⚠ Active warning — SupplementIndex Safety Review: FDA alerts. Undeclared PDE5 inhibitors.
📰Read the full Sildenafil/Tadalafil (hidden) evidence review on GMJ News →Complete clinical article, references and updates on news.gmj.ge. This page is the structured safety summary.⚠ DANGEROUS — see overview [1]
ℹ️ Not obtained from food. Not applicable — this substance is not a dietary nutrient and should not be consumed as food.
🔬 Lab interpreter
ℹ️ No validated blood test. There is no established laboratory test to assess status or guide dosing for this ingredient. Clinical response and symptoms are the practical guide.
⚕ For professionals — confirm ranges against your local laboratory.
Clinical verdict
Hidden sildenafil/tadalafil in 'natural' male enhancement supplements is the #1 hidden drug problem in sexual health products. FDA found them in HUNDREDS of products. LETHAL DANGER: patient on nitrates (angina) takes 'herbal Viagra' containing hidden sildenafil → fatal hypotension. If a 'natural' product works within 30–60 minutes for ED: it contains a pharmaceutical [1].
1 How much do I need?
👤 Adults: Specific dosage data under clinical review
👴 Elderly: Specific dosage data under clinical review
🤰 Pregnancy: See guidance
ABSOLUTELY CONTRAINDICATED [1].
👦 Pediatric: See guidance
ABSOLUTELY NOT [1].
🏃 Athletes: Standard dose
⚖️ Obesity: Standard dose
Fat-soluble compounds may require dose adjustment in obesity.
🩺 Renal: Consult specialist
Dose adjustment may be needed in renal impairment.
🌱 Vegan: Standard dose
How to take
🍽 Timing: DO NOT USE [1].
💊 With food: N/A [1].
🚫 Avoid: COMPLETELY [1].
2 Which form?
| Form | Bioavailability | Vegan | Cost |
|---|---|---|---|
| ['See overview', 'restricted/banned', 'See overview [1].'] | Standard | Check label |
3 Common questions
DANGER ▼
Hidden sildenafil/tadalafil in 'natural' male enhancement supplements is the #1 hidden drug problem in sexual health products. FDA found them in HUNDREDS of products. LETHAL DANGER: patient on nitrates (angina) takes 'herbal Viagra' containing hidden sildenafil → fatal hypotension. If a 'natural' product works within 30–60 minutes for ED: it contains a pharmaceutical [1].
4 Clinical evidence
Strong
See overview [1]. HIGH
Moderate
See overview [1]. MODERATE
Insufficient
See overview [1]. LOW
5 Safety, toxicity & adverse events
Absolute contraindications
✕ Dangerous as a hidden adulterant — undeclared PDE-5 inhibitors in 'natural' sexual-enhancement products can cause fatal hypotension with nitrates
✕ Concurrent nitrates or nitric-oxide donors (life-threatening)
✕ Cardiovascular disease in which sexual activity/vasodilation is contraindicated
Relative
⚠ Alpha-blockers — risk of hypotension
🚩 Red flags
● DANGEROUS — see overview [1]
6 Interactions
Drug interactions
See overview Lethal/major
Action: DO NOT USE [1].
7 Cite this page
Vancouver: Pkhakadze G. Sildenafil/Tadalafil (hidden) — safety profile [Internet]. Tbilisi: PHIG; 2026 [cited 2026 Aug 07]. Available from: https://supplement.ge/ingredients/sildenafil-tadalafil-hidden/
APA 7th: Pkhakadze, G. (2026). Sildenafil/Tadalafil (hidden) — Safety profile. Public Health Institute of Georgia. https://supplement.ge/ingredients/sildenafil-tadalafil-hidden/
📋 Editorial information
Author: Prof. G. Pkhakadze, MD, MPH, PhD
Institution: Public Health Institute of Georgia (PHIG)
Affiliation: David Tvildiani Medical University (DTMU)
First published: January 2026
Last reviewed: 2026-05-29
Next review: February 2027
References: 1 cited sources
COI: SupplementIndex receives no funding from supplement manufacturers. All content independently authored by PHIG.
Process: Systematic literature review
📄 License & reuse
Published under Creative Commons Attribution 4.0 International (CC BY 4.0). You may share and adapt for any purpose with attribution.
Pkhakadze G. "Sildenafil/Tadalafil (hidden) — Safety Profile." SupplementIndex, PHIG, 2026. https://supplement.ge/ingredients/sildenafil-tadalafil-hidden/ CC BY 4.0.
GP
Prof. G. Pkhakadze, MD, MPH, PhD
Professor of Public Health · Head of Department, DTMU
Editor-in-Chief, Georgian Medical Journal (ISSN 3088-4322)
Chair, Public Health Institute of Georgia · UEMS Public Health Section
Educational and public health purposes. CC BY 4.0. Consult your healthcare provider before starting any supplement. Corrections: info@accreditation.ge. Publisher: PHIG