Is There a Generic Viagra?
Yes. Viagra, the brand name of the drug sildenafil, is now sold as a generic drug by many manufacturers around the world. Sildenafil is essentially the exact same medication as Viagra, which was the first major erectile dysfunction (ED) medication on the market and is made by Pfizer Inc.
Generic Viagra hasn’t been around very long. Though Pfizer’s patent on the popular ED medication ran out in 2020, Pfizer started making and selling generic sildenafil in 2017. Once other companies could legally sell their own sildenafil tablets in 2020, the options for consumers quickly expanded.
The pharmaceutical giant Pfizer discovered the erectile dysfunction benefits of sildenafil by accident.
Researchers were testing the medication to treat high blood pressure and angina — chest pain associated with heart disease. They found that the medication was especially effective at inducing erections. The Food and Drug Administration approved Viagra in 1998, making it the first oral drug specifically prescribed for erectile dysfunction.
Pfizer was also the first to introduce generic Viagra through a subsidiary called Greenstone. Other companies around the world also manufacture sildenafil pills. Among them are Teva Pharmaceuticals, Aurobindo, Cambia, Mylan, Bristol Labs, and others.
Sildenafil is best known as a treatment for erectile dysfunction, the inability to get or keep an erection. Sildenafil should be taken prior to intercourse with the understanding that its effects last only a few hours.
Sildenafil is also approved for the treatment of pulmonary hypertension (PH) — elevated blood pressure in the arteries of the lungs and in the right side of the heart. Revatio is the brand name of sildenafil prescribed for PH.
Generic sildenafil is always sold as sildenafil. There are currently no other brand names for the drug, aside from Viagra and Revatio.
Sildenafil for ED or PH requires a prescription in the United States. The United Kingdom allows for over-the-counter sales of the drug, in part to discourage the market for fake sildenafil, one of the most commonly counterfeited drugs in the world.
Instead of “the little blue pill,” as Viagra is known, sildenafil is often sold as a little white pill by Pfizer’s competitors. The appearance of the pill doesn’t change its effectiveness or how it works in the body.
While generic sildenafil and Viagra are equally safe and effective, there is one key difference between the medications: cost. Viagra costs around $60 to $70 per tablet, while generic sildenafil can range from under $1 to up to $10 per pill, depending on the manufacturer and dose.
Sildenafil doesn’t cure ED. It treats ED symptoms. Likewise, sildenafil doesn’t cure PH. It just helps control blood pressure in the pulmonary arteries.
Sildenafil is in a class of medications called phosphodiesterase type 5 (PDE5) inhibitors. These drugs restrict the action of phosphodiesterase enzymes (PDEs), which degrade cGMP, a type of molecule that relaxes smooth muscle tissue in the body, such as those in the blood vessels that allow the penis to become erect. Taking sildenafil improves circulation by helping the arteries relax enough to fill more easily with blood.
Sildenafil is quickly absorbed into the bloodstream, reaching maximum concentration in about an hour for most users. Generic Viagra, like other PDE5 inhibitors, can cause a drop in blood pressure, so if you take medications for blood pressure control or you tend to have low blood pressure, ask your doctor if it’s safe to use sildenafil.
Sildenafil doesn’t trigger an erection on its own, nor does it increase sexual desire. Sexual stimulation is still required. However, for most healthy people, sildenafil can make an erection easier to achieve. A 4-year study found that sildenafil is generally safe to use over the long-term.
Sildenafil is available as a tablet in a range of doses. Like Viagra, generic sildenafil is sold in 20-milligram (mg), 25-mg, 50-mg, and 100-mg tablets. The 50-mg dose is standard, though some doctors start patients on a 25-mg dose to see if that is sufficient.
For ED, sildenafil is taken on an as-needed basis, ideally an hour before intercourse. However, it may be effective as soon as 30 minutes before intercourse and may still be effective 3 or 4 hours later.
After 4 hours, the effects of sildenafil tend to wear off. It’s recommended that you take sildenafil no more than once daily.
Sildenafil prescribed for PH is available in 5-mg and 20-mg pills and liquid form. It’s usually taken three times per day.
Sildenafil may cause side effects, most of which are minor and temporary. Some of the most common are:
- headaches
- flushing (feeling of warmth under the skin)
- heartburn
- diarrhea
- insomnia
- tingling in the limbs
- muscle aches
- sensitivity to light
Serious side effects of sildenafil
More serious side effects should prompt an immediate call to your doctor or 911. They include:
- blurry vision or sudden and severe loss of vision
- diminished hearing
- ringing in ears
- dizziness or lightheadedness
- fainting
- shortness of breath
- chest pain
- itching or burning during urination
- rash
- erection that is painful or lasts longer than four hours
Like any powerful medication, sildenafil can have some potentially serious interactions with other drugs.
Combination with certain blood pressure and heart medications can cause changes in blood pressure
In particular, you shouldn’t take sildenafil if you take a nitrate medication for angina or high blood pressure.
If you take other medications for high blood pressure, such as diuretics, ACE inhibitors, or calcium channel blockers, you may be at risk of experiencing a dangerous drop in blood pressure.
This can result in dizziness, headache, fainting or falling, and in severe blood pressure drops, less oxygen moving through your organs.
Don’t take with other ED medications
You should also avoid taking sildenafil with any other ED medications. The combination can lower blood pressure, causing fainting, dizziness, and in some rare cases, heart attack.
Combining with alcohol can affect blood pressure
Alcohol and sildenafil can combine to lower blood pressure too much. You should avoid alcohol if you’re taking sildenafil.
Grapefruit can delay sildenafil’s effect and increase the chance of side effects
The only real food interaction that can occur with generic Viagra is with grapefruit and grapefruit juice. These products can raise the levels of sildenafil in your body, but can also delay the time the drug takes effect.
CP450 drugs increase the chance of side effects and change the effectiveness of sildenafil
Similar to grapefruit, medications known as cytochrome P450 (CP450) inhibitors, inducers, and substrates can delay how long it takes sildenafil to work and can increase your chance of side effects.
CP450 medications include:
- cimetidine
- clopidogrel
- chloramphenicol
- fluvoxamine
- omeprazole
- modafinil
There are a number of different treatments for ED. In addition to medications or other medical interventions, maintaining a healthy lifestyle can impact the success of your ED treatment.
Sildenafil is just one of several ED medications on the market.
Other oral medications
The four major PDE5 inhibitors are:
- sildenafil (Viagra)
- tadalafil (Cialis)
- vardenafil (Levitra)
- avanafil (Stendra)
All of those medications, except avanafil (Stendra), are available as generic medications.
Penis pump
There are some nonpharmacological treatments for ED, including a vacuum erection device, also known as an erectile dysfunction pump.
It works by placing a seal around the end of the penis and attracting blood to the arteries in the penis via air suction.
Surgery and injections
Penile implants and penile injections to treat ED are other options to consider. Talk with a urologist to learn more about treatments you may want to consider.
Generic Viagra, sildenafil citrate, works the same as Viagra, but at a lower cost.
While Pfizer still manufactures the “little blue pill,” other companies, globally and in the United States, make sildenafil that may look different but is still an effective treatment for erectile dysfunction.
