Is Viagra covered by insurance?

Viagra and other similar drugs for treating erectile dysfunction, like Cialis or Levitra, are expensive medications. Here’s some guidance on how to find out if your health insurance plan covers any of these medications (or their generic counterparts) and what you can expect if you’re paying with cash.

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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.

If you’re looking to try Viagra to treat your erectile dysfunction (ED), you might be surprised by what a big dent this little blue pill can make in your wallet. Considering ED is a medical condition with far-reaching impacts on your health and quality of life, you might think it’s a given that Viagra (and other erectile dysfunction drugs that work in a similar way) would be covered by insurance. Unfortunately, that’s not always the case.

The good news is, even if your insurer does not cover Viagra, there are more affordable options available.

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Will my insurance cover Viagra?

As with any medication, treatment, or diagnostic test, every health insurance plan has different policies about what they will and won’t cover. Many insurance companies have a listing of drugs they’ll cover under different plans available on their websites.

For instance, some large group plans under Blue Cross Blue Shield appear to cover a portion of the cost of Viagra, as well as other phosphodiesterase-5 (PDE5) inhibitors (the drug class Viagra is a part of), such as Cialis and Levitra (Blue Cross Blue Shield, 2021). Cigna also seems to cover these medications under some of their plans (Cigna, 2021).

No matter what insurance plan you have, it’s important to call your insurance provider to verify which medications they’ll cover and under what circumstances. They may have certain requirements for prior authorization (where someone from the insurance company will need to review the prescription from your healthcare provider before authorizing coverage). Or, they might limit how much you can get at once and how many refills are available. You’ll also need to find out about any copayments.

Viagra is not the only medication available to treat erectile dysfunction. When you call your insurance provider for verification, be sure to also ask about insurance coverage for any of the following medications as well (if Viagra isn’t covered):

  • Sildenafil citrate (this is the active ingredient in Viagra; see Important Safety Information)
  • Cialis (or its generic counterpart, tadalafil; see Important Safety Information)
  • Levitra (vardenafil)
  • Stendra (avanafil)

If your insurance provider covers certain medications but not others, speak with your healthcare provider to see if switching to a covered medication makes sense for you. Your insurance provider may also offer different coverage for different dosages or uses. For example, Cialis is available in two ways: as-needed (2.5 mg, 5 mg, 10 mg, or 20 mg) or daily (2.5 mg and 5 mg) (Brock, 2016). Your insurance may cover one but not the other.

If your insurance does cover any of these medications, you may still need to pay a copay, or coverage may only go into effect after meeting your deductible. Every plan is different.

What does Viagra cost out-of-pocket?

If your insurance plan does not cover Viagra, the out-of-pocket drug costs can be quite high. It can cost up to $2,000 for 30 pills of a 100 mg dose (GoodRx-a). Every pharmacy offers its own rates, though, so it’s worth shopping around.

The cash price for Cialis varies widely based on the dosage. For the lowest dose (2.5 mg), Cialis generally costs around $350 for 30 pills, while the highest dose (20 mg) can cost over $2,000 (GoodRx-b).

The average retail price for Levitra is around $1,700 across all dosages for 30 pills (GoodRx-c).

What causes erectile dysfunction (ED) in men over 50?

Finally, Stendra, which is a less commonly prescribed medication for ED, costs around $1,600 out-of-pocket (GoodRx-d).

Don’t feel too discouraged by those steep prices, though! There are more affordable options available.

Cheaper alternatives to Viagra, Cialis, and Levitra

While there isn’t currently a generic version of Stendra available (it’s still under patent, so only the brand name is available for now), there are cheaper versions of the other three PDE5 inhibitors on the market.

Cheaper alternatives to Viagra

There are two cheaper versions of sildenafil citrate (the active ingredient in Viagra) available: generic Viagra and generic Revatio (see Important Safety Information).

Generic Viagra is similar to Viagra and comes in the same doses.

Revatio is a medication that’s FDA-approved for treating a specific type of high blood pressure in the lungs (Croom, 2008).

It may seem confusing, but Revatio has the same active ingredient as Viagra. The difference is that it comes in different strengths. While Viagra comes in 25 mg, 50 mg, and 100 mg tablets, Revatio comes in 20 mg tablets. Some healthcare providers prescribe generic Revatio at doses of 20 mg, 40 mg, 60 mg, 80 mg, or 100 mg to treat ED. However, this is considered off-label prescribing since Revatio, and its generic form are not specifically FDA-approved for ED.

Generic Revatio is a much more affordable alternative to Viagra, available for as low as $10 for 30 doses of 100 mg (depending on the pharmacy) (GoodRx-e).

Cheaper alternatives to Cialis

The active ingredient in Cialis is tadalafil, which is a longer-acting medication than sildenafil citrate (that means it lasts longer in the body), but it’s about equally effective (Gong, 2017). You can get tadalafil for around $20 for 30 doses (with some minimal variation with different doses) (GoodRx-f). And, of course, it depends on which pharmacy you use.

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Cheaper alternatives to Levitra

Levitra is the brand name for vardenafil, which is another PDE5 inhibitor that treats ED in a similar way to sildenafil citrate and tadalafil (Morales, 2009). Vardenafil is quite a bit cheaper than brand name Levitra but is still relatively pricey, costing close to $250 on average for 30 doses (GoodRx-c).

Is Viagra covered by Medicare or Medicaid?

If you’re on a Medicare or Medicaid plan, you will need to look into your specific plan benefits to find out about prescription drug coverage. In general, there’s a better chance of one of the generic versions—sildenafil citrate, tadalafil, or vardenafil—being covered under your Medicaid or Medicare plan than their brand name counterparts. Medicare part D plans are for prescription drug coverage.

How do PDE5 inhibitors treat erectile dysfunction?

Viagra, Cialis, Levitra, and their generic counterparts are all examples of PDE5 inhibitors, medications that treat sexual dysfunction in men. PDE5 inhibitors block an enzyme called PDE5. This enzyme, when not blocked, breaks down cyclic guanosine monophosphate (cGMP), which is a chemical that causes the blood vessels in the penis to relax. When PDE5 is blocked (with PDE5 inhibitors), cGMP levels increase, causing better blood flow to the penis. Better blood flow to the penis makes for stronger erections (Huang, 2013).

Make the right choice for your budget

All of these medications work in similar ways, with some differences in how long they last in the body and side effects. Ultimately, the medication you choose will depend on your healthcare professional’s medical advice, as well as what will fit best in your budget. Call your insurance provider to find out if any of these medications are covered under your plan. If they’re not covered, shop around for the most affordable options offered by different licensed pharmacies.

References

  1. Blue Cross Blue Shield. “Blue Cross Clinical Drug List – January 2021.” Retrieved from https://www.bcbsm.com/content/dam/public/Consumer/Documents/help/documents-forms/pharmacy/clinical-drug-list-formulary.pdf on January 20, 2021.
  2. Brock, G., Ni, X., Oelke, M., et al (2016). Efficacy of Continuous Dosing of Tadalafil Once Daily vs Tadalafil On Demand in Clinical Subgroups of Men With Erectile Dysfunction: A Descriptive Comparison Using the Integrated Tadalafil Databases. The Journal of Sexual Medicine, 13(5), 860–875. Doi: 10.1016/j.jsxm.2016.02.171. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27114197/
  3. Cigna. “Cigna Performance 3-Tier Prescription Drug List – starting January 1, 2021.” Retrieved from https://www.cigna.com/static/www-cigna-com/docs/individuals-families/member-resources/prescription/performance-3-tier.pdf on January 20, 2021.
  4. Croom, K. F., & Curran, M. P. (2008). Sildenafil: a review of its use in pulmonary arterial hypertension. Drugs, 68(3), 383–397. Doi: 10.2165/00003495-200868030-00009. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18257613/.
  5. Gong, B., Ma, M., Xie, W., Yang, X., Huang, Y., Sun, T., Luo, Y., & Huang, J. (2017). Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. International Urology and Nephrology, 49(10), 1731–1740. Doi: 10.1007/s11255-017-1644-5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603624/.
  6. GoodRx-a. Viagra (sildenafil); 2020. Retrieved from https://www.goodrx.com/viagra?dosage=100mg&form=tablet&label_override=Viagra&quantity=30&sort_type=popularity on January 20, 2021.
  7. GoodRx-b. Cialis (tadalafil); 2020. Retrieved from https://www.goodrx.com/cialis on January 20, 2021.
  8. GoodRx-c. Levitra (vardenafil); 2020. Retrieved from https://www.goodrx.com/levitra?dosage=20mg&form=tablet&label_override=Levitra&quantity=30&sort_type=popularity on January 20, 2021.
  9. GoodRx-d. Stendra (avanafil); 2020. Retrieved from https://www.goodrx.com/stendra on January 20, 2021.
  10. GoodRx-e. Sildenafil (generic Revatio, Viagra); 2020. Retrieved from https://www.goodrx.com/sildenafil on January 20, 2021.
  11. GoodRx-f. Tadalafil (Cialis); 2020. Retrieved from https://www.goodrx.com/tadalafil-cialis on January 20, 2021.
  12. Huang, S. A., & Lie, J. D. (2013). Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. P & T : A Peer-Reviewed Journal for Formulary Management, 38(7), 407–419. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776492/.
  13. Morales, A. M., Mirone, V., Dean, J., & Costa, P. (2009). Vardenafil for the treatment of erectile dysfunction: an overview of the clinical evidence. Clinical Interventions in Aging, 4, 463–472. Doi: 10.2147/cia.s3878. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2801586/.

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Important Safety Information for Sildenafil (Viagra)

What are the most important things I need to know about VIAGRA® (sildenafil citrate) 25 mg, 50 mg, and 100 mg tablets and generic VIAGRA®?

Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate emergency medical attention.

  • VIAGRA® and generic VIAGRA® can cause serious side effects. Serious, but rare, side effects include:
    • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, seek emergency medical attention right away. If it is not treated right away, priapism can permanently damage your penis.
    • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you have any sudden vision loss
    • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away

    Who should not take VIAGRA® or generic VIAGRA®?

    Do not take VIAGRA® or generic VIAGRA® if you:

    • Take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
    • Are allergic to sildenafil, as contained in VIAGRA® and REVATIO®, or any of the ingredients in VIAGRA® or generic VIAGRA® tablets.
    • Are a women or a child

    When should I call my primary provider?

    Call your primary provider right away if you:

    • Have an erection that lasts longer than 4 hours
    • Experience a sudden loss of vision in one or both eyes
    • Experience a sudden decrease in or loss of hearing
    • Experience chest pain, dizziness, or nausea during sex
    • Take too much Viagra or sildenafil citrate

    If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

    What are the most common side effects of VIAGRA® and generic VIAGRA®?

    The most common side effects are:

    • headache
    • flushing
    • upset stomach
    • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
    • stuffy or runny nose
    • back pain
    • muscle pain
    • nausea
    • dizziness
    • rash

    What should I tell my Roman-affiliated provider before taking VIAGRA® and generic VIAGRA®?

    Before you take VIAGRA® or generic VIAGRA® , tell your healthcare provider if you:

    • Have or have had heart problems such as a heart attack,irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
    • Have had heart surgery within the last 6 months
    • Have pulmonary hypertension
    • Have had a stroke
    • Have low blood pressure, or high blood pressure that is not controlled
    • Have a deformed penis shape
    • Have had an erection that lasted for more than 4 hours
    • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
    • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
    • Have ever had severe vision loss, including an eye problem called NAION
    • Have bleeding problems
    • Have or have had stomach or intestinal ulcers
    • Have liver problems
    • Have kidney problems or are having kidney dialysis
    • Have any other medical conditions

    Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

    VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works, causing side effects.

    Especially tell your healthcare provider if you take any of the following:

    • Medicines called nitrates
    • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
    • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
    • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
    • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
    • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
    • Other medicines that treat high blood pressure
    • Other medicines or treatments for ED
    • VIAGRA® contains sildenafil, which is the same medicine found in another drug called REVATIO®. REVATIO® is used to treat a rare disease called pulmonary arterial hypertension (PAH). VIAGRA® should not be used with REVATIO® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

    Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

    What is the FDA-approved use of VIAGRA® and generic VIAGRA®?

    VIAGRA® (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED).

    Roman-affiliated doctors may prescribe VIAGRA® or generic VIAGRA® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment. While this is not an FDA-approved use of the drug, the American Urological Association has included the use of sildenafil citrate in the treatment of PE in its Guideline on the Pharmacologic Management of Premature Ejaculation.

    You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

    Please see the full Prescribing Information for complete safety information.

    Product names referenced herein are trademarks of their respective owners.

    Important Safety Information for Tadalafil (Cialis)

    What Is The Most Important Information I Should Know About CIALIS® (tadalafil) and generic CIALIS®?

    • CIALIS® and generic CIALIS® can cause serious side effects. Serious, but rare, side effects include:
      • An erection that won’t go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis, including the inability to have erections.
      • Changes in vision. Color vision changes, such as seeing a blue tinge (shade) to objects or having difficulty telling the difference between the colors blue and green.
      • Sudden decrease or loss of vision. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including CIALIS® and generic CIALIS®) reported a sudden decrease or loss of vision in one or both eyes. It is uncertain whether PDE5 inhibitors directly cause the vision loss. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including CIALIS® and generic CIALIS®, and call a healthcare provider right away.
      • Sudden loss or decrease in hearing. Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including CIALIS® and generic CIALIS®. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience these symptoms, stop taking CIALIS® and generic CIALIS® and contact a healthcare provider right away.
      • ED is a condition where the penis does not fill with enough blood to harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his healthcare provider for help if the condition bothers him.
      • CIALIS® and generic CIALIS® help increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away. Some form of sexual stimulation is needed for an erection to happen with CIALIS® or generic CIALIS®.
      • CIALIS® and generic CIALIS® do not:
        • Cure ED
        • Increase a man’s sexual desire
        • Protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your healthcare provider about ways to guard against sexually transmitted diseases.
        • Serve as a male form of birth control
        • Take CIALIS® or generic CIALIS® exactly as your healthcare provider prescribes it. Your healthcare provider will prescribe the dose that is right for you. Do not change your dose or the way you take CIALIS® or generic CIALIS® without talking to your healthcare provider.

        Who Should Not Take CIALIS® or generic CIALIS®?

        Do not take CIALIS® or generic CIALIS® if you:

        • Have severe liver disease. Tell your doctor if you have mild to moderate liver disease as you may need dosage reductions.
        • Have severe kidney disease. Tell your doctor if you have mild to moderate kidney disease as you may need dosage reductions
        • Take any medicines called “nitrates”
        • Use recreational drugs called “poppers” like amyl nitrite and butyl nitrite
        • Take any medicines called guanylate cyclase stimulators, such as riociguat
        • Are allergic to CIALIS®, tadalafil or ADCIRCA®, or any of its ingredients

        When should I call my primary provider?

        Call your primary provider right away if you:

        • Have an erection that lasts longer than 4 hours
        • Experience a sudden loss of vision in one or both of your eyes
        • Experience a sudden decrease or loss hearing
        • Take too much CIALIS® or generic CIALIS®
        • Have an allergic reaction to CIALIS® or generic CIALIS®
        • Symptoms of an allergic reaction may include:
        • Rash
        • Hives
        • Swelling of the lips, tongue, or throat
        • Difficulty breathing or swallowing

        Call your healthcare provider or get help right away if you have any of the symptoms of an allergic reaction listed above.

        If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

        What Should I Tell My Roman-affiliated Provider Before Taking CIALIS® and generic CIALIS®?

        Tell your Roman-affiliated provider about all your medical problems, including if you:

        • Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS® and generic CIALIS® if your healthcare provider has told you not to have sexual activity because of your health problems.
        • Have pulmonary hypertension
        • Have low blood pressure or have high blood pressure that is not controlled
        • Have had a stroke
        • Have liver problems
        • Have kidney problems or require dialysis
        • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
        • Have ever had severe vision loss, including a condition called NAION
        • Have stomach or intestinal ulcers
        • Have a bleeding problem
        • Have a deformed penis shape or Peyronie’s disease
        • Have had an erection that lasted more than 4 hours
        • Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

        Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

        Especially tell your healthcare provider if you take any of the following:

        • Medicines called nitrates
        • Medicines called guanylate cyclase stimulators, such as riociguat (Adempas®), used to treat pulmonary hypertension
        • Medicines called alpha blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), 4 Jalyn® (dutasteride and tamsulosin HCl) or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. If CIALIS® or generic CIALIS® is taken with certain alpha blockers, your blood pressure could suddenly drop. You could get dizzy or faint.
        • Other medicines to treat high blood pressure (hypertension)
        • Medicines called HIV protease inhibitors, such as ritonavir (Norvir® , Kaletra® )
        • Oral antifungals such as ketoconazole (Nizoral® ), itraconazole (Sporanox® )
        • Antibiotics such as clarithromycin (Biaxin® ), telithromycin (Ketek® ), erythromycin (several brand names exist. Please consult your healthcare provider to determine if you are taking this medicine).
        • Other medicines or treatments for ED.
        • Tadalafil is also marketed as ADCIRCA® for the treatment of pulmonary arterial hypertension. Do not take both CIALIS® or generic CIALIS® and ADCIRCA®. Do not take sildenafil citrate (Revatio®, Viagra®) with CIALIS® or generic CIALIS®.

        Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

        What are the most common side effects of CIALIS® or generic CIALIS®?

        The most common side effects with CIALIS® and generic CIALIS® are:

        • Headache
        • Indigestion
        • Back pain
        • Muscle aches
        • Flushing
        • Stuffy or runny nose

        What is the FDA-approved Use of CIALIS® and generic CIALIS®?

        CIALIS® and generic CIALIS® are prescription medicines used to treat erectile dysfunction (ED), symptoms of benign prostatic hyperplasia (BPH), or both.

        Roman-affiliated doctors may prescribe CIALIS® for the treatment of premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment.

        You are encouraged to report negative side effects of prescription products to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

        Please see the full Prescribing Information for complete safety information.

        Important Safety Information for Sildenafil (Revatio)

        This Important Safety Information has been adapted from the Prescribing Information for REVATIO®.

        What are the most important things I need to know about sildenafil 20 mg tablets?

        • Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate emergency medical attention.
        • Sildenafil can cause serious side effects. Serious, but rare, side effects include:
          • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, seek emergency medical attention right away. If it is not treated right away, priapism can permanently damage your penis
          • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking sildenafil and call your healthcare provider right away if you have any sudden vision loss
          • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking sildenafil and contact a doctor right away

          Who should not take sildenafil?

          Do not take sildenafil if you:

          • Take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
          • Are allergic to sildenafil, as contained in VIAGRA® and REVATIO®, or any of the ingredients in generic sildenafil citrate tablets.
          • You’ve ever had blockage of veins in your lungs, which is called pulmonary veno-occlusive disease
          • Are a women or a child

          Sildenafil contains the same medicine as VIAGRA® (sildenafil citrate), which is used to treat erectile dysfunction (impotence) and REVATIO®, which is used to treat pulmonary hypertension. Do not take sildenafil with VIAGRA, REVATIO, or other PDE5 inhibitors.

          When should I call my primary provider?

          Call your primary provider if you:

          • Have an erection that lasts longer than 4 hours
          • Experience a sudden loss of vision in one or both eyes
          • Experience a sudden decrease in or loss of hearing
          • Take too much sildenafil citrate

          If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

          What are the most common side effects of generic sildenafil citrate?

          The most common side effects are:

          • Headache
          • Flushing
          • Upset stomach
          • Abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
          • Stuffy or runny nose
          • Back pain
          • Muscle pain
          • Nausea
          • Dizziness
          • Rash
          • Trouble sleeping
          • Fever
          • Respiratory infection
          • Nausea
          • Vomiting
          • Bronchitis
          • Pharyngitis

          What should I tell my Roman-affiliated provider before taking sildenafil citrate?

          Before you take sildenafil citrate, tell your healthcare provider if you:

          • Have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
          • Have had heart surgery within the last 6 months
          • Have pulmonary hypertension
          • Have had a stroke
          • Have low blood pressure, or high blood pressure that is not controlled
          • Have a deformed penis shape
          • Have had an erection that lasted for more than 4 hours
          • Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
          • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease
          • Have ever had severe vision loss, including an eye problem called NAION
          • Have bleeding problems
          • Have or have had stomach or intestinal ulcers
          • Have liver problems
          • Have kidney problems or are having kidney dialysis
          • Have any problem with the shape of your penis or Peyronie’s disease
          • Have any other medical conditions

          Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

          Sildenafil may affect the way other medicines work, and other medicines may affect the way sildenafil works, causing side effects.

          Especially tell your healthcare provider if you take any of the following:

          • Medicines called nitrates
          • Medicines called guanylate cyclase stimulators such as Adempas® (riociguat)
          • Medicines called alpha-blockers such as Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl), Uroxatral® (alfuzosin HCl), Jalyn® (dutasteride and tamsulosin HCl), or Rapaflo® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA® with alpha-blockers can lead to a drop in blood pressure or to fainting
          • Medicines called HIV protease inhibitors, such as ritonavir (Norvir®), indinavir sulfate (Crixivan®), saquinavir (Fortovase® or Invirase®), or atazanavir sulfate (Reyataz®)
          • Oral antifungal medicines, such as ketoconazole (Nizoral®) and itraconazole (Sporanox®)
          • Antibiotics, such as clarithromycin (Biaxin®), telithromycin (Ketek®), or erythromycin
          • Other medicines that treat high blood pressure
          • K antagonists (like coumadin or warfarin)
          • Other medicines or treatments for ED
          • Sildenafil is the same medicine found in VIAGRA® and REVATIO®. REVATIO® is used to treat a rare disease called pulmonary arterial hypertension (PAH). VIAGRA® should not be used with REVATIO® or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])

          Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.

          What is the FDA-approved use of sildenafil citrate 20 mg tablets?

          Sildenafil citrate 20 mg tablets are the generic version of REVATIO®, prescription medicine used to treat pulmonary hypertension. Sildenafil citrate is also the active ingredient in VIAGRA® (sildenafil citrate 25 mg, 50 mg, and 100 mg tablets), which is FDA approved to treat erectile dysfunction (ED).

          Roman-affiliated doctors may prescribe sildenafil citrate 20 mg tablets for the treatment of ED or premature ejaculation (PE), if they believe in their medical judgment that it is an appropriate course of treatment.

          Please see the Prescribing Information for complete safety information.

          Product names referenced herein are trademarks of their respective owners.