Last week I mentioned that it could be dangerous to buy your prescription medications online.

Is this really a problem? Am I just being an overly protective doc? You be the judge.

There are various reasons for purchasing medications online, but finances drive most of them.

I understand why this happens—some medications are extremely expensive, a problem compounded by the fact that insurance coverage is not always the best. In fact, some policies no longer cover the more expensive medications at all.

If you have been prescribed a medication that is breaking your budget, what are you supposed to do? Online suppliers provide an alternative that can sound compelling, until something goes wrong.

But what can go wrong, you may ask? According to the FDA Consumer Guide, here are some of the concerns:

• Some medications are fake.
  • They are made to look like the name brand drugs, but have no actual medicine in them.
  • Some are said to be ‘generics’ of the name brands, but there aren’t any generics for that drug. Some sites will state that these are available from manufacturers in other countries that the US won’t allow to be marketed in the US, or that the pharmaceutical companies are keeping them secret so they can make more money. Not true.
• Some are too strong or too weak.
  • It may be the actual medication, but the quality controls are not there to protect you. You may get a higher dose in one pill, and a lower dose in the next one. Depending on the drug, this can be life threatening.
• Some may have dangerous ingredients.
  • They may have been ‘cut’ with a substance that may be physically hazardous. Yeah … really. This makes the medication go further, and increase the profits for that company.
  • Remember, these medications may not be FDA-approved or regulated, depending on where that company is located.
• The drugs you are buying may be expired.
  • Sometimes this matters—sometimes it doesn’t. But when it does, it’s a big deal.
•   The medications aren’t:
  • Made with safe standards
  • Shipped safely
  • Stored properly
  • Labeled correctly
• Some sites:
  • Aren’t U.S. or state licensed pharmacies
    • Some are not pharmacies at all
• May give an incorrect diagnosis.
• May not protect your personal information, and may have the sale of your information as the main goal of the website.

If you are in a position in which you must purchase online (and I hope you are not) there are some things you can do to protect yourself. The most important practices that help protect you are:

• Make sure that the pharmacy is located in the U.S. and licensed in the state in which it resides.
• Make sure the site has a licensed pharmacist available.
• Make certain the online pharmacy requires a written prescription. If they don’t, run away.
• Be certain that there is a way to speak with a person. Some sites have a Contact Us button that doesn’t go anywhere. Check that out to make sure.
• Don’t join anything, and if they say you must, run away again.
• Look for the information about who has access to your records. This should be stated and easy to find.

If you are not sure about the site, ask your friends or doctor about it. They will usually have some insight, and it may prevent a dangerous outcome.