Addition of synthetic pharmaceutical ingredients in dietary supplements is a great concern of the present time. Dietary supplements marketed for various health benefits are fraudulently admixed with pharmaceutical compounds to boost the desired effect on the human body.
Various approved pharmaceutical drugs and their analogues, which are often very difficult to detect, have been found in food supplements advertised as a remedy for diseases. The phosphodiesterase type 5 (PDE-5) inhibitors, such as sildenafil citrate, tadalafil hydrochloride, vardenafil hydrochloride, udenafil, mirodenafil hydrochloride, lodenafil carbonate, avanafil, and their unapproved designer analogues, are fraudulently added to herbal supplements. More exotic analogues synthesized by minor modifications to parent structures of approved PDE-5 inhibitors also have been added by traders to make their detection much more difficult. In addition, adulteration with optical isomers of tadalafil has also been reported. Up to the year of 2018, 80 synthetic PDE-5 inhibitors were found in herbal supplements among which, 62% of sildenafil, 26% of tadalafil, 9% of vardenafil, and 3% of others were reported. Analgesics, such as paracetamol, antihistamines, theophylline, bromhexine, diazepam, chlordiazepoxide, glibenclamide, hydrochlorothiazide, aminopyrine, and phenytoin are frequently found in food supplements. Non-steroidal anti-inflammatory drugs, such as aspirin, mefenamic acid, and phenacetin, have also been reported in several dietary supplements.
To get rid of obesity and extra weight, people purchase several weight-reducing dietary supplements, which are often adulterated with synthetic drugs. Some are controlled by regulatory agencies and others are banned due to their adverse effect on human health.
Other related substances are growth hormone, erythropoietin, chorionic gonadotropin, β-2 agonists, hormones, and metabolic modulators, such as aromatase inhibitors and selective estrogen receptor modulators. Cannabinoids and glucocorticosteroids are also prohibited in athletic competition. New, modified, or “designer” steroids are of greatest concern because of the relatively little information available about their pharmacology and probable side effects. The presence of such adulterants poses a major risk for athletes since it results in a positive anti-doping control test, and the World Anti-Doping Agency does not justify whether it was deliberate or accidental doping.
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