✓ Medically reviewed by · Last reviewed: May 2026
Pharmacy Researcher · 8 years experience
Pharmacy researcher with 8 years reviewing clinical drug information, generic formulation equivalence, and international pharmaceutical standards. Focuses on patient-facing accuracy in medication education.
Quick Answer
Stendra and Avana contain the identical active molecule — avanafil hydrochloride — at dose-equivalent strengths (50, 100, 200 mg). Both are the newest of the four FDA-approved PDE5 inhibitors and the fastest-onset (15–30 minutes). Both are also the most PDE5-selective — producing lower rates of headache, flushing, and visual disturbance than older PDE5 inhibitors. The differences are regulatory and economic: Vivus’s Stendra US MSRP is approximately $50–$60 per 100 mg pill. Avana is manufactured by Centurion Laboratories under WHO-GMP certification and ships worldwide from MedsBase — at roughly $1–$2 per pill. Same drug, ~40× price gap.
Avanafil is the fourth and most recent PDE5 inhibitor to reach the US market — FDA-approved in April 2012, nine years after vardenafil and tadalafil. It was specifically engineered to address two limitations of the older PDE5 inhibitors: slow onset (sildenafil and tadalafil both require ~30–60 minutes to reach therapeutic effect) and cross-reactivity-driven side effects (sildenafil’s PDE6 cross-reactivity producing visual disturbance, tadalafil’s PDE11 cross-reactivity producing back/muscle pain).
Avanafil’s pivotal trial program1 demonstrated meaningful erection rigidity within 15 minutes of dosing in some users and reliable effect by 30 minutes — faster than any other PDE5 inhibitor. The molecule is also more selective for PDE5 over both PDE6 (retinal) and PDE11 (skeletal muscle), producing lower headache rates (~7% vs sildenafil’s ~16%), lower flushing rates, and effectively negligible visual disturbance.
The trade-off, where it exists, is a slightly shorter useful effective window (~4–5 hours, similar to sildenafil and vardenafil; significantly shorter than tadalafil’s 36 hours). For users prioritising rapid-onset spontaneity without the longer-tail commitment of tadalafil, avanafil sits at a sweet spot.
Stendra’s US patent was held by Vivus, which subsequently licensed to Metuchen Pharmaceuticals; in the EU the molecule is marketed as Spedra by Menarini. Centurion Laboratories produces the Avana generic for the global export market — MedsBase carries the full Avana line including dose strengths above the labelled Stendra maximum and combination formats.
TL;DR comparison table
| Stendra (brand) | Avana (generic) | |
|---|---|---|
| Active ingredient | Avanafil | Avanafil |
| Drug class | PDE5 inhibitor (most selective) | PDE5 inhibitor (most selective) |
| Manufacturer | Vivus / Metuchen (US); Menarini (EU as Spedra) | Centurion Laboratories Pvt Ltd (WHO-GMP) |
| Available doses | 50, 100, 200Â mg | 50, 100, 200Â mg + Avana Extra (300Â mg) + Super Avana (with dapoxetine) |
| Onset of action | 15–30 minutes (fastest of the PDE5 class) | Same |
| Half-life | ~5 hours | Same |
| Effective window | 4–5 hours | Same |
| Food-effect | Minimal (less than sildenafil; can be taken with food) | Same |
| Headache rate (100Â mg) | ~7% (lowest among PDE5 inhibitors) | Same |
| Typical 2026 price (100 mg) | ~$50–$60/pill US MSRP | ~$1–$2/pill on MedsBase |
| Regulatory status | FDA-approved (US prescription) | WHO-GMP; not FDA-registered |
Both pills contain the same molecule: avanafil
Avanafil is a pyrimidine-derivative PDE5 inhibitor developed by Vivus Inc and approved by the FDA on 27 April 2012. The pivotal trial program (Goldstein et al., Journal of Sexual Medicine, 20121) was a 12-week placebo-controlled study in 646 men with mild-to-severe ED across the 50, 100, and 200 mg dose arms. At the 200 mg dose, successful intercourse attempts rose from 13% on placebo to 57% on treatment. Onset data showed a substantial fraction of users responding within 15 minutes — not seen consistently with the older PDE5 inhibitors.
Vivus’s US patent on avanafil expired in 2023. FDA-approved generic avanafil entered US retail pharmacies in late 2023 / early 2024. Outside the US, generic avanafil has been widely available earlier under different patent regimes. Avana is among the most widely distributed generic avanafil products globally, produced by Centurion Laboratories — the same WHO-GMP-certified facility supplying Cenforce, Vidalista, Vilitra, and Poxet.
How avanafil differs from sildenafil, tadalafil, and vardenafil
All four PDE5 inhibitors share the same primary mechanism: blocking PDE5 in penile smooth muscle, allowing cGMP accumulation, smooth-muscle relaxation, and improved blood flow into the corpus cavernosum during sexual arousal. The differences are in PK/PD details and selectivity.
- Onset: avanafil 15–30 min; sildenafil 30–60 min; vardenafil 25–60 min; tadalafil 30–60 min. Avanafil is the fastest.
- Effective window: avanafil 4–5 hours; sildenafil 4–6 hours; vardenafil 4–6 hours; tadalafil up to 36 hours. Avanafil is shorter than tadalafil, comparable to the others.
- PDE5 vs PDE6 selectivity (visual side effects): avanafil > vardenafil > tadalafil >> sildenafil. Avanafil produces effectively no blue-tint visual disturbance.
- PDE5 vs PDE11 selectivity (back/muscle pain): avanafil > sildenafil > vardenafil >> tadalafil. Avanafil produces no meaningful muscle-pain signal.
- Headache rate: avanafil ~7%; sildenafil ~16%; vardenafil ~15%; tadalafil ~14%.
The pattern: avanafil’s selectivity profile produces the cleanest side-effect signature of the class. The trade-off is the shorter effective window relative to tadalafil. For users who don’t need tadalafil’s 36-hour duration and want the cleanest tolerability profile, avanafil is often the preferred molecule.
Bioequivalence
FDA-approved generic avanafil products sold in US retail pharmacies since 2023 are FDA Orange Book AB-rated. Avana, manufactured by Centurion Laboratories under WHO-GMP, is not US FDA-registered but applies the same Cmax/AUC bioequivalence criterion. Both produce equivalent plasma avanafil concentrations at equivalent doses.
Doses and dose recommendations
Standard avanafil dosing:
- Starting dose: 100 mg, taken 15–30 minutes before anticipated sexual activity.
- Range: 50–200 mg depending on response and tolerability.
- Maximum: 200Â mg once per 24 hours.
Avana Extra 300 mg exceeds the FDA-labelled 200 mg ceiling and is not a routine recommended dose. As with the other PDE5 inhibitors, the dose-response curve plateaus — doubling the dose does not double the response, but it does increase side-effect rates. Most users do well at 100 or 200 mg.
Super Avana combines avanafil 100Â mg with dapoxetine 60Â mg for men with both ED and premature ejaculation; the same combination pattern as Super P-Force (sildenafil + dapoxetine), Super Vidalista (tadalafil + dapoxetine), and Super Vilitra (vardenafil + dapoxetine).
Price comparison
| Channel | 100 mg avanafil — per pill |
|---|---|
| Stendra brand, US retail pharmacy | ~$50–$60 MSRP |
| Generic avanafil, US retail (since 2023) | $15–$30 |
| Avana 100, MedsBase | ~$1–$2 |
Side effects: identical molecule, identical profile
Avanafil’s side-effect profile applies across all supply chains and is generally the most favourable of the PDE5 class:1
- Headache (~7%) — the lowest rate among PDE5 inhibitors
- Facial flushing (~4%)
- Nasal congestion (~3%)
- Back pain (~2%) — lower than tadalafil
- Visual disturbance (negligible) — much lower than sildenafil
- Dyspepsia (~2%)
Contraindications
Do not combine avanafil (either brand) with any of the following:
- Organic nitrates (nitroglycerine, isosorbide mononitrate, isosorbide dinitrate)
- Riociguat (Adempas)
- Recreational “poppers” (amyl nitrite, butyl nitrite, isobutyl nitrite)
- Strong CYP3A4 inhibitors (ritonavir, ketoconazole, itraconazole, clarithromycin) — markedly elevate avanafil levels; dose reduction required
- Alpha-blockers — stagger dosing to avoid orthostatic hypotension
Caution in severe cardiovascular disease, recent stroke or MI (within 6 months), severe hepatic impairment, severe renal impairment, and hereditary degenerative retinal disorders.
Manufacturer disclosure: who makes Avana?
Avana is manufactured by Centurion Laboratories Pvt Ltd, Vadodara, Gujarat — the same WHO-GMP-certified facility producing Cenforce, Vidalista, Vilitra, and Poxet. WHO-GMP certification under the Indian Central Drugs Standard Control Organisation, ISO 9001:2015 quality management. Per-batch release for Avana includes HPLC content assay confirming avanafil within USP specification, dissolution testing, and stability monitoring. Certificates of Analysis are available on request.
How to order Avana from MedsBase
Avana ships worldwide from MedsBase in discreet packaging. Payment via crypto (Plisio), credit card via a regulated crypto on-ramp (statement descriptor is the on-ramp provider name — a regulated card-payment processor — never MedsBase), or SEPA where available. See our credit card payment guide. Orders are covered by the MedsBase Reshipment Assurance Policy. Browse the full Avana product range.
Who should choose avanafil?
- Users wanting the fastest onset: avanafil 15–30 minutes is the fastest of the class. If the use pattern is genuinely spontaneous (no 30–60 minute waiting period feasible), avanafil is the molecule of choice.
- Users who get headache or flushing on sildenafil or vardenafil: avanafil’s cleaner side-effect profile is the principal pharmacological reason to switch.
- Users who get back/muscle pain on tadalafil: avanafil’s PDE11 selectivity produces effectively no muscle-pain signal.
- Users with sildenafil-induced visual disturbance: avanafil’s PDE5 vs PDE6 selectivity is even greater than vardenafil’s.
- Cost-conscious long-term users: Avana at $1–$2/pill is the lowest-cost avanafil option globally.
For the broader ED-medication overview, see our complete ED medication guide. For the other PDE5 brand-vs-generic comparisons: Viagra vs Cenforce, Cialis vs Vidalista, Levitra vs Vilitra.
Pricing context: The brand-vs-generic price comparison on this page is one entry in MedsBase’s broader Brand-vs-Generic Medication Pricing Index — a quarterly-updated reference covering 15 brand-vs-generic pairs across ED, GLP-1, hair-loss, PrEP, and cosmetic clusters, with full methodology and citation disclosure.
Frequently Asked Questions
Is Avana literally the same drug as Stendra?
Yes. Both contain avanafil as the active ingredient at the same labelled doses (50, 100, 200Â mg). The mechanism, onset, half-life, effective window, and side-effect profile are pharmacologically identical. The differences are the manufacturer, the inactive excipients, and the price.
How fast does avanafil work?
15–30 minutes for most users. A substantial subset of users respond within 15 minutes. This is faster than sildenafil, vardenafil, or tadalafil at standard doses and applies equally to Avana and Stendra — it is a property of the avanafil molecule.
Is Avana FDA-approved?
No. Avana is not registered with the US FDA because it is not marketed in the United States. However, Centurion Laboratories manufactures Avana under WHO-GMP certification. Generic avanafil products that ARE sold in US pharmacies (since 2023) are FDA Orange Book AB-rated and therapeutically substitutable for Stendra.
Why is avanafil better tolerated than other PDE5 inhibitors?
Avanafil has greater selectivity for PDE5 over the other phosphodiesterase isoenzymes — particularly PDE6 (which sildenafil cross-reacts with, producing visual disturbance) and PDE11 (which tadalafil cross-reacts with, producing back/muscle pain). The result is the lowest headache rate, lowest flushing rate, and effectively negligible visual or muscular side effects in clinical trials.
Should I switch from Vidalista to Avana?
Depends on your priorities. Tadalafil (in Cialis or Vidalista) has the longest effective window (36 hours) — ideal for users wanting flexibility around sexual timing across a day or two. Avanafil has the fastest onset and cleanest side-effect profile but only 4–5 hour window. If you regularly experience back/muscle pain on tadalafil, switching to avanafil is reasonable.
Can I take Avana with food?
Yes. Avanafil’s absorption is meaningfully less affected by food than sildenafil. A high-fat meal modestly delays peak concentration but does not substantially affect onset or maximum effect.
How is Avana so much cheaper than Stendra?
Three reasons. First, the branded Stendra price still carries a marketing margin recovered after the 2023 US patent expiry. Second, WHO-GMP manufacturing under Indian regulatory oversight has dramatically lower production costs than Vivus or Metuchen US-based manufacturing. Third, Avana has no DTC advertising, no sales-rep visits, and no PBM rebate structure. The cost difference reflects marketing economics, not the molecule.
What about Super Avana?
Super Avana combines avanafil 100Â mg with dapoxetine 60Â mg for men who have both erectile dysfunction and premature ejaculation. One tablet, both effects in the same window. See our Priligy vs Poxet guide for dapoxetine specifically.
Sources
- Goldstein I, McCullough AR, Jones LA, et al. A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction. Journal of Sexual Medicine. 2012;9(4):1122–1133.
- US Food and Drug Administration. NDA 202276, Stendra (avanafil). Approval letter, 27 April 2012.
- Hellstrom WJG, Kaminetsky J, Belkoff LH, et al. Efficacy of avanafil 15 minutes after dosing in men with erectile dysfunction. Journal of Urology. 2015;194(2):485–492.
- Centurion Laboratories Pvt Ltd. WHO-GMP certification under the Indian Central Drugs Standard Control Organisation.
Last clinically reviewed: 18 May 2026.
Written by
Sophie ChenPharmaceutical Content Researcher · 8 years experience
Sophie Chen is a pharmaceutical content researcher with 8 years covering generic medication access and clinical pharmacology. She specialises in international regulatory frameworks, bioequivalence standards, and patient-facing education on therapeutic drug classes. She is not a clinician.