Avanafil Sudden Hearing Loss: Causes & What to Do

Available Treatments

Pricing Disclaimer: Prices on some pages may not be up to date — the live pricing table below and pricing shown during consultation are official current prices and take precedence over any other figures on the site.

Avanafil and Sudden Hearing Loss: What You Need to Know

Published: 15 November 2026

Avanafil sudden hearing loss is a very rare but serious side effect that requires immediate medical attention. Avanafil (brand name Spedra) is a PDE5 inhibitor used to treat erectile dysfunction, and like other medicines in this class, it has been linked to sudden sensorineural hearing loss (SSHL) in a small number of cases [6]. Understanding the warning signs and knowing when to seek help can protect your hearing and ensure you use ED treatment safely.

How Common Is Avanafil Sudden Hearing Loss?

Sudden hearing loss with avanafil is classified as a very rare side effect, meaning it affects fewer than 1 in 10,000 people taking the medicine [6][12]. The British National Formulary lists sudden hearing loss under the uncommon or rare side effects for all PDE5 inhibitors, including avanafil, sildenafil, tadalafil, and vardenafil [3][4][5][6]. While the exact incidence is difficult to determine because many cases may go unreported, clinical trials and post-marketing surveillance suggest that the risk remains extremely low.

It's important to put this risk into perspective. Millions of men worldwide use PDE5 inhibitors safely and effectively for erectile dysfunction [9]. The vast majority will never experience hearing problems. However, because sudden hearing loss can be permanent if not treated promptly, all users should be aware of the warning signs and know when to seek urgent medical help.

Certain factors may slightly increase the risk, including pre-existing hearing problems, cardiovascular disease, diabetes, high blood pressure, smoking, and being over 50 years old [6][12]. If you have any of these risk factors, it's especially important to discuss them during your online consultation before starting avanafil or any other ED treatment.

Why Does Avanafil Cause Sudden Hearing Loss?

The exact mechanism behind avanafil sudden hearing loss is not fully understood, but researchers believe it relates to how PDE5 inhibitors affect blood flow in the inner ear [6]. Avanafil works by blocking the enzyme phosphodiesterase type 5 (PDE5), which increases blood flow to the penis during sexual stimulation. However, PDE5 is also found in other parts of the body, including the cochlea (the hearing organ in the inner ear).

When PDE5 is inhibited, it may alter blood flow or pressure in the delicate structures of the inner ear, potentially damaging the hair cells responsible for converting sound waves into nerve signals [6][12]. Another theory suggests that PDE5 inhibitors might affect other phosphodiesterase enzymes (such as PDE6, which is found in the retina and possibly the ear), leading to unintended effects on hearing or vision.

Sudden sensorineural hearing loss typically occurs in one ear and may be accompanied by tinnitus (ringing in the ears) or dizziness [6][12]. The onset is usually rapid—within hours of taking the medicine—though some cases have been reported days later. Because the inner ear has limited ability to repair itself, prompt treatment is essential to maximise the chance of recovery.

Other PDE5 Inhibitors and Hearing Risk

All PDE5 inhibitors—sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Spedra)—carry a similar warning about sudden hearing loss [3][4][5][6]. There is no strong evidence that one is significantly safer than another in this regard. If you experience sudden hearing loss with one PDE5 inhibitor, you should not switch to another without discussing it with your GP or a specialist, as the risk may apply to the entire class of medicines.

How Long Does Avanafil Sudden Hearing Loss Last?

The duration and outcome of avanafil sudden hearing loss vary widely between individuals. Some people experience partial or complete recovery within days to weeks, especially if they seek medical help immediately [6][12]. Others may have permanent hearing loss or persistent tinnitus. The sooner treatment begins, the better the chance of recovery, which is why sudden hearing loss is considered a medical emergency.

Treatment typically involves high-dose corticosteroids (such as prednisolone) to reduce inflammation in the inner ear, often started within 72 hours of symptom onset for the best results [12]. Your GP or an ear, nose, and throat (ENT) specialist will assess the severity and may arrange urgent hearing tests (audiometry) to determine the extent of the loss. In some cases, additional treatments such as intratympanic steroid injections (steroids injected directly into the middle ear) may be considered.

If you develop sudden hearing loss while taking avanafil, you should stop the medicine immediately and not take any further doses until you have been assessed by a doctor [6][12]. Even if your hearing improves on its own, it's essential to have a medical review to rule out other serious causes (such as stroke or acoustic neuroma) and to discuss whether it's safe to use ED treatment in the future.

Self-Care Tips and What to Do If You Notice Hearing Changes

If you notice any sudden change in your hearing, muffled sounds, ringing in the ears, or a feeling of fullness in one or both ears after taking avanafil, stop taking the medicine immediately and seek urgent medical advice [6][12]. Do not wait to see if it gets better on its own—early treatment significantly improves the chance of recovery. Contact your GP for an urgent same-day appointment, call NHS 111, or go to A&E if out of hours.

While waiting for medical help, avoid loud noises and do not insert anything into your ear. Do not take another dose of avanafil or any other PDE5 inhibitor. Make a note of when you took the medicine, the dose, and when the hearing change started, as this information will help your doctor assess the situation. If you also experience dizziness, vertigo, or balance problems, these should be reported as they may indicate inner ear involvement.

After recovery (or if your hearing loss is permanent), your doctor will discuss whether it's safe to use ED treatment again. In many cases, alternative treatments such as vacuum erection devices, alprostadil injections or cream, or psychological therapy may be recommended instead [2][7]. Never restart avanafil or any PDE5 inhibitor without explicit approval from your GP or a specialist.

Protecting Your Hearing While Using ED Treatment

To minimise any potential risk, always use the lowest effective dose of avanafil and avoid taking it more frequently than recommended (maximum once per day) [6]. Do not combine avanafil with other PDE5 inhibitors or with medicines that interact dangerously, such as nitrates, nicorandil, or riociguat. Avoid excessive alcohol, which can worsen both ED and side effects. If you have pre-existing hearing problems or risk factors, discuss these openly during your consultation so your prescriber can tailor your treatment plan.

When to Seek Urgent Medical Help for Avanafil Sudden Hearing Loss

Sudden hearing loss is a medical emergency, and you should seek help immediately if you experience any of the following after taking avanafil: sudden reduction or loss of hearing in one or both ears, sudden onset of ringing, buzzing, or hissing in the ears (tinnitus), a feeling of fullness or pressure in the ear, dizziness or vertigo, or difficulty understanding speech [6][12]. These symptoms can occur within hours of taking the medicine or, less commonly, a day or two later.

Do not delay seeking help in the hope that the symptoms will resolve on their own. Contact your GP for an urgent same-day appointment, call NHS 111 for advice, or go to your nearest A&E department if it's out of hours. If you also experience chest pain, shortness of breath, or an erection lasting more than four hours, call 999 immediately, as these are separate emergencies that require immediate treatment.

When you see a healthcare professional, tell them you have been taking avanafil (Spedra) and when you last took a dose. Bring the medicine packet or patient information leaflet with you if possible. The doctor will examine your ears, may perform a hearing test, and will decide whether to start treatment with corticosteroids or refer you urgently to an ENT specialist. Early intervention is key to preserving your hearing.

Alternatives to Avanafil If Sudden Hearing Loss Persists

If you have experienced sudden hearing loss with avanafil, your doctor will usually advise against using any PDE5 inhibitor in the future, as the risk may apply to the entire class [3][4][5][6]. Fortunately, there are several alternative treatments for erectile dysfunction that work through different mechanisms and do not carry the same hearing risk [2]. Your GP or a specialist can help you find a safe and effective option.

Non-oral treatments include alprostadil, which can be given as a cream (Vitaros) applied to the tip of the penis or as an injection (Caverject) into the side of the penis [7]. These work by directly relaxing blood vessels in the penis and do not affect PDE5 enzymes elsewhere in the body. Vacuum erection devices (VEDs) are mechanical pumps that draw blood into the penis and are held in place with a constriction ring; they are safe, non-invasive, and can be used alongside other treatments.

Psychological therapy, such as cognitive behavioural therapy (CBT) or psychosexual counselling, can be very effective, especially if anxiety, stress, or relationship issues contribute to your ED [2]. Lifestyle changes—losing weight, stopping smoking, reducing alcohol, exercising regularly, and managing conditions like diabetes and high blood pressure—can also improve erectile function naturally [1][2]. Your GP can refer you to appropriate services and support you in finding the best approach for your individual situation.

Discussing Alternatives During Your Consultation

At Cured Pharmacy, every prescription treatment is supplied only after an online consultation reviewed by a UK-registered prescriber. If you have a history of sudden hearing loss or other serious side effects with PDE5 inhibitors, please declare this during your consultation. Our prescribers will assess your medical history, current medications, and any risk factors to recommend the safest and most appropriate treatment for you. You can also ask questions and discuss concerns at any stage of the process.

Scientific References

1. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 15 November 2026]
2. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 15 November 2026]
3. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 15 November 2026]
4. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 15 November 2026]
5. Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 15 November 2026]
6. Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 15 November 2026]
7. Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998). Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338(20), 1397–1404. https://pubmed.ncbi.nlm.nih.gov/9580646/ [accessed 15 November 2026]
8. Electronic Medicines Compendium. (n.d.). Summaries of Product Characteristics and Patient Information Leaflets. https://www.medicines.org.uk/emc/ [accessed 15 November 2026]
9. NHS. (n.d.). Erectile dysfunction (impotence). https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ Accessed 15 November 2026.

Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.