If Priligy (dapoxetine) isn't available, doesn't suit you, or you want options, there are several realistic replacements. Some work as drugs, others are topical or behavioral. Below I’ll list common choices, how they differ, and quick safety notes so you can bring a smart question to your doctor.
Dapoxetine is a short-acting SSRI made for premature ejaculation (PE). When it’s not an option, doctors often use other SSRIs off-label: paroxetine, sertraline, or fluoxetine. Those typically need daily dosing and can take weeks to show benefit. Expect higher rates of common SSRI side effects (nausea, sleep changes, sexual side effects) and discuss interactions with other meds.
Tramadol, an opioid with serotonin effects, can delay ejaculation in some men. It works for some but carries risks: dizziness, nausea, and dependence. It’s not a first-line long-term choice.
If erectile dysfunction is part of the problem, PDE5 inhibitors like sildenafil or tadalafil can help. They don’t directly treat PE but can improve confidence and performance, which often raises the time to ejaculation. Combining a PDE5 inhibitor with an SSRI or topical agent is common under a doctor’s guidance.
Topical anesthetics (lidocaine or prilocaine creams/sprays) numb the penis slightly and often add minutes to intercourse. They’re fast, used as needed, and have fewer systemic risks. Don’t overuse them — too much numbness can reduce pleasure and affect your partner. Use a condom if you’re worried about transfer.
Behavioral approaches work for many men. The stop-start and squeeze techniques, pelvic floor exercises, and sex therapy with a counselor or sex therapist are low-risk and can produce lasting gains. These take time and practice but avoid drug side effects.
Supplements like L-arginine, zinc, or certain herbal blends are marketed for PE, but evidence is mixed. If you try supplements, check interactions (especially with blood pressure meds) and buy from reputable sources. Avoid unregulated mixes that promise miracle results.
Safety first: don’t mix SSRIs with MAO inhibitors or certain migraine drugs. Avoid combining tramadol with high-dose SSRIs without medical oversight. If you buy meds online, use verified pharmacies and read our guide on safe ordering to avoid counterfeit products.
How to decide: describe your goals, side effects you’ll tolerate, and any other meds you take. If you want quick on-demand help, topical anesthetic or dapoxetine (where available) are options. For long-term change, consider daily SSRI plus behavioral therapy.
Talk to a prescriber before starting anything. A proper check can rule out hormonal issues, infections, or medication causes. If you want, read our deeper guides on ED medications and safe online pharmacies to plan your next steps.
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