Stendra (Avanafil) – Patient Guide

Stendra contains avanafil, a medicine used to treat erectile dysfunction (ED) in adult men. It helps increase the ability to get and keep an erection when you are sexually stimulated.

This guide is designed to be patient-friendly and provides practical information about how Stendra works, how to take it, food and alcohol considerations, safety points, and common questions. Always follow the advice of a healthcare professional and the instructions provided with your product.

Quick facts

• Active ingredient: Avanafil
• Medicine type: PDE5 inhibitor (a type of erectile dysfunction medicine)
• Common use: Helps treat erectile dysfunction (ED)
• How it works: Improves blood flow to the penis in response to sexual stimulation
• Typical onset: Some men may notice effects within about 15–30 minutes
• When to take: Usually taken before sexual activity (timing matters)

Basic product information

Stendra is an oral tablet containing avanafil. Different strengths may be available (commonly 50 mg, 100 mg, and 200 mg, depending on product availability). The correct dose depends on individual factors such as other medicines, kidney/liver function, and response.

Important: Stendra is for adult men only. It should not be used by women or children.

How Stendra works (mechanism of action)

Avanafil belongs to the group of medicines called PDE5 inhibitors (phosphodiesterase type 5 inhibitors).

During sexual stimulation, the body releases nitric oxide, which increases levels of cGMP (cyclic guanosine monophosphate) in penile tissue. cGMP helps relax blood vessels and improves blood flow, supporting erection.

PDE5 breaks down cGMP. Avanafil inhibits PDE5, which helps maintain higher cGMP levels, supporting improved blood flow and making it easier to achieve and maintain an erection when you are sexually aroused.

Key point: Stendra does not cause an automatic erection. Sexual stimulation is still required.

Pharmacokinetics (how the body absorbs and processes it)

Pharmacokinetics describes what the body does to the medicine—absorption, distribution, metabolism, and elimination.

• Absorption: Avanafil is absorbed after oral dosing. Peak concentration typically occurs within about 30 minutes to 1 hour, though individual timing can vary.
• Onset of action: Many men experience the start of effectiveness relatively quickly, with some noticing effects in as little as 15–30 minutes (actual timing varies).
• Metabolism: Avanafil is primarily metabolised by liver enzymes (notably CYP3A4).
• Elimination: It is cleared from the body mainly through metabolism and excretion of metabolites (details vary by patient).
• Duration: The effect window can be several hours. The “best time” depends on dose, your physiology, and external factors such as meals and other medicines.

If you have liver problems, kidney impairment, or you take medicines that affect liver enzymes, dose adjustments or extra caution may be needed.

What Stendra is used for (indications)

Stendra is used for the treatment of erectile dysfunction (ED). This refers to difficulty achieving or maintaining an erection sufficient for satisfactory sexual performance.

Stendra is indicated for use in adult men. It is not intended for use in children or adolescents.

Timing and typical use

Correct timing improves the chance of successful treatment.

• Take before sexual activity: Stendra is typically taken before planned sex.
• Typical timing: Many men take it about 15–30 minutes before sex, but for some, up to 1 hour may be more appropriate. Follow your prescriber’s advice and product instructions.
• Sexual stimulation required: The medicine helps your body respond to arousal; it does not replace sexual stimulation.

How to take it: Swallow the tablet with water. Do not crush or chew unless your product instructions say otherwise.

Dosing (general guidance)

Dosing can vary by individual circumstances and local product guidance. Use the dose that has been recommended for you.

Maximum frequency: Do not take more than once within a 24-hour period. Your healthcare professional may recommend a specific plan based on your health and other medicines.

Starting low if needed: If you take interacting medicines or have liver/kidney issues, your doctor may advise a lower dose or a different schedule.

Food interactions (meal effects)

Food—especially a heavy, high-fat meal—may delay how quickly avanafil is absorbed, which can reduce or shift the timing of effectiveness.

• After a light meal: Often less affected; timing may remain relatively predictable.
• After a heavy or high-fat meal: You may need to take Stendra earlier than usual or expect a slower onset.
• Practical approach: Many people find it helpful to test timing with the same meal pattern on separate occasions to learn what works for them.

Tip: If you want the most reliable timing, consider taking it on an emptier stomach or after a light meal.

Alcohol interactions

Moderate alcohol may worsen erectile function. Heavy drinking can significantly affect sexual performance and may increase dizziness or low blood pressure symptoms when combined with PDE5 inhibitors.

• Avoid binge drinking: This can make ED worse and increase risk of side effects.
• Go slow: If you choose to drink alcohol, keep it moderate and ensure you feel steady and alert.
• Hydration matters: Alcohol can cause dehydration, which can affect circulation and how you feel.

Seek urgent help if: you faint, feel severe dizziness, or have chest pain.

Medicine interactions (including alcohol and other drugs)

Because avanafil is metabolised by CYP3A4, some medicines can raise avanafil levels in your body, increasing side effects and risk. Others can reduce effectiveness.

Do not combine with nitrates

Stendra must not be taken with nitrate medicines (for chest pain/angina) such as:

• Glyceryl trinitrate (GTN)
• Isosorbide dinitrate/mononitrate
• Any “nitrate” class medicines

Combining PDE5 inhibitors with nitrates can cause a dangerous fall in blood pressure.

Caution with “nitrite” containing substances and some recreational drugs

Some substances used recreationally (“poppers”) can also contain nitric oxide–related compounds. These can interact dangerously with PDE5 inhibitors. Avoid combining.

Strong CYP3A4 inhibitors (may increase avanafil levels)

Examples can include certain:

• Antifungal medicines (e.g., ketoconazole, itraconazole)
• Some HIV medicines
• Some antibiotics/antivirals (depending on the active ingredient)

These can markedly increase avanafil exposure, requiring avoidance or significant dose adjustment under medical supervision.

Alpha-blockers (for prostate symptoms or blood pressure)

Taking avanafil with alpha-blockers may lead to dizziness or low blood pressure in some men. Doctors may:

• Start with a lower dose of avanafil
• Separate dosing times
• Monitor symptoms when starting or adjusting treatment

Antihypertensives (blood pressure medicines)

Because PDE5 inhibitors can also lower blood pressure, additive effects may occur when combined with other blood pressure-lowering medicines.

Other ED medicines

Do not use Stendra together with another PDE5 inhibitor (e.g., sildenafil, tadalafil, or vardenafil) at the same time.

“Please check your medicines” rule

If you take any regular medications (including herbal products), ask a healthcare professional or pharmacist to check for interactions.

Safety profile and when to seek advice

Like all medicines, Stendra can cause side effects. Most are mild to moderate and temporary, but some require medical attention.

Common side effects

• Headache
• Flushing (warmth/redness)
• Indigestion or nausea
• Stuffy or runny nose
• Dizziness

Less common but important warnings

Stop using the medicine and seek urgent medical help if you experience:

• Chest pain or symptoms of a heart problem
• Severe dizziness, fainting, or signs of dangerously low blood pressure
• Vision changes (including sudden loss of vision)
• Hearing changes (including sudden hearing loss or ringing)
• Prolonged erection (erection lasting more than 4 hours—this is an emergency)

Who needs extra caution

Talk to a healthcare professional before using Stendra if you have any of the following:

• Heart disease or significant cardiovascular symptoms
• History of stroke
• Low blood pressure
• Severe liver impairment
• Severe kidney impairment
• Retinitis pigmentosa (a specific inherited eye condition)
• Blood disorders or conditions predisposing to priapism

Practical use tips for better results

• Plan the timing: Take it shortly before sexual activity. If you notice it’s not working at your usual time, adjust timing rather than increasing frequency.
• Consider meal effects: If using after a heavy meal, onset may be slower—try a different meal pattern to learn your timing.
• Stay within dosing limits: Do not exceed the recommended maximum frequency.
• Be honest about other medicines: Interactions are a common reason ED treatments don’t work or cause side effects.
• Manage expectations and stress: Anxiety, performance pressure, smoking, and poor sleep can reduce effectiveness.
• Use supportive lifestyle measures: Regular exercise, healthy weight, reducing smoking, and limiting alcohol may improve ED long-term.
• If it’s not working: Consider that ED can have multiple causes (vascular, hormonal, neurological, psychological). A clinician can help identify the underlying issue.

Alternative options

If Stendra isn’t suitable or doesn’t provide the desired results, there are several alternatives for ED treatment:

Other PDE5 inhibitors

• Sildenafil (e.g., brand options vary)
• Tadalafil (often has a longer duration)
• Vardenafil

Different PDE5 inhibitors vary in onset, duration, and how meals affect them.

Non-PDE5 options

• Vacuum erection devices (mechanical approach)
• Penile injections or intraurethral therapy (specialist-guided)
• Hormone assessment if low testosterone is suspected
• Psychosexual therapy if anxiety or relationship factors are contributing

Your best option depends on your medical history, medication interactions, and personal preference (e.g., preferred onset vs duration).

Stendra and erectile dysfunction: indications and medical context

ED can be influenced by blood vessel health, diabetes, hypertension, cholesterol, smoking, stress, depression, and medications. ED can also be an early sign of cardiovascular disease in some men.

If you experience new or worsening ED, it may be worthwhile to discuss with a healthcare professional. Treating ED can improve quality of life, but addressing underlying health causes can also reduce future health risks.

Market and legal context for Australia (general information)

In Australia, availability and access to ED medicines are regulated. Treatment pathways commonly involve:

• Pharmacist or clinician assessment to confirm suitability and safe use
• Consideration of medical history and potential drug interactions (particularly nitrates and certain cardiovascular conditions)
• Education on correct timing, dosing limits, and side effects

Online pharmacies may require you to complete a health questionnaire and/or provide relevant information so that medication can be supplied appropriately under Australian requirements. Availability can vary across regions and suppliers.

Always check that any product you receive is sourced legitimately and is consistent with Australian medicine supply standards.

Recent guidance and evolving safety awareness

Recent years have reinforced several general safety themes relevant to PDE5 inhibitors:

• Strict avoidance of nitrates with PDE5 inhibitors
• Increased attention to cardiovascular risk assessment (especially if you have heart disease)
• Awareness of drug-drug interactions via CYP3A4 inhibitors and alpha-blockers
• Prompt action for serious adverse events such as prolonged erection, sudden vision or hearing changes

Because guidance can update and because individual risk varies, it’s wise to recheck interaction advice whenever you start or stop other medicines.

Delivery and availability (what to expect from an online pharmacy)

Online pharmacies in Australia may offer delivery options to eligible postcodes and require standard compliance checks. Availability of Stendra may differ by:

• Tablet strength (50 mg, 100 mg, 200 mg)
• Stock levels and supplier arrangements
• Packaging format (carton sizes and blister packs)

Common delivery expectations include:

• Order processing time: often 1–2 business days (varies)
• Shipping time: can vary by location and courier
• Tracking: may be offered for many deliveries
• Packaging: discreet delivery where permitted

If you need the medicine urgently for a planned event, allow extra time for delivery and remember that timing of dosing is also important for effectiveness.

How to store Stendra

• Store at room temperature according to the label.
• Keep tablets in the original packaging to protect from moisture.
• Keep out of reach of children.
• Check expiry date on the pack and do not use after expiry.

FAQ – Frequently asked questions

1) How quickly does Stendra work?

Many men notice effects within about 15–30 minutes. For some, it may take closer to 1 hour, especially after a heavy meal. Your best timing may depend on your usual diet and response.

2) Does Stendra work without sexual stimulation?

No. Stendra supports erection in response to sexual arousal. It does not automatically cause an erection.

3) Can I take Stendra with food?

It can be taken with or without food, but a heavy, high-fat meal may delay onset and reduce predictability. For more reliable timing, consider a lighter meal or follow your clinician/pharmacist’s advice.

4) How much alcohol can I have?

There is no single safe amount for everyone. Alcohol can worsen ED and increase dizziness. If you drink, keep it moderate and avoid binge drinking—especially if you’ve experienced dizziness with ED medicines before.

5) What should I do if I get side effects?

Mild headache or flushing is common and usually settles. If side effects are bothersome, discuss dose adjustment with a healthcare professional. Stop and seek urgent help for severe dizziness, chest pain, vision/hearing changes, or prolonged erection.

6) What if Stendra doesn’t work for me?

It may depend on dose, timing, meal effects, stress, and the cause of ED. Do not increase frequency beyond recommended limits. Check for interactions with other medicines and consider medical review to address underlying causes.

7) Can I combine Stendra with other ED treatments?

Do not combine with another PDE5 inhibitor. If considering other therapies (vacuum device, injections), discuss with a clinician to ensure safe coordination.

8) Is Stendra safe if I have high blood pressure or heart disease?

Many men with stable cardiovascular conditions may use PDE5 inhibitors under medical guidance, but safety depends on your specific heart status and medicines. If you have cardiovascular disease, seek medical advice before using Stendra and follow guidance closely.

9) Why can’t I take Stendra with nitrates?

Nitrates (used for chest pain/angina) can interact with PDE5 inhibitors and may cause a dangerous drop in blood pressure. This combination is considered unsafe.

10) How should I take it for the best chance of success?

• Take it shortly before planned sex (often 15–30 minutes, possibly up to 1 hour).
• Avoid heavy, high-fat meals close to dosing.
• Use moderation with alcohol.
• Be sure to include sexual stimulation.
• Review all medicines you take for interactions.

When to seek medical help urgently

Get urgent medical assistance if you develop:

• Chest pain or serious shortness of breath during/after use
• Fainting or severe dizziness
• Sudden vision loss or sudden hearing changes
• An erection lasting longer than 4 hours

Summary

Stendra (avanafil) is an oral PDE5 inhibitor used to treat erectile dysfunction in adult men. It works by enhancing the body’s natural response to sexual stimulation, improving blood flow to the penis. Timing is important—especially around meals—and interactions with certain medicines (particularly nitrates) can be dangerous. Used correctly, Stendra can help many men achieve and maintain erections for successful sexual activity.