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Viagra

Viagra is a drug developed to treat erectile dysfunction, a common condition that affects many men. Approved by the US Food and Drug Administration on 27 March 1998, it was the first oral medication specifically for ED, offering a new option for those struggling with the condition.

A close-up image of a blue Viagra pill manufactured by Pfizer.

Viagra, a household name in the treatment of erectile dysfunction (ED), has changed the lives of millions of men since its introduction in 1998. Designed to treat a condition that impacts an estimated 30 million men in the United States alone, the drug offers a reliable solution for those struggling to achieve or maintain an erection sufficient for sexual activity.

Developed by Pfizer, Viagra was the first oral medication approved by the Food and Drug Administration (FDA) [1] and the European Medicines Agency (EMA) soon after [2], marking a turning point in the way the condition was treated and discussed. Originally discovered by chance while researchers were investigating treatments for heart disease, Viagra's journey from laboratory surprise to global phenomenon underlines its importance in modern medicine. Today, it remains a cornerstone of ED therapy, widely prescribed and available in both branded and generic forms.

Viagra's active ingredient, sildenafil, was originally researched for the treatment of high blood pressure and angina [3]. However, studies showed that it significantly improved erectile function, leading to its repurposing. This discovery allowed for a rapid approval process, taking just two years from patenting in 1996 to market availability, which is remarkably fast for pharmaceuticals. Since its introduction, Viagra has become widely recognised, with sales reaching around $1 billion in its first year, reflecting its commercial success and impact on men's health.

Viagra held a dominant 57.3% share of the global ED drugs market in 2024 [4]. In 2024, Viagra generated global sales of approximately $1.81 billion, contributing significantly to the total ED drugs market sales of $2.92 billion [4]. Europe accounted for approximately 30% of the global sildenafil market in 2023, with Germany, the UK, and France being the major contributors [5].

In the US, an estimated 1.13 million patients were prescribed sildenafil in 2022 [6]. Following patent expiry and increased competition, Pfizer's global Viagra sales fell from a peak of $2.05 billion in 2012 to $1.21 billion in 2017 [7].

What is Viagra?

Viagra is a pharmaceutical drug used to treat ED, a condition in which men have difficulty achieving or maintaining an erection suitable for sexual activity. Its active ingredient, sildenafil, belongs to a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors [8]. Viagra works by relaxing blood vessels in the penis, increasing blood flow to facilitate an erection when a man is sexually stimulated. This mechanism targets the physical barriers to achieving an erection, making it effective for many men with erection disorder. Viagra is available as a branded drug manufactured by Pfizer and in generic forms, which contain the same active ingredient, sildenafil citrate, and are a more affordable option. Both versions are FDA-approved and widely prescribed, ensuring accessibility for those seeking treatment.

How effective is it?

Viagra has been shown to be highly effective in treating erection problems, with clinical trials showing that 90% of men experience improved erections after taking the drug [9]. Users typically report an improved ability to achieve and maintain an erection sufficient for sexual activity, and often describe increased confidence and satisfaction with their sexual experiences. The drug usually works within 30 to 60 minutes of taking it, making it a reliable option for planned intimacy. Its effects last for about 4 to 6 hours, providing a window of opportunity for sexual activity. Data from health organisations such as the American Urological Association consistently support the efficacy of Viagra, particularly for men with ED caused by physical factors such as diabetes or high blood pressure, although it also benefits those with psychological or mixed causes of ED.

Benefits of Viagra

Viagra offers significant benefits for men coping with impotence, backed up by extensive research and patient feedback. The benefits go beyond physical improvements to include a positive impact on emotional wellbeing and relationships. Here are the main benefits:

  • High success rates: Clinical studies show that men were 3.57 times as likely to have improved erections on sildenafil compared with those on a placebo [10], making it a reliable option for treating ED caused by various conditions, such as diabetes or high blood pressure.
  • Rapid onset of action: Viagra typically takes effect within 30 to 60 minutes, allowing men to plan sexual activity with confidence and spontaneity.
  • Improved confidence: By restoring erectile function, Viagra helps men regain confidence, with many reporting reduced anxiety about sexual performance.
  • Improved relationship satisfaction: Research shows that approximately 80% of men using Viagra experience improved sexual satisfaction, which often leads to increased emotional intimacy and communication with partners.
  • Well-studied safety profile: As the first FDA-approved oral ED medication, Viagra has been extensively studied, providing reassurance of its efficacy and safety when used under medical supervision.

These benefits make Viagra a valuable tool for improving both sexual health and the overall quality of life, helping men to fight ED with greater ease and optimism.

Who can benefit from Viagra?

Viagra is designed for men with ED, a condition that can be caused by physical, psychological or a combination of factors. It is effective for a wide range of men, including those with common underlying medical conditions such as diabetes, which affects up to 50% of men with the condition, or high blood pressure, which is a common cause of ED. Psychological factors such as stress and anxiety, or depression can also lead to ED and Viagra can help in these cases by addressing the physical component of achieving an erection.

Men with mixed causes, where both physical and emotional factors are involved, may also find Viagra beneficial. Although suitable for many, a doctor's assessment and diagnosis is essential to ensure safe use, especially for those with heart disease, low blood pressure or other health problems. Consultation with a healthcare professional will help determine if Viagra is appropriate based on individual health needs.

Potential risks and side effects

Viagra is generally well tolerated, but like any erection medication, it carries potential risks and side effects that should be discussed with a healthcare provider. Most side effects are dose-related, mild and temporary [11], but awareness of both common and rare complications is important for safe use. The following is an overview based on clinical data:

Common side effects:

  • Headache: Experienced by 15-20% of users, often mild and treatable with over-the-counter medicines.
  • Flushing: A warm or flushed face occurs in approximately 10-15% of men and usually resolves quickly.
  • Nasal congestion: About 5-10% report a stuffy nose, which is typically temporary.
  • Upset stomach: Upset stomach occurs in about 5-7% of users and is frequently relieved by taking the medicine with food.

Rare but serious side effect:

  • Priapism: An erection lasting longer than 4 hours, although rare (less than 1% of cases), requires immediate medical attention to prevent tissue damage.
  • Sudden loss of vision or hearing: Extremely rare (less than 0.1%), but any sudden change in vision or hearing requires urgent medical attention.
  • Heart problems: Rarely, men with pre-existing heart conditions may experience chest pain or irregular heartbeat, requiring immediate medical evaluation.

Most side effects are short term and diminish as the body adjusts to the potency remedy. Men are encouraged to consult their doctor to weigh the benefits against the potential risks, especially if they have underlying health conditions such as heart disease or low blood pressure. Open communication with a healthcare provider will ensure that Viagra is used safely and effectively.

Cost and availability

Viagra is widely available, but there are considerations about cost and safe supply. The typical price range for Viagra (brand-name sildenafil) in the European Union in 2025 varies by country, dosage, and pharmacy, but based on available data, it generally falls between €10 and €25 per 50 mg pill for the original Viagra. Generic sildenafil is significantly cheaper, often ranging from €1 to €5 per 50 mg pill. Prices can be higher at local pharmacies compared to online or telehealth providers, and costs may be lower with insurance or subsidies through national healthcare systems in some EU countries.

Viagra and generic sildenafil are available through various channels:

  • Pharmacies: Local and chain pharmacies dispense both brand name and generic versions with a valid prescription (more information).
  • Telehealth services: Reputable online platforms offer consultations and prescriptions, providing convenience while ensuring medical oversight.
  • Online pharmacies: Legitimate online sources can be cost-effective, but buyers need to verify the pharmacy's credentials to avoid counterfeit drugs (Viagra Professional, Viagra Super Active, Super Viagra), which pose serious health risks.

To ensure safety, men should only order Viagra from reputable pharmacies or telemedicine providers. Discussing cost-saving options, such as generics, with a doctor or pharmacist can make treatment more accessible while maintaining quality and safety.

Generic Viagra

Generic Viagra is made from the same active ingredient as Pfizer's brand name Viagra, but at a more affordable price. Approved by the FDA in 2016 [12], generic sildenafil meets the same regulatory standards for safety, efficacy, and quality, so it is just as effective in treating ED. Generic Viagra is a cost-effective alternative for men who want to optimise their health care spending.

Generic sildenafil is widely available through pharmacies, telehealth services and online providers, making it accessible to men seeking treatment. Men are encouraged to discuss generic options with their doctor or pharmacist to explore cost savings while maintaining the same benefits of improved erectile function. Choosing generic Viagra medicaments, such as Kamagra, can reduce the financial burden of ED treatment without compromising quality.

Viagra vs. other ED treatments

Viagra, with its active ingredient sildenafil, is one of several PDE5 inhibitors used to treat ED. While it shares the same mechanism as other drugs in its class (increasing blood flow to the penis), each Viagra replacement has different characteristics. Below is a comparison with other PDE5 inhibitors to help understand Viagra's place among ED treatments.

Viagra vs. Cialis

Viagra takes effect in 30–60 minutes and lasts 4–6 hours, ideal for planned intimacy. Cialis (tadalafil) offers a longer duration of up to 36 hours, earning it the nickname 'weekend pill', and can be taken daily in low doses for spontaneous sexual activity. Cialis may suit men who prioritise flexibility, while Viagra is favoured for its predictable window.

Viagra vs. Levitra

Levitra (vardenafil) has a similar onset (30–60 minutes) and duration (4–6 hours) to Viagra, but some studies suggest it may work slightly better for men with diabetes-related ED. Both are similarly effective, although Levitra may cause fewer visual side effects in some users.

Viagra vs. Spedra

Spedra (avanafil) has a faster onset of action, often within 15–30 minutes, making it the quickest option for spontaneous intimacy. Its duration (4–6 hours) is the same as Viagra, but its newer formulation may appeal to men who want a quicker effect.

All PDE5 inhibitors are effective, with success rates of 70–85% in clinical trials, but the best choice depends on individual needs such as timing, duration or specific health conditions. Side effect profiles are similar, although their frequency and intensity vary slightly. Consultation with a doctor is essential to determine the most appropriate option, considering lifestyle, medical history and preferences.

Key takeaways

Viagra remains a cornerstone in the treatment of ED, providing a reliable and well-researched solution for millions of men seeking to restore sexual potency. With its proven efficacy, real-life experience, rapid onset of action and availability in both branded and low-cost generic forms, it addresses a common condition that affects men of all ages and health profiles.

Not only is ED treatable, but it is also a sign to prioritise overall health, as it can reflect underlying physical or psychological problems. By consulting a healthcare professional, men can explore Viagra or other therapeutic options tailored to their needs to ensure safe and effective treatment.

References

  1. U.S. Food and Drug Administration (March 1998), "Drug Approval Package: Viagra (Sildenafil citrate)", accessdata.fda.gov
  2. European Medicines Agency (May 2024), "Summary of the European public assessment report (EPAR) for Viagra", ema.europa.eu
  3. H A Ghofrani, I H Osterloh, F Grimminger (Aug 2006), "Sildenafil: from angina to erectile dysfunction to pulmonary hypertension and beyond", Nature reviews, Drug discovery, nature.com
  4. Grand View Research (Nov 2024), "Erectile Dysfunction Drugs Market Size, Share & Trends Analysis Report By Product (Viagra, Cialis, Levitra/Staxyn), By Mode of Administration (Oral, Injectable), By Region, And Segment Forecasts, 2025 - 2030", grandviewresearch.com
  5. Dataintelo Consulting (Jul 2023), "Sildenafil Drug Market | Global Forecast From 2025 To 2033", dataintelo.com
  6. ClinCalc DrugStats (2025), "Sildenafil; Drug Usage Statistics, United States, 2013 - 2022", ClinCalc, clincalc.com
  7. StatInvestor (2025), "Pfizer's Viagra revenue worldwide 2003-2017", statinvestor.com
  8. Wikipedia (2024), "PDE5 inhibitor", wikipedia.org
  9. W Steers, A T Guay, A Leriche, C Gingell, T B Hargreave, P J Wright, D E Price, R A Feldman (Nov 2001), "Assessment of the efficacy and safety of Viagra® (sildenafil citrate) in men with erectile dysfunction during long-term treatment", International Journal of Impotence Research, nature.com
  10. A Burls, L Gold, W Clark (Dec 2001), "Systematic review of randomised controlled trials of sildenafil (Viagra) in the treatment of male erectile dysfunction", The British Journal of General Practice, pubmed.ncbi.nlm.nih.gov
  11. S G Moreira Jr, R E Brannigan, A Spitz, F J Orejuela, L I Lipshultz, E D Kim (Sep 2000), "Side-effect profile of sildenafil citrate (Viagra) in clinical practice", Adult Urology, goldjournal.net
  12. Da Hee Han, PharmD (Mar 2016), "FDA Approves First Generic Version of ED Drug", Medical Professionals Reference, empr.com