Drug interactions
Avanafil + Nitroglycerin sublingual
Severity: Contraindicated
Avanafil and Nitroglycerin sublingual: contraindicated 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
Avanafil enhances the vasodilatory effect of sublingual nitroglycerin, risking severe hypotension and syncope. Emergency use of nitroglycerin for angina soon after avanafil is hazardous.
What this interaction means in plain words
Avanafil and Nitroglycerin sublingual are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Nitrates raise cGMP while avanafil blocks its breakdown by PDE5, causing additive vasodilation.
What to do
Do not use together; do not give nitrates within 12 hours of avanafil. Patients with chest pain after a dose should seek emergency care and disclose avanafil use.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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
Frequently asked questions
Can I take Avanafil with Nitroglycerin sublingual?
MediHelp rates the interaction as contraindicated. Avanafil and Nitroglycerin sublingual are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Avanafil enhances the vasodilatory effect of sublingual nitroglycerin, risking severe hypotension and syncope. Emergency use of nitroglycerin for angina soon after avanafil is hazardous.
How serious is the interaction between Avanafil and Nitroglycerin sublingual?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not use together; do not give nitrates within 12 hours of avanafil. Patients with chest pain after a dose should seek emergency care and disclose avanafil use.
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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