Drug & supplement interaction

Butea Superba + Avanafil

Avanafil brand name: Stendra.

Moderate Interaction
The bottom line Moderate

Butea Superba has a moderate interaction with Avanafil. Butea superba is thought to inhibit phosphodiesterase and cause vasodilation.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Butea Superba and Avanafil

Here is the interaction we found between these two, with the evidence behind it.

Moderate

PHOSPHODIESTERASE-5 INHIBITORS

Why this applies to Avanafil

Avanafil falls under PHOSPHODIESTERASE-5 INHIBITORS — the group Butea Superba interacts with.

Butea superba is thought to inhibit phosphodiesterase and cause vasodilation. Theoretically, concurrent use of phosphodiesterase-5 inhibitors and Butea superba might result in additive vasodilation and hypotension. Phosphodiesterase-5 inhibitors include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: avanafil (Stendra) already works by relaxing blood vessels so more blood can flow into the penis. Butea superba is thought to do something similar in the lab, possibly blocking the same kind of enzyme and widening blood vessels too. So if you take both at once, the worry is that their effects could stack up and drop your blood pressure more than expected.

That could show up as lightheadedness, dizziness, headache, flushing, or feeling faint, especially when you stand up quickly. I'll be honest with you though: this concern is theoretical, based on how the herb behaves in test tubes, not on solid human studies. Still, because both target blood flow, I'd play it safe and check with your doctor or pharmacist before combining them.

References
  1. Cherdshewasart W, Nimsakul N. Clinical trial of Butea superba, an alternative herbal treatment for erectile dysfunction. Asian J Androl 2003;5:243-6.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Butea Superba Also Interacts With Other Medications

Butea Superba has 6 moderate known drug interactions in our database — the Avanafil one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Butea Superba

Covers the 2,830 medications we’ve checked against Butea Superba. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Avanafil

This page covers Butea Superba only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Avanafil page lists 144 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Mistletoe (major), Grapefruit (major), Hawthorn (major) and St. John's Wort (major).

By severity: 5 major · 98 moderate · 41 minor.

From our pharmacist’s overview on the Avanafil page

“Avanafil (Stendra) treats erectile dysfunction by widening blood vessels, and I read this list of 144 supplements as one that warrants real care rather than panic. Most of the risk runs through a single liver enzyme, CYP3A4, which clears avanafil and which 121 of these ingredients can affect.”

Reviewed by 2 · Jul 18, 2026

Open the Avanafil interaction page

One more smart check

Taking Butea Superba as Part of a Dietary Supplement Product? Check It for Interactions

We hold 23 real supplement products containing Butea Superba, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Butea Superba. Your product may carry other ingredients that interact with Avanafil too, on top of Butea Superba — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Butea Superba and Avanafil Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Butea Superba
Steady interest

#1,183 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Avanafil
Top half

#742 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Butea Superba

What is Butea Superba?

Butea Superba
  • Erectile dysfunction
  • Low libido
  • Male sexual performance
  • General vitality and energy
  • Traditional tonic

Butea superba is a Thai herb traditionally used to support male sexual health, but the human evidence is very limited and mostly small or low-quality. Its safety has not been well studied, so caution is advised, and you should talk with a pharmacist or doctor before trying it—especially if you have a medical condition or take other medicines.

Read the full Butea Superba monograph & all interactions
Medication

About Avanafil

What Is Avanafil Used For?

Brand name: Stendra

Avanafil — sold as Stendra and under the generic name Avanafil — is used to treat erectile dysfunction (ED) in adult men. ED is the inability to get or keep an erection firm enough for sexual activity.

The medication works only when there is sexual stimulation. It is taken as needed, not on a daily schedule.

See full Avanafil drug information
Keep checking

Other Drugs & Butea Superba

Browse every other medication we’ve checked against Butea Superba — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
6Moderate
0Minor
2,823No known interaction
Moderate

6 interactions

No interaction 2,823 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Butea Superba and Avanafil Together: Common Questions

Can you take Butea Superba with Avanafil?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Butea Superba and Avanafil interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Avanafil and Butea Superba?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.