On this page Jump to a section
- Key facts
- What avanafil is and how to take it
- Avanafil vs sildenafil, tadalafil, vardenafil
- Choose by timing, routine and treatment history
- Avanafil side effects vs placebo
- Nitrates, CYP3A4 and alcohol
- Cost of Stendra and avanafil
- Why consider sildenafil or tadalafil?
- What each path includes
- Prepare for your online visit
- If you want ED treatment now
- Mendoxa plans and prices
- FAQ
- How we wrote this
- Sources and references
Key facts at a glance
- Strengths
- 50, 100 and 200 mg tablets; usual start 100 mgSTENDRA (avanafil) label · DailyMed
- Timing
- As early as about 15 minutes before sex (100/200 mg); about 30 minutes (50 mg); once per day at mostSTENDRA (avanafil) label · DailyMed
- FDA approval
- STENDRA approved April 27, 2012Drugs@FDA · STENDRA (avanafil)
- Do not combine
- Contraindicated with organic nitrates; not for use with riociguat or strong CYP3A4 inhibitorsSTENDRA (avanafil) label · DailyMed
- Mendoxa
- Does not prescribe avanafil; its compounded 3-in-1 tablet is not FDA-approvedFDA compounding Q&A
What avanafil (Stendra) is and how to take it
Avanafil is the active ingredient; Stendra is the brand name. It treats erectile dysfunction in adult males (STENDRA (avanafil) label). FDA approved Stendra on April 27, 2012 (Drugs@FDA: STENDRA (avanafil)).
- Strengths: 50 mg, 100 mg and 200 mg tablets (STENDRA (avanafil) label).
- Starting dose: 100 mg, taken as needed as early as approximately 15 minutes before sexual activity (STENDRA (avanafil) label).
- Adjusting: 200 mg is also taken about 15 minutes before; 50 mg about 30 minutes before. The label says to use the lowest dose that works (STENDRA (avanafil) label).
- Limit: no more than once per day, and sexual stimulation is required (STENDRA (avanafil) label).
- Food: may be taken with or without food (STENDRA (avanafil) label).
Searching for “Stendra 100”? That is the 100 mg tablet, the usual starting dose in the STENDRA (avanafil) label; your prescriber decides whether it fits your medicines and health.
Avanafil vs sildenafil vs tadalafil vs vardenafil
Each cell below comes from that drug’s own FDA label. The labels describe timing and pharmacokinetics; they are not head-to-head trials, so the table cannot show which drug works better for you.
| Label point | Avanafil (STENDRA) | Sildenafil (VIAGRA) | Tadalafil (CIALIS) | Vardenafil |
|---|---|---|---|---|
| When to take (as needed) | As early as about 15 minutes before sex at 100 or 200 mg; about 30 minutes at 50 mg (STENDRA (avanafil) label) | About 1 hour before sex; anywhere from 30 minutes to 4 hours before (Viagra (sildenafil) label) | At least 30 minutes before anticipated sexual activity (patient counseling) (Cialis (tadalafil) label) | About 60 minutes before sex (vardenafil label) |
| Duration window and half-life | No duration window stated; half-life about 5 hours (STENDRA (avanafil) label) | Dosing window of 30 minutes to 4 hours before sex; half-life about 4 hours (Viagra (sildenafil) label) | Improved erectile function up to 36 hours after dosing; half-life 17.5 hours (Cialis (tadalafil) label) | No duration window stated; half-life about 4 to 5 hours (vardenafil label) |
| High-fat meal | May be taken with or without food; a high-fat meal delayed peak by 1.12 to 1.25 hours (200 mg) and lowered peak level 39% (STENDRA (avanafil) label) | Delayed peak about 60 minutes and lowered peak level 29% (Viagra (sildenafil) label) | Absorption not influenced by food (Cialis (tadalafil) label) | High-fat meals lowered peak level 18% to 50% (vardenafil label) |
| Tablet strengths | 50, 100, 200 mg (STENDRA (avanafil) label) | 25, 50, 100 mg (Viagra (sildenafil) label) | 5, 10, 20 mg listed in this brand label (Cialis (tadalafil) label) | 2.5, 5, 10, 20 mg listed in this brand label (vardenafil label) |
| As-needed start · maximum dose | 100 mg · 200 mg, once per day at most (STENDRA (avanafil) label) | 50 mg · 100 mg, once per day at most (Viagra (sildenafil) label) | 10 mg · 20 mg, once per day at most in most patients (Cialis (tadalafil) label) | 10 mg · 20 mg, once per day at most (vardenafil label) |
Sources: STENDRA (avanafil) label; Viagra (sildenafil) label; Cialis (tadalafil) label; vardenafil label. Accessed Oct 25, 2026.
Read the duration row carefully: half-life describes drug elimination; it does not set a fixed window of erectile benefit. A time for taking a tablet before sex is also different from how long it may help. The individual label links above keep those measures separate.
Read more in our guides to sildenafil, tadalafil, vardenafil and sildenafil vs tadalafil.
Avanafil vs Viagra or Cialis: which question should you ask?
- Want less advance planning? Ask whether avanafil’s labeled 15-minute timing at 100 or 200 mg fits you (STENDRA (avanafil) label).
- Want a longer opportunity for sex? Ask about tadalafil: its label describes benefit up to 36 hours and also a once-daily ED option (Cialis (tadalafil) label).
- Comfortable taking a tablet ahead of time? Sildenafil’s usual timing is about 1 hour before sex (Viagra (sildenafil) label).
- Already tried an ED tablet? Bring its name, how you used it and what happened to the visit; the STENDRA (avanafil) label calls for medical assessment of ED and its possible causes.
Use our sildenafil vs tadalafil guide to prepare your questions, or review Viagra side effects. These label comparisons do not establish a winner for your individual needs.
Avanafil side effects: label rates vs placebo
Headache was the most common adverse reaction and rose with dose: 5.1% at 50 mg to 10.5% at 200 mg, versus 1.7% on placebo (STENDRA (avanafil) label).
| Adverse reaction | Placebo (n=349) | Avanafil 50 mg (n=217) | Avanafil 100 mg (n=349) | Avanafil 200 mg (n=352) |
|---|---|---|---|---|
| Headache | 1.7% | 5.1% | 6.9% | 10.5% |
| Flushing | 0.0% | 3.2% | 4.3% | 4.0% |
| Nasal congestion | 1.1% | 1.8% | 2.9% | 2.0% |
| Nasopharyngitis | 2.9% | 0.9% | 2.6% | 3.4% |
| Back pain | 1.1% | 3.2% | 2.0% | 1.1% |
Sources: STENDRA (avanafil) label. Accessed Oct 25, 2026.
These are reported adverse reactions from the placebo-controlled trials summarized in Table 1 of the STENDRA (avanafil) label, not a prediction of your individual risk or a comparison with another drug.
Serious warnings on the STENDRA (avanafil) label: seek immediate help for an erection lasting more than 4 hours; stop and get care for sudden vision loss, which may signal NAION, or a sudden decrease or loss of hearing.
Who should not take avanafil: nitrates, riociguat, CYP3A4 and alcohol
Review your full medicine list before starting. Avanafil is contraindicated with organic nitrates, including occasional use, and should not be used when sexual activity is inadvisable because of cardiovascular status (STENDRA (avanafil) label).
| Situation | What the STENDRA (avanafil) label says |
|---|---|
| Known allergy to a tablet ingredient | Contraindicated (STENDRA (avanafil) label) |
| Organic nitrates (regular or occasional) | Contraindicated (STENDRA (avanafil) label) |
| Riociguat or vericiguat (GC stimulators) | Do not use (STENDRA (avanafil) label) |
| Strong CYP3A4 inhibitors such as ketoconazole, ritonavir, itraconazole, clarithromycin | Do not use (STENDRA (avanafil) label) |
| Moderate CYP3A4 inhibitors | Maximum 50 mg, not more than once every 24 hours (STENDRA (avanafil) label) |
| Alpha-blockers | Be stable on the alpha-blocker first; start at 50 mg (STENDRA (avanafil) label) |
| Alcohol | Substantial drinking (more than 3 units) may increase dizziness or low-blood-pressure symptoms (STENDRA (avanafil) label) |
| Other ED treatments | Combinations with other ED treatments have not been studied (STENDRA (avanafil) label) |
Sources: STENDRA (avanafil) label. Accessed Oct 25, 2026.
See ED medication and nitrates and ED and alcohol.
Could Mendoxa ED care fit you?
Online ED visit · Prescription required · Independent licensed providers · Not available in California
Cost of Stendra and generic avanafil
SingleCare listed the following prices when accessed Oct 25, 2026. These are source quotes for the specified product and quantity, not an offer from Mendoxa.
| Source and product | Average retail price as listed | Lowest coupon price as listed | Quantity as listed |
|---|---|---|---|
| SingleCare · Stendra (brand) · SingleCare Stendra page | $501.13 | $207.34 | Six 200 mg tablets |
| SingleCare · avanafil (generic) · SingleCare avanafil page | $645.93 | $207.34 | Six 200 mg tablets |
Sources: SingleCare Stendra page; SingleCare avanafil page; generic avanafil label. Accessed Oct 25, 2026.
Ask the pharmacy to confirm the exact product, quantity and final amount before filling a prescription. A coupon quote does not establish what your insurance will pay.
Why discuss sildenafil or tadalafil first?
Start the conversation with the routine you want. Sildenafil has an as-needed schedule (Viagra (sildenafil) label); tadalafil has as-needed and once-daily ED schedules (Cialis (tadalafil) label). That makes them useful options to discuss alongside avanafil (STENDRA (avanafil) label), without assuming one medicine suits everyone. Explore generic Cialis and the ED medication comparison.
Both also have generic ED tablet labels on DailyMed: generic sildenafil label and generic tadalafil label. Ask the provider how these options fit your preferred routine.
Mendoxa does not prescribe avanafil. Independent licensed providers working with Mendoxa assess you for a compounded rapid-dissolve tablet containing sildenafil, tadalafil and apomorphine. It is not FDA-approved. The Viagra (sildenafil) label, Cialis (tadalafil) label and APOKYN (apomorphine) label describe separate products; APOKYN is an injectable Parkinson’s treatment, and its label is not approval of this ED combination.
Read about the sublingual ED tablet and combination ED tablet.
What each path includes
Use this to frame the conversation with a prescriber; it is not a self-treatment guide.
| Path | What it includes | Boundary |
|---|---|---|
| Ask your own clinician about avanafil | Prescription of brand STENDRA or a generic avanafil tablet if suitable (STENDRA (avanafil) label; generic avanafil label) | Pharmacy cash prices vary; Mendoxa does not prescribe avanafil |
| Standalone sildenafil or tadalafil | A single FDA-approved PDE5 medicine, often as a generic (Viagra (sildenafil) label; Cialis (tadalafil) label) | Both require sexual stimulation and are contraindicated with nitrates (sildenafil label; tadalafil label) |
| Vardenafil | Another as-needed PDE5 option taken about 60 minutes before sex (vardenafil label) | Dose limits with some CYP3A4 inhibitors (vardenafil label) |
| Mendoxa 3-in-1 visit | Online review by Independent licensed providers of a compounded sildenafil + tadalafil + apomorphine rapid-dissolve tablet; Prescription required | Compounded drugs are not FDA-approved; ingredient reference APOKYN (apomorphine) label; no avanafil |
Sources: STENDRA (avanafil) label; generic avanafil label; Viagra (sildenafil) label; Cialis (tadalafil) label; vardenafil label; FDA compounding Q&A; Mendoxa care information. Accessed Oct 25, 2026.
Compare all ED medication options before the visit, and bring your medicine list.
What to tell the provider before your visit
List prescription medicines, over-the-counter products and supplements, plus any heart, kidney, liver, vision or hearing history; the STENDRA (avanafil) label asks patients to disclose these before treatment.
Do not add avanafil to another ED treatment yourself: combinations with other ED therapies have not been studied in the STENDRA (avanafil) label. Tell the provider exactly what you already take.
- The APOKYN (apomorphine) label contraindicates use with 5HT3 antagonists such as ondansetron and warns about nausea and fainting.
If you want ED treatment now
Start with the Mendoxa 3-in-1 visit to ask whether its compounded rapid-dissolve tablet fits your ED care. Independent licensed providers assess suitability; Prescription required.
The tablet combines sildenafil, tadalafil and apomorphine; it is not FDA-approved. Ingredient references are the Viagra (sildenafil) label, Cialis (tadalafil) label and APOKYN (apomorphine) label.
Have your medicine list and previous treatment experience ready. Use the online visit to ask whether this option is appropriate for you; the provider makes the prescribing decision. The table below shows the available quantities and costs.
Mendoxa ED plans and prices
The Mendoxa ED tablet is a compounded rapid-dissolve tablet with sildenafil (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis) and apomorphine (APOKYN label). It dissolves under the tongue. A licensed clinician decides if it fits you and selects the strength. Compounded medicines are not FDA-approved.
| Tablets per month | 1-month total | Per tablet (1 month) | 3-month total | Per tablet (3 months) |
|---|---|---|---|---|
| 6 tablets / month | $129 | $21.50 | $329 | $18.28 |
| 10 tablets / month | $149 | $14.90 | $379 | $12.63 |
| 20 tablets / month | $179 | $8.95 | $449 | $7.48 |
The 3-month total covers three months at the monthly tablet quantity shown.
If prescribed · Cancel anytime · Available in 49 states (not California). Prices from the Mendoxa intake at try.mendoxa.co/f/ed on Oct 25, 2026. The intake always shows the current price.
Another PDE5 comparison: sildenafil vs vardenafil.
Where avanafil fits in the timeline of ED pills: Viagra history and FDA approval dates.
FAQ
Is avanafil the same as Stendra?
Yes. Avanafil is the active ingredient and STENDRA is the brand (STENDRA (avanafil) label). DailyMed also lists a generic avanafil tablet in 50, 100 and 200 mg (generic avanafil label).
How fast does avanafil work?
The STENDRA (avanafil) label says 100 or 200 mg can be taken as early as approximately 15 minutes before sexual activity, and 50 mg about 30 minutes before. Sexual stimulation is required.
Can I take avanafil with food or alcohol?
Food is allowed; the STENDRA (avanafil) label says it may be taken with or without food. Substantial alcohol (more than 3 units) with avanafil may increase dizziness or low-blood-pressure symptoms.
Is there a generic avanafil?
DailyMed lists a generic avanafil tablet from Camber under an abbreviated new drug application (generic avanafil label). Ask the pharmacy whether it can fill your exact prescription; a label listing does not confirm local stock.
Is avanafil better than Viagra or Cialis?
The labels do not establish that. Avanafil’s labeled lead time is shorter (STENDRA (avanafil) label); tadalafil’s labeled window extends to 36 hours (Cialis (tadalafil) label); sildenafil is usually taken about 1 hour before sex (Viagra (sildenafil) label). A prescriber matches the drug to your health and medicines.
How long does avanafil last?
The STENDRA (avanafil) label reports a terminal half-life of approximately 5 hours but does not give a fixed duration-of-benefit window. Half-life should not be read as a promise that erections will be easier for exactly that long.
Ready to see if the Mendoxa ED tablet fits you?
From $129/month if prescribed · Cancel anytime · Available in 49 states (not California)
How we wrote this
Written by the Mendoxa editorial team · Sources: DailyMed/FDA. Medical facts on this page come from the FDA-approved labels on DailyMed and Drugs@FDA; each drug name links to its label. We checked every linked source on Oct 25, 2026. Avanafil facts come only from the STENDRA (avanafil) label, the generic avanafil label and the Drugs@FDA record for STENDRA (avanafil); comparison cells come from the Viagra (sildenafil) label, Cialis (tadalafil) label and vardenafil label, not from head-to-head trials. We reproduced the adverse-reaction percentages and checked the comparison against each linked label; timing, duration of benefit and half-life are different measures. Third-party prices are SingleCare’s displayed quotes, without our own per-tablet calculations. The APOKYN (apomorphine) label concerns an injection for Parkinson’s disease, not an approved ED tablet, and does not establish that the compounded combination is safe or effective.
Updated Oct 25, 2026. This page is general information, not medical advice. A licensed clinician decides what fits you.
References
- DailyMed: VIAGRA (sildenafil citrate) tablet, film coated, label revised 12/2017. Accessed Oct 25, 2026.
- DailyMed: CIALIS (tadalafil) tablet, film coated, label revised 3/2026. Accessed Oct 25, 2026.
- DailyMed: APOKYN (apomorphine hydrochloride) injection, label revised 6/2022. Accessed Oct 25, 2026.
- FDA (Drugs@FDA): VIAGRA (sildenafil) prescribing information, NDA 020895. Accessed Oct 25, 2026.
- FDA (Drugs@FDA): CIALIS (tadalafil) prescribing information, NDA 021368. Accessed Oct 25, 2026.
- FDA: Compounding and the FDA, questions and answers. Accessed Oct 25, 2026.
- DailyMed: STENDRA (avanafil) tablets label, Metuchen Pharmaceuticals (revised 10/2022). Accessed Oct 25, 2026.
- DailyMed: avanafil tablets (generic), Camber Pharmaceuticals (revised 11/2025). Accessed Oct 25, 2026.
- Drugs@FDA: NDA 202276, STENDRA (avanafil), approved April 27, 2012. Accessed Oct 25, 2026.
- DailyMed: vardenafil hydrochloride tablets label. Accessed Oct 25, 2026.
- SingleCare: Stendra prices (updated 10/25/2026). Accessed Oct 25, 2026.
- SingleCare: avanafil prices (updated 10/25/2026). Accessed Oct 25, 2026.
- DailyMed: generic sildenafil ED tablets (Advagen). Accessed Oct 25, 2026.
- DailyMed: generic tadalafil ED tablets. Accessed Oct 25, 2026.
- Mendoxa ED care (product, format, max 1 dose per 24 hours). Accessed Oct 25, 2026.
- Mendoxa ED intake: plan prices (term_options). Accessed Oct 25, 2026.
About Mendoxa
Mendoxa (mendoxa.co) is a US telehealth brand. Independent licensed providers (licensed clinicians in the LocumTele network) review each online visit, and prescriptions are filled by Rush Pharmacy, a licensed US pharmacy. Available in 49 states (not California).
- Prescription required. A licensed clinician reviews every visit and can say no. A prescription is not automatic.
- A compounded medicine is not an FDA-approved finished product (FDA compounding Q&A).
- Plans: 1 month or 3 months, from $129. If prescribed · Cancel anytime · Available in 49 states (not California).
Compounded medication prescribed only if a licensed U.S. clinician decides it is appropriate. Not FDA-approved as a finished product. Not available in California. This site is not for emergencies. Call 911 if you need urgent care.