Which painkillers can not be sold without a prescription. The list of medicines dispensed in the provision of additional free medical care - Rossiyskaya Gazeta. Drugs for the treatment of prostate adenoma
IP and IBLP
In general, in order No. 403n, the topic of IBLP leave is spelled out separately, which is not in order No. 785. It will be regulated by paragraph 13 of the first of the mentioned acts. This paragraph, in particular, determines that when the IBLP is dispensed, the exact time of this very issue, in hours and minutes, is indicated on the prescription or prescription spine that remains with the buyer.
Violation of the secondary
With the entry into force of Order No. 403n, new accents will appear on the topic of the possibility of violating the secondary (consumer) packaging of medicines. The norm of the "retiring" order No. 785 allows this to be done in exceptional cases, if the pharmacy organization cannot fulfill the doctor's prescription.
Order No. 403n, which replaces it, is more specific in this regard and more in line with modern requirements, medical practice and consumer needs. Paragraph 8 of the order determines that violation of the secondary packaging and dispensing of the medicinal product in the primary packaging is allowed in cases where the amount of the drug indicated in the prescription or required by the consumer (in case of over-the-counter dispensing) is less than the amount of the drug contained in the secondary packaging.
In this case, the buyer must be provided with instructions for use or a copy of it, and violation of the primary packaging is prohibited. By the way, the new order does not contain a rule that, in case of violation of the secondary drug, the drug should be dispensed in a pharmacy package with the obligatory indication of the name, manufacturer's batch, expiration date of the drug, series and date according to the laboratory packing journal, which is determined by order No. 785.
"Medication Released"
Clause 4 of Order No. 403n of the Ministry of Health of the Russian Federation regulates the topic of prescription forms and the list of drugs dispensed on them. In particular, Form No. 107/y-NP dispenses narcotic and psychotropic drugs of Schedule II, with the exception of narcotic and psychotropic drugs in the form of transdermal therapeutic systems.
The remaining prescription drugs, as you know, are dispensed according to the forms of the form No. 107-1 / y. According to paragraph 22 of the order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing drugs, as well as forms of prescription forms ...”, prescriptions written out on the forms of this form are valid for two months from the date of issuance. However, for patients with chronic diseases, it is allowed to set the validity of the prescription form No. 107-1 / y up to one year and exceed the recommended amount of the drug for prescribing per prescription, established by Appendix No. 2 of this order.
Such a prescription, which also indicates the periods and the amount of dispensing of the medicinal product (in each period), is returned to the buyer, of course, with the appropriate notes on the date of dispensing, dosage and quantity of the dispensed drug. This is prescribed by paragraph 10 of order No. 403n. He also determines that the next time the patient contacts the pharmacy with the same prescription, the first-timer must take into account the notes on the previous release of the drug.
The prescription remains in the pharmacy
There are some changes on the topic indicated in the title of this chapter. Paragraph 14 of the new order establishes that the retailer retains (with the mark "Drug product dispensed") and stores:
within 5 years prescriptions for:
within 3 years prescriptions for:
within 3 months recipes for:
The order of the Ministry of Health of Russia No. 403n did not do without a cherry on the cake, however, a dubious one. In paragraph 15 of the order, it is written that prescriptions that are not specified in the previous paragraph 14 (we listed them a little higher) are marked with the stamp “The drug is dispensed” and returned to the indicator. This seems to imply that Form 107-1/2-month-validity prescriptions become "single use." We advise readers to pay special attention to this new norm.
The topic of combating the abuse of alcohol-containing drugs in the pharmacy range, which was recently trumpeted by the media, was also reflected in the new order on the rules of dispensing. According to the current procedure, prescriptions for such drugs are returned to the patient (with a stamp "released"); under the new order, they must remain in the pharmacy organization.
To not get caught
The procedure for working with incorrectly written prescriptions is now described in a little more detail (paragraph 15 of order No. 403n). In particular, when they are registered by a pharmacist in the journal, it is necessary to indicate the identified violations in the preparation of the prescription, the full name of the health worker who issued it, the name of the medical organization in which he works, and the measures taken.
Clause 17 of Order No. 403n contains a rule that a pharmacist is not entitled to provide false or incomplete information about the presence of drugs in the assortment of a pharmacy facility - including drugs that have the same INN - and also hide information about the availability of drugs that have a lower price. Similar provisions are contained in subparagraph 2.4 of article 74 of the Law of November 21, 2011 No. 323-FZ “On the basics of protecting the health of citizens in the Russian Federation” and paragraph 54 of the Rules of Good Pharmacy Practice (order of the Ministry of Health of the Russian Federation of August 21, 2016 No. 647n). Here, the only new thing is that this norm first appears in the order on the rules of leave.
It was a review of the order, so to speak, "on a fresh trail." Probably, readers will find in it other points and norms that deserve special attention. Write to the editors of Katren-Style magazine about them, and we will address your questions to leading industry experts. We will also ask them about the problem of “one-time” prescriptions with a two-month validity, which was mentioned above, as well as the dispensing of ethyl alcohol and alcohol-containing drugs in the light of the provisions of the new order No. 403n.
Materials about the order of the Ministry of Health No. 403n:
What could be more important for a pharmacy organization than the order in which drugs are dispensed. As soon as the pharmacists had time to return from their summer vacation and look around, a new order of the Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n was published with annexes “On approval of the rules for dispensing drugs for medical use, including immunobiological drugs, by pharmacy organizations, individual entrepreneurs with pharmaceutical license. Order No. 403n on the vacation procedure was registered with the Ministry of Justice of the Russian Federation on September 8; the beginning of its action is September 22 of the current year.
The first thing I want to say in this regard is to forget now the number "785". The new order 403n, with amendments and additions, recognizes as invalid the well-known order of the Ministry of Health and Social Development of December 14, 2005 No. 785 “On the procedure for dispensing medicines”, as well as the orders of the Ministry of Health and Social Development No. 302, No. 109 and No. 521 that made changes to it. new normative legal act repeat - sometimes almost verbatim - the corresponding fragments of the predecessor order. But there are also differences, new provisions, on which we will focus to a greater extent, setting out the first observations and notes in the margins of the freshly baked order of the Ministry of Health No. 403n.
IP and IBLP
Order of the Ministry of Health of the Russian Federation No. 403n consists of three appendices. The first approves new rules for dispensing medicinal products, including immunobiological medicinal products (IBLP); the second - the requirements for the release of narcotic and psychotropic drugs, drugs with anabolic activity, and other drugs subject to subject-quantitative accounting (PKU). The third annex establishes the rules for dispensing medicines according to the requirements of invoices of medical organizations, as well as individual entrepreneurs (IEs) who have a license for medical activities.
The release of over-the-counter drugs and under the new procedure will be allowed both for pharmacies and pharmacy points, and for individual entrepreneurs and pharmacy kiosks. Otherwise, if we sum up points 2 and 3 of order No. 403n and the list of drugs, the following picture emerges.
- The release of narcotic and psychotropic drugs can only be carried out by pharmacies and pharmacy points that have the appropriate license.
- The rest of the prescription drugs are dispensed by pharmacies, drugstores and individual entrepreneurs (of course, those who have a license for pharmaceutical activity - this clarification will be further considered accepted by default and omitted).
- The release of immunobiological prescription drugs is carried out by pharmacies and pharmacy points. Individual entrepreneurs are not mentioned in this provision of paragraph 3, which means that they cannot dispense drugs of this group, which we advise you to pay special attention to.
In general, in order No. 403n, the procedure for dispensing IBLP drugs is prescribed separately, which is not in order No. 785. It will be regulated by paragraph 13 of the first of the mentioned acts. This paragraph, in particular, determines that when the IBLP is dispensed, the exact time of this very issue, in hours and minutes, is indicated on the prescription or prescription spine that remains with the buyer.
It is possible to release IBLP under two conditions. Firstly, if the buyer has a special thermal container, in which it is possible to comply with the required mode of transportation and storage of these thermolabile drugs. The second condition is an explanation (pharmacy worker to the buyer) of the need to deliver this drug to a medical organization, despite the fact that it can be stored in the mentioned container for no more than 48 hours.
Recall in this regard that this topic is also regulated by subparagraph 8.11.5 of the Sanitary and Epidemiological Rules "Conditions for the transportation and storage of immunobiological preparations" (SP 3.3.2.3332-16), which are approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation of February 17, 2016 No. 19 It obliges the pharmacy worker to instruct the buyer on the need to comply with the "cold chain" when transporting IBLP.
The fact of this briefing is recorded by a mark - on the drug package, prescription or other accompanying document. The mark is certified by the signature of the buyer and the first owner (or other representative of the pharmacy organization) and also includes the date and time of the vacation. However, SanPiN does not specify that the time in this case should be entered in hours and minutes.
Violation of the secondary
With the amendments and additions to Order No. 403n, new accents will appear on the topic of the possibility of violating the secondary (consumer) packaging of medicines. The norm of the "retiring" order No. 785 allows this to be done in exceptional cases, if the pharmacy organization cannot fulfill the doctor's prescription.
Order No. 403n, which replaces it, with a list of drugs in this regard, is more specific and more in line with modern requirements, medical practice and consumer needs. Paragraph 8 of the order determines that violation of the secondary packaging and dispensing of the medicinal product in the primary packaging is allowed in cases where the amount of the drug indicated in the prescription or required by the consumer (in case of over-the-counter dispensing) is less than the amount of the drug contained in the secondary packaging.
In this case, the buyer must be provided with instructions for use or a copy of it, and violation of the primary packaging is prohibited. By the way, in the new order of the Ministry of Health of the Russian Federation No. 403n there is no rule that, in case of violation of the secondary drug, the drug should be dispensed in a pharmacy package with the obligatory indication of the name, factory batch, expiration date of the drug, series and date according to the laboratory packing journal, which is determined by order No. 785.
What does this mean in practice? Let's assume two situations: the first - preparation X tablets (or pills) No. 56, primary packaging - blister; the second - the preparation of N tablets No. 56, in a vial. And in both cases, there is a question about his release to the patient who presented the prescription to the head of state, on which, say, 28 tablets or 42 tablets (pellets) are written.
It is clear that in the first case this is permissible, since it is possible to release 28 or 42 tablets without breaking the primary packaging (blister), and in the second case it is unacceptable, since the primary packaging in this situation is a vial, and it is strictly forbidden to break it. So, our pioneers do not have the right to count pills or dragees from a bottle, as they do in pharmacies in some foreign countries.
"Medication Released"
Clause 4 of Order No. 403n of the Ministry of Health of the Russian Federation regulates the topic of prescription forms and the list of drugs dispensed on them. In particular, Form No. 107/y-NP dispenses narcotic and psychotropic drugs of Schedule II, with the exception of narcotic and psychotropic drugs in the form of transdermal therapeutic systems.
According to the form No. 148–1 / y-88, the following are released:
- psychotropic drugs of Schedule III;
- narcotic and psychotropic medicinal products of Schedule II in the form of transdermal therapeutic systems;
- drugs included in the list of medicines subject to PKU, with the exception of those drugs that are dispensed in accordance with the form No. 107 / y-NP;
- drugs with anabolic activity and related to the anatomical-therapeutic-chemical classification (ATC) recommended by the World Health Organization as anabolic steroids (code A14A);
- preparations specified in clause 5 of the “Procedure for the sale of medicinal products to individuals containing, in addition to small amounts of narcotic drugs, psychotropic substances and their precursors, other pharmacologically active substances” (Order of the Ministry of Health and Social Development of the Russian Federation dated May 17, 2012 No. 562n);
- preparations manufactured according to a prescription for a medicinal product and containing a narcotic or psychotropic substance included in Schedule II and other pharmacologically active substances in a dose not exceeding the highest single dose, and provided that this combination medicinal product is not a narcotic or psychotropic medicinal product Schedule II drug.
The list of other prescription drugs, as you know, are released according to the forms of the form No. 107-1 / y. According to paragraph 22 of the order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing drugs, as well as forms of prescription forms ...”, prescriptions written out on the forms of this form are valid for two months from the date of issuance. However, for patients with chronic diseases, it is allowed to set the validity of the prescription form No. 107-1 / y up to one year and exceed the recommended amount of the drug for prescribing per prescription, established by Appendix No. 2 of this order.
Such a prescription, which also indicates the periods and the amount of dispensing of the medicinal product (in each period), is returned to the buyer, of course, with the appropriate notes on the date of dispensing, dosage and quantity of the dispensed drug. This is prescribed by paragraph 10 of order No. 403n. He also determines that the next time the patient contacts the same prescription for the list of drugs at the pharmacy, the first-timer must take into account the notes on the previous release of the drug.
At the time when the maximum amount indicated in the prescription is purchased, it must be stamped “Medicinal product dispensed”. And a one-time vacation of the entire amount, according to the same paragraph, is allowed only in agreement with the doctor who wrote out this prescription.
The prescription remains in the pharmacy
There are some changes on the topic indicated in the title of this chapter. Paragraph 14 of the new order No. 403n of the Ministry of Health establishes that the retailer retains (with the mark “Drug product dispensed”) and stores:
within 5 years prescriptions for:
- narcotic and psychotropic drugs of Schedule II, psychotropic drugs of Schedule III (according to the outgoing Order 785, they are stored for 10 years);
within 3 years prescriptions for:
- drugs dispensed free of charge or at a discount (according to forms No. 148-1 / y-04 (l) or No. 148-1 / y-06 (l));
- combined medicinal products containing narcotic drugs or psychotropic substances included in Schedules II and III, manufactured in a pharmacy organization, drugs with anabolic activity, drugs subject to PKU;
within 3 months recipes for:
- preparations in liquid dosage form containing more than 15% ethyl alcohol by volume of finished products, other preparations related by ATC to antipsychotics (code N05A), anxiolytics (code N05B), hypnotics and sedatives (code N05C), antidepressants (code N06A ) and not subject to CSP.
Note that in the 785th order there is no this group of recipes for three-month storage.
Order No. 403n of the Ministry of Health did not do without a cherry on the cake, however, a dubious one. In paragraph 15 of the order, it is written that prescriptions that are not indicated in the previous paragraph 14 (we listed them a little higher) are marked with the stamp “The drug is dispensed” and returned to the indicator. This seems to imply that Form 107-1/2-month-validity prescriptions become "single use." We advise readers to pay special attention to this new norm.
The topic of combating the abuse of alcohol-containing drugs in the pharmacy assortment, which was recently trumpeted by the media, was also reflected in the new order on the procedure for dispensing drugs. According to the current procedure, prescriptions for such drugs are returned to the patient (with a stamp "released"); under the new order, they must remain in the pharmacy organization.
To not get caught
The order of vacation with incorrectly written prescriptions is now described in a little more detail (paragraph 15 of order No. 403n). In particular, when they are registered by a pharmacist in the journal, it is necessary to indicate the identified violations in the preparation of the prescription, the full name of the health worker who issued it, the name of the medical organization in which he works, and the measures taken.
According to this paragraph, during drug dispensing, the pharmacist informs the buyer not only about the mode of administration and doses, but also about the rules for storage at home and interaction with other drugs.
Theoretically, this means the following. The pharmaceutical inspector can approach the first table in the guise of an ordinary buyer - so to speak, make a test purchase. And if the first-timer, dispensing the medicine, does not inform him, for example, that this medicine must be stored at a temperature not exceeding 25 ° C, or if he does not take an interest in whether he is currently taking other medicines, then the inspector can “throw off the mask” and draw up an act on an administrative offense. So the norm of paragraph 16 is serious and fraught. And, of course, it requires that the pervostolnik be thoroughly savvy on the complex and voluminous topic of drug interaction.
Clause 17 of Order No. 403n, as amended, contains a rule that a pharmacist is not entitled to provide false or incomplete information about the availability of drugs in the assortment of a pharmacy facility - including drugs that have the same INN - and also hide information about the availability of drugs that have a lower price . Similar provisions are contained in subparagraph 2.4 of article 74 of the Law of November 21, 2011 No. 323 FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” and paragraph 54 of the Rules of Good Pharmacy Practice (Order of the Ministry of Health of the Russian Federation of August 21, 2016 No. 647n). Here, the only new thing is that this norm first appears in the order on the order of vacation.
These were explanations of order No. 403n, so to speak, "on a fresh trail." Probably, readers will find in it other points and norms that deserve special attention. Write to the editors of Katren-Style magazine about them, and we will address your questions to leading industry experts. We will also ask them about the problem of “one-shot” prescriptions with a two-month validity, which was discussed above, as well as the dispensing of ethyl alcohol and alcohol-containing drugs in light of the provisions of the new Order No. 403 of the Ministry of Health.
On October 5, our website will host a webinar by Larisa Garbuzova, Ph.D. D., Associate Professor of the Department of Management and Economics of Pharmacy, North-Western State Medical University (St. Petersburg), dedicated, and on October 25, Executive Director of the National Pharmaceutical Chamber Elena Nevolina on the same topic. Register for both webinars.
Materials on the order of the Ministry of Health No. 403n.
Tranquilizers (anxiolytics) are psychotropic drugs indicated primarily for the treatment and elimination of anxiety, anxiety, fear, emotional tension, while they practically do not impair cognitive functions. On the modern pharmaceutical market, there is a wide range of various sedative drugs that can be purchased without a doctor's prescription.
benzodiazepine derivatives
The most famous and common tranquilizers with a pronounced antiphobic and anti-anxiety effect. They are divided into 3 subgroups: drugs of long, medium and short duration.
Long-acting anxiolytics (Phenazepam, Chlordiazepoxide, Diazepam) are strong drugs and have many unwanted side effects that override their advantages and lead to the development of serious complications, so they are rarely sold without a prescription.
Intermediate- and short-acting (daily tranquilizers) drugs have fewer side effects and are safer and can be purchased without a prescription, but it is still recommended to take only after consulting a doctor.
Intermediate-acting drugs
Alprazolam (Xanax, Alzolam, Helex, Zolomax)
The active substance is alprazolam.
It is used as a remedy that most actively eliminates panic attacks and acts as a vegetative stabilizer. Also, the drug is prescribed for worsening sleep, decreased appetite, loss of interest in the outside world.
At the beginning of treatment, a minimum dose is prescribed, which varies from 0.25 to 0.5 milligrams 3 times a day, then gradually the dose can be increased to a maximum of 4.5 milligrams. For debilitated and elderly patients, the initial dose is 0.25 mg 2-3 times a day. The dose should be reduced gradually to avoid withdrawal symptoms.
Side effects: possible rash, itching, urinary incontinence, development of leukopenia, anemia, impaired renal function, etc.
Contraindications: myasthenia gravis, shock, coma, acute alcohol poisoning, pregnancy, age under 18, intolerance to the components of the drug, pregnancy, lactation, impaired kidney or liver function.
Lorazepam (Lorafen)
Available in tablets, dragees; the active substance is lorazepam.
The drug of medium duration of action has a hypnotic and powerful antiphobic effect, is effectively used in all types of neurosis for the treatment of senestopathic, hypochondriacal disorders, and helps to stabilize the autonomic nervous system.
Adults and teenagers take 0.5-4 milligrams 1-3 times a day. The maximum daily dose should not exceed 10 milligrams.
Side effects: ataxia, muscle weakness, dizziness, dysphagia, dry mouth, itching, skin rash.
Contraindications: angle-closure glaucoma, myasthenia gravis, acute alcohol intoxication, hypersensitivity to lorazepam, lactation.
During pregnancy, use only under strict indications and always under the supervision of a physician. Use with caution in case of impaired renal function, suspected sleep apnea, shock, epilepsy, lung diseases.
Medazepam (Rudotel)
The active substance is medazepam.
Eliminates psychoneurotic tension, fear, anxiety, motor agitation, increased fussiness. Also, the medicine stabilizes the work of the autonomic nervous system, helps to restore emotional balance and an adequate assessment of one's own illness.
Tablets are taken 2-3 times a day, starting with a dosage of 5 milligrams; gradually increase the dose to 30 milligrams per day. Rarely, 40 milligrams of the drug is allowed. The elderly and adolescents - 10-20 milligrams per day; children aged 10 years and older - 2 milligrams per day. Duration of therapy - no more than 60 days. A month later, the course can be repeated.
Side effects: dry mouth, drop in blood pressure, disinhibition, depression, loss of orientation, confusion, dyspeptic disorders.
Contraindications: intolerance to medazepam, pregnancy, lactation, myasthenia gravis, pathology of the kidneys or liver, various forms of addiction (alcohol, drugs), children under 10 years of age.
With respiratory failure, intraocular hypertension, cerebellar ataxia, Medazepam tablets are prescribed with caution.
Daytime tranquilizers
Drugs with a predominant anti-anxiety effect and minimally pronounced sedative, muscle relaxant and hypnotic properties.
The following medicines can be purchased without a doctor's prescription:
Gidazepam
The active substance is gidazepam.
Eliminates irritability, migraine, soothes, softens withdrawal symptoms in alcoholism, improves sleep.
Take orally 20-50 milligrams 3 times a day. The average dose in the treatment of patients with neurosis-like and neurotic disorders is 60-150 milligrams per day, migraines - 40-60 milligrams. The course of treatment is from 7 days to 1-2 months.
Side effects: drowsiness, slowing down the speed of motor and mental reactions, drug dependence, gait disturbance.
Contraindications: liver or kidney failure, myasthenia gravis, pregnancy, hypersensitivity, lactation.
Oxazepam (Nozepam, Tazepam)
The active substance is oxazepam.
It is prescribed for neurosis, psychovegetative disorders (for example, disorders in women associated with menopause or severe premenstrual syndrome). As part of complex therapy, the drug is used for reactive depression. The dosage is set depending on the indications, the age of the patient and the development of the therapeutic effect.
The daily dose varies from 10 to 120 milligrams.
Side effects: fatigue, difficulty concentrating, dullness of emotions, paradoxical reactions (fear, hallucinations, insomnia, etc.), nausea, vomiting, allergic reaction, urinary retention, impaired kidney function.
Contraindications: acute alcohol intoxication, coma, shock, myasthenia gravis, angle-closure glaucoma, respiratory failure, pregnancy, lactation, children under 6 years of age, intolerance to drug components.
Prazepam (Demetrin)
The active substance is prazepam.
The drug stabilizes affective reactivity, normalizes sleep, improves mood, reduces tension and fear, and at the same time does not reduce concentration and reflexes. In addition, tablets help to get rid of functional autonomic disorders in various psychosomatic disorders.
For adults, the recommended daily dose is 20 milligrams, that is, 2 tablets (0.5 tablets in the morning, 0.5 in the afternoon and 1 in the evening). For children from 3 to 12 years old, the medicine is prescribed 10-15 milligrams, that is, 0.5 tablets 2-3 times a day.
Side effects: a feeling of slight fatigue, dizziness.
Contraindications: severe impairment of kidney or liver function, myasthenia gravis. If necessary, and only with the permission of a doctor, Prazepam is prescribed during pregnancy and lactation.
Tofisopam (Grandaxin)
Available in tablets, powder; the active substance is tofisopam.
The drug is prescribed for the treatment of autonomic disorders, reduced activity, neurosis, severe stress. Also with menopause, premenstrual syndrome, myasthenia gravis, as part of complex treatment for cardialgia.
The daily dose for adults is 150 milligrams. Multiplicity of reception - 3 times a day.
Side effects: nausea, loss of appetite, depression of the respiratory centers, pain in the muscles, dry mucous membranes, convulsions, confusion, rarely jaundice.
Contraindications: 1st trimester of pregnancy, lactation, age up to 18 years, severe depression, intolerance to the components of the drug, respiratory arrest syndrome during sleep.
Trioxazine
The active substance is trimetosine.
Reduces feelings of anxiety, fear, emotional instability.
Adults are prescribed at a dosage of 0.5-1.5 grams per day. If necessary, the dose can be increased to 2.5-3 grams per day. Children from 1 to 6 years old are prescribed 0.5 tablets 3-5 times a day; from 7 to 12 years - 1 tablet 3-5 times a day.
Side effects: weakness, lethargy, drowsiness, dry mouth.
Contraindications: hypersensitivity to the drug.
Tranquilizers of a new generation of non-benzodiazepine nature
They help eliminate almost the entire complex of anxiety-neurotic manifestations, ensure the maintenance of a habitual lifestyle, social activity, while being safe, that is, they have a minimum number of side effects and unwanted reactions.
OTC are:
Afobazole
The active substance is afobazole.
The drug is used in adults with neurasthenia, generalized anxiety disorders, adaptation disorders, bronchial asthma.
Consume inside after meals. The optimal single dose is 10 milligrams, the daily dose is 30 milligrams. If necessary, the maximum dose can be increased to 60 milligrams. The course of treatment is 2-4 weeks.
Side effects: rarely - headache, allergic reaction.
Contraindications: pregnancy, lactation, galactose intolerance, hypersensitivity to the active substance, age up to 18 years.
Benactizine (Amizil)
The active substance is benactizine.
In neurological and psychiatric practice, the drug is prescribed as a sedative for neurosis, which is accompanied by fear, anxiety, mental depression.
Take orally after meals 1-2 milligrams 1-4 times a day; course of treatment - 4-6 weeks.
Side effects: dizziness, constipation, nausea, tachycardia, urinary retention.
Contraindications: prostate adenoma, glaucoma, hypersensitivity, lactation, pregnancy.
Buspirone (Spitomin)
The active substance is buspirone hydrochloride.
It is used to treat anxiety conditions of various etiologies, especially neuroses, accompanied by a feeling of anxiety, anxiety, irritability, tension.
At the beginning of treatment, 5 milligrams are prescribed 2-3 times a day. To achieve the maximum therapeutic effect, the daily dose is gradually increased to 15-30 milligrams. Tablets should be taken at the same time of day, without chewing, with water.
Side effects: non-specific chest pain, hypertension, loss of consciousness, heart failure, changes in blood counts, bradycardia, nightmares, etc.
Contraindications: age under 18, pregnancy, lactation, renal failure, myasthenia gravis, congestive glaucoma.
Mebicar (Mebix, Adaptol)
The active ingredient isdione.
The drug is intended for the treatment of neurotic disorders (emotional lability, panic disorders, irritability, anxiety, etc.) resulting from debilitating neuropsychic, psychoemotional and physical stress. Also, tablets are indicated for the treatment of patients with ischemic myocardial disease, rehabilitation after a heart attack, to reduce the craving for smoking, with neurosis-like conditions in patients with alcoholism.
Take orally 0.3-0.9 grams 2-3 times a day (regardless of food). The maximum daily dosage is 10 grams. The course for therapy and prevention - from a week to 6 months.
Side effects: allergic reaction, hyperthermia, decrease in body temperature and blood pressure, dyspeptic disorders.
Contraindications: hypersensitivity to the active substance of the drug.
Mexidol
The active substance is ethylmethylhydroxypyridine succinate.
The drug has antioxidant, tranquilizing, nootropic, antihypoxic, membrane stabilizing properties. In addition, it improves memory, has a pronounced stress-protective effect (increases the body's resistance to stress), and has the ability to stop and prevent seizures.
For the treatment of neurosis-like and neurotic conditions, take 125-250 milligrams orally; the maximum daily dose is 800 milligrams (6 tablets). The duration of therapy is 2-6 weeks.
Side effects: allergic reactions are possible.
Contraindications: acute renal or hepatic failure, intolerance to the components of the drug, age under 18, lactation, pregnancy.
Oxylidine
The active substance is benzoclidine hydrochloride.
It has a calming effect, reduces the excitability of the nervous system, enhances the effect of painkillers, sleeping pills and narcotic drugs. It is used for all types of neurosis, cerebrovascular accident, atherosclerosis.
At the beginning of treatment, take 0.02 grams 3-4 times a day before meals; then the daily dose is increased to 0.2-0.3 grams. After achieving the desired effect, the dose should be reduced to 0.02 grams per day. The duration of treatment is from 2 weeks to 2 months.
Side effects: nausea, allergic reaction.
Contraindications: severe form of hypertension, kidney pathology.
Stresam
Available in capsules; The active substance is etifoxine hydrochloride.
Stabilizes and significantly improves the condition with a feeling of fear, anxiety disorders, depressed mood, without causing drowsiness and lethargy, allows you to lead a normal life.
Take orally, regardless of food intake, 50 milligrams (1 capsule) three times a day or 100 milligrams (2 capsules) 2 times a day. The duration of treatment ranges from several days to 4-6 weeks.
Side effects: urticaria, skin rashes, Quincke's edema.
Contraindications: myasthenia gravis, shock conditions, severe liver or kidney dysfunction, age up to 18 years, hypersensitivity to the active substance of the drug, lactation, pregnancy.
Phenibut (Anvifen, Noofen)
The active substance is aminophenylbutyric acid.
The tranquilizing effect of the drug is realized by reducing the excitability of brain structures that are responsible for inhibition and emotions. The main indications for the use of Phenibut are: anxiety disorders, symptoms of asthenic syndrome, memory disorder, decreased emotional activity, insomnia, etc.
Side effects: nausea, jumps in blood pressure, headaches.
Contraindications: pregnancy, lactation, hypersensitivity to the drug, age up to 8 years, renal failure.
During pregnancy and breastfeeding
Almost all of the above drugs have a toxic effect on the fetus and increase the risk of congenital malformations, therefore, during pregnancy, an anxiolytic can only be prescribed by a doctor, and only if absolutely necessary.
children
At the age of 3 to 18 years, with the permission of a doctor, drugs such as Prazepam (Demetrin), Trioxazine, Phenibut, Oxazepam (Nozepam, Tazepam) can be prescribed.
For the elderly
In the absence of contraindications, all drugs are allowed only in lower doses. The required dosage is prescribed by the attending physician.
In accordance with Article 55 of the Federal Law of April 12, 2010 No. 61-FZ “On the Circulation of Medicines” (Collected Legislation of the Russian Federation, 2010, No. 16, Art. 1815; No. 31, Art. 4161; 2013; No. 48, 6165; 2014, No. 52, article 7540; 2015, No. 29, article 4388; 2016, No. 27, article 4238), paragraph 3 of Article 12 of the Federal Law of September 17, 1998 No. immunoprophylaxis of infectious diseases” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 1998, No. 38, Art. 4736; 2009, No. 1, Art. 21; 2013, No. 48, Art. 6165) and subparagraphs 5.2.169, 5.2.183 of the Regulations on the Ministry of Health of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 19, 2012 No. 608 (Collected Legislation of the Russian Federation, 2012, No. 26, Art. 3526; 2013, No. 16, Art. 1970; No. 20, Art. 2477; No. 22, 2812; No. 33, 4386; No. 45, 5822; 2014, No. 12, 1296; No. 26, 3577; No. 30, 4307; No. 37, 4969; 2015, No. 2, item 491; No. 12, item 1763; No. 23, item 3333; 2016, No. 2, item 32 5; No. 9, Art. 1268; No. 27, Art. 4497; No. 28, Art. 4741; No. 34, Art. 5255; No. 49, Art. 6922; 2017, no. 7, art. 1066), I order:
1. Approve the rules for dispensing medicinal products for medical use, including immunobiological medicinal products, by pharmacy organizations, individual entrepreneurs licensed for pharmaceutical activities, in accordance with.
2. Recognize as invalid:
Order of the Ministry of Health and Social Development of the Russian Federation dated December 14, 2005 No. 785 “On the Procedure for Dispensing Medicines” (registered by the Ministry of Justice of the Russian Federation on January 16, 2006, registration No. 7353);
Order of the Ministry of Health and Social Development of the Russian Federation of April 24, 2006 No. 302 “On Amendments to the Order of the Ministry of Health and Social Development of the Russian Federation of December 14, 2005 No. 785” (registered by the Ministry of Justice of the Russian Federation on May 16, 2006, registration number 7842);
Order of the Ministry of Health and Social Development of the Russian Federation of February 12, 2007 No. 109 “On Amendments to the Procedure for Dispensing Medicinal Products, approved by Order of the Ministry of Health and Social Development of the Russian Federation of December 14, 2005 No. 785” (registered by the Ministry of Justice of the Russian Federation March 30, 2007, registration number 9198);
Order of the Ministry of Health and Social Development of the Russian Federation of August 6, 2007 No. 521 “On Amendments to the Procedure for Dispensing Medicines, approved by Order of the Ministry of Health and Social Development of the Russian Federation of December 14, 2005 No. 785” (registered by the Ministry of Justice of the Russian Federation August 29, 2007, registration number 10063).
| Minister | IN AND. Skvortsova |
psychotropic medicinal products included in the List of Psychotropic Substances, the circulation of which in the Russian Federation is limited and for which the exclusion of certain control measures is allowed in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List III), the List (hereinafter - psychotropic medicinal products of List III );
narcotic and psychotropic drugs of list II in the form of transdermal therapeutic systems;
medicinal products included in the list of medicinal products for medical use subject to subject-quantitative accounting, with the exception of the medicinal products specified in and of this paragraph, and medicines dispensed without a prescription (hereinafter referred to as medicinal products subject to subject-quantitative accounting);
medicinal products with anabolic activity (in accordance with the main pharmacological action) and related to the anatomical-therapeutic-chemical classification recommended by the World Health Organization (hereinafter referred to as ATC) to anabolic steroids (code A14A) (hereinafter referred to as medicinal products with anabolic activity );
Medicinal products specified in paragraph 5 of the Procedure for dispensing to individuals medicinal products for medical use containing, in addition to small amounts of narcotic drugs, psychotropic substances and their precursors, other pharmacologically active substances, approved by order of the Ministry of Health and Social Development of the Russian Federation dated May 17, 2012 No. 562n;
medicinal products manufactured according to a prescription for a medicinal product and containing a narcotic drug or psychotropic substance included in List II of the List and other pharmacologically active substances in a dose not exceeding the highest single dose, and provided that this combined medicinal product is not a narcotic or psychotropic medicinal product of list II.
According to prescriptions issued on prescription forms of form No. 148-1 / y-04 (l) or form No. drugs at a discount (hereinafter referred to as drugs dispensed free of charge or at a discount).
According to prescriptions issued on prescription forms of form No. 107-1 / y, other medicinal products are dispensed that are not specified in this paragraph, with the exception of over-the-counter medicinal products.
5. The release of medicinal products not specified in these Rules, in accordance with the instructions for their medical use, is carried out without prescriptions.
6. Dispensing of medicinal products is carried out during the term of its validity specified in the prescription when a person applies to a retail trade entity.
If the retailer does not have the medicinal product specified in the prescription, when a person applies to the retailer, the prescription is accepted for service within the following terms (hereinafter referred to as deferred service):
a prescription marked “statim” (immediately) is serviced within one working day from the day the person applied to the retailer;
a prescription marked “cito” (urgently) is serviced within two working days from the day the person applied to the retailer;
a prescription for a medicinal product included in the minimum range of medicinal products for medical use necessary for the provision of medical care is serviced within five working days from the date of the person's application to the retailer;
a prescription for a medicinal product dispensed free of charge or at a discount and not included in the minimum range of medicinal products for medical use necessary for the provision of medical care is serviced within ten working days from the date of the person's application to the retailer;
prescriptions for medicinal products prescribed by decision of the medical commission are serviced within fifteen working days from the date of the person's application to the retailer.
Expired prescription drugs may not be dispensed unless the prescription expired while on deferred maintenance.
Upon expiration of a prescription while it is on deferred maintenance, the medicinal product is dispensed under such a prescription without reissuing it.
7. Medicinal products are dispensed in the amount specified in the prescription, except for cases when the maximum allowable or recommended amount for prescribing per prescription is established for the medicinal product.
When a prescription is presented that exceeds the maximum allowable or recommended amount of the medicinal product for prescribing per prescription, the pharmacist informs the person who submitted the prescription, the head of the relevant medical organization about this and dispenses to the indicated person the maximum permissible or recommended amount of the medicinal product established accordingly for prescribing per one prescription with putting down the appropriate mark in the recipe.
If a retail entity has a medicinal product with a dosage different from the dosage of the medicinal product specified in the prescription, the dispensing of the existing medicinal product is allowed if the dosage of such a medicinal product is less than the dosage indicated in the prescription. In this case, the amount of the medicinal product is recalculated, taking into account the course of treatment indicated in the prescription.
If the dosage of the medicinal product available at the retailer exceeds the dosage of the medicinal product specified in the prescription, the decision to dispense the medicinal product with such a dosage is made by the medical professional who issued the prescription.
8. The medicinal product is dispensed in primary and secondary (consumer) packages, the labeling of which must comply with the requirements of Article 46 of the Federal Law of April 12, 2010 No. II - the requirements of paragraph 3 of Article 27 of the Federal Law of January 8, 1998 No. 3-FZ "On Narcotic Drugs and Psychotropic Substances".
Violation of the primary packaging of the medicinal product during its dispensing is prohibited.
Violation of the secondary (consumer) packaging of the Medicinal Product and dispensing of the Medicinal Product in the primary packaging is allowed if the amount of the Medicinal Product specified in the prescription or required by the person purchasing the Medicinal Product (in the case of non-prescription dispensing) is less than the amount of the Medicinal Product contained in the secondary (consumer) ) packaging. In this case, when dispensing the Medicinal Product, the person purchasing the Medicinal Product is provided with an instruction (copy of the instruction) on the use of the dispensed Medicinal Product.
9. When dispensing medicinal products by prescription, a pharmacist shall make a mark on the prescription for the dispensing of a medicinal product indicating:
name of the pharmacy organization (surname, name, patronymic (if any) of an individual entrepreneur);
trade name, dosage and quantity of the dispensed medicinal product;
last name, first name, patronymic (if any) of a medical worker in the cases specified in and these Rules;
details of the identity document of the person who received the medicinal product, in the case specified in these Rules;
last name, first name, patronymic (if any) of the pharmaceutical worker who dispensed the medicinal product, and his signature;
date of release of the medicinal product.
10. When medicinal products are dispensed under a prescription issued on a prescription form No. drug, with a mark containing the information specified in these Rules.
When a person next applies to a retailer with this prescription, the notes on the previous release of the medicinal product under such a prescription are taken into account and if the person purchases the amount of the medicinal product corresponding to the maximum amount indicated by the medical professional in the prescription, and also after the expiration of the prescription, on the prescription the stamp “Drug is dispensed” is affixed and the prescription is returned to the person.
A one-time dispensing of a medicinal product under a prescription issued on a prescription form No. 107-1 / y, the validity of which is one year, and in which the periods and the number of dispensing of the medicinal product (in each period) are indicated, is allowed only upon agreement with a medical professional, who wrote the prescription.
11. When dispensing medicinal products under a prescription issued on a prescription form No. 148-1 / y-04 (l) or form No. 148-1 / y-06 (l), the completed spine of such a prescription is transferred by a pharmaceutical worker to the person purchasing ( recipient) medicines.
12. When dispensing a narcotic and psychotropic medicinal product of List II, the pharmacy or pharmacy point stamp is affixed to the prescription for the dispensing of the medicinal product, which indicates their full name (if there is a seal).
13. When dispensing an immunobiological medicinal product, the exact time (in hours and minutes) of dispensing the medicinal product shall be indicated on the prescription or prescription stub, which remains with the person purchasing (receiving) the medicinal product.
An immunobiological medicinal product is dispensed to a person who purchases (receives) a medicinal product, if he has a special thermal container in which the medicinal product is placed, with an explanation of the need to deliver this medicinal product to a medical organization, provided that it is stored in a special thermal container for a period not exceeding 48 hours after purchasing it.
14. Prescriptions remain and are stored at the retailer (with the mark "Medicinal product dispensed") for:
narcotic and psychotropic drugs of list II, psychotropic drugs of list III - within five years;
medicines dispensed free of charge or at a discount - for three years;
combined medicinal products containing narcotic drugs or psychotropic substances included in lists II and III of the List, manufactured in a pharmacy organization, medicinal products with anabolic activity, medicinal products subject to quantitative accounting - within three years;
medicinal products in liquid dosage form containing more than 15% ethyl alcohol by volume of finished products, other medicinal products classified by ATC as antipsychotics (code N05A), anxiolytics (code N05B), hypnotics and sedatives (code N05C), antidepressants ( code N06A) and not subject to quantitative accounting - within three months.
18. Dispensing counterfeit, substandard and counterfeit medicines is prohibited.
II. Requirements for the dispensing of narcotic and psychotropic medicinal products, medicinal products with anabolic activity, other medicinal products subject to quantitative accounting
19. Dispensing of narcotic and psychotropic medicinal products, medicinal products with anabolic activity, medicinal products subject to quantitative accounting is carried out by pharmaceutical workers holding positions included in the list of positions of pharmaceutical and medical workers in organizations that have been granted the right to dispense narcotic medicinal products and psychotropic drugs to individuals, approved by Order of the Ministry of Health of the Russian Federation No. 681n dated September 7, 2016 (registered by the Ministry of Justice of the Russian Federation on September 21, 2016, registration No. 43748).
20. Narcotic and psychotropic drugs of list II, with the exception of drugs in the form of transdermal therapeutic systems, are dispensed upon presentation of an identity document to the person specified in the prescription, his legal representative or a person who has a power of attorney issued in accordance with the legislation of the Russian Federation for the right to receive such narcotic and psychotropic medicinal products.
21. Narcotic and psychotropic drugs of list II (with the exception of drugs in the form of transdermal therapeutic systems), intended for citizens who have the right to receive drugs free of charge or receive drugs at a discount, are dispensed upon presentation of a prescription written out on a prescription form No. 107 / y-NP, and a prescription issued on the prescription form of form No. 148-1 / y-04 (l) or form No. 148-1 / y-06 (l).
Medicinal products specified in these Rules, intended for citizens who have the right to receive medicines dispensed free of charge or at a discount, are dispensed upon presentation of a prescription written out on a prescription form No. form No. 148-1 / y-04 (l) or form No. 148-1 / y-06 (l).
22. After the dispensing of narcotic and psychotropic medicinal products of List II, including in the form of transdermal therapeutic systems, psychotropic medicinal products of List III, the person who received the medicinal product shall be issued a signature with a yellow stripe at the top and an inscription in black on it "Signature", which states:
the name and address of the location of the pharmacy or pharmacy;
number and date of the issued prescription;
surname, name, patronymic (if any) of the person for whom the medicinal product is intended, his age;
number of the medical card of the patient receiving medical care on an outpatient basis for whom the medicinal product is intended;
surname, name, patronymic (if any) of the medical worker who issued the prescription, his contact phone number or the phone number of the medical organization;
surname, name, patronymic (if any) and signature of the pharmaceutical worker who dispensed the medicinal product;
date of release of the medicinal product.
23. The release of ethyl alcohol is made according to the prescription, taking into account the established requirements for the volume of containers, packaging and completeness of medicinal products.
Medicinal products containing ethyl alcohol, including those manufactured by prescription by a retail trade entity that has a license for pharmaceutical activities with the right to manufacture medicinal products, are dispensed subject to the established requirements for the volume of containers, packaging and completeness of medicinal products.
24. Separate dispensing of medicinal products that are part of a medicinal product manufactured by a retail trade entity is prohibited.
25. It is prohibited to dispense medicines specified in these Rules by a retail trade entity according to prescriptions of veterinary organizations.
III. Requirements for the dispensing of medicinal products according to the requirements-waybills of medical organizations, individual entrepreneurs with a license for medical activities
26. The requirement-invoice for the dispensing of medicinal products is drawn up in accordance with the Instructions on the procedure for prescribing medicinal products and issuing prescriptions and invoices, approved by order of the Ministry of Health and Social Development of the Russian Federation dated February 12, 2007 No. 110 "On the procedure for prescribing and prescribing medicines, medical devices and specialized health food products” (registered by the Ministry of Justice of the Russian Federation on April 27, 2007, registration number 9364) .
It is allowed to dispense medicines according to the requirements-invoices of medical organizations and individual entrepreneurs holding a license for medical activities, issued in electronic form, if the medical organization, an individual entrepreneur holding a license for medical activities, and a retail trade entity are, respectively, participants in the information exchange system information.
27. Dispensing of narcotic and psychotropic medicinal products of list II, psychotropic medicinal products of list III, other medicinal products subject to subject-quantitative accounting, including those sold without a prescription, is carried out according to separate requirements-waybills.
28. It is prohibited to sell narcotic and psychotropic drugs of list II, including in the form of transdermal therapeutic systems, psychotropic drugs of list III according to the requirements-waybills of an individual entrepreneur who has a license for medical activities.
29. When dispensing medicinal products, the pharmaceutical worker checks the proper execution of the invoice request and puts a mark on it on the quantity and cost of the dispensed medicinal products.
30. All requirements-invoices, according to which medicinal products are dispensed, shall be left and stored at the retailer:
for narcotic and psychotropic drugs of list II, psychotropic drugs of list III (in relation to pharmacies and pharmacy points) - within five years;
for medicinal products subject to subject-quantitative accounting - within three years;
for other medicinal products - within one year.
31. Violation of the primary packaging of a medicinal product when it is dispensed on demand-invoice is allowed by a retail trade entity that has a license for pharmaceutical activities with the right to manufacture medicinal products. In this case, the medicinal product is dispensed in a package drawn up in accordance with the established procedure, with the provision of instructions (copies of instructions) for the use of the dispensed medicinal product.
______________________________
*(1) Subparagraph “h” of paragraph 5 of part 4 of Article 18, subparagraph “k” of paragraph 1 of part 1 of Article 33 of the Federal Law of April 12, 2010 No. 61-FZ “On the Circulation of Medicines” (Collected Legislation of the Russian Federation, 2010 , No. 16, item 1815; No. 42, item 5293; No. 49, item 6409; 2014, No. 52, item 7540).
*(2) Orders of the Ministry of Health of the Russian Federation:
dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing medicines, as well as forms of prescription forms for medicines, the procedure for issuing these forms, their accounting and storage” (registered by the Ministry of Justice of the Russian Federation on June 25, 2013, registration No. 28883), as amended by orders of the Ministry of Health of the Russian Federation dated December 2, 2013 No. 886n (registered by the Ministry of Justice of the Russian Federation on December 23, 2013, registration No. 30714), dated June 30, 2015 No. 386n (registered by the Ministry of Justice August 6, 2015, registration No. 38379) and April 21, 2016 No. 254n (registered by the Ministry of Justice of the Russian Federation on July 18, 2016, registration No. 42887) (hereinafter - order No. 1175n);
dated August 1, 2012 No. 54n "On approval of the form of prescription forms containing the prescription of narcotic drugs and psychotropic substances, the procedure for their manufacture, distribution, registration, accounting and storage, as well as the rules for registration" (registered by the Ministry of Justice of the Russian Federation on August 15, 2012 ., registration No. 25190), as amended by orders of the Ministry of Health of the Russian Federation dated June 30, 2015 No. 385n (registered by the Ministry of Justice of the Russian Federation on November 27, 2015, registration No. 39868) and dated April 21, 2016 No. 254n ( registered by the Ministry of Justice of the Russian Federation on July 18, 2016, registration No. 42887) (hereinafter - Order No. 54n).
*(3) Collection of Legislation of the Russian Federation, 1998, No. 27, art. 3198; 2004, no. 8, art. 663; No. 47, Art. 4666; 2006, no. 29, art. 3253; 2007, no. 28, art. 3439; 2009, no. 26, art. 3183; No. 52, Art. 6572; 2010, no. 3, art. 314; No. 17, art. 2100; No. 24, art. 3035; No. 28, Art. 3703; No. 31, art. 4271; No. 45, art. 5864; No. 50, art. 6696, 6720; 2011, no. 10, art. 1390; No. 12, art. 1635; No. 29, art. 4466, 4473; No. 42, art. 5921; No. 51, art. 7534; 2012, no. 10, art. 1232; No. 11, Art. 1295; No. 19, Art. 2400; No. 22, Art. 2864; No. 37, Art. 5002; No. 48, art. 6686; No. 49, Art. 6861; 2013, no. 9, art. 953; No. 25, Art. 3159; No. 29, Art. 3962; No. 37, Art. 4706; No. 46, Art. 5943; No. 51, Art. 6869; 2014, no. 14, art. 1626; No. 23, Art. 2987; No. 27, Art. 3763; No. 44, Art. 6068; No. 51, art. 7430; 2015, no. 11, art. 1593; No. 16, Art. 2368; No. 20, Art. 2914; No. 28, Art. 4232; No. 42, art. 5805; 2016, no. 15, art. 2088; 2017, No. 4, art. 671; No. 10, Art. 1481.
*(4) Appendices No. 1 and 2 to Order No. 54n.
*(5) Clause 9 of the procedure for prescribing and prescribing drugs, approved by order No. 1175n.
*(6) Order of the Ministry of Health of the Russian Federation dated April 22, 2014 No. 183n “On approval of the list of medicinal products for medical use subject to subject-quantitative accounting” (registered by the Ministry of Justice of the Russian Federation on July 22, 2014, registration No. 33210) with by the order of the Ministry of Health of the Russian Federation of September 10, 2015 No. 634n (registered by the Ministry of Justice of the Russian Federation on September 30, 2015, registration No. 39063).
*(7) Subparagraph 3 of paragraph 9 of the procedure for prescribing and prescribing medicines, approved by order No. 1175n.
*(8) Registered by the Ministry of Justice of the Russian Federation on June 1, 2012, registration No. 24438, as amended by orders of the Ministry of Health of the Russian Federation dated June 10, 2013 No. 369n 29064), dated August 21, 2014 No. 465n (registered by the Ministry of Justice of the Russian Federation on September 10, 2014, registration No. 34024), dated September 10, 2015 No. 634n (registered by the Ministry of Justice of the Russian Federation on September 30, 2015, registration No. 39063).
*(9) Decree of the Government of the Russian Federation of December 26, 2015 No. 2724-r (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2016, No. 2, Art. 413).
*(10) Annexes No. 1 and No. 2 to the procedure for prescribing and prescribing medicines, approved by order No. 1175n.
*(11) Collection of Legislation of the Russian Federation, 2010, No. 16, art. 1815; No. 42, art. 5293; 2014, no. 52, art. 7540.
* (12) Collection of Legislation of the Russian Federation, 1998, No. 2, art. 219; 2012, no. 53, art. 7630; 2013, no. 48, art. 6165; 2015, no. 1, art. 54.
*(13) Appendix No. 2 to the procedure for prescribing and prescribing medicines, approved by order No. 1175n.
*(14) Order No. 1175n and Order No. 54n.
*(15) Article 74 of the Federal Law of November 21, 2011 No. 323-FZ “On the Basics of Protecting the Health of Citizens in the Russian Federation” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2011, No. 48, Art. 6724; 2013, No. 48, Art. 6165).
*(16) Article 57 of the Federal Law of April 12, 2010 No. 61-FZ "On the Circulation of Medicines".
*(17) In relation to the person specified in Part 2 of Article 20 of the Federal Law of November 21, 2011 No. 323-FZ “On the Basics of Protecting the Health of Citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, No. 48, Art. 6724 ; 2012, No. 26, items 3442, 3446; 2013, No. 27, items 3459, 3477; No. 30, item 4038; No. 39, item 4883; No. 48, item 6165; No. 52, item 6951 2014, No. 23, item 2930; No. 30, item 4106, 4206, 4244, 4247, 4257; No. 43, item 5798; No. 49, item 6927, 6928; 2015, No. 1, item 72, 85; No. 10, items 1403, 1425; No. 14, item 2018; No. 27, item 3951; No. 29, items 4339, 4356, 4359, 4397; No. 51, item 7245; 2016, No. 1, 9, 28; No. 15, 2055; No. 18, 2488; No. 27, 4219).
*(18) Part 4.1 of Article 45 of the Federal Law of April 12, 2010 No. 61-FZ “On the Circulation of Medicines” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2010, No. 16, Art. 1815; 2014, No. 52, Art. 7540; 2015, No. 51, art. 7245), Decree of the Government of the Russian Federation dated July 23, 2016 No. 716 “On the procedure for compiling a list of medicinal products for medical use, in respect of which requirements are established for the volume of containers, packaging and completeness, a list of medicinal products for veterinary use, in respect of which the requirements for the volume of containers are established, and the definition of such requirements ”(Collected Legislation of the Russian Federation, 2016, No. 31, article 5030).
*(19) As amended by orders of the Ministry of Health and Social Development of the Russian Federation of August 27, 2007 No. 560 (registered by the Ministry of Justice of the Russian Federation on September 14, 2007, registration No. 10133), of September 25, 2009 No. 794n ( registered by the Ministry of Justice of the Russian Federation on November 25, 2009, registration No. 15317), dated January 20, 2011 No. 13n (registered by the Ministry of Justice of the Russian Federation on March 15, 2011, registration No. 20103), by orders of the Ministry of Health of the Russian Federation dated August 1, 2012 No. 54n (registered by the Ministry of Justice of the Russian Federation on August 15, 2012, registration No. 25190), dated February 26, 2013 No. 94n (registered by the Ministry of Justice of the Russian Federation on June 25, 2013, registration No. 28881).
*(20) Clause 4 of Article 31 of the Federal Law of January 8, 1998 No. 3-FZ “On Narcotic Drugs and Psychotropic Substances” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 1998, No. 2, Art. 219; 2003, No. 27, Art. 2700; 2013, No. 48, article 6165; 2015, No. 1, article 54).
*(21) Order of the Ministry of Health of Russia dated October 26, 2015 No. 751n “On Approval of the Rules for the Manufacture and Dispensing of Medicinal Products for Medical Use by Pharmacy Organizations, Individual Entrepreneurs Licensed for Pharmaceutical Activities” (registered by the Ministry of Justice of the Russian Federation on April 21, 2016 , registration number 41897).
Document overview
New rules have been approved for dispensing medicinal products for medical use, including immunobiological ones, by pharmacies and individual entrepreneurs licensed for pharmaceutical activities.
Medicines are dispensed without a prescription, by prescription and according to the requirements of medical organizations and individual entrepreneurs who have a license for medical activities. The rules apply to pharmacies, pharmacy points, pharmacy kiosks and individual entrepreneurs licensed for pharmaceutical activities. Of these, only pharmacies and drugstores can dispense prescription drugs, as well as narcotic and psychotropic drugs. For the release of the latter, there must be an appropriate license.
As before, there are separate prescription forms for psychotropic drugs; drugs dispensed free of charge; for others. It is clarified which drugs are dispensed for them. Recipe service times have been kept the same.
The features of the release of the immunobiological preparation are fixed. So, on the prescription or prescription spine, which remains with the purchaser, the exact time (in hours and minutes) of the holiday is indicated. In this case, the purchaser must have a special thermal container. The first one receives clarifications on the delivery time of the drug to the medical facility.
The shelf life of recipes has been clarified.
The requirements for the release of narcotic and psychotropic, anabolic drugs, as well as drugs subject to subject-quantitative accounting, have been revised.
The order of the Ministry of Health and Social Development of Russia on the procedure for dispensing medicines has become invalid (taking into account the changes made).
Clomipramine 3. Imipramine 4. Paroxetine 5. Sertraline 6. Pipofesin 7. Fluoxetine 8. Betahistine 9. Aminophenylbutyric acid 10. Vinpocetine 11. Piracetam 12. Glycine 13. Tizanidine 14. Ethylmethylhydroxypyridine succinate infections: 1. Doxycycline 2. Tetracycline 3. Amoxicillin + Clavulanic acid 4. Cephalexin 5. Benzathine benzylpenicillin 6. Cefuroxime 7. Sulfasalazine 8. Clarithromycin 9. Azithromycin 10. Ciprofloxacin 11. Fluconazole 12. Clotrimazole 13. Tiloron 14. Acyclovir 15. Metronidazole 16. Benzyl benzoate Antitumor agents: 1. Hydroxycarbamide 2. Busulfan 3. Mercaptopurine 4. Melphalan 5. Methotrexate 6. Chlorambucil 7. Mitomycin 8. Cyclophosphamide 9. Azathioprine 10. Tamoxifen 11. Medroxyprogesterone 12. Anastrozole 13. Interferon alfa-14. 2a 15. Interferon alfa-2b Bone strengthening: 1. Calcitonin 2.
List of discounted medicines for 2018
Preferential drugs are prescribed by the attending physician in accordance with medical indications, prescriptions are certified by the head of the department. 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.
List of free medicines
No one followed the dosages of conventional sedatives and did not note on the prescription how much and when it was already bought. And often the recipe was not asked at all. Even if you used to buy an antibiotic, sedative or medicine for your grandmother without a prescription, this does not mean that the drug is really on sale. Even common drugs are on the prescription list, and buying them can now be a problem.
So what? 03/02/17 Pharmacies operate under new rules It depends on whether a prescription is needed and what category the drug belongs to. There are several such categories, it is pointless to study them all in advance, but you need to keep in mind. OTC drugs can be bought at a pharmacy, drugstore, kiosk, or from an individual entrepreneur with a license.
And pharmacy kiosks do not sell prescription drugs - you will have to look for a full-fledged pharmacy.
Medical supply 2018
Even if these pills are needed all the time - for example, painkillers for a seriously ill person. Or sleeping pills and sedatives for regular use. The same situation with alcohol-containing drugs - the prescription will remain in the pharmacy.
Info
Whether it is possible to write out a prescription not for one time, but for a long period, the doctor decides and pharmacies are checked. No, this recipe will not be taken away. Although there are rumors that they are being taken away. Do not believe the rumors - read the law. They can pick it up only if the prescription was issued before September 22, and then the sales rules for this drug changed.
How to deal with prescriptions for a long time is written in paragraph 10 of the new rules. When a pharmacy sells a prescription drug that is valid for a year, the pharmacist must note when and how much the drug was sold. And the prescription is returned. The next time, this prescription will be sold again in the right amount of the medicine: past sales will be taken into account and again put a mark.
New drug dispensing rules: stop panicking
And the list of the minimum required range of medicines, in turn, has expanded by two positions. List of free medicines Group of analgesics: 1. Codeine 2. Morphine 3. Narcotine 4. Papaverine 5. Thebaine 6.
Trimeperidine 7. Acetylsalicylic acid 8. Ibuprofen 9. Diclofenac 10. Ketoprofen 11. Ketorolac 12. Paracetamol and Panadol Antiepileptic: 1. Benzobarbital 2. Valproic acid 3. Hydrochloroquine 4.
Penicillamine 5. Carbamazepine 6. Clonazepam 7. Topiramate 8. Ethosuximide 9. Phenobarbital 10. Oxcarbazepine Antiparkinsonian: 1. Trihexyphenidyl 2. Levodopa 3. Benserazide 4. Amantadine 5.
Attention
Carbidol Psycholeptics: 1. Zuclopenthixol 2. Haloperridol 3. Quetiapine 4. Olanzapine 5. Risperidone 6. Periciazine 7. Sulpiride; 8. Trifluoperazine 9. Thioridazine 10. Flupentixol 11.
Fluphenazine 12. Chlorpromazine 13. Oxazepam 14. Diazepam. Psychoanaleptics: 1. Amitriptyline 2.
Free Medicines 2018
INNs included in the list of free drugs for 2018: Name of the drug Dosage form Drugs for the treatment of diseases of the liver and biliary tract Succinic acid + meglumine + inosine + methionine + nicotinamide r/r for infusion Antidiarrheal, intestinal anti-inflammatory and antimicrobial drugs Mesalazine suppositories, suspension, tablets Drugs for the treatment of diabetes mellitus Lixisenatide r / r for subcutaneous administration Empagliflozin tablets Other drugs for the treatment of diseases of the gastrointestinal tract and metabolic disorders Eliglustat capsules Hemostatics Eltrombopag tablets Drugs that affect the renin-angiotensin system Valsartan + sacubitril tablets Lipid-lowering drugs Alirocumab r / r for subcutaneous administration Evolocumab r/r for subcutaneous administration Pituitary and hypothalamus hormones and their analogs Lanreotide gel for subcutaneous administration prolong.
Upd: Will Corvalol and Valocordin be sold by prescription on September 22?
Betamethasone 3. Hydrocortisone 4. Methylprednisolone 5. Methylprednisolone aceponate 6. Prednisolone 7. Fludrocortisone 8. Desmopressin 9. Levothyroxine sodium 10. Bromocriptine 11. Thiamazole 12. Allopurinol For diabetes: 1.
Gliclazide 2. Glibenclamide 3. Glucagon 4. Insulin aspart 5. Insulin aspart biphasic 6. Insulin detemir 7. Insulin glargine 8. Insulin glulisin 9. Insulin biphasic 10. Insulin lispro 11.
Insulin isophane 12. Insulin soluble 13. Insulin lispro biphasic 14. Repaglinide 15. Metformin Drugs for the treatment of kidneys: 1. Finasteride 2. Doxazosin 3. Tamsulosin 4. Cyclosporine Ophthalmic drugs: 1.
Timolol 2. Pilocarpine Asthma drugs: 1. Beclomethasone 2. Aminophylline 3. Budesonide 4. Beclomethasone + Formoterol 5. Ipratropium bromide + fenoterol 6. Salbutamol 7. Formoterol 8.
Tiotropium bromide 9. Acetylcysteine 10. Ambroxol Antihistamine type drugs: 1.
Changed the rules for the sale of drugs in pharmacies
Experts did not give up, discovering new classes of antimicrobial drugs, as well as improving existing ones. Semi-synthetic and synthetic preparations with a complex structure and a wide spectrum of action have appeared. However, all of them lose their effectiveness over time, because pathogen defense mechanisms also develop.
Mortality from bacterial infections, especially such as pneumonia, is on the rise, because there is simply nothing to treat them. This problem was raised by the World Health Organization at the beginning of the 21st century and proposed a number of measures to solve it. One of them is the prescription of ABP in pharmacies. Antibiotics without prescriptions For a long time, this is how they were sold, which led to rampant uncontrolled self-medication. Patients independently, without medical advice, "prescribed" a medicine for themselves at the first sign of malaise.
Which medicines will be available on prescription only from 2018?
Who writes "free" prescriptions What kind of free drugs can be prescribed in a particular case, you can check with your doctor or a representative of the health insurance organization that pays for the treatment. Preferential drugs are prescribed by the attending physician in accordance with medical indications, prescriptions are certified by the head of the department. The prescription must have an expiration date, usually one month (30 days).
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.
Patients' opinions Consumers who are accustomed to taking antibiotics without a doctor's prescription are naturally unhappy with the ban on their free sale. They motivate this by their reluctance to go to the clinic, because the queues there are huge, and in general “you can do without a doctor” and “I always get treated like that.” Such statements only confirm the correctness of the introduced restriction, since it is not necessary to rely on the consciousness of this category of patients.
Only legislation can protect their health and life from their own irresponsible actions. The adequate part of society perceived the ban positively, since these people are already responsible for taking any medications and buy them at the pharmacy only after a preliminary visit to the doctor.
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. Read 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 they promise to extend this list by March, as the head of Rospotrebnadzor decided, she advocated the sale of all prescription drugs, which is described in this article.
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!
