Stendra (Avanafil)

Name: Stendra
Brand: A Menarini Farmaceutica Internazionale SRL
SKU: 6875
Availability: InStock

Type

Product

Manufacturer

Country

Dosage

Qty-Price (USD)

Type:

Product: Stendra Tablet

Manufacturer: A Menarini Farmaceutica Internazionale SRL

Country: United Kingdom

Dosage: 50 mg

Qty-Price (USD):

Type:

Product: Stendra Tablet

Manufacturer: A Menarini Farmaceutica Internazionale SRL

Country: United Kingdom

Dosage: 100 mg

Qty-Price (USD):

Type:

Product: Stendra Tablet

Manufacturer: A Menarini Farmaceutica Internazionale SRL

Country: United Kingdom

Dosage: 200 mg

Qty-Price (USD):

Generic Equivalent of Stendra

Type

Product

Manufacturer

Country

Dosage

Qty-Price (USD)

Type:

Product: Avanafil (Avanair - Cipla)

Manufacturer: Generic

Country: India

Dosage: 200 mg

Qty-Price (USD):

Stendra Information

medically reviewed by Dr. HaVy Ngo, Pharmacist on June 11, 2025.

Stendra and Avanafil at CanadaPharmacyOnline.com

Brand Stendra, manufactured by A Menarini Farmaceutica Internazionale SRL, is available in the United Kingdom.

Generic avanafil is sourced from manufacturers that meet applicable regulatory standards. The specific manufacturer of your dispensed medication may vary.

Important Information about Generic Avanafil:

Generic avanafil contains the same active ingredient as the brand-name Stendra, and meets the same effectiveness, safety, and quality standards. This means it is designed to work in the same way as Stendra. While specific bioequivalence studies are conducted to ensure generic medications have comparable absorption rates and overall effects, individual responses to any medication can vary. Talk to your doctor or pharmacist if you have any questions about using generic avanafil.

For information about generic drug approval and bioequivalence, please visit the FDA website: https://www.fda.gov/drugs/buying-using-medicine-safely/generic-drugs

Dosage:

Brand Stendra is commonly available in the strengths of 50 mg, 100 mg, and 200 mg oral tablets.

Generic avanafil is only available in 200 mg oral tablets (at this pharmacy).

Your doctor will determine the appropriate dose and treatment duration based on your individual needs and medical condition.

Usage:

Brand Stendra (avanafil) is a prescription medication used to treat erectile dysfunction (ED) or impotence.

For more information, refer to the product labeling information: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/202276s000lbl.pdf.

Mechanism of Action:
Stendra (avanafil) works by targeting a specific enzyme in the penis called PDE5. When you become sexually aroused, your body naturally releases a substance called nitric oxide, which helps to relax the blood vessels in the penis, allowing more blood to flow in and create an erection. Stendra helps by preventing the PDE5 enzyme from breaking down another important chemical, cGMP, which is crucial for this blood vessel relaxation. By preserving cGMP, Stendra allows for increased blood flow to the penis, making it easier to get and keep an erection during sexual activity. It's important to remember that Stendra doesn't cause an erection on its own; sexual stimulation is still necessary for it to work effectively.

Use Stendra exactly as your doctor prescribes. Do not change your dosage or stop using the medication without consulting your doctor. Follow the instructions on Avanafil (Stendra) – Uses, Side Effects, and more | WebMD.com. Consult your doctor for personalized guidance and safe use.

The information below summarizes some, but not all, potential side effects, risks, and interactions. Before taking Stendra, it is essential to discuss all possible aspects with your doctor or pharmacist.

Side Effects:

The information below is a partial list of side effects; individual reactions can vary. Before starting Stendra, it is crucial to discuss potential side effects and risks with your doctor or pharmacist.

Common side effects: These are examples of some common side effects of Stendra, but others are possible. Contact your doctor promptly if any side effects are persistent, worsening, or concerning, or if you experience any other concerning symptoms.
• Back pain: Some individuals report mild back pain, though the exact reason is not fully understood.
• Diarrhea.
• Dizziness: It can occur due to the widening of blood vessels.
• Flushing: A feeling of warmth or redness in the face, neck, or chest.
• Headache: This is the most frequently reported side effect due to the widening of blood vessels.
• Indigestion or upset stomach.
• Nasal congestion: A stuffy or runny nose, sometimes described as cold-like symptoms.
• Sore throat.

Serious or rare side effects: Stop taking Stendra and seek immediate medical attention if you experience any of the following:
• Chest pain or symptoms of a heart attack: Pain or tightness in the chest, arms, neck, or jaw, shortness of breath, nausea, or lightheadedness, particularly during sexual activity.
• Priapism (prolonged erection): An erection lasting longer than 4 hours, especially if painful, requires immediate medical attention to prevent permanent damage to the penis.
• Severe allergic reaction: Signs may include hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
• Severe low blood pressure (hypotension): Symptoms can include dizziness, faintness, blurred vision, or sweating when getting up suddenly. This risk is higher if Stendra is taken with certain other medications, especially nitrates.
• Sudden decrease or loss of hearing: This may be accompanied by ringing in the ears (tinnitus) and dizziness.
• Sudden vision loss: This can occur in one or both eyes and may be a sign of a serious eye condition called Non-Arteritic Ischemic Optic Neuropathy (NAION).

Contraindications:

This is not an exhaustive list of contraindications. It is crucial to discuss all your medical conditions, past and present, and all medications you are taking with your doctor or pharmacist before starting Stendra.

Stendra should not be used if:
• Concomitant Use with Guanylate Cyclase (GC) Stimulators: Medications like riociguat (Adempas) or vericiguat (Verquvo), which are used to treat pulmonary hypertension, also affect the nitric oxide/cGMP pathway. Combining Stendra with these GC stimulators can lead to dangerously low blood pressure.
• Hypersensitivity/Allergy: Stendra is contraindicated in patients with a known hypersensitivity or allergic reaction to avanafil or any of the other components in the Stendra tablet.
• Severe Hepatic Impairment: Stendra is contraindicated in patients with severe hepatic impairment (Child-Pugh Class C) for similar reasons regarding safety and efficacy.
• Severe Renal Impairment: Stendra is contraindicated in patients with severe renal impairment (creatinine clearance less than 30 mL/min) because its safety and efficacy have not been established in this group.
• Use of Nitrates: This is the most critical contraindication. Stendra significantly potentiates the hypotensive (blood pressure-lowering) effects of organic nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate), which are often used to treat chest pain (angina) or other heart conditions. The combination can lead to a sudden, severe, and potentially fatal drop in blood pressure. This applies to any form of organic nitrate, whether regularly or intermittently used, including recreational "poppers" (amyl nitrite/butyl nitrite).

Tell your doctor about all your medical conditions, past and present, before starting Stendra. This is crucial because certain conditions can affect whether Stendra is right for you. These conditions may include, but are not limited to:
• Alpha-Blockers: While not an absolute contraindication, caution is advised when Stendra is co-administered with alpha-blockers (used for high blood pressure or prostate enlargement) due to the risk of additive hypotensive effects, potentially leading to symptomatic low blood pressure (dizziness, lightheadedness, fainting). If co-administered, Stendra should be initiated at the lowest dose (50 mg) in patients on stable alpha-blocker therapy.
• Anatomical Deformation of the Penis or Predisposition to Priapism: Patients with conditions like angulation, cavernosal fibrosis, Peyronie's disease, sickle cell anemia, multiple myeloma, or leukemia should use Stendra with caution due to the increased risk of priapism (prolonged erection).
• Cardiovascular Conditions: Stendra should not be used in men for whom sexual activity is medically inadvisable due to their underlying cardiovascular status. This includes conditions like:
o Recent myocardial infarction (heart attack) or stroke (within the last 6 months).
o Life-threatening arrhythmia.
o Unstable angina or angina occurring during sexual intercourse.
o Resting hypotension (blood pressure < 90/50 mmHg) or uncontrolled hypertension (blood pressure > 170/100 mmHg).
o New York Heart Association Class II or greater congestive heart failure.
o Left ventricular outflow obstruction (e.g., aortic stenosis, idiopathic hypertrophic subaortic stenosis).
• History of NAION: Patients who have experienced non-arteritic ischemic optic neuropathy (NAION) in one eye should use Stendra with caution, as it is not clear whether PDE5 inhibitors are a direct cause or a risk factor for recurrence.
• Strong CYP3A4 Inhibitors: Stendra is metabolized by the CYP3A4 enzyme. Co-administration with strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir, atazanavir, clarithromycin, indinavir, telithromycin, nelfinavir, saquinavir) is generally contraindicated or strongly not recommended as it can significantly increase avanafil levels, increasing the risk of side effects.

Drug Interactions:

Before taking Stendra, it is essential to discuss all potential risks and interactions with your doctor or pharmacist. For complete and up-to-date information, refer to the Mayo Clinic: https://www.mayoclinic.org/drugs-supplements/avanafil-oral-route/description/drg-20075594.

• Alcohol: Excessive alcohol consumption (e.g., more than three units) while taking Stendra can increase the risk of orthostatic hypotension (a drop in blood pressure upon standing), leading to symptoms like dizziness, headache, and increased heart rate, as both alcohol and Stendra are vasodilators.
• Alpha-Blockers: These medications (e.g., alfuzosin, doxazosin, prazosin, tamsulosin, terazosin) are often prescribed for high blood pressure or an enlarged prostate. Both Stendra and alpha-blockers cause blood vessel dilation and can lower blood pressure. When taken together, there's an additive effect that can lead to symptomatic hypotension (dizziness, lightheadedness, fainting). If Stendra is used with an alpha-blocker, it should generally be started at the lowest dose (50 mg) after the patient is stable on their alpha-blocker therapy.
• Certain antibiotics (e.g., clarithromycin, telithromycin)
• Certain antifungals (e.g., ketoconazole, itraconazole)
• Certain HIV protease inhibitors (e.g., ritonavir, atazanavir, indinavir, saquinavir, nelfinavir)
• Grapefruit juice also inhibits CYP3A4 and should be avoided or limited.br> • Guanylate Cyclase (GC) Stimulators (Absolute Contraindication): Medications like riociguat (Adempas) or vericiguat (Verquvo), used for pulmonary hypertension, also interact dangerously with Stendra. Their combined vasodilatory effects can lead to a severe drop in blood pressure.
• Moderate CYP3A4 Inhibitors: These also increase avanafil exposure, though to a lesser extent than strong inhibitors. If co-administered, the dose of Stendra may need to be reduced (e.g., to a maximum of 50 mg once every 24 hours). Examples include:
o Erythromycin
o Aprepitant
o Diltiazem
o Fluconazole
o Fosamprenavir
o Verapamil
• Nefazodone (an antidepressant)
• Nitrates (Absolute Contraindication): This is the most dangerous interaction. Stendra, like other PDE5 inhibitors, significantly enhances the blood pressure-lowering effects of organic nitrates (e.g., nitroglycerin, isosorbide dinitrate, isosorbide mononitrate), which are used to treat chest pain (angina). Combining them can cause a sudden, severe, and potentially fatal drop in blood pressure. This includes both prescribed nitrates and recreational "poppers" (amyl nitrite/butyl nitrite). If nitrate administration is medically necessary in an emergency, at least 12 hours should pass after the last dose of Stendra, and nitrates should only be given under strict medical supervision.
• Other Antihypertensive Medications: Stendra itself is a mild vasodilator and can cause a small decrease in blood pressure. When taken with other medications for high blood pressure (e.g., amlodipine, enalapril), there can be an additive hypotensive effect. While generally not a contraindication, blood pressure monitoring may be advised, and some patients might experience increased dizziness or lightheadedness.
• Other PDE5 Inhibitors: Stendra should not be used with other PDE5 inhibitors (e.g., sildenafil, tadalafil, vardenafil) as this would significantly increase exposure to these drugs and the risk of side effects.
• Strong CYP3A4 Inhibitors: Stendra is primarily broken down in the body by the CYP3A4 enzyme in the liver. Taking Stendra with strong inhibitors of this enzyme can significantly increase the levels of avanafil in your bloodstream, raising the risk of side effects, including severe hypotension (very low blood pressure), fainting, visual changes, and priapism (prolonged erection).

Pregnancy and Breastfeeding:

Stendra (avanafil) is a medication specifically designed to treat erectile dysfunction in men, helping them achieve and maintain an erection during sexual stimulation. It's important to understand that Stendra is not intended for use by women, and therefore, it is not recommended during pregnancy or while breastfeeding.

Use in Children:

Stendra (avanafil) is a medication approved specifically for the treatment of erectile dysfunction in adult men. It is not approved or recommended for use in children under 18 years of age. This is because extensive clinical trials to determine its safety, effectiveness, and appropriate dosing in pediatric patients have not been conducted. As such, potential risks or benefits for children are currently unknown. Always consult your child’s doctor for the most appropriate and safest treatment.

Frequently Asked Questions about Stendra at CanadaPharmacyOnline.com:

Why is Stendra more affordable in Canada than in the United States?

Prescription drug prices, including Stendra, are generally lower in Canada than in the US due to a combination of factors, primarily government price regulations, differing market dynamics, and other economic considerations. In Canada, provincial and federal governments negotiate drug prices with pharmaceutical companies, which often results in lower costs compared to the US, where market forces play a more significant role. For more information, see the FAQs on Prescription Drug Importation from the Kaiser Family Foundation (KFF): https://www.kff.org/health-costs/issue-brief/faqs-on-prescription-drug-importation/

How do I order from your pharmacy?

Ordering from us is very simple. You can purchase online or call Customer Service at 1866.920.3784; for more information or to learn about the ordering process, visit our How to Order page.

Is there a generic for Stendra?

Yes, there is a generic alternative for this product, called Avanafil.

Can I buy over the counter from you?

No, Stendra requires a valid prescription from your doctor. We do not sell this product without a valid prescription.

Is there a limit on how many Stendra I am allowed to order at one time?

CanadaPharmacyOnline.com can only dispense a maximum of a three-month supply of Stendra at one time, as per your doctor's prescription.

Blog Post

Your Problems in Bed Might Be Psychological Erectile Dysfunction

News:

ED is Not Just a Bedroom Problem (article published on May 30, 2025)

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The information on this page is sourced from independent third parties contracted by CanadaPharmacyOnline. While we cannot guarantee its medical accuracy, we strongly recommend consulting a healthcare professional for personalized advice regarding medications or medical conditions.

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