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

Most common
headache (up to 15%)
dyspepsia (up to 10%)
nasal congestion (up to 4%)
back pain (up to 9%)

Avanafil

Most common
headache (up to 16%)
dyspepsia (up to 12%)
nasal congestion (up to 10%)
flushing (up to 12%)

Cialis vs. Avanafil Dosage

Cialis

Dosage
Dosage Table
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

Dosage
Dosage Table
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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