Updated: 13 September 2026
Surveillance period: July 2026 | Official release: 10 September 2026 | Published by BPOM: 11 September 2026
Hidden drugs in herbal supplements are under renewed scrutiny after Indonesia’s food and drug regulator, BPOM, identified pyrimidenafil in three products marketed for male stamina. The agency cancelled their marketing authorisations following laboratory findings from its July surveillance. [1]
For patients, the concern is not simply that a product contains an unfamiliar ingredient. Someone choosing what they believe is a herbal preparation may unknowingly take a pharmaceutical compound without knowing its dose, interactions or suitability for their health. [1,7]
The alert also highlights an important distinction: a product secretly adulterated with drugs should not be confused with transparent, quality-controlled traditional medicine. However, the word “herbal” on a label is not, by itself, evidence of either safety or effectiveness. [7,9]
Which Male Stamina Products Were Named?
BPOM identified pyrimidenafil in the following products, manufactured by PT Bintang Kupu-Kupu, Tangerang. [1]
| Product | Undeclared compound | BPOM action |
|---|---|---|
| EXIE | Pyrimidenafil | Marketing authorisation cancelled |
| YUBOKKI | Pyrimidenafil | Marketing authorisation cancelled |
| DURAMAX | Pyrimidenafil | Marketing authorisation cancelled |
The same July surveillance identified 35 additional unlicensed traditional medicine products containing pharmaceutical ingredients, including sildenafil, sibutramine, dexamethasone and paracetamol. BPOM advised consumers not to use products listed in its warning. [1] (Pom Indonesia)
A Separate Alert Covered May and June
A second announcement, also dated 10 September and published on 11 September, reported 31 illegal traditional medicines and health supplements from May–June surveillance. Thirty contained pharmaceutical ingredients. The remaining supplement failed microbiological quality requirements; it should not be described as another confirmed drug-adulteration finding. [2]
Detected substances included sildenafil, ketoconazole, allopurinol, dexamethasone, meloxicam, phenylbutazone, prednisone, piroxicam, sibutramine and diclofenac. These findings extended beyond sexual enhancement to products promoted for pain, itching, slimming and other purposes. [2]
BPOM also found that 15 products displayed fictitious registration numbers, while 16 were not registered. A number printed on a package therefore needs verification rather than automatic acceptance. [2] (Pom Indonesia)
What Is Pyrimidenafil?
Pyrimidenafil is a synthetic compound with activity against phosphodiesterase type 5, usually abbreviated to PDE5. Sildenafil, a medicine used for erectile dysfunction, acts on this same enzyme. PDE5 inhibition affects the signalling involved in blood vessel relaxation and penile blood flow. [3,4]
This does not make pyrimidenafil an interchangeable alternative to sildenafil. Similar laboratory activity does not establish an equivalent dose, duration of action, interaction profile or safety margin in patients. [3,4]
Newly Detected by BPOM, Not Newly Discovered Worldwide
BPOM described pyrimidenafil as a substance it had identified for the first time during its surveillance of traditional medicines in Indonesia. The compound itself had already appeared in scientific literature. [1,3]
In a study published in 2020, Tachikawa and colleagues identified pyrimidenafil as an illegal adulterant in a supplement promoted for libido. Their work concerned chemical identification and PDE5 inhibitory activity, not a clinical trial establishing safe treatment in people. The September 2026 development is therefore a new Indonesian surveillance finding, rather than the first worldwide discovery of the compound. [3] (PubMed)
Why Hidden Sexual Enhancement Drugs Can Be Dangerous
An appropriately prescribed erectile dysfunction medicine has a stated strength, dosing instructions and precautions. A clinician can consider the patient’s medical history and other medicines before recommending it. A hidden ingredient removes those safeguards. [4,5]
A person may take additional capsules because the packaging suggests a natural preparation, combine the product with another sexual enhancement treatment, or fail to mention it during a medical consultation. Undeclared ingredients can consequently create risks involving excessive exposure, underlying disease and drug interactions. [7,8]
The Important Interaction With Nitrate Heart Medicines
Sildenafil must not be combined with nitrates because the combination can cause a dangerous reduction in blood pressure. Nitrates include nitroglycerin, also called glyceryl trinitrate, and medicines such as isosorbide mononitrate and isosorbide dinitrate. [4,5]
Other medicines, including alpha blockers and some blood pressure treatments, can also increase the blood pressure lowering effects of sildenafil. Certain medicines can raise sildenafil concentrations by affecting its breakdown. [4]
These are established warnings for sildenafil. They explain why undeclared PDE5-active compounds are concerning, but they should not be presented as a complete, clinically proven safety profile for pyrimidenafil. [3,4] (Labeling Pfizer)
Symptoms That Need Prompt Attention
Anyone who becomes unwell after taking a sexual enhancement product should tell the treating clinician exactly what was taken and when. The following symptoms require particular attention. [4,5]
| Symptom after taking the product | What to do |
|---|---|
| Chest pain, fainting or severe breathlessness | Seek emergency medical care immediately. |
| An erection lasting four hours or longer | Attend emergency care, even if it is not painful. |
| Sudden loss or marked reduction of vision or hearing | Obtain urgent medical assessment. |
| Severe or persistent dizziness, headache or palpitations | Seek prompt medical advice rather than taking another dose. |
With chest pain after a suspected PDE5-containing product, call emergency services and disclose the exposure before nitrate treatment is considered. Do not self-treat the chest pain with a nitrate without urgent medical advice. [4,5] (MedlinePlus)
What Should You Do After Using an Affected Product?
Stop using the male stamina products named in the pyrimidenafil alert and discuss the exposure with a doctor or pharmacist. Keep the packaging, batch details and purchase information, and note the amount taken and the time of the last dose. These details can help clinicians assess the situation and support a regulatory report. [1,5,7]
Bring a complete list of prescription medicines, nonprescription products and supplements. Do not stop an essential prescribed medicine to make it possible to continue taking an unverified supplement. A pharmacist or doctor should review the combination. [5,9]
A Different Precaution Applies to Hidden Steroids
The broader BPOM findings also included corticosteroids such as dexamethasone and prednisone. People who have taken a steroid-adulterated product regularly for several weeks may need medical supervision when stopping it. This is a separate issue from the pyrimidenafil finding in the three male stamina products. [2,6]
Singapore’s Health Sciences Authority has warned that abruptly stopping products containing hidden steroids can cause serious withdrawal symptoms, including fatigue, confusion and low blood pressure. Someone who has used a suspected steroid-containing preparation regularly should obtain urgent medical advice about stopping safely, rather than attempting a home taper using an unidentified product. [6] (Health Sciences Authority)
Why This Matters Beyond Indonesia
The BPOM announcement concerns findings in Indonesia. It does not, by itself, establish that the three named brands are being sold in every international market.
The wider problem, however, is not limited to one country. The United States Food and Drug Administration maintains warnings about sexual enhancement and energy products containing hidden ingredients. It cautions that such products may be promoted through online shops, social media and apparently favourable customer reviews. [7]
The FDA also explains that its notification database covers only a fraction of contaminated products. A supplement’s absence from a warning list should not be interpreted as proof that it has been tested and found safe. [7] (U.S. Food and Drug Administration)
What Published Research Shows
A study by Tucker and colleagues, published in JAMA Network Open in 2018, analysed FDA warnings issued from 2007 through 2016. The researchers identified 776 adulterated supplement entries, including 353 marketed for sexual enhancement. Across the full dataset, 157 entries involved more than one unapproved pharmaceutical ingredient. [8]
This was an analysis of products already associated with regulatory warnings, not a random survey of everything on sale. Its percentages cannot be used to estimate the proportion of all supplements that contain hidden drugs. Nevertheless, the study documents a recurring pattern of pharmaceutical adulteration across sexual enhancement, weight loss and other product categories. [8] (JAMA Network)
How to Assess a Product Beyond Its Herbal Label
A credible product should provide enough information for its identity, manufacturer and ingredients to be checked. Claims of rapid results, glowing reviews or attractive packaging cannot replace that information. [7,9]
In Indonesia, consumers should verify the current authorisation through the official BPOM product database or BPOM Mobile. The product details should match the packaging, and recent safety announcements should also be checked. An old registration claim does not override a subsequent cancellation. [1,2]
Independent quality testing can provide useful information about a product’s contents and manufacturing quality. However, the National Institutes of Health Office of Dietary Supplements explains that quality assurance seals do not guarantee that a product is effective or safe for every person. [9]
It is therefore useful to ask two different questions: “Does this product contain what it claims?” and “Is this preparation appropriate for me?” Evidence supporting one does not automatically answer the other. [9] (Office of Dietary Supplements)
What This Means for Patients Who Prefer Ayurveda
Patients should not have to choose between an interest in traditional medicine and a commitment to safety. The relevant distinction is between transparent, professionally assessed care and a product whose actual contents are unknown.
For someone seeking Ayurvedic care, a responsible consultation should include disclosure of current medicines and supplements, a review of relevant health conditions, and discussion of the proposed preparation’s ingredients and quality documentation. This is particularly important when the patient also takes heart medicines, blood pressure treatments or other long-term prescriptions. [4,9]
Individualised prescribing should not be confused with an assurance that a preparation can never cause an adverse effect. Product quality, the amount taken, other medicines and the patient’s health all remain relevant. [9]
For an Ayurvedic consultation at Panaceayur, bring the supplement packaging, current medicine list and relevant medical reports. The discussion should begin with the cause of the symptoms and the safety of the treatment plan, rather than simply replacing one stamina product with another.
Persistent Sexual Symptoms Deserve a Proper Assessment
The phrase “low stamina” can conceal several different concerns. Difficulty maintaining an erection is not the same as reduced sexual desire, and neither should automatically be assumed to indicate low testosterone.
Erectile dysfunction can be associated with diabetes, vascular disease, high blood pressure, hormone disorders, certain medicines, anxiety or depression. Smoking, excessive alcohol use and insufficient physical activity may also contribute. [10]
A temporary change in erection quality does not establish that an underlying condition has been treated. Sildenafil itself does not increase sexual desire, which illustrates why a product producing an erectile effect may not address the problem the patient originally wanted to solve. [5]
A confidential medical assessment can help identify the relevant cause and guide treatment more appropriately than repeatedly trying products advertised for instant performance. [10] (NIDDK)
Frequently Asked Questions
Does This Warning Mean All Herbal Medicines Are Unsafe?
No. Findings involving particular adulterated products cannot be applied to every herbal preparation. Equally, a traditional or natural label does not establish safety. Each product needs to be assessed according to its contents, quality and suitability for the person taking it.
Can a Product Be Trusted Because It Previously Had a Registration Number?
Current status matters. A registration claim may be false, and an authorisation may subsequently be cancelled. Verify the product against the regulator’s current records and safety notices rather than relying only on the packaging. [1,2]
Does a Strong or Rapid Effect Prove That a Supplement Works Safely?
No. A noticeable effect does not establish what caused it, whether the dose was appropriate or whether repeated use is safe. Regulatory investigations have found pharmaceutical ingredients in products promoted as natural sexual enhancement treatments. [7,8]
Should Everyone Who Took a Named Product Go to Hospital?
Emergency assessment is important when warning symptoms occur, including chest pain, fainting, severe breathlessness or a prolonged erection. People without those symptoms should still stop the affected male stamina product and obtain professional advice, especially when other medicines or significant health conditions are involved. [1,4,5]
The Patient Safety Message
Hidden drugs in herbal supplements deny patients the information needed to make informed treatment decisions. A trustworthy approach to sexual health begins with clear ingredients, verifiable product quality, an appropriate assessment and a review of possible interactions—not a promise of instant performance. [7,9,10]
References
- Badan Pengawas Obat dan Makanan. (2026a, September 10). BPOM ungkap pyrimidenafil sebagai modus baru temuan obat bahan alam mengandung BKO [Press release No. HM.01.2.1.09.26.269; published online September 11, 2026].
https://www.pom.go.id/siaran-pers/bpom-ungkap-pyrimidenafil-sebagai-modus-baru-temuan-obat-bahan-alam-mengandung-bko
Used for: The July 2026 detection of pyrimidenafil in EXIE, YUBOKKI and DURAMAX, cancellation of their marketing authorisations, and identification of 35 additional unlicensed products containing pharmaceutical ingredients. (Pom Indonesia) - Badan Pengawas Obat dan Makanan. (2026b, September 10). Jangan tertipu klaim alami, BPOM temukan 31 obat bahan alam dan suplemen kesehatan ilegal mengandung BKO [Press release No. HM.01.2.1.09.26.268; published online September 11, 2026].
https://www.pom.go.id/siaran-pers/jangan-tertipu-klaim-alami-bpom-temukan-31-obat-bahan-alam-dan-suplemen-kesehatan-ilegal-mengandung-bko
Used for: The separate May–June 2026 surveillance findings involving 31 illegal products, including 30 containing undeclared drugs and one failing microbiological quality requirements. Also documents fictitious registration numbers. (Pom Indonesia) - Tachikawa, H., Nishiyama, R., Ichikawa-Kaji, Y., Uemura, N., Takaku, Y., Kishimoto, K., Ono, Y., Tayama, K., Suzuki, T., Suzuki, J., & Moriyasu, T. (2020). Structure elucidation of a PDE5 inhibitor detected as an illegal adulteration in a libido-boosting dietary supplement. Food Additives & Contaminants: Part A, 37(12), 2023–2032.
https://pubmed.ncbi.nlm.nih.gov/33136535/
Used for: This laboratory study identified pyrimidenafil in a supplement sold in Tokyo and demonstrated PDE5-inhibitory activity. It establishes that the compound was documented before the Indonesian alert, but does not establish clinical safety in humans. (PubMed) - Pfizer Laboratories. (2017, December). Viagra (sildenafil citrate) tablets, for oral use [Prescribing information].
https://labeling.pfizer.com/ShowLabeling.aspx?id=652
Used for: Established sildenafil precautions, including the contraindication with nitrate medicines, interactions with alpha blockers and antihypertensives, and warnings about prolonged erections and sudden vision or hearing changes. (Labeling Pfizer) - American Society of Health-System Pharmacists. (2023, August 15). Sildenafil. MedlinePlus.
https://www.medlineplus.gov/druginfo/meds/a699015.html
Used for: Patient information about sildenafil, medicine interactions, symptoms requiring urgent medical attention, and the distinction between improving erectile function and increasing sexual desire. (MedlinePlus) - Health Sciences Authority. (2025, March 25). HSA alert: Four products found with potent or banned ingredients; three consumers experienced adverse effects with one hospitalised for emergency surgery [Press release].
https://www.hsa.gov.sg/announcements/hsa-alert-four-products-found-with-potent-or-banned-ingredients-three-consumers-experienced-adverse-effects/
Used for: Documented adverse effects from adulterated products and the warning that people regularly exposed to hidden corticosteroids may need medical supervision when stopping them. (Health Sciences Authority) - U.S. Food and Drug Administration. (n.d.). Sexual enhancement and energy product notifications. Retrieved September 13, 2026, from
https://www.fda.gov/drugs/medication-health-fraud-notifications/sexual-enhancement-and-energy-product-notifications
Used for: Regulatory warnings about hidden pharmaceutical ingredients in sexual enhancement products, misleading online promotion, and the limitation that the FDA’s notifications cover only a fraction of potentially contaminated products. (U.S. Food and Drug Administration) - Tucker, J., Fischer, T., Upjohn, L., Mazzera, D., & Kumar, M. (2018). Unapproved pharmaceutical ingredients included in dietary supplements associated with US Food and Drug Administration warnings. JAMA Network Open, 1(6), Article e183337.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2706496
Used for: This analysis identified 776 adulterated supplement entries in FDA warnings from 2007–2016, including 353 marketed for sexual enhancement. It documents a recurring safety problem but does not estimate adulteration across the entire supplement market. (JAMA Network) - Office of Dietary Supplements. (2023, January 4). Dietary supplements: What you need to know. National Institutes of Health.
https://ods.od.nih.gov/factsheets/WYNTK-Consumer/
Used for: Supplement safety, interactions with medicines, the importance of discussing supplement use with healthcare professionals, and why quality assurance seals do not guarantee effectiveness or safety for every individual. (Office of Dietary Supplements) - National Institute of Diabetes and Digestive and Kidney Diseases. (2024, October). Symptoms & causes of erectile dysfunction. National Institutes of Health.
https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
Used for: Medical, psychological, medication-related and lifestyle contributors to erectile dysfunction, supporting the need to investigate persistent symptoms rather than relying on unverified stamina products. (niddk.nih.gov)
