Duralast

Duralast is the brand name of a medication containing dapoxetine. Dapoxetine falls under the drug class of SSRIs (selective serotonin reuptake inhibitors) and is used to treat premature ejaculation in men.

Before you start taking Duralast, there are a few things that you should know, such as what it is, how it works, and what risks accompany its use. You also may want to consider natural treatments first, so we’ll look at common alternatives.

What is Duralast?

Duralast is a drug containing the chief ingredient, dapoxetine. It is used in the treatment of premature ejaculation (PE). It is a selective serotonin reuptake inhibitor (SSRI).

Premature ejaculation is the condition where ejaculation occurs just before or as soon as penetration happens during sexual intercourse. It is associated with emotional and personal distress in men and may cause interrelationship problems.

In some cases, premature ejaculation may occur due to erectile dysfunction, as difficulty in maintaining an erection may lead to faster ejaculation.

Duralast can treat premature ejaculation by preventing serotonin uptake in the nervous system.

Duralast is manufactured by Sun Pharma Laboratories, a pharmaceutical company based in India.

What’s The Dose of Duralast?

Duralast is available in two doses:

30 mg
60 mg

It comes in a package of 4 pills per pack. You should take Duralast about 1 hour before sex, and the maximum dose is one pill per day.

It is a prescription-only drug and should be taken only when needed. Therefore, there is no need for daily consumption.

How Long Does it Take for Duralast To Kick In?

It takes about 1 to 3 hours for Duralast to kick in. The onset and performance levels may vary from person to person.

How Long Does Duralast Last?

Duralast lasts for about 3 to 4 hours. However, sometimes its effects can last up to 12 hours. This is enough time for sexual intercourse to take place.

How Much Does Duralast Cost?

Duralast costs about 0.58 USD per 30 mg tablet. This price is less compared to other PE medications.

The History of Duralast

The base ingredient of Duralast, dapoxetine, was initially used as a treatment for depression. Later on, researchers discovered its potential to treat premature ejaculation accidentally.

Because of its rapid absorption, elimination, and fast-acting properties, dapoxetine became a PE medication instead of an antidepressant.

Dapoxetine was first made by Eli Lilly pharmaceutical. It was bought by Johnson and Johnson in 2003. It was submitted as a new drug application to the FDA in 2004. As of 2005, dapoxetine was in phase III clinical trials and pending review by the FDA.

After this, Sun Pharma Laboratories started producing this drug named Duralast to treat premature ejaculation.

Who Should Take Duralast?

Duralast is for men who prematurely ejaculate before or as soon as penetration occurs. It is for men in the group of 18 to 64 years.

It is a prescription-only drug, so you need to be examined by your doctor to confirm your diagnosis. They may prescribe this medication after your diagnosis is confirmed. Pregnant and lactating mothers cannot consume Duralast.

Is Duralast Safe?

Duralast is safe for use in most men. However, it cannot be used in those with liver conditions or must be used with caution as it may worsen the symptoms.

Common Side Effects of Duralast

Duralast may result in side effects in some people. When a drug is taken orally, it acts on the body as a whole and not just a single system.

Most of these side effects are due to improper dosing or overdosing. Contact your doctor immediately if you experience any side effects after taking Duralast.

Some of the most common side effects of using Duralast include the following:

Dizziness
Drowsiness
Erectile dysfunction
Fatigue
Headache
Increased sweating
Indigestion
Nausea
Restlessness
Tremor
Vomiting

Potential Drug Interactions With Duralast

Some medications can interact with Duralast. Their interactions can range from mild to potentially dangerous, so it is always good to inform your doctor beforehand if you take any of these medications.

The following drugs can interact with Duralast:

MAOI Inhibitors

The dapoxetine present in Duralast can interact with MAOI inhibitors. This interaction can cause side effects such as hyperthermia, myoclonus, mental status changes, rigidity, and autonomic instability. These medications include isocarboxazid, phenelzine, selegiline, etc.

Thioridazine

Thioridazine, a medication for mood disorders, can cause QTc interval prolongation, leading to ventricular arrhythmias. In addition, dapoxetine in Duralast can inhibit CYP2D6 enzymes, causing inhibition of thioridazine metabolism. This could lead to high levels of thioridazine in the blood and cause arrhythmias.

Alcohol

Duralast can worsen the side effects of any kind of alcohol. It can cause side effects such as headaches, nausea, vomiting, etc. So it is advised to avoid taking it with alcohol.

Nitrates

Nitrates are the medications used to treat angina and coronary artery disease. Duralast can interact with these medications and cause a rapid drop in blood pressure.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Since Duralast is an SSRI, combining it with another SSRI can cause excess accumulation of serotonin in the body and cause serotonin syndrome. It includes symptoms like agitation, confusion, rapid pulse, dilated pupils, etc.

Anti-Hypertensive Medications

These include medications such as alpha-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and angiotensin II receptor blockers. Duralast may increase their blood pressure-lowering abilities.

CYP3A4 inhibitors

The CYP3A4 enzymes metabolize Dapoxetine. So the medications that inhibit this enzyme can slow down the metabolism of Duralast. This can prolong the duration of action and make it have a more prolonged effect on the body. These include drugs such as ritonavir, ketoconazole, itraconazole, erythromycin, and others.

CYP3A4 Inducers

These medications work in the opposite manner of the CYP3A4 inhibitors. These include medicines like rifampicin, carbamazepine, phenytoin, and phenobarbital. These medications can enhance the action of the CYP3A4 enzyme resulting in faster metabolism of Duralast and thereby shortening its duration of action.

Who Should Avoid Using Duralast

Duralast should be avoided by people with:

Blood disorders (hemophilia, leukemia, sickle-cell anemia)
Glaucoma
History of priapism
History of syncope
Hypersensitivity to Duralast
Kidney failure or severe kidney disease
Low blood pressure
Mania or severe depression
Moderate or severe hepatic impairment
NAION or “crowded” optic disc
Orthostatic hypotension
Retinitis pigmentosa
Severe heart disease, such as heart valve failure

How Does Duralast Work?

Dapoxetine, the chief ingredient of Duralast, is a selective serotonin reuptake inhibitor (SSRI). It slows down the ejaculatory expulsion reflex and stops the neuronal reuptake of serotonin.

Many parts of the nervous system control ejaculation in the human body. The ejaculatory pathways start at the thoracolumbar and lumbosacral levels of the spinal cord.

Signals are sent to the brain and then influenced by different nuclei in the brain. Dapoxetine is capable of stopping the ejaculatory expulsion reflex at the supraspinal level. It does this by controlling the actions of the lateral paragigantocellular (LPGi) nucleus [1].

The serotonin (5-HT) in the brain can also inhibit ejaculation. Therefore, premature ejaculation can be caused by a decrease in serotonin levels. Dapoxetine can increase the level of serotonin in the nervous system and improve control over ejaculation [2]. It then helps slow down the speed of ejaculation, allowing a more prolonged erection.

Thereby, Duralast can prevent premature ejaculation by stopping the reuptake of serotonin and making an erection last longer. These actions ensure that the erection lasts long enough for intercourse without premature ejaculation.

Medical Research Involving Duralast

There is some medical research regarding the combination drug dapoxetine. Dapoxetine is shown to be effective in treating PE [3]. Studies on Duralast itself are limited because Duralast is based on the already extensively researched dapoxetine.

Once a patent expires, pharmaceutical companies use formulations from the original manufacturers to reproduce drugs at a cheaper rate. However, if further research were to be conducted on the new brand names of any patented drug, this would make the drug equally costly.

Best Duralast Alternatives

There are many other alternatives to Duralast to treat ED. Some of them may use the same active ingredient, sildenafil, while others may contain ingredients with a slightly different mechanism of action.

Pharmaceutical Alternatives

SSRIs (escitalopram like Lexapro, sertraline like Zoloft, paroxetine like Paxil, fluoxetine like Prozac)
Sildenafil (Viagra, Cenforce, Kamagra, Fildena, P-Force, Vygex, & more)
Tadalafil (Cialis, Adcirca, Vidalista, Tadacip, Forzest, & more)
Sildenafil and dapoxetine combination (Suhagra force, Da Sutra, Dapsil-D)
Tadalafil and dapoxetine combination (Uphold, TD pill, Dejac-T, ED Save Plus, Duraplus, Edon-D)
Topical anesthetics
Clomipramine
Tramadol

Natural Duralast Alternatives

Many herbs and nutrients are widely used to treat premature ejaculation. However, it is worth noting that most natural alternatives lack scientific evidence to back their advocated benefits.

You can start with these if you are hesitant to start prescribed medications. Then, if they don’t work, you can always switch to the pharmaceutical ones.

Here are some of the natural herbs and nutrients that may help with ED and PE:

Catuaba (Trichilia catigua or Erythroxylum Catuaba) — This herb may help treat ED and impotence [4].

Zinc — Zinc deficiency has been reported in some men with sexual dysfunction. Thus, taking zinc supplements may help increase testosterone and treat sexual dysfunction [5].

Horny Goat Weed (Epimedium spp.) — This plant contains a compound called icariin that can act as a PDE5 inhibitor [6].

L-Arginine — This supplement can increase nitric oxide levels, which can induce an erection [7].

Korean Red Ginseng (Panax quinquefolium) — Their extracts have been shown to improve nitric oxide production, which promotes dilation of the arteries in the penis and causes an erection [8].

Ginger — Ginger can increase blood flow to the penis and help sustain an erection for a longer duration [4].

Ashwagandha — This herb works as an aphrodisiac and may help increase libido and prevent premature ejaculation [9].

Where to Buy Duralast

Duralast is a prescription-only drug in most countries. So once you get the prescription for it, you can buy it from the nearest pharmacy or online. The latter may be a better alternative as it is discrete and straightforward.

However, natural alternatives are a good place to start since most are safe and easily accessible. Talk with your doctor if you’re already taking medication.

References

Clément, P., Bernabé, J., Gengo, P., Denys, P., Laurin, M., Alexandre, L., & Giuliano, F. (2007). Supraspinal site of action for the inhibition of ejaculatory reflex by dapoxetine. European urology, 51(3), 825-832.
Kendirci, M., Salem, E., & Hellstrom, W. J. (2007). Dapoxetine, a novel selective serotonin transport inhibitor for the treatment of premature ejaculation. Therapeutics and clinical risk management, 3(2), 277
McMahon, C. G. (2011). Efficacy of dapoxetine in the treatment of premature ejaculation. Clinical Medicine Insights: Reproductive Health, 5, CMRH-S7337.
Lim, P. H. (2017). Asian herbals and aphrodisiacs used for managing ED. Translational andrology and urology, 6(2), 167.
Dissanayake, D. M. A. B., Wijesinghe, P. S., Ratnasooriya, W. D., & Wimalasena, S. (2009). Effects of zinc supplementation on the sexual behavior of male rats. Journal of human reproductive sciences, 2(2), 57.
Shindel, A. W., Xin, Z. C., Lin, G., Fandel, T. M., Huang, Y. C., Banie, L., … & Lue, T. F. (2010). Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The journal of sexual medicine, 7(4), 1518-1528.
Moody, J. A., Vernet, D., Laidlaw, S., Rajfer, J., & Gonzalez-Cadavid, N. F. (1997). Effects of long-term oral administration of L-arginine on the rat erectile response. The journal of urology, 158(3), 942-947.
De Andrade, E., De Mesquita, A. A., de Almeida Claro, J., De Andrade, P. M., Ortiz, V., Paranhos, M., … & Erdogrun, T. (2007). Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian journal of andrology, 9(2), 241-244.
Sahin, K., Orhan, C., Akdemir, F., Tuzcu, M., Gencoglu, H., Sahin, N., … & Juturu, V. (2016). Comparative evaluation of the sexual functions and NF-κB and Nrf2 pathways of some aphrodisiac herbal extracts in male rats. BMC Complementary and Alternative Medicine, 16(1), 1-11.