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Do not use avanafil if you are taking a nitrate, including prescription nitrate medications or recreational drugs that contain nitrate (amyl nitrate or butyl nitrate, sometimes called "poppers"). Taking these medications together can suddenly lower blood pressure to unsafe levels. You should not take avanafil even if you do not use a nitrate very often, as you cannot predict when you might need the nitrate. You must wait at least 12 hours after taking avanafil to use a nitrate.
Other Phosphodiesterase Type-5 Inhibitors (PDE5 Inhibitors)
Avanafil is a PDE5 inhibitor and should not be used in combination with other PDE5 inhibitors, including PDE5 inhibitors used to treat a condition known as pulmonary hypertension (high blood pressure in the blood vessels of the lungs). Using more than one PDE5 inhibitor can increase your risk for serious side effects.