If the embarrassment of talking to your doctor about impotence has kept you from getting a prescription for Viagra, you may be in luck—if you live in the United Kingdom. Regulators there have decided the little blue pill can be sold over the counter, without a prescription, to men 18 and older. Pfizer, the drug’s manufacturer, hopes to have 50mg tablets on shelves by the spring.
The UK regulatory body that made the change, the Medicines and Healthcare products Regulatory Agency (MHRA), said it did so in part to discourage men from buying pills from unregulated online merchants. On the site for Viagra, Pfizer warns that it’s “one of the most counterfeited drugs in the world,” which seems plausible to anyone who’s ever waded through the quagmire of boner pill solicitations in their spam folder.
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Fake viagra can contain harmful ingredients—Pfizer says it’s found pills containing blue printer ink, amphetamines (you know, speed), and metronidazole, an antibiotic that can cause an allergic reaction, diarrhea, or vomiting instead of making you tumescent.
“Erectile dysfunction can be a debilitating condition,” Mick Foy, MHRA’s group manager in vigilance and risk management of medicines, told the BBC, “so it’s important men feel they have fast access to quality and legitimate care, and do not feel they need to turn to counterfeit online supplies which could have potentially serious side-effects.” (Sildenafil, the active ingredient in Viagra, is already available free of charge through the UK’s National Health Service.)
Of course, not every bootleg blue pill contains printer ink, speed, and drywall, and it’s worth drawing a distinction between dangerous fakes and knock-offs that are more threatening to Big Pharma’s profits than they are to public health. (Reuters reports that sales of Viagra have declined since 2012 as Pfizer’s patents expired.) The fake drug industry is the shadow side of the above-ground, regulated industry, and by many accounts it’s becoming increasing difficult to police. On any one of the tens of thousands of fly-by-night pharmacy websites, a counterfeit (but perfectly safe and effective) Viagra might be indistinguishable from one that’s potentially harmful. As an eager consumer, you can’t know.
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The MHRA wants to steer men away from such sites and toward their neighborhood pharmacist, who will decide whether Viagra is appropriate for each patient who inquires. They can offer advice on whether and how it should be used, and nudge people toward their doctor when necessary. People with liver failure, severe kidney failure, or who have severe heart disease or are at a high risk of cardiovascular disease, or take certain medicines that could interact with Viagra shouldn’t take the blue pull, and it’ll be up to pharmacists to mediate with patients.
That has some pharmacists concerned. Before making its decision, the MHRA had 47 responses to its public comment period; 33 supported making Viagra available over the counter, while one was “unsure.” Among the 13 who didn’t support the plan were eight pharmacists, some of whom were concerned about abuse and misuse of the drug, or that patients might withhold health information in order to get it. The MHRA decided the benefits outweighed those risks.
All of which is well and good, but also academic if you’re living outside the UK, in places where Viagra still requires a prescription. Tonic reached out to Pfizer to see if the company plans to push for over-the-counter status in other countries. The response was not exactly illuminating. “While we do not have information to share on specific Rx to OTC switch programs in the United States, generally we consider prescription drugs—both within the Pfizer portfolio and outside it—for potential switch to non-prescription status,” a Pfizer spokesperson said in an emailed statement. “Our objective is to provide consumers with significantly greater access to medicines with well-established efficacy and safety profiles without a prescription.” And, again, Viagra sales are down globally.
So if you’re a guy in the US waiting for Viagra to be available without a prescription, seems like there’s a sliver of hope. But in the meantime, why not trust your doctor?
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