Florida pharmacists and drug store workers checked their inventories after state investigators conceded there was a small chance bogus or watered down medications may have made their way onto shelves. Concerns about the safety of the state's drug supply surfaced when prosecutors indicted 19 people on Monday for allegedly diluting or selling fake prescription drugs in the wholesale market.

Michael Mann, chief of investigations for the state Department of Law Enforcement, said Tuesday that authorities had not uncovered counterfeit drugs at large chains but there was no way to be completely sure that all the compromised medication had been seized from the network of distributors. The drugs involved include Neupogen, which is often prescribed for cancer and HIV patients; Gammagard, for HIV patients; and Epogen, for patients with cancer, AIDS or kidney failure.

Officials with Walgreen Co. and Eckerd Corp., two of the nation's biggest retail drug chains, said their pharmacists had fielded some calls Tuesday from patients concerned about their medications. But the companies said the tainted medications did not find their way into their stores. They stressed that the vast majority of their medications are supplied directly from manufacturers and any distributors or wholesalers they use are fully vetted.

Dr. Margaret Fischl, director of the AIDS Clinical Research Unit at the University of Miami School of Medicine, said her office planned to discuss the case with patients in the coming days. She said the faulty medications could drastically affect patients' health, forcing unwarranted changes in their treatment or unnecessary procedures. "You could be doing tests that are absolutely not necessary. You could be exposing patients to other interventions that are not needed," Fischl said. "To me ... you're playing with people's well-being and their lives."

Authorities said the 19 people indicted this week represented some of the most egregious cases involved in a sophisticated scheme to substitute genuine medications with weaker or bogus drugs. More indictments are expected.

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