Avanafil, a new rapid-onset phosphodiesterase 5 inhibitor for the treatment of erectile dysfunction

Importance of the field: Erectile dysfunction (ED) is a common sexual problem, affecting up to half of men over 50 years of age. Phosphodiesterase type 5 (PDE5) inhibitors (sildenafil, tadalafil and vardenafil) are currently the first-line treatment option presented to patients with ED. There exists a significant number of men who remain dissatisfied with the available therapies and are either unable to achieve their therapeutic goals or unwilling to tolerate adverse side effects. Therefore, development of novel PDE5 inhibitors with enhanced selectivity, faster onset of action, increased potency and improved tolerability is desirable. Areas covered in this review: Preclinical and clinical studies of avanafil, a new oral PDE5 inhibitor being investigated for the treatment of ED. Data were obtained by searching for all English peer-reviewed articles on Medline and any related abstracts presented on avanafil at major international congresses. What the reader will gain: An understanding of the pharmacokinetic and pharmacodynamic characteristics of avanafil and insight into the drug's clinical efficacy and safety profile. Take home message: We propose that avanafil, which displays enhanced selectivity, faster onset of action, and a favorable side-effect profile relative to currently available PDE5 inhibitors, may offer an alternative first line treatment option for men with ED.