Rapid-Onset Cavernosal & Pulmonary PDE5 Inhibitor • Rx

Sildenafil Citrate

Brand Reference: Viagra, Revatio

Medically Reviewed by Dr. Julian Sterling, MD, FACS (NPI #1376841536)
91.40%
Patient “Worth It”
52 verified logs
$5.40
Lowest Monthly Cash

Sildenafil Citrate Clinical & Real-World Cost Fact Matrix

Metric Verified Benchmark Source
Sildenafil Citrate RxNorm Concept ID 966571 U.S. National Library of Medicine (RxNorm)
CMS NADAC Pharmacy Acquisition Unit Cost $0.0540 / unit CMS Medicaid NADAC Weekly Feed
Walk-In Chain Pharmacy Cash Average $138.00 / mo CMS NADAC + U.S. Retail Markup Index
Mark Cuban Cost Plus Wholesale Price $5.40 / mo Cost Plus Drugs Wholesale Feed
Community Mean Out-of-Pocket Paid $6.80 / mo 52 Zero-PHI Verified Patient Logs
INSTANT PRESCRIPTION & CASH ROUTING

Verified Online Prescribers & Wholesale Pharmacies for Sildenafil Citrate

DotMD Club Members get $29 flat-rate script renewals →
Mark Cuban Cost Plus Drugs (Wholesale Pharmacy)
Requires an existing doctor prescription. Need a script? Pair with a $29 DotMD Club TeleMed consult.
$5.40/mo
Wholesale Cash Price
View Wholesale Rx →
Ro Body & Metabolic Clinic (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days
$ 45.00
Consult / Starting Tier
Start Online Visit →
Hone Health Hormone & At-Home Biomarker Lab (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~3 days
$ 65.00
Consult / Starting Tier
Start Online Visit →
Hims & Hers Direct Cash Pharmacy (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days • Rx included in monthly tier
$ 49.00
All-In Monthly
Start Online Visit →

Sildenafil Citrate Clinical Pharmacology & DailyMed Monograph

RxCUI 966571 • NDC 00378-1657-93

Blocks PDE5-catalyzed hydrolysis of NO-stimulated cGMP inside cavernosal smooth muscle, decreasing intracellular Ca2+ to dilate helicine arteries and compress subtunical venules during sexual arousal.

CMS National Average Drug Acquisition Cost (NADAC) tracking places Sildenafil Citrate (Viagra / Revatio, RxCUI 966571) at $0.0540 per unit, whereas walk-in chain pharmacies bill cash patients an average of $138.00 monthly—creating a 96% ($132.60/mo) wholesale arbitrage spread down to $5.40.

Systemic exposure to Sildenafil Citrate reflects 41% fasting oral (high-fat meal delays Tmax by 60 min and cuts Cmax 29%) absorption kinetics and hepatic cyp3a4 (major) and cyp2c9 n-demethylation to active uk-103,320, sustaining receptor engagement across a 3–4 hours half-life window (30–45 minutes fasting response profile).

Dosing protocols (20 mg PO (generic Revatio tablet arbitrage: 1–5 tabs PRN) or 50 mg PO 1 hour pre-activity or 100 mg PO PRN) balance efficacy (91.40% patient satisfaction across 52 logs) against facial flushing (19% of reports), nasal stuffiness (15% of reports), transient blue-cyan pde6 tint (6% of reports), with strict avoidance in organic nitrates or amyl/butyl nitrites; riociguat co-administration; hereditary retinitis pigmentosa.

Half-Life
3–4 hours
Bioavailability
41% fasting oral (high-fat meal delays Tmax by 60 min and cuts Cmax 29%)
Metabolism & Clearance
Hepatic CYP3A4 (major) and CYP2C9 N-demethylation to active UK-103,320
Clinical Onset
30–45 minutes fasting

Standard Adult Titration & Dosages

20 mg PO (generic Revatio tablet arbitrage: 1–5 tabs PRN) 50 mg PO 1 hour pre-activity 100 mg PO PRN

Absolute & Relative Contraindications

  • Organic nitrates or amyl/butyl nitrites
  • Riociguat co-administration
  • Hereditary retinitis pigmentosa

Logged Side-Effect Incidence (52 Reports)

Facial flushing 19%
Nasal stuffiness 15%
Transient blue-cyan PDE6 tint 6%

Sildenafil Citrate Patient Dosage Logs & Out-of-Pocket Cost Ledger

Across 52 verified cash-pay logs, Sildenafil Citrate achieves a 91.40% Worth-It rating with out-of-pocket spend averaging $6.80/mo versus $138.00/mo walk-in retail.

15-Second Anonymous Micro-Log (Zero-PHI Architecture)

Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.

Effectiveness: 5/5 • Worth It Dosage: 20 mg PO (generic Revatio tablet arbitra • Paid: $4.75/mo via Cost Plus Drugs
Facial flushing

Switched to Cost Plus Drugs at 20 mg PO (generic Revatio tablet arbitrage: 1–5 tabs PRN) for Sildenafil Citrate; monthly out-of-pocket dropped to $4.75 compared with $138.00 retail.

Effectiveness: 5/5 • Worth It Dosage: 50 mg PO 1 hour pre-activity • Paid: $5.51/mo via Local Pharmacy

Completed 10 weeks on Sildenafil Citrate (50 mg PO 1 hour pre-activity). Zero notable side effects on steady dosing.

Effectiveness: 4/5 • Worth It Dosage: 100 mg PO PRN • Paid: $6.26/mo via TeleMed
Transient blue-cyan PDE6 tint

Consistent biomarker response on 100 mg PO PRN Sildenafil Citrate sourced via TeleMed ($6.26/mo cash pay without insurance prior authorization).