FEATURE: Viagra still mistaken for aphrodisiac in Indonesia

Asian Economic News, March 6, 2000

JAKARTA, March 1 Kyodo

You are an Indonesian man who feels sexually "strong" enough, but you want to be stronger. You think Viagra, the "wonder pill," as it frequently called, may be the answer.

Wrong, say health experts and pharmacists.

"There has been a misperception in the Indonesian society that Viagra is an aphrodisiac and can be sold freely without prescriptions from doctors," said Simon Tobing, pharmaceutical division director of PT Pfizer Indonesia Tbk., Viagra's local manufacturer.

"Viagra is not an aphrodisiac," Tobing emphasized at a news conference Wednesday.

Viagra (sildenafil citrate) should be used only to help restore a man's ability to respond naturally to sexual stimulation, said Irawan Rustandi, the firm's medical director.

"It is a strong medicine only effective for those suffering from erectile dysfunction and its effect cannot be found in people with normal erectile function," Irawan said. "So, it is not a drug for sex adventurers.

"But of course, there are some negative side effects when a healthy patient takes medicine they don't need to take," he added.

Pfizer formally announced Wednesday that the Indonesian government had finally eased market restrictions on the drug following months of public debate, allowing high-dose, 100-milligram pills to be sold to patients with a prescription.

"To buy the pill, people will only need a prescription and the pharmacist is no longer required to report the name of the consumer to the local health ministry's office," said Sampurno, director general of drugs and food supervision.

The government allowed PT Pfizer Indonesia Tbk to sell medium-dose, 50-milligram Viagra pills in August last year, but only authorized urologists, internists and cardiologists could prescribe it.

But even with strict regulations, the pill was easily available on the Indonesian black market.

"I hope with the legalization of the sale of the drug, we can minimize the illegal market," Sampurno said.

Six million people over 40 are estimated to suffer from impotency in Indonesia, but less than 10% consult physicians "because they are ashamed," Tobing said.

He said many live with their problem, while others try to find a solution on their own, including buying Viagra on the black market.

Since it was approved by the U.S. Food and Drug Administration in March 1998, about 14 million Viagra prescriptions have been filled globally and about 5 million patients have reported satisfactory results.

The blue pill is now available in more than 70 countries, but several Asian states have banned the sale of it for various reasons.

Viagra, which increases blood flow to the penis to establish and maintain an erection, was found in many places in Indonesia long before its official marketing at prices between 20,000 rupiah ($2.70) and 40,000 rupiah per pill.

Pfizer now prices it between 80,000 rupiah and 160,000 rupiah, much higher than black-market prices.

"The fake Viagra costs much less than the official price, but its content of sildenafil citrate is also much below the standard," Tobing said.

In downtown Glodok in West Jakarta, where a large variety of modern and traditional Chinese medicines can be bought, fake Viagra pills are also for sale.

Many drugstore owners say they are ignorant of legal procedures for selling Viagra and are unaware that high doses of Viagra could produce dangerous side effects.

Due to the pill's high cost, many pharmacies sell it in single doses, seldom giving customers warnings about possible side effects.

"We urge the public to obtain Viagra from legal sources only," Pfizer's Finance Director Derek Kosti said, adding that the company pledges to "continue to educate the public and to avoid illegal usage of Viagra."

Andy Sutianto, a pharmacist at Medical Pharma Drugstore in Jakarta, said pharmacists have a moral duty to protect patients from counterfeit, low-quality drugs, but that responsibility lies with individual patients.

Viagra is most dangerous for patients when taken in conjunction with heart and circulation medications that contain nitrates.

So far, however, no serious side effects resulting from the misuse of Viagra have been reported in Indonesia.