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

Most common
headache (up to 15%)
dyspepsia (up to 10%)
nasal congestion (up to 3%)
back pain (up to 6%)

Avanafil

Most common
headache (10-16%)
dyspepsia (4-12%)
nasal congestion (1-10%)
flushing (5-12%)

Tadalafil vs. Avanafil Dosage

Tadalafil

Dosage
Dosage Table
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

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

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

Common Symptoms and Related Diseases You Can Explore

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