[Updated January 9, 2019]
Purchasing veterinary medications such as heartworm preventatives online can offer significant cost savings, but how can you be sure that you’re buying the real thing and not counterfeit products from China, which can be impossible to tell apart?
I recently read about a dog who tested positive for heartworms despite being given monthly preventative medications. The reason may be that the heartworm preventative the owner purchased online was not what it claimed to be.
The Veterinary Information Network (VIN) looked into Nuheart, a generic form of ivermectin that claims to be comparable to Heartgard. It is sold over the counter in Australia, where no prescription is required. VIN reported that one online pet pharmacy marketing Nuheart in the U.S. lists a street address in Washington state that belongs to Mail Boxes Plus. That same address is linked to a number of other online pharmacies whose websites are registered to entities that share an address in the South Pacific Cook Islands. None of those companies responded to VIN’s attempts to contact them by phone or email.
This is just one example of a widespread problem with drugs being sold on the Internet that may be counterfeit, adulterated, or expired. Warnings abound regarding the dangers of buying medications online. The U.S. Food and Drug Administration (FDA) states that it “has found companies that sell unapproved pet drugs and counterfeit pet products, make fraudulent claims, dispense prescription drugs without requiring a prescription, and sell expired drugs.”
So how can you be sure that “what you see is what you get”? One solution is to look for the Veterinary-Verified Internet Pharmacy Practice Sites (Vet-VIPPS) seal of approval from the National Association of Boards of Pharmacy (NABP).
When Vet-VIPPS was first announced in 2009, it sounded like a great idea. Unfortunately, no veterinary pharmacies were approved at that time, but the situation has improved. A quick search yielded 11 verified online veterinary pharmacy sites. I was pleased to see four sites I’ve recommended on the list: 1-800-PetMeds, Drs. Foster & Smith, PetCareRx, and National Pet Pharmacy.
Note that these pharmacies will not offer to sell you prescription medications without a prescription. Administering medication without the help of a veterinarian is not a smart way to save money. Mistakes can range from giving the wrong dosage to using the wrong medication entirely, or giving dangerous combinations of drugs. Some inappropriate medications are only ineffective; others could be dangerous or even fatal.
The FDA has the following suggestions for protecting yourself when purchasing pet medications online, using the acronym AWARE:
-Ask your veterinarian if she knows anything about the site you plan to use.
-Watch for red flags, such as not requiring a prescription, not listing an address and phone number, or not having a pharmacist available to answer questions.
-Always check for site accreditation, such as from Vet-VIPPS.
-Report problems and suspicious online pharmacies. They suggest reporting any problems first to the manufacturer, and then to the FDA’s Center for Veterinary Medicine (see www.fda.gov/AnimalVeterinary/SafetyHealth or call 1-888-FDA-VETS).
-Educate yourself about online pharmacies.
Use common sense when purchasing medications online; if a deal seems too good, you’re likely not getting the real thing.
Another consideration when buying medications online is that the manufacturer’s warranty may be invalidated by an online purchase. Manufacturers of heartworm preventatives in particular guarantee products only when purchased from a veterinarian; not even a VIPPS-accredited pharmacy will do.
Fortunately, some online pharmacies offer their own guarantees. For example, 1-800-PetMeds claims that its guarantee is even better than the manufacturer’s: it will cover the cost of treatment if your dog becomes infected while taking heartworm product purchased from its site as long as the drug has been used for nine consecutive months prior to diagnosis (see 1800petmeds.com/guarantee.jsp). Drs. Foster & Smith also offers its own guarantee for all heartworm preventatives it sells (drsfostersmith.com/general.cfm?gid=569).
Many pets need to take drugs that have been compounded, where the drug’s dosage, form, or flavor are manipulated to make them work for animals. Compounding pharmacies produce drugs in dosages suitable for small dogs, in flavors that pets are willing to eagerly eat, and in forms such as transdermal, where the drug is applied to the skin rather than given orally. Compounding pharmacies can also be a source for drugs that have been discontinued. Because of their specialized nature, compounded drugs don’t go through an FDA drug-approval process, and so are not formally tested for safety or efficacy.
Compounded drugs can be life-savers for some pets, but they can be ineffective if poor quality ingredients are used and deadly when mistakes are made. Twenty-one polo horses died in 2009 after being injected with a vitamin compound that included a toxic amount of selenium due to an error by the compounding pharmacy that made it.
The NABP doesn’t list any compounding pharmacies, although Choice Compounding Pharmacy (choicecompoundingpharmacy.com) was recently granted approval. In addition, there’s a separate organization, the Pharmacy Compounding Accreditation Board (PCAB), that focuses on this area of specialization. The PCAB was created in 2004 in an attempt by the pharmacy industry to police itself and raise the quality of compounded drugs. Go to its website at pcab.info to search for accredited compounding pharmacies by state.
Not every pharmacy without approval from VIPPS or PCAB sells counterfeit or dangerous products. The approval process is costly and takes time; not all pharmacies can afford it. In the absence of reliable information, however, these accreditations offer peace of mind when buying veterinary medications for your dog from someone other than your veterinarian.
– Mary Straus
For more information:
-To find a Vet-VIPPS online pharmacy, see:
nabp.net/programs/accreditation/vet-vipps/
-Pharmacy Compounding Accreditation Board: pcab.info
-“Online Veterinary Pharmacies Exploit Cross-Border Regulatory Gaps”:
news.vin.com/vinnews.aspx?articleId=18361
-FDA Animal & Veterinary:
www.fda.gov/ForConsumers/ConsumerUpdates/ucm048164.htm
www.fda.gov/AnimalVeterinary/SafetyHealth/ReportaProblem/ucm055305.htm
