Sildenafil Citrate (Viagra, Revatio)
What It Is: A phosphodiesterase (PDE) inhibitor
What It's Approved to Treat: Erectile dysfunction in men or to improve the ability to exercise in adults with pulmonary arterial hypertension
Common Off-label Uses: Enhancing sexual performance in people not diagnosed with erectile dysfunction, improving sexual function in women taking certain antidepressants
CNN called it "the little blue pill that could," and Viagra has certainly made a name for itself over the last two decades. In 1989, Pfizer scientists introduced a drug called sildenafil citrate that they anticipated would help treat high blood pressure and a type of chest pain associated with coronary heart disease called angina. During the drug's clinical trials, volunteers began reporting increased erections several days after taking a dose, and in 1998, the FDA approved the use of Viagra to treat erectile dysfunction [source: Wilson].
A decade later, scientists began finding evidence that the little blue pill could potentially help some women experiencing sexual dysfunction, too. Between 30 to 70 percent of people taking antidepressants experience sexual dysfunction, and a Pfizer-funded study found that seven out of nine women on antidepressants who had problems achieving orgasm recovered when they took Viagra [source: Carollo].
Female sexual response is complicated, and the FDA hasn't approved Viagra for this use in women, but another prescription medication called flibanserin (Addyi), originally developed as an antidepressant, is FDA-approved to treat low sexual desire in premenopausal women [source: Tobah].
Author's Note:5 Medications That Are Prescribed for Off-Label Use
The conversation around the promotion of off-label prescription uses has evolved considerably over the last few years. Originally, the FDA prohibited pharmaceutical sales representatives from promoting a drug's off-label use if the medication didn't come with adequate instructions for the use. But in 2012, a court ruling deemed off-label promotions as protected free speech, as long as the statements aren't false or misleading [source: Cain]. Regardless of legal details, having open, honest, well-informed conversations with your doctor around any and all recommended medications seems like the best way to go.
More Great Links
- American Cancer Society. "Off-label Drug Use." March 17, 2015. (Feb. 19, 2018). https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/off-label-drug-use.html
- American Heart Association. "What Is Atrial Fibrillation?" (Feb. 19, 2018). http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300294.pdf
- Carollo, Kim. ABC News. "Viagra for Prostate Cancer? 10 Multi-Use Drugs." Sep. 28, 2010. (Feb. 19, 2018). http://abcnews.go.com/Health/MensHealth/viagra-top-multi-drugs/story?id=11738009
- Consumer Reports. "Off-label drug prescribing: What does it mean for you?" July 2015. (Feb. 19, 2018). https://www.consumerreports.org/cro/2012/05/off-label-drug-prescribing-what-does-it-mean-for-you/index.htm
- First, Amanda. Prevention. "Are Off-Label Drugs Ever OK?" Feb. 11, 2013. (Feb. 19, 2018). https://www.prevention.com/health/healthy-living/are-label-drugs-safe
- Guzman, Flavio. Pharmacology Institute. "Quetiapine Indications: FDA-Approved and Off-label Uses." Feb. 9, 2018. (Feb. 19, 2018). https://psychopharmacologyinstitute.com/antipsychotics/quetiapine/quetiapine-indications/#Off-Label_Uses
- Healthline. "Hypertensive Heart Disease." (Feb. 19, 2018). https://www.healthline.com/health/hypertensive-heart-disease
- Ipaktchian, Susan. Stanford Medicine News Center. "14 drugs identified as most urgently needing study for off-label use, Stanford professor says." Nov. 24, 2008. (Feb. 19, 2018). https://med.stanford.edu/news/all-news/2008/11/14-drugs-identified-as-most-urgently-needing-study-for-off-label-use-stanford-professor-says.html
- Medline Plus. "Sildenafil." Jan. 15, 2018. (Feb. 19, 2018). https://medlineplus.gov/druginfo/meds/a699015.html
- Medscape. "Dutasteride (Rx)." July 2016. (Feb. 19, 2018). https://reference.medscape.com/drug/avodart-dutasteride-342823#91
- Ogbru, Annette (Gbemudu). RxList. "Beta Blockers." April 25, 2016. (Feb. 19, 2018).
- Radley DC, Finkelstein SN, Stafford RS. "Off-label prescribing among office-based physicians." Arch Intern Med. 2006 May 8;166(9):1021-6. (Feb. 19, 2018). https://www.ncbi.nlm.nih.gov/pubmed/16682577/
- Siferlin, Alexandra. Time. "11 Surprising Uses For Botox." Jan. 5, 2017 (Feb. 19, 2018). http://time.com/4501839/botox-inection-wrinkles-migraine-depression/
- Thaler, Malcolm. Personal correspondence. Jan. 31, 2018.
- Tobah, Yvonne Butler. Mayo Clinic. "Is there an equivalent of Viagra for women?" April 11, 2017. (March 2, 2018).
- U.S. Food & Drug Administration. "Understanding Unapproved Use of Approved Drugs 'Off Label.'" https://www.fda.gov/ForPatients/Other/OffLabel/ucm20041767.htm. Feb. 5, 2018. (Feb. 19, 2018).
- Wilson, Jacque. CNN. "Viagra: The little blue pill that could." March 27, 2013. (March 2, 2018).
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