A strong trend is observed towards increasingly professional counterfeitsand imitations of Viagra, Cialis and Levitra, with regard to theappearance of tablets, capsules and packaging. The professionalpresentation will deceive potential consumers into assuming theseproducts are legal, efficacious and safe. However, a high health risk isposed by the increased use of potent active substances, mixtures thereof,and the rising number of active substances in adulterated herbalaphrodisiacs that have no known safety or toxicological profile(analogs). Consumers can not be certain of any of these products as totheir pharmacological and toxicological safety.These are the results of a trend analysis based on illegal erectogenicsanalysed by the RIVM, the Nederlands Forensisch Instituut and the DouaneLaboratorium. Suspect samples were seized by the Dutch inspectoratesoutside the official medicines distribution chain over 2005-2006. Theanalysis data was combined in order to draw a more accurate picture ofcurrent trends in the Netherlands and the associated health risk. Thismaterial is supplemented with the results of a Pan-European investigationinto the infiltration of counterfeit Cialis in the official distributionchain, the determination of the pharmacological potency of somesildenafil analogs, and a literature survey, which made it possible topredict which new analogs can be expected in the nearfuture.
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