Sildenafil is the medical name for the active ingredient in Viagra tablets. The patent for Viagra held by the drug company Pfizer expired in June 2013. Since then a number of UK licenced brands of sildenafil have become available from various pharmaceutical manufacturers. These companies often market sildenafil branded by their company names, e.g. Sandoz sildenafil, Mylan sildenafil, Accord, Actavis, Ajanta, Pfizer, Teva, Torrent, Dr Reddys, Bristol Labs, Zentiva, etc. Patients with a brand preference can request preferred brand after making an order with Dr Fox.
Generic treatment
As long as doctors write prescriptions using the medical name of the active ingredient, sildenafil, and not a brand name, pharmacists are free to supply any one of the available sildenafil brands. This sort of prescribing, using the medical name not the brand name, is called generic prescribing. Sildenafil is sometimes called generic Viagra. It is more accurate to say Viagra is a brand of sildenafil, and that sildenafil is the generic name.
Prices of sildenafil
Sildenafil is relatively cheap to produce, each tablet costing only a few pence to make. Pharmaceutical companies supplying sildenafil – since the patent of Viagra expired – now compete mainly on price and prices have come down dramatically. There is not much to choose in terms of wholesale price from one of the new producers of sildenafil to another, but compared with pre-patent expiry, prices have fallen a lot. The wholesale price is the price pharmacies pay. Patients pay a considerable mark-up, which varies from one pharmacy to another. Some online suppliers are much lower cost than others (compare prices of sildenafil).
The original brand of sildenafil from Pfizer, Viagra, is still available, but at the same high price as before, despite its market share shrinking. It remains popular only with men who can afford the original and who are reluctant to switch. Pfizer have also launched a generic sildenafil product as well.
Levitra (vardenafil), Cialis (tadalafil) and the newer tablet Spedra (avanafil) are alternatives to sildenafil. Spedra is still under patent and considerably more expensive.
Benefits of low cost treatment
Erectile dysfunction (ED) treatment is now affordable to more men than before. The market in fake ED treatments from unregulated overseas websites has reduced and the NHS has increased the availability of treatment. These are welcome changes for men with ED who previously faced high prices, or cheap and potentially dangerous supplies from illegal websites, or severe restriction and rationing on the NHS.
Some have argued that low cost ED treatment is not a good thing. They suggest it will encourage recreational rather than therapeutic use. Those familiar with the treatment of ED through online clinics have not noticed a change in requests for treatment. The vast majority of men who take tablets for the treatment of ED do so for genuine medical reasons. The tablets usually work well to relieve a potentially distressing condition.
Dr Fox provides sildenafil 50mg tablets from 50p each following an online consultation.
Are all brands of sildenafil the same?
Sildenafil is a molecule with a structure that remains the same from one brand to another. The way it is absorbed into the bloodstream, works in the tissues, its side-effects and the way it is metabolised are always the same.
All the companies supplying sildenafil produce it in the same strengths and quantities, 25mg, 50mg, and 100mg tablets in packets of 4 (and also usually packets of 8 tablets). The packaging and information leaflets supplied with the tablets are similar from one brand to another. What varies is the shape, colour, size, and consistency of the tablets. Some are white and chalky, others are blue, hard, and smooth. Some are scored (Torrent, Sandoz, Zentiva) and can be easily divided, others are not. These differences are cosmetic, not differences in the active ingredient.
One sildenafil tablet of the same strength should be very much like another. Each will contain the same amount of the active ingredient. If the brand has a UK licence, it will have been subject to the same standards of production and safety checks.
All medicine sold by UK pharmacies is required to be ‘UK licenced’, meaning quality checks have been carried out on each batch produced to ensure bioequivalence. This ensures both branded and generic versions contain the same active ingredient at the same level, and for all intents and purposes are the same medicine. Regulatory definitions of bioequivalence do allow for a small margin of difference.
Where tablets contain the same active ingredient medical professionals take it for granted that the effectiveness of each will be the same. There have been no studies to check the effect of one brand compared with another. Studies of this type are not normally carried out. They are difficult to do, requiring large numbers of men to be tested, and from a medical point of view there is no obvious reason to undertake such studies.
Brand preference
Patients become used to their tablets. They become familiar with the size, shape, colour, texture, and taste of their tablets. They know from previous experience what to expect when they take a particular tablet. By and large, they don’t like to change to a new brand of tablet, no matter whether they know the active ingredient is the same or not. It is reasonable for men with erectile dysfunction, or any medical condition, to take this approach, even if medical professionals find it inconvenient. However the NHS usually are only able to prescribe generic sildenafil.
If a person knows their tablet they know what to expect. It is largely a matter of confidence, and confidence in the medicine can be a factor in a successful outcome for the patient. Of course there can be many reasons why erectile dysfunction drugs do not work on any given occasion.
Sandoz sildenafil for example is blue in colour, small, hard, and scored. On the face of it, Accord sildenafil, which is white and chalky, does not look as if it will do the same job, and no amount of explanation is likely to change this perception.
If patients have a particular brand preference please send a message with your order and we will endeavour to supply that brand if available.
Supply issues
Problems arise when brands go out of stock. It is perhaps surprising that pharmaceutical companies are fairly frequently unable to fill wholesale orders from pharmacies, but it happens quite a lot. The supply chain for medicines is long and complicated, and drugs are sometimes produced in small batches. Whatever the reason, shortages are the bane of patient’s and pharmacist’s lives. Patients tend to be sceptical when told a medicine is out of stock. Pharmacists end up ringing around suppliers to see what can be done, or even borrowing from other pharmacies.
When men are supplied with a brand with which they are not familiar it is easy to wonder if it is not working as well, or if the side effects are different. These concerns are common when the appearance of a medicine changes. It happens in lots of areas of medicine, from asthma and hay-fever to blood pressure treatment and ED.
Sildenafil from Dr Fox
Dr Fox usually supplies the brands stated below but may supply any licenced brand when there are national stock shortages. If we need to substitute brands, patients will be notified, and we hope better explanation will allay some of the concerns and reduce customer queries.
To re-order, please log-in, or complete a new erectile dysfunction consultation.
Comparing brands
| Brand | Tablet type | Pack photo |
|---|---|---|
 Accord | Light blue, almond shape, with strength (mg) imprinted on one side, plain on reverse |  |
 Actavis | Light blue, elliptical, with ‘SL’ plus strength (mg) imprinted on one side, plain on reverse |  |
 Ajanta | Dark green, oval, imprinted with ‘AP’ logo on one side, and strength (mg) on reverse |  |
 Aurobindo | White to off-white, round, biconvex debossed with ‘SL’ on one side and ’25’, ’50’, or ‘100’ on reverse (Aurobindo Pharma – Milpharm Ltd) Summary of product characteristics |  |
 Bristol Labs | Light blue, triangular, with strength (mg) imprinted on one side, and ‘BL’ imprinted on reverse Summary of product characteristics |  |
 Consilient | White, oblong tablets, marked ’25, ’50’, or ‘100’ on one side – product marketed as Vizarsin |  |
 Dr Reddy’s | Blue, round, imprinted with ‘SC’ logo on one side, and strength (mg) on reverse Summary of product characteristics |  |
 Mylan | Blue, round, imprinted with ‘M’ on one side, and ‘SL’ with strength (mg) on reverse |  |
 Pfizer (generic) | White, diamond, imprinted with ‘Pfizer’ on one side, and ‘SIL’ with strength (mg) on reverse Summary of product characteristics |  |
Pfizer (Viagra) | Dark blue, diamond, imprinted with ‘Pfizer’ on one side, and ‘VGR’ with strength (mg) on reverse Summary of product characteristics |  |
 Sandoz | Light blue, round, slightly dotted, scored for easy division, imprinted with strength (mg) on reverse Summary of product characteristics |  |
 TEVA | White, oval, imprinted with ‘S’ and the strength (mg) on one side, and plain on reverse Summary of product characteristics |  |
 Torrent | Blue, round, scored for easy division, imprinted with ’86’ (25mg), or ’87’ (50mg), or ’88’ (100mg) on one side, and plain on reverse |  |
 Zentiva | Light blue, round, scored for easy division, imprinted with ‘J’ on one side, and ‘124’ (25mg), or ‘125’ (50mg), or ‘126’ (100mg) on reverse |  |