Priligy alternatives: what actually works for premature ejaculation

Up to about 30% of men report premature ejaculation at some point. If Priligy (dapoxetine) didn’t work for you or you can’t take it, there are practical alternatives — both drug and non-drug — that can help. Below I break down the main options, what to expect, and simple steps to pick the right one with your doctor.

Medical alternatives — quick facts

Short-acting SSRI: Dapoxetine (Priligy) is unique because it acts fast and is taken only when needed. Other SSRIs — paroxetine, sertraline, fluoxetine — are used off-label and are taken daily. They tend to delay ejaculation reliably but can cause nausea, fatigue, or reduced libido.

Topical anesthetics: Lidocaine-prilocaine creams or sprays numb the glans and cut sensitivity. Apply 10–20 minutes before sex, then wipe off to reduce numbness for your partner. They work fast and don’t require daily dosing, but you might notice less sensation.

Tramadol: An opioid that can delay ejaculation for some men. It’s used off-label and carries risks — dizziness, drowsiness, dependence — so it’s a second-line choice and needs close medical supervision.

PDE5 inhibitors (sildenafil, tadalafil): Not direct treatments for premature ejaculation, but they help when erectile dysfunction coexists. Some men notice delayed ejaculation when using these drugs, especially combined with SSRIs — discuss interactions with your prescriber.

Non-drug options & how to choose

Behavioral techniques are low-risk and worth trying first. Methods like stop-start and squeeze help you learn control. Pelvic floor exercises (Kegels) strengthen muscles involved in ejaculation — do short, frequent sets daily and you may see improvement in weeks.

Condoms and thicker condoms reduce sensation and often add a few minutes. Combine condoms with topical anesthetic for more effect. Sex therapy or cognitive-behavioral therapy works well when anxiety or relationship issues play a role — bring your partner along if possible.

How to decide? Ask yourself: do you need something only for occasional encounters (use-as-needed)? Do you want a daily medication? Are side effects acceptable? Start with the least invasive option: behavior techniques and condoms or topicals. If those fail, discuss dapoxetine versus daily SSRIs with your doctor. If pain, mood disorders, or other health issues exist, that changes the choice.

Safety notes: don’t mix MAOIs with SSRIs or dapoxetine. Tramadol plus SSRIs raises serotonin syndrome risk. PDE5 inhibitors interact dangerously with nitrates. Always tell your prescriber about all meds and supplements.

If you’re thinking about buying meds online, use a verified pharmacy and get a prescription when required. Your doctor or pharmacist can help check interactions and suggest the safest option for your situation.

Practical next step: try one non-drug approach for 4–8 weeks first, then talk to your clinician about a drug trial if needed. Treatment often works best when you combine medical and behavioral approaches.