Spedra (Avanafil) Tablets 50mg, 100mg or 200mg – 4 or 8 Tablets

Spedra contains avanafil, a prescription-only medicine for erectile dysfunction (ED) in men aged 18 and over. It is a PDE5 inhibitor that helps blood flow into the penis when you are sexually aroused, and can be taken from about 15 minutes before sex. At Ways Pharmacy it is supplied under a Patient Group Direction (PGD) only after a pharmacist has assessed your health, heart risk and current medicines and confirmed that it is suitable for you.

How to access this medicine

1. Start your free online assessment. Complete a health questionnaire, including a blood pressure reading taken in the last 3 months with a photo of the monitor display. For this medicine the questionnaire also includes a short erectile function score (SHIM). You confirm your identity by uploading photo ID or showing it on a video call. If you do not have a recent reading, you can have your blood pressure checked free of charge at our Holborn pharmacy.
2. Pharmacist reviews and speaks with you. A GPhC-registered pharmacist contacts you by phone or video to go through your heart health, current medicines and answers, and confirms whether this medicine is suitable.
3. If suitable, we send you a payment link. Once the pharmacist confirms the medicine is suitable, we send you a secure payment link for the confirmed pack by email or message. You can also call 020 8106 7084. If it is not suitable — including when the pharmacist gives advice only — you pay nothing and the pharmacist explains your other options.
4. We post your medicine or you collect it. Orders paid by 3pm on a weekday are posted the same day (see our shipping policy), or you can collect from Holborn.

There is no separate consultation fee. If the medicine you chose is not suitable, the pharmacist may suggest another option.

About this medicine

Dosage

• Usual starting dose: one 100mg tablet with water about 15 to 30 minutes before sexual activity
• No more than one dose in 24 hours
• Sexual stimulation is needed for it to work. Taking it with food may delay the effect
• Depending on how well it works and any side effects, the pharmacist may lower the dose to 50mg or raise it to 200mg (the maximum)

The pharmacist decides which strength is suitable for you after the assessment, and the payment link is for that strength.

Under our PGD each supply is 4 or 8 tablets, and repeat supplies are no more often than every 1 or 2 weeks respectively, after a check with the pharmacist.

Warnings and who should not take this medicine

• Women and anyone under 18
• Anyone using nitrates (such as GTN spray or isosorbide mononitrate), nicorandil, nitric oxide donors such as amyl nitrite ("poppers"), or riociguat
• Anyone already taking another erectile dysfunction medicine
• Mild or severe ED on the SHIM score — this option is for men whose score shows moderate ED (8–16 points)
• Anyone for whom sexual activity is inadvisable because of heart disease, including unstable angina, angina during sex, or heart failure in the last 6 months
• A stroke in the last 6 months or a heart attack in the last 90 days, uncontrolled heart rhythm problems, or narrowing of the aortic valve (aortic stenosis)
• Blood pressure below 90/50 or above 170/100
• Liver problems, or severe kidney problems
• Inherited retinal disorders such as retinitis pigmentosa, or previous sudden sight loss caused by NAION
• Conditions that increase the risk of priapism (such as sickle cell disease, multiple myeloma or leukaemia), a penile deformity such as Peyronie's disease, a bleeding disorder or an active stomach ulcer
• Anyone taking strong CYP3A4 inhibitors, such as ketoconazole, itraconazole, ritonavir or indinavir

Tell the pharmacist about every medicine you take, including alpha-blockers (such as doxazosin or tamsulosin), blood pressure medicines, antibiotics such as erythromycin or clarithromycin, and grapefruit juice. Alcohol taken with avanafil can make dizziness or fainting more likely.

Possible side effects

The most common are headache, flushing and a blocked nose. Dizziness, back pain and indigestion can also occur. They are usually mild and short-lived. Do not drive if you feel dizzy or your vision is affected.

Stop taking it and get urgent medical help if you have chest pain during or after sex (call 999), an erection lasting more than 4 hours, sudden loss or change of vision or hearing, or swelling of the face, lips or throat.

More information about the service and other options is on our erectile dysfunction treatment page.

Regulatory information

• Legal status: Prescription-only medicine (POM), supplied under a Patient Group Direction after pharmacist assessment
• Pharmacy: Ways Pharmacy, 77 Southampton Row, London WC1B 4ET · GPhC-registered premises 9012227
• Patient information leaflet: electronic Medicines Compendium (emc)
• Report suspected side effects through the MHRA Yellow Card Scheme

This page gives factual information about a prescription-only medicine and is not an advertisement to the public. It is supplied only after a pharmacist has assessed that it is suitable for you.