Buying prescription drugs online

Millions of consumers are using the Internet to get health information. And thousands of web sites are offering health information. Some of those sites are reliable and up-to-date; some are not. How can you tell the good from the bad?

First, it's important to carefully consider the source of information and then to discuss the information you find with your health care professional. These questions and answers can help you determine whether the health information you find on the Internet or receive by e-mail from a Web site is likely to be reliable.

The medicines that sold online can be fake (counterfeit or 'copycat' medicines); can be too strong or too weak, or have dangerous ingredients, or have expired (are out-of-date), or haven't been approved or checked for safety and effectiveness, can be made using non-safe standards, or not safe to use with other medicine or products you use.

Be sure your privacy is protected: look for privacy and security policies that are easy-to-find and easy-to-understand. Don't give any personal information such as social security number, credit card, or medical or health history, unless you are sure the website will keep your information safe and private.

Your medicines benefits and risks

Although medicines can make you feel better and help you get well, it's important to know that all medicines, both prescription and over-the-counter, have risks as well as benefits.

The benefits of medicines are the helpful effects you get when you use them, such as lowering blood pressure, curing infection or relieving pain. The risks of medicines are the chances that something unwanted or unexpected could happen to you when you use them. Risks could be less serious things, such as an upset stomach, or more serious things, such as liver damage.

There are several types of risks from medicine use: a) The possibility of a harmful interaction between the medicine and a food, beverage, dietary supplement (including vitamins and herbals), or another medicine. Combinations of any of these products could increase the chance that there may be interactions. b) The chance that the medicine may not work as expected. c) The possibility that the medicine may cause additional problems.

The same is true before using any medicine. Every choice to take a medicine involves thinking through the helpful effects as well as the possible unwanted effects.

The benefit and risk decision is sometimes difficult to make. The best choice depends on your particular situation. You must decide what risks you can and will accept in order to get the benefits you want.

In many situations, the expert advice of your doctor, pharmacist, or other health care professionals can help you make the decision.

Before use a medicine make sure you understand the directions; ask your doctor if you have questions or concerns. Always double check that you have the right medicine.

Before starting any new medicine or dietary supplement (including vitamins or herbal supplements), ask your doctor again if there are possible interactions with what you are currently using.

You always have to pay attention to how you are feeling; note any changes. Write down the changes so that you can remember to tell your doctor, pharmacist, or other health care professional.

Precautions for over-the-counter medicine

Drug interactions may make your drug less effective, cause unexpected side effects, or increase the action of a particular drug. Some drug interactions can even be harmful to you.

Early in a drug's development, companies conduct research to detect or predict potential interactions between drugs. Experts evaluate the drug-interaction studies as part of assessing a drug's safety.

Not everything that happens in a test tube will become meaningful in humans, though. Results from these test-tube studies can tell us whether need to do further testing in people to find out if an interaction is clinically significant.

Over the last several years, there has been a substantial increase in the number of drug-interaction studies the FDA sees in new drug applications. If drug interactions are significant enough, they can prevent a drug from being approved by the FDA. If the agency determines that known drug interactions can be managed and that a drug's benefits outweigh the risks for the intended population, a drug will be approved. Drug-interaction information then goes into the drug's labeling in the sections on "clinical pharmacology," "precautions," "warnings," "contraindications," and "dosage and administration."

Health professionals also use computer systems with drug-interaction screening software, electronic prescribing, and other technology. Mark Langdorf, M.D., chair of the department of emergency medicine at the University of California, Irvine, says, "In a busy emergency room, you have to quickly find out what a patient is taking and how those drugs could interact with other treatments."

The large number of drugs on the market, combined with the common use of multiple medications, makes the risk for drug interactions significant. Consumers need to tell doctors what they're taking and ask questions, and health professionals could do a better job at trying to get the information they want.

So rather than asking patients what medications they take, doctors should make the questions specific: "Are you taking any over-the-counter medication? Are you taking any herbal treatments or vitamins?"

Examples of food with tyramine are cheese and soy sauce. Grapefruit juice should not be taken with certain blood pressure-lowering drugs or cyclosporine for the prevention of organ transplant rejection. Alcohol should not be taken with pain relievers such as Tylenol (acetaminophen) or ibuprofen because of the increased risk of liver damage or stomach bleeding.

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