Over the last week, the FDA issued a series of seven warnings about supplements that contain undeclared drugs.  Six of the products contain numerous undeclared active drug ingredients including the usual suspects sildenafil, tadalafil, and testosterone propionate on the erectile dysfunction side of the house and piroxicam for relieving pain/arthritis.

The seventh product, Tawon Liar, really caught my attention.  Why?  Because this is the third warning that the FDA has issued over the past 4+ years for this specific product (see notice here).  This “supplement,” which is “promoted for pain, rheumatism, insomnia, improving the immune system, increasing energy and lowering cholesterol,” “contains tapentadol, dexamethasone, and meloxicam not listed on the product label.”  The FDA warned consumers first on January 7, 2022, again on February 16, 2023, and now again on May 29, 2026.

The FDA notes that:

  • Tapentadol, the active ingredient in the FDA-approved prescription drugs Nucynta and Nucynta ER, is a controlled substance (an opioid) used to treat severe pain.
  • Meloxicam and ketorolac (note that ketorolac was cited in the 2023 notice but appears to have been replaced by tapentadol in this latest warning) are non-steroidal anti-inflammatory drugs (NSAIDs).
  • Dexamethasone is a corticosteroid commonly used to treat inflammatory conditions.

In the warning, the FDA goes on to discuss the potentially serious or fatal side effects or adverse events that could develop based on continued use of this product.

While we know that the FDA is taking action to notify consumers on an ongoing basis about these types of illegal products, the question is why the supply of this product has kept popping up in the U.S. over the past four years.

We know that there is a task force between the FDA and U.S. Customs and Border Patrol that has been working diligently trying to stop these dangerous illegal products from reaching the hands of unsuspecting U.S. consumers; however, the flow of these products appears to be outstripping the ability of the Agencies to stem it.  Perhaps it’s time to focus on more stringent criminal enforcement efforts directed at the sellers of these products domestically as well as the international importers.  From what I see, while the current efforts to ebb the flow of these products into the U.S. are well intended, these warnings seem to have become more frequent over the past few years, indicating to me that more needs to be done to deter the bad actors involved in importing and selling these dangerous products to unsuspecting consumers.