Ask Dr. H: Generic Viagra produced in India

Question:

My husband has been taking Viagra for years. As you know, it is very expensive and there is no generic here in the United States. I heard on the radio that there is a much cheaper Viagra available. It is one-fourth the price of brand-name Viagra. What I received is "Fiagra." It is from India. When I called the distributor, they said it's exactly the same. Have you heard of it? Is it safe?

Answer: Viagra is not yet available in a generic form in the United States. But generic versions are sold in many other countries, including India and Canada. The problem with ordering drugs over the Internet, from a radio ad, or from a magazine ad is that you don't know what you're getting. You may receive a perfectly acceptable generic drug manufactured to good quality standards, but you also may get a counterfeit drug that not only is lacking in the active ingredient, but may contain substances hazardous to your health, such as boric acid or talc. Also, you need to be cautious any time you divulge personal or credit-card information to a third-party distributor.

As far as Fiagra is concerned, it is produced by Ultratech India, a seemingly reputable pharmaceutical company with a wide array of pharmaceuticals that it supplies to a worldwide market. Check out the website, www.ultratechindia.com. Ultratech states on the website that it meets several international pharmaceutical standards. It does not appear to be a counterfeit drug manufacturer, but that is hard to know for sure.

Q: I know that there are drugs such as Valtrex that can cut down on the number of outbreaks of genital herpes once you have it, but why isn't there a vaccine that can prevent someone from getting herpes altogether?

A: Efforts to produce a vaccine to protect against herpes simplex virus types 1 and 2 have failed. The results of a large study published in the Jan. 5 issue of the New England Journal of Medicine showed that while the vaccine was roughly 60 percent effective in protecting against HSV1 infection (the virus responsible for cold sores), it was essentially useless in preventing HSV2 infection (the leading cause of genital herpes). The study involved 8,323 uninfected women, a larger number than prior studies that suggested the vaccine protected more than 70 percent of women against HSV2, but was ineffective in men.

It is very difficult to develop vaccines against herpes viruses, many of which have complex life cycles and can lie dormant in the body for long periods. Thus far, the only vaccine that can successfully protect against infection by a member of the herpes family is the chicken pox vaccine.

So it's back to the lab for HSV researchers. Research will continue, but in the meantime, those who have had genital herpes can halve the number of outbreaks and greatly decrease the risk of unknowingly passing on the virus to a partner between outbreaks by taking the antiviral medication Valtrex or Famvir daily. Condoms are also effective in reducing the risk of transmitting the virus.