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What is Stendra?-Effects, side effects, active ingredients, how to purchase online, etc.-

What is Stendra?

Stendra is said to be the fourth ED treatment after Viagra , Cialis and Levitra .

Originally developed by Tanabe Pharma in USA, in 2012 we transferred development and marketing rights to Vivis in the United States worldwide, except in USA and parts of Asia.

Although it is an unapproved drug in USA, it has already been approved by the FDA (Food and Drug Administration) in the United States in April 2012.
Prescriptions have also started not only in the United States, but also in Europe and South Korea.

It is also called an ED treatment drug for Asians because it was developed by a USA pharmaceutical company .

The main ingredient is avanafil, which, like other ED drugs, works by inhibiting the action of the enzyme PDE5 to support erections and longevity.

“Avanafil” has a quicker effect and a longer duration of effect than other ED treatments, so it can be considered as an improvement drug for Viagra and Levitra.

Since Stendra is still an unapproved drug in USA, it is difficult to obtain official information.
However, some people may be interested in hearing the effect of being a haste type and having a strong effect.

This time, I will introduce this Stendra in an easy-to-understand manner.

History of ED treatment Stendra

As explained at the beginning, Stendra is an ED treatment originally developed by Tanabe Seiyaku in USA, and the main ingredient is “Avanafil”.

However, due to various circumstances, in 2012, all rights except development and sales rights in USA and some parts of Asia were transferred to Vivis Corporation of the United States.

Vivis received FDA approval in February of the same year, and officially launched sales in April.
Due to the exceptional speed, most development would have already been completed by the time the rights were transferred.

Currently, sales have already started in the United States, European countries, and South Korea, and in USA, it is possible to obtain it in the form of “personal import agency”.

In USA, the official approval from the Ministry of Health, Labor and Welfare has not yet been granted, so there is little evidence in USA, and it is difficult to obtain information.

However, compared to other ED drugs, it is said to be more immediate and have fewer side effects, so it can be said that it is a drug that is attracting attention in the future.

Stendra developed by Menarini

Menarini Asia Pacific Holdings is a Singapore-based company.

Under the umbrella of Menarini Group, the world’s largest biopharmaceutical company headquartered in Italy, the group develops therapeutics in a wide range of fields such as diabetes, hematology, clinical chemistry and immunology.

Tanabe Seiyaku Co., Ltd., which was developing Stendra on May 1, 2016, entered into a business alliance with Stendra AP and signed a license agreement to develop and sell an ED treatment drug named “Spedra” in 10 countries in the Asia-Pacific region.

The main component of “Spedra” is “Avanafil” which is the same as Stendra.

Menarini AP has exclusive rights to Avanafil (Spedra) in China, Hong Kong, Macau, Taiwan, Indonesia, Malaysia, the Philippines, Singapore, Vietnam, and Thailand. you will get it.


The content of avanafil in Stendra is classified into three types, “50mg”, “100mg” and “200mg”, and it is sold as a bottle type by Vivis.

The shape is a milky white oval tablet, and the grain size increases according to the avanafil content.

In addition, generics of avanafil have already been released overseas, and if you search for “Stendra” by keyword, many drugs called “Avana” will be hit at the top.

This ” Avana ” is sold by a pharmaceutical company called Sunrise Remedies in India, and the shape is a red triangular tablet.

On the other hand, the aforementioned “spedra” is a white oval tablet.

“Avana” and “Spedra” are sold in boxes with chemicals enclosed in plastic sheets.
The content of avanafil is “50mg”, “100mg” and “200mg” for both Avana and Spedra, just like Stendra.

ED drugs are not taken continuously as internal medicine, but are taken before sexual intercourse when erection is difficult.

For those who do not need to take medicine for every sexual activity, Avana and Spedra are easier to buy and more cost effective than bottle-sold Stendra .


Pharmacology is data that confirms the effects of a drug through various tests (including animal experiments and clinical experiments).

This is the most important data when the Ministry of Health, Labor and Welfare in USA and the FDA in the United States approve it as a drug.
Formally, not only the test results but also the test method will be considered.

As mentioned earlier, avanafil is not yet officially licensed in USA, so there is only English evidence.

Therefore, in this section, we will explain the pharmacology of avanafil based on the evidence confirmed by each medical institution.

Even Levitra (Vardenafil), which was said to be the most rapid-acting ED drug in the past, was said to take about 30 minutes to take effect after taking it.

However, avanafil is said to be effective in about 15 minutes . (When taking 200 mg)

All ED medications work by blocking the action of an enzyme called PDE5 (phosphodiesterase 5), which blocks blood flow to the penile arteries.

This is a consistent pharmacology from Viagra to Stendra, but Avanafil, the main ingredient of Stendra, is characterized by the “earliest” effect.

In addition, PDE5 inhibitors have the disadvantage of being susceptible to diet.

In particular , sildenafil and vardenafil are easily absorbed by the fat contained in foods and drinks, so it was necessary to take the medicine after the time between meals and sexual activity.

However, if you take avanafil 2 hours after eating, the effect will start to appear in a short time of about 15 minutes at the shortest.

Compared to conventional ED drugs, it is characterized by less time constraints and higher convenience.

Active ingredient that Menalini focused on

The effectiveness of Avanafil, which Menarini AP focused on, lies in its “immediate effect”.

Pharmacological studies have shown that Avanafil, like Sildenafil and Vardenafil, is absorbed by fat, but its action is rapid, so it is generally less affected by food.

It takes about 30 minutes to 1 hour after taking Viagra (Sildenafil) and 15 to 30 minutes after taking Levitra (Vardenafil) before the effect starts to appear.

Avanafil contained in Stendra and Spedra is effective in about 15 minutes at the shortest after taking it, so it will start to work almost without problems if 2 hours have passed after eating.

Viagra and slow-acting Cialis should be at least 3 hours after a meal, and some say it’s more difficult to take the drug than Avanafil.

However, Cialis has a long duration and is almost unaffected by food once it is absorbed.

It is also called a weekend pill in the West, and it is said that if you take it on Friday night, the effect will last until Sunday morning.

Since it has a longer action time than other PDE5s and does not have immediate effect, Viagra and Levitra are prescribed for people who do not have an effect.

Based on the above, it can be said that Avanafil is an easy-to-use treatment drug compared to conventional ED treatment drugs .

How to use Stendra

As you can see from the above-mentioned pharmacology, it is best to take Stendra 15 minutes to 1 hour before starting sexual activity.

The lower the avanafil content, the slower it will start to work, so if you take this amount of time into consideration and take into consideration individual differences, there should be no problem.

It has a relatively long duration of action of 6 to 7 hours, so it is said that there is little concern that the effect will wear off in the middle like Viagra.

Also, as with all ED drugs, avoid continuous administration.

With Stendra, the effect lasts longer than Viagra, so you can eliminate the anxiety that the effect will be cut off in the middle and the anxiety of taking additional doses during the action.

Since it is an unapproved drug, there are few reports in USA, but it is important to check the sites of urology departments and ED clinics that provide ED treatment without taking such articles.
Be aware of the advantages and disadvantages before taking the correct dose.

It is said that there are relatively few side effects, but it is necessary to be careful because USA people and Westerners have slightly different constitutions and physiques, so the effects may appear differently.

Avanafil active ingredient in Stendra

In this section, I would like to explain in detail what kind of action the active ingredient “Avanafil” of Stendra has .

Avanafil, like other ED treatments, is prescribed for the purpose of maintaining and improving erectile dysfunction by inhibiting the action of PDE5 (phosphodiesterase 5), an enzyme that inhibits the inflow of blood into the penile artery .

The mechanism of erection is that when the brain detects sexual stimulation, a hormone called “cGMP (cyclic guanosine monophosphate)” is released near the penis through the spinal cord.

This hormone acts to dilate the penile arteries, fill the smooth muscles with blood, and increase the corpus cavernosum tissue, causing an erection.

Ultimately, with ejaculation as a signal, a large amount of PDE5, which is widely distributed in the smooth muscle of the penis, is released into the blood by instructions from the brain, cGMP is decomposed, and the penile arteries contract to achieve an erection. will be the flow.

However , patients with erectile dysfunction have relatively stronger PDE5 activity because cGMP activity is inactivated or weakened.

Therefore, ED treatment drugs such as Avanafil are used to support normal erections by inhibiting the action of enzymes that cause erectile dysfunction.

Ability to inhibit PDE5, the cause of ED

Various countries are collecting data on which drug among the well-known ED drugs has the strongest ability to inhibit PDE5.

In general

  • Vardenafil( Levitra )≥Avanafil( Cialis )>SildenafilViagra )>Tadalafil(Cialis)

It has been with.

On the other hand, vardenafil is the most effective ingredient, but at the same time it has a high risk when taken.

Although the effect is weak, the data of the clinical trial called tadalafil, which is highly safe, has been published.

Since the effects of pharmaceuticals depend on the constitution of the individual, it is not possible to determine which one is the most effective, but if you are worried about side effects, start taking tadalafil, then prescribe Viagra, Levitra, and so on. is recommended.

Stendra is a low to medium capacity Viagra, so it may be your next choice if you don’t get the results you want.

However, since this ED treatment drug has a short history and there are few prescription cases in USA, it is expected that more side effect information will be added in the future.

Mechanism of action of avanafil

Avanafil, like other ED drugs , also has the effect of inhibiting PDE5, so its mechanism of action is similar to that of sildenafil, but the major difference is the time required for its action to start.

The basic mechanism of action (how the drug works) is the same as sildenafil .

Let’s take a closer look at the mechanism of erection explained in the previous item.

When the brain feels sexual arousal, it releases a substance called nitric oxide into the body.
Nitric oxide has the effect of softening and dilating blood vessels.

The smooth muscle near the penis stimulated by nitric oxide secretes a hormone called cGMP and dilates the penile arteries.

When cGMP finishes ejaculation, it is broken down by the action of an enzyme called PDE5, the blood concentration decreases, the penile artery contracts, and the erection ends.

In other words, the mechanism of action of ED treatments, including avanafil, is not to “erection” but to “inhibit the action of PDE5, which interferes with the maintenance of erection . “

Therefore , it does not have the same effects as sex drugs or aphrodisiacs .

When blood vessels dilate due to the action of cGMP and the blood flow increases, excitement is a side effect, and since a large amount of PDE5 is also distributed in the heart sphincter, the dilation of blood vessels in the heart causes strong palpitations. It is often misunderstood as an improvement in sexual excitement.

Therefore, there are some cases where you take it continuously to get sexual arousal, but this is a dangerous action and you should definitely refrain from it.

Other indications for avanafil

Avanafil, vardenafil, and tadalafil were originally developed for the treatment of ED, but they are all said to be modified forms of Viagra’s ingredient sildenafil.

Sildenafil was originally developed to treat high blood pressure, especially severe pulmonary hypertension.

However, there were many reports that male subjects showed improvement in ED symptoms at the time of clinical trials, and there is a history that it was developed in earnest as an ED treatment drug after that.

From this, it can be seen that the ED improving effect of sildenafil was a “side effect”.

Sildenafil is currently used in the treatment of pulmonary hypertension, unstable angina pectoris, and cardiac-derived hypertension such as atrioventricular block.

Paradoxically, the active ingredients of ED treatments other than sildenafil have a similar mechanism of action, which means that they can be used to treat chronic severe hypertension.

Avanafil is not approved in USA, so the indications other than ED treatment, such as sildenafil and vardenafil, are as follows.

  • Pulmonary hypertension
  • chronic heart failure
  • postoperative interest
  • Congenital ventricular septal defect
  • congenital arteriosclerosis

The effect of Stendra

The efficacy of Stendra is the improvement of Subari ED ( erectile dysfunction ).

Stendra is also said to be the fourth ED treatment.

Even conventional Viagra , Cialis , and Levitra have an ED improvement rate of 70% or more, and Stendra, which has been further improved, is expected to have a high ED treatment effect.

The word “effect” is often used as a group, but “effect” and “effect” have different meanings.

  • Effect: The desired “result” of taking a drug
  • Efficacy: Taking “expected” to produce the desired results As mentioned above, they are similar but have slightly different meanings.

Therefore, I will explain the performance of Stendra (Avanafil) by separating the “effects” and “efficacy” that are not usually noticed.


The efficacy of avanafil, the active ingredient of Stendra, is that it is taken because it can be expected to improve ED.

Even if you say ED in one word

  • complete erectile dysfunction (impotence)
  • center fold
  • Inability to ejaculate (delayed ejaculation)
  • premature ejaculation
  • Not hard enough to insert

There are some symptoms such as.

If any of these can be expected to improve, then Stendra has a “effect” on ED.

Pharmaceuticals spend a huge amount of money on development and undergo clinical testing (trials) before finally receiving approval from the government. is prescribed with

However, since it is unclear whether or not it will suit the individual patient unless it is actually taken, it is necessary to take it while expecting “efficacy” at the time of the first prescription and confirm the “effect”.

Since Stendra is said to have an immediate effect and an “effect” comparable to that of Levitra (Vardenafil), it can be said that it is a drug that can be expected to have a considerably high effect of improving ED.

However, “efficacy” is an effect that can be expected when taking the medicine correctly , so read the precautionary statements carefully and take it as instructed .

In the case of personal import agency, it is recommended to attach a USA-translated Noh book or purchase from a vendor whose drug information can be confirmed on the site.


On the other hand, Stendra’s “effect” is “ED improvement effect”.

To put it a little bit more, clinical trials have confirmed some improvement in any of the above symptoms of ED.

In clinical tests, it is slightly inferior to Levitra, but there is not much difference in efficacy, and it can be considered that it has an ED improvement effect of nearly 80%.

In terms of side effects, it has been confirmed by clinical tests in Europe and the United States that it is second only to Cialis in terms of side effects.

From this, it can be said that the “efficacy” that can be seen from the clinical examination of Stendra is “well-balanced and highly effective . ”

However, safety may be questioned as Viagra and Viagra generics , which have just been approved by the US FDA in 2012 and still contain sildenafil as the active ingredient , boast the top share in the world.

It may take some time for Stendra to be officially approved in USA.

There are two types of ED: organic ED, which is caused by physical illness or trauma, and psychogenic ED, which is caused by mental stress.

In psychogenic ED, administration of PDE5 inhibitors may not be effective, so in such cases, patients may visit a psychiatrist or psychosomatic medicine department to investigate and treat the mental factors.

Impact of Stendra from clinical data

In this section, we will examine how Stendra works and what effect it has from actual clinical data.

Avanafil, the main ingredient of Stendra, is said to have the effect of improving ED by reaching the maximum blood flow concentration in about 15 minutes at the shortest after taking 200 mg.
The effect will come out in 30 minutes with 100 mg and 45 minutes to 1 hour with 50 mg, so it is recommended to start with 100 mg when taking it with the expectation of immediate effect.

Stendra is said to be unaffected by diet, but the English version of Stendra’s evidence states: “When taking Stendra 200 mg with a high-fat diet, Tmax (maximum blood concentration arrival time) is 1.12 to 1.25 hours. ) Is prolonged and Cmax (maximum blood concentration) is reduced by 39%. ”

Viagra is a drug that “postprandial administration prolongs Tmax by 1.8 hours and reduces Cmax to 42%”, but although there is some improvement compared to Viagra, dramatic improvement is seen. Not.

    • Tmax (time to reach maximum blood concentration): Time to reach maximum blood concentration after administration
    • Cmax (maximum blood concentration): maximum blood concentration of the active ingredient

How to take Stendra

When prescribing Stendra as an ED treatment , take it 1 hour to 30 minutes before sexual activity.

The reason is that the active ingredient avanafil begins to work in about 15 minutes to 1 hour.

Stendra is not a drug that must be taken before sexual activity if an erection is possible, and it is not meant to be taken regularly like oral medications.
It is also recommended to avoid continuous use.

As will be explained in detail later, there are cases where PDE5 (phosphodiesterase 5) inhibitors are contraindicated and should not be used in combination, and cases where caution is required when taking them.

Particular attention should be paid to those who are taking nitrates and those who are taking AGA (male pattern baldness) treatments “Propecia” and “Zagaro”.

action time

Avanafil, the active ingredient of Stendra, starts to take effect in about 15 minutes at the shortest when 200 mg is taken, and lasts for 5 hours at the shortest and 8 hours on average.

The duration of effect of Cialis (tadalafil), which boasts the longest duration of action among ED treatments , is less than 36 hours, but it is a duration of action that can be said to be no problem to support the maintenance of erection during one sexual activity.

Compared to other ED drugs, “Viagra ( Sildenafil )” has an average duration of action of 2 to 6 hours, about 4 hours, and “Levitra (Vardenafil)” is said to have about the same duration of action as Stendra. I’m here.

Comparing the time it takes to start working,

  • Stendra: 15 minutes to 1 hour after taking
  • Levitra : About 15 minutes to 1 hour after taking
  • Viagra : 45 minutes to 1 hour after taking
  • Cialis: 1 to 4 hours after taking

Stendra is the fastest acting ED drug.

If the effect begins to appear after you start taking it, side effects such as increased blood flow, a feeling of blood in your head, palpitations, and redness in your eyes are likely to occur.

However, this is not a condition in which the drug should be discontinued due to minor side effects.
Rather, it’s a good condition to think of it as a sign that the medicine is starting to work.

How to take Stendra

Drinking it with water or lukewarm water about 30 minutes before sexual activity makes it possible to maintain an erection through sexual arousal and stimulation.
The recommended dosage for first-time users is 100mg.

Since it is a medicine made in countries with good physique, it may be too effective for people with a relatively small USA figure.
In that case, we recommend cutting it to 25 to 50 mg and drinking.

If it appears to be effective and tolerable, adjusting the dose to suit you may produce more desirable results.

However, the daily dose is limited to once regardless of the dose .
Also, take at least 24 hours between doses.

If you have a small amount of alcohol (a glass of red wine, a small bottle of beer), you can take it with you.

Rather, there are reports that the synergistic effect of alcohol’s blood flow-increasing effect and relaxation effect improves the efficacy of the drug.
However, please avoid excessive alcohol and eating snacks together.

Use Stendra effectively with the right usage, the right time of day, and the right dose for your body.

Dietary Effects of Active Ingredient Stendra

Stendra is said to be less affected by food than conventional products, but in clinical trials, it tends to be less effective when taken with meals of 800 kcal or more.
Therefore, it is recommended to take the medicine 2 hours after the meal is completely digested.

Also, when you drink it, water or lukewarm water is recommended, but refrain from drinking it with drinks such as milk or cafe au lait that contain fat.

It is said that meals of 800 kcal or less will not be significantly affected, but it is safer to avoid taking fat-containing drinks if you want to get the effect more reliably.

Avoid taking it with drinks containing citrus juice, such as grapefruit juice.

Grapefruit and citrus fruits contain a component called furanocoumarin acid.
The action of furanocoumarin acid enhances the effects and side effects of avanafil, which can be overkill.

If you eat a dessert that uses grapefruit or citrus fruits during your meal, be sure to take Stendra at least 1 hour after eating.

Grapefruit is said to be incompatible with not only ED remedies but also various medications such as heart medicine, hypertension medicine, and cold medicine, so if you take any medicine, take furanocoumarin acid for 10 hours before and after. You have to be careful not to.

Comparison with other ED treatments

In this section, we will explain the advantages and disadvantages of Stendra, which is called the fourth ED treatment drug, compared to other ED treatment drugs.

First of all, I will explain by comparing the effects.

The order of efficacy is Levitra>Stendra>Viagra>Cialis, but there are many people who say that Viagra is the most effective depending on their constitution.

In addition, when comparing Levitra and Stendra, it is said that Levitra is slightly more effective, and there is almost no difference in feeling .

Next, for immediate effect, this is Stendra>Levitra>Viagra≥Cialis.

The most notable feature of Stendra is its fast-acting effect, with a 200mg dose showing results in as little as 15 minutes.
This is about 1/2 of Levitra, which is said to take effect in an average of 30 minutes after taking it.

The duration of action is Cialis(up to 36 hours)>Stendra(up to 8 hours)>Levitra(up to 7 hours)>Viagra(up to around 6 hours), and the strength of side effects is said to be Viagra> Levitra>Stendra>Cialis. .

In this comparison, Stendra can be said to be a well-balanced ED drug.

Side effects of Stendra

Stendra is also a medicine, so there are always side effects.

In particular , ED drugs have “main side effects” that are felt due to a sudden increase in blood flow, and “rare side effects” that occur due to allergies to the main ingredient, avanafil.

Many of the “main side effects” are the result of Stendra starting to take effect and are not a major problem.
However, there are cases where it is better to discontinue the drug if the symptoms are severe.

On the other hand, “rare side effects” can cause serious health problems, so in this case, stop taking the drug immediately and consult a urologist or ED clinic.

Main side effects

The side effects of Stendra often have the same symptoms as other ED treatments.

Avanafil works by dilating blood vessels and increasing blood flow, which makes the following side effects more likely to occur:

  • flush
  • Hot flashes
  • headache
  • palpitation
  • Red eye
  • stuffy nose
  • dizzy

And so on.

These side effects are the “main side effects” seen in about 10 to 15% of people who take Stendra, and are medically considered to be “signs that the drug has begun to work.”
Therefore, some people have minor symptoms and do not mind at all.
Even if left untreated, it will not become serious afterwards.

In rare cases, transient visual abnormalities may occur, and at this time, the person becomes hypersensitive to light and feels “dazzling” or “colors look different from usual”.
However, this photosensitivity also disappears spontaneously after the half-life of avanafil (about 5 to 8 hours).

In the English version of the evidence, it is recognized as an ED treatment with relatively few side effects, so if you take it normally without excessive worry, it will not lead to serious health damage.

These “main side effects” should be noted when you have headaches or dizziness that make you unable to stand, or when you have eye pain due to red eye.

For those who are concerned about headaches, it can be used in combination with pain relievers such as Loxonin.

Rare side effects

A “rare side effect” is a side effect that occurs with a probability of less than 1% after taking the drug.
The incidence rate is very low, but once it develops, it tends to become severe.

Rare side effects can occur with any medicine, so there is no need to worry too much, but if by any chance you experience a “rare side effect” such as the one described below while taking Stendra, use it immediately. and consult a urologist or ED specialist clinic.

  • Cardiovascular system: facial edema, hypertension, angina pectoris, myocardial infarction, syncope, tachycardia, etc.
  • Psycho-nervous system: hypertonia, anxiety, amnesia, etc.
  • Liver system: increased γ-GTP, liver dysfunction, etc.
  • Respiratory system: dyspnea, nosebleed, etc.
  • Digestive system: abdominal pain, diarrhea, vomiting, acid reflux, etc.

Other glaucoma, conjunctivitis, asthenia, burning sensation, etc. have been reported, but since it is a new drug in history, serious side effects may occur in the future in addition to the above.

However, since the incidence rate is 0.01 to 1% or less for both, there is no need to be overly cautious.

The drug is said to have fewer side effects than Viagra.

Since the side effects are transient, if you take the medicine according to the indication, the medicine will stop working and the symptoms will disappear at the same time, but if you really care about it, consult your doctor.
In that case, please tell me that “I felt unwell after drinking Stendra”.

Precautions for using Stendra

Stendra, like other ED treatments , is contraindicated when taken with nitrates and antihypertensives.

In addition , people in their 40s and 50s who are prone to develop ED ( erectile dysfunction ) are also prone to develop AGA (male pattern baldness) at the same time.

Since ED may occur as a side effect of AGA therapeutic drugs, if you are taking AGA therapeutic drugs ( Propecia or Zagallo) and have a tendency to ED , consult a medication doctor and follow the instructions.
It is quite possible that ED will be improved by discontinuing the administration of AGA drugs.

LOH syndrome (age-related hypogonadism), which is also called menopause in men, has been confirmed to have the same symptoms as ED.
Since LOH syndrome is prone to mental symptoms (depression, insomnia, etc.), ED that develops at the same time may also develop from the psyche.

For psychogenic ED, PDE5 (phosphodiesterase 5) inhibitors such as Stendra and Viagra are unlikely to be effective, so we recommend that you first consult a urologist or an ED clinic.

People who are careful about taking

The effects of Stendra are more immediate than Levitra and are similar in many other respects.

All ED drugs are drugs that block the activity of the enzyme PDE5.
Therefore, it can be said that it has the same characteristics as other drugs in that the basic mechanism of action does not change .
Therefore, it is safe to assume that people who have taken other ED drugs in the past have almost the same points of caution.

If you drink an appropriate amount of alcohol (about the same amount as a glass of wine), it is said that the vasodilatory effect of alcohol will be added and the effect will be more likely to be seen.

If you are a weak drinker (geto) or have no tolerance for alcohol, do not force yourself to drink it with alcohol.
There is a risk that the effects and side effects of Stendra may become too strong when taken together.

If headaches and palpitations, which are the main side effects of the active ingredient Avanafil, are too strong, it will reduce libido.

In addition, people who are vulnerable to alcohol may develop acute alcohol intoxication even in small amounts, so be careful when using it in combination with Stendra.
If you are self-identified as a lower door, drink with water or lukewarm water.

Precautions for combined use

Avanafil, the active ingredient in Stendra, is metabolized by an enzyme called CYP3A4 in the liver.

Some medicines have the ability to inhibit or promote the action of the CYP3A4 enzyme, so those who are taking ingredient drugs with such mechanisms of action should be careful about co-administration with avanafil. it won’t work.

Now, from here, we will introduce representative drugs for each of the CYP3A4 enzyme inhibitors and accelerators.

Please check your medicine notebook, and if you are taking any of the applicable medicines, be sure to consult your doctor before purchasing Stendra.

  • CYP3A4 enzyme inhibitor (drug that interferes with the action of CYP3A4 enzyme)
  • Macrolide antibiotics: Claris, erthromycin, etc.
  • Prostate cancer drug; bicalutamide
  • CYP3A4 enzyme inducer (drug that strengthens the action of CYP3A4 enzyme)
  • Tuberculosis drugs: Rifadin, Tegledol, etc.

In addition, patients receiving antihypertensive drugs such as α-blockers and antihypertensive drugs, acute heart failure drugs, and benign prostatic hyperplasia drugs should also be careful when using Stendra .

And as I introduced earlier, it is basically NG to use with grapefruit or citrus juice.

People who should not take

Stendra is an ED treatment and should not be taken by “women” or “unmarried minors”.

Sildenafil preparations for women have been developed overseas because Viagra has a certain effect on frigidity in women , but other ED treatment ingredients have little evidence regarding administration to women, so administration to women Is contraindicated.

Also , if you have any effects on your body such as allergic reactions due to the ingredients contained in Stendra, or if you are currently taking a drug designated as a contraindicated drug, do not take Stendra. Hmm.

Avanafil, the active ingredient, is a drug that has the effect of promoting blood flow, so it is not suitable for people with cardiovascular diseases.

Even if you do not think of anything in particular, do not continue to take this medicine forcibly if you feel strong side effects after taking it and you are concerned that it may harm your health.
Even if you are concerned about the possibility that it does not suit your constitution, do not overdo it.
Talk to a urologist or an ED treatment specialist.

Contraindicated drugs

ED treatments such as Stendra have common contraindications.

The most contraindicated contraindicated drug is “nitrate”.
“Nitric acid” is a drug given to relieve severe ischemic chest pain such as angina attacks and dyspnea.

In addition to sublingual tablets and swallows, there are patches, inhalants, sprays, etc., but all of them are contraindicated for use with Stendra.

  • Typical nitric acid agent
  • nitrol tablets
  • Nitroglycerin sublingual tablet
  • Sawadour
  • Sigmat tablets, etc.

In addition, because avanafil has a high vasodilatory effect, other ED treatments such as “Adempas”, “Viagra”, ” Cialis “, and ” Levitra “, which have similar vasodilatory effects, are also available. It is designated as a contraindicated drug.

And one of the powerful actions of avanafil is that it inhibits the action of PDE5, but since this enzyme is also widely distributed in cardiac smooth muscle, antiarrhythmic agents that are administered to control the action of PDE5 are also available. Contraindicated in combination.

  • Typical antiarrhythmic agent
  • Amiodarone
  • Lis Modern
  • Lith Modern R, etc.

Since there are very few cases of administration of Stendra in USA, hypotensive attacks such as “hypotension”, “orthostatic hypotension”, “anemia”, and “LOH syndrome” have become chronic and are receiving medication. People with severe rotatory vertigo or severe tinnitus (Meniere’s Syndrome) or idiopathic hearing loss should also avoid taking Stendra.

The side effects of Stendra can increase the symptoms of these diseases.

Generic drug of Stendra

Although it is still an unapproved drug in USA, generic drugs (generic drugs) have already been developed and sold overseas .

In USA, “Avana” has the largest share of the Stendra generics handled by personal import agents .
Avana tablets have a triangular shape with a red color.

100mg is the most widely distributed, and it is popular as a fast-acting ED drug.

Since the price is cheaper than Stendra, it is said that there are more Avana dealers in USA than Stendra . Viagra Generic
is the only ED treatment currently approved for the development and sale of generic drugs in USA.

Levitra generics are scheduled to be approved in 2018, but that is still undecided.
There is no precedent in USA for generics to be approved before the original drug.

Therefore, it can be inferred that Avanafil is also approved for Stendra generics after being approved for Stendra generics for domestic pharmaceutical manufacturers.

Development of Stendra Generic

India is said to be the country that develops and manufactures the most generic drugs in the world.

The generic version of Stendra, Avana, is also being developed by Sunrise Remedies, a pharmaceutical company based in Ahmedabad, India .
Established in 1993, the pharmaceutical company is one of the world’s leading manufacturers of generic drugs.

Many Indian pharmaceutical companies try to make products in accordance with GMP (Good Manufacturing Practice) by WHO (World Health Organization), and it is said that they are more reliable than generics in China and South Korea. ..

The reason why the development of generic drugs is so active in India is that the population is the second largest in the world and the difference between rich and poor is large, so the demand for generic drugs is high, and the drug is actively provided to Doctors Without Borders. There is a humane reason to have gone.

Constraints and bio-related industries are attracting particular attention along with the IT industry in India.
Developed and manufactured pharmaceuticals are the mainstay of India’s export commodities.

Various types

The most popular Stendra generic in USA is Avana , but there are many other types.

Private import agency of general pharmaceuticals in USA is a scheme in which cheap overseas pharmaceuticals are purchased locally through brokers in Singapore, Hong Kong, etc., and sent directly to users from there.

The “individual import agency” will take care of the customs clearance application at this time.
By law, it is not illegal to personally import unapproved drugs in USA as long as they are within the limits.

The restrictions are that “prescription amount exceeding one month cannot be imported” and “import under personal name”.
Since the import agent is entrusted to an individual, it is a rule that it cannot be shipped to a place other than the company or the person’s name, so it is necessary to be careful.

Now, I would like to introduce some typical Stendra generics other than Avana.

  • Drama
  • Super Avana
  • Zudena
  • top avana
  • Extra Super Avana

And so on.

Super Avana , Top Avana , and Extra Super Avana are types of drugs that contain dapoxetine, the active ingredient of Priligy, a premature ejaculation treatment, in addition to Avanafil.
In India, mixed generics that combine ED drugs and premature ejaculation drugs are used as popular treatments.

What is “Abana”, which is famous for generics of Stendra?

Generic drugs are also called “generic drugs”, and are distributed under a system in which multiple pharmaceutical companies apply to the government and obtain permission to develop, manufacture, and sell after the original drug’s manufacturing patent or development patent expires. increase.

Since the development of a new drug is very expensive, the original drug is protected by a patent, and the generic drug cannot be developed until the patent expires.

Stendra is a drug marketed by the US company Vivis after receiving FDA approval in 2012.

India is world-famous as a country where the legal development of patents has not yet caught up and many generic medicines whose patents have not expired are developed.

However, in order to develop and manufacture generics even in such India, “safety tests” and “dissolution tests (tests to compare how new drugs and generics dissolve in acids and alkalis and check whether there is no difference in performance) are required. , “Biological equivalence test (test to determine whether the time to reach the maximum blood concentration of the drug and the time to metabolism is equivalent to that of the original drug)”, etc. Indian-made generics are said to have a high degree of reliability because they are not manufactured in India.

“Avana”, the most famous generic of Stendra, is also a drug developed and manufactured by Sunrise Remedies in India, and is an ED remedy with a red package and triangular tablets.

For generic drugs, the manufacturer can freely select side effects other than the main component, but strict quality checks are carried out so that the mechanism of action and side effects do not differ from those of the original drug .

Therefore, Avana is not significantly less effective than Stendra.

Benefits of Stendra Generic

The biggest merit of generic drugs is that the price of the drug is cheaper because the development cost can be significantly reduced.

USA generic drug regulations emphasize safety so as not to significantly deviate from the efficacy and side effects of the original drug.
Therefore, generic drugs are seen as copies of the original branded drugs.

Generic medicines made in USA are also devised, such as orange-flavored, coffee-flavored, and OD tablets that can be taken without water, but overseas there are many pharmaceuticals with more positive added value.

A product called ED + premature ejaculation drug has been released by combining Stendra generic with the premature ejaculation treatment ingredient “dapoxetine”.

At first glance, such a combined type seems to be highly convenient, but if it is taken by people who do not have premature ejaculation, there may be a risk of delayed ejaculation or long-term erection.

Also, since multiple active ingredients are combined, the risk of side effects increases, so be careful when taking them.
Personal import of overseas pharmaceuticals is at your own risk.

Another advantage of Stendra is that it has fewer side effects than Viagra .
When purchasing Stendra generic, it would be better to focus only on ED treatment to avoid risks.

Beware of fake Stendra

Stendra is still an unapproved ED drug in USA, so it is common to use a personal import agency when purchasing.

However, when using a personal import agency, you need to be careful of counterfeits and inferior products.
The purchase method is almost the same as regular online shopping, but when selling pharmaceuticals in USA, it is necessary to notify the Ministry of Health, Labor and Welfare.

Therefore, an application permit number is always given to individual drug import agents.
This is one of the signs to tell if you are a legitimate trader.

Also, the Ministry of Health, Labor and Welfare has published a list of registered distributors, so it is a good idea to refer to it when using a personal import agency site.

Although it is legal to use a personal drug import agency, it is a self-responsibility.
It is important not to buy fake, fake or inferior goods, but if you do buy something that seems to be fake, please report it to the Consumer Affairs Agency, Consumer Center or police immediately.

Domestic prescription of Stendra

All ED treatments are currently free medical treatment without insurance.
Usually, a doctor issues a prescription and purchases it through an in-hospital prescription or a dispensing pharmacy (a pharmacy where a pharmacist is resident and sells prescription drugs).

However, Stendra is not yet approved in USA, so it cannot be handled by prescription.
Stendra is usually not available at general urology or ED clinics.

However, there are a few clinics that prescribe medicines purchased on personal import agency sites as in-hospital dispensing.
Even in this case, you will always receive a prescription after receiving a medical examination at a medical institution that handles it.

However, since it is a medicine purchased through a personal import agency, it is not possible to receive a large prescription.
However, in the case of many ED drugs, many are prescribed in units of one tablet, so that point is not much of a problem.

In addition, it is the selling price that you should be aware of when prescribing in USA.
The price of medicines sold by free medical treatment or personal import agency can be set freely by the medical institution.

Therefore, even with the same drug, price differences are likely to occur.

In the case of ED treatment drugs that have already been approved in USA, even if there is a price difference, it will be about several hundred yen, but in the case of unapproved drugs, it is not uncommon for it to differ by several thousand yen.

Private import of overseas pharmaceuticals

For individual imports of overseas pharmaceutical products, you can use “proxy” to simplify customs clearance procedures.

However, there are some restrictions on its use.

  • Limited to personal use (cannot be sent to companies)
  • You cannot import the amount used for more than one month with one order.
  • Use at your own risk


The most important thing to note here is that “use is at your own risk” .

In particular, the “pharmaceutical side effect relief system” does not apply to drugs that have not been approved in USA, such as Stendra.
This system is applied when a drug approved in USA is purchased based on a doctor’s prescription, and a subsidy such as treatment costs is provided in the event of serious side effects.

Also, even if you try to file a lawsuit if you are caught in a bad product or a fake, you cannot judge an overseas broker or pharmaceutical company under USA law.
In other words, if you use a personal drug import agency and cause some kind of medical accident or health damage, you risk falling asleep.

In order to prevent such a situation, the reliability of the personal import agency you use is the biggest key.

Whether or not drug information such as online word-of-mouth evaluation, reviews on comparison sites, side effect information and contraindications for concomitant use, and medication precautions are posted in detail, and whether USA Nohsho (instruction manual) is posted , Check if you are registered as a registered distributor with the Ministry of Health, Labor and Welfare, if you disclose information on overseas brokers and pharmaceutical companies, if there is a compensation system for inferior goods, etc. before using it.

About counterfeit products

When Viagra was announced and sold overseas, it was very popular in USA even though it was still an unapproved drug, and many people obtained it through private import agents .

However, at that time, the personal import agency itself was not a major issue, so there were many counterfeit and inferior goods, and medical accidents such as health hazards occurred frequently, which became a big problem in the Diet.

Even now, there are online shopping sites such as adult shops that sell ED medicines, but it is safe to assume that most of the unlicensed personal import agents are dealing with counterfeit products.

In the case of counterfeit products, we do not know what is included in the ingredients, so please do not purchase them.

Be wary of vendors who market ED drugs like Stendra as ” aphrodisiacs ” or “sex drugs.”

ED drugs only play a role in inhibiting the PDE5 enzyme.
It is not a drug that makes you sexually sensitive or increases the degree of arousal by taking it, but the category is “medicine for treating ED”.

How to buy Stendra

Since Stendra is a drug , you might think that you can buy it at a pharmacy or an ED clinic, but that is not the case.
Since it is an unapproved drug in USA, basically it is not available in USA.

If you want to purchase it, you will get it from an overseas broker through a “personal import agency”.
Even if it is a personal import agency, you can purchase it in the same way as using general online shopping.

It’s easy, but it’s different from a mail order company, so you need to be careful of the following points.

  • The amount of one purchase is limited
  • The shipping fee is relatively high because it is sent directly from an overseas broker.
  • The price fluctuates due to the exchange rate, so the price will change from time to time
  • It is not possible to purchase medicines for others (the transfer of medicines is regulated by the Pharmaceutical Affairs Law).
  • It may take 2 weeks to 1 month to reach you.

With these things in mind, you will buy and take medicine at your own risk.

Not available at pharmacies/drugstores

In addition, Stendra is in the same therapeutic drug category as Viagra, Cialis, and Levitra, which are already approved in USA, so even if it is approved in the future, it cannot be purchased at drug stores or general pharmacies.

Prescription drugs are drugs that a doctor issues a prescription, and a pharmacist dispenses the drug at a dispensing pharmacy based on the prescription information before selling it.

Since generic drugs are also prescription drugs, the idea is the same.
If you do not have a prescription, you cannot sell it at a dispensing pharmacy, and you need to see a doctor at a medical institution such as a urology department or an ED specialty clinic.

Very rarely, there are cases where dispensing pharmacies in the city also handle ED treatment drugs and AGA treatment drugs with the permission of personal import agency, but since there are not so many, it is usually mainly purchased online. Probably.

Even if you use the personal import agency online, you do not need to create any troublesome application documents.
You can get it by selecting the product, putting it in the cart, and making a payment, just like using general online shopping.

However, once again , personal imports of pharmaceutical products are within the scope of self-responsibility, so be careful when choosing a vendor.

Mail order situation of Stendra

If you’re thinking of buying Stendra in USA, searching for “Stendra” online will probably hit ” Avana “.
“Abana” is an Indian generic Stendra .

It contains the same amount of the active ingredient avanafil, and generics made in India are highly reliable, so it is thought that the popularity is concentrated on avana, which is cheaper than Stendra.
Also, since there are many bottle types of Stendra, the fact that Avana, which is packaged in a sheet, is easier to use when drinking immediately before sexual activity may also affect the difference in popularity in USA.

When purchasing Stendra (Avana) online, be aware that you are using a “personal import agency”.

The subsidy system (pharmaceutical side effect damage relief system) for relief is not applied to drugs purchased on behalf of individual importers even if side effects or any abnormalities occur.

In addition, even if you are brought to a trial due to serious health damage, you can sue an individual import agency, but you cannot sue an overseas broker or pharmaceutical company, so it is within the scope of your own responsibility.
Even now, it is said that nearly half of the ED treatments that are individually imported from overseas are counterfeit or inferior products, so be sure to check the reliability when choosing a vendor.

Summary of Stendra

Stendra was originally developed by Tanabe Pharma in USA, but due to various reasons, it is an ED treatment drug whose rights have been transferred to a pharmaceutical company called Vivis in the United States .

Since 2012, it has been on sale in the United States, Europe, South Korea, etc., and has begun to attract attention because it is more effective than Levitra and has fewer side effects than Viagra .

In the future, it has been decided that Singapore-based Menarini AP will launch under the name “Spedra” in Asia.

Since it is still an unapproved drug in USA, it is common to purchase it through an online private import agency to obtain it, but in India, the Stendra generic ” Avana ” has already been developed and sold.

Avana is popular because of its low price, and together with Stendra, it is an ED treatment drug that is attracting attention in USA in the future.

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