Your Online Medical Consultation


Are you male?

Do you persistently have problems getting or keeping an erection when sexually aroused?

Have you seen a doctor or nurse about your erectile dysfunction?

Have you used this medication at this strength in the past AND did not suffer from any side effects?

Side effects would include:

  • Blurred vision
  • Chest pain
  • Dizziness
  • Feeling sick
  • Headaches
  • Hot flushes, including facial flushing
  • Indigestion
  • Stuffy nose
  • Erection that lasts more than 4 hours


Are you currently experiencing any emotional or psychological problems?

Have you ever experienced any of the following?

  • Dizziness or light-headedness immediately after standing
  • Severe breathlessness, clamminess/sweatiness whilst exercising or doing a strenuous activity
  • Pain, heaviness or tightness in your chest that may have spread into your left shoulder/arm or into your neck

Have you ever been advised by a doctor or health care professional to avoid strenuous exercise or do you experiences shortness of breath and/or chest pain when walking for more than 5 minutes at a fast pace?


Have you had your blood pressure checked in the last 6 months?

This can often be done in your GP waiting room or at the local pharmacy

Was your last blood pressure reading between 100/60-140/90?

If you are unsure, you can often check your blood pressure in a GP waiting room or at your local pharmacy.

Do you have any allergies to any medication or substances?

Answer ‘no’ if this does not apply to you

Are you taking any medication, or have you recently finished a course of medication?

Such as:

  • GTN Glyceryl tri-nitrate
  • Nitrate spray, tablet, patches, gels, or creams
  • Nicorandil
  • Riociguat for pulmonary hypertension

This includes medication prescribed by your doctor, bought in the pharmacy or online, herbal supplements, recreations drugs

This includes tablets, patches, inhalers, injections, contraception and all other forms of medication

Answer ‘no’ if this does not apply to you

Do you suffer from any medical problems?

Such as:

  • An erection that has lasted more than 4 hours
  • A physical condition affecting the shape of the penis (e.g. angulation, Peyronie’s disease, cavernosal fibrosis)
  • Diabetes
  • Eye problems such as degenerative retinal disorders or macular degeneration?
  • Heart problems such as angina, cardiomyopathy, uncontrolled blood pressure, irregular heart rhythm, heart attack, heart operation
  • Kidney disease
  • Liver disease
  • Stroke


This also includes previous admissions to the hospital or any surgeries

Answer ‘no’ if this does not apply to you


I am NOT taking any nitrate medication.

Nitrate medication is often taken for chest pain/angina. It an be administered as a spray, tablet or patch. Included glycerol-tri-nitrate, GTN, isosorbide mononitrate, isosorbide dinitrate, nicorandil etc.
This medication can cause a fatal interaction with treatment for erectile disfunction medication.

I am aware that I should not take any combination of erectile dysfunction medication at the same time

I understand that I should seek immediate medical advice of I have a continuous erection for 4 hours or more


We strongly recommend that you inform your GP of any treatment you receive. Would you like e-Surgery to do this in your behalf?

Please write the name of your GP surgery below if you want us to let them know.

This will ensure that any new medication started by your GP will not interact with this treatment.

Answer ‘no’ if you do not want us to inform your GP

I agree to the following

  • I am 18 years of age or older
  • This treatment is for my use only
  • I confirm that I have understood all the questions asked and have answered all questions to the best of my knowledge.
  • I have read the patient information leaflet supplied with this medication
  • I will contact e-Surgery and inform my GP if I experience any side effects from this treatment or if there are any changes to my health
  • I have answered all questions truthfully and accurately.

I have read, understood and agree to abide by terms and conditions and privacy policy and cookie policy of e-Surgery

What is this?

Your answers form the basis of your medical consultation. It is important you are open and honest, so our doctors can ensure this medication safe and effective for you

Avanafil (Spedra)

Spedra is one of the newest erectile dysfunction drugs. It’s main advantage is the speed of onset, Spedra works in just 15min after ingestion.

Onset of Action: 15-30min
Duration of Action: ~5 Hours
Read our Expert Insight article for more information on how Spedra compares to other ED medication: The Hard Truth About ED Medication

Choose from your desired treatment below, and complete a short questionnaire to help our GPs make sure this medication is safe for you to take. All prices include a private prescription from one of our experienced GPs. Please only choose the 200mg dose if you have already tried the 100mg and found the response to be inadequate. 


Important Facts about Spedra (Avanafil)

Most frequent questions and answers about using Spedra (avanafil) for erectile dysfunction treatment

Spedra contains the active substance avanafil, which is a PDE type 5 inhibitor. It is a form of treatment for men suffering from erectile dysfunction (impotence). This is when you cannot get or keep a hard, erect penis suitable for sexual activity.

Spedra (Avanafil) is a form of erectile dysfunction treatment for adult males.

It works by helping the blood vessels in your penis to relax. This increases the blood flow to your penis, helping it stay hard and erect when you get sexually excited. 

You can NOT take Spedra if:

  • You are allergic to any of the ingredients
  • You are taking nitrate medicines
  • You are taking HIV/AIDS medication
  • You are taking fungal infection medication
  • You have a serious cardiac problem
  • You have had a stroke or heart attack in the last 6 months
  • You have low/high blood pressure
  • You have chest pain
  • You have a serious liver or kidney problem
  • You have loss of vision in one eye due to not enough blood in your eye
  • Certain serious eye problems run in your family
  • You are taking riociguat

If you are not sure of any of the terms above, you should discuss with your doctor.


Tell your doctor or pharmacist if you are taking, or have recently taken any other medication. Below is a list of medications that you should be aware of, as they may interfere with Spedra (avanafil):

  • Alpha blockers
  • Arrhythmia medication
  • Antibiotics
  • Phenobarbital or primidone
  • Carbamazepine
  • CYP3A4 inhibitors
  • Riociguat

Spedra should not be used together with other erectile dysfunction treatments. 

Spedra should be taken only by adult males above the age of 18, with diagnosed erectile dysfunction.

If you have heart trouble, priapism, penis deformation or a bleeding disorder, you should talk with your doctor or pharmacist before taking Spedra (avanafil).

If you take too many Spedra tablets then you should tell your doctor straight away. 

Grapefruit juice can increase exposure to the medicine and should be avoided within 24 hours prior to taking Spedra.

Always take Spedra tablets exactly as prescribed by your doctor or pharmacist. If you aren’t sure, always ask a doctor or pharmacist first. 

The recommended Spedra (Avanafil) dose is a 100 mg tablet, but you may have been given a 200 mg Spedra tablet, if a 100 mg Spedra tablet was deemed too weak, or a 50 mg Spedra tablet if the 100 mg tablet was deemed too strong. 


You should take Spedra 15-30 minutes before you have sexual intercourse. 

Spedra can be taken with or without food, but if taken with food, it may take longer to work. 

Drinking alcohol at the same time as taking Spedra 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.

Always take Spedra tablets exactly as prescribed by your doctor or pharmacist. If you aren’t sure, always ask a doctor or pharmacist first. 

We recommend to start with the 100mg dose if it is your first time trying Spedra. If you experience side effects you should reduce to the 50mg dose. If you find the 100mg is not strong enough, you can try the 200mg dose. 

Spedra is commonly taken in an effort to increase sexual performance. However, due to the risk of side effects it should only be used to treat erectile dysfunction. 

As with any form of medication, Spredra tablets have side effects. For a full list of side effects, please read the Patient Information Leaflet of Spedra (Avanafil).  Below are a few of the common side effects of taking Spedra Tablets :

  • Headache
  • Flushing
  • Nasal congestion

For a full list of side effects, please read the Patient Information Leaflet of Spedra (Avanafil).

Keep Spedra tablets out of the sight and reach of children.

Do not use Spedra (Avanafil) after the expiry date which is stated on the blister and carton after “EXP”.

Spedra tablets (Avanafil) do not require any special storage conditions.

Do not throw away any Spedra tablets via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

Click here for a PDF copy of the patient information leaflet

Learn More About Erectile Dysfunction

Most frequent questions and answers about erectile dysfunction

Erectile dysfunction (ED), sometimes called impotence is a common issue in males. ED is the inability to achieve/maintain an erection with is suitable enough to carry out sexual activities.

It is an age associated condition, and is treatable and thus normally nothing to worry about.

Erectile dysfunction is not neccessarily a curable disease; however, it is more certainly treatable.

  • Oral Drugs 
  • Injection Therapy
  • MUSE (medicated urethral system for erection)
  • Vacuum pumps
  • Hormonal supplements 
  • Penile implants
  • Sex therapy 

Erection problems can be caused by a variety of things.

Most men may occasionally fail to achieve or maintain an erection due to stress, tiredness, drinking too much alcohol or anxiety. If you are unable to achieve or maintain an erection regularly, it could be a sign of an underlying health condition. If this is the case, you should visit your GP or a sexual health clinic.

Possible causes of erectile dysfunction include: 

  • Narrowing of penis blood vessels
  • High cholesterol
  • Hormone problems
  • Other medication interfering with your erection
  • Diabetes
  • Spinal cord injury
  • Prostate gland surgery

In order to get harder and stronger erections, after being diagnosed with erectile dysfunction, there are a series of medications available:

  • Oral Drugs – Work by increasing the blood flow to the penis by relaxing penile blood vessels.
  • Injection Therapy – An injectable form of medication, which is inserted into the penis just before sexual activity.
  • MUSE (medicated urethral system for erection) – A pill that you inject in the tip of the penis.
  • Vacuum pumps – A vacuum pump is placed over the penis, causing increased blood flow. A constrictor ring is then placed as the base of the penis to trap the blood, sustaining a hard erection for sexual activity.
  • Hormonal supplements  – If low testosterone levels is the cause of ed, testosterone can be given.
  • Penile implants – Used as a last resort to mechanically increase blood flow
  • Sex therapy – Used if the cause of ed is psychological. 

Natural long-term solutions to helping erectile dysfunction can include exercise or lifestyle changes. Decreased circulation can be caused by fatty diets and low levels of exercise. Therefore, eating healthy and carrying out more exercise can help with ED.

Sex therapy is a natural method of treating ED, and is especially effective as dealing with ED caused by psychological effects.

Erectile dysfunction pills, otherwise known as blue pills, are a form of ED medication that relax the blood vessels in your penis to increase blood flow. This increased blood flow helps for you to achieve and maintain an erection.

A range of ED pills are available, most of which require a prescription. For example, Viagra (sildenafil), Cialis (tadalafil), Spedra (avanafil) and Levitra. Viagra connect is the only over-the-counter ED medication, which does not require a prescription. 

Only males can get erectile dysfunction, as it is a condition relating to the penis. 

It is often psychological in origin and therefore males with high stress levels may be more likely to get erectile dysfunction. Other risk factors can include diabetes, obesity, spinal cord injury or prostate gland surgery.

ED is an age related condition, affecting about half of men by age 40.

Erectile dysfunction is the consistent inability to achieve or maintain a hard erection. Most men may occasionally fail to achieve or maintain an erection due to stress, tiredness, drinking too much alcohol or anxiety. 

If you suspect that you have erectile dysfunction, you should consult with your GP or visit a sexual health clinic to discuss treatment options.

You can find out more information about erectile dysfunction on a variety of websites. These include the NHS website, NHS inform, Mayo clinic and WebMD.

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