Buying medicines online safely

Buying medicines online can save money and improve access, and it is also the main route by which people acquire counterfeit pharmaceuticals.

The scale of the problem

Regulators and international bodies have repeatedly found that a large proportion of websites selling prescription medicines operate outside any legal framework.

Analyses of seized counterfeit medicines have found wrong active ingredients, wrong doses, no active ingredient at all, and contaminants including industrial chemicals and undeclared pharmaceuticals.

The categories most affected are the ones people are embarrassed to discuss or cannot easily obtain: erectile dysfunction treatments, weight loss drugs, anabolic steroids, sedatives, opioids and, increasingly, GLP-1 medications.

Falsified versions of weight loss injectables have caused documented harm including hospital admissions from insulin substitution.

How to verify a legitimate pharmacy

Specific checks rather than impressions.

Registration with the national pharmacy regulator, verified on the regulator's own register rather than by clicking a logo on the site — logos are trivially copied.

Many countries operate a common logo or seal scheme with a verification link.

A named responsible pharmacist and a physical address in a country whose regulator you can check.

A requirement for a valid prescription for prescription-only medicines, which is the single clearest marker.

A genuine consultation process for services that prescribe, involving clinical questions and the ability to refuse.

Clear contact details and the ability to speak to a pharmacist.

And prices that are not implausible, since a fraction of the market price is a signal rather than a bargain.

The warning signs

Which are consistent.

No prescription required for prescription-only medicines.

A questionnaire that cannot result in refusal.

Unsolicited email or social media marketing.

No physical address, or one in a jurisdiction with no meaningful regulation.

Payment only by bank transfer or cryptocurrency.

Spelling and grammar errors in official-looking material.

Claims of miracle results.

Unbranded packaging, or packaging in a language inconsistent with the claimed source.

And any site selling controlled drugs without a prescription, which is straightforwardly illegal.

Where online supply is genuinely useful

The legitimate uses.

Repeat prescriptions delivered, which is convenient for people with mobility difficulties or long working hours.

Regulated online consultation services for defined conditions, which have expanded considerably and are a reasonable route for people who will not attend in person — including for sexual health, contraception and erectile dysfunction.

Over-the-counter products at lower prices.

Continuity for people who travel.

And access in areas with limited local pharmacy provision.

What to check on arrival

Practical inspection.

Packaging that matches what you have received before, including batch number and expiry date.

An information leaflet in your language.

Tablets matching the described appearance, marking and colour.

No damage, and appropriate temperature control for anything requiring refrigeration.

And any doubt resolved by taking it to a community pharmacy, who will look at it.

Report suspected counterfeits to the national medicines regulator, which most countries have a mechanism for.

The specific categories to be careful with

Where risk concentrates.

Weight loss and GLP-1 medications, where demand has outstripped supply and a substantial illicit market has emerged, including compounded and falsified products with dosing errors.

Anabolic steroids and performance products, which are frequently contaminated and which carry substantial health risks independent of authenticity.

Sedatives and opioids, where counterfeit tablets containing potent synthetic opioids have caused deaths in several countries.

Antibiotics, where self-medication without diagnosis is unsafe and contributes to resistance.

And supplements for sport or weight loss, which have repeatedly been found to contain undeclared pharmaceuticals.

Saving money legitimately

The alternatives to risky sourcing.

Ask about generics and therapeutic alternatives.

Compare prices between registered pharmacies, including online ones, since cash prices vary considerably.

Check prepayment certificates, annual caps and exemptions where your system has them.

Ask for longer prescription durations where clinically appropriate.

Check manufacturer patient assistance programmes for expensive medicines.

And tell the prescriber that cost is a problem, which frequently produces a solution nobody had considered.

Importing medicines

A legal as well as a safety question.

Personal importation rules vary by country and frequently prohibit importing prescription medicines without authorisation, with seizure at customs a common outcome.

Medicines bought abroad may have different formulations, strengths or names.

And travelling with your own medicines requires a copy of the prescription and, for controlled drugs, sometimes a licence — which is worth checking before travelling rather than at the border.

General information only, not medical or legal advice. Verify any online pharmacy with your national regulator, and never buy prescription medicines without a prescription.