Rx vs. OTC Viagra<\/h3>\n
First, let’s define some terms. The United States has two types of drugs: prescription-only (Rx)<\/strong> and over-the-counter (OTC)<\/strong>. Rx meds typically have effects that could harm a patient if used without a doctor\u2019s supervision. OTC drugs aren\u2019t likely to harm a patient if taken according to the directions.<\/p>\n Both Rx and OTC drugs come in brand-name (Viagra and Zyrtec, for example) and generic (sildenafil and cetirizine) versions. The brand and generic of any particular drug are considered identical, but generic drugs are significantly less expensive because there may be several drug makers manufacturing their own versions, creating competition that drives prices down.<\/p>\n Now things get murkier. There are a countless number of products that you can buy over-the-counter that you may take for one benefit or another, but that aren\u2019t classified as OTC drugs. This includes multivitamins, amino acids, plant extracts and more, but they can also take the form of \u201cherbal Viagra<\/strong>\u201d and \u201cmale enhancement<\/strong>\u201d pills that are readily available at the finest convenience stores and gas stations across the United States.<\/p>\n These items are considered dietary supplements by the FDA, not drugs.\u00a0<\/strong>Believe it or not, this places them outside of the FDA\u2019s regulatory jurisdiction and the quality\/purity requirements that otherwise protect both Rx and OTC drugs. Supplement manufacturers don\u2019t need to get FDA approval or even notify the FDA to market and sell their products. Besides some loose requirements for labeling and safety, they also don\u2019t have compliance obligations to any standards for quality and potency. This leaves the door wide open for unscrupulous manufacturing practices, and when problems emerge, the results can be devastating.<\/p>\n In an example from 2019<\/a>, poison centers in central Virginia began reporting unusual cases of severe hypoglycemia (low blood sugar) in men after using a \u201cmale enhancement\u201d supplement called V8 purchased at a local gas station. Lab analysis showed the tablets contained glyburide, a diabetes medicine that causes the pancreas to release insulin to lower your blood sugar. Blood sugar below 50 mg\/dL can cause irreversible damage to the brain and nervous system, and the risk of death increases as blood sugar continues to decrease. Seventeen men were poisoned by this product, and it was very fortunate no one died.<\/p>\n You may have seen websites offering \u201cViagra\u201d for sale without a prescription and wondered if it was a legit operation.<\/p>\n Spoiler Alert: Probably not.<\/p>\n Viagra and its generic version, sildenafil, are prescription-only drugs in the United States<\/strong> (and many other countries). That means it\u2019s illegal to buy or sell them without a prescription from a doctor. Because Viagra works so well for an embarrassing sexual health issue that affects so many men, there is an intense demand for it that people are willing to go around the health system to satisfy.<\/p>\n But going around the health system also goes around the mechanisms it uses to protect patients from being harmed by dangerous, adulterated, and contaminated drugs. As a result, Viagra has become the most counterfeited drug<\/a> in the world, and a large percentage of Viagra sold on the internet is fake or adulterated. In many instances, tablets that looked like brand-name Viagra had no sildenafil in them<\/a> at all. Others contained the wrong amount of sildenafil, or worse, contained other dangerous drugs like fentanyl or poisonous substances like quinine.<\/p>\n Unfortunately, Viagra is a ripe target for counterfeiting, as it presents a perfect storm of conditions to drive demand to the black market:<\/p>\n Restricted Access:<\/strong> It\u2019s illegal to obtain except by prescription, which requires a doctor\u2019s office visit.<\/p>\n High Efficacy:<\/strong> Viagra is extremely effective at what it does, and people want it.<\/p>\n Relieves Embarrassing Problem:<\/strong> It specifically helps men with their sexual performance, which is an often embarrassing area of worry and anxiety for many men living with erectile dysfunction.<\/p>\n Strictly speaking, there is no such thing as \u201cover-the-counter Viagra”.<\/strong> But starting in 2018, the United Kingdom began relaxing regulations<\/a> to allow Viagra to be sold without a prescription by a pharmacist (chemist). The product, Viagra Connect<\/a>, is made by pharma giant Pfizer, and is only available as a brand-name tablet in the 50 milligram strength.<\/p>\n Despite the media\u2019s tendency to lean on the term over-the-counter, Viagra Connect still isn\u2019t true OTC because men still need to ask for the product and consult with the pharmacist as to their health and the ED symptoms they\u2019re experiencing. This gives the pharmacist an opportunity to identify any health problems, drug interactions, or contraindications that would make treatment with Viagra dangerous to a patient.<\/p>\n Pfizer developed the Viagra Connect program specifically because so many men were ordering \u201cViagra\u201d online without a prescription and receiving fakes or dangerous counterfeits. Their hope is that by making it easier to obtain medication for ED, more men will be encouraged to be proactive in seeking treatment for erectile dysfunction within the healthcare system, where safeguards exist to protect the pharmaceutical supply chain.<\/p>\n In the United States, telehealth providers like eDrugstore.com have been taking the initiative to remove the barriers to treatment many men face. Technology has tranformed the process of getting ED treatment from an inconvenient, embarrassing ordeal to a proactive, empowering health decision by allowing patients to connect directly with a doctor to discuss erectile dysfunction<\/a> and other sexual health<\/a> issues via confidential videoconference.<\/p>\nSupplementary Supplement Information<\/h3>\n
Why Can\u2019t I Just Buy Viagra on the Internet Without a Script?<\/h3>\n
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<\/h3>\nIf Not Over-the-Counter, Then How About Behind It?<\/h3>\n
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<\/p>\nTelemedicine Solves the Access Problem<\/h3>\n