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When taking this medication, you might experience mild side effects such as headache, flushing, or dizziness. These are generally not serious, but if they persist or worsen, it's a good idea to inform a healthcare professional. To help prevent dizziness and lightheadedness, especially when standing up, try to rise slowly from sitting or lying positions.

However, be aware of more serious side effects, especially if you have heart problems. Engaging in sexual activity can exert extra pressure on your heart. If you experience severe dizziness, fainting, chest, jaw, or left arm pain, or nausea, seek immediate medical help. Rarely, there can be a sudden decrease in vision or even permanent blindness, a condition known as NAION. This risk is slightly higher if you have conditions like heart disease, diabetes, or high blood pressure, are over 50, or smoke. If such vision issues occur, stop using the medication and contact a medical professional promptly.

Another rare but serious side effect includes sudden hearing loss, sometimes accompanied by ringing in the ears or dizziness. Should this occur, discontinue the medication and seek medical attention right away. A prolonged erection lasting four hours or more requires immediate medical intervention to prevent long-term issues. Though rare, serious allergic reactions can happen, characterized by symptoms like rash, severe dizziness, swelling, or difficulty breathing. If you notice these, get urgent medical assistance.

This summary covers key known side effects, but it's not exhaustive. If you experience any other unusual symptoms, consult a healthcare professional for advice.

Certain medications can interact with this drug. Specifically, riociguat and vericiguat may cause issues. Avanafil, when taken with nitrates, can lead to a significant drop in blood pressure, which might result in dizziness, fainting, or, in rare cases, a heart attack or stroke. Therefore, avoid using avanafil with drugs for chest pain or angina like nitroglycerin and isosorbide, as well as recreational drugs known as "poppers" that contain amyl or butyl nitrite.

If you are using alpha blockers such as doxazosin or tamsulosin for an enlarged prostate or high blood pressure, combining these with avanafil might lower your blood pressure too much, causing dizziness or fainting. Your doctor might prescribe a lower dose of avanafil to reduce this risk.

Additionally, some medications can interfere with how avanafil is removed from the body, potentially altering its effectiveness. These include adagrasib, azole antifungals like itraconazole and ketoconazole, cobicistat, clarithromycin, HIV protease inhibitors such as indinavir and tipranavir, nefazodone, ribociclib, rifampin, and ritonavir, among others.

Finally, do not take avanafil with other products containing avanafil or with similar drugs used to treat erectile dysfunction or pulmonary hypertension, such as sildenafil, tadalafil, or vardenafil.