Concerns Regarding The Source Of Your Pet’s Medication

     Being part of the veterinary community for many years, we have recently come face to face with the growing number of internet pharmacies offering medical supplies, prescription medications and flea control products for pets.     Occasionally a client of ours will ask if we will write a prescription for a medication so that he/she may get it through a catalog, television advertisement, or the Internet. Sometimes we get faxes from internet pharmacies asking for our permission to dispense prescription medications (e.g., flea and heartworm preventive), as well as non-prescription flea products. Although we will write prescriptions for our clients, we have serious concerns about filling such requests and we would like to explain why we usually recommend against getting medication through these channels.     

     Many of the major veterinary pharmaceutical manufacturers and distributors do not sell or condone selling their products directly to these outlets for resale to the public. They sell them only to veterinarians who have a valid license to practice veterinary medicine and who have a doctor/client/patient relationship with the person ordering the medications. This means that your pet must be examined by your veterinarian within the last year (in order to be certain that the medications will be safe and effective for your pet). Therefore it becomes a question of quality control. Where are the catalog and internet pharmacies getting these drugs if not directly from the drug companies or distributors? How have they been handled, transported and stored? If they are not getting the drugs directly from the manufacturers, they may be obtaining them unethically, if not illegally. Some internet pharmacies have had multiple lawsuits against them for unethical and/or illegal sale of products. We have received letters from several of the manufacturers (such as Novartis who makes Sentinel, Interceptor and Program, and Bayer who makes Advantage and Pfizer who makes Rimadyl) telling us that they will only stand behind their products when they are sold or prescribed by a licensed, practicing veterinarian. (This is why we have opened up our own online pharmacy/store.  The medications, food, neutraceuticals, etc. that you order through our store are sent directly from the manufacturer that we purchase our in-clinic products from).

     In other words, any product guarantee or assistance with adverse drug reactions may not be honored if the manufacturers’ products are purchased through a non-authorized source, such as internet pharmacies, groomers, and pet stores.     In addition, we are concerned with the quality of the medication that is being sold. We, as well as many of our colleagues, have seen products obtained here in the United States that are labeled for sale in foreign countries, with directions written in languages other than English. Recently, counterfeit and non-E.P.A. approved Advantage and Frontline were found in multiple San Diego pet stores.

     We believe that your pet deserves a Doctor/Patient relationship when dispensing most medications so there is never a question of quality or safety. All medications that you purchase from Governor Animal Clinic come with assurances from the drug manufacturers as well as us, that the products are legally acquired and ethically prescribed. More importantly, if untoward reactions do occur, the manufacturer and veterinarian are ready to help. Most veterinarians stand behind the medications they sell and if side effects or reactions do occur they will evaluate and treat your pet, often with the help of the drug company, at minimal or no charge.     

     Because your veterinarian cares about you  and the quality of the products administered to your pet, we hope that you would be diligent in choosing where you purchase your pet's medications.  Your veterinarian has your pet’s welfare foremost in mind and only sells products that have been obtained, handled, shipped and stored properly. Finally, many of the products sold by internet and catalog pharmacies can actually be more expensive than the same products obtained from your veterinarian. Even when the products are less expensive, there are often shipping and handling fees.

Purchasing Pet Drugs Online: Buyer Beware

"Discount pet drugs—no prescription required" may appeal to pet owners surfing the Web, but FDA experts say it can be risky to buy drugs online from sites that tout this message and others like it.

Some of the Internet sites that sell pet drugs represent legitimate, reputable pharmacies, says Martine Hartogensis, D.V.M., deputy director of the Office of Surveillance and Compliance in FDA's Center for Veterinary Medicine (CVM). But others are fronts for unscrupulous businesses operating against the law.

FDA has found companies that sell unapproved pet drugs and counterfeit pet products, make fraudulent claims, dispense prescription drugs without requiring a prescription, and sell expired drugs.

Pet owners who purchase drugs from these companies may think they are saving money, says Hartogensis, but in reality, they may be short-changing their pet's health and putting its life at risk.

CVM regulates the manufacture and distribution of animal drugs, while individual state pharmacy boards regulate the dispensing of prescription veterinary products.

Some foreign Internet pharmacies advertise that veterinary prescription drugs are available to U.S. citizens without a prescription. But, says Hartogensis, "There is a risk of the drugs not being FDA-approved."

A foreign or domestic pharmacy may claim that one of its veterinarians on staff will "evaluate" the pet after looking over a form filled out by the pet owner, and then prescribe the drug. "A veterinarian should physically examine an animal prior to making a diagnosis to determine the appropriate therapy," says Hartogensis.

CVM is especially concerned that pet owners are going online to buy two types of commonly used prescription veterinary drugs—nonsteroidal anti-inflammatory drugs (NSAIDs) and heartworm preventives.

"Both drugs can be dangerous if there is no professional involvement," says Hartogensis. "It's not generally a concern if the owner uses a legitimate online pharmacy and mails in a prescription from their veterinarian, who is monitoring the animal. But if there is no veterinarian–client–patient relationship, it's a dangerous practice."

Veterinarians often prescribe NSAIDs to relieve pain in dogs. NSAIDs should not be purchased on the Internet without a veterinarian's involvement because

• dogs should undergo blood testing and a thorough physical examination before starting NSAIDs
• dogs should be monitored by a veterinarian while they are taking NSAIDs
• veterinarians should discuss possible side effects of NSAIDs with the owner
• the prescription should be accompanied by a Client Information Sheet that explains important safety information to the owner

Heartworm disease is a potentially fatal condition transmitted by the bite of a mosquito that is carrying infected larvae of the heartworm parasite. Dogs, cats, and ferrets can get heartworm. Heartworm preventives, given daily, monthly, or semiannually, depending on the product, kill the larvae before they become adult worms.

The American Heartworm Society recommends

• using heartworm medication for dogs year-round, no matter where you live in the United States
• getting dogs tested yearly to make sure they're not infected with heartworm

"Testing is important even in dogs regularly treated with heartworm preventive products due to the occasional reports of product ineffectiveness," says Hartogensis. An Internet pharmacy veterinarian cannot draw blood from the animal to perform the test. If the test isn't done, a pet owner could be giving heartworm preventives to a dog that has heartworms, potentially leading to severe reactions.

• Order from a Web site that belongs to a Vet-VIPPS accredited pharmacy. Vet-VIPPS—the Veterinary-Verified Internet Pharmacy Practice Sites—is a voluntary accreditation program of the National Association of Boards of Pharmacy (NABP). NABP gives the Vet-VIPPS seal to online pharmacies that dispense prescription animal drugs and comply with NABP's strict criteria, including federal and state licensing and inspection requirements, protecting patient confidentiality, quality assurance, and validity of prescription orders. Look for the Vet-VIPPS seal displayed on a pharmacy's Web site or check with NABP⁴ (click on "Accreditation Programs") to find out if a pharmacy is Vet-VIPPS accredited. Because this is a new program, begun in 2009, a small number of pharmacies are currently Vet-VIPPS accredited.
• Order from an outsourced prescription management service that your veterinarian uses. These state-licensed Internet pharmacy services work directly with the veterinarian, require that a prescription be written by the veterinarian, and support the veterinarian-client-patient relationship. Ask your veterinary hospital if it uses an Internet pharmacy service.

This article appears on FDA's Consumer Health Information Web page⁵, which features the latest on all FDA-regulated products.

Updated: March 11, 2010