Safety

How to spot a counterfeit ED pill

Counterfeit erectile-dysfunction tablets are not a weaker version of the real drug. Laboratory work on seized and purchased samples has found no active ingredient, the wrong dose, a different PDE5 inhibitor than the one printed on the box, and chemical analogues that have never been approved as medicines. Some of those analogues were designed to fool screening tests. You cannot see any of that from the color of a tablet.

Packaging clues

• Misspellings, odd grammar, or a manufacturer name that does not match the company on the FDA label.
• A blurred or pixelated logo, a seal that was already broken, or a lot number and expiration date that are missing, smeared, or printed in a different type from the rest of the carton.
• A blister that does not match the pharmacy’s stock bottle. In the United States, generics are usually dispensed in a pharmacy vial with your name, the drug name, the strength, the directions, the quantity, and the pharmacy’s phone number. A loose foil strip in an envelope is not that.
• No patient information leaflet, or a leaflet that promises the drug is safe with nitrates. The real leaflet says the opposite.

The tablet itself

FDA-approved products have a consistent shape, color, and imprint. Brand Viagra, for example, has a specific diamond shape and debossing that Pfizer documents. Generics are allowed to look different from the brand and from each other. “It isn’t blue” does not prove a generic is fake, and “it is blue and diamond-shaped” does not prove it is real. Counterfeiters copy the famous appearance on purpose.

Use the imprint. A legitimate tablet has a code you can match to the dispensed product with the pharmacist or with a reputable identifier that uses FDA drug-listing data. Crumbling texture, a chemical smell, dye that comes off on a wet finger, or tablets of uneven size inside one blister are reasons to stop and take the remaining product back to a pharmacist. Do not swallow the rest while you wait.

Seller clues that travel with the pill

• No prescription required, or a “doctor” who approves every order in seconds without asking about nitrates, chest pain, or other medicines.
• Payment by cryptocurrency, wire, or gift card only.
• Spam, social-media ads, or a price far below every licensed U.S. pharmacy for the same strength and count.
• A .pharmacy address can be a real NABP signal. A picture of a seal, pasted on a site that lives on another domain, is not. The check is described on the pharmacy verification page.

What to do if you already took one

If you feel faint, have chest pain, have an erection lasting longer than 4 hours, or develop sudden vision or hearing changes, get emergency care and bring the product. Otherwise, stop taking it, do not throw away the evidence, and contact a pharmacist or clinician. You can report the seller and the reaction to FDA MedWatch (1-800-FDA-1088, or fda.gov/medwatch). If you take nitrates for your heart, treat any undeclared PDE5 exposure as urgent even if you feel well, and call your clinician or emergency services for advice rather than waiting for symptoms.

The same chemicals show up in products that never claim to be Viagra. Those are covered under gas-station supplements.

Sources

• FDA medication-health-fraud notices on tainted sexual-enhancement products and counterfeit drug warnings.
• FDA MedWatch, for reporting suspected counterfeits and adverse reactions.