Viagra vs. Revatio Uses: What Are the Differences?

When it comes to erectile dysfunction medication, Viagra® is probably the most well-known option out there. Containing the active ingredient sildenafil citrate, this “little blue pill” helps men get and maintain harder, longer-lasting erections by increasing blood flow to the penis.

Viagra isn’t the only drug made from sildenafil, though. There’s also Revatio®. Revatio uses sildenafil to increase blood flow, too. And like Viagra, Revatio is manufactured and sold by the pharmaceutical giant Pfizer. Both drugs can even produce similar effects when used as prescribed.

But when it comes to Revatio vs. Viagra, these drugs have some notable differences you should know about — including who they’re prescribed to. Read on for a detailed breakdown.

The best way to separate Viagra and Revatio is by dosage and what they’re typically prescribed for.

Viagra is prescribed to men dealing with erectile dysfunction, while Revatio is FDA-approved to treat pulmonary arterial hypertension (PAH) — a type of high blood pressure in the lungs.

Before explaining how Viagra and Revatio differ from a functional perspective, we’re going to dive deeper into how they’re similar.

Similarities Between Viagra and Revatio

Both Viagra and Revatio:

• Contain the active ingredient sildenafil

• Share similar side effects

• Can have drug interactions

• Require a prescription

Find out more below.

Both Drugs Contain the Active Ingredient Sildenafil

Sildenafil is a medication used to treat both ED and PAH. It belongs to a class of drugs called PDE5 inhibitors (or phosphodiesterase type-5 inhibitors). These medications inhibit the PDE5 enzyme in the smooth muscle cells of blood vessels. This makes blood vessels widen, letting more blood flow to certain types of tissue.

Both Drugs Share Similar Side Effects

Viagra and Revatio can cause similar side effects, including:

• headaches

• nasal congestion

• runny nose

• flushing

• indigestion

In rare cases, they can also cause blurred vision, loss of vision, and temporary loss of hearing.

You shouldn’t take these drugs if you have a bleeding disorder, stomach ulcer, or existing cardiovascular disease.

Both Drugs Can Have Drug Interactions

Both medications may cause drug interactions if you’re taking drugs for other health conditions.

If you’re taking nitrate medications (like nitroglycerin, dinitrate, or isosorbide mononitrate) or alpha-blockers for existing heart problems like heart attack or heart failure, adding sildenafil to your regimen can cause serious side effects. There can also be dangerous interactions if used with nitrite “poppers,” street drugs containing amyl nitrite.

You also shouldn’t take these drugs with bosentan, an endothelin receptor antagonist, as this drug can affect the absorption of sildenafil.

Other drugs that have reported interactions with sildenafil include:

• ketoconazole

• itraconazole

• ritonavir

• saquinavir

• riociguat

• erythromycin

Both Drugs Require a Prescription

When being evaluated for a prescription, you must inform your healthcare provider about any medical conditions you currently have or previously had.

While they’re both sildenafil-based medications, Revatio and Viagra aren’t taken in the same way. Revatio must be taken every day to treat PAH, while Viagra can be taken ad hoc (when necessary or as needed for ED treatment) — but no more than once a day.

With this in mind, be sure to follow your healthcare provider’s instructions on how to take Revatio or Viagra to avoid any mishaps.

As noted, Viagra is a brand-name drug for erectile dysfunction. It comes in tablet form and is available in several doses. This medication is meant to be used as needed and taken 30 minutes to up to four hours before sexual activity.

After four hours, Viagra becomes less effective and may not provide a significant amount of relief from erectile dysfunction.

Research has shown that some men find sildenafil helps with their erections for as little as 20 minutes, while others anecdotally experience the effects for a whole 24 hours — though the official label doesn’t support its effects lasting this long.

What’s interesting about sildenafil is that it wasn’t initially created to treat erectile dysfunction. Pfizer developed it in the late ‘80s as a potential treatment for angina (chest pain).

During early clinical trials, many participants reported experiencing erections while using sildenafil. Sildenafil gained approval from the U.S. Food and Drug Administration (FDA) in 1998 for the treatment of erectile dysfunction.

Our guide to how Viagra works goes into more detail about the biological process of getting an erection, as well as how Viagra can make it easier if you’re prone to ED.

Viagra Side Effects

Like any medication, you may experience side effects from taking this ED medication.

The potential side effects of Viagra may include:

• Headaches

• Flushing

• Indigestion or heartburn

• Nausea

• Nasal congestion

• Eye problems (like blurred vision)

• Back pain

• Muscle pain

• Dizziness

• Low blood pressure

Many of these side effects are more common when Viagra is taken at a moderate or high dose, such as 50 or 100 milligrams.

In rare cases, Viagra and generic sildenafil may cause other side effects, including prolonged or painful erections (referred to as priapism).

Priapism is an extremely rare side effect that requires medical attention. People diagnosed with sickle cell anemia, leukemia, and multiple myeloma have a higher risk of developing this condition.

Other rare side effects include loss of hearing and loss of vision. Patients with a history of non-arteritic anterior ischemic optic neuropathy (NAION) should avoid this medication to lower the risk of vision loss.

You may also experience an allergic reaction to sildenafil. Stop taking it immediately if you experience symptoms like hives, itching, or swelling.

Revatio is the second brand name for sildenafil. But unlike Viagra, it’s not FDA-approved to treat erectile dysfunction.

Revatio is FDA-approved for treating pulmonary arterial hypertension, a type of high blood pressure affecting the lungs’ arteries.

While Viagra entered the market in the late ’90s, Revatio was approved by the FDA in 2005 as a treatment for PAH.

This medication (and generic Revatio) contains a lower dose of sildenafil than Viagra. Each Revatio tablet contains 20 milligrams of sildenafil. In comparison, a Viagra tablet contains 25, 50, or 100 milligrams of the active ingredient.

So what does this all mean?

It means each individual Revatio 20mg tablet has about one-fifth the amount of sildenafil as the strongest Viagra tablet. Yet, despite the different strengths, these medications are essentially the same drugs producing similar effects in the body.

This also indicates that Revatio can be effective in treating erectile dysfunction.

While the amount of sildenafil per tablet is lower than Viagra, many men with mild or moderately severe ED find their condition is effectively treated with the 20-milligram dose found in Revatio. It is also possible for healthcare providers to prescribe Revatio off-label for ED in multiples of 20mg, including 40mg, 60mg, 80mg, and 100mg. These doses approximate the doses of Viagra and can be achieved by taking multiple 20mg tablets at once. But remember, only do this if your healthcare provider prescribed it.

So although Revatio isn’t FDA-approved for ED, it can increase blood flow to your penis, leading to an erection.

Revatio Side Effects

Revatio’s side effects are similar to Viagra’s side effects because the active ingredient is the same. All the side effects listed above, such as headaches, flushing, dizziness, indigestion, vision problems, hearing loss, low blood pressure, and risk of priapism are also associated with Revatio.

Other adverse effects, as listed on Revatio’s drug packet and DailyMed include:

• Diarrhea

• Nosebleeds

• Insomnia

• Shortness of breath

• Worsening pulmonary veno-occlusive disease

While Viagra and Revatio have the same active ingredient, similar outcomes, similar side effects, and similar drug interactions, they are actually different.

To help clear the air, here’s a rundown of the main differences between Revatio and Viagra:

• Conditions for which they are FDA-approved. Viagra is FDA-approved to treat erectile dysfunction, whereas Revatio is FDA-approved to treat pulmonary arterial hypertension. The medications can be prescribed off-label for other conditions if a healthcare provider deems it appropriate, including Revatio (and generic Revatio) being prescribed for ED.

• Dosage. Although both medications contain sildenafil, they’re dosed for different purposes. Viagra dosage ranges from 25 to 100 milligrams per tablet. Meanwhile, Revatio is only available as a 20-milligram oral tablet.

• Price. Depending on where you buy the medications and your coverage, the prices of Viagra and Revatio may differ.

At this point, you may be wondering, Which medication is better for me? That’s up to you and your healthcare professional to decide.

But we can tell you, from a purely functional standpoint, Viagra and Revatio can both be used to treat erectile dysfunction because they contain the same active ingredient.

Your healthcare provider can suggest the best dosage to treat your erectile dysfunction symptoms while minimizing uncomfortable side effects.

Check out our guide on how to take Viagra for the best results for more tips and insight.

Oh, and if you want to save on ED medications, the generic version of either medication may be a good option. Buying generic drugs, in general, lets you access the same benefits as brand-name medications at a significantly lower price per tablet.

For example, we offer access to generic sildenafil pills at a fraction of the cost of brand-name Viagra, as well as chewable ED hard mints containing sildenafil.

If you were thinking about skipping these prescription medications for something you can take without a prescription, think again.

The FDA advises people to avoid certain male-enhancement products sold through retailers like Amazon and eBay because they may contain dangerous drug ingredients.

You can visit the FDA’s MedWatch page for the latest reports and safety alerts on prescription drugs, over-the-counter medications, biologics, medical devices, and other FDA-regulated products.

From the looks of it, Viagra and Revatio are essentially the same except for FDA-approved indication, dosage, and price.

Both can be used as an erectile dysfunction medication, and your healthcare provider can help you decide how to approach your sexual dysfunction problems as well as which medication might be best for you.

Here’s what to keep in mind:

• Viagra and Revatio contain the same active ingredient. Both drugs contain sildenafil citrate, and the brand-name versions are manufactured by the same company. Both Revatio and Viagra increase blood flow and have similar side effects.

• The medications are not prescribed the same way. Viagra and Revatio contain the same ingredient but are FDA-approved to treat different medical conditions. Viagra is used in specific doses and formulations to treat ED. Revatio is used in specific doses and formulations to treat pulmonary arterial hypertension.

• Both drugs have potential drug interactions. Any medication that contains sildenafil — and other PDE5 inhibitors, such as tadalafil (Cialis®), vardenafil (Levitra®), or avanafil (Stendra®) — has the potential to interact with other medications. This includes drugs for high blood pressure and heart disease.

• You should avoid non-prescription supplements that claim they can treat ED. These products are notorious for containing dangerous ingredients.

If you suspect that you’re dealing with psychological ED caused by mental health conditions like anxiety or depression, consider seeking counseling for sexual performance anxiety.

No matter what type of erectile dysfunction you may have, Hims’ team of healthcare providers can offer medical advice on how to improve your erections and get your sex life back on track.