Avanafil + Dapoxetine (Top Avana)

Read these points before you start. If any of them apply to you, talk to your doctor or pharmacist first.

• Never take it if you use a nitrate medicine for chest pain (such as nitroglycerin/GTN spray or isosorbide) or recreational "poppers" (amyl nitrite). Together they can make your blood pressure drop to a dangerous level.
• Do not take it if you use riociguat, a medicine for high blood pressure in the lungs.
• Check with your doctor first if you have heart disease, have been told to avoid sex because of your heart, or had a heart attack or stroke in the last 6 months.
• Tell your doctor if you have very low or uncontrolled high blood pressure, or liver or kidney problems.
• Tell your doctor if you have an eye disease such as retinitis pigmentosa, or have ever suddenly lost sight in one eye.
• Tell your doctor if your penis has an unusual shape (for example Peyronie's disease) or you have a condition that can cause long erections, such as sickle cell anaemia, leukaemia or multiple myeloma.
• Tell your doctor if you have a bleeding problem or an active stomach ulcer.
• Some medicines can raise the amount of this medicine in your blood, such as ritonavir and other HIV medicines, ketoconazole, itraconazole, clarithromycin and erythromycin. Alpha-blockers (for example doxazosin or tamsulosin) can make your blood pressure drop more.
• Do not drink lots of alcohol or grapefruit juice with it. They can raise side effects like dizziness and low blood pressure.
• It does not protect against pregnancy or sexually transmitted infections.
• This product also contains dapoxetine. Do not take it with antidepressants (SSRIs, SNRIs, tricyclics or MAOIs), lithium, tramadol, triptans for migraine or St John's wort, because this could cause serotonin syndrome.
• Do not take it if you have heart failure or serious heart rhythm problems, or if you have fainted often in the past.
• Do not take it if you have moderate or severe liver problems.
• Tell your doctor if you have ever had depression, mania, bipolar disorder or epilepsy.
• It is only for men aged 18 to 64.
• Avoid alcohol. With this medicine it greatly increases the chance of dizziness and fainting.
• Combination tablets like this are not approved in the USA or UK. Talk to your doctor before using it.
• Tell your doctor or pharmacist about every other medicine, vitamin or herbal product you use.
• Keep this product out of the reach and sight of children.