Viagra turns 20

The first oral medication indicated for erectile dysfunction, Viagra was initially intended for the treatment of cardiovascular diseases.

Just 20 years ago, a blue diamond-shaped pill was poised to enter the US pharmaceutical market and, at the same time, revolutionize the sexual lives of millions of men around the world. Approved on March 27, 1998 by the US Drug Administration (FDA), the drug produced by the Pfizer laboratory has since been the subject of 65 million prescriptions and has been sold to billions of copies.

Originally, Viagra was not intended to treat erectile dysfunction. Sildenafil citrate – the chemical name for Viagra – known for its ability to dilate blood vessels, was first tested by the Pfizer laboratory to treat angina pectoris. But over the course of clinical trials, the molecule proved insufficiently effective to treat this disease due to the narrowing of the arteries responsible for supplying the heart with oxygen. On the other hand, an unexpected side effect attracted the attention of the researchers: in some participants, taking the drug was accompanied by erections up to several days after treatment.

In 1993, Pfizer redirected its research towards male impotence, a disorder that affects one-third of men over 40 years of age. This time, the results are convincing. The treatment of “erectile dysfunction” was until then the poor child of modern pharmacopoeia, with neither practical nor effective treatments. The US Drug Administration (FDA) gave the green light for the new treatment on March 27, 1998. Its sale under the name of Viagra started in early April in the United States.

A stunning success

The success of the blue diamond-shaped tablet was immediate: 150,000 prescriptions were written in the United States in the first two weeks of marketing, three million in the first three months. Viagra provoked a worldwide craze even before its authorization outside American soil. It became available in Israel, Poland, Saudi Arabia in spring 98 at rates three to five times higher than the US legal price (about $ 10).

Counterfeits quickly came: fake Viagra made in Thailand or India became available on the internet a few weeks after the beginning of the drug’s commercialization. Viagra was soon ranked as the number one counterfeit medicine.

After officially landing in Europe in September 1998, global sales of Viagra soared by more than 30% in 1999 and 2000, quickly surpassing the $ 1 billion a year mark. A surprise for the pharmaceutical group that originally hoped for only a hundred million dollars in revenue per year.

The misuse or “recreational” use of Viagra appeared just as quickly. As early as 1999 a British study showed a marginal but real use of the blue pill among young people accustomed to nightclubs. In 2012, a US study estimates that 8% of young Americans use Viagra or other “erection facilitators” (Cialis, Levitra) in order to reassure themselves about their sexual performance.

Viagra, whose generic forms have been available since 2013 in Europe and since the end of 2017 in the United States, is also experienced as a dopant by athletes. However, the World Anti-Doping Agency (WADA) does not include it on the list of banned products: Sildenafil citrate would not have a doping effect, except at high altitude.

For now, there is no female equivalent as effective as Viagra. And for good reason, the mechanisms underlying the decline of libido in a woman are very different from those involved in erectile dysfunction. Only flibanserin, a molecule marketed under the name Addyi by the Sprout laboratory, has been approved for marketing in the United States since August 2015. This drug is designed to treat the lack of desire in women.

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Shakes Gilles

Editor of The Talking Democrat. He enjoys bike riding, kayaking and playing soccer. On a slow weekend, you'll find him with a book by the lake.