WASHINGTON (Reuters) -- "Herbal" Viagra and other so-called natural
alternatives for treating impotence advertised on the Internet and in
men's magazines are often contaminated with real drugs and could kill
those who take them, researchers said.

They said the flood of e-mail spam touting alternatives to prescription
erectile dysfunction drugs was a sign of how popular such products were,
but the researchers suggested that governments monitor and regulate
supplements more closely.

"These are being marketed as being safe and natural products," said Dr.
Neil Fleshner of Princess Margaret Hospital in Toronto, Canada. "It is
plausible that deaths have occurred or could occur."
Fleshner and colleagues bought seven "herbal" erectile dysfunction
products to find out what was in them.

Two contained significant levels of prescription phosphodiesterase
inhibitors -- sildenafil, sold by Pfizer under the brand name Viagra and
tadalafil, Eli Lilly and Co's Cialis.
"We think the implications of this are quite dramatic," Fleshner told a
news conference.
"Since these compounds are not natural, deliberate contamination of
these products must be considered," added Fleshner, whose team presented
the findings to a meeting of the American Urological Association in San
Francisco.
The erectile dysfunction drugs affect blood flow and can be deadly when
taken with certain heart drugs containing nitrates. The researchers said
they would continue efforts to get the U.S. Food and Drug Administration
to more closely regulate "alternative" products.
Advertising guidelines

Current law allows non-prescription supplements to be advertised so long
as they do not make specific health claims, such as lowering
cholesterol. However, the FDA does move to stop the marketing of
products that contain prescription medicines.

"The law, in my opinion, is way off the mark," Dr. Ira Sharlip of
Pacific Urology in San Francisco told the news conference.
They sell products out of the office. They haven't gone through any sort
of clinical trial and (yet) they are 'doctor-approved'.
-- Dr. Mark Moyad, American Urological Association
A British study said other herbal products could also be dangerous.
Dr. Ramesh Thurairaja and colleagues at the Bristol Royal Infirmary in
Britain did a "Google" Internet search using the words "herbal" and
"Viagra".
"I actually picked up 160,000 hits last year," Thurairaja told a news
conference. "Two weeks ago I typed the same two words in and got 690,000
hits."

Many of the sites also touted penis enlargement products, Thurairaja
noted.
His team assessed the first 50 Web sites and found only 36 percent
offered any advice on who should not use the products and just 21
percent listed potential side-effects.

Only 21 percent offered information from someone with medical training
and 24 percent clearly stated that their information was not to replace
doctors' advice.

"The commonest ingredients were yohimbe, ginseng and gingko biloba,"
Thurairaja said. "All these herbs have been previously investigated in
the past and are known to have side effects such as skin reaction and
cardiovascular disorders."
The AUA's Dr. Mark Moyad said many "alternative" products were being
pushed by doctors.
"They sell products out of the office," Moyad said. "They haven't gone
through any sort of clinical trial and (yet) they are
'doctor-approved'."

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."