Who still has to write the US line?
A licensed US clinician. The order scan covers how that line is written and filled. The sildenafil panel holds the 25-100 mg card those visits refer to.
Yuki Tanaka tags OTC myths on this scan so the board does not treat a UK P pack as a US grocery item.
Can a US pharmacist convert 50 mg to OTC at the window?
No. A US pharmacist can fill a written 25, 50, or 100 mg line. They cannot reclassify the tablet into an over-the-counter sale because a customer asks. State boards did not get that lever.
Counseling at the window still matters. Nitrates, alpha-blockers, and ritonavir still change the fill. Counseling is not the same as an OTC hand-off.
Is any Viagra strength on a US grocery shelf?
None of the three ED strengths sit in an open US aisle. A cashier cannot ring up 50 mg the way they ring up an antacid. That is the whole OTC answer for this country.
Export cartons and 'research' listings are not a US over-the-counter switch. They are a different supply problem. Check a website on BeSafeRx instead of treating a cart as an aisle.
What does a no-prescription banner tell you?
FDA's BeSafeRx list treats 'no prescription needed' as a mark of an unsafe shop. A real US pharmacy requires a prescription from a licensed clinician before it ships 25-100 mg.
Deep discounts without a history are not a legal OTC shortcut. They are the pattern BeSafeRx was written to flag. This board will not invent a cash figure to decorate that warning.
Do 25 mg and 100 mg change the US Rx rule?
No. The smaller tablet and the ceiling tablet are still prescription only in the United States. Dropping to 25 mg for age or CYP does not create an aisle product.
Climbing to 100 mg after a clean 50 mg trial is still a labeled prescriber move. It is not a reason the FDA opened a walk-up lane.
How is the UK pharmacy lane different?
MHRA moved Viagra Connect 50 mg from prescription-only to a pharmacy (P) medicine. A UK pharmacist screens the man, then may supply 50 mg without a GP script. That lane is 50 mg, not 25 and not 100.
The United States did not copy that reclassification. Do not walk into a US shop with a Connect story and expect the same sale. The Connect scan keeps the two countries apart.