What Is Spedra 200mg Used For? Uses, How It Works and Who It is For

Spedra 200mg is licensed in the UK for one thing: the treatment of erectile dysfunction in adult men. That is the whole of its licensed indication. It is not licensed for any other condition, in any other group, at any strength.

Avanafil, the active substance avanafil, is a PDE5 inhibitor belonging to the medication group known as phosphodiesterase type 5 inhibitors. It works on the blood flow side of the problem, and only where the body's own signalling is already working. It is not a stimulant, not a hormone, and not a treatment for low desire.

One thing before the detail. Spedra should not be taken with another erectile dysfunction medication. 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

• The licensed indication is the "treatment of erectile dysfunction in adult men", per NICE. Nothing else.
• Drug class: a phosphodiesterase type 5 inhibitor, usually shortened to PDE5 inhibitor.
• It does nothing on its own. NICE states avanafil has no effect in the absence of the stimulation that starts the process.
• 200mg is the licensed maximum, not the starting point. NICE describes the recommended dose as 100mg, which "may be increased to a maximum dose of 200 mg or decreased to 50 mg".
• Do not take it with another erectile dysfunction medicine. The safety and efficacy of combining these treatments have not been studied.
• Contraindicated with nitrates, potent CYP3A4 inhibitors, severe liver or kidney impairment, unstable angina, certain forms of heart failure, and in patients with previous loss of vision in one eye due to NAION or known hereditary degenerative retinal disorders.
• It has never been evaluated in men whose erectile dysfunction is caused by spinal cord injury or other neurological disorders.
• It is a prescription only medicine. Supply requires a clinical assessment.

What is Spedra 200mg used for? The licensed indication

Spedra 200mg is used for the treatment of erectile dysfunction in adult men. That is the licensed indication in full, and there is no second use.

When people search spedra 200 mg uses, what is spedra 200 mg used for, spedra uses or what is avanafil used for, they are all asking about the same single indication. The brand name and the ingredient name do not describe different products or different purposes. Spedra is the brand. Avanafil is the ingredient. Avanafil 200mg uses and spedra 200mg indications are the same list, and it has one item on it.

Erectile dysfunction is defined by NICE as a persistent inability to attain and maintain an erection sufficient for normal function. The word that matters there is persistent. Persistent erectile difficulties are the condition described by the clinical definition, occasional difficulty does not by itself establish erectile dysfunction.

Spedra 200mg for erectile dysfunction is therefore the only use with a licence behind it, and every other question about what the tablet might do is answered by that one line.

What causes the condition Spedra treats

NICE describes erectile dysfunction as associated with "physical causes such as diabetes mellitus, hypertension and radical prostatectomy" as well as "psychological or emotional causes".

That list matters more than it looks, for two reasons.

Some physical causes involve vascular factors. Diabetes and hypertension can affect the blood vessels and other processes involved in erectile function, while PDE5 inhibitors support the erectile response through the nitric oxide-cGMP pathway.

Second, the study results differed between populations. NICE reports generally higher response rates in the general erectile dysfunction population than in men with diabetes or men who had undergone bilateral nerve-sparing radical prostatectomy. This shows why trial results should not be used to predict an individual's response solely from the dose.

Avanafil is one of four medicines NICE names as first line drug treatment for erectile dysfunction, alongside sildenafil, tadalafil and vardenafil. It is a first line option, not a last resort and not a stronger tier.

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What Spedra 200mg is not used for

Avanafil is licensed for erectile dysfunction in adult men and for nothing else. Using it for any other condition is outside its licence, and this page will not support that. This section exists because the question is asked often and usually gets a vague answer.

It is not licensed for any other condition affecting men. There are separate conditions with their own separate licensed treatments and their own separate consultations. Avanafil is not one of them, and a medicine that increases blood flow does not treat a problem of a different mechanism. If you have a concern other than erectile dysfunction, raise that concern specifically at a consultation rather than assuming this tablet covers it.

It is not licensed for women. The indication is adult men. There is no female indication for avanafil at any strength.

It is not licensed for anyone under 18.

It is not a treatment for low desire. This is the most common misunderstanding about the whole class. Avanafil acts on blood flow after the body's own signal has been sent. If the signal is not being sent, the medicine has nothing to amplify.

It is not licensed as a performance product for men without erectile dysfunction, and its contraindications and potential adverse effects still apply.

It has never been evaluated in some groups. NICE states plainly that "avanafil has not been evaluated in men with erectile dysfunction due to spinal cord injury or other neurological disorders". That is not the same as saying it does not work. It means nobody has measured it, and the honest position is to say so rather than to fill the gap.

Spedra 200mg drug class and mechanism of action

Spedra 200mg belongs to the drug class known as PDE5 inhibitors, short for phosphodiesterase type 5 inhibitors. NICE describes avanafil as a "reversible inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5)."

That sentence contains the whole mechanism, so here it is unpacked.

Spedra 200mg: how it works, step by step

NICE states that inhibition of PDE5 by avanafil "produces increased levels of cGMP in the corpus cavernosum of the penis. This results in smooth muscle relaxation and inflow of blood into the penile tissues."

In plain terms:

• A nerve signal releases nitric oxide into the blood vessels of the tissue. This is the starting signal, and the medicine plays no part in it.
• Nitric oxide activates a pathway that increases cyclic GMP, a messenger chemical.
• Cyclic GMP relaxes the smooth muscle in the walls of the blood vessels.
• Relaxed vessels let blood flow in, and the tissue firms as it fills.
• PDE5 breaks cyclic GMP down, which is how the whole process reverses.
• Avanafil slows step 5. More cyclic GMP stays present, so step 3 lasts longer.

That is what Spedra 200mg does, and it is the answer to, Spedra 200mg what does it do. It does not create an erection. It helps sustain the erectile response that sexual stimulation has already initiated.

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Why "no effect on its own" is the most important fact here

NICE states that avanafil has no effect in the absence of the stimulation that triggers step 1. Nothing happens from swallowing the tablet by itself.

This single fact explains three things people find confusing.

• Why it can appear not to work. If step 1 has not happened, there is nothing at step 5 to slow down.
• Why the underlying cause can affect the response. Erectile dysfunction can have different physical or psychological causes, and response to treatment varies between individuals and study populations.
• Why a higher strength is not a different mechanism. Spedra 200mg does exactly what Spedra 50mg does. Spedra 200mg how it works and spedra mechanism of action are the same answer at every strength, with more avanafil available to slow the enzyme.

Why Spedra must never be taken with another ED medicine

Do not take Spedra 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.

This is particularly important at 200mg because 200mg is already the maximum licensed single dose of avanafil. If Spedra is not working as expected, speak to your prescriber rather than taking another erectile dysfunction medicine yourself.

The product information does not establish a safe interval for combining Spedra with another PDE5 inhibitor or erectile dysfunction treatment. If you want to change treatment, discuss this with your prescriber.

Who can take Spedra 200mg, and when it is prescribed

Spedra 200mg is prescribed to adult men with erectile dysfunction, after a clinical assessment establishes that this class of medicine is appropriate and that no contraindication applies. Suitability is decided by the assessment, not by the search.

When is Spedra 200mg prescribed?

200mg is the top of the licensed range, so it is not usually where treatment starts. 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".

In practice a prescriber is deciding between three licensed strengths on the basis of your history, your other medications including any prescription medication or herbal remedies, and how you have responded to anything tried before. The number is a clinical output, not a request. Your prescriber will determine the appropriate treatment and strength.

Spedra should be used with caution if you have a bleeding disorder or active peptic ulceration, because there is limited safety information in these groups. It should also be used with caution in people with conditions that may predispose them to priapism, such as sickle cell anaemia or multiple myeloma. Alcohol can increase the likelihood of low blood pressure, dizziness or fainting when taken with avanafil.

Spedra should be used with caution if you have a bleeding disorder or active peptic ulceration, because there is limited safety information in these groups. It should also be used with caution in people with conditions that may predispose them to priapism, such as sickle cell anaemia or multiple myeloma. Alcohol can increase the likelihood of low blood pressure, dizziness or fainting when taken with avanafil.

Always store Spedra properly as per the instructions to maintain its effectiveness. If you are considering buying Spedra online, ensure you use trusted online doctor services that provide a doctor straight consultation and a valid marketing authorisation.

Remember, never take more Spedra or add another erectile dysfunction medicine without speaking to your prescriber. The safety and efficacy of combining avanafil with other PDE5 inhibitors or ED treatments have not been studied.

Who avanafil is not suitable for

NICE states avanafil is contraindicated in men:

Care is also needed with alpha blockers and other blood pressure medicines, which NICE lists among the special warnings, because both lower blood pressure. Alcohol can increase the risk of symptomatic low blood pressure, dizziness or fainting when taken with avanafil.

There is limited data in older men. NICE notes that "limited data are available in older men aged 70 years or above". That is a gap in the evidence rather than a bar, and it is a reasonable thing to raise if it applies to you.

Tell the prescriber everything you take, including anything bought without a prescription. The interactions that matter here are with common medicines, not obscure ones.

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Spedra 200mg dosage and uses: how the two connect

The licensed use is one condition, and the licensed dosage is a range of three strengths within it. Those are separate decisions and both belong to the prescriber.

Searches for spedra 200mg dosage and uses, or avanafil uses and dosage, usually combine two questions that have different answers. The use never changes. The dose is individual. This page describes what the licence permits and gives no instruction on what to take.

What can be said generally, because it applies to the medicine rather than to any individual:

• It is taken as needed, not on a daily schedule.
• Once daily is the maximum frequency, whatever the strength.
• Never take an extra tablet because the first did not appear to work.
• Never add a different erectile dysfunction medicine.

If a medicine is not working as expected, that is a consultation, not a reason to take more. Timing, food, alcohol and an untreated underlying cause are all possible explanations, and each has a different answer.

Spedra 200mg benefits, and the honest limits

The benefit of avanafil is a measurable improvement in erectile function in men for whom the underlying mechanism is intact enough to amplify. The limit is that the benefit varies enormously depending on why the condition exists.

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".

Read the two rows against each other. 200mg in men with diabetes moved the score by 5.3 points, which is less than 100mg achieved in the general group. The results differed between study populations, showing why trial results should not be used to predict how an individual will respond based on dose alone.

What the benefits are, stated plainly

• It treats a symptom, not a cause. It does not repair blood vessels, reverse diabetes or restore nerve function. It works alongside whatever is happening underneath.
• It is taken only when needed, so there is no daily commitment.
• It is a licensed first line option, one of four NICE names, rather than something reached for after other things fail.
• The benefit of avanafil is an improvement in erectile function in men with erectile dysfunction when sexual stimulation is present.

What it does not do

• It does not work without the body's own starting signal.
• It does not treat any condition other than the one it is licensed for.
• It does not produce the same result in everyone, and NICE's own figures show the range.
• It has not been evaluated in erectile dysfunction caused by spinal cord injury or other neurological disorders.

Treatment suitability depends on an individual clinical assessment. Results vary between individuals.

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Spedra 200mg uses and side effects: what comes with it

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 of PDE5 inhibition. Headache, flushing and nasal or sinus congestion are recognised adverse effects of avanafil. That is why they cannot be separated from how the medicine works, and why the whole class shares a side effect profile.

One finding is worth knowing if you are weighing 200mg. In the general population trial, adverse events were reported by 42.2% of the 100mg group and 38.9% of the 200mg group, 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%. The results do not show a simple dose-response pattern for adverse events in these study groups, although these were separate groups rather than a direct comparison designed to establish dose-related risk.

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 if the medicine consistently does not work as expected, if side effects persist, or if you think a different treatment might suit you better. Do not resolve any of those by taking more, or by adding something else.

To understand whether treatment is appropriate for you, you can check your eligibility for erectile dysfunction treatment through an online consultation with UK registered prescribers, or read our guide to erectile dysfunction treatment options and how the right one is chosen. EveryDayMeds is a GPhC registered pharmacy, and clinical assessment happens before supply.