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Letters Rogue online pharmacy

Success of rogue online pharmacies: sewage study of sildenafil in the Netherlands

BMJ 2014; 349 doi: (Published 02 July 2014) Cite this as: BMJ 2014;349:g4317
  1. Bastiaan J Venhuis, senior scientific officer1,
  2. Pim de Voogt, professor of environmental chemistry2,
  3. Erik Emke, scientific researcher2,
  4. Ana Causanilles, PhD student2,
  5. Peter H J Keizers, scientific officer1
  1. 1National Institute for Public Health and the Environment RIVM, PO Box 1, 3720 BA Bilthoven, Netherlands
  2. 2KWR Watercycle Research Institute, PO Box 1072, 3430 BB, Nieuwegein, Netherlands
  1. bastiaan.venhuis{at}

The internet continues to harbour thousands of rogue online pharmacies.1 We investigated the success of their practice by measuring the sewage load of the erectile dysfunction drug sildenafil in three cities in the Netherlands.

We measured concentrations of sildenafil and two metabolites at the three main sewage treatment plants serving Amsterdam, Eindhoven, and Utrecht for seven consecutive days. …

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