Stendra (avanafil) is marketed as the ED pill with fewer side effects thanks to its higher selectivity for PDE5. But what do actual patients say? We reviewed clinical trial data and thousands of patient reviews to give you the unfiltered picture.
Clinical Trial Side Effects: The Official Numbers
In clinical trials, the most commonly reported side effects of avanafil were:[3]
| Side Effect | 100mg | 200mg | Placebo |
|---|---|---|---|
| Headache | 5.7% | 6.4% | 1.7% |
| Flushing | 3.0% | 4.1% | 0.5% |
| Nasal congestion | 2.1% | 2.9% | 0.4% |
| Nasopharyngitis | 2.2% | 2.5% | 1.6% |
| Back pain | 1.2% | 2.0% | 0.7% |
These rates are generally comparable to or slightly lower than those reported for sildenafil and tadalafil. Notably, visual disturbances (the “blue tinge” reported with sildenafil) are extremely rare with avanafil, because it has minimal activity against PDE6 in the retina.[4]
What Patient Reviews Actually Say
Patient reviews on platforms like WebMD paint a more nuanced picture than the clinical trial numbers suggest. Reviews are sharply divided:[1]
The Positive Reviews
Satisfied patients consistently praise two things: speed and tolerability. Multiple reviewers report erections within 15–20 minutes, and several older patients note that Stendra works with noticeably fewer side effects than Viagra or Cialis.
The Negative Reviews
The most common complaint is simple: it didn’t work. Multiple reviewers report taking the full 200mg dose with no meaningful improvement in erectile function. Some describe trying Stendra after success with other PDE5 inhibitors and being disappointed by the results.
Individual responses to ED medications vary significantly. About 30–35% of men don’t respond to any PDE5 inhibitor, and among those who do respond, effectiveness can differ between specific drugs. Not responding to avanafil doesn’t mean other PDE5 inhibitors won’t work, and vice versa.
Serious Side Effects to Watch For
Rare but important side effects include:[3]
- Priapism — a painful erection lasting more than 4 hours. This is a medical emergency requiring immediate treatment.
- Sudden hearing loss — reported rarely with all PDE5 inhibitors.
- Sudden vision loss — associated with non-arteritic anterior ischemic optic neuropathy (NAION).
- Dangerous blood pressure drop — especially when combined with nitrates or alpha-blockers.[3]
Who Should NOT Take Stendra
Avanafil is contraindicated if you:[5]
- Take any nitrate medication (nitroglycerin, isosorbide) for chest pain
- Take “poppers” (amyl nitrite, butyl nitrite)
- Have severe liver disease
- Are on dialysis
- Have had a recent heart attack or stroke
Wondering if Stendra is right for you? A licensed telehealth provider can evaluate your health history and recommend the best option.
Find a Provider →The Bottom Line
Stendra’s side effect profile is genuinely favorable in clinical data—slightly lower rates than sildenafil, and virtually no visual disturbances. But patient reviews reveal that efficacy is inconsistent, with a notable segment of users reporting it simply didn’t work for them. If you try Stendra and it doesn’t deliver, that’s not unusual—talk to your provider about trying a different PDE5 inhibitor or an alternative approach.