Authorities say the counterfeit versions have A031410 or A041410 written on the bottom of the carton or on the blister strip inside.

Initial tests do not suggest they are a risk to health. But patients have been advised to return them to pharmacies.

Patients with concerns are advised to consult their GP or phone Lilly UK, which makes Cialis, on 0800 085 3847.

“Patients who are in possession of this counterfeit drug should return it immediately,” said Professor Kent Woods, chief executive of the Medicines and Healthcare products Regulatory Agency (MHRA).

If patients think that they have taken the product and are concerned about any side effects they should consult their doctor Professor Kent Woods, MHRA

“Whilst initial tests show that the product does not pose an immediate risk to patients, the quality of this product cannot be guaranteed.

“If patients think that they have taken the product and are concerned about any side effects they should consult their doctor.”

The counterfeit tablets are understood to have found their way into some pharmacies. Investigations are underway to try to find out how this happened.

Patient complaint

Lilly UK brand tadalafil
the fake drugs after a patient complained about a crumbling tablet.

The company investigated and found that the tablet was counterfeit. It then contacted the MHRA.

“We want to emphasise that genuine Cialis is not affected by this matter,” it said in a statement.

It is believed to be the first time that fake drugs have found their way into the legitimate supply chain in the UK for 10 years.

“This incident highlights the need for the greatest vigilance and scrutiny, especially when medicines are introduced into the system other than from their original manufacturers,” said Dr Richard Barker, director general of the Association of the British Ed pills
Industry.

“The best protection against dipendenza tadalafil
is to ensure that the products bought are those supplied by the authentic manufacturer.

“Only then can the industry feel confident that its products are reaching patients in the same condition as they left the factory, and that patients are receiving medication that they can trust absolutely.”

are receiving medication that they can trust absolutely.”

By Tom Murphy, The Associated Press

INDIANAPOLIS - Drug maker Eli Lilly and Co. has received FDA approval to offer its erectile dysfunction drug, Cialis, in a new daily dose.

The daily version will take pressure off users who would otherwise have a “shot clock” or window of effectiveness to worry about, Lilly officials say. Cialis also is offered at a higher dose that provides a 36-hour window.

With the daily dose, men will not need to take Cialis in anticipation of sex because it is already in their system, said Shawn Heffern, Lilly’s U.S. marketing director for the drug.

“They’ve got a lot of pressure to perform, and the worst thing we can do is then put a shot clock on them or some limited amount of time … where they need to have sex or otherwise it’s out of their system and doesn’t work,” he said.

Lilly said in a statement the daily dose is geared for men who tadalafil cialis
having sex twice a week or more tablet tadalafil
.

Cialis rang up US$798 million in sales during the first nine months last year. In 2006, it registered $971 million for the full year, a 30 per cent increase over 2005.

Heffern said the drug is on track to top $1 billion in sales for 2007. He declined to say how the daily dose will affect revenue.

Cialis trails market leader Viagra in sales. The Pfizer Inc. erectile dysfunction drug collected $1.26 billion in sales during the first nine months of 2007.

The daily dose could increase Cialis sales depending on how it’s priced, said George Farra, numero cas tadalafil
and principal of Woodley Farra Manion Portfolio Management. His firm manages nearly 285,000 Lilly shares.

“The cost will probably be an issue. It becomes more of a monthly fixed cost,” Farra said. “For those who favour tadalafil online
, this is about as good as it gets.”

Viagra and another erectile dysfunction drug, Levitra, also can be taken daily. But Cialis is the only drug approved for a daily treatment regimen.

Shares of Indianapolis-based Eli Lilly rose $1.51, or 2.8 per cent, to $56.06 Tuesday. Farra said he thinks the FDA approval helped spur the increase.

“It’s positive news without a doubt,” he said.

Doping up Canadians is priority 1 for Harper and the Drug companies.

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NEW YORK (Reuters) -
Eli Lilly and Co on Tuesday said U.S.
regulators approved andrologia tadalafil
use of two low-dose forms of its
Cialis generic cialis 10mg
drug, offering greater convenience for
men expecting frequent sexual activity.

ADVERTISEMENT

The Indianapolis drugmaker said the once-daily
formulations, in dosages of 2.5 milligrams and 5 milligrams,
will allow men to attempt sexual activity any time between
doses.

“In clinical trials, when taken without restrictions on the
timing of sexual activity, Cialis for once daily use improved
erectile function over the course of therapy,” Lilly said in a
release.

The low-dose daily formulations, already approved in parts
of Europe, “may be most appropriate for men with erectile
dysfunction who anticipate more frequent sexual activity (e.g.
twice weekly),” Lilly said.

The company said the low-dose formulations provide “a new
option for men who may be looking for a dosing option that can
be taken without regard to timing of sexual activity.”

The treatment, which has global annual sales of $1.2
billion, has been available in the United States since 2003 in
dosages of 5 milligrams, 10 milligrams and 20 milligrams, and
taken as needed. Those dosages provide uk can cialis female tadalafil take
for up to
36 hours.

Company berman sister female viagra study
Keri McGrath said no dosage forms of
the medicine, including the newly approved lower ones, are
appropriate for heart patients who take nitrates, including
andrologia tadalafil
.

Members of the class of drugs to which Cialis belongs –
including Pfizer Inc's rival Viagra and GlaxoSmithKline Plc's
Levitra — can dangerously lower blood pressure when used
alongside nitrates.

The drugs, used by millions of men worldwide, also carry
new warnings about potential risk of sudden hearing loss.

Shares of Lilly were up $1.05, or 1.9 percent, to $55.60 in
morning trading on the New York Stock Exchange, in line with a
2 percent advance for the drug sector.

(Reporting by Ransdell Pierson, editing by Gerald E.
McCormick)

PARIS (Reuters) -
French customs officials have intercepted
a shipment of 224,000 fake Viagra and Cialis anti-impotence
pills worth 2.4 million euros ($3.5 million), the Budget
Ministry said on Monday.

Cialis tadalafil generic rezeptfrei

The copies of the best-selling drugs were found on December
18 during a search at the French capital's main air hub at
Roissy, in a freight cargo on its way to Brazil from India.

“Branded Powergra and Erectalis, each box contained, in
fact, four tablets in the tadalafil and generic
shape and color of
Viagra or Cialis pills,” Budget Minister Eric Werth's office,
which is also in charge of customs, said in a cialis soft tab
.

“The cialis tadalafil generic rezeptfrei
Pfizer and Eli Lilly, which respectively own
the Viagra and Cialis brands, quickly cialis tadalafil generic rezeptfrei
the counterfeit
nature of these products and the 224,000 pills were seized,”
Werth's office added.

PARIS (Reuters) -
French customs officials have intercepted
a shipment of 224,000 fake Viagra and Cialis cream for erectile dysfunction

pills worth 2.4 million euros ($3.5 million), the Budget
Ministry said on Monday.

Cialis tadalafil generic rezeptfrei

The copies of the best-selling drugs were found on December
18 during a search at the French capital's main air hub at
Roissy, in a freight cargo on its way to Brazil from India.

“Branded Brand tadalafil
and Erectalis, each box contained, in
fact, four tablets in the characteristic shape and color of
Viagra or Cialis pills,” Budget Minister Eric Werth's office,
which is also in charge of customs, said in a statement.

“The tadalafil
Pfizer and Eli Lilly, which tadalafil loc mx
own
the Viagra and Cialis brands, quickly confirmed the counterfeit
nature of these products and the 224,000 pills were seized,”
Werth's office added.

LOS ANGELES - Many of the pills marketed as safe herbal alternatives to Viagra and other prescription sex medications pose a hidden danger: For men on common heart and blood-pressure drugs, popping one could lead to a stroke, or even death.

“All-natural” products with names like Stamina-RX and Vigor-25 promise an apothecary’s delight of rare Asian ingredients, but many work because they contain unregulated versions of the very penis erectile dysfunction probs
s they are supposed to replace.

That dirty secret represents a special danger for the millions of men who take nitrates — drugs prescribed to lower blood pressure and regulate heart disease. When mixed, nitrates and impotency pharmaceuticals can slow blood flow catastrophically, leading to a heart attack or stroke.

An Associated Press investigation shows that spiked herbal impotency pills are emerging as a major public health concern that officials haven’t figured out how to track, much less tame.

Emergency rooms and poison control hot lines are starting to log more incidents of the long-ignored phenomenon. Sales of “natural sexual enhancers” are booming — rising to nearly $400 million last year. And dangerous knockoffs abound.

At greatest risk are the estimated 5.5 million American men who take nitrates — generally older and more likely to need help with erectile dysfunction.

The all-natural message can be appealing to such men, warned by their doctors and ubiquitous TV commercials not to take Viagra, Cialis or Levitra.

James Neal-Kababick, director of Oregon-based Flora Research Laboratories, said about 90 percent of the hundreds of samples he has analyzed contained forms of patented pharmaceuticals — some with doses more than twice that of prescription erectile dysfunction medicine. Other testers report similar results, particularly among pills that promise immediate results.

While no deaths have been reported, the AP found records of emergency room visits attributed to all-natural sex pills in Georgia, Chicago, Philadelphia, San Diego and elsewhere.

An elderly man in a retirement community north of Los Angeles took an in-the-mail sample and landed in the hospital for four days. A Michigan man sued the maker of Spontane-ES, blaming it for the stroke he suffered 20 minutes after taking a freebie that was advertised as “extremely safe.” Tim Fulmer, a lawyer representing Spontane-ES, said the pill did not contain any pharmaceutical and was not responsible for the stroke.

Mark B. Mycyk, a Chicago emergency room doctor who directs Northwestern University’s clinical toxicology research program, said he is seeing increasing numbers of patients who unwittingly took prescription-strength doses of the alternatives, a trend he attributes to ease of purchase on the Internet and the desperation of vulnerable men. He said he wouldn’t be surprised if there’d been undetected deaths from bad herbal pills.

Some herbal labels warn off users with heart or blood-pressure problems if they have taken their medicine within six hours; some doctors say 24 hours or more would be safer.

The AP often couldn’t determine from records whether incidents reported to tracking systems of the federal Food and Drug Generic soft tab cialis
and state poison control centers involved mixing herbal alternatives with nitrates.

Some men in their 30s who went to emergency rooms after taking herbal sex pills were presumably otherwise healthy, but they showed the transitory side effects of the active ingredients in regulated impotency pharmaceuticals, such as difficulty seeing clearly or severe headaches, records show.

While public health officials don’t know the extent of the problem, they agree that incidents are vastly underreported, with national tracking systems capturing perhaps as little as 1 percent of them. Victims may be embarrassed, and doctors rarely ask about supplements.

Since 2001, sales of supplements marketed as natural sexual enhancers have risen $100 million, to $398 million last year, including herbal mixtures, according to estimates by Nutrition Business Journal. Some legitimate herbal mixtures claim to work gradually over weeks; it’s the herbals marketed for immediate trysts that often are the problem.

Tight budgets, weak regulations and other priorities limit the FDA’s ability to police the products, often promoted via blasts of e-mail spam and fly-by-night Web sites.

“The Internet poses many enforcement challenges,” said Dr. Linda Silvers, who leads an FDA team that targets fraudulent health products sold online. “A Web site can look sophisticated and legitimate, but actually be an illegal operation.”

In many cases, the ingredients used to alter herbal pills come from Asia, particularly China, where the sexual enhancers are cooked up in labs at the beginning of a winding supply chain. The FDA has placed pills by two manufacturers in China and one from Malaysia on an import watch list.

Pills like Cialis generally retail at pharmacies for between $13 and $20, while herbals can cost less than $1, up to about $5.

Many health insurance plans provide limited coverage for prescription sex pills, especially for those with soft tablet tadalafil
difficulties. Few over-the-counter treatments are covered, and herbals aren’t likely to be among them, in part because they’re classified as foods not pharmaceuticals, said Mohit M. Ghose, spokesman for America’s Health Insurance Plans, which represents major health insurers.

Spiked pills have turned up in Thailand, Taiwan, Canada, Australia, New Zealand, Hong Kong, Malaysia, the United Kingdom and the United States, according to testing done by Pfizer Inc., the New York-based pharmaceutical giant that developed Viagra. The company said that 69 percent of 3,400 supplements it purchased in China contained sildenafil citrate, the main ingredient in Viagra. Pfizer didn’t check for the patented ingredients of its rivals.

Under U.S. law, because such pills are “dietary supplements,” they’re far less regulated than pharmaceuticals and face few barriers to market. Viagra, by contrast, underwent years of testing before it was publicly available.

While herbal alternatives often contain exact copies of the patented drugs, some makers tweak the molecules to keep the effect of the original pharmaceutical while avoiding the scrutiny of the FDA and outside testing labs.

Federal officials have only recently stepped up book guest order viagra
and prosecutions, and in any case, the FDA’s recall power is limited. Last week, in response to safety concerns about imported toothpaste, dog food and toys, President Bush recommended that the FDA be authorized to order mandatory recalls of dangerous products.

Currently, recalls are voluntary, and even if the agency determines that a product poses a “significant health risk,” a firm may refuse to cooperate. Plus, recalled products are widely offered on the Internet and pills are hard to round up.

Before a product called Nasutra was recalled a year ago by its manufacturer, the FDA had received a 30-year-old man’s report of a raging headache and an erection that wouldn’t go down. Following the recall, a 32-year-old man reported having spontaneous nose bleeds after taking the pill, records show.

E-mails requesting comment from Nasutra LLC, the company that voluntarily recalled the product in September 2006, were not returned. The FDA says the firm is located in Los Angeles; there is no listed phone number in the region.

During the past year, the FDA has orchestrated eight recalls of “herbal” pills that contained the ingredients found in Viagra, Cialis or Levitra, or their unregulated chemical cousins. Many of the firms were based around Los Angeles, their offices ranging from an unsigned door in a grungy hall on the fringe of downtown to a gated complex near Beverly Hills.

One recall involved a pill called Liviro3.

The current owner of the drug’s marketing and distributing firm said that after he tried the product, he quit his job at a car dealership and bought the brand name and stock of several thousand pills in 2004 for $450,000. In January, he said, FDA agents seized his stockpile after an agency lab found that Liviro3 contained tadalafil, the main ingredient in Cialis. The man told the AP he’d had no idea the pills were drug-laced.

One prosecution involved V. Vigor Corp., the Long Island-based maker of Vigor-25. While the product was advertised as containing Asian ginseng, lycium fruit and Chinese yam rhizome, FDA testing indicated that the pills contained Viagra.

Company executive Michael Peng had agreed to stop selling Vigor-25 following an FDA agent’s visit in late 2004, according to an arrest warrant affidavit. But between then and his arrest in September, at least 4.5 million pills were packaged for distribution, the affidavit said. According to prosecutors, Peng thought he could evade tests simply by switching from the sildenafil citrate he imported from China to Levitra’s active ingredient, vardenafil — a shipment of which U.S. Customs intercepted from Thailand.

Peng, who said through his attorney that he was “unaware that there was anything other than natural supplements” in Vigor-25, faces a charge of misbranding — in this instance, claiming that a pharmaceutical is a dietary supplement.

Two other pills, Spontane-ES and Stamina-RX, were made by companies run by Jared Wheat, who’s facing federal charges in Atlanta that he peddled knockoff pharmaceuticals cooked in a Central American lab. Prosecutors tried to keep Wheat from posting bail by asserting that he contemplated killing an FDA investigator and bribing a prosecutor.

Fulmer rejected those assertions, which did not lead to charges, saying Wheat is hardworking and nonviolent. Fulmer said Wheat’s two businesses are legitimate and continue to be successful.

Wheat was granted bond after pledging approximately $7.5 million in cash and property; he’s free under home confinement.

___

Associated Press researcher Julie Reed in New York and Associated Press writer Andrew Bridges in Washington contributed to this report.