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Sildenafil

Sildenafil (Viagra®) is an oral medication taken as needed to treat erectile dysfunction.

Medical Review byMike Bohl, MD, MBA, MPH, MS, ALMUpdated Jul 2, 2025

Medication Name

Basics

Sildenafil is the active ingredient in the brand-name medication Viagra®. Sildenafil works the same way as Viagra and has the same benefits and risks, according to the FDA. 

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor, an oral medication used to treat erectile dysfunction (ED) by increasing blood flow to the penis. It is taken only as needed, usually about an hour before sexual activity, though it can be effective if taken between 30 minutes to four hours prior. 

It is very important not to take Viagra more than once a day, as exceeding this frequency increases the risk of serious side effects, including vision loss and significant drops in blood pressure.

*Sildenafil Approved Uses

Viagra (sildenafil citrate) is indicated to treat:

  • Erectile dysfunction (ED)

*Sildenafil Drug Category

Phosphodiesterase-5 (PDE5) inhibitor

*Sildenafil Side Effects

Most common adverse reactions (≥2%) include:

  • Headache

  • Flushing

  • Indigestion

  • Abnormal vision

  • Nasal congestion

  • Back pain

  • Muscle pain

  • Nausea

  • Dizziness

  • Rash

Sildenafil Cost

The cost of sildenafil may vary depending on factors such as your insurance plan, the dosage, the quantity, and where you buy it.

Without insurance, the average retail price of sildenafil is about $23 per tablet, but coupons and discount cards may bring the cost to less than $1 per tablet. Insurance may cover all or some of the cost of the drug.

Hims offers access to sildenafil starting at $4 per use after a thorough medical consultation.  Based on your symptoms and medical history, a healthcare provider will determine if the product is a good fit for your needs.

*Interactions & Contraindications

  • Administration of Viagra to patients using nitric oxide donors, such as organic nitrates or organic nitrites in any form

  • Known hypersensitivity to sildenafil or any component of tablet

  • Drug interactions: Nitrates, alpha blockers, antihypertensives, CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole, saquinavir, erythromycin)

*Warnings & Precautions

  • Patients should not use Viagra if sexual activity is inadvisable due to cardiovascular status

  • Patients should seek emergency treatment if an erection lasts >4 hours

  • Patients should stop Viagra and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non arteritic anterior ischemic optic neuropathy (NAION)

  • Patients should stop Viagra and seek prompt medical attention in the event of sudden decrease or loss of hearing

  • Caution is advised when Viagra is co-administered with alpha-blockers or anti-hypertensives

  • Decreased blood pressure, fainting, and prolonged erection may occur at higher sildenafil exposures

FAQs

At any dose, sildenafil takes about 30 to 60 minutes to start working. It’s recommended to take the medication about an hour before sex.

Sildenafil’s starting dose is typically 50 mg, but your provider may adjust the dose down to 25 mg or up to 100 mg depending on the severity of your ED and how you respond to the medication. 

Sildenafil’s effects last for about four hours after taking the medication, meaning you should be able to get and maintain erections hard enough for sex within that four-hour window.

Viagra and sildenafil are chemically identical and work exactly the same. Viagra is the brand-name version of sildenafil. Both are effective treatments for ED, but Viagra tends to be more expensive and may differ a bit when it comes to packaging and pill appearance.

References

*This information is from the label for brand name Viagra®. See the Full Prescribing Information for more complete information. Sildenafil, the active ingredient in Viagra, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sildenafil.

Editorial Standards

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

  1. VIAGRA® (sildenafil citrate) tablets, for oral use. (2014). https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf

  2. GoodRx. (n.d.). Sildenafil prices, coupons, and savings tips. https://www.goodrx.com/sildenafil

All trademarks are the property of their respective owners. Use of third-party trademarks is for informational purposes only and does not imply endorsement or affiliation with Hims, Inc.
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