Generic Stendra (Avana / Avanafil): Drug interactions, Contraindications, Side effects, Coupons
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CONTENT
- General information
- What does Stendra do?
- How to take
- Stendra’s Interaction with Other Medication
- Contraindications
- Side Effects
- Important facts
- Clinical studies on avanafil
- Avanafil headache, dizziness, leg pain: is it normal?
- Drug interactions
- Stendra replacement should be used in the following cases
- Tips for more effective use
- Storage and disposal of Stendra
- FAQ
The growing problem of male sexual dysfunction has urged pharmaceutical companies to quickly respond to the modern market requirements. This article is dedicated to Avanafil that is a new-generation medication marketed at the name of Stendra.
General information
Stendra refers to PDE5 inhibitors that are tailored to the treatment of erectile dysfunction. It was approved by FDA in 2012. In 2013 the drug was announced to enter European, Australian and New Zealand markets.
Stendra’s main active ingredient is Avanafil, the new-generation PDE5 inhibitor that can meet the competition of such market leaders as Sildenafil, Tadalafil or Vardenafil. Avanafil’s competitive advantages include fast adsorption in the human body (within 30-45 minutes) and response: more than two thirds of the customers prove their ability to start sexual intercourse in 15 minutes after the intake of Avanafil. The medical action lasts for up to 6 hours usually.
Stendra is produced in the form of pills containing 50 or 100 mg of Avanafil.
What does Stendra do?
The major therapeutic indication of Stendra (Avanafil) is erectile dysfunction treatment.
Erectile dysfunction is connected with an inability to reach and maintain erection for the period needed to start and finish coitus. In most cases ED problems are caused by the age-related factors. However, the reasons of ED can also involve such factors as bad habits, professional stresses, hard working conditions, suffered health disorders, bad eating habits and so on. As a result, men, often even younger than 40 years old, are not able to conduct healthy sexual life.
Stendra does not treat the reason of erectile dysfunction, but it effectively improves the symptoms. The major distinctive feature of Avanafil is that it influences only natural mechanisms of erection. In order to get rid of the ED reason additional therapy or changes of lifestyle and habits are required.
Avanafil relaxes plain muscles and widens the blood vessels. More intense blood flow provides more stable and stronger erection. Avanafil is effective only if there is a sexual excitement as the excitement is responsible for the emission of cGMP (cyclic guanosine monophosphate) that works in penis. Avanafil starts acting after the emission takes place and prevents cGMP from fast degradation. As a result, a man is able to maintain erection and to conduct full sexual intercourse.
Stendra is available only with the prescription and is not tailored to children under 18 years old and women.
How to take
Being a prescription drug Stendra (Avanafil) should be taken just as prescribed by the doctor. One should refrain from changing the dosage or intake schedule without consulting the doctor.
Stendra (Avanafil) is to be taken once a day 15- 30 minutes before the coitus. The starting Stendra dose for adults is 100 mg. In case of low effectiveness the dosage can be increased up to 200 mg. The dosage increase should be agreed upon with the doctor as the larger portion of Avanafil may cause strong side effects and health problems.
Avanafil can be taken regardless of meal. Grapefruit and grapefruit juice should be excluded as it decreases the effect of the drug. Alcohol and tobacco should also be excluded as they may both slowdown the drug action and cause negative consequences to the man’s health.
Before starting using Stendra patients are recommended to study thoroughly the customer leaflet available with the medication and to obtain comprehensive medical consultation in order to avoid risks and undesired health problems.
Interaction with Other Medication
Like other PDE5 inhibitors Stendra (Avanafil) has certain restrictions as far as medicine combinability is concerned. Certain drugs should not be co-administered with Avanafil as their simultaneous intake may cause stronger side effects of the drug. The complete list of drugs is usually provided inside the package.
Here the short list of the most dangerous medications one should take into account when treating with Avanafil is provided.
- Nitrate drugs. Nitrate-containing drugs (nitroglycerin, amyl nitrite, isosorbide mononitrate, erythrityl tetranitrate etc.) may cause blood pressure problems such unexpected and sharp drop of blood pressure.
- HIV/AIDS treatment drugs (atazanavir, boceprevir, darunavi, indinavir etc.) intensify certain side effects of Stendra.
- Antibiotics (telithromycin, clarithromycin, erythromycin) and antifungal drugs (posaconazole, itraconazole, ketoconazole and others) may have negative influence on gastrointestinal system of the human body.
- PDE5 inhibitors (Levitra, Viagra, Cialis and their generics) should be taken together with Avanafil due to the possible cardio – vascular problems they may cause.
One should take into account that it is not possible to forecast all the effects of the drug interactions that is why it is vitally important to inform the doctor about the medications being taken regularly at the present moment including vitamins, herbal products, nutritive supplements and so on. Personal sensitivity and health state are the major factors that are responsible for the strength of the drug interaction in the human body.
Contraindications
As it was mentioned above Stendra is not prescribed for children and women. As for the adult men the list of contraindications includes serious disorders of human systems that are involved in the sex activity or ED treatment drug metabolism.
The first group of contraindications refers to the cardio-vascular diseases. Cardio-vascular system is the one that has the largest load during sexual intercourse. Thus, if the patient suffers from any CV diseases he will be recommended to refrain from taking Stendra or to take smaller dosages.
Cardio-vascular diseases include:
- Heart stroke. If the patient has a heart stroke less in his medical history (less than 6 months ago) he will be recommended not to take Avanafil.
- Heart rhythm problems, heart disease or coronary artery disease. In these cases constant control and strict adherence to the doctor’s recommendations are required.
- State of hypertension or hypotension. Sharp changes in the blood pressure are the risk factor while using Avanafil. Depending upon the disease severity the patient will recommended to take smaller dosages or to refrain from the therapy with Avanafil.
Among the other health disorders that may trigger side effects of Avanafil one can mark the following:
- Gastrointestinal diseases (stomach and duodenal ulcers, liver and kidney diseases). Gastrointestinal system takes part in the process of Avanafil metabolism. So, being a strong medication Avanafil may negatively influence the damaged vitals.
- Retinal disorders. Problems with eyes may be intensified by the intake of Avanafil as the given medication influences eye vessels.
- System diseases like diabetes and others;
- Blood diseases like anemia, leukemia, multiple myeloma, sickle-cell anemia and other bleeding problems. As Avanafil influences the blood vessels and intensifies blood flow the problems with blood can lead to the serious damages of health.
- Allergic reactions.
Besides, if a patient has a physical deformity of penis increased load on penis vessels, muscles and tissues may cause serious damages of penis.
Side Effects Of Stendra
Stendra (Avanafil) is reported to have rare side effects occurring in patient with good health. The most common of them are headache, hot flushes, fever, and irregular heartbeat. Nevertheless, the medical leaflet contains all the possible side effects for patients to be informed about the consequences that may occur.
- From the side of cardio-vascular system side effects may include tachycardia, hypertension, angina (stable or unstable), deep vein thrombosis and others.
- Gastrointestinal side effects involve nausea, stomach discomfort and pain, vomiting, constipation or diarrhea, gastritis, and dry mouth.
- From the side of genitourinary system the patient may experience priapism, hematospermia, hematuria etc.
- The patient may also experience pains in muscles and bones, myalgia, pains in back, spasms in muscles and so on.
- From the side of sense and respiratory organs the most frequently experienced side effects involve blurred vision or vision loss, nasal congestion, bronchitis, sinusitis, and nasopharyngitis.
- Besides, the patient may suffer from dizziness, insomnia or somnolence, and depression.
Before the Avanafil therapy the patient should obtain doctor’s instructions concerning the possible side effects regarding his own health state as well as recommendations how to act if any side effect occur.
Generic Stendra at My Canadian Pharmacy
Avana 100 is one of the most famous generics of Stendra at My Canadian Pharmacy. The medication is produced by Indian pharmaceutical company and is gaining popularity among customers due to its attractive price and good effectiveness.
Avana 100 is manufactured in the form of oral tablet containing 50 and 100 mg of Avanafil and is offered in the box of 4 pills.
Avana 100 is taken once a day 15 minutes before the sexual activity. The drug should not be taken regularly, only if needed. The daily dose should not be less than 50 mg and exceed 200 mg of Avanafil.
Avana 100 is not for use in children and women (especially pregnant and lactating). The medicine is not prescribed for those patients who suffer from cardio-vascular diseases, some gastrointestinal disorders or blood problems.
Like the other PDE5 inhibitors Avana100 may cause certain side effects, if improperly taken. The most common side effects involve headaches, hot flashes and dizziness. To avoid side effects it is advised to adhere to doctor’s recommendations and to control one’s health state.
Important Stendra facts
The agent of Stendra, avanafil, is an active ingredient for the treatment of erectile dysfunction. The approval of avanafil under the trade name Stendra took place in 2013, in the European countries avanafil has been on the market since 2014 under the trade name of Spedra. In the USA avanafil 2012 was approved under the trade name Stendra.
It belongs to the active substance group of the phospodieestrase5 inhibitor (PDE5 inhibitor, acts vasodilating and promotes the condition of an erection by biochemical interventions in the metabolism.
Responsible for the condition of an erection are complex physiological processes in which the penis, the blood circulation and the central nervous system are involved. These processes are controlled at the cellular level via enzymes and neuronal messengers. In a sexually non-excited state, the penis’s blood vessels are only minimally perfused – permanent contractions of the smooth muscles of the penis arteries prevent uninhibited blood flow. Through sexual arousal this blockage is lifted, the corpuscles are filled with blood, so that an erection can arise. They can grow to three to four times their normal size.
Nitric oxide (NO), which in turn activates the secretion of the enzyme guanylate cyclase, is formed as the initiator of these processes. This initiates the production of the neurotransmitter cGMP (cyclic guanosine monophosphate), which lowers the potassium level in the muscle cells and thus triggers the relaxation of the muscles of the penis arteries.
The erection stops as long as the NO and cGMP activation in the cells is able to prevent a renewed contraction of the penis arteries. It sounds off when the body-borne enzyme phosphodiesterase5 (PDE5) begins to degrade cGMP: the blood flow into the corpus cavernos is stopped by resetting the arterial contraction.
The mode of action of avanafil (Stendra) inhibits the production of PDE5 and thus counteracts the premature degradation of cGMP. In this way the active ingredient promotes the condition as well as strength and duration of an erection. As long as the effect of avanafil persists, repeated erections are possible without taking a new tablet.
Prerequisites for the activation of NO and cGMP are sexual stimuli and personal desire. Both and therefore the individual desire cannot replace drugs. However, avanafil, like the other PDE5 inhibitors, improves the ability to respond to sexual stimulation with an erection and maintain it up to the time of sexual intercourse.
Clinical studies on avanafil
Efficacy and tolerability of avanafil are well documented by clinical trials. During the development phase of the drug, it was demonstrated that PDE5 is significantly superior to other phosphoestrase inhibitors (PDE3, PDE6) and has a relatively low risk of side effects. Like other PDE5 inhibitors, avanafil (Stendra) is effective in patients with mild, moderate and severe erectile dysfunction.
A US study shows that men with diabetes mellitus as a possible cause of erectile dysfunction benefited greatly from the ingestion of the active ingredient and without increased health risks.
Dosage and administrationAvanafil (Stendra) is used orally in tablet form. Those who want to buy Stendra can purchase the tablets at doses of 50, 100 or 200mg of avanafil. The product is taken with a little water. By taking high-fat meals, effectiveness can be reduced. The effect of avanafil (Stendra) begins within 30 minutes. The highest concentration in the blood reaches the active substance after 30 to 45 minutes. The effect lasts about six hours. No further tablets should be taken during this period.
The recommended starting dose is 100mg. Dose adjustments are made upwards or downwards if necessary. Unlike with tadalafil with avanafil (as well as the active substance sildenafil and vardenafil) no low dose dauermedications are possible. The tablets are thus taken exclusively before a planned sexual contact.
Avanafil headache, dizziness, leg pain: is it normal?
The most common side effects of avanafil are headaches, which are felt by more than 10% of the users. Occasionally, up to one in every 100 users, dizziness, somnolence, visual disturbances, heartbeat irregularities and palpitations (conscious perception of one’s heartbeat) may occur. Pain leg is a very uncommon side effect of avanafil that needs to be reported to your prescriber without delay.
Rare side effects include flu-like symptoms, sleep disorders, mood changes, hypertension, and heart problems. The intake of avanafil (generic Stendra) may also rarely cause premature ejaculation, changes in urine or certain blood tests. Very rarely there can occur a sudden decrease or the temporary loss of the hearing or sight or permanent reefs without lusciousness. In such cases, immediate, emergency medical treatment is necessary.
As with other medicines, Stendra can cause side effects. The possible side effects of Stendra are divided into severe and other side effects. If severe side effects are observed, the treatment should be discontinued immediately and a doctor should be consulted.
Continuous (priapism) over 4 hours. If a priapism is not treated in time, a permanent damage to the penis and a permanent loss of the erectile capacity is threatened. Priapism can be favored, for example, by sickle cell anemia, leukemia or a multiple myeloma. Blurred vision or sudden loss or sudden loss of vision. These symptoms can occur, for example, in a non-arteritic ischemic optic neuropathy (short: NAION). Sudden decrease or loss of hearing. Symptoms may also be associated with dizziness or ringing in the ear.
Drug interactions
Stendra can be used alongside with SSRI inhibitors, such as Zoloft. As a matter of fact, it is not uncommon for patients taking such drugs to require treatment with PDE5 inhibitors like Viagra, Stendra, Cialis, Levitra and others, since ED is a known side effect of antidepressants.
However, nitrates and other nitric oxide donors (amyl nitride, glycerin nitrate) release NO – the effect of such medicines and afanavil (stenra) increase reciprocally and can lead to a life-threatening blood pressure drop.
Some antiviral agents (atazanavir, nelfinavir, ritonavir) for HIV treatment, certain anti-fungal agents (anti-fungal agents) and some antibiotics and anti-epileptics also interact with avanafil and should not be used with this medicine. Avanafil should not be used with other PDE5 inhibitors. Caution is recommended when alpha blockers are used to treat hypertension and benign prostate changes. As a rule, however, it is possible to switch to medications which are well tolerated with avanafil (generic Stendra).
During the intake of afanavil, the consumption of larger amounts of alcohol should be avoided, as this can reduce blood pressure and reduce the ability to develop an erection.
Stendra replacement should be used in the following cases
Avanavil may only be used by men. Allergic reactions to this active substance, severe functional impairment of the liver or kidneys, severe cardiovascular diseases, an uncontrolled hypertension and low blood pressure with a systolic value <90 mmHG are absolute contraindications. In the first three to six months after a heart attack or stroke, as well as some serious eye diseases or familial disposition, avanafil (generic Stendra) must not be used. The physician should prescribe avanafil or other PDE5 inhibitors for mild symptoms of hepatic and renal dysfunction and cardiovascular disease only after a particularly careful risk-benefit assessment. Children under 18 years of age are not allowed to use avanafil (generic Stendra).
an allergy to avanafil. the use of other medicines for erectile dysfunction. These include, for example, Viagra, Cialis or Levitra with the active ingredients sildenafil, tadalafil and vardenafil. the use of medicines against fungal infections such as ketoconazole, itraconazole or voriconazole. a treatment with antibiotics such as clarithromycin or telithromycin. the use of drugs against AIDS and HIV (for example ritonavir, indinavir, saquinavir, nelfinavir or atazanavir). a present angina pectoris, as well as other heart diseases or heart problems. existing or in the course of sexual intercourse. low (under 90/50 mmHg) or high blood pressure (higher 170/100 mmHg), which is not regulated by medication. severe liver and kidney disorders. a loss of vision due to an insufficient blood supply in the eye or severe eye problems in the kinship. Blood clotting disorders or acute peptic ulcers. Stroke or heart attacks that have occurred in the last 6 months. (priapism), or diseases that can cause a change in the shape of the penis. These include, but are not limited to, angulation, peyronie disease, or coronary artery fibrosis. under 18 years of age.
Avanafil (generic Stendra) is a prescription active ingredient, whose promiscuous use can be dangerous for your health. Doses that are higher than needed are fraught with exaggerated side events. Make sure that your chosen dosage of avanafil is approved by the prescriber before proceeding with the therapy. Maximal doses of the drug (Stendra 200mg) should only be used in the absence of comorbidities, contraindications and older age. Use maximal dose of avanafil only if lower doses turn out to be ineffective. Self-medication without medical advice can lead to considerable health risks due to dosing errors and non-considered contraindications.
Stendra is offered in tablet form in doses of 50mg, 100mg and 200mg avanafil. The pack sizes are available from 4 to 32 tablets. The recommended dose of avanafil is 100mg. The maximum daily dose is 200mg. There should be a waiting period of at least two days between each revenue. When taking moderate CYP3A4 inhibitors such as amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, verapamil or fosamprenavir, the recommended dose is also 100mg. However, the dosage should always be determined and determined by a doctor individually and to the respective patient.
Tips for more effective use
Stendra should be taken approximately 15 to 30 minutes before sexual intercourse. The medication can be taken between meals or meals. When taken with meals, however, a delayed onset of action is possible. Grapefruit juice can affect the effect of avanafil uncontrolled. Therefore, between the consumption of grapefruit juice and the intake of avanafil should be at least 24 hours. Stendra should not be taken with alcohol, as alcohol in combination with avanafil may cause an increase in heart rate and blood pressure drop.
Avanafil has a rapid resorption, which results in a maximum plasma concentration after an average of 30 to 45 minutes in a sober state. Avanafil is largely eliminated via liver metabolism. The metabolism of avanafil is comparatively intense. The active substance is excreted mainly via the stool (63 per cent) and in a smaller amount via the urine (21%). The terminal half-life of avanafil is approximately 6 to 17 hours.
After taking Stendra, dizziness and reduced vision may occur. If these symptoms occur, driving and operating machinery must be omitted. It is therefore advisable to plan the acquisition of Stendra at least in such a way that no car rides or the operation of machines have to be carried out until the drug has completely disintegrated in the body.
Storage and disposal of Stendra
Stendra is to be kept outside the empire of children. In addition, there are no special storage conditions. Stendra should not be taken after the expiry date stated on the packaging, which always refers to the last month.
The medicinal product should be treated professionally and not disposed of in waste water or household waste. The local pharmacist must advise which regulations apply in which state.
FAQ
What is the difference between Stendra and other ED drugs such as Viagra?
Stendra is a new medication that appeared at the market several years ago. Like any other ED treatment drugs it refers to the group of PDE5 inhibitors that cure the ED symptoms by influencing natural mechanisms of erection. Manufacturers of Stendra claim that the medication has rare side effects which usually disappear in the course of treatment. Like other PDE5 inhibitors Stendra is available with prescription and should be taken once a day. Stendra has the same contraindications as most of branded ED treatment medications and their generics have.
Do I have side effects if I overdose?
If you decide to take larger dosage without consulting your health care expert you may certainly suffer from side effects. The dosage your doctor recommends is prescribed according to your current health state. If you have any health problems increased dosage of Avanafil will intensify side effects related to your troubled area. That is why it is important to follow the doctor’s recommendations and not to increase the dosage without visiting the doctor.
What should I do if I forget to take the daily dosage?
Stendra is taken on demand and does not require regular intake. If you want to have sex you just need to take the prescribed dosage half an hour before the sexual intercourse. Do not split the dosage or take two dosages within 24 hours. In the first case you will not have the desired effect, in the second case you may suffer from the unwanted deterioration of the health state.