Avanafil

Therapeutic indications

Avanafil is indicated for:

Erectile dysfunction

Men, only Adults (18 years old or older)

Treatment of erectile dysfunction in adult men.

In order for avanafil to be effective, sexual stimulation is required.

For this indication, the medical literature mentions below treatments (click for details):

Treatment 1: Oral - 50-200 mg once

Contraindications

Active ingredient Avanafil is contraindicated in the following cases:

Loss of vision in one eye because of non-arteritic anterior ischemic optic neuropathy (NAION)

Patients who have loss of vision in one eye because of non-arteritic anterior ischemic optic neuropathy (NAION), regardless of whether this episode was in connection or not with previous PDE5 inhibitor exposure.

Potent CYP3A4 inhibitors

Co-administration of avanafil with potent CYP3A4 inhibitors (including ketoconazole, ritonavir, atazanavir, clarithromycin, indinavir, itraconazole, nefazodone, nelfinavir, saquinavir and telithromycin) is contraindicated.

Severe renal impairment

Avanafil is contraindicated in patients with severe renal impairment (creatinine clearance <30 mL/min).

Severe hepatic impairment

Avanafil is contraindicated in patients with severe hepatic impairment (Child Pugh class C).

Nitrates

Patients who are using any form of organic nitrate or nitric oxide donors (such as amyl nitrite).

Avanafil was shown to augment the hypotensive effects of nitrates compared to placebo in healthy subjects. This is thought to result from the combined effects of nitrates and avanafil on the nitric oxide/cGMP pathway. Therefore, administration of avanafil to patients who are using any form of organic nitrate or nitric oxide donor (such as amyl nitrite) is contraindicated. In a patient who has taken avanafil within 12 hours, where nitrate administration is deemed medically necessary in a lifethreatening situation, the likelihood of a significant and potentially dangerous drop in blood pressure is increased. In such circumstances, nitrates should still only be administered under close medical supervision with appropriate haemodynamic monitoring.

Guanylate cyclase stimulators

The co-administration of type 5 phosphodiesterase (PDE5) inhibitors, including avanafil, with guanylate cyclase stimulators, such as riociguat is contraindicated as it may potentially lead to symptomatic hypotension.

Pre-existing cardiovascular disease

Physicians should consider the potential cardiac risk of sexual activity in patients with pre-existing cardiovascular disease before prescribing avanafil.

The use of avanafil is contraindicated in:

  • Patients who have suffered from a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months;
  • Patients with resting hypotension (blood pressure <90/50 mmHg) or hypertension (blood pressure >170/100 mmHg);
  • Patients with unstable angina, angina with sexual intercourse, or congestive heart failure categorised as New York Heart Association Class 2 or greater.

Hereditary degenerative retinal disorders

Patients with known hereditary degenerative retinal disorders.

Medication Recommendation

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