New rules for dispensing medicines. Prescription tablet. What do the Russians promise the new rules for dispensing drugs

In accordance with the requirements of the legislation on licensing pharmaceutical activities, employees of pharmacy organizations engaged in retail trade in medicines and their dispensing are responsible for compliance with the rules for the circulation of medicines. Pharmacy employees need to know the modern procedure for prescribing medicines and the rules for issuing prescription forms, know the algorithms for conducting a pharmaceutical examination of a prescription in order to avoid errors when dispensing medicines.

About the requirements of the legislation for the preparation of prescription forms for medicines tells Natalia Zolotareva, Candidate of Pharmaceutical Sciences, Associate Professor of the Department of Management and Economics of Pharmacy, St. Petersburg State Chemical and Pharmaceutical Academy.

Decree of the Government of the Russian Federation of December 22, 2011 No. 1081 "Regulations on Licensing Pharmaceutical Activities" is a key document that defines the list of licensing requirements and conditions that the state imposes today on licensees engaged in retail trade in medicinal products for medical use, namely for pharmacy organizations , individual entrepreneurs with a license for pharmaceutical activities.

These licensees must comply with the rules for dispensing medicinal products for medical use without fail. The same document defines the concept of "gross violation of licensing requirements and conditions", which include issues related to the dispensing of medicines. If the established leave rules are violated, the control authorities have the right to regard the identified violations as gross with all the ensuing consequences, ranging from fairly serious penalties and including suspension of the licensee's activities.

WHAT ARE THE VACATION RULES DETERMINED TODAY?

Let's start with legal regulation in order to figure out how to properly accept prescriptions, namely from Federal Law 04/12/10 No. 61-FZ "On the Circulation of Medicines" (Chapter 10 "Pharmaceutical Activities", Article 55), which reads: "The rules for dispensing drugs (MP) for medical use by pharmacy organizations and individual entrepreneurs are approved by the authorized federal executive body." What legislative acts have been approved that regulate the procedure for dispensing medicines?

• Federal Law No. 323-FZ "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation";
• Federal Law of February 7, 1992 No. 2300-I "On Protection of Consumer Rights";
• Decree of the Government of the Russian Federation of 19.01.98 No. 55 "On approval of the rules for the sale of certain types of goods ...";
• Order of the Ministry of Health of the Russian Federation of August 31, 2016 No. 647n "On Approval of the Rules for Good Pharmacy Practice of Medicinal Products for Medical Use" (entered into force on March 1, 2017);

and departmental regulations - orders of the Ministry of Health of Russia:

• No. 1175n of 2012.12 (entered into force on July 1, 2013), which determines the procedure for prescribing and prescribing drugs, as well as prescription forms;
• No. 54n dated August 1, 2012 (entered into force on July 1, 2013), is dedicated to a special prescription form for a narcotic drug and a psychotropic substance;
• No. 785 of December 14, 2005 "On the procedure for dispensing medicines";
• No. 157n dated March 16, 2010 "On approval of the maximum allowable amount of a narcotic drug, psychotropic substance and their precursor contained in preparations."

The process of dispensing medicines by prescription involves close interaction between a medical and pharmaceutical worker. The first one is responsible for prescribing the drug subject to the necessary requirements, and the second one must, before dispensing the drug on prescription, conduct its pharmaceutical examination, if necessary, transfer it for manufacturing, then release the drug. The requirement for feedback between pharmaceutical and medical organizations remains important. Literally, the regulatory requirement involves the regular sending of information about all incorrectly written prescriptions to a medical organization. Such feedback, regular and properly established, removes a number of questions about the identified violations in terms of prescription drug dispensing.

FIVE RECIPES FORMS

Two key regulatory documents are directly related to the procedure for prescribing the drug, the forms of the prescription form - this is order No. 1175n and order No. 54n (both came into force on July 1, 2013).

Traditionally valid regulatory documents have determined the forms of prescription forms. To date, there are 5 forms of prescription forms: No. 107-1 / y, 148-1 / y-88, 148-1 / y-04 (l), No. 148-1 / y-06 (l), a special prescription form . From January 1, 2016, by order No. 385n, separate changes were made to the forms of prescription forms 148-1 / y-88, 107-1 / y. But in order to use the stocks of previously purchased prescription forms for their intended purpose, it was allowed to use old-style forms before the entry into force of the order of the Ministry of Health of Russia dated 06/30/15 No. 385n "On Amendments to the Order of the Ministry of Health of the Russian Federation dated August 1, 2012 No. 54n" On approval of the form of prescription forms containing the prescription of narcotic drugs or psychotropic substances, the procedure for their manufacture, distribution, registration, accounting and storage, as well as the rules for registration, "that is, until July 1, 2016. After that, pharmacy workers must demand those forms prescription forms, the structure of which has been changed in accordance with the current regulatory documents.

Order No. 1175n brought a lot of new things to the procedure for prescribing and prescribing drugs. The first place in terms of the importance of innovation can be given to the very paradigm of prescribing drugs. If earlier a health worker could use any name of the drug: INN, grouping or trade, as it was convenient for him, then in connection with the entry into force of this regulatory document, prescribing drugs according to INN is clearly established as a priority. If it is missing, then the grouping name should be used, and in the absence of both names, by trade name.

Specialists with a secondary medical education have appeared in the list of those who have the right to prescribe and write out prescriptions: paramedics, midwives. Only if such powers are assigned to them by the relevant order of the head of the medical organization. Individual entrepreneurs traditionally also have the right to prescribe drugs, write prescriptions, but there are certain restrictions, for example, related to the fact that medical professionals engaged in private medical activities do not have the right to prescribe narcotic and psychotropic drugs from Lists 2 and 3.

If a prescription comes under a trade name, what should be done with it? Can it be rejected, or is it written out correctly? The answer to this question is in the order of the Ministry of Health No. 1175n - the health worker has the right to use the trade name when prescribing in case of individual intolerance and / or for health reasons, but this decision must be confirmed by the medical commission, as evidenced by the corresponding stamp on the back of the prescription.

DIFFERENCES FOR RECIPES FORMS

What is the difference between these forms of prescription forms and how to correctly issue them to health workers in order to prevent incorrect pharmaceutical examination at the pharmacy?

√ Special prescription form(the most difficult one is in terms of the composition of the details, the structure, although from the point of view of its use there is only one case when a health worker can and should use this form). This strict accounting form has several degrees of protection and is intended for prescribing narcotic and psychotropic drugs from List 2 of the List approved by Decree of the Government of the Russian Federation of 03/21/11 No. 181 "On the procedure for importing into the Russian Federation and exporting from the Russian Federation narcotic drugs, psychotropic substances and their precursors" (for example, morphine, promedol, prosedol, etc.). List 2 is updated regularly. Working with Schedule 2 and 3 narcotic drugs requires a separate license, unlike working with potent poisonous drugs.

All prescription forms differ in terms of purpose of use, structure, composition of details, validity period and shelf life.

The current regulatory documents require that in the event that a narcotic drug or psychotropic substance is prescribed for privileged categories of citizens, in addition to a special prescription form, it is necessary to provide forms 148-1 / y-04 (l), No. 148-1 / y-06 (l) . The special prescription form has undergone changes - it has become larger, and from June 30, 2015, the validity period of this prescription form has also been significantly increased - from 5 to 15 days from the date of issue. The stamp of the medical organization must be clearly legible (its name, address and telephone number). The form of the form has a series, number, date of issue of the prescription, an indication of "child" or "adult" (underlined); Full name of the patient, age (number of full years (children under one year - number of months), series and number of the compulsory medical insurance policy, number of the outpatient medical record. In Latin, according to INN, indicating the dosage, packaging and quantity, the corresponding drug is indicated. Only in In this form of the prescription form, the number of prescribed psychotropic and narcotic drugs from Schedule 2 must be indicated not only in numbers, but also in words.

All this is certified by the personal signature of the doctor, as well as the personal seal of the health worker. This form must indicate the full name of the authorized person, which may be the head or deputy head of the medical organization, structural unit, or an appointed authorized person who certifies these forms (full name, signature). It is additionally certified by the seal of the medical organization or the seal for prescriptions. Further, in the prescription form, there is a mark of the pharmacy organization on the release of the medicinal product. If the pharmacy worker is satisfied with everything in the design of the prescription form, he indicates what is dispensed, dosage, packaging. It is certified by the full name (in full), the date of issue and the seal of the pharmacy organization.

√ Prescription form 148-1/u-88- the form of which is simpler in terms of the composition of the details, but if we talk about the purposes of the form, we get 5 options for use.

1. Narcotic and psychotropic drugs from Schedule 2, but in the form of transdermal therapeutic systems, i.e. any other dosage form of a narcotic drug or psychotropic substance included in Schedule 2 must be written out on a special prescription form. Traditionally, this form is used to prescribe and prescribe psychotropic drugs from Schedule 3.
2. Other drugs subject to quantitative accounting, but there is an addition - with the exception of drugs sold without a doctor's prescription.
3. For prescribing drugs with anabolic activity (anabolic steroids).
4. Also, since 2012, the procedure for dispensing combined preparations containing small amounts of narcotic and psychotropic substances and their precursors, as well as other pharmacologically active substances, has changed. We are talking about combinations that are indicated in clause 5 of the order of the Ministry of Health of Russia dated May 17, 2012 No. 562 “On approval of the Procedure for dispensing to individuals drugs for medical use containing, in addition to small amounts of narcotic drugs, psychotropic substances and their precursors, other pharmacological active substances” .
5. When prescribing individually manufactured medicinal products that contain narcotic drugs and psychotropic substances from Schedule 2 of the List of Decree No. 681, provided that the content of narcotic and psychotropic drugs in these combined drugs does not exceed the highest single dose, and the drug itself is not included in List 2.

This form is valid for 15 days. Since August 2016, either the full address of the patient with an index or the number of the patient's medical record is indicated on the prescription form.

√ Prescription Form 107-1/y- the simplest form of a prescription form. At the same time, the regulatory documents indicate the following: this form should be used to prescribe and prescribe combined drugs containing small doses of narcotic, psychotropic substances, their precursors and other pharmacologically active substances, but those combinations that are indicated in paragraph 4 of the order of the Ministry of Health of Russia No. 562 .

The form must contain the stamp of the medical organization, name (in full), address, phone number, date, indication of "adult" or "child", the patient's full name (in full), his age, the name of the doctor (in full), the name of the drug in Latin according to INN with indication of dosage, packing and dosage.

Up to three drug names can be written on this prescription form (unlike other forms, where only one name can be indicated). Personal signature and seal of the doctor on the form. Valid up to 60 days. For chronic patients, an extension up to 1 year is possible.

MAJOR VIOLATIONS IN PRECISING

The St. Petersburg State Chemical-Pharmaceutical Academy conducted a study during which the prescriptions placed in the journal of incorrectly written prescriptions were analyzed. Sometimes health workers do not indicate the expiration date of the prescription, incorrectly fill out the “full address” requisite, the name of the doctor and patient is not fully indicated, the stamps are not clearly readable, the details regarding the age of the patient are incorrectly filled out, there are no notes from the medical commission, when the prescription is issued under the trade name, there are extra seals and inscriptions, exceed the norm of LP release.

The last one is a common mistake. The current regulations set the maximum allowable dispensing rates and the recommended amount per prescription. But any rule allows an exception, it is marked by order No. 1175n (clause 15, clause 22, clause 23), which makes it possible to legally exceed the established norms for the release of medicines.

Based on materials from an online seminar organized by the St. Petersburg Union of Doctors

We continue to reveal the secrets of the order of the Ministry of Health No. 403n "On approval of the rules for dispensing medicines ...".

Today, the questions of our readers - pharmacists and pharmacists - are answered by Executive Director of the Association of Pharmacy Institutions "SoyuzPharma" Dmitry Tselousov.

I would like to know about the norms for the release of ethyl alcohol in its pure form for external use. In what weight units should it be released now?

The Ministry of Health tried to regulate the issue of dispensing alcohol-containing medicines.

Orders of the Ministry of Health No. 47n dated February 8, 2017 and No. 979n dated December 21, 2016, which are designed to limit the volume of containers of alcohol-containing drugs, do not apply to pure ethyl alcohol, since these orders indicate drugs in the form of tinctures containing alcohol.

Paragraph 23 of Order No. 403n of the Ministry of Health refers to the dispensing of alcohol specifically for external use, since it is hardly possible for a patient to use pure alcohol otherwise. However, this paragraph does not take into account the possibility of packaging alcohol for external use in industrial pharmacies.

What to do with the maximum allowable norms for dispensing medicines? Sometimes a patient comes with a prescription where they are exceeded...

The prescription should contain a note from the doctor why the patient needs more medicine than prescribed. This applies not only to the maximum allowable rate, but also to the recommended number of drugs per prescription.

If there are no such explanations, the pharmacy worker dispenses medicines within the maximum allowable norm or recommended amount. This must be noted in the recipe. It is necessary to warn the patient and the medical organization about exceeding the norm.

There is a subtle point here: according to the order of the Ministry of Health No. 1175n "On approval of the procedure for prescribing and prescribing drugs ...", such a prescription is invalid, and medicine cannot be dispensed according to an invalid prescription - this is indicated by the same order No. 1175n (if the drug is potent, the pharmacist and pharmacist generally subject to criminal liability).

From the point of view that if we are talking about the usual form 107, you can release the drug and it is enough just to record violations of the prescription in the journal, I do not agree. And I would like to warn experts that the inspectors may also disagree with this. However, Order No. 403n still allows medicines to be dispensed if the excess of the maximum allowable norm and the recommended amount in the prescription is not justified.

By order of the Ministry of Health and Social Development No. 785 of December 14, 2005, which has become invalid, the pharmacy has a stamp “The medicine has been dispensed”. In accordance with order No. 403n, there should be another stamp - "The drug is released." Does the stamp need to be redone?

The meaning of the inscriptions "Medicine dispensed" and "Medicine dispensed" is identical, so the stamp should not be changed.

According to paragraph 16 of Order No. 403n, a pharmaceutical worker informs the person purchasing the drug about the interaction with other drugs. How to do this if the patient is already taking some medications prescribed to him earlier (sometimes he cannot even remember their names)?

Of course, the pharmaceutical worker cannot know what the patient is taking. And the patient himself will not always remember the ornate names of his drugs. In this regard, I believe that advice on drug interactions should be based solely on the instructions for the purchased product.

Patients choose pharmacy organizations for specialists who can competently provide pharmaceutical consulting services. In part, this information is mastered during training within the framework of the course of pharmaceutical chemistry, and in part it is learned at trainings during training from manufacturing companies. In this case, the pharmaceutical specialist is guided solely by the knowledge base that he has managed to accumulate during his work activity.

- What about the release of immunobiological preparations?

In accordance with clause 8.11.5. “Conditions for the transportation and storage of immunobiological medicinal products”, approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation of February 17, 2016 No. 19 “On Approval of Sanitary and Epidemiological Rules SP 3.3.2.3332-16” (registered with the Ministry of Justice of Russia on April 28, 2016 No. 41968), vacation It is allowed to sell immunobiological medicinal products in retail sales provided that they are delivered to the place of their direct use in a thermal container or thermos in compliance with the requirements of the cold chain. That is, the retail sale of immunobiological preparations is allowed subject to the cold chain - this means that if a pharmacy wanted to sell immunobiological preparations, it was obliged to provide the buyer with a thermal container. The ordinance is still in effect. But now, in accordance with order 403n, the drug is dispensed if the visitor has a thermal container.

Is this condition feasible, because a sick person is not required to understand the categories of medicines? And is it worth interpreting it as the right of a pharmacy to refuse a vacation?

Apparently, the pharmacy organization will seek ways to provide the patient with such a container, or at least with cold elements. For example, dry ice packs.

- Will the patient have to pay for the thermal container?

Of course, the patient is obliged to pay for the thermal container, because he must have it in stock.

Expired prescription drugs may not be dispensed unless the prescription expired while the prescription was on deferred maintenance. In such a situation, the release of the drug is carried out without reissuing the prescription. But often, due to procurement and supply problems, drugs reach pharmacies already when both the prescription that was on deferred maintenance has expired and the deferred maintenance period (10 or 15 days) has also expired. Is it possible to release the remedy according to such a prescription without reissuing the document?

Indeed, in accordance with paragraph 6 of the order of the Ministry of Health No. 403n, it is prohibited to dispense medicines under prescriptions with expired validity, except for the case when the prescription expired while it was on deferred maintenance.

I would also like to draw attention to an issue that remains unresolved. What to do with the minimum assortment if it has a persistent defect? Order No. 403n retains the old norm from Order No. 785 - a drug from the minimum range must be dispensed within five days. But this period does not save the pharmacy. If the check recorded the absence of a drug, a fine is still issued. The jurisprudence is very extensive…

Photos from open sources

We are all used to change. We are no longer so afraid of reports of the next economic crisis, because in our memory there have already been several of them. Innovations in the educational standard of schools and higher educational institutions are not surprising. But the news in the field of health care and access to medicines cannot but cause concern. There are practically no healthy people in the modern world. We all have some kind of chronic disease and are often forced to purchase certain medicines. And when there is information in the news feeds that changes are coming in this process from a certain period, we experience feelings.

From the beginning of 2017, a new order of the Ministry of Health on the rules for dispensing medicinal products from pharmacy chains comes into force. The new order will directly affect every inhabitant.

In particular, a ban is introduced to sell a number of medicines in large quantities in one hand. This restriction is introduced for alcohol-containing tinctures and syrups, the mass fraction of ethyl alcohol in which is above 15%. Now they will be sold in one hand in the amount of no more than two bottles. Namely, with such means, many of us treat our colds at home on our own. We advise you to take care of their availability in advance, since at the peak of the incidence you will often have to visit the pharmacy under the new vacation conditions. The advice is especially relevant, taking into account the long shelf life of the latter.

Fans of online shopping should also listen to the innovations, since any online pharmacy in Moscow will follow them from the new year.

A welcome change is that prescriptions for patients with chronic diseases will be able to purchase the necessary medicines for the future. Today it is possible to do this only for the next two months. In this case, documentary evidence of the fact of departure or the impossibility of getting to the pharmacy in the future is required. Since January 2017, this period has been extended to a calendar year.

If the pharmacy does not have drugs from the list of vital and necessary drugs, then it will have to purchase them and provide them for sale no later than a week after the patient's request. Today, this period is prescribed as five calendar days. But if it is necessary for the buyer to take the medicine immediately, which is indicated on the prescription by the doctor's mark “statim”, the pharmacy is obliged to provide this product on the day of the request.

Under the new document, pharmacy workers are prohibited from advising the buyer of more expensive drugs if a cheaper analogue is available. Also, pharmacists will have to give detailed advice about the properties and contraindications of a particular drug, its expiration date, storage methods and doses used. Currently, such information is provided only at the request of the pharmacy employee himself and is not necessarily regulated in any way. Therefore, even when purchasing medicines in an online pharmacy. In 2017, you can count on the professional participation of a specialist in choosing one or another product, on advice on its use and storage.

We can only hope that all these innovations will be implemented and will benefit the interests of pharmacy customers.

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What drugs will be available on prescription from 2017?

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.

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.

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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 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!

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

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 and previously there was a clause "dispensed by prescription." 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 of "prescription drugs only" will work in full.

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 a doctor:

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, was also there, as well as Nimesil, a well-known painkiller.

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

Since 2017, pharmacies will not be able to sell prescription drugs if instead of an official document with a doctor’s signature and seal there is a “handwritten piece of paper”

Going to the pharmacy for medicines, do not be lazy, open the Internet. Type in the search engine the desired medication and look at the instructions for it. If there is a note “Only by prescription”, it means that without this very prescription, the remedy you need will not be sold.

Medicines are divided into those that can be freely bought at a pharmacy, and those that are dispensed only by prescription. In relation to the latter, from January 1, 2017, the rules for their vacation are being tightened. Under the heading "only by prescription" do not fall medicines that are freely available - on the windows of pharmacies. without problems, you can buy antiviral, many cough and cold medicines, some enzyme and painkillers.

And although the innovation caused a lot of controversy, for pharmacy workers this is by no means news. Order No. 785 "On the procedure for dispensing medicines" has been in force since December 14, 2005. But now the very form of the “doctor's note” is changing.

If before a prescription was considered a banal sheet on which the scribbles of the prescribed medicine were drawn by the doctor’s hand, this “gag” will no longer pass from the new year. A prescription form (form No. 107 / y) is required. With the personal seal of the doctor, the seal of the medical institution, dosage and frequency of use.

Remember, recipes also have an expiration date. Now it is 60 days. For chronic patients, the duration of the prescription may be longer.

So far, the official list of all drugs that must be dispensed strictly by prescription. In January, the Ministry of Health will draw up a list of medicines that will be dispensed only by prescription. In the meantime, they will focus on the instructions for medicines.

State Duma deputies plan to tighten control over pharmacies. For the sale of drugs without a doctor's prescription, even now you can "run into" a fine, but the deputies propose to increase the administrative penalty to 10 thousand rubles. And as a last resort, it is proposed to close the pharmacy for three months.

Since 2017, control over the sale of medicines will be strengthened Is it worth buying medicines? (TV and radio company "Seim")

in recent years, they have had a mania to prohibit everything, limit punishment, etc., all laws are directed at the negative; there is not a single law to give provision to provide an increase in favor of the people, even with authoritarianism you rarely see such a well, well, let's see where this curve leads

Here you go. I've been reading nonsense) Comments about nothing. Why stand in line with a pressure of 180 when there is an ambulance for such a situation. Although, in general, it is supposed to stock up on medicines as soon as they come to an end, and not on the day of the crisis (. Someone wrote about an antibiotic that should always be in the first aid kit Are you sure? And what (read, from what) should be at home? Do you think that one antibiotic cures everything? Nonsense! And they will do the right thing not to sell it. Otherwise, citizens drink "a harmful antibiotic for 2.5 days .. and so most cause its resistance to bacteria (addiction to the drug), the next time it no longer affects the microbe.So we returned to society tuberculosis, which became difficult to select drugs and increased mortality.Afraid of the drug, do not start drinking..it will be completely bad , then the doctor will write out a prescription, And in a difficult situation, you yourself will drink it to the end. And Valocordin is not at all a harmless drug, because it contains Phenobarbital (read on Wiki), but it does not save from death at all. rather from fear)) So fast and fast again oh, if you really feel bad. PS. I ALWAYS take a coupon through the Internet, I have never sat at the office for 3 hours. strictly on time and almost always on time. Doctors are not interested in accepting 35 instead of 15 people. why "get unrealistic"?!

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You give me a paper. Starting from the new year, the sale of medicines without a prescription will be tightened

In recent months, while shopping at a pharmacy, Kursk residents have been hearing from pharmacists a warning that from January 1, 2017, most drugs will be dispensed strictly by prescription. But is this true and what barriers will now be put up for patients?

Whose order?

On June 21, 2016, the State Duma adopted in the first reading government bill No. 1093620-6 “On Amendments to the Code of Administrative Offenses of the Russian Federation in terms of improving administrative responsibility in the healthcare sector”. And in September, at a meeting with Roszdravnadzor of the Russian Federation, it was announced that from January 1, 2017, prescription drugs will be under special control of the department.

“In fact, the order of the Ministry of Health and Social Development of the Russian Federation No. 785 “On the procedure for dispensing medicines” is valid from December 14, 2005. It is he who regulates the procedure for dispensing medicines from pharmacies, regardless of the form of ownership. Therefore, we still fine pharmacies for selling drugs without a prescription, ”explained Lyudmila Ilyukhina, deputy head of the department for licensing, supervision and control in the field of medical and social activities of the regional department of Roszdravnadzor.

Lethal injection. Kursk children are dying from a "harmless" medicine

Recall that 70% of drugs registered in the Russian Federation are dispensed strictly according to prescriptions, and only 30% - without it. But what will change in the new year? Nothing but tougher legislation in terms of control and supervision of pharmacies. Now Roszdravnadzor is constrained by the current legislation and cannot effectively influence pharmacies for violating the quality and safety of medical and pharmaceutical activities. It's just that pharmacists did not always pay attention to these requirements, and the population did not see the problem and did not understand it.

How will they punish?

The current version of the Code of Administrative Offenses does not establish administrative liability for a number of violations in the field of laboratory and clinical practice rules during clinical and preclinical studies of medicinal products for medical use, procedures for the provision of medical care in terms of non-compliance with the mandatory requirements established by them, procedures for conducting medical examinations, examinations and examinations , as well as the procedure for prescribing and prescribing drugs. Therefore, amendments were made to the Code of Administrative Offenses of the Russian Federation (CAO).

The price of health. Do beneficiaries have enough medicines?

The new law proposes completely different fines and penalties for violating the drug trade rules, including over-the-counter dispensing of prescription drugs.

So from January 1, 2017, if the fact of selling a medicine without a prescription is revealed, Roszdravnadzor can fine a pharmacist who violated the law in the amount of 5 to 10 thousand rubles (now - from 1,500 to 3 thousand rubles); the official will have to pay from 20 to 30 thousand rubles (now - from 5 to 10 thousand rubles); legal - from 100 to 150 thousand rubles (now - from 20 to 30 thousand rubles). Closing of a drugstore for 3 months (90 days) can become apogee.

Therefore, you understand, most pharmacies, if not all, will not want to take risks and will work strictly according to the letter of the law.

Blame self-medication

The impetus for the changes was the level of self-treatment of the population, which has recently gone off scale, and sometimes turns into very tragic consequences. Here it is already worth dealing with another problem - the lack of doctors and queues in hospitals that force people to go to the pharmacy and consult a pharmacist, which medicines should be taken for a particular disease.

“But the pharmacy must follow the doctor's recommendation, draw the buyer's attention to the storage conditions and the frequency of administration, no more. And the prescription itself is an appeal from a doctor to a pharmacist, what exactly he should give to the patient, - Ilyukhina notes. - And now it also happens that a person really visited a doctor, but came to the pharmacy not with a prescription written on official letterhead, but with a piece of paper on which the doctor indicated the name of the drug. And on these scraps pharmacists dispense drugs. This whole situation needs to change.”

The level of self-medication may be off scale, but this trend has a logical explanation - how long will a person have to sit in a hospital queue for a prescription? Especially considering that the majority prefer not to go on sick leave with every cold, but to carry it on their feet, since hospital authorities do not favor hospitals, and many of us do not consider sluggish SARS to be a real disease, supporting our immunity with medicines (not even antibiotics) from the nearest pharmacy. But now, before going to the pharmacy, you will have to go on a “crusade” to the hospital and sit there in line, most likely not an hour or two.

Shortage and queues

It is impossible to say right now which drugs will be dispensed only by prescription: a clear list does not exist in fact, it was abolished in 2011, as it was too long and cumbersome. So you will have to focus on the packaging of the drug, which should indicate the name, doses, form of release, manufacturers, expiration date, storage conditions and the release rule - with or without a prescription.

On September 22, new rules for dispensing medicines came into force - Order of the Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n “On approval of the rules for dispensing medicines”, which regulates the sale of medicines in pharmacies. The document caused a lot of noise and confusion among both patients and pharmacy staff. Today we tried to answer the most important questions about the new order that a simple pharmacy visitor may have.

Does the new order make all drugs prescription drugs?

No. The new dispensing rules only slightly change how certain prescription drugs are sold. It does not impose any restrictions on conventional over-the-counter drugs.

And now you can't just buy a prescription drug?

In fact, selling prescription drugs without a prescription has always been illegal. For this, the pharmacy faces a rather big fine and deprivation of the license. But, as everyone knows, the severity of the law is compensated by the optionality of its implementation. Therefore, a number of pharmacies neglect the rules. However, the emergence of new dispensing rules means close attention to their implementation, and therefore, pharmacies are now more reverent about prescription dispensing.

How do you know if you need a prescription for a drug?

Whether the drug is prescription or not - this is stated in the instructions for use. In addition, such information is always indicated on the packaging. Approximately 70% of all drugs registered in Russia are prescription drugs.

In an ideal world, the doctor knows by heart which drugs require a prescription and which do not. But in the harsh reality, very often such information has to be checked independently. Therefore, when a doctor advises you on any medications, you can check them via the Internet right at the appointment and immediately ask for a prescription.

Prescriptions are written only on special forms. The most common is form No. 107-1 / y. It looks like this:

To check if a drug is a prescription drug, you can go to the site and enter the name of the drug. All prescription drugs on our website are marked "prescription". By the way, not so long ago we had a special label for drugs, the prescription for which remains in the pharmacy.

How is it - "the prescription remains in the pharmacy"?

The pharmacy has a list of drugs that are subject to strict accounting. As a rule, these are medicines containing narcotic or psychotropic substances included in a special list. Prescriptions for such drugs always remain in the pharmacy to control their sale. The turnover of narcotic substances is checked not only by Roszdravnadzor, but also by the structures of the Ministry of Internal Affairs.

But now, according to the new dispensing rules, the pharmacy must also keep prescriptions for certain drugs (antidepressants, tranquilizers, antipsychotics, hypnotics and sedatives, as well as alcohol-containing drugs with an alcohol content of more than 15%) *.

"Alcohol-containing drugs"? So, now you need to get a prescription for Corvalol or valerian?

No. Again, the new order does not make prescription drugs. This applies only to prescription drugs. Corvalol, valerian tincture, and many other popular tinctures and elixirs are available over the counter. Accordingly, no one can require a prescription for them, if this is not stated in the instructions for use.

Okay, let's say I have a prescription, but it contains several drugs, and one of them is marked "remaining in the pharmacy." And I want to buy just one. Will they take my prescription?

Yes. Exceptions are made only for annual prescriptions, provided that you do not buy the entire prescribed amount of the drug at one time (this also requires the permission of the doctor who wrote the prescription).

For example, you are prescribed a course of antidepressants for a year, and you only need to purchase one package. In this case, the pharmacy has no right to take your prescription. The pharmacist only makes a note of how much of the drug you bought and returns the prescription.

Can I get medicine if the prescription is not for me?

Yes. Almost all drugs are dispensed simply to the bearer of the prescription. Both the patient himself and his friend, relative, or just an acquaintance can get the drug in a pharmacy. The main thing is the presence of the recipe.

An exception is made only for narcotic or psychotropic drugs. Prescriptions for such drugs are issued on a special form No. 107 / u-NP. It is easy to distinguish from other recipes because it is pink in color. When receiving such drugs at a pharmacy, you must have a power of attorney to receive medicines and a passport confirming that you are the one to whom the power of attorney was issued.

At the same time, the Ministry of Health emphasizes that the power of attorney can even be handwritten. You can write in it that "I trust such and such drugs to receive such and such medicines according to such and such a prescription to such and such a person." And be sure to indicate the passport data of this person. In addition, the date of its compilation must be indicated in it. Notarization of such a power of attorney is not required.

What else has changed with the new order of drug dispensing?

Now all prescriptions are stamped that "the drug is dispensed." Thus, they cannot be reused. Therefore, if you suddenly need another standard of the drug, you will need to get a new prescription.

Also, the pharmacist is now obliged to inform the buyer about the rules for storing the medicine, its interaction with other drugs, as well as about its method and doses of administration. In addition, a pharmacy employee cannot hide information about the availability of drugs with the same active ingredient, but cheaper. Such a norm existed earlier in the law “On the Fundamentals of Protecting the Health of Citizens” and the Rules of Good Pharmacy Practice, but now it has been duplicated in the order of leave.

* Below is a list of INNs, prescriptions for which, according to the new order, will now remain in the pharmacy. Please note that active ingredients (INN) are listed here, not specific brand names.

INN
agomelatine
asenapine
aminophenylbutyric acid
amisulpride
amitriptyline
aripiprazole
belladonna alkaloids + phenobarbital + ergotamine
bromod
buspirone
venlafaxine
vortioxetine
haloperidol
hydrazinocarbonylmethy
hydroxyzine
dexmedetomidine
doxylamine
duloxetine
zaleplon
ziprasidone
zuclopenthixol
imipramine
quetiapine
clomipramine
lithium carbonate
lurasidone
maprotiline
melatonin
mianserin
milnacipran
mirtazapine
olanzapine
paliperidone
paroxetine
periciazine
perphenazine
pipofezin
pirlindol
podophyllotoxin
promazine
Prudnyak fruit extract
risperidone
sertindole
sertraline
sulpiride
tetra
tiapride
thioridazine
tofisopam
trazodone
trifluoperazine
morpho
fluvoxamine
fluoxetine
flupentixol
fluphenazine
chlorpromazine
chlorprothixene
citalopram
escitalopram
etifoxine

Main photo istockphoto.com

Dear residents and guests of Krasnoyarsk and the Krasnoyarsk Territory!

Since March 1, 2017 pharmacies work 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 OF GOOD PHARMACY PRACTICE OF DRUGS FOR MEDICAL USE" and the 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 List of medicines available without a doctor's prescription should only be dispensed by prescription.

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.

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.

Available for prescription only:

LIST OF MEDICINES SUPPLIED ON THE PRECIPATIONS OF A DOCTOR (PARADICTHER) WHEN PROVIDING ADDITIONAL FREE MEDICAL ASSISTANCE TO CERTAIN CATEGORIES OF CITIZENS WHO HAVE THE RIGHT TO RECEIVE STATE SOCIAL ASSISTANCE

I. Anticholinesterase agents

II. Opioid analgesics and mixed action analgesics

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

IV. Means for the treatment of gout

V. Other anti-inflammatory drugs

VI. Means for the treatment of allergic reactions

VII. Anticonvulsants

VIII. Remedies for the treatment of parkinsonism

IX. Anxiolytics

X. Antipsychotics

XI. Antidepressants and normothymic drugs

XII. Means for the treatment of sleep disorders

XIII. Other drugs affecting the central nervous system

XIV. Means used in narcology

XV. Means for the prevention and treatment of infections

Antibiotic

Synthetic antibacterial agents

Anti-tuberculosis drugs

XVI. Antivirals

XVII. Antifungals

XIX. Antineoplastic, immunosuppressive and concomitant drugs

Cytostatic and immunosuppressive agents

Hormones and antihormones for the treatment of tumors

Concomitant drugs for the treatment of tumors

XX. Means for the treatment of osteoporosis

XXI. Means that affect hematopoiesis, the coagulation system

XXII. Drugs affecting the cardiovascular system

Antianginal agents

Antihypertensive drugs

Medicines for the treatment of heart failure

XXIII. 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

XXIV. 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

XXV. Means for the treatment of prostate adenoma

XXVI. Means affecting the respiratory system

XXVII. Means used in ophthalmology

XXVIII. Medications affecting the uterus

XXIX. Vitamins and minerals

XXX. Antiseptics and disinfectants

XXXI. Other funds

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.