Recent developments in counterfeits and imitations ofViagra, Cialis and Levitra. A 2005-2006 update

A strong trend is observed towards increasingly professional counterfeits and imitations of Viagra, Cialis and Levitra, with regard to the appearance of tablets, capsules and packaging. The professional presentation will deceive potential consumers into assuming these products are legal, efficacious and safe. However, a high health risk is posed by the increased use of potent active substances, mixtures thereof, and the rising number of active substances in adulterated herbal aphrodisiacs that have no known safety or toxicological profile (analogs). Consumers can not be certain of any of these products as to their pharmacological and toxicological safety. These are the results of a trend analysis based on illegal erectogenics analysed by the RIVM, the Nederlands Forensisch Instituut and the Douane Laboratorium. Suspect samples were seized by the Dutch inspectorates outside the official medicines distribution chain over 2005-2006. The analysis data was combined in order to draw a more accurate picture of current trends in the Netherlands and the associated health risk. This material is supplemented with the results of a Pan-European investigation into the infiltration of counterfeit Cialis in the official distribution chain, the determination of the pharmacological potency of some sildenafil analogs, and a literature survey, which made it possible to predict which new analogs can be expected in the near future.