Chris Crepeau couldn't understand why he felt the way he did.
As usual, the New Jersey man took his daily dose of Lipitor for high cholesterol. Still, he didn't feel quite right.
Then he found out the dangerous truth, the current bottle of his medicine might not be authentic — and then his doctor told him his cholesterol was double what it should be.
"He said there would be no other explanation," Crepeau said. "If you haven't stopped taking the medication, then there is no other explanation than that the pills were not Lipitor."
His tale is a cautionary one in a prescription-reliant America, with drug enforcement and pharmaceutical officials warning that even when pills look the part, they may be counterfeit.
And it's not a black-and-white problem: Counterfeit pills may work very much like the real medicine; they may work a little bit; or they may not work at all.
“Consumers will now get counterfeit products, and they work – or they work to some degree. But the reality of it is that they still have no idea what they’re putting in their body," Assistant Special Agent in Charge William Walker of the Department of Homeland Security investigations unit in Philadelphia told NBC10.
At the Connecticut laboratory of pharmaceutical giant Pfizer, the company tests roughly 1,000 samples of medication a year for concerned customers, law enforcement agencies and internal investigations.
Pfizer's director of investigations Brian Donnelly said an overwhelming number of the samples turn out to be counterfeit.
In many cases, people buying drugs from off-market sources are vulnerable to dealers looking to turn fake pills into cash. Donnelly said the risk outweighs the reward of cheaper medicine.
He said the saddest cases are cancer patients trying to buy affordable off-market pills.
"They're going to take a chance that this is going to be their cure," Donnelly said. "And now, they get this product and there's nothing in it."
For Crepeau, the Ocean County man whose counterfeit prescription led to spike cholesterol levels, he didn't take that type of chance. Yet he still almost paid the deadly price of the counterfeit drug market.
During his counterfeit scare back in 2003, he had filled his Lipitor prescription through the drugstore chain Rite Aid. At the time, the pharmacy alerted customers that its Lipitor distributor may have provided counterfeit medicine. Rite Aid sued that distributor, but a confidentiality agreement prevents the company from disclosing the outcome of the case.
Such breaks in the supply chain are rare. But because of the slip-up, Crepeau doesn’t think twice about off-market pills.
"I don't buy it online. I don't order it from other countries," he said. "I know it's a significant difference in price, but what are you going to do?"