Overview: Doctors may consider prescribing medications “off-label” for premature ejaculation, including selective serotonin reuptake inhibitors (SSRIs), most notably paroxetine (Paxil.) However, there are potential risks to the approach, and it’s often best paired with ED medications and behavioral treatment options.
Is There Really A Drug For Premature Ejaculation?
There is no drug specifically designed to treat PE that’s FDA-approved in the U.S. Instead, there are medications that are prescribed “off-label” to treat it. Technically speaking, an off-label use is one that’s not approved by government authorities. It tends to exploit either a common side effect or primary effect of the medication in ways that haven’t been subject to the full range of study to be declared medically useful for that purpose.
In that context, there are multiple drugs that have a delay of orgasm as a common side effect and are similarly well-understood; thus, they might be used off-label to treat PE. They might even be drugs you’re considering taking for their primary purposes.
Which Is the Best Drug for PE?
Two classes of drugs are most often prescribed for premature ejaculation: selective serotonin reuptake inhibitors (SSRIs, which are antidepressants) and phosphodiesterase-5 inhibitors (PDE5 inhibitors, as mentioned above).
SSRIs for Premature Ejaculation
The most commonly used medication to treat PE is paroxetine, an SSRI sold under the name Paxil. Several studies (like this one) have found SSRIs to be an effective treatment for PE because of their side effect of delaying ejaculation.
PDE5 Inhibitors
Research shows that phosphodiesterase-5 inhibitors (PDE5 inhibitors) like sildenafil (better known as Viagra) or tadalafil (aka Cialis) can treat PE symptoms in many men because of their mechanism of action.
These erectile dysfunction medications work by opening up the blood vessels of the penis to enable longer, firmer erections. However, since it’s taken orally, Viagra travels through and opens up blood vessels across the entire body, not just the penis. If you have a circulatory disorder, for example, this may be useful regardless of whether you need Viagra in bed or not.
However, these drugs have on the market for decades, with well-understood side effects and risks, so doctors frequently prescribe them off-label for premature ejaculation.
SSRI Plus a PDE5 Inhibitor
Other studies show that ED meds are more effective still when combined with an SSRI as part of a multi-pronged approach.
Is There a Downside to Off-Label Prescriptions?
There are reasons to be careful around off-label use, and it should only be done after discussing the issue thoroughly with your doctor. For example, SSRIs can have counterproductive side effects, like loss of libido or nausea, and paroxetine shouldn’t be taken by anyone on blood thinners, which include most over-the-counter analgesics like aspirin and ibuprofen.
Another drug notable for delayed orgasm is Tramadol, an analgesic, but that medication has a high risk of becoming dependency-forming, a side effect most doctors would insist isn’t worth risking unless the patient is under severe emotional distress and has exhausted all other options.
Beyond this, the trials mentioned above are all small ones. While the results are promising, larger-scale clinical trials would be necessary for a definitive answer. Secondly, an analysis of paroxetine and PE studies found that the efficacy of paroxetine varies widely from experiment to experiment. While it seems to work well for some men, it is not a solution for everyone.
The Bottom Line
The best approach to treatment is to work with your doctor and develop a multi-pronged approach. PE is a complicated and personal issue, and there’s no one pill or technique that best addresses it. Information is your best tool on the way to better sexual health, and working with your doctor can ensure that journey is a safe one.
How eDrugstore Can Help
If you and your doctor decide that a PE med trial is a good option for you, please see our lifestyle medication guide to learn more about PDE5 inhibitors, including Viagra, Cialis, Levitra, and more. We also offer a premature ejaculation kit, which may be a better option for some men.
If you would prefer to talk to one of our doctors about PE or erectile dysfunction, we offer a free medical consultation with a U.S.-licensed physician who can help you decide which PE treatment may be best for you. Simply call 1-800-467-5146 to get started.
Dan is a long-time freelance writer focusing on technology, science, health, and medicine, with a lifelong interest in physics, biology, and medicine. His work has taken a particular focus on scientific studies “beyond the headlines,” reading the study to more closely examine the results.
