To ensure the safety of prescription medications the Food and Drug Administration (FDA) requires that medications go through safety clinical trials, and that the benefits outweigh the risks associated with a drug before it is approved for marketing and sale in the United States. Unfortunately pharmacists outside the United States that dispense drugs manufactured outside of the United States are not bound by federal regulations, posing a health hazard for those who choose to purchase from them. Because some pharmacies, even within the United States, import and distribute non-FDA approved drugs manufactured outside of the country, it is important to make sure that the online pharmacy you choose only dispenses FDA approved prescription medications. The main concerns about purchasing prescription medication from rogue online pharmacies that dispense drugs not approved by the FDA approved are, the drugs you receive might be counterfeit, contaminated, sub-potent, super potent or the wrong drug, all of which could jeopardize your health. In the worst-case scenario, you may not receive any medication at all despite paying for it. Therefore, it is important to make sure that the online pharmacy is licensed and based in the United States and if not that it is accredited and dispenses drugs approved by its government.
Since rogue pharmacies tend to want to be invisible and unreachable except in cyberspace, it is important to obtain up-to-date contact information in the form of a physical address and telephone number. With that information you can attempt to obtain a Better Business Bureau report. If a Better Business Bureau report is not available you can then do an advanced Dun & Bradstreet search to make sure that the business does in fact exist. Avoid doing business with operations that only provide you with an e-mail address as a form of contact. In addition to possibly precluding you from obtaining credentials and information about business practices, the provision of just an e-mail address might be an indicator of the quality of customer service you can expect or not expect. Also obtain the license number and any accreditation credentials from the pharmacy then verify the information through the state pharmacy board of the state in which the pharmacy is based, an all important step because some of the alleged Internet pharmacies are not really legitimate licensed operations. In addition to verifying license status and the fact that the pharmacy is located in the United States and meets quality standards, state boards of pharmacy or the National Association of Boards of Pharmacy (NABP) can also let you know if an online pharmacy is accredited by Verified Internet Pharmacy Practice Sites (VIPPS) or other recognized accreditation programs. VIPPS pharmacy sites can also be identified by the VIPPS hyperlink seal displayed on their Web sites.
Many pharmacies online advertise the filling of prescriptions without a doctor’s order which can certainly be a health hazard if a prescription is filled without a thorough knowledge and understanding of your health record. The pharmacies that do this tend to hurdle the legal requirement of a doctor/patient relationship by having you fill out a questionnaire which is supposedly reviewed with you by their doctor during a telephone consultation. If you elect to participate in this type of interaction and relationship (which I do not recommend) be sure that the pharmacy engaging in this practice is compliant with the telemedicine laws of the state in which it is based since the definition of the establishment of a doctor/patient relationship varies from state to state. Also obtain the credentials of the doctor providing the telephone consultation including the state in which he or she is licensed and the license number, then verify that information through the medical board of the state in which the doctor is licensed to make sure that a valid license is held for the state in which you are located at the time of the telephone consultation. Otherwise the alleged relationship established by telephone and Internet would not be a legitimate one inasmuch as the interaction would be tantamount to the practice of medicine without a license. The take-home message is avoid buying prescription medications online without the order of a physician who is thoroughly familiar with your health history based not only on subjective information, but objective data as well including a physical examination, laboratory tests and x-rays if warranted. A doctor’s order also prevents the unauthorized substitution of generic prescription medication for brand-name medication, so make sure you know whether or not their doctor has authorized generic substitution, and if not be sure to know what the brand-name pill looks like before it arrives following shipment. The best way to be familiar with what brand-name pills look like is to order the first prescription from a local pharmacy and keep one or two of the pills in their respective bottles for comparison when your shipment arrives.
Although the legal ramifications of not being compliant with federal and state laws regarding the sale, importation and distribution of pharmaceutical medications generally rest with the pharmacy, the purchase and possession of controlled substances such as narcotics without a doctor’s prescription can result in legal consequences for the buyer, depending on the state of residence. Thus, the message is the same. Do not buy prescription medications, particularly controlled substances, without a doctor’s prescription. If you are elect to purchase medication not available in the United States and not approved by the FDA from a foreign Internet pharmacy for treatment of a condition for which your doctor feels it is indicated, be sure to obtain and keep on record a letter or note from your physician stating that.