Pill pusher pushes regulators' limits.

The N.C. Board of Pharmacy is finding e-commerce can be quite a pill. Late last year, a North Carolina pharmacist sent an e-mail to the board's executive director, David Work, asking him to look at a Web site that promises to help browsers "beat the system" and buy medications, including experimental and unapproved drugs, without prescriptions. Work pulled up the site, which he terms "a do-it-yourself doc-in-a-box," and started digging to see if he could prevent it from doing business in North Carolina.

Posted by a Stuart, Fla., company called PrescriptionRx, the site (www.PrescriptionRx.com) promises drug savings of 200% to 400%. It sells a $79.95 software package to "patients" to enter their ailments. The program makes a diagnosis and suggests appropriate drugs. Most you can't get over-the-counter, such as the sedative Valium, the painkiller Vicodin and the impotence drug Viagra. No prescription? No problem. It gives phone numbers, addresses and Web sites of foreign pharmacies where the drugs can be ordered without a doctor's permission.

"It's dangerous," Work says. "Drugs are prescribed for a reason. They aren't safe to use without supervision." Not to mention it could mean lost sales for North Carolina pharmacists. No matter how bothersome the board finds the site, it might be forced to live with it. The state can regulate North Carolina sales of pharmacies in other states but not in other countries.

"If they're just selling information, it's a gray area," says Brad Stone of the Food and Drug Administration. It's not illegal for a nondoctor to give medical advice. "There's nothing we or the board can do about it." The only possibility, he says, is if the board can prove PrescriptionRx has a direct financial tie with the foreign pharmacists it's touting. That would make it a promoter of unapproved drugs, which is illegal.

PrescriptionRx, savvy enough to foresee the heat, says at the bottom of its site that it is simply providing hard-to-find information, a service protected under the First Amendment. The fine print also includes a warning that "self-diagnostic software is not a substitute for a doctor." Of course, that's just below where it talks of bypassing the "pharmaceutical and medical profession mega-profit mongers."