Thinking of buying prescription drugs online to save time and money? A word of caution: With counterfeit medications on the rise, sometimes the best price isn't the best deal.

The FDA reports that some online pharmacy sites are selling unknowing consumers counterfeit pills. To date, the FDA has uncovered more than 30 online pharmacies selling counterfeit drugs. At least four of these sites have been previously identified by FDA's Office of Criminal Investigations as being associated with the distribution of counterfeit generic versions of popular brand name drugs.

The FDA is encouraging consumers to avoid foreign and offshore pharmacies, particularly those based in India, Mexico, and China. Often these overseas pharmacies sell what they call generic versions of FDA-approved drugs, and claim their pharmacies are either FDA or WHO approved. Unsuspecting customers may not be aware: The FDA does not approve pharmacies. It's up to individual states and local boards of pharmacy to approve or license drug stores.

An Internet drug store can look very sophisticated and legitimate, but actually be an illegal operation. Consumers should be especially suspicious if there is no way to contact the online pharmacy by phone, or if the advertised prices are dramatically lower than other competitors. Consumers are urged to treat any drugs purchased from overseas pharmacies or firms claiming to be FDA-approved as being suspect.

According to the World Health Organization, counterfeiting poses "an enormous public health challenge." Just about every type of drug has been counterfeited, from antihistamines and erectile dysfunction treatments to medicines designed to combat serious diseases, such as AIDS, malaria, and cancer. Many of the counterfeit drugs are made by organized criminals in unsanitary conditions that would never pass FDA approval. These criminals make huge profits by avoiding overhead costs, quality control and regulatory enforcement.

Since January 2006, customs officials around the world have seized more than 3 million counterfeit or suspected counterfeit tablets, in more than 1,000 separate actions. In 2004 a woman with mild anemia died of liver failure after taking a highly toxic counterfeit. Another woman was fatally poisoned by fake drugs she received over the Internet laced with deadly metals.

In February 2004 an overseas pharmacy based in India was caught selling counterfeit contraceptive patches which contained no active ingredients. The phony birth control patches were being sold as Ortho Evra transdermal patches made by Ortho-McNeil Pharmaceutical, Inc.

In May 2007, the FDA uncovered a ring of 24 online pharmacies selling fake Viagra, the erectile dysfunction treatment manufactured by Pfizer Inc. According an analysis conducted by Pfizer and submitted to the FDA, none of the capsules ordered off the web sites contained sildenafil citrate, the active ingredient in authentic Viagra. An FDA analysis showed that other "prescription drugs" from the bogus pharmacy sites contained only talc and starch.

The FDA's Office of Criminal Investigation is working with the Department of Homeland Security's Bureau of Immigration and Custom Enforcement's (ICE) Cyber Crimes Center to combat counterfeiting and other illegal internet drug sales. A warning by the FDA states, "Trafficking in counterfeit, unapproved adulterated, or misbranded products is a felony violation of the Federal Food Drug, and Cosmetic Act." Consumers who are looking to buy prescription drugs over the internet should only purchase from sites bearing the Verified Internet Pharmacy Practice Sites (VIPPS) seal, showing that they comply with the National Boards of Pharmacy standards.

"The FDA will continue to do all it can to protect Americans from unsafe and counterfeit drugs purchased from illegal foreign sites," said FDA Commissioner Mark B. McClellan. "This case highlights the serious risks posed by foreign drug operations that bypass FDA safeguards. People are risking their health, in some cases their very lives, by buying illegal internet drugs."

Legitimate online drug stores offer customers health products with the benefits of convenience, privacy, and cheaper prices. Even with the advantages afforded by online pharmacies, consumers should be wary of the risk of counterfeit drugs. You might throw your money away on ineffective pills, or even worse, you could be harmed by taking drugs that aren't what they pretend to be.

Here are some web sites offering guidelines and tips for buying prescription drugs online:

The National Association of Boards of Pharmacy offers a list of Verified Internet Pharmacy Practice Sites (VIPPS). The NABP was established in 1904 to assist state licensing boards in developing, implementing, and enforcing uniform standards for the pharmacy industry.

The FDA has more information about counterfeit drugs at http://www.fda.gov/oc/initiatives/counterfeit/qa.html

Consumers can help in the fight against counterfeiting and illegal internet drug sales by reporting any suspected counterfeit drugs at http://www.fda.gov/oc/buyonline/buyonlineform.htm or by calling 1-800-332-1088.