Get generic for Viagra shipped right to your door

Get started

Stendra vs. Viagra: Which Is More Effective?

Kelly Brown MD, MBA

Reviewed by Kelly Brown MD, MBA

Written by Geoffrey C. Whittaker

Published 06/24/2019

Updated 04/12/2024

If you’ve been parsing through Stendra reviews, chances are you’re weighing it against other erectile dysfunction (ED) medications. And since Stendra® is the newest FDA-approved ED med on the market, we get why you’d want to compare it to some of the ones that have been around for longer — like Viagra®.  

First things first, studies show that both Stendra and Viagra are highly effective at treating erectile dysfunction. 

Dialing in on the differences: Stendra gets absorbed more rapidly (which means it tends to work faster), generally lasts longer, and has a lower risk of causing side effects. Since Stendra is only available as a brand-name medication, it’s also on the pricier side. 

Below, we’ve compared Stendra and Viagra on a variety of factors so you can determine which ED medication could be best for you. We’ve even explored where Cialis® comes in to help round out your investigation.

  • Stendra and Viagra belong to a class of medications called phosphodiesterase type 5 or PDE5 inhibitors, which treat erectile dysfunction by increasing blood flow to the erectile tissue inside your penis.

  • Both medications can be taken before sex. Viagra typically starts working in 30 minutes to one hour, whereas Stendra is a faster-acting medication that can begin working in 15 to 30 minutes.

  • Although both medications work by increasing blood flow to your penis, Stendra is more selective in its effects. In other words: It’s more targeted. This means that it’s slightly less likely to cause some side effects than Viagra.

  • Contrary to popular belief, neither Stendra nor Viagra cause random erections or affect your sex drive. Both medications only cause erections when you have a form of sexual stimulation, such as sexual intercourse or a sexual thought.

  • Stendra was developed in the 2000s and got FDA approval in 2012. Viagra was FDA-approved back in 1998. As an older medication, Viagra is now available as a generic, making it more affordable than Stendra. The generic name for Viagra is sildenafil, which is its active ingredient. 

  • There’s no Stendra generic on the market right now, which makes it hard to compare its active ingredient Avanafil vs. Viagra on every level. Because Stendra is so new, it’s unlikely that a generic version will become available in the next few years.

If you’re wondering which option is fastest, there’s a clear answer. In fact, Stendra is the fastest-acting erectile dysfunction treatment out there, often taking effect in as little as 15 minutes.

Dosage can impact speed, though. And Stendra is currently available in three doses: 50mg, 100mg and 200mg. 

  • The 100mg and 200mg Stendra tablets typically start working within 15 minutes, meaning you can take them just a few minutes before you plan to have sex.

  • The smaller 50mg dose of Stendra typically starts to work 30 minutes. You’ll have to think about it a bit earlier, but the 50mg dose is still a convenient option for spur-of-the-moment sexual activity.

Viagra and generic medications containing sildenafil, on the other hand, normally take action in about one hour, meaning more planning is required. 

Another point in Stendra’s favor is that it can be taken with or without food, without any significant impact on the speed it takes to work. 

That’s different from Viagra, which may take longer to start working if you take it at the same time as a meal, particularly if the meal’s full of fats. 

To sum it up, Stendra might be a more useful option if you want a fast-acting ED medication that can be taken with dinner. 

Stendra also takes the top spot when it comes to longevity. Avanafil has a slightly longer half-life than sildenafil (five hours vs. four), which means one tablet of Stendra generally provides relief from erectile dysfunction for longer than an equivalent dose of Viagra.

A normal dose of Stendra lasts for around six hours, with its effects typically fading as its concentration declines.

Compare that to a typical dose of Viagra or generic sildenafil, which lasts for around three to five hours, with its effectiveness waning as its concentration decreases.

Notably, the effects of Viagra are usually most noticeable during the first one to two hours after you take it. 

Both Stendra (avanafil) and Viagra (sildenafil) are short-acting ED medications designed for use as needed, such as before you have sex. Neither medication should be taken more than once per day, making them best for sexual activity that’s pre-planned for a specific time.

Clinical studies of avanafil (the active ingredient in Stendra) and sildenafil (the active ingredient in Viagra) show that both medications are very effective at treating erectile dysfunction for most men.

Despite being a relatively new medication, Stendra is backed up by several large-scale studies:

  • In a 2012 study published in the journal BJU International, researchers found that avanafil was “effective and well tolerated” as a treatment option for erectile dysfunction. In this study, men with ED who received the medication at a dose of 100mg or 200mg showed significant improvements in an International Index of Erectile Function erectile function domain self report (IIEF-EFD), a scoring system used to assess erection quality.

  • A 2014 clinical review found that men with erectile dysfunction who used avanafil displayed improvements in erection quality at all dosages, from the lowest 50mg dose to the strongest 200mg tablet. The researchers also noted that the effectiveness of avanafil increased with dosage, with little increase in side effects.

In short, Stendra is proven to work well as a treatment for erectile dysfunction, with large-scale studies backing up its effectiveness. 

As for Viagra, there are countless studies showing its success as a treatment for ED: 

  • In a 1998 study, researchers noted that sildenafil, Viagra’s active ingredient, is an “effective, well-tolerated treatment” for men with ED.

  • In a clinical review from 2002, researchers stated that over 95 percent of men with ED who used sildenafil over one to three years reported feeling satisfied about the effects of the treatment on their erections.

So, although some users might prefer one medication to the other, Stendra and Viagra are both highly effective treatments for ED. Study data shows that both medications work well for improving erection quality and enhancing sexual performance. 

Stendra and Viagra can both cause similar side effects. However, studies show that fewer men experience several common side effects, such as headaches and nasal congestion, with Stendra than with Viagra.

Headaches are the most common side effect of both medications: 

  • According to FDA clinical trials data, 10.5 percent of men who use Stendra at the highest prescribed dose report headaches. A smaller percentage of men who use Stendra at 50mg and 100mg doses also report dealing with headaches after using the medication.

  • In contrast, approximately 28 percent of men who take Viagra at the highest prescribed dose report experiencing headaches, making this side effect nearly three times as common among men who use Viagra to treat ED.

This is a prevailing trend for other side effects as well: 

  • Facial flushing is a common side effect of both Stendra and Viagra. However, it occurs in only 4.3 percent of men who use the highest prescribed dose of Stendra, versus 18 percent of men who use Viagra.

  • Similarly, side effects such as nasal congestion, heartburn and back pain are all significantly more likely to occur with Viagra than with Stendra.

  • More severe side effects, such as loss of vision and other vision-related issues, also appear more frequently among men who use Viagra than among Stendra users.

These differences are likely the result of Stendra’s more selective effects in the body. Stendra specifically targets the PDE5 enzyme, meaning it has a lower risk of causing side effects from inhibiting PDE1, PDE6 and other enzymes.

This allows it to more specifically expand the blood vessels that supply the erectile tissue inside the penis, with reduced effects elsewhere in the body. 

Still, some of the more serious risks remain fairly even between the two medications:

  • All PDE inhibitors have a potential side effect risk of runny nose, vision loss, low blood pressure, indigestion, hearing loss and others.

  • Stendra and Viagra can both cause a side effect called priapism — a prolonged, painful erection that may last for four hours or longer. Priapism is highly uncommon, but it’s a serious issue that requires urgent medical attention to avoid damaging the tissue inside your penis.

  • Both Stendra and Viagra have the potential to cause drug interactions when they’re taken with other medications and substances. Specifically, they can interact with nitrates like nitroglycerin, and other blood pressure medications, such as alpha-blockers. When used together, these medications may cause a rapid decline in blood pressure levels that could cause dizziness, fainting or serious cardiovascular events.

To reduce your risk of experiencing interactions while using Stendra or Viagra, it’s important to inform your healthcare professional about any medications you currently use or have recently used before taking either ED treatment.

It’s also important to avoid any recreational drugs that could cause interactions with Stendra or Viagra. 

choose your chew

add a boost to your sex life with our new chewable formats

Stendra and Viagra are both safe medications, provided they’re used as prescribed. 

If you’re a healthy male with no history of cardiovascular disease, kidney disease, high blood pressure or other health issues, you can safely use either drug as prescribed by your doctor.

To keep yourself safe, make sure to closely follow your healthcare provider’s instructions and only use Stendra or Viagra as prescribed. 

Both medications are sold as prescription drugs only, meaning you’ll need to talk to your doctor before you can use either Stendra or Viagra. 

It’s also important to tell your healthcare provider if you currently have any medical conditions that may affect your use of Stendra or Viagra, or if you’ve previously suffered a heart attack or stroke.

Choose your chew

As you probably know, there are more ED treatments than Stendra, Viagra and generic sildenafil. If you tend to have frequent, spontaneous or daily sex and want a longer-lasting medication for the treatment of erectile dysfunction,  Cialis may be a better fit.

Cialis, or generic tadalafil, is often referred to as the “weekend pill.” 

It got this nickname because of its 17.5 hour half-life, which allows a single dose to provide erectile dysfunction relief for as long as 36 hours

Since Cialis can be used on a daily basis, it’s worth considering if you need an ED pill that’s “always on.”

That said, Stendra’s lower incidence of side effects and quicker time to effect (like Viagra, Cialis also requires around one hour to take effect within the body) may make Stendra better for people who don’t see the benefits they want from Cialis.

Of course, cost is an important factor when comparing medication options — even a tiny difference in the price of two medications can add up, often to a substantial amount. 

Because the active ingredient in Viagra (sildenafil) is now available as a generic medication, it’s a significantly more affordable option than Stendra. 

To put the difference in pricing into perspective, generic sildenafil costs $3 per pill via our online telehealth platform. Meanwhile, since Stendra is only available as a brand-name medication, it costs $53 per dose. 

Like Stendra, brand-name Viagra is also priced at a significant premium at $139 per dose. 

From a value-for-money perspective, generic sildenafil is the most affordable option for treating erectile dysfunction. It contains the exact same active ingredient as Viagra and works the same way within your body, making it a comparatively cost-effective ED treatment option.

sildenafil citrate

get hard for 95% cheaper than Viagra

If you frequently have weak erections, or find it difficult to maintain an erection sufficient for sex, Viagra and Stendra are both safe, effective medications that can improve your sexual performance and satisfaction.

  • As the newest ED medication on the market, Stendra offers many of the same benefits as older drugs like Viagra with fewer side effects. 

  • Stendra is less likely to cause common side effects and has fewer severe side effects than older ED treatment medications, such as Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil). 

  • If you’re prone to headaches, nausea or other adverse effects from Viagra, you’ll likely benefit from giving Stendra a try.

  • Both Cialis and Stendra have longer half-lives than Viagra, making them great options for men with more flexible sex lives. Just keep in mind: Stendra has the faster onset of action.

  • On the other hand, Viagra’s availability and affordable pricing as generic sildenafil mean it offers great value if you use ED drugs frequently.  

Need help dealing with common sexual health issues such as erectile dysfunction or premature ejaculation? We offer a wide range of erectile dysfunction treatments and other medications for improving sexual performance online, including Levitra® (vardenafil), Stendra, tadalafil (generic Cialis) and sildenafil (generic Viagra). 

You can also find out more about the unique benefit of Stendra as a treatment for ED in our full Stendra 101 guide. 

9 Sources

  1. Dhaliwal, A. & Gupta, M. (2022, May 20). PDE5 Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549843/
  2. VIAGRA- sildenafil citrate tablet, film coated. (2017, August). Retrieved from https://www.accessdata.fda.gov/spl/data/40578e70-350a-4940-9630-55d90989c146/40578e70-350a-4940-9630-55d90989c146.xml
  3. STENDRA- avanafil tablet. (2017, August). Retrieved from https://www.accessdata.fda.gov/spl/data/41d308f4-9a6a-48bb-b7a0-d63da9818078/41d308f4-9a6a-48bb-b7a0-d63da9818078.xml
  4. Katz, E.G., Tan, R.B., Rittenberg, D. & Hellstrom, W.J. (2014). Avanafil for erectile dysfunction in elderly and younger adults: differential pharmacology and clinical utility. Therapeutics and Clinical Risk Management. 10, 701-711. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155803/
  5. CIALIS- tadalafil tablet, film coated. (2017, May). Retrieved from https://www.accessdata.fda.gov/spl/data/05dbd8b6-1b9d-436a-a67c-8a16713f753f/05dbd8b6-1b9d-436a-a67c-8a16713f753f.xml
  6. Zhao, C., et al. (2012, December). Efficacy and safety of avanafil for treating erectile dysfunction: results of a multicentre, randomized, double-blind, placebo-controlled trial. BJU International. 110 (11), 1801-1806. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22448738/
  7. Wang, H., et al. (2014, August). The effectiveness and safety of avanafil for erectile dysfunction: a systematic review and meta-analysis. Current Medical Research and Opinion. 30 (8), 1565-1571. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24701971/
  8. Goldstein, I., et al. (1998, May). Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. The New England Journal of Medicine. 338 (20), 1397-1404. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9580646/
  9. Carson, C.C., Burnett, A.L., Levine, L.A. & Nehra, A. (2002, September). The efficacy of sildenafil citrate (Viagra) in clinical populations: an update. Urology. 60 (2 Suppl 2), 12-27. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12414330/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kelly Brown MD, MBA
Kelly Brown MD, MBA

Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.

She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.

Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.

Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.

Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.

Education & Training


Research

Published as Kelly Walker



Read more

Related Articles

Viagra, without the office visits

Treat erectile dysfunction with the original ED treatment