Hello! It is wonderful that you are proactively managing your health. Taking Tryptomer (amitriptyline) and Tanz alongside Duralast (dapoxetine) requires caution. Both amitriptyline and dapoxetine increase serotonin levels, which can raise the risk of a rare but serious reaction called serotonin syndrome, causing symptoms like dizziness or sweating, even when taken at different times. Additionally, Tazzle (tadalafil) combined with these medications can sometimes cause your blood pressure to drop, making you feel lightheaded. While these low doses are often well-tolerated, please consult your prescribing doctor. They can safely review this combination to ensure your treatment is both safe and highly effective for you. Take care!