Cialis vs. Avanafil
See how Cialis and Avanafil compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Cialis lasts up to 36 hours and can be taken once daily or as needed, while avanafil is taken only as needed and can start working in about 15 minutes.
Both drugs are PDE5 inhibitors that share risks of headache, dyspepsia, and nasal congestion, and both are contraindicated with nitrates.
Cialis is FDA-approved for ED and BPH symptoms, while avanafil is approved only for erectile dysfunction and has no generic version available.
Cialis vs. Avanafil Drug Summary
Cialis
Cialis (tadalafil) is a PDE5 inhibitor used to treat erectile dysfunction and BPH symptoms. It can be taken once daily at a low dose for continuous effect or as needed at higher doses before sexual activity.
Avanafil
Avanafil is a PDE5 inhibitor used only to treat erectile dysfunction in adult men. It is taken as needed, roughly 15 to 30 minutes before sexual activity, and comes in three dose strengths depending on response.
Cialis vs. Avanafil Side Effects
Cialis
Avanafil
Cialis vs. Avanafil Dosage
Cialis
Avanafil
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once daily | At the start |
| Maximum dose | 20 mg as needed | If needed |
| Dose changes | 3 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg as needed | At the start |
| Maximum dose | 200 mg as needed | If needed |
| Dose changes | 2 increases | As tolerated |
Cialis
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once daily | At the start |
| Maximum dose | 20 mg as needed | If needed |
| Dose changes | 3 increases | As tolerated |
Avanafil
| STAGE | DOSE | WHEN |
| Starting dose | 50 mg as needed | At the start |
| Maximum dose | 200 mg as needed | If needed |
| Dose changes | 2 increases | As tolerated |
Cialis vs. Avanafil Indications
Cialis
Cialis is FDA-approved to treat erectile dysfunction, the urinary symptoms of BPH, and both conditions together. It is sometimes used off-label for pulmonary arterial hypertension, though that use is approved under the separate brand name Adcirca, not Cialis.
Erectile dysfunction
BPH symptoms (enlarged prostate)
ED and BPH symptoms together
Off-label: pulmonary arterial hypertension
Avanafil
Avanafil is FDA-approved only to treat erectile dysfunction in adult men. It has no additional approved uses, and its fast onset makes it a common choice for men who want to plan sexual activity on shorter notice.
Erectile dysfunction
No other FDA-approved uses
Fast onset for on-demand use
Not approved for use in women or children
Cialis vs. Avanafil Pros and Cons
Cialis
Cialis offers the longest duration of any PDE5 inhibitor, working for up to 36 hours, so timing sex around a dose matters less. Its once-daily option also treats BPH symptoms, making it useful for men with both conditions. It requires the same nitrate precautions as other PDE5 inhibitors.
Pros
Up to 36 hours of effect, the longest of any PDE5 inhibitor
Only PDE5 inhibitor approved for once-daily use in ED and BPH
Also relieves BPH urinary symptoms
Cons
Slower onset than avanafil, so less useful for spontaneous timing
Only tamsulosin is approved for combined use among alpha-blockers
Once-daily dosing means taking a pill every day even when not needed
Avanafil
Avanafil's main advantage is speed, since it can start working in as little as 15 minutes, faster than any other PDE5 inhibitor. It comes in three dose strengths, giving some flexibility to match response and side effects. It is not approved for any use besides erectile dysfunction and has no generic version in the U.S.
Pros
Fastest onset of any PDE5 inhibitor, as quick as 15 minutes
Three dose strengths allow fine-tuning to response
Shorter duration may suit men who prefer less lingering effect
Cons
No generic version available in the U.S.
Only approved for erectile dysfunction, with no other indications
Cannot be used with severe renal or hepatic impairment
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