Sildenafil repurposing: from failed heart drug to Viagra (1991–1998)
1991–1998What Happened
Pfizer developed sildenafil as a treatment for angina and hypertension. Clinical trials in Wales showed disappointing cardiovascular results, but male participants reported an unexpected side effect: sustained erections. Pfizer pivoted the drug's development entirely, and the FDA approved Viagra for erectile dysfunction in March 1998.
Outcome
Viagra generated $1 billion in sales in its first year, becoming one of the fastest-adopted drugs in history.
Sildenafil was later approved a third time—as Revatio for pulmonary arterial hypertension—making it one of the most successfully repurposed compounds in pharmaceutical history.
Why It's Relevant Today
The Viagra story demonstrates how a drug's most important medical application can emerge from unexpected clinical observations. GLP-1 drugs, developed for metabolic conditions, may be following a similar trajectory if psychiatric benefits are confirmed.
