Sildenafil vs Avanafil UK - Compare Prices & Efficacy

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Sildenafil vs Avanafil: Which Erectile Dysfunction Treatment Is Right for You?

Published: 20 August 2026

When comparing sildenafil vs avanafil, UK patients often ask which PDE5 inhibitor offers faster onset, better tolerability, and superior value. Both medications treat erectile dysfunction effectively, but they differ significantly in pharmacokinetics, duration of action, and side effect profiles. As a UK-registered pharmacy with over a decade of clinical experience dispensing ED treatments, we've helped thousands of patients navigate this choice—and the decision often comes down to lifestyle, timing preferences, and individual response.

Sildenafil vs Avanafil: Mechanism of Action and Clinical Pharmacology

Both sildenafil and avanafil belong to the phosphodiesterase type 5 (PDE5) inhibitor class, meaning they work by blocking the enzyme that degrades cyclic guanosine monophosphate (cGMP) in penile tissue. Elevated cGMP levels promote smooth muscle relaxation and increased blood flow to the corpus cavernosum, facilitating erection in response to sexual stimulation [1]. However, the selectivity and binding kinetics differ markedly between these two agents.

Sildenafil, the active ingredient in Viagra, has been available since 1998 and demonstrates moderate selectivity for PDE5 over other phosphodiesterase isoforms. Avanafil, approved by the MHRA more recently, exhibits significantly higher selectivity for PDE5 compared to PDE6 and PDE11, which may explain its reduced incidence of visual disturbances and back pain [2]. This enhanced selectivity translates to a cleaner side effect profile in many patients, though individual variation remains substantial.

Onset Time and Duration: Sildenafil vs Avanafil Compared

One of the most clinically significant differences when evaluating sildenafil vs avanafil is onset of action. Sildenafil typically requires 30–60 minutes to reach therapeutic effect, with peak plasma concentrations occurring around 60 minutes post-dose [3]. Patients are generally advised to take sildenafil on an empty stomach, as high-fat meals can delay absorption by up to an hour.

Avanafil, by contrast, demonstrates a notably faster onset—often as rapid as 15–30 minutes in clinical trials—making it the fastest-acting PDE5 inhibitor currently licensed in the UK [4]. This rapid absorption allows for greater spontaneity, a key advantage for patients who prefer not to plan intimacy hours in advance. Duration of action is similar for both: sildenafil remains effective for approximately 4–6 hours, while avanafil offers a comparable window, though some patients report a slightly shorter duration with avanafil at lower doses.

Food Interactions: Sildenafil vs Avanafil

Avanafil's pharmacokinetics are less affected by food intake compared to sildenafil, allowing patients to take it with or without meals without significant loss of efficacy. This flexibility is particularly valued by patients who prefer not to fast before dosing, and it represents a practical advantage in real-world use.

Efficacy and Clinical Trial Data: Sildenafil vs Avanafil Outcomes

In head-to-head comparisons and meta-analyses, both sildenafil and avanafil demonstrate robust efficacy in treating erectile dysfunction across a range of severities and aetiologies. Sildenafil has been evaluated in thousands of patients over more than two decades, with success rates (defined as achieving erections sufficient for intercourse) ranging from 60% to 85% depending on dose and patient population [1].

Avanafil has shown comparable efficacy in pivotal trials, with the 100 mg and 200 mg doses achieving successful intercourse in approximately 57%–80% of attempts, versus 27%–35% with placebo [4]. Importantly, avanafil demonstrated efficacy as early as 15 minutes post-dose in a subset of patients, a unique feature not consistently observed with sildenafil. Both medications are effective in patients with diabetes, hypertension, and post-prostatectomy ED, though individual response varies.

Patient Satisfaction: Sildenafil vs Avanafil

Patient-reported outcome measures suggest that avanafil may offer higher satisfaction scores related to spontaneity and reduced planning burden, while sildenafil's longer track record and familiarity contribute to confidence and trust. Choice between the two often hinges on personal preference rather than objective superiority.

Feature Sildenafil Avanafil
Onset of Action 30–60 minutes 15–30 minutes
Duration 4–6 hours 4–6 hours
Food Interaction Delayed by high-fat meals Minimal food effect
PDE5 Selectivity Moderate High
Common Side Effects Headache, flushing, visual disturbances Headache, flushing (lower incidence)
Starting Dose 50 mg 100 mg
UK Price (Cured Pharmacy) From £0.45 Consult for pricing
Availability Generic widely available Branded/limited generic

Side Effects and Tolerability: Sildenafil vs Avanafil Safety Profiles

When assessing sildenafil vs avanafil for tolerability, both are generally well-tolerated, but their side effect profiles differ in frequency and type. Common adverse effects of sildenafil include headache (16%), flushing (10%), dyspepsia (7%), nasal congestion (4%), and visual disturbances such as blue-tinged vision (3%) due to PDE6 inhibition in the retina [1][2].

Avanafil's enhanced PDE5 selectivity results in a lower incidence of visual side effects and back pain compared to sildenafil and other PDE5 inhibitors. Headache (10–12%), flushing (4–10%), and nasal congestion (3–5%) remain the most common adverse events, but discontinuation rates due to side effects are notably lower with avanafil [4]. Both medications are contraindicated in patients taking nitrates, and both require caution in those with significant cardiovascular disease.

Dosing and Flexibility: Sildenafil vs Avanafil Regimens

Sildenafil is available in 25 mg, 50 mg, and 100 mg tablets, with 50 mg being the standard starting dose for most patients. Dose adjustments are made based on efficacy and tolerability, and the medication is taken as needed, approximately one hour before sexual activity. At Cured Pharmacy, sildenafil is available from £0.45 per tablet, representing the cheapest UK price for this highly effective treatment.

Avanafil is available in 50 mg, 100 mg, and 200 mg doses, with 100 mg typically recommended as the initial dose. The ability to take avanafil as little as 15 minutes before intercourse offers a significant lifestyle advantage for spontaneous intimacy. When comparing sildenafil vs avanafil for dosing convenience, avanafil's rapid onset and food tolerance provide practical benefits, though sildenafil's lower cost and extensive clinical history remain compelling factors.

Titration and Personalisation

Both medications allow for dose titration based on individual response. Patients who experience inadequate response or bothersome side effects should consult their prescriber for dose adjustment rather than discontinuing treatment altogether. Our UK-registered clinical team provides free consultations to optimise therapy for each patient.

Cost and Accessibility: Sildenafil vs Avanafil UK Pricing

Price is a major consideration for many patients when choosing between sildenafil vs avanafil. Sildenafil, now available as a generic medication, is significantly more affordable than branded or newer alternatives. At Cured Pharmacy, sildenafil starts from £0.45 per tablet, with 20% off your first order using code Ednew, making it the most cost-effective PDE5 inhibitor available in the UK.

Avanafil, being a newer agent still under patent in some formulations, typically commands a higher price point. While it offers advantages in onset time and tolerability, the cost difference can be substantial over time for patients requiring regular treatment. Both medications are available via our free online consultation process, which takes under three minutes and is reviewed by UK-registered prescribers. All medicines are dispensed by our GPhC-registered pharmacy (9012511) under the supervision of Superintendent Pharmacist Tarun Kumar (GPhC 2233073).

For patients prioritising affordability without compromising efficacy, sildenafil remains the gold standard. For those valuing rapid onset and enhanced spontaneity, avanafil may justify the additional cost. Our clinical team can help you weigh these factors based on your individual circumstances and preferences.

Scientific References

  1. Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998). Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338(20), 1397–1404. [accessed 20 August 2026]
  2. Yuan, J., Zhang, R., Yang, Z., Lee, J., Liu, Y., Tian, J., ... & Lyseng-Williamson, K. A. (2013). Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis. European Urology, 63(5), 902–912. [accessed 20 August 2026]
  3. Nichols, D. J., Muirhead, G. J., & Harness, J. A. (2002). Pharmacokinetics of sildenafil after single oral doses in healthy male subjects: absolute bioavailability, food effects and dose proportionality. British Journal of Clinical Pharmacology, 53(S1), 5S–12S. [accessed 20 August 2026]
  4. Goldstein, I., McCullough, A. R., Jones, L. A., Hellstrom, W. J., Bowden, C. H., Didonato, K., & Nguyen, H. (2012). A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction. Journal of Sexual Medicine, 9(4), 1122–1133. [accessed 20 August 2026]
  5. NHS. (2026). Erectile dysfunction (impotence). https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ Accessed 20 August 2026.

Information on this page is for educational purposes only and is not medical advice. All prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting any new medication.

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Faq

Which is better: sildenafil vs avanafil?
Neither is universally better—sildenafil offers proven efficacy and the cheapest UK price, while avanafil provides faster onset and fewer visual side effects. Choice depends on your priorities: cost versus speed and tolerability.
How quickly does avanafil work compared to sildenafil?
Avanafil can work in as little as 15–30 minutes, whereas sildenafil typically requires 30–60 minutes. This makes avanafil ideal for spontaneous intimacy.
Is sildenafil safer than avanafil?
Both sildenafil and avanafil are safe and well-tolerated PDE5 inhibitors when used appropriately. Avanafil's higher selectivity may reduce certain side effects like visual disturbances, but individual response varies.
Can I take sildenafil and avanafil together?
No, you should never combine PDE5 inhibitors. Taking sildenafil vs avanafil concurrently increases the risk of serious side effects, including hypotension. Use only one as prescribed.
Does food affect sildenafil vs avanafil differently?
Yes—high-fat meals can delay sildenafil absorption significantly, while avanafil is minimally affected by food, offering greater dosing flexibility.
What is the cheapest option: sildenafil vs avanafil?
Sildenafil is far more affordable, starting from £0.45 at Cured Pharmacy with 20% off your first order using code Ednew. Avanafil is considerably more expensive due to patent status.
Do I need a prescription for sildenafil or avanafil in the UK?
Yes, both sildenafil and avanafil are prescription-only medicines (POM) in the UK. Cured Pharmacy provides a free online consultation with UK-registered prescribers to assess suitability.
Which lasts longer: sildenafil vs avanafil?
Both medications offer similar duration of action, typically 4–6 hours. Neither is designed for prolonged daily effect—consider tadalafil if you prefer a longer-acting option.
Tarun Kumar, Prescribing Pharmacist

Medically reviewed by

Tarun Kumar, Prescribing Pharmacist (GPhC 2233073)

Last reviewed: 20 August 2026

Last updated on 20 August 2026.

Review History

Our experts continually monitor new findings in health and medicine, and we update our articles when new information becomes available.

Why this page was updated on 20 August 2026

Content checked and updated as part of our periodic review, to ensure accuracy and currentness.

Current version (20 August 2026)

Edited by: The Editorial Team

Medically reviewed by:

Tarun Kumar, GPhC No. 2233073, Prescribing Pharmacist


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