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The US Food and Drug Administration issued a warning letter to China-based HelloCig Electronic Tech Company on Thursday for selling two e-liquids that contain erectile dysfunction drugs. No prescription drug is approved to be inhaled partly because no studies have been conducted on the risks, making it illegal.

The active ingredients tadalafil and sildenafil can turbocharge hypertension medications, driving down blood pressure dangerously low. Dr Premal Patel, a urologist at the University of Miami, warns that is a major concern because heart medications are common among men with erectile dysfunction problems.

Erectile dysfunction could be a harboring of cardiac problems in the future, the same blood vessels providing blood to the heart provide blood to the penis. One of the marketed liquids, E-Cialis HelloCig E-Liquid, contains both tadalafil and sildenafil. Another one, E-Rimonabant, contains sildenafil and is marketed with a picture of an anti-obesity drug.

Vaping tadalafil and sildenafil work by dilating blood vessels to improve blood flow to the penis; they can also be prescribed to lower blood pressure in the lungs. But the drugs were designed to be swallowed. There was one trial in the early 2000s for an erectile dysfunction drug delivered via nasal spray, produced by a New Jersey pharmaceutical company.

It would have become the first erectile dysfunction drug to act on the central nervous system.  Studies ever done on these drugs are from an oral perspective, e-cigarettes allow users to ingest high concentrations of substances – be it nicotine or vitamins – very quickly.

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