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Avanafil (active ingredient)

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What are the common side effects of Avanafil?


Avanafil can cause a sudden drop in blood pressure. When combined with other specific medications, your blood pressure can drop to particularly unsafe levels, resulting in dizziness, fainting, and even a heart attack or stroke. Seek immediate medical help if this occurs.

Other common side effects include:

  • Headache
  • Flushing
  • Indigestions
  • Runny or stuffy nose

These side effects generally decrease over time, going away altogether within a few hours.

You may also experience back or muscle aches within 12-24 hours of taking Avanafil. These aches typically go away completely within two (2) days.

Sexual activity can strain your heart, particularly if previous heart issues such as heart disease or a heart attack have already weakened your heart. If you experience chest pains, dizziness, or nausea during sexual activity, stop right away and seek professional medical help immediately.




What are the uncommon side effects of Avanafil?


Uncommon side effects of Avanafil may include, but are not limited to, the following:

  • An erection lasting longer than four (4) hours. Known as priapism, an erection that won’t go away must be treated as soon as possible to avoid longterm damage, including the inability to have an erection.
  • Changes in color vision. You may see a blue hue or have difficulty differentiating between blue and green colors.
  • Sudden decrease in or loss of vision. In particularly rare instances, men taking Avanafil or other ED medications may have a sudden decrease in or loss of vision in one or both eyes. If you experience a sudden vision decrease or loss, stop taking Avanafil and seek immediate medical help.
  • Sudden decrease in or loss of hearing. Ringing in your ears and/or dizziness may accompany a sudden decrease in or loss of hearing, though it is rare. If you experience a sudden hearing decrease or loss, stop taking Avanafil and seek immediate medical help.




What should I avoid while taking Avanafil?


Combining alcohol with Avanafil may cause side effects, especially if you are drinking more than the recommended amount.

Combining grapefruit or grapefruit juice with Avanafil can result in unwanted side effects.




How long does Avanafil stay active in my body?


One tablet of Avanafil contains active ingredients that may stay in your body for up to or past two (2) days. Other medications you may be on, especially for kidney or liver health, can cause the active ingredients to linger longer than two days.




Who should not take Avanafil?


Avanafil is not right for everyone. Only your healthcare provider and you can decide if Avanafil is right for you. Only those who have specifically been prescribed Avanafil should take it. Never share Avanafil with others, even if their symptoms are similar, as it may cause serious harm.

Women and children under the age of 18 should never take Avanafil.




Who should I contact if I have a reaction to Avanafil?


If you experience serious side effects such as fainting, heart attack, loss of vision or hearing, or significant allergic reaction, seek immediate medical help.

Contact your physician or professional health care provider if you have questions about Avanafil.




What is the best way to store Avanafil?


Keep Avanafil at room temperature, between 59°F and 85°F (15-30°C). Always store Avanafil and all medications out of reach from children.




What medications interfere with (are contraindicated) Avanafil?


Do not take Avanafil if you are currently taking other ED medicines or treatments, including Stendra, as these effects have not been studied.

Do not take Avanafil if you are currently taking any medications known as “nitrates”. Nitrates are often used to treat angina, a symptom of heart disease, that can result in pains in your jaw, chest, or arm. Ask your physician or healthcare provider if any of your other medications are nitrates. Nitrates may also be found in medicines including:

  • Isosorbide dinitrate
  • Isosorbide mononitrate
  • Recreational drugs known as “poppers”, which often contain nitrites called amyl nitrite or butyl nitrite

Do not take Avanafil if take any medication known as “guanylate cyclase stimulators”, which include Riociguat (Adempas), a drug that treats pulmonary hypertension and chronic-thromboembolic pulmonary hypertension.

Other medications that can affect how you handle Avanafil include:

  • Medicines known as “alpha blockers”, which can be prescribed for prostate problems and/or high blood pressure, among other issues. Combining alpha blockers with Avanafil can result in dizziness or fainting. Alpha blockers may include, but are not limited to the following:
    • Cardura, aka doxazosin mesylate
    • Flomax, aka tamsulosin HCl
    • Hytrin, also known as (aka) terazosin HCl
    • Jalyn, aka dutasteride or tamsulosin HCl
    • Minipress, aka prazosin HCl
    • Rapaflo, aka silodosin
    • Uroxatral, aka alfuzosin HCl
  • Medicines that treats high blood pressure (hypertension)
  • Nizrola, aka ketoconazole and Sporanox, aka itraconazole
  • Some types of antibiotics, including:
    • Biaxin, aka clarithromycin
    • Ketek, aka telithromycin
    • Erythromycin, aka several brand names
  • Medicines known as “HIV protease inhibitors”, including
    • Norvir or Kaletra, aka ritonavir
    • Crixivan, aka indinavir
    • Fortavase or Invirase, aka saquinavir
    • Reyataz, aka atazanavir
  • Some types of antifungals, including:
    • Nizoral, aka ketoconazole
    • Sporanox, aka itraconazole




Can I take Avanafil if I am allergic to Stendra?


No. If you have had an allergic reaction to Stendra, do not take Avanafil. Allergic reactions can include:

  • Hives
  • Rash
  • Swelling of your lips, throat, or tongue
  • Difficulty breathing or swallowing




What does my healthcare provider need to know before I take Avanafil?


Avanafil is not right for everyone. Only your healthcare provider and you can decide if Avanafil is right for you. Your physician or healthcare provider must know all medications and non-prescription drugs or medicines you are currently taking.

Ask your healthcare provider if your heart is healthy enough for you to have sexual activity. You should not take Avanafil if your healthcare provider has told you not to engage in sexual activity due to health problems. Before taking Avanafil, tell your healthcare provider about all your medical problems, particularly if you have ever had:

  • Heart surgery in the last six (6) months
  • Previous heart issues, such as irregular heartbeats, angina, heart failure, or heart attack
  • Pulmonary hypertension
  • Low blood pressure
  • High blood pressure that is not currently under control
  • Stroke
  • Liver problems
  • Kidney problems and/or required dialysis
  • Retinitis pigmentosa (a rare eye disease)
  • Severe vision loss, including a condition known as NAION
  • Stomach ulcers
  • Bleeding problems
  • Deformed penis shape and/or Peyronie’s disease
  • History of priapism (an erection that’s lasted for longer than four (4) hours)
  • Blood cell problems, such as multiple myeloma, sickle cell anemia, or leukemia

In the case of an emergency medical situation related to your heart, you must disclose the last time you took Avanafil.




Warning for Airplane Pilots


The U.S. Federal Aviation Authority approves the use of Avanafil (Stendra) for the treatment of ED in its pilots. However, pilots may not use Avanafil within eight (8) hours of pilot duties.

The FAA also restricts the use of other ED medications for pilots.





Safety Information

What are the common side effects of Avanafil?


Avanafil can cause a sudden drop in blood pressure. When combined with other specific medications, your blood pressure can drop to particularly unsafe levels, resulting in dizziness, fainting, and even a heart attack or stroke. Seek immediate medical help if this occurs.

Other common side effects include:

  • Headache
  • Flushing
  • Indigestions
  • Runny or stuffy nose

These side effects generally decrease over time, going away altogether within a few hours.

You may also experience back or muscle aches within 12-24 hours of taking Avanafil. These aches typically go away completely within two (2) days.

Sexual activity can strain your heart, particularly if previous heart issues such as heart disease or a heart attack have already weakened your heart. If you experience chest pains, dizziness, or nausea during sexual activity, stop right away and seek professional medical help immediately.




What are the uncommon side effects of Avanafil?


Uncommon side effects of Avanafil may include, but are not limited to, the following:

  • An erection lasting longer than four (4) hours. Known as priapism, an erection that won’t go away must be treated as soon as possible to avoid longterm damage, including the inability to have an erection.
  • Changes in color vision. You may see a blue hue or have difficulty differentiating between blue and green colors.
  • Sudden decrease in or loss of vision. In particularly rare instances, men taking Avanafil or other ED medications may have a sudden decrease in or loss of vision in one or both eyes. If you experience a sudden vision decrease or loss, stop taking Avanafil and seek immediate medical help.
  • Sudden decrease in or loss of hearing. Ringing in your ears and/or dizziness may accompany a sudden decrease in or loss of hearing, though it is rare. If you experience a sudden hearing decrease or loss, stop taking Avanafil and seek immediate medical help.




What should I avoid while taking Avanafil?


Combining alcohol with Avanafil may cause side effects, especially if you are drinking more than the recommended amount.

Combining grapefruit or grapefruit juice with Avanafil can result in unwanted side effects.




How long does Avanafil stay active in my body?


One tablet of Avanafil contains active ingredients that may stay in your body for up to or past two (2) days. Other medications you may be on, especially for kidney or liver health, can cause the active ingredients to linger longer than two days.




Who should not take Avanafil?


Avanafil is not right for everyone. Only your healthcare provider and you can decide if Avanafil is right for you. Only those who have specifically been prescribed Avanafil should take it. Never share Avanafil with others, even if their symptoms are similar, as it may cause serious harm.

Women and children under the age of 18 should never take Avanafil.




Who should I contact if I have a reaction to Avanafil?


If you experience serious side effects such as fainting, heart attack, loss of vision or hearing, or significant allergic reaction, seek immediate medical help.

Contact your physician or professional health care provider if you have questions about Avanafil.




What is the best way to store Avanafil?


Keep Avanafil at room temperature, between 59°F and 85°F (15-30°C). Always store Avanafil and all medications out of reach from children.




What medications interfere with (are contraindicated) Avanafil?


Do not take Avanafil if you are currently taking other ED medicines or treatments, including Stendra, as these effects have not been studied.

Do not take Avanafil if you are currently taking any medications known as “nitrates”. Nitrates are often used to treat angina, a symptom of heart disease, that can result in pains in your jaw, chest, or arm. Ask your physician or healthcare provider if any of your other medications are nitrates. Nitrates may also be found in medicines including:

  • Isosorbide dinitrate
  • Isosorbide mononitrate
  • Recreational drugs known as “poppers”, which often contain nitrites called amyl nitrite or butyl nitrite

Do not take Avanafil if take any medication known as “guanylate cyclase stimulators”, which include Riociguat (Adempas), a drug that treats pulmonary hypertension and chronic-thromboembolic pulmonary hypertension.

Other medications that can affect how you handle Avanafil include:

  • Medicines known as “alpha blockers”, which can be prescribed for prostate problems and/or high blood pressure, among other issues. Combining alpha blockers with Avanafil can result in dizziness or fainting. Alpha blockers may include, but are not limited to the following:
    • Cardura, aka doxazosin mesylate
    • Flomax, aka tamsulosin HCl
    • Hytrin, also known as (aka) terazosin HCl
    • Jalyn, aka dutasteride or tamsulosin HCl
    • Minipress, aka prazosin HCl
    • Rapaflo, aka silodosin
    • Uroxatral, aka alfuzosin HCl
  • Medicines that treats high blood pressure (hypertension)
  • Nizrola, aka ketoconazole and Sporanox, aka itraconazole
  • Some types of antibiotics, including:
    • Biaxin, aka clarithromycin
    • Ketek, aka telithromycin
    • Erythromycin, aka several brand names
  • Medicines known as “HIV protease inhibitors”, including
    • Norvir or Kaletra, aka ritonavir
    • Crixivan, aka indinavir
    • Fortavase or Invirase, aka saquinavir
    • Reyataz, aka atazanavir
  • Some types of antifungals, including:
    • Nizoral, aka ketoconazole
    • Sporanox, aka itraconazole




Can I take Avanafil if I am allergic to Stendra?


No. If you have had an allergic reaction to Stendra, do not take Avanafil. Allergic reactions can include:

  • Hives
  • Rash
  • Swelling of your lips, throat, or tongue
  • Difficulty breathing or swallowing




What does my healthcare provider need to know before I take Avanafil?


Avanafil is not right for everyone. Only your healthcare provider and you can decide if Avanafil is right for you. Your physician or healthcare provider must know all medications and non-prescription drugs or medicines you are currently taking.

Ask your healthcare provider if your heart is healthy enough for you to have sexual activity. You should not take Avanafil if your healthcare provider has told you not to engage in sexual activity due to health problems. Before taking Avanafil, tell your healthcare provider about all your medical problems, particularly if you have ever had:

  • Heart surgery in the last six (6) months
  • Previous heart issues, such as irregular heartbeats, angina, heart failure, or heart attack
  • Pulmonary hypertension
  • Low blood pressure
  • High blood pressure that is not currently under control
  • Stroke
  • Liver problems
  • Kidney problems and/or required dialysis
  • Retinitis pigmentosa (a rare eye disease)
  • Severe vision loss, including a condition known as NAION
  • Stomach ulcers
  • Bleeding problems
  • Deformed penis shape and/or Peyronie’s disease
  • History of priapism (an erection that’s lasted for longer than four (4) hours)
  • Blood cell problems, such as multiple myeloma, sickle cell anemia, or leukemia

In the case of an emergency medical situation related to your heart, you must disclose the last time you took Avanafil.




Warning for Airplane Pilots


The U.S. Federal Aviation Authority approves the use of Avanafil (Stendra) for the treatment of ED in its pilots. However, pilots may not use Avanafil within eight (8) hours of pilot duties.

The FAA also restricts the use of other ED medications for pilots.





Avanafil FAQs

Can I take Avanafil for ED?


Yes, Avanafil is used for the treatment of erectile dysfunction in men.

Compared to other erectile dysfunction meds Avanafil has a faster onset of action, reduced side effect profile, and better tolerability. Avanafil is a second-generation class of PDE-5 inhibitor and the dosage can be titrated higher to obtain the desired erectile response.




Can I take Avanafil for BPH?


No. Only Tadalafil (Cialis) for daily use been approved for the treatment of BPH.




How should I take Avanafil?


Take Avanafil exactly as prescribed by your physician or healthcare professional. A dose of 100 milligrams (mg) is standard, though your physician may increase dosage up to 200 mg or decrease as low as 50 mg based on your initial and longer-term tolerability and efficacy.

Do not take Avanafil more than once per day. Do not break or split an Avanafil tablet unless instructed by your health care provider; swallow it in its entirety, unless otherwise instructed by your healthcare provider. Do not use other ED medicines or treatments while taking Avanafil.

Avanafil is typically prescribed for use as needed. In this situation, always take the lowest effective dose: take your prescribed Avanafil dosage 15 minutes before sexual activity. If taking 30 minutes before, you may lower the dosage.

Never share Avanafil with others, even if their symptoms are similar, as it may cause serious harm.




When is the best time to take Avanafil before sex?


When taking Avanafil on an as-needed basis, take one tablet before expected sexual activity. Generally, Avanafil provides maximum sexual benefit 15-30 minutes after taking the tablet.

Despite taking Avanafil as prescribed, sexual stimulation is still necessary for an erection.




Can Avanafil improve my sexual desire?


Avanafil will not improve your desire for sexual activity or cure ED. A man’s sexual desire is only one of the many functions of testosterone. A low testosterone level can decrease a man’s desire for sexual activity. Avanafil does not protect from sexually transmitted diseases (STDs). Avanafil is not a form of birth control for men.




Should I take Avanafil with food?


You may take Avanafil with or without food, though a high-fat meal can prevent the medication from reaching its full potential and efficacy.




Can I take Avanafil and drink alcohol?


Do not take Avanafil with more than a moderate amount of alcohol. Avanafil can still be effective after three (3) alcoholic drinks, though the Centers for Disease Control and Prevention generally recommends no more than two (2) alcoholic drinks per day for men. One drink is generally defined as 12 ounces of a regular beer (approximately 5% ABV), 5 ounces of wine, or 1.5 ounces of distilled spirits (such as vodka, whiskey, gin, tequila, etc.).

Drinking too much alcohol can increase your odds of a headache, dizziness, elevated heart rate, or lower blood pressure and reduce the efficacy of the medication.