Avanafil review
The fast one — and the one least likely to tint your vision
Our overall score
Written by J. Porter, MPH
Medically reviewed by A. Vance, MD
Last reviewed
The short version
Avanafil is the newest PDE5 inhibitor and the only one approved for dosing as little as 15 minutes before sex. Its greater selectivity for PDE5 also means fewer visual side effects. The catch is price: generic availability is limited, and it remains far more expensive than sildenafil or tadalafil.
Best for: People who want spontaneity without tadalafil's long tail, or who get visual side effects from sildenafil.
What works
- Works faster than anything else in the class
- Least likely to cause blue-tinged vision or light sensitivity
- Food has only a modest effect on absorption
- More forgiving of imperfect timing
What to watch
- Cost is the dominant drawback — often 10× or more per dose versus generic sildenafil
- Limited generic availability keeps prices high
- Not stocked by every pharmacy
- Insurance coverage is inconsistent
Get emergency help for these
- An erection lasting more than 4 hours — this can cause permanent damage
- Sudden loss of vision or hearing
- Chest pain during or after sex — tell responders you took a PDE5 inhibitor
At a glance
- Generic name
- Avanafil
- Brand name
- Stendra
- Drug class
- PDE5 inhibitor
- FDA approved
- 2012
- Typical doses
- 50 mg, 100 mg, 200 mg
- Usual starting dose
- 100 mg as needed, 15–30 minutes before sex
- Onset
- As little as 15 minutes
- Duration
- About 6 hours
- Half-life
- ~5 hours
- Effect of food
- Can be taken with or without food; a heavy meal causes only a modest delay
- Generic available
- Limited availability
- Typical cost
- Often $15–$50+ per tablet — the most expensive of the fourChecked July 15, 2026. Prices vary widely by pharmacy — treat as a ballpark, not a quote.
What makes avanafil different
Avanafil is the same class as the others but was engineered for two specific improvements: speed and selectivity.
On speed, it is the only PDE5 inhibitor whose FDA labeling supports dosing as little as 15 minutes before sex. In practice that is the difference between a drug you plan around and one you can take when the evening turns that direction.
On selectivity, avanafil binds PDE5 far more preferentially over PDE6 — the related enzyme in the retina — than sildenafil does. PDE6 inhibition is what produces the blue tinge, light sensitivity, and blurring that some sildenafil users describe. Those effects are correspondingly rare with avanafil, which makes it a targeted fix for a specific, common complaint.
Dosing
- Usual start
- 100 mg, 15–30 minutes before sex
- Range
- 50 mg to 200 mg
- Frequency
- No more than once in 24 hours
- Food
- With or without — a heavy meal delays it only modestly
- Alpha blockers or mild liver impairment
- A 50 mg starting dose is typical
The cost problem
This is the honest reason avanafil is not the default recommendation. Sildenafil and tadalafil both lost exclusivity years ago and now cost a few dollars a month. Avanafil has not seen the same generic competition, and per-dose pricing frequently runs an order of magnitude higher.
That trade is worth it for some people — if sildenafil reliably gives you visual disturbances, or if the planning window is the thing standing between you and actually using the medication, paying more for a drug you will take is better than saving money on one you won't. For most people starting treatment, though, it makes sense to try a generic first.
Safety and interactions
The rest of the class-wide cautions apply unchanged: riociguat is contraindicated, strong CYP3A4 inhibitors require dose reduction or avoidance, alpha blockers call for a low starting dose, and recent cardiovascular events warrant a conversation before starting. Priapism lasting over four hours, or sudden vision or hearing loss, is an emergency.
Common side effects are headache, flushing, and nasal congestion, at rates in line with the rest of the class — with the notable exception of the visual effects, which are meaningfully less frequent.
Common questions
Does avanafil really work in 15 minutes?
Its labeling supports dosing 15 minutes before sex at the 200 mg dose, based on trial data. Individual response varies, and allowing 30 minutes is a reasonable margin.
Is avanafil worth the extra cost?
For most people starting treatment, no — a generic is the sensible first try. It becomes worth considering if sildenafil or tadalafil caused side effects you couldn't tolerate, particularly visual ones, or if the timing window is the practical barrier.
Is there a generic version of Stendra?
Generic avanafil exists but availability has been limited, and prices have not fallen the way they did for sildenafil and tadalafil. Ask your pharmacist to check current stock and cash pricing.
Can I take avanafil after a large meal?
Yes. A high-fat meal delays onset somewhat but far less than it does with sildenafil or vardenafil, which is part of what makes avanafil practical on short notice.
Sources
- 1.Stendra (avanafil) prescribing information — U.S. Food and Drug Administration
- 2.Erectile Dysfunction: AUA Guideline — American Urological Association