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Buying Drugs Across the Border

Discount pharmacies line the borders. But do these drugs meet U.S. standards? Read this before you cross the line.

Handled With Care? continued...

For its part, the FDA warns that drug safety regulations differ from one country to the next and that people who buy drugs over the Internet or across the border can't be sure that the drugs they're getting have been properly handled. Even when the drugs come from a reliable manufacturer, some medications, such as liquid antibiotics, may not get the refrigeration they require. Other drugs may lose potency after only a few months as they sit in storage or may be sold past their expiration dates.

The FDA cautions that potential health risks from imported drugs include:

  • Uncertainties about quality assurance procedures in manufacturing plants not monitored by the FDA
  • Potential counterfeit drugs packaged to look like the real thing
  • Presence of "untested substances" that may be unsafe or not be legal for use in the U.S.
  • Lack of medical supervision of patients taking drugs that require close monitoring and dose adjustment, such as diabetes medications and anticoagulants (blood thinners)
  • Problems with labeling about proper use and storage of medications, or labels that are printed in an unfamiliar language

Good Neighbor Policy

Critics of cross-border pharmacies also warn that regulations that apply to drugs sold within a country to that country's citizens may not apply to drugs sold only for export. They point to Canada, for example, which requires that all drugs sold in Canada to Canadian citizens be approved for use by Health Canada, the federal agency that is the equivalent of the FDA and the CDC in the U.S. But if a drug is made only for export outside Canada, the watchdog agency does not apply the same rules and standards.

"If a drug is made in Canada and only intended for export, not for domestic use, there are different regulations that are applied," says Joel Lexchin, MD, associate professor in the School of Health Policy and Management at York University in Toronto, Ontario. But Lexchin says that should not be a concern to American consumers. "As far as I know, everything that's being purchased by Americans is also being used by Canadians, so that sort of the thing is just not an issue."

Indeed, Jirina Vlk, a spokesperson for Health Canada, tells WebMD that in many cases the Canadian regulations may be more stringent than those of the U.S. For example, the antidepressant Prozac is approved for use in children under the age of 18 in the U.S., but not in Canada, so the Canadian product will contain warnings about using the drug in children.

Lexchin points out that the chemicals used to make drugs in both Canada and the U.S. may come from many different countries. "When you buy a drug in the United States that is supposedly manufactured in the United States, it may have been tableted or made into a cream there, but the ingredients that are in there may have come from a variety of different countries, and the FDA does not consider that those are unsafe."

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