ExtraSuperTadarise is a combination preparation whose main ingredients include Tadalafil and Dapoxetine. It is used for the treatment of male erectile dysfunction (ED) and premature ejaculation (PE). Tadalafil is a PDE5 inhibitor that improves erectile function by increasing blood flow to the penis; Dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSRI) used to delay ejaculation time.
What Are the Side Effects of ExtraSuperTadarise?
Tadalafil-Related Side Effects
Headache (incidence of 15% at a 20 mg dose).
Dyspepsia (10%).
Back pain and myalgia (6%).
Nasal congestion (3%).
Facial flushing (3%).
Visual abnormalities (such as cyanopsia, incidence < 0.1%).
Dapoxetine-Related Side Effects
Nausea (8.5%–20.7%).
Dizziness (6.2%–12.1%).
Insomnia (3.1%–5.9%).
Fatigue (2.9%–6.1%).
Diarrhea (3.9%–6.8%).
Severe Side Effects of ExtraSuperTadarise That Require Vigilance
Cardiovascular Risks
Life-threatening interaction with nitrate medications: Concomitant use with any form of organic nitrates (e.g., nitroglycerin) can lead to life-threatening hypotension.
QT interval prolongation: High doses may prolong the QT interval (mean increase of 3.5 milliseconds at a Tadalafil dose of 100 mg).
Risk of myocardial infarction: Sexual activity itself poses risks to patients with cardiovascular disease; this medication should not be used in cardiovascular patients for whom sexual activity is inappropriate.
Neurological Reactions
Syncope (related to Dapoxetine, incidence approximately 0.06%–0.2%).
Serotonin syndrome (especially when used concomitantly with other SSRIs).
Seizures (rare but require vigilance).
Other Severe Risks
Priapism (persistent penile erection): Erections lasting more than 4 hours require emergency treatment to prevent permanent damage.
Sudden hearing loss: A class effect of PDE5 inhibitors, usually unilateral.
Non-arteritic anterior ischemic optic neuropathy (NAION): The risk is increased in patients with cardiovascular risk factors.
Precautions for ExtraSuperTadarise Administration
Administration in Special Populations
Hepatic impairment: The maximum dose for patients with mild to moderate hepatic impairment should not exceed 10 mg per day; severe hepatic impairment is a contraindication.
Renal impairment:
Moderate renal impairment (CrCl 30–50 mL/min): Maximum dose of 10 mg every 48 hours.
Severe renal impairment (CrCl < 30 mL/min): Maximum dose of 5 mg per day.
Elderly patients: No dose adjustment is required for patients aged ≥ 65 years, but careful monitoring is necessary.
Important Administration Guidelines
Timing of administration: It is recommended to take the medication 30–60 minutes before sexual activity.
Effect of food: A high-fat meal may delay the absorption of Dapoxetine but does not affect Tadalafil.
Alcohol restriction: Avoid excessive alcohol consumption (≥ 5 units) to prevent enhanced hypotensive effects.

