VIAGRA A KILLER WHEN COMBINED WITH "POPPERS'

Panel warns gays of deadly reactions with nitrite inhalants

Viagra may be a miracle drug for those with impotence, but as a party
drug to enhance sex, it can be a killer.

The medicine, when combined with inhaled stimulants known as
"poppers," long a fixture on the gay party scene, can be particularly
deadly, a panel of gay health experts told a gathering of more than
100 men in the Castro Tuesday night.

"If you take Viagra at 6 a.m. and then you take poppers the next
evening -- even that could be fatal," said Dr. Marshall Forstein of
the Fenway Community Health Center in Boston.

Forstein, in San Francisco this week for a national conference of the
Gay and Lesbian Medical Association, was one of three panelists who
urged caution in the use of Viagra.

Almost as soon as the prescription potency drug came on the market in
March, some men with no history of "erectile dysfunction" have sought
to use Viagra as a performance enhancer. The panelists said there was
already a thriving black market for the drug in the gay community
where users think it can improve sexual performance.

Forstein warned that many side effects of the drug were still being
studied, including its possible interactions with anti-AIDS drugs such
as protease inhibitors. He said studies were also being done on its
possible interaction with antidepressants.

But experts have already seen lethal interactions. Last month, three
gay men died in Southern California after using Viagra, poppers and
crystal methamphetamine, health officials there reported.

Forstein said poppers -- amyl nitrite, a prescription drug, and its
illegal cousin, butyl nitrite -- heighten sensation by dilating blood
vessels. Combining that drug with Viagra, which also dilates blood
vessels, can result in a deadly drop in blood pressure.

Pfizer Inc., the maker of Viagra, initially advised doctors that
Viagra should not be combined with nitrite-containing medications such
as nitroglycerin because patients' blood pressure could drop
precipitously. More recently, Pfizer issued a warning advising that
combining Viagra with inhaled recreational nitrites would produce the
same effect.

The Food and Drug Administration has said there was no evidence that
Viagra by itself was dangerous, although the agency did repeat
warnings that heart patients who took nitroglycerin should never take
the impotence pill because the drug mix could be deadly.

Forstein warned that even casual exposure to poppers by a person using
Viagra could be dangerous.

"If you're using Viagra, and your lover wants to use poppers, have him
do it in another room," Forstein said. "Why ruin sex by having someone
die on you."

The panel was sponsored by the Stop AIDS Project, which sees the abuse
of Viagra as a new health risk for gay men.

For more information on Viagra use among gay men the project can be
reached at (415) 575-0150. CQ

Checked-by: "Rich O'Grady"