A PDE5 inhibitor for erectile dysfunction
Avanafil
A fast-acting PDE5 inhibitor that helps a man get and keep an erection in response to sexual stimulation.
What is Avanafil?
Avanafil is a PDE5 inhibitor used to treat erectile dysfunction. It improves blood flow into the penis when a man is sexually aroused, helping him get and keep an erection. It is one of the faster-acting tablets in its class, but it only works when there is sexual stimulation and must never be combined with nitrate heart medicines.
Education and reference only. This is a plain-language guide to Avanafil — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Avanafil is a phosphodiesterase type-5 (PDE5) inhibitor used to treat erectile dysfunction in adult men. It belongs to the same family as sildenafil (Viagra) and tadalafil but is one of the quicker-acting options. It does not cause an automatic erection; it only helps when a man is sexually aroused. It is taken when needed rather than every day.
How it works
When a man is sexually aroused, the body releases chemical signals that relax the blood vessels in the penis, allowing it to fill with blood and become erect. Avanafil blocks an enzyme (PDE5) that would otherwise reverse this process too quickly. By keeping the blood vessels relaxed, it helps a firmer erection develop and last long enough for sex. Because it depends on arousal, nothing happens without sexual stimulation.
Company & origin
Originated / developed by: Developed by Mitsubishi Tanabe Pharma and marketed in the UK by Menarini..
A newer phosphodiesterase type-5 (PDE5) inhibitor introduced in the 2010s, designed to work quickly for erectile dysfunction.
What it treats
Conditions Avanafil is used for
Practical use
How to take Avanafil
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it a short time before you plan to have sex, as advised by your prescriber.
- Remember it only works if you are sexually aroused — it will not cause an erection on its own.
- A large, fatty meal or a lot of alcohol can delay how quickly it works and make it less reliable.
- Do not take more than one dose in a day, and do not combine it with other erectile-dysfunction medicines.
- Avanafil is taken only when needed, so there is no regular dose to miss; never double up to make up for sex you did not have.
Weighing it up
Advantages & disadvantages of Avanafil
Advantages
- Acts quickly, so it can be taken closer to the time of sex than some alternatives.
- Effective for many men with erectile dysfunction, including some common underlying causes such as diabetes.
- Taken only when needed, which suits men who do not want a daily tablet.
Disadvantages
- Only works with sexual stimulation, so it does not restore desire.
- Can cause headache, flushing and a blocked or runny nose.
- Must never be used with nitrates and needs care with alpha-blockers and certain other medicines.
Practical use
Good to know
Avanafil is taken shortly before sex rather than on a fixed schedule, and it tends to start working faster than some older options. It only works with sexual stimulation, so it is not an aphrodisiac. A heavy meal or a lot of alcohol can slow it down or make it less reliable. Most men tolerate it well, but it must never be taken with nitrate medicines for angina, as the combination can cause a dangerous drop in blood pressure.
Who should not take it / use with caution
- Men taking nitrate medicines (such as GTN), the heart medicine nicorandil, or riociguat (a medicine for pulmonary hypertension), as the combination can dangerously lower blood pressure.
- Men who have recently had a heart attack or stroke, have very low or poorly controlled blood pressure, or certain serious heart conditions.
- Men with certain inherited eye diseases (such as retinitis pigmentosa) or a previous episode of sudden vision loss linked to a PDE5 inhibitor.
Monitoring
- Review of heart health and blood pressure before starting, as sex is a form of exertion.
- A check on how well it is working and whether any side effects are troublesome.
- Discussion of underlying causes of erectile dysfunction, such as diabetes or low mood.
Side effects
- Headache, facial flushing, and a blocked or runny nose.
- Dizziness and, less often, back pain or indigestion.
- Rarely, a painful erection lasting several hours (priapism) or sudden loss of vision or hearing — seek urgent medical help if these happen.
Key interactions
- Nitrate medicines for angina and the heart medicine nicorandil must never be combined with it.
- Alpha-blockers for blood pressure or the prostate, and other blood-pressure medicines, can add to its blood-pressure-lowering effect.
- Some antifungals, antibiotics and HIV medicines, and large amounts of grapefruit juice, can raise its levels and the risk of side effects.
Available as: Tablets.
Answers
Avanafil: frequently asked questions
How quickly does avanafil work?
Avanafil is one of the faster-acting PDE5 inhibitors and is usually taken a short time before sex. It still depends on sexual stimulation, so nothing happens until you are aroused. A heavy meal or a lot of alcohol can slow it down.
Can I take avanafil with my heart medicines?
It must never be taken with nitrate medicines (such as GTN spray or tablets) or with nicorandil, because together they can cause a dangerous fall in blood pressure. Tell your prescriber about all your heart and blood-pressure medicines so they can check it is safe.
Will avanafil increase my sex drive?
No. It only improves the physical ability to get and keep an erection when you are already aroused; it does not boost desire. If low libido is the main problem, that is worth discussing separately with your clinician.
Is avanafil the same as Viagra?
They are in the same family (PDE5 inhibitors) but are different medicines — Viagra is sildenafil, while avanafil's brand name is Spedra. Avanafil tends to act more quickly, but the choice depends on what suits you best.
What should I do if my erection will not go down?
An erection lasting several hours (priapism) is a medical emergency that can damage the penis if untreated. Seek urgent medical help if an erection lasts more than four hours rather than waiting for it to settle.
The wider class
About PDE5 inhibitors
Avanafil belongs to the pde5 inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
Browse by body system
Authoritative sources
- BNF: Avanafil.
- electronic Medicines Compendium (SmPC): Spedra (avanafil).
- NICE CKS: Erectile dysfunction (impotence).
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