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Last updated May 14, 2020. 5 minute read

Viagra vs. generic Viagra vs. sildenafil. What's the difference?

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. The biggest difference when choosing is the dose and cost of these medications.

Linnea Zielinski Written by Linnea Zielinski
Reviewed by Dr. Mike Bohl, MD, MPH

Viagra is the Kleenex of erectile dysfunction. It’s just one of many options, including generic versions, and yet it’s as synonymous with ED as Kleenex is with runny noses. But while ignoring the generic facial tissue for Kleenex will only cost you a couple of bucks, there can be over a $50 difference—per pill—between Viagra and its generic alternative. Ready to consider the alternatives? Here’s what you need to know.

Vitals

  • Erectile dysfunction causes issues getting or maintaining an erection.
  • Viagra is 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.
  • The biggest difference when choosing is the dose and cost of these medications.

Viagra, and its generic version, are just a couple of the prescription medications available to treat erectile dysfunction. Researchers involved with one study that looked at 27,000 men from eight different countries found that only 58% of participants with ED had ever sought help from a medical professional for the condition. So, though they found that roughly 8% of men 20–29 and 11% of men age 30–39 have erectile dysfunction, the true numbers of men experiencing this common condition may be higher (Rosen, 2004). A 2019 study found that between 3 and 76.5% of men experience erectile dysfunction globally (Kessler, 2019).

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) and Levitra (generic name vardenafil). All of these ED treatments belong to a class of drugs called phosphodiesterase-5 inhibitors (PDE-5 inhibitors), which just means they all work in a similar way. Each of these medications helps by relaxing muscles in the penis and improving blood flow in order to treat ED.

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What is Viagra?

Viagra is the brand name of sildenafil, which is manufactured and sold by Pfizer. The active ingredient is sildenafil citrate, and 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 sexual activity. Though Viagra tablets can start to take effect and help achieve an erection in just 12 minutes, the medication reaches peak levels in your body after 30–120 minutes (Eardley, 2002). It can last in your body for up to four to five hours, but your age, health, and diet all affect the exact amount of time it will work. 

Like stories you may have heard, Viagra was initially developed to treat another condition entirely. Pfizer developed sildenafil to treat a specific type of hypertension (abnormally high blood pressure) but noticed something interesting during clinical trials: Participants in the studies were having 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 create this medication. This launch allowed other companies to manufacture and sell “generic Viagra.”

What is generic Viagra?

“Generic Viagra” is another term for medicine with the active ingredient and dosage as Viagra, but it is not sold under the brand name. These generic drugs and Viagra are bioequivalent, which means they act the same way and produce the same results in the body. These medicines are also approved by the FDA to treat erectile dysfunction. In fact, they differ from Viagra in only two ways: first, these sildenafil tablets may not be produced by Pfizer, and second, they cost a lot less.

It’s important to note that, like the effects of Viagra, the effects of these generic medications don’t include spontaneous erection. Sexual stimulation is still needed for an erection. They simply make it easier to get and keep one.

What is sildenafil?

Sildenafil is the active ingredient in Viagra and “generic Viagra,” but those aren’t the only medications that use it. In fact, it’s approved by the FDA in the treatment of conditions other than ED. Sildenafil is also used in Revatio, which treats pulmonary arterial hypertension (PAH), a condition in which the pressure in blood vessels that carry blood from your heart to your lungs is higher than normal (Barnett, 2006).

One big difference between Revatio and the sildenafil-based medicines that have been approved by the FDA for the treatment of ED is the dose. Revatio comes in only one dose, 20 mg. Viagra and generic Viagra come in three doses: 25 mg, 50 mg, and 100 mg. But there’s also generic Revatio, which also uses sildenafil as its active ingredient. Generic versions of this PAH medication can be used off-label to treat ED and has many more dosing options. 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 these medicines 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 one is right for me?

Since they have the same active ingredient, Viagra, generic Viagra, and 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. You’ll need to talk to your healthcare provider if you’re considering either, as they have the same drug interactions, including nitrates (like nitroglycerin).

Choosing between these erectile dysfunction medications comes mostly down to cost. Branded Viagra can be up to $70 a pill, while off-label sildenafil can be as low as $2. 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.