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Price competitive.
Effect:
Erection possible 30 minutes after taking the pill.
Side-effects:
Can be fatal for patients on medication with nitrates or for cardio-vascular patients.Temporary loss of colour vision, nausea and headache.

This consequently increases the supply and leads to erection. It isn’t as if the disorder doesn’t have optional cures, but no treatment matches the drug in the sheer simplicity of its administration. Which explains the euphoric reception to its arrival.

“We can now give oral tablets to the patients,” says Saxena, “and it will also stop them from going to the quacks.” For eminent Mumbai-based andrologist Vijay Kulkarni, “it’s one more tool for treating the patient”.

Tempering the ebullience, however, are experts who sound a word of caution. Viagra is not, they emphasise, an aphrodisiac, as is widely assumed. The potential danger arising from its misuse is why it has been cleared only as a prescription drug.

Says DCGI Ashwini Kumar: “It has been approved on the condition that it be used cautiously under therapeutic conditions.” For the genuine patient though, the readily available, cheap, effective tablet is nothing but good news.

After Viagra’s four-year run in the market worldwide, the drug’s effectiveness is not disputed and is bound to have a big impact. But there’s a flipside. Sildenafil can be fatal for people on nitrates and those with cardio-vascular problems.

If taken with nitrates, it reduces the patients’ blood pressure dramatically. Possible temporary side-effects are headache and nausea. A more serious effect is loss of blue-green colour vision. The correct dose is, hence, of prime importance; all Indian versions of sildenafil will be available in 25 mg, 50 mg and 100 mg doses.

Misuse of sildenafil can also lead to tragicomic mishaps. Doctors cite numerous instances where normal people took Viagra to enhance their sexual performance. The result was an embarrassing and painfully prolonged erection that lasted for days and required surgery to rectify. Both doctors and manufacturers emphasise that sildenafil is a treatment, not a cure.

It temporarily acts on a specific part of the body but it does not solve the underlying reason for the disorder. “Sexual dysfunction is about more than just Viagra,” says Kulkarni, “Psycho-sexual counselling is very important.” All companies Torrent, Cadila and Ranbaxy emphasise the need for patients to be educated by urologists, endocrinologists and psychiatrists.

S.D. Kaul, Regional Director, Asia & Middle East, Ranbaxy

Side-effects notwithstanding, the pharmaceutical companies are upbeat. “We’re on top of the world,” exclaims a jubilant S.D. Kaul, regional director, Asia and Middle East, Ranbaxy. He has reason to be. With India’s billion-plus population, the sheer numbers translate to tremendous market potential. “The market would run to about Rs 50-100 crore. It’s a blockbuster drug,” says Kaul.

Other companies provide similar estimates. But with so many vying for a slice of the pie, a bit of shine may rub off soon. Stiff competition will define price and profit margins to the patient’s benefit. The approximate price of the new drug is Rs 20 per tablet, which is already a big gain for patients who are currently shelling out Rs 500 per tablet for the imported Viagra in the grey market.

The affordability of the genuine sildenafil brands could also adversely affect the popularity of the anti-impotence herbal drugs.

With the product being identical, marketing strategy will decide the winners and losers in the Great Indian Sildenafil Contest. Brand name, colour and even the shape of the tablets are being depicted as distinguishing features to gain an edge in the market.

As for Ranbaxy’s brand, Caverta, “the name derives from the cavernosa, the part of penis that plays a vital role in erection”, explains Kaul. Torrent’s choice, Androz, derives from andrology a science that deals with the study of the masculine constitution, according to R. Balasubramanian, vice-president, marketing, Torrent.

Penegra was Cadila’s choice both because it refers to problems of penetration, and the penis, says President Ganesh Nayak. Blue and diamond shaped, the Penegra pill is an exact copy of Viagra. Ranbaxy’s red triangular tablets are deliberately designed to be different, while Torrent’s tablets are blue and round.

“We have made a conscious effort to retain the round shape like regular tablets to tell the patients that ED is neither fun nor serious. It’s just another curable condition,” says Balasubramanian.

An India-specific marketing challenge for the companies is people’s reluctance to talk openly about sexual matters. Says Kaul: “We don’t just have to create a brand but also a market, as ED is a hush-hush affair here.” Besides, impotence is not just any other disease like diabetes or malaria.

Striking at the very core of manhood, its impact finds an echo in every aspect of man’s life: the wife doomed to a celibate existence and the boss stuck with a depressed, less-productive employee. Small wonder then that the drug is seen as the best thing to happen to the Indian male in a long, long time.

Some of the optional cures available to erectile dysfunctional patients in India are:

  • The most popular and affordable treatment so far has been the papaverine injection. At Rs 15-20 per shot, it is the price, not convenience, that dictates its popularity. The drug has to be injected locally into the phallus, a painful procedure that can lead to infection unless done in aseptic conditions, according to Professor N.K. Mohanty, head of urology at Delhi’s Safdarjung Hospital.
  • The vacuum erection device is the only non-invasive treatment that has no side-effects, says Mohanty. There are no injections, no tablets – only a hollow tube that creates a vacuum and sucks blood into the penis, leading to an erection. At Rs 10,000- 20,000 one-time cost, the price at least induces a sense of satisfaction.
  • Some men – such as traumatic paraplegics – suffer from extreme impotence. A penile implant is then the only option. The device is designed to last a lifetime. But, insists Ajit Saxena, senior consultant urologist at Delhi’s Apollo Hospital, implants should be prescribed only after a thorough psychological assessment, when all else fails. This procedure involves placing an artificial implant into the phallus. The price can range from Rs 40,000 to Rs 2 lakh but the result is near-normal function. The biggest drawback is infection and rejection by the body, which occurs in about 2 to 3 per cent of the surgeries.


In desi Viagra market, companies fight over names

Aug 2, 2013, 03.31AM IST TNN [ Manish Raj ]

Apart from similar marketing and advertising strategy, the desi viagras also have names in common, leading to disputes.

CHENNAI: Kamagra, Silagra, Edegra, Penegra, Zenegra. the complete list can fill reams. With more than 124 pharmaceuticals vying for their share of the pie in the multi-crore Indian viagra industry, the competition is often cutthroat. Apart from similar marketing and advertising strategy, the desi viagras also have names in common, leading to disputes. One such dispute has landed before the Intellectual Property Appellate Board (IPAB).

Settling a trademark dispute between two major desi viagra players on Wednesday, the IPAB disallowed them from using two trademarks. While Vee Excel Drugs and Pharmaceuticals Pvt Ltd, Delhi was restrained from using the name Vega Asia, HAB Pharmaceuticals and Research Ltd, Thane was directed to drop the trademark Vegah Tablets.

Both the companies were selling sildenafil citrate tablets used to treat erectile dysfunction and had filed cross-suits against each other. HAB claimed it started using the trademarks Vega, Vegah, Veega, Vigora etc in 2001 and the trademark Vega Asia used by Vee was similar to its. Vee, however, claimed it adopted and started using Vega and its formative trademarks in 2000 and over a period of time, its trademark Vega Asia and design of rocket had become its distinguishing features. It said the trademark Vegah used by HAB was similar to its trademark and should be removed.

On perusal of the documents, the board found that HAB had been using the trademark Vega since 2001 while Vee started using the trademark Vega Asia in 2002. “The trademarks are deceptively similar and are likely to cause confusion and deception. In such a case the prior user has the better right. The mark which is in subsequent use shall not remain on the register,” it said.

It also said that as only the trademark Vega was used by HAB in 2001 and not Vegah, it has to discontinue the second trademark. Citing three pervious judgments on trademarks, the board said a registration did not confer any new right to the trademark but merely afforded protection for the mark. Also, advertisement in newspaper did not constitute proof of use of the trademark and in the absence of an admission, facts could be proved by means of documentary evidence, it said.

According to the documents submitted in the board, the annual turnover of Vee was Rs.1,25,65,498 in the year 2004-05 while HAB had sold tablets worth Rs 700 lakh in the year 2007-08.


Common use

The main component of Viagra is Sildenafil Citrate.
Sildenafil Citrate affects the response to sexual stimulation. It acts by enhancing smooth muscle relaxation using nitric oxide, a chemical that is normally released in response to sexual stimulation. This smooth muscle relaxation allows increased blood flow into certain areas of the penis, which leads to an erection.
Sildenafil Citrate is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension.
Sildenafil Citrate may also be used for other purposes not listed above.

Dosage and direction

Usually the recommended dose is 50 mg. It is taken approximately 0,5-1 hour before sexual activity. Do not take Viagra more then once a day.
A high fat meal may delay the time of the effect of this drug.
Try not to eat grapefruit or drink grapefruit juice while you are being treated with Sildenafil Citrate .

Precautions

Before you start taking Sildenafil Citrate. tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
Aged people may be more sensitive to the side effects of the drug.

Viagra is contraindicated in patients who take another medicine to treat impotence or using a nitrate drug for chest pain or heart problems.
This medicine should not be taken by women and children as well as in patients with a known hypersensitivity to any component of the tablet.

Possible side effect

The most common side effects are headache, flushing, heartburn, stomach upset, nasal stuffiness, lightheadedness, dizziness or diarrhea.
A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs.
Many people who use this medicine do not have serious side effects.
In case you notice any side effects not listed above, contact your doctor or pharmacist.

Drug interaction

This drug should not be used with nitrates and recreational drugs called “poppers” containing amyl or butyl nitrite; alpha-blocker medications; other medications for impotence; high blood pressure medicines, etc.
Consult your doctor or pharmacist for more details.

Missed dose

Viagra is used as needed, so you are unlikely to be on a dosing schedule.

Overdose

If you think you have used too much of this medicine seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Storage

Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs away from reach of children and pets.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.



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