¹Department of Urology, Bristol Royal Infirmary, Bristol, UK

Correspondence: R Thurairaja, Department of Urology, Bristol Royal Infirmary, Marlborough Street, Bristol BS2 8HW, UK. E-mail: rthurairaja@doctors.org.uk

Received 27 April 2004; Revised 29 September 2004; Accepted 29 September 2004; Published online 28 October 2004.

Abstract

The objective of the study was to investigate the safety and reliability of internet websites selling and providing medical information regarding herbal substitutes for Viagra. Using keywords 'Herbal' and 'Viagra', websites selling and providing medical information regarding herbal substitutes were identified. The top 50 sequential sites were assessed for safety and reliability against the Health on the Net (HON) criteria. Medically trained staff provided information in only 21% of the sites yet just 24% stated that the information was not a replacement for medical advice. No sites warned patients about erectile dysfunction (ED)-associated cardiovascular disease. In all, 88 and 70% of sites indicated drug efficacy and ingredients but only 36 and 21% provided contraindications and side effects, respectively. All sites fell short of the HON requirements. In conclusion, acquiring medical information and herbal substitutes for ED from the internet is convenient and easy. However, patients should be cautious as safety and reliability of this approach is poor.