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Viagra approved in Canada for Treatment of Erectile Dysfunction

Medical Update Memo
March 9, 1999

Summary
Pfizer Canada announced on March 9 that the federal Health Protection Branch has approved the oral therapy Viagra (sildenafil citrate) for the treatment of erectile dysfunction. It is anticipated that the therapy will be available by prescription at the end of March. Erectile dysfunction can occur as the result of multiple sclerosis.

Background
On March 9, Pfizer Canada announced that the federal Health Protection Branch has approved the use in Canada of Viagra (sildenafil citrate), a new type of medication for erectile dysfunction (ED). In large Phase III clinical trials involving more than 4,500 men with ED, the drug was found to be effective as a treatment for ED in about 70 percent of the treated group compared to placebo. Participants were diagnosed as having mild, moderate or complete ED because of a broad range of medical conditions including high blood pressure, high cholesterol levels, spinal cord injury, diabetes and prostate surgery. The median age was 55, and participants had experienced ED for an average of five years prior to the trials.

Erectile dysfunction is defined as the consistent inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity. It is associated with a broad range of medical conditions including multiple sclerosis, diabetes, prostate cancer surgery, spinal cord injury, cardiovascular diseases and depression.

Viagra works by increasing the blood flow to the penis which is necessary for establishing and maintaining an erection. The drug is the first in a new class of medications known as phosphodieterase type 5 inhibitors. It is taken orally as a single tablet in three different choices of dosage strength about 30 minutes to one hour before anticipated sexual activity.

Although the original clinical trial did not include men with multiple sclerosis, clinical trials of Viagra's safety and efficacy in men with MS are now underway in the United States and Europe. Results are anticipated sometime in 1999.

Erectile dysfunction is the most commonly reported sexual concern of men with multiple sclerosis. Some studies suggest that up to 70 percent of men with MS experience ED at some point in the disease.

Viagra should not be taken by individuals who are taking any form of nitrates, including the heart medicine nitroglycerine. The combined use of nitrates and Viagra may lead to sudden and potentially dangerous drops in blood pressure. During the clinical trial, the most common side effects of taking Viagra were headache, facial flushing and indigestion.

As with other treatments which can benefit people with MS, the Multiple Sclerosis Society of Canada will be urging provincial governments as well as private and group health insurance payers to provide coverage for this new drug.

Disclaimer
The Multiple Sclerosis Society of Canada is an independent, voluntary health agency and does not approve, endorse or recommend any specific product or therapy but provides information to assist individuals in making their own decisions.

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