Spedra Doses Explained: Which Strengths Actually Exist (and Why 200mg Is the Maximum)

• States exactly which three strengths exist and names the four that do not
• Explains why a strength that does not exist is a counterfeit warning sign rather than a rare find
• Covers how UK medicine supply notifications actually work, with the regulator's own figures
• States plainly why avanafil must never be combined with another erectile dysfunction medicine

Spedra is licensed in the UK in three strengths only: 50mg, 100mg and 200mg. There is no 25mg, no 150mg, no 300mg and no 400mg.

That matters more than it sounds. If you have found a listing for a strength that does not exist, you have not found a rare option. You have found a warning sign, and this page explains exactly why.

200mg is the ceiling. 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". There is nothing above 200mg to prescribe, request or buy.

This page sets out the three real strengths, names the four that are not real, explains why the maximum is where it is, and covers what availability and supply issues actually look like in the UK.

One thing before any of it. Spedra should not be taken with another erectile dysfunction medication. NICE names other erectile dysfunction treatments among the special warnings and precautions for avanafil. The safety and efficacy of combining avanafil with other PDE5 inhibitors or other erectile dysfunction treatments have not been established.

Key things to know

• Three strengths exist: 50mg, 100mg and 200mg. That is the complete list.
• 200mg is the licensed maximum single dose, and NICE states the maximum recommended dosing frequency is once daily.
• Spedra 25mg, 150mg, 300mg and 400mg do not exist as UK licensed products.
• A listing for a strength that does not exist is a counterfeit indicator. MHRA has seized approximately 19.5 million doses of illegal erectile dysfunction medicines between 2021 and 2025.
• All three strengths and all six pack sizes were in stock here at the time of writing.
• Do not take it with another erectile dysfunction medicine. If you are switching treatments, speak to your prescriber about the appropriate approach.
• A higher strength adds less than most people expect. The trial gap between 100mg and 200mg was 1.1 points on the erectile function questionnaire.
• UK supply issues are formally notified to DHSC, and a notification does not automatically mean a shortage.

Spedra strengths available: the complete list

Three strengths of Spedra are licensed and supplied in the UK. Here they are, with the pack sizes and standard prices available here.

Spedra doses available, spedra strengths available and what strengths does Spedra come in all have the same three item answer. So does the search spedra 50mg 100mg 200mg, which is simply the full list typed out.

Spacing makes no difference to any of this. Whether a strength is written as 200mg or 200 mg, it describes the same thing, and a strength that does not exist does not begin to exist because it is typed with a space in it.

Avanafil is the active ingredient in all three. The strengths differ in how much avanafil is in each tablet, not in how the medicine works, the licensed timing, or the maximum frequency. NICE gives one licensed timing for avanafil and one maximum frequency, not one per strength.

All three are the same medicine at different amounts. Avanafil is a PDE5 inhibitor, and NICE names it among four first line drug treatments for erectile dysfunction alongside sildenafil, tadalafil and vardenafil.

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

Spedra strengths that do not exist

There is no Spedra 25mg, no Spedra 150mg, no Spedra 300mg and no Spedra 400mg. None of these is a UK licensed product, and none of them is available from any legitimate UK pharmacy.

This section exists because these four are searched constantly, and because the honest answer protects people.

Why people search for strengths that are not real

Four things generate these searches, and only one of them is harmless.

Confusion with another medicine. Other medicines in this class have different strength ranges. Sildenafil is licensed at 25mg, 50mg and 100mg, so spedra 25mg is often somebody carrying a sildenafil strength across to the wrong brand. That is an understandable mix-up, but the strengths should not be assumed to be interchangeable.

Assuming the pattern continues. If 50, 100 and 200 exist, 400 looks like the next step. It is not. Licensed strengths are set by what was trialled and approved, not by doubling.

Looking for more effect. Someone on 200mg who wants a stronger option searches for one. There is nothing above 200mg. There is nothing above 200mg in the licensed Spedra strength range.

Having seen it listed somewhere. This is the one that matters, and it is covered next.

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What it means if you have seen one of these listed

A website offering Spedra 300mg or Spedra 400mg is not offering a UK licensed Spedra product, because no such strength exists in the UK licence.

That leaves two possibilities, and neither is good. The product may therefore be unlicensed, counterfeit or otherwise not what the listing claims. You cannot rely on the stated strength or contents.

MHRA has highlighted the scale of illegal erectile dysfunction medicine seizures. Approximately 19.5 million doses 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 names exactly 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."

A strength that does not appear in the UK licence is an important warning sign. If the stated strength is not 50mg, 100mg or 200mg, it is not a UK licensed Spedra strength.

Why 200mg is the Spedra maximum dose

200mg is the maximum because that is where the licence stops, and the licence stops there because that is what the clinical trials evaluated and the regulator approved.

NICE states the position plainly. The recommended dose is 100mg, and "the dose may be increased to a maximum dose of 200 mg or decreased to 50 mg". NICE also states that "the maximum recommended dosing frequency is once daily".

Read those two statements together, because between them they close every route above 200mg.

200mg is the licensed maximum dose, and NICE states that the maximum recommended dosing frequency is once daily.

A licensed maximum is not an arbitrary cap. It reflects the doses that were studied, the safety data collected at those doses, and the balance the regulator judged acceptable. Going above it means leaving the evidence base entirely, with no data on what happens.

Treatment suitability depends on an individual clinical assessment, and your prescriber will determine the appropriate treatment and strength.

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Is there a Spedra higher than 200mg?

No. Spedra 300mg does not exist as a UK licensed product, and there is no licensed Spedra strength above 200mg.

What a prescriber can do instead, if 200mg is not working as expected:

• Look at why it is not working. Review factors such as timing, food, alcohol use, other medicines and underlying health with your prescriber rather than assuming that a higher dose is needed.
• Review your other medicines and medical conditions with your prescriber, as some conditions and medicines can affect whether avanafil is appropriate.
• Consider a different medicine in the class. There are four first line options NICE names, and one of them comes in a daily format that works differently.
• Consider other evidence-based treatments for erectile dysfunction if appropriate.

What nobody can do is prescribe a strength that does not exist. That is not caution, it is arithmetic.

Why Spedra must never be combined with another ED medicine

Do not take Spedra with another erectile dysfunction medicine. This is particularly important when someone is looking for a higher strength, because taking another PDE5 inhibitor is not a way to increase the licensed dose.

NICE includes other treatments for erectile dysfunction among the special warnings and precautions for avanafil. The safety and efficacy of combining avanafil with other PDE5 inhibitors or other erectile dysfunction treatments have not been established.

If Spedra has not suited you or 200mg has not produced the expected result, speak to your prescriber about changing treatment rather than adding another medicine or taking extra tablets.

How Spedra works and important considerations

Spedra is a PDE5 inhibitor that enhances nitric oxide signalling, helping increase blood flow to the penis during sexual stimulation. It requires sexual stimulation to be effective and does not cause an erection on its own.

Spedra can be taken with or without food, although a high-fat meal may delay its onset. Grapefruit juice can increase avanafil exposure, so check the product information and speak to a healthcare professional if you regularly consume it.

Alcohol can increase the risk of dizziness and low blood pressure when taken with Spedra, and it may also impair erectile function.

If you have cardiovascular disease, previous stroke or heart attack, liver or kidney problems, or take medicines for blood pressure or prostate symptoms, discuss these with your prescriber before starting Spedra.

When to seek urgent medical treatment

Seek urgent medical treatment if you experience any of the following serious side effects after taking Spedra:

• Prolonged erections lasting more than four hours (priapism).
• Sudden decrease or loss of vision or hearing.
• Chest pain, fainting, or severe dizziness.
• Severe allergic reaction including swelling of the face, lips, or throat.
• A severe allergic reaction, particularly swelling of the face, lips or throat or difficulty breathing.

If you experience sudden vision loss or sudden hearing loss, seek urgent medical attention.

Do not take nitrate medications for chest pain if you have taken Spedra, as this can dangerously lower your blood pressure.

Do not combine Spedra with other PDE5 inhibitors or erectile dysfunction medicines. The safety of such combinations has not been established.

If you are using online doctor services or seeing a healthcare professional, always inform them of all medications you are taking, including over the counter medicines, to avoid harmful interactions.

Grapefruit juice can increase avanafil exposure, so check the product information and discuss it with a healthcare professional if relevant to you.

Avoid excessive alcohol when taking Spedra, as it can increase the risk of dizziness and low blood pressure and may impair erectile function.

If you have a history of serious liver conditions, consult your doctor before using Spedra, as liver impairment may affect dosing and safety.

Spedra is typically taken approximately 15 to 30 minutes before sexual activity and can be taken with or without food. A high-fat meal may delay its onset.

Spedra is available in 50mg, 100mg and 200mg strengths. NICE describes 100mg as the recommended dose, which may be increased to 200mg or decreased to 50mg depending on clinical circumstances.

If you experience side effects such as nasal congestion, headache, or itching, these are generally mild and temporary but should be reported if persistent.

Spedra enhances blood flow to the penis during sexual stimulation but does not cause an erection without stimulation.

If you have Peyronie's disease or another penile condition, discuss it with your prescriber before starting Spedra.

Never adjust your dose without consulting a healthcare professional, as taking a lower dose or a higher dose without guidance can be unsafe.

Buying Spedra online should always be done through a regulated UK pharmacy to ensure genuine medication and proper clinical oversight.

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Would a higher strength even help? What the trial data shows

The step from 100mg to 200mg was much smaller than the doubling of the number suggests, which is worth knowing before assuming a hypothetical 300mg would deliver more.

Response was measured in three 12 week randomised controlled trials with 1,334 participants, plus a 52 week extension in 712 men, using the IIEF, which NICE describes as "a 15-item questionnaire, self-administered measure of erectile function".

Avanafil, the active ingredient in Spedra, is a PDE-5 inhibitor that increases blood flow to the penis but requires stimulation to be effective. It is known as one of the fastest-acting ED medications available, often starting to work within 15 to 30 minutes after intake. The dose of Spedra should be taken about 15 to 30 minutes before activity, and it can be taken with or without food, however, a high-fat meal may delay its onset.

The gap between placebo and 100mg is 5.4 points. The gap between 100mg and 200mg is 1.1 points. Doubling the avanafil added roughly a fifth of what the first dose added over placebo.

Results also differed between the study populations. The 200mg result in men with diabetes was 5.3 points, compared with 8.3 points for 100mg in the general population. These figures come from different populations and should not be interpreted as showing that the underlying cause matters more than the dose.

Adverse-event rates did not increase consistently with dose across the reported study populations. In the general population trial, adverse events were reported by 42.2% on 100mg and 38.9% on 200mg, while the post-prostate-surgery study showed the opposite pattern.

Commonly reported adverse effects include headache, flushing and nasal or sinus congestion, while other effects occur less frequently. If side effects are severe or persistent, speak to a healthcare professional.

Spedra should not be combined with other PDE5 inhibitors or erectile dysfunction medicines. The safety of such combinations has not been established. Nitrate medicines are also contraindicated because the combination can cause a potentially dangerous fall in blood pressure.

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

Take Spedra only as prescribed. NICE states that the maximum recommended dosing frequency is once daily.

Understanding how long does Spedra last is important: The available NICE and MHRA material used here does not establish a directly comparable duration-of-action figure for Spedra.

If you have concerns about side effects such as itching or other discomfort during stimulation, discuss these with your doctor straight away to ensure safe and effective treatment.

In summary, Spedra 200mg is the highest available dose licensed in the UK to treat erectile dysfunction, with proven effectiveness and safety when used correctly under medical supervision. It is important to avoid combining it with other ED medications or substances that can interact dangerously and to use it only as directed by a healthcare professional.

Spedra 200mg availability, stock and shortages

All three Spedra strengths and all six pack sizes were in stock here at the time of writing. Availability can change, and this section explains what to do and what it means when it does.

Spedra 200mg availability, spedra 200mg out of stock and spedra 200mg unavailable uk are usually asked by someone who has hit a stock message and wants to know whether it is temporary, local or national. Those are three different things.

Stock messages are not the same as a shortage, and the difference matters because it changes what you should do next.

How UK medicine supply issues actually work

Supply problems in the UK are formally notified rather than left to rumour, and the system has published figures.

Companies holding a marketing authorisation are required to report potential supply issues to DHSC "at least 6 months in advance or as soon as reasonably practicable". Those reports are called supply issue notifications.

DHSC has published the scale of that system: "just over 5,600 notifications have been reported to DHSC since October 2020", running at around 1,600 in both 2022 and 2023. The highest single month recorded was February 2024, with 283 notifications.

The critical point is what DHSC says about them. Because established supply issue management processes exist, not all supply issue notifications result in an actual supply issue or shortage, or have an impact on patients.

In plain terms: a notification is an early warning inside the system, not an announcement that a medicine has run out. Spedra shortage searches often reflect a single pharmacy's stock position rather than a national supply problem.

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What to do if the strength you need is unavailable

Do not solve an availability problem by changing what you take. Solve it by asking, and let a prescriber make the call.

• Check other pack sizes of the same strength. Availability is often pack specific rather than strength specific.
• Ask the pharmacy directly. They can tell you whether it is a local position and roughly what to expect.
• Speak to your prescriber about alternatives. There are four first line medicines in this class, and switching is a straightforward clinical conversation.
• Do not buy from a supplier you have not checked. An availability gap is exactly when people take a risk they would not normally take, and it is exactly when counterfeit supply meets demand.

What not to do, in every case:

• Do not take two lower-strength tablets to create a higher dose unless your prescriber has specifically instructed you to do so. Do not exceed the prescribed dose or dosing frequency.
• Do not alter or split tablets unless your prescriber or pharmacist has confirmed that this is appropriate for that product.
• Do not add another erectile dysfunction medicine unless specifically advised by a healthcare professional.
• Do not order a strength that does not exist. It is not a licensed product wherever it appears.

Checking a supplier takes a minute. MHRA advises using 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".

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 discuss options, view the erectile dysfunction treatments available.

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 the combination can cause a dangerous fall in blood pressure.

If you have taken a tablet from an unverified source and feel unwell, say so. It changes what a medical team can safely give you, and there is nothing to be gained by leaving it out.

Speak to your prescriber if a strength is not working as expected, if side effects persist, or if availability is making treatment difficult. Do not respond by taking more than prescribed, taking another dose, or adding another erectile dysfunction medicine.

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 as a route to obtaining any amount above the licensed maximum. The strength and the quantity supplied are prescribing decisions.

Statements about which strengths exist describe UK licensed products. They are not a comment on what may be marketed elsewhere, and a product offered under a strength not listed here should not be treated as a licensed medicine.

Availability described here reflects the position at the time of writing and can change. Prices are standard website prices at the time of writing, are subject to change, and are not introductory, promotional or first order prices.

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 two erectile dysfunction medicines 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.