Tonic Health Foods and Sildenafil (so-called Viagra)

　While the problem is that "dangerous drugs" are sold mainly on the Internet, tonic health foods of unapproved and unlicensed drugs are mainly sold on the Internet, and despite health hazards, similar products are sold. Drugs mixed in tonic health foods are mainly male hormones (methyl testone) yohinbin and local anesthesia (lidcaine), and recently sildenafil.
　Sildenafils are substances that have pharmacological effects similar to sildenafil (so-called biagra). The first drug approved is sildenafil citric acid (biagra), which is originally used as a treatment for male sexual dysfunction. In addition, it is said to be a PDE5 inhibitor because pharmacological action inhibits phosphodiesterase5 (PDE5), an enzyme that decomposes cyclic GMP. This PDE5 inhibitor has been researched one after another, and hydrates of valdenafil hydrochloride (Levitra) and dadaraphyll (cyalis) have been approved as pharmaceuticals. Recently, tonic health foods (tablets, capsules, drinks) mixed with sildenafils have been found one after another, which has become a problem.
　When we tested a tonic health food at our office, there was a case where a dadaraphyll of more than 20 mg (for one cyalis) was detected in one capsule (see photo).

　This sample was sold on the Internet, and it was reported that it was also detected in Tokyo and Saga prefectures, respectively. One of them was imported and sold in Yokohama City, so the Medical Safety Division ordered this company to collect products. In addition, as a new problem, the number of products that have similar chemical structures to syldenafil, valdenafil, and dadaraphyll and other substances that have a tonic effect have increased (see figure for the structural formula of each substance). Since these substances are not pharmaceuticals, care must be taken because they have not been investigated for safety or toxicity.
　The analysis of sildenafils is mainly confirmed and quantified by a liquid chromathograph mass spectrometer (LC/MS). However, since there is no standard product for the analysis of substances that have a similar structure to the sildenafil etc. mentioned above, the structure of those substances must be determined. In order to determine the structure, the MS spectrum alone is not enough, and nuclear magnetic resonance (NMR) spectrum, gas chromatographic mass spectrometer (GC/MS), infrared absorption (IR) spectrum and elemental analysis are also required, and time and costly.
　Side effects of sildenafil are reported to include headache, hot flashes, visual impairment, etc. Combined with sildenafil with nitric acid or nitrogen monoxide (such as nitroglycerin), a treatment agent for angina pectoris, can cause excessive drop in blood pressure, cause cardiac arrest, and death. If you are using nitric acid with angina pectoris, do not take Viagras and avoid abuse of tonic health foods even if it is not angina. Also, if you want to take Viagras, it is important to consult a specialist before taking it.