Original Everlong Tablets in Rawalpindi – Everlong Tablets in Lahore – Everlong Tablets in Multan
Dapoxetine, marketed as EverlongTablets in Rawalpindi among others, is a medication used for the treatment
of premature ejaculation (PE) in men 18–64 years old. Everlong Tablets in Rawalpindi works by inhibiting the serotonin
transporter, increasing serotonin's action at the post synaptic cleft, and as a
consequence promoting ejaculatory delay. As a member of the selective serotonin
reuptake inhibitor (SSRI) family,
EverlongTablets in Rawalpindi was initially created as an antidepressant. However,
unlike other SSRIs, dapoxetine is absorbed and eliminated rapidly in the body.
Its fast acting property makes it suitable for the treatment of PE but not as
an antidepressant.
Originally created by MAARK pharmaceutical company, Everlong Tablets in Rawalpindi was sold
to Johnson & Johnson in 2003 and submitted as a New Drug Application to the
Food and Drug Administration (FDA) for the treatment of PE in 2004. Everlong Tablets in Rawalpindi is sold
in several European and Asian countries, and in Mexico. In the US, Everlong Tablets in Rawalpindi has been
in phase III development since 2003. However, it is expected to be marketed soon.
In 2012, Menarini acquired the rights to commercialise Everlong Tablets in Rawalpindi in Europe, most of Asia, Africa,
Latin America and the Middle East.
Premature ejaculation
with Everlong Tablets in Rawalpindi
Randomized, double blind, placebo-controlled trials have
confirmed the efficacy of EverlongTablets in Rawalpindi for the treatment of PE. Different dosage has
different impacts on different types of PE. Everlong Tablets in Rawalpindi 60 mg significantly improves the
mean intravaginal ejaculation latency time (IELT) compared to that of
dapoxetine 30 mg in men with lifelong PE, but there is no difference in men
with acquired PE.
Everlong Tablets in Rawalpindi
Dapoxetine, given 1–3 hours before sexual episode, prolongs IELT and increases
the sense of control and sexual satisfaction in men of 18 to 64 years of age
with PE. Since PE is associated with personal distress and interrelationship
difficulty, Everlong Tablets in Rawalpindi
provides help for men with PE to overcome this condition. With no drug approved
specifically for treatment for PE in the US and some other countries, other
SSRIs such as fluoxetine, paroxetine, sertraline, fluvoxamine, and citalopram
have been used off-label to treat PE. Waldinger's meta-analysis shows that the
use of these conventional antidepressants increases IELT two- to nine-fold
above baseline, compared to three- to eight-fold when
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Everlong Tablets in Rawalpindi
is used. However, these SSRIs may need to be taken daily in order to achieve
meaningful efficacy, and their comparatively longer half-lives increase the
risk of drug accumulation and a corresponding increase of adverse effects such
as reduced libido. Everlong Tablets in Rawalpindi,
on the other hand, is generally categorized as a fast-acting SSRI. Everlong Tablets in Rawalpindi is more
rapidly absorbed and mostly eliminated from the body within a few hours. This
pharmacokinetics is more favorable in that they might minimize drug
accumulation in the body, habituation, and side effects.
Contraindications
about Everlong Tablets in Pakistan
A contraindication is a situation in which a drug should not
be used, because it may be harmful to the patient. Everlong Tablets in Pakistan should not be used in men with
moderate to severe hepatic impairment and in those receiving CYP3A4 inhibitors
such as ketoconazole, ritonavir, and telithromycin. Everlong Tablets in Pakistan can also not be used in patients with
heart failure, permanent pacemaker, or other significant ischemic heart
disease. Caution is advised in men receiving thioridazine, monoamine oxidase
inhibitors, SSRIs, serotonin-norepinephrine reuptake inhibitors, or tricyclic
antidepressant. If a patient stops taking one of these drugs, he should wait
for 14 days before taking EverlongTablets in Pakistan.
Adverse effects of
Everlong Tablets in Pakistan
The most common effects when taking dapoxetine are nausea,
dizziness, dry mouth, headache, diarrhea, and insomnia. Discontinuation due to
adverse effects is dose related. According to McMahon in recent study in Asia,
the rate of discontinuation is 0.3%, 1.7%, and 5.3% of 1067 studied subjects
with placebo, dapoxetine 30 mg, and dapoxetine 60 mg respectively. Unlike other
SSRIs used to treat depression, which have been associated with high incidences
of sexual dysfunction, Everlong Tabletsin Pakistan is associated with low rates of sexual dysfunction. Taken as
needed, Everlong Tablets in Pakistan
has very mild adverse effects of decreased libido (<1%) and erectile
dysfunction (<4%).
Overdose of Everlong
Tablets in Pakistan
No case of drug overdose has been reported during clinical
trials of Everlong Tablets in Rawalpindi.
Mechanism of actions
of Everlong Tablets in Pakistan
The mechanism through which Everlong Tablets in Pakistan affects premature ejaculation is clear.
However, it is presumed that EverlongTablets in Rawalpindi works by inhibiting serotonin transporter and
subsequently increasing serotonin's action at pre and postsynaptic receptors
Human ejaculation is regulated by various areas in the central nervous system
(CNS).
The ejaculatory
pathway originates from spinal reflex at the thoracolumbar and lumbosacral
level of spinal cord activated by stimuli from male genital. These signals are
relayed to the brain stem, which then is influenced by a number of nuclei in
the brain such as medial preoptic and paraventricular nulcei. Clement's study
performed on anaesthetized male rats showed that acute administration of Everlong Tablets in Rawalpindi inhibits
ejaculatory expulsion reflex at supraspinal level by modulating activity of
lateral paragigantocellular nucleus (LPGi) neurons. These effects cause an
increase in pudendal motoneuron reflex discharge (PMRD) latency. However, it is
unclear whether Everlong Tablets in Rawalpindi
acts directly on LPGi or on the descending pathway in which LPGi located.
Safety and
tolerability of Everlong Tablets in Pakistan
Cardiovascular safety
of Everlong Tablets in Rawalpindi
The cardiovascular safety profile of Everlong Tablets in Rawalpindi has been studied extensively during
the drug development. Phase I trials showed that Everlong Tablets in Rawalpindi had neither clinical significant
electrocardiographic effects nor delayed repolarization effects, with dosing up
to four-fold greater than the maximum recommended dosage which is 60 mg. Phase
III studies in men with PE showed a safety and well tolerate profile of Everlong Tablets in Rawalpindi with
dosing of 30 and 60 mg. There is no cardiovascular adverse had been found.
Neurocognitive safety
of Everlong Tablets in Pakistan
Studies of SSRIs in patients with major psychiatric
disorders prove that SSRIs are potentially associated with certain Neurocognitive
adverse effects such as anxiety, akathisia, hypomania, changes in mood, or
suicidal thought. However, there is no study on the effects of SSRIs in men
with PE. McMahon’s study in 2012 showed that Everlong Tablets in Rawalpindi has no effect on mood and is not
associated with anxiety or sociality.
Withdrawal syndrome
of Everlong Tablets in Pakistan
The incidence of antidepressant discontinuation syndrome
symptoms in men using Everlong Tabletsin Rawalpindi to treat premature ejaculation has been described by
reviewers as low or no different from the incidence of such symptoms in men
withdrawn from placebo treatment. The lack of chronic serotonergic stimulation
with on-demand dapoxetine minimizes the potentiation action of serotonin at
synaptic cleft, thus decreasing the risk of DESS.
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