Sildenafil vs Avanafil
Sildenafil (Viagra) is the long-standing standard, while avanafil (Stendra) is the newest PDE5 inhibitor, designed for faster onset and fewer side effects.
PDE5 inhibitor
PDE5 inhibitor
The original ED pill, taken about an hour before sex, with a shorter and more predictable window than tadalafil.
The newest ED pill, designed for fast onset — some men can take it as little as 15 minutes before sex.
Erectile dysfunction
Erectile dysfunction
- Erectile dysfunction
- Pulmonary arterial hypertension (as Revatio)
- Erectile dysfunction
- ED: 50 mg about 1 hour before activity (range 25–100 mg), no more than once daily
- Onset about 30–60 minutes; effect lasts roughly 4–6 hours
- A heavy or high-fat meal can delay how fast it works
- ED: 100 mg about 15–30 minutes before activity (range 50–200 mg), no more than once daily
- The 100 mg and 200 mg doses may be taken as early as 15 minutes before activity
- Effect lasts roughly 4–6 hours
- Headache
- Flushing
- Indigestion
- Nasal congestion
- Dizziness
- Bluish or blurred vision
- Priapism (erection lasting more than 4 hours)
- Sudden loss of vision (NAION)
- Sudden loss or decrease in hearing
- Headache
- Flushing
- Nasal congestion
- Back pain
- Priapism (erection lasting more than 4 hours)
- Sudden loss of vision (NAION)
- Sudden loss or decrease in hearing
- Adult men with erectile dysfunction
- Men who prefer a shorter, more predictable duration and often the lowest cash price per dose
- Adult men with erectile dysfunction
- Men who want the fastest onset among PDE5 inhibitors
- Use with nitrates in any form
- Use with the guanylate cyclase stimulator riociguat
- Known hypersensitivity to sildenafil
- Use with nitrates in any form
- Use with the guanylate cyclase stimulator riociguat
- Known hypersensitivity to avanafil
- Additive low blood pressure when combined with alpha-blockers or antihypertensives
- Blood levels increase with strong CYP3A4 inhibitors such as ketoconazole or ritonavir
- Not recommended in men for whom sexual activity is inadvisable due to cardiovascular status
- Effectiveness may be reduced when taken with a high-fat meal
- Additive low blood pressure when combined with alpha-blockers or antihypertensives
- Blood levels increase with strong CYP3A4 inhibitors such as ketoconazole or ritonavir
- Not recommended in men for whom sexual activity is inadvisable due to cardiovascular status
- Use caution with alcohol, which can add to blood-pressure lowering
Bottom line: which should I choose?
Choose sildenafil for the lowest cost and decades of data. Choose avanafil if you want the fastest onset, as little as 15 minutes, and a lower chance of side effects like flushing, accepting the higher brand-only price. Both last a few hours, and neither can be combined with nitrates.
Common questions
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