Avanafil is a prescription medicine used to treat erectile dysfunction (ED), the persistent difficulty in getting or maintaining an erection firm enough for sexual activity. It belongs to the same broad group of medicines as sildenafil and tadalafil, but it is known for a relatively rapid onset in suitable patients.
Avanafil helps an erection develop when sexual stimulation occurs. It does not automatically produce an erection, increase sexual desire, or cure the underlying cause of ED. Persistent or worsening ED should be assessed because it may be associated with diabetes, high blood pressure, high cholesterol, obesity, smoking, medication effects, hormone problems, psychological factors, or cardiovascular disease.
How Does Avanafil Work?
Avanafil is a phosphodiesterase type 5 (PDE5) inhibitor. During sexual stimulation, nitric oxide is released in the penis. Avanafil supports this natural pathway, helping penile blood vessels relax so that blood flow can increase. Sexual stimulation is still necessary for a response.
How and When Is Avanafil Taken?
Avanafil is used as needed rather than as a routine daily ED tablet. It is available in 50 mg, 100 mg, and 200 mg doses. The usual starting dose is 100 mg, but only a prescribing clinician should select or adjust the dose based on response, side effects, medical conditions, and other medicines.
- The 100 mg or 200 mg dose may be taken as early as approximately 15 minutes before sexual activity.
- The 50 mg dose is generally taken approximately 30 minutes before sexual activity.
- Do not take more than one prescribed dose in 24 hours.
- Use the lowest dose that provides adequate benefit.
- Sexual stimulation is required for the medicine to work.
Avanafil may be taken with or without food. However, a high-fat meal can delay absorption in some people. Heavy alcohol intake can worsen erections and increase the chance of dizziness, headache, a rapid heartbeat, or low blood pressure.
What Are the Potential Advantages?
- A relatively rapid onset compared with some older ED medicines
- On-demand use without daily dosing
- Can be taken with or without food
- Multiple dose strengths allow clinician-guided adjustment
Faster onset does not mean avanafil is automatically the best option for every man. The choice of ED medicine depends on medical history, other medicines, timing preferences, frequency of sexual activity, previous response, side effects, availability, and cost.
Common Side Effects
Most side effects are mild and temporary. They may include:
- Headache
- Facial flushing or warmth
- Blocked or stuffy nose
- Sore throat or cold-like symptoms
- Back discomfort
Speak with the prescribing clinician if side effects are persistent, troublesome, or unexpected.
Who Should Not Take Avanafil?
Never take avanafil with nitrate medicines used for chest pain, such as nitroglycerin or isosorbide, or with recreational “poppers”. The combination can cause a dangerous fall in blood pressure. Avanafil must also not be combined with soluble guanylate cyclase stimulators such as riociguat or vericiguat.
Avanafil should not be used when sexual activity is medically inadvisable because of cardiovascular status. Tell the prescriber about heart disease, a recent heart attack or stroke, low or uncontrolled blood pressure, kidney or liver disease, dialysis, previous sudden vision or hearing loss, bleeding problems, stomach ulcers, penile curvature, or conditions that increase the risk of a prolonged erection.
Important Medicine Interactions
Strong CYP3A4 inhibitors can raise avanafil levels and should not be combined with it. These include certain antifungal, antibiotic, and HIV medicines. Moderate CYP3A4 inhibitors may require the dose to be limited. Men taking an alpha-blocker should be stable on that treatment before avanafil is considered, and a lower starting dose is generally used. Blood-pressure medicines and substantial alcohol intake can add to its blood-pressure-lowering effect.
Do not combine avanafil with sildenafil, tadalafil, vardenafil, or any other ED treatment unless a specialist has specifically advised it. Always provide the clinician with a complete list of prescription medicines, non-prescription products, supplements, and recreational substances.
When Is Urgent Medical Care Needed?
Seek urgent medical help for chest pain, fainting, severe breathlessness, an erection lasting longer than four hours, sudden loss or marked reduction of vision or hearing, or signs of a severe allergic reaction. If chest pain occurs after avanafil, do not take a nitrate; tell the emergency team what you took and when.
What If Avanafil Does Not Work?
A poor first response may relate to timing, a heavy meal, inadequate sexual stimulation, anxiety, an unsuitable dose, or an underlying health problem. Do not increase the dose yourself. A clinician can review how the medicine was used and decide whether further attempts, dose adjustment, another PDE5 inhibitor, counselling, a vacuum device, or a different treatment is appropriate.
Avanafil and Male Fertility
Avanafil may help couples when ED makes timed intercourse difficult, but it does not treat low sperm count or poor sperm quality. Men trying to conceive who have persistent ED should have both sexual health and fertility factors assessed.
The Bottom Line
Avanafil is an effective first-line PDE5 inhibitor for many men with ED and may begin working relatively quickly. It should be prescribed after a proper assessment, used no more than once daily, and never combined with nitrates or guanylate cyclase stimulators.
This article provides general information and is not a prescription. Consult a qualified clinician for diagnosis and treatment suited to your health and current medicines.