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Stendra 200mg(avanafil) is a selective inhibitor of cGMP-specific PDE5. Avanafil is designated chemically (S)-4-[(3-Chloro-4-methoxybenzyl)amino]-2-[2-(hydroxymethyl)-1-pyrrolidinyl]-N(2-pyrimidinylmethyl)-5-pyrimidinecarboxamide and has the following structural formula. The simultaneous use of avanafil with organic nitrates and poppers is strictly contraindicated: their interaction can lead to a sharp decrease in blood pressure and fatal complications from the cardiovascular system (stroke, etc.). The minimum interval between the use of organic nitrates and avanafil should be 12 hours.