It’s been three years since legendary Aussie cricketer Shane Warne was found dead in a villa on the island of Koh Samui.

At the time, an autopsy revealed the 52-year-old, who was in Thailand for a ‘lads’ holiday’ and was known for his love of partying, had died from a heart attack.

But this week, the Mail revealed a possible ‘cover-up’ in Warne’s death. 

A senior Thai police official alleged he was ordered to quietly dispose of a packet of Kamagra – a sex drug containing sildenafil, the same active ingredient as Viagra – that had been found in the hotel room shortly after Warne’s body was discovered.

The drug was described as ‘super strong’.

The officer, who spoke on condition of anonymity, said: ‘We were ordered by our seniors to get rid of the bottle. These orders were coming from up high, and I think senior officials from Australia were also involved because they did not want their national figure to have an ending like this.

‘So, the official report came out as that he suffered a heart attack and no other details as to what could have caused it. No one will come out to confirm the Kamagra because it remains a sensitive subject. There were lots of powerful invisible hands behind all this.’

With known links between sildenafil (the active ingredient in both Viagra and Kamagra) and cardiovascular issues, speculation is now rife as to whether the presence of the substance in Warne’s hotel room could have contributed to his death.

Australian cricketer Shane Warne is seen here in CCTV footage of his last moments alive before he suffered a massive heart attack in a villa on the island of Koh Samui in Thailand

Australian cricketer Shane Warne is seen here in CCTV footage of his last moments alive before he suffered a massive heart attack in a villa on the island of Koh Samui in Thailand

A Skyn condom was found in Warne's bag near where his body was discovered

A Skyn condom was found in Warne’s bag near where his body was discovered

A selfie of Shane Warne in Koh Samui, Thailand, before his death, believed to be his last one

A selfie of Shane Warne in Koh Samui, Thailand, before his death, believed to be his last one

Dr Sara Whitburn, Chair of the RACGP Sexual Health Special Interest Group, says that while Viagra has a high safety profile, heart problems – which Warne was known to suffer from – must be taken into consideration when prescribing the drug.

‘It is important to consider someone’s cardiovascular health when prescribing Viagra,’ she explains.

‘Cardiovascular disease can be a cause for erectile dysfunction, but needs to be considered before prescribing medication like Viagra as cardiac medication and cardiac problems can be a contraindication for prescribing PDE5 inhibitors.’

Dr Whitburn says that while Viagra is generally safe, some side effects can occur, including headache, nausea, dizziness, nasal congestion, muscle pain and back pain. 

‘Users should be aware that there is a small risk of a condition called priapism (prolonged, painful erection) and vision problems (mostly in older people),’ she adds. 

There are also a number of underlying conditions that can make taking these types of medication more dangerous, says Dr Whitburn, which is why patients are required to undergo a full history and examination before being prescribed erectile dysfunction medication.

‘Viagra works by dilating blood vessels to help with erectile problems, so there are some contraindications to using PDE5 inhibitors, including the use of nitrates for angina (chest pain), heart failure, resting hypotension (low blood pressure), recent stroke and myocardial infarction (heart attack) as Viagra can make these conditions worse,’ she says.

According to Australia’s Therapeutic Goods Association, there have been 1,104 reported cases of adverse events related to sildenafil in the past 30 years.

A senior Thai police official this week alleged that knock-off Viagra, known as 'Kamagra', was also found in the room but was quietly disposed of to avoid causing embarrassment

A senior Thai police official this week alleged that knock-off Viagra, known as ‘Kamagra’, was also found in the room but was quietly disposed of to avoid causing embarrassment 

The presence of Kamagra in the room was omitted from the police report into his death

The presence of Kamagra in the room was omitted from the police report into his death

Death was the reported outcome in 42 of those cases.

The TGA’s database is responsible for monitoring which medications and drugs are associated with what outcomes in the Australian public, and is vital for keeping both the public and medical professionals abreast of potential complications.

In the UK, where certain products containing sildenafil were reclassified to be able to be sold without a prescription in 2018, there have been a reported 205 fatalities linked to sildenafil and tadalafil (sold under the brand name Cialis).

Cialis works similarly to Viagra but is preferred by many men because it lasts longer (up to 36 hours) whereas Viagra is only effective for a few hours.

Here in Australia, the Australian Medical Association (AMA) has stood firm against attempts to downschedule both drugs, insisting they remain prescription-only.

There have been four attempts made to allow it to be sold over the counter, but in its most recent statement after voting down the request last year, the AMA said: ‘The risk profile for sildenafil remains significant given the broad range of contraindications, particularly among the key consumer market of older men.

‘The AMA’s position is that the downscheduling of prescription drugs should only occur when patient benefits and safety are demonstrated and supported by data.

‘The submission also contends that allowing the drug to be accessible over the counter sends a signal to consumers that it is low risk when there is no evidence to support this.’

Warne's body is picked up at Surat Thani Hospital after the autopsy, which found he died of natural causes

Warne’s body is picked up at Surat Thani Hospital after the autopsy, which found he died of natural causes

Warne is believed to have started using Viagra during his relationship with English actress Elizabeth Hurley (pictured together in November 2013 in Sydney, Australia)

Warne is believed to have started using Viagra during his relationship with English actress Elizabeth Hurley (pictured together in November 2013 in Sydney, Australia)

And while the only legal method to get your hands on drugs such as Viagra and Cialis in Australia remains consulting with your doctor first, a rising black market trade – both online and overseas – poses ongoing health risks.

Both drugs can be found under the counter at sex shops, and can also be imported relatively cheaply from Asia. The TGA often warns against so-called ‘natural’ remedies or ‘dietary supplements’ which actually contain sildenafil and tadalafil.

Kamagra in particular is seen as a risky option for men looking for sexual enhancers because of its strength. A single packet of Kamagra contains 100mg of sildenafil citrate – which is double the recommended dosage for first-time Viagra users.

There have even been alarming reports of men who’ve required treatment for lead poisoning after taking Kamagra purchased online from India.

In addition to the jelly form, Kamagra also comes as a 100mg pill and a ‘super strength’ version that also includes 60mg of dapoxetine, a drug used to treat premature ejaculation. 

Dapoxetine is known to be dangerous to some men with heart, kidney and liver problems. All versions of Kamagra are unlicensed medications in the UK and Australia, meaning it is illegal to buy or sell. 

While we will likely never know for sure whether Warne took Kamagra before his death, the fact remains that black-market Viagra-type products are ubiquitous in Thailand. A police handout shows authorities raiding a Thai pharmacy that was selling knock-off Viagra

While we will likely never know for sure whether Warne took Kamagra before his death, the fact remains that black-market Viagra-type products are ubiquitous in Thailand. A police handout shows authorities raiding a Thai pharmacy that was selling knock-off Viagra

Kamagra is a risky option for men looking for sexual enhancers. A packet contains 100mg of sildenafil citrate - which is double the recommended dosage for first-time Viagra users

Kamagra is a risky option for men looking for sexual enhancers. A packet contains 100mg of sildenafil citrate – which is double the recommended dosage for first-time Viagra users

Other risky options include any type of knock-off Viagra that includes the word ‘black’ or comes in the form of a black pill.

Typically these are double the maximum strength, or 200mg. While they promise  better results, in reality all they will do is make the side effects worse.

Some Viagra users in online sex tourism forums describe the ‘black’ variants as ‘widow-makers’. However, it is unclear if they are responsible for any deaths. 

Dr Whitburn adds: ‘When buying medication online or on the black market, there is a risk that the medication does not contain the correct or active medication or contains higher or lower doses than expected, especially if it is not a reputable online provider.’

While we will likely never know for sure whether Warne took Kamagra before his death, or whether taking it contributed to his heart attack, the fact remains that black-market Viagra-type products are ubiquitous in Thailand.

Other risky options include any type of knock-off Viagra that includes the word 'black' or comes in the form of a black pill; typically these are double the maximum strength, or 200mg The TGA often warns against so-called 'natural' remedies or 'dietary supplements' which actually contain sildenafil and tadalafil

Other risky options include any type of knock-off Viagra that includes the word ‘black’ or comes in the form of a black pill; typically these are double the maximum strength, or 200mg (example seen left). The TGA often warns against so-called ‘natural’ remedies or ‘dietary supplements’ which actually contain sildenafil and tadalafil (example seen right)

Kamagra is widely available in pharmacies throughout Thailand, or at least in the main tourist areas, and no prescription is required. You can even buy it on the street.

For Aussie men traveling with sex in mind, obtaining sildenafil this way is preferable to bringing prescription drugs from home or getting a script from a Thai doctor.

Warne’s trip to Koh Samui was described as a boys’ holiday, but the fact remains a Skyn condom was found in his bag when police were photographing the room where he died. It doesn’t take a genius to work out what his plans might have been.

And his Viagra use back home wasn’t exactly secret either. Shortly after his death, a Sydney gossip columnist reported the former cricketer was a prolific user and had been taking it for at least a decade before his fateful trip to Thailand.

He apparently wasn’t embarrassed by it, openly discussed it with his mates and saw it as more of a sexual enhancer than a treatment for impotence. It is believed he began using it during his relationship with English actress Elizabeth Hurley.

Statement on Viagra side effects 

The Therapeutic Goods Administration… [has] received a total of 1,322 adverse event reports for products containing sildenafil.

In 1,017 of those cases, sildenafil was the single suspected medicine involved in the reported adverse event. Of the reports received, 99 reported a fatal outcome to the TGA.

All medicines can cause side effects (also known as adverse events). Most of these are minor, but sometimes, in rare circumstances, they can be potentially serious.

The TGA applies scientific and clinical expertise to its decision-making to ensure that, based on currently available data, the overall benefits of a product outweigh the risks in the intended population, when used for the approved indications.

The TGA continues to work with the Australian Border Force to help intercept and deter unlawful imports of therapeutic goods from entering Australia, including the unlawful import of products containing sildenafil and/or tadalafil.

Several safety alerts regarding products containing sildenafil and other similar products have been issued by the TGA, most recently in December 2024.

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