Sildenafil often looks different from brand-name Viagra®. Brand-name Viagra®, often called the little blue pill, is made by the pharmaceutical company Pfizer, but other companies can make generic versions. These pills contain the same active ingredient as Viagra®, sildenafil citrate, but each company’s design may look different. For example, sildenafil might be a white, round pill from one manufacturer but could look like a white, diamond-shaped pill from another.
Erectile DYsfunction / Sildenafil Citrate
Sildenafil citrate
Sildenafil is the generic form of the brand Viagra®. Both medications work similarly in the body.
Viagra® is a type of medication known as a PDE5 inhibitor that is used to treat erectile dysfunction. It comes in several different doses and is taken as-needed.

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Disclaimer: The information provided on this page is not a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns about your health, please talk to a doctor.

Overview

Sildenafil should be taken without food 30-60 minutes before sex and its effects last up to 6-8 hours.

Serious side effects include an erection lasting more than 4 hours, sudden vision loss in one or both eyes, and sudden hearing decrease or loss. If these occur, seek medical attention immediately.

Talk to your doctor or nurse practitioner about your medical conditions and your medications before taking sildenafil. Do not take sildenafil if you are allergic to its ingredients or if you are already taking nitrates (such as nitroglycerin), street drugs called “poppers” (such as amyl nitrate, amyl nitrite, butyl nitrate), or guanylate cyclase stimulators (such as riociguat).
What is generic for Viagra®?
Viagra® and generic Viagra® both contain the same active ingredient: sildenafil citrate. Sildenafil citrate is a type of medication known as a PDE-5 inhibitor. All forms of sildenafil citrate work the same way in the body but differ in dosage and appearance. Viagra® and generic Viagra® are available in 25 mg, 50 mg, and 100 mg tablets. While the manufacturer of the medication and the appearance of the pills may differ, the active ingredient works the same way in your body.
What is sildenafil citrate?
Sildenafil citrate is the chemical name of the active ingredient in Viagra®. When sildenafil is sold in 25, 50, or 100 mg dosages, it’s called Viagra® or it is the generic for Viagra®. When it is sold in a 20 mg dosage, it is called Revatio or it is the generic for Revatio. Revatio is FDA approved for treating pulmonary hypertension. Both Viagra® and Revatio contain the exact same ingredient (i.e., sildenafil citrate), they simply differ in the strength in which they are produced. Healthcare professionals on the Roman platform have the discretion to prescribe 20 mg sildenafil citrate tablets for ED in doses ranging between 20 mg and 100 mg if they believe that it is an appropriate course of treatment for a particular patient. Sildenafil citrate 20 mg tablets for ED is an off-label usage of the medication. It is up to the medical judgment of the doctor or nurse practitioner to decide if off-label treatment is appropriate for a patient based on his unique medical history, symptoms, and preferences. The Roman Pharmacy Network is able to fill prescriptions for sildenafil citrate 20 mg tablets that are issued by a healthcare professional on the Roman platform.
Sildenafil vs Viagra®
Sildenafil contains the same active ingredient as Viagra®, sildenafil citrate. On our platform, sildenafil is available in 20 mg tablets. Multiple tablets of Sildenafil can be combined to equal doses of 40 mg, 60 mg, 80 mg, and 100 mg. When sildenafil tablets are prescribed in these doses for erectile dysfunction, it is considered off-label use. This is because sildenafil is FDA-approved for pulmonary hypertension, not erectile dysfunction. However, the active ingredient in the medication is the same, and in certain situations, it can be appropriate for providers to prescribe medications off-label, especially if the dosing flexibility allowed by the sildenafil better suits your needs.
How does sildenafil citrate work?

1. In order to understand how sildenafil citrate works to treat ED, it’s important to first understand the basics of how erections work.

2.cGMP causes the corpora cavernosa to relax. Allowing blood to rush into the Cavernosal arteries.

3.While blood rushes into the penis, the veins that drain blood from the penis get compressed causing the increased blood to be trapped in the penis causing an erection.

4. An enzyme called phosphodiesterase-5 breaks down cGMP leading the penis to return to its flaccid state.

5. PDE5 inhibitors (PDE5i), like sildenafil citrate, block this enzyme, leading to higher levels of cGMP and improving the ability to obtain and maintain an erection.
How should I take sildenafil?
Sildenafil should be taken 30–60 minutes before sex. It’s important to take it without a meal because fat in a meal can decrease and delay its absorption, which can lower sildenafil’s effectiveness. Even though the instructions are to take it 30–60 minutes before sex, sildenafil lasts in the body for up to 6–8 hours.
How long does sildenafil take to work?
Sildenafil is a short acting medication with a rapid onset. It should be taken 30–60 minutes before sex, and it reaches peak blood levels in 60 minutes on average. Fat in a meal can delay the effects of sildenafil and also decrease the amount that is absorbed. Remember that sildenafil will not give you a spontaneous erection without sexual stimulation.
How long does sildenafil last?
Sildenafil is a short acting drug with an average half-life of 4–5 hours, which means that half the medicine is gone from the body after 4–5 hours in healthy people. The time that it takes to eliminate sildenafil may be prolonged in older people and people with liver or kidney disease and the drug may work longer in these people.
Common side effects of sildenafil
The most common side effects of sildenafil include headaches, facial flushing, stuffy nose, and upset stomach. Serious side effects that are rare include an erection that will not resolve even after 3–4 hours (priapism), hearing loss, which can be sudden, and vision loss in one or both eyes. For more information about side effects, see sildenafil side effects below.
How to get sildenafil
Sildenafil is one of the medications offered on our platform. In order to determine which medication might be right for you, it’s best to complete the online visit and connect with a US-licensed healthcare provider to further discuss your options. If prescribed, your medication will be mailed directly to your door in discreet packaging.
Does Roman offer genuine Viagra®?
Roman offers genuine, branded Viagra® and generic Viagra® to treat erectile dysfunction (ED) in 25, 50, or 100 mg dosages. Roman also offers sildenafil citrate in 20 mg tablets, which can be prescribed by doctors off-label to treat ED in doses ranging between 20 mg and 100 mg if they find it medically appropriate to do so. The active ingredient, sildenafil citrate, is identical in both medications.
Important safety information
Important safety informationFAQ
Generic forms of Viagra® are safe when taken as prescribed. Generic Viagra® has the same active ingredient (sildenafil citrate) as branded Viagra®. While the appearance of the pills may differ, the active ingredient acts the same way and produces the same results in the body. Before you get a prescription for generic Viagra®, your healthcare provider will check if you have any underlying health conditions and if you’re taking certain other medications that could make generic Viagra® less safe for you.
Sildenafil can cause adverse reactions if you combine it with other prescription drugs. Medications that can interact with sildenafil include certain cardiovascular medicines, like nitrates (nitroglycerin) and blood pressure medications (especially alpha-blockers). Thus, it is typically recommended to avoid taking sildenafil if you are on any of those medications. You should also avoid taking sildenafil together with the recreational drug “poppers.” Your healthcare provider can tell you more about drug interactions.
When sildenafil is sold in 25, 50, or 100 mg dosages, it’s called Viagra®, or it is the generic for Viagra®. On our platform, sildenafil is also available in 20 mg tablets. Multiple tablets of sildenafil can be combined into equal doses of 40 mg, 60 mg, 80 mg, and 100 mg. When sildenafil tablets are prescribed in these doses for erectile dysfunction, it is considered off-label. A healthcare provider will help you find out what dose of sildenafil is right for you.
Taking more than the recommended amount of sildenafil citrate greatly increases your risk of side effects, including severe ones that can be dangerous, such as severe low blood pressure or an erection that won’t go away even after 4 or more hours (priapism). Never take more than the amount prescribed to you by your doctor or nurse practitioner. If you have any severe side effects after taking more than the recommended amount, or even after taking the amount of medicine prescribed to you, seek out emergency medical attention immediately.
The FDA requires a prescription for sildenafil and other ED medications. Buying sildenafil without a prescription is not advisable because you may not know what exactly is in the pills you are buying. It’s also important for a healthcare provider to review your health history to see if medication is right for you. The only safe and legal option is getting a prescription from a licensed healthcare provider. Completing an online visit through Roman can connect you with a US-licensed healthcare professional who will review your information and prescribe medication if it is right for you.
Sildenafil is cheaper than branded Viagra®. On our platform, sildenafil is available in 20 mg tablets. Multiple tablets of sildenafil can be combined to equal doses of 40 mg, 60 mg, 80 mg, and 100 mg. One 20 mg pill only costs $2, so a dose of 60 mg would cost you $6.
Buying medication online can have risks when the source is not reputable. One study showed that 77% of Viagra® sold online was counterfeit. Counterfeit PDE5i can have variable amounts of the active drug ranging from 0%–200+% of the drug. In cases where the active ingredient is present in lower amounts than expected, this can mean lack of effectiveness even though the same dose of active drug may work well in a given individual. In cases where much more active drug than listed is included, there is a higher potential for side effects, including dangerous ones like extremely low blood pressure or an erection that won’t go away even after 4 or more hours (priapism). It is also common for counterfeit drugs to contain harmful ingredients like talcum powder, commercial paint, and printer ink.
With Roman, you can always be sure you are getting genuine medication with active ingredients in the correct amount without harmful additives. Roman drugs are manufactured by pharmaceutical companies that are regulated by the FDA. In fact you will likely find many of the same manufacturers we use in your local pharmacy. With Roman, you never need to worry about what’s actually in the pills you are taking.