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
Do not use Spedra/Avanafil together with other treatments for erectile dysfunction, such as Viagra/sildenafil, Cialis/tadalafil or vardenafil.
- 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