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Dizziness may occur. If this effect persists or worsens, tell your doctor or pharmacist promptly. This medication may make you sleepy during the day. Tell your doctor if you have daytime drowsiness. Your dose may need to be adjusted. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor right away if any of these unlikely but serious side effects occur: memory loss, mental/mood/behavior changes (such as new/worsening depression, abnormal thoughts, thoughts of suicide, hallucinations, confusion, agitation, aggressive behavior, anxiety). Rarely, after taking this drug, people have gotten out of bed and driven vehicles while not fully awake ("sleep-driving"). People have also sleepwalked, prepared/eaten food, made phone calls, or had sex while not fully awake.

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BUYING MEDICINES ONLINE? KNOW THESE RISKS:

The safest way to get medicines is from a pharmacist. It is important to take great care when buying medicines over the internet, particularly if the medicine would normally only be available from a pharmacy. If you buy medicines over the internet, you may be putting yourself at serious risk of harm.

RISKS AND CONCERNS:

Illegal or unethical online pharmacies sometimes send outdated, counterfeit medications or substitutes. But doctors argue that this can happen at medical shops too. "We cannot be sure that the medicines sold in pharmacies are not fake. It s the same with online pharmacies too. It s not about how the medicine is sold, but about how the regulatory bodies have to behave.

Other concerns include the location of these pharmacies. The internet has removed the boundaries between countries. The brand names may often cause confusion. They may be the same brands but with different medicines, or even lookalike drugs with different ingredients. Ultimately, the patient is at the receiving end of wrong medicines.

Sometimes, medicines sold online without prescription may be counterfeit, have no active ingredients and may even contain harmful ingredients.

Experts say there is no proper technical infrastructure in place to monitor the sale of online drugs. Those who complain against online pharmacies say that they encourage self-medication, customers make illegal purchases of habit-forming drugs, prescriptions are not verified online and patients buy drugs without original prescriptions.

Buying prescription and over-the-counter drugs on the Internet from a company you don t know means you may not know exactly what you re getting.

There are many websites that operate legally and offer convenience, privacy, and safeguards for purchasing medicines. But there are also many "rogue websites" that offer to sell potentially dangerous drugs that have not been checked for safety or effectiveness. Though a rogue site may look professional and legitimate, it could actually be an illegal operation.

These rogue sites often sell unapproved drugs, drugs that contain the wrong active ingredient, drugs that may contain too much or too little of the active ingredient, or drugs that contain dangerous ingredients.

For example, FDA purchased and analyzed several products that were represented online as Tamiflu (oseltamivir). One of the orders, which arrived in an unmarked envelope with a postmark from India, consisted of unlabeled, white tablets. When analyzed by FDA, the tablets were found to contain talc and acetaminophen, but none of the active ingredient oseltamivir.

FDA also became aware of a number of people who placed orders over the Internet for one of the following products:


Ambien (zolpidem tartrate)

Xanax (alprazolam)

Lexapro (escitalopram oxalate)

Ativan (lorazepam)

Instead of receiving the drug they ordered, several customers received products containing what was identified as foreign versions of Haldol (haloperidol), a powerful anti-psychotic drug. As a result, these customers needed emergency medical treatment for symptoms such as difficulty in breathing, muscle spasms, and muscle stiffness-all problems that can occur with haloperidol.

Other websites sell counterfeit drugs that may look exactly like real FDA-approved medicines, but their quality and safety are unknown.

SIGNS OF A TRUSTWORTHY WEBSITE:


It s licensed by the state board of pharmacy where the website is operating. A list of these boards is available at the website of the National Association of Boards of Pharmacy.

It has a licensed pharmacist available to answer your questions.

It requires a prescription for prescription medicines from your doctor or another health care professional who is licensed to prescribe medicines.

It provides contact information and allows you to talk to a person if you have problems or questions.

Another way to check on a website is to look for the National Association of Boards of Pharmacy s (NABP) Verified Internet Pharmacy Practice Sites™ Seal, also known as the VIPPS® Seal.

This seal means that the Internet pharmacy is safe to use because it has met state licensure requirements, as well as other NABP criteria. Visit the VIPPS website to find legitimate pharmacies that carry the VIPPS® seal.

SIGNS OF AN UNSAFE WEBSITE:


It sends you drugs with unknown quality or origin.

It gives you the wrong drug or another dangerous product for your illness.

It doesn t provide a way to contact the website by phone.

It offers prices that are dramatically lower than the competition.

It may offer to sell prescription drugs without a prescription-this is against the law!

It may not protect your personal information.

KNOW YOUR MEDICINES:

Before you get any new medicine for the first time, talk to a health care professional such as your doctor or pharmacist about any special steps you need to take to fill your prescription.



ANY TIME YOU GET A PRESCRIPTION REFILLED:


check the physical appearance of the medicine (color, texture, shape, and packaging)

check to see if it smells and tastes the same when you use it

alert your pharmacist or whoever is providing treatment to anything that is different

Be aware that some drugs sold online

are too old, too strong, or too weak

aren t FDA-approved

aren t made using safe standards

aren t safe to use with other medicines or products

aren t labeled, stored, or shipped correctly

may be counterfeit

HOW TO PROTECT YOURSELF:


Only buy from state-licensed pharmacy websites.

Don t buy from websites that sell prescription drugs without a prescription.

Don t buy from websites that offer to prescribe a drug for the first time without a physical exam by your doctor or by answering an online questionnaire.

Check with your state board of pharmacy or the National Association of Boards of Pharmacy to see if an online pharmacy has a valid pharmacy license and meets state quality standards.

Look for privacy and security policies that are easy to find and easy to understand.

Don t give any personal information-such as a social security number, credit card information, or medical or health history-unless you are sure the website will keep your information safe and private.

Use legitimate websites that have a licensed pharmacist to answer your question.

Make sure that the website will not sell your personal information, unless you agree.








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