{ "schema_version": 1, "kind": "condition", "id": "premature-ejaculation", "name": "Premature Ejaculation", "category": "chronic", "sources": "EAU Guidelines on Sexual and Reproductive Health 2024 · UK eMC Fortacin Spray / EMLA 5% Cream SmPC (or DailyMed EMLA Cream Package Insert)", "review_status": "reviewed", "verified_against": "EAU Guidelines on Sexual and Reproductive Health 2024 · UK eMC Fortacin Spray / EMLA 5% Cream SmPC (or DailyMed EMLA Cream Package Insert) · Premature Ejaculation - disease-level clinical article (premature-ejaculation-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1456, "generic": "Dapoxetine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 30.0, "adult_dose": "30 mg orally taken 1 to 3 hours before intended sexual activity (max 60 mg once daily if 30 mg tolerated but insufficient)", "adult_duration": "On-demand PRN", "dose_source": "EAU Guidelines on Sexual and Reproductive Health 2024", "rationale": "Dapoxetine is a short-acting SSRI designed specifically for on-demand use before intercourse; its rapid onset and clearance delay ejaculation without the accumulation seen with standard SSRIs taken daily.", "cautions": [ "Contraindicated in severe heart failure, significant ischemic heart disease, heart block, or severe hepatic impairment.", "Do not combine with MAOIs, CYP3A4 inhibitors, or other SSRIs/SNRIs.", "May cause dizziness, nausea, headache, syncope, or orthostatic hypotension; advise patient to stay hydrated." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not indicated in pediatric populations under 18 years", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DAPOXEMED 30 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES", "price_egp": 17.5, "pack_count": 3, "unit_price": 5.83, "strength_mg": 30.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MATUJAC 30 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HOCHSTER PHARMACEUTICAL INDUSTRIES > NOVELL PHARMA", "price_egp": 21.0, "pack_count": 3, "unit_price": 7.0, "strength_mg": 30.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WESTOXETIN 30 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 21.0, "pack_count": 3, "unit_price": 7.0, "strength_mg": 30.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EJADAXTIN 30 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WADI ELNEEL BENTA", "price_egp": 23.0, "pack_count": 3, "unit_price": 7.67, "strength_mg": 30.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PREDAPOX 30 MG 6 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 86.0, "pack_count": 6, "unit_price": 14.33, "strength_mg": 30.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DELEPE 30 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PENTA PHARMA-EGYPT > PENTA PHARMA", "price_egp": 45.0, "pack_count": 3, "unit_price": 15.0, "strength_mg": 30.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DERILGY 30 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE > BIOMED PHARMACEUTICALS", "price_egp": 65.0, "pack_count": 3, "unit_price": 21.67, "strength_mg": 30.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PRILIGY 30 MG 3 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MENARINI > EGYPTIAN PHARMACEUTICAL TRADING COMPANY", "price_egp": 382.0, "pack_count": 3, "unit_price": 127.33, "strength_mg": 30.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "premature-ejaculation" }, { "id": 1459, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Premature Ejaculation - disease-level clinical article (premature-ejaculation-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Dapoxetine has a poor side-effect profile and extremely high discontinuation rates in European data." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "premature-ejaculation" }, { "id": 1460, "generic": "Paroxetine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "10 to 40 mg/day", "adult_duration": null, "dose_source": "Premature Ejaculation - disease-level clinical article (premature-ejaculation-full.txt)", "rationale": "Off-label daily SSRI used as initial drug of choice to delay ejaculatory onset in premature ejaculation.", "cautions": [ "May cause sexual dysfunction (decreased libido, anorgasmia, erectile dysfunction).", "Avoid abrupt withdrawal to prevent serotonin discontinuation syndrome." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Paroxetine should not be used in the treatment of children and adolescents under the age of 18 years. That sentence is the Paroxetine 20 mg film-coated tablets SmPC section 4.2, verbatim.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "XANDOL 20MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EUROPEAN EGYPTIAN PHARM. IND.", "price_egp": 42.0, "pack_count": 20, "unit_price": 2.1, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PAXETIN 20 MG 10 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 22.8, "pack_count": 10, "unit_price": 2.28, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPANX 20MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 24.0, "pack_count": 10, "unit_price": 2.4, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PAROXETINE 20 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 93.0, "pack_count": 30, "unit_price": 3.1, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PAROXETINE CR 12.5 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 99.0, "pack_count": 30, "unit_price": 3.3, "strength_mg": 12.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PAROXEDEP CR 37.5 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "APEX PHARMA", "price_egp": 117.0, "pack_count": 30, "unit_price": 3.9, "strength_mg": 37.5, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SEROXAT CR 25MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 321.0, "pack_count": 30, "unit_price": 10.7, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PAROXEDUR XL 25 MG 30 EXT. REL. F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "P&C LABS > BIOMED", "price_egp": 94.5, "pack_count": null, "unit_price": null, "strength_mg": 25.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "premature-ejaculation" }, { "id": 1461, "generic": "Fluoxetine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "20 to 40 mg/day", "adult_duration": null, "dose_source": "Premature Ejaculation - disease-level clinical article (premature-ejaculation-full.txt)", "rationale": "Off-label daily SSRI used to delay ejaculatory onset in premature ejaculation.", "cautions": [ "May cause sexual dysfunction (decreased libido, anorgasmia, erectile dysfunction).", "Long half-life; monitor for drug interactions." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "FLUOXETINE should only be used in children and adolescents aged 8 to 18 years for the treatment of moderate to severe major depressive episodes and it should not be used in other indications.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ALZAC 10MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI)", "price_egp": 18.0, "pack_count": 20, "unit_price": 0.9, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUOZAC 10MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 18.0, "pack_count": 20, "unit_price": 0.9, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PHILOZAC 10MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 9.0, "pack_count": 10, "unit_price": 0.9, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUTIN 20 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 26.0, "pack_count": 14, "unit_price": 1.86, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OCTOZAC 20MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "OCTOBER PHARMA", "price_egp": 21.6, "pack_count": 10, "unit_price": 2.16, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROZAC 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ELI LILLY", "price_egp": 118.0, "pack_count": 14, "unit_price": 8.43, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DURAZAC WEEKLY 90MG 4 DELAYED REL. CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOPHARM EGYPT > ANDALOUS PHARMA", "price_egp": 48.0, "pack_count": null, "unit_price": null, "strength_mg": 90.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FIESTO 90MG 4 DELAYED RELEASE CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "INTERNATIONAL DRUG AGENCY (IDI) > SINA PHARM", "price_egp": 48.0, "pack_count": null, "unit_price": null, "strength_mg": 90.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "premature-ejaculation" }, { "id": 1462, "generic": "Sertraline", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "50 to 200 mg/day", "adult_duration": null, "dose_source": "Premature Ejaculation - disease-level clinical article (premature-ejaculation-full.txt)", "rationale": "Off-label daily SSRI used to delay ejaculatory onset in premature ejaculation.", "cautions": [ "May cause sexual dysfunction (decreased libido, anorgasmia, erectile dysfunction).", "Take with food to reduce gastrointestinal side effects." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Sertraline should not be used in the treatment of children and adolescents under the age of 18 years, except for patients with obsessive compulsive disorder aged 6-17 years old. That sentence is the LUSTRAL 50 mg film coated tablets SmPC section 4.2, verbatim.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "OPIRALINE 50 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 29.0, "pack_count": 20, "unit_price": 1.45, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AGRELOCIT 50 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS > ATM PHARMACEUTICAL INDUSTRIES", "price_egp": 34.8, "pack_count": 20, "unit_price": 1.74, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPR-STAT 50MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 21.6, "pack_count": 10, "unit_price": 2.16, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OPIRALINE 100MG 10 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 32.0, "pack_count": 10, "unit_price": 3.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SIRTO 50MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 34.0, "pack_count": 10, "unit_price": 3.4, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOODAPEX 100 MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 123.0, "pack_count": 30, "unit_price": 4.1, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LUSTRAL 50 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "VIATRIS", "price_egp": 136.0, "pack_count": 20, "unit_price": 6.8, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERLIFT 100MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > REXCEL", "price_egp": 74.0, "pack_count": 10, "unit_price": 7.4, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "premature-ejaculation" }, { "id": 1463, "generic": "Citalopram", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "20 to 40 mg/day", "adult_duration": null, "dose_source": "Premature Ejaculation - disease-level clinical article (premature-ejaculation-full.txt)", "rationale": "Off-label daily SSRI used to delay ejaculatory onset in premature ejaculation.", "cautions": [ "May cause sexual dysfunction and QTc prolongation at higher doses." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No paediatric dose is stated in the sources held for this drug.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "CITALIFE 10 MG 20 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 31.2, "pack_count": 20, "unit_price": 1.56, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PURACIT 20MG 14 F.C. 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TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 43.0, "pack_count": 10, "unit_price": 4.3, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CITALO 40 MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 180.0, "pack_count": 30, "unit_price": 6.0, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIPRAM 20 MG 28 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "H.LUNDBECK A/S DENMARK > MULTIPHARMA", "price_egp": 232.0, "pack_count": 28, "unit_price": 8.29, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LECITAL 40MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JOSWE MEDICAL-JORDAN > SPACE MEDICAL", "price_egp": 255.0, "pack_count": 30, "unit_price": 8.5, "strength_mg": 40.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RAMDEEP 2MG/ML SYRUP 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA", "price_egp": 21.75, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "CITALO 2MG/ML ORAL SOLUTION 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA", "price_egp": 38.0, "pack_count": null, "unit_price": null, "strength_mg": 2.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "premature-ejaculation" }, { "id": 1464, "generic": "Escitalopram", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "10-20 mg/day", "adult_duration": null, "dose_source": "Premature Ejaculation - disease-level clinical article (premature-ejaculation-full.txt)", "rationale": "Off-label daily SSRI used to delay ejaculatory onset in premature ejaculation.", "cautions": [ "May cause sexual dysfunction (decreased libido, anorgasmia, erectile dysfunction)." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Escitalopram should not be used in the treatment of children and adolescents under the age of 18 years (see section 4.4). 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TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 63.0, "pack_count": 14, "unit_price": 4.5, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ESCITA 10 MG 14 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GENESIS PHARMACEUTICALS", "price_egp": 77.0, "pack_count": 14, "unit_price": 5.5, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "JOVIAPRAM 20 MG 30 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SUN PHARMA EGYPT LIMITED", "price_egp": 201.0, "pack_count": 30, "unit_price": 6.7, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIPRALEX 10 MG 28 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LUNDBECK > MULTIPHARMA", "price_egp": 392.0, "pack_count": 28, "unit_price": 14.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TALOSCITO 20 MG 30 SCORED F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "P & C LABS", "price_egp": 157.5, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "XYGAROT 5MG/5ML SYRUP 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ESCITALOBORG 5 MG/5ML SYRUP 125 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "premature-ejaculation" }, { "id": 1457, "generic": "Lidocaine + Prilocaine", "line": 2, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "For Fortacin spray: 3 actuations (sprays) applied to glans penis 5 minutes before intercourse. For EMLA 5% cream: apply 1-2 g (thin layer) to glans penis 15-30 minutes before intercourse, wiped off prior to penetration.", "adult_duration": "On-demand PRN", "dose_source": "Fortacin 150 mg/ml + 50 mg/ml cutaneous spray solution SmPC (eMC product 100391). Section 4.1: \"Fortacin is indicated for the treatment of primary premature ejaculation in adult men.\" Section 4.2: \"3 actuations applied to cover the glans penis\"; \"After 5 minutes any excess spray should be wiped off prior to intercourse\"; \"A maximum of 3 doses can be used within 24 hours with at least 4 hours between doses.\" The EMLA figure shown alongside comes from a different product and rests on no named document - see the caution.", "rationale": "Lidocaine-prilocaine is a topical local anesthetic combination applied to the glans to reduce sensitivity and delay ejaculation; it offers a non-oral alternative to dapoxetine, though residue must be wiped off or a condom used to avoid numbing the partner.", "cautions": [ "Fortacin's own ceiling: \"A maximum of 3 doses can be used within 24 hours with at least 4 hours between doses.\" Prilocaine can cause methaemoglobinaemia, so the limit matters.", "THE EMLA ROUTE IS OFF-LABEL AND ITS FIGURE RESTS ON NO NAMED DOCUMENT. EMLA Cream 5% SmPC section 4.1 (eMC 7994) carries no premature-ejaculation indication. Its only genital-skin figures sit under \"Skin of male genital organs - Prior to injection of local anaesthetics\": \"1 g/10 cm2 for 15 minutes\" or \"1-2 g/10 cm2 for 60 minutes\". The same SmPC states that application to genital skin \"should only be performed by or under the supervision of a healthcare professional\". Fortacin is the licensed alternative here.", "Must wipe off residue before intercourse or use a condom to prevent numbness in partner.", "Avoid applying to broken or inflamed penile skin.", "Contraindicated in history of allergy to local anaesthetics of the amide type." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable - condition restricted to adult males", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "MELACAINE 5% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "> MELANO PHARMA", "price_egp": 36.5, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EMLA 5% CREAM 5 GM 5 TUBES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ASTRA ZENECA > PHOENIX GROUP", "price_egp": 120.0, "pack_count": null, "unit_price": null, "strength_mg": 5000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PRIDOCAINE TOPICAL CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 32.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ANASEZIAGO CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ESRAA PHARMACEUTICAL OPTIMA > ELIXIR PHARMA", "price_egp": 55.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AVRISURG TOPICAL CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEDIZEN PHARMACEUTICAL INDUSTRIES", "price_egp": 55.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PRIDOCAINE TOPICAL CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 55.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MANOVIPERCAINE PLUS TOPICAL SPRAY 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 56.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "premature-ejaculation" }, { "id": 1458, "generic": "Behavioral therapy and sex counseling", "line": 1, "is_adjunct": true, "form": null, "strength_mg": null, "adult_dose": "Practice behavioral techniques (stop-start technique, squeeze technique, pelvic floor muscle training) regularly during sexual activity", "adult_duration": "Ongoing (minimum 4-8 weeks)", "dose_source": "EAU Guidelines on Sexual and Reproductive Health 2024", "rationale": "Stop-start and squeeze techniques, together with pelvic floor training, teach the patient to recognize and control arousal levels; they are used alongside pharmacologic or topical treatment and work best combined with partner communication and anxiety reduction.", "cautions": [ "The best results are achieved when this is combined with partner communication and anxiety reduction.", "Rule out co-existing erectile dysfunction or thyroid disorders prior to initiating therapy." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "premature-ejaculation" } ] }