Avanafil (Stendra®) is a medication that increases blood flow to the penis. It’s taken as needed for ED and starts working in about 15 minutes.
Avanafil
*image for illustrative purpose only
Avanafil
*image for illustrative purpose only
Avanafil is the active ingredient in the brand-name medication Stendra®, a phosphodiesterase type 5 (PDE5) inhibitor that is approved to treat erectile dysfunction (ED). Avanafil works the same way as Stendra and has the same benefits and risks, per the FDA.
The drug is taken as needed and starts working in about 15 minutes, which is faster than other common oral ED treatments. Stendra lasts up to six hours.
Its action in the body is also more selective than other common oral ED treatments, which can make Stendra less likely to cause side effects. Side effects are still possible, including headache, flushing, and congestion. Also, there is a risk of experiencing low blood pressure when Stendra is used with nitrates, alpha-blockers, other blood pressure medications, and alcohol.
Stendra (avanafil) is indicated to treat:
Erectile dysfunction (ED)
Phosphodiesterase-5 (PDE5) inhibitor
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
Avanafil is currently only available as the brand-name medication Stendra®, although a generic version of Stendra has been approved and may become commercially available in 2025. It is currently unknown what the cost will be.
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)
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
Stendra or avanafil starts working quickly, typically within 30 minutes of taking the medication.
A standard dose of Stendra or avanafil (100 mg) lasts about five hours, although the effects may wear off gradually over that time. The most significant improvements in ED are seen within the first few hours after taking the drug.
Three doses are available: 50 mg, 100 mg, and 200 mg. The recommended starting dose is usually 100 mg.
Both Stendra (avanafil) and Viagra are FDA-approved medications to treat erectile dysfunction, so they can both be safe and effective for ED, but there are some differences to consider. While Stendra has a faster onset of action and is less likely to cause side effects, Viagra tends to be more widely available and affordable.
*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 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.
Kumar MA, et al. (2022). Efficacy and safety of avanafil as compared with sildenafil in the treatment of erectile dysfunction: A randomized, double blind, multicenter clinical trial. https://pmc.ncbi.nlm.nih.gov/articles/PMC9303470
STENDRA™ (avanafil) tablets, for oral use. (2012). https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/202276s000lbl.pdf