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When you hear "plant" and "herb", you immediately think about a healthy alternative to synthetic drugs. A herbal "Viagra" would come without the risk of a possible deadly stroke. But a new AP investigation revealed that products like Stamina-RX and Vigor-25, advertising an array of Asian panacea plants, can hide in fact illegal versions of the same Viagra, Cialis or Levitra they are supposedly meant to replace. The problem with these chemicals is that they cannot be combined with nitrates (aimed to lower blood pressure) and the patients may know this, but not the fact they are not using Asian roots.

Nevertheless, the market of "natural sexual enhancers" has exploded by $400 million in 2006 in the US alone, and this is a high risk for the health of about 5.5 million American men medicating with nitrates. "About 90 % of the hundreds of samples I have analyzed contained forms of patented pharmaceuticals - some with doses more than twice that of prescription erectile dysfunction medicine.", James Neal-Kababick, director of Oregon-based Flora Research Laboratories told AP.

The AP investigation signaled cases of patients visiting emergency rooms after consuming "natural" sex pills all around the US. For example, a man from Michigan suffered a stroke 20 minutes after ingesting an "extremely safe" Spontane-ES.

Some "plant drug" labels advise consumers with heart or blood-pressure items to avoid taking the sex pills within six hours after taking their heart medication, but doctors say at least 24 hours would be more adequate.

The "natural" pills even affected healthy young men in their 30s, the patients experiencing typical Viagra and other PDE5 inhibitors effects, like sight and hearing impairments or severe headaches. In 2006, Nasutra, a "herbal" pill, caused in a 30-year-old man a severe headache and a continuous erection, while a 32-year-old man experienced spontaneous nose bleeds. Moreover, it is estimated that only 1% of the cases are recorded, because the victims are too embarrassed to talk about such issues. While many herbal mixtures claim to have a slow effect in weeks, those aimed for rapid effect pose most health issues. "A Web site can look sophisticated and legitimate, but actually be an illegal operation.", Dr Linda Silvers, a FDA official leading a team targeting fraudulent health products sold online, told AP.

Usually, the ingredients come from Asian countries (like China, Thailand and Malaysia), invading the market with cheap illegal stuff. A "herbal" Cialis costs $1-5; compare this with the pills made by Eli Lilly Co. and ICOS Corp. sold at the price of $13-20.

Illegal false pills, hiding PDE5 inhibitors under herbal names, have been encountered in Thailand, Taiwan, Canada, Australia, New Zealand, Hong Kong, Malaysia, UK and the US, and 69 % of the Chinese sex pills contain the main ingredient of Viagra, sildenafil. A small chemical trick of the drug's molecule enables the maintaining of the desired qualities while bypassing customs checking as "diet supplements".

In 2006, the FDA banned 8 "herbal" pills containing PDE5 inhibitors like in Viagra, Cialis or Levitra. Vigor-25 was presented as delivering a mix of chemicals from Asian ginseng, lycium fruit and Chinese yam rhizome, while in fact it contained just the active chemical from Viagra.

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