Our receptionist was in with her own dog who had become suddenly mysteriously ill with severe muscle cramping, nausea, and fever. She had just given all of her dogs their monthly heartworm preventative, the same type they had been taking for years, and because they were all the same size she gave each dog a dose out of the same box. Within hours she found that all of her dogs were showing the same symptoms. Clearly there was something wrong with the medication, so I called the manufacturer to discuss the adverse reaction. The first thing they asked was where the medication was purchased. Because our receptionist prefers to use a brand of heartworm preventative that we don’t generally keep in stock we have her order it from a reputable online pharmacy. As soon as the manufacturer discovered the medication had been ordered online they lost all interest in pursuing it any further. I thought they would have wanted to investigate whether there could have been a glitch in the manufacturing process or if somebody may be making counterfeit medication and passing it off as theirs, but the only response I could get was “Talk to the Hand.“ It made me start to wonder how often this sort of thing happens when medication is purchased online.
What I have discovered is that there is no reliable measure of the frequency of counterfeit, expired, adulterated, inactivated, or improperly stored and handled medication in the online pharmacy industry on both the human side and the animal side. The consensus is that fake or unsafe medicine comes much more commonly from developing countries in Latin America and Asia, but anywhere there is an opportunity to make money there will be opportunists ready to take advantage. In pet medications the most common counterfeit products are flea and tick preventatives, heartworm preventatives, and non steroidal anti-inflamatories. Frontline and Advantage brands of flea and tick treatments were specific victims of skillful counterfeiters who managed to produce packaging that was almost undistinguishable from the real stuff.
This is not to imply that all online pharmacies sell dangerous, fake, expired, ineffective products, but it can be difficult to sort out the good ones from the bad ones. A slick looking home page is no guarantee of trustworthiness, but can sometimes seem like the only thing available by which to judge the quality of the business. One thing that can really help is the brown Vet-VIPPS (Veterinary Verified Internet Pharmacy Practice Sites) seal that will appear on the front page of any internet pharmacy that has chosen to participate in a voluntary accreditation program overseen by the National Association of Boards of Pharmacy (NAVP). In order to be certified, a business has to meet exacting standards for where they get their products, how they handle sensitive customer information, etc. Using an online pharmacy with the vet-VIPPS seal improves your chances of getting the product you think you are getting, but know that manufacturers will not stand behind medication that is purchased from any online pharmacy, whether certified or not.
If you buy your heartworm preventative from your veterinarian and you give it appropriately, but your dog still tests positive for heartworm disease then most manufacturers will pay for treatment for your dog. The same goes if your animal still has fleas or ticks after using a flea and tick product purchased from your veterinarian. Everyone has to make their individual choice for whether that extra guarantee is worth some extra expenditure as well.