up.
Avoid grapefruit juice for 24 hours before your dose.
Grapefruit juice is a potent CYP3A4 inhibitor. It raises drug levels.
Food may be taken with the dose. It makes little difference.
Drink enough water. Good hydration lowers the fainting risk.
Never combine this medicine with recreational drugs.
MDMA, LSD and ketamine can cause serotonin syndrome with dapoxetine.
Sedative drugs such as opioids and benzodiazepines worsen drowsiness.

Before-use safety checklist

Do I hold a valid prescription from a registered doctor?
Am I aged between 18 and 64?
Have I already tolerated dapoxetine 30 mg without faintness?
Have I confirmed that I take no nitrate medicine of any kind?
Have I checked for a nitrate spray as well as tablets?
Am I free of all antidepressants and serotonin-acting medicines?
Have I had an orthostatic blood pressure check?
Have I ever fainted? If yes, this product is contraindicated.
Have I declared any heart, liver, kidney or mental health condition?
Have I given my doctor a full list of my medicines?
Have I planned to avoid alcohol and driving after the dose?
Do I know the fainting warning signs and what to do?

Side Effects

Common side effects, by ingredient

Dapoxetine rates are from phase 3 trials. Tadalafil rates are from as-needed trials.

Side effect	Source drug	At lower dose	At this product’s dose
Nausea	Dapoxetine	11.0% at 30 mg	22.2% at 60 mg
Dizziness	Dapoxetine	5.8% at 30 mg	10.9% at 60 mg
Headache	Dapoxetine	5.6% at 30 mg	8.8% at 60 mg
Diarrhoea	Dapoxetine	3.5% at 30 mg	6.9% at 60 mg
Fatigue	Dapoxetine	2.0% at 30 mg	4.1% at 60 mg
Insomnia	Dapoxetine	2.1% at 30 mg	3.9% at 60 mg
Headache	Tadalafil	11% at 10 mg	15% at 20 mg
Indigestion	Tadalafil	8% at 10 mg	10% at 20 mg
Back pain	Tadalafil	5% at 10 mg	6% at 20 mg
Muscle pain	Tadalafil	4% at 10 mg	3% at 20 mg
Blocked nose	Tadalafil	3% at 10 mg	3% at 20 mg
Flushing	Tadalafil	3% at 10 mg	3% at 20 mg

Dapoxetine side effects are clearly dose related. They roughly double at 60 mg.
Nausea caused 2.2% of men to stop dapoxetine. Dizziness caused 1.2%.
Tadalafil back pain starts 12 to 24 hours after the dose.
Tadalafil back pain usually clears within 48 hours.

Less common and rare side effects

Body system	Reported effects
Fainting and blood pressure	Fainting, vasovagal fainting, low blood pressure, dizziness on standing
Heart rhythm	Sinus arrest, slow heartbeat, fast heartbeat, palpitations
Serious cardiovascular (rare)	Heart attack, sudden cardiac death, stroke
Mood and mental state	Anxiety, agitation, restlessness, abnormal dreams, reduced libido
Mood (uncommon)	Depression, depressed mood, nervousness, confusion, apathy, nightmares
Nervous system	Drowsiness, poor concentration, tremor, tingling, tooth grinding
Eyes	Blurred vision, dilated pupils, eye pain, visual disturbance
Eyes (rare, serious)	NAION, retinal vein or artery occlusion, visual field defect
Ears	Ringing in the ears, vertigo, sudden decrease or loss of hearing
Digestive	Vomiting, constipation, abdominal pain, wind, dry mouth, reflux
Sexual	Erectile dysfunction, ejaculation failure, orgasm difficulty, loss of libido
Urinary and genital	Prolonged erection, priapism
Skin	Sweating, cold sweat, itching, rash, hot flushes
Skin (rare, serious)	Stevens-Johnson syndrome, exfoliative dermatitis
General	Feeling hot, feeling jittery, weakness, feeling drunk

Drug Interactions – Avoid With

Risk level	Drug or substance	What happens
NEVER COMBINE	All organic nitrates and nitrite poppers	Severe, possibly fatal blood pressure drop
NEVER COMBINE	Nitrate sprays and patches, not just tablets	Same risk. Easy to overlook.
NEVER COMBINE	Riociguat and other guanylate cyclase stimulators	Blood pressure may fall to an unsafe level
NEVER COMBINE	MAOI antidepressants, and for 14 days after stopping	Risk of fatal serotonin reactions
NEVER COMBINE	Other SSRIs, SNRIs and tricyclic antidepressants	Serotonin syndrome
NEVER COMBINE	Lithium, tramadol, triptans, linezolid, L-tryptophan	Serotonin syndrome
NEVER COMBINE	St John’s Wort and serotonergic herbal products	Serotonin syndrome
NEVER COMBINE	Thioridazine, and for 14 days after stopping	Dangerous heart rhythm disturbance
NEVER COMBINE	Ketoconazole, itraconazole, ritonavir, saquinavir	Dapoxetine exposure roughly doubles
NEVER COMBINE	Telithromycin, nefazodone, nelfinavir, atazanavir	Dapoxetine exposure roughly doubles
NEVER COMBINE	Other PDE-5 inhibitors, or other tadalafil products	Accidental double dosing
NEVER COMBINE	Super Tadapox, or any other dapoxetine product	Accidental double dosing of both drugs
NEVER COMBINE	Recreational drugs: MDMA, LSD, ketamine	Serotonin syndrome, arrhythmia, high fever
DOSE PROBLEM	Moderate CYP3A4 inhibitors: erythromycin, clarithromycin	Dapoxetine must be capped at 30 mg
DOSE PROBLEM	Fluconazole, verapamil, diltiazem, aprepitant	Dapoxetine must be capped at 30 mg
USE WITH CAUTION	Potent CYP2D6 inhibitors such as fluoxetine	Dapoxetine active fraction may double
USE WITH CAUTION	Alpha-blockers: doxazosin, tamsulosin, alfuzosin	Reduced tolerance to standing; fainting risk
USE WITH CAUTION	Blood pressure medicines and angiotensin II blockers	Additional blood pressure fall
USE WITH CAUTION	Warfarin, aspirin, NSAIDs, antiplatelet drugs	SSRIs can affect platelets and bleeding
USE WITH CAUTION	Sedatives, opioids, benzodiazepines, antiepileptics	Added drowsiness and dizziness
AVOID	Alcohol	Drowsiness, poor judgement, fainting, injury
AVOID	Grapefruit juice, within 24 hours before the dose	Potent CYP3A4 inhibition raises drug levels
REDUCED EFFECT	Rifampicin, carbamazepine, phenytoin, phenobarbital	Tadalafil exposure falls sharply

Emergency Warning Signs

Stop the medicine and get emergency medical care if any of these occur:

Fainting, or loss of consciousness of any kind.
An erection lasting more than 4 hours, whether painful or not.
Sudden loss of vision in one or both eyes.
Sudden decrease or loss of hearing, with or without ringing.
Chest pain, pressure, or pain spreading to the arm, neck or jaw.
Chest pain or dizziness during sex. Stop the activity at once.
A very fast, very slow or irregular heartbeat.
Slurred speech, facial droop, or one-sided weakness.
Swelling of the lips, tongue, face or throat.
A widespread rash with blistering or peeling skin.
A seizure.
Any new thoughts of self-harm, or a sudden worsening of mood.

Why Choose This Combination

One tablet addresses two conditions that often occur together.
Many men with erectile dysfunction also have premature ejaculation.
Tadalafil offers the longest action of the common ED medicines.
Its effect can last up to 36 hours.
Dapoxetine is purpose-built for on-demand use in premature ejaculation.
Unlike older SSRIs, it is not taken every day.
In trials, dapoxetine 60 mg raised median time to ejaculation.
The median rose from about 1.05 minutes to about 1.91 minutes.
Nearly 48% of men on 60 mg reached at least 2 minutes.
On placebo the figure was about 23%.
At 24 weeks, 35.5% on 60 mg rated their condition better or much better.
On placebo the figure was 14%.
A 2023 trial found the combination beat either drug used alone.
Taking one tablet is simpler than remembering two.

What does not hold up

It does not last only 4 to 5 hours. Tadalafil lasts up to 36 hours.
It is not FDA-approved, though tadalafil the molecule is.
It is not a performance enhancer for men without a diagnosis.
It does not improve emotional connection or relationship satisfaction.
It does not increase libido. Dapoxetine can reduce it.

Storage Instructions

Store at 25 °C, following the tadalafil requirement.
Short excursions from 15 °C to 30 °C are permitted.
Dapoxetine alone needs no special storage conditions.
The stricter of the two rules applies to the combined product.
Keep tablets in the original blister until use.
Protect from direct sunlight, heat and moisture.
Do not refrigerate and do not freeze.
Do not store in a bathroom cabinet or a parked car.
Keep out of the reach of children.
Do not use tablets that are chipped, discoloured or damaged.
Do not use after the printed expiry date.
Do not dispose of it in wastewater or household waste.
Return unused medicine to a pharmacy for disposal.
Never share this medicine with another person.

Sanjay Gangani

B.Pharm, CMO & Pharmacist

Licensed pharmacist (B.Pharm) with 12+ years in clinical pharmacy and patient care. Reviews every article for evidence-based accuracy before it is published on ACTIZA Store.

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Tadapox (Tadalafil/Depoxetine)