In 2018, Pfizer’s blockbuster erectile dysfunction (ED) drug Viagra, which contains sildenafil, became available as an over-the-counter (OTC) medication in the United Kingdom.

In the UK, OTC Viagra is sold under the name ‘Viagra Connect,’ which contains 50 mg sildenafil citrate. It can be obtained from local pharmacies without providing a prescription.

However, in the United States, Viagra is only available under a prescription. You cannot buy Viagra over the counter or without a prescription in the US.

Although Viagra is available as an OTC medicine in the UK, patients are still required to speak with a pharmacist, who will determine whether the drug is good for them. If not, the patients will be referred to a doctor.

In 2018, Dr. Philip Werthman, Director, Center for Male Reproductive Medicine and Vasectomy Reversal in Los Angeles, told Healthline that Viagra is generally not a dangerous drug.

He said, “It’s not like it needs to be a controlled substance from the standpoint of a huge amount of side effects. I’d like to see it OTC from that standpoint. And it would probably bring down the cost.”

However. Dr. Werthman noted that ED could sometimes indicate a potentially serious underlying illness, such as heart disease. “From that perspective, I would want to see it in the hands of doctors,” he said.

“You can overdose and end up in the hospital. You don’t want people using it as a recreational drug,” Dr. Werthman explained. “You don’t want 18- to 22-year-olds messing around with this stuff. There are many tradeoffs and I don’t know what the right answer is. The UK is doing it first, so we’ll get to see the unintended consequences.”

At the time, the Medicines and Healthcare products Regulatory Agency (MHRA) reclassified the use of Viagra OTC in the UK in order to discourage men from buying the blue pill online from illegal websites.

Dr. Werthman said people can buy Viagra legally from online pharmacies with doctor screening. However, he cautioned them about the dangers of buying the drug from the black market.

He said, “But on the black market, you don’t know what you’re getting. Is it Viagra or is it laced with something else? There’s no quality control or assurance.”

Meanwhile, Pfizer is working to sell a generic version of Viagra, which still will not be available without a prescription in the United States. At the same time, Teva Pharmaceuticals is working on its own generic version of sildenafil.

Generic Viagra is expected to cost about half as much as the brand Viagra. Other generic versions of Viagra, which are predominantly manufactured in India and China, have already hit the market. The bottom line is you can buy Viagra OTC without needing a prescription in the UK by answering a short questionnaire in a pharmacy to make sure it is suitable for you. However, you cannot do so in the United States.