Tadalafil vs Avanafil
Tadalafil (Cialis) and avanafil (Stendra) sit at opposite ends of the timing spectrum. Avanafil is built for fast, on-demand use, while tadalafil is built for a long window.
PDE5 inhibitor
PDE5 inhibitor
A long-acting ED pill that can work for up to 36 hours from a single dose, so timing is flexible.
The newest ED pill, designed for fast onset — some men can take it as little as 15 minutes before sex.
Erectile dysfunction / BPH
Erectile dysfunction
- Erectile dysfunction
- Benign prostatic hyperplasia (BPH)
- Erectile dysfunction with BPH
- Pulmonary arterial hypertension (as Adcirca)
- Erectile dysfunction
- ED as-needed: 10 mg before activity (range 5–20 mg)
- ED once-daily: 2.5–5 mg taken at the same time each day
- BPH: 5 mg once daily
- Onset about 30 minutes to 2 hours; effect lasts up to 36 hours
- 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
- Back pain
- Muscle aches
- Nasal congestion
- Indigestion
- 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 with signs and symptoms of BPH
- Men who prefer dosing flexibility over planning around a pill
- 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 tadalafil
- 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
- Use caution with alcohol, which can add to blood-pressure lowering
- 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 avanafil if you want the fastest onset, as little as 15 minutes, and prefer to dose only when needed, with a lower rate of some side effects. Choose tadalafil if you would rather take one dose that lasts up to 36 hours, or a small daily dose that removes timing entirely. Avanafil is usually the pricier, brand-only option, and neither is used with nitrates.
Common questions
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