Provided by You Health



Avanafil (Stendra) is used to treat men who have erectile dysfunction (also called sexual impotence). Avanafil (Stendra) belongs to a group of medicines called phosphodiesterase 5 (PDE5) inhibitors. These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly. The penis is one of the areas where this enzyme works.

Erectile dysfunction is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection. When a man is sexually stimulated, his body's normal response is to increase blood flow to his penis to produce an erection. By blocking the PDE5 enzyme, Avanafil (Stendra) helps to maintain an erection after the penis is stroked by increasing blood flow to the penis. Without physical action to the penis, such as that occurring during sexual intercourse, Avanafil (Stendra) will not work to cause an erection.

Use Avanafil (Stendra) exactly as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the chance of side effects or other problems is increased.

Special patient instructions come with Avanafil (Stendra). Read the directions carefully before you start using Avanafil (Stendra) and each time you get a refill of your medicine.

You may take this medicine with or without food.

Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Dosage of Avanafil (Stendra) (Stendra)

For treatment of erectile dysfunction (as needed):

Adults—At first, 100 milligrams (mg) as a single dose, no more than once a day, taken 15 minutes before sexual intercourse. Avanafil is not intended for use in women and children

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. However, Avanafil (Stendra) is not indicated for use in women.


Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals.

Side Effects

The most common side effects of Avanafil (Stendra) are:

  • Headache
  • Flushing
  • Stuffy or runny nose
  • Sore throat
  • Back pain

Drug Interactions

When you are taking Avanafil (Stendra), it is especially important that your healthcare professional know if you are taking any of the medicines listed below. Using Avanafil (Stendra) with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amyl Nitrite
  • Erythrityl Tetranitrate
  • Isosorbide Dinitrate
  • Isosorbide Mononitrate
  • Itraconazole
  • Nitroglycerin
  • Pentaerythritol Tetranitrate
  • Propatyl Nitrate
  • Riociguat

Using Avanafil (Stendra) with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atazanavir
  • Boceprevir
  • Clarithromycin
  • Cobicistat
  • Conivaptan
  • Darunavir
  • Duvelisib
  • Efavirenz
  • Etravirine
  • Fosnetupitant
  • Indinavir
  • Ivosidenib
  • Ketoconazole
  • Larotrectinib
  • Lopinavir
  • Lorlatinib
  • Nefazodone
  • Nelfinavir
  • Netupitant
  • Nevirapine
  • Posaconazole
  • Ritonavir
  • Saquinavir
  • Telaprevir
  • Telithromycin
  • Voriconazole

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Doxazosin
  • Erythromycin
  • Tamsulosin

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Abnormal penis, including curved penis and birth defects of the penis
  • Erection that lasted for more than 4 hours
  • Heart surgery within the last 6 months
  • Coronary artery disease
  • Crowded disc or low cup to disc ratio in the eye (an eye disorder)
  • Diabetes
  • Heart disease
  • Hyperlipidemia (high fats in the blood)
  • Hypertension (high blood pressure - including poorly-controlled or uncontrolled)
  • Non-arteritic anterior ischemic optic neuropathy or NAION (serious eye condition)
  • Smoking: May increase the chance for a serious side effect in the eye called NAION.
  • Angina (severe chest pain), unstable
  • Arrhythmia (irregular heartbeat within the last 6 months)
  • Blood vessel problems (e.g., aortic stenosis, idiopathic subaortic stenosis)
  • Congestive heart failure
  • Heart attack (within the last 6 months)
  • Hypotension (low blood pressure)
  • Retinal disorders (eye problem)
  • Retinitis pigmentosa (an inherited eye disorder)
  • Stroke
  • Bleeding disorders
  • Stomach ulcers: past or current
  • Leukemia (blood related cancer)
  • Multiple myeloma (blood related cancer)
  • Sickle-cell anemia (blood disorder)—Avanafil (Stendra) should be used with caution in these patients as problems with prolonged erection of the penis may occur.


It is important that you tell all of your doctors that you take Avanafil (Stendra). If you need emergency medical care for a heart problem, it is important that your doctor knows when you last took Avanafil (Stendra).

Do NOT use this medicine if you are also using a nitrate medication, often used to treat angina (chest pain) or high blood pressure. Nitrate medications include nitroglycerin, isosorbide, Imdur®, Nitro-Bid®, Nitro-Dur®, Nitrol® Ointment, Nitrolingual® Spray, Nitrostat®, and Transderm Nitro®. Some illegal ("street") drugs called "poppers" (such as amyl nitrate, butyl nitrate, or nitrite) also contain nitrates. Do not use this medicine if you also use riociguat (Adempas®).

Do not take this medicine if you are also using other PDE5 inhibitors, such as sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®). If you take more Avanafil (Stendra) than you were prescribed or take it together with these other medications, the chance for side effects will be higher.

It is important to tell your doctor about any heart problems you have now or may have had in the past. This medicine can cause serious side effects in patients with heart problems.

If you experience a prolonged or painful erection for 4 hours or more, contact your doctor immediately or go to the nearest Emergency Room. This condition may require prompt medical treatment to prevent serious and permanent damage to your penis.

If you experience sudden loss of vision in one or both eyes, contact your doctor immediately or go to the nearest Emergency Room.

Check with your doctor right away if you have a sudden decrease in hearing or loss of hearing, which may be accompanied by dizziness and ringing in the ears.

If you already use medication for high blood pressure (hypertension), Avanafil (Stendra) could make your blood pressure go too low. Call your doctor right away if you have more than one of these symptoms: blurred vision, confusion, dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly, sweating, or unusual tiredness or weakness.

Do not drink excessive amounts of alcohol (e.g., more than 3 glasses of wine or 3 shots of whiskey) when taking Avanafil (Stendra). When taken in excess, alcohol can increase your chances of getting a headache or becoming dizzy, increase your heart rate, or lower your blood pressure.

This medication does not protect you against sexually transmitted infections (including HIV or AIDS). Use protective measures and ask your doctor if you have any questions about this.

Do not take other medications unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter (OTC)) medicines and herbal or vitamin supplements.