Spedra 200mg Tablets (Avanafil): Pack Sizes, Dosage and How to Take Them

• Lists all six pack sizes with the cost per tablet worked out for each
• Explains what the licence permits on dosage without giving an instruction or a schedule
• Covers how to report a suspected side effect, which almost no product page mentions
• States plainly why avanafil must never be combined with another erectile dysfunction medicine

Spedra 200mg tablets contain 200mg of avanafil and come in six pack sizes here, from 4 tablets at £29.69 to 32 tablets at £224.99. They are a prescription only medicine, so supply follows a clinical assessment rather than a checkout.

200mg is the highest of three licensed avanafil strengths, alongside 50mg and 100mg, and 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 one applies to you is a prescriber's decision.

This page covers the pack options, what the licence permits, how the medicine is taken in general terms, and what to do if something goes wrong, including how to report a suspected side effect to the regulator.

One thing before any of it. Spedra must never be taken with another erectile dysfunction medication. For technical and medical reasons, these two medications should not be used together, as they can react immediately. NICE names other erectile dysfunction treatments among the special warnings and precautions for avanafil. They work through the same enzyme, so combining them compounds one effect rather than adding two, and the reaction is immediate.

Key things to know

• Spedra 200mg tablets contain 200mg of avanafil, a PDE5 inhibitor licensed for erectile dysfunction in adult men.
• Six pack sizes are available here: 4, 8, 12, 16, 24 and 32 tablets.
• Prices start at £29.69 for 4 tablets, which is £7.42 per tablet, up to £224.99 for 32 tablets at £7.03 per tablet.
• The 8 and 12 tablet packs work out at more per tablet than the 4 tablet pack. The arithmetic is below.
• 200mg is the licensed maximum single dose, and NICE states the maximum recommended dosing frequency is once daily.
• Avanafil is branded only in the UK. There is no generic version.
• Do not take it with another erectile dysfunction medicine.
• Suspected side effects can be reported to MHRA through the Yellow Card scheme.

What Spedra 200mg tablets are

Spedra 200mg tablets are a prescription only medicine containing 200mg of avanafil, licensed in the UK for the treatment of erectile dysfunction in adult men. Spedra is the brand name. Avanafil is the active ingredient.

Searches for spedra 200mg tablets, avanafil 200mg tablets spedra, spedra 200 mg tablet and spedra 200mg tablets uk all describe the same product. Spedra is the brand name and avanafil is the active ingredient.

Avanafil is one of four medicines NICE names as first line drug treatment for erectile dysfunction, alongside sildenafil, tadalafil and vardenafil.

Spedra 200mg film coated tablets: what that means

A film coated tablet has a thin outer layer over the core, which makes it easier to swallow and protects the contents. It is a standard pharmaceutical format rather than anything unusual.

People searching spedra 200mg film coated tablets are usually checking they have the right product. The authoritative description is on the pack and in the patient information leaflet inside it, both of which state the pharmaceutical form in full. We would rather point you there than assert a descriptor from memory.

What matters more than the coating is that the tablet is genuine, UK sourced and dispensed against a prescription.

Spedra 200mg pack size options and prices

Here is every Spedra 200mg pack at its standard price, with the cost per tablet worked out so the packs can be compared directly.

These are standard prices, not introductory or first order prices.

Spedra 200mg tab 4s, spedra 200mg tablets 4 pack and spedra 200mg tablets 8 pack are the two most searched pack sizes, and the two worth checking most carefully.

The pack size point worth checking before you order

The 8 tablet pack works out at £7.54 per tablet and the 12 tablet pack at £7.50, against £7.42 for the 4 tablet pack. Both mid-sized packs cost more per tablet than the smallest one. The cost per tablet falls below the 4-pack figure at 16 tablets, at £7.31, continuing down to £7.03 at 32 tablets.

We publish that because it is what the arithmetic shows. Larger packs are usually assumed to be better value, and in this range that does not hold until 16 tablets.

Moving from the 4-pack to the 32-pack saves £12.53 in total. Eight separate 4-tablet packs would cost 8 × £29.69 = £237.52, compared with £224.99 for one 32-tablet pack. That is 39 pence less per tablet, or about 5.3%.

The quantity supplied forms part of the prescribing decision, not purely a purchasing one. A prescriber can supply less than you ask for if a smaller amount is more appropriate.

You can view the Spedra tablets product page and all its pack options to see the full range across all three strengths. Prices are standard website prices at the time of writing and are subject to change.

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Why Spedra must never be taken with another ED medicine

Do not take Spedra with another erectile dysfunction medicine. NICE includes other treatments for erectile dysfunction among the special warnings and precautions for avanafil. The UK product information states that the safety and efficacy of combining avanafil with other PDE5 inhibitors or other erectile dysfunction treatments have not been studied, and patients should be advised not to use them together.

If you are changing from one erectile dysfunction medicine to another, speak to your prescriber rather than taking the two treatments together. The absence of a published half-life does not provide a basis for calculating a safe interval yourself.

This also applies if you have tablets left from a previous prescription. Do not use them alongside your new treatment unless your prescriber specifically advises you to do so.

Spedra 200mg tablets dosage: what the licence permits

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 and gives no instruction on what to take.

Read the first two rows together. 200mg is not the standard starting dose. It is the top of a range beginning at 100mg that can move either way, and where you sit in it is a clinical output rather than a request. Treatment suitability depends on an individual clinical assessment, and your prescriber will determine the appropriate treatment and strength.

How to take Spedra 200mg tablets

Specific instructions come from your prescriber and from the patient information leaflet inside the pack. What follows applies to the medicine generally rather than to any individual.

• Take it as needed rather than on a regular daily schedule.
• Allow the licensed lead time. NICE states that it should be taken 25 to 30 minutes beforehand. The UK product information gives approximately 15 to 30 minutes before sexual activity.
• Swallow the tablet whole with water. It can be taken with or without food, although a high-fat meal may delay the onset of activity.
• Be aware food may delay onset, per NICE. A substantial meal is a bigger variable than most people expect.
• Alcohol can increase the risk of dizziness and low blood pressure when taken with avanafil, and it may also impair erectile function.
• Do not take more than one in any day. Once daily is the licensed maximum, whatever the strength.
• Never take an extra tablet because the first did not appear to work.
• Do not combine Spedra with another erectile dysfunction medicine. The safety and efficacy of combining avanafil with other PDE5 inhibitors or other erectile dysfunction treatments have not been studied.
• Grapefruit juice can increase avanafil exposure, so check the patient information leaflet and speak to your prescriber or pharmacist about whether you should avoid it.

If it is not working as expected, discuss the timing, food, alcohol, other medicines and your underlying health with your prescriber rather than taking an additional dose.

Spedra works by increasing blood flow to the penis, but it requires stimulation to be effective. Without being stimulated, the medicine will not produce an erection.

If you experience a persistent erection lasting more than four hours, known as priapism, seek urgent medical treatment immediately to prevent serious damage.

Tell your prescriber about any cardiovascular disease, previous stroke or heart attack, liver or kidney problems, or other significant medical conditions. They will determine whether avanafil is appropriate for you.

If you develop sudden vision loss, sudden hearing loss, chest pain, fainting, an erection lasting more than four hours, or signs of a serious allergic reaction, seek urgent medical attention.

Tell your prescriber if you have Peyronie's disease or other penile conditions, so they can assess whether treatment is appropriate.

Always inform your healthcare provider about all medications you are taking, including herbal remedies and other ED medications, to avoid dangerous interactions.

Store Spedra tablets as directed, away from moisture and heat, and keep out of reach of children.

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Storage and missed doses

Store the pack as the leaflet directs, out of sight and reach of children, and check the expiry date before use.

There is no missed dose to make up. Avanafil is taken as needed rather than on a schedule, so the usual missed dose advice does not apply. If you did not take it when you intended, do not take two later to compensate.

Do not use tablets prescribed for someone else, and do not pass yours on. The assessment behind a prescription is specific to one person's history.

Spedra tablets 200mg vs 100mg

The two strengths differ in how much avanafil is in each tablet, not in how the medicine works, the licensed timing, or the maximum frequency.

Two findings in that table are worth reading carefully.

The effect difference is smaller than the number suggests. Scores rose 8.3 points on 100mg and 9.4 on 200mg, against 2.9 on placebo. The step from placebo to 100mg was five times larger than the step from 100mg to 200mg.

Side effects were not higher on the higher strength in that trial. Adverse events ran at 42.2% on 100mg and 38.9% on 200mg, and the 200mg group had the fewest discontinuations of any group including placebo. That pattern reversed after prostate surgery, at 38.4% and 45.5%, and these are differences between groups of roughly 160 men rather than a demonstrated dose response.

Neither finding is a reason to request a particular strength. That is a prescribing decision, and results vary between individuals.

Spedra 200mg tablets prescription: how supply works

Spedra 200mg tablets cannot be supplied without a prescription. Buying Spedra 200mg tablets online means completing a clinical assessment first, then having a prescriber decide whether avanafil is appropriate for you.

The process at a registered UK pharmacy runs in this order:

• You complete an online consultation covering your medical history, current medicines and cardiovascular health.
• A UK registered prescriber reviews it and can approve, ask for more information, suggest something different, or decline.
• If appropriate, a prescription is issued for a specific strength and quantity.
• The pharmacy dispenses and dispatches the medicine.

Step 2 is what people searching spedra 200mg tablets online usually hope to skip, and it is the step that makes the supply both legal and safe.

The prescriber is looking for reasons avanafil would be unsafe. NICE states it is contraindicated in men taking nitrates, taking potent CYP3A4 inhibitors such as ketoconazole and clarithromycin, with severe liver or kidney impairment, with unstable angina, with congestive heart failure of New York Heart Association class 2 or greater, with resting blood pressure below 90/50 or above 170/100 mmHg, and with previous non-arteritic anterior ischaemic optic neuropathy or known hereditary degenerative retinal disorders.

Nitrates are the single most important thing to declare, including a glyceryl trinitrate spray prescribed years ago that you may no longer think of as a current medicine.

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Buying genuine Spedra 200mg tablets in the UK

MHRA has warned about the scale of counterfeit and unlicensed erectile dysfunction medicines.

Approximately 19.5 million doses of illegal erectile dysfunction medicines were seized between 2021 and 2025, with 4.6 million in 2021, 1.8 million in 2022, 3.2 million in 2023, 5.5 million in 2024 and 4.4 million in 2025.

MHRA's warning is specific about who is most at risk: "Unlicensed erectile dysfunction medicines can be especially dangerous for people with heart disease, high blood pressure, or those taking other medications, and can raise the risk of heart attack, stroke and dangerously low blood pressure."

That is the same list of conditions the consultation asks about. A supply route with no assessment cannot screen for any of them.

How to check a supplier is legitimate

MHRA's own advice is to use UK registered pharmacies, and states that for online pharmacies in Great Britain "you can check on the General Pharmaceutical Council's (GPhC) website that it is properly registered". MHRA also advises using online pharmacies displaying the official green cross logo.

Four practical checks:

• Confirm the pharmacy on the GPhC register. Registration is public and verifiable.
• Check a real consultation happens, and that it is capable of returning a no.
• Check the strength exists in the UK licence. Avanafil is licensed at 50mg, 100mg and 200mg. Anything else is a warning in itself.
• Treat urgency messaging and an unusually low price as warnings, not as finds.

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 see the wider range, view the erectile dysfunction treatments available and check whether treatment is appropriate for you.

Spedra 200mg tablets side effects

NICE lists the most common adverse events for avanafil as headache, flushing, and nasal and sinus congestion, each occurring in between 1 in 10 and 1 in 100 people, plus back pain, dizziness, drowsiness and altered vision each between 1 in 100 and 1 in 1,000. Those figures come from clinical studies with 2,144 participants.

These common side effects are consistent with the vasodilatory effects of PDE5 inhibition. Because avanafil can affect blood vessels beyond the penile tissues, effects such as headache, flushing and nasal or sinus congestion can occur.

NICE describes drug related events in the main trial as mild to moderate in severity, and reports that no serious adverse events in any study were considered treatment related.

Seek urgent medical attention for an erection lasting more than four hours, sudden loss of vision or hearing, chest pain, fainting, or signs of an allergic reaction. Do not take a nitrate for chest pain if you have taken avanafil.

How to report a suspected side effect

Suspected side effects can be reported directly to MHRA through the Yellow Card scheme, and this is worth knowing because almost no product page mentions it.

MHRA states that "reporters are asked to submit Yellow Card reports even if they only have a suspicion that the medicine or vaccine may have caused the adverse reaction", and that "the existence of an adverse reaction report does not necessarily mean that the medicine or vaccine has caused the reaction".

Reporting a suspicion is useful even when you are not certain, which is exactly the situation most people are in. Tell your prescriber as well, because a persistent side effect often has a clinical answer such as a change of medicine.

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Spedra 200mg tablets review: what the evidence shows

No customer reviews, ratings or star scores appear on this page. For a prescription-only medicine, individual customer reviews would not provide a reliable basis for assessing whether treatment is appropriate.

Response can vary between study populations and between individuals. In the trials, avanafil 200mg moved the erectile function score by 9.4 points in a general population and 5.3 points in men with diabetes.

What the published evidence shows, from three 12 week randomised controlled trials with 1,334 participants plus a 52 week extension in 712 men:

• 200mg beat placebo clearly, 9.4 points against 2.9 on the erectile function questionnaire.
• The results differed between study populations as well as between strengths. In the general population, the erectile function score rose 8.3 points on 100mg and 9.4 on 200mg, while results in the diabetes population were different.
• Over 52 weeks, 21.5% of men were still taking it, and only 2.8% stopped because of an adverse event.
• NICE reports an analysis in which avanafil was less effective than three other medicines in its class on one global question, though that was an indirect comparison rather than a head to head trial.

MHRA also cautions against comparing medicines using reported figures, stating that "it is not possible to compare the safety of different medicines or vaccines by comparing the numbers presented in the reports", because reporting rates are influenced by many factors.

Results vary between individuals, and no medicine in this class can be described as better than another as a general statement.

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 taken avanafil. Tell the medical team what you have taken and when, because avanafil can interact with nitrate treatment and cause a potentially dangerous fall in blood pressure.

If what arrives does not match what you expected, in appearance, packaging or labelling, do not take it and contact the pharmacy that supplied it.

Speak to your prescriber, if the medicine consistently does not work as expected, if side effects persist, or if the pack size or strength is not working for you. 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.

Nothing on this page should be read as a reason to request a particular strength or pack size. Both the strength and the quantity supplied are prescribing decisions. Your prescriber will determine the appropriate treatment.

The description of the tablet format on this page is general. The pack and the patient information leaflet supplied with your medicine state the pharmaceutical form and are the authoritative record of what you have been given.

All prices are standard website prices at the time of writing and are subject to change. They are not introductory, promotional or first order prices, and every cost per tablet figure is calculated from the standard pack price shown alongside it.

Trial figures describe average changes across defined study populations and are not predictions for any individual. The information here is not a complete account of avanafil, and the patient information leaflet supplied with your medicine is the authoritative document.

Never take more than the prescribed amount of any medicine, never take a second dose in the same day, never take an extra tablet because one did not appear to work, and do not combine Spedra with another erectile dysfunction medicine unless specifically advised by a healthcare professional.

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