Generic Sildenafil: How It Compares With Viagra

Same active drug, different maker and tablet. Here is what the FDA and the labels say a generic sildenafil is and is not.

Generic sildenafil is the same medicine as Viagra. The FDA defines a generic as an approved copy of a brand drug with the same active ingredient, strength, dosage form and route of administration, and it must deliver the drug at the same rate and to the same extent.¹ Generic sildenafil for ED comes in the same 25, 50 and 100 mg strengths as Viagra, and one manufacturer's generic label gives the same starting dose, 50 mg about 1 hour before sexual activity.²³ The differences are in the inactive ingredients, the look of the tablet and who makes it.

Is generic sildenafil the same as Viagra?

For the active drug, yes. Viagra is supplied as blue, film-coated, diamond-shaped tablets in 25 mg, 50 mg and 100 mg, stamped with the maker's name and strength.³ A generic label from Northstar Rx lists pale blue to blue caplet-shaped tablets in the same three strengths, stamped differently, and is indicated for the same condition, erectile dysfunction.² The FDA says generics must meet the same quality standards, including for products made outside the United States.¹

What can differ is described plainly by the FDA: small, allowable differences between products from different companies, such as certain inactive ingredients, can sometimes feel noticeable to patients. In most cases they do not matter clinically, but in a minority of patients they may affect tolerability or absorption.¹ If a generic seems to cause a new side effect, the FDA advises talking to a pharmacist or prescriber and reporting it.¹

Why do some generic sildenafil tablets say 20 mg?

A 20 mg sildenafil tablet is usually not the ED product. The Revatio label describes 20 mg tablets for pulmonary arterial hypertension, and a generic 20 mg sildenafil label is also indicated for that condition.⁷⁴ Our guide to sildenafil 20 mg goes through what the evidence supports. Viagra and generic ED tablets are labeled for 25, 50 and 100 mg, covered in sildenafil 50 mg.

The two labels also warn against combining: the Viagra label says combinations with Revatio or other sildenafil-containing products have not been studied and may lower blood pressure further.³ Taking a 20 mg tablet from one prescription on top of an ED tablet from another is the kind of overlap a pharmacist can catch.

What stays the same with a generic?

All of the safety information. The label's contraindications apply to every sildenafil tablet: it must not be taken with nitrates in any form or with guanylate cyclase stimulators such as riociguat.³ Timing is the same, so a high-fat meal still delays absorption by about 60 minutes on average.³ See sildenafil with or without food and how long sildenafil lasts. The maximum is one dose a day.³

Generic sildenafil versus a compounded sildenafil product

A generic is an FDA-approved copy of a specific brand product. A compounded drug is made by a pharmacy for an individual patient and is not FDA-approved: the FDA does not review compounded drugs for safety, effectiveness or quality before they are marketed.⁵ The label on the product, not the marketing, tells you which one you have. Not every prescription drug has a generic, and the FDA points to its Orange Book for checking.¹

Our pick: Quattro from Vea Health Sponsored

Quattro is our pick in this guide because we have a financial relationship with Vea Health. It is not a generic and it is not a sildenafil-only product, and we make no claim that it is better, faster or safer than generic sildenafil.

Vea Health describes Quattro as a compounded sublingual dose combining sildenafil, tadalafil, vardenafil and apomorphine, prescribed only after a licensed clinician reviews a health history.⁸ It suits a man who has tried a standard tablet and wants to discuss a dissolving combination with a clinician, accepting that it is compounded and not FDA-approved.⁵ The Viagra and Cialis labels both say combinations with other PDE5 inhibitors have not been studied, so the clinician's review matters and a clinician may decline.³⁹

Questions to ask the pharmacist about a generic

• Is this an FDA-approved generic or a compounded product?
• Which maker supplied it, and does the tablet look the same as last time?
• Is the strength the ED strength (25, 50 or 100 mg) or the 20 mg tablet?
• Does anything I take, including nitrates or alpha-blockers, rule it out? Our ED medication interactions guide lists the main ones.

Questions readers ask

Is generic sildenafil as good as Viagra?

The FDA requires generics to deliver the same active ingredient at the same rate and extent as the brand. Small differences in inactive ingredients are allowed and rarely matter clinically.

What strengths does generic sildenafil come in for ED?

One generic label lists 25, 50 and 100 mg tablets, the same strengths as Viagra. Generic 20 mg tablets are labeled for pulmonary arterial hypertension.

Why does my generic look different from Viagra?

Generics may differ in shape, color and markings, because only the active ingredient, strength and dosage form must match. Inactive ingredients can differ too.

Is compounded sildenafil the same as generic sildenafil?

No. A generic is an FDA-approved copy of a brand product, while a compounded drug is made by a pharmacy for an individual patient and is not FDA-approved.

Does generic sildenafil have the same side effects?

The safety information is the same, including the nitrate contraindication. If a generic seems to cause a new side effect, ask a pharmacist or prescriber and report it to the FDA.

Further reading

Part of our guide: How ED Medications Work: Timing, Food, Interactions and Combinations

• Sildenafil Headache: How Common Is It?
• Tadalafil With Alcohol: How Much Is Too Much?
• What Is Tadalafil Used For? The Three Approved Uses
• Tadalafil Brand Names: Which Brand Is Used for What