Issues for surgery
Risk of hypotension if continued.
Advice in the perioperative period
Elective surgery
Advise patient not to take the day prior to and the day of procedure.
Emergency surgery
Follow the advice as for elective surgery. If dose(s) taken prior to admission, monitor BP.
Post-operative advice
Hold whilst inpatient.
Interactions with common anaesthetic agents
Hypotension
PDE5 inhibitors can increase the risk of hypotension when used concomitantly with inhalational or intravenous anaesthetics.
Interactions with other common medicines used in the perioperative period
Hypotension
PDE5 inhibitors can increase the risk of hypotension when used concomitantly with the antiemetics droperidol and prochlorperazine.
Macrolides
Clarithromycin and erythromycin are predicted to increase the exposure to PDE5 inhibitors due to inhibition of CYP3A4. Concurrent use of avanafil with clarithromycin is contraindicated.
Further information
None relevant.
References
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://www.medicinescomplete.com (Accessed on 20th September 2023)
Baxter K, Preston CL (eds), Stockley’s Drug interactions (online) London: Pharmaceutical Press. http://www.medicinescomplete.com (Accessed on 20th September 2023)
Summary of Product Characteristics – Spedra® (avanafil) 100mg tablets. A. Menarini Farmaceutica Internazionale SRL. Accessed via www.medicines.org.uk 20th September 2023 [date of revision of the text January 2021]