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Can't breathe? Use Viagra

It’s not exactly the mile high club, but it’s pretty close. Something takes your breath away, expectations are high and you better come through in the clutch--or else.

At 20,000 feet, life and death revolve mainly around one thing: oxygen, or the lack thereof. In a twist of medical fate, erectile dysfunction drugs, the same prescription concoction that helps millions of men maintain erections and keeps their bedfellows happy, may also help high-altitude climbers’ lungs absorb more oxygen, according to a prominent physician and hiker.

“There’s some connection between the penis and the lung, evolutionarily speaking,” said Dr. Peter Hackett, who runs the medical clinic at Colorado’s Telluride Ski area and who has hiked Mt. Everest.

At high altitudes, the dearth of oxygen in the air and immense pressure from the atmosphere significantly raise a hiker’s blood pressure. The strain on blood vessel walls is “kind of like a sausage under too much pressure,” Hackett said.

The technical name for the condition is high-altitude pulmonary edema, which can cripple the most seasoned of hikers. A 2001 University of Colorado study took a look at a skier whose retinas burst at 14,000 feet because there was too much pressure on and not enough oxygen in his blood vessels.

For Kelly Hice, a tennis instructor from Detroit, a 12,000-foot mountain proved to be too much. The 44-year-old succumbed to oxygen deprivation while hiking at Colorado’s Telluride Mountain resort last Christmas.

His companions rushed him to the hospital, where Hackett prescribed oxygen and Cialis, an erectile inducer similar to Viagra.

“I can’t say I didn’t think, ‘Well, am I going to get an erection?’” Hice said. Instead, the Cialis helped increase the blood flow to more vital organs. Hice credits the drug with saving his life.

Pfizer, the manufacturer of Viagra, isn't keen about the virility pills being used to offset altitudinal impairments.

“Viagra is not approved for the treatment of high-altitude illness,” said Shreya Prudlo, a Pfizer spokeswoman. “We do not suggest or recommend the use of Viagra for this condition.” The drug, Prudlo said, is approved only for erectile dysfunction.

“There have been a number of independent studies that discuss the use of Viagra in patients with high-altitude sickness,” she said. “Pfizer has not conducted such trials.”

Most hikers who have used erection drugs get the pills from their medical providers. Viagra and Cialis are the most popular, but several less well-known brands provide the same effects.

But they can also include some nasty side effects, warns the Food and Drug Administration. Taken with a nicotine patch or gum, erectile dysfunction drugs can dangerously lower blood pressure. The pills can also cause headaches and stomach pain, not something a hiker wants to experience at 10,000 feet. The FDA further warns that enzyme inhibitors in erection drugs can cause cardiac arrhythmia or congestive heart failure.

For this reason, some in the medical profession are uncomfortable about prescribing Viagra and variants for the lungs.

“Sometimes it’s very logical to use things off-label that aren’t approved by the FDA,” said Mona Counts, a Pennsylvania nurse practitioner and a former ski patrol member. “Still, it’s risky.”

Similar caution was voiced by Allison Gannett, a world champion free skier who nonetheless was intrigued by Hackett’s theory. “I have always wanted to try Viagra,” she said, “or should I call it Niagara since I’m a chick?” But serious adventurers, she said, use Biomox, a drug used for altitude sickness.

“When you’re dealing with a life-or-death situation like pulmonary edema, you want to use a correct drug for the job,” Gannett said. “I always discourage clients from using Viagra. I’d rather go with the one that works.”

Not so for Jen Brill, co-founder of a ski retreat on Silverton Mountain, Colo., who says Viagra is the way to go. Her Web site details a plethora of ways to prepare for skiing on the mountain, where avalanche beacons are de rigueur. The site recommends Viagra for use on the 9,000-foot peak.

“That high, your lungs don’t get enough oxygen,” Brill said. “We do recommend Viagra for some people.”

Pfizer has no plans to market Viagra for high-altitude uses, but it does market Viagra’s generic, sildenafil citrate, to treat pulmonary hypertension under the brand name Revatio.

Hackett’s fascination with Viagra began in 2000 when he read about a joint study between British and Kazakhstani scientists testing nontraditional drugs in the high Kazakhstan altitude. “It was a natural step to take the study from Kazakhstan and use it for hiking,” he said.

Those excited about experiencing Viagra’s sexual benefits with the glaciers around should think twice, though. “There has to be sexual stimulation, which is usually not available on a mountain climbing expedition,” Hackett said. “You are just struggling to survive."

Viagra can aid breathing, he added, but it won’t prevent the nausea, headache and general fatigue that can occur at high altitudes. And Viagra isn’t for everybody.

While it is helpful for patients who have experienced oxygen deprivation before, it's hard to predict whether the blue pills will increase athletic performance.

“There are some people who will benefit from taking Viagra at higher altitude,” Hackett said. “There are some who won’t.”

Despite the debate over its effectiveness, Hackett doesn’t see Viagra or Cialis being banned anytime soon from competitive sports because so few take place at high altitudes. Cyclists and cross-country runners don’t race or train above 8,000 feet, he said.

“Until there’s competitive mountain climbing, using Viagra is not going to be much of a problem,” Hackett said.

For Hice, though, one brush with death won’t keep him away from high altitudes. This summer he plans to hike in Yellowstone National Park, and in the winter he’ll head back to Telluride, with either Viagra or Cialis in tow.

“Hey, if it helps, I’m up for it,” he said.

E-mail: ejs2132@columbia.edu