Not All Blue Pills Are Created Equal: What You Need to Know

When Viagra® was approved as a treatment for erectile dysfunction in 1998, it was marketed as the “little blue pill.” You may remember those early ad campaigns starring Bob Dole or the ones where men in suburbia jumped for joy because they’d finally found a solution for their problems in bed.

Though Viagra (the brand name for sildenafil citrate) was the first FDA-approved ED medication, many others followed in its wake, including Cialis® (tadalafil), Levitra® (vardenafil), and Stendra® (avanafil). These drugs worked similarly to Viagra, but they didn’t come in a blue pill.

There are other blue medications, but they’re nothing like Viagra. For instance, counterfeit pills that contain the opioid fentanyl or other substances can come in a blue tablet, and mistaking it for Viagra can have dire consequences for your health.

It should go without saying, but you should never take a medication like Viagra unless it’s been prescribed by a healthcare provider after a thorough consultation. The problem with Viagra being known as the “little blue pill” is that some people may take any blue pill recreationally in hopes of staying rock hard all night.

In this guide, we’ll discuss how Viagra works, how to access it safely, and why you should never take counterfeit pills.

People often refer to Viagra as the “little blue pill” or simply the “blue pill.” The reason is obvious — Viagra tablets are small, blue, diamond-shaped pills.

Generic Viagra tablets, which contain the active ingredient sildenafil citrate, are often blue, but not always. The tablet's color does not affect how well the medication works. A white sildenafil pill (generic Viagra) works exactly the same as a blue Viagra pill because it contains the same active ingredient.

No, not every blue pill is Viagra.

Other blue pills can include Xanax® (alprazolam), Adderall® (amphetamine and dextroamphetamine), Vicodin® (hydrocodone), and Percocet® (oxycodone).

Knowing that not every blue pill is Viagra is important because there’s a growing trend of men who don’t have ED taking Viagra recreationally in an effort to improve sexual performance. To access the medication without a prescription, they may turn to illegal drug sellers and online pharmacies, which are infamous for selling counterfeit prescription drugs.

Some counterfeit ED medications have been found to contain inconsistent doses of the active ingredient and contaminants like talcum powder, commercial paint, and printer ink. Even worse, these pills may also include other hidden drugs, including opioids.

For instance, in 2022, a Louisiana man was arrested for illegally possessing a large amount of narcotics with the intent to sell, including 610 pills of suspected Viagra. When the pills were sent to the lab for testing, they were found to contain over 28 grams of fentanyl.

Fentanyl is a synthetic opioid that is 100 times more powerful than morphine and 50 times stronger than heroin. According to the Drug Enforcement Administration (DEA), two out of every five fake prescription pills with fentanyl contain a potentially lethal dose.

And even if you’re lucky, and you do get your hands on some genuine Viagra, it’s still not safe to take the medication unless you’ve consulted with a medical provider. While Viagra has a solid safety record and is generally well-tolerated, the medication may not be safe for you if you have a medical condition like heart disease or heart failure, or if you’re taking medication for high blood pressure.

All this is to say that if you’re thinking of taking a blue pill that wasn’t prescribed to you, whether you’ve been told it’s Viagra or Vicodin, it’s not safe. You should always get medical advice from a healthcare provider first and only take medication that’s been prescribed specifically for you.

If you’ve been prescribed Viagra or generic Viagra (sildenafil), here’s a quick rundown of how the medication works and why it’s an effective treatment for ED:

• Viagra promotes blood flow to the penis. Viagra and other similar ED medications, like Cialis and Stendra, block PDE5, an enzyme found in the smooth muscle cells of blood vessels.

• Increased blood flow leads to an erection. As blood flows to the penis, it becomes easier to get and keep an erection.

• Viagra doesn’t cause an erection on its own. It simply improves blood flow to the penis. An erection will only occur when you're sexually aroused.

• Viagra starts working within 30 minutes to an hour. Viagra should start working within 30 to 60 minutes and lasts about four hours. This doesn’t mean you’ll have an erection for four hours, but it does mean the medication should stick around long enough for you to make it from dinner to the bedroom without the effects wearing off.

The most common side effects of Viagra include:

• Headaches

• Dizziness

• Back pain

• Nasal congestion (rhinitis)

• Facial flushing

• Nausea

• Indigestion or heartburn (dyspepsia)

• Visual changes (blurred vision or sensitivity to light)

• Rash

• Low blood pressure

Though rare, more serious side effects may occur, including:

• Priapism (a prolonged, non-sexual erection that persists even after ejaculation)

• Vision loss

• Hearing loss

If you want to improve your erections and think an ED medication like Viagra can help, you’ll need a prescription from a licensed healthcare provider.

You can discuss your symptoms with your usual provider or a urologist or connect with a healthcare provider on the Hims platform. After a thorough medical evaluation, they’ll determine your eligibility.

Remember, whether you take brand-name Viagra or the generic version sildenafil, the effects are exactly the same. The only difference is that sildenafil is less expensive. You may also want to consider Hims Hard Mints, which can contain the same active ingredient as Viagra in personalized dosages. These mints aren’t blue, but they are as effective as standard Viagra or sildenafil tablets.

As we said before, though the little blue pill is famous for being the first-ever FDA-approved medication for ED, Viagra isn’t the only ED treatment out there.

Other ED treatments include:

• Other PDE5 inhibitors: The closest thing you’ll get to Viagra is its generic version, sildenafil. But other PDE5 inhibitors work similarly in promoting blood flow to the penis. They include Cialis (tadalafil), vardenafil (the generic version of Levitra, which isn’t available anymore), and Stendra (avanafil). All medications can be taken as needed before sex, but Cialis can also be taken daily in a lower dose.

• Therapy: Some men with ED, especially younger men, have psychogenic ED. This means their symptoms have psychological causes, like sexual performance anxiety or relationship issues. Talking to a counselor or sex therapist can help you come up with strategies to confront these issues so you can have a more satisfying sex life.

• Healthy lifestyle changes: Erectile problems can sometimes be a wake-up call to clean up your lifestyle. Following a healthy diet, limiting alcohol, exercising, and losing weight are just a few lifestyle tweaks you can make to improve and prevent erectile dysfunction.

• Vacuum erection devices (VEDs): VEDs help you obtain an erection by pulling blood into the tissues inside your penis. They are commonly paired with cock rings to help maintain the erection.

• Alprostadil: Alprostadil is an FDA-approved medication that is injected into the penis to treat erectile dysfunction. It’s also available as a urethral suppository.

• Penile implants: Penile implants, or penile prostheses, consist of bendable rods or inflatable devices that help the penis maintain an erect position.

Viagra revolutionized the treatment of ED when it was approved by the FDA in 1998. While its blue color became iconic, it's important to remember that not all blue pills are Viagra, and some counterfeit versions can be dangerous. Here’s what we know:

• Viagra works by increasing blood flow to the penis. By blocking the enzyme PDE5, Viagra helps blood flow to the penis, promoting better erections.

• Not every blue pill is Viagra. Some counterfeit Viagra pills may contain dangerous substances like fentanyl, which can be life-threatening.

• Always consult a healthcare provider before taking Viagra. Viagra is a well-tolerated ED medication, but it may not be safe for everyone, especially if you have underlying health conditions.

Want to learn more about how Viagra works? Read these guides on how to take sildenafil and how to take Viagra for best results.