Seniors  |  Adults  |  Medication safety  |  Medicines

Online Pharmacies: Avoid the Frauds

The Bottom Line

Internet pharmacies offer a convenient way to obtain prescription drugs and are frequently used by health insurers. Unfortunately, only about 4% of online pharmacies are actually legal, licensed pharmacies. Fraudulent pharmaices may allow you to purchase prescription medicines without a prescription. The medicines they send may be fake, wrong, or contaminated.

The Full Story

Only about 4 percent of online pharmacies meet federal and state laws. How can you tell if an online pharmacy is legitimate or if it's a fraud? But, about 25 percent of online customers have purchased prescription medicines from online pharmacies. How can you tell if an online pharmacy is legitimate or if it's a fraud?

Fraudulent online pharmacy sites might ask you to fill out a questionnaire instead of requiring a prescription. Often, they are overseas and/or do not provide a mailing address. They are not licensed to do business in your state (or in any state).

Fraudulent online pharmacies offer drug prices that seem unbelievably low. There's a reason: the "drugs" they sell may be fakes. They may have no active ingredients and so cannot help you. Or, they may contain the wrong ingredient or wrong amount. The drugs may be contaminated or they may be old. You may get worse instead of better. Or, you can have unexpected side effects.

Drugs from fraudulent online pharmacies can put your health at risk, or the health of your family. Be sure to look for online pharmacies that are legitimate to protect yourself. A recent study showed that users of "rogue" internet pharmacies had "much higher risks of adverse events"; physicians weren't monitoring dosage, results, contraindications, or adverse effects.

The U.S. Food and Drug Administration (FDA) has established a web site to aid consumers when buying medicines from online pharmacies and offers some tips for selecting a legitimate online pharmacy. Only use sites that:

  • require you to provide a prescription.
  • provide a physical street address in the United States.
  • are licensed by the state in which you reside.
  • offer consultation with a licensed pharmacist.

The National Association of Boards of Pharmacy (NABP) has established standards for online pharmacies and maintains a list of its Verified Internet Pharmacy Sites (VIPPS). VIPPS-designated pharmacies are the safest and include the legitimate online pharmacy services used by many health insurance companies.

If you think you may have taken the wrong medicine, use the webPOISONCONTROL® online tool for guidance or call Poison Control 24 hours a day at 1-800-222-1222.

Rose Ann Gould Soloway, RN, BSN, MSEd, DABAT emerita
Clinical Toxicologist

William G. Troutman, PharmD
Clinical Toxicologist & Professor of Pharmacy emeritus

For More Information

"BeSafeRx: Know Your Online Pharmacy" (FDA)

"Find a VIPPS Online Pharmacy" (NABP)


Cicero TJ, Ellis MS. Health outcomes in patient using no-prescription online pharmacies to purchase prescription drugs. J Med Internet Res. 2012;14(6):e174 doi:10.2196/jmir.2236


Call 1-800-222-1222 or

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Prevention Tips

If you choose to purchase medications online, be sure that the pharmacy is accredited in your state. The safest online pharmacies have met the criteria as Verified Internet Pharmacy Sites. Do NOT purchase prescriptions from online "pharmacies" that do not require a prescription or do not provide a mailing address.

This Really Happened

A 67-year-old man had a history of alcohol abuse, substance abuse, and carbon monoxide (CO) poisoning. During treatment for CO poisoning, his medicines were diphenhydramine and ephedrine.

His doctors learned that the patient had been taking a "tranquilizer" that he purchased over the internet. He was trying to treat his drug addictions without medical treatment or counseling. He did not know the name of the drug.

As a result of taking the "tranquilizer", the patient had constant mouth movements. He thrust his tongue out almost constantly. He had trouble walking and trouble speaking. These conditions were now permanent. They are characteristic of an older type of psychiatric drug which he probably received when he requested a "tranquilizer".

Reference: Levesque CA. Tardive dyskinesia associated with internet drug purchase: letter to the editor. Mayo Clin Proc. 2004;70:1587-1588.