A woman who bought drugs on the internet and took them for four years went blind as a result, doctors say.
The case highlights the dangers of the multimillion-pound international market in prescription medicines available from online pharmacies across the globe.The easy availability of drugs has allowed many people to bypass their doctors and self-prescribe medicines which they hope will boost their energy, improve their sex life or help them lose weight.
The 64-year-old woman from Sunderland diagnosed herself with chronic fatigue syndrome and, on the advice of a neighbour, bought oral steroids from an online pharmacy in Thailand. She later complained of loss of vision and doctors at Sunderland Eye Infirmary found cataracts in both eyes and signs of glaucoma (high pressure), both side effects of steroid use.
Dr Philip Severn and Dr Scott Fraser, consultant ophthalmologists, writing in The Lancet, warn colleagues to watch for patients who may have bought drugs online. "Some of the drug therapies can be counterfeit and contain a concoction of compounds that bear little resemblance to the drug named on the bottle," they say.
"Even if the patient receives the actual drug, there are many problems with this unchecked availability, including interactions with coexisting treatment, side effects and the lack of careful medical monitoring."
Popular lifestyle drugs including Viagra for impotence, Reductil for weight loss and Prozac for depression are among the biggest internet sellers. Many internet pharmacies offer online prescriptions allowing patients to consult a doctor by e-mail instead. The British Medical Association is opposed to the practice but it is not against the law.
The General Medical Council has successfully prosecuted doctors for inappropriate prescribing and failing to make adequate diagnoses over the internet.
Websites based abroad, which may use a ".co.uk" address, are not subject to British jurisdiction, and many sell medicines without a prescription as well as controlled drugs, such as stimulants and opiate-based painkillers.
The Medicines and Healthcare Products Regulatory Agency has warned of the growing problem of counterfeit drugs. Every year, the agency seizes £3m of stolen or faked Viagra, the best-selling internet drug.
Dr Fraser said he had heard of the dangers of buying drugs over the internet but it was the first time he had seen the effects. "Most patients aren't going to say if they have bought drugs over the Net," he said. "Buying drugs in this way is a gamble. Even if it is the right drug and it is not a counterfeit, because she wasn't monitored, she suffered the side effects.
"I am not saying doctors must be in control of all prescriptions, but with steroids, although they are life-saving drugs, patients must be monitored because of the side effects, which included diabetes, bone loss and eye problems."
The woman had catar-acts removed from both eyes and will require treatment for glaucoma for the rest of her life, Dr Fraser added.
The Royal Pharmaceutical Society said it was developing a register of approved online pharmacies.
Available onthe internet
* Viagra, made by Pfizer, for impotence. About £50 for four tablets. Most widely sold prescription drug on the internet.
* Xenical, made by Roche, for weight loss. About £65 for 85 capsules. Marketed as a potential panacea for the obesity epidemic.
* Prozac, made by Eli Lilley, for depression. About £20 for 30 tablets. The best known anti-depressant, with low toxicity compared to older drugs.
* Valium, made by Roche, for anxiety. About £50 for 30 tablets. Known as mother's little helper, it is effective but addictive.
* Ritalin, made by Novartis, for attention deficit disorder. About £20 for 60 tablets. Abused by students and others to increase concentration.
* Lipitor, made by Pfizer, for high cholesterol. About £40 for 30 tablets. The world's best-selling drug - counterfeit versions exist.
Source
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The Independent online http://news.independent.co.uk/
http://news.independent.co.uk/uk/health_medical/article1218435.ece
By Jeremy Laurance, Health Editor
Published: 11 August 2006
