Avanafil for Erectile Dysfunction (Spedra)
Fast-acting treatment for erectile dysfunction: Learn about Spedra (avanafil), its uses, dosage, side effects, and effectiveness.
| Type of medicine | Also called |
|---|---|
| Phosphodiesterase type-5 inhibitor | Spedra® |
About avanafil
Avanafil is a medication specifically designed to treat erectile dysfunction (ED) in adult men, also known as impotence. This condition occurs when a man cannot achieve or maintain a penile erection sufficient for satisfactory sexual performance. ED affects millions worldwide and can stem from physical causes like narrowed arteries reducing blood flow to the penis, psychological factors, or conditions such as diabetes and cardiovascular disease.
Avanafil belongs to the class of drugs called phosphodiesterase type-5 (PDE5) inhibitors. It works by blocking the PDE5 enzyme, which normally breaks down cyclic guanosine monophosphate (cGMP). During sexual stimulation, nitric oxide release leads to cGMP production, relaxing penile smooth muscles and increasing blood flow for an erection. By inhibiting PDE5, avanafil sustains higher cGMP levels, enhancing erectile response—but only with sexual arousal.
Unlike some PDE5 inhibitors, avanafil is noted for its rapid onset, with peak plasma concentrations reached in 30-45 minutes, allowing effects as early as 15 minutes post-dose in many users. It is available as tablets (50 mg, 100 mg, 200 mg) under brand names like Spedra® (Europe) and Stendra® (US), prescribed for on-demand use.
In the UK, avanafil is available on NHS prescription only for ED linked to specific medical conditions; otherwise, private prescriptions require full payment. Clinical trials demonstrate its efficacy across general ED populations, including those with diabetes or post-prostatectomy.
Before taking avanafil
Allergy
Instruct patients to avoid avanafil if allergic to it or any ingredients. Rare hypersensitivity reactions may occur.
Pregnancy and breastfeeding
Avanafil is not indicated for women and poses no pregnancy or breastfeeding risks, as it is exclusively for male ED.
Other medicines, food and drink, and alcohol
Contraindications: Do not use with nitrates (e.g., for angina) or nitric oxide donors, due to severe hypotension risk. Avoid guanylate cyclase stimulators like riociguat. Use caution with alpha-blockers, antihypertensives, or CYP3A4 inhibitors (e.g., ketoconazole, ritonavir).
- Food: Best on an empty stomach; fatty meals or food delay absorption.
- Alcohol: Limit intake, as excess impairs erections and increases side effects.
- Grapefruit juice: Avoid for 24 hours prior, as it inhibits metabolism.
- No interaction with moderate alcohol in studies, but heavy use reduces efficacy.
Health conditions
Consult a doctor if you have:
- Heart disease, recent stroke/heart attack, or unstable angina.
- Hypotension, uncontrolled hypertension, or retinal disorders.
- Severe liver/kidney impairment (dose adjustment needed).
- Deformation of the penis (e.g., Peyronie’s disease) or priapism history.
- Conditions predisposing to priapism (e.g., sickle cell anemia).
Avanafil slightly prolongs QT interval; caution in congenital long QT syndrome. No significant sperm effects observed in studies.
How and when to take avanafil
Take one tablet 15-30 minutes before sexual activity. Maximum one dose per 24 hours. Swallow whole with water; with/without food, but food delays onset.
Dosage:
| Starting dose | Adjustments |
|---|---|
| 100 mg | Increase to 200 mg if needed; reduce to 50 mg if side effects or with moderate CYP3A4 inhibitors. |
Effects last up to 4-6 hours, but timing flexible (works >6 hours post-dose). Requires sexual stimulation. Do not exceed prescribed dose; seek medical help for erections >4 hours (priapism).
Common questions about avanafil
How does avanafil work?
Avanafil selectively inhibits PDE5, preserving cGMP for penile vasodilation during arousal.
When should I take it?
15-30 minutes pre-sex; fastest on empty stomach.
Does food affect it?
Yes, high-fat meals delay absorption.
Can I take it with alcohol?
Moderate yes; excess reduces effectiveness.
Is it safe with other ED drugs?
No—never combine with sildenafil, tadalafil, etc.
How long does it last?
Up to 4 hours typically; ~2/3 attempts successful even 15 min or >6h post-dose.
Side-effects of avanafil
Generally well-tolerated; <2% discontinue due to adverse events. Common (>1/100):
- Headache, flushing, nasal congestion.
- Back pain, muscle aches (less than others).
Rare: Visual disturbances (lower risk vs. sildenafil), dizziness, palpitations, priapism, sudden hearing/vision loss (seek immediate help).
Monitor; report persistent issues. No serious drug-related events in long-term use.
How to cope with side effects of avanafil
- Headaches: Rest, hydrate; paracetamol if needed.
- Flushing: Cool environment.
- Nasal congestion: Decongestants.
- Discuss dose reduction if intolerable.
Pregnancy, breastfeeding and fertility while taking avanafil
Not for women. No adverse sperm effects in studies (up to 26 weeks).
What happens if I take too much avanafil?
Overdose symptoms: prolonged erection, hypotension. Seek emergency care; no specific antidote—supportive treatment.
Further information
- Monitor progress with doctor; adjust if ineffective/too strong.
- Store below 30°C, dry place.
- Full details in Patient Information Leaflet.
Frequently Asked Questions (FAQs)
Q: Is Spedra faster than Viagra?
A: Yes, avanafil onset is 15-30 min vs. 60 min for sildenafil; ~2/3 users succeed within 15 min.
Q: Does avanafil cure ED?
A: No, symptomatic treatment only; address underlying causes.
Q: Can I take it daily?
A: No, on-demand only; max once/24h.
Q: Works with diabetes?
A: Yes, effective in diabetic ED patients.
Q: Age limit?
A: Adult men (>18); not for under 18.
References
- Avanafil: a review of its use in patients with erectile dysfunction — PubMed/NCBI. 2013-08-22. https://pubmed.ncbi.nlm.nih.gov/23955441/
- Spedra (Avanafil) | LloydsPharmacy Online Doctor UK — LloydsPharmacy. Accessed 2026. https://onlinedoctor.lloydspharmacy.com/uk/erectile-dysfunction/spedra
- Spedra – Erectile Dysfunction – BPAS — BPAS. Accessed 2026. https://www.bpas.org/more-services-information/erectile-dysfunction/spedra/
- Spedra 50 mg, 100 mg and 200 mg tablets – Medicines.ie — Health Products Regulatory Authority. Accessed 2026. https://www.medicines.ie/print?id=33810&type=xpil&pilId=2471
- Spedra | European Medicines Agency (EMA) — EMA. Accessed 2026. https://www.ema.europa.eu/en/medicines/human/EPAR/spedra
- Avanafil for erectile dysfunction (Spedra) | Patient.info — Patient.info. Accessed 2026. https://patient.info/medicine/avanafil-for-erectile-dysfunction-spedra
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