Advice when supplying AVARANTE
If the supply of AVARANTE is deemed appropriate, encourage your customer to read the patient information leaflet and share the following advice:6
Consult your doctor within 6 months for a clinical review of potential underlying conditions and risk factors associated with EPs
Tell your doctor you’re taking AVARANTE, especially if new medication is prescribed
Stop taking AVARANTE and seek medication attention immediately if you experience serious side effects, for example:
A painful, long-lasting erection (more than 4 hours)
Sudden vision defect or loss
Sudden decrease or loss of hearing
Chest pain within 48 hours of taking AVARANTE (remember not to take any nitrates to relieve this; instead, get into a semi-sitting position and try to relax)
Dizziness or nausea during or after sex
An allergic reaction (including sudden wheeziness, difficulty breathing, dizziness or swelling of eyelids, face, lips and throat)
A serious skin reaction (including peeling and swelling of the skin, blistering of the mouth, genitals and around the eyes and fever)
Heart attack or stroke
Seizures or fits
Take this medicine frequently (i.e. at least twice a week) without consulting a GP or pharmacist about alternative options
Take another AVARANTE tablet within 36 hours of a previous dose
Use at the same time as another PDE5 inhibitor
Take with grapefruit juice, as this may increase the incidence of side effects
Drink large amounts of alcohol before sexual activity. This is to get maximum benefit from treatment
Take any medication containing nitrates, nitric oxide donors or recreational drugs such as poppers or laughing gas with AVARANTE as the combination may cause a dangerous drop in blood pressure
Additional counselling points
COMMON
SIDE EFFECTS
LIFESTYLE
ADVICE
FOR MEN STRUGGLING WITH PERFORMANCE ANXIETY

AVARANTE is generally well tolerated. A full list of side effects associated with AVARANTE can be found in the SmPC.13
The most commonly reported side effects are:
Headache
Back pain, muscle aches, pain in arms and legs
Facial flushing, hot flush
Nasal congestion
Dyspepsia

All men should be provided with appropriate lifestyle advice as these can help to reduce the risk factors for EPs.6 It has been suggested that weight loss and increased exercise may reduce the risk of EPs by up to 70%.11
You can offer advice on:
Weight management
Healthy eating
Regular exercise
Reducing stress
Quitting smoking
Moderating alcohol consumption
Avoiding recreational drugs

Performance anxiety refers to a fear or worry that something won't be accomplished in the way one would like it to happen. In this kind of stressful situation, the body reacts by increasing the stress hormone cortisol, blood vessels constrict and blood flow becomes more difficult, affecting the ability to get or maintain an erection.23
Create a relaxed atmosphere
Try breathing exercises
A massage may be helpful
Being open with a partner about anxiety and worries
Therapy sessions can provide a safe space to discuss insecurities and receive support and guidance