Drug interactions
Avanafil + Fluconazole
Severity: Major
Avanafil and Fluconazole: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fluconazole is a moderate CYP3A4 inhibitor and lowers the clearance of avanafil, which is mainly metabolized by CYP3A4. Higher avanafil exposure raises the risk of adverse effects such as hypotension, flushing, headache and priapism.
What this interaction means in plain words
Avanafil and Fluconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Avanafil belongs to Genitourinary; Fluconazole belongs to Anti Fungals.
Why it happens
Inhibition of CYP3A4-mediated metabolism of avanafil by fluconazole increases its systemic exposure.
What to do
Limit avanafil to 50 mg, no more than once every 24 hours, while fluconazole is taken. Monitor for hypotension and prolonged erection.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Avanafil
- Amyl nitrite + Avanafil Contraindicated
- Atazanavir + Avanafil Contraindicated
- Avanafil + Clarithromycin Contraindicated
- Avanafil + Conivaptan Contraindicated
- Avanafil + Darunavir Contraindicated
- Avanafil + Fosamprenavir Contraindicated
Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Frequently asked questions
Can I take Avanafil with Fluconazole?
MediHelp rates the interaction as major. Avanafil and Fluconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Fluconazole is a moderate CYP3A4 inhibitor and lowers the clearance of avanafil, which is mainly metabolized by CYP3A4. Higher avanafil exposure raises the risk of adverse effects such as hypotension, flushing, headache and priapism.
How serious is the interaction between Avanafil and Fluconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit avanafil to 50 mg, no more than once every 24 hours, while fluconazole is taken. Monitor for hypotension and prolonged erection.
What other medicines interact with Avanafil?
MediHelp also lists interactions of Avanafil with, for example, Amyl nitrite, Atazanavir, Clarithromycin. The full list is on the Avanafil page.
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