{"id":62245,"date":"2024-03-10T10:15:28","date_gmt":"2024-03-10T10:15:28","guid":{"rendered":"https:\/\/medsname.com\/malegra-dxt-plus\/"},"modified":"2026-05-04T05:53:15","modified_gmt":"2026-05-04T05:53:15","slug":"malegra-dxt-plus","status":"publish","type":"product","link":"https:\/\/medsbase.com\/el\/malegra-dxt-plus\/","title":{"rendered":"Malegra DXT Plus"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">&#9889; Quick Answer &mdash; What is Malegra DXT Plus?<\/h3>\n<p style=\"margin:0;\"><strong>Malegra DXT Plus<\/strong> \u03c0\u03b5\u03c1\u03b9\u03ad\u03c7\u03b5\u03b9 <strong>sildenafil 100 mg + duloxetine 60 mg<\/strong> \u03ba\u03b1\u03b9 \u03c7\u03c1\u03b7\u03c3\u03b9\u03bc\u03bf\u03c0\u03bf\u03b9\u03b5\u03af\u03c4\u03b1\u03b9 \u03b3\u03b9\u03b1 \u03c3\u03c4\u03c5\u03c4\u03b9\u03ba\u03ae \u03b4\u03c5\u03c3\u03bb\u03b5\u03b9\u03c4\u03bf\u03c5\u03c1\u03b3\u03af\u03b1 \u03bc\u03b5 \u03c0\u03c1\u03cc\u03c9\u03c1\u03b7 \u03b5\u03ba\u03c3\u03c0\u03b5\u03c1\u03bc\u03ac\u03c4\u03b9\u03c3\u03b7. \u0394\u03b9\u03b1\u03c4\u03af\u03b8\u03b5\u03c4\u03b1\u03b9 \u03c3\u03b5 <strong>100+60 mg (packs of 10 \/ 30 \/ 60 \/ 90 \/ 180 tablets)<\/strong>. \u0397 \u03ba\u03bb\u03b9\u03bd\u03b9\u03ba\u03ae \u03b5\u03c0\u03af\u03b4\u03c1\u03b1\u03c3\u03b7 \u03b4\u03b9\u03b1\u03c1\u03ba\u03b5\u03af \u03c0\u03b5\u03c1\u03af\u03c0\u03bf\u03c5 <strong>4\u20136 hours for ED; duloxetine steady-state over 2\u20134 weeks<\/strong>. \u039a\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03ac\u03b6\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7 Sunrise Remedies.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>\u0391\u03c5\u03c4\u03cc \u03c0\u03bf\u03c5 \u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03b5\u03c4\u03b5 \u03bc\u03b5 \u03c4\u03b7\u03bd MedsBase:<\/strong> \u03a0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03b7\u03bc\u03ad\u03bd\u03bf\u03c2 \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ae\u03c2 WHO-GMP \u00b7 \u0394\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u00b7 \u03a0\u03b1\u03b3\u03ba\u03cc\u03c3\u03bc\u03b9\u03b1 \u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae \u00b7 1,400+ \u03b5\u03c0\u03b1\u03bb\u03b7\u03b8\u03b5\u03c5\u03bc\u03ad\u03bd\u03b5\u03c2 <a href=\"https:\/\/medsbase.com\/el\/reviews\/\">\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ad\u03c2 \u03c0\u03b5\u03bb\u03b1\u03c4\u03ce\u03bd<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd <a href=\"https:\/\/medsbase.com\/el\/medsbase-re-shipment-assurance-policy\/\"><strong>\u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03b3\u03b3\u03cd\u03b7\u03c3\u03b7\u03c2 \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2<\/strong><\/a> \u2014 \u03b5\u03ac\u03bd \u03c4\u03bf \u03b4\u03ad\u03bc\u03b1 \u03c3\u03b1\u03c2 \u03b4\u03b5\u03bd \u03c6\u03c4\u03ac\u03c3\u03b5\u03b9 \u03b5\u03bd\u03c4\u03cc\u03c2 20 \u03b5\u03c1\u03b3\u03ac\u03c3\u03b9\u03bc\u03c9\u03bd \u03b7\u03bc\u03b5\u03c1\u03ce\u03bd, \u03c4\u03bf \u03b5\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03c5\u03bc\u03b5.<\/p>\n<h3>\u0393\u03b9\u03b1\u03c4\u03af \u03bd\u03b1 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03af\u03bb\u03b5\u03c4\u03b5 \u03b1\u03c0\u03cc \u03c4\u03b7 MedsBase<\/h3>\n<p>\u03a4\u03b1 \u03b3\u03b5\u03bd\u03cc\u03c3\u03b7\u03bc\u03b1 \u03c6\u03ac\u03c1\u03bc\u03b1\u03ba\u03ac \u03bc\u03b1\u03c2 \u03c0\u03c1\u03bf\u03ad\u03c1\u03c7\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ad\u03c2 \u03c0\u03bf\u03c5 \u03c0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd WHO-GMP \u03ba\u03b1\u03b9 \u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03bd\u03c4\u03b1\u03b9 \u03c0\u03b1\u03b3\u03ba\u03bf\u03c3\u03bc\u03af\u03c9\u03c2 \u03c3\u03b5 \u03b4\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae, \u03b1\u03c0\u03bb\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u2014 \u03c7\u03c9\u03c1\u03af\u03c2 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5 \u03c3\u03c4\u03bf \u03b5\u03be\u03c9\u03c4\u03b5\u03c1\u03b9\u03ba\u03cc \u03c4\u03bf\u03c5 \u03b4\u03ad\u03bc\u03b1\u03c4\u03bf\u03c2. \u039f\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u03b4\u03c1\u03bf\u03bc\u03bf\u03bb\u03bf\u03b3\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03bc\u03ad\u03c3\u03c9 \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf\u03c5 \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae (\u03bf\u03b9 \u03c0\u03b5\u03c1\u03b9\u03b3\u03c1\u03b1\u03c6\u03ad\u03c2 \u03b5\u03ba\u03ba\u03b1\u03b8\u03ac\u03c1\u03b9\u03c3\u03b7\u03c2 \u03c0\u03b5\u03c1\u03b9\u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03bf\u03c5\u03bd \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ce\u03bd \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u2014 \u03c0\u03bf\u03c4\u03ad \u201cMedsBase\u201d \u03ae \u03bf\u03c0\u03bf\u03b9\u03bf\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5). \u0393\u03af\u03bd\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b4\u03b5\u03ba\u03c4\u03ad\u03c2 \u03ba\u03b1\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03c1\u03c5\u03c0\u03c4\u03bf\u03bd\u03bf\u03bc\u03af\u03c3\u03bc\u03b1\u03c4\u03b1 \u03ba\u03b1\u03b9 \u03c4\u03c1\u03b1\u03c0\u03b5\u03b6\u03b9\u03ba\u03ae \u03bc\u03b5\u03c4\u03b1\u03c6\u03bf\u03c1\u03ac SEPA. \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2 \u0395\u03be\u03b1\u03c3\u03c6\u03b1\u03bb\u03af\u03c3\u03b5\u03ce\u03c2 \u03bc\u03b1\u03c2.<\/p>\n<p><strong>Malegra DXT Plus<\/strong> combines <strong>sildenafil 100 mg<\/strong> (a short-acting PDE5 inhibitor for erectile dysfunction) with <strong>duloxetine 60 mg<\/strong> (an SNRI \u2014 serotonin-norepinephrine reuptake inhibitor \u2014 that delays ejaculation). Unlike dapoxetine (engineered for on-demand PE use), duloxetine is a <strong>daily-use SNRI<\/strong> where the ejaculation-delay effect builds over 2\u20134 weeks of continuous dosing.<\/p>\n<p>Manufactured by Sunrise Remedies, Malegra DXT Plus is intended for men with <strong>\u03c4\u03b1\u03c5\u03c4\u03cc\u03c7\u03c1\u03bf\u03bd\u03b7 \u03c3\u03c4\u03c5\u03c4\u03b9\u03ba\u03ae \u03b4\u03c5\u03c3\u03bb\u03b5\u03b9\u03c4\u03bf\u03c5\u03c1\u03b3\u03af\u03b1 \u03ba\u03b1\u03b9 \u03c0\u03c1\u03cc\u03c9\u03c1\u03b7 \u03b5\u03ba\u03c3\u03c0\u03b5\u03c1\u03bc\u03ac\u03c4\u03b9\u03c3\u03b7<\/strong> who tolerate or specifically prefer SNRI-based therapy over SSRI alternatives.<\/p>\n<h2 class=\"wp-block-heading\">What Is Malegra DXT Plus?<\/h2>\n<p>Malegra DXT Plus is a combination tablet containing:<\/p>\n<ul>\n<li><strong>Sildenafil 100 mg<\/strong> \u2014 a PDE5 inhibitor; improves erectile response, effects last 4\u20136 hours<\/li>\n<li><strong>Duloxetine 60 mg<\/strong> \u2014 an SNRI; extends ejaculatory latency when taken daily for 2\u20134+ weeks<\/li>\n<\/ul>\n<p><strong>\u03a3\u03b7\u03bc\u03b1\u03bd\u03c4\u03b9\u03ba\u03cc:<\/strong> duloxetine is <strong>not an on-demand PE drug<\/strong>. It requires continuous daily dosing to reach steady-state pharmacology. The PE-delay benefit builds gradually and stops when you stop \u2014 it is also not FDA-approved specifically for PE (use is off-label). For on-demand PE, a dapoxetine-based combination such as <a href=\"https:\/\/medsbase.com\/el\/super-p-force\/\" rel=\"noopener\">Super P-Force<\/a> \u03ae <a href=\"https:\/\/medsbase.com\/el\/super-tadarise\/\" rel=\"noopener\">Super Tadarise<\/a> is more practical.<\/p>\n<h2 class=\"wp-block-heading\">How Does Malegra DXT Plus Work?<\/h2>\n<ul>\n<li><strong>Sildenafil<\/strong> blocks PDE5 in the corpus cavernosum, extending cyclic GMP activity and allowing increased blood inflow during sexual arousal<\/li>\n<li><strong>Duloxetine<\/strong> inhibits both serotonin and norepinephrine reuptake. The raised synaptic serotonin delays the ejaculatory reflex; the norepinephrine component gives duloxetine a more &#8220;activating&#8221; profile than pure SSRIs<\/li>\n<\/ul>\n<p>Duloxetine has a half-life of ~12 hours, substantially shorter than fluoxetine (active metabolite persists 7\u201315 days). Steady-state concentration is reached in 3\u20134 days, but the clinical PE-delay effect typically takes 2\u20134 weeks to stabilise.<\/p>\n<h2 class=\"wp-block-heading\">Sildenafil vs Duloxetine vs Dapoxetine \u2014 Why the Combination Matters<\/h2>\n<table>\n<thead>\n<tr>\n<th>Drug class<\/th>\n<th>Role in this tablet<\/th>\n<th>On-demand vs daily<\/th>\n<th>Onset of PE benefit<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>Sildenafil (PDE5i)<\/strong><\/td>\n<td>ED component \u2014 provides erectile support<\/td>\n<td>On-demand, per tablet<\/td>\n<td>25\u201360 minutes before activity<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td><strong>Duloxetine (SNRI)<\/strong><\/td>\n<td>PE component \u2014 delays ejaculation<\/td>\n<td>Daily dosing required<\/td>\n<td>2\u20134 weeks to full effect<\/td>\n<\/tr>\n<tr>\n<td><strong>Dapoxetine (SSRI)<\/strong> <em>(not in this tablet \u2014 comparison only)<\/em><\/td>\n<td>On-demand PE<\/td>\n<td>On-demand 1\u20133 h pre-activity<\/td>\n<td>Same day<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">\u03a7\u03c1\u03ae\u03c3\u03b5\u03b9\u03c2 \u03ba\u03b1\u03b9 \u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2<\/h2>\n<ul>\n<li><strong>\u03a3\u03c5\u03bd\u03c5\u03c0\u03ac\u03c1\u03c7\u03bf\u03c5\u03c3\u03b1 \u0395\u03bd\u03b5\u03c1\u03b3\u03b5\u03b9\u03b1\u03ba\u03ae \u0394\u03c5\u03c3\u03bb\u03b5\u03b9\u03c4\u03bf\u03c5\u03c1\u03b3\u03af\u03b1 (ED) \u03ba\u03b1\u03b9 \u03a0\u03c1\u03c9\u03c7\u03c9\u03c1\u03ae \u0395\u03ba\u03c3\u03c0\u03b5\u03c1\u03bc\u03ac\u03c4\u03b9\u03c3\u03b7 (PE)<\/strong> where daily SNRI therapy is acceptable<\/li>\n<li><strong>PE with mood, anxiety, or chronic-pain overlap<\/strong> \u2014 duloxetine is also FDA-approved for generalized anxiety, diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain<\/li>\n<li><strong>Men who did not respond well to SSRIs<\/strong> and want SNRI cover instead<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Malegra DXT Plus Dosage and Administration<\/h2>\n<table>\n<thead>\n<tr>\n<th>\u03a3\u03b5\u03bd\u03ac\u03c1\u03b9\u03bf<\/th>\n<th>\u03a3\u03c5\u03bd\u03b9\u03c3\u03c4\u03ce\u03bc\u03b5\u03bd\u03b7 \u03a0\u03c1\u03bf\u03c3\u03ad\u03b3\u03b3\u03b9\u03c3\u03b7<\/th>\n<th>\u03a3\u03b7\u03bc\u03b5\u03b9\u03ce\u03c3\u03b5\u03b9\u03c2<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>First-time combination use<\/strong><\/td>\n<td>1 tablet daily under medical supervision<\/td>\n<td>Sildenafil is per-tablet on-demand; duloxetine effect builds over 2\u20134 weeks<\/td>\n<\/tr>\n<tr>\n<td><strong>ED \u2014 single dose<\/strong><\/td>\n<td>100 mg sildenafil component works per tablet<\/td>\n<td>25\u201360 min before sexual activity<\/td>\n<\/tr>\n<tr>\n<td><strong>PE \u2014 sustained effect<\/strong><\/td>\n<td>Duloxetine requires 2\u20134 weeks of daily dosing<\/td>\n<td>Do not expect immediate PE relief from a single tablet<\/td>\n<\/tr>\n<tr>\n<td><strong>Maximum sildenafil exposure<\/strong><\/td>\n<td>1 \u03b4\u03b9\u03c3\u03ba\u03af\u03bf \u03b1\u03bd\u03ac 24 \u03ce\u03c1\u03b5\u03c2<\/td>\n<td>Contains a full 100 mg sildenafil dose<\/td>\n<\/tr>\n<tr>\n<td><strong>\u0397\u03c0\u03b1\u03c4\u03b9\u03ba\u03ae \u03b4\u03c5\u03c3\u03bb\u03b5\u03b9\u03c4\u03bf\u03c5\u03c1\u03b3\u03af\u03b1<\/strong><\/td>\n<td><strong>\u0391\u03c0\u03bf\u03c6\u03cd\u03b3\u03b5\u03c4\u03b5<\/strong> \u2014 black-box-style warning for duloxetine<\/td>\n<td>Duloxetine is hepatically cleared; hepatotoxicity is a recognised risk<\/td>\n<\/tr>\n<tr>\n<td><strong>Heavy alcohol use<\/strong><\/td>\n<td><strong>\u0391\u03c0\u03bf\u03c6\u03cd\u03b3\u03b5\u03c4\u03b5<\/strong><\/td>\n<td>Amplifies hepatotoxicity risk with duloxetine<\/td>\n<\/tr>\n<tr>\n<td><strong>Creatinine clearance &lt;30 mL\/min<\/strong><\/td>\n<td>Avoid \u2014 duloxetine levels rise substantially<\/td>\n<td>Use separate dose-adjusted components<\/td>\n<\/tr>\n<tr>\n<td><strong>\u0397\u03bb\u03b9\u03ba\u03b9\u03c9\u03bc\u03ad\u03bd\u03bf\u03b9 (65+)<\/strong><\/td>\n<td>\u03a7\u03c1\u03ae\u03c3\u03b7 \u03bc\u03b5 \u03c0\u03c1\u03bf\u03c3\u03bf\u03c7\u03ae<\/td>\n<td>Higher hyponatraemia risk with SSRIs and SNRIs<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3 class=\"wp-block-heading\">How to Take Malegra DXT Plus Properly<\/h3>\n<ul>\n<li>Swallow the tablet whole with water \u2014 can be taken with or without food; a heavy fatty meal slows sildenafil onset slightly<\/li>\n<li>For sustained PE benefit, take daily at roughly the same time (build-up phase = 2\u20134 weeks)<\/li>\n<li>For ED benefit on any given day, take 25\u201360 min before anticipated activity<\/li>\n<li>Do not exceed one tablet per 24 hours<\/li>\n<li>Do not combine with MAOIs \u2014 14-day washout required before starting; 5 days required after stopping duloxetine before starting an MAOI<\/li>\n<li><strong>\u039c\u03b7\u03bd \u03b4\u03b9\u03b1\u03ba\u03cc\u03c8\u03b5\u03c4\u03b5 \u03b1\u03c0\u03cc\u03c4\u03bf\u03bc\u03b1<\/strong> after several weeks of use \u2014 taper over 2 weeks to reduce discontinuation syndrome (dizziness, headache, nausea, electric-shock sensations, insomnia). Duloxetine has a shorter half-life than fluoxetine, so discontinuation symptoms are more pronounced<\/li>\n<li>Avoid alcohol \u2014 amplifies hepatic risk and sedation<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Side Effects of Malegra DXT Plus<\/h2>\n<table>\n<thead>\n<tr>\n<th>\u03a3\u03c5\u03c3\u03c4\u03b1\u03c4\u03b9\u03ba\u03cc \/ \u03a3\u03bf\u03b2\u03b1\u03c1\u03cc\u03c4\u03b7\u03c4\u03b1<\/th>\n<th>\u03a0\u03b1\u03c1\u03b5\u03bd\u03ad\u03c1\u03b3\u03b5\u03b9\u03b1<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>Sildenafil \u2014 \u03c3\u03c5\u03c7\u03bd\u03ad\u03c2<\/strong><\/td>\n<td>Headache, flushing, dyspepsia, nasal congestion, visual disturbance (blue tinge)<\/td>\n<\/tr>\n<tr>\n<td><strong>Duloxetine \u2014 common<\/strong><\/td>\n<td>Nausea, dry mouth, somnolence OR insomnia (variable), constipation, decreased appetite, sweating, dizziness<\/td>\n<\/tr>\n<tr>\n<td><strong>Duloxetine \u2014 less common<\/strong><\/td>\n<td>Blood pressure elevation (norepinephrine effect), sexual dysfunction (delayed\/absent orgasm \u2014 mechanism of benefit for PE), fatigue, urinary hesitation, headache<\/td>\n<\/tr>\n<tr>\n<td><strong>Duloxetine \u2014 uncommon but important<\/strong><\/td>\n<td>Hepatotoxicity (elevated liver enzymes; rarely severe). Abnormal bleeding (SNRI class effect). Hyponatraemia (especially elderly). Suicidal ideation \u2014 highest risk in first weeks, and in young adults &lt;25<\/td>\n<\/tr>\n<tr>\n<td><strong>\u03a3\u03c0\u03ac\u03bd\u03b9\u03b5\u03c2<\/strong><\/td>\n<td>Serotonin syndrome (with other serotonergic drugs), Stevens-Johnson syndrome, priapism, acute glaucoma (mydriasis \u2192 angle closure), severe hepatotoxicity, urinary retention<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Key safety note:<\/strong> duloxetine carries a class-of-antidepressant warning for transient increase in suicidal thoughts, particularly in young adults (&lt;25) during the first weeks. Regular contact with a prescriber during initiation is essential. Also a well-documented risk of hepatotoxicity \u2014 avoid with heavy alcohol use, pre-existing liver disease, or chronic hepatitis.<\/p>\n<h2 class=\"wp-block-heading\">\u03a0\u03c1\u03bf\u03b5\u03b9\u03b4\u03bf\u03c0\u03bf\u03b9\u03ae\u03c3\u03b5\u03b9\u03c2 \u03ba\u03b1\u03b9 \u03c0\u03c1\u03bf\u03c6\u03c5\u03bb\u03ac\u03be\u03b5\u03b9\u03c2<\/h2>\n<ul>\n<li><strong>\u039a\u03b1\u03c1\u03b4\u03b9\u03b1\u03b3\u03b3\u03b5\u03b9\u03b1\u03ba\u03ae \u03ba\u03b1\u03c4\u03ac\u03c3\u03c4\u03b1\u03c3\u03b7 \u03b3\u03b9\u03b1 \u03c3\u03b5\u03be<\/strong> \u2014 \u03b7 \u03c3\u03b5\u03be\u03bf\u03c5\u03b1\u03bb\u03b9\u03ba\u03ae \u03b4\u03c1\u03b1\u03c3\u03c4\u03b7\u03c1\u03b9\u03cc\u03c4\u03b7\u03c4\u03b1 \u03b5\u03c0\u03b9\u03b2\u03ac\u03bb\u03bb\u03b5\u03b9 \u03ba\u03b1\u03c1\u03b4\u03b9\u03b1\u03ba\u03ae \u03c6\u03cc\u03c1\u03c4\u03c9\u03c3\u03b7. \u0386\u03bd\u03b4\u03c1\u03b5\u03c2 \u03bc\u03b5 \u03b5\u03bd\u03b5\u03c1\u03b3\u03ae \u03c3\u03c4\u03b7\u03b8\u03ac\u03b3\u03c7\u03b7, \u03c0\u03c1\u03cc\u03c3\u03c6\u03b1\u03c4\u03bf \u03ad\u03bc\u03c6\u03c1\u03b1\u03b3\u03bc\u03b1 (\u03b5\u03bd\u03c4\u03cc\u03c2 90 \u03b7\u03bc\u03b5\u03c1\u03ce\u03bd), \u03b1\u03bd\u03b5\u03be\u03ad\u03bb\u03b5\u03b3\u03ba\u03c4\u03b7 \u03b1\u03c1\u03c1\u03c5\u03b8\u03bc\u03af\u03b1 \u03ae \u03c3\u03bf\u03b2\u03b1\u03c1\u03ae \u03ba\u03b1\u03c1\u03b4\u03b9\u03b1\u03ba\u03ae \u03b1\u03bd\u03b5\u03c0\u03ac\u03c1\u03ba\u03b5\u03b9\u03b1 \u03c0\u03c1\u03ad\u03c0\u03b5\u03b9 \u03bd\u03b1 \u03c5\u03c0\u03bf\u03b2\u03bb\u03b7\u03b8\u03bf\u03cd\u03bd \u03c3\u03b5 \u03ba\u03b1\u03c1\u03b4\u03b9\u03b1\u03ba\u03ae \u03b1\u03be\u03b9\u03bf\u03bb\u03cc\u03b3\u03b7\u03c3\u03b7 \u03c0\u03c1\u03b9\u03bd \u03be\u03b5\u03ba\u03b9\u03bd\u03ae\u03c3\u03bf\u03c5\u03bd \u03b1\u03bd\u03b1\u03c3\u03c4\u03bf\u03bb\u03ad\u03b1 PDE5<\/li>\n<li><strong>\u03a0\u03af\u03b5\u03c3\u03b7 \u03b1\u03af\u03bc\u03b1\u03c4\u03bf\u03c2<\/strong> \u2014 \u03bf\u03b9 \u03b1\u03bd\u03b1\u03c3\u03c4\u03bf\u03bb\u03b5\u03af\u03c2 PDE5 \u03c0\u03c1\u03bf\u03ba\u03b1\u03bb\u03bf\u03cd\u03bd \u03ae\u03c0\u03b9\u03b5\u03c2, \u03c0\u03b1\u03c1\u03bf\u03b4\u03b9\u03ba\u03ad\u03c2 \u03bc\u03b5\u03b9\u03ce\u03c3\u03b5\u03b9\u03c2 \u03c4\u03b7\u03c2 \u03c0\u03af\u03b5\u03c3\u03b7\u03c2\u00b7 \u03c7\u03c1\u03b7\u03c3\u03b9\u03bc\u03bf\u03c0\u03bf\u03b9\u03b5\u03af\u03c4\u03b5 \u03bc\u03b5 \u03c0\u03c1\u03bf\u03c3\u03bf\u03c7\u03ae \u03b5\u03ac\u03bd \u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03b5\u03c4\u03b5 \u03c0\u03bf\u03bb\u03bb\u03b1\u03c0\u03bb\u03ac \u03b1\u03bd\u03c4\u03b9\u03c5\u03c0\u03b5\u03c1\u03c4\u03b1\u03c3\u03b9\u03ba\u03ac<\/li>\n<li><strong>\u03a0\u03c1\u03b9\u03b1\u03c0\u03b9\u03c3\u03bc\u03cc\u03c2<\/strong> \u2014 \u03c5\u03c8\u03b7\u03bb\u03cc\u03c4\u03b5\u03c1\u03bf\u03c2 \u03ba\u03af\u03bd\u03b4\u03c5\u03bd\u03bf\u03c2 \u03c3\u03b5 \u03ac\u03bd\u03b4\u03c1\u03b5\u03c2 \u03bc\u03b5 \u03b4\u03c1\u03b5\u03c0\u03b1\u03bd\u03bf\u03ba\u03c5\u03c4\u03c4\u03b1\u03c1\u03b9\u03ba\u03ae \u03b1\u03bd\u03b1\u03b9\u03bc\u03af\u03b1, \u03c0\u03bf\u03bb\u03bb\u03b1\u03c0\u03bb\u03cc \u03bc\u03c5\u03ad\u03bb\u03c9\u03bc\u03b1 \u03ae \u03bb\u03b5\u03c5\u03c7\u03b1\u03b9\u03bc\u03af\u03b1\u00b7 \u03b6\u03b7\u03c4\u03ae\u03c3\u03c4\u03b5 \u03ac\u03bc\u03b5\u03c3\u03b7 \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u03c0\u03b5\u03c1\u03af\u03b8\u03b1\u03bb\u03c8\u03b7 \u03b5\u03ac\u03bd \u03b7 \u03c3\u03c4\u03cd\u03c3\u03b7 \u03b4\u03b9\u03b1\u03c1\u03ba\u03b5\u03af \u03c0\u03b5\u03c1\u03b9\u03c3\u03c3\u03cc\u03c4\u03b5\u03c1\u03bf \u03b1\u03c0\u03cc 4 \u03ce\u03c1\u03b5\u03c2<\/li>\n<li><strong>\u038c\u03c1\u03b1\u03c3\u03b7<\/strong> \u2014 \u03b4\u03b9\u03b1\u03ba\u03cc\u03c8\u03c4\u03b5 \u03ba\u03b1\u03b9 \u03b6\u03b7\u03c4\u03ae\u03c3\u03c4\u03b5 \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u03b1\u03be\u03b9\u03bf\u03bb\u03cc\u03b3\u03b7\u03c3\u03b7 \u03b5\u03ac\u03bd \u03b5\u03bc\u03c6\u03b1\u03bd\u03b9\u03c3\u03c4\u03bf\u03cd\u03bd \u03be\u03b1\u03c6\u03bd\u03b9\u03ba\u03ad\u03c2 \u03bf\u03c0\u03c4\u03b9\u03ba\u03ad\u03c2 \u03b1\u03bb\u03bb\u03b1\u03b3\u03ad\u03c2\u00b7 \u03ad\u03c7\u03bf\u03c5\u03bd \u03b1\u03bd\u03b1\u03c6\u03b5\u03c1\u03b8\u03b5\u03af \u03c3\u03c0\u03ac\u03bd\u03b9\u03b5\u03c2 \u03c0\u03b5\u03c1\u03b9\u03c0\u03c4\u03ce\u03c3\u03b5\u03b9\u03c2 \u03bc\u03b7 \u03b1\u03c1\u03c4\u03b7\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae\u03c2 \u03c0\u03c1\u03cc\u03c3\u03b8\u03b9\u03b1\u03c2 \u03b9\u03c3\u03c7\u03b1\u03b9\u03bc\u03b9\u03ba\u03ae\u03c2 \u03bf\u03c0\u03c4\u03b9\u03ba\u03ae\u03c2 \u03bd\u03b5\u03c5\u03c1\u03bf\u03c0\u03ac\u03b8\u03b5\u03b9\u03b1\u03c2 (NAION)<\/li>\n<li><strong>\u0391\u03ba\u03bf\u03ae<\/strong> \u2014 \u03c3\u03c0\u03ac\u03bd\u03b9\u03b5\u03c2 \u03b1\u03bd\u03b1\u03c6\u03bf\u03c1\u03ad\u03c2 \u03b3\u03b9\u03b1 \u03be\u03b1\u03c6\u03bd\u03b9\u03ba\u03ae \u03b1\u03c0\u03ce\u03bb\u03b5\u03b9\u03b1 \u03b1\u03ba\u03bf\u03ae\u03c2 \u03b1\u03b9\u03c3\u03b8\u03b7\u03c4\u03b7\u03c1\u03b9\u03b1\u03ba\u03bf\u03cd \u03bd\u03b5\u03c5\u03c1\u03ce\u03bd\u03b1 \u2014 \u03b4\u03b9\u03b1\u03ba\u03cc\u03c8\u03c4\u03b5 \u03ba\u03b1\u03b9 \u03c3\u03c5\u03bc\u03b2\u03bf\u03c5\u03bb\u03b5\u03c5\u03c4\u03b5\u03af\u03c4\u03b5 \u03ad\u03bd\u03b1\u03bd \u03b3\u03b9\u03b1\u03c4\u03c1\u03cc \u03b5\u03ac\u03bd \u03b5\u03c0\u03b7\u03c1\u03b5\u03b1\u03c3\u03c4\u03b5\u03af\u03c4\u03b5<\/li>\n<li><strong>\u0391\u03bb\u03ba\u03bf\u03cc\u03bb<\/strong> \u2014 \u03c3\u03b7\u03bc\u03b1\u03bd\u03c4\u03b9\u03ba\u03ae \u03ba\u03b1\u03c4\u03b1\u03bd\u03ac\u03bb\u03c9\u03c3\u03b7 \u03b1\u03bb\u03ba\u03bf\u03cc\u03bb \u03c3\u03b5 \u03c3\u03c5\u03bd\u03b4\u03c5\u03b1\u03c3\u03bc\u03cc \u03bc\u03b5 \u03bf\u03c0\u03bf\u03b9\u03bf\u03bd\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03b1\u03bd\u03b1\u03c3\u03c4\u03bf\u03bb\u03ad\u03b1 PDE5 \u03bc\u03c0\u03bf\u03c1\u03b5\u03af \u03bd\u03b1 \u03b5\u03bd\u03b9\u03c3\u03c7\u03cd\u03c3\u03b5\u03b9 \u03c4\u03bf \u03b6\u03ac\u03bb\u03b7, \u03c4\u03bf\u03bd \u03c0\u03bf\u03bd\u03bf\u03ba\u03ad\u03c6\u03b1\u03bb\u03bf \u03ba\u03b1\u03b9 \u03c4\u03b7\u03bd \u03c7\u03b1\u03bc\u03b7\u03bb\u03ae \u03b1\u03c1\u03c4\u03b7\u03c1\u03b9\u03b1\u03ba\u03ae \u03c0\u03af\u03b5\u03c3\u03b7<\/li>\n<li><strong>\u03a7\u03c5\u03bc\u03cc\u03c2 \u03b3\u03ba\u03c1\u03ad\u03b9\u03c0\u03c6\u03c1\u03bf\u03c5\u03c4<\/strong> \u2014 \u03b1\u03bd\u03b1\u03c3\u03c4\u03ad\u03bb\u03bb\u03b5\u03b9 \u03c4\u03bf CYP3A4 \u03ba\u03b1\u03b9 \u03bc\u03c0\u03bf\u03c1\u03b5\u03af \u03bd\u03b1 \u03b1\u03c5\u03be\u03ae\u03c3\u03b5\u03b9 \u03c4\u03b1 \u03b5\u03c0\u03af\u03c0\u03b5\u03b4\u03b1 \u03c4\u03bf\u03c5 \u03b1\u03af\u03bc\u03b1\u03c4\u03bf\u03c2<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">\u0391\u03bd\u03c4\u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2 \u2014 \u03a0\u03bf\u03b9\u03bf\u03c2 \u0394\u0395\u039d \u03a0\u03c1\u03ad\u03c0\u03b5\u03b9 \u03bd\u03b1 \u039b\u03ac\u03b2\u03b5\u03b9 \u0391\u03c5\u03c4\u03cc \u03c4\u03bf \u03a6\u03ac\u03c1\u03bc\u03b1\u03ba\u03bf<\/h2>\n<ul>\n<li><strong>\u03a4\u03b1\u03c5\u03c4\u03cc\u03c7\u03c1\u03bf\u03bd\u03b7 \u03c7\u03c1\u03ae\u03c3\u03b7 \u03bf\u03c0\u03bf\u03b9\u03bf\u03c5\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03bd\u03b9\u03c4\u03c1\u03b9\u03ba\u03bf\u03cd<\/strong> \u2014 GTN, \u03bc\u03bf\u03bd\u03bf\/\u03b4\u03b9\u03bd\u03bf\u03c4\u03c1\u03b9\u03ba\u03cc \u03b9\u03c3\u03bf\u03c3\u03bf\u03c1\u03b2\u03af\u03b4\u03b9\u03bf, \u03bd\u03b9\u03ba\u03bf\u03c1\u03b1\u03bd\u03b4\u03af\u03bb\u03b7, \u03b1\u03bc\u03c5\u03bb\u03bf\u03bd\u03b9\u03c4\u03c1\u03b9\u03ba\u03cc (\u201cpoppers\u201d)<\/li>\n<li><strong>\u03a4\u03b1\u03c5\u03c4\u03cc\u03c7\u03c1\u03bf\u03bd\u03b7 \u03c7\u03c1\u03ae\u03c3\u03b7 \u03b4\u03b9\u03b5\u03b3\u03b5\u03c1\u03c4\u03ce\u03bd \u03b3\u03bf\u03c5\u03b1\u03bd\u03c5\u03bb\u03b9\u03ba\u03ae\u03c2 \u03ba\u03c5\u03ba\u03bb\u03ac\u03c3\u03b7\u03c2<\/strong> \u03cc\u03c0\u03c9\u03c2 \u03c4\u03bf \u03c1\u03b9\u03bf\u03c3\u03b9\u03b3\u03ba\u03bf\u03c5\u03ac\u03c4<\/li>\n<li>\u03a0\u03c1\u03cc\u03c3\u03c6\u03b1\u03c4\u03bf \u03ad\u03bc\u03c6\u03c1\u03b1\u03b3\u03bc\u03b1 \u03c4\u03bf\u03c5 \u03bc\u03c5\u03bf\u03ba\u03b1\u03c1\u03b4\u03af\u03bf\u03c5 (\u03b5\u03bd\u03c4\u03cc\u03c2 90 \u03b7\u03bc\u03b5\u03c1\u03ce\u03bd), \u03b1\u03c3\u03c4\u03b1\u03b8\u03ae\u03c2 \u03c3\u03c4\u03b7\u03b8\u03ac\u03b3\u03c7\u03b7 \u03ae \u03c3\u03c4\u03b7\u03b8\u03ac\u03b3\u03c7\u03b7 \u03ba\u03b1\u03c4\u03ac \u03c4\u03b7 \u03b4\u03b9\u03ac\u03c1\u03ba\u03b5\u03b9\u03b1 \u03c3\u03c5\u03bd\u03bf\u03c5\u03c3\u03af\u03b1\u03c2<\/li>\n<li>\u039a\u03b1\u03c1\u03b4\u03b9\u03b1\u03ba\u03ae \u03b1\u03bd\u03b5\u03c0\u03ac\u03c1\u03ba\u03b5\u03b9\u03b1 NYHA Class II \u03ae \u03bc\u03b5\u03b3\u03b1\u03bb\u03cd\u03c4\u03b5\u03c1\u03b7 \u03c4\u03b1 \u03c4\u03b5\u03bb\u03b5\u03c5\u03c4\u03b1\u03af\u03b1 6 \u03bc\u03ae\u03bd\u03b5\u03c2<\/li>\n<li>\u0391\u03bd\u03b5\u03be\u03ad\u03bb\u03b5\u03b3\u03ba\u03c4\u03b7 \u03b1\u03c1\u03c1\u03c5\u03b8\u03bc\u03af\u03b1, \u03c5\u03c0\u03cc\u03c4\u03b1\u03c3\u03b7 (\u03a0\u0391 170\/100)<\/li>\n<li>\u0395\u03b3\u03ba\u03b5\u03c6\u03b1\u03bb\u03b9\u03ba\u03cc \u03b5\u03c0\u03b5\u03b9\u03c3\u03cc\u03b4\u03b9\u03bf \u03c4\u03b1 \u03c4\u03b5\u03bb\u03b5\u03c5\u03c4\u03b1\u03af\u03b1 6 \u03bc\u03ae\u03bd\u03b5\u03c2<\/li>\n<li>\u0393\u03bd\u03c9\u03c3\u03c4\u03ae \u03bc\u03b7 \u03b1\u03c1\u03c4\u03b7\u03c1\u03b9\u03b1\u03ba\u03ae \u03c0\u03c1\u03cc\u03c3\u03b8\u03b9\u03b1 \u03b9\u03c3\u03c7\u03b1\u03b9\u03bc\u03b9\u03ba\u03ae \u03bf\u03c0\u03c4\u03b9\u03ba\u03ae \u03bd\u03b5\u03c5\u03c1\u03bf\u03c0\u03ac\u03b8\u03b5\u03b9\u03b1 (NAION) \u03c3\u03b5 \u03ad\u03bd\u03b1 \u03ae \u03ba\u03b1\u03b9 \u03c4\u03b1 \u03b4\u03cd\u03bf \u03bc\u03ac\u03c4\u03b9\u03b1<\/li>\n<li>\u03a3\u03bf\u03b2\u03b1\u03c1\u03ae \u03b7\u03c0\u03b1\u03c4\u03b9\u03ba\u03ae \u03b4\u03c5\u03c3\u03bb\u03b5\u03b9\u03c4\u03bf\u03c5\u03c1\u03b3\u03af\u03b1 (Child-Pugh C)<\/li>\n<li>\u03a5\u03c0\u03b5\u03c1\u03b5\u03c5\u03b1\u03b9\u03c3\u03b8\u03b7\u03c3\u03af\u03b1 \u03c3\u03c4\u03bf \u03b5\u03bd\u03b5\u03c1\u03b3\u03cc \u03c3\u03c5\u03c3\u03c4\u03b1\u03c4\u03b9\u03ba\u03cc \u03ae \u03c3\u03b5 \u03bf\u03c0\u03bf\u03b9\u03bf\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03b2\u03bf\u03b7\u03b8\u03b7\u03c4\u03b9\u03ba\u03cc \u03c5\u03bb\u03b9\u03ba\u03cc<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">\u0391\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03b9\u03b4\u03c1\u03ac\u03c3\u03b5\u03b9\u03c2 \u03a6\u03b1\u03c1\u03bc\u03ac\u03ba\u03c9\u03bd<\/h2>\n<table>\n<thead>\n<tr>\n<th>\u03a6\u03ac\u03c1\u03bc\u03b1\u03ba\u03bf \/ \u03a4\u03ac\u03be\u03b7<\/th>\n<th>\u0391\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03af\u03b4\u03c1\u03b1\u03c3\u03b7<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong>\u039d\u03b9\u03c4\u03c1\u03b9\u03ba\u03ac (GTN, ISMN, ISDN, \u03b1\u03bc\u03c5\u03bb\u03bf\u03bd\u03b9\u03c4\u03c1\u03b9\u03ba\u03cc\/\u201dpoppers\u201d)<\/strong><\/td>\n<td><strong>\u0391\u03c0\u03cc\u03bb\u03c5\u03c4\u03b7 \u03b1\u03bd\u03c4\u03ad\u03bd\u03b4\u03b5\u03b9\u03be\u03b7<\/strong> \u2014 \u03c3\u03bf\u03b2\u03b1\u03c1\u03ae, \u03b4\u03c5\u03bd\u03b7\u03c4\u03b9\u03ba\u03ac \u03b8\u03b1\u03bd\u03b1\u03c4\u03b7\u03c6\u03cc\u03c1\u03b1 \u03c5\u03c0\u03bf\u03c4\u03cc\u03bd\u03b7\u03c3\u03b7<\/td>\n<\/tr>\n<tr>\n<td><strong>\u0391\u03bd\u03c4\u03b1\u03b3\u03c9\u03bd\u03b9\u03c3\u03c4\u03ad\u03c2 \u03ac\u03bb\u03c6\u03b1-\u03b1\u03b4\u03c1\u03b5\u03bd\u03b5\u03c1\u03b3\u03b9\u03ba\u03ce\u03bd \u03c5\u03c0\u03bf\u03b4\u03bf\u03c7\u03ad\u03c9\u03bd (\u03b4\u03bf\u03be\u03b1\u03b6\u03bf\u03c3\u03af\u03bd\u03b7, \u03c4\u03b1\u03bc\u03c3\u03bf\u03c5\u03bb\u03bf\u03c3\u03af\u03bd\u03b7, \u03b1\u03bb\u03c6\u03bf\u03c5\u03b6\u03bf\u03c3\u03af\u03bd\u03b7)<\/strong><\/td>\n<td>\u03a0\u03c1\u03bf\u03c3\u03b8\u03b5\u03c4\u03b9\u03ba\u03ae \u03bc\u03b5\u03af\u03c9\u03c3\u03b7 \u03c4\u03b7\u03c2 \u03b1\u03c1\u03c4\u03b7\u03c1\u03b9\u03b1\u03ba\u03ae\u03c2 \u03c0\u03af\u03b5\u03c3\u03b7\u03c2 \u2014 \u03c3\u03c4\u03b1\u03b8\u03b5\u03c1\u03bf\u03c0\u03bf\u03b9\u03ae\u03c3\u03c4\u03b5 \u03c0\u03c1\u03ce\u03c4\u03b1 \u03c4\u03b7 \u03b4\u03cc\u03c3\u03b7 \u03c4\u03bf\u03c5 \u03b1\u03bd\u03c4\u03b1\u03b3\u03c9\u03bd\u03b9\u03c3\u03c4\u03ae \u03ac\u03bb\u03c6\u03b1-\u03c5\u03c0\u03bf\u03b4\u03bf\u03c7\u03ad\u03c9\u03bd, \u03be\u03b5\u03ba\u03b9\u03bd\u03ae\u03c3\u03c4\u03b5 \u03bc\u03b5 \u03c4\u03b7 \u03c7\u03b1\u03bc\u03b7\u03bb\u03cc\u03c4\u03b5\u03c1\u03b7 \u03b4\u03cc\u03c3\u03b7 PDE5<\/td>\n<\/tr>\n<tr>\n<td><strong>\u0391\u03bd\u03b1\u03c3\u03c4\u03bf\u03bb\u03b5\u03af\u03c2 CYP3A4 (\u03ba\u03b5\u03c4\u03bf\u03ba\u03bf\u03bd\u03b1\u03b6\u03cc\u03bb\u03b7, \u03b9\u03c4\u03c1\u03b1\u03ba\u03bf\u03bd\u03b1\u03b6\u03cc\u03bb\u03b7, \u03c1\u03b9\u03c4\u03bf\u03bd\u03b1\u03b2\u03af\u03c1, \u03ba\u03bb\u03b1\u03c1\u03b9\u03b8\u03c1\u03bf\u03bc\u03c5\u03ba\u03af\u03bd\u03b7)<\/strong><\/td>\n<td>\u0391\u03cd\u03be\u03b7\u03c3\u03b7 \u03c4\u03c9\u03bd \u03c0\u03bb\u03b1\u03c3\u03bc\u03b1\u03c4\u03b9\u03ba\u03ce\u03bd \u03b5\u03c0\u03b9\u03c0\u03ad\u03b4\u03c9\u03bd PDE5 \u2014 \u03bc\u03b5\u03af\u03c9\u03c3\u03b7 \u03c4\u03b7\u03c2 \u03b4\u03cc\u03c3\u03b7\u03c2 \u03ae \u03b1\u03c0\u03bf\u03c6\u03c5\u03b3\u03ae \u03c3\u03c5\u03bd\u03b4\u03c5\u03b1\u03c3\u03bc\u03bf\u03cd<\/td>\n<\/tr>\n<tr>\n<td><strong>\u0395\u03c0\u03b1\u03b3\u03c9\u03b3\u03b5\u03af\u03c2 CYP3A4 (\u03c1\u03b9\u03c6\u03b1\u03bc\u03c0\u03b9\u03ba\u03af\u03bd\u03b7, \u03c6\u03b1\u03b9\u03bd\u03c5\u03c4\u03bf\u0390\u03bd\u03b7, \u03ba\u03b1\u03c1\u03b2\u03b1\u03bc\u03b1\u03b6\u03b5\u03c0\u03af\u03bd\u03b7, \u03c5\u03c0\u03b5\u03c1\u03b9\u03ba\u03cc)<\/strong><\/td>\n<td>\u039c\u03b5\u03af\u03c9\u03c3\u03b7 \u03c4\u03c9\u03bd \u03c0\u03bb\u03b1\u03c3\u03bc\u03b1\u03c4\u03b9\u03ba\u03ce\u03bd \u03b5\u03c0\u03b9\u03c0\u03ad\u03b4\u03c9\u03bd PDE5 \u2014 \u03b7 \u03b1\u03c0\u03bf\u03c4\u03b5\u03bb\u03b5\u03c3\u03bc\u03b1\u03c4\u03b9\u03ba\u03cc\u03c4\u03b7\u03c4\u03b1 \u03bc\u03c0\u03bf\u03c1\u03b5\u03af \u03bd\u03b1 \u03bc\u03b5\u03b9\u03c9\u03b8\u03b5\u03af<\/td>\n<\/tr>\n<tr>\n<td><strong>\u03a1\u03b9\u03bf\u03c3\u03b9\u03b3\u03ba\u03bf\u03c5\u03ac\u03c4 \u03ba\u03b1\u03b9 \u03ac\u03bb\u03bb\u03bf\u03b9 \u03b4\u03b9\u03b5\u03b3\u03ad\u03c1\u03c4\u03b5\u03c2 sGC<\/strong><\/td>\n<td>\u0391\u03bd\u03c4\u03b5\u03bd\u03b4\u03b5\u03b9\u03ba\u03bd\u03cd\u03b5\u03c4\u03b1\u03b9 \u2014 \u03ba\u03af\u03bd\u03b4\u03c5\u03bd\u03bf\u03c2 \u03c3\u03bf\u03b2\u03b1\u03c1\u03ae\u03c2 \u03c5\u03c0\u03cc\u03c4\u03b1\u03c3\u03b7\u03c2<\/td>\n<\/tr>\n<tr>\n<td><strong>\u0386\u03bb\u03bb\u03b1 \u03b1\u03bd\u03b1\u03c3\u03c4\u03bf\u03bb\u03b5\u03af\u03c2 PDE5<\/strong><\/td>\n<td>\u039c\u03b7\u03bd \u03c3\u03c5\u03bd\u03b4\u03c5\u03ac\u03b6\u03b5\u03c4\u03b5 \u2014 \u03c0\u03c1\u03cc\u03c3\u03b8\u03b5\u03c4\u03b5\u03c2 \u03c0\u03b1\u03c1\u03b5\u03bd\u03ad\u03c1\u03b3\u03b5\u03b9\u03b5\u03c2 \u03c7\u03c9\u03c1\u03af\u03c2 \u03b5\u03c0\u03b9\u03c0\u03bb\u03ad\u03bf\u03bd \u03b1\u03c0\u03bf\u03c4\u03b5\u03bb\u03b5\u03c3\u03bc\u03b1\u03c4\u03b9\u03ba\u03cc\u03c4\u03b7\u03c4\u03b1<\/td>\n<\/tr>\n<tr>\n<td><strong>\u0391\u03bd\u03c4\u03b9\u03c5\u03c0\u03b5\u03c1\u03c4\u03b1\u03c3\u03b9\u03ba\u03ac<\/strong><\/td>\n<td>\u039c\u03b9\u03ba\u03c1\u03ae \u03c0\u03c1\u03cc\u03c3\u03b8\u03b5\u03c4\u03b7 \u03bc\u03b5\u03af\u03c9\u03c3\u03b7 \u03c4\u03b7\u03c2 \u03c0\u03af\u03b5\u03c3\u03b7\u03c2 \u2014 \u03c3\u03c5\u03bd\u03ae\u03b8\u03c9\u03c2 \u03ba\u03bb\u03b9\u03bd\u03b9\u03ba\u03ac \u03b1\u03c3\u03ae\u03bc\u03b1\u03bd\u03c4\u03b7<\/td>\n<\/tr>\n<tr>\n<td><strong>\u03a7\u03c5\u03bc\u03cc\u03c2 \u03b3\u03ba\u03c1\u03ad\u03b9\u03c0\u03c6\u03c1\u03bf\u03c5\u03c4<\/strong><\/td>\n<td>\u0391\u03bd\u03b1\u03c3\u03c4\u03ad\u03bb\u03bb\u03b5\u03b9 \u03c4\u03bf CYP3A4 \u2014 \u03b1\u03c0\u03bf\u03c6\u03cd\u03b3\u03b5\u03c4\u03b5 \u03bc\u03b5\u03b3\u03ac\u03bb\u03b7 \u03ae \u03c4\u03b1\u03ba\u03c4\u03b9\u03ba\u03ae \u03c0\u03c1\u03cc\u03c3\u03bb\u03b7\u03c8\u03b7<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>\u03a0\u03ac\u03bd\u03c4\u03b1 \u03bc\u03bf\u03b9\u03c1\u03b1\u03c3\u03c4\u03b5\u03af\u03c4\u03b5 \u03bc\u03b9\u03b1 \u03c0\u03bb\u03ae\u03c1\u03b7 \u03bb\u03af\u03c3\u03c4\u03b1 \u03c4\u03c9\u03bd \u03c4\u03c1\u03b5\u03c7\u03bf\u03c5\u03c3\u03ce\u03bd \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03c9\u03bd \u03c3\u03b1\u03c2, \u03c3\u03c5\u03bc\u03c0\u03b5\u03c1\u03b9\u03bb\u03b1\u03bc\u03b2\u03b1\u03bd\u03bf\u03bc\u03ad\u03bd\u03c9\u03bd \u03c4\u03c9\u03bd \u03c7\u03c9\u03c1\u03af\u03c2 \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u03c3\u03c5\u03bd\u03c4\u03b1\u03b3\u03ae \u03c0\u03c1\u03bf\u03ca\u03cc\u03bd\u03c4\u03c9\u03bd, \u03c8\u03c5\u03c7\u03b1\u03b3\u03c9\u03b3\u03b9\u03ba\u03ce\u03bd \u03bd\u03b1\u03c1\u03ba\u03c9\u03c4\u03b9\u03ba\u03ce\u03bd \u03ba\u03b1\u03b9 \u03b2\u03bf\u03c4\u03ac\u03bd\u03c9\u03bd, \u03bc\u03b5 \u03c4\u03bf\u03bd \u03b9\u03b1\u03c4\u03c1\u03cc \u03c3\u03b1\u03c2 \u03c0\u03c1\u03b9\u03bd \u03be\u03b5\u03ba\u03b9\u03bd\u03ae\u03c3\u03b5\u03c4\u03b5 \u03b1\u03c5\u03c4\u03cc \u03c4\u03bf \u03c6\u03ac\u03c1\u03bc\u03b1\u03ba\u03bf.<\/p>\n<h2 class=\"wp-block-heading\">\u03a4\u03b9 \u03bd\u03b1 \u039a\u03ac\u03bd\u03b5\u03c4\u03b5 \u03c3\u03b5 \u03a0\u03b5\u03c1\u03af\u03c0\u03c4\u03c9\u03c3\u03b7 \u03a5\u03c0\u03b5\u03c1\u03b4\u03bf\u03c3\u03bf\u03bb\u03bf\u03b3\u03af\u03b1\u03c2<\/h2>\n<p>\u03a4\u03b1 \u03c3\u03c5\u03bc\u03c0\u03c4\u03ce\u03bc\u03b1\u03c4\u03b1 \u03c5\u03c0\u03b5\u03c1\u03b4\u03bf\u03c3\u03bf\u03bb\u03bf\u03b3\u03af\u03b1\u03c2 PDE5 \u03c0\u03b5\u03c1\u03b9\u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03bf\u03c5\u03bd \u03c3\u03bf\u03b2\u03b1\u03c1\u03cc \u03c0\u03bf\u03bd\u03bf\u03ba\u03ad\u03c6\u03b1\u03bb\u03bf, \u03ad\u03bd\u03c4\u03bf\u03bd\u03b7 \u03c5\u03c0\u03cc\u03c4\u03b1\u03c3\u03b7, \u03b6\u03ac\u03bb\u03b7, \u03c0\u03cc\u03bd\u03bf \u03c3\u03c4\u03b7\u03bd \u03c0\u03bb\u03ac\u03c4\u03b7 \u03ae \u03c3\u03c4\u03bf\u03c5\u03c2 \u03bc\u03cd\u03b5\u03c2 \u03ba\u03b1\u03b9 \u03c0\u03b1\u03c1\u03b1\u03c4\u03b5\u03c4\u03b1\u03bc\u03ad\u03bd\u03b7 \u03c3\u03c4\u03cd\u03c3\u03b7. \u0397 \u03b4\u03b9\u03b1\u03c7\u03b5\u03af\u03c1\u03b9\u03c3\u03b7 \u03b5\u03af\u03bd\u03b1\u03b9 \u03c5\u03c0\u03bf\u03c3\u03c4\u03b7\u03c1\u03b9\u03ba\u03c4\u03b9\u03ba\u03ae, \u03bc\u03b5 \u03c5\u03b3\u03c1\u03b1\u03bd\u03b1\u03c0\u03bb\u03ae\u03c1\u03c9\u03c3\u03b7 \u03ba\u03b1\u03b9 \u03ba\u03b1\u03c1\u03b4\u03b9\u03b1\u03ba\u03ae \u03c0\u03b1\u03c1\u03b1\u03ba\u03bf\u03bb\u03bf\u03cd\u03b8\u03b7\u03c3\u03b7. \u0395\u03c0\u03b9\u03ba\u03bf\u03b9\u03bd\u03c9\u03bd\u03ae\u03c3\u03c4\u03b5 \u03b1\u03bc\u03ad\u03c3\u03c9\u03c2 \u03bc\u03b5 \u03c4\u03b7\u03bd \u03c4\u03bf\u03c0\u03b9\u03ba\u03ae \u03c5\u03c0\u03b7\u03c1\u03b5\u03c3\u03af\u03b1 \u03b4\u03b7\u03bb\u03b7\u03c4\u03b7\u03c1\u03af\u03c9\u03bd \u03ae \u03c4\u03bf \u03c4\u03bc\u03ae\u03bc\u03b1 \u03b5\u03c0\u03b5\u03b9\u03b3\u03cc\u03bd\u03c4\u03c9\u03bd \u03c0\u03b5\u03c1\u03b9\u03c3\u03c4\u03b1\u03c4\u03b9\u03ba\u03ce\u03bd \u03b5\u03ac\u03bd \u03c5\u03c0\u03bf\u03c8\u03b9\u03ac\u03b6\u03b5\u03c3\u03c4\u03b5 \u03c5\u03c0\u03b5\u03c1\u03b4\u03bf\u03c3\u03bf\u03bb\u03bf\u03b3\u03af\u03b1.<\/p>\n<h2 class=\"wp-block-heading\">\u039f\u03b4\u03b7\u03b3\u03af\u03b5\u03c2 \u0391\u03c0\u03bf\u03b8\u03ae\u03ba\u03b5\u03c5\u03c3\u03b7\u03c2<\/h2>\n<ul>\n<li>\u0391\u03c0\u03bf\u03b8\u03b7\u03ba\u03b5\u03cd\u03c3\u03c4\u03b5 \u03c3\u03b5 \u03b8\u03b5\u03c1\u03bc\u03bf\u03ba\u03c1\u03b1\u03c3\u03af\u03b1 \u03ba\u03ac\u03c4\u03c9 \u03b1\u03c0\u03cc 30\u00b0C \u03c3\u03b5 \u03be\u03b7\u03c1\u03cc \u03bc\u03ad\u03c1\u03bf\u03c2, \u03bc\u03b1\u03ba\u03c1\u03b9\u03ac \u03b1\u03c0\u03cc \u03ac\u03bc\u03b5\u03c3\u03b7 \u03b7\u03bb\u03b9\u03b1\u03ba\u03ae \u03b1\u03ba\u03c4\u03b9\u03bd\u03bf\u03b2\u03bf\u03bb\u03af\u03b1<\/li>\n<li>\u03a6\u03c5\u03bb\u03ac\u03be\u03c4\u03b5 \u03c3\u03c4\u03b7\u03bd \u03b1\u03c1\u03c7\u03b9\u03ba\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 blister \u03bc\u03ad\u03c7\u03c1\u03b9 \u03c4\u03b7 \u03c7\u03c1\u03ae\u03c3\u03b7<\/li>\n<li>\u039a\u03c1\u03b1\u03c4\u03ae\u03c3\u03c4\u03b5 \u03bc\u03b1\u03ba\u03c1\u03b9\u03ac \u03b1\u03c0\u03cc \u03c0\u03b1\u03b9\u03b4\u03b9\u03ac \u03ba\u03b1\u03b9 \u03ba\u03b1\u03c4\u03bf\u03b9\u03ba\u03af\u03b4\u03b9\u03b1<\/li>\n<li>\u039c\u03b7\u03bd \u03c7\u03c1\u03b7\u03c3\u03b9\u03bc\u03bf\u03c0\u03bf\u03b9\u03b5\u03af\u03c4\u03b5 \u03bc\u03b5\u03c4\u03ac \u03c4\u03b7\u03bd \u03b7\u03bc\u03b5\u03c1\u03bf\u03bc\u03b7\u03bd\u03af\u03b1 \u03bb\u03ae\u03be\u03b7\u03c2 \u03c0\u03bf\u03c5 \u03b1\u03bd\u03b1\u03b3\u03c1\u03ac\u03c6\u03b5\u03c4\u03b1\u03b9 \u03c3\u03c4\u03b7 \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1<\/li>\n<li>\u0391\u03c0\u03bf\u03c1\u03c1\u03af\u03c8\u03c4\u03b5 \u03c4\u03b1 \u03b1\u03c7\u03c1\u03b7\u03c3\u03b9\u03bc\u03bf\u03c0\u03bf\u03af\u03b7\u03c4\u03b1 \u03b4\u03b9\u03c3\u03ba\u03af\u03b1 \u03bc\u03ad\u03c3\u03c9 \u03c3\u03c5\u03c3\u03c4\u03ae\u03bc\u03b1\u03c4\u03bf\u03c2 \u03b5\u03c0\u03b9\u03c3\u03c4\u03c1\u03bf\u03c6\u03ae\u03c2 \u03c3\u03b5 \u03c6\u03b1\u03c1\u03bc\u03b1\u03ba\u03b5\u03af\u03bf, \u03cc\u03c0\u03bf\u03c5 \u03b1\u03c5\u03c4\u03cc \u03c5\u03c0\u03ac\u03c1\u03c7\u03b5\u03b9<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">\u03a3\u03c7\u03b5\u03c4\u03b9\u03ba\u03ad\u03c2 \u0395\u03bd\u03b1\u03bb\u03bb\u03b1\u03ba\u03c4\u03b9\u03ba\u03ad\u03c2 \u039b\u03cd\u03c3\u03b5\u03b9\u03c2 \u03c3\u03c4\u03bf MedsBase<\/h2>\n<p>\u03a8\u03ac\u03c7\u03bd\u03b5\u03c4\u03b5 \u03b3\u03b9\u03b1 \u03c3\u03c7\u03b5\u03c4\u03b9\u03ba\u03ad\u03c2 \u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b5\u03c2 \u03c3\u03c4\u03c5\u03c4\u03b9\u03ba\u03ae\u03c2 \u03b4\u03c5\u03c3\u03bb\u03b5\u03b9\u03c4\u03bf\u03c5\u03c1\u03b3\u03af\u03b1\u03c2 \u03ae \u03c3\u03b5\u03be\u03bf\u03c5\u03b1\u03bb\u03b9\u03ba\u03ae\u03c2 \u03c5\u03b3\u03b5\u03af\u03b1\u03c2;<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/el\/modula\/\" rel=\"noopener\">Modula<\/a> \u2014 tadalafil 5 mg, \u03b9\u03b4\u03b1\u03bd\u03b9\u03ba\u03cc \u03b3\u03b9\u03b1 \u03b7\u03bc\u03b5\u03c1\u03ae\u03c3\u03b9\u03b1 \u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b1 \u03bc\u03b5 \u03c7\u03b1\u03bc\u03b7\u03bb\u03ae \u03b4\u03cc\u03c3\u03b7<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/vidalista\/\" rel=\"noopener\">Vidalista<\/a> \u2014 Centurion Labs tadalafil, 2.5 \u03ad\u03c9\u03c2 80 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/tadacip\/\" rel=\"noopener\">Tadacip<\/a> \u2014 Cipla tadalafil 20 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/megalis\/\" rel=\"noopener\">Megalis<\/a> \u2014 Macleods tadalafil 10 mg \/ 20 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/suhagra\/\" rel=\"noopener\">Suhagra<\/a> \u2014 Cipla sildenafil 25\/50\/100 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/erectile-dysfunction\/\" rel=\"noopener\">\u03a0\u03b5\u03c1\u03b9\u03b7\u03b3\u03b7\u03b8\u03b5\u03af\u03c4\u03b5 \u03c3\u03b5 \u03cc\u03bb\u03b5\u03c2 \u03c4\u03b9\u03c2 \u03b8\u03b5\u03c1\u03b1\u03c0\u03b5\u03af\u03b5\u03c2 \u0395\u03ba\u03c6\u03c5\u03bb\u03b9\u03c3\u03bc\u03bf\u03cd \u03c4\u03b7\u03c2 \u0395\u03bd\u03af\u03c3\u03c7\u03c5\u03c3\u03b7\u03c2 \u2192<\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">\u03a3\u03c5\u03c7\u03bd\u03ad\u03c2 \u0395\u03c1\u03c9\u03c4\u03ae\u03c3\u03b5\u03b9\u03c2<\/h2>\n<h3 class=\"wp-block-heading\">Is Malegra DXT Plus on-demand or daily?<\/h3>\n<p><strong>Mixed.<\/strong> The sildenafil component is on-demand (per-tablet ED effect). The duloxetine component is daily, requiring 2\u20134 weeks to build steady-state PE-delay effect. Duloxetine is NOT a single-dose PE drug \u2014 a one-off tablet won&#8217;t delay ejaculation meaningfully.<\/p>\n<h3 class=\"wp-block-heading\">Why use duloxetine instead of dapoxetine?<\/h3>\n<p>Dapoxetine is engineered for on-demand PE use with a short half-life. Duloxetine is an SNRI that also treats anxiety, chronic pain, and depression \u2014 so it can make sense for men with overlapping issues. For isolated PE, dapoxetine is usually simpler. For PE + chronic pain or PE + anxiety, duloxetine may solve two problems at once.<\/p>\n<h3 class=\"wp-block-heading\">How is duloxetine different from fluoxetine?<\/h3>\n<p>Fluoxetine is an SSRI (serotonin only) with a very long half-life (active metabolite 7\u201315 days). Duloxetine is an SNRI (serotonin + norepinephrine) with a shorter half-life (~12 h). Duloxetine is more &#8220;activating&#8221; (energising effect from the norepinephrine component) and has clearer data for chronic pain and anxiety. Fluoxetine has a gentler discontinuation profile because of its long tail.<\/p>\n<h3 class=\"wp-block-heading\">When does the PE-delay effect start?<\/h3>\n<p>Duloxetine usually requires <strong>2\u20134 \u03b5\u03b2\u03b4\u03bf\u03bc\u03ac\u03b4\u03b5\u03c2<\/strong> of daily dosing for full effect; some men notice partial improvement within 1\u20132 weeks. If you expect immediate relief from the first tablet, this product will disappoint \u2014 consider a dapoxetine-based combination instead.<\/p>\n<h3 class=\"wp-block-heading\">How long does the sildenafil effect last?<\/h3>\n<p>4\u20136 hours per tablet, as with any sildenafil product.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Malegra DXT Plus with alcohol?<\/h3>\n<p><strong>Avoid regular drinking.<\/strong> Duloxetine + alcohol amplifies hepatotoxicity risk \u2014 this is not a theoretical concern; duloxetine is specifically contraindicated with chronic alcohol use. Occasional single drinks are less risky but should still be discussed with a clinician.<\/p>\n<h3 class=\"wp-block-heading\">Does duloxetine cause sexual side effects?<\/h3>\n<p>Yes \u2014 delayed orgasm is one of duloxetine&#8217;s documented effects, which is also the mechanism of its PE benefit. In some men this becomes excessive (anorgasmia) and may require dose reduction. Erectile function itself is usually preserved or enhanced by the sildenafil component.<\/p>\n<h3 class=\"wp-block-heading\">Can I stop Malegra DXT Plus abruptly?<\/h3>\n<p><strong>\u038c\u03c7\u03b9.<\/strong> Duloxetine discontinuation syndrome is more pronounced than with fluoxetine because of the shorter half-life. Taper over at least 2 weeks under medical supervision. Symptoms of too-fast taper include dizziness, nausea, insomnia, anxiety, headache, and electric-shock sensations.<\/p>\n<h3 class=\"wp-block-heading\">Is Malegra DXT Plus safe for men with heart conditions?<\/h3>\n<p><strong>\u038c\u03c7\u03b9<\/strong> if you use nitrates, have had a recent MI, or have unstable angina \u2014 sildenafil is contraindicated. Duloxetine may also modestly raise blood pressure via its norepinephrine effect. Cardiac review and careful selection are required.<\/p>\n<h3 class=\"wp-block-heading\">Can I take Malegra DXT Plus if I&#8217;m already on another antidepressant?<\/h3>\n<p><strong>Usually no.<\/strong> Combining duloxetine with other serotonergic drugs (SSRIs, other SNRIs, MAOIs, some migraine drugs, tramadol, some opioids) risks serotonin syndrome. Switching antidepressants requires a washout and medical supervision.<\/p>\n<h3 class=\"wp-block-heading\">What about liver problems?<\/h3>\n<p>Duloxetine is hepatically cleared and can cause hepatotoxicity. Avoid if you have hepatic impairment, chronic hepatitis, or heavy alcohol use. Stop and seek medical advice if you develop yellow skin\/eyes, right upper abdominal pain, or severe fatigue.<\/p>\n<h3 class=\"wp-block-heading\">What if Malegra DXT Plus doesn&#8217;t work for my PE after 4 weeks?<\/h3>\n<p>Options: increase duloxetine dose (requires medical supervision), switch to a dapoxetine-based combination, add behavioural therapy (stop-start \/ squeeze technique), or try topical anaesthetics under medical guidance. Persistent PE warrants clinical review \u2014 it can sometimes reflect anxiety, thyroid issues, or prostate inflammation.<\/p>\n<p><!-- medsbase-faq-h3-converted --><\/p>\n<p class=\"medsbase-link-boost-2026-05-04\" data-marker=\"mb-link-boost-malegra-fxt\"><a href=\"https:\/\/medsbase.com\/el\/malegra-dxt-plus\/\">Malegra DXT Plus<\/a> is the high-shoulder duloxetine 60 mg + sildenafil 100 mg combination for ED with persistent PE; users who would rather take a fluoxetine-based SSRI route at a lower SSRI dose can switch to <a href=\"https:\/\/medsbase.com\/el\/malegra-fxt\/\">Malegra FXT (\u03c3\u03b9\u03bb\u03b4\u03b5\u03bd\u03b1\u03c6\u03af\u03bb\u03b7 100 mg + \u03c6\u03bb\u03bf\u03c5\u03bf\u03be\u03b5\u03c4\u03af\u03bd\u03b7 40 mg)<\/a> \u03b1\u03bd\u03c4\u03af \u03b1\u03c5\u03c4\u03bf\u03cd.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">\u03a3\u03c7\u03b5\u03c4\u03b9\u03ba\u03ad\u03c2 \u0395\u03bd\u03b1\u03bb\u03bb\u03b1\u03ba\u03c4\u03b9\u03ba\u03ad\u03c2<\/h3>\n<p>\u0386\u03bb\u03bb\u03b1 \u03c0\u03c1\u03bf\u03ca\u03cc\u03bd\u03c4\u03b1 \u03c3\u03b5 <strong>\u03a5\u03b3\u03b5\u03af\u03b1 \u0391\u03bd\u03b4\u03c1\u03ce\u03bd<\/strong> \u03c0\u03bf\u03c5 \u03bf\u03b9 \u03c0\u03b5\u03bb\u03ac\u03c4\u03b5\u03c2 \u03b5\u03be\u03b5\u03c4\u03ac\u03b6\u03bf\u03c5\u03bd \u03b5\u03c0\u03af\u03c3\u03b7\u03c2:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/el\/super-tadarise\/\">Super Tadarise<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/kamagra-gold\/\">Kamagra Gold<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/megalis\/\">Megalis<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/malegra-fxt\/\">Malegra FXT<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/tadasoft\/\">Tadasoft<\/a><\/li>\n<\/ul>\n<p><!-- medsbase-guide-dapoxetine --><\/p>\n<p style=\"margin:20px 0 0;padding:12px 16px;background:#f4f8fb;border-left:3px solid #2c7cb0;border-radius:3px;font-size:14px\">\ud83d\udcda <strong>\u039c\u03ac\u03b8\u03b5\u03c4\u03b5 \u03c0\u03b5\u03c1\u03b9\u03c3\u03c3\u03cc\u03c4\u03b5\u03c1\u03b1:<\/strong> <a href=\"https:\/\/medsbase.com\/el\/what-is-dapoxetine-and-how-its-used-for-pe-treatment\/\">\u0391\u03b3\u03bf\u03c1\u03ac\u03c3\u03c4\u03b5 Dapoxetine Online (2026): \u0391\u03c5\u03c4\u03cc\u03bd\u03bf\u03bc\u03b1 &amp; \u03a3\u03c5\u03bd\u03b4\u03c5\u03b1\u03c3\u03c4\u03b9\u03ba\u03ac \u03a0\u03c1\u03bf\u03ca\u03cc\u03bd\u03c4\u03b1 \u2014 \u03a7\u03c9\u03c1\u03af\u03c2 \u03a3\u03c5\u03bd\u03c4\u03b1\u03b3\u03ae<\/a><\/p>","protected":false},"excerpt":{"rendered":"<p>\u2705 \u0392\u03b5\u03bb\u03c4\u03b9\u03ce\u03bd\u03b5\u03b9 \u03c4\u03b7 \u03c3\u03b5\u03be\u03bf\u03c5\u03b1\u03bb\u03b9\u03ba\u03ae \u03b1\u03c0\u03cc\u03b4\u03bf\u03c3\u03b7<br \/>\n\u2705 \u0398\u03b5\u03c1\u03b1\u03c0\u03b5\u03cd\u03b5\u03b9 \u03c4\u03b7 \u03c3\u03c4\u03c5\u03c4\u03b9\u03ba\u03ae \u03b4\u03c5\u03c3\u03bb\u03b5\u03b9\u03c4\u03bf\u03c5\u03c1\u03b3\u03af\u03b1<br \/>\n\u2705 Improves premature ejaculation<br \/>\n\u2705 \u0395\u03bd\u03b9\u03c3\u03c7\u03cd\u03b5\u03b9 \u03c4\u03b7\u03bd \u03b9\u03ba\u03b1\u03bd\u03bf\u03c0\u03bf\u03af\u03b7\u03c3\u03b7<br \/>\n\u2705 Enhances sexual endurance<\/p>\n<p>Malegra DXT contains Sildenafil &amp; Duloxetine.<\/p>","protected":false},"featured_media":62246,"comment_status":"closed","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3143,3142,3145,3151],"product_tag":[4144,5110,3153,3154],"class_list":{"0":"post-62245","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-erectile-dysfunction","8":"product_cat-mens-health","9":"product_cat-premature-ejaculation-treatment","10":"product_cat-sildenafil","11":"product_tag-duloxetine","12":"product_tag-malegra-dxt-plus","13":"product_tag-sildenafil","14":"product_tag-viagra","16":"first","17":"instock","18":"shipping-taxable","19":"purchasable","20":"product-type-variable","21":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product\/62245","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/comments?post=62245"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/media\/62246"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/media?parent=62245"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_brand?post=62245"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_cat?post=62245"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_tag?post=62245"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}