Dr. Alexander Olshinitzky, an Israeli physician who treats impotence and diabetic foot, said he has received numerous queries from observant patients about whether they can take Viagra during the holiday. Another impotence expert, from Jerusalem, said he has had calls from abroad on the same question.

Olshinitzky added with a smile that some women may welcome the news that Viagra contains chametz, as "surveys show that before Pesach and during the first days of the holiday, women are so tired and stressed from preparations that they're not very interested in sex."

Rosenberg noted that all drugs taken for life-threatening conditions, even if they contain leaven, can — and must — be taken during the holiday. "If an effective substitute drug that does not contain leaven is available, it should be taken. Some might argue whether impotence is a life-threatening condition, but one should consult one's doctor."

He added that when a Jewish patient wants to know whether he can and should fast on Yom Kippur, "he should ask a secular — and not a religious — physician. An Orthodox physician would say to himself: 'Oy! Can I tell a Jew to eat on Yom Kippur?' But a secular physician will merely determine: 'Can this person safely fast or not?' One could say the same is true of Pesach medications. Patients with chronic illnesses should not be overly strict with themselves about drugs they need that have leaven."

Decades ago, the active ingredient in most medications was bound together with wheat starch. Since then, most companies — even those abroad — have switched to potato flour and other unleavened materials, said Rosenberg.

Every year Clalit Health Service collects information from manufacturers and importers on medications sold here, and Viagra was found to contain a leavened coating. "There are still problems with some syrups and suspensions, as well as flavorings containing sorbitol (a form of alcohol that may be made from grains)," he said.

"Sometimes an antibiotic can be switched to a non-chametz substitute; it's best to consult one's doctor."

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