October 19, 2021

What you need to know about Generic Viagra (Sildenafil)

Yes. Viagra, the brand name for the drug sildenafil, is now sold as a generic drug by many manufacturers around the world. Sildenafil is essentially the same drug as Viagra, which was the first major erectile dysfunction (ED) drug on the market and is manufactured by Pfizer Inc.

Generic Viagra hasn’t been around for very long. Although Pfizer’s patent on the popular erectile dysfunction drug expired in 2020, Pfizer began manufacturing and selling generic sildenafil in 2017. Once other companies were able to legally sell their own sildenafil tablets in 2020, the options for consumers have expanded rapidly.

Pharmaceutical giant Pfizer accidentally discovered the benefits of sildenafil for erectile dysfunction.

Researchers were testing the drug to treat high blood pressure and angina, chest pain associated with heart disease. They found the drug to be particularly effective in 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 maintain an erection. Sildenafil should be taken before sex, with the understanding that its effects only last a few hours.

Sildenafil is also approved for the treatment of pulmonary hypertension (PH) – high 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 still sold under the name sildenafil. There is currently no other brand name for the drug other than Viagra and Revatio.

Sildenafil for ED or PH requires a prescription in the United States. The UK is allowing over-the-counter sales of the drug, in part to discourage the market for fake sildenafil, one of the most counterfeit drugs in the world.

Instead of the “little blue pill,” as Viagra is called, sildenafil is often sold as a small white pill by Pfizer’s competitors. The appearance of the pill does not change its effectiveness or how it works in the body.

While generic sildenafil and Viagra are also safe and effective, there is one key difference between the drugs: cost. Viagra costs around $ 60 to $ 70 per pill, while generic sildenafil can range from under $ 1 to $ 10 per pill, depending on the manufacturer and the dose.

Sildenafil does not cure erectile dysfunction. It treats the symptoms of ED. Likewise, sildenafil does not cure PH. It simply helps control the blood pressure in the pulmonary arteries.

Sildenafil belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. These drugs limit the action of phosphodiesterase (PDE) enzymes, which break down 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 with blood more easily.

Sildenafil is rapidly 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 are taking medicines to control blood pressure or if you tend to have low blood pressure, ask your doctor if you it is safe to use sildenafil.

Sildenafil does not trigger an erection on its own and does not increase sexual desire. Sexual stimulation is always necessary. However, for most healthy people, sildenafil can make it easier to get an erection. A 4 year study have found that sildenafil is generally safe to use over the long term.

Sildenafil is available in tablet form in a range of dosages. Like Viagra, generic sildenafil is sold in tablets of 20 milligrams (mg), 25 mg, 50 mg, and 100 mg. The 50 mg dose is standard, although some doctors start patients at a 25 mg dose to see if this is enough.

For erectile dysfunction, sildenafil is taken as needed, ideally an hour before sex. However, it can be effective as early 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 is recommended that you do not take sildenafil more than once a day.

Sildenafil prescribed for PH is available in 5 mg and 20 mg tablets and in liquid form. It is usually taken three times a day.

Sildenafil can cause side effects, most of which are minor and temporary. Some of the most common are:

  • headache
  • flushing (feeling hot under the skin)
  • stomach pains
  • diarrhea
  • insomnia
  • tingling in the limbs
  • muscle aches
  • light sensitivity

Serious side effects of sildenafil

More serious side effects should prompt you to call your doctor or 911 immediately. They include:

  • sudden and severe blurred vision or loss of vision
  • reduced hearing
  • ringing in the ears
  • dizziness or lightheadedness
  • fainting
  • shortness of breath
  • chest pain
  • itching or burning during urination
  • eruption
  • erection that is painful or that lasts more than four hours

Like any strong drug, sildenafil can have potentially serious interactions with other drugs.

Combination with certain blood pressure and heart medications can cause changes in blood pressure

In particular, you should not take sildenafil if you are taking nitrate medication for angina or high blood pressure.

If you take other medicines for high blood pressure, such as water pills, ACE blockers, or calcium channel blockers, you may experience a dangerous drop in your blood pressure.

This can lead to dizziness, headache, fainting, or falling, as well as severe drops in blood pressure, with less oxygen flowing to your organs.

Do not take with other erectile dysfunction drugs

You should also avoid taking sildenafil with other erectile dysfunction drugs. The combination can lower blood pressure, causing fainting, dizziness and, in rare cases, a heart attack.

Combination with alcohol can affect blood pressure

Alcohol and sildenafil can combine to lower blood pressure too much. You should avoid alcohol if you are taking sildenafil.

Grapefruit may delay the effect of sildenafil and increase the risk of side effects

The only real food interaction that can occur with generic Viagra is with grapefruit and grapefruit juice. These products can increase the levels of sildenafil in your body, but can also delay the effect of the drug.

CP450 drugs increase the risk of side effects and alter the effectiveness of sildenafil

Like grapefruit, medicines called cytochrome P450 (CP450) inhibitors, inducers, and substrates can delay the time it takes for sildenafil to work and increase the risk of side effects.

CP450 drugs include:

  • cimetidine
  • clopidogrel
  • chloramphenicol
  • fluvoxamine
  • omeprazole
  • modafinil

There are a number of different treatments for erectile dysfunction. 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 erectile dysfunction drugs on the market.

Other oral medications

The four main inhibitors of PDE5 are:

  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • vardenafil (Levitra)
  • avanafil (Stendra)

All of these medicines, except avanafil (Stendra), are available as generic medicines.

Penis pump

There are certain non-pharmacological treatments for erectile dysfunction, 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 drawing blood to the arteries in the penis by aspiration of air.

Surgery and injections

Penile implants and penile injections to treat erectile dysfunction are other options to consider. Talk to a urologist to find out 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 makes the “little blue pill,” other companies around the world and in the United States are making sildenafil which may look different but is still an effective treatment for erectile dysfunction.


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