Extra Super P-Force (Sildenafil & Dapoxetine 100mg/100mg) Tablets

Extra Super P-Force general information

What is Extra Super P-Force used for?

Extra Super P-Force tablets 100mg/100mg are a combination medication used to treat erectile dysfunction (impotence) and premature ejaculation in men.  Erectile dysfunction (ED) is inability to achieve or maintain a hard, erect penis suitable for sexual activity, due to insufficient blood flow into the penis.  Extra Super P-Force tablets relax the blood vessels in the penis increasing blood flow and causing an erection, which is the natural response to sexual stimulation.  Extra Super P-Force tablets are also used to treat premature ejaculation that has persisted for more than six months.  Premature ejaculation is the most common sexual dysfunction in men of all ages and is defined as early ejaculation with minimal sexual stimulation before or soon after penetration.  Premature ejaculation is not a one-off problem but can persist and recur over a length of time and can cause great distress and problems with relationships.  Extra Super P-Force tablets 100mg/100mg help improve control over ejaculation and increase the time interval before ejaculation occurs during intercourse, by delaying the ejaculation process.  Extra Super P-Force tablets 100mg/100mg work by separate mechanisms to remedy two sexual dysfunction disorders but will only work if sexually aroused.   

How does Extra Super P-Force work?

Extra Super P-Force tablets 100mg/100mg contain sildenafil and dapoxetine, which are used in combination to treat erectile dysfunction and premature ejaculation.  Sildenafil in Extra Super P-Force tablets acts on the erectile tissue of the penis to increase blood flow which causes an erection.  During sexual stimulation nitric oxide is released in the erectile tissue of the penis which activates the enzyme guanylate cyclase.  This enzyme increases levels of a chemical called cyclic guanosine monophosphate (cGMP), which relaxes the blood vessels in the penis and allows blood to fill the spongy erectile tissues to cause an erection.  Another enzyme called phosphodiesterase type 5 (PDE5) breaks down cGMP preventing blood flow into the penis, which causes loss of an erection.  Sildenafil in Extra Super P-Force tablets inhibit the action of PDE5 which resolves erectile dysfunction by allowing the natural process of sexual stimulation to activate the cGMP mechanism for achieving and maintaining an erection. 

Dapoxetine in Extra Super P-Force tablets 100mg/100mg is a selective serotonin reuptake inhibitor (SSRI), and these drugs are normally used as antidepressants.  However, dapoxetine has been specifically designed for treating premature ejaculation, as it has a rapid onset of action, with maximum effect within 1-2 hours and a short half-life, which means that it is rapidly eliminated from the body within 24 hours.  Ejaculation is a reflex that is mediated by the sympathetic nervous system.  When sexual stimulation has reached a certain threshold, sensory nerve cells in the spinal cord are activated and nerve impulses are sent to the brain, which then send messages back to motor neurones controlling the muscles in the penis that contract to effect ejaculation.  The ejaculation reflex is thought to be mediated by serotonin, a specific brain chemical or neurotransmitter that is involved is transmitting nerve signals, which enables brain cells to communicate.  Low levels of serotonin in certain areas of the brain are thought to contribute to premature ejaculation.  Dapoxetine in Extra Super P-Force tablets 100mg/100mg blocks the reuptake of serotonin from the synapse, which is the gap between nerve cells across which chemical messages are sent from one nerve cell to another.  If the re-uptake of serotonin by the first nerve cell (pre-synaptic) is blocked, this means that there is more serotonin remaining for the receiving nerve cell (post-synaptic), which allows nerve cells to communicate with each other for longer.  This action of dapoxetine in Extra Super P-Force tablets helps prolong the ability to maintain sexual activity without premature ejaculation and maintain control over ejaculation for longer¹. 

Sildenafil and dapoxetine in Extra Super P-Force tablets 100mg/100mg work by different mechanisms of action to control two sexual dysfunction disorders².

What does Extra Super P-Force contain?

Extra Super P-Force tablets contains the active ingredients sildenafil (100mg) and dapoxetine (100mg), which are used in combination to treat erectile dysfunction and premature ejaculation.

Treating sexual dysfunction with Extra Super P-Force

Extra Super P-Force tablets 100mg/100mg contain sildenafil and dapoxetine, which are used in combination to treat erectile dysfunction and premature ejaculation.  Sildenafil in Extra Super P-Force tablets is a phosphodiesterase type 5 (PDE5) inhibitor, used to treat erectile dysfunction in men (impotence).  It acts directly on the erectile tissue of the penis and works by inhibiting the breakdown, by the enzyme PDE5, of a chemical called cGMP, produced in the erectile tissue of the penis during sexual arousal, and this action increases blood flow into the penis causing an erection.  Dapoxetine in Extra Super P-Force tablets 100mg/100mg is a selective serotonin reuptake inhibitor (SSRI) used to treat premature ejaculation.  Premature ejaculation is reflex controlled by the brain neurotransmitter serotonin and low levels of serotonin are thought to contribute to premature ejaculation.  Dapoxetine in Extra Super P-Force tablets 100mg/100mg blocks the reuptake of serotonin from the synapse, which is the gap between nerve cells across which chemical messages are sent from one nerve cell to another, which increases the amount of serotonin and allows nerve cells to communicate with each other for longer.  This action of dapoxetine in Extra Super P-Force tablets helps prolong the ability to maintain sexual activity without premature ejaculation and maintain control over ejaculation for longer.  When taken before planned sexual activity, Extra Super P-Force tablets 100mg/100mg work by different mechanisms of action to control two sexual dysfunction disorders.

What are the side effects of Extra Super P-Force?

The most commonly reported side effects when taking Extra Super P-Force tablets 100mg/100mg include headache, dizziness, nasal congestion, indigestion, nausea, diarrhoea, insomnia, fatigue flushing rash.

When should Extra Super P-Force not be used?

You should not use Extra Super P-Force tablets 100mg/100mg if you:

• are allergic to sildenafil or dapoxetine or any ingredients in Extra Super P-Force
• have liver or kidney disease
• have abnormally high or low blood pressure
• have an eye disease like non-arteritic anterior ischaemic optic neuropathy (NAION), which causes loss of vision or if you have retinitis pigmentosa
• have a condition where sexual intercourse inadvisable due to cardiovascular or heart problems or you have had a heart attack or stroke in the last 6 months
• have a bleeding disorder
• have a history of orthostatic hypotension (dizziness when standing up), without discussion with your doctor
• have depression, bipolar disorder, unstable epilepsy or schizophrenia
• are taking any monoamine oxidase inhibitor medications as these can cause serious reactions if taken with Extra Super P-Force or within 14 days  
• are taking any nitrate medication, such as nitroglycerin for angina, as it may lead to a severe drop in blood pressure
• are taking medicines that interact with Extra Super P-Force including thioridazine for schizophrenia, monoamine oxidase inhibitors (MAOIs) for depression, migraine medicines like sumatriptan, the analgesic tramadol, SSRI antidepressants like paroxetine or citalopram, SNRI antidepressants like venlafaxine, lithium for mood disorders, calcium channel blockers like verapamil or diltiazem for hypertension, the anticoagulant warfarin, HIV treatments like ritonavir, saquinavir and atazanavir, antifungals like ketoconazole, antibiotics like erythromycin and rifampicin, NSAIDs like aspirin or ibuprofen, alpha-blockers like doxazosin for high blood pressure, cimetidine for treating ulcers, herbal remedies containing St. John´s Wort

What medications interact with Extra Super P-Force?

Several medications interact with Extra Super P-Force tablets 100mg/100mg and should either not be taken while you are taking Extra Super P-Force or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Extra Super P-Force: any nitrate medication, such as nitroglycerin for angina, as it may lead to a severe drop in blood pressure, monoamine oxidase inhibitors for depression, thioridazine for schizophrenia, the anticoagulant warfarin increases risk of bleeding, NSAIDs like aspirin or ibuprofen St. John´s Wort, migraine medicines like sumatriptan, the analgesic tramadol, SSRI antidepressants like paroxetine or citalopram, SNRI antidepressants like venlafaxine, lithium for mood disorders
• Drugs that affect Extra Super P-Force: thioridazine for schizophrenia, antifungals like ketoconazole, antibiotics like erythromycin, HIV treatments like ritonavir and atazanavir, calcium channel blockers like diltiazem for hypertension
• Drugs that are affected by Extra Super P-Force: alpha-blockers like doxazosin for high blood pressure

How should Extra Super P-Force be taken?

You should take your Extra Super P-Force tablets 100mg/100mg swallowed whole with a glass of water with or without food and avoid alcohol.  You should take your Extra Super P-Force tablets 1-3 hours before planned sexual activity.  For premature ejaculation, Extra Super P-Force tablets will have maximum effect within 1-2 hours.  For erectile dysfunction Extra Super P-Force tablets 100mg/100mg work will have maximum effect within 30 minutes and last for around 4 hours.  You should not take more than one tablet in 24 hours and only if you plan to have sex. 

How long should you take Extra Super P-Force?

You should only take Extra Super P-Force tablets 100mg/100mg when you plan to have sex; it is not intended as a regular medication. 

How should Extra Super P-Force be stored?

You should store your Extra Super P-Force tablets 100mg/100mg below 25°C in a cool dry place. 

References

1. Russo A, Capogrosso P, Ventimiglia E, La Croce G, Boeri L, Montorsi F, Salonia A.  Efficacy and safety of dapoxetine in treatment of premature ejaculation: an evidence-based review. Int J Clin Pract 2016 Sep;70(9):723-33.
2. Abu El-Hamd M, Abdelhamed A. Comparison of the clinical efficacy and safety of the on-demand use of paroxetine, dapoxetine, sildenafil and combined dapoxetine with sildenafil in treatment of patients with premature ejaculation: A randomised placebo-controlled clinical trial. Andrologia 2018 Feb; 50 (1).