This guide explains what Spedra is, why it acts so quickly, its doses and timing, the side effects and the nitrates contraindication. It is based on the UK Summary of Product Characteristics, the NHS and NICE, and is general information rather than personal medical advice.
What Spedra is
Spedra is the brand name for avanafil, a PDE5 inhibitor licensed for erectile dysfunction in adult men 1. It is the most recently introduced of the four PDE5 inhibitors available in the UK, alongside sildenafil, tadalafil and vardenafil 1.
Like the others, it supports an erection during sexual arousal by helping the blood vessels in the penis relax, and it treats the symptom of ED rather than its underlying cause 12. What sets it apart is how quickly it works 1.
Avanafil is designed for a fast onset, often within 15 to 30 minutes, which is faster than the others typically act 1. For men who want less planning and more spontaneity, without the long duration of tadalafil, that speed is its main appeal 13.
It is a prescription-only medicine, so a clinician assesses whether it is suitable, taking account of your health, other medicines and any conditions that would make it unsafe 12.
Why it acts quickly
Avanafil is absorbed and reaches effective levels in the body relatively quickly compared with the other PDE5 inhibitors, which is the basis of its fast onset 1. The SmPC reflects that it can be taken as little as 15 to 30 minutes before sexual activity 1.
As with all PDE5 inhibitors, it works only with sexual stimulation1. The fast onset is about how soon it is ready to support an erection, not about producing one without arousal 1.
Its effect lasts a few hours, shorter than tadalafil's long window, so it suits people who want quick, on-demand use rather than a medicine working across a day or more 13. That combination of speed and a moderate duration is its distinctive profile 1.
Food has less effect on avanafil's onset than on sildenafil, though a very heavy, high-fat meal may still slow it a little 1. This adds to its convenience for on-demand use 1.
Doses and how to take it
Spedra is taken as needed, about 15 to 30 minutes before sexual activity 1. The usual dose is 100 mg, which a prescriber may increase to 200 mg or reduce to 50 mg, depending on how well it works and how well it is tolerated 1.
A lower dose may suit people who are more sensitive to side effects, who are older, or who have certain conditions or take interacting medicines 1. The right dose is an individual decision made with a prescriber 1.
It should not be taken more than once in 24 hours1. As with the other PDE5 inhibitors, alcohol can reduce its effect and worsen side effects, so moderation helps 12.
If the first attempt is not successful, that is common and does not necessarily mean it is the wrong medicine; it can take a few proper attempts 1. A prescriber can review the dose if needed 12.
Considering treatment for erectile dysfunction? You can start an assessment with a Cloud Pharmacy clinician, who will review your medical history and confirm whether treatment is appropriate.
Side effects
The most common side effects of avanafil are headache, flushing and nasal congestion1. These are usually mild and reflect the medicine's effect on blood vessels 1.
Less commonly, people can experience back pain, dizziness or other effects 1. As with the class, most listed effects are uncommon, and many people tolerate it well 1.
Seek emergency care for an erection lasting more than four hours (priapism), or for sudden loss of vision or hearing 1. These are uncommon but need prompt action 1.
If side effects are troublesome, a prescriber may suggest a lower dose or a different option 12. The aim is to balance benefit and tolerability 1.
Nitrates and other key cautions
Avanafil must never be combined with nitrates (such as GTN), nicorandil or 'poppers', because the combination can cause a dangerous drop in blood pressure; this is an absolute contraindication 1.
Alpha-blockers need caution because of the blood-pressure-lowering effect, and some medicines, including certain antifungals and HIV medicines, can raise avanafil levels, so a prescriber needs your full medicine list 1. There are heart-related situations where it should be avoided or used only on advice 1.
These cautions are why avanafil is assessed before prescribing 12. Honesty about your health and medicines is part of the safeguard 1.
Our guides on nitrates and alpha-blockers cover these interactions in detail 1.
Who Spedra may suit
Spedra may particularly suit men who value a fast onset and want to keep things spontaneous, without the long duration of tadalafil or as much planning as sildenafil can need 13. Its speed and moderate duration are its selling points for on-demand use 1.
It can also be a useful alternative if another PDE5 inhibitor has not suited someone, whether on effect or tolerability 13. As with the class, one option suiting better than another is common 3.
Whether Spedra is right for you, and at what dose, is an individual decision based on how quickly you want it to work, how it suits you and your health, made with a prescriber 13. Our guide comparing the PDE5 inhibitors helps weigh the options 3.
The choice is genuinely personal, and having a fast-acting option in the toolkit means a medicine can usually be found to fit 13.
Getting Spedra safely
Spedra is a prescription-only medicine, so it should be obtained through a registered pharmacy after a proper assessment, in person or via a regulated online service 12. The assessment checks suitability, your medicines and your heart health 1.
Buying it from unregulated websites is risky, because the MHRA warns that fake ED medicines are common online 4. A legitimate supply always comes with an assessment 24.
If you think Spedra might suit you, you can start an assessment with a clinician to discuss whether it is appropriate and at what dose 12. And because persistent ED can signal an underlying condition, an assessment also helps make sure nothing important is missed 23.
Used as directed and obtained safely, avanafil's fast onset makes it a convenient, effective option for the men it suits 1.
Setting realistic expectations
As with any ED medicine, a few realistic expectations help 1. Spedra acts quickly, but it still needs sexual stimulation to work, so a relaxed setting matters and performance anxiety can blunt the effect, especially the first few times 12.
It is also common for the first attempt not to be a complete success, which does not necessarily mean the medicine is wrong; giving it a few proper attempts under good conditions, and avoiding too much alcohol beforehand, gives it a fair trial 1.
If, after a few attempts, it consistently does not help, a prescriber can review whether a higher dose or a different option suits you better, and check whether anything underlying is contributing 12. That is useful information rather than a failure 1.
Keeping expectations realistic, and giving a fast-acting medicine a fair chance, is the most sensible way to judge whether Spedra works for you 13.
ED as a signal worth investigating
Persistent ED can be an early signal of an underlying condition such as diabetes, high blood pressure or heart disease, because the blood-vessel health behind erections overlaps with general cardiovascular health 23. For some men it is the first sign 3.
Psychological factors, stress, sleep, alcohol and some medicines can also contribute, so ED is often best understood in the round 23. A fast-acting medicine treats the symptom, but it does not investigate the cause 2.
This is why an assessment for Spedra is worthwhile beyond authorising a prescription: it can look at your wider health and check that nothing important is being missed 23. The NHS encourages reviewing persistent ED 2.
So pairing the convenience of a fast-acting medicine with a proper look at why the ED is happening is the most sensible approach 23.
It is also worth remembering that ED is extremely common and that needing a medicine for it is nothing to feel awkward about 23. Many men use a PDE5 inhibitor successfully, and a confidential assessment is a routine, sensible part of getting one safely rather than a hurdle 24.
If you think Spedra's fast onset would suit you, the practical next step is an assessment, where a clinician can confirm whether it is appropriate, choose the right dose, and check your wider health at the same time 12. Approached that way, it is a convenient and effective option for the men it suits 14. The fast onset is a real practical advantage, and using it through a proper service keeps it safe 12. As with any ED medicine, needing it is common and a confidential assessment is a routine, sensible step rather than a hurdle 23. Many men find a fast-acting option fits their lives well, and a prescriber can confirm whether it is right for you 12. If it appeals, an assessment is the simple, safe way to start, and to check the medicine is suitable for your health and other medicines before you use it 12.
Frequently asked questions
How fast does Spedra work?
Avanafil is the fast-acting PDE5 inhibitor and can be taken as little as 15 to 30 minutes before sex 1. It works only with sexual stimulation, so the fast onset is about how soon it is ready, not producing an erection without arousal 1.What doses does Spedra come in?
The usual dose is 100 mg, adjusted between 50 mg and 200 mg by response and tolerability, no more than once in 24 hours 1. The right dose is decided with a prescriber 1.Does food affect Spedra?
Food affects avanafil less than sildenafil, though a very heavy, high-fat meal may still slow it a little 1. This adds to its convenience for on-demand use 1.Can I take it with nitrates?
No, never. Combining avanafil with nitrates, nicorandil or 'poppers' can dangerously lower blood pressure and is an absolute contraindication 1. Tell your prescriber all your medicines, including alpha-blockers 1.What are the common side effects?
Headache, flushing and nasal congestion are most common 1. Seek emergency care for an erection lasting more than four hours, or sudden vision or hearing loss 1.Who might Spedra suit?
Men who value a fast onset and spontaneity without tadalafil's long duration, or who have not been suited by another PDE5 inhibitor 13. Whether it is right for you is a decision with a prescriber 13.Your next step
Spedra is avanafil, the fast-acting PDE5 inhibitor for erectile dysfunction, often working within 15 to 30 minutes. It is taken as needed shortly before sex, usually at 100 mg and adjusted between 50 mg and 200 mg, works only with sexual stimulation, and must never be combined with nitrates. Common side effects such as headache, flushing and nasal congestion are usually mild, while an erection lasting over four hours or sudden vision or hearing loss need emergency care.
Its fast onset and moderate duration make it appealing for spontaneity, and it can be a useful alternative if another PDE5 inhibitor has not suited you. Get it only through a registered pharmacy after a proper assessment, which also checks your heart health and whether the ED needs further investigation. If you think Spedra might suit you, you can start an assessment with a Cloud Pharmacy clinician to confirm whether it is appropriate and at what dose.
Disclaimer
This guide is for general information only and does not constitute medical advice, diagnosis or treatment. The information here describes general clinical context based on UK regulatory sources cited above; it is not a recommendation for any specific medicine or treatment, which can only be made by a prescriber following individual assessment.
If you are considering treatment, speak to your GP or pharmacist, or arrange a consultation with a Cloud Pharmacy clinician. Prescription-only medicines are issued only after clinical assessment and where appropriate.
If you experience side effects from any medicine, you can report them through the Yellow Card scheme at yellowcard.mhra.gov.uk.
References
- Spedra (avanafil) SmPC 4.1/4.2/4.3/4.4/4.5/4.8/5.1/5.2 (PDE5 inhibitor for ED; fast onset, take ~15-30 min before sex; usual 100 mg, range 50-200 mg, max once/24h; works only with stimulation; food effect less than sildenafil; common side effects headache/flushing/nasal congestion; nitrates absolute contraindication; alpha-blocker/CYP3A4 cautions; priapism >4h, vision/hearing loss)
- NHS erectile dysfunction (assessment; persistent ED warrants review; underlying conditions; general framing)
- NICE CKS erectile dysfunction (PDE5 inhibitor class; choosing between agents; no single best option)
- MHRA #FakeMeds (fake ED medicines common online; buy only from registered pharmacies)
