Several definitions of illegal medicines are used across countries and organisations (WHO, Impact, Medicrime).

The terms used for illegal medicines also vary: “counterfeit”, “fake”, “adulterated”, “non-compliant”, “sub-standard” medicines, etc.

In general, a distinction can be made between three categories of illegal medicines:

• counterfeit or falsified medicines
  • the marketing under an existing brand of a medicine of unknown origin (fake “Viagra” fake “Tramadol”, a powerful analgesic)
• imitation medicines
  • good quality medicines from countries that do not recognise the European and US patents
  • medicines of unknown origin of questionable quality, containing the correct active substances, or not, with the right or wrong dosages
  • medicines containing unexpected or unknown substances fabricated by chemical synthesis (such as new psychoactive substances)
  • medicines that cannot be found on the official market (e.g., female viagra)
• “sub-standard” or “non-compliant” medicines
  • authentic medicines that do not meet the standards, which have escaped the controls and that are siphoned off and put back on sale (e.g. expired medicines).

DID YOU KNOW? The word “counterfeit” refers more to the image of a brand that is copied. In theory, a counterfeit drug may have a composition identical to the original. In reality, a counterfeit product often has a falsified composition, that is to say that the composition does not match the original drug, which can lead to health risks.

Illegal medicines are a global problem but the categories of illegal medicines and the associated risks vary across regions.

In developed countries, illegal medicines belong to the class of so-called “comfort” medicines, i.e. related to lifestyle:

• medicines against erectile dysfunction (such as Viagra)
• diet pills
• anabolic steroids and growth hormones (used by bodybuilders to increase muscle mass)
• painkillers (such as Tramadol, a strong painkiller).

In Belgium, the most common illegal medicines are Viagra imitations. There are hundreds of names by which Viagra imitations can be sold, such as: “Vigr X”, “Black ants”, “Night bullet”, etc.

In developing countries, illegal medicines generally fall into the category of anti-infectives, that is to say medicines that fight against infections caused by bacteria (tuberculosis, meningitis), viruses (HIV) or parasites (malaria).

This is a very serious public health issue because people die from a disease that was incorrectly treated. In addition, the consumption of sub-standard medicines containing low doses of active substances increases the risk of antibiotic resistance, and in this case even genuine medicines become ineffective.

DID YOU KNOW? Besides the problem of counterfeit medicines, adulterated food supplements are also a concern. A number of studies have revealed the presence of synthetic medicines in food supplements containing plants that are supposed to treat weight or erectile problems.

The composition of illegal medicines makes them either ineffective or dangerous:

• they may not contain any active substance (e.g. sugar)
• the expected substances are present but not in the correct dosages
• they may contain substances that vary from the original composition
• they may contain derivatives of the original substances, the effect of which is uncertain
• they may contain impurities that are potentially toxic to vital organs such as the liver, kidneys and pancreas

DID YOU KNOW? One sign for which you should be wary about on the Internet are prescription medicines that are sold without prescription. There is a reason for the existence of prescriptions, as they allow the doctor to decide whether such a person can consume a given medicine without danger. There are, for example, contra-indications for prescribing Viagra.

Most illegal medicines are sold over the Internet. 
Only pharmacies open to the public who have a site notified to the Federal Agency for Medicines and Health Products (AFMPS) can sell medicines over the Internet.

A website and an online pharmacy may not sell medicines that require a prescription.

The Federal Agency for Medicines and Health Products (FAMHP) has created an awareness-raising website about medicines sold over the Internet.