I Took Knockoff Viagra Until I Learned What’s In It

Bypassing the need to get a prescription saved me the $20 co-pay I’d need to shell out to see a doctor, which would also save me some blushes.

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Sep 25 2018, 2:10pm

David Jones / Getty

Before 1998, men had options for treating erectile dysfunction but none of them were what you might describe as fun. They included losing weight, giving up smoking, reducing alcohol consumption, avoiding fatty foods, becoming less sedentary, meditating, and telling a complete stranger that you’ve been thumbing-in softies at a hundred bucks an hour.

Even if you had the gumption to make these all of these lifestyle changes, your chances of straightening the situation out once and for all were far from guaranteed. You’d just could end up adding years to your life. Flaccid years.

Then came Sildenafil. Originally a medication developed by Pfizer to treat angina pectoris (chest pain due to heart disease) and hypertension (high blood pressure), Sildenafil suddenly revealed itself to be quite effective at making penises stand at attention. Pfizer called it Viagra and made tens of billions of dollars over the next 20 years. (Pfizer’s patent will expire in 2020.)

Though marketed to men who experienced erectile dysfunction, Viagra was also adopted by recreational users who quickly discovered that it offset the erection withering effects of alcohol, drugs, fatigue, sexual indifference, performance anxiety, or a thick Boston accent.

I first got my hands on some Viagra for a writing assignment in 2002. Getting it involved meeting a connect at a park in what was then a shady part of Brooklyn. Once there, I pressed a folded twenge into the palm of some dude who then slipped a 100 mg pill into my jacket pocket during an awkward hug.

“Cut that shit in quarters,” he said before we parted ways. I did as he directed and sure enough, 25 mg of Viagra produced a wickedly hard boner that hung around for hours, regardless of whether I was turned on or not. I also found that it made orgasming a real challenge. This caused my partner to tap out several times over a marathon five-hour session and strongly suggested that I flush the rest. I didn’t. Indeed, the remaining 75 percent of the pill outlasted the relationship.


After becoming single and unable to mingle, I took a quarter on a rainy Sunday afternoon and had myself a time. I then gave a quarter to a friend. Some weeks later I took the last quarter at the first sex party I ever attended. Viagra, I concluded, certainly did the trick but was surplus to my requirements not worth fucking with on the regular.

A couple of years later something happened—or rather didn’t happen—during first time sex with a beautiful woman on her actual birthday. She was extremely gracious and kind about it and suggested that we have another sleepover date the following week. We did and the exact same thing didn’t happen. Distraught, I told a good friend about the debacle.

A decade older than I—and starting to become aware the passing of time—he told me that he’d recently been getting counterfeit Viagra from his enterprising cocaine dealer for $5 per 100 mg pill, a tiny fraction of what the real mccoy cost at the time. As 25 mg was all he needed, that equated to around $1.25 per effective dose. I bought two pills—at least eight doses—from him for $10. I wasn’t only saving on the pill itself— bypassing the need to get a prescription saved me the $20 co-pay I’d need to shell out to see a doctor which would also save me some blushes.

I was never granted a third date with the birthday girl, but I took a quarter pill the next time I had a sleepover date with someone new, lest I establish a vicious circle. It worked like a charm. In fact, the galvanizing effects of the phoney Viagra seemed to last well into the following evening.


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For the next few years, I kept a few of these things nearby in case of emergencies or extenuating circumstances. I then expanded my definition of an emergency or extenuating circumstance to include having one too many drinks, attending sex parties, or tangling with partners whose libido dwarfed my own. It wasn’t until this year that I discovered the extent to which the pills could be jam-packed with potentially harmful, even deadly contaminants.

“Erectile dysfunction (ED) drugs are the most counterfeited medications in the world,” says New York-based sexual health specialist Michael Reitano, explaining that the high cost of erectile dysfunction medications, the embarrassment some men feel with the condition, and the ease of buying mostly foreign, counterfeit drugs online without a prescription conspire to make manufacturing counterfeit ED medications an extremely lucrative business.

This is probably a good place to mention that Reitano is the doctor-in-residence at Roman—an online pharmacy that specializes in getting legal, generic sildenafil to men with ED at a lower cost while obviating trips to a doctor and a pharmacy. You may recall that Pfizer patent on Viagra doesn’t run out in 2020. Here’s the deal:

Sildenafil is also the active ingredient in the med Revatio, which is used to treat pulmonary hypertension. Reitano explains that Sildenafil in Revatio is identical to Sildenafil in Viagra except for the strength—20 mg in the former and 25 mg in the latter. Likewise, the generic of Revatio and the generic of Viagra are identical except for the dose size. The generic version of Revatio is what Roman is shipping out to beleaguered members.

“Oddly, the 20 mg generic Sildenafil is ideal for the treatment of ED,” Reitano says, adding that it allows men to titrate the dose they need from a low of 20 mg to a high of 100 mg. “Sometimes 20 mg is all they need but 40 or 60 might be needed at other times.”

To get their mitts on some generic Sildenafil, Roman users have to sign up and answer an online questionnaire. Pending a Roman-affiliated doctor’s assessment based on their answers, the discreetly packaged 20 mg pills show up in the mail shortly thereafter. All this to say that Reitano has a vested interest in people not acquiring boner pills from dubious sources. It’s not mere protectionism at play—counterfeit pills are often chock full of random stuff.

A study from 2012 found that fake Viagra from Hong Kong, USA, UK, Canada, China, and India contained at least one of the following: talcum powder, commercial paint, printer ink, drywall, amphetamines, diabetes drugs, even a powerful antifungal medication called metronidazole. And that list doesn’t include the unidentified material.

Lest you think this is a case of what-you-don't-know-can’t-hurt-you, think again. In 2008, 149 men and one woman presented to five different emergency rooms in Singapore with extremely low blood pressure. Seven remained in comas, and four died. The outbreak was traced to the use of counterfeit Cialis and three natural remedies (Power 1 Walnut, Santi Bovine Penis Erecting Capsule, and Zhong Hua Niu Bian). It turned out that the fake Cialis and the herbal remedies had all been contaminated with a medication called glyburide, which is given to diabetics to lower high sugar. It’s not known to help erectile function, and to people without diabetes it can be deadly.

“Counterfeit medications are often provided without a prescription and any concern for drug interactions,” Reitano says. Once my friend realized that his coke dealer was getting the fugazi pills for less than 10 percent of what he was selling them for, he put some cryptocurrency to practical use and had a year’s supply of “Cenforce” shipped over for a few satoshis. To Reitano’s point, at no point during the transaction was he quizzed about other medications he was taking.

Reitano tells me that the use of nitrate medications, alpha blockers, or the recreational use of poppers, can drop someone’s blood pressure when combined with ED medications and result in death. He adds that other medications can interact with sildenafil making them more ineffective or toxic. Reitano refers me to a study that found that how erratic the amount of sildenafil is in counterfeit ED medication can be, ranging from 0 to 200 percent of the advertised dose. In sum, getting ED meds from a legal and domestic pharmacy would seem to be the move, even if it doesn't end up being as cheap.

After absorbing the studies Reitano referred me to, I told my uninsured friend that he—and I—have been playing Russian Roulette with illegally sourced boner meds that we didn’t even need but used in a pinch or simply for funsies. I added that if he wanted to continue sporting the crowbar-like erection and fleeting refractory period of men less than half his age, that he may want to think about going straight and getting above-board sildenafil delivered to his door. He wasn’t having it.

“Look, you don’t have to be an avid Adam Smith reader to know that poisoning your customer base is bound to affect your bottom line in the medium term,” he says. “These companies want your dick to be stiff; they don’t want you to be stiff. It’s bad for business.” He also drew a parallel between dodgy Sildenafil and his dealer’s other wares. “People will enthusiastically snort coke knowing full well that at 30 to 50 percent of the bag’s contents is literally anything but coke.”

While I appreciated what he was saying, I pointed out that, unlike sildenafil, there’s no easy, legal means of buying cocaine, much less a way having it delivered to your door in a discrete package. “I’m on a budget,” he says. “And while the generic stuff is a good deal cheaper than Viagra, it’s still 700 percent more than what I’m paying for the knock-off stuff. I haven’t suffered any ill effects, it works, and if the good people at Cenforce want more of my bitcoin, they have the incentive to not kill me. I’ll take my chances.”

Once more people with the means learn of the risks, I’m sure that companies like Roman will slow down the trade of counterfeit erection pills. But as long as there are people who’ll take a chance for a steep discount, some guy in a factory will be putting drywall, talcum powder, printer ink, and who knows what else in the mix.

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