{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:03:57Z","timestamp":1777885437822,"version":"3.51.4"},"reference-count":35,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["DTB"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:p>Although premature ejaculation is the most common ejaculation problem, it is poorly understood and currently has no\u00a0standard definition.<jats:sup>1<\/jats:sup> Typically, it involves reduced time to ejaculation, inability to control or delay ejaculation and\u00a0associated distress.<jats:sup>1-5<\/jats:sup> Treatments that have been assessed include psychosexual counselling, antidepressants (e.g.\u00a0selective serotonin reuptake inhibitors), phosphodiesterase type-5 inhibitors, tramadol and topical anaesthetic agents (e.g. lidocaine\/prilocaine cream). A new formulation (cutaneous spray) of lidocaine\/prilocaine (Fortacin-Plethora Solutions Ltd.) was launched in the UK in November 2016 for the treatment of primary premature ejaculation.<jats:sup>6,7<\/jats:sup> Here,\u00a0we consider the evidence for lidocaine\/prilocaine spray and whether it has a role in the treatment of premature ejaculation.<\/jats:p>","DOI":"10.1136\/dtb.2017.4.0469","type":"journal-article","created":{"date-parts":[[2017,4,13]],"date-time":"2017-04-13T06:35:17Z","timestamp":1492065317000},"page":"45-48","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Lidocaine\/prilocaine spray for premature ejaculation"],"prefix":"10.1136","volume":"55","member":"239","published-online":{"date-parts":[[2017,4,13]]},"reference":[{"key":"2025082700282764000_55.4.45.1","unstructured":"European Association of Urology, 2016. Guidelines on Male sexual Dysfunction: erectile dysfunction and premature ejaculation, 2016. [online]. Available: https:\/\/uroweb.org\/guideline\/male-sexual-dysfunction\/#1 [Accessed 22 March 2017]"},{"key":"2025082700282764000_55.4.45.2","doi-asserted-by":"publisher","DOI":"10.1136\/dtb.2014.3.0240"},{"key":"2025082700282764000_55.4.45.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2008.00901.x"},{"key":"2025082700282764000_55.4.45.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2010.01975.x"},{"key":"2025082700282764000_55.4.45.5","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1111\/jsm.12504","article-title":"An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE)","volume":"11","author":"Althof","year":"2014","journal-title":"J Sex Med"},{"key":"2025082700282764000_55.4.45.6","unstructured":"Fortacin 150mg\/ml+50mg\/ml cutaneous spray, solution. Summary of product characteristics, EU. Plethora Solutions Limited, November 2013."},{"key":"2025082700282764000_55.4.45.7","unstructured":"Specialist Pharmacy Services, 2016. Lidocaine+prilocaine [online]. Available: https:\/\/www.sps.nhs.uk\/medicines\/lidocaine-prilocaine\/ [Accessed 22 March 2017]"},{"key":"2025082700282764000_55.4.45.8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/j.1742-1241.2010.02479.x","article-title":"Update on treatments for premature ejaculation","volume":"65","author":"Hellstrom","year":"2011","journal-title":"Int J Clin Pract"},{"key":"2025082700282764000_55.4.45.9","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s11930-014-0014-x","article-title":"Current diagnosis and management of premature ejaculation","volume":"6","author":"Bailey","year":"2014","journal-title":"Curr Sex Health Rep"},{"key":"2025082700282764000_55.4.45.10","doi-asserted-by":"publisher","DOI":"10.1177\/1756287212453866"},{"key":"2025082700282764000_55.4.45.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2010.01913.x"},{"key":"2025082700282764000_55.4.45.12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2006.00239.x"},{"key":"2025082700282764000_55.4.45.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2008.08041.x"},{"key":"2025082700282764000_55.4.45.14","doi-asserted-by":"crossref","first-page":"380","DOI":"10.5489\/cuaj.12002","article-title":"Evolving therapeutic strategies for premature ejaculation: the search for on-demand treatment \u2013 topical versus systemic","volume":"6","author":"Morales","year":"2012","journal-title":"Can Urol Assoc J"},{"key":"2025082700282764000_55.4.45.15","doi-asserted-by":"crossref","unstructured":"Melnik T , et al . Psychosocial interventions for premature ejaculation. Cochrane Database Syst Rev 2011; 8: CD008195. DOI: 10.1002\/14651858.CD008195.pub2. [Last assessed as up-to-date 6 January 2011].","DOI":"10.1002\/14651858.CD008195.pub2"},{"key":"2025082700282764000_55.4.45.16","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/00926230500442292","article-title":"Effects of a new functional-sexological treatment for premature ejaculation","volume":"32","author":"de Carufel","year":"2006","journal-title":"Sex Marital Ther"},{"key":"2025082700282764000_55.4.45.17","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1002\/sm2.65","article-title":"Behavioral therapies for management of premature ejaculation: a systematic review","volume":"3","author":"Cooper","year":"2015","journal-title":"Sex Med"},{"key":"2025082700282764000_55.4.45.18","doi-asserted-by":"crossref","first-page":"487","DOI":"10.21037\/tau.2016.04.02","article-title":"Emerging and investigational drugs for premature ejaculation","volume":"5","author":"McMahon","year":"2016","journal-title":"Transl Androl Urol"},{"key":"2025082700282764000_55.4.45.19","unstructured":"British Association for Sexual Health and HIV, 2012. Premature ejaculation (PE) BASHH guidelines update [online]. Available: https:\/\/www.bashh.org\/documents\/4754.pdf [Accessed 22 March 2017]."},{"key":"2025082700282764000_55.4.45.20","doi-asserted-by":"publisher","DOI":"10.1177\/1756287211424172"},{"key":"2025082700282764000_55.4.45.21","doi-asserted-by":"crossref","unstructured":"Cooper K , et al . Interventions to treat premature ejaculation: a systematic review short report. Health Technol Assess 2015; 19.","DOI":"10.3310\/hta19210"},{"key":"2025082700282764000_55.4.45.22","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1111\/jsm.12925","article-title":"The combination of dapoxetine and behavioral treatment provides better results than dapoxetine alone in the management of patients with lifelong premature ejaculation","volume":"12","author":"Cormio","year":"2015","journal-title":"J Sex Med"},{"key":"2025082700282764000_55.4.45.23","doi-asserted-by":"crossref","unstructured":"Martyn-St James M , et al . Phosphodiesterase type 5 inhibitors for premature ejaculation: a systematic review and meta-analysis. Eur Urol Focus 2016; http:\/\/dx.doi.org\/10.1016\/j.euf.2016.02.001 .","DOI":"10.1016\/j.euf.2016.02.001"},{"key":"2025082700282764000_55.4.45.24","doi-asserted-by":"crossref","unstructured":"Martyn-St James M , et al . Tramadol for premature ejaculation: a systematic review and meta-analysis. BMC Urol 2015; 15: 6.","DOI":"10.1186\/1471-2490-15-6"},{"key":"2025082700282764000_55.4.45.25","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1071\/SH15042","article-title":"Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis","volume":"13","author":"Martyn-St James","year":"2016","journal-title":"Sexual Health"},{"key":"2025082700282764000_55.4.45.26","unstructured":"Regional Drug and Therapeutics Centre, 2015. New drug evaluation: lidocaine\/prilocaine spray for the treatment of premature ejaculation [online]. Available: http:\/\/rdtc.nhs.uk\/sites\/default\/files\/publications\/nde_145_lidocaine_prilocaine.pdf [Accessed 22 March 2017]."},{"key":"2025082700282764000_55.4.45.27","unstructured":"European Medicines Agency, 2013. CHMP assessment report: lidocaine\/prilocaine Plethora [online]. Available: http:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/EPAR_-_Public_assessment_report\/human\/002693\/WC500155496.pdf [Accessed 22 March 2017]."},{"key":"2025082700282764000_55.4.45.28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2006.06583.x"},{"key":"2025082700282764000_55.4.45.29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2009.08456.x"},{"key":"2025082700282764000_55.4.45.30","unstructured":"Bupivacaine 0.5%w\/v solution for injection. Summary of product characteristics, EU. Accord Healthcare Limited, October 2014."},{"key":"2025082700282764000_55.4.45.31","unstructured":"Personal communication. Plethora Solutions. February 2017."},{"key":"2025082700282764000_55.4.45.32","unstructured":"NHS Business Services Authority, 2017. NHS electronic drug tariff [online]. Available: http:\/\/www.drugtariff.nhsbsa.nhs.uk\/#\/00429017-DC\/DC00428978\/Home [Accessed 22 March 2017]"},{"key":"2025082700282764000_55.4.45.33","unstructured":"International Society for Sexual Medicine, 2015. ISSM quick reference guide to PE [online]. Available: http:\/\/www.issm.info\/images\/uploads\/ISSM_Quick_Reference_Guide_to_PE_-_website_JAN_2015.pdf [Accessed 22 March 2017]"},{"key":"2025082700282764000_55.4.45.34","unstructured":"All Wales Medicines Strategy Group, 2012. Dapoxetine (Priligy\u00ae) for the treatment of premature ejaculation in men aged 18 to 64 years old: A. Menarini Pharma UK [online]. Available: http:\/\/www.awmsg.org\/awmsgonline\/app\/appraisalinfo\/1671 [Accessed 22 March 2017]."},{"key":"2025082700282764000_55.4.45.35","unstructured":"All Wales Medicines Strategy Group, 2014. Lidocaine\/prilocaine (Tempe\u00ae) cutaneous spray solution: Plethora Solutions Holdings PLC [online]. Available: http:\/\/www.awmsg.org\/awmsgonline\/app\/appraisalinfo\/1846 [Accessed 22 March 2017]."}],"container-title":["Drug and Therapeutics Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/dtb.2017.4.0469","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:28:43Z","timestamp":1756279723000},"score":1,"resource":{"primary":{"URL":"https:\/\/dtb.bmj.com\/lookup\/doi\/10.1136\/dtb.2017.4.0469"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2017,4,13]]},"published-print":{"date-parts":[[2017,4]]}},"alternative-id":["10.1136\/dtb.2017.4.0469"],"URL":"https:\/\/doi.org\/10.1136\/dtb.2017.4.0469","relation":{},"ISSN":["0012-6543","1755-5248"],"issn-type":[{"value":"0012-6543","type":"print"},{"value":"1755-5248","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4]]}}}