PharmaceuticalPharmaceuticalVasodilatorPDE5 inhibitor

Avanafil

Also known as Stendra · Spedra

Written by enwyReviewed 5 Aug 20262 sources0 comments

Avanafil is a newer, highly selective PDE5 inhibitor designed for rapid onset — often effective within 15-30 minutes — and a short duration, which limits the persistence of side effects. Its high PDE5 selectivity (low PDE1/PDE6 activity) reduces visual disturbance and flushing relative to sildenafil.

01 Overview

Avanafil was engineered for fast onset and clean selectivity, inhibiting PDE5 with minimal activity at PDE6 (retina) and PDE1 (vasculature/heart), which translates clinically into fewer visual and vasodilatory complaints. Its short half-life (~5 hours) and rapid absorption make it the quickest-acting oral PDE5 inhibitor.

In PED use it appeals to those wanting on-demand erectile support with rapid onset and a lower side-effect burden. As with the class, it must never be combined with nitrates, and its efficacy still depends on sexual stimulation.

02 Mechanism

Rapid-onset, highly PDE5-selective inhibitor with low affinity for PDE1 and PDE6, raising cavernosal cGMP.

03 Dosing

Tier	Dose	Route	Notes
Low	50 mg	Oral	Lowest approved dose; taken ~15-30 min before activity.
Erectile function	100–200 mg	Oral	100-200 mg on demand; 200 mg is the label ceiling.

04 Effects

Effect	Magnitude	Evidence
Rapid-onset erectile supportFastest-acting oral PDE5 inhibitor; effective in many men within 15-30 minutes.	as fast as ~15 min	Clinical
Fewer visual/vasodilatory effectsHigh PDE5 selectivity lowers rates of visual disturbance and flushing.	vs sildenafil	Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
HeadacheVasodilatory headache is the most frequent adverse effect.	Mild	Common	Clinical
Flushing and nasal congestionFacial flushing and stuffy nose from vasodilation.	Mild	Common	Clinical
Nitrate interaction (severe hypotension)Additive, potentially fatal hypotension with nitrates or NO donors.	Life-threatening	Rare but potentially fatal	Clinical

06 Legal status

United Kingdom

POM (Spedra)

as of Jan 2026

United States

Prescription drug (Rx)

Approved as Stendra. · as of Jan 2026

07 References

Avanafil for the treatment of erectile dysfunction: phase 3 trialJ Sex Med, 2012

Stendra (avanafil) FDA labelUS FDA

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.