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 What Doctors Don't Tell You: Viagra: Now would you like to take it for your prostate, sir?  
Drugs are not always prescribed to treat the condition for which they were originally intended, or for which they earned their original license.

The latest to get the 'off-label' treatment is that great urban myth Viagra (sildenafil). It was licensed to treat impotence, or erectile dysfunction (ED) - but now experts are looking for other conditions it can treat. It's been mooted as a therapy for rapid ejaculation, lower urinary tract symptoms, and for those undergoing radical prostatectomies.

'With the efficacy and safety issues of sildenafil for erectile dysfunction basically settled, you need to explore new frontiers', said Harin Padma-Nathan, clinical professor at the University of Southern California, in a paper presented to the Annual Scientific Meeting of the American Urological Association.

This Star Trek-like adventure, to boldly go where the drug hasn't been licensed to go, doubtlessly grabbed the imagination of all who read these heroic words.

But once we've cleared the tears from our eyes, some of Prof Padma-Nathan's comments might make a Vulcan blush. It's interesting he considers the safety issues to have been settled. It is a view with which the Israeli drug regulators may take issue as they banned the drug because of its dubious safety record. It might also cause consternation in the homes of the men who died after taking the drug.

But these are the mere twitterings of a sourpuss. Warp factor nine, Scottie, the drug can take it (even if the public can't).

* And here's a funny thing. 'All-natural' herbal products that also claim to treat penile dysfunction are allowed on the American market by the drugs regulator, the Food and Drug Administration (FDA). But the FDA will swoop if they discover the products contain Viagra. Perhaps the FDA knows something that Prof Padma-Nathan doesn't.

(Source: Journal of the American Medical Association, 2003; 289: 2784-6).

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