title: Adulterated and Counterfeit Male Enhancement Nutraceuticals and Dietary Supplements Pose a Real Threat to the Management of Erectile Dysfunction: A Global Perspective.
abstract: Erectile dysfunction prevalence globally is noticeably high. This is accompanied by an increase in the use of nutraceuticals for male enhancement. However, the global market is invaded by counterfeit and adulterated nutraceuticals claimed to be of natural origin sold with a therapeutic claim. The objective of this article is to review male enhancement nutraceuticals worldwide with respect to claim, adulterants, and safety. The definition of such products is variable across countries. Thus, the registration procedures differ as well. This facilitates the manipulation of the process, which leads to widespread adulterated and counterfeit products without control. The tele-advertisement and Internet pharmacies aided the widespread sale of male enhancement nutraceuticals, unfortunately, the spurious ones. Finally, based on literature, most of these products were found to be adulterated with active pharmaceutical ingredients (API) and mislabeled as being natural. These products represent a major health hazard for consumers due to lack of clear regulations.
authors.affiliation: a Faculty of Pharmacy, Department of Pharmaceutics , Alexandria University , Alexandria , Egypt.
authors.forename: Fatema
authors.initials: F
authors.lastname: ElAmrawy
authors.affiliation: b Faculty of Pharmacy, Department of Pharmaceutics , Benghazi University , Benghazi , Libya.
authors.forename: Ghada
authors.initials: G
authors.lastname: ElAgouri
authors.affiliation: a Faculty of Pharmacy, Department of Pharmaceutics , Alexandria University , Alexandria , Egypt.
authors.forename: Ola
authors.initials: O
authors.lastname: Elnoweam
authors.affiliation: a Faculty of Pharmacy, Department of Pharmaceutics , Alexandria University , Alexandria , Egypt.
authors.forename: Samar
authors.initials: S
authors.lastname: Aboelazayem
authors.affiliation: a Faculty of Pharmacy, Department of Pharmaceutics , Alexandria University , Alexandria , Egypt.
authors.forename: ElMohanad
authors.initials: E
authors.lastname: Farouk
authors.affiliation: a Faculty of Pharmacy, Department of Pharmaceutics , Alexandria University , Alexandria , Egypt.|c Department of Pharmaceutical Sciences , Appalachian College of Pharmacy , Oakwood , VA , USA.
authors.forename: Mohamed I
authors.initials: MI
authors.lastname: Nounou
mesh_terms: D058110:Counterfeit Drugs; D019587:Dietary Supplements / Q000032:analysis*; D004340:Drug Contamination; D004348:Drug Labeling / Q000331:legislation & jurisprudence; D004534:Egypt; D007172:Erectile Dysfunction / Q000188:drug therapy; D005060:Europe; D006801:Humans; D020407:Internet; D007880:Legislation, Drug; D008297:Male; D008877:Middle East; D004364:Pharmaceutical Preparations; D058986:Phosphodiesterase 5 Inhibitors / Q000032:analysis / Q000627:therapeutic use; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D058110:Counterfeit Drugs; D004364:Pharmaceutical Preparations; D058986:Phosphodiesterase 5 Inhibitors
keywords: adulteration; male enhancement; safety; sildenafil