The Medical Letter on Drugs and Therapeutics
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Avanafil (Stendra) - Another PDE5 Inhibitor for Erectile Dysfunction

The FDA has approved avanafil (Stendra – Vivus), an oral phosphodiesterase type-5 (PDE5) inhibitor, for treatment of erectile dysfunction. It is the fifth PDE5 inhibitor to be approved for this indication.1 Advertisements on Stendra’s website imply that it has a faster onset of action than other PDE5 inhibitors.

PDE5 INHIBITORS — There is no convincing evidence that any one PDE5 inhibitor is safer or more effective than any other. Their efficacy varies with the etiology of the erectile dysfunction, but in placebo-controlled trials in men with various etiologies, they generally have had an efficacy rate of 60-70%.2 The PDE5 inhibitors all have similar onsets of action, but tadalafil has a much longer duration of action than the other three.1

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