Over half of Viagra in Netherland’s sewage unaccounted for by legal dispensing

1. Sildenafil (Viagra) and its metabolites in sewage water can be used to estimate sildenafil consumption by the population. 

2. About 60% of estimated sildenafil use was unaccounted for by data from the national dispensary database. 

Evidence Rating Level: 4 (Below Average) 

Study Rundown: Illicit online pharmacies have proliferated and dispense counterfeit or substandard medications. In order to quantify the prevalence of rogue online pharmacies, the concentrations of the erectile dysfunction medication, sildenafil, were measured in sewage treatment plants in the Netherlands. The amount of legally dispensed medication was extracted from the national dispensary database, and consumption during the testing period was estimated using the repetitive dispensing behaviors of patients in the sampled area. It was found that at least 60% of sildenafil in the sewage loads of each city could not be accounted for by the legally dispensed fraction of the medication, suggesting that illicit online pharmacies may be more rampant than previously thought.

This study’s limitations lie in its small sample size and protocol for measuring the percentage of legally dispensed sildenafil.  The repetitive dispensing behaviors for patients in the sampled area may not reflect true consumption as it was conducted over a short period of only seven days. The results are precise, however, as the percentage of unaccountable sildenafil was consistent across all three cities.

Click to read the study, published today in BMJ

Relevant Reading: Record number of fake drugs are seized in crackdown

In-Depth: This study attempted to quantify the prevalence of rogue online pharmacies in the Netherlands by calculating the differences in actual concentration and expected concentration of sildenafil and two of its metabolites in sewage loads. Expected concentration was calculated based on information from the national dispensary database.  Samples were taken at three sewage treatment plants, in Amsterdam, Eindhoven, and Utrechtover the course of seven days.  To provide a conservative estimate, loss to degradation was not assumed, and there was no indication of dumping of unused drugs. In each of the three cities, at least 60% of the sildenafil in the sewage loads was not accounted for by legally dispensed medication.

Image: PD

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.