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400 supplements it purchased in China contained sildenafil citrate, some makers tweak the molecules to keep the effect of the original pharmaceutical while avoiding the scrutiny of the FDA and outside testing labs. Warned by their doctors and ubiquitous TV commercials not to take Viagra, who’s facing federal charges in Atlanta that he peddled knockoff pharmaceuticals cooked in a Central American lab. Mail spam and fly; much less tame. Recalled products are widely offered on the Internet and pills are hard to round up.

From a once, the FDA has placed pills by two manufacturers in China and one from Malaysia on an import watch list. A shipment of which U. And in any case, but should they be?

Federal officials have only recently stepped up investigations and prosecutions, and in any case, the FDA’s recall power is limited. According to prosecutors, Peng thought he could evade tests simply by switching from the sildenafil citrate he imported from China to Levitra’s active ingredient, vardenafil — a shipment of which U. Mycyk, a Chicago emergency room doctor who directs Northwestern University’s clinical toxicology research program, said he is seeing increasing numbers of patients who unwittingly took prescription-strength doses of the alternatives, a trend he attributes to ease of purchase on the Internet and the desperation of vulnerable men. In many cases, the ingredients used to alter herbal pills come from Asia, particularly China, where the sexual enhancers are cooked up in labs at the beginning of a winding supply chain.

A Web site can look sophisticated and legitimate, but actually be an illegal operation. 398 million last year, including herbal mixtures, according to estimates by Nutrition Business Journal. The AP often couldn’t determine from records whether incidents reported to tracking systems of the federal Food and Drug Administration and state poison control centers involved mixing herbal alternatives with nitrates. An Associated Press investigation shows that spiked herbal impotency pills are emerging as a major public health concern that officials haven’t figured out how to track, much less tame. James Neal-Kababick, director of Oregon-based Flora Research Laboratories, said about 90 percent of the hundreds of samples he has analyzed contained forms of patented pharmaceuticals — some with doses more than twice that of prescription erectile dysfunction medicine.

Many of the pills marketed as safe herbal alternatives to Viagra and other prescription sex medications pose a hidden danger: For men on common heart and blood-pressure drugs, popping one could lead to a stroke, or even death. Long Island-based maker of Vigor-25. For men on common heart and blood-pressure drugs, popping a pill marketed as a safe herbal alternative to Viagra could lead to a stroke, or even death. Few over-the-counter treatments are covered, and herbals aren’t likely to be among them, in part because they’re classified as foods not pharmaceuticals, said Mohit M.

Pfizer didn’t check for the patented ingredients of its rivals. That dirty secret represents a special danger for the millions of men who take nitrates — drugs prescribed to lower blood pressure and regulate heart disease. Too amazing to be true?

While herbal alternatives often contain exact copies of the patented drugs, some makers tweak the molecules to keep the effect of the original pharmaceutical while avoiding the scrutiny of the FDA and outside testing labs. More women opting for preventive mastectomy – but should they be? Prosecutors tried to keep Wheat from posting bail by asserting that he contemplated killing an FDA investigator and bribing a prosecutor. Last week, in response to safety concerns about imported toothpaste, dog food and toys, President Bush recommended that the FDA be authorized to order mandatory recalls of dangerous products.

Two other pills, Spontane-ES and Stamina-RX, were made by companies run by Jared Wheat, who’s facing federal charges in Atlanta that he peddled knockoff pharmaceuticals cooked in a Central American lab. Company executive Michael Peng had agreed to stop selling Vigor-25 following an FDA agent’s visit in late 2004, according to an arrest warrant affidavit. But many doctors are puzzled because the operation doesn’t carry a 100 percent guarantee, it’s major surgery — and women have other options, from a once-a-day pill to careful monitoring.

Many of the firms were based around Los Angeles, their offices ranging from an unsigned door in a grungy hall on the fringe of downtown to a gated complex near Beverly Hills. While no deaths have been reported, the AP found records of emergency room visits attributed to all-natural sex pills in Georgia, Chicago, Philadelphia, San Diego and elsewhere. Tight budgets, weak regulations and other priorities limit the FDA’s ability to police the products, often promoted via blasts of e-mail spam and fly-by-night Web sites. The all-natural message can be appealing to such men, warned by their doctors and ubiquitous TV commercials not to take Viagra, Cialis or Levitra.

Many health insurance plans provide limited coverage for prescription sex pills, especially for those with health-related difficulties. When mixed, nitrates and impotency pharmaceuticals can slow blood flow catastrophically, leading to a heart attack or stroke. Following the recall, a 32-year-old man reported having spontaneous nose bleeds after taking the pill, records show. While the product was advertised as containing Asian ginseng, lycium fruit and Chinese yam rhizome, FDA testing indicated that the pills contained Viagra. The company said that 69 percent of 3,400 supplements it purchased in China contained sildenafil citrate, the main ingredient in Viagra.

Victims may be embarrassed, and doctors rarely ask about supplements. New York-based pharmaceutical giant that developed Viagra. He said he wouldn’t be surprised if there’d been undetected deaths from bad herbal pills. E-mails requesting comment from Nasutra LLC, the company that voluntarily recalled the product in September 2006, were not returned. An elderly man in a retirement community north of Los Angeles took an in-the-mail sample and landed in the hospital for four days.

This material may not be published, broadcast, rewritten or redistributed. Vigor-25, faces a charge of misbranding — in this instance, claiming that a pharmaceutical is a dietary supplement. 5 million American men who take nitrates — generally older and more likely to need help with erectile dysfunction. Before a product called Nasutra was recalled a year ago by its manufacturer, the FDA had received a 30-year-old man’s report of a raging headache and an erection that wouldn’t go down. At greatest risk are the estimated 5.