Does Spedra work better than Viagra? Not on the evidence so far — it works sooner, not better. Spedra (avanafil) is taken about 15 to 30 minutes before sex (Spedra CMI), Viagra (sildenafil) about one hour before (Viagra CMI). In the largest comparison of trials, avanafil 100 mg worked less well than sildenafil 50 mg, with a similar rate of side effects (Chen et al., 2015). Both are registered in Australia and both need a prescription.
How do Spedra and Viagra compare side by side?
From the Australian consumer medicine information for each, and the ARTG:
| Spedra | Viagra | |
|---|---|---|
| Medicine | avanafil | sildenafil |
| Usual dose | 100 mg; 50 mg to 200 mg | 50 mg; 25 mg to 100 mg |
| When to take it | About 15 to 30 minutes before sex | About one hour before sex |
| With food | With or without food; a meal may delay it | Slower after a heavy meal |
| Grapefruit juice | Avoid in the 24 hours before a dose | Not named on the leaflet; a study advises avoiding it |
| How often | No more than one dose in 24 hours | |
| On the ARTG | Spedra 50, 100 and 200 mg, since 2016 | Viagra 25, 50 and 100 mg, since 1998 |
Does Spedra work faster than Viagra?
On the label, yes, by about half an hour. On an empty stomach, Spedra reaches its highest level in the blood within 30 to 45 minutes (Spedra product information); Viagra "normally takes between half an hour and one hour" to start working (Viagra CMI). In a trial where men tried for sex about 15 minutes after the tablet, 25.9% of attempts succeeded on Spedra 100 mg against 14.9% on placebo (Spedra product information), so a fast start is possible, not assured. Australian Prescriber notes that "in some men, erection occurs 20 minutes after a 200 mg dose" (Australian Prescriber, 2019).
Does Spedra work better than Viagra?
Probably not, though the trials disagree. A network analysis of 82 trials with 47,626 men compared starting doses: sildenafil 50 mg had the greatest effect, while avanafil 100 mg had "similar overall adverse events" but "a markedly lower global efficacy" (Chen et al.). Australian Prescriber read the same analysis as showing that "avanafil appears to have lower efficacy relative to sildenafil", though the confidence intervals overlap.
Direct comparisons are few. In a trial in India of 220 men, avanafil 100 mg did better than sildenafil 50 mg on an erection score after 8 and 12 weeks and acted sooner; two of its authors were employees of the drug company Zydus Healthcare (Kumar et al., 2022). In 160 men after prostate cancer surgery, avanafil 200 mg and sildenafil 100 mg scored much the same over six months, with firmer erections on sildenafil (Della Camera et al., 2020). In Spedra's main trial, 57% of attempts at sex succeeded on 100 mg, against 27% on placebo (Spedra product information). Tadalafil against sildenafil is a separate question: tadalafil vs sildenafil.
Does Spedra have fewer side effects?
Possibly, depending on the dose. Australian Prescriber says avanafil "has a lower frequency of adverse effects, depending on the dose", and in the prostate-surgery study side effects affected 5% of men on avanafil against 20% on sildenafil (Della Camera et al.). The common ones are much the same: for Spedra, headache, flushing, dizziness, cold and flu symptoms, back pain and indigestion (Spedra CMI); for Viagra and the rest of its class, headache, flushing, nasal congestion and indigestion (healthdirect).
The main warnings match. Neither may be taken with nitrates, amyl nitrite ("poppers") or riociguat, and Spedra must not be taken with certain medicines for HIV, fungal infections and bacterial infections (Spedra CMI; Viagra CMI; EMA — Viagra). Grapefruit juice "should be avoided within 24 hours prior to taking SPEDRA" (Spedra CMI); for sildenafil, a study found grapefruit raised the amount absorbed and advised against it (Jetter et al., 2002).
Does Spedra last longer than Viagra?
No label says so. The effects of Viagra can last up to 4 hours (healthdirect — Sildenafil); neither the Spedra CMI nor its product information gives a figure for how long it keeps working. For a window of up to 36 hours the medicine is Cialis, set against Viagra and vardenafil in Viagra vs Cialis vs Levitra. Neither Spedra nor Viagra delays ejaculation: medicines of their class are not an established treatment for premature ejaculation on their own (RACGP). What does is in is there medication to last longer in bed?
Is Spedra available in Australia?
Yes. Spedra 50, 100 and 200 mg tablets have been on the Australian Register of Therapeutic Goods since April 2016 (ARTG — Spedra), and healthdirect lists avanafil (Spedra) among the PDE5 inhibitors available here. "This medicine is only available with a doctor's prescription" (Spedra CMI), as is sildenafil.
The short answer
Spedra can be taken closer to sex than Viagra, but pooled trials put it below sildenafil for effect, with side effects similar or somewhat fewer depending on the dose. The one trial that found it better had drug-company employees among its authors. Which ED medicine suits whom is answered in which erectile dysfunction drug is best?, and other medicines are set side by side in our comparisons of ED medicines.
