That depends on the online pharmacy and is changing. Avanafil Stendra. It might work longer if you have mild to moderate erectile dysfunction. Its effects might last longer if you have mild to moderate ED. Sildenafil Viagra.As an alternative to Viagra, a person may wish to try any of the following: Alternative oral drugs: Including vardenafil, tadalafil, and avanafil. Nonoral drugs: Such as penile self injections.  · There’s a Free, Low-Risk Alternative to Viagra, Study Shows. Regular exercise sessions can be as effective as popping Viagra pills when it comes to dealing with erectile dysfunction (ED). According to new research, just three 30 minute sessions per week could be enough to see a difference. Researchers from the Baylor College of Missing: without. Key takeaways: Muse, Caverject, and Trimix can be good substitutes for Viagra (sildenafil). But they require insertion or injection into the penis. There’s some evidence that L-arginine might help with ED as an oral supplement. But it may not be safe for everyone. There’s not much evidence that trazodone, ginseng, or yohimbine help with .