What is Spedra?
Spedra is the trade name for a drug called Avanafil. Spedra is one of a class of drugs known as PDE-5 (Phosphodiesterase type 5) inhibitors. Spedra and the other PDE-5 inhibitors can help men with erectile dysfunction (male impotence) by enhancing the erectile response when a man is sexually stimulated. Aside from Spedra, the other drugs in this class are Viagra, Cialis (Tadalafil) and Levitra (Vardenafil).
How does Spedra work?
Spedra does not cause a man to be sexually aroused, it is only effective if you are sexually aroused.
To understand how it works you need to understand the mechanics of how a man gets an erection. When you get sexually stimulated, the nervous system in the erectile tissue of your penis releases nitric oxide (NO). The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP).
The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection.
Spedra works by inhibiting a specific phosphodiesterase type 5 enzyme which is found in various body tissues, but primarily in the corpus cavernosum penis, as well as the retina. This maintains the level of cGMP in the smooth muscle cells. If you are not turned on, your brain will not stimulate the release of any nitric oxide and you will not produce any cGMP.
Is Spedra effective?
Clinical studies have shown that when compared to placebo, Spedra and the other drugs in the same class, result in significant improvement in erectile function.
The claimed advantage of Spedra is that it has very fast onset of action compared with other PDE5 inhibitors. It is absorbed quickly, reaching a maximum concentration in about 30–45 minutes. About two-thirds of the participants in trials were able to engage in sexual activity within 15 minutes.
Throughout all trials of Spedra, statistically significant improvements in all primary efficacy outcomes were observed for all three doses (50mg, 100mg and 200mg) of avanafil compared with placebo. These were maintained with long-term treatment.
Although established to be a safe and effective drug, Spedra isn't appropriate for everyone and may not work in all cases.
How does it affect blood pressure?
Spedra can slightly lower blood pressure. This is not a problem for most men. But Spedra's effect on blood pressure is exaggerated if it is taken with a nitrate drug. Nitrates are one of the treatments doctors prescribe for angina.
If you take Spedra when you are also taking nitrates, the combined effect of the Spedra and the nitrates can lower your blood pressure to such an extent that it could prove fatal. Never take Spedra at the same time as taking nitrates.
If I have a heart condition can I take it?
If you have a heart condition it is important that you discuss this with the doctor before taking Spedra. Spedra may not be appropriate because of the danger of interacting with the nitrates.
Can women take it?
Spedra is not currently licensed for use by women.
How quickly does it work?
It is usual to take one Spedra tablet thirty minutes before sex. Spedra can be taken with or without food; if taken with food, it may take longer to work.
Positive effects can last for four hours or longer.
Spedra should not be taken more than once a day.
Grapefruit juice should be avoided within 24 hours prior to taking Spedra. Drinking alcohol at the same time as taking Spedra may increase your heart rate and lower your blood pressure. It may also decrease your ability to get an erection.
Why are there different doses?
Spedra is available in three dosages: 50mg, 100mg and 200mg. Some men may respond to a lower dose of Spedra. Some men may already be taking medicines that interact with Spedra and thus need to adjust the dosage they are taking.
What dose is right for me?
The doctor needs to decide which dosage of Spedra is most appropriate. The doctor will take into account potential drug interactions, your age, the severity of your erectile dysfunction and any previous experience you have had with these medications.
What if it does not work the first time I use it?
Spedra might not work the first time you take it. Most doctors advise taking these medications at least eight times before trying a different medicine.
What are the side-effects?
Spedra's Side effects are generally mild and brief. The most commonly reported adverse effects were headache, flushing and nasal congestion. The recommended dose of Spedra is 100mg approximately 30 minutes before sexual activity. The dose may be increased to a maximum of 200mg or decreased to 50mg, dependent on individual efficacy and tolerability.
Does it interact with other medicines?
Spedra interacts with many drugs. The following list is not complete but it is important to inform the doctor of all prescription and non-prescription medication taken, especially:
- nitrate medications (e.g. glyceryl trinitrate (GTN), nitroglycerin, isosorbide mononitrate or dinitrate)
- azole antifungals (e.g., itraconazole, ketoconazole)
- rifamycins (e.g., rifampicin)
- Alpha blockers, prescribed for prostate disease or high blood pressure
- Ritonavir, Amyl, Butyl or Isopropyl nitrates ('Poppers')
- Before taking any erectile dysfunction medication it is important to read the drug information sheet that comes with the packaging.
Who shouldn't use it?
Men who have any of the following conditions should also avoid taking it: severe heart or liver problems, recent stroke or heart attack, low blood pressure, certain rare inherited eye diseases.
Does it treat the underlying causes of impotence?
Spedra will not resolve the underlying cause of erectile dysfunction although if the cause is primarily psychological, it may help to break the cycle of anxiety and failure associated with being unable to achieve a satisfactory erection.
What kind of tests might highlight the underlying causes of male impotence?
A blood test for diabetes should be performed along with cholesterol and triglyceride blood tests. It is becoming increasingly accepted among doctors that sex hormone levels (Testosterone) should also be checked by way of a blood test.
What other impotence treatments are available?
The other drugs, Viagra, Levitra and Cialis work in similar ways. Viagra is often prescribed as the first line treatment. Cialis has a much longer half life than Viagra and Levitra and therefore its effect lasts much longer.
This does not mean one has prolonged erections but the length of time available for further erections is increased without the need to take further doses. It also means however that the side effects if present will last longer. Levitra, like Cialis, can be taken with food whereas Viagra should be taken on an empty stomach.
Some studies have shown Levitra to be more suitable for men suffering from diabetes. Spedra is claimed to act faster and to last for four to six hours. Other treatments include Caverject ('Alprostadil') which is a medication injected directly into the penis and MUSE (another form of 'Alprostadil') which is a pellet inserted into the urethra. These may be of use for men who have to take Nitrates and are therefore unable to take the PDE5 inhibitors. The use of vacuum pumps and other mechanical devices for producing and maintaining erections are alternatives to taking medication.