Drug Interactions, Kratom Guides

Is Kratom Safe to Use With Avanafil?

Avanafil is a phosphodiesterase 5 (PDE5) inhibitor used to treat erectile dysfunction. It is also used in combination with other drugs to treat premature ejaculation.

Taking avanafil and kratom together can result in a few different reactions. Kratom seems to help improve erectile dysfunction and other sexual problems, but some studies show it has the opposite effect.

There’s also the issue of the two substances being metabolic inhibitors. Using them together means taking two drugs that could have different or similar actions and could cause problems either way.

However, is this interaction severe?

Last updated 1 week ago by Wade Paul

Is Kratom Safe to Use With Avanafil?

Does Kratom Interact With Avanafil (Stendra)?

Kratom can interact indirectly with avanafil. Both can improve erectile dysfunction, and the same enzyme metabolizes both. This means an increased risk of side effects and adverse reactions.

Combining kratom and avanafil implies a mild to moderate risk of interaction.

Always consult your prescribing physician before taking kratom and avanafil together.

Kratom’s interaction with avanafil can happen in two ways:

1. Increased Effects (Agonistic Interaction)

Kratom and avanafil can have an agonistic interaction.

An agonistic interaction occurs when two or more substances exhibit similar effects in the body. It means that one drug can boost the effects of another drug.

Avanafil inhibits phosphodiesterase 5 (PDE5) in the body [1]. This helps produce and maintain an erection in people with erectile dysfunction.

On the other hand, kratom can increase libido and even help erectile dysfunction, though it’s through a different mechanism of action [5]. It’s important to note that kratom has the opposite effect on some people and can worsen these problems [4]. Long-term kratom users can present with loss of libido, infertility, and impotence.

Using the two compounds together can increase the effects; however, kratom could render the medication less effective in some cases.

2. Slowed Elimination (Metabolic Competitor)

Kratom and avanafil can metabolically compete with each other.

The P450 family of enzymes is in charge of drug metabolism in the body. Metabolic inhibition occurs when two medications require the same enzymes to be processed and eliminated. As a result, they are forced to compete for it. This effect may slow the metabolization of one or both medicines.

The enzyme cytochrome P450 enzymes, particularly CYP3A4 and CYP2C, metabolize avanafil.

Kratom is metabolized by the cytochrome enzymes of the liver, namely CYP3A4, CYP2D6, and CYP2C9.

As a result, combining kratom and avanafil can cause the latter’s plasma levels to rise in the body. This may cause avanafil to have a more substantial effect.

There will also be a slowdown in the clearance of avanafil, causing it to last longer and cause more side effects such as lower blood pressure, fainting, etc.

Kratom & Avanafil (Stendra) Interactions

Avanafil is classified as a PDE5 inhibitor. It restricts phosphodiesterase 5 in the blood vessels and other body parts, causing vasodilation. Kratom interacts with other PDE5 inhibitors in similar ways.

Other PDE5 inhibitors include:

Is it Safe to Take Kratom With Avanafil (Stendra)?

It may not be safe to take them both together due to their similar actions in the body.

Kratom can slow down avanafil’s elimination process and provoke increased plasma levels of avanafil. This can lead to a higher risk of side effects, so be careful if you want to take them together.

Small amounts with enough time between doses may help prevent these interactions.

Take these medications only after you have consulted with your prescribing physician. Never start them of your own accord. If you encounter any unusual side effects, get medical aid immediately.

What is Avanafil (Stendra)?

Avanafil (Stendra) is a phosphodiesterase 5 inhibitor used to treat erectile dysfunction and premature ejaculation. It also has blood-pressure-lowering effects.

Avanafil can suppress a specific phosphodiesterase type 5 enzyme present in various bodily tissues, particularly the corpus cavernosum of the penis.

This drug has rapid effects compared to other PDE5 inhibitors — its onset of action is 15 minutes. It is rapidly absorbed, with a maximum serum concentration within 30 to 45 minutes.

Generic & Brand Names

  • Stendra
  • Spedra

Avanafil Details & Specifications

Drug NameAvanafil
Trade NameStendra, Spedra
ClassificationPhosphodiesterase 5 (PDE5) Inhibitors
CYP MetabolismCYP3A4, CYP2C9
Interaction With KratomAgonistic, Metabolic Competition
Risk of InteractionModerate

What is Avanafil (Stendra) Used for?

Avanafil is regularly taken through oral administration and is supplied as oval, pale yellow tablets containing 50 mg, 100 mg, or 200 mg.

In the clinical field, avanafil has several indications; some of these are:

Erectile Dysfunction

Phosphodiesterase 5 (PDE5) inhibitors are in several regions of the body. The corpora cavernosa, platelets, skeletal muscles, and vascular and visceral muscles are the areas where it is most concentrated.

During a sexual act, sexual stimulation stimulates a nerve in the pelvic region, releasing nitric oxide (NO). The increase in cyclic guanosine phosphate (cGMP) levels is caused by NO. The relaxation of the penile smooth muscles and corpora cavernosa is caused by increased cGMP levels. It also causes an erection by increasing blood flow to the penis. This action may be irregular or hampered in users with erectile dysfunction due to the actions of PDE5 on blood vessels that cause constriction.

Avanafil inhibits the PDE5, allowing for more blood flow into the penis, and helping to cause an erection and maintain it [1].

Cardioprotective Effects & Blood Pressure Control

One randomized controlled clinical trial showed that PDE5 inhibition with sildenafil could potentially cause vasodilation effects, which can help decrease high blood pressure levels. Hence, avanafil might also help lower blood pressure; however, more studies are needed [2].

Premature Ejaculation

Avanafil is used with other drugs like dapoxetine to treat premature ejaculation. It does this by allowing the proper blood flow into the penis via PDE5 inhibition and inhibiting the serotonin selective recapture inhibitors (SSRI), which help the erection last longer [3, 6].

What’s the Dose of Avanafil (Stendra)?

The recommended dose is 100 mg, as early as 15 min before sexual activity, and not taken more than once a day.

However, the doses of avanafil may range from 50 to 200 mg (maximum dose). This compound is rapidly absorbed; the median time to maximum plasma concentration is 30–45 min in the fasting state and 1 h 20 min when the drug is taken together with a high-fat meal [7].

What Are the Side Effects of Avanafil?

Avanafil may cause mild to serious side effects. Suspend avanafil consumption and consult your doctor if you experience any of the following symptoms:

  • Back pain
  • Chest pain
  • Cough
  • Diarrhea
  • Dry mouth
  • Excessive sweating
  • Flushing
  • Headache
  • Insomnia
  • Light-headedness
  • Muscle aches
  • Nausea
  • Pain in extremities
  • Priapism
  • Stomach upset
  • Stuffy or runny nose
  • Upper respiratory tract infections

Other severe side effects of avanafil include:

  • Allergic reaction (swelling of throat, face, ears, difficulty breathing, and/or skin rash)
  • Blurry vision or vision loss
  • Hearing impairment
  • Shortness of breath

What is Kratom?

Kratom (Mitragyna speciosa) is tree found in Southeast Asia that has been used as traditional medicine for centuries. Some of its alkaloids — 7-hydroxymitragynine and mitragynine — mimic the effects of opioids like morphine.

Depending on its alkaloid profile and the dose you take, kratom can be used as a stimulant (small doses) or as a sedative with analgesic properties (larger doses). Kratom is overall safe and effective; however, it can create addiction and withdrawal symptoms when taken in excessive quantities and over a long period.

What’s Kratom Used for?

You’ll find many uses for kratom since it’s highly dose-dependent. Kratom strains will also play a role in what effects you’ll get, but we will cover that further down.

Here are the most common reasons people use kratom.

Also see: Best Kratom for Weight Loss: Can It Really Help?

What’s the Dose of Kratom?

The amount will depend on what effects you’re looking for. Smaller doses are best for energy and mood, while larger doses work for pain and sleep. Still, there are certain things to consider, like strain, body weight, tolerance, and whether you’ve eaten. Use a dosage calculator to get a dose tailored to your needs.

The recommended dose of kratom is 2 grams for starters. The dosage can increase with time, but use as little as possible to avoid addiction and adverse side effects.

Learn more about taking kratom tolerance breaks to avoid dependence.

What Are the Side Effects of Kratom?

Kratom is well-tolerated when used responsibly, but there are some side effects. These mostly show up when the user takes too much. Some of these are relatively severe — but they’re also infrequent.

Common side effects of kratom:

Related: What Are the Kratom Wobbles?

What Are the Different Types of Kratom?

You’ll find kratom divided by color, a simple way to separate the different strains. There are three major kratom strains, but others do exist. Here’s a simplified explanation of each one, along with the most popular strains in each group.

White Vein Kratom

White vein kratom helps increase concentration power and can even help raise cognition. It also enhances mood and also possesses energy-boosting properties. 

Red Vein Kratom

Red vein kratom can decrease anxiety and insomnia, have strong pain-relieving actions, and effectively treat chronic pain. These can be very calming and work well for anxiety.

Green Vein Kratom

Green vein kratom can have stimulant and sedative effects that alter with your intake. It can help enhance mood and provide an extra boost of energy.

Yellow Vein Kratom

Yellow kratom is derived from a fermented form of the green vein kratom, making it smoother and more relaxing.

Also see: What is Fermented Kratom?

Key Takeaways: Is it Safe to Mix Kratom & Avanafil (Stendra)?

Combining kratom and avanafil implies a moderate risk of interaction. Their interaction can be agonistic, with kratom causing a possible increase in libido and avanafil being used to treat erectile dysfunction. Using them together can increase each other’s effects.

There can also be an issue with their metabolization since both use the same enzymes. This can cause an increased risk of side effects.

If you are willing to take the risk and combine these two substances, the best practice is to take each compound within at least a 2-hour window after taking the other.

Regardless, do not take these medications without talking to your prescribing physician before you begin. 

References

  1. Belkoff, L. H., McCullough, A., Goldstein, I., Jones, L., Bowden, C. H., DiDonato, K., … & Day, W. W. (2013). An open-label, long-term evaluation of the safety, efficacy, and tolerability of avanafil in male patients with mild to severe erectile dysfunction. International journal of clinical practice, 67(4), 333-341.
  2. Oliver, J. J., Melville, V. P., & Webb, D. J. (2006). Effect of regular phosphodiesterase type 5 inhibition in hypertension. Hypertension, 48(4), 622-627.
  3. McMahon, C. G. (2011). Efficacy of dapoxetine in the treatment of premature ejaculation. Clinical Medicine Insights: Reproductive Health, 5, CMRH-S7337.
  4. LaBryer, L., Sharma, R., Chaudhari, K. S., Talsania, M., & Scofield, R. H. (2018). Kratom, an emerging drug of abuse, raises prolactin and causes secondary hypogonadism: case report. Journal of investigative medicine high impact case reports, 6, 2324709618765022.
  5. Singh, D., Grundmann, O., Murugaiyah, V., Rahim, A. B. M., Chawarski, M., & Balasingam, V. (2020). Improved sexual functioning of long-term daily users of Mitragyna speciosa (Korth.). Journal of Herbal Medicine, 19, 100293.
  6. Martyn-St James, M., Cooper, K., Ren, S., Kaltenthaler, E., Dickinson, K., Cantrell, A., … & Hood, C. (2017). Phosphodiesterase type 5 inhibitors for premature ejaculation: a systematic review and meta-analysis. European urology focus3(1), 119-129.
  7. Kedia, G. T., Ückert, S., Assadi-Pour, F., Kuczyk, M. A., & Albrecht, K. (2013). Avanafil for the treatment of erectile dysfunction: initial data and clinical key properties. Therapeutic advances in urology5(1), 35-41.

Further Reading