Avanafil (e.g., Stendra®) – Patient Information for Customers in Australia

Avanafil is a medicine used to treat erectile dysfunction (ED). It belongs to a group of medicines known as PDE5 inhibitors. This page explains how avanafil works, what to expect, how to take it safely, and how it may interact with food, alcohol, and other medicines—tailored to a general audience in Australia.

Information provided here is for education only. Always follow the directions given by your healthcare professional and read the product information for your specific brand.

At a Glance

• Medicine: Avanafil
• Used for: Erectile dysfunction (difficulty getting and/or maintaining an erection)
• How it works: Helps increase blood flow to the penis during sexual stimulation
• When it can work: Often within about 15–30 minutes for many people
• Common forms: Oral tablets
• Key cautions: Do not combine with nitrates; be cautious with certain heart and blood-pressure medicines

Basic Product Information

Brands and pack sizes vary. Your pharmacy will supply the correct product for your region and needs.

How Avanafil Works (Mechanism of Action)

Avanafil works by blocking an enzyme called PDE5. During sexual stimulation, your body releases nitric oxide, which triggers a pathway that increases levels of cGMP (cyclic guanosine monophosphate) in the blood vessels of the penis. cGMP helps relax smooth muscle and allows more blood to flow to achieve an erection.

PDE5 normally breaks down cGMP. By inhibiting PDE5, avanafil helps maintain cGMP levels, supporting improved blood flow when you are sexually stimulated.

• Important: Avanafil does not cause an erection by itself. Sexual stimulation is still required.
• Effect: It may improve the ability to get and keep an erection adequate for sexual activity.

Pharmacokinetics (How the Body Handles Avanafil)

“Pharmacokinetics” describes how the drug is absorbed, distributed, metabolised, and eliminated. While individual responses differ, the following general patterns are commonly observed:

• Absorption: Avanafil is absorbed after you swallow the tablet. Peak levels in the blood typically occur within about 0.5–1.5 hours (varies by person and circumstances).
• Time to effect: Many people notice an improvement within 15–30 minutes, although it may take longer depending on food intake and other factors.
• Metabolism: Avanafil is primarily metabolised by liver enzymes (including CYP3A4).
• Elimination: The medicine and its metabolites are removed from the body mostly via hepatobiliary pathways (through the liver and bile) and to some extent through the kidneys.

Because metabolism involves liver enzymes, drug interactions can be important—especially with medicines that inhibit or strongly affect CYP3A4.

Typical Use in Australia (Indications and When It’s Used)

Avanafil is indicated for the treatment of erectile dysfunction (ED) in adult men. ED is commonly defined as the repeated inability to achieve or maintain an erection sufficient for satisfactory sexual performance.

ED has many possible causes, including vascular disease, diabetes, hypertension, medication side effects, hormonal factors, stress, anxiety, and relationship factors. Avanafil addresses the blood flow component but does not treat every underlying cause.

• Primary indication: Erectile dysfunction
• Not intended for: Treating women, or improving sexual desire directly

How to Take Avanafil (Dosing and Timing)

Your exact dose and schedule should follow the directions provided by your healthcare professional and the product instructions. Below are general “typical” patterns used for ED treatment.

Typical ED dosing approach (general information)

• Starting dose: Often begun at a standard starting strength (commonly 100 mg for many adult patients).
• Adjustment: Depending on response and tolerability, the dose may be increased or decreased.
• Maximum frequency: Do not exceed the prescribed maximum daily dose.

Timing before sexual activity

• Avanafil may work quickly—often within 15–30 minutes.
• Many people take it about 30 minutes before anticipated sexual activity.
• If you took it with a heavy meal, it may take longer to be fully effective.

Practical tips for best results

• Plan ahead: Try timing doses when you expect sexual stimulation.
• Use the right context: Sexual arousal is necessary for the medicine to help erections.
• Don’t “double up”: If it doesn’t work as expected one time, don’t take extra doses—adjust timing and factors with clinician guidance.

Food Interactions (Meals, Fatty Foods, and Timing)

Food can affect how fast avanafil is absorbed. In general, a high-fat meal may slow absorption and delay the onset of effect.

• After a heavy or fatty meal: You may need to allow more time before sex (for example, taking it earlier than usual).
• Faster onset: Taking it on a relatively empty stomach may lead to quicker effects for some people.

If you want consistent results, consider using a similar meal pattern each time (and keep your dosing schedule as directed).

Alcohol and Medicine Interactions

Alcohol

Alcohol may worsen ED by affecting blood flow, nerve signalling, and erection quality. Moderate alcohol might be manageable for some people, but heavy drinking can reduce effectiveness and increase side effects such as dizziness or headaches.

• Recommendation: Keep alcohol intake moderate, especially when trying avanafil for the first time.
• Be cautious: Avoid driving or risky activities if you feel light-headed.

Major medicine interactions to know

Do not combine avanafil with nitrates (for chest pain/angina) because the combination can cause a potentially dangerous drop in blood pressure. This includes prescription nitrates and certain “nitric oxide” related treatments.

Also use caution with alpha-blockers (often prescribed for prostate symptoms or high blood pressure), as the combination may cause dizziness or a fall in blood pressure. Dose spacing and appropriate starting regimens may reduce risk, as advised by a clinician.

Other medicines that may interact

• Strong CYP3A4 inhibitors (can increase avanafil levels): e.g., certain antifungals and some HIV treatments.
• Moderate CYP3A4 inhibitors: may still require dose adjustment.
• Blood pressure and heart medicines: particularly those that lower blood pressure.
• Other ED medicines (PDE5 inhibitors such as sildenafil, tadalafil, or similar): do not mix unless specifically directed.
• “Lifestyle” or herbal products: some may affect liver enzymes or blood pressure. Always discuss before combining.

For safety, inform your pharmacist/doctor about all medicines you take—including over-the-counter products and supplements.

Safety Profile (Side Effects and When to Seek Help)

Like all medicines, avanafil can cause side effects. Most are mild to moderate and improve without needing treatment, but some require urgent attention.

Common possible side effects

• Headache
• Flushing (warmth or redness)
• Stuffy or runny nose (nasal congestion)
• Dizziness
• Indigestion or mild gastrointestinal discomfort
• Back pain (less common than with some other PDE5 inhibitors)

Serious side effects—seek urgent medical help

• Chest pain, severe dizziness, fainting, or symptoms of dangerously low blood pressure.
• Vision changes or sudden loss of vision.
• Sudden hearing changes or ringing in the ears.
• Priapism (an erection lasting more than 4 hours).
• Severe allergic reaction such as swelling of the face/lips, trouble breathing, or widespread rash.

If any urgent symptoms occur, stop taking the medicine and seek medical help immediately.

Who should be extra cautious

• People with significant heart disease or unstable cardiovascular conditions.
• People taking multiple medicines that affect blood pressure.
• People with severe liver or kidney impairment—dose may require adjustment.
• People with a history of non-arteritic anterior ischaemic optic neuropathy (NAION).

Practical Use Tips (Getting the Best and Safest Results)

• Start with a plan: Choose timing that matches your lifestyle and food patterns.
• Give it appropriate tries: If a dose doesn’t work, it may be due to timing, food, arousal, or expectations. Avoid increasing dose without guidance.
• Be honest about your health: ED can be an early sign of vascular disease. Discuss cardiovascular risk factors with a clinician.
• Manage stress and performance anxiety: These are common contributors to ED and can reduce response.
• Avoid mixing with other PDE5 inhibitors: This increases risk of side effects without improving safety.
• Keep an eye on blood pressure symptoms: If you feel unusually dizzy or faint, seek advice.

Alternative Options (Other Treatments for ED)

If avanafil isn’t suitable or doesn’t provide enough benefit, there are several alternatives. The “best” option depends on your health profile, timing preferences, and other medicines.

Other PDE5 inhibitors

• Sildenafil (often has a different onset/duration profile)
• Tadalafil (can have a longer duration for some people)
• Vardenafil (another PDE5 inhibitor option)

Because all PDE5 inhibitors work through similar pathways, the major cautions (especially nitrates) generally apply to the class.

Non-PDE5 options

• Vacuum erection devices
• Intracavernosal injections or intraurethral therapies (used under clinical supervision)
• Psychosexual support when anxiety/stress contributes significantly
• Lifestyle changes: weight management, exercise, smoking cessation, limiting alcohol, and improved sleep
• Address underlying conditions: diabetes control, blood pressure management, and reviewing medication side effects

Market and Legal Context in Australia (General Overview)

In Australia, medicines for ED are regulated through the Therapeutic Goods Administration (TGA) and are supplied according to Australian laws and pharmacy standards. Availability online may depend on product classification, prescriber requirements, and verification steps used by the pharmacy.

• TGA oversight: Avanafil-containing products are evaluated for quality, safety, and performance.
• Pharmacy supply: Online pharmacies must comply with Australian requirements, including patient checks and appropriate packaging/labeling.
• Safety screening: Many services include an assessment process to identify contraindications and interaction risk (especially cardiovascular risk and nitrates).

Availability and branding can vary by region and supplier. If you cannot find a specific strength or brand, your pharmacy can advise on suitable options.

Recent Guidance and Practical Advice

ED medicines, including PDE5 inhibitors, are commonly associated with a few long-standing safety themes:

• Never combine with nitrates due to risk of dangerously low blood pressure.
• Be cautious with alpha-blockers and other blood-pressure-lowering medicines.
• Consider cardiovascular assessment when ED appears alongside chest pain, breathlessness, fainting, or known heart disease.
• Stop and seek help for rare but serious events such as prolonged erection or sudden vision/hearing loss.

Guidance evolves over time, and recommendations may differ based on individual risk factors. If you have heart disease, take complex medications, or have had previous serious side effects with PDE5 inhibitors, discuss with a healthcare professional before use.

Delivery, Availability, and What to Expect from an Online Pharmacy

When ordering through an Australian online pharmacy, availability typically depends on stock, tablet strength, and regulatory/verification requirements. Delivery timelines vary by location.

• Stock checks: Some products may require confirmation before dispatch.
• Packaging: Medicines should arrive in appropriate packaging with clear labelling and patient information.
• Discreet delivery: Many online pharmacies offer discreet packaging.
• Tracking: Orders are often dispatched with tracking information.

If you have urgent timing needs, contact the pharmacy to confirm dispatch and delivery estimates.

FAQ – Avanafil (Erectile Dysfunction) in Australia

1. How quickly does avanafil work?

Many people experience improvement in erections in about 15–30 minutes after taking avanafil. A heavy or fatty meal can slow absorption, so you may need to allow more time.

2. How long does it last?

The duration varies by person, dose, and whether you eat beforehand. In general, the medicine’s effect can last for several hours, but the strongest and most predictable response typically occurs within the earlier period after dosing.

3. Can I take avanafil every day?

Avanafil is commonly used on an as-needed basis for ED. Whether you should take it daily or only before sex depends on your clinician’s plan and your product instructions. Follow your specific directions.

4. What if it doesn’t work for me?

If avanafil doesn’t help, it may be due to timing, food intake, insufficient sexual stimulation, alcohol use, or other health/medication factors. Avoid increasing dose without guidance. Talk to a healthcare professional about adjusting timing, ruling out underlying causes, or switching therapies.

5. Can I drink alcohol while using avanafil?

Moderate alcohol may be manageable, but heavy drinking can reduce effectiveness and increase side effects like dizziness. Keep alcohol intake limited and avoid if you notice light-headedness.

6. Are there medicines I must not combine with avanafil?

Yes. Do not combine avanafil with nitrates (often used for angina/chest pain). Also use extra caution with certain blood-pressure medicines and strong CYP3A4 inhibitors. Always check with your pharmacist about your specific medicines.

7. Does avanafil treat the cause of erectile dysfunction?

Avanafil improves erectile function by enhancing blood flow during sexual stimulation. It does not directly treat all causes of ED (such as diabetes, cardiovascular disease, hormonal issues, or anxiety). Addressing underlying factors improves long-term results.

8. Can avanafil be used with other ED tablets?

Typically, you should not combine PDE5 inhibitors together. Combining can increase the risk of side effects. If you’re considering another ED option, discuss with a clinician or pharmacist.

9. Are there fertility or “penis size” effects?

Avanafil does not permanently change penis size. It helps erections adequate for sexual activity. If you have concerns about fertility or anatomy, speak with a healthcare professional.

10. When should I seek urgent help?

Seek urgent medical care if you have chest pain, fainting, severe dizziness, sudden vision/hearing changes, severe allergic reaction, or an erection lasting more than 4 hours.

Important Reminder

ED is common, and effective treatments exist. Avanafil can help many people, but safety depends on your health, current medications, and cardiovascular risk. If you’re unsure whether it’s appropriate for you—or you have complex medical conditions—seek advice before use.

For the most accurate guidance, check the patient information provided with your specific product and follow the instructions from your healthcare professional or pharmacist.