Overview section
Extra Super Tadarise is a combined oral product marketed in some countries to address two male sexual health conditions at once: erectile dysfunction (ED) and premature ejaculation (PE). It pairs tadalafil, which supports erection, with dapoxetine, which is used to delay ejaculation. This page summarizes how the combination is presented, safety management considerations, guidance on price levels, and how U.S. regulations affect availability. For cost details see the section Standard prices in the United States. For advice for legal decisions, see American law notes.
- Primary purpose: dual treatment for ED and PE in adult men
- Not approved for sports performance or recreational enhancement
- Information here is focused on the United States context
Running components and potency
The marketed fixed-dose tablet commonly contains:
- Tadalafil dose of 40 mg - a PDE5 inhibitor that improves penile blood flow during sexual stimulation.
- Dapoxetine 60 milligrams - a short-acting SSRI used in several countries to increase ejaculatory control and prolong time to ejaculation.
Typical fixed formulation: 40 mg tadalafil combined with 60 mg dapoxetine in a single tablet.
The intended use case
This product is intended for adult men who have been clinically evaluated and diagnosed with both erectile dysfunction and premature ejaculation. It is not suitable for self-diagnosis or unsupervised use.
- Erectile dysfunction: inability to achieve or sustain an erection adequate for sexual performance.
- Premature ejaculation: poor ejaculatory control with personal distress or relationship difficulty.
Always consult a qualified health professional before starting any treatment for sexual dysfunction.
Amount to be administered and administration method
- Use exactly as prescribed by your clinician; do not exceed the recommended dose.
- Swallow the tablet whole with plenty of water. Do not split, crush, or chew the tablet.
- It can be taken regardless of food intake. High-fat meals may delay when the medicine starts to work.
- Common timing: one hour before planned sexual activity, unless your prescriber gives different instructions.
- The combination is usually prescribed for on-demand use rather than daily dosing, unless otherwise directed.
If you have a scheduled regimen and you miss a dose, see Missing a dose: what you should know.
Critical safety advisories and safety protocols
- Do not self-medicate without evaluation for causes of ED or PE.
- Not for use in persons under 18 years of age.
- Exercise caution in people older than 65; watchful oversight or dose changes may be necessary.
- Both tadalafil and dapoxetine can lower blood pressure and cause dizziness or fainting.
- Penile structural disorders, such as Peyronie disease, increase the risk of prolonged or painful erections; seek medical advice first.
- Blood dyscrasias like sickle cell disease, leukemia, or multiple myeloma raise the risk of priapism; discuss ancillary choices with your treating clinician.
- Severe liver or kidney impairment may preclude safe use or require specialist oversight.
- Immediate medical attention is required for sudden vision or hearing changes occurring during or after use.
- Provide your clinician with a complete list of medications, supplements, and herbal preparations to avoid harmful people engage through a series of two-way communication in actions..
Who should not be using it
- Known hypersensitivity to tadalafil, dapoxetine, or any excipient in the tablet.
- Uncontrolled low blood pressure or a history of symptomatic hypotension.
- People younger than eighteen years.
- Active or significant bleeding disorders.
- Unstable seizure disorders or untreated epilepsy.
- History of mania, bipolar disorder, or uncontrolled psychiatric illness.
- Concurrent use of recreational nitrites (poppers) or other agents that cause severe user contact and responses drive engagement and learning..
- Concomitant use of interacting antidepressants or MAO inhibitors without specialist oversight; see How drugs interact with meals.
- Recent myocardial infarction, unstable angina, serious arrhythmias, or severe heart failure unless cleared by a cardiologist.
- Severe hepatic or renal disease where the risks outweigh potential benefits.
Reactions you may notice
It is possible that adverse effects do not occur for all users. Commonly reported reactions include:
- A pressure in the head along with facial flushing, or a warm sensation
- Nose congestion or runny nose
- Vertigo, somnolence, or general fatigue
- Nausea and other signs of GI distress, indigestion, or dry mouth
- Backache or muscle soreness
- More sweating than usual
- Reduced sexual desire
- Blood pressure lowering effects, which can rarely cause fainting
Stop using the product and seek urgent medical care for signs of chest pain, severe fainting, allergic reaction (rash, swelling, shortness of breath), sudden loss of vision or hearing, or an erection lasting longer than four hours.
Potential food-the reciprocal contact between individualss between people can shape outcomes. between medications
- Nitrates and nitric oxide donors (including amyl nitrite/poppers): combined use can cause severe hypotension. Do not mix. these drugs.
- Riociguat and other pulmonary hypertension agents: additive blood pressure reduction is possible.
- MAO inhibitors and some antidepressants can interact with dapoxetine, increasing risk of serotonin-related negative health impacts.
- Central nervous system depressants such as antipsychotics, sedatives, opioids, and some anti-seizure medicines may worsen drowsiness and dizziness.
- Strong CYP3A4 inhibitors (certain antibiotics, antifungals, and antiviral agents) can raise tadalafil or dapoxetine concentrations.
- CYP3A4 inducers (for example, rifampin) may reduce the drugs efficacy.
- Concurrent anti-anginal or antiarrhythmic therapy may compound cardiovascular effects; review alongside your prescriber.
- Ethyl alcohol can amplify dizziness and blood pressure lowering; limit intake or avoid.
- Grapefruit or grapefruit juice may increase tadalafil exposure and should be avoided while taking it.
Counsel on the dose was skippeds
Because this combination is usually taken as needed before sexual activity, missing a dose is uncommon. If a prescriber has advised a routine schedule, contact them for instructions and do not double the next dose to make up for a missed one.
Overdose situation information page
If an excessive amount is taken, obtain emergency medical help immediately. Possible signs of experiencing an overdose include:
- Severe nausea or vomiting
- Prolonged erection or priapism
- Chest discomfort, palpitations, or very rapid heart rate
- Marked dizziness, fainting, or agitation due to low blood pressure
- Nosebleeds, flushing, or dry mouth
Take the medication packaging with you to the emergency department if available so clinicians can identify the exact product and strengths involved.
Storage area instructions
- Keep at room temperature in a sealed container away from moisture.
- Avoid exposure to heat and direct sunlight.
- Store where children and pets cannot reach and cannot see it.
Equivalent medicines and different treatment options
If you need treatments that address ED and/or PE, consider discussing the following legally available options in the United States with a licensed clinician:
- Tadalafil alone (generic tadalafil, brand Cialis): FDA-approved for ED and benign prostatic hyperplasia; available as both as-needed and daily dosing options.
- Sildenafil (Viagra and generic sildenafil): a commonly used on-demand ED medication with a shorter duration for many users.
- Vardenafil (Levitra) and avanafil (Stendra): other PDE5 inhibitor options; avanafil may provide faster onset for some patients.
- Premature ejaculation approaches:
- Topical anesthetics such as lidocaine-prilocaine creams, sprays, or wipes to reduce penile sensitivity.
- Oral SSRIs like sertraline or paroxetine are often used off-label for PE under medical supervision.
- Behavioral techniques such as start-stop or squeeze methods and psychotherapy are nonpharmacologic different choices.
- Dapoxetine (Priligy) is used for PE in several countries but is not approved by the FDA for use in the United States.
Many clinicians in the U.S. combine an approved ED medicine with a topical anesthetic or an SSRI when clinically appropriate. Always pursue these strategies under medical supervision to ensure safety and legality.
Common pricing approach levels in the USA
The following are approximate out-of-pocket cost ranges in U.S. united States dollars. Actual costs vary with pharmacy, location, dosage, and discount programs.
- Extra Super Tadarise (40 mg tadalafil + 60 mg dapoxetine): not FDA-approved and not dispensed by U.S. medicine dispensaries. Overseas web vendors may list tablets at about $3 to $8 each, but authenticity and legality are uncertain. See Notes on U.S. law.
- Generic tadalafil 10-20 mg: commonly about $1 to $5 per tablet with discount programs; brand Cialis tablets are often $20 to $60 per tablet without discounts.
- Generic sildenafil 50-100 mg: roughly $0.50 to $2 per tablet with savings cards; brand Viagra costs significantly more.
- Avanafil (Stendra) brand: often priced around $15 to $40 per tablet.
- Topical lidocaine-prilocaine products for PE: estimated $20 to $40 per month depending on use and product.
- Generic SSRIs used off-label for PE: usually inexpensive per month when generic and covered by insurance.
Insurance coverage, manufacturer coupons, pharmacy discount programs, and telehealth services can change the final price substantially. For FDA-approved ED medications, telemedicine providers and pharmacy savings programs often offer lower out-of-pocket options.
Notes on American law
- Prescription requirement: PDE5 inhibitors approved by the FDA (tadalafil, sildenafil, vardenafil, avanafil) are prescription-only in the United States.
- Dapoxetine status: dapoxetine is not approved by the FDA. Products that contain dapoxetine, including some fixed-dose combinations, are unapproved for U.S. marketing.
- Importation rules: importing unapproved drugs for personal use is generally prohibited and shipments may be refused, detained, or seized by customs alongside the FDA. Exceptions are rare and not a reliable pathway to obtain medication.
- Quality and safety: medications purchased from unverified overseas websites may be counterfeit, substandard, or contaminated. Use U.S.-licensed pharmacies and prescribers whenever possible.
- Telemedicine: U.S.-licensed clinicians can evaluate ED and PE and prescribe FDA-approved therapies using telehealth in most states, subject to state rules and also the clinician-patient relationship.
- Sporting considerations: PDE5 inhibitors are not banned by major anti-doping organizations, but athletes should consult their team or federation medical staff prior to use.
If you seek treatment in the United States, speak with a licensed clinician about approved and legal options that are safe and appropriate for your health needs.
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