Tadalafil vs. Avanafil
See how Tadalafil and Avanafil compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Tadalafil and avanafil are both PDE5 inhibitors for erectile dysfunction, but tadalafil also treats BPH and pulmonary arterial hypertension, while avanafil is approved only for ED.
Tadalafil's long half-life allows once-daily or as-needed dosing that can work for up to 36 hours, while avanafil acts faster, sometimes within 15 minutes, but wears off sooner.
Both drugs carry the same nitrate and guanylate cyclase stimulator warnings, so people taking those medications should not use either one.
Tadalafil vs. Avanafil Drug Summary
Tadalafil
Tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor used to treat erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension. It comes as a pill, taken daily or as needed, with effects lasting up to 36 hours.
Avanafil
Avanafil is a phosphodiesterase type 5 (PDE5) inhibitor approved only to treat erectile dysfunction in adult men. It comes as a pill taken as needed before sexual activity, with some men noticing effects within about 15 minutes.
Tadalafil vs. Avanafil Side Effects
Tadalafil
Avanafil
Tadalafil vs. Avanafil Dosage
Tadalafil
Avanafil
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once daily | At the start |
| Maximum dose | 40 mg once daily | If needed |
| Dose changes | 5 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 |
Tadalafil
| STAGE | DOSE | WHEN |
| Starting dose | 2.5 mg once daily | At the start |
| Maximum dose | 40 mg once daily | If needed |
| Dose changes | 5 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 |
Tadalafil vs. Avanafil Indications
Tadalafil
Tadalafil is FDA-approved to treat erectile dysfunction, benign prostatic hyperplasia (BPH), and both conditions together. It is also approved for pulmonary arterial hypertension (WHO Group 1) to improve exercise ability. This makes it the only PDE5 inhibitor with uses beyond erectile dysfunction.
Erectile dysfunction
Benign prostatic hyperplasia (BPH)
Erectile dysfunction and BPH combined
Avanafil
Avanafil is FDA-approved only to treat erectile dysfunction in adult men. It is not approved for BPH, pulmonary hypertension, or use in women or children. Its label covers a single, focused indication.
Erectile dysfunction in adult men
Not approved for BPH or pulmonary hypertension
Not approved for use in women or children
Tadalafil vs. Avanafil Pros and Cons
Tadalafil
Tadalafil's long half-life supports both as-needed and daily dosing, and it is the only PDE5 inhibitor also approved for BPH and pulmonary hypertension. It has been on the market since 2003, giving prescribers decades of real-world experience with it.
Pros
Longest half-life of any PDE5 inhibitor, lasting up to 36 hours
Only PDE5 inhibitor also approved for BPH and pulmonary hypertension
Daily dosing option available, removing the need to plan around sex
Generic version available, unlike avanafil
Cons
Slower onset than avanafil, which can act within 15 minutes
Extra caution needed with alpha-blockers due to blood pressure risk
Longer duration means longer exposure if side effects occur
Daily dosing option means taking a pill even without sexual activity
Avanafil
Avanafil works faster than other PDE5 inhibitors, with some men noticing effects in as little as 15 minutes. It is approved only for erectile dysfunction, without the additional approved uses that tadalafil has for BPH or pulmonary hypertension.
Pros
Fastest onset of any PDE5 inhibitor, working in as little as 15 minutes
Simple as-needed dosing, with no titration schedule required
No special caution around alpha-blockers noted on its label
Shorter duration may mean fewer hours of potential side effects
Cons
Not approved for BPH, PAH, or daily dosing like tadalafil
Cannot be used with severe kidney or liver impairment
No generic version currently available in the U.S.
Fewer years on the market than tadalafil, approved in 2012 vs. 2003
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