Spedra 200mg (Avanafil): Dosage, How It Works, Side Effects and Reviews

• Publishes the trial figures comparing avanafil 200mg directly against 100mg and placebo, which most pages never show
• Explains the licensed maximum dose accurately, without giving a dose or an escalation plan
• Standard pack prices for all six 200mg pack sizes, with cost per tablet calculated
• States plainly why avanafil must never be combined with another erectile dysfunction medicine

Spedra 200mg is the highest of the three licensed avanafil strengths, and it is not where treatment normally begins. NICE describes the recommended dose as 100mg, from which "the dose may be increased to a maximum dose of 200 mg or decreased to 50 mg". Which of the three applies to you is a prescriber's decision, made from your medical history rather than from a preference for a bigger number.

The part most pages skip is what the extra 100mg actually bought in the trials. It is measurable, it is smaller than the jump in the number suggests, and it is published. This page shows those figures side by side.

One thing before any of it. Spedra should not be taken with another erectile dysfunction medicine. The UK product information states that the safety and efficacy of combining Spedra with other PDE5 inhibitors or other erectile dysfunction treatments have not been studied, and patients should be advised not to use them together.

Key things to know

• Spedra 200mg contains 200mg of avanafil. It is the highest of three licensed strengths, alongside 50mg and 100mg.
• NICE describes the recommended dose as 100mg, which "may be increased to a maximum dose of 200 mg or decreased to 50 mg".
• 200mg is the licensed maximum. NICE states "the maximum recommended dosing frequency is once daily".
• In the main trial the 200mg group scored 9.4 points higher on the erectile function questionnaire, against 8.3 for 100mg and 2.9 for placebo. The gap between the two strengths was 1.1 points.
• Do not take it with another erectile dysfunction medicine. The safety and efficacy of combining these treatments have not been studied.
• Contraindicated with nitrates, in severe liver or kidney impairment, in unstable angina, and in heart failure of a defined severity.
• Avanafil is currently listed in the UK as Spedra, with no generic avanafil product listed in the sources checked.
• It is a prescription only medicine. Supply requires a clinical assessment.

What Spedra 200mg is

Spedra 200mg is a prescription only tablet containing 200mg of avanafil, a PDE5 inhibitor licensed in the UK for erectile dysfunction in adult men. Spedra is the brand name. Avanafil is the active ingredient doing the work.

Searches for spedra 200 mg avanafil, avanafil 200mg and avanafil 200mg tablets uk all describe the same product by its ingredient rather than its brand.

Avanafil is currently listed in the UK as Spedra, with no generic version listed in the sources checked.

Avanafil is one of four medicines NICE names as first line drug treatment for erectile dysfunction, alongside sildenafil, tadalafil and vardenafil. Spedra 200mg tablets come in six pack sizes here.

Why Spedra must never be combined with another ED medicine

Do not take Spedra with another erectile dysfunction medicine. This is the most important statement on the page and it overrides everything below it.

NICE lists other treatments for erectile dysfunction among the special warnings and precautions for avanafil. The reason is mechanical. Every tablet in this class slows the same enzyme, so taking two does not combine two effects. It doubles one:

The UK product information states that the safety and efficacy of combining Spedra with other PDE5 inhibitors or other erectile dysfunction treatments have not been studied. Patients should be advised not to take Spedra in such combinations.

This is particularly important because 200mg is already the maximum licensed single dose of avanafil. If treatment is not working as expected, speak to your prescriber rather than taking additional medicine.

The product information does not establish a safe interval for combining Spedra with another PDE5 inhibitor or erectile dysfunction treatment. If treatment has not suited you, speak to your prescriber about changing it rather than combining medicines yourself.

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How Spedra 200mg works

Avanafil inhibits an enzyme called PDE5, which breaks down cGMP involved in the erectile response. Slowing it lets the body's own signal run longer, so more blood reaches the tissue and stays there.

• Nerve signals release nitric oxide into the blood vessels of the tissue.
• Nitric oxide raises cyclic GMP, a messenger that tells the smooth muscle in the vessel walls to relax.
• Relaxed vessels let more blood in, and the tissue firms as it fills.
• PDE5 breaks cyclic GMP down, which is how the process reverses.
• Avanafil slows step 4, so the effect of step 2 lasts longer.

Avanafil does not start the process. It amplifies a signal that must already be there.

A higher strength is not a different mechanism. Spedra 200mg does exactly what Spedra 50mg does, with more avanafil available to slow the enzyme. Avanafil supports the erectile response but does not treat every underlying cause of erectile dysfunction. Whether it is appropriate depends on the individual's clinical circumstances.

Spedra 200mg dosage and maximum dose

200mg is the licensed maximum single dose of avanafil, and NICE states the maximum recommended dosing frequency is once daily. This page describes what the licence permits. It does not tell you what to take, and gives no schedule for moving between strengths.

Read the first two rows together. 200mg is not the standard dose. It is the top of a range that starts at 100mg and can move either way. Spedra 200mg dosage and spedra 200mg max dose are the same fact from two sides: 200mg is the maximum licensed dose.

Spedra 200mg: how to take it, in general terms

Questions about spedra 200mg how to take it belong with your prescriber and with the patient information leaflet in the pack. What can be said generally:

• It is taken as needed, not daily, with a licensed timing of approximately 30 minutes beforehand.
• Food can delay the onset of activity, according to NICE and the product information.
• Once daily is the maximum frequency. Two tablets in a day is outside the licence whatever the strengths.
• Do not add another erectile dysfunction medicine. The safety and efficacy of combining Spedra with other PDE5 inhibitors or ED treatments have not been studied.
• Alcohol can increase the risk of low blood pressure, dizziness and other side effects while taking Spedra, and may also reduce your ability to get an erection.
• If you have a bleeding disorder or active peptic ulceration, tell your prescriber before taking Spedra so that the potential benefits and risks can be assessed. Severe liver or kidney impairment are contraindications.
• Inform your healthcare provider about any other medications you are taking, including herbal remedies and prescription medication, as Spedra can interact with other medicines such as nitrates, HIV medications, or certain antibiotics.
• If you experience sudden vision loss, sudden hearing loss, a severe allergic reaction, or an erection lasting more than four hours, seek urgent medical attention.
• Spedra works by increasing blood flow during stimulation, so stimulation is required for it to be effective.

If you are prescribed 200mg and it is not working as expected, that is a consultation, not a reason to take more. Treatment suitability depends on an individual clinical assessment.

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Spedra 200mg vs 100mg: what the trial data actually shows

200mg performed better than 100mg in the trials, but by a margin far smaller than the doubling of the number suggests. This comparison is rarely published, so here are the figures in full.

The evidence comes from three 12 week randomised controlled trials with 1,334 participants between them, plus a 52 week extension in 712 men. Response was measured with the IIEF, which NICE describes as "a 15-item questionnaire, self-administered measure of erectile function". The figures below are the change in the erectile function domain score.

Effect by strength, general population

The gap between placebo and 100mg is 5.4 points. The gap between 100mg and 200mg is 1.1 points. The increase from 100mg to 200mg was 1.1 points, compared with a 5.4-point difference between 100mg and placebo.

Effect by strength, men with diabetes

Both strengths did less here. 200mg in men with diabetes moved the score by 5.3 points, less than 100mg achieved in the general group. The results differed between the study populations, so the figures should not be used to predict how a particular individual will respond to either strength.

Side effects by strength, and the result nobody expects

In this trial the 200mg group reported fewer adverse events than the 100mg group, and had the fewest discontinuations of any group including placebo. Although the study was not designed to establish that 200mg is safer than 100mg. The same pattern appeared in the diabetes trial, at 35.4% on 100mg and 32.1% on 200mg.

Two caveats belong with that. It did not hold everywhere: after prostate surgery, adverse events ran at 38.4% on 100mg and 45.5% on 200mg. And these are differences between groups of roughly 160 men, not a demonstrated dose response.

The modest conclusion is the right one. Side effects with avanafil are not simply proportional to strength, and the assumption that 200mg automatically means double the side effects is not what the data shows.

So is 200mg better than 100mg?

Not as a general statement, and it is not a choice to make from a table. The step from placebo to 100mg is much larger than the step from 100mg to 200mg, the higher strength did not consistently carry a higher side effect rate, and the results differed between study populations. Your prescriber will determine the appropriate treatment and strength. Results vary between individuals.

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How long does Spedra 200mg last, and how long does it take to work

On timing, avanafil is licensed around taking it approximately 30 minutes beforehand. On duration, no figure is published in the NICE or MHRA guidance this page draws on, so none is given here.

Spedra 200mg: how long to work

NICE describes the recommended dose as taken "approximately 30 minutes" beforehand. That is the licensed timing, the point the licence is written around, rather than a measured average.

NICE recorded a pending submission to evaluate the approved timing at approximately 15 minutes rather than 30, which is not a licence change. Spedra 200mg how long to work is answered by the licence rather than by the strength, because no separate timing is published for each one.

Food delays onset. NICE states that "if it is taken with food, the onset of activity may be delayed". After a substantial meal, that delay is a bigger variable than the difference between strengths.

Spedra tablets should not be taken with grapefruit juice within 24 hours prior to dosing, as grapefruit juice can increase exposure to the active ingredient avanafil, potentially increasing the risk of side effects.

Spedra is part of a medication group known as PDE-5 inhibitors, which includes other erectile dysfunction medications.

Spedra should not be combined with other erectile dysfunction treatments, including sildenafil, tadalafil or vardenafil. The safety and efficacy of these combinations have not been studied.

Avoid combining Spedra with other erectile dysfunction treatments or ED medications, including sildenafil, tadalafil, or vardenafil.

Alcohol consumption should be limited while taking Spedra 200mg, as it may increase heart rate, lower blood pressure, and exacerbate side effects such as dizziness and nasal congestion.

Spedra is contraindicated in certain cardiovascular circumstances, including myocardial infarction, stroke or life-threatening arrhythmia within the previous six months, unstable angina and certain cases of heart failure.

Seek urgent medical attention for sudden vision loss, sudden hearing loss, or an erection lasting more than four hours.

Spedra's active ingredient avanafil works by increasing blood flow during stimulation, requiring the individual to be aroused for the medication to be effective.

Private prescription and online doctor services provide access to Spedra 200mg in the UK, ensuring that a clinical assessment is conducted to determine the right treatment and dosage.

Clinical trials have demonstrated Spedra's effectiveness in treating mild erectile dysfunction and other erectile dysfunction ED conditions, with different doses available to tailor treatment.

If you have any concerns about side effects of Spedra or the right treatment for you, consult your doctor immediately.

How long does Spedra 200mg last

No duration figure for avanafil appears in the sources this page uses, and this page will not invent one.

Duration figures circulate widely and are often copied from a different medicine in the same class. Pharmacokinetics do not transfer between molecules. A half life belongs to one substance, and a figure for sildenafil or tadalafil tells you nothing reliable about avanafil.

The patient information leaflet in your pack is the authoritative document for both onset and duration. If duration is your main consideration, say so at the consultation.

Spedra 200mg side effects: what is reported and what is serious

NICE lists the most common adverse events for avanafil as headache, flushing, and nasal and sinus congestion, all with an incidence between 1 in 10 and 1 in 100, plus back pain between 1 in 100 and 1 in 1000. Those figures come from clinical studies with 2,144 participants and cover avanafil as a whole rather than one strength.

These effects are consistent with the vasodilatory effects associated with PDE5 inhibition. Headache, flushing and nasal or sinus congestion are recognised adverse effects of avanafil.

Follow the prescribed dose to reduce the risk of adverse effects. Serious symptoms such as sudden vision loss, sudden hearing loss or an erection lasting more than four hours require urgent medical attention.

Spedra contains the active ingredient avanafil, a PDE-5 inhibitor that increases blood flow by relaxing blood vessels and red blood cells in the penis during stimulation. It is an effective treatment for erectile dysfunction (ED) when taken as prescribed.

Do not combine Spedra with nitrates or other PDE5 inhibitors. Nitrates are contraindicated because avanafil can enhance their blood-pressure-lowering effect, while combinations with other PDE5 inhibitors have not been studied.

If you experience any unusual symptoms such as chest pain, prolonged erection, or sudden changes in vision or hearing, seek urgent medical help. Always consult your doctor straight away if side effects persist or worsen.

Spedra can be supplied by appropriately registered UK pharmacies following a clinical assessment. Buying prescription medicines from unauthorised sources carries a risk of counterfeit or unlicensed products.

Spedra is taken approximately 15 to 30 minutes before activity, requiring stimulation to be effective.

Consult your doctor regarding any other medications you take, as Spedra can interact with drugs like ritonavir, indinavir, and certain antibiotics. Avoid grapefruit juice 24 hours before taking Spedra, as it can increase exposure to the active ingredient and risk of side effects.

Spedra 200mg is the highest licensed dose and should not be exceeded or combined with other ED treatments. Proper use and adherence to dosing guidelines are essential for safety and effectiveness.

Is Spedra 200mg safe?

It is a licensed UK medicine with an established safety profile, and it is not safe for everyone, which is what the clinical assessment exists to establish. NICE concludes that "the overall safety profile of avanafil appears to be similar to that of other PDE5 inhibitors and no new safety concerns have been raised".

The question is spedra 200mg safe usually means one of two things. Is the strength itself more dangerous than 100mg? The trial data above does not show that. Is it safe for me? That depends on your history, and there are clear situations where the answer is no.

When avanafil must not be used

NICE states avanafil is contraindicated in men:

• Nitrates are contraindicated with avanafil because of the risk of a potentially dangerous drop in blood pressure.
• With severe liver or kidney impairment.
• With unstable angina.
• With congestive heart failure of New York Heart Association class 2 or greater, a standard scale for grading how much heart failure limits activity.

Care is also needed with alpha blockers, often prescribed for blood pressure or prostate symptoms, because both lower blood pressure. Tell the prescriber about everything you take, including anything bought without a prescription.

Reducing the chance of side effects

Do not double up, never take a second tablet in the same day, and never add another erectile dysfunction medicine. Alcohol can increase the risk of low blood pressure, dizziness and other side effects, and may also reduce your ability to get an erection. Report what happens, because a persistent side effect is information your prescriber needs, and the response is often a change of medicine rather than of strength.

Spedra 200mg vs Viagra and Spedra 200mg vs Cialis

No head to head trials compare these medicines, so no ranking between them is evidenced. NICE states directly that "it is not known how avanafil compares to other PDE5 inhibitors" and that "there are no direct head-to-head comparisons".

On spedra 200mg vs viagra, effectiveness has not been compared. The real differences are licensed timing, strength ranges, and whether a generic version exists. Sildenafil has one. Avanafil does not.

On spedra 200mg vs cialis, the meaningful difference is format rather than strength. Tadalafil is also available as a lower-strength daily treatment option, meaning it is taken regularly rather than only when sexual activity is anticipated. That is a preference, not a clinical ranking.

There is no dose equivalence between any of them. 200mg of avanafil is not equivalent to 200mg of anything else, because the milligram figure describes how much of one particular molecule is in the tablet.

These are all PDE5 inhibitors and should not be combined with another PDE5 inhibitor or other erectile dysfunction treatment.

Spedra 200mg price and pack sizes

Standard prices at this pharmacy for every Spedra 200mg pack, with cost per tablet calculated so the packs can be compared directly.

A pricing point worth checking before you order

The 8 and 12 tablet packs work out at a higher cost per tablet than the 4 tablet pack, at £7.54 and £7.50 against £7.42. Larger packs are usually assumed to be better value, and in this range that assumption does not hold until the 16 tablet pack.

Work out the cost per tablet before choosing a pack, and remember that quantity is a clinical question first. The amount supplied is part of the prescribing decision, not a shopping choice.

How 200mg compares with the other strengths

The step from 100mg to 200mg costs £5.40 more per pack of four, around 22% more for double the avanafil. Set that against the trial figures above, where the same step added 1.1 points to the questionnaire score. Neither number tells you what to take, but together they show that price and effect do not move in step.

Avanafil is currently listed in the UK as Spedra, with no generic version listed in the sources checked. That is a licensing and market position rather than a statement about the medicine.

Prices are standard website prices at the time of writing and are subject to change.

Where to buy Spedra 200mg, and how to check a supplier is legitimate

Spedra is a prescription-only medicine and legitimate supply requires an appropriate prescribing process and clinical assessment.

MHRA reported seizing nearly 20 million doses of illegally traded medicines worth almost £45 million during 2025, and more than 4 million of those doses were erectile dysfunction treatments. MHRA's stated position is blunt: "Products sold illegally online may contain harmful substances or the incorrect dosage, and either of these could seriously damage your health."

Incorrect or unknown dosing is one important risk when buying unauthorised medicines. If you are looking at 200mg you are at the licensed ceiling. A tablet sold as 200mg containing an unknown amount of an unknown substance has no ceiling at all.

Spedra works by enhancing blood flow during stimulation, which is essential for its effectiveness. It requires appropriate physiological stimulation to activate the mechanism that avanafil amplifies.

Do not combine Spedra with other PDE5 inhibitors or other erectile dysfunction treatments. The safety and efficacy of these combinations have not been studied.

Common side effects include headache, flushing, tiredness, sinus congestion, and occasionally itching during stimulation. Serious symptoms requiring urgent medical attention include sudden vision loss, sudden hearing loss, an erection lasting more than four hours, or signs of a severe allergic reaction.

Consult your healthcare provider about any other medications you are taking, including HIV medications like ritonavir or indinavir, certain antibiotics, and avoid grapefruit juice 24 hours before taking Spedra. These can interact with avanafil and increase the risk of side effects.

Alcohol may increase heart rate, lower blood pressure and increase side effects such as dizziness and nasal congestion. It may also reduce the ability to get an erection.

Access to Spedra 200mg is available through UK-registered pharmacies that provide online consultations and private prescribing services. This ensures a clinical assessment is conducted, which is crucial for safe and effective treatment.

A content strategy involving keyword selection based on user search intent helps improve the visibility of information about Spedra and erectile dysfunction treatments online. Using natural language and integrating terms related to treatment options, side effects, and safety guidelines enhances organic traffic and engagement.

Effective content planning and distribution across digital marketing channels, including email marketing and social media integration, support patient education and awareness. Monitoring performance metrics helps optimize messaging and conversion rates.

Lead generation techniques focus on attracting individuals seeking treatment and capturing contact data for follow-up. Clear, authoritative information builds trust and encourages users to seek professional advice.

Evergreen content strategies ensure that information about Spedra remains relevant over time, addressing common questions and concerns about treatment, dosing, and safety.

Using visual content, such as infographics, can aid understanding of how Spedra works and the importance of medical guidance. Storytelling techniques create emotional connections that support patient confidence in treatment decisions.

Overall, Spedra 200mg is a clinically effective treatment option when used as prescribed, with safety and efficacy dependent on proper medical assessment and adherence to guidelines.

How to check any online supplier

• Check the pharmacy is on the GPhC register. Registration is public and verifiable. A site that does not display registration details is telling you something.
• Check there is a real consultation. A legitimate service asks about your medical history, current medicines and cardiovascular health, and is prepared to say no.
• Check that the medicine is authorised for UK supply and that the pharmacy is appropriately registered.
• Check nobody is pressuring you. Countdown timers on prescription only medicine are a commercial tactic, not a clinical one.

What that looks like here: EveryDayMeds is a GPhC registered pharmacy. Treatment follows an online consultation with UK registered prescribers, clinical assessment happens before supply, and medication is genuine and UK sourced.

To find out whether treatment is appropriate for you, you can check your eligibility for erectile dysfunction treatment or read our guide to erectile dysfunction treatment options and how the right one is chosen.

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Spedra 200mg reviews: why this page publishes data instead

No customer reviews, ratings or star scores appear on this page, and that is deliberate.

Spedra 200mg is a prescription only medicine at the top of its licensed range. Testimonials would encourage people to choose a strength on the basis of other people's experiences rather than a clinical assessment, and the strength is precisely the thing that should not be chosen that way.

There is a specific problem with looking for a spedra 200mg review, or for spedra 200mg reviews forum threads, on a medicine like this one. The trial figures above show why: the same 200mg dose moved the questionnaire score by 9.4 points in one group and 5.3 in another. A strong account from someone whose underlying cause differs from yours tells you very little about your own likely result.

Unmoderated sources carry a second risk. Unmoderated discussions can also contain unsafe advice about combining medicines, changing doses or sourcing prescription medicines without appropriate clinical assessment.

What appears here instead is verified data, with the population, participant numbers and placebo comparison attached.

Red flags: when to seek urgent help

Seek urgent medical attention if any of the following happen after taking avanafil:

• An erection lasting more than four hours, known as priapism, whether or not it is painful.
• Sudden loss of vision in one or both eyes.
• Sudden loss of hearing, with or without ringing or dizziness.
• Chest pain, especially during or shortly after exertion.
• Fainting, or dizziness severe enough to make you fall.
• Signs of an allergic reaction, including swelling of the face, lips or throat, or difficulty breathing.

Do not take a nitrate for chest pain if you have recently taken avanafil. Tell the medical team what you have taken and when, because avanafil can significantly increase the blood-pressure-lowering effect of nitrates.

Speak to your prescriber, without urgency, if the medicine consistently does not work as expected, if side effects persist, or if you are thinking about changing strength. Do not resolve any of those by taking more, or by adding something else.

Medical Disclaimer

This article is general information and does not replace personalised medical advice. It gives no dosing instructions and should not be used to self diagnose, self prescribe, self medicate, or to start, stop or change any medicine.

Avanafil is a prescription only medicine. Suitability depends on an individual clinical assessment by an appropriately qualified prescriber, who will consider your medical history, current medicines and cardiovascular health. This medicine should only be used under the supervision of an appropriately qualified prescriber. Results vary between individuals.

The strength described here is the highest in the licensed range. Nothing on this page should be read as a reason to request it, to move up to it, or to take more of a lower strength to reach it. Your prescriber will determine the appropriate treatment and strength. Trial figures quoted here describe average changes across defined study populations and are not predictions for any individual.

Prices are standard website prices at the time of writing and are subject to change. The patient information leaflet supplied with your medicine is the authoritative document and should be read before you take anything.

Never take more than the prescribed amount of any medicine, never take an extra tablet because one did not appear to work, and do not take Spedra with another erectile dysfunction medicine.

If you experience chest pain, an erection lasting more than four hours, sudden vision loss or sudden hearing loss, seek urgent medical attention.