Dear Doctors column March 19, 2007
Question:
What can you tell me about buying prescription drugs online?
Answer:
Buying prescription medications online can offer convenience, especially to people who have limited mobility or transportation or who live far from the nearest brick and mortar pharmacy. In addition, lower prices for certain medication are sometimes available online, and genuine deals can save consumers money.
Buying online does carry some risks, however, and consumers need to make sure they are dealing with a legitimate pharmacy or risk getting counterfeit, mislabeled, or expired pills that may cause harm. In February 2007, for example, the Food and Drug Administration (FDA) reported that a number of people ordering drugs for insomnia, depression, and anxiety (Ambien, Xanax, Lexapro, and Ativan) instead received haloperidol, a powerful antipsychotic often used to treat schizophrenia. At least five of these people needed emergency treatment for symptoms that included difficulty breathing, muscle spasms, and muscle stiffness. The FDA has put images of the counterfeit tablets online.
Other safety problems with drugs purchased online can include:
Ø Medications that are too strong or too weak.
Ø Drugs that aren’t made using safe manufacturing standards.
Ø Drugs that could adversely interact with your other medications.
Ø Drugs that aren’t labeled, stored, or shipped correctly.
The FDA offers the following advice for safely buying prescription medications online:
Ø Get a consultation with your doctor, including a physical exam, before starting any new medication. Your doctor can make sure you are taking the right medication, diagnose underlying conditions, and discuss potentially harmful side effects and drug interactions.
Ø Use only the medications prescribed by your doctor or another health care professional licensed to write prescriptions in the United States.
Ø Use a licensed pharmacy. The National Association of Boards of Pharmacy (NABP) can link you to your state board of pharmacy, which can tell you whether an internet pharmacy is state-licensed. A quicker way to find a licensed online pharmacy is to visit the Verified Internet Pharmacy Site, which requires sites carrying their seal of approval to maintain state licenses and allow inspection by the NABP.
Ø Select sites that provide access to a registered pharmacist. Reputable sites offer a toll-free number for a licensed pharmacist, who can answer any questions you have about your medications.
Ø Beware of online prescribing. Reputable sites require a prescription from a properly licensed health care professional. Some sites offer online prescribing services, allowing customers to fill out a questionnaire that is then reviewed by a practitioner. According to the America Medical Association, a health care professional who offers a patient a prescription based solely on an online questionnaire has not met the appropriate medical standard of care. Without an in-person consultation, including physical exam, patients risk misdiagnosis and receiving a potentially dangerous or unhelpful drug.
Ø Check to make sure the site has appropriate security and privacy protections. Read the site’s policies to make sure your credit card and personal health information is protected.
Ø Shop around. Buying online is sometime cheaper, but your local drugstore may match or beat internet prices.
Ø Consider sticking with US-based sites. The FDA opposes buying drugs from other countries, noting it cannot guarantee the safety of imported drugs, including those purchased from Canadian sites. This is controversial topic, and many drugs from Canadian pharmacies are available at significantly lower prices than those found in the United States. The US government is currently tolerating individual purchases, but the practice is officially discouraged. Drugs from foreign sites may be subject to confiscation. In addition, there is no guarantee that medications from foreign sites are FDA-approved, held to the same rigorous standards safety standards as those sold in the United States, or properly labeled.
Ø Beware of confusing foreign brand names and US brand names. Many foreign medications are marketed under names similar to the brand names of drugs sold in the Unites States, but these drugs are not always the same. In the United Kingdom, for example, the active ingredient in Amyben is amiodarone ─ a medication for abnormal heart rhythms. Consumers could easily confuse Amyben with Ambien, the US brand name of a popular sleeping pill. Taking Amyben instead of Ambien could result in serious health problems. The FDA has identified 105 US brand names that have similar-sounding foreign counterparts with different active ingredients.
Ø Report Web sites that have questionable practices. This helps the FDA keep track of problem sites and can help protect other consumers. Click here to report a suspicious site to the FDA.
Ø Some medications should not be purchased online. Read this FDA Consumer Alert for a list of drugs that have special safety restrictions. Unsupervised use of these drugs can result in serious health problems. Accutane, for example, can cause birth defects, fetal death, and serious mental health conditions and should only be taken by people who are being closely monitored by their physician.
For more information visit the FDA’s Web page, “Buying Medications and Medical Products Online.” This resource offers in-depth information about buying medications as well as tips for purchasing medical devices, including contact lenses, online.