Viagra vs. Avanafil

See how Viagra and Avanafil compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Viagra and avanafil are both PDE5 inhibitors taken as needed before sex, but avanafil tends to work faster, sometimes within 15 minutes.

  • Viagra has been available as a generic for years, while avanafil has no generic version in the U.S. yet.

  • Both drugs carry the same core warnings, including a dangerous interaction with nitrates and caution for men with heart disease.

Viagra vs. Avanafil Drug Summary

Viagra

Viagra (sildenafil) is a phosphodiesterase type 5 (PDE5) inhibitor used to treat erectile dysfunction. It is taken by mouth as needed, usually 30 to 60 minutes before sexual activity. Approved in 1998, it was the first oral ED medication on the market.

Avanafil

Avanafil is a phosphodiesterase type 5 (PDE5) inhibitor also used to treat erectile dysfunction. It is taken by mouth as needed and has the fastest onset among PDE5 inhibitors, working in as little as 15 minutes for some men. It was approved by the FDA in 2012.

Viagra vs. Avanafil Side Effects

Viagra

Most common
headache (up to 28%)
flushing (up to 19%)
dyspepsia (up to 17%)
abnormal vision (up to 11%)

Avanafil

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

Viagra vs. Avanafil Dosage

Viagra

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

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

Viagra vs. Avanafil Indications

Viagra

Viagra is FDA-approved to treat erectile dysfunction in adult men. It works by relaxing blood vessels in the penis to improve blood flow during sexual stimulation. It is not approved for use in women or in children.

  • Treats erectile dysfunction in adult men

  • Taken as needed before sexual activity, not daily

  • Available in 25 mg, 50 mg, and 100 mg tablets

  • Not approved for women or pediatric patients

Avanafil

Avanafil is FDA-approved to treat erectile dysfunction in adult males. Like Viagra, it increases blood flow to the penis to support an erection during sexual stimulation. It is not approved for use in females or in pediatric patients.

  • Treats erectile dysfunction in adult men

  • Taken as needed, often shortly before activity

  • Available in 50 mg, 100 mg, and 200 mg tablets

  • Not approved for women or pediatric patients

Viagra vs. Avanafil Pros and Cons

Viagra

Viagra has decades of clinical use and is widely available as generic sildenafil, which often means broad insurance coverage. It typically takes 30 to 60 minutes to work and can be slowed by a heavy meal. Its side effect profile is well documented after more than 25 years on the market.

Pros

  • Available as low-cost generic sildenafil

  • Longest real-world track record, approved since 1998

  • Multiple dose strengths let you fine-tune your response

Cons

  • Slower onset, typically 30 to 60 minutes before sex

  • Higher reported rate of abnormal vision side effects

  • High-fat meals can delay how fast it works

Avanafil

Avanafil is the newest PDE5 inhibitor and stands out for its fast onset, sometimes working within 15 minutes. It has no generic version in the U.S., which can make it a pricier option without insurance. Its trial rates for headache and flushing were somewhat lower than Viagra's.

Pros

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

  • Lower reported rates of headache and flushing than Viagra

  • Food has less effect on how well it works

Cons

  • No generic version available in the U.S.

  • Newer drug with less long-term real-world data

  • Not recommended for severe kidney or liver impairment

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