Avanafil and Urapidil: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Avanafil
Urapidil
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of hypotension
Interaction Deep Dive
Concomitant use of avanafil and urapidil may increase the risk of symptomatic hypotension due to additive vasodilation. Although coadministration of avanafil and urapidil has not been studied, standing and supine blood pressures were decreased when avanafil was coadministered with the alpha blockers doxazosin and tamsulosin in studies of healthy subjects. When concomitant use is necessary, initiate avanafil at a dose of 50 mg, and initiate it only in patients stable on urapidil therapy. When initiating urapidil in patients already receiving avanafil, begin urapidil at the lowest dose1.
Why it happens (mechanism)
Additive vasodilation
Literature reports
2 reports — tap to read
a) Coadministration of avanafil with doxazosin was associated with a mean maximum decrease in supine and standing blood pressure of -6 mmHg (95% CI, -9.1 mmHg to -2.9 mmHg) and -2.5 mmHg (95% CI, -6.5 mmHg to 1.5 mmHg), respectively, compared with doxazosin plus placebo in a randomized, double-blind, crossover trial (n=24). Healthy subjects received doxazosin 1 mg for 1 day, 2 mg for 2 days, 4 mg for 4 days, and 8 mg for 11 days; avanafil 200 mg or placebo was administered on days 15 and 18, 1.3 hours after the doxazosin dose 1.
b) Coadministration of avanafil with tamsulosin was associated with a mean maximum decrease in supine and standing blood pressure of -3.1 mmHg (95% CI, -6.4 mmHg to 0.1 mmHg) and -3.6 mmHg (95% CI, -8.1 mmHg to 0.9 mmHg), respectively, compared with tamsulosin plus placebo in a randomized, double-blind, crossover trial (n=24). Healthy subjects received tamsulosin 0.4 mg daily for 11 days; avanafil 200 mg or placebo was administered on days 8 and 11, 3.3 hours after the tamsulosin dose 1.
Common questions
Can I take Avanafil and Urapidil together?
Increased risk of hypotension Always confirm with your pharmacist or prescriber before making any change.
How serious is the Avanafil and Urapidil interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Avanafil or Urapidil need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (1)
- Product Information: STENDRA(R) oral tablets, avanafil oral tablets. Metuchen Pharmaceuticals LLC (per FDA), Freehold, NJ, 2022. DailyMed
Keep reading about Avanafil
Keep reading about Urapidil
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