Spedra

When you are aroused your tissues release a chemical called nitric oxide (NO), this, in turn, causes the release of a second chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscles at the sides of your penis to relax, allowing blood to rush in. The veins that drain the blood from your penis also get compressed, trapping the increased blood in your penis, resulting in an erection. An enzyme called phosphodiesterase-5 (PDE5) breaks down the cGMP and your penis will return to its original state.

Spedra/Avanafil is a PDE5 inhibitor, meaning it blocks the action of PDE5. As your levels of cGMP remain high, the muscles at the side of your penis relax, more blood rushes in and you can achieve a firmer and longer-lasting erection. It is important to remember that Spedra/Avanafil only exerts its action when you are sexually aroused. It does not increase your sexual desire, and it will not resolve any underlying physical causes of your ED.

It is one of the fastest-acting treatments for ED, taking as little as 15-30 minutes to take effect, and can last for up to four hours. The time it takes to work will be different for each man. If taken with food it can have a slower effect, so, it’s best to take it on an empty stomach or after a low-fat meal. The higher strength tablets (100mg and 200mg) should be taken approximately 15-30 minutes before you desire their effect. The lower strength tablets should be taken about 30 minutes before sexual activity. Spedra/Avanafil will only help you to get an erection when you are sexually aroused.

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You must not take more than 1 tablet a day or exceed the dose recommended for you. If you feel that your dose is not appropriate, that the effects of the medication are too much, or not enough, your doctor can alter your dose.

If you do take more than the recommended dose, your risk of side effects, including serious ones, like low blood pressure or an erection that won’t go away even after 4 hours, dramatically increases. If you do experience any side effects, particularly serious side effects, you should seek medical attention immediately.

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Spedra/Avanafil cannot be used if you:

• are a woman (this medicine is for men only)
• are under 18 years old
• are allergic to Avanafil or any of the other ingredients of this medicine
• are taking “nitrate” medicines for chest pain (angina), such as amyl nitrite or glyceryl trinitrate. Spedra/Avanafil can increase the effects of these medicines and severely lower your blood pressure
• are taking medicines for HIV or AIDS such as ritonavir, indinavir, saquinavir, nelfinavir or atazanavir
• are taking medicines for fungal infections such as ketoconazole, itraconazole or voriconazole or certain antibiotics for bacterial infections, such as clarithromycin or telithromycin
• have a serious cardiac problem
• have had a stroke or heart attack in the last 6 months
• have low blood pressure or high blood pressure not controlled by medicines
• have chest pain (angina) or you get chest pain during sexual intercourse
• have a serious liver or kidney problem
• have loss of vision in one eye due to not enough blood getting to your eye (non-arteritic ischemic optic neuropathy [NAION])
• have a family history of certain serious eye problems (such as retinitis pigmentosa).
• are taking riociguat

Your doctor must take special care before starting you on Spedra/Avanafil if you:

• Have heart trouble, as it may be risky for you to have sexual intercourse
• Suffer from priapism, a persistent erection lasting 4 hours or more. This can happen if you have conditions like sickle cell disease, multiple myeloma or leukaemia.
• Have a physical condition that affects the shape of your penis (such as angulation, Peyronie"s disease or cavernosal fibrosis)
• Have any bleeding disorder or active peptic ulceration.

If any of the above applies to you, talk to your doctor or pharmacist before taking Spedra/Avanafil. Check with your doctor or pharmacist if you are not sure.

If you experience a sudden decrease or loss of vision or hearing, stop taking Spedra/Avanafil and contact your doctor immediately.

Please tell your doctor if you are using, have recently used or might use any other medicines, including medicines obtained without a prescription. Some medicines may cause problems, especially these:

• Nitrates, medicines for chest pain (angina) such as amyl nitrite or glyceryl trinitrate. Spedra/Avanafil has been shown to increase the effects of these medicines and severely lower your blood pressure
• Medicines for HIV or AIDS such as ritonavir, indinavir, saquinavir, nelfinavir or atazanavir
• Medicines for fungal infections such as ketoconazole, itraconazole or voriconazole
• Certain antibiotics for bacterial infections, such as clarithromycin or telithromycin
• Alpha-blockers – for prostate problems or for lowering your high blood pressure
• Medicines for an irregular heartbeat ("arrhythmia") such as quinidine, procainamide, amiodarone or sotalol
• Antibiotics for infections such as erythromycin
• Phenobarbital or primidone – for epilepsy
• Carbamazepine – for epilepsy, to stabilise your mood or for certain types of pain
• Other medicines that may reduce the breakdown of Spedra/Avanafil in the body including amprenavir, aprepitant, diltiazem, fluconazole, fosamprenavir, and verapamil
• Riociguat

Do not use Spedra/Avanafil together with other treatments for erectile dysfunction, such as Viagra/Sildenafil, Cialis/Tadalafil or Vardenafil.

Other considerations:

• You can take Spedra/Avanafil with or without food – but preferably not after a heavy or high-fat meal as this may delay the effect
• Grapefruit juice can increase exposure to the medicine and should be avoided within 24 hours prior to taking Spedra/Avanafil.
• Drinking alcohol at the same time as taking Spedra/Avanafil may increase your heart rate and lower your blood pressure. You may feel dizzy (especially when standing), have a headache or feel your heart beating in your chest (palpitations). Drinking alcohol may also decrease your ability to get an erection.
• If you feel dizzy, or if your vision is affected after taking Spedra/Avanafil don’t drive, cycle or operate any tools or machines

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