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Counterfeit ED medications are heavily marketed on the internet, often for substantially less than the price of the genuine medicine from a pharmacy. Two thirds of men who purchase ED medications without a prescription do so over the internet, and up to 90% of all counterfeit ED medications are sold over the internet.
Although limited, evidence suggests that younger men are more likely to purchase medicines online, and thus have a higher risk of purchasing a counterfeit medicine, than their older counterparts. As ED treatments have only recently been approved for legal supply, the prevalence of both legal and counterfeit ED medications has increased exponentially in the 21st century. In Europe, an estimated 2.5 million men use counterfeit ED treatments – roughly the same number as obtain ED medications from legal sources. Laboratory analyses of seized ED counterfeits have shown marked variations in composition from their genuine counterparts (that is, differences in the types and amounts of ingredients contained). Doses of the active ingredient contained in counterfeits vary, from not containing any active ingredient, to containing up to twice the dose of the medicine they are supposed to mimic. Counterfeit ED drugs have also been shown to contain potentially hazardous substances, including commercial paint, talcum powder and printer ink.
Another reason why ED medications are easy to counterfeit is that ED is a problem that men are often embarrassed to discuss with their doctor.
Men who have self-diagnosed their ED and need for treatment can easily buy counterfeit drugs because many internet sites sell them without prescription. In addition to being available without a prescription, counterfeit ED drugs sold on the internet are often significantly cheaper than their genuine counterparts. Some men may order ED drugs online for convenience, even if they have a prescription for the medication. Untreated ED is associated with a reduced quality of life and an increased risk of psychological complaints, including stress, depression and low self-esteem. Medicines that contain incorrect doses of the stated active ingredient, or contain active or inactive ingredients without listing them, have the potential to create serious health problems. There is a potential for drug overdose and drug–drug interaction when there is more active ingredient in a medication than is stated, or when a substitute is used for the active ingredient. The potential for drug–drug interactions is serious when medications contain unlisted (active or inactive) ingredients with the potential to interact with other drugs. PDE-5 inhibitors are known to interact with nitrate-containing drugs to cause serious hypotension (low blood pressure). If an active ingredient is unlisted or listed as another active ingredient, it may be contraindicated in a different group of people to the listed active ingredient, even if both ingredients are used to treat the same condition. Even in cases where the correct active ingredient is contained in the correct quantity, people have limited opportunities to receive information about contraindications when they buy medicine from illegal online sources. There are risks associated with circumventing the healthcare system which occur when prescription-only drugs are purchased on the black market. Other health issues which underlie ED may remain undiagnosed when a man uses counterfeit ED treatment. An individual’s perception of their health problems is not necessarily accurate in the medical sense.
Even if a man has medically confirmed ED, he may not be a candidate for medicine if his ED is underpinned by psychological factors, including life stress and depression, rather than biophysical factors. Regardless of the underlying cause, most men with ED have comorbid emotional symptoms, such as depression or low self-esteem. Counterfeit drugs masquerading as tadalafil (a PDE-5 inhibitor used to treat ED) and herbal sexual enhancement products have previously been found to contain an ingredient normally used to treat diabetes. In 2007, 150 non-diabetic men were admitted to hospital in Singapore with hypoglycaemia after taking counterfeit ED drugs containing glyburide (also known as glibenclamide), a diabetes drug.
ED has a range of possible causes, including problems with the blood vessels, emotional problems, and hormone imbalances.
Counterfeit ED drugs are dangerous and often contain ingredients which are not listed on the packaging. Counterfeit drugs often look the same as genuine medicines, and differences can only be detected through laboratory testing. If you suspect a drug you have purchased is counterfeit, report it to the TGA immediately so further investigations can be conducted.
Consult with a doctor or other health professional before using the drug for the first time. For more information about drugs, including an introduction to pharmacology, generic versus branded drugs, and the meaning of drug schedules and pregnancy categories, see Drugs. For more information on erectile dysfunction, types, causes and treatments of erectile dysfunction, and tips for dealing with it, see Erectile Dysfunction.
About myVMCVirtual Medical Centre is Australia’s leading source for trustworthy medical information written by health professionals based on Australian guidelines.



Please be aware that we do not give advice on your individual medical condition, if you want advice please see your treating physician. A significant proportion of counterfeit medicines seized in association with internet marketing claim to treat ED. Conservative estimates suggest that as many 15,000 websites market medicines to treat erectile dysfunction. A European study reported that 94% of online pharmacy websites surveyed did not name a pharmacist, 90% did not require a prescription and 85% had no physical address. In a European study, 41% of men aged 18–40 years purchased medicines from sources outside the healthcare system (e.g. Millions of counterfeit PDE-5 inhibitors (the main class of drugs used to treat ED) are seized each year, and this class of drug accounts for the majority of counterfeit medicine seizures. Counterfeit ED treatments are the most commonly-seized type of counterfeit medicine in Europe, and the global increase in the prevalence of counterfeit medicines of any type is partly attributed to the expansion of counterfeit ED treatments. Only 10% of counterfeit ED drugs tested in the European Union contained an amount of active ingredient that was within 10% of the quantity contained in the original product. The medications are expensive, enabling counterfeit manufacturers to make large profits, particularly if they fix manufacturing costs by leaving out the expensive active ingredients contained in the genuine medication. Even counterfeit drugs that do contain the active ingredients provide lucrative profits of up to 2000%. Counterfeit drug manufacturers take advantage of this vulnerability by making their products available without prescription, enabling men to access prescription medicines without seeking medical advice. However, many do not visit a doctor to discuss their ED, perhaps because they are too embarrassed. In Australian pharmacies, ED medications containing PDE-5 inhibitors are available only on prescription.
In one French study, 12% of men with prescriptions for PDE-5 inhibitors reported buying their medicine online, which creates a significant risk of purchasing a counterfeit version of the medicine. Counterfeits that contain no active ingredients are unlikely to harm a person’s health (unless they contain a toxic ingredient), but will not treat the condition. Drug–drug interactions are interactions that can occur when an individual takes two medicines at the same time.
Drug–drug interactions are difficult to assess when the ingredient causing the interaction is unknown. Nitrate-containing drugs are commonly used to treat diabetes, heart conditions, hypertension and hypercholesterolaemia. This may be because they are dangerous substances which are always dangerous for human consumption (e.g. For example, men taking nitrate-containing medications, which contraindicate the use of PDE-5 inhibitors, may choose to use a natural ED treatment instead.
People with genuine ED may remain untreated because the counterfeit products they purchase do not contain an effective dose of the stated active ingredient. 65% of men who actually have a medically-indicated need for ED treatment, but self-treat with counterfeit medicines instead of consulting their doctors, miss the opportunity to be investigated for conditions that commonly co-occur with and may underpin ED.
35% of men who self-treat with ED counterfeits do not have symptoms that would warrant a medical diagnosis of ED and their treatment is not medically indicated.
In these cases, psychological interventions rather that pharmacological treatment is indicated. ED is therefore most effectively treated with a holistic approach that combines pharmacological interventions with psychological (e.g. When taken by non-diabetic people, the ingredient produces serious and sometimes fatal reactions. It was linked to different brands of illegal products, but raised suspicions that the contaminated drugs were manufactured by the same source. This information will alert your doctor to the possibility that the reaction is caused by the counterfeit drug and help your problem be diagnosed quickly and accurately.
Medicines informal market in Congo, Burundi and Angola: Counterfeit and sub-standard antimalarials. Erectile dysfunction and cardiovascular disease: Efficacy and safety of phosphodiesterase type 5 inhibitors in men with both conditions.
British Society for Sexual Medicine guidelines on the management of erectile dysfunction [online].
They may have moved up to a more demanding position in their work, they often have started a family, bought a home, and gotten into debt. These sites receive almost 13 million hits and sell over two million erectile dysfunction tablets each month. However, containing the same amount of the active ingredient does not mean the counterfeit medicine is exactly the same. Another European study reported that 60% of men who purchased prescription-only medicines online believed that they would be able to access the same medicines online as they would get from a real pharmacy or doctor.


Men may then become disillusioned, think their ED cannot be treated, and may be discouraged from seeking professional treatment for their ED in the future.
These include cardiovascular disease, diabetes and metabolic syndrome, dyslipidaemia, high blood pressure, and endocrine disorders.
Sometimes the medicines are incompatible and can interact dangerously, putting the person’s health at risk. Using nitrate-containing drugs is contraindicated for PDE-5 inhibitor use, meaning that people who use nitrate-containing medicines cannot use PDE-5 inhibitors.The conditions these medications are used to treat are all common in men who have ED, suggesting that a significant proportion of men using counterfeit ED drugs are at risk of potentially fatal drug interactions. This may discourage patients from seeking professional treatment in the future because they think it will not work for them.
These include serious conditions such as hypertension and diabetes, which are associated with significant morbidity and mortality and may remain undiagnosed and untreated when men circumvent the healthcare system. ED may also be underpinned by hormonal abnormalities which require hormone replacement therapy and which PDE-5 inhibitors are not effective in treating.
Traces of glyburide were detected in 85% of the men’s blood or urine samples, and 44 admitted to using illegal sexual enhancement products. Further questioning revealed that his condition occurred after consuming a PDE-5 inhibitor. If the drug has been stored incorrectly, is past the use by date, or uses active ingredients from a different source, the way the drug is absorbed by the body may differ from the original. Over 30% of men who purchase counterfeit ED drugs do so without consulting a health professional. Doctors commonly check for these conditions when assessing erectile dysfunction and, if necessary, treat them.
Unlisted ingredients which are safe for human consumption in some situations may also be dangerous if they are included in ED medications. Drug samples obtained from these men were analysed and showed doses of 13–100 mg of glyburide per tablet. Laboratory analysis confirmed the medicine to be a counterfeit masquerading as tadalafil.This is the first Australian case of severe hypoglycaemia induced by counterfeit ED drugs. Men who purchase counterfeit ED drugs therefore do not receive the most effective form of treatment, even if the drugs they purchase are good replicas of the originals (which usually they are not).
Many of the tablets also contained sildenafil (another PDE-5 inhibitor and the active ingredient in Viagra).
It serves to remind the public that Australia is at risk of an outbreak similar in style to that which occurred in Singapore. While these drugs can be taken safely by diabetics, in non-diabetics they can cause fatal hypoglycaemia (very low blood sugar). Not only that, but in many men there’s also a link between back pain and erectile dysfunction.
As a matter of fact, several sources of back pain can cause ED, including… Tight hip flexors Pinched nerves Herniated discsBeet Juice For ErectionsI’ve been testing raw beet juice for erections for the last several weeks and the test has gone extremely well, to say the least. I had been using dry beet root juice powder from Amazon that you mix up with water and drink. This provided some erection benefits, but the raw beet juice has outclassed […]Causes Of ED In Your 20’s and 30’sWhen I started my first site back in 2009 I was surprised how often I was contacted by twenty and thirty somethings complaining of ED. We spend a lot of time on this blog telling you about obscure herbal treatments and supplements that can help increase your libido and virility.
They’re proven techniques, and many have been known for their effects for […]Celery And Erectile DysfunctionThis is a guest post about celery and erectile dysfunction written by David Janes. Boosts nitric oxide Elevates sex drive Reduces platelet aggression Increases testosterone production And even makes you smell better to women Now here’s David….Dietary Fat and ErectionsI’ve been jacking around with my diet lately, especially my final meal of the day, to test its impact on morning erections.
And while I’m not much of a fan of tasteless low fat eating, I am becoming a fan for this particular meal.
Hi Mark, I have difficulty getting an erection. I have a new girlfriend and am having sex for the first time in a while. A couple of my buddies have been telling me that eating blueberries can help fix my erectile dysfunction.
They’re kind of hippie types, so I’m not sure how much of their Granola Wisdom to take seriously.
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