Cialis vs. Stendra for Erectile Dysfunction: Important Differences and Potential Risks.

Key takeaways

Tadalafil (Cialis) and avanafil (Stendra) are both medications used to treat erectile dysfunction (ED) and belong to the same drug class, phosphodiesterase-5 (PDE-5) inhibitors. However, they have several differences. Tadalafil (Cialis) is also FDA-approved for treating benign prostatic hyperplasia (BPH), while avanafil (Stendra) is only approved for ED. Tadalafil can be taken either as needed or daily, with effects lasting up to 36 hours, whereas avanafil is taken as needed and lasts up to 6 hours. Both medications are available as lower-cost generics. Common side effects of both medications include headache, flushing, and indigestion. Both medications can cause dangerously low blood pressure if taken with nitrates or certain other medications, so it's important to discuss all your medications with your healthcare provider.

Tadalafil

(Cialis)

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Stendra

(avanafil)

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Summary for Cialis

Prescription only

Tadalafil (Cialis) is used for erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) in adults. It belongs to the drug class called phosphodiesterase 5 (PDE-5) inhibitors. Tadalafil (Cialis) is a tablet you take by mouth. For ED, you can take a dose either just before sex or once every day. And for BPH, it's taken once a day. Side effects include headache and indigestion. Tadalafil (Cialis) can interact with many medications, including blood pressure medications. Some drug interactions can lead to very low blood pressure and dizziness. Tadalafil (Cialis) is available as a brand-name and generic version.

Indications for Cialis

Pros and Cons for Cialis

Pros

A first-choice medication for ED
For ED only, can take either as needed or once daily
Lasts longer than other ED medications
Can treat ED and BPH at the same time

Cons

Can take up to 2 hours to get its full effect for ED
Can cause side effects like headache, stomach upset, and back pain
Not recommended if you've had a heart attack in the past 3 months, or a stroke or heart failure in the past 6 months
Can't take if you've recently taken nitrates like isosorbide mononitrate (Monoket) or nitroglycerin (Nitrostat)

Common Side Effects for Cialis

When taken as needed for ED:

Headache (11-15%)
Indigestion (4-10%)
Back pain (3-6%)

When taken once daily for ED:

Headache (3-6%)
Indigestion (4-5%)
Common cold symptoms (3-4%)
Back pain (3%)
Upper respiratory tract infection (3%)

When taken once daily for BPH:

Headache (2-4%)
Indigestion (up to 2%)
Common cold symptoms (2%)
Back pain (1-2%)

Warnings for Cialis

Risk of heart problems in people with heart disease
Low blood pressure
Prolonged or painful erection (priapism)
Vision changes
Hearing loss
Interactions with other medications

Summary for Stendra

Prescription only

Stendra (avanafil) is a phosphodiesterase 5 (PDE5) inhibitor that's used to treat erectile dysfunction (ED). Stendra (avanafil) is taken by mouth as needed, at most once a day. It works best if you take it about 15 to 30 minutes before sexual activity. Some of the more common side effects of Stendra (avanafil) include headache and flushing. Stendra (avanafil) is brand name only and isn't available as a lower-cost generic.

Indications for Stendra

Erectile dysfunction (ED)

Pros and Cons for Stendra

Pros

Works faster than some other medications in its class (can be taken 15 minutes before sex)
Take it only when needed
Can be taken with or without food

Cons

Can cause dangerously low blood pressure if you've recently taken nitrates, such as nitroglycerin (Nitrostat)
Can't take if you have serious heart problems, such as heart attack or stroke in the past 6 months
Not available as a lower-cost generic