There can be fake anything, and yes there are fake niles. Also, Organon's Nile sust has had some problems this past year or so...inaccurate dosing. If you're going to go with an Organon sust, you'd be better suited for the time being to go with Karachi's. However, I'm sure Organon will at some point work things out with the nile line, but I haven't heard of any new news about it lately.