|Drug class||PDE5 inhibitor|
|Main uses||Erectile dysfunction|
|Side effects||Headache, flushing, stuffy nose, back pain|
|Onset of action||Within 15 min|
|Duration of action||2 hr|
|Typical dose||50 to 200 mg|
|Chemical and physical data|
|Molar mass||483.96 g·mol−1|
|3D model (JSmol)|
Avanafil, sold under the brand names Stendra and Spedra, is medication used to treat erectile dysfunction. It is taken by mouth. Effects generally begin within 15 minutes and last for up to 2 hours.
Common side effects include headache, flushing, stuffy nose, and back pain. Other side effects may include priapism, vision loss, and hearing loss. It should not be used with nitrovasodilator. It should also be avoided in people with significant liver or kidney problems. It is a PDE5 inhibitor and works by blocking the phosphodiesterase enzyme, thus increasing levels of cyclic guanosine monophosphate (cGMP).
Avanafil was approved for medical use in the United States in 2012 and Europe in 2013. In the United Kingdom 4 pills of 100 mg costs the NHS about £14 as of 2021. This amount in the United States is about 210 USD.
It is taken at a dose of 100 mg about 15 minutes before sex.
Mechanism of action
Avanafil acts by inhibiting a specific phosphodiesterase type 5 enzyme found in various body tissues, primarily in the corpus cavernosum penis. Other similar drugs are sildenafil, tadalafil and vardenafil. The advantage of avanafil is that it has very fast onset of action compared with other PDE5 inhibitors. It is absorbed quickly, reaching a maximum serum concentration in about thirty to forty-five minutes.
Avanafil can be synthesized from a benzylamine derivative and a pyrimidine derivative:
It was invented at Mitsubishi Tanabe Pharma, formerly known as Tanabe Seiyaku Co., and licensed to Vivus Inc., which partnered with Menarini Group to commercialise Spedra in over forty European countries, Australia, and New Zealand. Metuchen Pharmaceuticals obtained exclusive rights within the United States.
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