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What should I discuss with my healthcare provider before taking avanafil?

You should not take avanafil if you are allergic to it. Avanafil should not be used together with nitrate medication, such as nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking avanafil with a nitrate medicine for chest pain or heart problems can cause a sudden and serious decrease in blood pressure.

To make sure you can safely take avanafil, tell your doctor if you have any of these other conditions:

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• liver disease;

• kidney disease (or if you are on dialysis);

• a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;

• a bleeding disorder such as hemophilia;

• a stomach ulcer;

• retinitis pigmentosa (an inherited condition of the eye) or a history of vision loss;

• a physical deformity of the penis (such as Peyronie's disease); or

• if you have been told you should not have sexual intercourse for health reasons.

Avanafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking a similar medication called sildenafil (Viagra). Most of these people also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.

It is not clear whether avanafil could cause vision loss. Stop using avanafil and get emergency medical help if you have sudden vision loss. FDA pregnancy category C. Avanafil is not for use in women. It is not known whether avanafil will harm an unborn baby. Although avanafil is not for use in women, it is not known if this medication passes into breast milk or if it could harm a nursing baby.

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