New England Journal of Medicine Highlights the Dangerous Problems of Counterfeit Viagra

The following post appeared on the web blog Knock Off Report(http://knockoffreport.com/on February 25, 2009.

The world, including the US, is being flooded with counterfeit Viagra and other erectile dysfunction medications. A report in the Feb 12, 2009 issue of the New England Journal of Medicine highlights the dangerous problems.

The article reports on a total of 150 non-diabetic patients with severe hypoglycemia (low blood glucose) were admitted to the five public hospitals in Singapore. The admissions were between January 1 and May 26, 2008. All the patients were men except one, ages ranged from 19 to 97 years (median, 51). Seven patients remained comatose as a result of prolonged decrease glucose to the brain,and four subsequently died.

Several patients (45/150 or 30%) admitted to ingesting illegal sexual-enhancement drugs before the onset of hypoglycemia. Samples of the drugs obtained from these patients and from drugs seized in police raids were analyzed by means of high-performance liquid chromatography. It was found that many of the preparations were contaminated with Glyburide (a powerful medication used to treat diabetes).

So people thought they were taking Cialis or Viagra. What they were often taking were herbal preparations (e.g. Santi Bovine Penis ErectingCapsule) that contained small amounts of the active ingredient (Cialis or Viagra), but which also contained glyburide.

Since none of the men were diabetic, they experienced a severe drop in blood sugar (hypoglycemia). Seven men sustained serious brain damage due to low blood sugar, of which four ultimately died.

Harmful ingredients found in counterfeit medicines include boric acid, leaded road paint, floor polish, shoe polish to get the sheen on the tablet, talcum powder, cement powder, chalk and brick dust, nickel and arsenic. Any active drug ingredient is usually minimal or simply wrong – one supply batch of fake Viagra was in fact amphetamine and not Viagra (sildenafil).

Here are some signs (from eDrugStore) to help you identify illegal "generic Viagra" [Cialis or Levitra:

• The site sells "generic VIAGRA" or "generic sildenafil citrate" [Viagra does not have a generic form available.]

• The site claims to sell a cheaper form of VIAGRA

• The price is cheaper than VIAGRA, by as much as 70%

• The site claims the drug is made to World Health Organization (WHO) standards, which may be a lie. The WHO does not review or approve any medication

• The drug is sold as a pill, but looks different from VIAGRA's normal color, shape and imprinting

• Delivery times may be extended (4 -21 days) due to product being shipped into the United States from a foreign country

• Shipping is initiated using a foreign country postal service to minimize chances of detection and seizure when entering United States

Source
An Unusual Outbreak of Hypoglycemia; N Engl J Med 2009 360: 734-736; Kao, Shih Ling, Chan, Cheng Leng, (Pharm.), B.Sc., Tan, Belinda, (Pharm.), B.Sc., Lim, C.C. Tchoyoson, Dalan, Rinkoo, Gardner, Daphne, Pratt, Edward, Lee, Marilyn, Lee, Kok Onn