A pharmacist with drugstores in Glendale and West Hills is "a danger to the public health and safety" for allegedly possessing counterfeit and expired prescription medications, state regulators contend.
As part of disciplinary proceedings, the California Board of Pharmacy temporarily suspended Margarita Kazarian's ability to work as pharmacist-in-charge at her Adams Square Pharmacy in Glendale or any other drugstore.
A pharmacist-in-charge is responsible for compliance with state and federal rules.
The board's enforcement action, which it released this week, accused Kazarian of possessing counterfeit Cialis, an erectile-dysfunction medication, and violating rules related to inventory practices. Authorities also accused her of misleading investigators.
Kazarian faces more severe discipline, including the possibility of license revocation, at an upcoming hearing.
"We view this as a serious case," said Virginia Herold, executive officer of the state board, which oversees and regulates pharmacies and pharmacists.
She said it's unusual for a temporary suspension to be issued prior to a hearing.
Reached Thursday at Adams Square Pharmacy, Kazarian told me that she denied all the allegations against her.
She said that even though she's been prohibited from serving as a pharmacist-in-charge, she can still work as a pharmacist and continues to fill customers' prescriptions.
"Yes, I can do that," Kazarian said. "I'm very busy."
She also owns Kenneth Road Pharmacy in Glendale and Park West Pharmacy in West Hills. Kazarian referred all additional questions to her lawyer, who didn't call me back.
Counterfeit drugs, often containing ineffective or dangerous ingredients, are a growing problem worldwide. Although fake meds turn up most frequently in developing countries, they also can make their way into the supply chains of developed nations.
Nine people were indicted by a federal grand jury in Oakland last month on charges of manufacturing counterfeit prescription drugs, including the popular anti-anxiety medication Xanax.
The presence of counterfeit drugs in U.S. pharmacies is relatively rare, but it does happen, said Dr. Gina Moore, director of clinical affairs for the University of Colorado's Skaggs School of Pharmacy and Pharmaceutical Sciences.
She said it would be easier for an independent pharmacist, as opposed to an employee of a large chain, to try to acquire counterfeit drugs in hopes of profiting from a significant markup.
"The controls don't necessarily exist with these stores as with the large chains," Moore said.
The Internet has helped create an estimated $75-billion global market for counterfeit drugs. Many counterfeit drugs originate in China and India, according to the National Assn. of Boards of Pharmacy.
Kazarian's Adams Square Pharmacy submitted two boxes of prescription meds last June for return to their respective manufacturers for refunds, according to the pharmacy board's petition for interim suspension.
The shipment included 30 tablets of Cialis, the petition said.
In November, the drug's manufacturer,
A subsequent investigation turned up "three trash bags and box full of empty manufacturer medication bottles" at Adams Square Pharmacy, according to the board.
It said expired drugs were stored with newer pills and containers were found that were "over-filled with medications of varying shapes, sizes and colors."
The board said investigators also discovered multiple containers "filled with loose medication tablets and capsules," and others containing expired pills.
The petition for interim suspension quoted Kazarian as saying that the loose pills had been returned by patients and were awaiting destruction and that the empty bottles were being held for recycling.
The board quoted Kazarian as saying that she never sold counterfeit Cialis to the public. She reportedly told investigators that the bogus pills found by Lilly must have come from a distributor.
Kazarian told the board that Adams Square Pharmacy had purchased 420, 20-milligram Cialis tablets since 2005. Of that number, she said, 148 were dispensed to customers, 30 were returned to Lilly for a $450 credit and 92 were seized by state investigators.
"Kazarian could not account for the remaining 150 tablets ... and does not know whether the tablets were sold, disposed or stolen," the petition stated.
The pharmacy board alleged that she knowingly shipped counterfeit meds for a refund from the manufacturer and attempted to mislead investigators with false statements.
"The image that emerges from the board's ... inspection is of a pharmacy that retains many loose and expired tablets and has medication containers over-filled with medications sitting loose on shelves," the petition said.
"The evidence thus showed that there is a danger that Adams Square Pharmacy may dispense medications to customers that are counterfeit, adulterated or non-effective," it said.
Permitting Kazarian to remain as pharmacist-in-charge, it contended, "will endanger the public health, safety or welfare."
A hearing on Kazarian's case will be scheduled after she is formally charged by the state attorney general's office.