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Viagra® (Sildenafil) information for patients; How to avoid getting ripped off when you buy Viagra online; also how does Viagra work; Viagra cost, Viagra side effects, dose, mechanism of action, warnings; Viagra price comparison; what is a PDE5 Enzyme Inhibitor?

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Picture of Authentic Viagra (figure 1) VS Picture of Generic Viagra (Figure 2)

Picture of Authentic Viagra (figure 1) VS. Picture of Generic Viagra (figure 2)

Pill 1: Picture of an authentic 100mg pill of Pfizer Viagra®

Pill 2: Picture of so-called generic Viagra 100mg tablet. Note the darker blue color and the wording sildenafil citrate on the generic pill. *The Generic Viagra is not FDA-Approved and can be dangerous to your health. The cost of Viagra in generic form is less, but the ingredients are unknown.

Please Note: We do not accept ads for generic Viagra on this page.

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Where Are The Best Places to Buy Viagra Online!

People always ask where to buy Viagra. So we investigated the top websites that sell Viagra before we wrote this page. We learned what to look for in order to find legitimate Viagra websites.


Who does this site recommend?

If you are looking for brand-name Viagra online manufactured by Pfizer Laboratories, without a prior prescription, I recommend AccessRx.com. They have been in business since 1998, are located in the USA in Tempe Arizona, and even offer overnight shipping. If you are unsure where to buy Viagra, see their website, which includes a Viagra price comparison.

They have customer service answering calls Mon-Sat and are open 24-hours a day online. They even have licensed physicians and pharmacists on staff to answer your medical questions.

Although their prices are higher than illegal generic Viagra, you are assured of getting brand-name, American, FDA-Approved Viagra delivered to your door in a couple of days without having to go to a doctor. The price of Viagra is just a few more dollars per pill, and it’s worth it, because you save the time and money associated with a visit to a doctor’s office and pharmacy.

View our Viagra Price Comparison page to see which other websites are selling the real genuine Viagra.

Click Here for a Viagra price comparison, for authentic Viagra.

When Purchasing Viagra Online You Need to Know That:

  • Half the Viagra sold on the internet is fake.
  • Most of the websites that sell Viagra are located in 3rd-world countries but they lie and pretend to be American or Canadian.

Illegal Viagra Leads 24% Jump in Counterfeit Medicine Seizures... fewer than 300 online pharmacies in Canada authorized by government agencies, more than 11,000 fake Canadian pharmacies are operating online from overseas jurisdictions … [Bloomberg]

How Much Does Viagra Cost... The Price of Viagra…

Authentic, FDA-approved Viagra does cost at least $34 per pill. So if you see websites where the cost of Viagra is $3, $5, or even $10 a pill, you will know that they are generic. Stay away from generic Viagra, as the pills are made from compounds that are not FDA-approved and can cause serious harm to your health. The cost of Viagra online should be about the same as you would get at your local pharmacy, but you can actually save money if you buy Viagra online because you won't have a co-pay like you would if you received a Viagra prescription from your local doctor.

There is no such thing as an FDA approved generic Viagra.

The government considers generic Viagra to be an illegal substance.

The Feds are concerned that generic Viagra may be unsafe because you have no way of determining the quality control that went into making the generic Viagra. They don't go after the people who buy it, but postal inspectors will confiscate it if they find it.

There are lots of websites that sell generic Viagra without a prescription. Your Viagra cost will be less if it is generic, but you are taking a chance with your health if you take generic sildenafil because the ingredients are completely unknown. If you are unsure where to buy Viagra, see my recommendation above.

Things To Be Suspicious Of:

  • You want to make sure there is a physical address on the website selling the Viagra. It should be a real address, not a P.O. box. If there is no address that is a bad sign.

    Why would someone want to hide their address? No address means that they are deliberately making it hard for you to track them down in case there is a problem.

Buying Viagra: Tips

  • The website where you buy Viagra should have a toll free telephone number. If something goes wrong you want to be able to speak to a real live person. It is very frustrating to only be able to communicate by e-mail when you have a problem.

  • Test the telephone number before you place your order. Ask the person who answers the phone where the Viagra is shipped from. If they don't answer to your satisfaction, it's a bad sign.

  • Do they have a 24-hour chat or IM customer service? The reliable, established internet pharmacies all have this service integrated into their sites. If they have such a service, test drive it.

    How long does it take for the person on the other end to respond? Ask them some questions such as: "How long have you been in business? Who is the manufacturer of your Viagra (it should be Pfizer)? Where is it shipped from? How long does it take to get my shipment. What is the cost of Viagra?

  • Ask them if they do the shipping and handling or if they only do the billing.

    There is a good chance that the person on the other end of the phone is just a go-between; a clerk in front of a credit card machine, doing the billing for hundreds of Viagra websites.

    In many instances, they have no idea who the Viagra merchant is; all they know is that once a month they get a commission check from someone they have never seen or met in person.

    Their job is answering the phone and ringing up your sale. After your credit card has been charged, the relationship is over.

  • You get what you pay for. If it seems too good to be true, it probably is too good to be true. The price of Viagra can be deceiving. You are better off paying $34.00 per pill at your local drugstore and getting genuine American Viagra than paying $6.00 for a so-called generic Viagra on the internet and getting a fake or harmful pill. Your Viagra cost is not the most important thing to consider.

  • Your first purchase should be for a small quantity of pills. Don't start off with thirty tablets. Buy five or ten. Make sure the Viagra is legit and the shipping and billing goes smoothly before you make a large purchase.

    You should never deal with a site from Russia or Nigeria, places where identity theft is common. Scammers in these countries have been known to set up sham Viagra web sites just so they could steal your credit card information.

Where does fake Viagra come from?

Most of the fake Viagra comes from China and South America where the laws regarding pharmaceuticals are lax.

Most of the Viagra selling websites are fly-by-night operations looking to make a quick buck with a low price of Viagra. They often masquerade as American or Canadian internet pharmacies but they are usually located outside the law in countries such as China, Japan, Cambodia or Bulgaria.

How Does Pfizer Deter Counterfeit Viagra?

Pfizer is trying to fight the introduction of fake Viagra into the pharmaceutical supply chain. Pfizer uses redundant high tech security features to make it easy to detect counterfeit Viagra pills and packaging:

  • Beginning On December 15th, 2005, all bottles of Viagra have had a very small identification microchip (known as a RFID) embedded into the bottle. The bottles are embedded with a Tagsys Flexible Module passive high-frequency (13.56 MHz) tag. This means that every bottle of Viagra has a special electronic fingerprint so that pharmacists and wholesalers can track the pedigree of the tablets inside to ensure that they are authentic and obtained legally.

  • Each Viagra label also contains a special two-dimensional barcode that works hand in hand with the RFID chip so that pharmacists and wholesalers can track the Viagra from the factory, through the supply chain down to the individual consumer.

  • The labels on the Viagra bottles (as well as many other Pfizer products such as Lipitor and Celebrex) are printed with a color shift ink bar which is hard to fake but easy to recognize with the naked eye, similar to what you see with paper money.

  • If you know where to buy Viagra safely, as mentioned above, you do not need to worry about counterfeit Viagra.

Real or Fake? What's The Big Deal?

Many sites sell counterfeit Viagra to unsuspecting people at highly inflated prices.

Sometimes they sell you a little baggie of half-tablets and Viagra crumbs. And when you try to call the "1-800" telephone number on the site you brought the pills from to complain, all you get is the run-around.

A common scheme is that people try to sell you sell so-called generic Viagra that contains no active ingredient. The poorer the country is, the easier it is to bribe local officials to look the other way.

One hundred dollars goes a long way out in the boondocks of China or Mexico. If you live in one of these countries, it is easy to open a pill factory to manufacture fake Viagra.

These little factories are like meth labs - they stay open a short while, manufacture several thousand bootleg or counterfeit pills and move on before they get caught. People who receive ineffective or harmful Viagra from these outfits quickly realize their Viagra price comparison should have included factors other than the cost of Viagra.

In the US, the price of Viagra is around $34 per pill (prices have been rising year-after-year) at your local pharmacy. It might make sense to shop online to purchase authentic Viagra, as the prices tend to be about only $3 higher than your local pharmacy, but you will not have to take time off work and wait at your doctor’s office, or hand out a co-pay. When you buy Viagra online, the internet prices vary by as much as 50% so it pays to perform a Viagra price comparison and go with a pharmacy you trust, or one that has been recommended by a friend.

If you buy a larger quantity, your price for Viagra should pay less per pill. If you buy a smaller quantity you will pay more per pill.

In general, the farther away the Viagra seller is, the easier it is for them to rip you off.

Avoid buying Viagra from Asia, South America, Mexico and the Caribbean because that's where a lot of the fake Viagra comes from.

Another reason to avoid buying Viagra from outside the United States is the pills might be confiscated by postal authorities when they reach the United States.

This is happening more and more each day as the FDA and the DEA crack down on the illegal importation of drugs into the USA.


Viagra History: Discovery Timeline

1989

  • Pfizer Scientists synthesize silendafil citrate and give it the code name UK-92, 480. The drug would not be known as Viagra until the mid-90s.
  • Experimental compound UK-92,480 is believed to be useful as a high blood pressure and angina treatment. The scientists hope it may act as a vasodilator and be useful in treating cardiovascular ailments such as hypertension and angina.

1991

  • Researchers at Pfizer's Sandwich, England research facility (Peter Ellis and Nick Terret) observe that drugs that inhibit the PDE5 enzyme may be helpful in reversing erectile dysfunction.
  • Early Phase 1 trials regarding the use of Viagra for angina are unremarkable.

1992

  • A second Phase 1 angina trial reveals that the drug has an unusual side effect; penile erections.
  • Phase 2 clinical study is conducted testing silendafil citrate's usefulness as an angina treatment.

1993

  • Pilot study using silendafil citrate as a treatment for erectile dysfunction is conducted in Bristol, England. Test subjects take it three times a day for a week. The studies had only 28 men involved.

1994

  • Second pilot study on silendafil as an Erectile dysfunction treatment demonstrates that a once per day dose is able to produce an erection.
  • Pfizer realizes it has something important; it accelerates the program examining silendafil citrate for erectile dysfunction.

1994 - 1997

  • 21 clinical trials are conducted involving 4,500 men demonstrate that Viagra (as it is now known) is safe and effective.

1997

  • Pfizer files a New Drug Application for Viagra (NDA 020895) with the United States FDA. FDA agrees to give it a priority review.

1998

  • FDA approves Viagra as the first oral treatment for erectile dysfunction. It was approved with a starting dose of 50 mg with the option to increase the dose to 100mg or reduce it to 25 mg.

Misc:

  • FDA lists two patents for Viagra. Patent number 5250534 expires on March 27, 2012. Patent number 6469012 (patent use code U-155; TREATMENT OF ERECTILE DYSFUNCTION) is set to expire on Oct 22, 2019.

How did they come up with the name VIAGRA?

The name Viagra is believed to be an amalgam of two words:

  • The "Vi-" part is associated with the words vigor (physical or mental strength, energy, or force) or vital (necessary to the continuation of life; life-sustaining).
  • The "-agra" part of the name Viagra is associated with Niagara Falls, the iconic American waterfall; a metaphor for a massive powerful natural phenomenon.

Why Does The Viagra Tablet Have An Unusual Shape

Unlike most tablets, the Viagra tablet has an unusual rounded-diamond-shape. It is believed that one reason Pfizer employs this tablet design is to make it harder to split the tablet with common tablet splitters.

The wholesale cost of Viagra in a 100 mg tablet is $31.00, so your Viagra cost will be slightly more than that. The price of Viagra in a 50 mg tablet is approximately the same. When people buy 100 mg tablets and split them into two 50 mg portions, they save about 50% per dose. Some people even cut them into quarters, which will save you even more money. A pill cutter is recommended to cut the Viagra in half or quarters.

The diamond shaped Viagra tablet will not fit into the typical tablet splitter which is designed to split round tablets. Since its launch in 1998, specially designed Viagra tablet splitters have become available.

(Incidentally, another erectile dysfunction drug, Cialis also has an irregular shaped tablet that discourages pill splitting).


How Much is Viagra… Viagra Price Comparison

Viagra Price Comparison: There is a lot of competition between sites that sell Viagra. This competition drives down the prices, but there are only a few U.S.-based sites that sell real Viagra. Our editors have searched the internet to find you the best cost for Viagra. If you are unsure where to buy Viagra, you should be able to get a good price on authentic Viagra if you comparison shop…

View our Viagra Price Comparison page to see which other websites are selling real, genuine Viagra.
Click Here to Comparison shop for Viagra.

Viagra Information On The Internet:

Viagra.com
Official website; Geared to patients; all about Viagra and erections.

PfizerPro.com
Official Viagra website for healthcare professionals; How to start and maintain patients on Viagra, Multimedia presentation, prescribing information, etc. This site also has a section where you can report an adverse regarding Viagra.

Official Viagra Prescribing Information
(Package Insert); dose, mechanism of action, side effects, precautions, warnings; patient information; very technical, don't get scared when you come to the section on warnings and side effects

Viagra.MD
The latest news in the Viagra industry geared towards consumers. Viagra.MD also goes over the most common side effects of Viagra, the dangers of taking counterfeit Viagra, and how to buy Viagra online safely.

Viagra Scientific Papers
National Library Of Medicine; automated Medline search; a listing of scientific papers in condensed form regarding Viagra.

Viagra Versus Levitra
From Forbes magazine 10/06/03; M. Herper and A. Lagorce; Side by side comparison of various characteristics; cost, pharmacokinetics, marketing tactics, etc.

Viagra Versus Cialis
From Forbes magazine 12/03/03; M. Herper; side by side comparison of various characteristics in slide show format.

Viagra News
(from Google) ; recently published news regarding Viagra.


What Is Viagra and How Does It Work?

All three of the erectile dysfunction drugs (Viagra, Levitra and Cialis) are similar in action. They block an enzyme that causes an erection to go flaccid. Although these drugs are similar in action, their dose, onset of action time and duration of action differ.

Viagra (Sildenafil) is a member of a family of drugs called PDE5 Inhibitors. Viagra was the first PDE5 inhibitor on the market. FDA was approved Viagra on March 27, 1998. The team of scientists who discovered Viagra won the Nobel Prize.

The BIG Discovery: cyclic guanosine monophosphate (cGMP)

Some very smart scientists discovered that cyclic guanosine monophosphate (cGMP) was the key to sustaining an erection.

They discovered that when a man gets sexually stimulated, a chain reaction occurs in the tissue of the penis that results in elevated levels of a substance called cyclic guanosine monophosphate (cGMP).

As long as there are sufficient levels of cGMP, the penis can remain erect. The more cGMP, the more robust and durable the erection.

If you inhibit the degradation (breakdown) of cGMP it stays around in the penis longer, producing a more durable erection.

Another way you can think of Viagra (and all other similar medicines) is that it preserves the elevated levels of cGMP that are created when a man is sexually stimulated for a stronger, more lasting erection.

That's how Viagra works - Viagra blocks the enzyme phosphodiesterase-5 (PDE5) which is responsible for the neutralization of cGMP. Viagra (Sildenafil) is a highly selective inhibitor of PDE5. (PDE5 is not the only phosphodiesterase involved in the erectile physiology but it appears to be the most important one).

The nice thing about Viagra and other PDE5 blockers is that they shouldn't cause erections at inappropriate times because they only block degradation of cGMP produced in reaction to sexual stimulation, such as thinking about something sexy.

If you are not being sexually stimulated, there is no cGMP to protect, so Viagra and similar drugs remain in the background.

The only bad news is that everyone's Viagra cost is going up, which means less men can take advantage of the powerful drug.


Viagra Research: Recent Scientific Papers

  • Sildenafil inhibits superoxide formation and prevents endothelial dysfunction in a mouse model of secondhand smoke induced erectile dysfunction. ... CONCLUSIONS: Short-term exposure to secondhand smoke impairs erectile function through excessive penile reactive oxygen species signaling and inducible nitric oxide synthase activity. Decreased penile constitutive nitric oxide synthase activity may be attributable to the decreased endothelial nitric oxide synthase activity resulting from increased oxidative stress. Sildenafil therapy restored nitric oxide synthase activity and decreased reactive oxygen species signaling, resulting in improved erectile function... [J Urol. 29 Feb;181(2):899-906. Epub 2008 Dec 17]
  • Editor's Note: It is believed that second hand smoke contributes to erectile dysfunction. This was a rodent trial (they used mice). The Viagra was shown to counteract the negative effects of second-hand smoke.
  • Clinical Implications: Has not been tested in humans but it is safe to assume that erectile dysfunction caused by second-hand smoke can be ameliorated by Viagra.
  • Efficacy, tolerability and satisfaction with sildenafil citrate 100-mg titration compared with continued 50-mg dose treatment in men with erectile dysfunction. ... After initial treatment with sildenafil 50 mg, patients titrated to 100 mg showed further increases in efficacy and satisfaction with no increase in the number or severity of adverse events than in those remaining on the starting dose... BJU Int. 2008 Aug 14
  • Editor's Note: Patients started on 50 mg of Viagra and increased to 100mg got an increase in efficacy without an increase in side effects.
  • Clinical implications: You can increase the dose of Viagra without increasing side effects; if someone is going to get side effects from Viagra they will be elicited at the lower doses.
  • Use of Sildenafil to Facilitate Weaning from Inhaled Nitric Oxide in Children with Pulmonary Hypertension following Surgery for Congential Heart Disease. ... purpose of this study was to evaluate the use of sildenafil in facilitating weaning from inhaled nitric oxide after congenital cardiac surgery in patients who had previously failed weaning, and to compare the effects of sildenafil on pulmonary and systemic hemodynamics ... Journal of Intensive Care Medicine 2008, doi:10.1177/0885066608321389; Jaclyn E. Lee, Pharm.D.1, Simon C. Hillier, MD2, and Chad A. Knoderer, Pharm.D.1*
  • Editor's Note: Children with congenital cardiac abnormalities requiring surgical intervention often suffer pulmonary hypertension as a complication of surgery. Usually they use nitric oxide gas as a treatment for the pulmonary hypertension but you have to wean the kids off of the nitric oxide gas gradually to avoid adverse effects In this experiment, after treatment with nitric oxide gas they tried Viagra by mouth as a step-down therapy to wean them off of the gas successfully.
  • Clinical implications: In the abstract, you notice that the reduction in Mean pulmonary artery and systemic arterial pressure was associated with a pValue of 0.066. Since this p-Value is greater than 0.05, the results should not be considered clinically significant. Therefore the clinical implications are unknown; more studies are warranted.

Non-Sexual Uses For Viagra:

The active ingredient in Viagra (sildenafil) is useful in treating a rare, potentially deadly condition known as pulmonary hypertension.

In this use, Viagra's Phosphodiesterase 5 blocking activity is thought to be beneficial in relaxing the smooth muscle tissue found in the lungs by increasing the levels of cyclic guanasine monophosphate (cGMP).

Pfizer sells a tablet called Revatio for this use. Each Revatio tablet contains 20mg of sildenafil (the active ingredient in Viagra) and it is taken 3 times a day approximately 4-6 hours apart.

Absorption, Bioavailability

Viagra is rapidly absorbed. Maximum observed plasma concentrations of Viagra are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. Viagra is about 40% biovailable. Viagra is highly protein bound (96%). When Viagra is taken with a high fat meal, the rate of absorption is reduced.

Metabolism, Half Life, Excretion

Viagra is mostly metabolized in the liver by an enzyme known as CYP3A4 and to a lesser extent CYPC229. Viagra breakdown products are excreted in the feces (80%) and in the urine (approximately 13%). Viagra's mean half life is about 4 hours.

If you are going to take any of the PDE5 inhibitors such as Viagra, it is very important that your doctor be aware if you have a liver condition (such as cirrhosis) or kidney condition (such as if you are on dialysis) because you may need a special dosage adjustment.

Likewise, if you try to obtain Viagra on the internet, please make sure that the person authorizing your prescription knows the true status of your liver function and your kidney function.

Dose:

For most patients, the recommended dose of Viagra is 50mg taken about 1 hour prior to anticipated sexual activity. However, the Viagra label states that it can be taken anywhere from 1/2 hour to 4 hours prior to sexual activity.

The dose of Viagra may be increased to 100mg or decreased to 25mg depending on efficacy and side effects. Sometimes people buy the 100mg tablets and break them in half to save money.

Viagra is available 25mg and 50mg and 100mg tablets.

The maximum recommended dose is one pill per day.

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