Drug reference

Avanafil

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 880, 881

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Erectile dysfunction ▶BY MOUTH ▶Adult: Initially 100 mg, to be taken approximately 15–30 minutes before sexual activity, then adjusted according to response to 50–200 mg (max. per dose 200 mg), to be taken as a single dose as needed; maximum 1 dose per day Erectile dysfunction in patients on alpha-blocker therapy ▶BY MOUTH ▶Adult: Initially 50 mg, to be taken approximately 15–30 minutes before sexual activity, then adjusted according to response to 50–200 mg (max. per dose 200 mg), to be taken as a single dose as needed; maximum 1 dose per day

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Dose Adjustments

DUE TO INTERACTIONS ▶Manufacturer advises max. 100 mg once every 48 hours with concurrent use of moderate inhibitors of CYP3A4.

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Contra Indications

Avoid if systolic blood pressure below 90 mmHg (no information available). blood pressure >170/100 mmHg. hereditary degenerative retinal disorders. history of non-arteritic anterior ischaemic optic neuropathy. life-threatening arrhythmia in previous 6 months. mild to severe heart failure. patients in whom vasodilation or sexual activity are inadvisable. recent history of myocardial infarction. recent history of stroke. recent unstable angina

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Cautions

Active peptic ulceration. anatomical deformation of the penis (e.g. angulation, cavernosal ﬁbrosis, Peyronie’s disease). bleeding disorders. cardiovascular disease. left ventricular outﬂow obstruction. predisposition to priapism (e.g. in sickle-cell disease, multiple myeloma, or leukaemia) CAUTIONS, FURTHER INFORMATION ▶Elderly For phosphodiesterase type-5 inhibitors, prescription potentially inappropriate (STOPP criteria) in severe heart failure characterised by hypotension i.e. systolic blood pressure less than 90 mmHg, or concurrent nitrate therapy for angina (risk of cardiovascular collapse). See also Prescribing in the elderly p. 33.

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National Funding Access Decisions

Scottish Medicines Consortium (SMC) decisions SMC No. 980/14 The Scottish Medicines Consortium has advised (September 2015) that avanaﬁl (Spedra ®) is not recommended for use within NHS Scotland, for treatment of erectile dysfunction in men as the clinical and economic analysis presented was not sufﬁciently robust. All Wales Medicines Strategy Group (AWMSG) decisions AWMSG No. 1261 The All Wales Medicines Strategy Group has advised (July 2015) that avanaﬁl (Spedra ®) is recommended as an option for use within NHS Wales for the treatment of erectile dysfunction in men. NHS restrictions Spedra ® is not prescribable in NHS primary care for the treatment of erectile dysfunction except in men who meet the criteria listed in part XVIIIB of the Drug Tariff. The prescription must be endorsed ’SLS’. For more information see Prices in the BNF, under How to use the BNF.

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Safety

Interactions

→Appendix 1: phosphodiesterase type-5 inhibitors

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Side Effects

▶Common or very common Headaches. nasal complaints. vasodilation ▶Uncommon Asthenia. dizziness. drowsiness. dyspnoea exertional. gastrointestinal discomfort. muscle complaints. nausea. pain. palpitations. respiratory disorders. vision blurred. vomiting ▶Rare or very rare Akathisia. angina pectoris. chest pain. diarrhoea. dry mouth. emotional disorder. gastritis. genital pruritus. gout. haematuria. hypertension. increased risk of infection. inﬂuenza like illness. insomnia . penis disorder. peripheral oedema. rash. seasonal allergy . sexual dysfunction. tachycardia. urinary frequency increased. weight increased

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Hepatic Impairment

Manufacturer advises avoid in severe impairment. Dose adjustments Manufacturer advises use lowest effective initial dose in mild to moderate impairment and adjust according to tolerance.

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Renal Impairment

Avoid if eGFR less than 30 mL/minute/1.73 m2.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Tablet ▶Spedra (A. Menarini Farmaceutica Internazionale SRL) Avanafil 50 mg Spedra 50mg tablets | 4 tablet P £10.94 DT = £10.94 | 8 tablet P £19.70 DT = £19.70 Avanafil 100 mg Spedra 100mg tablets | 4 tablet P £14.08 DT = £14.08 | 8 tablet P £26.26 DT = £26.26 Avanafil 200 mg Spedra 200mg tablets | 4 tablet P £21.90 DT = £21.90 | 8 tablet P £39.40 DT = £39.40

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Clinical care

Patient And Carer Advice

Onset of effect may be delayed if taken with food.

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Dose text by age group

Adult

Initially 100 mg, to be taken approximately

First-line fragment. Read the complete Indications and Dose section above.

PDF page 880

Adult

Initially 50 mg, to be taken approximately

First-line fragment. Read the complete Indications and Dose section above.

PDF page 880

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Avanafil

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 880, 881

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 880

Dose Adjustments

DUE TO INTERACTIONS ▶Manufacturer advises max. 100 mg once every 48 hours with concurrent use of moderate inhibitors of CYP3A4.

PDF page 880

Contra Indications

PDF page 880

Cautions

PDF page 880

National Funding Access Decisions

PDF page 881

Safety

Interactions

→Appendix 1: phosphodiesterase type-5 inhibitors

PDF page 880

Side Effects

PDF page 880

Hepatic Impairment

Manufacturer advises avoid in severe impairment. Dose adjustments Manufacturer advises use lowest effective initial dose in mild to moderate impairment and adjust according to tolerance.

PDF page 881

Renal Impairment

Avoid if eGFR less than 30 mL/minute/1.73 m2.

PDF page 881

Dose and formulations

Medicinal Forms

PDF page 881

Clinical care

Patient And Carer Advice

Onset of effect may be delayed if taken with food.

PDF page 881

Dose text by age group

Adult

Initially 100 mg, to be taken approximately

First-line fragment. Read the complete Indications and Dose section above.

PDF page 880

Adult

Initially 50 mg, to be taken approximately

First-line fragment. Read the complete Indications and Dose section above.

PDF page 880

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.