Avanafil Brand Name– Stendra
What is Avanafil
Avanafil belongs to the phosphodiesterase type 5 (PDE5) inhibitors drug class, a class of drugs commonly indicated for treatment of erectile dysfunction (ED).
PDE5 inhibitors do not inhibit prostaglandins as do some agents for treating impotence (e.g., alprostadil).
The safety and efficacy of avanafil was studied in three clinical trials; compared to placebo, improved erections were recorded in patients with organic and/or psychogenic ED when avanafil was administered prior to visual sexual stimulation.
Avanafil is taken prior to sexual activity without regard to food. Patients with preexisting cardiovascular disease should discuss the potential cardiac risks associated with sexual activity with their healthcare professional. As with other PDE5 inhibitors, avanafil has systemic vasodilatory proprieties.
In clinical evaluation, avanafil (200 mg) reduced the sitting blood pressure of healthy subjects by 8 mmHg systolic and 3.3 mmHg diastolic, with the maximum decrease observed at 1 hour after dosing.
Patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects, especially in combination with sexual activity.
Avanafil should not be used by men who also take nitrates because the combination can cause a sudden drop in blood pressure that can be dangerous. According to ED treatment guidelines, oral phosphodiesterase type 5 inhibitors (PDE5 inhibitor) are considered first-line therapy.
Stendra (avanafil) was FDA approved in April 2012.
Indications
- erectile dysfunction (ED)
Side Effects
- abdominal pain
- angina
- arthralgia
- back pain
- blurred vision
- constipation
- cough
- depression
- diarrhea
- dizziness
- drowsiness
- dyspepsia
- dyspnea
- elevated hepatic enzymes
- epistaxis
- fatigue
- flushing
- gastritis
- gastroesophageal reflux
- headache
- hearing loss
- hematuria
- hyperglycemia
- hypertension
- hypoglycemia
- hypotension
- increased urinary frequency
- infection
- influenza
- insomnia
- muscle cramps
- musculoskeletal pain
- myalgia
- nasal congestion
- nausea
- nephrolithiasis
- non-arteritic anterior ischemic optic neuropathy
- orthostatic hypotension
- palpitations
- peripheral edema
- pharyngitis
- priapism
- pruritus
- rash
- sinusitis
- syncope
- thrombosis
- tinnitus
- urinary urgency
- vertigo
- visual impairment
- vomiting
- wheezing
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- angina
- aortic stenosis
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- children
- coagulopathy
- coronary artery disease
- dialysis
- geriatric
- hearing impairment
- heart failure
- hepatic disease
- human immunodeficiency virus (HIV) infection
- hypertension
- hypotension
- idiopathic hypertrophic subaortic stenosis
- infants
- leukemia
- multiple myeloma
- myocardial infarction
- neonates
- nitrate/nitrite therapy
- non-arteritic anterior ischemic optic neuropathy
- penile structural abnormality
- peptic ulcer disease
- Peyronie’s disease
- polycythemia
- pregnancy
- priapism
- renal disease
- renal failure
- renal impairment
- retinitis pigmentosa
- sickle cell disease
- stroke
- tinnitus
- visual disturbance
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Guaifenesin; Phenylephrine
- Alfuzosin
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Alpha-blockers
- Amiodarone
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Amyl Nitrite
- Apalutamide
- Aprepitant, Fosaprepitant
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Omeprazole
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Boceprevir
- Bosentan
- Brigatinib
- Brompheniramine; Carbetapentane; Phenylephrine
- Butabarbital
- Carbamazepine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Phenylephrine
- Cenobamate
- Ceritinib
- Chlophedianol; Guaifenesin; Phenylephrine
- Chloramphenicol
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Phenylephrine
- Ciprofloxacin
- Clarithromycin
- Cobicistat
- Codeine; Phenylephrine; Promethazine
- Crizotinib
- Dabrafenib
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Desipramine
- Dexamethasone
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Diltiazem
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Phenylephrine
- Doxazosin
- Dronedarone
- Dutasteride; Tamsulosin
- Duvelisib
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Encorafenib
- Enzalutamide
- Erythromycin
- Erythromycin; Sulfisoxazole
- Ethanol
- Etravirine
- Fedratinib
- Fluconazole
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- Glimepiride; Rosiglitazone
- grapefruit juice
- Guaifenesin; Phenylephrine
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrocodone; Phenylephrine
- Idelalisib
- Imatinib
- Indinavir
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lefamulin
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Lopinavir; Ritonavir
- Lorcaserin
- Lorlatinib
- Lumacaftor; Ivacaftor
- Mephobarbital
- Metformin; Rosiglitazone
- Methohexital
- Mifepristone
- Mitotane
- Nefazodone
- Nelfinavir
- Nevirapine
- Nicardipine
- Nifedipine
- Nitrates
- Nitroglycerin
- Nitroprusside
- Octreotide
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Pentobarbital
- Perindopril; Amlodipine
- Phenobarbital
- Phenoxybenzamine
- Phentolamine
- Phenylephrine
- Phenylephrine; Promethazine
- Phenytoin
- Posaconazole
- Prazosin
- Primidone
- Quinine
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Riociguat
- Ritonavir
- Rosiglitazone
- Sapropterin
- Saquinavir
- Secobarbital
- Silodosin
- Tamsulosin
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Terazosin
- Thiopental
- Ticagrelor
- Tipranavir
- Trandolapril; Verapamil
- Tucatinib
- Verapamil
- Vigabatrin
- Voriconazole
- Zafirlukast
- Zanubrutinib
