Online prescribing of sildanefil (Viagra) on the world wide web - PubMed

Background: The digital landscape has witnessed a notable increase in the availability of prescription medications, including Viagra, sold directly to consumers through online platforms. However, there remains a significant lack of information regarding the operational structure and ethical standards of these "virtual pharmacies," particularly concerning the responsible issuance of "online prescriptions."

Objective: This study aims to assess the prevalence and accessibility of Viagra on the Internet, even in cases where usage is patently contraindicated, thereby uncovering potential public health concerns.

Methods: An extensive search was conducted across the World Wide Web to identify entities that claim to provide online prescriptions for Viagra or market it without any prescription requirements. To evaluate these services, we assumed the identity of a fictitious patient—specifically a 69-year-old woman with an identified sexual history of experiencing "no orgasm," compounded by health conditions such as obesity, coronary artery disease, and hypertension, alongside a medication regimen that included captopril, pravachol, atenolol, and erythromycin.

Results: Our findings revealed a total of 22 unique online outlets, categorized into three distinct groups: two required a valid written prescription from a licensed physician, nine dispensed the medication outright without any prescription, and eleven provided an "online prescription" following a purported review by a physician of the online order form that contained relevant medical inquiries. We proceeded to test ten of these online facilitators, including eight located within the United States, resulting in a total order of 66 pills valued at US$ 1,802.84. Of the suppliers, three—including two European vendors—successfully delivered the medication within timelines of 6, 10, and 34 days, respectively, despite the evident contraindications associated with Viagra. Alarmingly, in 80% of the cases, no comprehensive medical history was solicited from us, and in 70% of the instances, the terminology used in the consultations was inappropriate, indicating a concerning lack of professionalism. Only in two isolated cases was the order form meticulously examined by a physician who disclosed his identity to the patient.

Conclusions: While it is noteworthy that a significant portion of Internet pharmacies chose to decline the delivery of Viagra, it remains imperative to inform the public of the myriad risks associated with the prescribing and dispensing of prescription medications through online platforms, particularly regarding the implications for health and safety in the absence of rigorous medical oversight.

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