Allison asked
Why would my general practitioner be reluctant to prescribe Revatio if he's prescribed Viagra? I assume the generic Revatio is cheaper than Viagra. Thanks!
Answer
As you probably know, Revatio contains the exact active ingredient as Viagra, known as Sildenafil. Revatio however, is only indicated for pulmonary hypertension and comes in a dose of 20 mg vs the higher strengths of Viagra. Revatio is available generically and therefore is seen often as an attractive option for Viagra users due to the relative lower cost of generic Revatio vs. brand name Viagra.
However, as you mentioned, many doctors are very hesitant to prescribe Revatio for erectile dysfunction patients. This hesitancy is well founded and very understandable from the doctors points of view. To prescribe Revatio for erectile dysfunction would technically mean the doctor is prescribing off label. Off label prescribing means that they are prescribing a drug for an un-approved indication (as odd as that is in the situation). If some odd adverse reaction were to happen to a patient, the doctor may be liable for using an off label drug. Seeing as how the same active ingredient IS available for erectile dysfunction (as Viagra), it doesn't really make sense for the doctor to take a chance to prescribe Revatio off label. Now, off label prescribing does happen all the time but since the same ingredient is available on the market, there is really no reason medically to prescribe Revatio for anything other than pulmonary hypertension.
This certainly is an odd situation and unfortunately, none of the erectile dysfunction drugs are going generically anytime soon. Cialis (Tadalafil) should be going generic in 2017 and Levitra (Vardenafil) in 2018.
