Turning to the Internet to curb the rising cost of prescription drugs is a bit like playing Russian roulette with your health, warn pharmacists and Food and Drug Administration officials.

While legitimate online pharmacies exist -- and frequently offer drugs for less money than your corner drugstore -- confirming their legitimacy can be a daunting task.

``It's hard to determine quality assurance online,'' said Randy McDonough, clinic manager of the Main at Locust Pharmacy in Davenport and a pharmacy instructor at the University of Iowa. ``Some meet the requirements, some do not. It's hard for a consumer to figure out who's legit and who's not.''

Peter Pitts, the FDA's associate commissioner for external affairs, said the government is very concerned that Americans are obtaining drugs from unsafe, unsecured and unregulated Web sites.

Mr. Pitts noted that many online pharmacies that purport to be American or Canadian actually import their drugs from foreign countries, including many in Asia that offer drugs currently deemed unsafe by the FDA.

``There are a lot of Internet pharmacies in the U.S. that do have high quality control,'' he said. ``The problem is profiteers masquerading as pharmacists. Unless you actually walk into a pharmacy, you don't know where these drugs are coming from.''

The FDA conducted a series of ``blitz'' exams of mail shipments of foreign drugs to U.S. consumers last fall, finding that shipments often contain dangerous unapproved or counterfeit drugs that pose potentially serious safety problems.

The exams were conducted over three days in mail facilities in Miami, New York, San Francisco and Carson, Calif. Of the 1,153 imported drug products examined, 1,019, or 81 percent, were in violation of U.S. drug laws.

Mr. Pitts said online sales of drugs are legal only if they come from licensed, FDA-approved Internet pharmacies. But a tight budget and limited number of employees mean the FDA traditionally has relied on state licensing and regulatory boards for enforcement, according to FDA officials.

Mr. McDonough said he understands the impulse to shop online for prescription drugs.

``I'm trying to be as objective as possible, because I know people are concerned about drug prices,'' he said. ``But I don't think the solution is ordering drugs from another country. There are too many issues of quality control, drugs being altered, and counterfeit drugs.''

Mr. McDonough said he's bothered by the laissez-faire attitude of many online pharmacies toward the requirement that a physician see a patient in person before writing a prescription.

``I don't think someone who doesn't have your medical history or deal with the physician/patient relationship should be providing medications,'' he said. ``You need that triad -- the physician/patient/pharmacist relationship -- working together for safety.''

Mr. Pitts warned that buying and possessing controlled substances -- drugs such as OxyContin, Vicodin, and other painkillers and narcotics -- from unauthorized pharmacies is illegal for the purchaser as well.

``People who buy controlled substances this way are liable and engaging in illegal activity,'' he said. ``But most importantly, they're really endangering themselves.''