Online commerce is convenient, quick and often cost-conscious. When it comes to purchasing prescription medicine online, however, the market is fraught with risk.

Late last month the FDA initiated a public education program to inform consumers about fake pharmacies and the dangers they present. Called BeSafeRx:Know Your Online Pharmacy, the website helps people vet possible online drug sources and understand how to spot the bogus players.

Just last week, as reported by Reuters, the FDA cracked down on more than 4,100 Internet pharmacies, bringing civil and criminal charges, removing offending websites and seizing drugs worldwide. More than 18,000 illegal pharmacy websites were shut down, and $10.5 million worth of drugs were seized.

Among the unapproved and potentially dangerous medicines in last week's action were Tamiflu, Viagra and Domperidone. The latter was removed from the U.S. market in 1998 because it may cause serious adverse side effects. The feds also confiscated Isotretinoin, previously marketed as Accutane in the U.S. It was prescribed to treat severe acne but carries serious risks including birth defects.

According to an FDA survey, 1 in 4 Internet consumers has purchased prescription medicine online. Three in 10 survey respondents said they lacked confidence about how to make safe online purchases. And with good reason: The National Association of Boards of Pharmacy reported that fewer than 3 in 100 online pharmacies meet state and federal laws.

In a news release announcing the BeSafeRx program, FDA Commissioner Margaret Hamburg said:

“Buying medicines from rogue online pharmacies can be risky because they may sell fake, expired, contaminated, not approved by FDA or otherwise unsafe products that are dangerous to patients. Fraudulent and illegal online pharmacies often offer deeply discounted products. If the low prices seem too good to be true, they probably are.”

Earlier this year, we wrote about counterfeit Adderall that was being sold over the Internet. (And last week we cautioned patients about another medication risk: unregulated compounding pharmacies, one of whose contaminated compounds led to a national outbreak of meningitis.)

It can be difficult to separate the legitimate from the scammers. Fraudulent online pharmacies use sophisticated marketing techniques or phony web storefronts to appear legitimate. And even if they do supply actual medicine, there’s a high probability that the products contain the wrong ingredients, have too little or too much of the active ingredient, have expired and/or are contaminated.

As noted on AboutLawsuits.com, even slight differences in how a drug is compounded can have a big effect on its effectiveness or side effects. Also, drugs purchased from rogue online pharmacies may arrive without medication guides, warnings about potentially dangerous drug combinations or other information about side effects, all of which is supposed to be provided to consumers.

Add to that the possibility for identification theft. Fake pharmacy websites can harvest valuable personal information, such as Social Security numbers, credit card and banking information they can use for fraudulent purposes, including selling it to other criminals. Doing commerce with these websites also invites email spam and harassing phone calls.

The feds say you should buy prescription medicine online only through pharmacies that:

• require a valid prescription from a doctor or other health-care professional;
• are located in the United States;
• have a licensed pharmacist available for consultation; and
• are licensed by your state’s board of pharmacy.

If you think you have discovered a rogue online pharmacy, the FDA wants to know. Report any website you believe is illegally selling human drugs, animal drugs, medical devices, biological products, foods, dietary supplements or cosmetics, by choosing one of these options:

1. If your report involves a life-threatening situation due to an FDA-regulated product you purchased from a website, call (866) 300-4374 or (301) 796-8240 immediately. Also, contact your doctor for medical advice.

2. If your report involves a serious reaction or problem with an FDA-regulated product, fill out an FDA MedWatch form and contact your doctor.

3. If your problem does not involve a life-threatening or otherwise serious reaction, fill out this form. To report e-mails promoting medical products that you think might be illegal, forward the email to webcomplaints@ora.fda.gov.