Key takeaways

The counterfeit pharmaceutical industry, valued at around $200 billion worldwide, includes dangerous fake drugs like Viagra, posing significant health risks.
Counterfeit Viagra often contains harmful substances, highlighting the importance of purchasing medications from reputable sources to ensure safety.
People take counterfeit medicine for various reasons, including price as well as the stigma around conditions like erectile dysfunction. Many people do not realize that they can purchase affordable generic options at pharmacies, which are safe and legal.
To avoid counterfeit Viagra, it’s crucial to obtain prescriptions from licensed pharmacies in the U.S. and verify online pharmacies through the VIPPS seal.

The counterfeit drugs are a dangerous and booming market in both developing and developed countries.

Worldwide, the counterfeit pharmaceutical industry is valued at around $200 billion (USD), making it the most profitable counterfeit goods industry in the world. It’s not just an overseas problem; the combination of expensive co-pays and online pharmacies are making counterfeit drugs a frightening reality for many Americans.

In April 2019, thousands of fake Viagra and Cialis pills, and sexual enhancement drugs, were seized at Greater Rochester International Airport. The illicit drugs were valued at over $60,000, and every single drug was a counterfeit posing as the real deal.

What are counterfeit drugs, and are they harmful?

Counterfeit drugs are drugs that are not legal, and have either been intentionally falsified to represent a drug on the market, or have not met quality standards of specifications.

According to the World Health Organization (WHO), “Substandard and falsified medical products may cause harm to patients and fail to treat the diseases for which they were intended.”

The ingredients contained in counterfeit medicines are alarming, to put it lightly. The U.S. Food and Drug Administration (FDA) takes counterfeit drugs seriously, and works with other agencies and the private sector to keep Americans safe from the dangers associated with illegal counterfeit drugs.

Viagra: one of the most counterfeit drugs in the world

According to Muhammed Zaman, author of Bitter Pills: The Global War on Counterfeit Drugs, Viagra is one of the most counterfeited drugs in the world.

The drug sildenafil citrate, known by its brand name Viagra, was approved by the FDA in 1998 as the first oral treatment approved for erectile dysfunction. Nearly two decades later it remains one of the most popular drugs for treating ED, which is why so many fakes persist.

Pfizer, the company that produces Viagra, conducted an investigation in 2011 on ingredients contained in counterfeit Viagra. The study involved Pfizer Global Security searching online for “Viagra,” using two popular search engines, and then ordering pills from the top 22 sites. Pfizer then tested the chemical composition of the Viagra pills. In addition to pills that contained too much of the active ingredient or not enough, they discovered ingredients such as blue printer ink, amphetamines (like speed), Metronidazole (a strong antibiotic commonly used to treat vaginal infections), or drywall as a binding agent.

Why do people take counterfeit medication?

There are many reasons why people take counterfeit medicine, both intentionally and unintentionally. Kristina Acri (Ph.D), an economist with Colorado College, who has been studying counterfeit drugs for two decades, said in an interview with NPR in 2017, “I think there are conditions—weight loss, erectile dysfunction, addiction—for which there’s a stigma attached to them. Patients may be too ashamed to see a physician… and that opens the door to counterfeiters.”

Sexual enhancement drugs are some of the most common counterfeit drugs in the world. And with erectile dysfunction treated like a pop culture reference instead of a real medical condition—which it is—it’s understandable that men would look for alternative outlets for obtaining medication. And they’re finding them, but at a dangerous cost.

For many years there was a high cost to purchasing Viagra. However when Pfizer released a generic in 2017, the financial burden was lessened. You can currently get 30 tablets of the generic at 50 mg for about $20-$25. However, there may still be an assumption that the high cost prohibits some patients from taking real Viagra and other sexual enhancement drugs.

Due to more affordable generic options, there really is no need to take the chance with counterfeits.

What are the consequences of taking counterfeit drugs?

Regardless of the rising popularity in counterfeit drugs, the dangers associated with taking illegal and unregulated substances from the black market are high.

“Counterfeit drugs are fraudulent and illegal,” says Dr. Laura Balsamini, Pharm.D., the national vice president of pharmacy services at Summit Medical Group. “They may contain no active ingredient, the wrong ingredients, ingredients in higher or lower quantities than labeled, or toxins, and may be manufactured in inferior conditions. These drugs are unregulated, lack evidence of safety or efficacy, and use may lead to harmful outcomes.”

In a 2017 study published in the Translational Andrology and Urology journal, a group of researchers looked at the dangers of counterfeit pills for sexual enhancement and counterfeit drugs that treat erectile dysfunction. The study notes that as the population ages, the popularity of these types of drugs has increased, as has counterfeiting of these drugs.

According to the research, many users don’t even know they’re taking fake drugs, and unknowingly put themselves in dangerous situations. The dangers and risks associated with taking counterfeit drugs are complex. Because the drugs are unregulated and created using unsafe practices, there’s no way of knowing what each pill contains. Additionally, patients who bypass the medical system aren’t screened for potential side effects, drug interactions, and other conditions that can be related to erectile dysfunction.

How do you avoid accidentally consuming counterfeit Viagra?

Viagra is a prescription drug that is not sold over-the-counter in the U.S. To avoid accidentally taking counterfeit pharmaceuticals, Dr. Balsamini says it’s imperative to get your prescription filled from a licensed pharmacy in the U.S. “To avoid accidentally purchasing counterfeit drugs, it is important to avoid purchasing medications from other countries,” she says. “If you do use an internet pharmacy site, ensure it is legitimate by checking the website for the VIPPS (Verified Internet Pharmacy Practice Sites) seal.”

Dr. Damon E. Davis, a urologist at Mercy Medical Center in Baltimore, Maryland, says he’s aware that some patients have used online overseas pharmacies to access medications, but he always advises against it. “Unless they’re absolutely certain the pharmacy is reputable, there is no way to ensure they are actually receiving the medication that was recommended,” he cautioned.

Pfizer recommends that you follow specific precautions when buying Viagra online, including ensuring that the website requires a valid prescription; that you’re purchasing from a U.S.-based online pharmacy with a listed U.S. address and phone number; that the doses are either 25 mg, 50 mg, and 100 mg (the only doses that legal Viagra is sold); and that you are purchasing from a VIPPS-Accredited Pharmacy.

Seeking treatment for erectile dysfunction

Erectile dysfunction is estimated to affect 30 million men in the United States alone. Treatment is available—whether it be Viagra, Cialis, or alternative medications—and your doctor can help you find the right medication plan.

“ED may be a result of another unaddressed acute or chronic issue or a medication or supplement you may be taking,” Dr. Balsamini says. “It is important that your provider and pharmacist also review your medications to determine if a treatment for ED may potentially interact with another medication you are currently taking.”

The bottom line is, if you’re thinking about purchasing Viagra, your first stop should be to your healthcare provider who is equipped to provide medical advice tailored to your health condition and specific symptoms.