Avanafil and Riociguat interaction
Avanafil and Riociguat: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Avanafil label · effective 2025-12-17
• Administration with guanylate cyclase (GC) stimulators such as riociguat and vericiguat ( 4.3 )
Concomitant Guanylate Cyclase (GC) Stimulators Do not use avanafil tablets in patients who are using a GC stimulator, such as riociguat or vericiguat.
When vasodilators are used in combination, an additive effect on blood pressure may be anticipated.
When vasodilators are taken in combination, blood-pressure-lowering effects of each individual compound may be increased.
When vasodilators are taken in combination, blood pressure-lowering effects of each individual compound may be increased.
From the Riociguat (Adempas) label · effective 2026-08-13
Phosphodiesterase Inhibitors Concomitant administration of Adempas with specific PDE-5 inhibitors (such as sildenafil, tadalafil, or vardenafil) or nonspecific PDE-5 inhibitors (such as dipyridamole or theophylline) is contraindicated [see Dosage and Administration (2.6), Drug Interactions ( 7.1 ) and Clinical Pharmacology ( 12.2 )].
PDE Inhibitors: Co-administration of Adempas with specific PDE-5 inhibitors (such as sildenafil, tadalafil, or vardenafil) and nonspecific PDE inhibitors (such as dipyridamole or theophylline), is contraindicated because of hypotension.
Clinical experience with co-administration of Adempas and other phosphodiesterase inhibitors (for example, milrinone, cilostazole, roflumilast) is limited.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.