• December 10, 2012 – 13:55

    Viagra on the Internet: Is It Real?

    The rate of availability of counterfeit medications is increasing dramatically worldwide, a substantial portion of which is attributable to the purchase of medications via the Internet.  A recent study sought to assess the requirement for prescription, cost, origin, and content of medications sold via the Internet and purporting to be the PDE5 inhibitor sildenafil citrate (VIAGRA®, Pfizer Inc, New York, NY, USA).

    The World Health Organization (WHO) estimates that medicines purchased over the Internet from sites that conceal their physical address are counterfeit ≥ 50% of the time.  In a European study, 62% of medicines ordered via the Internet and without a prescription were substandard or counterfeit.  In an analysis of samples seized worldwide for suspicion of being counterfeit Viagra, 83% of the samples ordered via the Internet were found to be counterfeit.  Recreational users and abusers of PDE5 inhibitor medication also report using the Internet as a source channel.

    In this trial, Pfizer monitored top search results for the query “buy Viagra” on two leading Internet search engines in March 2011.  Orders were placed from 22 unique Web sites claiming to sell Viagra manufactured by Pfizer.  Tablets received were assessed for chemical composition.  No website examined required a prescription for purchase or a health screening survey; 90% offered illegal “generic Viagra.”  Cost per tablet ranged from $3.28–$33.00.  Shipment origins of purchases were Hong Kong (N = 11), the United States (N = 6), and the United Kingdom (N = 2) as well as Canada, China, and India (N = 1 each).  Notably, the four Internet pharmacies claiming to be Canadian did not ship medication from a Canadian address.  

    Of 22 sample tablets examined, 17 (77%) were counterfeit, 4 (18%) were authentic, and 1 (5%) was an illegal generic. Counterfeit tablets were analyzed for sildenafil citrate, the active pharmaceutical ingredient (API) of Viagra, and contents varied between 30% and 50% of the label claim.  Contaminants such as talcum powder, commercial paint, printer ink, and other active pharmaceutical entities have been found in counterfeit Viagra.  Although non-genuine “fillers” were not further assessed in this study, filler ingredients are associated with significant risk because they generally comprise the majority of tablet weight.

    This study provides additional evidence that online sites claiming to sell authentic Viagra are not often legitimate. Besides the health risks possible from ingesting counterfeit products, credit card fraud and identity theft are also concerns with Internet ordering of medications.  There is evidence that Web sites that illegally supply POM without a prescription manipulate web searching to preferentially direct consumers to their fraudulent sites.  Consumers should use extreme caution when purchasing Viagra, as well as any other medications, via the Internet.

    Reference: Campbell N, Clark JP, Stecher VJ, Goldstein I.  Internet-ordered Viagra (sildenafil citrate) is rarely genuine.  J Sex Med 2012;9(11):2943-2951.