Avanafil Vs. Sildenafil: Drug Comparison

Avanafil is the active ingredient in the brand-name medication Stendra^®. The information below is about brand name Stendra. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Stendra (avanafil) is a phosphodiesterase type 5 (PDE5) inhibitor that is approved to treat erectile dysfunction (ED). It is taken as needed and starts working in about 15 minutes, which is faster when compared to other common ED treatments. Stendra lasts up to 6 hours. Its action in the body is also more selective than other common ED treatments, which can make Stendra less likely to cause side effects. Side effects are still possible, including heading, flushing, and congestion. Stendra also should not be combined with nitrates, and there is a risk of experiencing low blood pressure when Stendra is used with nitrates, alpha-blockers, other blood pressure medications, and alcohol.

Sildenafil is the active ingredient in the brand-name medication Viagra^®. The information below is about brand name Viagra. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Viagra (sildenafil citrate), a phosphodiesterase type 5 (PDE5) inhibitor, is an oral medication used to treat erectile dysfunction (ED). It is taken only as needed, usually about an hour before sexual activity, though it can be effective if taken between 30 minutes to 4 hours prior. It is very important not to take Viagra more than once a day, as exceeding this frequency increases the risk of serious side effects, including vision loss and significant drops in blood pressure.

Phosphodiesterase-5 (PDE5) inhibitor

Phosphodiesterase-5 (PDE5) inhibitor

Stendra (avanafil) is indicated to treat:

• Erectile dysfunction (ED)

Viagra (sildenafil citrate) is indicated to treat:

• Erectile dysfunction (ED)

• Typically taken orally as needed approximately 15 minutes before sexual activity, up to once daily

• Comes in 50 mg, 100 mg, and 200 mg tablets

• Typically taken orally as needed approximately 60 minutes before sexual activity, up to once daily

• Comes in 25 mg, 50 mg, and 100 mg tablets

Most common adverse reactions (greater than or equal to 2%) include:

• Headache

• Flushing

• Nasal congestion

• Inflammation of the nasal passages and back of the throat

• Back pain

Most common adverse reactions (≥2%) include:

• Headache

• Flushing

• Indigestion

• Abnormal vision

• Nasal congestion

• Back pain

• Muscle pain

• Nausea

• Dizziness

• Rash

• Administration of Stendra to patients using any form of organic nitrate is contraindicated

• Hypersensitivity to any component of the Stendra tablet

• Administration with guanylate cyclase (GC) stimulators such as riociguat and vericiguat

• Drug interactions: Nitrates, alpha-blockers, antihypertensives, alcohol, CYP3A4 inhibitors (e.g., ketoconazole, ritonavir, erythromycin)

• Administration of Viagra to patients using nitric oxide donors, such as organic nitrates or organic nitrites in any form

• Known hypersensitivity to sildenafil or any component of tablet

• Drug interactions: Nitrates, alpha blockers, antihypertensives, CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole, saquinavir, erythromycin)

• Patients should not use Stendra if sexual activity is inadvisable due to cardiovascular status or any other reason (

• Use of Stendra with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to low blood pressure

• Patients should seek emergency treatment if an erection lasts greater than 4 hours

• Patients should stop Stendra and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non-arteritic ischemic optic neuropathy (NAION). Stendra should be used with caution, and only when the anticipated benefits outweigh the risks, in patients with a history of NAION. Patients with a “crowded” optic disc may also be at an increased risk of NAION

• Patients should stop taking Stendra and seek prompt medical attention in the event of sudden decrease or loss of hearing

• Patients should not use Viagra if sexual activity is inadvisable due to cardiovascular status

• Patients should seek emergency treatment if an erection lasts >4 hours

• Patients should stop Viagra and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non arteritic anterior ischemic optic neuropathy (NAION)

• Patients should stop Viagra and seek prompt medical attention in the event of sudden decrease or loss of hearing

• Caution is advised when Viagra is co-administered with alpha-blockers or anti-hypertensives

• Decreased blood pressure, fainting, and prolonged erection may occur at higher sildenafil exposures

*This information is from the label for brand name Stendra^®. See the Full Prescribing Information for more complete information. Avanafil, the active ingredient in Stendra, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient avanafil.

*This information is from the label for brand name Viagra^®. See the Full Prescribing Information for more complete information. Sildenafil, the active ingredient in Viagra, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sildenafil.