Regulators Warn of Hidden Drugs in Sexual Enhancement and Honey Products

Health regulators in Australia and the United States have issued warnings and a recall after laboratory testing found undeclared prescription medicines in products marketed as sexual enhancement supplements and honey sachets. The Therapeutic Goods Administration (TGA) issued three safety alerts, while Pure Vitamins and Natural Supplements, LLC launched a nationwide recall of honey products on March 14, 2026.

The TGA's first alert covers 11 products sold as sexual enhancement supplements: Nano Volume capsules, Lustra 80 tablets, Candy Power For Man lozenges, Kama Exstasy200 tablets, Kama Super Platinum tablets, Nano Epigen Size capsules, Rock II Hard tablets, Cobra Max capsules, Black Bull Extreme cream, Gold Lion tablets and Black Cat capsules. Laboratory testing found they contained undeclared sildenafil, tadalafil or dapoxetine. A separate investigation found Grakcu capsules contained undeclared sildenafil and tadalafil, a combination of two phosphodiesterase type 5 inhibitors that the regulator said could increase the risk of adverse effects, particularly in people with underlying cardiovascular disease or those taking interacting medicines. "Consumers may not realise they are taking prescription medicines as sildenafil and tadalafil are not declared on the product label," the TGA said.

The third alert related to counterfeit "honey" sachets for sexual enhancement, including Black Horse Honey, Royal Honey VIP, Vital Honey, Helmi's Honey and Etumax Royal Honey, all of which were found to contain undeclared tadalafil. The TGA said tadalafil is a prescription-only medicine in Australia and may interact with nitrates, potentially lowering blood pressure to dangerous levels. The products are considered counterfeit under the Therapeutic Goods Act 1989. The TGA is working with the Australian Border Force to prevent further importation of Grakcu capsules.

In the United States, Pure Vitamins and Natural Supplements, LLC recalled Boner Bear Honey, Red Bull Extreme, and Blue Bull Extreme because they contain sildenafil and tadalafil, the active ingredients in Viagra and Cialis, which are not listed on the labels. Consumers were advised to discontinue use, return the products for a refund, and report adverse reactions to the FDA's MedWatch program.

Separately, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) has warned about adverse effects and drug-herb interactions, noting that about 1 in 3 older people uses herbal preparations or dietary supplements alongside prescription medicines. Such reactions may go underreported because patients often do not disclose herbal use and clinicians do not routinely ask. A 2018 review in the British Journal of Clinical Pharmacology found concurrent use is particularly common among patients with hypertension, diabetes, cancer, seizures, and depression. Reported adverse effects include elevated liver enzymes, gastrointestinal disturbances, disruption of international normalised ratio in patients taking warfarin, and kidney damage. Acute rejection episodes following heart, renal, or liver transplant were also reported in patients stabilised on immunosuppressants who were taking St John's wort.

The president of the National Institute of Medical Herbalists said St John's wort is a strong inducer of drug-metabolising cytochrome P450 enzymes, and more than 600 known drug interactions have been reported, almost 300 of them major. Other herbal products that clinicians should know about include meadowsweet, celery seed, garlic, ashwagandha, valerian, and German chamomile, each with specific cautions.

The UK's Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) is reviewing evidence on idiosyncratic herb-induced liver injury (HILI). The committee has noted that consumption of food supplements containing botanicals is increasing and that the safety profile is often not well characterised, with increasing reports of hepatotoxicity and liver injury related to their consumption. In 2002, the Committee on Safety of Medicines concluded that kava kava could cause serious liver toxicity, leading to a statutory prohibition. In 2024, COT statements on green tea catechins and turmeric and curcumin supplements identified the possibility of idiosyncratic adverse effects on the liver.