Short answer: The Stendra label starts at 100 mg by mouth, as needed, as early as about 15 minutes before sexual activity, with or without food. The dose can go up to 200 mg (also about 15 minutes before) or down to 50 mg (about 30 minutes before), and the lowest dose that works is used. It is taken at most once per day. With an alpha-blocker it starts at 50 mg.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Stendra is approved for: Stendra is a PDE5 inhibitor approved to treat erectile dysfunction in adult males (section 1).
Source
STENDRA (avanafil) tablets, for oral use, prescribing information and Patient Information. Metuchen Pharmaceuticals. DailyMed, version published July 24, 2024. DailyMed setid fa7d93e3-b69b-4e02-8146-89760cd8e9d6
Stendra is an oval, pale yellow tablet taken by mouth, in 50 mg, 100 mg and 200 mg strengths (section 3). It may be taken with or without food (section 2.2).
Sexual stimulation is required for a response, and the maximum recommended frequency is once per day (section 2.1).
Tablets are stored at 20 to 25 C (68 to 77 F) and protected from light (section 16).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Situation | Dose on the label | Timing |
|---|---|---|
| Starting dose | 100 mg | As early as approximately 15 minutes before sexual activity |
| Increase | 200 mg | As early as approximately 15 minutes before sexual activity |
| Decrease | 50 mg | Approximately 30 minutes before sexual activity |
| Stable on an alpha-blocker | Start at 50 mg | Approximately 30 minutes before sexual activity |
| Moderate CYP3A4 inhibitors (such as erythromycin, diltiazem, fluconazole, verapamil) | Maximum 50 mg | Not to exceed once every 24 hours |
| Strong CYP3A4 inhibitors (such as ketoconazole, ritonavir, clarithromycin) | Do not use | Not applicable |
| Nitrates in any form | Contraindicated | Not applicable |
The lowest dose that provides benefit should be used, and the maximum recommended dosing frequency is once per day.
No dose adjustment is needed for mild to moderate kidney impairment (creatinine clearance 30 to less than 90 mL/min). Stendra is not used in severe kidney disease or on dialysis, which have not been studied.
No dose adjustment is needed for mild to moderate liver impairment (Child-Pugh A or B). Stendra is not used in severe liver disease, which has not been studied.
Peak levels come at a median 30 to 45 minutes when fasting. A high-fat meal delayed the peak by about 1.12 to 1.25 hours and lowered it by 39%, which the label calls of minimal clinical significance. The half-life is about 5 hours.
In the open-label extension, men started on 100 mg could change dose; 536 (about 75%) moved up to 200 mg and 5 (under 1%) moved down to 50 mg.
Stendra is taken as needed before sexual activity, so the label has no missed-dose rule. It says the maximum recommended frequency is once per day, and the Patient Information says not to take it more than 1 time a day.
In Dose Track you set up Stendra as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.