TY  - JOUR
PY  - 2021//
TI  - Drug adulteration of sexual enhancement supplements: a worldwide insidious public health threat
JO  - Fundamental and clinical pharmacology
A1  - Yéléhé-Okouma, Mélissa
A1  - Pape, Elise
A1  - Humbertjean, Lisa
A1  - Evrard, Marion
A1  - El Osta, Rabih
A1  - Petitpain, Nadine
A1  - Gillet, Pierre
A1  - El Balkhi, Souleiman
A1  - Scala-Bertola, Julien
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - Worldwide, the consumption of dietary supplements for the enhancement of sexual performance is common. Consumers are generally fond of these products because they often want to avoid drugs, preferring "natural" than "chemical" solutions. This is challenging, as many of these supplements labelled "herbal" or "natural" are actually adulterated with drugs, mainly phosphodiesterase-5 inhibitors. This phenomenon is facilitated by fewer demanding regulations for marketing supplements. Thus, consumers may be widely exposed to serious adverse events, such as acute liver injury, kidney failure, pulmonary embolism, stroke or even death. We aim to warn physicians about this issue. This multidisciplinary review simultaneously deals with clinical consequences of this phenomenon, analytical toxicology, and regulation. Indeed, after outlining this worldwide issue and highlighting that a drug-adulterated dietary supplement is actually a falsified drug, we discuss its main contributing factors. Then, we describe some examples of adverse events of which a case of sildenafil-tadalafil-induced ischaemic stroke that benefited medical care in our hospital. Furthermore, we present some means to avoid adulteration and discuss their limitations that may be explained by the heterogeneity of the regulation of dietary supplements between countries. Doing so, we point out the requirement of a global harmonization of this regulation for an efficient eradication of this public health threat. Meanwhile, dietary supplements should be considered adulterated until proven otherwise. Thus, we encourage physicians to investigate these products in the drug histories of their patients, especially when clinical conditions cannot be explained by classical aetiologies.<p />  <p>Language: en</p>
LA  - en
SN  - 0767-3981
UR  - http://dx.doi.org/10.1111/fcp.12653
ID  - ref1
ER  -