Viagra Corner: Despatches from the Frontiers of Medicine

IN A coincidence that will not be lost on readers of the Kama Sutra, deaths linked with Viagra in the first four months after it was licensed in the United States reached 69.

The figures from the US Food and Drug Administration (FDA) show that 46 of the patients had heart attacks and two had strokes. In the rest, the cause of death was unknown.

The FDA said it had not changed its view of the drug's safety but would continue to evaluate the need for regulatory action. More than 3.6 million prescriptions for Viagra were dispensed between late March and July. The average age of those who died was 64.

FDA-required labels warn that Viagra should not be used by heart patients who are taking nitroglycerine or other nitrate drugs. The combination can cause a sudden drop in blood pressure. Of the 69 deaths, 12 patients were taking nitroglycerine or a nitrate medication, the FDA reported.

Twenty-five of the patients died or had the onset of symptoms leading to death four to five hours after using the drug, 18 of them immediately following sexual intercourse.

Pfizer, the maker of Viagra, has said it "is safe and effective" when used properly.