section name header

Pronunciation

av-AN-a-fil

Classifications

Therapeutic Classification: erectile dysfunction agents

Pharmacologic Classification: phosphodiesterase type 5 inhibitors

Indications

REMS


Action

  • Enhances effects of nitric oxide released during sexual stimulation. Nitric oxide activates guanylate cyclase, which produces levels of cyclic guanosine monophosphate (cGMP). cGMP produces smooth muscle relaxation of the corpus cavernosum, which promotes blood flow and subsequent erection. Inhibits the enzyme phosphodiesterase type 5 (PDE5), PDE5 inactivates cGMP.
Therapeutic effects:
  • Enhanced blood flow to the corpus cavernosum and erection sufficient to allow sexual intercourse. Requires sexual stimulation.

Pharmacokinetics

Absorption: Rapidly absorbed following oral administration.

Distribution: Minimal amounts enter semen.

Protein Binding: 99%.

Metabolism/Excretion: Mostly metabolized by the liver (primarily by the CYP3A4 enzyme system), metabolites excreted in feces (62%) and urine (21%). One metabolite had inhibitory activity on PDE5.

Half-Life: 5 hr.

Time/Action Profile

(effect on BP)

ROUTEONSETPEAKDURATION
POwithin 1 hr1–2 hrunknown





Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Derm: flushing

EENT: nasal congestion, nasopharyngitis, sudden hearing/vision loss

GU: priapism

MS: back pain

Neuro: headache, dizziness

Interactions

Drug-drug:

Route/Dosage

Availability

Assessment

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Stendra