Stendra

Generic Name: avanafil (a VAN a fil)
Brand Names: Stendra

What is Stendra?

Stendra (avanafil) relaxes muscles and increases blood flow to particular areas of the body.

Stendra is used to treat erectile dysfunction (impotence).

Stendra may also be used for purposes not listed in this medication guide.

Important information

Do not take Stendra if you are allergic to avanafil, or if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking Stendra with a nitrate medicine can cause a sudden and serious decrease in blood pressure. If you become dizzy or nauseated during sexual activity, or if you have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of Stendra.

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Do not take Stendra more than once a day. Allow 24 hours to pass between doses. Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Stendra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking a similar medication called sildenafil (Viagra). Most of these people also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.

Stop using Stendra and get emergency medical help if you have sudden vision loss.

Before taking this medicine

You should not take Stendra if you are allergic to avanafil. Stendra should not be used together with nitrate medication, such as nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking Stendra with a nitrate medicine for chest pain or heart problems can cause a sudden and serious decrease in blood pressure.

To make sure you can safely take Stendra, tell your doctor if you have any of these other conditions:

  • heart disease or heart rhythm disorder;

  • a recent history (in the past 6 months) of a heart attack, stroke, heart surgery, or life-threatening heart rhythm problem;

  • congestive heart failure;

  • angina (chest pain), high or low blood pressure;

  • liver disease;

  • kidney disease (or if you are on dialysis);

  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;

  • a bleeding disorder such as hemophilia;

  • a stomach ulcer;

  • retinitis pigmentosa (an inherited condition of the eye) or a history of vision loss;

  • a physical deformity of the penis (such as Peyronie's disease); or

  • if you have been told you should not have sexual intercourse for health reasons.

Stendra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking a similar medication called sildenafil (Viagra). Most of these people also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.

It is not clear whether Stendra could cause vision loss. Stop using this medicine and get emergency medical help if you have sudden vision loss.

FDA pregnancy category C. Stendra is not for use in women. It is not known whether avanafil will harm an unborn baby. Although Stendra is not for use in women, it is not known if this medication passes into breast milk or if it could harm a nursing baby.

See also: Pregnancy and breastfeeding warnings (in more detail)

How should I take Stendra?

Take Stendra exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results. This medicine can be taken with or without food.

Stendra is usually taken only when needed, about 30 minutes before sexual activity. Follow your doctor's instructions.

Stendra can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.

Do not take Stendra more than once a day. Allow 24 hours to pass between doses. Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Store Stendra at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Since Stendra is used as needed, you are not likely to be on a dosing schedule.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid?

Drinking alcohol can increase certain side effects of Stendra. Avoid drinking more than 3 alcoholic beverages while you are taking Stendra.

Grapefruit and grapefruit juice may interact with Stendra and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Avoid using other medicines to treat erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) while you are taking Stendra.

This medication will not protect you from sexually transmitted diseases--including HIV and AIDS. Using a condom is the only way to protect yourself from these diseases.

Stendra side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Stendra: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. If you become dizzy or nauseated during sexual activity, or if you have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of Stendra.

Stop using Stendra and call your doctor at once if you have any of these serious side effects:

  • changes in vision or sudden vision loss;

  • ringing in your ears, or sudden hearing loss;

  • chest pain, pounding heartbeats or fluttering in your chest;

  • pain, swelling, warmth, or redness in one or both legs;

  • shortness of breath, swelling in your hands or feet;

  • feeling light-headed, fainting; or

  • penis erection that is painful or lasts 4 hours or longer.

Less serious Stendra side effects may include:

  • redness or warmth in your face, neck, or chest;

  • headache, mild dizziness;

  • cold symptoms such as stuffy nose, sinus pain, or sore throat;

  • diarrhea, constipation, upset stomach; or

  • back pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Stendra?

Tell your doctor about all other medicines you use, especially:

  • conivaptan (Vaprisol);

  • imatinib (Gleevec);

  • isoniazid (for treating tuberculosis);

  • nefazodone;

  • rifabutin (Mycobutin), rifampin (Rifadin, Rimactane, Rifater, Rifamate), or rifapentine (Priftin);

  • an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek);

  • antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), posaconazole (Noxafil), or voriconazole (Vfend);

  • an antidepressant such as nefazodone;

  • a barbiturate such as phenobarbital (Solfoton);

  • drugs to treat high blood pressure or a prostate disorder, such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin), silodosin (Rapaflo), or tamsulosin (Flomax, Jalyn);

  • heart or blood pressure medication such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), diltiazem (Cardizem, Cartia, Dilacor, Diltia, Diltzac, Taztia, Tiazac), enalapril (Vasotec), nicardipine (Cardene), nifedipine (Nifedical, Procardia), quinidine (Quin-G), verapamil (Calan, Covera, Isoptin, Verelan, Tarka), and others;

  • HIV or AIDS medications such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva), etravirine (Intelence), nevirapine (Viramune), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), or saquinavir (Invirase);

  • seizure medications such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), and others; or

  • the hepatitis C medications boceprevir (Victrelis) or telaprevir (Incivek).

This list is not complete and other drugs may interact with Stendra. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about Stendra.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Stendra only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 1.01. Revision Date: 2012-05-14, 2:52:23 PM.

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