Warning: Adenafil is Not an FDA-Approved Medication
Adenafil is not a recognized or FDA-approved medication for erectile dysfunction, and there is no legitimate clinical evidence supporting its use. This appears to be either a counterfeit product, a misspelling of an approved PDE5 inhibitor, or a potentially dangerous unregulated substance being marketed fraudulently.
Critical Safety Concerns
- No established safety profile exists for any product called "adenafil," meaning risks of cardiovascular events, drug interactions, and other serious adverse effects are completely unknown
- Counterfeit ED medications frequently contain variable amounts of active ingredients, contaminants, or entirely different substances that can cause serious harm or death
- The absence of regulatory oversight means no quality control, no standardized dosing, and no accountability for adverse events
FDA-Approved PDE5 Inhibitors for Erectile Dysfunction
If the question refers to a legitimate PDE5 inhibitor, the FDA-approved first-line options include:
Sildenafil (Viagra)
- Starting dose: 50 mg taken approximately 1 hour before sexual activity, with titration to 100 mg or reduction to 25 mg based on efficacy and tolerability 1, 2
- Efficacy: 69% successful intercourse attempts versus 35.5% with placebo 1, 2
- Duration of action: up to 12 hours 3
- Most common adverse effects: headache, flushing, dyspepsia, nasal congestion, abnormal vision 2
Tadalafil (Cialis)
- As-needed dosing: 10 mg taken prior to sexual activity, with option to increase to 20 mg or decrease to 5 mg 4
- Daily dosing: 2.5-5 mg once daily for spontaneous sexual activity 4
- Duration of action: up to 36 hours, allowing greater spontaneity 4
- Efficacy: 69% successful intercourse attempts versus 33% with placebo 1, 4
- Lower rates of flushing compared to sildenafil 4
Vardenafil
- Similar efficacy to sildenafil and tadalafil (68% successful intercourse versus 35% placebo) 1
- Does not inhibit phosphodiesterase-6, avoiding the rare color vision changes seen with sildenafil 5
Absolute Contraindications for All PDE5 Inhibitors
- Concurrent nitrate use in any form (organic nitrates, nitroglycerin, isosorbide) due to potentially fatal hypotension 4, 2, 6
- Wait 24 hours after sildenafil/vardenafil or 48 hours after tadalafil before administering emergency nitrates 4, 6
Cardiovascular Risk Stratification Required
Before prescribing any legitimate PDE5 inhibitor:
- Verify the patient can walk 1 mile in 20 minutes or climb 2 flights of stairs without symptoms 4, 6
- Refer to cardiology if cardiovascular risk is indeterminate or patient cannot perform moderate physical activity 4, 2
- High-risk patients requiring cardiac stabilization first: unstable angina, uncontrolled hypertension, recent MI/stroke (within 2 weeks), NYHA Class II-IV heart failure 6
Recommendation
Do not use any product marketed as "adenafil." If erectile dysfunction treatment is needed, prescribe FDA-approved PDE5 inhibitors (sildenafil, tadalafil, or vardenafil) after appropriate cardiovascular screening and verification of no nitrate use 1, 4, 2.