Drug Interactions, Kratom Guides

A Handy Guide to the Interaction Between Dapoxetine & Kratom

According to the American Urology Association, between 30 to 40% of men will experience premature ejaculation at some point in their lives.

Until recently, the only way to treat this condition was through psychological and behavioral techniques: that has all changed with the arrival of dapoxetine.

Dapoxetine was originally an antidepressant but could help treat premature ejaculation — though it isn’t available in the US yet. Since kratom is prone to interact with SSRIs like dapoxetine, it’s essential to understand what the combination of these two compounds could look like.

Last updated 5 months ago by Wade Paul

A Handy Guide to the Interaction Between Dapoxetine & Kratom

Does Kratom Interact With Dapoxetine?

Yes, kratom could interact with dapoxetine.

Dapoxetine’s metabolization is mainly carried out by the CYP enzymes 2D6 and 3A4 [1]. This is of great importance as kratom is known to be a potent inhibitor of both these enzymes [2].

Kratom can exert a powerful inhibitory effect on dapoxetine’s metabolizing process, increasing the levels and leading to adverse effects, primarily serotonin syndrome [3]. This situation can be deadly, so kratom and SSRIs must be only used under a doctor’s care.

Aside from metabolization, the two compounds do not interact in a meaningful way.

Dapoxetine Specs

Drug NameDapoxetine
Trade NameSublocade, Probuphine, Belbuca, Butrans, Buprenex, Sixmo, Subutex
Other NamesN/A
ClassificationSSRI
CYP MetabolismCYP2D6 and CYP3A4
Interaction With KratomMetabolic inhibitor
Risk of InteractionModerate

Is it Safe to Take Kratom With Dapoxetine?

The only way to safely take kratom with prescription medications like dapoxetine is with a doctor’s supervision.

Both compounds are highly well-tolerated and don’t seem to cause serious health events. However, the FDA has not yet approved dapoxetine, so it’s not available in the US.

The most salient danger in this combination is no doubt kratom’s inhibitory effect in dapoxetine, as it can lead to a toxic level of the compound within the body.

However, since dapoxetine is taken on-demand and has a very short half-life, the risk is significantly reduced. The chances are even lower if you don’t use kratom for some hours before and after taking dapoxetine.

Using them at the same time means more risk.

If you happen to have a CYP2D6 genetic deficiency (7% of Caucasians and about 1% of Asians have this condition), this further increases the risk.

What is Dapoxetine?

Dapoxetine — known commercially as Priligy — is a prescription SSRI.

SSRIs inhibit the serotonin transporter, a protein molecule that transports serotonin from the synaptic cleft back to the presynaptic neuron. This leads to increased levels of available serotonin for the brain.

Serotonin is an essential neurotransmitter with critical functions in regulating mood, learning, memory, and a vast suite of other physiological processes.

Dapoxetine has specific characteristics that set it apart from other SSRIs — mainly the fact that it is absorbed and cleared quite rapidly from the body [4]. This made it less effective as an antidepressant.

Dapoxetine can be taken on an on-demand basis and is ingested orally.

What is Dapoxetine Used for?

Almost all SSRIs treat depression-related conditions. However, due to dapoxetine’s rapid absorption, it is not suitable for this purpose.

Through the use of randomized, double-blind trials, dapoxetine seems to be an effective treatment for premature ejaculation (PE) [1]. It is the first pharmacological pill approved for the treatment of this condition.

Other SSRIs like fluoxetine and sertraline have been prescribed off-label to treat PE. However, these SSRIs present significant drawbacks compared to dapoxetine as they have much longer half-lives, leading to a higher incidence of negative effects.

Recently, the efficacy of dapoxetine as an antidepressant has been reconsidered in the UK. Researchers are looking at it as a method of antidepressant treatment focused on reducing stress [5]. 

What’s the Dose of Dapoxetine?

Dapoxetine is available in either 30 or 60 mg tablets; it should be taken roughly 1-3 hours before sexual activity.

Determining your proper dosage is only possible through consulting with a medical professional. Since dapoxetine is a prescription drug, you will have to complete this process before receiving your prescription.

Only take dapoxetine according to your prescription.

Generic & Brand Name Versions

Dapoxetine is available under the following brand names:

  • Priligy
  • EJ-30
  • Dapox
  • Dasustra
  • Duralast
  • Ejalong
  • Kutub
  • Sustinex

What Are the Side Effects of Dapoxetine

Dapoxetine’s side effects correlate with the dosage. However, they rarely lead to a discontinuation of use.

The most common adverse effects that can arise as a result of dapoxetine include:

  • Nausea
  • Dizziness
  • Headache
  • Diarrhea
  • Dry mouth
  • Insomnia

Contraindications to dapoxetine use include the following:

  • Severe hepatic impairment
  • Other CYP3A4 inhibitors
  • Monoamine oxidase inhibitors
  • Other SSRIs
  • Heart failure or other heart conditions
  • Pacemakers

What is Kratom?

Kratom is a psychoactive herbal extract from a plant species named Mitragyna speciosa. This evergreen tree is native to Southeast Asia and grows abundantly in Thailand and Indonesia, where people have found numerous medicinal uses for kratom.

The scientific research on kratom is still lacking, but it’s quickly becoming popularized in the United States and Europe.

Regretfully, the FDA appears to be targeting kratom for legislation. At the moment, it’s still unregulated in many states, though many states have banned it.

Nonetheless, we do know some things.

Kratom owes its therapeutic properties to its many alkaloids, primarily mitragynine and 7-hydroxymitragynine. Alkaloids are naturally-occurring compounds that often have pharmacological effects.

What is Kratom Used for?

The most remarkable property of the kratom plant is undoubtedly the broad spectrum of effects it can produce.

Kratom behaves much like a stimulant with powerful nootropic properties in low doses. Much like coffee, it produces mental and physical energy, often with a boost in concentration.

Kratom also possesses mood-enhancing effects, creating feelings of euphoria.

Kratom acts more like a relaxant in larger doses and produces sedative and analgesic benefits.

At this range, kratom provides chronic pain relief and can even help treat anxiety.

And there’s more — kratom can work as a sleeping aid, helps with weight loss, and alleviates the symptoms of opioid withdrawal.

What’s the Dose of Kratom?

One of the things to always keep in mind is that generalized dosage recommendations are always suspect.

Remember: everyone is different, and factors like body weight and genetics are always in play.

That said, it helps to know what a low dose is and at what range the amount becomes acute.

For kratom, the following amounts are usually the rule of thumb:

  • Low dose — (1-4 grams)
  • Medium dose — (4-8 grams)
  • High dose — (8-12 grams)

Learn more about kratom dosage with our dosing guide.

What Are the Side Effects of Kratom?

Kratom, like all drugs, has its fair share of side effects:

  • Constipation
  • Dizziness
  • Insomnia
  • Nausea
  • Itchiness
  • Loss of muscle coordination
  • Low blood pressure
  • Low libido
  • Nausea
  • Poor appetite
  • Seizures
  • Tremors

Kratom can also cause symptoms of mental and physical dependence.

Kratom addiction is less likely when compared to pharmacological drugs like antidepressants or painkillers, but it’s always a possibility.

Make sure to become familiar with the dangers of kratom use.

What Are the Different Types of Kratom?

Kratom exists in four different strain varieties.

The different strains all have certain qualities that make them unique, but, in the end, they’re still the same plant and have the same basic attributes.

If you want to make your kratom experience as specific as possible, then pick the right strain for the job.

A) White Vein Kratom

The nootropic, stimulating effects are primarily associated with the white-veined kratom strains.

The kratom community loves this strain because it helps them get the biggest punch out of the stimulant benefits of kratom. Some people even replace their coffee with a cup of kratom tea, enjoying its long-lasting effects.

B) Red Vein Kratom

If you’re looking at kratom because of the chronic pain relief or anxiety relief it can provide, then what you want is red-vein kratom.

Kratom users interested in the pharmacological benefits of kratom usually pick this strain. Many even abandon their medication; however, no one should stop taking a prescription without a doctor’s guidance.

C) Green Vein Kratom

Green vein kratom doesn’t provide the targeted experience of a red or white strain.

However, it does provide the whole swathe of effects associated with kratom. If you are interested in everything kratom can provide, green veins are the way to go.

D) Yellow Vein Kratom

Yellow vein kratom is not much different than green. Its only real property is the fact that it’s the least potent out of all the strains — perfect for first-timers.

Key Takeaways: Is it Safe to Mix Kratom & Dapoxetine?

This mixture has moderate risks because kratom can slow down dapoxetine’s metabolization. The answer to this question depends on how often you’re taking these compounds, and only a doctor knows what’s best.

There is a clear risk stemming from the inhibitory effect of kratom on dapoxetine’s metabolization. If both drugs are used often and usually simultaneously, this could easily lead to complications.

However, if one were to space out the use of kratom and dapoxetine or make sure to never consume both compounds on the same day, the risk is significantly reduced.

Make sure to keep this in mind if you use both of these drugs. Regardless, it’s best to call your doctor and ask for guidance.

References

  1. McMahon, C. G. (2012). Dapoxetine: a new option in the medical management of premature ejaculation. Therapeutic advances in urology, 4(5), 233-251.
  2. Hanapi, N. A., Ismail, S., & Mansor, S. M. (2013). Inhibitory effect of mitragynine on human cytochrome P450 enzyme activities. Pharmacognosy research, 5(4), 241.
  3. Scotton, W. J., Hill, L. J., Williams, A. C., & Barnes, N. M. (2019). Serotonin syndrome: pathophysiology, clinical features, management, and potential future directions. International Journal of Tryptophan Research, 12, 1178646919873925.
  4. ANDERSSON, K. E., Mulhall, J. P., & Wyllie, M. G. (2006). Pharmacokinetic and pharmacodynamic features of dapoxetine, a novel drug for ‘on‐demand’treatment of premature ejaculation. BJU international, 97(2), 311-315.
  5. Rafi, H., & Farhan, M. Dapoxetine: An Innovative Approach in the Therapeutic Management in Animal Model of Depression.