Cialis vs. Stendra

See how Cialis and Stendra compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Cialis can be taken daily at a low dose or as needed at a higher dose, while Stendra is only taken as needed before sex.

  • Stendra tends to work faster, in as little as 15 minutes, but Cialis lasts far longer, up to 36 hours.

  • Cialis is also FDA-approved for BPH symptoms and comes as a generic, while Stendra is brand-only and treats ED alone.

Cialis vs. Stendra Drug Summary

Cialis

Cialis (tadalafil) is a PDE5 inhibitor tablet used to treat erectile dysfunction and the urinary symptoms of an enlarged prostate (BPH). It can be taken as a low daily dose or as a larger dose only when needed, and its effects can last up to 36 hours.

Stendra

Stendra (avanafil) is a PDE5 inhibitor tablet used only to treat erectile dysfunction. It's taken as needed before sexual activity and can start working in as little as 15 minutes.

Cialis vs. Stendra Side Effects

Cialis

Most common
Headache (up to 15%)
Back pain (up to 9%)
Flushing (up to 4%)
Nasal congestion (up to 4%)

Stendra

Most common
Headache (up to 10.5%)
Back pain (up to 2%)
Flushing (up to 3.4%)
Nasal congestion (up to 2.1%)

Cialis vs. Stendra 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

Stendra

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. Stendra Indications

Cialis

Cialis is FDA-approved to treat erectile dysfunction, the urinary symptoms of BPH, or both conditions at once. It's also used off-label, under the brand name Adcirca, for pulmonary arterial hypertension.

  • Erectile dysfunction in adult men

  • Signs and symptoms of BPH

  • Combined ED and BPH symptoms

Stendra

Stendra is FDA-approved for one purpose: treating erectile dysfunction in adult men. It has no approved use for prostate symptoms or any other condition.

  • Erectile dysfunction in adult men

  • Not approved for BPH or other urologic conditions

  • Not approved for use in women or pediatric patients

Cialis vs. Stendra Pros and Cons

Cialis

Cialis offers flexible dosing, from a low daily pill to an as-needed higher dose, and it's the only PDE5 inhibitor also approved for BPH. It's available as a generic, which usually lowers the out-of-pocket cost compared to brand-only options.

Pros

  • Can be taken daily, removing the need to plan around sex

  • Longest duration of any PDE5 inhibitor, up to 36 hours

  • Also FDA-approved for BPH symptoms

Cons

  • Slower onset than Stendra, needs more advance planning

  • Higher reported rates of dyspepsia and headache in trials

  • Not recommended with most alpha-blockers except tamsulosin

Stendra

Stendra works faster than other PDE5 inhibitors, with some doses effective in as little as 15 minutes. It's brand-only, so it tends to cost more and isn't approved for any use beyond ED.

Pros

  • Fastest onset of any PDE5 inhibitor, as early as 15 minutes

  • Lower reported rates of headache and flushing in trials

  • No dose adjustment noted for use with tamsulosin

Cons

  • No generic available, typically $660 to $1,900 per month, often not covered by insurance

  • Not recommended within 6 months of heart attack, stroke, or serious arrhythmia

  • Only approved for ED, with no additional approved uses

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