The Herbal Supplements Booby Prize? Six Drugs, No Herbs.

A dietary supplement spiked with a real prescription drug? That's about as newsworthy as it becoming dark after sunset. But it's not every day when you see a supplement spiked with more than one drug and far less common when there are six drugs present (in a bottle of whatever that is supposed to be "natural" and "drug-free.)" That takes a rare level of diligence.

So, it should not be surprising that If you stuff enough erectile dysfunction drugs, FDA approved or otherwise, into a capsule it's a pretty good bet that Lord Hardwicke is going to experience some sort of physiological response. And that's exactly why Ata International Inc. got swatted down by the FDA for selling some junk called BLUEFUSION Capsules. You can't buy it on Amazon anymore, so here's what the bottle looks like. I may have taken some liberty with the label. 

What was supposed to be in the bottle? Who knows? Who cares? But here's what was found - a collection of two approved erectile dysfunction (ED) drugs, two more that work by the same mechanism, and two more that are in there for some reason or other. (Figure 1).

Figure 1. The chemical structures of the six drugs found in bottles of BLUEFUSION. Note that the three drugs in the left column are structurally similar analogs.

What is all this stuff and why was it in the bottle?

What's most surprising about this case is that someone who really knew what he was doing (more or less) put this concoction together. It make sense for at least four of them to be in there. Here are the drugs that were detected:

1. Sildenafil - the generic name for Viagra, a vasodilator that works by inhibiting the enzyme PDE5. This results in increased blood flow to the penis.
2. Tadalafil - the generic name for Cialis. Cialis works by the same mechanism as Viagra, but is structurally dissimilar. 

3. Desmethyl carbodenafil - This is an interesting choice. Desmethyl carbodenafil is a very close structural analog of sildenafil. Any medicinal chemist would look at its structure and conclude that it would much like Viagra. This drug has been used to spike products before. The subtly named Stiff Bull Herbal Coffee was recalled by the FDA in 2016 because it contained the drug.

4. Dithiodesmethyl carbodenafil - Same thing. A structurally similar Viagra analog. This drug has also been used before; it was found in a libido enhancing supplement called Apollo+, which was recalled by the Finnish Food Safety Authority (who knew?) in 2015.

5. I have no idea why Scutellarin or Daidzein were in the bottle. Maybe rats in the factory knocked over some bottles. 

Should you take a theoretical herbal remedy for ED? The world's worst flow chart.

First, let's create a reasonable facsimile of a hypothetic dietary supplement and give it a typical name. 

Woodrow's Zipper Buster^®. There had better be rave reviews in the Comments section. Do you know how long it took me to get those two phallic structures to look right???

Now let's take a look at what could possibly be the world's worst flow chart and see whether it helps us rationally determine whether or not Zipper Buster^® should be used by men who may need a little extra help in the sack. 

What this flow chart is supposed to convey (and fails miserably) is the following logic:

• Does Zipper Buster contain a bunch of stupid herbs or a known pharmacologically active drug? If it contains the drug it will work. If it doesn't it won't. 
• Should you take the stuff that works (left side of chart)? If it's an unapproved drug, no. This is dangerous. If it contains an approved drug, the answer is still no. The dose and purity are unknown. This is also dangerous. And drugs like Viagra can make your entire body go permanently stiff if taken with certain blood pressure medications. 
• Benefit: Probably will work. Risk: High
• Verdict: 

On the right side of the chart is when the bottle contains only the herb - no drug added. Should you take this?

• Will it do anything for you ED? No.
• It may or may not be safe since no one really knows what's in it.
• No benefit, unknown risk.
• Verdict:

The people running Ata International Inc. ought to be ashamed of themselves. Hopefully, they will receive a stiff penalty.