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Patients Clamor for Impotence Drug

April 20, 1998

NEW YORK (AP) _ Duke University Medical School urologist Craig Donatucci has given up answering calls on the new pill for impotence.

Patients asking about Pfizer Inc.’s drug, Viagra, now get a recorded message: ``Because of the volume of patient calls for Viagra, Dr. Donatucci is unable to take phone calls concerning this new drug.″

Although the drug started hitting pharmacy shelves earlier this month, many druggists haven’t gotten their first shipment and doctors are still evaluating the latest impotence treatment. But patients aren’t waiting to get in line.

With very limited supplies available, Viagra snatched 5 percent of the market from competing drugs during its first week of sales, according to IMS America, a research information company. Those sales were for the week ending April 3, and Pfizer didn’t expect the drug to be widely available until April 15.

Atlanta urologist John Stripling wore out his hand writing 500 prescriptions in two weeks. Now he’s using a rubber stamp to prescribe the pill.

``I’ve never seen such interest in a prescription drug in all of my years of medicine,″ said Stripling, who had 300 people waiting when for the drug to become available and is getting 25 calls a day from interested patients.

Doctors and drug industry analysts expect Viagra to eclipse competing impotence nostrums within months.

The drug owes its marketability less to what it does than to what it doesn’t do: make strong men wince. Existing impotence drugs must be either injected into the penis or inserted directly into the urinary tract, both unpopular delivery methods.

Few of the 30 million men who suffer from erectile dysfunction now do anything about it. The problem gets worse as men age. Two men in five have problems getting an erection at age 40. Nearly seven in 10 do at age 70. Pfizer estimates the number of men coping with impotence worldwide at 140 million.

The drug should bring Pfizer $300 million in sales during the rest of the year, said Mariola Hagger, an analyst with Deutsche Morgan Grenfell. Many analysts expect it to bring in more than $1 billion in annual sales after 2000.

``It doesn’t make you 21 again, but it does solve the problem,″ said Robert W. Shay, a 70-year-old Los Angeles resident who took part in clinical trials of the drug from 1996 to 1997.

Shay, who used to take performance-boosting injections, said Viagra works about as well as the shots but is more discrete and less painful.

The drug Pfizer tested on British university students was supposed to work as a treatment for angina, raising blood flow to the heart. But the rush of blood filled another organ instead. Pfizer decided that one man’s side-effect was another man’s cure and developed it as an impotence treatment.

It remains one of only a handful of impotence drugs. Penile implants have been available for years, the FDA only approved the first drug, Caverject, in 1995. The injectible drug from Pharmacia & Upjohn Co.’s relaxes smooth muscle in the penis, allowing blood to flow in and cause an erection.

Unlike the injections, which can leave the user erect for an hour without outside stimulation, Viagra allows the user to react normally to sexual stimulation.

In December 1996, the FDA approved Muse, a suppository version of the same drug, a synthetic form of the hormone prostaglandin E that is generically called alprostadil. But Muse still left many users squeamish. To insert the tiny medicated pellet, a slender plunger is pushed 1 1/2 inches into the end of the penis.

Muse still holds 69.3 percent of the market for impotence drugs, compared with 21 percent for Caverject, and 4.5 percent for another injectible drug, Schwartz Pharma’s Edex, according to IMS.

Viagra could have further applications. Researchers are already looking at whether Viagra could be used to treat women with sexual dysfunction.

Some doctors say they’re worried that sexually potent men will use the drug as a performance booster _ a kind of sexual steroid. A 52-year-old Viagra user in Atlanta, who didn’t want his name used, said that’s what he’d do if he didn’t already need Viagra.

``If I was 16 or 17 and I could get ahold of the stuff, I would,″ he said. ``If it’s not a miracle, it’s as close as you can get.″

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