Tadapox (Tadalafil 20 mg + Dapoxetine 60 mg): Information on Combination Products for ED and Premature Ejaculation

Reviewed by the Lucas Clinic Medical Team | Updated May 2026

Tadapox is marketed online as a combination tablet containing tadalafil 20 mg (the active ingredient in Cialis) and dapoxetine 60 mg (a short-acting SSRI for premature ejaculation). The intent of this combination is to simultaneously address two distinct male sexual health conditions — erectile dysfunction (ED) treated by tadalafil, and premature ejaculation (PE) treated by dapoxetine — in a single tablet taken before sexual activity. Tadapox is not FDA approved in the United States. It does not have MHRA approval in the United Kingdom, EMA approval in the European Union, or regulatory approval from Health Canada or the Australian TGA.

This page provides factual information on the product's regulatory status, the pharmacological challenges of combining these two drugs in a single form, and the licensed alternatives available for men who experience both ED and PE.

What Is Tadapox?

Tadapox combines two agents with different mechanisms of action, different target conditions, and different pharmacokinetic profiles. Tadalafil is a long-acting PDE5 inhibitor with a half-life of approximately 17.5 hours and a duration of effect up to 36 hours — it is taken 1–2 hours before sexual activity or as a daily low dose. Dapoxetine is a short-acting SSRI with a Tmax of 1–2 hours and a half-life of approximately 1.5 hours for the parent compound — it is taken 1–3 hours before sexual activity on-demand and cleared within 24 hours. On paper, combining them in a single on-demand tablet has a certain logic: both are taken before sexual activity with similar timing, and they target distinct physiologies (erection quality vs. ejaculatory latency).

However, the combination has never been subjected to regulatory-standard randomised controlled trials for the fixed-dose formulation. The interaction profile between tadalafil and dapoxetine in co-administration — particularly regarding hypotension (tadalafil vasodilates; dapoxetine can also cause orthostatic hypotension, particularly in syncope-prone individuals) and serotonergic safety — has not been fully characterised in populations across the comorbidity spectrum. Such characterisation is required before a combination product can be approved. Additionally, dapoxetine itself is not FDA-approved for any indication.

Regulatory Status

In jurisdictions where dapoxetine is approved (UK, EU, Australia), tadalafil is also separately approved as a prescription product. Prescribing both separately — after individual screening for appropriateness of each — is theoretically possible under physician direction. Using a single fixed-dose combination sourced from unlicensed online pharmacies eliminates all of that individual screening, has no regulatory quality guarantee, and exposes the patient to both sets of risks without medical oversight. British and European regulators have not approved a tadalafil/dapoxetine fixed-dose combination. No licensing dossier for such a product has been filed with the EMA as of the time of writing.

Available Strengths and Forms

Tadapox is sold as a fixed combination tablet: tadalafil 20 mg + dapoxetine 60 mg per tablet. Both components represent the maximum approved doses of each agent when used individually. Maximum tadalafil dose (20 mg) is recommended only after titration from 10 mg, in patients with good tolerability. Maximum dapoxetine dose (60 mg) is recommended only when 30 mg is tolerated but inadequate. These doses should not be assumed appropriate for every patient. Since Tadapox originates from unregulated manufacturers, actual potency may differ from labelled amounts, and no pharmacovigilance or quality control system is in place to monitor adverse effects across users.

Pricing of Tadapox vs. Licensed Alternatives

Tadapox is typically sold online at $0.50–$2.50 per tablet in bulk (10–200 tablet packs). Licensed alternatives: generic tadalafil 20 mg in the US costs approximately $2–$12 per dose from legitimate pharmacies via telehealth; licensed dapoxetine (where available) is priced approximately £5–£8 per dose in the UK. Co-prescribing both licensed agents separately after individual clinical assessment carries a slightly higher cost but provides safety, quality, and regulatory assurance that are absent in unlicensed combination product. For patients in the US, the appropriate route is: consult a urologist or sexual medicine specialist who can assess both conditions (ED and PE), prescribe licensed tadalafil or another PDE5 inhibitor, and recommend off-label SSRI options for PE (given dapoxetine's non-approval status in the US).

Frequently Asked Questions

Can a doctor prescribe tadalafil and dapoxetine together?

In jurisdictions where dapoxetine is approved (UK, EU, Australia), a physician could prescribe both tadalafil and dapoxetine as separate prescriptions for a patient with co-existent ED and PE, after individual clinical screening for each agent. This would be a clinically reasoned decision for a specific patient, with appropriate assessment of contraindications for each drug separately. This is different from purchasing an unlicensed fixed-dose combination online with no medical review. In the US, dapoxetine is not approved; US physicians managing co-existent ED and PE would typically use a PDE5 inhibitor for erection and consider off-label daily low-dose SSRI (sertraline, paroxetine) for ejaculation — separate prescriptions, separate clinical assessments.

What are the key risks of tadalafil + dapoxetine combination?

The primary safety concern is additive hypotension — both tadalafil (via PDE5 vasodilation) and dapoxetine (via serotonin-mediated cardiovascular effects, particularly orthostatic hypotension) can lower blood pressure. In patients with borderline BP, cardiac disease, or syncope risk, this combination could cause significant symptomatic hypotension or fainting. Dapoxetine is specifically contraindicated in patients with cardiovascular disease, history of syncope, and those using MAOIs or other serotonergic agents. Tadalafil is contraindicated with nitrates. Both contraindication lists must be screened simultaneously before any combined use — a process that requires a medical consultation, not a self-purchase online.

Are there any clinical trials supporting Tadapox?

Specific trials of the Tadapox brand/formulation in controlled conditions equivalent to FDA or EMA review standards are not available in peer-reviewed literature as of the publication date of this page. Some academic studies have investigated the combination of PDE5 inhibitors with SSRIs for co-existent ED/PE, generally using licensed agents separately in clinical populations with oversight. These studies suggest plausible pharmacological rationale but are insufficient to support regulatory approval of a specific fixed-dose unlicensed formulation. Until a manufacturer submits a regulatory-standard clinical trial package for a tadalafil/dapoxetine fixed combination, the product will remain without legitimate approval in any major market.

← Back to Sexual Health Medications