If you have erectile dysfunction and are looking at Stendra compared to Viagra and Cialis then read on. If you are among the estimated 30 million men in the United States who experience erectile dysfunction and you want to take one of the erectile dysfunction drugs, the recent approval of Stendra (avanafil) by the Food and Drug Administration (FDA) means you now have five drugs from which to choose. Is Stendra your best choice because it is the newest drug? How does Stendra compare with other drugs for erectile dysfunction? And most important, how effective is Stendra compared to Viagra and Cialis?
The Five Erectile Dysfunction Drugs
The five FDA-approved erectile dysfunction drugs on the market are avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (both Levitra and Staxyn, an orally dissolving form of Levitra). All of these drugs belong to the same drug class known as phosphodiesterase (PDE) inhibitors because they all work by blocking the enzyme phosphodiesterase type 5 (PDE-5).
When PDE-5 is blocked, this increases blood flow to the penis, which in turn will, in most cases, result in an erection. We say “most cases” because the efficacy of all five drugs are similar, depending on the dose taken, and average about 77% to 84%.
Even though these erectile dysfunction drugs all belong to the same drug class, they do not share the same base ingredient and so there are some differences between them in terms of how long before they work (onset of action), side effects, and how long the drug effect lasts.
Stendra for Erectile Dysfunction
Because Stendra is the newest addition to the arsenal of erectile dysfunction drugs, let’s take a closer look at it before we do a comparison with the other ED drugs. In clinical trials, overall 77% of men with general erectile dysfunction who took Stendra achieved an erection compared with 54% of men who took placebo. Among men with erectile dysfunction related to diabetes, 63% achieved an erection after taking Stendra compared with 42% who took placebo.
Let’s look at the results of one 12-week Phase III trial in particular. A total of 646 men were randomly assigned to take either 50, 100, or 200 mg of avanafil 30 minutes before initiating sexual activity. There were no restrictions on food or alcohol use. Of the 300 sexual attempts made during the study, 64% to 71% were successful among men who took avanafil compared with 27% among men who took placebo. Other good news: 59% to 83% of the 80 attempts at sexual intercourse made more than 6 hours after taking Stendra were successful compared with only 25% successful attempts in men who took placebo. In some men, Stendra worked in as little as 15 minutes. (Goldstein 2012)
In fact, one thing that may separate Stendra from the other four ED drugs is how fast it works. Dr. Wayne Hellstrom, professor of urology at Tulane University School of Medicine in New Orleans, stated in a Reuters article that Stendra “is potentially the fastest acting of the four,” as clinical trials have shown it can work as fast as 15 minutes. However, there have been reports of Cialis working in about 15 minutes as well.
How Fast Do ED Drugs Work?
Some erectile dysfunction drugs work faster than others, and food can be a contributing factor (Stendra Compared to Viagra and Cialis):
- Cialis: 15 to 45 minutes, food has no effect
- Levitra and Staxyn: 25 minutes, but can be delayed if taken with a fatty meal
- Stendra: 30 minutes, food not believed to have an effect
- Viagra: 30 minutes, but can be delayed if taken with food
How Long Do ED Drugs Last? (Stendra Compared to Viagra and Cialis)
The erectile dysfunction drugs differ in how long a man can expect to be able to achieve an erection. Actual times can vary, depending on the dose taken and other factors.
- Cialis: 36 hours
- Levitra and Staxyn: 4 to 5 hours
- Stendra: more than 6 hours in some patients
- Viagra: 4 to 5 hours
Side Effects of ED Drugs
Although the side effects associated with all of the ED drugs are somewhat similar, there are differences that may be important to some men.
- Cialis: Most common are headache and indigestion. Less common are back pain, dizziness, facial flushing, muscle aches, nasal congestion.
- Levitra and Staxyn: Most common are facial flushing and headache. Less common are dizziness, indigestion, nasal congestion, nausea.
- Stendra: Most common are flushing, headache, nasal congestion, and runny nose. Less common are back pain, diarrhea, dizziness, hypertension, influenza, muscle aches, and upper respiratory infection.
- Viagra: Most common are facial flushing, headache, indigestion. Less common are altered vision, diarrhea, dizziness, nasal congestion, rash, and urinary tract infection.
Rare Side Effects of All ED Drugs
All five erectile dysfunction drugs may cause rare side effects that include a sudden loss of vision in one or both eyes, sudden loss of hearing in one or both ears, and color vision changes. If you experience any of these side effects, contact your healthcare provider immediately.
Another rare side effect is priapism, or a 4 hour erection. Men who experience an erection that lasts 4 hours or longer should seek immediate medical attention.
Warnings about ED Drugs
Before you take Stendra or any of the other ED drugs, you should tell your healthcare provider about all medications and supplements you are taking, both prescription and over-the-counter. This is especially critical if you are taking nitrates, because the combination can cause a drastic, sudden drop in blood pressure. You should also tell your doctor if you have ever had the following:
- Heart problems, such as heart attack, angina, heart failure, irregular heartbeat
- Heart surgery within the last 6 months
- Stroke
- Low or high blood pressure
- Peyronie’s disease
- Priapism
- Blood disease, such as multiple myeloma, leukemia, sickle cell anemia
- Retinitis pigmentosa (a genetic eye disease)
- Bleeding problems
- Stomach ulcers
- Liver problems
- Severe vision loss
- Kidney problems
- Any other medical conditions
Men with erectile dysfunction have a variety of oral drugs that can help them manage this disease. Other possible treatment options include penis pumps, suppositories, penile injections, penile implants, counseling, and natural remedies. Before starting any type of erectile dysfunction treatment, men should review all their options and discuss them with a knowledgeable healthcare provider.
Resources for “Stendra Compared to Viagra and Cialis”:
Goldstein I et al. A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction. J Sex Med 2012 Apr; 9(4): 1122-33 Stendra compared to Viagra and Cialis?
WebMD Stendra compared to Viagra and Cialis?