Grand Theft Auto V contains nudity, strong profanity, copious amounts of violence, implied sex acts, and allows players to smoke weed and snort cocaine, says the Entertainment Software Rating Board.
The US rating board's summary details all the potentially offensive aspects of the open world title by Rockstar, which it deems suitable only for those older than 16.
"The game includes depictions of sexual material/activity: implied fellatio and masturbation; various sex acts that the player's character procures from a prostitute," said the board.
"While no nudity is depicted in these sequences, various sexual moaning sounds can be heard."
According to the ESRB, nudity in the game is present primarily in two settings: a topless lap dance in a strip club, and a location that includes male cult members with exposed genitalia.
There are opportunities to smoke marijuana from a bong or joint, as well as use cocaine.
"Players' character can, at various times, consume alcohol and drive while under the influence," said the ESRB.
"The words "f***," "c**," and "n*****" can be heard in the dialogue."
Grand Theft Auto V has been rated R18 in New Zealand and Australia. It will be available for Xbox 360 and PlayStation 3 from September 17.