Spedra®

Spedra is a modern medication for treating erectile dysfunction that contains the active ingredient avanafil. It was approved in 2013, making it the newest PDE-5 inhibitor on the market.

What sets Spedra apart is its very fast onset of action: in some men, the medication takes effect after as little as 15 minutes. This allows for maximum spontaneity.

The active ingredient avanafil is highly selective for PDE-5 and affects other enzymes less than older active ingredients in this class.

The medication is prescription-only and is distributed by Menarini.

Avanafil belongs to the group of PDE-5 inhibitors, but because of its chemical structure it acts particularly quickly and selectively.

The mechanism: During sexual arousal, nitric oxide (NO) is released, which activates the production of cGMP. cGMP relaxes the blood vessels in the penis, more blood flows in, and an erection occurs.

The enzyme PDE-5 breaks down cGMP. Avanafil inhibits this enzyme, so cGMP acts longer and the erection is supported.

Why avanafil works so quickly: The chemical structure of avanafil allows rapid absorption into the blood and a quick onset of action. The effect can be noticeable after as little as 15 minutes.

High selectivity: Avanafil is particularly selective for PDE-5. It affects other PDE enzymes (found, for example, in the eyes or in the cardiovascular system) less than sildenafil does.

Spedra is suitable for men who:

Want maximum spontaneity:

• Can be taken shortly before sexual intercourse (15-30 min.)
• No long advance planning needed
• Ideal for unplanned intimate moments

Do not tolerate other PDE-5 inhibitors optimally:

• Alternative in case of intolerance
• Different side effect profile

Typical indications:

• Erectile dysfunction of various causes
• ED of organic, psychological, or mixed origin
• Men with diabetes who have erection problems

Available strengths:

• 50 mg – Lowest dose
• 100 mg – Recommended starting dose
• 200 mg – Maximum single dose

Dosage recommendations:

• Standard: 100 mg about 15-30 minutes before sexual intercourse
• If it works well: You can stay at 100 mg
• If the effect is insufficient: Increase to 200 mg
• If side effects are severe: Reduce to 50 mg

Older men: No routine dose adjustment required.

Maximum dose: 200 mg per day, no more than once daily

How to take it:

• About 15-30 minutes before planned sexual intercourse
• With a glass of water
• Can be taken with or without food
• Very high-fat meals may slightly delay the onset of action

The advantage of the fast action: In most men, Spedra works within 15-30 minutes – sometimes even faster.

Duration of action: The effect lasts about 6-12 hours. During this period, erections are possible with sexual stimulation.

Frequency: No more than one dose per 24 hours.

Alcohol: Moderate alcohol consumption is possible. However, excessive alcohol can reduce effectiveness.

Absolute contraindications:

• Taking nitrates: Combination with nitrates or amyl nitrite is strictly contraindicated because of the risk of a severe drop in blood pressure

• Severe heart disease: Heart attack or life-threatening heart rhythm disorder within the last 6 months, unstable angina pectoris, angina pectoris during sexual intercourse, severe heart failure

• Low blood pressure (below 90/50 mmHg)

• Uncontrolled high blood pressure (above 170/100 mmHg)

• Stroke within the last 6 months

• Severe liver impairment

• Severe kidney impairment (creatinine clearance below 30 ml/min)

• Hereditary retinal disorders

• Loss of vision in one eye due to NAION (non-arteritic anterior ischaemic optic neuropathy), regardless of whether it was related to previous use of a PDE-5 inhibitor

• Concurrent strong CYP3A4 inhibitors (ketoconazole, ritonavir, etc.)

• Concurrent guanylate cyclase stimulators such as riociguat (possible symptomatic drop in blood pressure)

Use with caution in:

• Anatomical deformities of the penis
• Conditions with a risk of priapism
• Moderate liver or kidney impairment

Common side effects (1-10%):

• Headache
• Facial redness (flushing)
• Stuffy nose

Uncommon (0.1-1%):

• Dizziness
• Back pain
• Feeling hot
• Sinus complaints
• Indigestion

Rare but serious:

• Priapism: Painful erection lasting more than 4 hours – seek medical help immediately
• Sudden loss of vision: See a doctor immediately
• Sudden hearing loss: Seek medical evaluation right away

Absolutely contraindicated:

• Nitrates and NO donors: Life-threatening drop in blood pressure
• Strong CYP3A4 inhibitors: Ketoconazole, itraconazole, ritonavir (contraindication)

Important interactions:

• Moderate CYP3A4 inhibitors (erythromycin, fluconazole): Maximum dose 100 mg, at least 48 hours between two doses
• Alpha blockers: Blood pressure may drop; start with the lowest dose
• Blood pressure medications: Additive blood-pressure-lowering effect
• Other PDE-5 inhibitors: Do not combine
• Grapefruit juice: May slightly increase avanafil levels