Dermatologists need to be aware that it is possible for patients to easily purchase isotretinoin online without a prescription, without physician oversight, and without adhering to the FDA-mandated i Pledge compliance program. A female patient recently presented to my office for a case of dry lips and acne flare-ups. We were discussing her therapy and within the first minute or two of the discussion, she said, “I’ve been on this pill I’ve been getting online called Accutane and I’m on my third month.” Upon inquiring about where she’d gotten the drug and who her dermatologist was, she said she didn’t have a prescription and had been getting it online, and that the process was simple. We had been talking about her dry lips and her acne flare-ups, and I had been thinking that she was in need of therapy—but she was already on her third month of isotretinoin without being on i Pledge, without any dermatologist supervision, and without any understanding of her dosage protocol or the risks involved if she had gotten pregnant or had any problems with her serological profile. After my initial tirade and scolding, I discussed the nuts and bolts of managing isotretinoin use with her as well as the consequence of her behavior. I, like a growing number of health officials, now know that patients can get a six-month supply of istoretinoin without a prescription by just using their credit card and their mailing address. A Google search for “buy isotretinoin” results in at least two pages filled with pharmacies that are based in Japan, India, Mexico, and Canada all offering a supply. buy cialis in mexico According to the FDA, 97% of online pharmacies are illegitimate and unsafe. Even experts have difficulty identifying a fake online pharmacy from its website alone. What looks like a discount online pharmacy from Canada or the U. could be a rogue website from anywhere in the world. Highly sophisticated criminal enterprises are utilizing malware, engaging in identity theft, and selling medicine that does not work, or worse, is dangerous to your health. Use our search tool to determine if your online pharmacy is certified and from a safe source. We will never use your personal information without your permission, and we will contact you for your permission first if your story is one we think should be shared with others. I've searched hundreds of online pharmacies trying to find low cost drugs, and using your search tool I found out they were all fake. It will take a lot of education and all of us working together to stop illegitimate and unsafe online pharmacies. I'm a physician and I had a hard time telling the difference. 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