Avanafil dosage
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avanafil dosage prescribing information 2024
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Here is a complete dosage guide for Avanafil (Stendra):
Avanafil (Stendra) - Dosage
Indication
Treatment of erectile dysfunction (ED) in adult males. It is a selective PDE5 inhibitor with a faster onset than sildenafil, vardenafil, or tadalafil.
Standard Adult Dosing
| Dose | Timing Before Activity | Notes |
|---|---|---|
| 100 mg | ~15 minutes | Starting/typical dose |
| 200 mg | ~15 minutes | If 100 mg insufficient |
| 50 mg | ~30 minutes | If tolerability issues arise |
- Taken as needed, no more than once per 24 hours
- May be taken with or without food (though a high-fat meal can delay absorption)
- Maximum dose: 200 mg/day
Dose Adjustments
| Situation | Recommended Dose |
|---|---|
| Alpha-blocker co-administration | Start at 50 mg |
| Moderate CYP3A4 inhibitor (e.g., erythromycin, fluconazole) | Max 50 mg per 24 hours |
| Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) | Contraindicated - do not use |
| Moderate hepatic impairment | Use with caution; adjust dose |
| Severe hepatic impairment | Not recommended |
| Severe renal impairment | Not recommended |
Pharmacokinetic Highlights
- Onset: ~15 minutes (fastest among PDE5 inhibitors)
- Duration of efficacy: 4-6 hours
- Half-life: ~6-17 hours
- Nitrate administration should be avoided for at least 12 hours after the last avanafil dose (vs. 24 h for sildenafil/vardenafil, 48 h for tadalafil)
Key Contraindications
- Organic nitrates (any form) - risk of severe hypotension
- Strong CYP3A4 inhibitors
- Not indicated in women, pediatric patients, or men for whom sexual activity is inadvisable
Common Side Effects
Headache (~10-12%), flushing, nasal congestion, and nasopharyngitis. Back pain and myalgia are less common than with tadalafil. Visual side effects are less common than with sildenafil or vardenafil.
Sources: Kaplan & Sadock's Comprehensive Textbook of Psychiatry; Smith and Tanagho's General Urology, 19th Ed.; Harrison's Principles of Internal Medicine 22E (2025); FDA Prescribing Information (Stendra, 2022); MedlinePlus - Avanafil
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