Penetal 30 mg Tablet 4's belongs to the class of medications called  ‘sex stimulants’ used in the treatment of premature ejaculation and erectile dysfunction in adult men. Premature ejaculation is when a man ejaculates (orgasms) more quickly with less sexual stimulation before the man or his partner would like. This could lead to problems in a sexual relationship. Erectile dysfunction is the inability to keep a hard and erect penis suitable for sexual activity.          

Penetal 30 mg Tablet 4's contains Dapoxetine and Sildenafil. Dapoxetine is a short-acting selective serotonin reuptake inhibitor (SSRI) that increases the serotonin levels in the brain, thereby increasing the time to ejaculate and improving the control over ejaculation. Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor and works by relaxing the blood vessels. It can improve blood flow to the penis and helps to get an erection when sexually stimulated.

You should use this medicine exactly as prescribed by the doctor. The common side-effects of Penetal 30 mg Tablet 4's are dizziness, headache, nausea (feeling sick), stuffy nose, facial flushing (reddening of the face), indigestion, dry mouth, and vision problems such as light sensitivity or blurred vision. These side-effects usually resolve without requiring medical attention. However, if any of these side-effects persist or get worse, inform your doctor immediately.

It is not recommended to take Penetal 30 mg Tablet 4's if you are allergic to any contents of it. Do not take Penetal 30 mg Tablet 4's if you have severe heart or liver problems, a recent history of heart attack or stroke, hypotension (low blood pressure), eye diseases or vision problems, a history of fainting, and mania or depression. Inform your doctor if you are taking medicines such as nitrates (to treat blood pressure or chest pain), antidepressants, antibiotics, or pain killers. Penetal 30 mg Tablet 4's should not be taken by children and women. It should be used with caution in the elderly. Do not take excessive amounts of alcohol while using Penetal 30 mg Tablet 4's as it may impair the ability of erection and increase the risk of side-effects. Penetal 30 mg Tablet 4's may cause dizziness and affect vision, so do not drive or operate heavy machinery if you are not fully alert.

Penetal 30 mg Tablet 4's is used in the treatment of premature ejaculation and erectile dysfunction. It helps to improve ejaculation and erection time. It can help to resolve your problems in sexual relationships and the stress, worry, or frustration associated with it. It helps to boost your confidence and improve sexual performance. Take this medicine exactly as prescribed by your doctor for the best results.

• Dizziness
• Headache
• Nausea (feeling sick)
• Stuffy nose
• Facial flushing (reddening of the face)
• Indigestion
• Dry mouth
• Vision problems such as light sensitivity or blurred vision

Before taking Penetal 30 mg Tablet 4's, inform your doctor if you have sickle cell anaemia (abnormal production of red blood cells), leukaemia (blood cancer), multiple myeloma (cancer of bone marrow), Peyronie’s disease (deformity in the penis), ulcer, or bleeding in the stomach, heart problems, been taking recreational drugs such as ecstasy and narcotics, mood disorders, mental illness, fits, are alcoholic, bleeding or blood clotting problems, kidney problems, and glaucoma (increased pressure in the eye). Penetal 30 mg Tablet 4's should not be taken along with medicines such as nitrates (to treat blood pressure or chest pain), antidepressants, antibiotics, or pain killers. Inform your doctor if you are taking any of the above medicines. If you experience a sudden decrease in vision or loss of vision while using Penetal 30 mg Tablet 4's, stop taking this medicine and consult your doctor immediately.

Drug-Drug Interactions: Penetal 30 mg Tablet 4's should not be used along with medicines used to treat chest pain (amyl nitrite and nitroglycerin), monoamine oxidase inhibitors (MAOI) used to treat depression, and other antidepressants (lithium and hypericum perforatum), a medicine used to treat psychosis (thioridazine), antibiotic (linezolid), pain killer (tramadol), a medicine that regulates sleep (tryptophan), medicines used to treat migraine. You should wait at least 14 days after stopping the above medicines before you start taking Penetal 30 mg Tablet 4's or wait at least 7 days after stopping Penetal 30 mg Tablet 4's before you start taking the above medicines. Penetal 30 mg Tablet 4's may interact with antifungal agents (ketoconazole and itraconazole), medicines used to treat HIV (ritonavir, saquinavir, and atazanavir, etc.), antibiotic (telithromycin), medicines used to treat high blood pressure, and alpha-blockers that are used to treat high blood pressure or prostate problems in men (alfuzosin, doxazosin, and tamsulosin, etc.)

Drug-Food Interactions: Do not drink grapefruit juice at least 24 hours before taking Penetal 30 mg Tablet 4's and avoid alcohol while taking this medicine as it may increase the risk of side-effects. In addition, avoid heavy meals before taking this medicine as it may cause Penetal 30 mg Tablet 4's to delay its effect.

Drug-Disease Interactions: Penetal 30 mg Tablet 4's should not be used in patients with severe heart or liver problem, a recent history of heart attack or stroke, hypotension (low blood pressure), retinitis pigmentosa (a rare inherited eye disease), or loss of vision due to non-arteritic anterior ischemic optic neuropathy (NAION) (an eye disease), history of fainting, and mania or depression.

• AMYL NITRITE
• NITROGLYCERIN
• LITHIUM
• HYPERICUM PERFORATUM
• THIORIDAZINE
• LINEZOLID
• TRAMADOL
• TRYPTOPHAN
• KETOCONAZOLE
• ITRACONAZOLE
• RITONAVIR
• SAQUINAVIR
• ATAZANAVIR
• TELITHROMYCIN
• ALFUZOSIN
• TAMSULOSIN
• DOXAZOSIN

• Maintaining a healthy weight, eating a balanced diet, and regular exercising may help you manage premature ejaculation.
• Pelvic floor exercises help in strengthening muscles.
• Decreasing the sensitivity of the penis by using condoms can be helpful.
• Share intimate time with your partner.
• Stay sexually active to prevent further problems.
• Eat foods that help in improving blood flow such as onions, garlic, bananas, chilli, eggs, omega-3 fatty acids, vitamin B1, and pepper.
• Exercise regularly as it helps in reducing stress.
• Avoid smoking and alcohol consumption.
• Get some sunlight; it helps in increasing melatonin which increases sexual desire.
• Pay attention to your partner. Spend quality time.

• Do not take Penetal 30 mg Tablet 4's if you have not been diagnosed with premature ejaculation and sexual dysfunction.
• Do not take other oral or local treatments for erectile dysfunction or premature ejaculation while using this medicine.
• Penetal 30 mg Tablet 4's should not be taken by women and children.
• Before prescribing Penetal 30 mg Tablet 4's, the doctor may perform a test to know if you have orthostatic hypotension (a sudden drop of blood pressure when standing up from a sitting or lying position).
• Penetal 30 mg Tablet 4's can be taken with or without food. However, you should not take heavy meals before taking Penetal 30 mg Tablet 4's as it may delay the onset of action of this medicine.
• Take this medicine 1 to 3 hours (but no more than 4 hours) before the anticipated sexual activity and do not take it more than once a day.
• Consult your doctor immediately if the erection persists for more than 4 hours after taking this medicine.
• Penetal 30 mg Tablet 4's may cause orthostatic hypotension (sudden drop in blood pressure while standing), so rise up slowly while standing up from a sitting or lying position.
• Do not stop taking this medicine suddenly without discussing it with your doctor.

Premature ejaculation: A man is said to have premature ejaculation when he ejaculates (orgasms) more quickly with less sexual stimulation before he or his partner would like. This could lead to frustration in man and problems in sexual relationships. This condition is also known as rapid ejaculation, premature climax or early ejaculation. Symptoms include regular inability to delay the orgasm or ejaculation for more than a minute after the start of intercourse. It can be classified into two types: lifelong/primary and acquired/secondary. Lifelong or primary premature ejaculation is when you experience this always or almost always since your first sexual experience, whereas acquired/secondary premature ejaculation is when you have had longer-lasting orgasms in your life but have developed early ejaculation. The causes of premature ejaculation could be poor self-esteem, depression, history of sexual abuse, worrying about ejaculation, anxiety about limited sexual experience, stress, dissatisfaction, or problems in a relationship.

Erectile dysfunction: It is the inability to keep a hard and erect penis suitable for sexual intercourse. It could be a sign of physical or psychological conditions such as fear of sexual failure, anxiety, depression, low self-esteem, or stress. Certain health-related factors such as smoking, drinking, overweight, being physically inactive, and high blood pressure also contribute to erectile dysfunction. Symptoms of erectile dysfunction include difficulty in getting an erection, difficulty in maintaining the erection during intercourse, and decreased sexual desire. Avoiding smoking, alcohol consumption, maintaining a healthy weight, regular exercising would be helpful in treating and preventing erectile dysfunction.