Avanafil
Stendra / Spedra (Avanafil)
Evidence grade 5 of 5, Settled. Read how the Atlas grades evidence.
The written rationale for this grade is still being prepared.
- FDA
- FDA Approved (2012)
Reference only. Not medical advice.
What can go wrong
Absolute contraindication with nitrates due to risk of severe hypotension. Common effects include headache, flushing, nasal congestion, and back pain. Caution with alpha-blockers and potent CYP3A4 inhibitors. Like all PDE5 inhibitors, rare reports of priapism and non-arteritic anterior ischemic optic neuropathy exist.
This is something to take to a clinician. The Atlas can tell you what is known about avanafil in general. It cannot tell you what is happening in your body, and the difference matters most for exactly the symptoms that bring people to this page.
Avanafil is the newest FDA-approved oral PDE5 inhibitor, cleared in April 2012 under the brand Stendra (Spedra in Europe). Its selling point is speed: many men achieve usable erections within about 15 minutes, and it is labeled for use as little as 15-30 minutes before intercourse. Its high PDE5 selectivity is intended to reduce visual and other off-target effects seen with older agents.
The fastest-acting PDE5 inhibitor on the US market.
What people take it for
What it is taken for. Approval, where it exists, covers only some of these.
How it works
Like other PDE5 inhibitors, avanafil blocks phosphodiesterase type 5, preventing breakdown of cyclic GMP in penile smooth muscle so that nitric-oxide-driven vasodilation and erection are sustained in response to arousal. Its rapid absorption and high selectivity for PDE5 over PDE6 (retina) and other isoforms underlie its fast onset and comparatively favorable visual side-effect profile.
What people get wrong
Often saidAvanafil is stronger than Viagra
ActuallyIt is faster and more PDE5-selective, not more potent; all PDE5 inhibitors enable rather than force an erection and require sexual stimulation.
Who profits, and who pushes back
Nobody is named here yet, because we have not done that work on this entry. Read that as unfinished. Somebody almost certainly sells this, and somebody almost certainly disputes it. Assume both until we have checked.
Set against the alternatives
Avanafil's main differentiator versus sildenafil and tadalafil is onset speed and PDE5 selectivity; it does not offer tadalafil's long duration or daily-dosing option. It remains less prescribed than generic sildenafil and tadalafil largely on cost.
| Avanafil | ~15-30 min onset | ~5 h half-life | FDA approved 2012 |
|---|---|---|---|
| Sildenafil | 30-60 min onset | ~4 h half-life | FDA approved 1998 |
| Tadalafil | 30-45 min onset | ~17.5 h half-life | FDA approved 2003 |
At a glance
- FDA approval
- 2012
- Onset
- ~15-30 minutes
- Half-life
- ~5 hours
- Doses
- 50, 100, 200 mg
- Class
- PDE5 inhibitor
What this entry does not yet cover
What follows is unfinished work on our side, not a finding about Avanafil. A short entry is not a safe entry.
- Cost and market. We have not documented what it sells for or who sells it.
- Supply chain. We have not mapped where it is made.
- Who uses it. We have not documented the user groups.
- What could change. No forward-looking summary yet.
- Children and teenagers. We have not checked what is known about younger people.
- Where we land. We have not taken a position on this yet.
Sources
The studies below are named and described, but not linked. You cannot open them from here and check our reading against them, which means this page is our summary of the literature rather than a document you can verify. Weigh it accordingly until the links exist.
The studies that matter
REVIVE trial2012
Avanafil significantly improved erectile function versus placebo in general ED population
REVIVE-Diabetes2012
Demonstrated efficacy in men with diabetes mellitus
Pooled rapid-onset analysis2013
Subset of men responded to intercourse attempts ~15 minutes after dosing