That brightly packaged sexual enhancement pill at the gas station might be laced with dangerous drugs

Sexual enhancement products sold in gas stations, convenience stores, or online often feature eye-catching packaging with names like Rhino, Anaconda, or Magnum. These products promise improved sexual performance but may contain hidden, undeclared drugs. In May 2023, the U.S. Food and Drug Administration (FDA) warned consumers about Rhino 7S Type F3 7000, which laboratory tests revealed contained sildenafil—the active ingredient in Viagra—and acetaminophen (the pain reliever in Tylenol), neither of which were listed on the label. This is not an isolated case. Since 2007, the FDA has maintained a growing list of sexual enhancement and energy products found to contain hidden pharmaceutical ingredients, including pills, gummies, honey, coffee, and chocolates. The problem extends beyond the U.S., with similar issues reported in Europe, Asia, and the Middle East.

In the U.S., dietary supplements like sexual enhancement pills are regulated differently from prescription drugs. Prescription drugs, such as Viagra, undergo a rigorous, multi-phase approval process that can take nearly a decade. They are evaluated for safety, effectiveness, dosing, and manufacturing quality before reaching consumers. Supplements, however, are regulated under the Dietary Supplement Health and Education Act of 1994, which places the responsibility on manufacturers to ensure their products are safe and properly labeled. The FDA does not approve supplements for safety or effectiveness before they hit the market. Instead, the agency periodically inspects manufacturing facilities and tests products only when linked to illnesses or suspected of containing illegal ingredients. This means supplements may contain hidden drugs without consumers' knowledge.

The hidden ingredients in sexual enhancement supplements can pose serious health risks. Sildenafil and tadalafil are drugs called phosphodiesterase type 5 inhibitors (PDE5 inhibitors), used to treat erectile dysfunction. Consuming them unknowingly is dangerous, especially if combined with nitrate medications (e.g., nitroglycerin for heart disease), which can cause a life-threatening drop in blood pressure. In the case of Rhino 7S, undeclared acetaminophen was also found, posing risks of overdose and liver damage if combined with other acetaminophen-containing products like cold medicine. A 2023 review identified 112 unapproved PDE5 inhibitors and related compounds found as adulterants in sexual enhancement products between 2003 and mid-2023. These supplements may contain approved drugs, unapproved versions, or chemically modified compounds, all of which can be harmful.

The problem of adulterated sexual enhancement products is not limited to the U.S. Studies have found undeclared erectile dysfunction drugs in supplements sold in Europe, Asia, and the Middle East. For example, a study in the United Arab Emirates found undeclared sildenafil, tadalafil, or vardenafil in over 12% of sexual enhancement products tested. The World Health Organization (WHO) warns that complex international supply chains and the growth of e-commerce make it difficult to control substandard or falsified health products. Manufacturers may source ingredients from one country, manufacture in another, and sell online to consumers worldwide. From December 2024 to May 2025, Interpol’s Operation Pangea XVII seized over 50 million doses of illicit pharmaceuticals in 90 countries, with erectile dysfunction medications being the second-most seized product type. The following year, another operation disrupted roughly 13,000 websites and social media channels linked to illicit medicine sales.

Despite warnings and seizures, dangerous products continue to reappear under new names or packaging. For instance, a supplement called POWER was found to contain PDE5 inhibitors in every version tested between 2007 and 2022, though the specific adulterants changed over time. The FDA acknowledges that its public warning list represents only a fraction of contaminated products, meaning the absence of a product from the list does not guarantee its safety. Online marketplaces are required under federal law to verify some high-volume third-party sellers but are not obligated to test supplements for hidden drugs or report every potentially adulterated product to the FDA. The FDA also does not require sexual enhancement supplements to carry a specific warning about undeclared pharmaceutical ingredients, even if they are labeled as natural or herbal. This leaves consumers without reliable ways to verify the contents of these products.