Is Avanafil Safe and Effective for Men Over 60?

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Key takeaways

• Avanafil is safe for most men over 60 when prescribed after a medical assessment.
• It works within 15 to 30 minutes and is taken about 30 minutes before sex.
• Starting dose is usually 100 mg, adjusted to 50 mg or 200 mg as needed.
• Always declare all medicines and health conditions during your consultation.
• New ED should prompt a GP check, as it can signal heart or diabetes risk.

How Does Avanafil Work for Men Over 60?

Avanafil belongs to a class of medicines called PDE5 inhibitors, which work by relaxing the blood vessels in the penis and allowing increased blood flow when you are sexually aroused [6]. It does not cause an erection on its own—sexual stimulation is still needed. The enzyme PDE5 normally breaks down a substance called cGMP, which helps maintain an erection; by blocking PDE5, avanafil allows cGMP levels to rise, making it easier to achieve and sustain an erection during sexual activity.

For men over 60, the underlying causes of erectile dysfunction are often related to changes in blood vessels, reduced testosterone, or conditions such as diabetes, high blood pressure, or heart disease [1][10]. Avanafil addresses the vascular component by improving blood flow, which is why it can be effective even when ED is linked to age-related changes or chronic health conditions. However, it is important to have a full medical assessment, as ED in older men can sometimes be an early warning sign of cardiovascular disease [2].

Clinical studies of avanafil included men across a wide age range, including those in their sixties and seventies, and demonstrated that the medicine was effective and generally well tolerated in older age groups [11]. The prescriber will consider your overall health, current medications, and any heart or blood-pressure conditions before recommending avanafil, ensuring it is safe and appropriate for you.

What Is the Right Avanafil Dosage for Men Over 60?

The usual starting dose of avanafil for most men, including those over 60, is 100 mg taken approximately 30 minutes before sexual activity [6]. Depending on how well it works and whether you experience any side effects, your prescriber may adjust the dose. If 100 mg is effective but you have mild side effects, the dose can be reduced to 50 mg. If the response is not strong enough and you tolerate the medicine well, the dose may be increased to the maximum of 200 mg.

Avanafil should be taken no more than once in a 24-hour period. It can be taken with or without food, though a heavy or high-fat meal may slow down how quickly it starts to work [6]. Many men find that taking it on an empty stomach or after a light meal gives the fastest results, often within 15 to 20 minutes, though the licensed advice is to allow about 30 minutes.

For men over 60 who are taking other medicines—particularly those for blood pressure, prostate problems (alpha-blockers), or certain antifungals and antibiotics—the prescriber may recommend starting at a lower dose or avoiding avanafil altogether if there is a significant drug interaction [6]. Always declare every medicine you take, including over-the-counter products and herbal supplements, during your online consultation so the prescriber can check for interactions and choose the safest dose for you.

Adjusting the Dose Based on Response

It is common for the first dose not to be perfect for everyone. Some men find 100 mg works well from the start, while others need a higher dose for a satisfactory effect or a lower dose to minimise side effects such as headache or flushing. Your prescriber can adjust the dose after your first few attempts, so it is helpful to keep a mental note of how the medicine worked and any side effects you noticed. Do not adjust the dose yourself or take more than one tablet in 24 hours, as this increases the risk of side effects without improving effectiveness.

At a glance

Is Avanafil Safe for Men Over 60 with Other Health Conditions?

Avanafil can be safe for many men over 60 with common health conditions such as high blood pressure, type 2 diabetes, or high cholesterol, provided these conditions are stable and well controlled [2][6]. However, it is not suitable for everyone. Men with severe heart disease, recent heart attack or stroke (within the past six months), unstable angina, severe heart failure, or very low blood pressure should not take avanafil or any other PDE5 inhibitor, as sexual activity itself may pose a risk [6].

If you have a history of heart problems, your GP or prescriber will assess whether your cardiovascular system is healthy enough for sexual activity before prescribing avanafil. This is a standard safety check for all ED medicines. Men who take nitrate medicines for angina (such as GTN spray, isosorbide mononitrate, or isosorbide dinitrate) must never use avanafil, as the combination can cause a dangerous drop in blood pressure [6]. The same applies to nicorandil and recreational drugs known as 'poppers' (amyl or alkyl nitrites).

Alpha-blockers, commonly prescribed for an enlarged prostate (benign prostatic hyperplasia), can interact with avanafil and increase the risk of dizziness or low blood pressure. If you are on an alpha-blocker such as tamsulosin, doxazosin, or alfuzosin, your prescriber will usually recommend starting avanafil at the lowest dose (50 mg) and ensuring you are stable on the alpha-blocker before adding the ED treatment [6]. Some medicines that affect liver enzymes—such as certain antifungals (ketoconazole, itraconazole), antibiotics (clarithromycin), or HIV medicines (ritonavir, cobicistat)—can raise avanafil levels in the blood, and in many cases avanafil is not recommended or the dose must be significantly reduced. Your prescriber will check all your current medicines during the consultation.

Kidney and Liver Function in Older Men

Kidney and liver function can decline with age, and this may affect how your body processes avanafil. Men with mild to moderate kidney impairment can usually take avanafil without dose adjustment, but those with severe kidney disease should use it with caution and only under close medical supervision [6]. Similarly, men with mild liver impairment may take avanafil, but it is not recommended for those with moderate to severe liver disease. Your prescriber will review your medical history and any recent blood tests to ensure avanafil is safe for you.

Common Side Effects of Avanafil in Older Men

The most common side effects of avanafil are headache, flushing (a warm, red feeling in the face or chest), nasal congestion, and back pain [6]. These effects are usually mild to moderate and tend to lessen as your body adjusts to the medicine. Headache and flushing occur because avanafil relaxes blood vessels throughout the body, not just in the penis. Drinking plenty of water and avoiding heavy alcohol can help reduce these side effects.

Some men experience dizziness, particularly if they stand up quickly after taking avanafil. This is more common in men who are also taking blood-pressure medicines or alpha-blockers. If you feel dizzy, sit or lie down until it passes, and avoid driving or operating machinery until you know how the medicine affects you. Indigestion and nausea are also reported occasionally.

Serious side effects are rare but require immediate medical attention. These include an erection lasting more than four hours (priapism), which can damage the penis if not treated promptly; sudden loss of vision in one or both eyes, which may be a sign of a condition called non-arteritic anterior ischaemic optic neuropathy (NAION); and sudden hearing loss or ringing in the ears [6]. If you experience chest pain during or after sex, stop sexual activity and seek urgent medical help—do not use a nitrate spray if you have taken avanafil in the past 24 hours, as this can be dangerous. Always tell the paramedics or doctor which ED medicine you have taken.

How Does Avanafil for Men Over 60 Compare to Other ED Treatments?

Avanafil is often compared to sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), as all four are PDE5 inhibitors licensed for erectile dysfunction in the UK. The main difference lies in how quickly they work and how long they last. Avanafil is one of the fastest-acting, with an onset of 15 to 30 minutes, making it a good choice for men who want spontaneity without a long wait [6][11]. Sildenafil typically takes about an hour to work, vardenafil around 25 to 60 minutes, and tadalafil at least 30 minutes but can last up to 36 hours [3][4][5].

For men over 60, the choice often depends on lifestyle and preference. Tadalafil's long duration (up to 36 hours) means you do not need to time it as precisely, which some men find more relaxing. However, others prefer avanafil or sildenafil because the effect wears off more quickly (around 4 to 6 hours for avanafil, 4 to 5 hours for sildenafil), which can feel more controllable. Tadalafil is also available as a low daily dose (2.5 mg or 5 mg), which means you do not need to plan ahead at all, though this option is less common for first-time users.

In terms of side effects, all PDE5 inhibitors share a similar profile—headache, flushing, nasal congestion—but individual responses vary. Some men tolerate one medicine better than another. Avanafil is sometimes said to have a slightly lower incidence of visual disturbances (such as a blue tinge to vision) compared to sildenafil, though this is not a major concern for most users [11]. Cost can also be a factor: generic sildenafil is the most affordable option at Cured Pharmacy, starting from £0.45 per tablet (£0.36 with code Ednew), while Spedra (avanafil) is £20.95 (£16.76 with code Ednew). Your prescriber can help you weigh up the pros and cons of each medicine based on your health, preferences, and budget.

Switching Between ED Medicines

If you have tried one PDE5 inhibitor and it did not work well or caused troublesome side effects, it is worth trying another. Response can vary between individuals, and a medicine that suits one man may not suit another. Your prescriber can suggest an alternative dose or a different PDE5 inhibitor during a follow-up consultation. Never take two different ED medicines on the same day, as this increases the risk of serious side effects.

Getting Avanafil for Men Over 60 from Cured Pharmacy

At Cured Pharmacy, avanafil is available as Spedra, supplied after a short online consultation reviewed by a UK-registered prescriber. The consultation asks about your medical history, current medicines, and any heart or blood-pressure conditions to ensure avanafil is safe for you. If approved, your medicine is dispensed by our GPhC-registered pharmacy (GPhC 9012511) and delivered discreetly to your home, usually within a few days.

Spedra is priced at £20.95, or £16.76 for your first order when you use the code Ednew at checkout. We also stock a range of other ED treatments, including generic sildenafil from £0.45 (£0.36 with code Ednew), tadalafil from £7.95 (£6.36 with code Ednew), and vardenafil at £16.95 (£13.56 with code Ednew). If cost is a concern, generic sildenafil or tadalafil may be a more affordable option, and they work just as well as the branded versions for most men.

If you are experiencing erectile dysfunction for the first time, or if it has worsened recently, we strongly encourage you to see your GP for a full health check. ED can be an early sign of cardiovascular disease or diabetes, and treating the underlying cause—alongside using an ED medicine—can improve both your sexual health and your overall wellbeing [1][2]. Once you have had an initial assessment, you can use our online service for convenient repeat prescriptions and ongoing support from our pharmacist team.

When to get urgent help

• Erection lasting more than 4 hours (priapism) – go to A&E immediately
• Sudden loss of vision in one or both eyes – stop the medicine and seek urgent care
• Chest pain during or after sex – call 999; do not take nitrate sprays if you've used a PDE5 inhibitor
• Sudden hearing loss or ringing in the ears – stop and see a doctor the same day
• Severe dizziness, fainting or palpitations – seek medical help promptly

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.

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