@Article{info:doi/10.2196/jmir.1.2.e10,
author="Eysenbach, Gunther",
title="Online Prescribing of Sildanefil (Viagra) on the World Wide Web",
journal="J Med Internet Res",
year="1999",
month="Dec",
day="31",
volume="1",
number="2",
pages="e10",
keywords="Internet; Referral and Consultation; Fees; Pharmaceutical; Prescriptions; Drug; Commerce; Physician's Practice Patterns; Impotence; Piperazines; Medical History Taking; Quality of Health Care",
abstract="Background: A growing number of prescription medicines such as Viagra® are offered and sold directly to consumers on the Internet. Little is known about the structure and ``quality'' of these ``virtual pharmacies'' in terms of how responsibly ``online-prescriptions'' are actually issued. Objective: To determine to what extent Viagra is sold on the Internet despite clear contraindications. Methods: The World Wide Web was searched for companies who offer to issue prescriptions for Viagra online or sell Viagra without prescription. We pretended to be a patient in which the ordered drug (Viagra) is clearly contraindicated, and tried to obtain an online prescription for this drug on the Internet. Our test case was as a 69-year-old woman giving a sexual history of having ``no orgasm,'' with obesity (165cm/78kg), coronary artery disease, and hypertension, and taking captopril, pravachol, atenolol, and erythromycin. Results: Twenty-two distinct companies were identified, consisting of three different types: 2 required a written prescription by a ``real'' physician, 9 dispensed the drug without any prescription at all, and 11 issued an ``online prescription'' after an alleged physician reviewed the online order form containing medical questions. We tested 10 of the latter type, among them 8 based in the USA. We ordered a total of 66 pills worth US{\$} 1,802.84. Three companies, among them both European companies, delivered within 6, 10, and 34 days respectively, despite Viagra being clearly contraindicated. In 80{\%} no complete history was taken, in 70{\%} inappropriate medical terminology was used, and in only 2 cases was the order form reviewed by a physician who identified himself. Conclusions: Although a surprisingly high number of Internet pharmacies declined delivery, the public should be alerted to the risks involved with prescription drug prescribing and dispensing via the Internet. ",
issn="1438-8871",
doi="10.2196/jmir.1.2.e10",
url="http://www.jmir.org/1999/2/e10/",
url="https://doi.org/10.2196/jmir.1.2.e10",
url="http://www.ncbi.nlm.nih.gov/pubmed/11720919"
}