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Biotech / Medical : PFE (Pfizer) How high will it go? -- Ignore unavailable to you. Want to Upgrade?

To: Frostman who wrote (3455)	6/11/1998 12:01:00 PM
From: Tunica Albuginea	Read Replies (3) \| Respond to of 9523

Frostman, in regards to you taking Hytrin and Viagra together, a couple of thoughts: At present I am in the process of reviewing all the info that came out yesterday in an effort to remain as unbiased as possible. My first impression now however is that this is a much bigger ball - o - wax than we were led to believe.It is possible possible however that the speed with which these reports have been appearing in the last 2 weeks from WSJ, Reuters, Bloomberg's, etc, that somebody will beat me to it. A word about the Wall Street Journal: Last year Barons ( owned by the Wall Street Journal ), wrote several damaging articles on Vivus, which I thought were poorly researched and done. However, I chose not to cancel my subscription to both. I recognized that nobody is perfect, and that reporters can be wrong at times, and we have to live with that. The important point though is to see the whole picture.And the picture that I see is that the Wall Street Jour and Barons are by and large one of the best, if not the No 1 source of accurate info. And so I stick with it In regards to the PFE affair what can be said at present with all fairness is that we don't have any data because the no of deaths reported are too small to draw any conclusions.And all that the FDA said is that they are not changing their previous reccommendations. They did not say that Phase IV has been completed and that Viagra is out of the woods. (( fda.gov ). This is an extremely complex matter because of the great no of variables involved both in diseases present and multiple drugs taken by these people. However do not underestimate the ability of physicians to get to the bottom of this. We have in the past and will do so again. In trying to arrive at a fair assessment of an issue, we essentially look for one thing: a consistent pattern and then try and tie in there a cause and effect relationship. The pattern that I think is now appearing to emerge is that deaths are being reported in people taking Viagra who are also taking other drugs , that a lot of these drugs cause hypotension and that PFE did not test for these drugs. The argument being made for PFE is that " you can't and you shouldn't have to test for all drug interactions". This argument does not hold however because we do have drugs that we have tested for multiple drug interactions. Those that we do it for are the so called widely used drugs, such as blood thinner Coumadin, or an immunesuppressant like Cyclosporin. The problem I think that PFE will be facing is that the drugs that these people were taking at the time of death , are widely used.Ace Inhibitors ( Zestril, Vasotec, ) and Calcium channel blockers and beta blockers are all widely used, ( fda.gov ). Now if it is found that these drugs interact with Viagra to produce unacceptable hypotension and death, then what will happen is that Viagra's use will be restricted in these type of patients. The catch there is that that will comprise 75% of the ED market, since ~75% of ED patients use these drugs or have arteriosclerosis &/or hypertension &/or diabetes &/or emphysema, the main disese factors observed so far. I am not rushing to judgement because I know that these things take time. It took one year with Posicor and 1 -2 years with Redux. I suspect however that research on Viagra will be greatly accelerated because the camera lens and the print media are on to it and will demand a quick answer. TA

To: Frostman who wrote (3455)	6/11/1998 11:21:00 PM
From: Solid	Respond to of 9523

Very good point. I am glad for you, and others who now may be informed, IF it is an interaction problem. My point is that much research HAS been done. Enough to satisfy the FDA and win approval. And that statistics are VERY supportive of the safety of the medication. My point was NOT that it is safe for all, or that ALL facts are yet known. Only that the FDA was confident enough to issue their statement, and they are responsible and accountable for the research and approval they give. The WSJ is responsible to get stories, make headlines and turn a profit. They gather information, but it may or may not be clinically correct to make a judgement with, and the subject of their investigation (PFE in this case) winds up being tried- short term anyway- in the media. Because I am a shareholder I care. Because I am human (could be me or friend/family member one day like you), I care about your insight as well and do not want to see the truth suppressed, just due process. I am glad for you that serendipity moved in your favor. It would reason to do as much due diligence with your personal use of Viagra as you hopefully do with researching your portfolio picks! Good luck!