We had a bad day today with online pharmacies. One client came in with Frontline Plus she had recently ordered, but it had all the obvious hallmarks of a counterfeit product. The logo and logo colors were wrong, it had an expiration date (and real Frontline Plus never expires), and it had instructions to apply it every two weeks instead of every four.

Next, I received an email from a woman who purchased a heartworm medication for her dog online and was worried it could be counterfeit. I had never heard of the product, and after some research it turns out it’s an Australian product that is being sold without a prescription to people in the U.S. I had no way of letting her know if the product was authentic, and I let her know that I had to be suspect because legitimate online pharmacies in our country request a prescription before dispensing heartworm medication. And this brings me to the third example . . .

A client came in with their dog for a heartworm test today because we couldn’t approve a refill for the heartworm pills without having a recent heartworm test result on file. An online pharmacy had contacted us last week for permission to fill the heartworm medication prescription for this owner, but we declined noting that we would only be able to approve it once the test was performed. As it turns out, the online pharmacy had sent the medication to the owner anyway! We called that company to ask what happened, and they said a specific employee at our hospital gave verbal approval over the phone to fill the prescription. This is disheartening because we only approve such prescriptions in writing, and that employee (who reliably denies giving verbal approval) knows and follows our online prescription policy appropriately.

That’s three strikes for the online pharmacy world in one single workday. Not encouraging.

If you’re worried you may have received a counterfeit medication, report it with the National Pesticide Information Center (NPIC) at 1-800-858-7378. Regarding the pharmacy that mailed the heartworm pills to our client without a prescription, I’m off to lodge a complaint with the FDA. Should be interesting!