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British Medical Bulletin Advance Access originally published online on February 9, 2009
British Medical Bulletin 2009 90(1):53-62; doi:10.1093/bmb/ldp001
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© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Should sildenafil be available over the counter?

Naomi Rubin and Kevan Wylie*

Porterbrook Clinic, 75, Osborne Road, Sheffield S11 9BF, UK

* Correspondence to: Dr Kevan Wylie, Porterbrook Clinic, 75, Osborne Road, Sheffield S11 9BF, UK E-mail: k.r.wylie{at}sheffield.ac.uk

Introduction: This article considers the process of re-classification of prescription drugs from prescription-only medications to over-the-counter (OTC) prescription drugs.

Sources of data: The recent change in classification for emergency contraception and simvastatin is explored in detail with similarities and differences being considered for a similar argument to be made for sildenafil.

Areas of agreement: The benefits for patients, physicians and other healthcare professionals are considered in detail.

Areas of controversy: We raise concerns about recently developed and existing patient group directions that, although extensive in their assessment, may omit to identify significant contributory factors which would necessitate appropriate medical intervention.

Growing points: While the decision for re-classification to OTC would depend on a number of factors, we argue that, with the proviso of proper assessments being made, sildenafil should be made available as an OTC medication.

Areas timely for developing research: The safety and use of OTC medications for erectile dysfunction at a time when many first line prescription agents are reaching generic status.

Keywords: sildenafil • PDE5 inhibitors • self-care • pharmacy • prescription

Accepted for publication January 6, 2009.


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