蒙
Enveloping
The Kama Sutra of Sildenafil
Repositions of Viagra
In the early 1990s chemists working at Pfizer conceived compound UK-92,480, which in preclinical trials (read as animal studies)1 was developed as investigational drug for hypertension and ischemic heart disease. It was patented under the name Sildenafil.
Subsequently during clinical trials, Sildenafil was found to be a disappointment for treatment of ischemic angina, however it stood out somewhat obviously that it could be used effectively in the soon to be, with marketing, hot diagnosis of Erectile Dysfunction (ED)2. The back story was that benefits became known when several study subjects would not return the excess test medications. Pfizer subsequently and profitably patented the medication as Viagra (a wordplay on virility and Niagra), presumably making the research facility in Sandwich, Kent its birthplace. Parketing lustily pounced on the fertile grounds of human sexuality and the life of the, if not party, pharmaceutical took off3. Sildenafil as Viagra overnight became the greatest breakthrough in treatment of impotency (reframed and marketed as ED) since Vincent Marie Mondat Penis Pump in the early 1800s.
Historically, the modern day “little blue pill”4 (in wink, nudge jargon) was not original. In a less regulated time, the little blue (“mass” of mercury) was used (among other things) as a treatment for syphillis5. All this hard marketing, (famously or shamelessly, the late Bob Dole appeared on several promotional television program slots)6 has made Viagra, if not the most used, most known brands of medicine.
In what is commonly called either repurposing, rebranding, or retasking in other professions, in the wild world of marketing it is referred to as repositioning7. Repurposing (etc) of medications is quite frequently found to be a more favorable fit, therapeutically (Id est buproprion as Wellbutrin and Zyban).
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And as it turns out, Sildenafil has many positions. For instance, and obliquely related to ED, research suggests that it is also indicated in Antidepressant associated ED8.
The fact that Sildenafil has not stood up to the test in treatment for ischemic heart disease has not deterred it from investigation at least for other perhaps less lucrative applications. Its use has been, on the ups, “off label” for Raynaud’s phenomena where the benefits yet need documentation.
It has been investigated for treatment of pulmonary hypertension when into the thin air of high altitude injury9. Its use has been suggested recently in a number of other therapies related to pulmonary hypertension.10 11 Most intriguing in an article published in December suggests that Sildenafil may be useful in treatment of Alzheimer’s disease.12
In winning the Ig Nobel prize for 2007, researchers in what must be a great relief to all jet set rodents everywhere, have also shown Viagra can relieve jet lag in hamsters13. Veterinarians have used sildenafil for treatment of cats and dogs diagnosed with pulmonary hypertension (and not ED).
While Viagra for ED has risen above all other indications, it has topped the charts for Pfizer bringing unknown benefits to the entire world, the success has brought along all the trappings of a profit making endeavor. Although not comfortably in the realm of home chemistry, the actual synthesis is accomplished through several easy steps14 making the production quite cost effective. Proving that there is money in those pills, Pfizer reported earnings are in the billions although all the marketing has not been successful or perhaps sane. In 2008, Pfizer was forced to discontinue an advergame (and yes, there is such a thing) called Viva Cruiser (actual name) when the FDA came down hard and blocking the program (see CS) for not including all that fine print associated with a drug.15
Sildenafil now has begat Cialis and Levitra as offspring in the forms of tadalafil (TA DA!) and vardenafil. These drugs have their own remarketing or what Psychology refers to as cognitive reframing.
