Pfizer’s battle for Viagra
Pfizer has always considered Viagra contraindicated by the use of a class of drugs called nitrates - medication often employed to manage angina, car - diovascular disease, and high blood pressure. The combination of Viagra and nitrates can result in a life - threatening drop in blood pressurc.l’” From the beginning, Pfizer included on its patient summary of information a warning against the use of Viagra online for those taking nitrates. The class of nitrates includes amyl nitrate or “poppers,” a recreational drug popular in the gay community and used to intensify sexual response and heighten excitement. In early May 1998, New York Times writer David Kirby reported how members of New York City’S gay community began circulating the danger of the Viagra/poppers combination through social circles after AIDS activists began
receiving calls from Pfizer representatives.
Pfizer spokeswoman Maryann Caprino said the warning about nitrates appears in Viagra’s federally approved package insert. But, she said, “You can’t use words like ‘poppers’ in your insert.” And sales representatives making the rounds to New York doctors in the last two weeks “could only talk off the package insert,” she said, which meant they couldn’t use the word poppers, either.l°2
After receiving a warning from a representative of an advocacy group, a physician with a large gay clientele “began warning patients about not mixing poppers and Viagra.” He thought a call from Pfizer to activists (and not physicians) was “a funny way to tell people.”103 By early 1999, however, Pfizer explicitly included a warning on its patient summary information about “poppers.” When asked about a public education campaign for gay men, Pfizer responded that such a campaign was only “a possibility.”
Over four years later Pfizer still hadn’t produced any educational literature for gay men. An October 2001 New York Times story, “Experts Fear a Risky Recipe,” reports how [Pfizer spokesman Geoff Cook] said he did not know whether the company would pursue a gay - oriented educational campaign. He stressed, however, that Pfizer had long warned against the use ofViagra for nonapproved purposes …. “Our position to not use Viagra for recreational purposes is well - known, but any pharmaceutical product can be abused,” Mr. Cook said. He added that Pfizer also advised caution when the drug was used with protease inhibitors, an important class ofHIV medications.
By this account, it would seem that Pfizer equates gay sex with the adjectives “recreational” and “nonapproved.” Writer David Tuller opens the story by acknowledging the similarities between gay men and straight men: “Many gay men, like straight men, are using Viagra solely for its approved purposeas a remedy for persistent erectile dysfunction.” He then chastises gay men for “treating [Viagra] as a recreational drug and taking it along with Ecstacy [sic] and other illegal substances.” The article includes examples of medical misfortunes befalling gay men who’ve combined Viagra with other drugs (including poppers). Distressingly, the article singles out gay men using Viagra as contributing to the spread of HN through a roundabout argument that would have readers thinking that all gay Viagra users have multiple partners, are recreational drug users, and frequent bathhouses. Fortunately, this news story does attempt a reflexive stance when Tuller reports that it is unclear “whether Viagra use itself can lead to an increase in risky behavior or whether those who tend to engage in risky behavior are simply more likely to take Viagra.” He adds, Some Viagra advocates say the drug may actually reduce HIV transmission by making it easier for men to maintain erections while using condoms. And others say that focusing on recreational Viagra use among gay men smacks of prejudice.?
Given the prevalence of straight men using Viagra even under the threat of death, heart attacks, and the panoply of other side effects, I would suggest there is prejudice at work here. And if Pfizer is marketing its product to straight men for whom procreation is no longer a goal (and, in some cases, impossible) then it seems clear that cultural constraints against sex as recreation is something reserved only for gay men. The double use of the adjective “recreational” for gay drug use and gay sex maligns both.
