It’s a story we’ve covered before (see Study: Substandard & Falsified TB Drugs & Interpol & FDA: Operation Pangea V), but according to experts, it is getting worse: The rise in fake, or substandard prescription drugs, often sold via online pharmacies.
Some of these drugs have none of the promised active ingredients, while others may be less potent than advertised, or are laced with potentially dangerous substitutes or fillers. Often more money is spent trying to duplicate the packaging of a legitimate product, than is spent producing the medicine itself.
And the end result can not only be tragic for the user – but also to society – as using substandard medicines is one of the ways that drug resistant bacteria, viruses, and parasites can be created and spread.
A prime example, In 2012, in FDA Warning On Fake Adderall we learned that some of these drugs don’t even come close to containing what they advertise:
FDA’s preliminary laboratory tests revealed that the counterfeit version of Teva’s Adderall 30 mg tablets contained the wrong active ingredients. Adderall contains four active ingredients – dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate. Instead of these active ingredients, the counterfeit product contained tramadol and acetaminophen, which are ingredients in medicines used to treat acute pain.
And if you think buying from a `Canadian online pharmacy’ is some kind of guarantee that you won’t get ripped off, know some of those are just web fronts for illegal pharmacies operated around the globe.
Yesterday The Lancet published a long report on the spectacular growth of fake online prescription drugs in:
In high-income countries it might not be at the forefront of every practitioner's mind, but the rise of online pharmacies in Europe and the USA could change that. WHO estimates that 50% of the drugs for sale on the internet are fake and even though the online dispensaries might look legitimate, a survey of 10 000 of them done by America's National Association of Boards of Pharmacy (NABP) found that 9938 did not comply with NABP patient safety and pharmacy practice standards or US state and federal laws. Most said they were based in Canada but were really a front for illegal offshore operations.
. . . .
WHO puts the annual death toll from counterfeit drugs at around 1 million. The largest single group is in Africa where around 200 000 people are said to die each year as a result of fake antimalarial drugs. In the USA, in the late 2000s, 81 people died from using an adulterated heparin imported from China and another 68 lost their lives in other parts of the world.
Unless you are buying your prescription drugs from an unscrupulous online pharmacy, Americans are most likely to encounter these fake or substandard medications while traveling to developing countries. The CDC’s Traveler’s Health website offers the following advice.
Counterfeit (or fake) medicines are manufactured using incorrect or harmful ingredients. These medicines are then packaged and labeled to look like real brand-name and generic drugs. Counterfeit medicines are unsafe because they may not be effective or may even harm you.
Counterfeiting occurs throughout the world, but it is most common in countries where there are few or no rules about making drugs. An estimated 10%–30% of medicines sold in developing countries are counterfeit. In the industrialized world (countries such as the United States, Australia, Japan, Canada, New Zealand, and those in the European Union), estimates suggest that less than 1% of medicines sold are counterfeit.
The only way to know if a drug is counterfeit is through chemical analysis done in a laboratory. Counterfeit drugs may look strange or be in poor-quality packaging, but they often seem identical to the real thing. The only way to make sure you have the real thing is to bring all the drugs you will need during your trip with you from the United States, rather than buying them while you are traveling.
If an emergency occurs and you must buy drugs during your trip, you can reduce your chances of buying drugs that are counterfeit:
- Buy medicines only from licensed pharmacies and get a receipt. Do not buy medicines from open markets.
- Ask the pharmacist whether the drug has the same active ingredient as the one that you were taking.
- Make sure that the medicine is in its original packaging.
- Look closely at the packaging. Sometimes poor-quality printing or otherwise strange-looking packaging will indicate a counterfeit product.
- If you buy drugs online, visit Buying Prescription Medicines Online: A Consumer Safety Guide to learn how to buy safely.