When You Can't Get Avanafil, You Still Have Options

If you've been prescribed Avanafil (brand name Stendra) for erectile dysfunction but can't find it at your pharmacy — or the cost is too high — don't panic. There are several effective alternatives in the same drug class that your doctor can prescribe instead.

In this guide, we'll explain what Avanafil is, how it works, and walk you through the best alternative medications available in 2026. Each of these treats erectile dysfunction using a similar mechanism, so switching is usually straightforward.

What Is Avanafil and How Does It Work?

Avanafil is a phosphodiesterase type 5 (PDE5) inhibitor approved by the FDA in 2012 for the treatment of erectile dysfunction in men. It works by blocking the PDE5 enzyme, which normally breaks down a chemical called cGMP in the blood vessels of the penis. By preserving cGMP levels, Avanafil helps the smooth muscles in the penis relax and allows increased blood flow during sexual stimulation.

Avanafil is known for its rapid onset — it can start working in as little as 15 minutes, making it one of the fastest PDE5 inhibitors available. It comes in 50 mg, 100 mg, and 200 mg tablets.

For a deeper dive, read our post on how Avanafil works.

Why You Might Need an Alternative

There are several reasons patients look for alternatives to Avanafil:

• Availability: Avanafil has a smaller market share than other ED drugs, so many pharmacies don't stock it. (See: Why is Avanafil so hard to find?)
• Cost: Brand-name Stendra costs $400 to $700 for a small supply. Even generic Avanafil runs $97 to $230 for 10 tablets with a discount card.
• Insurance: Most plans don't cover Avanafil or require prior authorization and step therapy with a cheaper drug first.
• Side effects: Some patients may experience side effects like headaches or flushing and want to try a different option. (See: Avanafil side effects)

Alternative 1: Sildenafil (Viagra)

Sildenafil is the most well-known ED medication in the world. Originally marketed as Viagra, it was the first PDE5 inhibitor approved by the FDA (in 1998) and has been available as an affordable generic since 2017.

Key Details

• How to take it: 25 mg, 50 mg, or 100 mg tablet taken about 30 to 60 minutes before sexual activity
• How long it lasts: 4 to 6 hours
• Generic available: Yes — widely available at most pharmacies
• Cost: As low as $3 to $10 per tablet with a discount card
• Common side effects: Headache, flushing, upset stomach, nasal congestion, vision changes (blue tint)

How It Compares to Avanafil

Sildenafil takes slightly longer to kick in (30 to 60 minutes vs. 15 to 30 minutes for Avanafil) and food — especially high-fat meals — can delay its absorption more. However, it's dramatically cheaper and available at virtually every pharmacy in the country.

Alternative 2: Tadalafil (Cialis)

Tadalafil, sold under the brand name Cialis, is unique among PDE5 inhibitors because of its long duration of action — up to 36 hours. It's also the only PDE5 inhibitor approved for daily use at a lower dose (2.5 mg or 5 mg).

Key Details

• How to take it: 5 mg, 10 mg, or 20 mg tablet. Can be taken as needed (10 mg or 20 mg) or daily (2.5 mg or 5 mg)
• How long it lasts: Up to 36 hours (as-needed dosing)
• Generic available: Yes — widely available
• Cost: As low as $3 to $15 per tablet with a discount card
• Common side effects: Headache, muscle aches, back pain, flushing, stuffy nose, indigestion

How It Compares to Avanafil

Tadalafil has a much longer window of effectiveness, which many patients prefer because it allows for more spontaneity. The daily dosing option is also attractive for men who want continuous ED coverage without timing a pill. It's widely available and very affordable as a generic.

Alternative 3: Vardenafil (Levitra / Staxyn)

Vardenafil was marketed as Levitra (tablets) and Staxyn (orally disintegrating tablets). It has a similar onset and duration to Sildenafil.

Key Details

• How to take it: 5 mg, 10 mg, or 20 mg tablet taken about 30 to 60 minutes before sexual activity
• How long it lasts: 4 to 6 hours
• Generic available: Yes
• Cost: As low as $10 to $30 per tablet with a discount card
• Common side effects: Headache, flushing, stuffy nose, indigestion, dizziness

How It Compares to Avanafil

Vardenafil is similar in speed and duration to Sildenafil but may be slightly better tolerated by some patients. It's more expensive than Sildenafil or Tadalafil generics but still considerably cheaper than Avanafil. The orally disintegrating tablet (Staxyn) is convenient for men who prefer not to swallow a pill with water.

How to Switch Medications Safely

Switching between PDE5 inhibitors is generally straightforward, but you should always involve your doctor. Here's what to keep in mind:

• Talk to your prescriber: Don't switch on your own. Your doctor will choose the right alternative and dose based on your health profile.
• Watch for interactions: All PDE5 inhibitors share the same major drug interactions — especially with nitrates (which are absolutely contraindicated) and alpha-blockers. For details, see our drug interactions guide.
• Give it a fair trial: Doctors typically recommend trying a new ED medication at least 4 to 8 times before concluding it doesn't work. The first time isn't always representative.
• Report side effects: If you experience persistent headaches, vision changes, or any concerning symptoms, contact your doctor promptly.

Don't Give Up on Avanafil Just Yet

Before switching to an alternative, consider whether Avanafil might still be available to you. Use Medfinder to check pharmacy stock near you, ask your pharmacist to order it, or explore online pharmacy options. For tips, read how to find Avanafil in stock near you.

If cost is the barrier, check out our guide on how to save money on Avanafil — discount cards can bring the price down significantly.

Final Thoughts

Avanafil is an excellent ED medication, but it's not the only one. If you can't fill your prescription due to availability, cost, or insurance issues, you have strong alternatives in Sildenafil, Tadalafil, and Vardenafil. All three are proven, widely available, and affordable as generics.

Talk to your doctor about what's right for you, and remember that getting effective ED treatment is what matters most — the specific medication is just the means to that end.