Stendra vs. Sildenafil

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

Key Takeaways

  • Both Stendra and sildenafil are PDE5 inhibitors that treat erectile dysfunction by increasing blood flow, but they differ in speed and price.

  • Stendra can start working in as little as 15 minutes, while sildenafil typically takes about an hour to take effect.

  • Sildenafil is available as an affordable generic, while Stendra has no generic option and usually costs more out of pocket.

Stendra vs. Sildenafil Drug Summary

Stendra

Stendra (avanafil) is a PDE5 inhibitor used to treat erectile dysfunction in adult men. It's taken as needed before sexual activity, with the 100 mg and 200 mg doses able to work in as little as 15 minutes.

Sildenafil

Sildenafil is a PDE5 inhibitor approved for erectile dysfunction in men and, as Revatio, for pulmonary arterial hypertension. It's taken as needed before sexual activity, usually beginning to work within about an hour.

Stendra vs. Sildenafil Side Effects

Stendra

Most common
headache (up to 10.5%)
flushing (up to 3.4%)
nasal congestion (up to 2.1%)
nasopharyngitis (up to 2.7%)

Sildenafil

Most common
headache (up to 16%)
flushing (up to 10%)
nasal congestion (up to 4%)
dyspepsia (up to 7%)

Stendra vs. Sildenafil Dosage

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

Sildenafil

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 25 mg as needed At the start
Maximum dose 100 mg as needed If needed
Dose changes 2 increases As tolerated

Stendra vs. Sildenafil Indications

Stendra

Stendra is FDA-approved only for treating erectile dysfunction in adult men. It has no other approved uses, and it is not approved for women, children, or any other condition, unlike some other PDE5 inhibitors.

  • Treats erectile dysfunction in adult men

  • Not approved for use in women

  • Not approved for pediatric use

  • No additional FDA-approved indications

Sildenafil

Sildenafil is FDA-approved for erectile dysfunction in men and, as Revatio, for pulmonary arterial hypertension. It's also used off-label for other conditions, though those uses aren't FDA-approved.

  • Treats erectile dysfunction in men

  • Pulmonary arterial hypertension (Revatio)

  • Off-label: Raynaud's phenomenon

  • Off-label: female sexual arousal disorder

Stendra vs. Sildenafil Pros and Cons

Stendra

Stendra stands out for its fast onset, working in as little as 15 minutes for some doses. Because there's no generic version, it tends to cost more and is less likely to be covered by insurance.

Pros

  • Fastest onset among PDE5 inhibitors, working in as little as 15 minutes

  • Lower rates of flushing and stomach upset compared with sildenafil

  • Available in three dose strengths for flexible dosing

  • Can be effective even when taken shortly before sexual activity

Cons

  • No generic version available in the U.S.

  • Rarely covered by insurance, including Medicare

  • Roughly $660 to $1,900 per month without insurance

  • Less long-term safety data than sildenafil, approved in 2012

Sildenafil

Sildenafil has the longest track record of any PDE5 inhibitor and is widely available as an affordable generic. It works reliably but typically takes about an hour to take effect, longer than Stendra.

Pros

  • Available as a low-cost generic in most pharmacies

  • Roughly $400 to $1,060 per month for brand, generic much cheaper

  • Decades of safety data since its 1998 approval

  • Also FDA-approved for pulmonary arterial hypertension

Cons

  • Slower onset, typically around 60 minutes before it works

  • Higher rates of headache and flushing than Stendra

  • Effectiveness can be delayed by high-fat meals

  • Less ideal for more spontaneous sexual activity

Common Symptoms and Related Diseases You Can Explore

Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.