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Viagra: The risks of getting it off the Internet

October 1, 1999
Web posted at: 9:46 AM EDT (1346 GMT)


In this story:

Viagra is medically warranted for many men

Getting Viagra via the Web is easy -- and dangerous

What is the medical industry doing to combat the problem?

RELATEDSicon



By Steven N. Gange, M.D.

  MESSAGE BOARD
Internet medicine
 

(WebMD) -- Viagra, the trade name for Pfizer's hot pharmaceutical product sildenafil, has taken the world by storm: 6 million prescriptions were written for the drug in its first six months on the market, according to the Federal Drug Administration (FDA), and it remains one of the most popular new drugs in history.

However, because of Viagra's efficacy and availability, some men have begun using it recreationally, and hence a troubling trend has emerged: The acquisition of prescription medicines via the Internet, without direct physician contact. What's the harm in using Viagra for improving sexual pleasure, goes the thinking, even if you don't have a problem with erections? But Viagra is a potent and even potentially dangerous medication if not properly administered. Here's what all men should know about the benefits -- and risks -- of this drug.

Viagra is medically warranted for many men

The American Medical Association (AMA) estimates that 10 million to 30 million American men have erectile dysfunction (ED), the inability to achieve and/or maintain an erection satisfactory for sexual intercourse. Prior to the FDA approval and release of Viagra in March 1998, however, many men with ED suffered in silence. Although other effective treatments existed, no reliable oral medication was available until Viagra arrived on the scene. Other treatment options, such as vacuum constriction devices (designed to pull blood into the penis) and injection therapy (in which drugs are injected into the side of the penis) seemed intimidating and cumbersome and kept some men from seeking treatment.

Viagra works by preventing the breakdown of a molecule in the penile tissue that helps maintain the increased blood flow required for an erection. It works well in most men: Depending on the cause of ED, up to 80 percent of men with this condition will respond to the drug, says Pzifer, the drug's manufacturer.

Getting Viagra via the Web is easy -- and dangerous

In addition to your local pharmacy, Viagra is available over the phone and the Internet. The interested consumer generally answers some medical history questions and, after accepting all associated risks, can order a supply of the pills. While these applications are theoretically reviewed by a physician, important information may be overlooked or misrepresented. And without a physical examination, serious underlying causes of ED (such as diabetes, vascular disease, hormonal imbalance and so on) could easily be missed.

Up to 18 percent of Viagra users experience side effects, says a study published in the May 1998 issue of the New England Journal of Medicine. Common side effects of Viagra include headache, facial flushing, upset stomach, nasal congestion and rare visual disturbances, according to the FDA. Viagra has also been linked to more than 100 deaths, according to the AMA. Most deaths occur in men who have a history of heart disease, but some deaths have occurred without that risk factor. Furthermore, Viagra should never be used in conjunction with a class of medications called nitrates, because of serious blood pressure complications and possible death.

Another risk for someone young and healthy using Viagra recreationally is priapism, a prolonged painful erection resulting in sludging of blood in the penis and often causing permanent ED, even with the proper treatment. Finally, even if the drug works without side effects, men should be concerned about the psychological dependence that could follow: Men who take Viagra before they really need it may grow to rely on it and may not be able to have sex without it.

What is the medical industry doing to combat the problem?

The ethics of online prescribing are currently under review by the Federation of State Medical Boards and the AMA. The AMA's board of trustees has taken a strong stance against dispensing Viagra -- and other prescription drugs -- over the Internet because it lowers the quality of care that a physician should offer. The board has urged state medical boards to investigate and take action against doctors who do not meet minimal standards of care when issuing prescriptions over the Internet. In addition, Pfizer has filed a complaint with the Federal Trade Commission and has asked it to monitor improper dispensation of the drug.

The bottom line: Although it is possible to get Viagra without seeing a doctor, you are risking your health by doing so. Viagra should be used only when medically necessary and prescribed after a clinical exam by a doctor.

BIO Steven N. Gange is a urologist at the Western Urological Clinic in Salt Lake City, UT.Copyright 1999 WebMD, Inc. All rights reserved.



RELATEDS AT WebMD:
Viagra

RELATED SITES:
Food and Drug Administration: Viagra Consumer Information
American Medical Association: Report of the Board of Trustees
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