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Stendra® vs. Avanafil: What's the Difference?

Kristin Hall, FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 2/1/2022

If you’re one of the 30 million American men affected by erectile dysfunction, you’ve likely spent some of your time looking into treatment options.

Erectile dysfunction (ED) can be treated using medication. One increasingly popular medication for ED is Stendra® -- a second-generation PDE5 inhibitor that received approval from the FDA in 2012.

If you’ve searched for information about Stendra before, you might have noticed “avanafil” used in place of Stendra in some guides, videos and other content. While it may seem like a different drug, avanafil is simply the active ingredient that’s found in Stendra.

Avanafil is what causes Stendra to treat erectile dysfunction by increasing blood flow to the soft, erectile tissue inside your penis. In short, it’s the ingredient that makes Stendra work.

Below, we’ve explained more about how Stendra and its active ingredient work, as well as what to expect if you choose Stendra to treat erectile dysfunction.

What is Stendra?

Stendra is the brand name for avanafil, an erectile dysfunction drug marketed by Vivus, Inc. It’s currently the only brand of avanafil that’s available in the United States. Like other medications for ED, Stendra is only available with a prescription.

Unlike older ED medications such as Viagra® (which contains the ingredient sildenafil), Cialis® (which contains tadalafil) and Levitra® (which contains vardenafil), Stendra is not available as a generic medication. 

Stendra belongs to a class of medications referred to as PDE5 inhibitors. It works by inhibiting the effects of the enzyme phosphodiesterase-5 (PDE5), which is found in the smooth muscle of your blood vessels.

PDE5 plays a significant role in regulating blood flow to certain areas of your body, including the corpora cavernosa, or erectile tissue of your penis.

By inhibiting the effects of PDE5, medications like Stendra make it easier to get and maintain an erection during sexual activity. 

Is it Possible to Buy Generic Avanafil?

Because Stendra is a new medication that only recently received approval from the FDA, there are currently no generic versions available for sale. 

In the United States, avanafil is currently only sold under the brand name Stendra. ​​In Australia, the United Kingdom and other countries, avanafil is sold under the brand names Spedra® and Zepeed™.

All of these medications contain avanafil as the active ingredient, and all have the same effects on erections and sexual performance. 

While generic avanafil isn’t yet available, Stendra isn’t a difficult medication to access. We offer Stendra online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate. 

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Stendra vs. Avanafil Dosage

Stendra comes in three different strengths: 50mg, 100mg and 200mg. The typical starting dose of Stendra for erectile dysfunction is 100mg, which can be taken on an as-needed basis around 30 minutes before sexual activity.

Based on the severity of your ED and your response to Stendra at this dosage, your healthcare provider may adjust your dosage to 50mg or 200mg.

In certain cases, such as if you are prescribed an alpha-blocker or a medication that inhibits the CYP3A4 enzyme, your healthcare provider may limit your Stendra dosage to 50mg, to be taken once per 24 hours.

Stendra vs. Avanafil Side Effects

Because Stendra contains the active ingredient avanafil, there are no real differences between the side effects of brand name Stendra and the side effects of avanafil. 

As a newer type of ED medication, Stendra is less likely to cause some side effects than older erectile dysfunction drugs such as Viagra. However, you may still experience one or more side effects while using Stendra to treat ED.

Common side effects of Stendra include:

  • Headache

  • Flushing

  • Nasal congestion

  • Nasopharyngitis (cold-like nasal symptoms)

  • Back pain

Stendra and other ED medications may also cause more serious adverse effects, such as loss of vision in one or both eyes, sudden hearing loss, ringing in the ears, dizziness, rash, swollen eyelids and itching. 

It’s important to contact your healthcare provider or seek medical treatment if you develop any of these side effects after taking Stendra. 

In rare cases, Stendra and similar ED medications may cause priapism -- a painful, prolonged erection that may last for four hours or longer. Priapism is a serious medical emergency that can result in damage to the tissue of your penis if left untreated.

If you develop a persistent or painful erection after taking Stendra, you should seek emergency medical attention as soon as you can. 

Like other ED medications, Stendra can cause drug interactions. Certain medications, such as nitrates and medications used to treat hypertension (high blood pressure), can produce a large, dangerous drop in blood pressure if used with Stendra.

You should not use Stendra if you have unstable angina, have suffered a myocardial infarction (heart attack) within the last six months, have a severe irregular heartbeat or suffer from other cardiovascular health issues, such as heart disease or heart failure.

Our guide Stendra side effects goes into more detail about these drug interactions and safety issues. 

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How Does Stendra (Avanafil) Compare to Viagra?

As a newer medication for the treatment of erectile dysfunction, Stendra offers several major advantages over Viagra. 

The first is that Stendra is a fast-acting medication. Although Stendra is designed for use 30 minutes before sex, research shows that it’s often starts working as a treatment for ED in as little as 15 minutes.

In comparison, Viagra is intended for use approximately one hour before sexual activity, with some effects noticeable after around 30 minutes.

This means that you can take Stendra sooner before sexual stimulation than Viagra, without needing to worry about whether or not the medication has taken effect in time. 

The second advantage of Stendra is that it’s less likely to cause several common side effects of ED medications than Viagra. 

In placebo-controlled trials, the most common adverse effects of Stendra were headache, facial flushing and nasal congestion, which were reported by 6.9 percent, 4.3 percent and 2.9 percent of men at a standard dose of 100mg.

In comparison, the same side effects occurred in 21 percent, 19 percent and 4.0 percent of men who used Viagra at a standard dose of 50mg in clinical trials.

Our Stendra vs. Viagra guide goes into more detail about the main differences between Stendra (avanafil) and Viagra (sildenafil). 

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Learn More About Stendra (Avanafil)

As the newest erectile dysfunction medication approved by the FDA, Stendra offers a range of unique advantages. It’s fast to work, easy to use and has a limited side effect profile, making it worth considering if you’re looking for a reliable treatment for ED. 

Avanafil is the active ingredient in Stendra. Unlike some other ED drugs, it isn’t available as a generic medication yet. 

We offer Stendra online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate. 

We also offer several other medications for erectile dysfunction, including sildenafil (the active ingredient in Viagra) and tadalafil (Cialis).

Interested in finding out more about how Stendra treats erectile dysfunction? Our full guide to Stendra explains how it works, why it’s effective and what you can expect if you use it to treat ED and improve your sexual performance. 

5 Sources

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.

  1. Definition & Facts for Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
  2. STENDRA™ (avanafil) tablets, for oral use. (2012, April). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/202276s000lbl.pdf
  3. Dhaliwal, A. & Gupta, M. (2021, June 25). PDE5 Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549843/
  4. Hellstrom, W.J., et al. (2015, August). Efficacy of Avanafil 15 Minutes after Dosing in Men with Erectile Dysfunction: A Randomized, Double-Blind, Placebo Controlled Study. Journal of Urology. 194 (2), 485-92. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25591992/
  5. VIAGRA® (sildenafil citrate) tablets, for oral use. (2014, March). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf

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.