Can Revatio Be Substituted For Viagra?

In our latest question and answer, our pharmacist discusses whether or not generic Revatio can be substituted for a prescription written for Viagra.

Nov 02, 2017

tjmander asked

I am curious if my pharmacy can give me Revatio instead of Viagra without getting another prescription? I have a prescription for Viagra but not Revatio.

Answer

Legally, no, a pharmacist cannot switch a prescription written for Viagra to Revatio, even though they contain the same active ingredient (sildenafil).

Revatio was approved by the FDA only for the treatment of pulmonary arterial hypertension and comes in a dose of 20 mg. Viagra is available in doses of 25 mg, 50 mg and 100 mg.

Here is the interesting part that creates confusion:  Revatio IS available generically as Sildenafil 20mg. However, because of how substitution laws work regarding prescriptions, you cannot legally dispense generic sildenafil 20 mg when a prescription is written for Viagra. The doses don't match up and the generic on the market is only approved specifically as a generic to Revatio.

Having the generic Revatio prescribed for Viagra is certainly attractive due to the high cost of brand name Viagra. To compound the problem, the patent on Viagra doesn't expire until 2020. A prescriber could technically write you a prescription for sildenafil 20 mg but there may be some hesitation on their part to do so. It would be technically be prescribing 'off label', outside the approved indications for the drug.

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