What is Stendra (Avanafil): How it Compares with Viagra & Cialis

The newest ED medication to be approved by the FDA is Stendra. Find out what you need know before deciding to try it.

The Promescent Team
Hands on, practical experience – this is our expertise
by The Promescent Team Last updated 12/11/2023

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Stendra is the most recent ED med that was approved by the FDA in 2012. Erectile dysfunction, or ED, is a chronic problem that affects over 30 million men in the US alone.

Left untreated, ED can lead to lowered self-esteem, depression, and anxiety around sex and relationships.

Quick FAQs

Stendra is an erectile dysfunction medication that is currently the newest to have been approved by the FDA.

There are no generic versions of Stendra currently available.

Stendra can last up to six hours when taken as prescribed.

However, there are many proven and researched medications that can help to quickly improve erection strength and frequency.

In this guide, we’ll look at Stendra (avanafil) to see if it’s effective and safe to use as a cure for ED.

What is Stendra?

Stendra is a prescription-only medication used to treat erectile dysfunction in men. Standra is the patented brand name, while the main active ingredient is avanafil.

Stendra was approved by the FDA in 2012 as a treatment for ED, which means it’s much newer than similar medications like sildenafil and tadalafil.

This newness is a benefit as well, as the medicine was created using newer advancements within the pharmaceutical industry to help minimize side effects and improve overall benefits.

Stendra is a PDE5 inhibitor which is similar to most other ED medications.

PDE5 inhibitors help to increase blood flow throughout the body, with a pronounced effect on the penis.

Many cases of erectile dysfunction are due to circulatory issues, which means that less blood is pumped into the penis causing a decrease in erection quality.

Some of the most common causes of ED include:

  • High blood pressure
  • Diabetes
  • Obesity
  • High cholesterol
  • Poor circulation

Stendra can help by increasing circulation and encouraging more blood flow into the penis when sexually excited. While Stendra is not an instant-erection medication, it does increase the chances of a firm and regular erection when in the mood.

According to multiple studies, Stendra is effective at treating erectile dysfunction in men. The studies reported that most men had firmer and more frequent erections when compared to the placebo group.

Based on research, Stendra is comparable to other known brands like Viagra and Cialis. In some cases, it may even be more effective and with fewer side effects.

Are There Generic Versions of Stendra?

There are currently no generic versions of Stendra available.

The medication was approved quite recently by the FDA in 2012. It usually takes more time for a medication to become available for generic use.

However, Stendra is sold in some countries outside of the US as Spedra. Spedra also contains avanafil, and comes in similar dosages as Stendra with the same intended usage.

Similar drugs, however, are available as generic medications. Viagra can be purchased as sildenafil, Cialias as tadalafil, and Levitra as vardenafil.

Stendra Ingredients

Stendra’s main active ingredient is avanafil, which has been shown to be effective and overall safe for most men as a treatment for ED.

Aside from avanafil, Stendra also contains a few standard pill-fillers to aid in preservation and absorption. 

There are no direct allergen warnings listed for Stendra, although users should cease usage of the medication if any reaction occurs.

Since it’s a prescription medication, a doctor will prescribe an initial dosage based on the patient's medical history and desired effect. Different Stendra Doses include:

  • 50mg
  • 100mg
  • 200mg

100mg is the average recommended dosage for first-time users. The dosage may be raised or lowered depending on factors such as:

  • If effects are felt
  • Side effects
  • Patient’s age
  • Health 

How to Take Stendra

If you're prescribed Stendra, you will be given an initial starting dosage ranging from 50mg to 200mg.

Stendra can be taken on an empty stomach or with food. Unlike similar medications, Stendra’s absorption is not affected by certain foods and should provide more consistent results over time.

Another benefit of Stendra is that it’s supposed to be taken 15-30 minutes before sexual activity. This is a slightly shorter time frame than other medications as well.

Stendra can only be taken once a day, and it’s recommended that you follow the instructions provided by the prescribing doctor. Taking more than prescribed, or combining it with other ED medications, may lead to serious side effects.

How Long Does Stendra Last?

Stendra generally lasts around six hours for most men. This does not mean that a man will have an erection for six hours.

However, it will increase blood flow during this time and make it easier to attain and maintain an erection when sexually excited.

How is Stendra Different From Other ED Medications?

Stendra's effects last slightly longer than Viagra. Here’s how it compares two of the top ED meds:

  • Stendra - 6 hours
  • Viagra - 4 hours
  • Cialis - 36 hours

Stendra’s shorter time can be a benefit for those who experience moderate side effects and don't want the medication active in their system for too long. 

But it might not provide the long-term relief or spontaneity that other medications may provide.

Stendra’s absorption is also not affected by whether it’s taken on an empty stomach or with food. 

Some similar medications may not respond when taken with fatty foods, whereas Stendra has much more leeway when taking the product.

Stendra is also generally safe to take with normal amounts of alcohol for most healthy men. 

While it’s still important to not drink excessively while taking any circulatory medication, Stendra has fewer side effects when combined with alcohol compared to similar medications.

Finally, Stendra seems to be as effective, if not more effective for some men, than other similar medications for treating ED. 

As a newer medication, it also targets the PDE5 enzyme more specifically than other ED medications. This can help to reduce unwanted side effects and increase the potential benefits.

While the medication has many benefits, one potential drawback is the lack of a generic version. This may make Stendra more expensive than comparable products, but for some, the potential benefits may be worth the slight increase in cost.

Stendra Side Effects

While Stendra’s side effect profile is relatively moderate, and does not seemingly increase with higher dosages, there are still some side effects that all users should be aware of.

Some common or possible Stendra side effects include:

  • Headache: This is one of the most common side effects that researchers have found. However, nearly all ED medications have headaches as a possible side effect.
  • Facial flushing: Some men may experience light facial flushing when taking Stendra.
  • Nasal congestion: Some men may feel congested when taking the Stendra.
  • Back pain: This is a rarer side effect, but some men have reported back pain when taking Stendra.
  • Sinus discomfort: If sinus pain persists or gets worse, it's important to tell your doctor and try a different Stendra dosage.

All of these side effects are relatively minor, but it’s important to mention them to your doctor so you can see if a lower Stendra dosage may be right for you.

Some possible severe side effects of Stendra for ED include:

  • Vision problems
  • Hearing problems
  • Dizziness
  • A prolonged erection that lasts four or more hours (priapism)

If any other above side effects occur, it’s important that you call 911 or head to an emergency room for assessment. 

It's important to take these rare side effects seriously as they can cause significant damage if they're not treated immediately.

Luckily, when compared to other PDE5 inhibitor medications, Stendra overall has fewer side effects since it’s a more targeted medication than Cialis and Viagra.

Stendra Drug Interactions

Stendra does have some drug interactions that you should be careful about. Your doctor should see your file in advance and note if there are any interactions with other medications you may be taking.

Make sure your doctor knows any non-prescription supplements so they can check if there are any known interactions.

Some of the most common medications that interact with Stendra are those prescribed for:

  • High blood pressure
  • Heart disease
  • Cardiovascular disease

When taken with nitrates, Stendra pills may cause a dangerous drop or change in blood pressure. Doctors will usually not prescribe ED medications to those who are taking, or have recently taken, nitrates due to this worrisome interaction.

Anyone using recreational drugs such as amyl nitrates or butyl nitrates, commonly referred to as “poppers,” should also avoid Stendra and other ED medications.

Stendra is generally safe to take with moderate amounts of alcohol as well, although long-term or heavy alcohol usage is not advised.


Overall, Stendra pills are an effective and relatively safe medication when used to treat erectile dysfunction.

While it does require a prescription, there are many online companies that allow for e-visits making it easy to purchase.

For those looking to avoid prescriptions, a natural supplement available to treat ED is VitaFLUX Nitric Oxide Booster. It can help to improve erection strength and increase stamina.

From Stendra to VitaFLUX, plus countless other well-researched treatments, there are many high-quality products available today that can help to make ED a thing of the past!

The Promescent Team

The Promescent Team

Our team has over a decade of experience in the sexual wellness field and are experts in sexual dysfunctions, like premature ejaculation. We help couples and individuals better understand treatment options available for different types of sexual needs and educate the public on all things related to intimacy. All of our authored content is medically reviewed for accuracy and reliability.


Absorption Pharmaceuticals LLC (Promescent) has strict informational citing guidelines and relies on peer-reviewed studies, academic or research institutions, medical associations, and medical experts. We attempt to use primary sources and refrain from using tertiary references and only citing trustworthy sources. Each article is reviewed, written, and updated by Medical Professionals or authoritative Experts in a specific, related field of practice. You can find out more about how we ensure our content is accurate and current by reading our editorial policy.

  • "Definition & Facts for Erectile Dysfunction - National Institute of Diabetes and Digestive and Kidney Diseases." Niddk.nih.gov, 2017, www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts. Accessed on Mar, 7, 2023.
  • Katz EG, Tan RB, Rittenberg D, Hellstrom WJ. Avanafil for erectile dysfunction in elderly and younger adults: differential pharmacology and clinical utility. Ther Clin Risk Manag. 2014 Aug 27;10:701-11. doi: 10.2147/TCRM.S57610. PMID: 25210457; PMCID: PMC4155803. Accessed on Mar, 7, 2023.
  • Smith BP, Babos M. Sildenafil. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558978/. Accessed on Mar, 7, 2023.
  • LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Tadalafil. [Updated 2017 Aug 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547910/. Accessed on Mar, 7, 2023.
  • "Symptoms & Causes of Erectile Dysfunction - National Institute of Diabetes and Digestive and Kidney Diseases." Niddk.nih.gov, 2017, www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes. Accessed on Mar, 7, 2023.
  • "Spedra (avanafil) facts - British Pregnancy Advisory Service." Bpas.org, 2015, www.bpas.org/more-services-information/erectile-dysfunction/spedra/. Accessed on Mar, 7, 2023.
  • Kloner RA, Goggin P, Goldstein I, Hackett G, Kirby MG, Osterloh I, Parker JD, Sadovsky R. A New Perspective on the Nitrate-Phosphodiesterase Type 5 Inhibitor Interaction. J Cardiovasc Pharmacol Ther. 2018 Sep;23(5):375-386. doi: 10.1177/1074248418771896. Epub 2018 May 8. PMID: 29739235. Accessed on Mar, 7, 2023.
  • "Nitrite ‘Poppers’: Here’s Why FDA Warned Against Their Use For Fun, Sex - Forbes." Forbes.com, 2021, www.forbes.com/sites/brucelee/2021/07/07/nitrite-poppers-heres-why-fda-warned-against-their-use-for-fun-sex/?sh=4cd701dae96f. Accessed on Mar, 7, 2023.
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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