Avanafil

What is Avanafil?

Avanafil is an oral medication designed to treat erectile dysfunction, a condition where men struggle to achieve or maintain an erection sufficient for sexual activity. Available in tablet form with strengths of 50 mg, 100 mg, and 200 mg, it is marketed as Stendra in the United States and Spedra in Europe. Approved by the FDA in 2012 and the EMA in 2013, Avanafil is a newer PDE5 inhibitor, offering a faster onset compared to some alternatives like sildenafil or vardenafil.

Key Features of Avanafil

• Active Ingredient: Avanafil
• Brand Names: Stendra, Spedra
• Manufacturer: Originally developed by Mitsubishi Tanabe Pharma; licensed to Vivus Inc. and others
• Strengths: 50 mg, 100 mg, 200 mg
• Primary Use: Erectile dysfunction

How Does Avanafil Work?

Avanafil inhibits the PDE5 enzyme, which regulates blood flow in the penis. By blocking PDE5, Avanafil increases levels of cyclic guanosine monophosphate (cGMP), relaxing smooth muscles and dilating blood vessels in the penile region. This enhances blood flow, enabling an erection during sexual stimulation. Avanafil requires sexual arousal to be effective and does not increase sexual desire or protect against sexually transmitted diseases like HIV. For more on PDE5 inhibitors, visit WebMD – Avanafil.

Mechanism of Action

1. PDE5 Inhibition: Avanafil prevents cGMP breakdown.
2. Muscle Relaxation: Increased cGMP relaxes penile blood vessels.
3. Enhanced Blood Flow: Improved circulation supports an erection.

Uses of Avanafil

Avanafil is primarily prescribed for erectile dysfunction in adult men. It may also be used for other conditions as determined by a healthcare provider, though such uses are less common. It is not intended for women or individuals under 18. Safe sex practices, such as using condoms, are recommended. For detailed uses, refer to Drugs.com – Avanafil.

Before Taking Avanafil

Before starting Avanafil, inform your doctor about:

• Allergies to Avanafil or any tablet ingredients.
• All medications, especially nitrates (e.g., nitroglycerin), riociguat, alpha-blockers, or CYP3A4 inhibitors.
• Medical conditions, including heart problems, recent heart surgery, penile deformities, blood disorders, liver or kidney disease, eye conditions (e.g., retinitis pigmentosa), or a history of priapism.
• Use of herbal products or supplements.

How to Take Avanafil

Avanafil is taken orally, with or without food. The timing before sexual activity depends on the dose:

• 100 mg and 200 mg: Take approximately 15 minutes before sexual activity.
• 50 mg: Take approximately 30 minutes before sexual activity.

Do not take Avanafil more than once in 24 hours. Swallow the tablet whole with water; do not crush or chew. Follow your doctor’s instructions carefully. For administration details, see MedlinePlus – Avanafil.

Dosage

The typical starting dose is 100 mg, taken as needed before sexual activity. Based on effectiveness and tolerability, the dose may be adjusted:

• Increased: Up to 200 mg, taken 15 minutes before sexual activity.
• Decreased: Down to 50 mg, taken 30 minutes before sexual activity.

The maximum recommended dose is 200 mg per day. Special considerations:

• Moderate CYP3A4 inhibitors (e.g., erythromycin): Maximum dose is 50 mg in 24 hours.
• Alpha-blockers: Starting dose is 50 mg.
• Strong CYP3A4 inhibitors (e.g., ketoconazole): Do not use Avanafil.

Always follow your doctor’s prescription to avoid complications. For dosage guidelines, visit Stendra Dosage Guide.

Side Effects

Avanafil is generally well-tolerated, but side effects can occur. Most are mild, but serious side effects require immediate attention.

Common Side Effects

• Headache (5-10% of users)
• Flushing (3-4%)
• Nasal congestion (2-3%)
• Back pain (1-3%)
• Nasopharyngitis (cold-like symptoms, 2-3%)

Serious Side Effects

• Prolonged erection (priapism, lasting over 4 hours)
• Sudden vision loss (possible non-arteritic anterior ischemic optic neuropathy, NAION)
• Sudden hearing loss or ringing in ears
• Allergic reactions (rash, itching, swollen eyelids)
• Chest pain or irregular heartbeat

If you experience serious side effects, stop taking Avanafil and seek medical help immediately. Report side effects to the FDA MedWatch or call 1-800-332-1088. For more on side effects, see Stendra Prescribing Information.

Precautions and Warnings

Avanafil is not suitable for everyone. Use caution if you have:

• Heart conditions (e.g., angina, heart failure, recent heart attack/stroke)
• High or low blood pressure
• Liver or kidney disease
• Blood disorders (e.g., sickle cell anemia)
• Penile deformities (e.g., Peyronie’s disease)
• Eye conditions (e.g., retinitis pigmentosa)
• History of priapism or bleeding disorders

Additional Precautions

• Alcohol: Limit to no more than 3 drinks (e.g., 3 glasses of wine or 3 shots of whiskey) to avoid increased side effects like dizziness or low blood pressure.
• Grapefruit: Avoid grapefruit and grapefruit juice, as they may affect Avanafil metabolism.
• Driving: Avoid driving if you experience dizziness or vision changes.
• Women and Children: Not for use in women (especially pregnant or breastfeeding) or individuals under 18.

Warning: Combining Avanafil with nitrates can cause a severe drop in blood pressure, potentially leading to heart attack or stroke. Inform all healthcare providers of Avanafil use, especially in emergencies. For precautions, check Stendra Safety Information.

Interactions with Other Medications

Avanafil can interact with medications, leading to serious effects. Key interactions include:

• Nitrates: Used for chest pain; can cause severe hypotension.
• Riociguat: Used for pulmonary hypertension; can cause hypotension.
• Alpha-blockers: Used for high blood pressure or prostate issues; may require dose adjustment.
• CYP3A4 inhibitors: Strong inhibitors (e.g., ketoconazole) are contraindicated; moderate inhibitors (e.g., erythromycin) limit dose to 50 mg.
• Other ED medications: Avoid concurrent use with sildenafil, tadalafil, or vardenafil.

Inform your doctor about all medications and supplements. If nitrates are needed in an emergency, at least 12 hours should pass since the last Avanafil dose, under close medical supervision. For interaction details, see Medscape – Avanafil Interactions.

Storage Instructions

Store Avanafil at room temperature, 68°F to 77°F (20°C to 25°C), in its original container, away from heat, moisture, and light. Keep out of reach of children. Dispose of unused or expired tablets via a medicine take-back program; contact your pharmacist or local recycling department. For disposal guidance, visit FDA Safe Disposal.

In Case of Emergency/Overdose

In case of overdose, contact the poison control center at 1-800-222-1222 or seek emergency medical attention. Symptoms may include severe dizziness, fainting, or prolonged erection. For emergencies like collapse or trouble breathing, call 911. For more on overdose, see Poison Help.

Additional Information

Keep all doctor appointments and do not share Avanafil with others. Maintain a list of all medications (prescription, over-the-counter, supplements) and share it with healthcare providers. For further details, consult your pharmacist or visit the Stendra Website.

Frequently Asked Questions (FAQ)

1. What is Avanafil used for?
   Avanafil treats erectile dysfunction (ED) in adult men, helping achieve and maintain erections during sexual stimulation.
2. How should I take Avanafil?
   Take orally, with or without food, 15 minutes before sexual activity for 100 mg or 200 mg doses, or 30 minutes before for 50 mg. Do not exceed one dose daily.
3. What are the possible side effects of Avanafil?
   Common side effects include headache, flushing, nasal congestion, back pain, and cold-like symptoms. Serious side effects include prolonged erection, sudden vision/hearing loss, and allergic reactions.
4. Can I take Avanafil with other medications?
   Avanafil interacts with nitrates, riociguat, alpha-blockers, and CYP3A4 inhibitors. Inform your doctor about all medications to avoid complications.
5. Is Avanafil safe for everyone?
   Avanafil is not safe for those taking nitrates, riociguat, or with certain heart conditions or allergies to Avanafil. Consult your doctor to assess suitability.

Conclusion

Avanafil, marketed as Stendra, is an effective treatment for erectile dysfunction, offering a rapid onset of action, often within 15 minutes for higher doses. Its ability to enhance blood flow during sexual stimulation makes it a valuable option for many men. However, safe use requires medical supervision, adherence to prescribed dosages, and awareness of potential side effects and interactions. The patient information leaflet provides essential guidance for safe use. Always consult a healthcare provider to ensure Avanafil is appropriate for your needs and source it from reputable pharmacies.