ED Pills

Revatio vs. Viagra: Differences and Similarities

April 19, 2021

Sometimes it can be very easy to confuse different medications in the world of pharmaceuticals. There are often several similar substances and chemicals that are marketed under completely different brand names. 

Two of the most commonly confused medications are Viagra® and Revatio. Both of these pharmaceuticals contain the same active ingredient of sildenafil and they are both sold by the same company: Pfizer. However, that’s pretty much where the similarities end as there are quite a few more differences between these two medications than most people seem to think. 

What is Viagra®? 

Easily the most famous treatment for erectile dysfunction, Viagra® is classified as a PDE5 inhibitor that helps to relax smooth muscles found in the penis and improve the blood flow to them in order to help achieve and maintain erections. 

Pfizer originally developed sildenafil, the active ingredient in Viagra®, in the late 1980s and early 1990s as a potential treatment for hypertension and angina. During the early tests, researchers discovered that sildenafil was actually a significantly more effective treatment for erectile dysfunction than for hypertension. Throughout the 1990s, sildenafil went through numerous clinical trials and in 1996 received an official patent. 

Pfizer began using the brand name Viagra® to market sildenafil as a treatment for erectile dysfunction and put the medicine on the market in 1998. There are three different dosage sizes for Viagra®: 25 mg, 50mg, and 100mg. The typical dose is the 50mg version, but it’s not uncommon for a patient to be prescribed a 100mg dose. 

Once Viagra® has been taken, it will stay in the body for around three to five hours. It takes about 30 minutes or so for the Viagra® to start working and the maximum benefits are felt after an hour.  

What Is Revatio? 

Another brand name for sildenafil is Revatio. Unlike Viagra®, which is marketed specifically for treating erectile dysfunction, Revatio is marketed as a treatment for pulmonary arterial hypertension which is a form of high blood pressure that affects the arteries found in the lungs. 

Revatio and Viagra® are both brand names owned and manufactured by the pharmaceutical company Pfizer, who originally designed, tested, and marketed sildenafil. While Viagra® has been an available medication on the health market since the late 1990s, Revatio wasn’t approved by the Food and Drug Administration until June of 2005

Revatio contains a lower dose of sildenafil than Viagra® as each tablet only contains around 20 mg of the chemical. Other than dosage size, there is no difference between the sildenafil found in either Viagra® or Revatio. 

They are essentially both the same drug, with the same side effects on the body. This means that while Revatio is intended to treat pulmonary arterial hypertension, it can also provide relief from erectile dysfunction. Although the amount of sildenafil is lower when compared to a tablet of Viagra®, many men with mild or moderate erectile dysfunction have found that it can be effectively treated by the 20mg of sildenafil provided by Revatio. 

What Are The Differences Between The Two? 

The two biggest differences between Viagra® and Revatio are exactly what they are intended for and the typical size of the doses. Revatio is used to treat pulmonary arterial hypertension, while Viagra® is used to treat erectile dysfunction. Along with the differing typical dosage sizes, Revatio also differs in that it can be administered as a tablet, injection, or oral liquid. Additionally, Revatio is administered three times a day while Viagra® is only used “as needed” before sexaul activities begin. 

Revatio 

Drug class: Phosphodiesterase 5 (PDE5) inhibitor

Status: Brand name and generic version available 

What is the generic name? Sildenafil citrate

What forms are available? Oral tablet, injection, oral suspension

What is the intended treatment? Pulmonary arterial hypertension 

What is the standard dosage? 20 milligrams three times a day

How long is the treatment? Short term or long term as dictated by doctor

Age restrictions: Must be an adult 18 years and older

Viagra® 

Drug class: Phosphodiesterase 5 (PDE5) inhibitor

Status: Brand name and generic version available

What is the generic name? Sildenafil citrate 

What forms are available? Oral tablet

What is the intended treatment? Erectile dysfunction

What is the standard dosage? 25mg, 50mg, or 100mg taken within an hour of sexual activity

How long is the treatment? Short term or long term as dictated by doctor

Age restrictions: Must be an adult 18 years and older

What Do They Treat? 

While being composed of exactly the same active ingredient of sildenafil, Revatio and Viagra® are intended to treat two completely different conditions. Revatio is marketed for the treatment of pulmonary arterial hypertension and can help to improve the ability to exercise and delay the worsening of the disease. Viagra® is marketed to specifically treat erectile dysfunction and helps a man to achieve and maintain erections for penetrative sexual intercourse. 

Pulmonary arterial hypertension is a fairly rare, progressive disease that affects the lungs. It’s characterized by high blood pressure in the lungs and will usually cause symptoms such as shortness of breath and dizziness. Around 10 and 15 people for every one million of the population will be diagnosed with this disease every year. 

Viagra®, or its nickname “little blue pill” may suggest, is much more well known than Revatio since more men are affected by erectile dysfunction than they are by pulmonary arterial hypertension. It’s estimated that roughly 30 million men are affected by erectile dysfunction in the United States alone so Viagra® will have many more users than Revatio. Sildenafil can also be used to treat a few other conditions as well:

  • High altitude pulmonary edema may occur when fluid builds up in the lungs at certain altitudes
  • Raynaud’s phenomenon which is characterized by the discoloration and loss of sensation of the fingers and toes in certain temperatures
  • Women experiencing female sexual arousal disorder (FSAD) which affects roughly 26% of American women

Sildenafil is not a primary treatment for these other conditions and is only recommended when other treatments have tried and been unsuccessful. 

How Effective Are They? 

Both Viagra® and Revatio are effective treatment options for their respective purposes. Sildenafil, the active ingredient found in both, is overall shown by clinical trials to be a safe and effective drug. 

In a systematic review, treatment with sildenafil for 12 weeks or more was found to improve the clinical symptoms of individuals with pulmonary hypertension. It was also found to help delay the progression of the disease in adults.

A similar review for men with erectile dysfunction found that sildenafil was both effective and well tolerated. When compared to a placebo, sildenafil helped to improve erectile dysfunction with generally mild side effects.

What Are The Side Effects? 

The list of the common side effects that are associated with sildenafil is pretty small as it’s considered to be a fairly safe medication. The most common side effects are headaches, indigestion and flushing (warmth and redness of the face or body). Most of these conditions are only felt by around 20% or fewer of patients so even though they are the most common, they are still relatively rare. 

While there are other side effects listed, they are more and more rare down the line. 

Some of the side effects that may be possible when taking sildenafil include:

  • Headaches
  • Indigestion
  • Flushing
  • Dizziness
  • Nausea
  • Nasal congestion
  • Abnormal vision
  • Back pain
  • Muscle pain
  • Shortness of breath
  • Insomnia 
  • Diarrhea
  • Rash

There are some possibilities for serious consequences depending on other medications being taken. Sildenafil is mainly processed by the liver and by CYP3A4 enzymes, so it should not be used with any other drugs that affect how these enzymes work. CYP3A4 inhibitors like ketoconazole and ritonavir can increase the level of sildenafil and cause adverse and dangerous side effects. 

In addition, Revatio and Viagra® should not be taken with drugs such as nitrates, alpha blockers, and other blood pressure medications like antihypertensives. Combining these drugs may result in hypotension, or dangerously low blood pressure. 

The Takeaway: Viagra® and Revatio have plenty of similarities, mainly the fact that they both contain the same active ingredient of sildenafil and are manufactured by Pfizer. However, they are used to treat completely different conditions, have different dose sizes, and one is taken daily while the other is taken when needed. 

Sildenafil is the active ingredient found in both Viagra® and Revatio and is considered to be a fairly safe and effective drug. Whether it’s being used to treat pulmonary arterial hypertension or erectile dysfunction, sildenafil has been found to be a leading option for both conditions. 

The most important thing when considering taking these medications is to talk to your doctor about how they could potentially affect other medications that you are taking. Outside of that issue, sildenafil only has rare side effects that are very rarely more than an inconvenience. 




SOURCES

https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts#:~:text=It%20affects%20about%2030%20million%20men%20in%20the%20United%20States.

https://www.sciencedirect.com/science/article/pii/S0954611114000237

https://medlineplus.gov/druginfo/meds/a699015.html

https://pubmed.ncbi.nlm.nih.gov/12076233/

https://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/021845s000_RevatioTOC.cfm