Medically reviewed by Thomas Fischer (Pharmacist). This article was written according to medical standards. More Info

Medically reviewed by Thomas Fischer (Pharmacist)More Info

In 2018, the Economic Times website said that by 2020, the U.S. market would be flooded with Viagra imitations as the drug patent from Pfizer was expiring. Physicians, pharmacists, and drug manufacturers alike were concerned. Were their predictions correct? 

Before the patent was done, Viagra was being copied and made available online. The counterfeit drug industry was already in full swing before the copyright was lost. The patent being finished didn’t matter to companies selling dangerous drugs online. 

Most fake drugs come from outside the U.S., including India. A search online for sildenafil will bring up pages upon pages of so-called pharmacies selling phony medication. Why are so many American men looking for Sildenafil from Indian pharmacies online? 

Why are American Men Googling “Sildenafil online India”?

Most American men who are looking for generic sildenafil are usually trying to bypass getting a prescription from a doctor. Trying to get medication without being examined by a doctor is dangerous. These kinds of medicines are restricted to protect people and their health. 

For some men, talking about erectile dysfunction (ED) with their family doctor is an uncomfortable discussion. To avoid this, they look to buy Viagra and Sildenafil online, without one. The other reason people buy from India is that the price of the medication is significantly lower than in the U.S. The profits for these medications are the highest among all drugs in the pharmacy industry in India.

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Sildenafil from India - What To Consider?

Sildenafil Citrate is the active ingredient in Viagra, which was brought on to the pharmaceutical market in 1998.  It was made to treat pulmonary hypertension, but the drug proved to be quite effective in treating erectile dysfunction also. When the drug patent expired in 2017, other companies were able to manufacture and distribute generic versions of the drug. 

Is it Legal to Order Sildenafil from India?

In the U.S., current laws do not allow consumers to buy drugs for “reimportation” or “personal importation”. 

Both practices are illegal. This applies to any drug, with or without FDA approval, and whether it has been purchased online, by mail, or in person. 

In some cases, customs agents can use discretion in allowing some medication through. There are some regulations put in place before that would happen. What would they be? 

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If a patient who needs the medication can’t get it in the U.S., it may be allowed through customs. The medicine must be considered one that does not “represent an unreasonable risk” to the patient. A U.S. based physician must have prescribed the medication. If treatment began in another country, the drug must be necessary to continue treatment.  

The person needing the prescription must verify in writing that the medication is for personal use. Personal use is defined as no more than a 90-day supply of the drug. If circumstances are proven, and the proper paperwork is provided, FDA officials may show discretion. This, of course, is not guaranteed, and charges may be laid if they feel you are importing the product illegally.

Is Sildenafil from India Available in the U.S.?

Sildenafil manufactured in India is available in the U.S. A drug company may be in the U.S., but the actual manufacturing site might be in another country. India has a significant drug manufacturing industry. 

After Pfizer’s patent on Viagra (sildenafil) ran out in 2017, drug companies all over the world applied to make a generic version of the medication. In 2018, fifteen companies around the world were approved to manufacture the medication. Seven of those companies are in India. 

They are overseen by the FDA and must pay licensing fees to the organization. Pharmaceutical companies look to expand their business, working with pharmacy benefit managers in the U.S. market. It is a huge business opportunity for foreign markets when a drug loses its patent status. 

Legitimate pharmaceutical companies work with American companies to provide made generic medications. They need to abide by regulations and laws put in place. Those that try to skirt around the rules are the dangerous ones that will put patients in harm’s way. 

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The Risks and Danger of Buying Sildenafil from Indian Pharmacies

Sildenafil is one of the most counterfeited medications available. Legitimate looking websites and low prices tend to pull in the curious. It can be very tempting to try to order from these sites.

Boric acid, printer ink, and rat poison were all found in medicines from other countries. Studies have shown that many other toxic ingredients were found in pills manufactured in foreign countries. Checks and balances are much different in other countries, and ordering from a dodgy internet source can be dangerous. 

Rogue companies that create pills like this sell them through fake pharmacy websites and distributors. Some products may have some of the active ingredients in them, but not enough to make them useful. Drugs with the correct amount of the active ingredient in the pills are more expensive on these websites. 

Packaging may look legitimate for these products, so a person may not think that they are getting scammed. There will be stamps and numbers on them. A closer inspection will reveal that most often, they don’t meet the labeling requirements for drugs and are not legitimate.

The FDA does inspect manufacturing sites, and India itself has a medication protection agency. Reports can be seen on the FDA’s website. Within the last five years, drug manufacturers have been sent warning letters from the FDA about their practices. 

The issues are in manufacturing plant safety, improper labeling, improper active ingredient levels. Some of the situations that were found were dirty facilities or missing or altered paperwork.  Some even refused to allow inspectors to enter. Packaging has been labeled as one medication, only to find a different one inside. 

What is an Alternative Solution?

For many, it is an uncomfortable talk with their family physician that makes them try to avoid a prescription. An alternative is to get a script online via a telehealth doctor. Speaking with a stranger is often easier than with a medical professional you have a history with.

Online telemedicine services are part of today’s health assessment tools. Many primary care physicians and health insurance companies provide routine E-visits. Employers offer telehealth services as part of their employee benefits package.

In today’s environment, these services are becoming a necessity. If travel is difficult or impossible, or if you don’t have a primary care physician, there are online telemedicine companies online to help.  They are safe and available 24/7. 

The National Consortium of Telehealth Resource Centers is an organization that provides information, help, and education to providers of telehealth services. They have standards and best practices that guide virtual doctors on how to best help patients. This helps them provide services as useful as visiting your doctor in an office. 

What Do I Need for an E-visit?

Telehealth providers need you to have video capabilities on your device, and a good internet connection. Discussions can happen over the telephone, but video consultation is a better option and is a legal requirement in some states. Once you find a provider that you feel comfortable with, schedule an appointment using the website instructions. 

Review the provider’s website before your consultation to make sure you have everything you need for your appointment. Make sure medical information and paperwork requested has been completed. 

Filling Your Prescription

If the doctor has concluded that a new prescription is a right treatment, the next step is getting it filled. Here online pharmacies can safely help you. The doctor can submit your script for you to an online pharmacy, or you can have it sent to one of your own choice for collection.

To make sure that you will receive the appropriate medication from a genuine pharmacy, check to see that the pharmacy has:

Erectile dysfunction is a treatable condition that at least a quarter of all men have experienced. Consulting with a physician and discussing your situation is the best way to get proper care for your health. Filling your prescriptions online can be done when following recommendations by regulatory bodies.

References:
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  1. Report Suspected Unlawful Sales of Pharmaceutical Drugs on the Internet
    Buying Controlled Substances Online: DEA Warning – Purchasing drugs online may be illegal and dangerous. URL: https://www.deadiversion.usdoj.gov/
  2. Quick Tips for Buying Medicines Over the Internet. What to look for when buying medicines online. In: U. S. Food and Drug Administration. URL: https://www.fda.gov/
  3. How to Buy Medicines Safely From an Online Pharmacy. In: U. S. Food and Drug Administration. URL: https://www.fda.gov/
  4. How to Buy and Use Medicine. In: USAGov, the Official Guide to Government Information and Services. URL: https://www.usa.gov/medicine
  5. Mondaini et al.: Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time. In: Int. J. Impot. Res. Band 14, Nr. 3, S. 225–228.
  6. Patrick W. Fisher; Fadi Salloum; Anindita Das; Haroon Hyder; Rakesh C. Kukreja: Phosphodiesterase-5 Inhibition With Sildenafil Attenuates Cardiomyocyte Apoptosis and Left Ventricular Dysfunction in a Chronic Model of Doxorubicin Cardiotoxicity. In: Circulation. Band 111, 2005, S. 1601–1610.