FDA’s warning against
“LIU BIAN LI”
Dr. P.Naina Mohamed
Pharmacologist
Introduction
• On 2nd June 2014, The Food and Drug
Administration (FDA) is advising consumers not to
purchase or use “Liu ...
Possible Mechanism of Action
“Liu Bian Li”
Undeclared Sildenafil
Inhibition of Phosphodiesterase 5 (PDE 5)
Inhibition of B...
Interaction with Nitrates
“Liu Bian Li”
Undeclared Sildenafil
Interact with prescription drugs like nitrates (Nitroglyceri...
Interaction with Protease
Inhibitors (Antiretrovirals)
“Liu Bian Li”
Undeclared Sildenafil
Interact with Protease Inhibito...
Interaction with
CYP3A4 Inhbitors
“Liu Bian Li”
Undeclared Sildenafil
Interact with CYP3A4 Inhibitors like Macrolide antib...
Conclusion
 FDA warns the Consumers should stop using this product
immediately and throw it away.
 FDA advises the Consu...
References
• http://www.fda.gov/Drugs/ResourcesForYou/Consumers/B
uyingUsingMedicineSafely/MedicationHealthFraud/ucm399
59...
References
• http://www.micromedexsolutions.co
m
• http://www.nlm.nih.gov/medlineplus/
druginfo/meds/a699015.html
• http:/...
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FDA’s warning against “LIU BIAN LI”

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On 2nd June 2014, The Food and Drug Administration (FDA) is advising consumers not to purchase or use “Liu Bian Li”.

“Liu Bian Li” is promoted and sold for sexual enhancement on various websites and in some retail stores.

FDA laboratory analysis confirmed that “Liu Bian Li” contains Sildenafil.

Published in: Education, Health & Medicine
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FDA’s warning against “LIU BIAN LI”

  1. 1. FDA’s warning against “LIU BIAN LI” Dr. P.Naina Mohamed Pharmacologist
  2. 2. Introduction • On 2nd June 2014, The Food and Drug Administration (FDA) is advising consumers not to purchase or use “Liu Bian Li”. • “Liu Bian Li” is promoted and sold for sexual enhancement on various websites and in some retail stores. • FDA laboratory analysis confirmed that “Liu Bian Li” contains Sildenafil. • Sildenafil is a Phosphodiesterase 5 (PDE 5) inhibitor and is approved for the treatment of Erectile Dysfunction (ED).
  3. 3. Possible Mechanism of Action “Liu Bian Li” Undeclared Sildenafil Inhibition of Phosphodiesterase 5 (PDE 5) Inhibition of Breakdown of cGMP Increase the concentration of cGMP in smooth muscle of corpus cavernosum and penile arteries Smooth muscle relaxation Increase the blood flow to corpus cavernosum Penile Erection
  4. 4. Interaction with Nitrates “Liu Bian Li” Undeclared Sildenafil Interact with prescription drugs like nitrates (Nitroglycerin) Excessive dilation of smooth muscle of blood vessels Potentiation of Hypotensive effects Blood pressure reduced to dangerous levels Contraindicated
  5. 5. Interaction with Protease Inhibitors (Antiretrovirals) “Liu Bian Li” Undeclared Sildenafil Interact with Protease Inhibitors like Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenavir, Fosamprenavir, Lopinavir, Atazanavir, , Tipranavir and Darunavir Protease Inhibitors block CYP3A4-mediated sildenafil metabolism Increased plasma levels of sildenafil Increased risk of sildenafil adverse effects (hypotension, visual changes, priapism) Contraindicated
  6. 6. Interaction with CYP3A4 Inhbitors “Liu Bian Li” Undeclared Sildenafil Interact with CYP3A4 Inhibitors like Macrolide antibiotics (Telithromycin, Erythromycin, Clarithromycin) and Antifungals (Voriconazole, Itraconazole, Ketoconazole) CYP3A4 Inhibitors block CYP3A4-mediated sildenafil metabolism Increased plasma levels of sildenafil Increased risk of sildenafil adverse effects (hypotension, visual changes, priapism)
  7. 7. Conclusion  FDA warns the Consumers should stop using this product immediately and throw it away.  FDA advises the Consumers who have experienced any negative side effects should consult a health care professional as soon as possible.  FDA announces to the public of a growing trend of dietary supplements or conventional foods with hidden drugs and chemicals. These products are typically promoted for sexual enhancement, weight loss, and body building, and are often represented as being “all natural.”  FDA claims that they are unable to test and identify all products marketed as dietary supplements on the market that have potentially harmful hidden ingredients.  FDA advises the Consumers to exercise caution before purchasing any product in the above categories.
  8. 8. References • http://www.fda.gov/Drugs/ResourcesForYou/Consumers/B uyingUsingMedicineSafely/MedicationHealthFraud/ucm399 597.htm?source=govdelivery&utm_medium=email&utm_so urce=govdelivery • Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e Laurence L. Brunton, Bruce A. Chabner, Björn C. Knollmann • Harrison's Online Featuring the complete contents of Harrison's Principles of Internal Medicine, 18e Dan L. Longo, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo, Eds. • Hurst's The Heart, 13e Valentin Fuster, Richard A. Walsh, Robert A. Harrington • Basic & Clinical Pharmacology, 12e Bertram G. Katzung, Susan B. Masters, Anthony J. Trevor • Clinician's Pocket Reference, 11e Leonard G. Gomella, Steven A. Haist
  9. 9. References • http://www.micromedexsolutions.co m • http://www.nlm.nih.gov/medlineplus/ druginfo/meds/a699015.html • http://www.rxlist.com/viagra- drug/clinical-pharmacology.htm • http://www.medicinenet.com/silden afil/article.htm • http://www.pfizer.com/files/products/ uspi_viagra.pdf

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