Newer PDE5 inhibitors: avanafil, udenafil, mirodenafil and lodenafil
Compare the PDE5 inhibitors developed after sildenafil and tadalafil, including Zydena and Mvix from South Korea and Helleva from Brazil.
Sildenafil, tadalafil and vardenafil are the best-known PDE5 inhibitors. Four newer ones followed. Only avanafil is authorized in Europe and the US; the other three were developed and approved in South Korea or Brazil.
Side by side
| Ingredient | Original brand | First documented in | Where approved | Notable feature |
|---|---|---|---|---|
| Avanafil | Spedra, Stendra | US and EU labels | EU, UK, US and others | Can be taken about 15–30 minutes before sex |
| Udenafil | Zydena | South Korea | South Korea | Half-life 11–13 hours; studied daily and on demand |
| Mirodenafil | Mvix | South Korea | South Korea | Also a film that dissolves in the mouth |
| Lodenafil | Helleva | Brazil | Brazil | A double molecule split in the body |
What they share
All four work in the same way as sildenafil, need sexual stimulation, and carry the same core warnings: no nitrates, no recreational nitrites (“poppers”) and no combining with another ED medicine. Their side effects in trials (headache, flushing, nasal congestion and indigestion) are the familiar PDE5 pattern.
Why the newer three are rare outside their home markets
Zydena, Mvix and Helleva are authorized by South Korea’s Ministry of Food and Drug Safety or Brazil’s Anvisa, not by the European or US regulators, and their evidence comes mostly from trials in Korean or Brazilian men. An Indian udenafil brand, Zudena, is listed by Sunrise Remedies for export.
Sildenafil, tadalafil, vardenafil and avanafil compared · All ingredients
Sources
Checked .
- The Use of Vasoactive Drugs in the Treatment of Male Erectile Dysfunction (J Clin Med, 2020) — Europe PMC
- Udenafil: efficacy and tolerability in the management of erectile dysfunction (Ther Adv Urol, 2013) — Europe PMC
- Mirodenafil for the treatment of erectile dysfunction: a systematic review (World J Mens Health, 2014) — Europe PMC
- Efficacy and tolerability of lodenafil carbonate: a phase III clinical trial (J Sex Med, 2010) — Europe PMC
- Spedra product information — European Medicines Agency
- Ministry of Food and Drug Safety — Ministry of Food and Drug Safety (South Korea)
- Anvisa — Anvisa (Brazil)