Before taking avanafil,
tell your doctor and pharmacist if you are allergic to avanafil, any other medications, or any of the ingredients in avanafil tablets. Ask your pharmacist or check the patient information for a list of the ingredients.
do not take avanafil if you are taking or have recently taken riociguat (Adempas) or nitrates such as isosorbide dinitrate (Dilatrate-SR, Isordil, in BiDil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure if any of your medications contain nitrates.
do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking avanafil.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax, in Jalyn), silodosin (Rapaflo), and terazosin; certain antifungal medications such as fluconazole (Diflucan), itraconazole (Onmel, Sporanox), and ketoconazole (Nizoral); aprepitant (Emend); clarithromycin (Biaxin, in Prevpac); diltiazem (Cardizem, Cartia, Tiazac); erythromycin (E.E.S, E-Mycin, Erythrocin); HIV protease inhibitors such as atazanavir (Reyataz, in Evotaz), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), and saquinavir (Invirase); other medications or treatments for erectile dysfunction; medications for high blood pressure; nefazodone; verapamil (Calan, Covera, Verelan, others); and telithromycin (Ketek). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with avanafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor if you have ever been advised by a doctor to avoid sexual activity for medical reasons, if you have had heart surgery within the past 6 months and if you have ever had an erection that lasted longer than 4 hours. Also tell your doctor if you have or have ever had a condition that affects the shape of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease; a heart attack; a stroke; an irregular heartbeat; a blocked artery; angina (chest pain); high or low blood pressure; heart failure; blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); ulcers; bleeding problems; or liver or kidney disease. Also tell your doctor if you have or have ever had retinitis pigmentosa (a rare inherited eye disease) or if you have ever had severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.
you should know that avanafil is only for use in males. Women should not take avanafil, especially if they are or may become pregnant or are breastfeeding. If a pregnant woman takes avanafil, she should call her doctor.
talk to your doctor about the safe use of alcoholic beverages during your treatment with avanafil. If you drink a large amount of alcohol (more than three glasses of wine or three shots of whiskey) while you are taking avanafil you are more likely to experience certain side effects of avanafil such as dizziness, headache, fast heartbeat, and low blood pressure.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking avanafil.
you should know that sexual activity may be a strain on your heart, especially if you have heart disease. If you have chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
tell all your healthcare providers that you are taking avanafil. If you ever need emergency medical treatment for a heart problem, the healthcare providers who treat you will need to know when you last took avanafil.