title: Health risks related to illegal and on-line sale of drugs and food supplements: results of a survey on marketed products in Italy from 2011 to 2013.
abstract: OBJECTIVE
  The increasing illegal and on-line market of medicines and food supplements is helping the widespread diffusion of harmful counterfeit and forbidden products among consumers of developed countries. The objectives of this survey were the description of the main frauds recognized by public officers and the detection of illegal or counterfeit drugs and food supplements.
  
  
  METHODS
  Medicines and food supplements found by Police forces on the illegal market or resulting from seizures made by Italian Customs authorities were visually inspected and analysed to evaluate their quality and the presence of other undeclared substances.
  
  
  RESULTS
  The visual inspection and the chemical analysis revealed unsuitable packaging (mostly lacking of adequate information for consumers), absence of the declared active substances and presence of undeclared active substances. Products containing doping agents, illegal substances and active ingredients requiring medical supervision were found.
  
  
  CONCLUSIONS
  The present work confirmed the health risk associated with assumption of medicines purchased on the Internet and from the illegal supply chain and evidenced a new threat to consumer safety related to the presence of pharmaceutical active ingredients in food supplements claiming to contain only "natural ingredients".
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Gaudiano
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Livia
authors.initials: L
authors.lastname: Manna
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Bartolomei
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Andrea Luca
authors.initials: AL
authors.lastname: Rodomonte
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Bertocchi
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Antoniella
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Romanini
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Alimonti
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Leandro
authors.initials: L
authors.lastname: Rufini
authors.affiliation: Dipartimento del Farmaco, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Valvo
mesh_terms: D003257:Consumer Product Safety; D058110:Counterfeit Drugs; D019587:Dietary Supplements; D004348:Drug Labeling; D064423:Drug Trafficking; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D020407:Internet; D007558:Italy; D004364:Pharmaceutical Preparations / Q000032:analysis; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D058110:Counterfeit Drugs; D013287:Illicit Drugs; D004364:Pharmaceutical Preparations