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Xrayser thinks long and hard about Viagra relicensing

Xrayser: "I’m not going into a room alone to talk to some old letch who can’t get his flag flying!"

Xrayser goes x-rated to examine why some health professionals still struggle to talk sensibly about the reclassification of sildenafil.

There's not long now before there’s rejoicing in the streets and joy to the world on the day that sildenafil is relicensed as a Pharmacy (P) medicine. Soon those interminable adverts for river cruises scattered among the re-runs of Midsomer Murders will be replaced by a smiling white couple in their 50s, dancing around their middle-class living room, while a voiceover says: “Lancelot sildenafil tablets have brought back the spring in their step…”

Surely over-the-counter (OTC) sildenafil is a good thing, because we have years of experience of use and because 20% of websites are already devoted to selling it?

Not according to our dispenser, whose first comment was: “Will they need a private conversation, like emergency hormone contraception (EHC)? Well I’m not going into a room alone to talk to some old letch who can’t get his flag flying!”

And there is our problem. We’ve reached the point where we can talk about piles, nits, worms and thrush, and treat with respect people who come in for EHC or chlamydia treatment, but when it comes to Ascension Deficit Disorder, we step right back into a Carry On film.

It’s not just pharmacy staff. At the surgery clinical meeting, I mentioned the possible reclassification of sildenafil, only for an entire room of doctors and nurses to respond with: “Glad you raised that”; “Can we expect some hard selling?”; and "There’ll be some stiff competition!” This was accompanied by a load of playground giggling.

In truth, this will not be an easy OTC sale. Presumably the WWHAM questions they need to ask will go something along the lines of:

Who’s it for?  Well I'm taking it, but really it's for the missus. She’s started on some hormone replacement therapy (HRT) and now she can’t keep her hands off me.

What are the symptoms? Ah, you know, the little soldier – Private Business – he’s not standing to attention when on active duty.

How long… Wouldn't you like to know. 

What action have you taken? A couple of years ago I paid 40 quid on the internet for 10 blue pills, but they must have been fakes. I might as well have eaten blue smarties for all the good they did.

Any other medication? Not really. Unless you count my heart medication, beta-blockers and nitrates…

I anticipate most people will log onto eBay or Amazon to stock up. This will quickly be followed by tabloid stories about drinks being spiked with sildenafil, sildenafil-fuelled swingers parties in the home counties, and hospital A&E departments full of old men with priapism. Yet this won’t stop huge sales of a drug that lists as a possible side effect “sudden cardiac death”.

But whatever happens, don’t – for God’s sake – let Jeremy Hunt get wind of this. He already thinks we’re funded through the sale of sandwiches and shampoo, and if he hears that we’re selling 'Viagra' – or 'sex drugs' as the tabloids will no doubt call them – he’ll knock another £250 million off the global sum.

5 Comments

Lance Roth, Manager

Thank you! 

Stephen Smullen, Community pharmacist

Best article and most accurate one I've read in a long time. Humour is what keeps pharmacists going despite all the cuts, mountains of paperwork and bureaucracy nowadays.

Stephen Eggleston, Community pharmacist

All schoolboy sniggering aside, I am assuming there will be a protocol to follow, with lists of exclusions. I suspect it may exclude those on medication for heart & BP problems - in other words, the greater proprortion of patients likely to have need of them. I hope any protocol is not so restrictive as to kill this off before it gets going

Leon The Apothecary, Student

Or pricing. The cost of sildenafil is super dirt cheap. Something that strikes me as worth thinking about, is Pharmacy a fundamentally suitable environment for consultations like this?

N O, Pharmaceutical Adviser

Greeeeeeaaaaaaaaaaatttttttt one after a very long time. Keep it UP ;-)

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