Features of Stendra (Spedra)
Stendra (Spedra) is the fourth drug developed for treating ED, characterized by its large white diamond-shaped tablets.

Effects of Stendra (Spedra)
The main ingredient of Stendra (Spedra), avanafil, works by inhibiting PDE-5 (phosphodiesterase type 5), an enzyme that contributes to erectile dysfunction.

PDE-5 enzyme breaks down cyclic guanosine monophosphate (cGMP), which is essential for achieving an erection.

When cGMP is broken down, an erection cannot occur, a condition known as ED (erectile dysfunction).

Avanafil inhibits the PDE-5 enzyme, dilates blood vessels around the penis, and relaxes the muscles in the internal penile tissue (known as the corpus cavernosum).

This action expands blood vessels and relaxes muscles, allowing more blood to flow easily into the internal penile tissue (corpus cavernosum), thereby facilitating an erection.

How Long Does Stendra (Spedra) Last?
The effects can last for 3 to 6 hours, but taking this medication does not force an erection; it occurs only when you are sexually stimulated or aroused.

Dosage of Stendra (Spedra)
This website offers tablets in two strengths—100 mg and 200 mg—for purchase.

If you are taking it for the first time, please use a pill cutter or similar tool to split the tablet and start with half a dose.

History of Stendra (Spedra)
The main ingredient of Stendra (Spedra), avanafil, was developed by Mitsubishi Tanabe Pharma as a treatment for erectile dysfunction (ED).

Subsequently, the global production and sales rights (excluding some Asian regions) were transferred to an overseas manufacturer, and the drug was approved by the U.S. Food and Drug Administration (FDA) in April 2012.

In March 2014, the Menarini Group launched avanafil under the brand name Stendra (Spedra) in the European market.

Other Information
Stendra (Spedra) can be taken without regard to meals. Compared to other ED medications, it offers the same onset time and erection strength as Viagra and is as effective or faster-acting as Levitra.

Related Pages for Stendra
List of Medications for Erectile Dysfunction
・ED Treatment Medications

Timing of Administration
The correct way to take Stendra is on an empty stomach, approximately 30 minutes to 1 hour before sexual activity.

After the first dose, wait at least 24 hours before taking another dose.

Recommended Dosage
The Stendra sold on this website comes in two strengths: 100mg/200mg. Using a pill splitter, these tablets can be divided to take half doses.

If the 100mg dose does not show noticeable effects, you may increase it to 200mg. Adjust the dosage according to your individual needs.

Some users take 2-3 times the recommended dosage for stronger effects, but this does not enhance efficacy.

The maximum single dose for sexual activity should not exceed 200mg.

For individuals with smaller body frames, 100mg may be sufficient.

Stendra containing 200mg of the active ingredient is more suitable for larger or taller men.

Recommended Initial Dosage
For first-time users of avanafil (the main component of Stendra), a starting dose of 50mg is advised.

Food Interactions
Although Stendra is less affected by food, it is not entirely immune. Consuming it with high-fat milk may form a stomach lining barrier that hinders absorption.

Therefore, it is recommended to take it 30 minutes before meals for optimal absorption of avanafil and reduced food interference.

If taken after meals, wait approximately 2 hours.

Incomplete digestion of food may affect drug absorption.

For high-fat meals like grilled meat or fried foods, 2 hours may not be enough for complete digestion, so fasting administration is preferred.

Once the medication is absorbed, normal eating can resume.

Alcohol Interactions
Although it can be taken with alcohol, vasodilation effects may accelerate intoxication. Avoid excessive drinking.

Contraindications
・Individuals with cardiovascular diseases (cerebrovascular disorders) who are not suitable for sexual activity

・Patients with severe liver impairment

・Patients with severe kidney dysfunction or undergoing dialysis

・Individuals with hypotension or uncontrolled hypertension

・Those who have undergone heart surgery in the past 6 months or have a history of stroke/myocardial infarction

・Patients with blood disorders such as multiple myeloma, leukemia, or sickle cell anemia

※Strictly follow your doctor's instructions for use

Main Side Effects
The main side effects include decreased blood pressure due to vasodilation, eye congestion, facial flushing, palpitations, nasal congestion, etc.

These are believed to be caused by vasodilation, and the side effects tend to diminish when increased sexual desire leads to enhanced blood flow to the penis.

Specific Symptoms
Specific symptoms include visual abnormalities, such as the sensation of wearing blue-tinted glasses or difficulty distinguishing between blue and green.

In most cases, this is temporary and not problematic, but if vision severely deteriorates, there is a risk of developing non-arteritic anterior ischemic optic neuropathy (NAION).

If you experience sudden vision loss or impairment, consult an ophthalmologist or another specialist.

Additionally, if you experience a painful erection lasting more than four hours, you may have priapism.

If your erection persists for more than four hours, seek immediate medical attention.

※What is Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION)?
When the blood supply to the optic nerve is cut off, the optic nerve cells begin to malfunction or die.
This condition is called ischemic optic neuropathy.
The causal relationship remains unclear, but there is reportedly a minor association among individuals taking erectile dysfunction medications.

※What is Priapism?
A prolonged erection, also known as priapism, refers to a condition where the penis remains erect and cannot or has difficulty returning to its normal state.
It is also referred to as penile rigidity.
The primary cause is believed to be a rupture in the penile cavernous artery system.
If your erection does not subside and persists continuously for four hours, seek immediate medical attention.

Contraindicated for Simultaneous Use
Drugs that must not be used simultaneously are those incompatible with Stendra and should not be taken together.

・Nitrates and nitric oxide donors
(Nitroglycerin, amyl nitrite, isosorbide mononitrate)
Simultaneous use may enhance the blood pressure-lowering effect.

・Amiodarone hydrochloride
(Ancaron tablets)
Simultaneous use may enhance the QTc prolongation effect of amiodarone hydrochloride.

・CYP3A4 inhibitors
(Antifungal drugs, antibiotics, HIV medications, telithromycin, nefazodone, ketoconazole, itraconazole, ritonavir, saquinavir, nelfinavir, atazanavir, clarithromycin, telithromycin, etc.)
Blood concentration of this drug may increase, and its half-life may be prolonged.

Precautions for Combined Use
Drugs that require caution when used in combination with Stendra.

・Grapefruit (including juice)
The furanocoumarin component in grapefruit inhibits the action of metabolic enzymes in the body, slowing drug breakdown.
As a result, more of the drug may be absorbed than necessary, leading to stronger effects and side effects.

・CYP3A4 inhibitors and inducers
Ritonavir, saquinavir, darunavir

・Antihypertensive drugs
Stendra has blood pressure-lowering effects. Simultaneous use with antihypertensive drugs may cause symptoms such as temporary dizziness or lightheadedness.

Reference Sites
In addition to product descriptions from the country of sale, we refer to the following websites for dosage instructions, side effects, contraindications, and precautions when used with other drugs.
・Avanafil - Wikipedia

・Store in a cool, dry place away from direct sunlight.

・Keep out of reach of children.

・Do not transfer from the original container to prevent accidental ingestion or product deterioration.

・When using single-dose packaging multiple times, store remaining medication with minimal air exposure and consume within 2 days.

・Do not use products past their labeled expiration date.

Menarini Group