MEN REACT PASSIONATELY TO NEW IMPOTENCY DRUG

It's not like everything had shut down. But the Sacramento man said he
needed to put some zip back into his sex life, so he talked to his
urologist.

The timing couldn't have been better.

Just about the time the 60-year-old legal professional made his
appointment, something called Viagra was coming onto the market. He got a
prescription. The results?

"More starting power," said the man, who asked to remain anonymous.

In less than two weeks, Viagra has turned the mostly circumspect world of
male impotence into the proving ground for the latest medical miracle.

By the tens of thousands, men both young and old who thought penile
erections were ancient history have rediscovered the wonders of sexual
pleasure.

At $10 a pill, the answer for them has been Viagra.

"Everybody had been waiting for the magic tablet," said Sacramento
urologist Paul Gottlieb. "It looks like we may have it."

Gottlieb, chairman of urology at Mercy San Juan Hospital, has prescribed
Viagra to 50 patients in the drug's less-than-a-fortnight market history.

So far, Viagra is batting a thousand with Gottlieb. "Phenomenal," he said.
"It is an-unheard-of thing."

The pill represents perhaps the greatest advance in the recent history of
treating
male impotence.

Before Viagra, men were limited to sometimes bulky, sometimes ineffective
contraptions and medications to deal with their sexual dysfunction --
injectable drugs, suction devices, penile implants.

The wonder sex drug came about pretty much by blunder.

Some European cardiologists were testing new possibilities in heart
medication when they stumbled on a drug called sildenafil.

It turned out that sildenafil didn't do much for the heart. But it sure had
an interesting side effect.

"Nobody wanted to give the drug back because they were getting erections,"
Gottlieb said. "It suddenly clicked on -- 'My God, this is what we're
looking for.'"

What sildenafil does is throw a roadblock on an enzyme that breaks down the
production of nitric oxide, the chemical released during sexual stimulation
that allows blood to swell into the penis.

No enzyme, more nitric oxide. More nitric oxide, better sex.

Or so the European researchers noted when they switched their tests from
one organ to another.

"Nobody dropped out of the clinical trial," Gottlieb said. "That is
absolutely unheard of."

Gottlieb said that across the country, Viagra -- the trade name for
sildenafil that is being marketed by Pfizer Inc. -- is selling in the
neighborhood of 30,000 prescriptions a day.

Viagra is gaining on Prozac as Americans' most popular prescribed drug.
Prozac is going at 50,000 prescriptions a day. Gottlieb predicted Viagra
will pass Prozac sometime "extremely" soon, based on patient response.

"They're ecstatic," he said. "It's making a huge difference in their lives."

The Mercy San Juan pharmacy is filling three to four prescriptions a day.
"It's been flying off the shelves ever since it came on the market," said
pharmacist Karen Bishop.

"It's like any other medication that comes on the market with a hype," said
Isac Sam, the pharmacist at the Safeway on Alhambra Boulevard near midtown.
"A lot of people want to go for it."

Patients pop a tab of Viagra an hour before intercourse. The beauty of the
drug, Gottlieb said, is that they have to be otherwise sexually stimulated
for the drug to take effect.

"For a single man, if he thinks he's going to have intercourse and takes a
tablet, but things don't work out, there's no problem," Gottlieb said.

There are some potential side effects to worry about -- headaches,
flushing, indigestion, dizziness, problems distinguishing between blue and
green and the like.

"But that's just been in a very small number of cases," Gottlieb said.
"Nobody has been giving the drug back."

Viagra is believed to be effective for up to 70 percent of impotent men,
whose numbers are believed to be in the millions.

It is off-limits to men already taking nitrate medications, such as
nitroglycerine, because of its interference with that nitrate-snuffing
enzyme.

Some Viagra fakes have already hit the market, a development that Gottlieb
termed "very scary" due to the lack of controls on drugs that are claimed
to contain the same erection-inducing properties of real-deal sildenafil.

The interest generated by the sex drug figures to have an impact in
reducing the prevalence of male impotence, leading to alternative
treatments for those who can't benefit from Viagra.

"As new treatments came out, we saw large numbers of men seeking them,"
Gottlieb said. ". . . This is going to bring in tens of millions for
treatment. It's happening now."

For most of them, it's working wonders. Just ask the 60-year-old Sacramento
man who said the only side effect he's experienced has been a smile on his
face.

Copyright ) 1998 The Sacramento Bee