New list of prescription drugs. Antibiotics without prescriptions: a list. What antibiotics can be bought at the pharmacy without a prescription

After the order of the Ministry of Health on the new rules for dispensing medicines came into force, pharmacies became stricter. For example, they do not sell antibiotics without a prescription. What else is possible and what is not possible under the new order, Elena Nevolina, executive director of the Pharmacy Guild, told RG.

1. Why is it now impossible to buy an antibiotic freely?

Antibiotics have always been classified as prescription drugs, which should only be used when prescribed by a doctor. In our country, they often treat any cold, just "just in case." The results of such uncontrolled reception are deplorable. In the world, strains of causative agents of serious diseases, such as tuberculosis, have appeared that do not respond to known antibiotics. Such diseases simply cannot be cured! In early October, the Strategy for Preventing the Spread of Antimicrobial Resistance in Russia was approved. One of the principles: to put the use of antibiotics under strict control. At the pharmacy, you need to present a prescription written on the form. Yes, it is inconvenient, unusual, takes time. But we must understand: the uncontrolled use of antibiotics does more harm than good.

2. Are there any restrictions on dispensing alcohol-containing drugs?

There are no conditions "two bottles of hawthorn in one hand" exist. Alcohol-containing drops, which belong to over-the-counter drugs (this is indicated by the manufacturer in the instructions), for example, the same hawthorn tinctures, drops like Corvalol are sold without any restrictions. True, soon such tinctures will not be sold in bottles of more than 25 ml. But now many manufacturers fulfill this condition.

3. Is it true that light sedatives are now also strictly prescription?

Here the situation is the same as with antibiotics. If the manufacturer indicated in the instructions for the drug that it is dispensed by prescription, the pharmacy is obliged to ask the buyer for a prescription. Therefore, drugs such as amitriptyline, phenibut, grandoxin should still be prescribed by a doctor. A simple form will suffice. And the pharmacist, releasing the medicine, must "repay" the prescription with a seal.

4. Prescription drugs, such as statins, often need to be taken for a long time. Will I have to visit the doctor regularly now?

If the doctor is sure that the patient needs long-term permanent treatment, the doctor has the right to write out a prescription, indicating its validity period - up to 1 year. Only the prescription should indicate how often and in what dose the patient can receive medicine on it. Each time, a note is made on the prescription that the medicine has been dispensed. A year later, the prescription with all the marks from the patient is withdrawn and remains in the pharmacy for storage. The shelf life of used prescriptions depends on which medicine was prescribed - it can be stored for three months, and five years, if we are talking about drugs and other strictly controlled drugs.

Strict control over the sale of antibiotics in pharmacies and their use in agriculture is a necessary measure. List of prescription drugs. What medicines are not allowed to be sold without a prescription? What foods are most likely to contain antibiotics?

The measure to control the sale of antibiotics is dictated by the government-approved federal strategy to combat microbial addiction to antibiotics until 2030. The main developer of the document was the Ministry of Health.

The very problem of antimicrobial resistance (addiction) is relevant not only for Russia, but for the whole world. Thus, according to international experts, it is the cause of more than 700 thousand deaths annually.

According to experts, by 2050 this figure may increase to 10 million people.

So today, according to the Minister of Health of the Russian Federation Veronika Skvortsova, our country is preparing to offer a fundamentally different vector for the development of the fight against antimicrobial resistance.

As the minister noted, Russian scientists received very good data at the level of preclinical studies. If they are confirmed at the level of clinical trials, then Russia will be one of the first states in the world to offer a new technique.

At first, as part of the strategy approved by the Cabinet of Ministers, it is planned to tighten control over the prescription of antibiotics in pharmacies, optimize doctors' prescriptions, and raise patients' awareness of the drugs against bacteria that they buy. We are also talking about reducing the maximum permissible levels of antibiotics in products.

So Rospotrebnadzor will have to develop methods for determining the residual effect of antibiotics in food products within three years and will train specialists from the countries of the Eurasian Union in modern methods of detecting them in food products.

The supervisory authority notes that the standards for the content of antibiotics in food in Russia are among the most stringent. According to the head of Rospotrebnadzor Anna Popova, the permissible content of antibiotics in meat, poultry and fish is much lower than in Europe and the United States.

So, if in the EU countries the permissible norm for the content of antibiotic residues in products is from 0.1 to 0.6 mg/kg, then in our country it is no more than 0.01 mg/kg.

What foods are most likely to contain antibiotics?

To put things in order in all this now will be Rospotrebnadzor. Most often, antibiotic residues are found in milk and dairy products (up to 1.1 percent), least often in baby food (less than 0.1 percent).

According to Rospotrebnadzor, in our country antibiotics are used to treat and prevent diseases in animals, birds, fish and bees. They are also added to feed for cattle and small cattle, pigs and poultry.

But, while killing microbes in animal feed, these drugs remain in the meat that is sold in our stores. People eat meat, fish and honey and also receive a certain dose of antibiotics.

Why are antibiotics that are administered to animals for prevention and treatment dangerous for humans?

One illustrative example can be cited in this regard. In the clinic, situations often arise when it is necessary to save the life of a patient with a severe form of pneumonia, who is in intensive care, and he is resistant to all antibiotics at our disposal.

It can be overcome by prescribing very high doses of these drugs, but no one has studied such regimens, and they are not in the instructions. Then the clinical pharmacologist has to take responsibility and give him high doses of the drug, because otherwise he will die.

Of course, the situation is very risky, because in the end we can get undesirable effects and not save a person's life. In other words, the off label mode is used only out of desperation.

The situation in pediatrics is even more difficult, and not only in our country, but throughout the world. There are very few special preparations and dosage forms for the treatment of children in the arsenal of doctors. Drug manufacturers do not conduct clinical trials of such forms, because it is very difficult to organize them, and it is generally impossible to study drugs for newborns in the clinic, for example.

The instructions for the vast majority of drugs do not indicate the possibility of their use in children; studies on these categories of patients are extremely rare.

But the baby must be saved - and doctors take the risk by applying drugs based on scientific evidence they know or the results of limited studies on small groups of patients. We save the child, but in doing so, we violate the instructions, which threatens not only with financial punishment, but also with a very real risk of legal consequences.

According to the research of our own scientists, up to 75 percent of prescriptions in pediatrics, and up to 90 percent in neonatology (treatment of children in the first month of life) are off-label drugs.

The main quality criterion for the inspector is compliance with the instructions for use of the medicinal product. It is almost impossible to explain to him that we violated the instructions because we were saving a life.

As a result, money is taken from the clinic for poor-quality provision of drug care, and the amounts can be considerable - up to 30 percent of what was earned. This is all the more offensive because doctors spend a lot of effort and insurance money, the patient recovers and is discharged, and the clinic is punished for this.

But if the patient had died, the clinic would have received a full rate, because it did not violate anything. This situation is absurd. This problem exists not only in our country. Great Britain, for example, a work was published and it was shown that in pediatrics half of the clinical recommendations contained examples of the use of drugs outside the instructions.

The situation can be saved by a new order of the Ministry of Health, which will give doctors the opportunity to act legally and officially in such situations. Moreover, the draft document states that the decision to use the medicine outside the instructions should be made by a medical commission. And not just on the basis of someone's opinions, but on the basis of data given in the specialized literature, or, perhaps, small observational studies, accumulated application experience, etc.

What medicines are forbidden to sell without a prescription

The ban on the sale of medicines without a prescription already exists. Since March 1, 2017, pharmacies have been operating in accordance with the order of the Ministry of Health of the Russian Federation of August 31, 2016 N 647n“On Approval of the Rules for Good Pharmacy Practice of Medicinal Products for Medical Use” and Order of the Ministry of Health and Social Development of the Russian Federation No. 785 “On the Procedure for Dispensing Medicines”.

The law states that all medicines, with the exception of those included in the List of medicines dispensed without a doctor's prescription, must be dispensed only by prescription.

This list is quite large and includes funds from almost all drug groups. Not all medicines will be sold by prescription, but only those that are in a special list published on the website of the Ministry of Health. This list will be updated every year.

It is now possible to buy a list of medicines dispensed by prescription of a doctor (paramedic) only by prescription when providing additional free medical care to certain categories of citizens who are entitled to receive state social assistance.

List of prescription drugs

The list of medicines dispensed by prescription of a doctor (paramedic) when providing additional free medical care to certain categories of citizens entitled to receive state social assistance:

Anticholinesterase agents

Opioid analgesics and mixed action analgesics

Non-narcotic analgesics and non-steroidal anti-inflammatory drugs

Means for the treatment of gout

Other anti-inflammatory drugs

Means for the treatment of allergic reactions

Anticonvulsants

Remedies for the treatment of parkinsonism

Anxiolytics

Antipsychotics

Antidepressants and normothymic drugs

Means for the treatment of sleep disorders

Other drugs affecting the central nervous system

Means used in narcology

Means for the prevention and treatment of infections

Synthetic antibacterial agents

Anti-tuberculosis drugs

Antivirals

Antifungals

Antineoplastic, immunosuppressive and concomitant drugs

Cytostatic and immunosuppressive agents

Hormones and antihormones for the treatment of tumors

Concomitant drugs for the treatment of tumors

Means for the treatment of osteoporosis

Means that affect hematopoiesis, the coagulation system

Drugs affecting the cardiovascular system

Antianginal agents

Antihypertensive drugs

Medicines for the treatment of heart failure

Drugs that affect the functions of the organs of the gastrointestinal tract

Means for the treatment of diseases accompanied by erosive and ulcerative processes in the esophagus, stomach, duodenum

Antispasmodics

Laxatives

Antidiarrheals

pancreatic enzymes

Hepatoprotectors

Cholagogue

Hormones and drugs that affect the endocrine system

Non-sex hormones, synthetic substances and antihormones

Anabolic steroid

Means for the treatment of diabetes

sex hormones

Gestagens

Androgens

Estrogens

Means for the treatment of prostate adenoma

Means affecting the respiratory system

Means used in ophthalmology

Medications affecting the uterus

Vitamins and minerals

Antiseptics and disinfectants

Other funds

Many patients have already experienced these innovations in their real life. Having fallen ill with a viral infection, they could not buy antibiotics for treatment. Currently, a consultation with a general practitioner is required to prescribe the correct treatment and prescribe an antibiotic strictly according to the prescription.

The list of drugs that are freely dispensed includes some antipyretic and antiviral, sorbents for the stomach, dietary supplements, iodine, brilliant green, hydrogen peroxide.

The new rules for dispensing prescription drugs should discourage people from self-medicating.

A prescription issued by a doctor will be valid for two months - 60 days or 1 year.

If pharmacists do not comply with the order for selling prescription drugs without appropriate documents, they face a fine of up to 50 thousand rubles. More severe penalties may be imposed for selling prescription drugs without a prescription, up to and including suspension of activities for up to 90 days.

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From January 1, 2017, it will be necessary to go to the pharmacy for medicine only with a prescription in hand. But prescription only not all medicines will be sold, from January 1, 2017 it will not be possible to buy the following medicines at a pharmacy without a prescription.

It is not yet known whether this list will continue, but most likely yes.

All new medicines containing narcotics are psychotropic. And such funds in the pharmaceutical market are only increasing every year. Alas, people do not solve problems, but for years they accept everything ...

The third group is combined drugs: narcotics, psychotropic substances and their precursors. It was decided to designate this group separately: antibiotics. We are used to prescribing them ourselves, but sometimes there is no other way, especially if you get sick on the weekend ... Many people send their relatives to the pharmacy for antibiotics ...

How it will be in practice, we will see.

Definitely, new tranquilizers and antidepressants will also join the ranks of prescription drugs.

Here are some drugs that will be sold by prescription.



It is sometimes surprising that the drug has remained the same, the same active ingredient, but the packaging is different 3D, and the price is already higher and the prescription may be asked.

Many live completely without drugs! Well done!

Previously, it was very easy to buy some drugs at a pharmacy and without a doctor's prescription. Now, more precisely at the beginning of this year, everything has changed, now previously approved drugs will have to be bought according to the list.

By the way, here is a list of medicines that will now be dispensed by prescription and nothing else.



I wonder why antihypertensive drugs, HES drugs, NSAIDs are on the list. After all, there are much more dangerous drugs that need to be sold according to the list.

In 2017, changes took place in the pharmaceutical sector, which are now being actively discussed.

The list of drugs that cannot be purchased without a prescription from a doctor has become longer. It contained drugs with a psychotropic effect, and good old antibiotics. Some indignation was caused by the fact that the cardiac remedy Valocordin was included in this list. Curantyl, so often prescribed for pregnant women, also appeared there, as well as Nimesil, a well-known painkiller.



Most likely, the list will be replenished with new names.

Currently, work is underway to compile such a list. Enough time was allocated to the Ministry of Health of the Russian Federation for such work, up to January 31, 2017.

It is already known that the list will definitely include drugs in the prescription form of which the line is indicated:

Presumably, it will be possible to buy without a prescription only thirty percent of the medicines that are presented for sale in pharmacies.



The following list of medicines also goes



The list includes psychotropic and narcotic drugs, as well as antibiotics. Also, the well-known Valocardin got into the list of prescription drugs.

Here is a list of drugs that can no longer be bought without a prescription:



Since the beginning of 2017, a list has been posted, which includes a list of drugs that are prohibited from being released without a prescription.

People, now, really cannot live without drugs, and pills, as they help us to increase our lifespan when we are sick.



This year, only those medicines that contain Khlopinin will be dispensed by prescription:

Also on this list is the well-known Valocordin:

And here is a complete list of medicines that will not be given to everyone, but only to those who will have a special piece of paper prescription from the doctor:



Since January 2017, the dispensing of medicines in pharmacies has become more strict. Many medicines that could previously be bought without a doctor's prescription are now simply not sold. Most of these drugs are antibiotics, but there are also conventional painkillers.

In the instructions for these drugs, there was previously a clause dispensed by prescriptionquot ;. But pharmacies sold them without any prescriptions. Now it is planned to organize unscheduled inspections, which will entail the issuance of fines to those pharmacies where medicines are sold without a prescription.

Another question arises - how should patients receive prescriptions? Everyone knows what queues are at the offices of district therapists. Therefore, now they are actively solving this issue so that the system prescription drugs only earned in full.

In- first, according to the recipes in 2017 In 2016, all the drugs that were dispensed by prescription in 2016 will be dispensed in Russia. No easing is planned in this list, unfortunately for drug buyers.

In Secondly, in Rospotrebnadzor (its head) they made a rather unexpected statement-suggestion that it is very desirable to sell all the drugs that are in pharmacies exclusively by prescription. That is absolutely everything. Maybe, with the exception of those medicines that are necessary for completing all kinds of first-aid kits. about it. The Ministry of Health proposes to soften this proposal, and we will see to what extent this softening will take place.

In a word, drug consumers are waiting for, if not a revolution in the dispensing system, then at least a reorganization of the list of prescription drugs in the direction of a clear increase. The list will be replenished with those medicines that are not required urgently, but negatively affect the body during self-medication.

It became known that in the early spring of 2017, presumably on March 1, pharmacies will not dispense medicines without a prescription, and those that were dispensed freely before 2017, their list is already known



but by March they promise to extend this list, so the head of Rospotrebnadzor decided, she advocated the sale of all prescription drugs, this is described in this article.

According to statistics, about 20 million people in Russia are entitled to free, so-called subsidized medicines. Approximately 15.5 million of these people prefer monetary compensation to medicines, and only about 4 million people enjoy their right to the full extent.

Who is entitled to such medicines in 2019 and in what cases can the state pay for treatment? About everything in order.

What medicines are given out for free

The list of free medicines is regulated by the government.

The document approving their receipt is the order of the Ministry of Health and Social Development of Russia “On approval of the list of medicines dispensed by prescription when providing additional medical care to certain groups of citizens eligible for state social assistance”, adopted in 2006, in September.

This document is regularly amended as some drugs are included in this list and others are excluded from it.

In 2019, the group of free medicines included all categories of medicines:

• non-narcotic and opioid analgesics;
• non-steroidal anti-inflammatory drugs;
• agents for the treatment of allergies, gout, and parkinsonism;
• anxiolytic, anticonvulsant, antipsychotic substances;
• antidepressants, antibiotics, sleeping pills;
• antiviral and antifungal drugs;
• medicines for the treatment of the cardiovascular, respiratory, digestive systems;
• hormones and many other drugs.

Who is eligible for free medicines

The categories of persons who are entitled to free medicines are prescribed in Article 6.1 of Law No. 178-FZ "On State Social Assistance" of July 17, 1999, in Article 125 of Law No. 122-FZ of August 22, 2004.

The prescription must indicate the expiration date, usually one month. This is the time during which the medicine must be received from the pharmacy. In the absence of a drug, a drug of similar action may be offered. The validity of the prescription can be extended, in which case the pharmacy is obliged to organize the issuance of the requested drug within 10 days.

If it is necessary to continue treatment, as well as in case of loss of a prescription, the doctor is obliged to prescribe the drug again.

Any person to whom the prescription is given can receive free medicine according to a prescription issued by a doctor. This is especially important when the patient himself is not able to take the medicine he needs.

Free medicines for children

Today, children under three years old have the right to free medicines in Russia, in addition, children under 6 years old from large families. This also includes babies suffering from rare, life-threatening diseases, the treatment of which is extremely expensive.

It is enough to register the child at the place of residence and receive a medical policy and SNILS at the pension fund department in order to receive free drugs in the future if necessary.

If there are no drugs in the pharmacy

In 2018, the Ministry of Health increased the amount of allocations for the state procurement of medicines for HIV-infected people to 21.6 billion rubles. Previously allocated 17.8 billion rubles.

According to a social survey conducted by the All-Russian People's Front, in 2018 most Russians are unable to access even subsidized medicines, since in many localities there is a shortage of them in state medical institutions and pharmacies.

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Last changes

From January 1, 2019, new Rules for organizing the provision of medicines for people with rare diseases will be in force, the list of which for budgetary drug provision was expanded by Federal Law-299 of August 3, 2018. It includes the following diseases:

• hemophilia,
• pituitary dwarfism,
• cystic fibrosis,
• Gaucher disease,
• malignant neoplasms of lymphoid, hematopoietic and related tissues,
• hemolytic uremic syndrome,
• multiple sclerosis,
• juvenile arthritis with systemic onset,
• mucopolysaccharidosis types 1-2 and 6,
• post-transplant period.

New INNs included in the list of free medicines: