Hims is a legitimate telemedicine company that sells FDA-approved generic sildenafil (the active ingredient in Viagra) through licensed mail-order pharmacies. It’s a publicly traded company on the New York Stock Exchange, regulated by the SEC, and holds an A+ rating with the Better Business Bureau. The medications are real, the prescriptions come from licensed providers, and the pharmacies are legally registered.
How Hims Operates as a Business
Hims & Hers Health, Inc. is not a shadowy online pharmacy. It trades publicly on the NYSE under the ticker HIMS and files annual reports with the SEC, meaning its financials and operations face regular regulatory scrutiny. The company runs two dedicated licensed mail-order pharmacies: XeCare, LLC and Apostrophe Pharmacy LLC, both of which provide prescription fulfillment exclusively for Hims & Hers customers. These pharmacies are registered with state boards of pharmacy as required by law for out-of-state mail-order operations.
The BBB has given Hims an A+ rating. The complaints on file mostly involve issues with canceling subscriptions and getting refunds, not concerns about counterfeit medication or fraud. That’s a meaningful distinction: billing frustrations are common with subscription services, but they’re very different from legitimacy problems.
What You’re Actually Getting
Hims primarily sells generic sildenafil, not brand-name Viagra. Sildenafil is the exact same active compound found in Viagra. Once Pfizer’s patent expired, the FDA approved multiple manufacturers to produce generic versions, and those generics must meet the same safety, potency, and manufacturing standards as the original. There is no pharmacological difference between generic sildenafil and brand-name Viagra.
The price difference, however, is enormous. Generic sildenafil through Hims runs roughly $2 to $10 per dose depending on the strength, while brand-name Viagra starts at $139 or more per dose. Most customers opt for the generic, and for good reason: it’s the same drug at a fraction of the cost.
The Prescription Process
You can’t just add sildenafil to a cart and check out. Hims requires a medical consultation before any prescription is issued. The process starts with an online intake form where you provide your symptoms and medical history. A licensed healthcare provider then reviews your information and determines whether treatment is appropriate for you.
In most states, this consultation happens asynchronously, meaning the provider reviews your form and sends treatment recommendations through a secure messaging portal. Some states require a live video visit, in which case you’ll be prompted to schedule one after submitting your intake form. If the provider approves treatment, the prescription is filled by one of the company’s affiliated pharmacies and shipped to your door.
This is a real medical screening, not a rubber stamp. The provider is required to evaluate whether sildenafil is safe for you based on your health history, current medications, and risk factors.
Safety Risks Worth Knowing
Sildenafil is generally safe for most men, but it carries serious risks in specific situations. The most critical one: you cannot take sildenafil if you use nitrate medications for chest pain or heart conditions, including nitroglycerin. The combination can cause a dangerous drop in blood pressure. The same applies to recreational drugs known as “poppers” (amyl nitrate or butyl nitrate).
You should also flag the following to your provider during the Hims intake process:
- Heart problems including a history of heart attack, irregular heartbeat, angina, heart failure, or heart surgery within the past six months
- Stroke history or uncontrolled high blood pressure
- Blood cell disorders such as sickle cell anemia, multiple myeloma, or leukemia, which can increase the risk of prolonged erections
- Vision concerns including a history of sudden vision loss or the eye condition NAION
- Liver or kidney problems, bleeding disorders, or active stomach ulcers
Sildenafil can also interact with blood pressure medications and alpha-blockers, potentially causing lightheadedness or fainting. If you experience sudden vision loss, sudden hearing loss, or an erection lasting more than four hours, those are medical emergencies that require immediate attention.
Shipping and Privacy
Hims ships most orders in a plain brown corrugated box with just the letter “h” on one side. The exterior doesn’t list the contents. The return address shows the company name, but nothing about what’s inside. If the standard box isn’t available, orders go out in a brown or white padded mailer. It’s not completely anonymous, but it’s discreet enough that a package on your doorstep won’t advertise what you ordered.
Common Frustrations to Expect
The most frequent complaints about Hims aren’t about the medication itself. They center on the subscription model. Hims defaults to recurring shipments, and customers have reported difficulty canceling orders or obtaining refunds. Before you start, it’s worth understanding exactly how the billing cycle works and how to manage or cancel your subscription through your account settings. The medication is legitimate, but the business model requires you to stay on top of your subscription if you don’t want ongoing charges.