The first bit of advice is that consumers should be wary of sites that sell drugs that are illegal offline. This can appear in a number of ways, such as when the medication in question is illegal in the US, but not in other countries. This can sometimes be the case for some antidepressants, anti-impotence drugs, and weight loss products. Other times, the medication in question could be considered illegal in most countries. In such a case, the website is likely an illegitimate one that consumers should avoid at all costs. The FDA advises that US customers not purchase any illegal or restricted medication off the Internet, citing that they're banned by the FDA because they might have harmful side effects or have not been put through thorough testing.
Other concerns pointed out by the FDA are those online pharmacies that allow users to order medicine online based on questionnaires. As any doctor or medical professional will tell you, filling in a questionnaire about your symptoms and your medical history is no substitute for an actual consultation with a flesh-and-blood doctor. Arguably, even over-the-phone and webcam-based consultations don't quite come close enough to providing enough information for a proper diagnosis. Besides the possible lack of details, there is also the very real risk of an incorrect diagnosis. The dangers of taking a drug, even one that doesn't require a prescription, based solely on the results of an online questionnaire (which can only accommodate a limited number of variables) can prove disastrous to someone's health. This can become even worse if the drugs do not have FDA approval, or are known to be dangerous when taken incorrectly.
Some FDA officials have also expressed alarm over the fact that some websites do not check for the prescriptions whenever orders are placed. A number of online pharmacies sell prescription-only drugs, but do not have a visible system for checking the validity of the order by asking for a copy of the prescription. This means that just about anyone with a credit card and an Internet connection can order any prescription-only medication without having to provide a prescription. This is, according to most authorities, the largest bypassing of any FDA regulation that has been found on the Internet, aside from selling illegal medications.
The online pharmacy industry does have some form of self-policing in place. The Verified Internet Pharmacy Practice Sites (VIPPS) program put into place by the National Association of Boards of Pharmacy (NABP) is an example of this. The standards of the program are rigid and very strict, designed to make it difficult for fraudulent sites to be certified as a compliant and trustworthy online pharmacy. The guidelines the program uses determine which sites gain approval, as well as which sites retain it.
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