Description Of Product
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Stendra (Avanafil) enhances the physiological erectile response following sexual arousal through the potentiation of nitric oxide effects on vascular smooth muscle. Nitric oxide is released into the corpus cavernosum in response to sexual stimulation. This stimulates the production of cGMP, leading to smooth muscle relaxation and subsequently vasodilation and erection of the penis. Stendra (Avanafil) selectively inhibits cGMP for PDE5 which is main enzyme that metabolizes cGMP in the penis, thus enhancing the erectile response of the penis.
Indications For Use
Treatment of erectile dysfunction or organic, psychogenic, or mixed etiology
Use with caution or avoid in persons with increased susceptibility to vasodilators including those with aortic stenosis, cardiomyopathy, and impaired autonomic control of blood pressure.
Use with caution in persons who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last six months.
Use with caution in persons with resting hypotension (blood pressure under 90/50) or hypertension (blood pressure 170/110).
Use with caution in persons with heart failure or coronary artery disease.
Erectile dysfunction – Stendra/Avanafil
As needed dosing: 100mg to 200mg as early as 15 minutes prior to anticipated sexual activity as a single dose and not more than once daily over 24 hours. Improvement in the strength and response of erectile function to sexual activity can last up to 24 hours following a single dose.
Points To Consider
Significantly improves the achievement and maintenance of an erection during intercourse
Improves overall sexual satisfaction
Improves orgasmic function
Faster acting than other PDE-5 inhibitors and can be taken as early as 15 minutes before sexual activity
Visual color distortion is reported much less frequently
Mild and transient side effects
Slower onset of action compared to injected or transurethral modes of delivery
Limited efficacy seen following radical prostatectomy
Contraindicated if you are using organic nitrates in any form due to additive hypotensive effects
Should be used with caution in individuals who have had a myocardial infarction, stroke, or life-threatening arrhythmia within the last six months
Pharmacist Tips On Using
How to Take Avanafil/Stendra: do not split the tablet; take the entire tablet and swallow whole. When used as needed, take at least 15 minutes prior to sexual activity. When used as once daily basis, try to take the same time each day regardless of sex.
You Need to Avoid: avoid large amounts of grapefruit and its juice (CYP3A4 inhibitor) and alcohol which may enhance the hypotensive effect.
If You Experience Chest Pain: seek medical attention immediately.
If You Experience Hearing Loss: if you experience a sudden decrease or loss in hearing. Seek medical attention.
If Your Penile Erection Does Not Go Down: Painful erections lasting > 6 hours is known as priapism and is rare. However, if your erection lasts longer than > 4 hours, seek medical attention. Certain medical conditions such as sickle cell anemia, multiple myeloma and leukemia have been associated with a higher risk of priapism.
Well tolerated, most side effects are transient and mild to moderate in nature. The most common side effects include:
Frequently Asked Questions
Should you take Avanafil/Stendra with food?
You can take Avanafil/Stendra with or without food.
Can you drink alcohol while using Avanafil/Stendra?
You should limit or completely avoid alcohol consumption when taking Avanafil/Stendra as the alcohol can increase the risk of symptomatic hypotension leading to dizziness and potentially cardiovascular collapse.
Can Avanafil/Stendra cause spontaneous erections?
No is the short answer. Avanafil/Stendra does not directly cause penile erections, but rather affects the penile response to sexual stimulation. Avanafil/Stendra inhibits the enzyme phosphodiesterase type 5 (PDE-5) which is responsible for the breakdown of cGMP in the corpus cavernosum of the penis. During sexual stimulation, there is a local increase in nitric oxide, inhibition of PDE-5 by Cialis/Tadalafil will lead to increased levels of cGMP and subsequently smooth muscle relaxation around the blood vessels resulting in a significant increase in blood flow into the corpus cavernosum of the penis.
Bottom line if you are not experiencing sexual stimulation there will be no penile erection.
How fast does Avanafil/Stendra work?
Cialis/Tadalafil has an onset of action within 30 minutes.
Can Avanafil/Stendra cause a painful erection?
Yes, a condition known as priapism which refers to an erection lasting longer than 6 hours has been reported but only rarely. Anytime you experience any erection lasting > 4 hours, seek medical attention immediately.
Can women use Avanafil/Stendra for sexual dysfunction?
There have been a couple of studies investigating the use of phosphodiesterase inhibitors such as Cialis and Viagra in women reporting mixed inconsistent results. The best available evidence comes from a randomized trial in women suffering from sexual disorders of desire, arousal, orgasm, and dyspareunia treated with Viagra/Sildenafil for 12 weeks. They found that Viagra/Sildenafil was not more effective than placebo in terms of improving any aspect of sexual function. However, positive effects were reported on sexual arousal and orgasm in premenopausal women with SSRI-associated sexual dysfunction.
Avanafil is the newest drug for erectile dysfunction, does it work better than the other PDE-5 inhibitors?
There is no evidence to suggest which phosphodiesterase-5-inhibitor works best. There are some special circumstances where one may be preferred over another. Cialis, Viagra, Levitra and Stendra all work the same, however duration of action of Cialis is up to 36 hours compared to 24 hours for Viagra and Levitra while Stendra has the fasted onset of action. The adverse effect profile is similar for all drugs with a few exceptions. Cialis, Levitra and Stendra have a considerably reduced frequency of visual color distortions compared to Viagra. Cialis, Levitra and Stendra are not recommended in patients who renal and/or hepatic impairment.