by Caspian Whitlock - 6 Comments

Every year, millions of people in the U.S. take prescription drugs without knowing if they’re real or fake. Counterfeit medications aren’t just a problem overseas-they’re slipping into American pharmacies, online stores, and even hospital supply chains. The good news? The FDA has built powerful tools to help you check if a drug is legitimate. You don’t need to be a pharmacist to use them. All you need is the drug’s name, the manufacturer, and access to a few free public databases.

What the FDA Databases Actually Do

The FDA doesn’t just approve drugs-they track them from the factory to your medicine cabinet. Three main systems work together to make this possible: the NDC Directory, the Drug Establishments Current Registration Site, and the DSCSA verification system. These aren’t just internal tools. They’re public resources designed to stop fake drugs before they reach patients.

The National Drug Code (NDC) is a unique 10- or 11-digit number printed on every prescription bottle in the U.S. It’s broken into three parts: the labeler code (who made it), the product code (what the drug is), and the package code (how it’s packed). If the NDC doesn’t match what’s in the FDA’s directory, it’s a red flag. The directory updates every single day, so even newly approved or recalled drugs show up fast.

The Drug Establishments Current Registration Site tells you who’s legally allowed to make or distribute drugs. If a company isn’t registered-or their registration expired-they shouldn’t be selling anything. You can search by company name or address. If a website claims to sell “FDA-approved” drugs but the company isn’t listed here, walk away.

Since November 2023, the Drug Supply Chain Security Act (DSCSA) requires every pharmacy, distributor, and manufacturer to verify drug packages electronically. That means when a pharmacy receives a shipment, their system checks the product’s unique identifier against the manufacturer’s database in real time. If it doesn’t match, the system flags it as suspect. This system caught over 12,000 suspect products in 2022 alone.

How to Check a Drug Yourself

You don’t need special software to verify a drug. Here’s how to do it in five minutes:

  1. Find the NDC number on the drug packaging. It’s usually printed near the barcode, sometimes labeled “NDC.”
  2. Go to the FDA’s NDC Directory at fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory.
  3. Enter the full NDC number in the search box. If nothing comes up, the number might be wrong-or the drug isn’t legally sold in the U.S.
  4. Check the labeler name. Does it match the company printed on the bottle? If not, it’s fake.
  5. Look at the product status. If it says “Inactive,” the drug was recalled or discontinued. Don’t take it.

For example, if you see a bottle of metformin with NDC 0054-4186-01, searching it shows it’s made by Teva Pharmaceuticals and is active. But if you find the same drug with NDC 12345-678-90, the search returns no results. That’s not a real FDA-listed drug.

Next, check the manufacturer. Search the Drug Establishments Current Registration Site using the company name from the label. If the company isn’t registered-or their registration expired in 2021 but they’re still selling in 2025-that’s a major warning sign.

A glowing supply chain network shows verified drugs in green and counterfeit ones in red, with an inspector guiding safety.

Red Flags for Counterfeit Drugs

Not all fake drugs are easy to spot. But here are the most common signs:

  • Unusual packaging: misspelled words, blurry logos, mismatched colors, or missing lot numbers.
  • Too cheap: if a drug costs 70% less than at your local pharmacy, it’s likely fake. Real medications have fixed prices due to regulation.
  • Online-only sellers: websites that don’t require a prescription or have no physical address are high-risk.
  • Unfamiliar brand names: some fakes use names that sound like real drugs but aren’t approved-like “Vigrafil” instead of “Viagra.”
  • Strange side effects: if you feel worse after taking a new pill, stop and check its NDC.

A 2022 FDA report found that 41% of counterfeit drugs contained the wrong active ingredient. Some had no medicine at all. Others had dangerous substances like rat poison, chalk, or industrial dyes. One batch of fake blood pressure pills was laced with lead. These aren’t rare cases-they’re common.

Why the System Isn’t Perfect

The FDA’s databases are powerful-but they’re only as good as the data people submit. About 38% of verification failures in 2021 happened because manufacturers and distributors used inconsistent NDC formats. One company might list a drug as 00001-234-56, another as 0001-234-56. The system can’t match them if the numbers aren’t formatted right.

Also, the system doesn’t track every single pill. Right now, it tracks product types, not individual packages. That means two bottles of the same drug from the same batch look identical in the system-even if one is fake. That’s changing. Starting in 2026, the FDA will switch to a standardized 12-digit NDC format and require more detailed tracking.

Another gap: foreign manufacturers. Only 35% of overseas drugmakers fully follow U.S. rules. That’s why counterfeit drugs often enter through international shipping. If you order drugs from Canada, Mexico, or India online, you’re bypassing the FDA’s protections entirely.

A grandmother and child examine a pill bottle as its NDC number becomes a spirit flying into an FDA database.

What You Can Do Right Now

Don’t wait for the system to fix itself. Here’s what to do:

  • Always get prescriptions from licensed U.S. pharmacies. Use the National Association of Boards of Pharmacy’s Verified Internet Pharmacy Practice Sites (VIPPS) list to find safe online pharmacies.
  • Ask your pharmacist to show you the NDC on the bottle and confirm it matches the FDA directory.
  • Report suspicious drugs to the FDA’s MedWatch program. Even one report can trigger an investigation.
  • Never buy drugs from social media sellers, pop-up websites, or “discount pharmacy” ads. They’re almost always fake.
  • If you’re unsure, call the manufacturer directly. Most have customer service lines for verifying product authenticity.

Real medications come with real safety. Fake ones come with real risks. In 2022, the FDA confirmed 1,700 cases of counterfeit drugs in the U.S. supply chain. That’s 1,700 people who could have been poisoned, overdosed, or had their condition worsen because they trusted a fake pill.

What’s Coming Next

The FDA is upgrading its systems fast. By 2024, the NDC Directory will include product images so you can compare your pill to the official version. By 2026, every package will have a unique digital identifier-like a serial number on a phone. That means you’ll be able to scan a QR code on your medicine bottle and instantly see if it’s real.

Some companies are already using AI to detect fake drugs. IBM and Google are testing machine learning tools that analyze packaging patterns, ink types, and even the way a pill is molded. Early tests show these tools can spot fakes with 99% accuracy.

But the biggest change? The FDA is pushing for global standards. Right now, the U.S. system works well inside the country. But if a fake drug comes from China, India, or Turkey, the system can’t always catch it. The FDA is working with international regulators to create a shared database-so a fake drug blocked in the U.S. gets flagged everywhere.

For now, your best defense is simple: know your NDC. Check the FDA’s databases. Ask questions. Don’t assume a drug is safe just because it’s sold online or looks right. The system is there to help you. Use it.

How do I find the NDC number on my medication?

The NDC number is printed on the drug’s packaging, usually near the barcode. It’s a 10- or 11-digit number, sometimes labeled “NDC.” If you can’t find it, check the box, blister pack, or the label on the bottle. If it’s not there, the product may not be legally distributed in the U.S.

Can I trust drugs bought online?

Only if they’re from a VIPPS-certified pharmacy. Look for the VIPPS seal on the website. Avoid sites that don’t require a prescription, have no physical address, or offer drugs at prices far below market value. Over 90% of online pharmacies selling prescription drugs without a prescription are illegal.

What should I do if I think I took a counterfeit drug?

Stop taking the medication immediately. Contact your doctor or pharmacist. Then report it to the FDA’s MedWatch program at fda.gov/medwatch. Include the NDC number, lot number, and photos of the packaging. Even one report can help prevent others from being harmed.

Are generic drugs more likely to be fake?

No. Generic drugs are just as safe as brand-name drugs when they’re FDA-approved. The same NDC verification rules apply. The problem isn’t generics-it’s unregulated sellers who sell fake versions of generics. Always check the NDC and manufacturer name. If it’s not listed in the FDA directory, it’s not real.

Does the FDA check every drug before it’s sold?

The FDA approves drugs before they enter the market, but it doesn’t inspect every single bottle. Instead, it relies on manufacturers to follow strict rules and submit accurate data. The databases help catch violations after the fact. That’s why reporting suspicious drugs is so important-it fills the gap.