Extra Super Viagra is a combination tablet: sildenafil 100 mg plus dapoxetine 100 mg — the erection medicine and the premature-ejaculation medicine in one dose, both at the upper end of their ranges. That combination is the whole story of this page, including its cautions.
Who it is for
Men who genuinely have both erectile difficulty and premature ejaculation, and who have already established that they tolerate both molecules. It is not a starting product, and it is not a stronger version of Viagra: the second ingredient does nothing for erections at all.
Before buying any combination, work out whether you actually have two problems. Hurrying because an erection is unreliable is extremely common and resolves when the erection is treated — PE and ED together sorts that out in a table. If only one condition is real, the single molecules are cheaper and easier to dose: sildenafil or dapoxetine.
About those strengths
Both halves sit at the top of their usual ranges. Sildenafil 100 mg is the maximum registered dose, and dapoxetine 100 mg is above the 60 mg that is the usual maximum in registered products. Practical consequence: this tablet is more likely to produce side effects than a lower-strength combination, and it offers no way to reduce one half without reducing the other.
If you have not used dapoxetine before, starting on 100 mg of it inside a fixed combination is not the cautious route. Starting separately — dapoxetine at 30 mg — tells you how you tolerate it before you commit to a tablet you cannot split the dose of.
How to take it
- One tablet, 1 to 3 hours before sex — the dapoxetine half sets the timing, and the sildenafil half is comfortably active within that window.
- With a full glass of water. Dapoxetine can cause fainting; water and staying seated if you feel light-headed are the standard precautions.
- One dose in 24 hours, never more.
- No alcohol on dosing days.
- Avoid a heavy fatty meal, which delays the sildenafil half.
Both sets of restrictions apply at once
- No nitrates, no poppers — absolute, from the sildenafil half.
- No antidepressants (SSRIs, SNRIs, tricyclics, MAOIs), lithium or tramadol, and not within the washout period after stopping them — from the dapoxetine half.
- Not with significant heart disease, a history of fainting, mania or severe depression, or serious liver disease.
- Care with alpha-blockers, other blood-pressure medicines and strong CYP3A4 inhibitors.
The absolute rule applies here as it does everywhere in this class: never combine this with nitrates (glyceryl trinitrate, isosorbide) or amyl nitrite "poppers" — together they can cause a dangerous fall in blood pressure. If you develop chest pain after taking it, tell the paramedics or the emergency department what you have taken, because nitrates are the treatment they would otherwise reach for.
Expect side effects from both halves: headache, flushing, blocked nose and visual tinge from sildenafil; nausea, dizziness and headache from dapoxetine. An erection lasting more than four hours, or sudden loss of vision or hearing, is a medical emergency.
Gentler ways to the same place
Tadapox pairs tadalafil 20 mg with dapoxetine 60 mg — a longer erection window and a lower dapoxetine dose. Taking the two molecules separately costs an extra tablet but lets you tune each dose independently, which is the sensible route while you are still finding out what works.
The Australian position
Sildenafil and dapoxetine are both Schedule 4 (prescription-only) in Australia, and fixed-dose combinations are not registered products here. Have a doctor clear the combination — and the strengths — before you use it.
Two ceilings crossed at once
This tablet pairs sildenafil with dapoxetine, and it is worth being precise about which limits apply to which half, because a combination product makes it easy to lose track:
| Component | Licensed maximum single dose | What that means here |
|---|---|---|
| Sildenafil | 100 mg | Anything above it buys side effects, not effect |
| Dapoxetine | 60 mg | Above it, nausea and fainting risk climb sharply |
The practical problem with a fixed combination is that you cannot adjust one half without the other. If the ED dose suits you but the dapoxetine makes you nauseated, a combination tablet gives you nowhere to go — which is the argument for establishing each molecule separately first, then moving to a combination once you know both doses work for you.
Sources
- TGA — Therapeutic Goods Administration: these molecules are Schedule 4 in Australia
- Healthdirect — Premature ejaculation
- Healthdirect — Erectile dysfunction
