Do not take STENDRA if you take any medicines called “nitrates” or “guanylate cyclase stimulators”, as these combinations can cause your blood pressure to drop suddenly to unsafe levels. A sudden drop in blood pressure can cause you to feel dizzy, faint, or have a heart attack or stroke.
Tell all of your healthcare providers that you take STENDRA. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took STENDRA.
Stop sexual activity and get medical help right away if you experience symptoms such as chest pain, dizziness, or nausea during sex. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease.
Do not take STENDRA if you:
- take nitrates, often prescribed for chest pain (angina), as this may cause a sudden, unsafe drop in blood pressure
- take guanylate cyclase stimulators such as riociguat (Adempas®), which are often used to treat pulmonary hypertension
- take street drugs called “poppers” such as amyl nitrate and butyl nitrate
- are allergic to STENDRA (avanafil) or any of the ingredients in STENDRA. Seek medical attention right away if you experience any symptoms of an allergic reaction such as rash, hives, swelling of the lips, tongue or throat, or difficulty breathing or swallowing.
Before you take STENDRA, tell your healthcare provider if you:
- have or have had heart problems such as a heart attack, irregular heartbeat, angina, or heart failure
- have had heart surgery within the last 6 months
- have pulmonary hypertension
- have had a stroke
- have low blood pressure, or high blood pressure that is not controlled
- have a deformed penis shape
- have had an erection that lasted for more than 4 hours
- have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
- have retinitis pigmentosa, a rare genetic (runs in families) eye disease
- have ever had severe vision loss, including an eye problem called nonarteritic anterior ischemic optic neuropathy (NAION)
- have bleeding problems
- have or have had stomach ulcers
- have liver problems
- have kidney problems or are having kidney dialysis
- have any other medical condition
STENDRA may affect the way other medicines work.
Tell your healthcare provider about all medicines you take, including any of the following:
- medicines called nitrates
- medicines called guanylate cyclase stimulators such as riociguat (ADEMPAS)
- medicines called HIV protease inhibitors such as ritonavir (NORVIR), indinavir (CRIXIVAN), saquinavir (FORTAVASE or INVIRASE) or atazanavir (REYATAZ)
- some types of oral antifungal medicines, such as ketoconazole (NIZORAL) and itraconazole (SPORANOX)
- some types of antibiotics, such as clarithromycin (BIAXIN), telithromycin (KETEK), or erythromycin
- medicines called alpha-blockers. These include HYTRIN (terazosin), FLOMAX (tamsulosin HCl), CARDURA (doxazosin), MINIPRESS (prazosin HCl), UROXATRAL (alfuzosin HCl), JALYN (dutasteride and tamsulosin HCl), or RAPAFLO (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of STENDRA with alpha-blockers can lead to a drop in blood pressure or to fainting
- other medicines that treat high blood pressure
- other medicines or treatments for ED
Do not drink too much alcohol when taking STENDRA (for example, more than 3 glasses of wine, or 3 shots of whiskey). Drinking too much alcohol when taking STENDRA can increase your chances of getting a headache or getting dizzy, increasing your heart rate, or lowering your blood pressure.
The most common side effects of STENDRA are headache, flushing, stuffy or runny nose, sore throat, and back pain.
Rare but serious side effects of STENDRA may include:
- an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away
- sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called nonarteritic anterior ischemic optic neuropathy (NAION). Stop if you have sudden vision loss in one or both eyes
- sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness
STENDRA does not protect against pregnancy or sexually transmitted diseases, including HIV.
- The starting dose of STENDRA is 100 mg taken as early as approximately 15 minutes before sexual activity.
- The dose may be increased to 200 mg taken as early as approximately 15 minutes before sexual activity, or decreased to 50 mg taken as early as approximately 30 minutes before sexual activity. The lowest effective dose should be used.
- STENDRA may be taken with or without food.
- Moderate consumption of alcohol is allowed (up to 3 drinks). Do not take more than 3 drinks (e.g. 3 glasses of wine or 3 shots of whiskey) when taking STENDRA.
- Sexual stimulation is required for an erection to occur after taking STENDRA.
- Do not take STENDRA more than once per day.
- The safety and efficacy of combinations of STENDRA with other treatments for ED has not been studied. Therefore, the use of such combinations is not recommended.
Reference: 1. Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120(2): 151-157.