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medingenuityStendra: Is It Faster? Is It Better?

Recently, a new PDE5 inhibitor, Stendra, (Avanafil) was approved by the FDA and you will be hearing about it very shortly. Based on the information that I have, in the majority of ways, it is simply a ME-TOO drug.

The main difference relates to onset of action. Stendra's main claim to fame will be onset of action as early as 15 minutes. Its T max, however, is 30 to 45 minutes in the fasting state. Although the package insert states it can be taken with or without food, a high fat meal reduces the rate of absorption and delays the T max to an hour and fifteen minutes. Duration of Stendra is the same as Viagra and Levitra at 4-6 hours. Viagra and Levitra report onset at 30 minutes to 1 hour. Cialis is about the same or a little longer, but duration is 24-36 hours.

Efficacy appears to be similar to the other PDE5 inhibitors, (Cialis, Viagra and Levitra).

The same safety precautions exist: 1) Contraindicated with the use of nitrates; 2) Caution in combination with Alpha Blockers; 3) Seek help for erection lasting more than 4 hours (I find this to be one of the best marketing ploys in the history of Urology in the last 30 years). I have never seen a man with an erection more than 1-2 hours with the use of any PDE5 inhibitor.

Side effects include headaches, facial flushing, nasal congestion, and back pain. In looking at the percentages it appears that the side effect profile is probably similar to Cialis or maybe slightly better.

Bottomline: Some Possibilities

  • Possible this will lead to more samples for our patients.

  • Possible this will drive the cost of the drugs down if Stendra is priced lower.

  • For the patient who wants more rapid onset, maybe it will be of benefit, however, duration will not come close to Cialis' 24-36 hours.

I shrug my shoulders and say try it. PDE5 drugs are safe drugs as long as there is no nitrate use. I explain to men that pills won't kill them, sex can. I am interested in learning your experience with Stendra.

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