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Head-to-head evidence comparison — which supplement is right for you?
Avanafil (Stendra) vs Tadalafil: they're closely matched on evidence (3.6 vs 3/10); take care combining them — there's a flagged interaction. Take the 60-second quiz for a pick tailored to your goals.
Avanafil (Stendra) and Tadalafil are closely matched across evidence, studies, and safety.
Verdict
Mostly mechanism / observational
Top outcomes
Verdict
Mostly mechanism / observational
Top outcomes
Shared outcomes (1)
Outcomes where both Avanafil (Stendra) and Tadalafil have evidence — compare verdict strength side-by-side.
Approved on-demand ED dosing is 50-200 mg taken roughly 15-30 minutes before activity (100 mg typical start; range 50-200 mg). It can be taken with or without food. Any use is clinician-directed; this is not a supplement regimen.
any
Oral tablet (avanafil)
Off-label longevity/vascular use mirrors low approved dosing (e.g. tadalafil 2.5–5 mg once daily, the dose used for BPH/daily ED) under a clinician. Not an approved longevity regimen.
any
Low daily-dose oral tablet
Additive hypotension, dizziness and syncope; a raised risk of priapism, and of a dangerous fall in blood pressure if a nitrate is ever needed acutely.
Never combine. There is no additive benefit — switching between PDE5 inhibitors means stopping one before starting the other, and any change should go through the prescriber.
Acute (~15-30 min onset)
Acute (per dose)
Acute (per dose)
Acute (per dose)
Years
Years
Acute to weeks
With interacting drugs
A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction.
The Journal of Sexual Medicine (2012) · Rct
REVIVE: 12-week phase-3 double-blind, placebo-controlled RCT of on-demand avanafil (50, 100, 200 mg) in men with erectile dysfunction
Avanafil for the treatment of erectile dysfunction: a multicenter, randomized, double-blind study in men with diabetes mellitus.
Mayo Clinic Proceedings (2012) · Rct
REVIVE-Diabetes: 12-week multicenter, randomized, double-blind RCT of avanafil in men with ED and diabetes mellitus
Avanafil for male erectile dysfunction: a systematic review and meta-analysis.
Asian Journal of Andrology (2014) · Meta analysis
Systematic review and meta-analysis pooling randomized placebo-controlled avanafil trials
Phosphodiesterase type-5 inhibitor use in type 2 diabetes is associated with a reduction in all-cause mortality.
Heart (British Cardiac Society) (2016) · Observational
Observational cohort of PDE5-inhibitor use in type-2 diabetics at high cardiovascular risk
Using Big Data to Uncover Association Between Sildenafil Use and Reduced Risk of Alzheimer's Disease.
Studies in health technology and informatics (2023) · Observational
Large real-world database study linking PDE5-inhibitor use to lower Alzheimer's incidence
Cardiovascular outcomes among sildenafil users: results of the International Men's Health Study.
International journal of clinical practice (2008) · Observational
⚠️ SILDENAFIL, NOT TADALAFIL. The registry followed sildenafil users. Both are PDE5 inhibitors and the cardiovascular question is a class question, but tadalafil's longer half-life and different selectivity mean this is not a tadalafil outcome.
Both Avanafil (Stendra) and Tadalafil are closely matched — the best choice depends on your specific health goals.
For libido & male vitality, Avanafil (Stendra) has a higher relevance score (55 vs 52).
Caution: Additive hypotension, dizziness and syncope; a raised risk of priapism, and of a dangerous fall in blood pressure if a nitrate is ever needed acutely. Never combine. There is no additive benefit — switching between PDE5 inhibitors means stopping one before starting the other, and any change should go through the prescriber. Always consult a healthcare provider before combining these supplements.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.