June 2013 Archives
Pfizer, the mega-pharmaceutical company behind Viagra, has started selling Viagra on its website. Or, at least, they are linking out to CVS's online pharmacy to sell and ship the drug. The ironies here are obvious and many, which we'll discuss below. But it's interesting to note just how prominent the company has made this new offering on its website. Here is a screencap of how they are marketing the new service:
This ad, which pops up right when you visit Viagra.com, emphasizes the "home delivery" aspect of their service. People may be embarrassed to pick up their pills in-person at a pharmacy, so this might be some benefit. However, there's nothing really new on offer here. There are plenty of online pharmacies ready to sell you Viagra, or any other drug, if you already have a doctor's prescription.
According to news reports, Pfizer began program in response to the prevalence of "fake" or "generic" Viagra sold online. Pfizer claims that many customers are unwittingly buying the fake Viagra online thinking it is real.
It's hard to believe that people ordering from very low-priced online pharmacies are under any illusion about what they are getting for their money. You get what you pay for, after all. People looking for a bargain know they aren't getting genuine Viagra; they are willing to take that risk to their health and well-being to get some knock-off manufactured who-knows-where. Some customers probably are getting fooled, but that's likely the small minority.
Pfizer's online pharmacy requires that you already have a prescription to order the drug. This differs from online pharmacies like Emedsrx.com which offer an online questionnaire about your health history. After you fill it out, a physician reviews your answers and prepares a prescription for you. These pharmacies sell genuine Viagra, but of course, their prices reflect that. Most consumers are smart enough to know the difference.
Title: Sildenafil Citrate 100 mg Starting Dose in Men with Erectile Dysfunction in an International, Double-Blind, Placebo-Controlled Study: Effect on the Sexual Experience and Reducing Feelings of Anxiety About the Next Intercourse Attempts
Source: Journal of Sexual Medicine, 2009, 6:2826-2835
Purpose of Study: Usually, patients are recommended to begin treatment with Viagra at a 50 mg dose. Later, if that doesn't work well, they may be increased to a 100 mg dosage. This is a standard method for administering medicines, since with a higher dose comes an increased risk of side effects.
Erectile dysfunction, though, isn't just a physical issue it is a psychological one as well. So patients might be disappointed if they try 50 mg and cannot achieve the type of erection they were hoping for. So, it might be psychologically beneficial to instead start at the higher dose of 100 mg to avoid this performance anxiety.
Result of Study: "After treatment with sildenafil 50 mg or 100 mg, men felt less anxiety, and 56.3% of men initiating treated with 100 mg sildenafil felt no anxiety about he next intercourse attempt compared with 38.8% of men initiating treatment at sildenafil 50 mg." In other words, the men who started out at 100 mg were much more confident, with less performance anxiety, than those who started out at 50 mg.
However, "Although improvements in functional measures were observed in the 100-mg group during the double-blind phase, the improvements were not statistically significant compared with the 50-mg group" In other words, the 100 mg patients didn't show much of a physical difference than the 50 mg patients. But they did show a different psychological reaction. This means that men may be very sensitive to very slight differences in erectile performance.
Points of Interest: According to this study, most patients begin taking Viagra at 50 mg but then increase to 100 mg. This is an interesting claim, but doesn't align with the feedback we've received from readers of this site, most of whom seem to do well at 50 mg.
Open Questions: This study didn't examine carefully the differences in side effects experienced by the 50 mg and 100 mg groups. This is an important consideration which we'd like to see studied along with the psychological benefits of a higher dose.
Viagra is produced in 25mg, 50mg, and 100mg versions. This makes sense, since most people only need a 25mg or 50mg dose. 100mg is too large of a dose for most people, and too high of a dose is more likely to cause side effects like headaches and flushing.
So why do online pharmacies usually sell the drug only in 100mg form? That's because customers can easily split the pill into two, four, or even eight pieces. This saves a lot of money over purchasing the 50mg or 25mg dose. Pharmaceuticals are generally sold by the pill, not by the dosage.
This also explains why online pharmacies often advertise their price "per dose" rather than emphasizing "per pill."
If you are interested in splitting pills, you might want to check out our review of pill splitters for ideas on how to pick and use one.