Starting from the mid-1990s, a lot of research on erectile dysfunction treatment has been conducted by numerous scientific teams, working at different pharmaceutical companies. This resulted in a proliferation of different impotence pills on the market, with Spedra being among the newest additions.

Developed by Vivus Inc. this medicine is based on the active ingredient avanafil and is sold under trade names Spedra and Stendra. Approved by the EMA1 in June 2013 and the FDA2 in April 2012, it is now sold in more than 40 European countries, but also Australia, New Zealand and the USA.

What’s on this page?

What is Spedra?

Spedra (or Stendra) is an impotence pill based on the active ingredient avanafil and is one of the newest alternatives to Viagra. Similarly to competitors, Spedra too belongs to the PDE-5 inhibitors class of pharmaceutical compounds. This means that avanafil shares its mechanism of action with other treatments such as Cialis, Levitra and Viagra. This topic will be explored in more detail below.

Can I buy Spedra without prescription?

Both in the EU and the US, Spedra is a prescription-only medicine and cannot be bought over the counter. This medicine is issued only after consultations with a medical professional who can make a decision on the necessity, safety and reliability of the treatment. These consultations can happen in two ways – the “traditional route”, where you take your time to make an appointment and visit a doctor, going to pharmacy afterwards in order to finally pick up your medicine, or you can choose to go through an online clinic.

Is it safe to buy Spedra online?

The only way to legally and safely buy Spedra online is through a certified online clinic. This means that the clinic of your choice needs to offer you consultations with a licenced medical professional who will use either an interview or a detailed questionnaire to determine whether you’re suitable for the treatment. This includes consideration of existing and underlying medical conditions, other medicines you might be taking that could cause harmful interactions, and the root causes of your ED problems. As with all other PDE-5 inhibitors, Spedra too is effective only in physiologically based impotence, while it can only act as a placebo in cases of so-called emotional ED.

How can Spedra help with impotence?

As was mentioned, Spedra, as a PDE-5 inhibitor shares its mechanism of action with other medicines belonging to the same class of compounds. Specifically, it works by inhibiting the effects of phosphodiesterase enzyme type 5 (PDE-5 for short) on cyclic guanosine monophosphate (cGMP). These two molecules play a crucial role in the bio-chemical and physiological processes involved in gaining, maintaining and losing an erection.

Specifically, cGMP reacts to sexual stimuli and the presence of Nitric oxide (NO) in order to cause the widening of blood vessels within the spongy tissue of the penis, increasing the blood flow and causing an erection. However, after ejaculation, PDE-5 enzymes start degrading cGMP molecules in order to narrow down the blood vessels and return the organ to the flaccid state, thus preventing potential injury.

In healthy men, this process is fine-tuned to produce the expected results, but in men struggling with impotence, usually, there’s an excess of PDE-5 within the system, meaning that cGMP gets degraded before it can act, or soon enough that erection doesn’t last long enough for a satisfying intercourse. This is where the magic of Spedra takes place. By relying on structural similarities between avanafil and cGMP, Spedra acts as a competitive binding agent of PDE-5. The result is an increased presence of cGMP and, by extension, stronger and longer lasting erection.

Spedra onset and duration

One thing that really helps Spedra stand out among the competition is its rapid onset. Avanafil seems to be absorbed by the body faster than any other PDE-5 inhibitor, reaching maximum concentration in as little as 30 minutes, while enabling men to gain an erection within 15 minutes of consumption. The effects will last between 4 and five hours after consumption, similarly to Viagra.3

How is Spedra used?

Spedra is available only in form of a hard tablet in multiple dosages. It should be consumed 15 minutes to half an hour prior to engaging in sexual activity, with or without water or food. However, it is important to mention that taking Spedra with too much food, or with food that is too greasy, the onset can be somewhat prolonged and the effects diminished.

How is Spedra dosed?

Spedra is available in three different dosages, namely 50mg, 100mg and 200mg. Usually, 100mg is the recommended starting dose if the patient isn’t too susceptible to avanafil effects. Over the course of the treatment, the doctor can decide to reduce the dose to 50mg and see if the effects are still present, or alternatively, if the starting dose isn’t enough to produce the desired effects, it will be increased to maximum 200mg. It is also important to note that it is highly advisable not to take more than one pill per day.

What are Avanafil side effects?

As with all prescription medication, avanafil-based Spedra also comes with potential side effects. In most cases, they are absent, but some individuals may experience a harsher reaction. If this happens, be sure to contact your doctor immediately in order to get info on what should be done next to prevent potentially harmful effects.

The most commonly experienced side effects manifest in 1 in 10 to 1 in 100 patients and these include:

  • Headaches
  • Flushing of the face
  • Nasal congestion

Those less common, documented in roughly 1 in 100 to 1 in 1000 patients are:

  • Dizziness
  • Nausea
  • Blurred vision
  • Back pain
  • Hot flushes
  • Heart palpitations and increased heart rate
  • General fatigue

What are avanafil contraindications?

In some cases, avanafil isn’t recommended and this can be either due to an existing medical condition or medicines used for the treatment of that condition. In either case, whether it’s worsening of symptoms or potentially harmful interaction of medicines, the doctor might advise against Spedra treatment. Some of the conditions that might pose a risk include:

  • Stomach ulcer
  • Diseases of the cardiovascular system
  • Leukaemia
  • Bleeding disorders
  • Priapism

On the other hand, potentially harmful interactions may occur if you’re currently taking some of the following drugs:

  • Other impotence treatments (PDE-5 inhibitors)
  • Medicines for treatment of angina (nitrates)
  • Medicines for treatment of high blood pressure
  • Herbal remedies and other substances which affect cardiovascular system
  • Prostate drugs (alpha-blockers)
  • Antibiotics
  • Epilepsy drugs


  1. Spedra (Avanafil) – EMA
  2. Spedra/Stendra – FDA
  3. Avanafil for Erectile Dysfunction – SAGE Journals