Viagra® vs. Sildenafil: What's the Difference?

March 15, 2021

4 mins

Viagra® is certainly the most well known and popular treatment for erectile dysfunction, and it has the longest history of safety and efficacy any FDA-approved erectile dysfunction medication on the market. Searching for more information about Viagra® will invariably lead you to the term "sildenafil" - for good reason. 

Sildenafil and Viagra® are the same thing. These products may have different names at a glance, but they share the same active ingredient. So what exactly is the difference between Viagra® and sildenafil? Not much.

Viagra® is the brand name for sildenafil citrate, its active ingredient and chemical name, that was invented and marketed by the pharmaceutical company Pfizer in 1998. This key difference results in a fairly large discrepancy between prices -- but more on that later. Sildenafil (or more accurately, sildenafil citrate) is the active ingredient found in Viagra® that is responsible for its effects when used to treat erectile dysfunction. Taking a 25mg, 50mg or 100 mg dose of Viagra® will produce almost identical results as the generically named sildenafil. 

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What is Sildenafil and How Does it Work? 

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor. It helps to block the PDE5 enzyme, a natural enzyme that affects certain muscles located in your penis and your heart. PDE5 can restrict blood flow through blood vessels and the spongy penis tissue called the corpus cavernosa. This tissue is what helps your penis become erect when you're aroused. During arousal, the corpus cavernosum fill with blood and create an erection. 

Sildenafil helps to stop PDE5 from restricting blood flow in these blood vessels, and as a result helps your penis to get enough blood and keep enough blood in the penis to create and maintain an erection.

What are the Differences? 

From a medical standpoint, there is no meaningful difference between Viagra® and sildenafil. Viagra® is the branded name for sildenafil citrate in the same way that Kleenex® is the branded name for facial tissue, and often used interchangeably. However, they're not exactly the same in all ways. 

• The pill itself. One difference, albeit fairly unimportant, is that Viagra® is formed into small diamond shaped pills that are blue. This pill design and appearance has been specifically patented by Pfizer, so it’s one of a kind, and has earned Viagra® the nickname "the little blue pill." It's recognized globally. Generic sildenafil can be sold as white or blue tablets, with different characteristics depending on the manufacturer. Some have a more chalky taste as a finish while others are smooth. Some are scored, to be easily divided, while others are not. The dosage sizes between Viagra® and sildenafil are also identical, as they can both be found in 25mg, 50mg and 100mg preparations. The precise recipe for Viagra® vs generic sildenafil also can vary, though there is no significant difference between them as far as active ingredients.  

• Price. As a generic medication, sildenafil is produced by several manufacturers, and the competition that exists between these organizations helps to regulate price and keep it more affordable for consumers. Viagra®, on the other hand, is a brand name and is only produced by Pfizer. The name recognition and customer loyalty allows them to charge a much higher price for the renowned “little blue pills.” As a result, the price difference between the Viagra® and generic sildenafil can be astounding. The cost for 1 tablet of 50 mg generic sildenafil can range as high as $50 pending on your pharmacy (Rex MD has it for as low as $10/dose). The cost for 1 tablet of 50 mg Viagra® can be as high as $90, and a one-month supply might cost you over $500! When it first launched in the U.S., there were no generics available, and Pfizer made a mint charging these premium prices, to the tune of more than $1 billion annually. The difference is shocking, especially when you consider that actively, they're mostly identical. With prices this high, it may come as no surprise that Viagra® is the most counterfeited drug in the world.

• Treatments. One of the differences between Viagra® and sildenafil is what they're used to treat. They both are commonly used to treat erectile dysfunction, of course, but sildenafil has been approved for other uses as well. While Viagra® is only legally approved to treat erectile dysfunction, sildenafil is also used to treat pulmonary arterial hypertension, under the brand name Revatio® when sold by Pfizer. This condition occurs when a person has high blood pressure in their arteries connecting their heart and lungs. Pulmonary arterial hypertension can cause smooth muscle in your lungs to become aggravated and inflamed, which in turn restricts blood flow in certain lung arteries. Sildenafil helps to dilate these arteries and reduce blood pressure.

• Prescriptions. In the United States, both Viagra® and sildenafil are only available via prescription, but in the United Kingdom patients are free to buy either of them over the counter. This decision was made by the Medicines and Healthcare Products Regulatory Agency (the United Kingdom’s version of the FDA) in order to reduce the amount of black market and unregulated Viagra tablets being sold. 

History of Sildenafil and Its Relation To Viagra****® 

Sildenafil citrate was created in the year 1989 by two British scientists named Peter Dunn and Albert Wood as a potential treatment for hypertension and angina, two conditions that are heavily associated with coronary heart disease. 

In 1991 Dr. Nicholas Terrett, known commonly as the father of Viagra, was named in the British patent for sildenafil citrate, intended as a heart medication. During Pfizer’s early trials of the drug during the 1990s, they discovered that it was not very effective as a heart medication...but patients taking part in the clinical trials reported increased erections as a side effect. 

Separate studies provided further data on the biochemical process that creates erections, which led to scientists understanding how sildenafil could open up blood vessels found in the penis and therefore enhance the effects of sexual stimulation. 

Sildenafil was studied in men with erectile dysfunction, and in 1998 was approved by the Food and Drug Administration specifically for treating erectile dysfunction. In June of 2013, Pfizer lost its United Kingdom patent for sildenafil, and as a result, generic manufacturers have been able to produce generic sildenafil. It costs a mere fraction of the price of Viagra® and has made treating erectile dysfunction a possibility for a wider range of patients. 

How Long Does Sildenafil Last?

Sildenafil should last for about on to four hours on average, during which time you need to initiate sexual intimacy, before its effects start to subside. It’s possible that you may be erect for up to 5 hours though (or even 18 hours in some cases) depending on how much you take, so it’s important to only take the recommended and prescribed dosage. Pfizer recommends calling a doctor if your erection lasts more than 4 hours.

There are other factors that will affect the effect the amount of time it lasts and they include:

• Diet. Eating a dense meal before taking sildenafil may cause the medicine to take effect more slowly. Fatty meals will make it harder for the drug to enter your bloodstream, so ideally it should be taken on an empty stomach.

• Lifestyle. Adding just 30 minutes of exercise 5 times a week can drastically improve the effectiveness of sildenafil. Exercise helps to reduce stress and increase energy levels. In addition, it also improves circulation and helps to keep your arteries and heart healthier.  

• Age. The older that you are the more differences in overall health and blood flow efficiency. Since there's clearly nothing you can do about your age, ensure the other factors are as good as they can be to compensate.

• Medications. Some drugs and medications will affect your blood pressure and can limit the effectiveness of sildenafil.

• Health. Underlying health issues can affect blood flow and other physical mechanisms such as nerve sensitivity, which will affect your ability to get or maintain an erection.

When You Should Avoid Sildenafil 

If you meet any of the following criteria you should avoid sildenafil or consult a physician before taking the medication:

• Take nitrates such as Isordil or nitroglycerin

• Having an existing heart condition

• Have had a stroke or heart attack in the last six months

• Take other medications that could interact with sildenafil

• Take alpha blockers for high blood pressure

• Have been diagnosed with Peyronie’s disease

• Have tinnitus or ringing in your ears

• Have kidney or liver disease

• Have sickle cell anemia

Potential Side Effects for Sildenafil 

Some of the most common side effects for sildenafil include:

• Nausea

• Dizziness

• Rashes

• Dangerously low blood pressure

• Sinus congestion

• Difficulty with digestion or gas

• Headaches or migraines

• Redness or flushing in your face

• Pain in your back

• Sudden loss of hearing or vision

• Priapism (erections lasting longer than four hours that can be quite painful)

The Takeaway: From a medical standpoint there is no meaningful difference between sildenafil and Viagra®. They are essentially identical: sildenafil is the active ingredient in Viagra®. The biggest difference is price -- with generic sildenafil being much cheaper.

When it comes to the differences between Viagra® and sildenafil, it’s easily summed up as brand name versus generic. What's the difference between a plastic bag and Ziploc? What's the difference between an adhesive bandage and a Band-Aid? The list goes on, but the difference is all about price.

At Rex MD, we believe that guys should be able to access affordable men's health prescriptions without breaking the bank, and with the convenience of online ordering. It's all done virtually - even the doctor's visit. Get started now with a free consultation and your choice of medications delivered to your door.

Sources

Good News, Guys: Viagra Prices to Tumble Today - WedMD