Stendra (Avanafil) - Oral

What Is Stendra?

Stendra (avanafil) is an oral medication used to treat erectile dysfunction (ED). It belongs to the drug class called phosphodiesterase-5 enzyme (PDE-5) inhibitors.

Avanafil does not directly cause a penis erection when you take it but works during sexual arousal. It affects the release of nitric oxide and an enzyme called cyclic guanosine monophosphate (cGMP) in the body. cGMP relaxes the muscle, causing an increase in blood flow to the penis.

Another enzyme called phosphodiesterase-5 enzyme breaks down cGMP. However, Stendra blocks the PDE-5 enzyme from breaking down cGMP, leading to a more prolonged erection. 

Stendra is available as tablets only with a prescription.

What Is Stendra Used For?

The Food and Drug Administration (FDA) approved Stendra to treat erectile dysfunction (ED). It is usually taken as needed, as directed by the healthcare provider.

How to Take Stendra

Stendra is not a routine or daily drug. Only use this pill as needed and as advised by your healthcare provider.

To use Stendra for ED, take it 15 to 30 minutes before sex for the 100 milligram (mg) dose and 30 minutes before sex for the 50 mg dose. Your healthcare provider may increase your dose to a maximum of 200 mg if needed. Do not take it more than once a day.

Grapefruit juice may affect your medicine. It can raise the levels of this drug in your system, which can cause:

• Hypotension (very low blood pressure)
• Syncope (passing out)
• Priapism (painful penis or erection lasting for more than four hours)

Storage

Store Stendra at room temperature (68–77 degrees Fahrenheit) away from light. You may store this medicine at mildly hot temperatures (86 degrees) during trips. Keep it in a dry place and away from children and pets. Do not keep this medication in your bathroom.

Make sure to properly get rid of unused and expired drugs. Do not throw them down the drain, toilet, or sink. Ask your pharmacist about the best ways to dispose of your pills. Check out drug take-back programs in your area.

What Are the Side Effects of Stendra?

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

In some people, Stendra may have little or no adverse effects. Contact your healthcare provider right away if your side effects do not go away or become bothersome. The most common side effect of Stendra include:

• Back pain
• Sore throat
• Flushing
• Runny or stuffy nose
• Headache

Severe Side Effects

Tell your medical provider right away if you have any serious adverse effects. If you have a medical emergency or if your symptoms are life-threatening, dial 911. Severe side effects of Stendra include:

• Chest pain or pressure
• Trouble speaking 
• Drooping on one side of the face
• Change in balance
• Throwing up
• Passing out
• Fast or abnormal heartbeat
• Terrible dizziness 
• Very upset stomach  
• Weakness on one side of the body
• Blurred, change, or loss of eyesight
• Painful erection (hard penis) or an erection that lasts for longer than four hours
• Ringing in the ears, change in hearing, or hearing loss

Dosage: How Much of Stendra Should I Take?

Modifications

Avoid taking Stendra and nitrates together. If there is a life-threatening emergency that requires you to take a nitrate, take the nitrate at least 12 hours after Stendra.

Taking Stendra with alpha-blockers or certain drugs that reduce your blood pressure may cause an excessive drop in your blood pressure. This can result in dizziness or fainting. Your healthcare provider may modify your dose based on how your body reacts to Stendra.

Missed Dose

Only take this medication as needed. Unless your provider tells you to, do not take more than once every 24 hours.

Overdose: What Happens If I Take Too Much Stendra?

Standard supportive treatment may be necessary in cases of an overdose. Contact your healthcare provider if you think you've taken too much Stendra.

Precautions

What Are Reasons I Shouldn't Take Stendra?

Do not take Stendra if you are:

• Hypersensitive to avanafil or any part of its formulation
• Taking any form of nitrates (either regularly or sparingly)
• Taking drugs in a class called guanylate cyclase stimulators (e.g., riociguat)

What Other Medications Interact With Stendra?

Certain drugs may affect how well Stendra works. Additionally, taking Stendra with medications such as alpha-blockers, blood pressure–lowering drugs, and substantial amounts of alcohol can lead to low blood pressure.

Avoid taking the following medications with Stendra:

• Caverject (alprostadil)
• Viagra (sildenafil)
• Cialis (tadalafil)
• Levitra (vardenafil)
• Fucithalmic (fusidic acid)
• Nipride (nitroprusside)
• Adempas (riociguat)
• Verquvo (vericiguat)

What Medications Are Similar?

Medications similar to Stendra that can also treat ED include:

• Viagra (sildenafil)
• Cialis (tadalafil)
• Levitra (vardenafil)

This list includes drugs also prescribed to treat ED. It is not a list of medicines recommended to take with Stendra. Do not take these drugs together unless your healthcare provider tells you to. If you have any problems, talk to your provider.

How Can I Stay Healthy While Taking Stendra?

Stendra works well when taken correctly. Before you start using this medication, be open and honest with your healthcare provider about your medical history. 

Tell your provider if:

• You have any of these health problems like heart disease, heart failure, kidney disease, high or low blood pressure.
• You have specific genetic eye problems like retinitis pigmentosa.
• You have had certain health problems in the last six months like stroke, heart attack, or abnormal heartbeat.
• You have had any heart procedure within the past six months.
• You take similar drugs like Stendra for ED or high pressure in the lungs.

Being transparent and open with your provider helps them select the most appropriate drugs for you. ED can be a manageable condition. Call your medical provider if you have any concerns while on this medicine.