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Sildenafil is the active ingredient in Viagra, so they are equally effective in terms of strength. Viagra is simply a brand name for sildenafil. Both are used to treat erectile dysfunction and work in the same way.

Sildenafil does not cause an erection without sexual stimulation. It works by enhancing the natural process of arousal, so sexual stimulation is necessary for it to be effective.

Viagra is more expensive than sildenafil because Viagra is the brand-name version of the drug, while sildenafil is the generic version. Brand-name drugs typically cost more due to the expenses associated with research, development, and marketing. Once the patent for a brand-name drug expires, generic versions can be produced, which are usually less expensive because they do not have the same development and marketing costs.

When taking sildenafil, one should avoid consuming grapefruit or grapefruit juice, as it can increase the levels of the medication in the bloodstream and lead to increased side effects. Additionally, it is important to avoid using other medications for erectile dysfunction or pulmonary hypertension without consulting a healthcare provider. Alcohol should be consumed in moderation, as it can increase the risk of side effects such as dizziness or low blood pressure. Lastly, avoid using recreational drugs known as "poppers" (amyl nitrate or nitrite) while taking sildenafil, as this combination can cause a dangerous drop in blood pressure.

Sildenafil primarily works by increasing blood flow to the penis, which helps a man achieve and maintain an erection. It is commonly used to treat erectile dysfunction. Additionally, sildenafil can be used to treat pulmonary arterial hypertension by relaxing blood vessels in the lungs, which allows blood to flow more easily.