The GoodRx Prescription Savings Blog

The latest updates on prescription drugs and ways to save from the GoodRx medical team

10 Things To Know About Generic Viagra

by Tori Marsh on December 11, 2017 at 4:51 pm

Good news! Viagra (sildenafil) has gone generic, cutting costs for the “blue little pill” in half.

Viagra is one of the most popular drugs on the market today, earning manufacturer Pfizer over one billion dollars a year. Its popularity has led to thousands of bad jokes, hundreds of cheesy commercials, and put the phrase “erectile dysfunction” on the radar. But how much do you actually know about the infamous erectile dysfunction pill?

Here are 10 things you should know to get better acquainted with Viagra, and its generic sildenafil.

There will be two manufacturers for generic sildenafil… if not more.

In 2013, generic manufacturer Teva Pharmaceuticals reached a settlement that allowed them to manufacture generic sildenafil starting on December 11th, 2017. As of last week, Teva was set up to be the sole manufacturer for generic Viagra until 2020, when the brand name patent expires.   

However, on December 6th, Viagra manufacturer Pfizer announced that they would also be releasing generic sildenafil, at a significantly reduced price. Ultimately this move will enable Pfizer to share in the profits of generic sildenafil. Smart move on their part.

Viagra’s patent officially expires in 2020, and we expect to see more manufacturers come to the table then, driving prices down. Stay tuned.

It will come in multiple dosages

Just like brand name Viagra, generic sildenafil will be sold in tablets of 25 mg, 50 mg, and 100 mg.

It will be 50% less than brand name Viagra

Yes, you read that right. Pfizer, the current manufacturer of brand-name Viagra announced they they will be releasing generic sildenafil at 50% off the current brand price. The average retail price of one tablet of Viagra is around $73, so we expect to see the price of generic sildenafil averaging at $30-$40 per tablet.

That is still on the pricey side for one tablet, but there is one more way to save. Generic manufacturer Teva offers a savings program for eligible patients to pay as little as $0 on their prescription. For more information on this program, see their website here.

Sildenafil won’t be different from brand name Viagra.

We consistently see patients voice concern about the efficacy of generic drugs. But keep in mind the rigorous process that drugs must go through before they hit the market. These processes ensure that generic medications contain the same active ingredients as their brand name counterparts, so there’s very few differences between brands and their generic counterparts. You can read more from the FDA about this here.

The biggest difference we can see right now? The color. The ‘little blue pill’ will now be the ‘little white pill’

A generic sildenafil already exists

Don’t let this confuse you. Sildenafil is the generic for two common drugs on the market right now, Revatio and Viagra, but these drugs are approved by the FDA for two different uses. Revatio is used to treat pulmonary arterial hypertension, while Viagra treats erectile dysfunction in men.

How can you distinguish between the two? Revatio-equivalent sildenafil is only sold as a 20 mg tablet, while Viagra’s generic sildenafil is sold in 25 mg, 50 mg, 100 mg tablets. For more on this, see our previous blog here.

It is the most counterfeited drug in the world

The problem of counterfeit Viagra is so widespread that Pfizer has even created their own security force to help cut down on the amount of unregulated drugs on the market. This team, called Pfizer Global Security, works with law enforcement, pharmacies and wholesalers to monitor distribution, and improve surveillance on counterfeit Viagra.

Why is this so important? One study done by the Pfizer Global Security team found that nearly 80% of online sites that claimed to sell Viagra were actually selling a counterfeit. The team has even found dangerous additives like blue printer ink, amphetamines (or speed), rat poison, road paint, and floor wax hidden in counterfeit Viagra—things you definitely don’t want to put in your body.

For more information on spotting fake Viagra, see Pfizer’s video on how to buy safely here.

It does have side effects

While you might have only heard of the good effects of Viagra, be aware that it does have some negative side effects. According to our friends at Iodine, people typically report side effects like headache, flushing, low blood pressure, abnormal vision, indigestion, and an erection lasting longer than five hours. Be sure to speak with your doctor or pharmacist if you experience any of these side-effects for a prolonged period of time.

It is available without a prescription in the UK

The UK just became the first company where patients can buy Viagra over the counter, without a prescription. It is sold under the name Viagra Connect, and is available as a 50 mg tablet for around $25 US dollars for four tablets.

This decision by the Medicines and Healthcare Products Regulatory Agency is aimed at reducing the amount of black market, unregulated Viagra tablets sold.

It treats more than erectile dysfunction

In fact, it was first intended to treat chest pain and angina. However, patients prescribed sildenafil for chest pain reported an interesting side effect, an increased amount of erections, and it was soon after approved to treat erectile dysfunction.

Since then, sildenafil’s indications have expanded to include high blood pressure and pulmonary arterial hypertension in addition to erectile dysfunction


FDA Recalls Lomotil For Diarrhea

by The GoodRx Pharmacist on December 8, 2017 at 5:28 pm

On November 16th, 2017, Manufacturer Greenstone LLC issued a voluntary recall of Lomotil (diphenoxylate/atropine), used to treat diarrhea. 

This is a class II recall, the most common type of recall, which means that there is a situation where the use of the recalled medication may cause temporary or medically reversible adverse health consequences, but the likelihood of serious adverse effects is small. For more information on the different types of recalls, see our overview here.

Who can recall a drug? 

A manufacturer can voluntarily recall their medication, or the Food and Drug Administration (FDA) can request or require that a manufacturer recalls a particular medication. In this case, the manufacturer has voluntarily recalled diphenoxylate/atropine.

Why were these products recalled?

Greenstone LLC has issued a recall due to possible sub-potent and super-potent tablets. In other words, some tablets may contain too much medication (super potent) or not enough medication (sub-potent).

Taking a diphenoxylate/atropine tablet that contains too much medication can cause life-threatening toxicity, coma, problems breathing, lethargy, skin flushing, and drowsiness. On the other hand, taking a diphenoxylate/atropine tablet that doesn’t contain enough medication can worsen diarrhea.   

Have there been any adverse events reported to the FDA from patients?

No. At this time, the FDA has not received any reports of adverse events associated with this recall.

Which products were recalled?

According to the FDA’s announcement, the affected products were distributed nationwide to wholesalers and retailers in the United States from November 2016 to June 2017.

This recall will affect the following:

  • Drug: Diphenoxylate/atropine 2.5 mg/0.025 mg tablets
  • Manufacturer: Greenstone, LLC
  • Bottle Size: 100-count (NDC 59762-1061-01), 1000 count (NDC 59762-1061-02)
  • Lots 
    • 100-count bottles: R83962, R93347, R93348, R93349, R93350, R93351, R93352, S57831, S57832, S57834
    • 1000-count bottles: R93356, R93357, R93358, R97310

Generic Viagra Now Available: Here’s How to Get It

by Thomas Goetz on December 7, 2017 at 2:44 pm

As of Monday, Dec. 11, 2017, two generic versions of Viagra (sildenafil) will be available in pharmacies: one by generic manufacturer Teva, and the other by the original manufacturer, Pfizer. Prices for generic sildenafil should be about half what they are for the brand version, according to the AP.

Current prices for Viagra are around $70, which would put the generic versions between $30 and $35. That’s before any additional discounts – check back at GoodRx to see what additional discounts might be available.

Pfizer announced plans to release its own generic version days before Teva’s version arrives on the shelves (Teva has planned a generic version since 2013). This will allow Pfizer – which sold more than $1 billion of Viagra in the US in 2016 – to keep some of that cashflow coming in. Other generic versions are expected to arrive in pharmacies in the summer of 2018, which should drive prices even lower.

More than 60 million men worldwide have used Viagra since it hit the market in 1998. Those are the official numbers from Pfizer; many men are embarrassed to ask their doctors for a prescription, and the Internet has long been awash in dubious offers for the drug without a prescription.

 

This story has been updated to reflect current news. The original story is below.

Pfizer, the manufacturer of erectile dysfunction med Viagra, just reached a settlement with generic manufacturer Teva that will allow Teva to start selling generic Viagra (sildenafil) in December 2017—that’s more than two years earlier than the current patent expiration in April 2020.

This is great for anyone using Viagra, as the cost of generic sildenafil will be lower, but a there are a few things to keep in mind.

The Teva generic will be the only one available for two-plus years, unless there are other settlements or the patent is contested successfully. This means that there won’t be a lot of competition to drive the generic price down once it hits the market.

There is also a chance that because the indication (the reason it’s prescribed) isn’t considered essential by many insurance plans, your odds of getting the generic covered may not be all that much better than the brand.

Some better news though: The patent expiration for Cialis also falls in that 2017 – 2020 window, in May 2018, so other generic options in the same class of drugs may help lower prices as well.

You may also be aware that generic sildenafil is already available, as a generic to pulmonary arterial hypertension drug Revatio. You can check out Dr. O’s article It’s Here! Finally a Viagra You Can Afford for more info.

Overall, don’t expect major changes for a little while longer yet, but they are coming.

In the meantime, you can see Viagra offers and prices here, and Cialis offers and prices hereViagra and Cialis both offer free trials, and Viagra offers a home delivery program.


Xarelto Generic Is Three Years Away: Here’s How to Save While You Wait

by Tori Marsh on December 6, 2017 at 5:22 pm

Xarelto is a commonly prescribed drug that helps prevent blood clots, stroke, and atrial fibrillation (a so-called anticoagulant).

The bad news? It’s really expensive, and Xarelto isn’t expected to be available as a generic for some time. If your doctor thinks Xarelto right for you, how can you make it affordable?

Here’s some information about Xarelto and how you can save.   

How popular is Xarelto?

Xarelto is the third most popular anticoagulant, a class of medications that also includes Coumadin (jantoven, warfarin), Praxada, and Eliquis. Commonly referred to as blood thinners, these drugs help to prevent blood clots that can cause deep vein thrombosis, pulmonary embolism, angina, stroke, and heart attack.

When will generic Xarelto be available?

As of December 2017, there is no generic available for Xarelto. However, it may become available as rivaroxaban in 2021, when the brand name patient expires. While you might have to wait three more years to save with the generic, there are other ways to cut costs on Xarelto.

Are there any cheaper anticoagulants I can try?

While Xarelto doesn’t have a generic, there are a couple of alternatives. Be sure you speak with your doctor to see if these alternatives will work for you.

  • Coumadin (warfarin, jantoven). Coumadin is a popular anticoagulant that has two affordable generic alternatives, warfarin and jantoven, that can cost as little as $4 for a one month supply. Very affordable, but what is the downside? Well, Coumadin can raise your risk of bleeding and bruising, so it requires regular blood tests to ensure its effectiveness.
  • Other anticoagulants. Pradaxa or Eliquis are both still only available in brand form – so they don’t have cheaper generic versions. Still, these alternatives may be more affordable, especially if they are covered by your prescription insurance.
  • For more information on how Xarelto compares to other anticoagulants, check out Iodine’s page on Xarelto alternatives. As always you’ll want to speak with your doctor if you think other medications might work better for you.

Xarelto still works best for me—how can I save?

  • Fill a 90-day supply. This can help shave a little more off of your out-of-pocket costs. Be aware that you will need a new prescription from your doctor, and approval from your insurance to fill for a higher quantity. Check in with your doctor, insurance, and/or pharmacist.
  • Use a Xarelto coupon from GoodRx. GoodRx offers discounts for Xarelto online, which can usually save at least 15% off the full retail price.
  • Split a higher dosage pill. This can help reduce costs, especially if two strengths are priced similarly. You’ll want to check in with your doctor to see if this is a safe option for you.
  • Try to appeal your coverage. If you have insurance, and your plan doesn’t cover Xarelto, ask your doctor about submitting an appeal. Some plans require prior authorizations—meaning you need permission from your insurance plan and a special request from your doctor before you can fill your prescription. If you have insurance, call your provider and ask how to get this process started.

The Best Medication for Insomnia: Ambien, Sonata, or Lunesta?

by Thomas Goetz on December 6, 2017 at 4:37 pm

These days, insomnia is pretty much part of the national condition. Every evening, millions of Americans use a prescription drug to help them get to sleep and stay asleep – usually a generic version of Ambien (sold under the generic name zolpidem), Sonata (zaleplon), or Lunesta (eszopiclone).   

These three medications are all so-called “z-drugs”: Non-benzodiazepines that calm the brain and induce sleep by inducing a sort of hypnotic effect. They’re considered safer to use than the benzodiazepine drugs, which have a higher risk of dependence and overdose.

How effective are these sleep drugs, anyway, and who do they work for best? It’s a straightforward enough question. But answering it isn’t so simple.

One problem is that in clinical trials, sleep medications are usually tested in sleep laboratories. Sleep labs look something like a motel room — there’s a bed and a bedside table, but also a machine that has all sorts of wires connected to it. These wires are hooked up to the study subjects to monitor vital signs as they sleep (or try to sleep). But a sleep lab is a poor proxy for real life. At best the labs are unfamiliar and somewhat uncomfortable; at worst they can heighten the anxiety that can cause insomnia.

And then there’s the problem of sample size: Sleep lab studies are expensive, so many clinical trials include fewer than 1,000 people, and sometimes fewer than 100 people, sleeping in the lab for just one or two nights.

 

Data from the Real World

Our friends at Iodine have collected a lot of data about the real-life experience of real people taking these drugs. Hundreds of people have shared their experiences with Ambien, Lunesta, and Sonata.

People rated these drugs in three respects: 1) how well did they think the drug worked, 2) how much of a hassle – in terms of side effects and other challenges – did the drug create, and 3) what was their overall satisfaction with the drug – a “worth it” score.

So what did people say? For one thing, younger people are less satisfied with sleep medications and find them to be more of a hassle, in terms of side effects – and older people find sleep drugs to work better with fewer side effects.

And then there’s the bottom line: which drug works best. Comparing the “worth it” scores for these three drugs, the Iodine data shows a clear preference for Ambien, in terms of overall satisfaction – the “worth it” score. People taking Ambien (zolpidem) say it’s worth it 67% of the time, while Lunesta (eszopiclone) gets a 55% worth it score, and just 42% of people say Sonata (Zaleplon) is worth it. That leaves a lot of people still unsatisfied with these sleep medications. And that means lots of people are still going to struggle with insomnia, even with medications.

These results are especially interesting compared to published research. A study in Japan that compared eszopiclone (Lunesta) versus zolpidem (Ambien), for instance, found that at doses of 2mg or higher, eszopiclone was comparably effective in helping people fall asleep and more effective in overall sleep efficiency (defined as the percentage of time people stayed asleep). But the effect depended entirely on dose: eszopiclone’s advantage disappeared when it was administered at 1 mg. That’s important because the FDA reduced the recommended dose for eszopiclone from 2 mg to 1 mg, following reports that people on higher doses were less alert in the morning and at a higher risk in activities such as driving a car. This followed an earlier FDA adjustment in the recommended dose for zolpidem in women from 10 mg to 5 mg. (We don’t know the dose for people in our survey).

And here’s where price matters: at GoodRx, prices for zolpidem are around $8 – that’s about half what they are for zaleplon, and 60% cheaper than a prescription for eszopiclone. Considering that people report better satisfaction with zolpidem than the others, it looks like the cheapest drug might also be the one people prefer most. In other words, Ambien (zolpidem) offers the best bang for the buck.

Prices shown are average GoodRx discounted prices as of Dec 6, 2017. Local results may vary.


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