Sildenafil, often called generic Viagra, is an as-needed treatment for erectile dysfunction. Bidwell Health offers a $45 online ED assessment for eligible adult men in Florida and 10 other states. A licensed clinician reviews your history and messages you if more information is needed. If treatment is appropriate, the prescription goes to your chosen pharmacy. Medication and any shipping are paid separately. No required subscription or video visit.
Yes. Eligible adult men physically in Florida can request a sildenafil prescription through Bidwell's online ED visit. You complete the intake, including your health history, medications and treatment preference. A Florida-licensed clinician decides whether to prescribe, adjust the plan or recommend an in-person evaluation.
For the Florida visit process and eligibility, see generic Viagra and other online ED treatment options in Florida. You can choose pharmacy pickup near home or a mail-order pharmacy; Bidwell does not dispense or ship tablets. Our Florida ED prescription guide walks through the visit and what happens next.
Sildenafil is a selective inhibitor of phosphodiesterase type 5 (PDE5), the enzyme that breaks down cyclic GMP in the smooth muscle of the penis. By blocking PDE5, sildenafil preserves cGMP levels, which allows the smooth muscle to relax and blood to flow into the corpus cavernosum during sexual arousal. It doesn't cause an erection on its own; it enables a normal erectile response when a man is sexually aroused. The Viagra prescribing information is the definitive reference for its mechanism, dosing, and safety.
Viagra is a brand name; sildenafil is the active ingredient. FDA-approved generic medicines must meet standards for the same active ingredient, strength and clinical benefit as their brand-name counterparts. Tablet appearance and inactive ingredients can differ. This ED guide concerns 25 mg, 50 mg and 100 mg tablets, not the separate pulmonary-hypertension treatment regimen.
Sildenafil is appropriate for most adult men with erectile dysfunction. The American Urological Association guideline recommends PDE5 inhibitors as first-line therapy for ED in the absence of contraindications. You can request an assessment through Bidwell if you:
You can start with an online assessment. Whether you need an examination, bloodwork or a specialist evaluation depends on your symptoms and medical history. If your history suggests a secondary cause (sudden onset ED after a heart attack, significant cardiac risk factors, features of hypogonadism), the reviewing licensed clinician may recommend an in-person evaluation instead of prescribing online.
This includes nitroglycerin, isosorbide and recreational "poppers." The combination can dangerously lower blood pressure. Do not use sildenafil if you have had an allergic reaction to it or an ingredient in the tablet.
Tell your clinician about a recent heart attack, stroke or serious arrhythmia, very low or uncontrolled blood pressure, severe liver or kidney disease, dialysis, a prior sudden loss of vision, retinal disease, or a history of prolonged erections. These can require a different dose, a different treatment or an in-person assessment. ED medication should not be used when sexual activity is unsafe because of your heart condition.
Alpha-blockers and other medicines can change the risk. Your clinician reviews the combination and dose; spacing tablets does not remove an interaction. See the MedlinePlus patient guide for precautions. If chest pain develops, seek emergency care and tell the team when you last took sildenafil; do not self-administer a nitrate.
| Dose | When to use | Notes |
|---|---|---|
| 25 mg | Older adults, renal/hepatic impairment, drug interactions | Lower starting dose; titrate up if tolerated |
| 50 mg | Most adults, first-time users | Standard starting dose; taken 30-60 min before activity |
| 100 mg | Inadequate response to 50 mg | Maximum recommended dose; not more than once in 24 hours |
Sildenafil is taken as needed, not daily. Take it 30-60 minutes before anticipated sexual activity, preferably on an empty stomach for fastest absorption. A heavy, high-fat meal can delay onset by an hour or more. Grapefruit juice raises sildenafil levels and should be avoided around dosing.
Do not exceed your prescribed dose or take extra tablets because a dose did not work. Some interactions require a lower dose or a longer interval than 24 hours. If response is inadequate, discuss timing, food, side effects and your health history with your clinician before changing treatment.
Sildenafil is generally well tolerated. The most common side effects in clinical trials (FDA label data) are:
Serious but rare side effects include priapism (painful erection lasting more than 4 hours; medical emergency, seek care immediately), sudden hearing loss, and NAION (non-arteritic anterior ischemic optic neuropathy). Stop the medication and seek urgent care for sudden vision or hearing loss.
For a deeper breakdown, see our full write-up on sildenafil side effects explained and how long sildenafil lasts.
The Bidwell visit is $45; sildenafil is purchased separately. The visit fee pays for clinician assessment, a treatment decision and 21 days of messaging about that visit. Your portal displays the messaging end date. See what happens after an online visit for when that window begins.
Pharmacy example, checked September 28, 2026: Cost Plus Drugs lists 30 sildenafil 50 mg tablets for $6.36, plus $5.25 standard shipping. With a $45 Bidwell visit, that example totals $56.61 before tax for the visit and one fill. Your clinician selects the dose; confirm the current price for your prescribed strength and quantity with your pharmacy.
Bidwell does not bill insurance for the visit. Ask your pharmacy whether insurance or a cash discount gives the better medication price. For dated pharmacy examples and visit-plus-medication totals, use our ED treatment cost comparison. Its source dates and quantity assumptions remain attached to the examples.
The intake offers 15, 30 or 45 tablets for as-needed use. The clinician decides the final quantity and may authorize one refill. How long the supply lasts depends on use. Another prescription after the approved tablets and refill are used requires a new $45 visit; there is no automatic subscription.
Bidwell Health is licensed to prescribe in:
You must be physically located in one of these states at the time of your visit. If you're outside this list, we're adding states; but we can't prescribe until we're licensed in your state.
Yes. Eligible adult men physically in Florida can request a $45 Bidwell ED assessment. A licensed clinician decides whether sildenafil is appropriate, and an approved prescription goes to the patient's chosen pharmacy. Medication and shipping are separate. See online ED treatment in Florida for the care pathway.
Yes. Eligible adult men in Florida and the other supported states can request a $45 online assessment. A licensed clinician reviews symptoms, health history and medications before deciding whether sildenafil is appropriate. Approved prescriptions can go to a chosen local or mail-order pharmacy. Medication and delivery are separate.
The Bidwell assessment is $45. Medication is paid separately to the pharmacy, with the price depending on strength, quantity, pharmacy, insurance or discounts, and delivery. See the dated ED cost comparison for strength, quantity and delivery assumptions.
50 mg taken about 60 minutes before sexual activity. Your provider may start at 25 mg if you're older, have kidney or liver impairment, or take interacting medications. The max dose is 100 mg, once in 24 hours.
Half-life is ~4 hours; clinical effect is strongest for 2-4 hours and the window is typically 4-6 hours. It requires sexual arousal to work. If you want a longer window, tadalafil offers 24-36 hours.
Light to moderate drinking is generally okay. Heavy drinking worsens ED on its own and increases sildenafil side effects like headache, flushing, and low blood pressure. Avoid grapefruit juice around dosing; it raises levels.
FDA-approved generic sildenafil contains the same active ingredient as Viagra and must meet FDA standards for equivalent clinical benefit at the corresponding strength. Appearance and inactive ingredients can differ. This guide covers FDA-approved generic sildenafil tablets.
Message your clinician about how you took it, your response and any side effects. Timing, a heavy meal, other medication and underlying health conditions can affect response. Do not increase the dose or combine ED medicines on your own. Your clinician may adjust treatment or recommend further evaluation.
No. Sildenafil helps erectile function during sexual stimulation; it is not contraception and does not prevent sexually transmitted infections. Use appropriate protection.
The intake offers 15, 30 or 45 tablets for as-needed use. Your clinician decides the final quantity and may authorize one refill. Supply duration depends on how often you use the tablets. Another prescription after the approved supply and refill are used requires a new $45 visit.
Sildenafil is FDA-approved only for men's ED and pulmonary hypertension. Off-label use for female sexual dysfunction exists but is not well supported by evidence. We don't prescribe sildenafil to women.
Sources checked September 28, 2026.