Extra Super P Force

Extra Super P Force is an imported generic made in India that puts two active substances into one tablet: sildenafil 100 mg and dapoxetine 100 mg. Sildenafil is a PDE5 inhibitor; it improves blood flow into the penis when a man is sexually aroused and so helps him achieve and keep an erection. Dapoxetine is a short-acting selective serotonin reuptake inhibitor developed specifically for premature ejaculation, where it lengthens the time before climax and gives a greater sense of control. The pack shown in the photo is the manufacturer’s own branded pack rather than a UK product.

There is one strength of Extra Super P Force, 100/100 mg, sold in packs of 12, 20, 32 or 60 tablets. The tablets cannot be adjusted to give a lower amount of one ingredient without lowering the other, which is one of the practical drawbacks of a fixed combination. Both ingredients start to work within an hour or so, but sildenafil acts for around four to five hours while dapoxetine is cleared much faster, so the timing that suits one component is not necessarily ideal for the other. Men who already take regular medicines, or who have never used either drug before, are the ones most likely to run into problems with a high fixed dose.

Extra Super P Force is not licensed by the MHRA. Each of its ingredients is available here separately. Sildenafil is a prescription-only medicine in 25, 50 and 100 mg strengths, with one 50 mg product also sold as a pharmacy medicine after a pharmacist’s assessment; it was first marketed as Viagra. Dapoxetine is licensed as Priligy 30 mg and 60 mg tablets, a prescription-only medicine for men aged 18 to 64 with premature ejaculation.

According to the UK SmPC, the usual sildenafil dose is 50 mg about an hour before sex, with 100 mg as the highest amount in any 24 hours. Dapoxetine is started at 30 mg, taken one to three hours beforehand, and the dose may be raised only to 60 mg; it should not be used more than once in 24 hours. The 100 mg of dapoxetine in each tablet of this product therefore exceeds the highest licensed UK dose. Taking more than one tablet a day is not appropriate. A doctor or prescriber decides whether either medicine, at any dose, is suitable for an individual man.

Sildenafil must never be combined with nitrates, including glyceryl trinitrate sprays and amyl nitrite (“poppers”), or with riociguat, because blood pressure can fall dangerously. It is unsuitable after a recent stroke or heart attack, with very low blood pressure, severe liver disease or certain inherited eye disorders such as retinitis pigmentosa. Dapoxetine is contraindicated in significant heart disease, including heart failure, conduction problems and ischaemic heart disease, in a history of mania or severe depression, and alongside other SSRIs, SNRIs, tricyclics, MAOIs, linezolid, thioridazine, St John’s wort, tramadol, triptans or strong CYP3A4 inhibitors such as ketoconazole, itraconazole and ritonavir. Alcohol makes fainting and dizziness more likely, and alpha-blockers for blood pressure or the prostate call for extra caution.

With Extra Super P Force, headache, flushing, dizziness, nausea, blocked nose and indigestion are the most frequent effects. Some men notice blurred vision or a bluish tinge to colours, trouble sleeping, diarrhoea or feeling anxious. Dapoxetine can cause fainting, often preceded by light-headedness, sweating or nausea; sitting or lying down straight away reduces the risk of injury. An erection lasting more than four hours, sudden loss of sight or hearing, or chest pain during sex needs urgent help at A&E. Suspected reactions can be reported through the Yellow Card scheme.