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12th July 1998

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Your Health

Mad rush for Viagra

By Dr. Sanjiva Wijesinha

A new drug must surely be special if it makes the cover of Time magazine within two months of being launched.

Today, a few months since it was released on the American market, the "wonder drug'' Viagra has become a household word in the US - and men across America have been rushing to buy the tablets at record breaking rates. No less than 113,134 prescriptions were written for the drug in its second week on the market.

The new medication Sildenafil (marketed by Pfizer under the trade name Viagra) is used to treat male impotence. It is only available on a doctor's prescription - but thanks to the American media's appetite for miracle cures, Viagra has put interest in male sexual performance firmly on TV screens, magazine covers and daily newpapers.

Sex, after all sells.

The condition for which Viagra is prescribed, Impotence, refers to man's inability to maintain an erection satisfactorily for sexual intercourse. Now impotence is known to increase steadily though slowly with age - and while it is difficult to obtain precise figures, estimates suggest that about 30% of men in their sixties and around 45% in their seventies do experience difficulty with erections.

Research from various centres suggest that it would be effective in about 70% of men who suffer from erectile problems.

A word of caution, though - Viagra is not a panacea for all men with erection difficulties, says Dr. Malcolm Lawrie, Director of Medical Affairs of Pfizer, Australia "We are taking pains to dispel any expectations that this drug is 100% effective.''

Impotence can arise due to anxiety (even anxiety about one's performance) - or to a variety of diseases such as high blood pressure, diabetes or raised cholesterol.

While Viagra is likely to be effective in 9 out of 10 patients with impotence brought on by anxiety or by moderate impairment from diseases of the blood vessels, the tablets will not help all patients. And it will have no effect on other sexual problems such as premature ejaculation.

The tablets must be taken half to one hour before sex; side effects can include headaches, flushing of the face and stuffiness of the nose.

At present, it is probably safer for those men who have heart disease to keep away from the drug - the unexpected fall in blood pressure that may occur in some of them can precipitate a heart attack.

"Viagra is absolutely contra-indicated in heart patients who are already on nitrate therapy - because the drug could cause an abrupt drop in blood pressure.'' says Dr. Michael Gillman, Brisbane-based specialist in Men's Health.

The only men who should take "Viagra'' adds American specialist Dr. Takshan de Alwis "are those who have been thoroughly evaluated by a doctor, because erectile problems can be a signal of some serious underlying disease.''

Adds Dr. Gillman, "The tablet enhances the action of Nitric Oxide and allows the normal neurochemical actions to proceed - so if there is nothing wrong with the man in the first place, this drug is not going to make much of a difference. If people without erectile dysfunction want to try it, they will only be wasting their money - because Sildenafil certainly isn't cheap."

Doctors hope that the publicity surrounding Viagra will encourage more men to seek advice from their doctors about the question of impotence. Based on the number of American men coming forward to consult their doctors since the new drug was released.

Seventy-four-year-old former US senator Bob Dole, who ran for president against Bill Clinton in 1996, was one of those who participated in the American trials of Sildenafil. He appeared recently on American national television to support Viagra describing it as "a great drug.''

To my simple mind, the big question now is whether this new drug will enable Dole to mount another challenge against Bill Clinton!

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