Basic Drug Info
Manufacturer: Sunrise Remedies Ltd.
Active Substance: Sildenafil citrate / duloxetine
Drug Form: Film-coated tablets
Available Doses: Sildenafil citrate 100 mg / 60 mg
What is Malegra DXT?
Malegra DXT is comprised of sildenafil and duloxetine and is employed in medicating erectile deficit (erectile dysfunction, or ED) aggravated by ejaculatory precocity (premature ejaculation, or PE). The drug is taken by mouth on demand, in anticipation of sexual activity.
The two active substances of Malegra DXT mutually enhance each other, helping to overcome the symptoms of comorbid condition that are often diagnosed in men with compromised sexual health. The connection between erectile deficit and shortened intravaginal ejaculatory latency time (IELT) is traced in a large number of patients and can be explained by general problems with sexual functions.
Insufficient blood supply to the penis during the moment of sexual arousal pre-conditions man’s inability to achieve and / or maintain a controllable erection, which then creates a stressful situation and has a detrimental effect on patient’s confidence, giving rise to a phenomenon known as “performance anxiety”. This latter then launches a series of negative thoughts that create more tension and further undermine the ability to engage in a healthy sexual rapport; a mechanism of psychological impotence that in a substantially large group of patients can be grounds for having a premature climax.
A reverse situation can also be true, with PE setting a scene for the development of ED. Either way, with the two conditions being undoubtedly the most prevalent sexual disorders in males, the pharmaceutical market found a conspicuous and meaningful addition to the family of sexual treatments with the introduction of the combinatory drug Malegra DXT.
What is sildenafil?
Sildenafil has become the first drug that can be administered orally for the treatment of erectile dysfunction, while being both safe and effective in treating within short and long-term; the substance became universally recognized as Viagra.
Viagra production, has given rise to strong public opinion. A large number of ED patients who used to seek help for their condition finally received treatment that yielded measurable results within minutes after administration. Currently, millions of men around the world have returned to normal sexual life and all thanks to the use of sildenafil.
In scientific terms, sildenafil is a representative of the class of cyclic guanosine monophosphate specific phosphodiesterase type 5 inhibitors; the acronym used for brevity of nomenclature is (cGMP specific) PDE5 inhibitors.
Sildenafil effects last during 4 to 6 hours; the drug’s efficacy window differs from one patient to another, being subject to individual response. User response largely depends on a variety of objective factors, such as age, general health condition, degree of erectile deficit, as well as variables like circumstances of drug administration.
What is duloxetine?
Duloxetine is an antidepressant drug belonging to the serotonin and norepinephrine reuptake inhibitor (SNRI) class. It is an analogue of fluoxetine (a selective serotonin reuptake inhibitor or SSRI) synthesized by the pharmaceutical company Eli Lilly.
Duloxetine is a selective inhibitor of serotonin (5-HT) and noradrenaline (NA) reuptake. These two monoamines are produced inside the respective presynaptic nerve endings and released into the synaptic wall (the space present between the presynaptic and postsynaptic termination) following the reception of certain stimuli.
Once in the synaptic space, 5-HT and NA interact with their postsynaptic receptors expressing their biological action. Afterwards, they bind to transporters assigned to their reuptake (SERT for serotonin and NET for noradrenaline) and are reported inside the presynaptic nerve termination.
Duloxetine inhibits both NET and SERT with high affinity, binding to them instead of endogenous monoamines. The inhibition of these transporters causes serotonin and noradrenaline to remain in the synaptic space for a prolonged time, thus allowing them to continue interacting with their receptors. Continuous receptor interaction results in an increase in the serotoninergic and noradrenergic signal, with consequent improvement in the pathologies treated.
The use of duloxetine in delay of ejaculation is off-label and is subject to therapy of choice by your doctor.
Recommendations for use
Malegra DXT is a prescription drug that needs to be taken according to recommendations of doctor. The drug should be taken by mouth approximately 1.5-2 hours before the sexual activity is planned; this will allow sufficient time for both of its components to get absorbed from the gastric tract and enter the blood stream.
Swallow a tablet of Malegra DXT with a half or a full glass of liquid, preferably water; avoid caffeine containing drinks and grapefruit juice. Alcohol drinks are absolutely prohibited from use alongside with drugs containing SNRI components.
Taking Malegra DXT on an empty stomach will intensify and speed up the onset of its effects, while ingestion after a light meal will dampen any potential side effects of either of the two substances contained therein. Keep in mind that heavy meals or meals with high content of fat will partially inhibit the health effects of the drug and / or delay their onset. This is true for the sildenafil component of Malegra DXT, but not duloxetine, whose efficacy is not affected by the timing of meals.
Malegra DXT should not be used in patients less than 18 years of age, because – in this category of patients – the drug increases the risk of suicide attempts and hostility (aggression, oppositional behavior and anger). Since duloxetine contained in Malegra DXT can cause drowsiness and dizziness, driving and using machines is not recommended. Abrupt discontinuation of duloxetine treatment is not recommended as withdrawal symptoms may occur.
Concerns for cardiovascular health associated with the incidence of cardiac symptoms as side effects of Malegra DXT occurring in 0.7% of patients have been recently counterbalanced by data of several researches of sildenafil effects on the heart. Lately on the pages of the internet sites that dealt with medicine and in particular the electronic medical journal BMC Medicine (Great Britain) it is increasingly recommended to use Viagra for treatment and prophylaxis of cardiovascular diseases.
According to experts of the institute of physiology at the Ruhr University in Bochum (Germany), the regular intake of this drug protects the cardiovascular system from many types of diseases. This effect occurs thanks to the active ingredient sildenafil which activates the titin protein in myocardial muscle cells, making them relax.
In parallel with German research, Sapienza scientists from the University of Rome also arrived at the same results. The head of the team of researchers Andres Isidore is of the opinion that sildenafil relaxes the blood vessels, improves the state of myocardial fibers and prevents damage to cardiac cells. Men taking Malegra DXT as an ultimate sexual enhancer also enhance their cardiovascular performance, as their heart becomes less exposed to the risk of stroke or heart attack with continued use of sildenafil.
The use of Malegra DXT should be avoided – or carried out with great caution – in patients who present the following conditions:
- Renal disorders;
- Seizure crises;
- Manic disorders;
- Bipolar disorders;
- Coagulation changes;
- Hyponatremia (low sodium levels in the bloodstream);
- Taking other medicines that can cause liver damage;
- Taking other medicines containing duloxetine.
If you are in any of these conditions, you must tell your doctor before starting duloxetine therapy.
Headache is one of the possible side effects, which comes when the medicine is not taken according to the instructions in the package insert. Headache after Malegra DXT may be due to overdose, combination with alcohol or nitrites.
Even in the case of strict compliance with all the rules of administration, the present side effect can occur in 10% of cases, which makes it the most frequent side effect, possible after taking Malegra DXT.
Dizziness occurs much less frequently and does not exceed 7% of cases.
Fewer users can develop such symptoms as drowsiness, migraine, ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, light-headedness, depression, insomnia. These occur in less than 1% of cases.
It should be noted that the frequency of side effects decreases as the body becomes accustomed to the drug. Thus, during Carson’s research, the headaches at the start of the study were present in 10% of erectile dysfunction patients, but after the 16 weeks they decreased to less than 1%, the rate of dizziness was also decreased from 7% to less than 1%.
An important fact is that two thirds of patients during this study gradually increased the dose of Malegra DXT.
- Most users (about 10%) report facial flushing.
- Not frequent Malegra DXT side effects (less than 1%) are tachycardia, heartbeat sensation, low blood pressure, myocardial ischemia, heart failure, deviation in ECG results.
- Rarely occurring (no more than in 0.5% of all registered cases) are atrial fibrillation and ventricular arrhythmia.
The effects of Malegra DXT associated with withdrawal can be as follows If duloxetine treatment is stopped abruptly, so-called withdrawal symptoms can occur. These symptoms include:
- difficulty sleeping;
- vivid dreams and nightmares;
- feeling of restlessness;
- nausea or vomiting;
- excessive sweating;
Usually, these symptoms do not occur in severe form and disappear within a few days, but – should they occur – it is still necessary to inform the doctor.