Avanafil, a new-generation PDE5 inhibitor, is a highly selective drug that specifically inhibits the PDE5 isoenzyme. It has minimal cross-reactivity with other PDE isoenzymes, which distinguishes it from other PDE5 inhibitors such as tadalafil, sildenafil, and vardenafil. Avanafil's selective action on PDE5 reduces the risk of adverse effects associated with the inhibition of other PDE isoenzymes. It has a relatively short half-life and achieves maximum plasma drug concentration within 30-45 minutes after dosing.

Avanafil has been found to be effective in improving penile tumescence and rigidity in response to visual stimulation in men with erectile dysfunction (ED), with peak effects occurring 20-40 minutes after taking the drug. Common side effects of avanafil are usually mild to moderate and include flushing and headache.

It has also shown lower rates of hypotensive episodes when coadministered with nitroglycerine compared to other PDE5 inhibitors. Further studies are needed to explore the potential use of avanafil in patients with concurrent nitrate use and its specific role in LUTS/BPH-ED therapy is yet to be established.