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自從威而鋼(VIAGRA )產品正式上市 以來,主述能改善男性勃起功能障礙之產品

有如雨後春筍般充斥市面,通常以中藥補劑 或健康食品售予供消費者服用;為維護國人 健康,本局一向將受理大陸產製中藥檢驗列 為例行工作之一。由於大陸壯陽類中藥送驗

市售大陸中藥標示壯陽功能產品之調查檢驗

曾木全 劉宜祝 林哲輝

第三組

摘 要

行政院衛生署藥物食品檢驗局自91 年 1 月起至 92 年 3 月止,受

理大陸產製中藥檢驗案件中,總共有22 件次計 17 種品目之大陸壯陽

類中藥檢出西藥成分,其中15 種檢出 sildenafil,2 種檢出 tadalafil,

其中安徽三體醫藥保健公司產製之藥品有三種品目,其餘隸屬於12

家不同之廠家。

檢體篩檢方法為檢體粉末經以50 %甲醇萃取、稀釋及過濾,取

濾液直接注入液相層析串聯式質譜儀(LC/MS/MS)分別進行正離子 電灑法(ESI+)之m/z 475 及 m/z 390 子代離子掃描,獲得之子代離 子質譜圖(Daughter ion spectrum)與本局自建液相層析質譜資料圖庫

(NLFD3/LM library)比對,初步快速篩檢是否含上述兩成分,若疑

似檢出者,須再經 HPLC 分離及串聯式質譜儀分析。儀器之分析條

件:分離管柱均為Cosmosil 5C18-AR, 4.6 150 mm。 移動相溶媒系,

sildenafil 為甲醇:乙腈:1 %醋酸 (25:17:58);tadalafil 為乙腈:水:

1 %醋酸(50 : 45: 5);流速:0.5 mL/min(1:1 分流),毛細管電 壓:3 kV;進樣圓錐口電壓及碰撞能量設定:sildenafil 為 80 V 及 25 eV;而 tadalafil 為 60 V 及 18 eV;離子源溫度:120℃;溶媒揮散溫 度:300℃,配合附光二極體陣列檢出器(photodiode array)檢測之 結果檢品溶液離子峰滯留時間、紫外光光譜圖及質譜圖與對照標準品 比對結果均相符,確認檢品摻加sildenafil 及 tadalafil 西藥成分。

為探討檢體中所含相當於sildenafil citrate 及 tadalafil 之量而配製 系列對照標準品溶液,以pirenzepine 作為內部標準品,分別選定親代 及子代離子(m/z 475.4>100.2, m/z 390.2>268.0)作多重離子裂解監控

(MRM, Multiple Reaction Monitoring)定量分析並製作檢量線,其線 性關係γ值分別為 0.9993 及 0.9985。

關鍵辭:sildenafil、tadalafil、pirenzepine、液相層析串聯式 質譜分析法、MRM 定量分析法、大陸壯陽類中藥、

中藥製劑摻加西藥成分。

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-137-

市售大陸中藥標示壯陽功能產品之調查檢驗

案件近年來暴增,且檢出西藥成分者眾(1),因 此為文探討其羼偽情形及含量,提供消費者 參考。

材料與方法

一、材料:

1. 標準品:sildenafil citrate 由臺灣輝瑞大藥 廠股份有限公司於辦理威而剛(Viagra)

藥品查驗登記時所提供之對照用標準 品;tadalafil 由臺灣禮來大藥廠股份有限 公司於辦理犀力士(Cialis)藥品查驗登 記時所提供之對照用標準品;pirenzepine.

2HCl 購自 Sigma 公司(St. Louis, USA)。

2. 檢體:自 91 年 1 月起至 92 年 3 月止,

受理大陸產製中藥檢驗案件中,共有17

種品目主治功能為增強性功能之中藥檢 體(Tab.3)。

3. 萃取溶媒:50 % v/v 之甲醇 二、儀器及裝置:

1. 串聯式質譜儀:Micromass Quattro Ultima LC/MS/MS

2. 液相層析儀:Waters 2690 Alliance HPLC 3. 紫外光檢測器:Waters 996 Photodiode ar-

ray

4. 數據處理軟體:MassLynx NT Quattro Data Acquisition

5. 質譜資料圖庫:本局自建電腦質譜資料 圖庫(NLFD3/LM:LC/MS/MS library created by Division 3 of BFDA)。

三、分析方法(2)

1. Sildenafil 及 tadalafil 之篩檢:精確稱取相 當於一膠囊、一錠研碎之粉末或5 mL 液

態檢體,置於離心管中,加入萃取溶媒 30mL,置於超音波水浴振盪 10 分鐘,取 出後,以3000 rpm 離心 10 分鐘,上清液 以濾紙過濾,殘渣再以相同步驟萃取三 次;收集濾液,置於100mL 容量瓶中定 容之。取2mL 以萃取溶媒稀釋成 50mL,

以濾膜過濾,濾液即為篩檢溶液。依Tab.

1 所載儀器參數設定儀器,再由旋轉進樣

注射閥直接注入2µL 篩檢溶液,分別選

取 sildenafil 之 (M + H)+離子裂片 m/z 475,及 tadalafil 之 (M + H)+離子裂片m/

z 390 作 ESI+子代離子掃描,獲得子代離 子質譜圖,並與NLFD3/LM 電腦質譜資

料圖庫比對,其比對相似性必須在80 %

以上(2),視為羼加該西藥成分。(Fig.

1,3)

2. 定量:取上述萃取液 2 mL,加入 25µg/

mL pirenzepine 2HCl 內部標準品溶液 2 mL,再以萃取溶媒稀釋成 50 mL,以濾 膜過濾,供作定量檢品溶液。檢品溶液 均含1.00µg/mL pirenzepine 2HCl 內部標 準品。

3. 系列對照標準品溶液配製:

取 sildenafil citrate 標準品儲備溶液,以 萃取溶媒稀釋成六種濃度為 0.05, 0.20, 1.00, 5.00, 10.00, 20.00 µg/mL,均含 1.00µ g/mL pirenzepine 2HCl 內部標準品之系列 標準溶液。另取 tadalafil 貯存標準品溶 液,以萃取溶媒稀釋成六種濃度為 0.05, 0.20, 1.00, 2.50, 5.00, 10.00µg/mL,均含 1.00µg/mL pirenzepine 2HCl 內部標準品

之系列標準溶液。依下列 HPLC 及質譜

分析條件(Tab.2),作多重離子裂解監 控(MRM)掃描分析(Fig.5, 7)。以分 析標的成分與內部標準品離子峰面積之

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Tab.1:Parameters of screen test for sildenafil & tadalafil by direct sampling via divert / injection valve

Target compound Sildenafil Tadalafil

Scan mode & selected ion Daughter ion scan of ESI+m/z 475 Daughter ion scan of ESI+m/z 390 Carrier Flow 50%AcCN,0.2 mL/min 50%AcCN,0.2 mL/min

Capillary(kV) 3.0 3.0

Cone(V) 80 60

Collision(eV):Argon 25 18

Source Temp(℃) 120 120

Desolvation Temp(℃) 300 300

Tab.2:Parameters of MRM analysis for target compound Parameters

Ingredients

Parent ion > Daughter ion (m/z) (m/z)

Dwell (sec)

Cone (volt)

Collision energy (eV)

Time interval

(min)

pirenzepine 352.2 > 113.1 0.25 100 20 0 15

sildenafil 475.4 > 100.2 0.25 80 25 0 15

tadalafil 390.2 > 268.0 0.25 60 18 0 15

Tab.4 : Parameters of GC/MS analytic method for synthetic drugs adulterated in TCM Instrument:H P 5973 MSD with HP6890 GC with Auto- Sampler

Software : HP MSD ChemStation,

Library :NLFD3,、PMW-Tox2、Wiley 275。

Injection pore * Injection type :Splitless

* Purge flow: 50.0ml/min Helium * Purge time: 2 mins

* Pressure: 10.5 psi * Temp.: 250 ℃ * Injected volume: 1 µl Column:

* HP-5MS(Crosslinked 5% PH ME Siloxane), Length:30M Film Thickness: 0.25 um, Column ID: 0.25mm

* Carrier gas flow: Helium 1.0 ml/min with constant flow

* Oven Temperature: Initial Temp: 100 ℃ Hold Time: 2 mins

* Temp ramping rate: 10 ℃/min by linear

* Final Temp:300 ℃ Final Time: 25 min Mass detector:

* Ionization mode: Electron impact (EI+)

* Ionization energy: 70 eV * Ionization current: 34.6 mA

* Ion source Temp: 230 ℃ * MS Quad Temp: 150 ℃

* Interface Temp.: 280 ℃ * Solvent delay: 4 min

* Scan range: 40--500 amu at 3.39 scan/sec * Dwell: 100

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-139- 市售大陸中藥標示壯陽功能產品之調查檢驗 Tab.3:檢體檢出 Sildenafil 或 Tadalafil 西藥成分含量測定結果及一次服用量

含量測定結果 標示一次

服用劑量 一次服用量 1 LKK 鹿茸膠囊 藍色蓋白色底膠囊,內裝褐色粉末 安徽三體醫藥保健公司 含 Sildenafil:28.3mg/cap 2 cap 57.6 mg 2 生命之星膠囊 紅色膠囊,內裝褐色粉末 大陸 塔山製藥 含 Sildenafil: 8.8mg/cap 3 cap 25.4 mg 3 精點速效膠囊 紅色膠囊,內裝褐色粉末 四平製藥廠(吉林省四平市) 含 Sildenafil:66.1mg/cap 2 cap 132.2 mg 4 "福濟"三便寶膠囊 藍色膠囊,內裝褐色粉末 中國商丘福源集團保健品廠 含 Sildenafil: 0.8mg/cap 2 cap 1.6 mg 5 牛寶膠囊 藍色蓋白色底膠囊,內裝褐色粉末 安徽三體醫藥保健公司 含 Sildenafil:34.8mg/cap 3 cap 104.4 mg 6 三體牛鞭勃動力膠囊 藍色蓋白色底膠囊,內裝褐色粉末 安徽三體醫藥保健公司 含 Sildenafil:39.8mg/cap 3 cap 119.4mg 7 金牛 BULL 營養液 褐色液 浙江黃岩延年退黑素有限公司 含 Sildenafil: 11.7mg/mL 8 mL 93.6 mg 8 先生口服液 褐色液 大陸 黃百靈製藥有限公司 含 Sildenafil: 2.0mg/mL 20 mL 40.0 mg 9 醒獅酒 淡黃色液 山東亞聖生物工程公司 含 Sildenafil: 4.5mg/mL 25~50 mL 112.5~225 mg 10 春濤滋補酒 淡黃色液 四川南充市圓通有限公司 含 Sildenafil: 1.4mg/mL 50 mL 70.0 mg 11 東寶生力酒 淡黃色液 吉林東寶生力酒業有限公司 含 Sildenafil: 1.4mg/mL 52 mL 72.8 mg 12 仙茸壯陽精 淡褐色液 上海北杰集團關東藥業有限公司 含 Sildenafil: 3.0mg/mL 10 mL 30.0 mg 13* 皇威鹿茸膠囊 紅色膠囊,內裝褐色粉末 秦皇島皇威製藥廠 含 Sildenafil:30.7mg/cap 2 cap 61.4 mg 14 神力益壽藥液 褐色液 陜西神力製藥有限公司 含 Sildenafil: 0.8mg/mL 50 mL 40.0 mg 15 蓉健腎膠囊 紅色膠囊,內裝褐色粉末 烏魯木齊市生化製藥廠 含 Sildenafil:24.3mg/cap 3 cap 72.9 mg 16 東方超能營養片 紅褐色膜衣錠 南昌市寶洁康生物科技有限公司 含 Tadalafil:10.5mg/tab 1~2 tab 10.5~21 mg 17 蓉杞參膠囊 深藍色膠囊,內裝褐色粉末 北京長城製藥廠 含 Tadalafil:14.4mg/ cap 3 cap 43.2 mg

* 註:13 號檢體另檢出 Methyltestosterone 西藥成分

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Fig-1:Library search result of sildenafil

Fig-2:Fragmentation of sildanafil by ESI+ daughter ion scan analysis

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市售大陸中藥標示壯陽功能產品之調查檢驗

Fig-3:Library search result of tadalafil

Fig-4:Fragmentation of tadalafil by ESI+ daughter ion scan analysis

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Fig-5:The MRM chromatograms of sildanafil standard and sample solution

Fig-6:The UV spectrum of sildanafil standard and sample solution

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市售大陸中藥標示壯陽功能產品之調查檢驗

Fig-7:The MRM chromatograms of tadalafil standard and sample solution

Fig-8:The UV spectrum of tadalafil standard and sample solution

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比值為Y軸(area ratio),標準品溶液濃 度為X軸作圖,求出分析標的成分之檢 量線方程式 Y=m X + b 及相關係數γ值

(Fig.9)。

4. HPLC 分析條件:

Column:Cosmosil 5C18-AR, 4.6 x 150 mm

Mobile phase:

sildenafil: CH3OH:CH3CN:1 % HOAc (25 : 17 : 58)

tadalafil :CH3CN:H2O:1 ﹪ HOAc

(50 : 45: 5)

Flow rate:0.5 mL/min(Split ratio:

1/1)

Injection volume:20µL

Photodiode array:scan range: 200 350 nm

Running time: 15 min

結果與討論

一、行政院衛生署藥物食品檢驗局自91

年1 月起至 92 年 3 月間受理壯陽類產品檢驗

案件中,檢出西藥成分之檢體有70 件之多,

其中大陸產製者即高達22 件(31.4%),涵

蓋15 個廠家;為瞭解其含量與服用劑量之相

關性,每廠家就不同品名檢體,取一個檢體 予以定性定量,共計17 個檢體,結果如 Tab.

4 所示。每件檢體外盒均標示含滋補中藥材,

但無標示內含西藥成分。由檢驗結果顯示,

大陸產製中藥檢出西藥成分比例甚高,羼偽 情形嚴重。

二、Sildenafil 雖可由傳統 TLC/UV 方法 檢出(3),惟其 UV 圖譜與 acetidenafil (M.W.

466)、hydroxyhomosildenafil(M.W.488)、

homosildenafil(M.W.488)等 類 緣 成 分(Fig.11)

(4~6)之 UV 圖 譜 極 為 相 似,難 於 辨 識

(Fig. 12),且以本局 GC/MS 之 SOP 分析法

(Tab. 4)為之,sildenafil 雖可獲得質譜圖,

但只出現m/z 99 與 404 之主要離子裂片,分 子離子裂片不明顯,鑑別性低(Fig. 10),且

耗時 40 分鐘以上,實難稱為理想之鑑別方

法。至於tadalafil 以上述 GC/MS 之 SOP 分析 法分析,能獲得滿意之質譜圖,但波峰滯留 時間亦需35 分鐘以上。兩成分若以 LC/MS/

MS 分析則只需進行簡易萃取,即可在 10 分 鐘以內完成定性定量(Fig. 5,7)。再由 photo- diode array 獲得之分析標的成分 UV 圖譜,可

與標準品 UV 圖譜作比對,更能確切證實檢

出結果(Fig. 6,8)。

三、Sildenafil 及 tadalafil 均以 MRM 方法 定量;sildenafil 之標準品濃度範圍為 0.05 ~ 20.00 µg/mL,其檢量線方程式為 Y=0.153X

─ 0.0346,線性關係γ2值為0.9993。tadalafil 之標準品濃度範圍為0.05 ~ 10.00 µg/mL,其 檢量線方程式為Y=0.1225X + 0.0317,線性關 係γ2值為0.9985。

四、依Pfizer 原開發廠產製之威而剛 VI- AGRA (sildenafil)仿單(7)記載建議劑量為 Fig-9:The calibration curve of sildanafil and tadalafil

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市售大陸中藥標示壯陽功能產品之調查檢驗

Fig-10:TIC and mass spectrum of sample adulternated sildenafil in TCM

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Fig-11: Structures of sildenafil analogues

Fig-12: UV spectrum of sildenafil analogues.

A:sildenafil B: homosildenafil C: hydroxyhomosildenafil D: acetildenafil

Acetildenafil

Acetildenafil

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市售大陸中藥標示壯陽功能產品之調查檢驗

一天一次,一次50 mg,最大耐受劑量為一次 100 mg;而 Lilly 公司產製之犀利士 Cialis

(tadalafil)仿單(8)記載,建議劑量為一天一 次,一次 10 mg,最大耐受劑量為一次 20 mg;再由 Tab. 4 含量測定結果及標示一次服 用劑量之相關性觀之,就檢出 sildenafil 檢 體,超過50 mg 者有 9 個廠牌,超過 100 mg 者有4 個廠牌;就 2 個檢出 tadalafil 檢體而 言,均超過建議劑量。

五、Sildenafil citrate 及 tadalafil 在藥理學 上均屬選擇性第五型磷酸二脂脢(phosphodi- sterase type 5)抑制劑(9),對正在服用含硝酸 鹽類之心血管疾病患者,可能造成危急性低 血壓,因此服用上述壯陽藥劑,均有過量及 安全性之顧慮。

參考文獻

1.姜郁美, 許光陽, 2004, 國人對用藥安全之認 知、行為及態度之探討---以懷疑中藥摻西 藥送驗之民眾為例, 台北醫學大學藥學系碩 士班碩士論文

2.Mu-Chuan Tseng and Jer-Huei Lin. 2002. De- termination of Sildenafil Citrate Adulterated in a Dietary Supplement Capsule by LC/MS/

MS. Journal of Food and Drug Analysis 10 : 112 – 119.

3.Wen, K. C. and Tsai, M. J. 1995. Series of Tes- ting Methods for Chinese Herbal Medicines (X) Analysis and Its Data, Spectra and Chro- matograms of Synthetic Drugs as Adulterants in Chinese Medicinal Preparations. National Laboratories of Foods and Drugs. Taipei, Ta- iwan. (in Chinese)

4.Mu-Chuan Tseng, Mei-Chih Lin, Kuo-Chih Lai, Yi-Chu Liu, Jer-Huei Lin, 2002. Analysis

of Synthetic Chemical Substances Adulte- rated in Traditional Chinese Medicines by Liquid Chromatography-Tandem Mass Spec- trometry. Study report of DOH91-FD-2073.

National Laboratories of Foods and Drugs.

Taipei, Taiwan, Department of Health, Execu- tive Yuan

5.L. Blok-Tip, B. Zomer, F. Bakker, K.D. Hartog, . ten Hove, M.Vredenbregt and D. de Kaste, 2004, Structure elucidation of sildenafil ana- logues in herbal products, Food Additives and Contaminants, Vol. 21 No. 8, pp. 737-748 6.M. H. Shin, M.K. Hong, W.S. Kim, Y. J. Lee

and Y. C. Jeoung., 2003, Identification of a new analogue of sildenafil added illegally to a functional food marketed for penile erectile dysfunction, Food Additives and Contamin- ants, Vol. 20 No. 9, pp. 793-796

7.Instruction pamphlet for VIAGRA(r) (Sildena- fil citrate) tablets. 2000. Distributed by Pfizer Labs. NY., U.S.A

8. Instruction pamphlet for CIALIS(r) (tadalafil) film-coated tablets. 2001. Distributed by Eli Lilly and Company Limited, England 9.Chemical structure of cGMP and the PDE-5

inhibitors sildenafil, vardenafil and tadalafil, Europan Fournal research-Erectile Dysfunc- tion, 2002, Internet information download from http://www.praxisklinik-sauerlach.de/

eurmedres/ 102002/inhalt/3-3.html

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Determination by Liquid Chromatography-Tandem Mass Spectrometry on Sildenafil and Tadalafil Adulterated in Tradi-

tional Chinese Medicines from China

MU-CHUAN TSENG, YI-CHU LIU, JER-HUEI LIN

Division of Pharmacognosy

ABSTRACT

The commercial VIAGRA(r) products have arisen a phenomenon. As aresult, many off Chinese medicines and food supplements claimed to have treatment effects on male erectile dysfunction. From Jan- uary 2002 to March 2003, Bureau of Food and Drug Agency (BFDA) received 22 samples in 17 different traded names that were marketed in China. All of the samples were found illegally adulterated with silden- afil or tadalafil. Among the 17 different branded samples, 3 were manufactured by An Wei San Tee Med- icinal Health Company(安徽三體醫藥保健公司), the rest were manufactured by different companies.

Sample powder was extracted with 50% methanol and analyzed by LC/MS/MS, detected by photo- diode array and tandem mass detector with positive electron spray ionization (ESI+) method. The testing conditions were set as following: Column: Cosmosil 5C18-AR, Mobile phase: methanol:acetonitrile:1% ac- etic acid (25:17:58) for sildenafil analysis; and acetonitrile:water:1% acetic acid(50 : 45: 5)for tadalafil analysis; Flow rate: 0.5mL /min (1:1 split); Voltage of capillary tube:3KV; Voltage of sample cone and col- lision energy were 80V/25eV and 60V/18eV for sildenafil and tadalafil respectively. The source tempera- ture was set on 120oC, and the solvent desolvation temperature on 350oC. The daughter ion scan was set at m/z 475 for sildenafil and m/z 390 for tadalafil to obtain a daughter ion spectrum. The result were then compared with the data library (NLFD3/LM) that was set up by the lab. The existence of the adulterants were confirmed when the ion peaks retention time of samples, as well as the UV and mass spectrum patterns of the samples matched with the sildenafil and tadalafil data as recorded in the library.

The quantity of sildenafil and tadalafil were calculated by calibration curves. Both pair of parent and daughter ion (m/z 475>100 and m/z 390>268) were chosen and multiple reaction monitoring (MRM) was performed. The results were then referred to the calibration curves (γ2=0.9993 and 0.9985) to deter- mine the amount of sildenafil and tadalafil in samples.

Keywords : LC/MS/MS, Chinese medicines, treatment of male erectile dysfunction, sil-

denafil citrate, tadalafil , pirenzepine, ESI., MRM, daughter ion scan

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