Revatio® vs. Viagra®: what’s the difference?

Most people have heard of Viagra, a prescription drug used to treat erectile dysfunction (ED). If you’re looking into Viagra and its cost, you may have come across another drug named Revatio. These drugs have the same active ingredient, sildenafil, which may leave you wondering: Is Revatio the same as Viagra, and can it be used for ED?

Keep reading to learn more about Revatio vs. Viagra.  

Viagra is a brand-name prescription drug. The Food and Drug Administration (FDA) first approved “the little blue pill” in 1998 to treat ED. 

ED is the inability to get or keep an erection strong enough to have satisfying sex. It is caused by a lack of blood flow to the penis. Any condition or factor that limits blood flow can lead to ED, among them (Khera, 2022):

• Diabetes

• High blood pressure

• Obesity

• Cigarette smoking

Also, several types of medications commonly cause sexual side effects. For example, antidepressants and blood pressure meds frequently cause ED and low sex drive (libido). The good news is that Viagra effectively treats ED in up to 70% of men who take it (Khera, 2022).

Besides ED, Viagra also has off-label uses, meaning healthcare providers can prescribe it for conditions outside of its FDA-approved uses, such as (Smith, 2022):

• Female sexual arousal disorder, which causes a lack of interest in sex

• Altitude sickness: headache, dizziness, shortness of breath, and other symptoms that occur after traveling to higher altitudes, where the air pressure and oxygen levels are lower

• Reynaud’s phenomenon, a condition that causes decreased blood flow to the fingers in response to cold

Revatio is a brand-name prescription drug, approved by the FDA in 2005 to treat symptoms of a condition called pulmonary arterial hypertension (PAH) (FDA, 2018). 

A type of hypertension (high blood pressure), PAH is a lung condition that affects the arteries in the lungs. It also affects the heart. Symptoms of PAH get worse over time, especially with physical activity like walking. Symptoms may include (Oldroyd, 2022):

• Shortness of breath

• Dizziness, which may lead to fainting

• Chest pain or pressure 

• Bluish tint of the lips or skin

• Swelling in the lower legs and abdomen

Revatio is not a cure for PAH, but it can help reduce the severity of these symptoms and improve the person’s ability to be physically active (Galiè, 2005).

Can you use Revatio for ED?

Your provider may prescribe Revatio off-label for ED and instruct you to take it as needed before sexual activity. If your healthcare provider deems it appropriate, it is safe for you to take it this way. Keep in mind that 50 milligrams (mg) is the most common dose of sildenafil that works for ED, and Revatio comes in strengths of 5 mg and 20 mg, so you might have to take multiple tablets to reach the recommended dose. You should not take more sildenafil than your provider prescribes.

The most common side effects of Viagra are usually temporary. They include (FDA, 2017):

• Headache 

• Flushing (skin reddening)

• Indigestion or upset stomach

• Abnormal vision, such as blue-tinged, distorted, or blurred vision

• Nasal congestion

• Back pain

• Muscle pain

• Nausea

• Dizziness

• Rash

Since the active ingredient in Viagra and Revatio is the same, the most common side effects are very similar and can include (FDA, 2018):

• Nosebleeds

• Headache

• Indigestion

• Flushing 

• Insomnia

• Shortness of breath

• Runny nose

Less commonly, these medications may cause serious side effects. Seek emergency medical care if you have an erection that lasts longer than four hours (priapism), trouble hearing, or sudden vision loss.Note that sildenafil may not be safe for everyone. Your healthcare provider may not prescribe this medication if you have certain medical conditions, such as cardiovascular (heart) disease, low blood pressure, vision problems, sickle cell anemia, or a recent heart attack.

Key similarities between Revatio and Viagra include the following (FDA, 2017; FDA, 2018):

• Same active ingredient—Both Viagra and Revatio contain sildenafil, which is the same thing as sildenafil citrate.

• Same drug class and mechanism of action—Revatio and Viagra belong to a class of drugs called phosphodiesterase-5 or PDE-5 inhibitors. 

• Same manufacturer—Pfizer is the pharmaceutical company behind both brands. The generic versions, however, are made by different manufacturers.

• Same interaction risks—For more details, see the section on potential interactions below.

• Similar side effects—Revatio and Viagra also cause similar side effects. The lists of common side effects aren’t identical because these lists come from clinical trials in which the medications were studied separately in different patient populations. 

To treat ED, Viagra works by increasing chemicals that relax the smooth muscle in the blood vessels of the penis. This increases blood flow to the penis when sexual stimulation occurs, helping the penis to become and stay erect. Other PDE-5 inhibitors include Cialis (tadalafil), Levitra (vardenafil), and Stendra (avanafil). 

To treat PAH, Revatio works by increasing chemicals that relax the lung’s blood vessels. This allows blood to flow more efficiently within your lungs, lowering blood pressure. Revatio helps improve the ability to exercise (such as climbing stairs) in people with PAH.

While Revatio and Viagra have a lot in common, there are some differences, including (FDA, 2017; FDA, 2018):

• Approved uses—The FDA approves Revatio to treat pulmonary arterial hypertension, while Viagra is approved to treat erectile dysfunction.

• Forms—Viagra comes only as an oral tablet, but providers may prescribe Revatio as an oral tablet, an oral liquid suspension, or give it as an injection into your vein.

• Tablet strengths—Revatio tablets come in 5 mg and 20 mg. Viagra comes in three strengths: 25 mg, 50 mg, and 100 mg.

• Dosing—Viagra is typically taken as one dose as needed, one hour before anticipated sexual activity. The maximum dosage of Viagra is one dose per 24 hours. In contrast, Revatio is usually taken three times daily, long-term, for pulmonary hypertension.

• Cost—The costs of Revatio and Viagra vary widely. The price you’ll actually pay depends on your pharmacy, the quantity and strength, and if you have an insurance plan that covers the drug. Coupons and discount programs are also available to those eligible. 

Sildenafil (the active ingredient in both Viagra and Revatio) carries serious interaction risks. You should not take Revatio, Viagra, or generic sildenafil with (FDA, 2017; FDA, 2018):

• Nitrates, medications to prevent or treat angina (chest pain), which work by widening blood vessels. Taking nitrates too close to sildenafil may cause a life-threatening drop in blood pressure. Examples of nitrates include nitroglycerin, isosorbide mononitrate, and isosorbide dinitratem) and the recreational drug amyl nitrite (also known as “poppers”).

• Soluble guanylate cyclase (sGC) stimulator drugs, which are used to treat PAH. An example is riociguat (Adempas). Combining riociguat and sildenafil may cause an unsafe drop in blood pressure.

Other medications may interact with sildenafil, and your provider may monitor you closely or adjust your dosage. You should also limit or avoid grapefruit and grapefruit juice while taking sildenafil. The combination may increase the risk of side effects.  

There is no better or worse when comparing these two drugs. Which drug is more appropriate for you depends on several factors, like the condition for which you’re taking the medication. For personalized medical advice, talk to a healthcare provider.

The table below summarizes some of the key differences and similarities between Revatio and Viagra:

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

July 20, 2022

Written by

Patricia Weiser, PharmD

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.