Firstmed Blog

Viagra (sildenafil) started off as a rather disappointing treatment for angina but doctors began to notice that patients were very reluctant to stop taking it, even after surgery had dealt with any angina problems. One by one the Viagra users confessed that a wonderful thing had happened after Viagra: their sex life had dramatically improved. Following this unexpected side effect Viagra was launched by Pfizer Pharmaceuticals in mid April 1998 in the US as a treatment for impotence and different degrees of erectile dysfunction. Within 14 days despite the high Viagra price, doctors were writing more than 110,000 Viagra scripts a week. In 14 weeks 2 million Viagra scripts had been written in the US alone and Viagra had become established as a new recreational drug in club culture world-wide. Substitute viagra, free viagra, herbal viagra, cheap viagra, viagra sale online, natural viagra, viagra alternative - Viagra sales leapt and so did sales of every kind of aphrodisiac on the impotence market, all promising more for less.

After five years with 96% of the erectile dysfunction (ED) market to itself, Pfizer’s Viagra isn’t the only game in town for ED sufferers any more and is facing some stiff competition from cheap generics available online and from Levitra and Cialis treatments lauched in 2003 by Bayer & GlaxoSmithKline and Lilly & Icos respectively. Today the Viagra stampede has settled down, with a black market firmly established and accelerated by the Internet, allowing more than 70 million web surfers to purchase Viagra relatively easily and cheaply on the open market despite being classified as a prescription drug. In addition a large number of online pharmacies have sprung up offering Viagra without a medical consultation, at heavily discounted prices. And then there is fake Viagra, containing little or no real Viagra.

So does all this competition mean that Viagra will become cheaper. Many patients feel that they are being over charged for these pills and ask when and where cheaper treatments will come from?

While Pfizer is currently the only legal producer of the original branded Viagra, there are literally over a hundred companies making generic versions, such the popular Indian variety ‘Kamagra’. However many people are quite rightfully reluctant to purchase generics which are illegally produced. As the only producers of the guaranteed branded product, Pfizer can maintain their high prices. This is all set to change in 2010 when Pfizer’s patent on Viagra expires and the market becomes a free for all. Other drug manufacturers will be allowed to produce sildenafil and be subject to the same regulations as Pfizer are. These are often cheaper than the original brand, and may be sold under the generic name or new brand names. A generic medicine is typically 20% to 80% less expensive than the brand-name original. The availability of lower-priced generic medicines brings down the price of originator drugs through market competition, producing even further savings to patients.

Effective competition between generic medicines and patent-expired original brands guarantees that customers can look forward to a lowering in price of branded pharmaceuticals.

Police in New Jersey in the United States have arrested several people in a crackdown on the illegal trading of prescription drugs, including the erectile dysfunction drug Viagra

The arrests, in Perth Amboy, took place following a tip off by a local doctor who claimed drug sales were occurring in a number of stores which did not have permits to operate as pharmacies, NJ.com reports.

Undercover police officers managed to purchase Viagra in seven shops in the area and they arrested ten individuals including store owners and employees.

Perth Amboy Police chief Michael Kohut highlighted the dangers associated with the illegal sale of drugs like Viagra. He told NJ.com: “There’s a need for qualified doctors to prescribe these drugs to make sure people are getting the right stuff.”

Meanwhile a medicine company in New Hampshire has pleaded guilty to conspiring to traffic counterfeit Cialis tablets, which are subscribed to men suffering with impotence.

Fake erectile dysfunction drugs often have no clinical effects at all but some can contain substances which can be harmful to health.

Pfizer, the company behind the erectile dysfunction drug Viagra, has announced that it is close its manufacturing plant in Sandwich, Kent.

The company claims that the decision has been taken to consolidate its global manufacturing operations in order to “efficiently” meet demand for its products.

Tony Maddaluna, vice president of Pfizer Global Manufacturing, said it is with “regret” that the company has chosen to close operations in the region after more than 50 years.

“This is the latest in a number of global manufacturing changes, to ensure we are operating as efficiently and effectively as possible and able to respond to the challengers of today’s business environment,” he explained.

According to the Independent, Viagra was first tested as a medicine for people suffering angina by scientists in Wales.

Having discovered that it could have potential benefits for men experiencing erectile dysfunction, Pfizer applied for marketing approval for the drug, which has now been used by over 30 million men worldwide.

A lot of people have heard of Viagra, but they are still not quite sure what to expect when they actually take it. The timescale can vary slightly from person to person and be influenced by external factors like food and alcohol. But generally speaking here is a run down of what happens from the time you pop that ‘little blue pill’.

AFTER FIVE MINUTES: You won’t feel the effect straight away. Wait for the drug to be absorbed into your bloodstream.

You may feel warmth and flushing of the face. This is because Viagra affects your blood flow and not just because you are excited about what is going on down there.

30 MINUTES: As the active ingredient in Viagra – sildenafil citrate – is absorbed, it disables an enzyme in the penis called PDE5. This frees up a chemical called cGMP, which is crucial for hot bedroom action.

30-60 MINUTES: Once the PDE enzymes have been disabled, levels of calcium within the penis muscle cells rise. This relaxes the muscle and increases blood flow.

And the better the blood flow, the better the erection. But only if the spirit is willing – Viagra can’t do all the hard work for you. It won’t work if there isn’t any stimulation.

ONE TO THREE HOURS: Your body will be primed for an erection for about three hours so within that time, and with the right stimulation, an erection can be achieved.

But we are not talking about three-hour long erections. You will orgasm as normal, but may recover more quickly and, while your body is still primed, you can become aroused again.

Viagra may make a man more loving as well as improve his physical performance, research suggests.

Scientists have discovered that the impotence drug can boost levels of a “cuddle chemical” in the brain.

Oxytocin, also known as the “love hormone”, is thought to promote romantic feelings and bonding between couples.

The hormone is released during orgasm in both men and women and has been linked to sexual arousal. It also plays important roles in childbirth and breast-feeding.

Viagra, the brand name of the drug sildenafil, overcomes impotence by blocking an enzyme that limits blood flow to the penis.

The same protein, phosphodiesterase type 5, also acts as a brake to regulate oxytocin release in the brain. Viagra eases the brake off and allows cells in the brain’s pituitary gland to generate more of the hormone.

Just as Viagra needs a sexual trigger to cure impotence, the drug will only induce oxytocin release in response to the right nerve messages.

The discovery was made by scientists who measured the oxytocin produced by rat pituitaries during nerve stimulation. When the pituitaries were exposed to sildenafil, they released three times more oxytocin than they did without the drug.

Professor Meyer Jackson, who led the study at the University of Wisconsin-Madison in the United States, said: “Erectile dysfunction drugs do not induce erections spontaneously, they enhance the response to sexual stimulation. Viagra will not induce the release of oxytocin on its own, but it will enhance the amount of release you get in response to electrical stimulation.”

Experts believe the release of oxytocin might provide a biological explanation for why people fall in love, especially after sex.
Source: Telegraph.co.uk

My constant trawl through medical archives in search of developments in the treatment of erectile dysfunction occasionally throws out some interesting and useful information. It appears that grapefruit juice can also affect the absorption of the popular erectile dysfunction drug Viagra (Sildenafil).

Researchers in Köln, Germany, conducted a study using 24 healthy, male subjects whose average age was 29 years. The men received a glass of grapefruit juice on an empty stomach and then one hour later another glass of grapefruit juice with Viagra 50 mg. Blood samples were collected over the next 24 hours. A week later the experiment was repeated with water being substituted for grapefruit juice.

Researchers found that the absorption of Viagra increased by 23% when taken with grapefruit juice instead of water. Grapefruit juice also delayed the absorption of Viagra. This latter point is important because Viagra is supposed to be taken one hour before sex, and taking the drug with grapefruit juice may result in disappointment for some users of Viagra.

The grapefruit juice used in this study was white juice and supplied by Döhler-Euro Citrus NBI, GmbH. Other brands, types and doses of grapefruit juice may have different effects. The researchers suggest that the combination of Viagra and grapefruit juice be “avoided.”
Men who use protease inhibitors are usually prescribed less-than-normal doses of Viagra because protease inhibitors can raise levels of Viagra several times greater than normal, which can cause dangerous side effects. Therefore, men who use protease inhibitors and Viagra may wish to also avoid taking Viagra with grapefruit juice.

I was reading an article about, Who Wants To Be A Millionaire host, Chris Tarrant’s messy divorce in the Daily Mail today and it struck me how the concept of Viagra is still sensationalist new fodder, even after all these years.

The article entitled Violence, Viagra and the truth about the war of the Tarrants, describes how revelations regarding Chris’s use of the ‘magic blue pill’ had been made public by his estranged wife.

She went into excruciating detail about Tarrant’s sexual problems, pouring scorn on her husband’s love-making skills, claiming that he was “clumsy and naive in bed” and had relied on Viagra for four years because he “couldn’t get it up”.

Obscene mudsling aside, one thing about the article that did strike me however, was the description of how she found out that her husband was taking Viagra. She described how when she found a packet of Viagra in the bin, Ingrid at first thought it must belong to her son Dexter. “I was very upset that he hadn’t talked to me about it,” she confirms. “Couples are supposed to be able to talk about everything, and I was so worried about him. I believe he has been popping the pills for years.”

So it goes to show that even the most wealthy and famous and seemingly unselfconscious have difficulties speaking to their partners about ED.

Condom maker Futura Medical are releasing a new condom that apparently helps men have firmer and bigger erections, as well as a longer-lasting sexual experience. The rubber works like Viagra — but also protects against sexually transmitted infections. Futura boss James Barder said: “We expect to get regulatory EU approval later this year and then it is a question of launching the product soon after.”

So how does it work? A powerful gel in the condom is absorbed through the skin and opens arteries, boosting blood flow and making the penis enlarge and stay erect. In the latest trials, 108 healthy couples tried the condom. They said it helped men get firmer erections compared with standard condoms, and made sex last longer. The study results underpinned hopes the contraceptive will start generating revenues in 2008. Market research has shown so far that interest in the condom is enormous, Barder said. “Up to 80 percent of existing condom users would be interested in trying the product and, more importantly, 49 percent of non-condom users would be interested in using it as it will help them maintain an erection,” he said.

Barder said global consumption of condoms was around 14 billion per year, of which half are branded condoms that are actually sold, with the rest being condoms distributed to promote safer sex and in developing countries.

Condoms are the only form of contraception that protect against STIs and unplanned pregnancy. Doctors hope it will encourage thousands more men to use condoms — the only protection against diseases like Aids and Chlamydia. Britain is currently facing its highest ever level of Aids infections, while one in ten women has Chlamydia — which can cause infertility.

The next advertisement I will be discussing for erectile dysfunction treatments is the “We are the Champions” Viagra ad that uses the Queen song to celebrate that triumphant feeling of getting Viagra.

In slow motion to Queen’s legendary anthem, The mailman is flinging letters in the air, guys are hugging each other in the street, an old man is shuffling down the porch with a smile on his face to join the party…A deliriously happy man bounds out the front door of his home and onto the street, taking part in the euphoria of ordinary men who have rediscovered their potency. A woman next door watches with disbelief as she waters her garden with a limp hose. A chap down the street joins in the party as he swerves his hips next to his lathered car. The postie throws the mail into the air and a businessman twirls his briefcase round and round, spilling his paper everywhere. By the end of the advert the neighbourhood is celebrating on the street. The Viagra pill appears on screen, with the words, “Talk to your doctor”.

Some have accused the ad of being less about the treatment of ED and more a celebration of Pfizer’s dominance of the ED market. Indeed, Viagra seems so sure of its universal recognition and consumer brand-loyalty that it can joke about the high price of Viagra, while surreptitiously gloating over its market supremacy in the ad.

But Viagra’s advertising campaigns were never the key to its success. After it received FDA approval in March 1998, Viagra had five straight years of being the only clinically tested ED medication available and immediately cornered the world market. Having no other similar products from which to differentiate itself, Viagra didn’t need to create an image for itself. Because of its unique clinical function, Viagra became an immediate cultural point for all issues relating to virility, male sexuality, and aging, and through this continual popular referencing, much more than the effects of its $100 million advertising budget, Viagra has achieved a level of brand recognition that is reserved only for superstar drugs Viagra continues to be a constant source of office jokes and comments for late night talk show hosts. More than simply spreading the word on what Viagra is, the enormous street and media buzz that Viagra has inspired over the last five years has established Viagra’s image overwhelmingly in terms of power and efficacy as the remedy for impotence.

Here’s the ad. Let us know it you what you think. Is it important partly that it allows a topic that is excruciatingly embarrassing for many men to be broached in a positive and even celebratory way, or is it a painfully victorious dance for Pfizer.

Alternative medicines for the treatment of erectile dysfunction have been used all over the world for thousands of years with varying levels of success. We at Firstmed are always interested in stories about new treatments and one such story came my way this morning.

It is being reported that Ugandan males suffering from ED are increasingly turning to a species of tree in a bid to achieve an erection.

The West African Omuboro tree is believed to have properties similar to drugs like Viagra, but its beneficial elements are proving to be its downfall, it has been warned.

Citropsis articulata, as the tree is scientifically known, grows slowly in tropical forests and is being harvested at a faster pace than it can reproduce. “Locals strip the tree of all its roots, leaving it with no chance of survival,” said Hannington Oryem-Orida, a professor of botany at Makerere University, the Independent reports.

Local people told the website that they use extracts from the plant - which can be found in the Mabira Forest - to treat erectile dysfunction or just to give their sex lives a boost, although the effects of the tree have yet to be scientifically proven.

This is another case where Viagra could perhaps prove useful in nature conservation. Traditional medicine has often relied on a bizarre mix of animal and plant parts to cure ailments ranging from gout to erectile dysfunction. This folk-medicine industry is known to supply much of the incentive for poachers who are slaughtering animals in places as widely separated as Africa, North America and Asia.

But if men switch from traditional remedies to drugs such as Viagra that may be changing, and a wide range of animal and plant species that have traditionally been sought for their virility enhancing properties may be offered a new lease of life.

Whether this will eventually have a positive impact on endangered animals and plants is as yet interesting speculation.