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Dec 13, 2021
5 min read

Viagra vs. sildenafil (generic Viagra): what’s the difference?

Viagra is probably the most well-known prescription medication that treats ED. Sildenafil is the active ingredient in Viagra and is sold without the brand name, sometimes called “generic Viagra” or simply “sildenafil.” These medicines have the same active ingredient and act the same way in the body. But depending on which one you get, the dosages available and the price you’ll pay can differ significantly. Read on to learn more.

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Viagra is to erectile dysfunction what Kleenex is to the common cold. They’re household names, but they’re brands, and they’re each just one of many options available. But while opting for the brand name when you have a runny nose probably won’t cost you more than a couple extra bucks, the brand name Viagra can differ significantly from the generic option, sometimes costing a difference of over $50—per pill. Ready to consider the alternatives? Here’s what you need to know.

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Viagra vs. generic Viagra (sildenafil)

Viagra, and its generic version, sildenafil (see Important Safety Information), are just a couple of the prescription medications available to treat erectile dysfunction. These two medications differ in two main ways: first, generic sildenafil tablets may not be produced by Pfizer, and second, they cost a lot less.

Although Viagra, or “the little blue pill,” reigns supreme in people’s minds as the go-to ED medication, you’ve likely seen other popular names such as Cialis (generic name tadalafil; see Important Safety Information) and Levitra (generic name vardenafil). These ED treatments all belong to a class of drugs called PDE-5 inhibitors, which work by improving blood flow into the penis to give you harder, longer-lasting erections.

What is Viagra?

Viagra is the brand name of sildenafil, which is manufactured and sold by Pfizer. The active ingredient is sildenafil citrate. Viagra comes in three doses: 25 mg, 50 mg, and 100 mg. 

This ED treatment is taken as needed between 30 minutes and 4 hours before you plan to have sex. Though Viagra tablets can start to take effect and help you achieve an erection in just 12 minutes, the medication reaches peak levels in your body after 30–120 minutes (Eardley, 2002). It usually lasts in your system for around 6 hours total, but your age, health, and diet all affect the exact amount of time during which it will work. 

Also, keep in mind that Viagra doesn’t give you an instant hard-on. You need to be aroused for it to work. Getting aroused tells the blood to go to your penis, and Viagra works by keeping the flow going once it starts.

Like stories you may have heard, Viagra was initially developed to treat another condition entirely. Pfizer developed sildenafil to treat high blood pressure but noticed something interesting during clinical trials: Male study participants had an easier time getting erections. 

The happy accident was quite lucrative for the company. In 1998, the little blue pill was approved by the U.S. Food and Drug Administration (FDA) for the treatment of ED, and by the end of 2005, more than 27 million men worldwide (17 million of them in the United States) had been prescribed Viagra (McMurray, 2007).

Sildenafil became available as a generic medication in December of 2017. Until then, only two companies (Pfizer and Teva Pharmaceuticals) could produce the drug. This change allowed other companies to manufacture and sell “generic Viagra.”

What is generic Viagra?

“Generic Viagra” is typically called sildenafil, and it has the same active ingredient and dosage as Viagra, but it is not sold under the brand name. These generic drugs and Viagra contain the same active ingredient (called sildenafil in both cases) and are bioequivalent, which means they act the same way and produce the same results in the body. 

So what’s the difference between Viagra and generic Viagra or sildenafil? Mostly, it’s the price tag. The brand name one costs more. A lot more. A single dose of brand-name Viagra can cost as much as $70, while you can get the generic version for $3 a dose, or even less (GoodRx, n.d.). 

Also, the pills themselves might look a little different. The brand name will have “Pfizer” etched into it in tiny letters and usually comes as a diamond-shaped blue pill. The generic can be white or blue and comes in various shapes. Depending on the company manufacturing it, it can have different printing on it. 

Still, when you get Viagra, whether it’s generic or brand name, make sure you’re getting it from a reputable pharmacy. In the United States, it always requires a prescription. That’s important because if someone offers you Viagra without a prescription, it’s likely fake. While fake versions may contain sildenafil, too, they have no regulation over the quantities of the drug they put in each pill, meaning it could contain much less, or worse, much more of the active ingredient than it should. Fake pills have also been found to contain a range of other undeclared ingredients, like drywall, antibiotics, and even printer ink (FDA, n.d.).  

What is sildenafil?

Sildenafil is the active ingredient in Viagra and “generic Viagra,” but to make matters more confusing, those aren’t the only medications that use it. That’s because, in addition to treating erectile dysfunction, sildenafil is approved by the FDA for the treatment of another condition, too. Sildenafil, under another brand name (Revatio; see Important Safety Information), is used to treat pulmonary arterial hypertension (PAH), a rare lung disorder (Barnett, 2006).

So now you’ve got three versions of sildenafil: Viagra (the brand name), sildenafil (the generic), and Revatio, the version used to treat PAH. And while the first two options come in three doses: 25 mg, 50 mg, and 100 mg, Revatio comes in increments of 20 mg. And Revatio can sometimes be even cheaper than regular generic Viagra.

While you probably won’t be able to take your regular prescription for Viagra to the pharmacy and get Revatio to save yourself some dough, your healthcare provider may prescribe you Revatio off-label to keep your bucks in the bank. 

In addition to the 20 mg dose Revatio comes in, these can also be prescribed in 40 mg, 60 mg, 80 mg, and 100 mg doses. Considering this form of the drug for the treatment of ED also makes it easier to work with healthcare providers on finding the right dose to maximize the effects of sildenafil that make erections easier while minimizing potential side effects.

Which is right for me?

Since they have the same active ingredient, Viagra and generic Viagra (sildenafil) help combat erectile dysfunction in the same way. It also means they have the same potential side effects, such as low blood pressure, nasal congestion, indigestion, headaches, facial flushing, back pain, and sudden loss of hearing or vision. 

They both may also cause priapism, a persistent and painful erection that can last more than four hours. No matter which drug you start, you’ll need to tell your healthcare provider about any other medications or supplements you’re taking. Viagra and generic sildenafil have the same drug interactions with other medications, like nitrates, for example.

Choosing between these erectile dysfunction medications comes mostly down to cost. That’s a question for you, your insurance provider, and your budget. A healthcare professional can help you figure out which dose of either is right for you.

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References

  1. Barnett, C. F. & Machado, R. F. (2006). Sildenafil in the treatment of pulmonary hypertension. Vascular Health and Risk Management, 2(4), 411–422. doi: 10.2147/vhrm.2006.2.4.411. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994020/
  2. Eardley, I., Ellis, P., Boolell, M., & Wulff, M. (2002). Onset and duration of action of sildenafil for the treatment of erectile dysfunction. British Journal of Clinical Pharmacology, 53. doi: 10.1046/j.0306-5251.2001.00034.x Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874251/
  3. FDA. MedWatch: FDA Safety Information & Adverse Event Reporting Program. U.S. Food and Drug Administration. Retrieved Dec. 13, 2021, from https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program. 
  4. GoodRx: ​​Viagra prices, Coupons & Savings Tips. (n.d.). Retrieved Dec. 13, 2021, from https://www.goodrx.com/viagra?dosage=25mg&form=tablet&label_override=sildenafil&quantity=10&sort_type=popularity. 
  5. McMurray, J. G., Feldman, R. A., Auerbach, S. M., DeRiesthal, H., & Wilson, N. (2007). Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction. Therapeutics and Clinical Risk Management, 3(6), 975–981. Retrieved from https://www.dovepress.com/therapeutics-and-clinical-risk-management-journal
  6. Rosen, R. C., Fisher, W. A., Eardley, I., Niederberger, C., Nadel, A., & Sand, M. (2004). The multinational Men’s Attitudes to Life Events and Sexuality (MALES) study: I. Prevalence oSf erectile dysfunction and related health concerns in the general population. Current Medical Research and Opinion, 20(5), 607–617. doi: 10.1185/030079904125003467. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15171225/