Avanafil UK: What It Is, How It Works and Spedra

Avanafil is a prescription medicine used to treat erectile dysfunction (ED) in adult men. It belongs to a group of medicines known as phosphodiesterase type 5 inhibitors, or PDE5 inhibitors. In UK-authorised medicine information, avanafil is the active ingredient in Spedra tablets, which are available in 50 mg, 100 mg and 200 mg strengths.

Avanafil works by supporting increased blood flow within the penis when appropriate stimulation occurs. It does not automatically create an erection and it does not permanently cure the underlying cause of erectile dysfunction.

The usual recommended dose is 100 mg taken when needed approximately 15 to 30 minutes before anticipated activity. Depending on effectiveness and tolerability, a clinician may reduce the dose to 50 mg or increase it to a maximum of 200 mg. The maximum normal dosing frequency is once per day.

For people searching "avanafil UK," "avanafil tablets," "avanafil Spedra" or "avanafil Stendra," this guide explains the names, doses, timing, effectiveness, food effects, interactions and important safety information.

What Is Avanafil?

Avanafil is the active medicinal ingredient used in Spedra for erectile dysfunction.

It is classified as a selective PDE5 inhibitor. PDE5 is an enzyme involved in regulating a chemical called cyclic guanosine monophosphate, usually shortened to cGMP. During the normal erectile response, cGMP helps smooth muscle within erectile tissue relax and allows increased blood flow into the penis.

Avanafil inhibits PDE5, allowing this signalling pathway to remain active for longer.

The result is improved support for achieving and maintaining an erection when stimulation occurs.

Importantly, avanafil has no erectile effect in the absence of appropriate stimulation.

What Is Avanafil Used For in Erectile Dysfunction?

Avanafil is authorised for treating erectile dysfunction in adult men.

Erectile dysfunction describes persistent or recurring difficulty getting or maintaining an erection.

Someone with ED may:

• Struggle to achieve an erection
• Achieve an erection but repeatedly lose it
• Experience reduced firmness
• Have erections that become unreliable

Avanafil helps manage the erectile response rather than treating every possible underlying cause of the condition.

UK product information therefore recommends assessing the potential cause of ED and considering cardiovascular health before pharmacological treatment begins.

Is Avanafil Available in the UK?

Yes. UK medicine information lists avanafil as a prescription-only medicine, with Spedra containing the active ingredient avanafil. The UK BNF also includes avanafil for erectile dysfunction.

UK-authorised Spedra tablets contain:

• Avanafil 50 mg
• Avanafil 100 mg
• Avanafil 200 mg

Avanafil therefore requires an appropriate assessment before treatment because its suitability depends on medical history, cardiovascular status and other medicines being taken.

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Are Avanafil and Spedra the Same?

They refer to different aspects of the same medicine.

Avanafil is the active ingredient.

Spedra is a brand of medicine containing avanafil, while Stendra is a common brand name for avanafil outside the UK.

The UK patient leaflet explicitly states that Spedra contains the active substance avanafil and belongs to the PDE5-inhibitor group of medicines.

Therefore, when someone searches "avanafil Spedra," they are essentially looking for information about the active ingredient and the medicine containing it.

For example:

Spedra 50 mg = 50 mg avanafil

Spedra 100 mg = 100 mg avanafil

Spedra 200 mg = 200 mg avanafil

Are Avanafil and Stendra the Same?

Stendra is also a brand name for avanafil, but it is associated with the US market rather than being the name used in the UK-authorised product information reviewed here.

The US FDA identifies Stendra as avanafil tablets used for erectile dysfunction, while UK product information identifies avanafil as the active ingredient in Spedra. Avanafil is rapidly absorbed, with the recommended dosing time for the 100 mg and 200 mg doses being approximately 15 to 30 minutes before sexual activity.

Therefore:

UK: avanafil is associated with Spedra

US: avanafil is also marketed under the name Stendra

The underlying active medicine is avanafil, and it works by blocking PDE5. During sexual stimulation, nitric oxide is released within erectile tissue.

This distinction explains searches such as "avanafil Stendra" and "avanafil Spedra."

How Do Avanafil Tablets Work to Improve Blood Flow?

Avanafil works by blocking PDE5.

During stimulation, nitric oxide is released within erectile tissue. This contributes to increased levels of cGMP, which causes smooth muscle to relax and blood flow into the penis to increase.

PDE5 normally breaks down cGMP.

By inhibiting PDE5, avanafil allows cGMP levels to remain elevated for longer, supporting the blood-flow response required for an erection.

Avanafil therefore assists a process that has already been initiated by stimulation.

It does not independently switch on an erection.

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Does Avanafil Cure Erectile Dysfunction?

No.

Avanafil can help improve erections, but it does not cure erectile dysfunction itself. The authorised UK patient leaflet explicitly states that Spedra does not cure the condition.

ED can result from several underlying factors, including problems affecting blood vessels, nerves, hormones, medicines or psychological wellbeing.

A man might therefore obtain good results from avanafil while still having an underlying condition contributing to ED.

For this reason, UK prescribing information recommends taking a medical history, performing an appropriate assessment and identifying potential underlying causes before ED medication is considered.

What Avanafil Tablet Strengths Are Available?

UK-authorised Spedra is available in three avanafil tablet strengths:

• Avanafil 50 mg
• Avanafil 100 mg
• Avanafil 200 mg

These strengths allow treatment to be adjusted based on individual response and tolerability.

A higher dose is not automatically better.

The aim is to use the dose that provides adequate effectiveness while minimising unwanted effects.

What Is the Normal Avanafil Dose?

The usual recommended starting and standard dose is avanafil 100 mg taken when needed approximately 15 to 30 minutes before anticipated activity.

Depending on individual effectiveness and tolerability:

100 mg may be reduced to 50 mg

or

100 mg may be increased to a maximum of 200 mg.

The maximum recommended normal dosing frequency is once per day.

Dose changes should be based on appropriate professional advice rather than simply increasing the amount after one unsuccessful attempt.

What Is Avanafil 50 mg?

Avanafil 50 mg is the lowest authorised Spedra strength.

The patient leaflet advises taking the 50 mg dose approximately 30 minutes before anticipated activity.

A lower dose may be appropriate when the standard 100 mg dose is too strong or where other clinical factors make a lower dose preferable.

People using certain alpha-blocker medicines may also require treatment to begin at 50 mg because of the possibility of additive blood-pressure lowering.

What Is Avanafil 100 mg?

Avanafil 100 mg is the usual recommended starting dose for adult men using Spedra.

It is generally taken approximately 15 to 30 minutes before anticipated activity.

If 100 mg provides adequate results and is well tolerated, there may be no reason to change the dose.

If it is ineffective despite correct use, or produces troublesome effects, the treatment can be reviewed.

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What Is Avanafil 200 mg?

Avanafil 200 mg is the highest authorised Spedra strength.

A clinician may consider 200 mg when the standard 100 mg dose does not provide an adequate response and the higher strength is medically appropriate.

Taking twice as much avanafil does not mean the response will automatically be twice as strong.

Clinical trial data from the general ED population found successful attempts in approximately:

• 47% with avanafil 50 mg
• 58% with avanafil 100 mg
• 59% with avanafil 200 mg
• 28% with placebo

These are study averages rather than predictions of individual response.

How Quickly Does Avanafil Work?

Avanafil is rapidly absorbed.

UK product information states that the standard 100 mg and 200 mg doses are generally taken around 15 to 30 minutes before anticipated activity.

In the fasted state, maximum blood concentrations are generally reached within approximately 30 to 45 minutes.

Clinical studies have demonstrated erectile responses in some men from approximately 15 minutes after taking avanafil.

Erectile responses may remain possible for several hours after taking avanafil, but the duration of effect varies between individuals.

However, this does not mean every person will experience an adequate response exactly 15 minutes after taking a tablet.

Individual response, food and the severity and cause of ED can influence the experience.

Can You Take Avanafil With Food?

Yes.

Avanafil can be taken with or without food, but eating can make it take longer to work.

The authorised pharmacokinetic data provide more precise information.

When avanafil 200 mg was taken after a high-fat meal:

• The average time to peak concentration was delayed by approximately 1.25 hours
• Peak concentration was reduced by approximately 39%
• Overall exposure to avanafil was not significantly changed

The main practical effect of a substantial meal is therefore on speed and predictability of absorption, rather than food making avanafil impossible to use.

Can You Take Avanafil on a Full Stomach?

Yes, but the onset may be delayed.

The UK patient leaflet states that the medicine can be taken with or without food and may take longer to work when taken after eating.

If avanafil appears slower than expected following a large or high-fat meal, that does not necessarily mean the medicine has failed.

Meal timing should therefore be considered when evaluating treatment response.

How Effective Is Avanafil?

Avanafil has demonstrated significantly better erectile-function outcomes than placebo in controlled clinical trials. Clinical trials have demonstrated significantly better erectile-function outcomes with avanafil than with placebo in most men with erectile dysfunction, although individual response varies.

The UK SmPC reports that 1,774 patients received avanafil across four randomised, double-blind, placebo-controlled trials involving the general ED population, men with diabetes and men experiencing ED following bilateral nerve-sparing prostate surgery.

All three authorised doses produced statistically significant improvements in the main effectiveness measures compared with placebo.

Response rates differed according to the underlying patient group.

For example, successful attempts averaged approximately 34% with avanafil 100 mg and 40% with 200 mg among men with diabetes, compared with about 21% on placebo.

This shows why individual responses can vary substantially.

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Does Avanafil Work for Everyone?

No.

No ED medicine produces a successful response in every individual or on every attempt.

Potential reasons for an inadequate response include:

• Incorrect timing
• Food delaying absorption
• Inadequate stimulation
• Unsuitable dose
• Significant vascular disease
• Diabetes-related nerve or blood-vessel damage
• Another medicine contributing to ED
• Psychological factors
• More severe underlying erectile dysfunction

Clinical trial results also demonstrate variation according to the underlying cause of ED.

If avanafil repeatedly fails despite correct use, the appropriate next step is treatment review rather than taking additional tablets beyond the recommended dose.

Does Avanafil Need Stimulation to Work?

Yes.

This is essential to understanding how avanafil tablets work.

The UK SmPC states that stimulation is required for a response to avanafil and that the medicine has no effect in its absence.

Avanafil strengthens the natural blood-flow mechanism involved in an erection.

It does not automatically produce an erection just because a tablet has been swallowed.

How Often Can You Take Avanafil?

The standard maximum dosing frequency is once per day.

There are situations where an even longer interval is required.

For example, when certain moderate CYP3A4-inhibiting medicines are being used, the authorised guidance limits avanafil to a maximum of 100 mg with at least 48 hours between doses.

This demonstrates why other medicines need to be checked before avanafil is prescribed.

Can Avanafil Be Taken With Alcohol?

Alcohol can increase the risk of blood-pressure-related effects from avanafil.

If you regularly drink alcohol, tell your doctor before taking avanafil.

The authorised product information states that combining alcohol with avanafil can increase the likelihood of symptomatic low blood pressure, including dizziness or faintness.

The patient leaflet also warns that drinking alcohol can:

• Increase heart rate
• Lower blood pressure
• Cause dizziness
• Cause headache
• Cause palpitations
• Make achieving an erection more difficult

Alcohol intake can therefore affect both the treatment experience and erectile performance itself.

Can You Have Grapefruit With Avanafil?

Grapefruit juice can increase exposure to avanafil.

The authorised UK leaflet advises avoiding grapefruit juice during the 24 hours before taking Spedra.

Avanafil is mainly metabolised through an enzyme called CYP3A4, and substances that inhibit this pathway can increase the amount of avanafil in the body.

What Are the Common Side Effects of Avanafil?

Like all medicines, avanafil can cause side effects, although not everybody experiences them.

The UK patient leaflet lists headache, flushing and nasal congestion as common side effects, meaning they may affect up to 1 in 10 people:

• Headache
• Flushing
• Nasal congestion

Uncommon effects include dizziness, lightheadedness, tiredness, back pain, indigestion, nausea, racing heartbeat and blurred vision.

If adverse effects are persistent or troublesome, discuss them with a healthcare professional rather than altering the dose independently.

What Serious Avanafil Side Effects Need Urgent Help?

Certain symptoms require prompt medical attention.

Chest pain during sexual activity should be treated as a serious side effect needing urgent medical attention, and patients should contact a doctor immediately.

The UK patient leaflet advises stopping the medicine and seeking immediate medical help for:

• An erection lasting more than four hours
• Sudden decrease or loss of vision
• Sudden decrease or loss of hearing

An erection lasting four hours or longer is known as priapism. Untreated priapism can damage penile tissue and potentially result in permanent loss of erectile function.

These symptoms should not be treated as normal expected effects of ED medication.

Who Should Not Take Avanafil?

Avanafil is not suitable for everyone.

The UK product information lists several contraindications, including people taking organic nitrate medicines or nitric oxide donors. Combining nitrates with avanafil can cause a potentially dangerous reduction in blood pressure, including medicines such as isosorbide mononitrate used to treat angina.

Avanafil is also contraindicated in certain people with:

A myocardial infarction, stroke or life-threatening arrhythmia within the previous six months

• Resting blood pressure below 90/50 mmHg or above 170/100 mmHg.
• Unstable angina, angina during sexual intercourse, or NYHA Class 2 or greater heart failure.
• Severe renal impairment (creatinine clearance below 30 mL/min).
• Severe hepatic impairment (Child-Pugh Class C).
• Loss of vision in one eye due to non-arteritic anterior ischaemic optic neuropathy (NAION).
• Known hereditary degenerative retinal disorders.

This is why avanafil should be used following an appropriate assessment rather than simply chosen based on how quickly the medicine is expected to work.

Why Can Avanafil Not Be Taken With Nitrates?

Both avanafil and nitrate medicines affect pathways that can reduce blood pressure.

When combined, their effects can be additive and result in a significant and potentially dangerous fall in blood pressure.

UK prescribing information therefore contraindicates avanafil with any form of organic nitrate or nitric oxide donor.

Anyone taking medicine for angina or another cardiovascular problem should provide a complete medication history before ED treatment is considered.

Does Avanafil Interact With Other Medicines?

Yes.

Avanafil is predominantly metabolised through CYP3A4, so medicines that strongly inhibit this enzyme can significantly increase avanafil exposure.

The UK product information therefore contraindicates its use with certain potent CYP3A4 inhibitors.

Additional caution or dose adjustment may be needed with medicines including:

• Alpha-blockers
• Some blood-pressure medicines
• Certain antibiotics
• Certain antifungal medicines
• Some medicines affecting heart rhythm
• Moderate CYP3A4 inhibitors

A complete medicine review is therefore an important part of determining whether avanafil is safe, including other medications, dietary supplements, recreational drugs, and whether the patient drinks alcohol.

Can Avanafil Be Taken With Other ED Tablets?

Avanafil should not simply be combined with another ED medicine.

The authorised UK information states that the safety and effectiveness of combining avanafil with other PDE5 inhibitors or other ED treatments have not been established and advises patients against these combinations.

Taking multiple ED medicines without clinical guidance may increase adverse effects, including blood-pressure-related problems.

Can Men With Diabetes Take Avanafil?

Avanafil has been specifically studied in men with diabetes and erectile dysfunction.

The UK SmPC states that routine dose adjustment is not required simply because someone has diabetes.

Clinical trials also demonstrated significantly better results than placebo among men with type 1 or type 2 diabetes and ED.

However, diabetes can affect nerves and blood vessels involved in erections, so response may differ from someone without these complications.

The individual's broader health and medication profile still needs assessment.

Can Older Men Take Avanafil?

Age alone does not automatically require a different avanafil dose.

The authorised UK information states that dose adjustment is not routinely required for adults aged 65 and older, although there is more limited clinical information for men aged 70 and above.

Other factors such as cardiovascular health, kidney function, liver function and other medicines may be more important when determining suitability.

Does Avanafil Affect Fertility?

Available studies included in the authorised UK medicine information did not show adverse effects on sperm concentration, count, movement or structure with the studied avanafil regimens.

However, avanafil is an erectile dysfunction medicine, not a fertility treatment.

Anyone undergoing fertility assessment should still discuss all regular and occasional medicines with their healthcare professional.

Is Avanafil a Prescription-Only Medicine in the UK?

Yes.

Follow the prescription label and use the medicine exactly as prescribed by a doctor.

The UK electronic Medicines Compendium identifies Spedra containing avanafil as a prescription-only medicine.

The clinical assessment is important because erectile dysfunction medication needs to be considered alongside:

• Cardiovascular health
• Blood pressure
• Other medicines
• Kidney and liver function
• Possible medicine interactions
• The underlying cause of ED

The aim is therefore not simply to determine whether avanafil may improve erections, but whether it can be used safely.

What If Avanafil Does Not Work?

One unsuccessful attempt does not necessarily mean avanafil will never work.

Before considering treatment ineffective, factors worth reviewing include:

• Whether the correct dose was taken
• Whether enough time was allowed
• Whether a heavy meal delayed absorption
• Whether appropriate stimulation occurred
• Whether excessive alcohol was consumed
• Whether the underlying ED is particularly severe

If avanafil continues to provide inadequate results despite correct use, the treatment and underlying cause of ED should be reviewed.

Do not take more than the prescribed dose or exceed the normal maximum dose of 200 mg once per day.

Is "Avanfil" the Same as Avanafil?

If you searched for "avanfil," the medicine name is normally spelled avanafil.

Avanafil is the active ingredient in UK-authorised Spedra tablets.

Search engines may still show relevant avanafil information when the shorter spelling is entered, but medicine names should be checked carefully when reading prescribing or safety information.