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Stendra (Avanafil): Review of the new-generation PDE5 inhibitor for ultra-fast action

Stendra is the original, brand-name medication, with the active ingredient Avanafil. It is one of the most modern medications for the treatment of erectile dysfunction (ED), belonging to the PDE5 inhibitor class. Its main distinguishing feature is its ultra-fast onset of action and high selectivity, which ensures a lower risk of certain side effects.

What is Stendra (Avanafil)?

Stendra is a highly selective PDE5 enzyme inhibitor, designed specifically to act faster than its predecessors (Sildenafil, Tadalafil).

1. Indication and dosage

The drug is intended for men who cannot achieve or maintain an erection sufficient for sexual intercourse.

• Standard Dose: 100 mg. This is the recommended starting and therapeutic dose for most men.

• Minimum Dose: 50 mg. Used for patients who require a lower dosage or to reduce the risk of side effects.

• Maximum Dose: 200 mg. Used only in cases where 100 mg proved insufficient, and only after consulting a doctor.

2. Key advantages of Avanafil (Stendra)

Avanafil has two unique pharmacokinetic profiles:

1. Ultra-Fast Start: This is the fastest PDE5 inhibitor. Due to rapid absorption, the effect can begin in as little as 15-20 minutes after intake (compared to 30-60 minutes for other drugs).

2. High Selectivity: Avanafil acts very precisely on PDE5 and has significantly less effect on other PDE types (e.g., PDE6, found in the retina, or PDE11 in muscles).

Detailed mechanism of action of Stendra

The mechanism of action of Stendra is identical to other PDE5 inhibitors.

1. Trigger: Sexual arousal causes the release of nitric oxide (NO).

2. Erectile Cycle: NO stimulates the formation of cyclic GMP (cGMP), which relaxes the smooth muscles of the penile blood vessels, ensuring a powerful blood flow.

3. PDE5 Blockade: Avanafil blocks the enzyme that degrades cGMP. Blocking this enzyme allows cGMP to persist longer, ensuring a stable, firm erection in response to stimulation.

Key takeaway: Stendra provides a rapid "window" of readiness (about 6 hours), but sexual arousal is always required to achieve an erection.

Instructions for using Stendra (100 mg)

Strict adherence to the instructions is necessary for safety and maximum efficacy.

1. Dosage and timing of intake

• Dosage: 100 mg (one tablet) – is the standard single dose.

• Frequency of Intake: Stendra should be taken no more than once per day.

• Method: Swallow the tablet whole with water.

• Timing: Take 15–30 minutes before planned sexual activity.

2. Influence of food and alcohol

• Food: Unlike Sildenafil, taking Stendra with a moderately high-fat meal does not significantly affect the onset of action.

• Alcohol: It is not recommended to combine Avanafil with excessive amounts of alcohol (more than 3 servings), as this can increase the risk of dropping blood pressure and dizziness.

Critical contraindications

The list of contraindications related to the vasodilating effect is strict.

• Interaction with Nitrates: Absolutely forbidden! Taking Stendra with any form of organic nitrates (Nitroglycerin) or nitric oxide donors ("poppers") causes a life-threatening drop in blood pressure.

• Severe Cardiovascular Diseases: Recent heart attack or stroke (within 6 months), severe heart failure, unstable angina.

• Blood Pressure: Persistent hypotension (pressure < 90/50 mmHg) or uncontrolled hypertension.

• Liver and Kidneys: Severe hepatic or renal failure.

Side effects of Avanafil (Stendra)

Thanks to its high selectivity, Avanafil has one of the best safety profiles among all PDE5 inhibitors.

• Common: Headache, facial flushing, nasal congestion.

• Specific: Avanafil very rarely causes visual disturbances ("blue haze") or the back and muscle pain sometimes seen with Sildenafil or Tadalafil.

Immediate medical attention is required for: An erection that lasts longer than 4 hours (priapism), or sudden loss of vision/hearing.

Professional advice on using

1. For Spontaneity: Stendra is the ideal choice for men who value spontaneity and do not want to wait an hour for the drug to take effect.

2. Hydration: To minimize headaches, drinking enough water on the day of intake is recommended.

3. Combinations: Avanafil is often combined with Dapoxetine (e.g., in Super Avana or Top Avana) for the simultaneous treatment of ED and premature ejaculation.

Stendra: Extended Q&A section

• How long does Stendra last? The erection effect lasts about 5-6 hours.

• What is the difference between Avanafil (100 mg) and Sildenafil (100 mg)? Avanafil acts much faster (15-20 min vs 45-60 min) and has a lower risk of side effects related to vision and muscles.

• What should I do if 100 mg did not work? Ensure you took the drug and that there was sufficient sexual stimulation. If the effect is insufficient, consult your doctor about switching to 200 mg.

• Does Stendra prolong sexual intercourse? No. Avanafil is intended only for ED treatment and does not affect the time to ejaculation.