Avanafil
Avanafil is the newest PDE5 inhibitor approved for erectile dysfunction (FDA 2012, marketed as Stendra in the US and Spedra in Europe). It offers faster onset and shorter duration than sildenafil or tadalafil, with a more selective enzyme profile that may reduce some side effects.
- Chemical formula
- C23H26ClN7O3
- CAS number
- 330784-47-9
- ATC code
- G04BE10
- Molecular weight
- 483.95 g/mol
- Drug class
- Phosphodiesterase type 5 (PDE5) inhibitor
- Also known as
- Stendra, Spedra
What is it?
Avanafil is a second-generation PDE5 inhibitor developed by Mitsubishi Tanabe and licensed to Vivus, FDA-approved in 2012 as Stendra and approved in Europe as Spedra. It is the most recent of the four PDE5 inhibitors (alongside sildenafil, tadalafil and vardenafil) for erectile dysfunction, distinguished by faster onset (some users report effect within 15 minutes) and a more selective enzyme profile that may reduce visual and cardiovascular side effects.
Mechanism of action
Avanafil selectively inhibits phosphodiesterase type 5 (PDE5) in the corpus cavernosum, increasing cGMP and enhancing nitric-oxide-mediated vasodilation in response to sexual stimulation. Compared with sildenafil and vardenafil, avanafil shows higher selectivity for PDE5 over PDE6 (retinal) and PDE11 (testicular), which translates clinically into less colour-vision disturbance and possibly fewer back-pain or muscle-ache effects.
Pharmacokinetics
Avanafil is rapidly absorbed with peak plasma at 30–45 minutes (compared with ~60 min for sildenafil/vardenafil and ~120 min for tadalafil). Bioavailability is reduced by high-fat meals though less than with sildenafil. Hepatic metabolism is via CYP3A4 with a terminal half-life of 6–17 hours, supporting on-demand dosing. The shorter window may suit users who want a more predictable, time-bounded effect.
Indications
Avanafil is approved for erectile dysfunction in adult men. Doses are 50, 100 and 200mg taken 15–30 minutes before sexual activity, no more than once daily. It has not been studied for pulmonary hypertension and is not used outside the ED indication, unlike sildenafil and tadalafil which have multiple approved uses.
Safety profile
The most common adverse effects are headache, flushing, nasal congestion and back pain — typical of the PDE5 class but generally less frequent than with older agents. Concurrent use with nitrates is contraindicated because of the risk of severe hypotension. Caution is required with alpha-blockers, strong CYP3A4 inhibitors, and in significant cardiovascular disease, hepatic or renal impairment. Priapism is a rare but serious risk.
Products containing this ingredient
Frequently asked questions
How does avanafil compare with sildenafil and tadalafil? ▾
Avanafil acts faster than sildenafil (15–30 min vs 30–60 min) and has a shorter window than tadalafil (6–17 h vs 17.5 h half-life). It also shows higher selectivity for PDE5 over PDE6 and PDE11, which may translate into fewer visual and muscle side effects. The choice between PDE5 inhibitors is mostly preference and tolerability, not efficacy.
Can avanafil be taken with food? ▾
Avanafil can be taken with or without food, although a high-fat meal may delay onset by about 30 minutes. According to the prescribing information, food does not substantially reduce overall efficacy — unlike sildenafil where a heavy meal can blunt the effect more noticeably. A light meal does not require any timing adjustment.
Is avanafil safer than older PDE5 inhibitors? ▾
Avanafil has a more selective enzyme profile, which may produce fewer visual disturbances and some other side effects, but the overall cardiovascular safety profile is similar to other PDE5 inhibitors. According to current guidelines, contraindications (nitrates, severe cardiovascular disease) apply equally to all PDE5 inhibitors regardless of generation.
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.