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    A Cat Can Order Viagra?

    Online prescriptions are easy to get. Do you know the risks?

    WebMD Feature

    May 1, 2000 (Washington, D.C.) -- Pietr Hitzig, MD, never listened to Alvin Chernov's heart. In fact, he never even met him, let alone checked his blood pressure or pulse. Yet in March 1997, via his Internet web site, the Maryland physician diagnosed the 25-year-old Arizona man with stress-related depression and prescribed two powerful muscle relaxants for him, as well as the diet drug combination widely known as fen-phen.

    Chernov received none of the careful monitoring routinely advised for patients on these drugs and, over the ensuing months, developed a pattern of behavior so bizarre that family members complained to both Hitzig and the Arizona Board of Medical Examiners. Six months later, Chernov committed suicide with a handgun. Family members attribute his death to the wild mood swings brought on by the drugs.

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    What Is a Drug Recall?

    Medicine is rigorously tested for safety and effectiveness before becoming available to the consumer. In the U.S., the FDA makes sure this happens. Once on the market, the FDA, along with the makers of the drug, continue to monitor the medicine for any unforeseen problems. Should an issue develop, or the safety of a medication come into question, a recall may be initiated.

    Read the What Is a Drug Recall? article > >

    Last July, Hitzig, 56, was indicted on 34 federal charges of prescribing medicine illegally between 1996 and 1998. His indictment was just one skirmish in what many law enforcement officials say could become an all-out war on drug-peddling web sites. While some sites distribute drugs both ethically and legally, the vast majority of the estimated 400 online pharmacies are mailing prescription drugs, like Viagra (for impotence) and Propecia (for hair loss), to anyone with a credit card who is willing to fill out a simple questionnaire.

    Medical experts complain that such practices expose patients to doses of drugs that, depending on their personal medical histories, could be lethal or cause them to become extremely ill.

    Regulators point to the case of Robert McCutcheon, a 52-year-old Illinois man who had a family history of heart problems. Without seeking the counsel of his doctor, he ordered Viagra over the Internet. In March of last year, after drinking a few beers on the way home from work, he went to his girlfriend's house, popped a Viagra, and died of a heart attack while having sex.

    Merck vigorously warns expectant mothers not to even handle its Propecia pills for fear of birth defects. But Lisa Meiners, an assistant attorney general in Missouri, was able to order the drug -- in a sting operation -- from a Texas online pharmacy despite being 26 weeks pregnant at the time. Missouri later barred the pharmacy from doing business within its borders.

    Online buyers might also find themselves obtaining defective, potentially dangerous drugs. "Americans can, unwittingly, order prescription drugs from rogue web sites that appear to be American-based companies, but are actually overseas sites offering drugs that are unapproved, counterfeit, contaminated, expired, mislabeled, manufactured in unapproved facilities, or not stored or handled in a proper manner," says Sen. James Jeffords (R-Vt.), the chairman of the U.S. Senate Committee on Health, Education, and Labor.

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