While the field of treatments for erectile dysfunction (ED) has a few juggernauts leading the way, there are alternative treatment options for those who feel that Viagra or Cialis aren’t as effective as they could be.

Two of the newest on the block are Spedra and Stendra. Despite having different names, the active ingredients in these medications are identical – both use avanafil. The only real difference is the branding, and where you can buy them.

Avanafil was first synthesised by Mitsubishi Tanabe Pharma, who then partnered with the Menarini Group to commercialise the medication in over 40 countries, including the UK. In the US, however, Metuchen Pharmaceuticals gained exclusive rights to the medication within the United States.

This leads us to the reason the same medication has 2 names: Spedra in the UK and Europe, while in the US it is sold as Stendra. Spedra and Stendra contain the same active ingredient, but there are differences in the inactive ingredients that make up the pill itself. These variations are fairly minor; much like buying paracetamol from a pharmacy or your corner shop, the treatment, dosage and actual medication are identical.

In most cases, Stendra in the UK will come from a US supplier.


Take an assessment to order Spedra online from £19.99


How Does Avanafil Work?

During an erection, blood flows into the penis. This blood fills spongy tissue within the penis, which expands and stiffens to create the erection.

Avanafil is a PDE-5 inhibitor, like most medications for ED. PDE-5 is an enzyme that causes blood vessels to tighten up. This allows your body to adjust your blood pressure as needed. However, it also means that less blood can travel through these blood vessels.

PDE5 inhibitors stop this enzyme from working, preventing blood vessels from contracting. This means increased blood flow into the penis, making it easier to achieve and maintain an erection.

Note that this does not mean you will get random erections – you still need to be sexually aroused or have sexual stimulation to achieve an erection with ED medication.

Spedra works best when taken on an empty stomach – it may take longer to take effect if taken with food. Take around 30 minutes before sexual intercourse, or 15 minutes before if taking the 200mg dose.

Both Spedra and Stendra are available in 50mg, 100mg and 200mg strengths. We advise starting with 50mg and only moving up if you find the lower doses aren’t effective.

Who Can Take Spedra?

Like all erectile dysfunction medications, Spedra will not be suitable for some patients. In particular, those with cardiovascular health conditions (such as heart disease) or are taking medications for cardiovascular conditions (such as alpha blockers) should speak to their doctor before using Spedra. It may be advised that you avoid sexual activity due to the risks of heart attack or other complications.

Avanafil can have reactions with some medications. Using avanafil while also taking nitrate drugs (often taken for angina) may result in dangerously low blood pressure. Those who are taking medications to treat HIV or AIDS (such as ritonavir or indinavir), antifungal medications (such as ketoconazole) or antibiotics (such as clarithromycin) should not use Spedra or Stendra. 

For a full list of possible contraindications, please read the Patient Information Leaflet.

Does Spedra Have Any Side Effects?

As with most prescription medications, some users may experience side effects when using Spedra. The most common side effects of the medication are headaches, flushing and nasal congestion. Around 1 in every 10 patients will experience these.

While much rarer, Spedra can have more serious side effects. If you experience any of the following, stop using Spedra and seek urgent medical attention;

  • An erection lasting more than 4 hours (priapism)
  • Blurred vision
  • Sudden decrease or loss of vision in one or both eyes
  • Sudden decrease or loss of hearing 


For more information about side effects, please consult the Patient Information Leaflet.


  • Stendra and Spedra (avanafil) are used in treating erectile dysfunction.
  • Both medications use the same active ingredient, in the same doses – only the inactive ingredients and branding are different.
  • As with all ED treatments, speak to your doctor before using Spedra or Stendra