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Viagra (sildenafil citrate) was discovered somewhat serendipitously during Pfizer’s efforts to develop a medicine for angina (chest pain). Sildenafil was being tested as a cardiovascular drug (a PDE5 inhibitor to help blood flow). In early trials, researchers noticed an unexpected side effect: many men taking the compound reported improved erections during sexual activity. Realizing this could be a new treatment area, Pfizer shifted focus from angina to erectile dysfunction (ED). Sildenafil was studied specifically for ED and, after successful trials, was approved by the U.S. FDA in 1998 as Viagra. It later also gained approval for pulmonary arterial hypertension under the brand Revatio (same drug, different dose). How it works: sildenafil inhibits phosphodiesterase type 5 (PDE5), which normally breaks down cGMP. During sexual arousal, nitric oxide increases cGMP in the penis, causing smooth muscle relaxation and increased blood flow. By blocking PDE5, sildenafil helps maintain the erection in response to stimulation. So, the discovery is often described as a fortunate sidetrack from cardiovascular research that led to a groundbreaking ED treatment.
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