Avanafil

Introduction

Avavanafil (generic name: avanafil) is a phosphodiesterase-type 5 (PDE5) inhibitor approved for the treatment of erectile dysfunction (ED) in adult men. The medication is supplied as oral tablets in three strengths-50 mg, 100 mg, and 200 mg. It belongs to the same therapeutic class as sildenafil and tadalafil but is distinguished by a rapid onset of action, often within 15 minutes, and a short half-life of approximately 5 hours. Clinical studies support its efficacy in improving erectile response when sexual stimulation is present.

What is Avanafil?

Avanafil is the generic version of well-known medications marketed under brand names such as Stendra. It contains the active compound avanafil, a selective PDE5 inhibitor that enhances the nitric-oxide/cGMP pathway in penile tissue. Our online pharmacy provides this generic alternative as a cost-effective treatment option for patients seeking reliable ED therapy without the premium price of brand-name products.

The drug was developed by Alvogen and received regulatory approval from the U.S. Food and Drug Administration (FDA) in 2012. It is also authorized in the European Union, Canada, and several other jurisdictions. Avanafil is formulated as film-coated tablets that are taken orally with or without food.

How Avanafil Works

PDE5 is an enzyme that degrades cyclic guanosine monophosphate (cGMP), a secondary messenger that relaxes smooth muscle in the corpus cavernosum. During sexual arousal, nitric oxide (NO) released from nerves stimulates guanylate cyclase to produce cGMP. Elevated cGMP levels cause smooth-muscle relaxation, increased blood flow, and erection.

Avanafil binds selectively to the active site of PDE5, preventing cGMP breakdown. As a result, cGMP accumulates, prolonging smooth-muscle relaxation and facilitating erection in response to sexual stimulation. The high selectivity of avanafil for PDE5 limits inhibition of related phosphodiesterases (e.g., PDE6, PDE1), reducing visual and auditory side-effects seen with less selective agents.

Pharmacokinetic data show that peak plasma concentrations are reached in 30-45 minutes, with a rapid onset of clinical effect reported as early as 15 minutes after dosing. Avanafil is metabolised primarily by hepatic CYP3A4, and its elimination half-life averages 5 hours, supporting once-daily or on-demand dosing.

Conditions Treated with Avanafil

• Erectile Dysfunction (ED) - The sole FDA-approved indication. Avanafil improves the ability to achieve and maintain an erection sufficient for satisfactory sexual activity when taken prior to anticipated intercourse. Clinical trials (e.g., the AVANAFIL Phase III studies) demonstrated statistically significant improvements in International Index of Erectile Function (IIEF) scores compared with placebo.

Off-Label and Investigational Uses of Avanafil

• Pulmonary Arterial Hypertension (PAH) - Small pilot studies have explored PDE5 inhibition for PAH, showing modest improvements in hemodynamic parameters. Avanafil is not approved for PAH, and safety data are limited.
• Raynaud’s Phenomenon - Case reports suggest that PDE5 inhibitors may alleviate vasospastic attacks by enhancing digital blood flow. Evidence is anecdotal, and off-label use should be considered only under specialist supervision.

These applications are not authorized by regulatory agencies. Any off-label use must be undertaken after thorough risk-benefit assessment by a qualified healthcare provider.

Is Avanafil the Right Medication for You?

Avanafil is appropriate for adult men who:

• Have a confirmed diagnosis of erectile dysfunction.
• Can tolerate oral medications and have no contraindications to PDE5 inhibition.

Clinical situations that favour avanafil include:

• Desire for a fast-acting option (onset ≤ 15 minutes).
• Need for flexible dosing (50 mg to 200 mg) to tailor efficacy and tolerability.

Contraindications and situations requiring caution:

• Concomitant use of nitrates (e.g., nitroglycerin) - risk of severe hypotension.
• Severe hepatic impairment - altered metabolism may increase exposure.
• Known hypersensitivity to avanafil or any tablet components.
• Uncontrolled hypertension or recent myocardial infarction - cardiovascular stability must be verified.

Patients with these conditions should discuss alternative therapies with their clinician.

Risks, Side Effects, and Interactions

Common

• Headache
• Flushing
• Nasal congestion or rhinorrhea
• Dyspepsia (indigestion)

These events are usually mild, transient, and resolve without medical intervention.

Rare

• Visual disturbances (e.g., changes in colour perception)
• Priapism (prolonged erection > 4 hours) - requires urgent medical attention.
• Auditory changes (e.g., sudden hearing loss)

Patients experiencing any of these should seek prompt evaluation.

Serious

• Severe hypotension, especially when combined with nitrates or alpha-blockers.
• Cardiovascular events (myocardial infarction, stroke) in high-risk individuals.

If serious adverse reactions are suspected, emergency medical care is indicated.

Drug-Drug Interactions

• Nitrates - Co-administration is contraindicated due to risk of profound hypotension.
• Alpha-blockers (e.g., terazosin) - May cause additive blood-pressure lowering; initiate avanafil at the lowest dose and monitor.
• CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) - Can increase avanafil plasma concentrations, raising the risk of side-effects; dose reduction may be required.
• CYP3A4 inducers (e.g., rifampin, carbamazepine) - May reduce avanafil efficacy; consider alternative dosing.

Food and Alcohol

• Avanafil can be taken with or without food; a high-fat meal may delay onset by up to 30 minutes.
• Moderate alcohol intake does not significantly affect efficacy but excess consumption can exacerbate hypotension and dizziness.

Use: Dosing, Missed Dose, Overdose

Standard dosing - Start with 100 mg taken 30 minutes before sexual activity. If the response is adequate and side-effects are tolerable, the dose may be increased to 200 mg. Patients who experience adverse effects can reduce to 50 mg. Dosing frequency must not exceed once per day.

Missed dose - Avanafil is taken on an as-needed basis rather than a fixed schedule. If a dose is forgotten and sexual activity is no longer anticipated, the dose should be omitted. Do not double the next dose.

Overdose - Symptoms may include severe headache, flushing, hypotension, and prolonged erection. Seek immediate medical attention. Management is supportive; there is no specific antidote.

Practical precautions -

• Avoid taking avanafil immediately before driving or operating heavy machinery if dizziness occurs.
• Do not combine with recreational nitrates (e.g., “poppers”).
• Store tablets at room temperature, protected from moisture and light.

FAQ

• What is the earliest time avanafil can be effective after taking a tablet? Avanafil may begin to work within 15 minutes, although the full effect is typically observed after 30 minutes.

• Can avanafil be taken with a high-fat meal, and does it affect the onset of action? Yes, avanafil can be taken with any type of food. A high-fat meal may delay absorption, potentially postponing the onset by up to 30 minutes.

• Is it safe to use avanafil if I have mild hypertension? Patients with controlled mild hypertension may use avanafil, but blood pressure should be monitored, especially if other antihypertensive agents are prescribed.

• How does avanafil differ from other PDE5 inhibitors like sildenafil? Avanafil has higher selectivity for PDE5, a faster onset (≈ 15 minutes), and a shorter half-life (≈ 5 hours) compared with sildenafil, which typically requires 30-60 minutes to act and has a half-life of about 4 hours.

• What should I do if I experience a prolonged erection lasting more than four hours? A priapism lasting longer than four hours is a medical emergency. Seek immediate care; prompt treatment can prevent permanent tissue damage.

• Can avanafil be used by men who are taking alpha-blockers for prostate enlargement? Caution is advised. If avanafil is prescribed, the initial dose should be the lowest (50 mg) and blood pressure monitored.

• Is avanafil detectable on standard drug tests? Avanafil is not typically screened for in standard workplace drug panels, as it is not a controlled substance.

• How should avanafil tablets be stored when traveling internationally? Keep tablets in their original blister pack, away from excessive heat, moisture, and direct sunlight. A small insulated pouch can protect them during long flights.

• Are there any known differences in avanafil formulation between regions (e.g., Europe vs. United States)? The active ingredient remains the same, but inactive excipients such as filler or coating agents may vary by manufacturer to meet regional regulatory standards.

• What clinical trials led to avanafil’s FDA approval? Two pivotal Phase III trials (AVANA-III and AVANA-IV) demonstrated statistically significant improvements in IIEF scores versus placebo, with a favorable safety profile across the 50 mg, 100 mg, and 200 mg dosing arms.

Glossary

Phosphodiesterase-type 5 (PDE5) Inhibitor

A class of drugs that block the PDE5 enzyme, preventing the breakdown of cGMP and thereby promoting smooth-muscle relaxation in the penis.

cGMP (Cyclic Guanosine Monophosphate)

A second-messenger molecule that mediates vasodilation and smooth-muscle relaxation; essential for the physiological process of erection.

Priapism

A prolonged, often painful erection lasting more than four hours without sexual stimulation, requiring urgent medical treatment to avoid permanent damage.

Buying Avanafil from Our Online Pharmacy

Patients who encounter cost barriers, limited pharmacy stock, or insurance restrictions can obtain avanafil through our online pharmacy. We source the medication from licensed, international suppliers that adhere to stringent quality-control standards, ensuring each batch meets the specifications required by regulatory agencies.

Key benefits of using our service include:

• Affordable pricing - Generic avanafil is offered at prices close to the manufacturer’s baseline, reducing out-of-pocket expenses.
• Verified quality - All tablets are procured from vetted, GMP-certified facilities, and undergo independent testing for potency and purity.
• Discreet delivery - Packages are shipped in unmarked, secure envelopes, with tracking options that protect patient privacy. Typical delivery times range from 7 days for express courier to approximately three weeks for standard airmail.
• Convenient access - The online-only model eliminates geographic obstacles, allowing patients in regions without local availability to receive the medication directly.

Our pharmacy operates as a broker service, partnering with overseas licensed pharmacies that maintain the same regulatory compliance as domestic pharmacies. This structure enables us to provide a reliable, confidential, and cost-effective pathway for patients seeking avanafil.

Disclaimer

The information presented about avanafil is intended for general educational purposes only and does not replace professional medical advice. Treatment decisions, including those involving off-label applications, should be made under the guidance of a qualified healthcare professional. Readers are assumed to be responsible adults capable of making informed health choices. Our online pharmacy offers access to avanafil for individuals who may encounter limited availability through conventional pharmacies or insurance channels, or who are looking for an affordable generic alternative. Always consult a qualified clinician before initiating, modifying, or stopping any medication.