Possible Dangers of Buying Medicines Over the Internet

The Food and Drug Administration (FDA) wants to warn consumers about the possible dangers of buying medicines over the Internet. Some Web sites sell prescription and over-the-counter drugs that may not be safe to use and could put people's health at risk.

So how can you protect yourself? FDA says that consumers should know how to recognize a legal Internet pharmacy and how to buy medicines online safely.

Don't Be Deceived

Buying prescription and over-the-counter drugs on the Internet from a company you don't know means you may not know exactly what you're getting.

There are many Web sites that operate legally and offer convenience, privacy, and safeguards for purchasing medicines. But there are also many “rogue Web sites” that offer to sell potentially dangerous drugs that have not been checked for safety or effectiveness. Though a rogue site may look professional and legitimate, it could actually be an illegal operation.

These rogue sites often sell unapproved drugs, drugs that contain the wrong active ingredient, drugs that may contain too much or too little of the active ingredient, or drugs that contain dangerous ingredients. Some Web sites sell counterfeit drugs that may look exactly like real FDA-approved medicines, but their quality and safety are unknown.

Signs of a trustworthy Web site

• It's located in the United States.
• It's licensed by the state board of pharmacy where the Web site is operating (visit www.nabp.info for a list of state boards of pharmacy).
• It has a licensed pharmacist available to answer your questions.
• It requires a prescription for prescription medicines from your doctor or another health care professional who is licensed to prescribe medicines.
• It provides contact information and allows you to talk to a person if you have problems or questions.

Another way to check on a Web site is to look for the National Association of Boards of Pharmacy's (NABP) Verified Internet Pharmacy Practice Sites™ Seal, also known as VIPPS® Seal.

This seal means that the Internet pharmacy is safe to use because it has met state licensure requirements, as well as other NABP criteria. Visit the VIPPS Web site to find legitimate pharmacies that carry the VIPPS® seal.

Signs of an unsafe Web site

• It sends you drugs with unknown quality or origin.
• It gives you the wrong drug or another dangerous product for your illness.
• It doesn't provide a way to contact the Web site by phone.
• It offers prices that are dramatically lower than the competition.
• It may offer to sell prescription drugs without a prescription—this is against the law!
• It may not protect your personal information.

Know Your Medicines

Before you get any new medicine for the first time, talk to your doctor or pharmacist about any special steps you need to take to fill your prescription.

Any time you get a prescription refilled

• Check the physical appearance of the medicine (color, texture, shape, and packaging).
• Check to see if it smells and tastes the same when you use it.
• Alert your pharmacist or whoever is providing treatment to anything that is different.

Be aware that some drugs sold online

• are too old, too strong, or too weak
• aren't FDA-approved
• aren't made using safe standards
• aren't safe to use with other medicines or products
• aren't labeled, stored, or shipped correctly
• may be counterfeit

Counterfeit Drugs

Counterfeit drugs are fake or copycat products that can be difficult to identify. The deliberate and fraudulent practice of counterfeiting can apply to both brand name and generic products, where the identity of the source is often mislabeled in a way that suggests it is the authentic approved product.

Counterfeit drugs may

• be contaminated
• not help the condition or disease the medicine is intended to treat
• lead to dangerous side effects
• contain the wrong active ingredient
• be made with the wrong amounts of ingredients
• contain no active ingredients at all or contain too much of an active ingredient
• be packaged in phony packaging that looks legitimate

For example, counterfeit versions of the FDA-approved weight loss drug Xenical, which contains the active ingredient orlistat, recently were obtained by three consumers from two different Web sites.

Laboratory analysis showed that the capsules that the consumers received contained the wrong active ingredient, sibutramine. Sibutramine is the active ingredient of a different medicine called Meridia, a prescription drug also approved by FDA to help obese people lose weight and maintain weight loss. In addition, sibutramine is classified as a controlled substance by the Drug Enforcement Administration (DEA) because of its potential for abuse and misuse.

Using medicine that contains an active ingredient that wasn't prescribed by your licensed health care provider may be harmful.

FDA also became aware recently of a number of people who placed orders over the Internet for one of the following products:

• Ambien (zolpidem tartrate)
• Xanax (alprazolam)
• Lexapro (escitalopram oxalate)
• Ativan (lorazepam)

Instead of receiving the drug they ordered, several customers received a product that contained haloperidol, a powerful anti-psychotic drug. As a result, these customers needed emergency medical treatment for symptoms such as difficulty in breathing, muscle spasms, and muscle stiffness—all problems that can occur with haloperidol. FDA continues to proactively protect consumers from counterfeit drugs. The agency is working with drug manufacturers, wholesalers, and retailers to identify and prevent counterfeit drugs. FDA also is exploring the use of modern technologies and other measures that will make it more difficult for counterfeit drugs to get mixed up with, or deliberately substituted for, safe and effective medicines.

How To Protect Yourself

• Only buy from state-licensed pharmacy Web sites located in the U.S.
• Don't buy from Web sites that sell prescription drugs without a prescription.
• Don't buy from Web sites that offer to prescribe a drug for the first time without a physical exam by your doctor or by answering an online questionnaire.
• Check with your state board of pharmacy or the National Association of Boards of Pharmacy to see if an online pharmacy has a valid pharmacy license and meets state quality standards.
• Look for privacy and security policies that are easy to find and easy to understand.
• Don't give any personal information, such as a social security number, credit card information, or medical or health history, unless you are sure the Web site will keep your information safe and private.
• Use legitimate Web sites that have a licensed pharmacist to answer your question.
• Make sure that the Web site will not sell your personal information, unless you agree.