Description
Extra super filana (Avanafil + Dapoxetine) 200 mg + 60 mg
Extra super filana appears to be a combination medicine containing avanafil and dapoxetine. Based on the identified ingredients, it combines a phosphodiesterase type 5 (PDE5) inhibitor used for erectile dysfunction with a selective serotonin re-uptake inhibitor (SSRI) used for premature ejaculation.
Active Ingredient and Medicine Class
Avanafil is a PDE5 inhibitor. Medicines in this class help improve erectile function by enhancing the normal erectile response to sexual stimulation. Dapoxetine is a short-acting SSRI. It is used for premature ejaculation and is distinguished from antidepressant SSRIs by its rapid onset and short duration of action.
Established Medical Uses
Avanafil is established for the treatment of erectile dysfunction in adult men. Dapoxetine is established for the treatment of premature ejaculation in adult men in jurisdictions where it is authorised. The combination of a PDE5 inhibitor with an SSRI has been studied for men who have premature ejaculation, including those with associated erectile dysfunction, but this does not mean every fixed-dose combination product has the same regulatory status in every country.
How It Works
Avanafil works by inhibiting PDE5, which helps preserve cyclic GMP in penile tissue during sexual stimulation. This supports smooth muscle relaxation and increased blood flow to the penis, making an erection more likely when arousal is present. Dapoxetine increases serotonin signalling by blocking serotonin reuptake. In the context of premature ejaculation, this can help delay ejaculation and improve perceived control.
Important Safety Information
Important contraindications and precautions are associated with both ingredients. Avanafil should not be used with nitrate medicines because of the risk of a marked fall in blood pressure. It also requires caution with alpha-blockers, strong CYP3A4 inhibitors, significant cardiovascular disease, and conditions where sexual activity is not advised. Dapoxetine should not be used with monoamine oxidase inhibitors, thioridazine, other serotonergic medicines in certain circumstances, or in people with a history of fainting related to serotonin-related medicines. It is also contraindicated in patients with significant heart problems or certain psychiatric and neurologic risks, depending on the local product information. Because both ingredients can interact with multiple medicines, the risk of clinically significant drug interactions is important.
Possible Side Effects
Avanafil may cause headache, flushing, nasal congestion, dizziness, back pain, and indigestion. More serious adverse effects can include priapism, sudden vision changes, and symptomatic low blood pressure. Dapoxetine commonly causes nausea, dizziness, headache, diarrhoea, insomnia, and somnolence. More serious reactions may include fainting, mood changes, serotonin syndrome, and sexual side effects. Not every patient will experience these effects, and the overall tolerability depends on the individual and on concomitant medicines.
Scientific Evidence
Human studies support avanafil as an effective PDE5 inhibitor for erectile dysfunction, with a favourable selectivity profile among PDE5 agents. Dapoxetine has shown benefit over placebo in multiple randomized trials and meta-analyses for prolonging intravaginal ejaculatory latency time and improving patient-reported control and satisfaction. For men with premature ejaculation, systematic reviews and meta-analyses suggest that combining an SSRI with a PDE5 inhibitor may improve ejaculation-related outcomes more than either class alone, although adverse events can be more frequent and the evidence base is still limited compared with licensed single-ingredient products.
Medical Information Notice
This page is an educational summary prepared from sources available at the time of review. It does not replace the official patient leaflet, prescribing information, or an individual assessment by a qualified healthcare professional.
Medical Sources
- European Medicines Agency (EMA) Priligy referral information for dapoxetine. View official EMA information
- DailyMed / U.S. prescribing information Avanafil tablets, prescribing information. View official prescribing information
- Mark Sanford. Avanafil: a review of its use in patients with erectile dysfunction. Drugs & Aging, 2013. View scientific article
- Sheridan M Hoy et al. Dapoxetine: in premature ejaculation. Drugs, 2010. View scientific article
- Yunjin Bai et al. Selective Serotonin Reuptake Inhibitors Plus Phosphodiesterase-5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis. Urology, 2015. View scientific article
