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Amazon receives FDA warning letter for supplements with undeclared ingredients

fda.gov

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Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#211

Post by JumpCrisscross »

sdbrown wrote: post #189
JumpCrisscross wrote: post #154

Earlier quoted context omitted.

> how does taking that same 60 milligrams in a larger volume of filler (e.g. water, or spread across more physical pills) change the fact that you've just taken 60 milligrams? It increases tolerance to mismeasurement and mistake. Same reason many pharmaceuticals require multiple pills for minimum dosing despite a concentrated form existing. A child eating a single pill, or you missing that you popped an extra pill in…

That doesn't change the difference between effective and toxic doses, it changes the potential scale of off-by-one user error. If 20 milligrams is delivered in 1 tablet, then 3 tablets is the toxic dose. If 20 milligrams is delivered in 5 tablets, then 15 is the toxic dose. A single daily tablet is far superior to multiple daily tablets in terms of patient adherence and hence disease management. Can you name specific…

Idk what to say, this is established medicine [1]. When you have a small TI you dilute to make measurement tolerances wider in absolute terms. This is a motivating factor behind prescription-strength medicine.

> Increased pill counts historically reduces patient adherence

Of course. There are tradeoffs. You want to know what also increases burden? Requiring a prescription.

[1] https://en.m.wikipedia.org/wiki/Therapeutic_index

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#212

Post by GuB-42 »

Xeoncross wrote: post #63

I purchased a vitamin c supplement that was pure white and odorless/tasteless. I posted a review and photos. Obviously fake filler of some sort, Amazon removed my review as inaccurate when it's obvious whatever was in those capsules was not ascorbic acid of any kind. They also claimed to have zinc (greenish) and elderberry (purple). It's not safe for Amazon to let any random exporter put stuff for sale without any sa…

Ascorbic acid is cheap in bulk, something like less than $5/kg if you buy it by the ton. Maybe cheap enough to be the filler.

And it is white and odorless in its pure form. It does have an acidic taste though, because it is an acid. I have some of it in my kitchen (pure bulk powder, not bought on Amazon) and I can tell you by experience.

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#213

Post by FredPret »

Amazon is a scam site.

I will buy my books from Indigo (Canada) from now on. Electronics and related doodads can come from Costco, Bestbuy, Walmart.

Maybe it's not as convenient, but you know what you're getting.

It's really unfortunate that Audible is in the Amazon family, because I'm not cancelling that any time soon.

I know much of the internet runs on AWS, but I'll never really trust that either.

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#214

Post by JumpCrisscross »

dahart wrote: post #198
JumpCrisscross wrote: post #162

Earlier quoted context omitted.

> co-pay and a quick Zoom call with a doc seems like a better choice to me Nobody is arguing it isn’t. The point is the forced choice is flawed. There wouldn’t be a market for the adultered stuff if the medicine were OTC.

> The point is the forced choice is flawed. There wouldn’t be a market for the adulterated stuff if the medicine were OTC. You haven’t convinced me that there’s anything wrong with the regulation. There might be, but again, the existence of a black market is not a valid reason to relax the regulation. The black market exists for guns and heroine and antibiotics and certain types of illegal porn too, not to mention cr…

> wouldn’t argue any of those should be less regulated just because you can buy them on the black market

I’d use that as evidence there is demand. Then I’d consider the harm of looser controls. The harm balance for Viagra seems minimal, particularly given so many people take it without bothering with a prescription. If you think Viagra is in the same harm bucket as guns and heroin, then yes, it makes sense to regulate it.

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#215

Post by hammock »

bumby wrote: post #207
hammock wrote: post #183

Earlier quoted context omitted.

How many of those are due to unknown, unlabeled risks? I’m willing to be that there are far more than 25,000 ER visits a year due to OTC drugs. Sometimes the risks are labeled. Other times they aren’t. And still other times people just didn’t follow the labeled directions. You can’t assume that every supplement ER visit was because of off-label ingredients or what FDA is saying here. That’s too far of a leap.

> You can’t assume that every supplement ER visit was because of off-label ingredients I already acknowledged this in the previous post. However, if you look at the rates of tainted supplements it probably isn’t a leap to assume a fair number can be attributed to unlisted ingredients. Some studies show contamination rates of nearly 60%. Again, I think the mitigation should be proportional to the risk. We might be abo…

>Some studies show contamination rates of nearly 60%.

And what % of "contamination" is dangerous ingredients (when directions are followed) vs harmless? You can’t assume that every contaminated supplement is dangerous. Fraudulent, maybe. Mislabeled, yes.

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#216

Post by maximinus_thrax »

FredPret wrote: post #213

Amazon is a scam site. I will buy my books from Indigo (Canada) from now on. Electronics and related doodads can come from Costco, Bestbuy, Walmart. Maybe it's not as convenient, but you know what you're getting. It's really unfortunate that Audible is in the Amazon family, because I'm not cancelling that any time soon. I know much of the internet runs on AWS, but I'll never really trust that either.

> Amazon is a scam site.

It is and I don't understand the downvotes here. With commingled inventory, I don't understand how people are ok with ingesting stuff they buy from Amazon.

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#217

Post by infamouscow »

FredPret wrote: post #213

Amazon is a scam site. I will buy my books from Indigo (Canada) from now on. Electronics and related doodads can come from Costco, Bestbuy, Walmart. Maybe it's not as convenient, but you know what you're getting. It's really unfortunate that Audible is in the Amazon family, because I'm not cancelling that any time soon. I know much of the internet runs on AWS, but I'll never really trust that either.

I've purchased quite a few paperbacks and hardcovers from Amazon because the author sidestepped the traditional publishing industry with Kindle Direct Publishing. I've enjoyed a number of book series this way.

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#218

Post by blagie »

giarc wrote: post #199
blagie wrote: post #158

Earlier quoted context omitted.

Here's my list of things I won't buy on Amazon.com: - Anything which goes in or on my body (foods, medicines, etc.). - Anything which is easily knocked off (SD cards, memory, SSDs, etc.) - Bed sheets (oddly enough, you'll often get lies on materials and fabric) - Thing I need reliably / reliably on-time (I cancelled Prime after several shipping issues) Since I cancelled Prime, things added to this list include: - Mos…

Hate to break it to you, but Aliexpress is likely less reliable than Amazon (or have the exact same products). eBay is likely the same and Walmart allows 3rd party sellers so it's pretty much the same as Amazon unless you source the products curated by Walmart.

I think you misread my comment.

I'll go to Aliexpress and eBay first for: "kids toys, cables, generic keyboards, battery chargers, basic tools, and basic clothing."

I have the exact same list for them as for Amazon. I'll go there first for those products since Aliexpress has much better prices than Amazon. eBay has better seller reviews. I certainly wouldn't buy food or medicine from them, though, or even bedsheets or SD cards.

Walmart is a lot better than Amazon. They do have a search filter to disable marketplace sellers, and if buying from Walmart proper, I do trust them to still get supply chains adequately right. Amazon did okay here too, even a half-decade ago; it crapped out with Covid and never fixed itself. Perhaps Walmart will crap out too, but it hasn't yet.

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#219

Post by loeg »

kayodelycaon wrote: post #2

I’m glad the conclusion says the products lists are not the only ones to which this letter applies. Otherwise Amazon could just remove the products mentioned and make the FDA play wack-a-mole. As a side note, this letter is exactly why I think a regulatory agency like the FDA is absolutely necessary. This stuff can kill people and it is impossible for the average person to protect themselves.

> As a side note, this letter is exactly why I think a regulatory agency like the FDA is absolutely necessary. This stuff can kill people and it is impossible for the average person to protect themselves.

The mislabeling is certainly a problem, but really these drugs (sildenafil and tadalafil) should be over-the-counter and cheaply available on Amazon as generics. That they are not is a failure of the same FDA. They have a great safety profile and limited contraindications, comparable to many other OTC drugs.

Re: Amazon receives FDA warning letter for supplements with undeclared ingredients

#220

Post by blagie »

emayljames wrote: post #209
giarc wrote: post #199

Earlier quoted context omitted.

Hate to break it to you, but Aliexpress is likely less reliable than Amazon (or have the exact same products). eBay is likely the same and Walmart allows 3rd party sellers so it's pretty much the same as Amazon unless you source the products curated by Walmart.

From much experience, AliExpress customer service is 100x better than Amazon. Very prompt refunds and dispute resolutions.

I agree with the math, but not the spirit.

0*100 = 0.

Aliexpress is fast, efficient, but completely random and automated in resolution. Products from Aliexpress are great 50% of the time, non-working or not shipped 10% of the time, and somewhere in between 40% of the time. It's cheap and complete roulette.

That's okay for a lot of things.

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