Advertisement

International Journal of Clinical Pharmacy

, Volume 40, Issue 1, pp 67–73 | Cite as

Sildenafil citrate use in Addis Ababa: characteristics of users and pharmacists’ dispensing practices

  • Dawit Teshome Gebregeorgise
  • Yajeb Melesse Belay
  • Sofia Kälvemark SporrongEmail author
Research Article
First Online:
  • 107 Downloads

Abstract

Background Studies have reported misuse of sildenafil citrate for recreational purpose, not least by healthy young men. This is becoming a major concern, for medical and other reasons. Objective The aim of this study was to document the characteristics of sildenafil citrate users and to explore the dispensing practices of the medicine in selected community pharmacies in Addis Ababa, Ethiopia. Setting Data was collected in community pharmacies in Addis Ababa, Ethiopia. Method A survey, using a self-administrated questionnaire, was conducted among customers who purchased sildenafil citrate from community pharmacies. Simple descriptive statistics were used to analyse data. Also, semi-structured interviews were conducted with community pharmacists. These were analysed thematically. Main outcome measures Socio-demographic characteristics (survey), themes (interviews). Results All survey respondents (n = 197) were men, 57.9% were below 40 years old, 53.8% had never been married and 58.4% had used sildenafil citrate before. A minority (16.2%) were diagnosed with erectile dysfunction. The main reason for buying sildenafil citrate was experimentation (45.7%). Pharmacists reported that sildenafil citrate was often dispensed without a prescription. The reason for this was, according to the interviewees, competition in the market. Also, the medicine was often dispensed without adequate information or counselling. Conclusions Selling and buying sildenafil citrate without a prescription seems to be common practice in pharmacies in Addis Ababa. It is crucial to strengthen the regulatory activity to protect customers from health risks. In addition pharmacy professionals should be supported to work in accordance with professional and legal standards.

Keywords

Community pharmacy Erectile dysfunction Ethiopia Misuse Sildenafil citrate 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgements

The authors would like to acknowledge the invaluable contribution of all community pharmacies and professionals who participated in data collection, and all respondents in both surveys and interviews.

Funding

This study did not receive any funding.

Conflicts of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Anonymous 1993. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993;270:83–90.Google Scholar
  2. 2.
    Park K, Hwang EC, Kim SO. Prevalence and medical management of erectile dysfunction in Asia. Asian J Androl. 2011;13:543–9.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Stranne J, Malmsten UG, Areskoug B, Milsom I, Molander U, Peeker R. Influence of age and changes over time on erectile dysfunction: results from two large cross-sectional surveys 11 years apart. Scand J Urol. 2013;47:198–205.CrossRefPubMedGoogle Scholar
  4. 4.
    Oladiji F, Kayode OO, Parakoyi DB. Influence of socio-demographic characteristics on prevalence of erectile dysfunction in Nigeria. Int J Impot Res. 2013;25:18–23.CrossRefPubMedGoogle Scholar
  5. 5.
    Mayo Clinic. Erectile dysfunction: causes. 2015. http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/dxc-20314091 Accessed 06 June 2017.
  6. 6.
    Al-Hunayan A, Al-Mutar M, Kehinde EO, Thalib L, Al-Ghorory M. The prevalence and predictors of erectile dysfunction in men with newly diagnosed with type 2 diabetes mellitus. BJU Int. 2007;99:130–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Njuguna J, Olieva S, Muruka C, Owek C. Khat consumption in Masalani town, Northeastern Kenya. J Psychoact Drugs. 2013;45:355–9.CrossRefGoogle Scholar
  8. 8.
    Freitas D, Athanazio R, Almeida D, Dantas N, Reis F. Sildenafil improves quality of life in men with heart failure and erectile dysfunction. Int J Impot Res. 2006;18:210–2.CrossRefPubMedGoogle Scholar
  9. 9.
    Hackett G, Kell P, Ralph D, Dean J, Price D, Speakman M, Wylie K. British Society for sexual medicine guidelines on the management of erectile dysfunction. J Sex Med. 2008;5:1841–65.CrossRefPubMedGoogle Scholar
  10. 10.
    Mulhall JP, Montorsi F. Evaluating preference trials of oral phosphodiesterase 5 inhibitors for erectile dysfunction. Eur Urol. 2006;49:30–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Vickers MA, Satyanarayana R. Phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction in patients with diabetes mellitus. Int J Impot Res. 2002;14:466–71.CrossRefPubMedGoogle Scholar
  12. 12.
    Ghofrani HA, Osterloh IH, Grimminger F. Sildenafil: from angina to erectile dysfunction to pulmonary hypertension and beyond. Nat Rev Drug Discov. 2006;5:689–702.CrossRefPubMedGoogle Scholar
  13. 13.
    Harte CB, Meston CM. Recreational use of erectile dysfunction medications in undergraduate men in the United States: characteristics and associated risk factors. Arch Sex Behav. 2011;40:597–606.CrossRefPubMedGoogle Scholar
  14. 14.
    Bechara A, Casabe A, De Bonis W, Helien A, Bertolino MV. Recreational use of phosphodiesterase type 5 inhibitors by healthy young men. J Sex Med. 2010;7:3736–42.CrossRefPubMedGoogle Scholar
  15. 15.
    Mitchell KR, Prah P, Mercer CH, Datta J, Tanton C, Macdowall W, Copas AJ, Clifton S, Sonnenberg P, Field N, Johnson AM, Wellings K. Medicated sex in Britain: evidence from the third National Survey of Sexual Attitudes and Lifestyles. Sex Transm Infect. 2016;92:32–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Korkes F, Costa-Matos A, Gasperini R, Reginato PV, Perez MDC. Recreational use of PDE5 inhibitors by young healthy men: recognizing this issue among medical students. J Sex Med. 2008;5:2414–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Tsai WK, Jiann BP. Data on the utilization of treatment modalities for ED in Taiwan in the era of PDE5 inhibitors. Int J Impot Res. 2014;26:141–5.CrossRefPubMedGoogle Scholar
  18. 18.
    Food, Medicine, Health Care Administration and Control Authority (FMHACA). List of Medicines for Community Pharmacy, Addis Ababa. 2012. http://www.fmhaca.gov.et/documents/List_of_Medicien_For_Community_Pharmacy_4th.pdf. Accessed 26 June 2017.
  19. 19.
    Food, Medicine, Health Care Administration and Control Authority (FMHACA). List of Medicines for Drug Shop, Addis Ababa. 2012. http://www.fmhaca.gov.et/documents/4th_LMDS_List_for_Drug_Shop.pdf. Accessed 26 June 2017.
  20. 20.
    Food, Medicine, Health Care Administration and Control Authority (FMHACA). Manual for Medicines Good Dispensing Practice. 2nd ed. 2012. http://www.fmhaca.gov.et/documents/Medicines_Good_Dispensing_Manual_second_edition_2012.pdf. Accessed 26 June 2017.
  21. 21.
    Tesso DW, Fantahun MA, Enquselassie F. Parent-young people communication about sexual and reproductive health in E/Wollega zone, West Ethiopia: implications for interventions. Reprod Health. 2012;9:13.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Central Statistical Agency. Population Projection of Ethiopia for All Regions At Wereda Level from 2014 – 2017. 2013. http://www.csa.gov.et/index.php/ehioinfo-internal?download=724:population-projection-of-ethiopia-for-all-regions-atwereda-level-from-2014-2017&start=5. Accessed 19 June 2017.
  23. 23.
    Addis Ababa city integrated land & information centre. Addis Ababa administrative divisions. http://www.ilic.gov.et/index.php/en/administrative-boundaries. Accessed 19 June 2017.
  24. 24.
    Alahdal A, Noor A, Bagalagel A. Use pattern of oral PDE-5 inhibitors in Jeddah, Saudi Arabia. JKAU Med Sci. 2008;15:27–38.CrossRefGoogle Scholar
  25. 25.
    Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–88.CrossRefPubMedGoogle Scholar
  26. 26.
    Kimura M, Shimura S, Kobayashi H, Tai T, Chikano Y, Baba S, Kano M, Nagao K. Profiling characteristics of men who use phosphodiesterase type 5 inhibitors based on obtaining patterns: data from the nationwide Japanese population. J Sex Med. 2012;9:1649–58.CrossRefPubMedGoogle Scholar
  27. 27.
    Simopoulos EF, Trinidad AC. Male erectile dysfunction: integrating psychopharmacology and psychotherapy. Gen Hosp Psychiatry. 2013;35:33–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Gareri P, Castagna A, Francomano D, Cerminara G, De Fazio P. Erectile dysfunction in the elderly: an old widespread issue with novel treatment perspectives. Int J Endocrinol. 2014;2014:878670.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Mondaini N, Ponchietti R, Muir GH, Montorsi F, Di Loro F, Lombardi G, Rizzo M. Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time. Int J Impot Res. 2003;15:225–8.CrossRefPubMedGoogle Scholar
  30. 30.
    Santtila P, Sandnabba NK, Jern P, Varjonen M, Witting K, von der Pahlen B. Recreational use of erectile dysfunction medication may decrease confidence in ability to gain and hold erections in young males. Int J Impot Res. 2007;19:591–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Moser C. The effect of sildenafil citrate on middle-aged “Normal” men. Electronic J Hum Sex. 2001;4. http://www.ejhs.org/volume4/Moser/body.htm.
  32. 32.
    Pfizer Product Inc. Revatio (sildenafil citrate tablets), cGMP-Specific Phosphodiesterase type 5 Inhibitor, Treatment of Pulmonary Arterial Hypertension. (Product Monograph) 2015. http://www.pfizer.ca/sites/g/files/g10028126/f/201512/REVATIO_PM_187384_E_0.pdf Accessed 06 June 2017.
  33. 33.
    Desai SD, Mehta MM. An unusual cause of headache in a medical tourist. J Family Med Prim Care. 2015;4:142–4.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Wu C, Zhanag H, Gao Y, Tan A, Yang X, Lu Z, Zhang Y, Liao M, Wang M, Mo Z. The association of smoking and erectile dysfunction: results from the Fangchenggang Area Male Health and Examination Survey (FAMHES). J Androl. 2012;33:59–65.CrossRefPubMedGoogle Scholar
  35. 35.
    Teshome D, Gedif T. Determinants of alcohol drinking and its association with sexual practices among high school students in Addis Ababa, Ethiopia: cross sectional study. Open J Prev Med. 2013;3:420–7.CrossRefGoogle Scholar
  36. 36.
    Gebrehanna E, Berhane Y, Worku A. Khat chewing among Ethiopian University Students—a growing concern. BMC Public Health. 2014;14:1198.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Astatkie A, Demissie M, Berhane Y, Worku A. Prevalence of and factors associated with regular khat chewing among university students in Ethiopia. Subst Abuse Rehabil. 2015;6:41–50.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Mohammed A, Engidawork E. Reproductive parameters are differentially altered following subchronic administration of Catha edulis F. (Khat) extract and cathinone in male rats. J Ethnopharmacol. 2011;134:977–83.CrossRefPubMedGoogle Scholar
  39. 39.
    Deressa W, Azazh A. Substance use and its predictors among undergraduate medical students of Addis Ababa University in Ethiopia. BMC Public Health. 2011;11:660.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Elmerstig E, Wijma B, Sandell K, Berterö C. Sexual interaction or a solitary action: young Swedish men’s ideal images of sexual situations in relationships and in one-night stands. Sex Reprod Healthc. 2014;5:149–55.CrossRefPubMedGoogle Scholar
  41. 41.
    Both R. A matter of sexual confidence. Young men’s non-prescription use of Viagra in Addis Ababa, Ethiopia. Cult Health Sex. 2016;18:495–508.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  • Dawit Teshome Gebregeorgise
    • 1
    • 2
  • Yajeb Melesse Belay
    • 1
    • 2
  • Sofia Kälvemark Sporrong
    • 1
    Email author
  1. 1.University of CopenhagenCopenhagenDenmark
  2. 2.Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health SciencesAddis Ababa UniversityAddis AbabaEthiopia

Personalised recommendations

Cite article

Buy options