Avana relates to a new generation of phosphodiesterase type 5 (PDE5) inhibitors, a drug with an erectogenic effect. Erectogenic means a pharmacological action that promotes blood circulation in the penis when aroused. The active ingredient is Avanafil. Available in dosages 50, 80, 100, 200, and 260 mg. Avana is specific for cyclic guanosine monophosphate (cGMP). The drug blocks the enzyme phosphodiesterase type 5 (PDE-5), thereby accumulating cGMP, which leads to relaxation of smooth muscles and blood flow to the penis. With intimacy, the cavernous cylinders are filled with blood, the penis increases in size and the drug's action occur only during sexual arousal, as an enzyme controls it. The drug allows you to maintain a man's potency during intercourse effectively and, unlike its predecessors, causes side effects much less often. One of the advantages of Avana is the speed of the onset of the effect - for most men, it is 15 minutes.
Avanafil is taken orally, after which it is immediately absorbed. It should be noted that fatty foods increase the period of onset of the drug's pharmacological action, reducing its absorption. It is recommended to be taken on an empty stomach. The effect of Avana is observed after half an hour. Maximum concentration occurs within 30-45 minutes. It binds to proteins, is actively metabolized by the CYP 3A4 and CYP 2C9 systems. The main metabolites are M4 and M16. Half-life from 6 to 18 hours. It is excreted with feces - more than 62%, with urine - about 21%. Systematic intake within a week 2 times a day at a dosage of 200 mg does not accumulate.
Avana is used to treat erectile dysfunction (impotence) in men. Namely: complete and partial lack of erection, short duration, insufficient blood supply to the penis, rapid sexual intercourse. The drug is taken from the age of 18. There are no restrictions for older adults.
Avana is recommended to be taken 30 minutes before the planned intercourse on an empty stomach.
The frequently prescribed dose is 100 mg once a day. It is allowed to increase up to 200 mg, but no more. Recommended to start with 50 mg, and if this dosage works, no increase is required. The effect of the drug is observed only with sexual stimulation.
Because of the spread of the cGMP-specific enzyme PDE5, which is influenced by the drug, in the human body, especially the cavernous body, retina, the following side effects can be observed: blurred vision, nasal congestion or dry nose, dry mouth, facial flushing, premature ejaculation, headache, dizziness. Allergic reactions - rash, increased blood pressure, tachycardia, heart pain, myalgia, the heat of passion, insomnia, Etc. Avana was approved by the FDA in 2012 and is still undergoing adverse drug studies for quality control and risk/benefit assessment. Medical professionals who report adverse drug effects are asked to write a case description through the national reporting system.
No cases of overdose have been identified. However, increasing the dosage to 800 mg/day in trials with volunteers increased the frequency and severity of side effects. If necessary, it is recommended to take standard measures of supportive therapy. Hemodialysis was not effective due to the binding of the drug to plasma proteins. Gastric lavage is ineffective because of very rapid absorption into the bloodstream.
• Avana is not used in men under the age of 18. • The sensitivity of the body to the active substance, as well as to the auxiliary components of the drug. • Men undergoing treatment for unstable angina pectoris, coronary artery disease, life-threatening arrhythmias, refractory arterial hypertension, as well as hypotension, taking drugs from the nitrate groups and nitric oxide donors. • Patients with a history of myocardial infarction, stroke in the last 6 months. • Groups of people who have problems with the gastrointestinal tract, namely, gastric ulcer, duodenal ulcer. • If you are taking antibiotics and antiviral drugs, you should consult with your doctor. • Simultaneous intake of riociguat
Avanafil enhances the action of nitrates, namely their hypotensive effect. Therefore, it is strictly contraindicated for joint use. If the prescription of nitrates is vital, and Avanafil was taken less than 12 hours ago, special medical supervision is necessary to control the patient's hemodynamics. The risk of developing hypotensive shock is high.
Avanafil has a vasodilating effect, which is one of the mechanisms for lowering blood pressure. Therefore, it is necessary to monitor blood pressure when taking any antihypertensive drugs together carefully.
Drinking alcohol while taking Avana also helps to lower blood pressure.
Avana is metabolized mainly by the CYP3A4 enzyme, being a substrate for it. Therefore, all inhibitors of this enzyme can increase the concentration of the drug in the blood. These include ketoconazole, erythromycin.
CYP450 inducers reduce the effectiveness of Avanafil.
Simultaneous intake of riociguat with Avanafil has a pronounced hypotensive effect.
Before establishing a diagnosis of erectile dysfunction, a thorough health history is necessary before prescribing the drug.
First of all, it is recommended to check the cardiovascular system and assess potential cardiac risks. The drug is a vasodilator, and patients with aortic stenosis may have undesirable effects when used.
Priapism - erection of more than 4 hours can lead to tissue necrosis and potency for life. Diseases predisposing to this condition: sickle cell anemia, myeloma, acute and chronic leukemia. Patients who experience a state of priapism while using the medication need urgent medical assistance.
Avana must be prescribed with caution for patients with visual impairment. In some cases, Avana has adverse effects on vision, namely anterior non-arteritic ischemic neuropathy.
The drug potentiates the antiplatelet effect of platelets when used with sodium nitroprusside in doses exceeding therapeutical.
In case of ringing in the ears, sudden hearing impairment, dizziness, you should consult a doctor.
A sexual disorder is not always an erectile dysfunction. It can be a decrease in libido - a violation of attraction to the opposite sex, a violation of ejaculation, or premature ejaculation - all this carries the impossibility of full sexual intercourse. Most often, all genital disorders are concomitants or symptoms of underlying diseases. Impotence means powerless. This term was used in the past, and nowadays, it is not used. It is outdated, inaccurate, and also carries unreasonably condemning stereotypes. Unlike potency, the term dysfunction is temporary and irregular. Many diseases lead to erectile dysfunction, and some of them are irreversible.
2 main groups lead to this pathology: organic, psychogenic.
Organic: hypogonadism, diabetes mellitus, damage to the cerebral cortex, dysfunction of the pituitary gland, thyroid disorders, hyperprolactinemia, urological diseases, dysfunction of the ovaries, neuropathy, vascular diseases, hypothermia, radiation, chemicals, burns, trauma, pelvic surgery, Etc.
Psychogenic: neuroses, neurasthenia, depression, mistrust of a partner, fear of failure.
Other group includes congenital anomalies of the penis and the genitourinary system as a whole.
Erectile dysfunction is also caused by taking medications: antineoplastic, contraceptives, psychotropic drugs, drugs that lower blood pressure, steroids used to increase muscle mass.
All men should know the predisposing factors for the occurrence of erectile dysfunction:
• Excess weight; • Age (statistics get higher after 40); • Frequent depression; • Alcohol abuse; • Smoking; • Drugs; • Physical inactivity; • Lack of vitamins and minerals; • Adverse environmental influences (radiation, chemicals)
Consult a doctor in case of alarming symptoms: a violation of the morning erection, a weak erection and you need long-term stimulation by a partner, a short erection, a decrease in the duration of intercourse, difficulty in the occurrence of sexual arousal, insufficient firmness and density of the penis, leading to a violation of penetration into the reproductive tract of a woman.
Prevention of all diseases starts from a healthy lifestyle: • quitting smoking, alcohol, and drugs, • regular sports activities, • complete nutrition, rich in vitamins and fiber, • taking medications strictly according to the doctor's prescription, • prevent prolonged sexual tension-erection, lead with timely ejaculation • in case of injury to the perineal area - consultation with a urologist.
Complications are primarily associated with sexual dissatisfaction and self-flagellation about this. Men often experience extreme stress if suddenly something did not work out or did not work out the way they wanted. It is one of the strongest psychological traumas, leading to a fall in a man's self-esteem. If erectile dysfunction occurs in men in marriage, there are quarrels, misunderstandings, problems in relationships that lead to the appearance of betrayal and lead to the breakdown of the family. If we talk about the health of a man's body as a whole, then erectile dysfunction leads to infertility, a violation of the human psyche, up to suicide.
Many men, faced with a similar problem, do not hurry to see a doctor. They are afraid of stereotypes, judgments, and ridicule. They take on traditional treatment methods at best or self-medicate with medications, which is even worse. Uncontrolled intake of even the safest "herbs" and tinctures can lead to allergic reactions of varying severity.
Natural and harmless treatment methods include activities of a general health nature: sleep in absolute darkness, sports, prevention of aggravations of chronic diseases, a diet low in fat and high in fiber.
Experts are confident that with special movements, a person can relax, let go of all problems, clear the mind, improve physical fitness, stretch muscles, which have a beneficial effect on the quality of the body and health—most effective in psychogenic dysfunction.
"Music heals" - An expression that everyone hears almost from childhood and for a good reason. Research proves the positive impact of music on mental health, helps cope with stress, improves the internal state, and brings the mind and body into harmony. Favorite, calm music and the sounds of nature will have a qualitative effect on your intimate life.
The world is developing rapidly, additional, new sources of stressful situations appear, and professional and personal responsibility increases. A man keeps everything in himself. Stresses accumulate and soon shoot out where they did not expect. They affect the state of health, including pathology in the genital area. Professional help will help you understand yourself, true problems, hidden fears, complexes, and feelings of shame. Psychotherapy is an effective method used in all stages of dysfunction treatment.
Some substances that enhance sexual desire are called aphrodisiacs. Yohimbine can be distinguished among the officially registered ones. It is a herbal substance that induces sexual desire.
One of the non-traditional methods of treating erectile dysfunction is acupressure of the foot, compression of certain points on the ear. Specific knowledge and skills are required to use these methods. Not all squeezes lead to arousal and affect libido. The procedure should be at least 1 time per day for 3-5 minutes to notice the result. Aromatherapy with oils has proven to be effective, especially if the dysfunction is psychogenic in nature.
All exercises that help improve blood circulation in the pelvic organs: bending forward, rotating the pelvis, running, relaxing and tightening the muscles of the anus, squatting, activating the glutes
Of course, it is best to use all of the above methods in conjunction with the medical recommendations prescribed by the attending physician. The results will be faster, more efficient, and more reliable.
Previously, psychological problems were considered the main cause of erectile dysfunction. Now statistics suggest otherwise. Only 15-20% of men who have erectile dysfunction cases are of the psychological nature of the disease. The remaining 80% have somatic diseases that lead to complications, including erectile dysfunction.Most men do not want to seek specialized help and admit it either to their partner or even to themselves, which refers to constant problems, stress, fatigue, feeling unwell, and headaches. It is not customary to talk about this in society, just as it is not customary to solve problems with a psychologist. Only 10% of men experiencing problems turn to an andrologist, and the remaining 90% claims that everything is fine with them and that these are temporary problems associated with any life situation. Psychologists identify several behavioral reasons that indicate the presence of issues, even if the man himself denies it:
1. Avoiding sexual intercourse by any means; 2. Ignoring a partner in a direct proposal, hints, and conversations about sex; 3. A man is never an initiator.
If the barrier is psychological, then the sexual partner can help to overcome it. If there is a healthy relationship and listening to each other, otherwise only a specialist (sexologist or andrologist) will help cope. If the problem is somatic, then online consultations, hotlines, where doctors anonymously answer all questions regarding the treatment, diagnosis, and clinic of erectile dysfunction, can help decide on an appointment with a doctor.