What Medicine Helps With Premature Ejaculation
- The question in the title is answered in the first line, then everything else supports that answer.
- Whether the medicine can be taken every day is answered properly, because the honest answer is no and almost nobody explains why.
- A medicine with no side effects does not exist for this condition, and this page says so with the recorded figures rather than dodging it.
- What to do when the medicine does not help is set out as a five step pathway rather than a shrug toward a prescriber.
Yes, there is a medicine for premature ejaculation. One medicine is licensed in the UK to treat premature ejaculation and nothing else, it is called dapoxetine, and it is sold under the brand name Priligy. It is a prescription medicine, taken before an occasion rather than every day.
That is the whole answer to the headline question. Everything below explains what sits behind it.
Several other medicines are used to delay ejaculation in the UK, and men who have experienced premature ejaculation for years often end up on one of them, but none is licensed for it, which means they are borrowed from another licensed use. There are also topical anaesthetics, and there are approaches that involve no medicine at all. Which of those treatment options suits you is a clinical decision rather than a shopping choice, and men who suddenly experience premature ejaculation after years without it may need a different answer again.
Key things to know
- One medicine is licensed in the UK to treat premature ejaculation, in adult men aged 18 to 64 years. Other medicines used for premature ejaculation may either have their own licensed indication for PE, such as Fortacin, or be used off label, depending on the medicine.
- It is taken before an occasion. It is not a daily medicine, and it must not be taken more than once in any 24 hours.
- No medicine for this condition is free of side effects. Nausea affected 11.0% of men on the lower strength and 22.2% on the higher one.
- In trials of 6,081 men, ejaculation timing rose from 0.9 minutes to 3.1 or 3.6 minutes depending on strength, against 1.9 minutes on placebo.
- Every medicine used to delay ejaculation in the UK needs a prescription. None can be bought over the counter.
- Treatment suitability depends on an individual clinical assessment, and your prescriber will determine the appropriate treatment.
Is there a medicine for premature ejaculation?
Yes. Dapoxetine is licensed in the UK for the treatment of premature ejaculation in adult men aged 18 to 64 years. NICE calls it a short acting selective serotonin reuptake inhibitor.
What being licensed actually means
Dapoxetine is one of the medicines specifically licensed for premature ejaculation in the UK. Fortacin, a lidocaine/prilocaine spray, is also licensed for primary PE in adult men.
That is worth knowing because it separates one medicine from everything else on offer. When you read about other options, you are reading about medicines borrowed from elsewhere, or about products that are not medicines at all. This distinction is important as it influences future behaviour and performance in intimate relationships, ensuring that treatments chosen are appropriate medications to safely treat PE and support ongoing pleasure and satisfaction for both the individual and their partner.
What else gets used
NICE records four other drug therapy options for this condition, and each is prescribed off label, meaning a licensed medicine used outside the terms it was authorised under.
- A longer acting selective serotonin reuptake inhibitor taken daily. NICE names citalopram, fluoxetine, paroxetine and sertraline.
- Clomipramine taken daily.
- Topical anaesthetics used before an occasion.
- Tramadol used before an occasion.
There is one more product worth naming by description rather than brand. A cutaneous spray containing lidocaine and prilocaine holds a separate UK licence for primary premature ejaculation in adult men, so among the topical anaesthetics one form is licensed for this while the cream form is not.
Medicine for premature ejaculation and how it works
Different premature ejaculation treatments work in different ways. Dapoxetine and other serotonergic medicines affect serotonin signalling and can delay ejaculation, while topical treatments such as Fortacin work locally by reducing sensitivity of the glans. The treatment effect therefore depends on the medicine rather than there being one mechanism shared by every option.
The mechanism in plain language
Nerve cells in the nervous system release serotonin and then take it back up again, which ends the signal. A selective serotonin reuptake inhibitor blocks that reuptake. Serotonin stays active for longer, and the ejaculatory reflex takes longer to complete.
Why medicine only addresses part of the problem
Nobody knows exactly what causes premature ejaculation. Lists of what causes premature ejaculation are published everywhere, but the NICE evidence summary does not publish one, so what causes premature ejaculation remains genuinely open.
You will find confident lists elsewhere naming physical causes, psychological and physical factors together, common physical explanations, hormone results such as follicle stimulating hormone or luteinising hormone, and even upbringing. None of those appears in the UK regulator record for this condition, so this page does not present them as established.
How quickly does the medicine work?
The licensed medicine begins to delay ejaculation on the day it is taken. NICE records a time to maximum plasma concentration of about 1 to 2 hours after intake.
That figure is a measurement of how the body handles the medicine, not an instruction about when to take it. Timing is your prescriber's to advise and the patient information leaflet's to state, and this page gives no timing instructions of its own.
The alternatives used outside their own licences behave differently. NICE explains the reason: because longer acting selective serotonin reuptake inhibitors have a longer onset of action than the shorter acting dapoxetine, they need to be taken on a daily basis. They delay ejaculation only once a level has built up over weeks, rather than on the day.
Can you take the medicine every day?
No, not the licensed one. It is designed to delay ejaculation on a single occasion, and the product information states it must not be taken more frequently than once every 24 hours.
Why it is not a daily medicine
The pharmacology explains it. Plasma levels are less than 5% of peak concentrations by 24 hours after a dose, so nothing accumulates between occasions. There is no benefit in taking it on a day you do not need to delay ejaculation, and there is a real cost, because side effects apply to every tablet taken.
This is the opposite of how those alternatives work. Those are daily medicines by design, because their effect depends on a concentration held over time.
The once in 24 hours limit
If a dose is missed, do not take an extra one to make up for it. Never take more than one tablet inside a 24 hour period, whatever the reason.
If a tablet seems to do nothing, taking a second one is the wrong response. Side effects rise with the amount taken, and the recorded rates make that plain. Nausea more than doubles between the two licensed strengths.
Only your prescriber decides the strength and how often treatment is appropriate. This page contains no dosing schedule.
Medicine for occasional versus regular use
| On-demand | Daily/off-label | |
|---|---|---|
| Examples | Dapoxetine; Fortacin | Some longer-acting SSRIs; clomipramine |
| Licensed specifically for PE | Dapoxetine and Fortacin | Generally no |
| Timing | Before sexual activity | Regular use |
| How it works | Depends on treatment | Effect develops with continued treatment |
| Suitability | Depends on individual circumstances | Depends on individual circumstances |
If you need treatment most days, tell the prescriber. Frequency of sexual activity is one factor that may influence which treatment options are considered.
Is there a medicine for premature ejaculation without side effects?
No. No medicine can be guaranteed to be free of side effects. Different treatments have different adverse-effect profiles, so the relevant question is which option has an acceptable balance of benefits and risks for you.
What the recorded figures show
NICE reports the most common effects by treatment arm.
| Side effect | Placebo | Lower strength | Higher strength |
|---|---|---|---|
| Nausea | 2.2% | 11.0% | 22.2% |
| Dizziness | 2.2% | 5.8% | 10.9% |
| Fainting | 0.05% | 0.06% | 0.23% |
The product information also records diarrhoea, vomiting, fatigue, insomnia and anxiety as common, and tremor, blurred vision, a fast heartbeat, low blood pressure and erectile dysfunction as uncommon. Headache is very common but is not broken down by strength, so no honest percentage by strength exists for it.
Notice what those numbers actually say. Most men on the lower strength did not get nausea. Side effects are common enough to plan for and far from universal.
The option with the fewest whole body effects
Topical anaesthetics work locally rather than through the same systemic mechanism as oral serotonergic medicines. They can therefore have a different adverse-effect profile, although reduced penile or genital sensation can occur.
That is a genuine choice rather than a ranking, and it is worth raising at consultation if side effects are your main worry.
What is the safest medicine for premature ejaculation?
We are not going to name one, because the safest premature ejaculation treatment is individual rather than universal. The medicine that is entirely appropriate for one man is contraindicated in another.
What decides safety for you
The licensed medicine is contraindicated in men with significant cardiac conditions such as heart failure, significant ischaemic heart disease or a history of fainting. It is contraindicated in men with a history of mania or severe depression. It is contraindicated in moderate and severe liver impairment, so liver function matters, and it is not recommended in severe kidney impairment.
It is also contraindicated alongside a long list of other medicines, including other serotonin reuptake inhibitors, tricyclics, monoamine oxidase inhibitors, lithium, linezolid, tramadol, St John's Wort, triptans, certain antifungals, telithromycin and PDE5 inhibitors.
Alcohol and recreational drugs
The recorded advice is that patients should not use dapoxetine in combination with recreational drugs or alcohol. Alcohol intake increases the drowsiness and dizziness the medicine can cause, which matters because fainting is the rare event the safety advice exists for.
Grapefruit juice belongs in the same category and should be avoided within 24 hours before a dose, because it affects the same enzyme pathway as several contraindicated medicines.
What is the best medicine for premature ejaculation?
There is no best medicine in general, and no pharmacy honestly claims one. There is one licensed option and several borrowed ones, and which fits depends on your history.
Compare these instead of chasing a ranking.
- Licensing status, meaning authorised for premature ejaculation or borrowed from another use.
- Pattern of use. Before an occasion, or every day.
- Your contraindications and interactions.
- Which side effects you would least want.
- Whether a real consultation stands behind the supply.
- Total cost across a year rather than one pack.
How to get medicine for premature ejaculation
Prescription medicines used to treat premature ejaculation should be supplied through the appropriate prescribing and pharmacy route following clinical assessment.
Medicine for premature ejaculation online
A remote consultation is a lawful route. What makes it lawful is the assessment, not the website.
A suitable consultation should give the prescriber enough information to assess whether treatment is appropriate, including relevant medical history, current medicines and important contraindications.
For prescription-only medicines, a seller that allows purchase without the required prescribing process should be treated as a major warning sign. Use the MHRA register to check whether an online seller is authorised to supply medicines.
Assessment is history led
Assessment is often based primarily on the medical and sexual history. Further examination or investigations may be considered when the history suggests another underlying condition.
Your medical history does most of the work. If a prescriber does want further tests, it will usually be because something specific in your history points that way, not as a matter of routine.
Medicine for premature ejaculation cost
Priligy tablets are listed on our site at a standard price of £19.79. That is the regular price rather than a promotional or first order figure.
Because the licensed medicine is used before an occasion rather than daily, what a year costs depends entirely on how often it is used. A single pack price therefore tells you very little, and two men on the same medicine can spend very different amounts.
Compare only suppliers who carry out a real consultation. A lower figure from a site that skips the clinical step is not a cheaper version of the same service, and no price on this page is described as the lowest available, because we have not audited the market.
Medicine for premature ejaculation reviews
Reviews are a weaker guide here than for almost any other product, and the reason is in the trial data rather than in anyone's honesty.
The problem with reading reviews for this condition
The placebo group in the trials went from 0.9 minutes to 1.9 minutes. Men taking a dummy tablet gained a full minute, which NICE records as roughly the minimum clinically important change in this condition.
Those men would have written entirely sincere reviews describing a real improvement. Their reviews would also have been worthless as evidence, because the tablet contained nothing. Many factors influence future intimate behaviour and performance, so individual experiences with premature ejaculation medicine can vary widely.
The figures worth reading instead
Patient-reported outcomes also showed improvements in perceived control and other measures of treatment response, although the exact percentages depend on the specific outcome and analysis.
- Control rated good or very good: 26.2% on treatment against 11.2% on placebo.
- Satisfaction: 37.9% against 24.4%.
- Discontinuation for any reason: 31.1% against 28.9%.
Read the first line carefully. Roughly three quarters of men on active treatment did not rate their control as good or very good. That is a real improvement over placebo and a long way from what advertising implies. Results vary between individuals.
What to do if the medicine does not help
Do not increase the amount, and do not buy something stronger from an unregulated seller. Work through these five steps instead.
Step one, judge it fairly first
One disappointing occasion is not evidence of failure. Nerves on a first attempt are common, and they push in exactly the wrong direction for anyone hoping to delay ejaculation.
Give it several occasions before concluding anything, and keep a rough note of what happened rather than relying on impressions.
Step two, check it is the right problem
Occasional episodes are not the condition. If it happens sometimes and not usually, and it is not causing you distress, no medicine is needed.
Alcohol, recreational drugs, tiredness and unfamiliar circumstances all shorten timing temporarily in men with no underlying medical condition. Treating that pattern with a medicine will not work, because there is nothing there to treat.
Step three, check for erectile dysfunction
This is the most common reason a premature ejaculation medicine underperforms, and it is easy to miss.
Some men rush because they are racing an erection they think will not last. If that is what is happening, a medicine that acts on serotonin will not fix it, because the problem is not the reflex. Treating erectile dysfunction can resolve the timing without touching the timing directly.
You can review the available erectile dysfunction treatments to see what the separate options are. The two are not taken together, and NICE records that dapoxetine should not be used with PDE5 inhibitors, giving sildenafil as its example.
Step four, look at what else is going on
Relationship problems and premature ejaculation often arrive together, and it is rarely obvious which came first. Performance anxiety works the same way, building with each difficult occasion.
A tablet does nothing for either. That is not an argument against medicine, it is an argument for adding something alongside it.
Step five, go back to your prescriber
Tell them what happened across several occasions, whether you had side effects, and anything that has changed since the consultation.
There are more treatments available. A prescriber may consider a different strength, a topical option, or a medicine borrowed from another use, and each is a clinical decision rather than a request you can make.
Other ways to manage premature ejaculation
Medicine is not the only way to manage premature ejaculation, and several approaches cost nothing and interact with nothing. Men who manage premature ejaculation without a prescription usually do it with these, and men who have experienced premature ejaculation for a long time often find they help most alongside a medicine.
Pelvic floor exercises and kegel exercises
Pelvic floor exercises, also called kegel exercises, train the pelvic floor muscles involved in ejaculation. The pelvic floor is the group of muscles you would use to stop the flow of urine mid-stream, and a stronger pelvic floor helps some men delay ejaculation a little.
Kegel exercises take weeks of consistent work rather than days, and results vary between individuals. Weak pelvic floor muscles are not a diagnosis in the regulator record, so treat pelvic floor training as a useful habit rather than a fix for a named fault.
Can premature ejaculation be cured?
There is no medicine that should be described as a guaranteed cure for premature ejaculation. Dapoxetine and other treatments are used to manage symptoms, while behavioural and psychological approaches may help some men develop better control over time. Whether symptoms improve permanently varies between individuals.
When it is not premature ejaculation
Two other ejaculation problems get confused with this one, and no medicine on this page treats either.
Retrograde ejaculation
Retrograde ejaculation is a separate condition, and retrograde ejaculation is not rapid ejaculation or early ejaculation under a different name. Semen travels backwards into the bladder instead of out, so the noticeable feature is little or no fluid rather than short timing.
The treatments discussed on this page are not treatments for retrograde ejaculation. Retrograde ejaculation needs its own assessment because the underlying causes and treatment approach are different.
Delayed ejaculation caused by a medicine
If your complaint is the opposite pattern, a medicine you already take may be responsible for it rather than any ejaculation problem of its own. MHRA prescribing material on SSRIs records that ejaculation may be delayed or abnormal among their adverse effects.
In that situation the first step is a review of what you already take, not another medicine on top.
Medical disclaimer
This page is general information, not medical advice, and gives no dosing or timing instructions. Medicine for premature ejaculation is prescription only and should be used only under the supervision of an appropriately qualified prescriber after an individual assessment. Always read the patient information leaflet supplied with your medicine, and speak to a prescriber or pharmacist about your own circumstances.
