Cenforce D (sildenafil, dapoxetine) is a combination medication that offers adult men relief from both erectile dysfunction (ED) and premature ejaculation (PE). This product should not be given to young patients below age 18, as effects on still-developing bodies are unclear.

The two active ingredients in Cenforce D are:

• Sildenafil is a PDE5 inhibitor found in the well-known brand Viagra. A vasodilator which improves blood flow, it allows a firm erection to form and be maintained long enough for intercourse. Sildenafil is effective in the vast majority of ED cases
• Dapoxetine is a fast-acting SSRI found in the brand-name Priligy. With effects wearing off too fast to make it ideal for treating mental disorders, it has since been approved for treating PE. It delays ejaculation, gives men a greater sense of control over ejaculation, and reduces anxiety about ejaculating too soon. How exactly dapoxetine works is unclear.

Both of Cenforce D's ingredients have been widely used by millions of men around the world; both are well-studied in clinical trials and real-world use, and both are considered safe when used as directed.

Note that while Cenforce D can alleviate ED and PE for a period, it is not a cure. If the underlying causes are not identified and addressed, use of Cenforce D or a similar product will likely need to continue indefinitely.

Dosage & Administration

Both sildenafil and dapoxetine begin working and remain effective for roughly the same amount of time; sildenafil typically starts producing effects 30 to 45 minutes after administration, and dapoxatine 30 minutes to 1 hour following administration. Both last, on average, between 4 to 6 hours, though a few men find they last considerably longer, up to 24 hours.

Cenforce D comes in tablets, and one tablet represents one dose. Currently Cenforce D is available only in 100 mg sildenafil/60 mg dapoxetine tablets, though this may change. Men new to using either of these ingredients should note that the standard starting dose is 50 mg sildenafil and 30 mg dapoxatine; these are only increased if needed and if no serious adverse effects develop at lower doses.

While some men do take more than 100 mg sildenafil in a dose, more than 60 mg dapoxatine should be avoided. At higher doses it can actually contribute to ED.

Treatment is simple; a dose is taken as-needed prior to intimacy:

• Take one tablet about one hour before intimacy.
• Effects will start to diminish after about 4 or 5 hours.
• Do not take more than one dose in a 24-hour period.
• Do not take more than three doses in 7 days.

A glass of fluid is recommended with each dose. Food is optional, and taking with food may ease gastrointestinal side effects if experienced. However, avoid heavy meals or high-fat meals with tablets, as they can delay absorption of the medication.

Some stimulation will be needed to acheive an erection; Cenforce D does not cause an erection to form spontaneously. The ability to form an erection should begin 30-45 minutes after a dose is taken to 4 or 5 hours afterwards. PE should be delayed during this time; in trials, the majority of men added several minutes to intercourse before ejaculation, whereas those who did not take dapoxatine ejaculated in less than one minute.

Potential Complications

As mentioned above, used as directed both of Cenforce D's ingredients are considered safe. However, this is considering the numerous factors that can influence dosage strength, or even use of the medications at all.

Otherwise healthy, younger men have little to worry about as long as Cenforce D is taken in recommended doses. Older men, or men with other medical conditions or taking other medications, have more to consider.

Cardiovascular conditions are the biggest concern with Cenforce D, or any product containing a PDE5 inhibitor. Men should not take Cenforce D without first speaking with a doctor about risks if there is any history of:

• High or low blood pressure
• Irregular heartbeat
• Blood cell or bleeding disorders
• Coronary artery disease
• Congestive heart failure
• Liver or kidney impairment
• High risk for heart attack or stroke
• Other cardiovascular issues

And medications of concern include:

• Other PDE5 inhibitors
• Nitrates
• Protease inhibitors
• Alpha-blockers
• Any hypertension treatment
• Antibiotics
• Antifungal medications
• Guanylate cyclase stimulators

The above are not the only medications that can interact with Cenforce D. To be on the safe side, always double-check with a doctor or pharmacist before mixing treatments.

If a doctor approves use of Cenforce D, side effects should be rare and mild. Most commonly encountered are:

• Headache
• Mild muscle aches
• Mild stomach upset
• Cold-like symptoms

PDE5 inhibitors are associated with vision or hearing impairment, though rare. Symptoms are usually---but not always---reversible when the medication wears off. Men with any vision or hearing difficulties may want to avoid Cenforce D.