Medical Review by Jennie Stanford, MD, FAAFP, DipABOM
Summary
- Stendra® may not be suitable for everyone. It may not be recommended for people with heart conditions, abnormal blood pressure, or vision issues like NAION.
- Stendra® can dangerously interact with nitrates, alpha-blockers, CYP3A4 inhibitors, and some blood pressure medications.
- Avoid combining Stendra® with other ED treatments. There’s limited research on safety when combined with other ED therapies, so it’s not recommended.
- Always discuss your medical history and current medications with your provider to ensure Stendra® is safe for you.
Stendra® can help many men with ED—but it’s not for everyone
Stendra® is a popular medication for erectile dysfunction (ED) in men—but like all medications, it’s only approved for use in specific ways, and it may not be right for everyone. If you’re planning to talk to your healthcare provider about whether Stendra® is right for you, it helps to be aware of some important information about this drug beforehand.
Lemonaid Health can help. Below, we explore the different reasons why you might choose not to take Stendra® for ED and provide some alternatives so that you can work with your healthcare provider to create a safe and effective treatment plan.
Medical conditions that increase Stendra’s risks
Stendra® is a branded form of the PDE5 inhibitor avanafil, which is FDA-approved for treating ED in men. However, it can have unwanted effects if people with specific medical conditions take it. Your healthcare provider will ask questions about your health status and medical history before issuing you a prescription for Stendra®, but it still helps to make yourself aware of these risks so that you can communicate clearly with them.
The following risks are all mentioned in the patient information for Stendra®. Read it in full to learn more.
Heart conditions
Your healthcare provider might not recommend Stendra® if you have pre-existing heart conditions or cardiovascular risk factors. That’s because heart problems can increase your cardiac risk during sex. Before prescribing you Stendra®, your provider may ask questions about your cardiovascular health to make sure having sex will not be a significant risk to your health and safety.
Abnormal blood pressure
Stendra® is a vasodilator, which means it dilates your blood vessels or prevents them from contracting. This causes your blood pressure to drop and increases blood flow, which can be dangerous if you have a condition that makes your blood pressure difficult to regulate.
Low blood pressure can increase your risk of heart attack or stroke. It’s vital that you are upfront and honest with your healthcare provider about any medical conditions that could affect your blood pressure so they can make accurate decisions about whether Stendra® is appropriate for you.
NAION
Non-arteritic anterior ischemic optic neuropathy (NAION) is a condition that may cause sudden vision loss in one or both eyes. It is rare but can cause permanent blindness.
The patient information for Stendra® states that you may be at increased risk of NAION if you have already experienced it in one eye—and some people taking PDE5 inhibitors like Stendra® have also suffered from this condition, although there is no direct evidence showing that the medication causes it directly.
Still, your healthcare provider may try to find out if you have any risk factors for NAION before prescribing Stendra® to you—and you should exercise caution with this medication if you have already had NAION at some point in your lifetime.
Risk factors for priapism
Priapism is a condition where you experience a painful erection lasting more than 4 hours. It is considered a medical emergency and requires urgent in-person treatment by a qualified practitioner.
Although rare, priapism is one of the potential serious side effects of PDE5 inhibitors like Stendra®. For this reason, Stendra® may not be recommended if you have other conditions that may increase your risk for priapism, such as:
- Sickle cell anemia
- Multiple myeloma
- Leukemia
How other medications can interact with Stendra®
Stendra® might also have adverse reactions by interacting with certain other medications, so your healthcare provider will need to review any medications you’ve recently taken before they can prescribe it to you.
Here are the main medications that the patient information for Stendra® warns to avoid, along with details on how Stendra® can interact with them:
Nitrates
Nitrates are often used as a treatment for chest pain and certain heart conditions like angina. These medications also dilate your blood vessels—so combining them with Stendra® can make your blood pressure drop to dangerous levels. You could get dizzy, faint, or even suffer a heart attack.
If you have taken nitrates recently, your healthcare provider may not recommend starting Stendra® until they have left your system completely. If you need to take nitrates while on Stendra®, you should wait at least 12 hours after your most recent Stendra® dose and only take the nitrates under close medical supervision, following the guidance of a qualified medical professional.
CYP3A4 inhibitors
CYP3A4 is a gene that plays an important role in metabolizing many different drugs and other substances in the body, including Stendra®. Any drug that blocks this gene may therefore cause levels of Stendra® to build up in your bloodstream beyond the levels that are generally considered safe.
Depending on the type and strength of any CYP3A4 inhibitor you are taking, your healthcare provider may recommend a lower dose of Stendra® or not recommend it at all. Patients taking strong CYP3A4 inhibitors should avoid using Stendra®, while those taking moderate ones may be advised to take no more than 50mg every 24 hours.
Alpha-blockers & other blood pressure medications
Alpha-blockers are a kind of medication commonly used to treat high blood pressure and some prostate problems. Some alpha-blockers lower your blood pressure, so taking them along with Stendra® may cause your blood pressure to drop to dangerous levels (similar to what happens if you take them with nitrates).
Some other medications for high blood pressure can also cause a similar effect, so it’s very important to be clear with your provider about any medications you might be taking if you are considering asking them about Stendra®.
While it may sometimes be possible to take Stendra® on these medications, caution should be used and your healthcare provider will most likely prescribe a lower dosage (50mg) if they prescribe Stendra® to you at all.
Other PDE5 inhibitors & ED therapies
The label for Stendra® states that there has not been enough research about combining it with other ED treatments to know how safe or effective this practice might be. Because of this, taking Stendra® with other medications or ED therapies is not recommended. Never experiment with any treatments for ED that have not been approved by your primary care provider.
Alcohol
Like nitrates, alpha-blockers, and other medications discussed above, alcohol is another vasodilator. It lowers your blood pressure after you drink it (although it causes your blood pressure to increase later, which can contribute to other health problems).
For this reason, it’s important to be cautious about consuming alcohol after taking Stendra®. Having more than 3 standard drinks in your system at the same time as Stendra® can have unwanted health effects, including:
- An increased heart rate
- A drop in blood pressure
- Dizziness
- Headache
Allergies & sensitivities
It’s possible to have an allergic reaction to Stendra®, although this doesn’t happen to most people. The most common symptoms of an allergic reaction to avanafil include:
- Skin conditions (rash, hives, itching, redness, swelling, blistered or peeling skin that may come with a fever)
- Respiratory conditions (wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness)
- Swelling (of the mouth, face, lips, tongue, or throat)
Consulting a healthcare provider before taking Stendra® is the best way to identify whether you might have an allergy to any of its ingredients. This can help you avoid potentially dangerous allergic reactions.
Alternatives to Stendra®
Stendra is just one popular PDE5 inhibitor. Other options include:
- Sildenafil (generic of Viagra®)
- Tadalafil (generic of Cialis® and Cialis® Daily)
Learn more about taking Stendra® with Lemonaid Health
Stendra® helps many men overcome the challenges of ED, but using it responsibly means knowing the risks and trusting your healthcare provider to recommend alternatives if they are better suited for your needs.
To learn more about Stendra®, get started with Lemonaid. Our US-based healthcare professionals can answer your questions about Stendra® and other ED treatments, and may be able to prescribe appropriate medication if clinically indicated.
Stendra® is a registered trademark of Vivus, Inc. Viagra® is a registered trademark of Pfizer, Inc. Cialis® is a registered trademark of Lilly ICOS LLC.
