Stendra

• Avanafil is used to treat male sexual function problems, including impotence and erectile dysfunction (ED). In combination with sexual stimulation, Avanafil works by increasing blood flow to the penis to help a man get and keep an erection.
• This drug does not protect against sexually transmitted diseases such as HIV, hepatitis B, gonorrhea or syphilis. To decrease your risk of infection, always use an effective barrier method (latex or polyurethane condom/dental dams) during all sexual activity. Request a medical provider callback from your patient dashboard for more details.

• Take this medication by mouth with or without food as directed by your medical provider, usually as needed. 
• Avanafil is available in different doses. Depending on your dose, take Avanafil about 15 minutes or 30 minutes before sexual activity. Follow your medical provider's instructions carefully on how many minutes before sexual activity to take this medication. Do not take more than once daily.
• Your prescribed dosage is based on your medical condition, response to treatment and other medications you may be taking. Be sure to tell your medical provider and pharmacist about all the products you use, including prescription drugs, nonprescription drugs and herbal products.
• Request a medical provider callback if your condition does not improve.

• Headache, flushing or dizziness may occur. If any of these effects last or get worse, request a medical provider callback promptly.
• To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
• Remember that this medication has been prescribed because your medical provider has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
• Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of the following serious side effects while having sex, stop and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain or nausea.

• In rare cases, sudden decreased vision, including permanent blindness in one or both eyes (NAION) may occur. If you experience this, stop taking Avanafil and get medical help right away. You have a slightly greater chance of developing NAION if you have:

  • Heart disease
  • Diabetes
  • High cholesterol
  • Certain other eye problems, including "crowded disk"
  • High blood pressure
  • Are over 50
  • Are a smoker
• In rare cases, a sudden decrease or loss of hearing—sometimes combined with ringing in the ears and dizziness—may occur. If you experience this, stop taking Avanafil and get medical help right away.
• In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away to prevent permanent complications.
• A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness or trouble breathing.
• This is not a complete list of possible side effects. If you notice other effects not listed above, contact us for medical advice about side effects. You may also report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

• Before taking Avanafil, tell your medical provider or pharmacist if you are allergic to it or have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Request a medical provider callback for more details.

• Before using this medication, provide us with your medical history, especially of issues like:

  • Heart problems such as heart attack or life-threatening irregular heartbeat in the past 6 months
  • Chest pain/angina
  • Heart failure
  • Stroke in the past 6 months
  • Kidney disease (dialysis)
  • Liver disease
  • High or low blood pressure
  • Dehydration
  • Penis conditions such as angulation, fibrosis/scarring or Peyronie's disease
  • History of painful/prolonged erection (priapism)
  • Conditions that may increase the risk of priapism such as sickle cell anemia, leukemia or multiple myeloma
  • Eye problems such as retinitis pigmentosa, sudden decreased vision or NAION
  • Bleeding disorders
  • Active stomach ulcers
• This drug may make you dizzy or cause vision changes, especially when combined with alcohol or marijuana (cannabis). Do not drive, use machinery or do anything that requires alertness or clear vision until you can do it safely. Limit alcoholic beverages. Let us know if you are using marijuana.
• Before having surgery, tell your prescriber about all the products you use, including prescription drugs, nonprescription drugs and herbal products.

• Drug interactions may change how your medications work or increase your risk for serious side effects.
• This webpage does not contain all possible drug interactions. Keep a list of all the products you use, including prescription/nonprescription drugs and herbal products, and share it with your prescriber. 
• Do not start, stop or change the dosage of any medicines without your medical provider's approval.
• Avanafil can cause a serious drop in your blood pressure when used with nitrates, possibly leading to dizziness, fainting and in rare cases heart attack or stroke. Do not use Avanafil with certain drugs used to treat chest pain/angina, including nitrates such as nitroglycerin and Isosorbide, or recreational drugs containing amyl or butyl nitrite known as "poppers." 
• If you are also taking an alpha blocker medication like Doxazosin or Tamsulosin to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low, leading to dizziness or fainting. Your medical provider may start treatment with a lower dose of Avanafil to minimize your risk of low blood pressure.

• Other medications can affect the removal of Avanafil from your body, which may affect how the medication works. Examples include:

  • Azole antifungals such as Itraconazole and Ketoconazole
  • Cobicistat
  • Macrolide antibiotics such as Clarithromycin and Erythromycin
  • HIV protease inhibitors such as Indinavir and Ritonavir
  • Nefazodone
  • Ribociclib
  • Rifampin
• Riociguat may interact with this drug.
• Do not take this medication with any other product that contains Avanafil or other similar medications used to treat erectile dysfunction or pulmonary hypertension such as Sildenafil, Tadalafil and Vardenafil.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call your local poison control center at 1-800-222-1222.

Do not share this medication with others.

Not applicable.

• Store at room temperature away from light and moisture.
• Do not store in the bathroom. Keep all medications away from children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.