Avanafil and Silodosin interaction

• Use of avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension ( 2.3 , 5.6 , 5.7 )

Caution is advised when PDE5 inhibitors are co-administered with alpha-blockers.

Consideration should be given to the following: • Patients should be stable on alpha-blocker therapy prior to initiating treatment with a PDE5 inhibitor.

Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitors.

• In those patients who are stable on alpha-blocker therapy, PDE5 inhibitors should be initiated at the lowest dose (Avanafil 50 mg).

Caution is also advised when alpha-adrenergic blocking agents including silodosin capsules are co‑administered with PDE5 inhibitors.

Concomitant use of PDE5 inhibitors with alpha-blockers including silodosin capsules can potentially cause symptomatic hypotension.

PDE5 Inhibitors Co‑administration of silodosin capsules with a single dose of 100 mg sildenafil or 20 mg tadalafil was evaluated in a placebo-controlled clinical study that included 24 healthy male subjects, 45 to 78 years of age.

Alpha-adrenergic blockers and PDE5 inhibitors are both vasodilators that can lower blood pressure.

During this period, the total number of positive orthostatic test results was greater in the group receiving silodosin capsules plus a PDE5 inhibitor compared with silodosin capsules alone.