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Drug vs. Drug

Revatio vs. Viagra: Differences, similarities, and which is better for you

Gerardo Sison medical writer headshot By | March 5, 2020

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

It can be easy to confuse the active ingredient found in Revatio and Viagra. Although they are each marketed to treat a different condition, they both contain the same primary ingredient—sildenafil. Both drugs are also produced by the same manufacturer, Pfizer.

Revatio and Viagra are part of a family of drugs called phosphodiesterase-5 (PDE-5) inhibitors. Other drugs in this category include Cialis (tadalafil) and Levitra (vardenafil). They work by increasing a substance called cGMP in the blood. This causes blood vessels to dilate which results in different effects depending on the dose of the drug.

With the availability of generic sildenafil, it’s important to know the difference between its two brand names. While Revatio and Viagra share the same ingredient, they are dosed differently and used for different conditions.

What are the main differences between Revatio and Viagra?

The main difference between Revatio and Viagra is in how they are used. Revatio is used for pulmonary arterial hypertension (PAH) while Viagra is used to treat erectile dysfunction (ED).

Revatio comes in different dosage forms such as tablets, injections, and oral liquids. Compared to Viagra, Revatio is administered three times per day at a lower dose.

Viagra is taken at a higher dose not more than once per day. It is usually taken between 30 minutes and 4 hours before sexual activity.

Main differences between Revatio and Viagra
Revatio Viagra
Drug class phosphodiesterase-5 (PDE5) inhibitor phosphodiesterase-5 (PDE5) inhibitor
Brand/generic status Brand and generic version available Brand and generic version available
What is the generic name? Sildenafil citrate Sildenafil citrate
What form(s) does the drug come in? Oral tablet
Injection
Oral suspension
Oral tablet
What is the standard
dosage?
20 mg three times daily 50 mg 1 hour before sexual activity as needed
How long is the typical treatment? Short term or long term as directed by a physician Short term or long term as directed by a physician
Who typically uses the medication? Adults 18 years and older Adults 18 years and older

Source: Revatio and Viagra

Conditions treated by Revatio vs. Viagra

Revatio is marketed for the treatment of pulmonary arterial hypertension. It can help improve the ability to exercise and delay the worsening of the disease. Viagra is marketed to treat erectile dysfunction. It can help men get and maintain an erection for sexual intercourse. Both drugs contain sildenafil, which is FDA-approved to treat PAH or ED depending on the dose.

Pulmonary arterial hypertension is a rare, progressive disease that affects the lungs. It is characterized by high blood pressure in the lungs and causes symptoms such as shortness of breath and dizziness. Between 10 and 15 people per million population are diagnosed with the disease each year.

Viagra, more commonly known as the “little blue pill”, may be more well-known than Revatio since more men may be affected by erectile dysfunction (ED) compared to those with PAH. ED is estimated to affect 18 million men in the U.S., which makes Viagra a popular drug for this reason.

Off-label uses of sildenafil include treatment of high altitude pulmonary edema. High altitude pulmonary edema occurs when fluid builds up in the lung at certain altitudes. In those who experience Raynaud’s phenomenon, sildenafil may be considered for treatment. Raynaud’s phenomenon is characterized by the discoloration and loss of sensation of the fingers and toes in certain temperatures. Sildenafil is only recommended as an option when other treatments are not available or have already been tried.

Sildenafil has also been shown to help treat women who experience female sexual arousal disorder (FSAD). This disorder is common in up to 26% of American women.

Condition Revatio Viagra
Pulmonary arterial hypertension Yes Yes (generic sildenafil)
Erectile dysfunction Yes (generic sildenafil) Yes
High altitude pulmonary edema Off-label Off-label
Raynaud’s phenomenon Off-label Off-label
Female sexual arousal disorder Off-label Off-label

Is Revatio or Viagra more effective?

Both Revatio and Viagra contain the same active ingredient—sildenafil. Since the brand names are marketed for different purposes, they are effective in their own way. Overall, sildenafil has been shown by clinical trials to be safe and effective.

In a systematic review, treatment with sildenafil for 12 weeks or more improved clinical symptoms of pulmonary hypertension. Sildenafil was also found to help delay the progression of the disease in adults.

According to a similar review of men with erectile dysfunction, sildenafil was found to be effective and well-tolerated. Compared to placebo, or no treatment at all, sildenafil helped improve erectile dysfunction with generally mild side effects. Sildenafil may especially be useful for men with Peyronie’s disease, a penile tissue disorder where scar tissue can cause the penis to bend in an abnormal way.

Depending on your condition, Revatio or Viagra may be prescribed. Talk to your healthcare provider to find out which treatment may work better for you. Since they both contain the same ingredient, you may be prescribed generic sildenafil in most cases.

Coverage and cost comparison of Revatio vs. Viagra

As a brand-name medication, Revatio is not generally covered by most insurance and Medicare plans. Generic sildenafil, however, is often covered by insurance plans. The average retail price can be over $200. A SingleCare coupon card can be used to lower this cost to around $13.95 depending on the pharmacy you go to.

Viagra is usually prescribed in small quantities of two to 10 tablets at a time since it is taken as needed. Most Medicare and insurance plans do not cover brand-name Viagra. Some insurance companies will require prior authorization for brand-name drugs in order for them to cover the drug. The average retail cost of Viagra is can range from $130 to over $200. With a SingleCare discount card, this cost can be reduced to under $50 for two 50 mg generic tablets.

Another cheaper alternative is to check out our partnership with Lemonaid Health where you can get Sildenafil for as little as $2 per pill.

  Revatio Viagra
Typically covered by insurance? No No
Typically covered by Medicare? No No
Standard dosage 20 mg (quantity of 30 tablets) 50 mg (quantity of 2 tablets)
Typical Medicare copay $3–$770 $22
SingleCare cost $13.95+ $50+

Common side effects of Revatio vs. Viagra

The most common side effects associated with sildenafil, the active ingredient in Revatio and Viagra, are headache, indigestion (dyspepsia), and flushing (warmth and redness of the face or body).

Based on clinical trials, those who take Revatio may experience other side effects such as insomnia, shortness of breath, diarrhea, nasal congestion, and muscle pain (myalgia). According to trials with Viagra, other common side effects may include nasal congestion, back pain, muscle pain, nausea, dizziness, and rash.

More serious side effects of sildenafil may include blurred vision or hearing loss.

  Revatio Viagra
Side Effect Applicable? Frequency Applicable? Frequency
Headache Yes 46% Yes 21%
Indigestion Yes 13% Yes 9%
Flushing Yes 10% Yes 19%
Dizziness Yes *not reported Yes 4%
Nausea Yes * Yes 3%
Nasal congestion Yes 4% Yes 4%
Abnormal vision Yes * Yes 2%
Back pain No Yes 4%
Muscle pain Yes 7% Yes 2%
Shortness of breath Yes 7% Yes <2%
Insomnia Yes 7% Yes <2%
Diarrhea Yes 9% No
Rash No Yes 2%

This may not be a complete list. Consult your doctor or pharmacist for possible side effects.
Source: DailyMed (Revatio), DailyMed (Viagra)

Drug interactions of Revatio and Viagra

Sildenafil is mainly processed by the liver. Therefore, both Revatio and Viagra interact with many of the same drugs. Since Revatio and Viagra are processed by CYP3A4 enzymes, they should not be used with other drugs that affect how these enzymes work.

CYP3A4 inhibitors like ritonavir and ketoconazole can increase the level of sildenafil in the blood and cause adverse side effects.

Revatio and Viagra should not be taken with other drugs called nitrates, alpha blockers, and other blood pressure medications (antihypertensives). Taking these drugs together can increase the risk of hypotension, or dangerously low blood pressure.

Riociguat is a drug that can treat pulmonary arterial hypertension. Because of its possible hypotensive effects, it is not recommended to be used when taking sildenafil.

Drug Drug Class Revatio Viagra
Ritonavir
Ketoconazole
Itraconazole
Erythromycin
CYP3A4 inhibitors Yes Yes
Isosorbide dinitrate
Isosorbide mononitrate
Nitroglycerin
Amyl nitrite
Nitrates Yes Yes
Terazosin
Tamsulosin
Doxazosin
Alfuzosin
Alpha blockers Yes Yes
Amlodipine
Lisinopril
Losartan
Valsartan
Hydrochlorothiazide
Antihypertensives Yes Yes
Riociguat Guanylate Cyclase (GC) Stimulators Yes Yes

This may not be a complete list of all possible drug interactions. Consult a doctor with all the medications you may be taking.

Warnings of Revatio and Viagra

Because Revatio and Viagra can affect blood pressure, their use should be cautioned in individuals with very low blood pressure or on medications for high blood pressure. Those with heart disease or who take medications for chest pain may need to take special precautions. Taking sildenafil may increase the risk of worsening heart disease, chest pain, or heart attacks in severe cases.

Although rare, some users of Revatio or Viagra have experienced a condition called anterior ischemic optic neuropathy (AION). This condition is characterized by a decrease or sudden loss of vision. Another related adverse side effect is the decrease or sudden loss of hearing. These adverse side effects have also been seen with other PDE-5 inhibitors.

Priapism is a persistent and painful erection lasting longer than 4 hours. It is a rare, adverse side effect associated with sildenafil. If you experience this adverse effect, seek immediate medical attention. Leaving priapism untreated could lead to damage of the penile tissue.

Talk to a doctor if you have any underlying conditions before taking Revatio or Viagra.

Frequently asked questions about Revatio vs. Viagra

What is Revatio?

Revatio (sildenafil) is a prescription drug used to treat pulmonary arterial hypertension (PAH) in adults 18 years and older. It works by dilating blood vessels and increasing blood flow to certain areas of the body. It is usually taken as a 20 mg tablet three times a day to help improve exercise capacity and delay disease progression.

What is Viagra?

Viagra is the brand name for sildenafil citrate. It is used to treat erectile dysfunction (ED) in men 18 years and older. It works by relaxing smooth muscles in the blood vessels to increase blood flow to the penis. Viagra can be taken as needed 1 hour before sexual activity.

Are Revatio and Viagra the same?

Revatio and Viagra contain the same active ingredient—sildenafil. However, they both contain different strengths of sildenafil. Revatio is taken at a lower dose three times per day while Viagra is taken at higher doses not more than once per day.

Is Revatio or Viagra better?

Both drugs are effective to treat their indicated conditions. Revatio is effective for treating pulmonary hypertension while Viagra is effective for treating erectile dysfunction. Both drugs contain the same active ingredient in different doses. Talk to your doctor to determine what form of sildenafil is best for you.

Can I use Revatio or Viagra while pregnant?

Sildenafil has been shown to help treat some conditions in women. However, the data regarding sildenafil use while pregnant is limited. Some studies show that there does not seem to be an increased risk of adverse effects with sildenafil. Consult a doctor for medical advice if you are pregnant or breastfeeding.

Can I use Revatio or Viagra with alcohol?

Drinking alcohol while on Revatio or Viagra is not generally recommended. Taking Revatio or Viagra and drinking alcohol could increase the risk of adverse side effects such as dizziness, flushing, and headache.

Does Revatio work for erectile dysfunction?

Revatio is specifically marketed to treat pulmonary arterial hypertension. Revatio is available in lower dose tablets compared to Viagra. Therefore, it may not be as effective as Viagra, which contains a higher dose of sildenafil. Talk to your doctor before using sildenafil for ED since certain doses are more effective than others.

How long does it take for Revatio to work?

The most notable decreases in blood pressure for those with PAH can be seen within 1 to 2 hours after administration with Revatio. Sildenafil and its active metabolite have half-lives of about 4 hours. For this reason, Revatio should be taken every 4 to 6 hours.

Does Revatio work like Viagra?

Revatio contains the same active ingredient as Viagra. Both medications contain sildenafil which can help treat different conditions depending on the dose given. Revatio provides sildenafil at a lower dose to treat PAH while Viagra tablets contain sildenafil in higher doses to treat ED.