They’re ubiquitous in gas stations and convenience stores across North America as a Viagra substitute. Now Health Canada is warning against ‘unauthorized sexual enhancement’ products for men — so called ‘Rhino pills’ — sold under a variety of brand names including ‘Stiff Rox’ and ‘Spanish Fly’ in convenience stores and variety shops located mainly in Ontario.The reason?Because they actually contain sildenafil and tadalafil, the active ingredients found in the Little Blue Pill and its various incarnations like Cialis to treat erectile dysfunction.The problem — apart from being restricted prescription drugs — is that they’re not disclosed on the labels, according to a nationwide news alert released on Monday morning.Consequently, the products “may pose serious health risks,” it says. .That is especially true when combined with medications containing nitrates for diabetes, high blood pressure, high cholesterol, heart disease or other conditions.Almost all the Rhino pills sold in North America can be traced to one man in California who smuggled sildenafil and tadalafil in from China. In 2021 he was sentenced by the US government to 46 months in federal prison but the products remain on store shelves.“When you’re prescribed those erectile dysfunction meds by a good physician, they will go over the benefits and potentials risks,” says Marc S. Cohen, MD, a urologist and medical adviser at Bastion Health in Sarasota, Florida.“There are all kinds of pill mills… where they say they are providing you with a particular product,” he says, but the quality of the ingredients and the chemicals used to produce them are unknown. According to the US Food and Drug Administration the products can cause serious harm and can even be fatal. Nonprofit news organization FairWarning reported problems from Rhino pills including penile pain, heart palpitations, congestive heart failure, coma and death.Viagra is one of the most successful prescription drugs of all time with annual sales peaking at USD$1.93 billion in 2008. A 2023 study by Interpol suggested about 80% of all websites claiming to sell Viagra were counterfeits accounting for about 22% of all illegal drug seizures last year.
