Avanafil or Vardenafil: How the Two Erectile Dysfunction Drugs Compare

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• Online consultation with UK-registered prescribers, available without a GP referral
• Ongoing clinical support if your treatment needs reviewing

Avanafil and vardenafil are both PDE5 inhibitor medicines licensed in the UK to treat erectile dysfunction, and neither is officially established as more effective than the other. Avanafil is the newest PDE5 inhibitor available in the UK, and the comparison comes down to practical differences: how quickly each medicine tends to start working, how food affects it, the licensed dose range, and the specific safety considerations that may matter for one person more than another.

This page compares avanafil and vardenafil directly for adult men in the UK who want clear information about prescribed erectile dysfunction treatment. It explains onset time, duration, food effects, dosing, safety differences, individual suitability, and how clinical assessment and online consultation help determine safe access under prescriber supervision.

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Avanafil and Vardenafil at a Glance

How Quickly Each One Starts Working

Avanafil tends to start working relatively quickly, with some men responding within 15 to 30 minutes. Vardenafil tablets generally start working within about 25 to 60 minutes. Both figures vary between individuals, and neither medicine works without sexual stimulation, whatever the onset time.

Why Onset Times are not a Simple Ranking

A faster typical onset does not mean a medicine works better, and both figures are averages rather than guarantees for any individual. Factors like food, general health and how the medicine happens to suit you personally can shift these timings in either direction. Someone might find vardenafil works predictably for them within 30 minutes, while someone else finds avanafil takes closer to the top of its range. Onset speed is one practical factor to weigh up, not a verdict on which medicine is more effective.

How Long Each One Lasts

Vardenafil's effects generally last around 4 to 5 hours. Avanafil can remain effective for several hours, although its duration is not usually expressed using the same specific 4-to-5-hour figure used for vardenafil. By contrast, tadalafil has a longer duration and can last up to 36 hours in the body. Neither medicine is intended for continuous, ongoing use in the way a once-daily medicine would be, both are taken as needed.

What "Duration" Actually Means in Practice with Sexual Stimulation

Duration figures describe the general window during which a medicine may still be having an effect, not a guarantee of how long any individual response will last on a given occasion. In pharmacokinetic terms, this is different from half life, which describes how quickly a medicine is cleared from the body. How long a medication lasts in practice is not always identical to its half-life. It is also not the same as how long you'd need to wait to take another dose, both avanafil and vardenafil have their own rules about only taking one dose in any 24-hour period, regardless of how long the previous dose's effects lasted.

How Food Affects Each One

Food affects avanafil more than it affects vardenafil. A high-fat meal delays avanafil's onset by around 1 hour 15 minutes and reduces its peak concentration by around 39% at the 200mg dose. For vardenafil, a high-fat meal has a milder effect, reducing peak concentration by around 18 to 20%. In practical terms, taking either medicine on an emptier stomach tends to make its timing more predictable, but this matters somewhat more for avanafil.

Planning Around a Meal

If you have eaten a large or high-fat meal, it is worth allowing extra time before expecting either medicine to take effect, and this is a more significant factor for avanafil given the size of the delay involved. If you have eaten a large or high-fat meal, it may take longer for the medicine to reach peak levels, particularly with avanafil.

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Dosing: What's Actually Available

Avanafil's Licensed Strengths

Avanafil is licensed in the UK at 50mg, 100mg and 200mg. There is no licensed 25mg, 150mg, 300mg or 400mg avanafil product, whatever might be advertised online. Avanafil does not currently have a UK generic equivalent.

Vardenafil's Licensed Strengths

Vardenafil is licensed in the UK at 5mg, 10mg and 20mg, with 20mg the maximum. Generic vardenafil is available in the UK, and Vardenafil Levitra refers to the former branded version that is no longer manufactured. Vardenafil is effective at lower milligram doses than sildenafil, but the milligram strengths of different PDE5 inhibitors should not be compared directly. Side effects vary according to the medicine, dose and individual.

What the Dose Ranges Do Not Tell You

It is tempting to look at avanafil's higher milligram figures (50 to 200mg) next to vardenafil's lower ones (2.5 to 20mg) and assume avanafil is somehow the stronger medicine. That comparison does not hold: each medicine has its own potency per milligram because they are different phosphodiesterase type inhibitors within the phosphodiesterase type 5 pde5 class, so the numbers reflect different scales rather than different strengths of effect. Neither dose range should be read as an indicator of overall effectiveness.

The Key Safety Difference: Drug Interactions vs Heart Rhythm

Avanafil and CYP3A4 Inhibitors

Avanafil's most distinctive safety consideration is its interaction with a group of medicines called CYP3A4 inhibitors, which affect how the liver processes avanafil. Potent CYP3A4 inhibitors are contraindicated with avanafil altogether. With moderate CYP3A4 inhibitors, the maximum avanafil dose is limited to 100mg, with at least 48 hours between doses. This is a genuinely distinctive caution among the PDE5 inhibitor medicines and is central to whether avanafil is suitable if you are taking certain other medicines.

Vardenafil and Heart Rhythm (QT Interval)

Vardenafil's most distinctive safety consideration is a measurable, dose-related effect on the heart's QT interval, the time it takes the heart's electrical system to reset between beats. A standard 10mg dose was associated with an average increase of around 8 milliseconds in studies looking at this specifically, while a much higher single 80mg dose was associated with an average increase of around 10 milliseconds.Because vardenafil can prolong the QT interval, it should be avoided in people with congenital QT prolongation and used cautiously in people taking medicines that can affect cardiac rhythm.

Why This Difference Matters for Choosing Between Them

If you are taking a medicine that is a CYP3A4 inhibitor, such as certain antifungal or antiviral medicines, that is a specific reason avanafil might need particular caution or an alternative approach. If you have a personal or family history of a heart rhythm condition affecting the QT interval, that is a specific reason vardenafil might need particular caution or an alternative approach. Neither consideration applies to everyone, which is exactly why an individual assessment, rather than a general comparison, decides what is suitable for you.

Shared Cautions and Commonly Reported Adverse Effects That Apply to Both

Some safety considerations apply to both medicines equally, regardless of which distinctive caution is more relevant to you individually. Both are absolutely contraindicated with nitrates and nicorandil, due to the risk of a dangerous drop in blood pressure. Both need caution alongside alpha-blocker medicines, uncontrolled blood pressure, and certain existing heart conditions. Neither should be combined with another PDE5 inhibitor medicine. These shared cautions are assessed alongside the medicine-specific ones during a proper consultation, because these drugs can lower blood pressure significantly and may carry a higher risk in some people.

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Is One "Better" Than the Other?

Neither medicine is established as generally more effective than the other. What suits one person may not suit another, based on individual health, other medicines, and personal preference around timing and food.

Why a General Comparison Can not Answer This For You

A comparison like this one can tell you how two medicines typically differ, but it can not tell you which will suit your own body, health conditions and current medicines. That's precisely the gap an individual clinical assessment fills, weighing the specific factors that apply to you rather than general averages.

What the Evidence Actually Shows

In clinical trials, avanafil improved erectile-function outcomes compared with placebo, with response varying by dose, study population and outcome measured. Across the PDE5 inhibitor class generally, response rates for the group as a whole range from around 56% to 84% depending on the population and measure used. These figures illustrate that both medicines have a solid evidence base, not that one outperforms the other, trials of different medicines are not designed to be compared directly against each other in this way.

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Where Avanafil and Vardenafil Fit Among the Four PDE5 Inhibitors

Avanafil and vardenafil are two of four PDE5 inhibitor medicines licensed in the UK, alongside sildenafil and tadalafil, sildenafil, sold as Viagra, was the first PDE5 inhibitor approved in the UK, while tadalafil is also known by the brand name Cialis. When a man is sexually stimulated, nitric oxide release triggers blood vessel dilation, and these medicines act on the pathway involved in erectile function by helping smooth muscle in penile blood vessels relax, they allow cGMP to accumulate and remain active longer to improve blood flow, although each has its own distinct timing profile, licensed dose range and specific cautions. This page focuses specifically on avanafil and vardenafil, a fuller comparison across all four medicines, including sildenafil and tadalafil, is covered separately.

How to Get Either Safely

What a Genuine Online Consultation Involves

A proper online consultation with UK-registered prescribers involves completing a health questionnaire covering your medical history, current medications and heart health, because erectile dysfunction is common and affects 52% of men aged 40 to 70, so screening for sexual dysfunction and wider risk factors matters before choosing an ed treatment. Sexual activity can temporarily increase cardiovascular demand, so cardiovascular health is considered when assessing whether ED treatment is appropriate. This is exactly the information used to determine whether avanafil or vardenafil (or a different treatment) is appropriate for you, taking into account the specific cautions each one carries and helping your clinician treat ED safely. Ongoing clinical support is available if your treatment needs reviewing later.

Medical Disclaimer

This page is for general information only and does not replace personalised medical advice. Treatment suitability depends on an individual clinical assessment, and your prescriber will determine the appropriate treatment for you. These medicines should only be used under the supervision of an appropriately qualified prescriber. Results vary between individuals.