Buying Medicines Online: Safety

The scene is becoming increasingly common in the U.S.: Consumers are replacing a trip to the corner pharmacy with a click onto the Internet. This is where they find hundreds of websites selling prescription medicines and other health products.

Many of these are safe, legal companies that genuinely offer convenience and privacy. They use the same safety measures as more traditional methods for prescribing medicines. For the most part, consumers can use these services with the same confidence they have in their neighborhood pharmacist. Some of these sites are familiar large pharmacy chains. Others are small, locally owned and operated pharmacies, set up to serve their customers electronically.

It is always important to be careful when buying medicines online. Some websites sell products that are not FDA-approved. This means they haven’t been checked for safety and effectiveness. Other websites may not follow established procedures meant to protect consumers. For example, some sites only ask you to fill out a questionnaire before ordering prescription medicines. They don’t require face-to-face interaction with a healthcare professional.

Buying medicines from sites like this may put your health at risk. You may end up with medicine that isn’t safe to take with other medicines or products that you use. Or the medicine you buy may be contaminated, fake, or outdated. The dose may be seriously different in each pill if the pills were not manufactured under the conditions required by the FDA.

A brave, new world

For some people, buying prescription medicines online offers advantages not available from a local pharmacy, including:

• Greater availability of medicines for people confined to their homes, or for those who live far from the pharmacy

• The ease of being able to compare many sites to find the best prices and products

• Greater convenience and access to a wide variety of products

• Easier access to written product information, and references to sources other than what you would typically find in traditional storefront pharmacies

• The ability to order products and talk with a pharmacist in the privacy of your home

Internet medicine shopping also claims to save consumers money. In some cases, this is true.

But consumers seeking health products online can find dozens of sites that the FDA says are legally questionable. Many of them specialize in providing medicines for erectile dysfunction, baldness, or weight loss. Others, based in foreign countries, promise to deliver prescription medicines at a much cheaper price than in the U.S. Foreign or illegal medicine sources may be different from those approved in the U.S. Or they may be past their expiration dates. Others make false health claims or advertise that you can buy medicines with no prescription.

Overseeing online sales

Whether new legislation will improve oversight of online pharmacies remains to be seen. State medical boards regulate medical practice, while state pharmacy boards oversee pharmacy practice. The FDA and the Federal Trade Commission make sure that medicine sellers make legal, scientifically proven claims for their products. Many other agencies, such as the U.S. Customs Service and the U.S. Postal Service, enforce laws regarding the shipment of medicine products.

The FDA regulates the safety, effectiveness, and manufacturing of pharmaceutical medicines. It also regulates a part of the prescribing process.

Regulating online sales of health products is still fairly new. But the FDA has successfully taken action against illegal sites. Some websites were developed during the height of the pandemic under emergency conditions, so some safeguards may be lacking, such as the physical exams generally expected as part of the provider–patient relationship.

How online sales work

In general, legal online pharmacies work this way:

• Consumers open an account with the pharmacy and submit their credit and insurance information. The pharmacy is licensed to sell prescription medicines by the state in which it operates.

• After creating an account, you must submit a valid prescription. Your healthcare provider can call it in. Or you can send it to the pharmacy by fax or mail.

• Some online pharmacies send products from a central spot. Others allow you to pick the prescription up at a local pharmacy. Prescriptions usually are delivered quickly, often with no shipping charge. For an extra fee, many sites will deliver overnight.

• Sites typically have a way for you to ask questions of the pharmacist, either through email, through a web portal, or a toll-free number.

Some sites have arisen for the safe and knowledgeable administration of a very few, highly specialized medicines. Check with an agency such as the National Association of Boards of Pharmacy to be sure the site is accredited for that service.

What consumers can do

With hundreds of medicine-dispensing websites in business, how can you tell which sites are legitimate ones? The FDA offers these tips to consumers who buy health products online:

• Check with the National Association of Boards of Pharmacy (NABP) to determine if the site is a licensed pharmacy in good standing. The NABP can be reached at 847-391-4406 or online at nabp.pharmacy.

• Don't buy from sites that offer to prescribe a prescription medicine for the first time without a physical exam, sell a prescription medicine without a prescription, or sell medicines not approved by FDA.

• Stay away from sites that don’t provide access to a registered pharmacist to answer questions.

• Stay away from sites that don’t identify whom you are dealing with or don't provide a U.S. address and phone number to contact if there's a problem.

• Beware of sites that advertise a new cure for a serious disorder or a quick cure-all for a wide range of health problems.

• Be careful of sites that use impressive-sounding terms to cover up a lack of good science. Also, watch out for sites that claim the government, the medical profession, or research scientists are working together to block a product.

• Don’t use sites that include undocumented case histories claiming amazing results.

• Talk with your healthcare provider before using any medicine for the first time.

If you think a site is illegal, you can report it to the FDA online at FDA.gov.