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This safety information provides essential guidance on the risks and precautions associated with the use of Stendra (avanafil). Please read these points carefully and consult your healthcare provider for any concerns or clarifications.

• Cardiovascular Risks: If you have experienced a heart attack, stroke, heart failure symptoms, abnormal blood pressure, or chest pain in the past six months, it is advised not to use Stendra (avanafil). The safety of this medication in such conditions has not been confirmed, and sexual activity may need to be limited. Consult a healthcare professional if you have these heart-related issues.

• Low Blood Pressure Concerns: Taking Stendra (avanafil) with alpha blockers or other high blood pressure medications can significantly reduce your blood pressure. Discuss your current medications with your healthcare provider before making any changes. Monitor your blood pressure regularly, and exercise caution when standing up from a sitting or lying position. Alcohol consumption can also lower blood pressure further, so it should be limited or avoided.

• Medication Interactions: Stendra (avanafil) can interact with certain medications, leading to serious side effects. Notify your healthcare provider of all medications you are taking. Avoid using Stendra (avanafil) with nitrate medications, as this can cause a dangerous drop in blood pressure. If you are on blood pressure medications, ensure they are controlled before starting Stendra (avanafil). Be aware of potential interactions with oral azole antifungals and ritonavir.

• Alcohol Use: Limit alcohol consumption while taking Stendra (avanafil), as it can exacerbate side effects like dizziness and headaches, and increase the risk of falls or injuries. Alcohol may also impair the effectiveness of the medication in treating erectile dysfunction. If you struggle to reduce alcohol intake, consult your healthcare team for support.

• Priapism Warning: Rarely, prolonged or painful erections lasting more than four hours (priapism) can occur. Seek immediate medical attention if this happens to prevent permanent damage or impotence. Individuals with certain medical conditions, such as sickle cell anemia or leukemia, may be at higher risk.

• Vision Loss Alert: Sudden changes in vision can occur, though they are rare. If you experience vision changes, seek emergency medical assistance immediately. Individuals with a "crowded" optic disc may be at increased risk for vision issues.

• Hearing Loss: Some individuals have reported hearing loss, tinnitus, or dizziness while taking Stendra (avanafil). If you experience changes in hearing, contact your healthcare provider or seek emergency care promptly.

• Contraindications: Do not use Stendra (avanafil) if you are taking soluble guanylate cyclase (sGC) stimulators like riociguat or nitrate medications due to the potential for serious health risks.

Review this information and discuss any concerns with your healthcare provider to ensure safe and effective use of Stendra (avanafil).

When taking this medication, some common side effects may include headache, flushing, stuffy nose, sore throat, runny nose, back pain, and symptoms similar to a common cold. These effects are generally mild and should not cause alarm. However, if they persist or worsen, it is advisable to consult a healthcare provider.

Other potential side effects that have been reported include high blood pressure, nausea, stomach upset, constipation, and rash. These are less common but should still be monitored. If you experience any of these, especially if they are severe, contact your healthcare provider.

There are rare but serious side effects associated with this medication that require immediate medical attention. These include a painful or prolonged erection lasting more than four hours, sudden vision loss in one or both eyes, sudden hearing loss, and symptoms of dangerously low blood pressure such as feeling faint, dizziness, blurry vision, or confusion. If any of these occur, seek urgent medical care.

Additionally, a very serious allergic reaction is rare but possible. Symptoms might include rash, severe dizziness, itching/swelling of the face, tongue, or throat, and trouble breathing. In such cases, stop taking the medication and seek immediate medical help. Always be vigilant for any side effects not listed here and discuss them with your healthcare provider.

When taking Stendra (Avanafil), it's important to be aware of potential interactions with other medications. Avanafil can significantly lower blood pressure if combined with nitrates, leading to dizziness, fainting, or in rare cases, heart attack or stroke. Avoid using avanafil with any nitrates, such as Nitroglycerin, isosorbide dinitrate, Isosorbide Mononitrate, or recreational drugs known as "poppers" (amyl or butyl nitrite). Additionally, if you are on alpha blockers like Doxazosin or Tamsulosin for conditions such as an enlarged prostate or high blood pressure, your doctor may need to adjust your avanafil dosage to prevent excessive drops in blood pressure.

Certain medications can interfere with how avanafil is processed in your body, potentially altering its effectiveness. These include drugs like Itraconazole, Ketoconazole, Clarithromycin, and Ritonavir, among others. It is crucial to inform your doctor about all medications and supplements you are taking to manage any potential interactions effectively.

Finally, do not use avanafil with other erectile dysfunction treatments or medications for pulmonary hypertension, such as Sildenafil, Tadalafil, or Vardenafil, to avoid adverse effects. Always consult your healthcare provider for personalized advice before starting or stopping any medication.