home Adviсe What prescription medications? Rules for dispensing prescription drugs. Prescription pill. What do the new rules for dispensing drugs promise for Russians?

What prescription medications? Rules for dispensing prescription drugs. Prescription pill. What do the new rules for dispensing drugs promise for Russians?

According to statistics, about 20 million people in Russia have the right to free, so-called preferential, medicines. Approximately 15.5 million of these people choose medication instead monetary compensation, and only about 4 million people enjoy their right to the full.

Who is entitled to such medications in 2019 and in what cases can the state pay for treatment? First things first.

What medications are given free of charge?

The list of free medicines is regulated by the government.

The document confirming their receipt is the order of the Ministry of Health and Social Development of Russia “On approval of the list medicines, dispensed with a doctor's prescription when providing additional medical care separate groups citizens entitled to receive state social assistance", adopted in 2006, in September.

This document is updated regularly as some drugs are added to the list and others are removed from it.

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

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

Almost any disease can be cured solely with the help of free drugs.

Who is eligible for free medicines

Categories of persons who have the right to free medicines, are spelled out in Article 6.1 of Law No. 178-FZ “On State Social Assistance” dated July 17, 1999, in Article 125 of Law No. 122-FZ of August 22, 2004.

The prescription must indicate its validity period, usually one month. This is the time within which the medicine must be obtained from the pharmacy. If the drug is not available, medication may be offered similar action. The validity of the prescription can be extended, and in this 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 the prescription, the doctor is obliged to prescribe the drug again.

Any person to whom the prescription is given can receive free medicine with a prescription prescribed by a doctor. This is especially important when the patient himself is not able to pick up the medicine he needs.

Free medicines for children

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

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

If the medicines are not available at the pharmacy

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

According to data from a social study conducted by the All-Russian Popular Front, the majority of Russians in 2018 are not even able to access discounted medications, since in many populated areas There is a shortage of them in public medical institutions and pharmacies.

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Last changes

From January 1, 2019, new Rules for organizing the provision of medicines to people who are sick will be in effect. rare diseases, a list of which for the budget drug provision Federal Law-299 dated August 3, 2018 was expanded. It included the following diseases:

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

New INNs included in the list of free medicines:

Name of the drug		Dosage form
Drugs for the treatment of liver and biliary tract diseases
Succinic acid + meglumine + inosine + methionine + nicotinamide	r/r for infusions
Antidiarrheal, intestinal anti-inflammatory and antimicrobial drugs
Mesalazine		suppositories, suspension, tablets
Medicines for the treatment of diabetes mellitus
Lixisenatide		r/r for subcutaneous administration
Empagliflozin		pills
Other drugs for treating diseases gastrointestinal tract and metabolic disorders
Eliglustat		capsules
Hemostatics
Eltrombopag		pills
Drugs affecting the renin-angiotensin system
Valsartan + sacubitril		pills
Lipid-lowering drugs
Alirocumab		r/r for subcutaneous administration
Evolocumab		r/r for subcutaneous administration
Hormones of the pituitary gland and hypothalamus and their analogues
Lanreotide		gel for subcutaneous administration prolong. actions
Antibacterial drugs for systemic use
Telavantzin
Daptomycin		lyophilisate for preparing solution for infusion
Tedizolid		pills,
Antiviral drugs for systemic use
Dasabuvir; ombitasvir + paritaprevir + ritonavir		tablets set
Narlaprevir		pills
Daclatasvir		pills
Dolutegravir		pills
Antitumor drugs
Cabazitaxel
Brentuximab vedotin		lyophilisate for the preparation of concentrate for the preparation of solution for infusion
Nivolumab		concentrate for the preparation of solution for infusion
Obinutuzumab		concentrate for the preparation of solution for infusion
Panitumumab		concentrate for the preparation of solution for infusion
Pembrolizumab		concentrate for the preparation of solution for infusion
Pertuzumab		concentrate for the preparation of solution for infusion
Trastuzumab emtansine		lyophilisate for the preparation of concentrate for the preparation of solution for infusion
Afatinib		pills
Dabrafenib		capsules
Crizotinib		capsules
Nintedanib		soft capsules
Pazopanib		pills
Regorafenib		pills
Ruxolitinib		pills
Trametinib		pills
Aflibercept		concentrate for the preparation of solution for infusion
Vismodegib		capsules
Carfilzomib		lyophilisate for preparing solution for infusion
Tumor necrosis factor alpha-1 [thymosin recombinant]*
Antitumor hormonal drugs
Enzalutamide		capsules
Degarelix		lyophilisate for the preparation of solution for subcutaneous administration
Immunomodulators
Peginterferon beta-1a		r/r for subcutaneous administration
Immunosuppressants
Alemtuzumab		concentrate for the preparation of solution for infusion
Apremilast		pills
Vedolizumab		lyophilisate for the preparation of concentrate for the preparation of solution for infusion
Tofacitinib		pills
Canakinumab		lyophilisate for the preparation of solution for subcutaneous administration
Secukinumab		lyophilisate for preparing a solution for subcutaneous administration; solution for subcutaneous administration
Pirfenidone		capsules
Anti-inflammatory and antirheumatic drugs
Dexketoprofen		r/r for intravenous and intramuscular administration
Levobupivacaine		injection
Perampanel		pills
Dimethyl fumarate		enteric capsules
Tetrabenazine		pills
Drugs for the treatment of obstructive airway diseases
Vilanterol + fluticasone furoate		dosed powder for inhalation
Glycopyrronium bromide + indacaterol		capsules with powder for inhalation
Olodaterol + tiotropium bromide		dosed solution for inhalation
Other drugs for the treatment of diseases of the respiratory system
Beractant		suspension for endotracheal administration
Drugs for the treatment of eye diseases
Tafluprost		eye drops
Aflibercept		solution for intraocular administration
Other remedies
Complex of b-iron(III) oxyhydroxide, sucrose and starch		chewable tablets
Yomeprol		injection

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In the last century, when antimicrobial drugs were just invented, it seemed that a panacea had been found. They gave the Nobel Prize for the discovery and began treating everyone with penicillin. However, why only in the last century? Until recently, you could easily buy antibiotics without a prescription. List prescription drugs was very narrow. But medical statistics and research recent years significantly changed the situation. Everything turned out to be not as rosy as many had hoped.

Let's start with the most important thing

A photo of the names of antibiotics without a prescription is shown below.

Only these drugs can be purchased freely at pharmacies today. All others are subject to restrictions, failure to comply with which is punishable by a hefty fine. And persuasion in the style of “just recently they sold everything to me” does not work - in May of this year, a new law was adopted in our country that strictly limited the possibility of selling medications. However, often ordinary people do not even understand that this was done for their own good. We rarely think about the ability different forms life to adapt to aggressive conditions, but the smaller this very life, the higher such qualities it has. This is especially true for viruses and microbes - penicillin, which killed them several decades ago, today does not frighten harmful microflora, since resistance has been developed. To understand the essence of this phenomenon, it is worth looking not for the list of approved antibiotics without prescriptions, but for the principle of operation of the drugs.

What was it like before?

In fact, the list of over-the-counter antibiotics has always been quite narrow: most drugs were legally allowed to be purchased only with an official doctor's certificate. The exception concerned only a few items included in special list essential medicines. Only the law did not contain serious punishments for offenses, so it was observed very conditionally. And yet there was no officially free sale before. Compliance problem has been a concern for the government for a long time, on the basis of which a new one was adopted this year normative act, designed to make the situation more stable.

Many are rightly indignant: it is very difficult to get to the clinic to get a prescription for the necessary medication. Huge queues, crowds, infections - you can get even sicker than before going to the doctor. So ordinary people are interested in the names of antibiotics without a prescription, hoping to bypass the unpleasant need to visit a specialist. The government does not deny: hospitals are indeed overloaded, and the impossibility of freely purchasing antimicrobial drugs only increases this volume.

Why is this necessary?

At the global level, doctors are sounding the alarm: microscopic life forms have developed a stable immunity to antibiotics. Lists that are sold without a prescription, of course, attract attention, but by doing so the person himself includes himself in the group increased risk: microscopic life forms in his body learn to survive even under the influence of substances so unfavorable to them, so in the future the disease will be more and more difficult to eliminate. There is a possibility fatal outcome from simple flu and its complications, and all because of the resistance of microbes to the drugs designed to fight them. And it was developed precisely because of the uncontrolled use of medicines by the broad masses. Doctors voice their predictions: millions of people are in danger due to current medical practices.

So what should I do?

As activists say, real benefit ban on sale antimicrobial agents can only be brought in the conditions of a well-established system for providing medical services to the population, because in the current situation a person either has to wait literally a week to get to the doctor, or independently search for names from the list of approved antibiotics without prescriptions, and also persuade pharmacists to break the law, to sell it to him useful drug. By the way, not only antimicrobials, but also many other medications that are now freely sold in pharmacies, by law must be distributed only if the patient has a correctly completed prescription with all stamps and signatures.

How to get a prescription?

If antibiotics from the list without prescriptions do not help or a person does not want to harm himself by using the drugs uncontrollably, the easiest way is to get an appointment at paid clinic. True, this is not cheap: even in the periphery, private clinics charge up to a thousand rubles per appointment, and in the capital region this figure is two to three times more. But if there is no way to pay, and the wait for an appointment at the clinic is too long, the person continues to be treated on his own - otherwise he faces a serious illness, numerous complications, even death.

Is everything so clear?

Many people say that the list of antibiotics without prescriptions in Russia is information of little significance, since a real permission from a doctor has a relatively low percentage of those wishing to purchase medications. If you refuse all those who do not have a piece of paper, pharmacies will lose a significant percentage of their profits. Not everyone is ready to do this, especially in a competitive and crisis market situation. Experts predict that drugs will continue to be sold in violation of established laws - this is to protect enterprises from ruin.

Is this beneficial for the client? On the one hand, you don’t need to limit yourself to a list of antibiotics without a prescription; you can hope that you will be able to buy everything you need. On the other hand, we should not forget about the immunity accumulated by microscopic life forms. In addition, when self-medicating, many stop taking medications not after the course duration has expired, but when the situation initially improves, and this is the most effective way development of resistance for microbes.

WHO: forecasts are disappointing

Scientists speaking on behalf of the World Health Organization reported that by 2050, about 10,000,000 deaths each year will be caused by the immunity of microscopic life forms to antimicrobial drugs. Against this background, dispensing rules have been tightened in all countries, and the list of over-the-counter antibiotics has been significantly reduced.

Drug resistance is natural process, which is stimulated by the improper use of medications. However, not only medicine plays a role, but also Agriculture, where such connections are widespread. Nowadays, some diseases can no longer be cured, although decades ago they were effectively eliminated with the help of antibiotics. Good example- new subtypes of tuberculosis, drug-resistant gonorrhea. And it's not full list dangerous infections. The consequences, especially when analyzing the near future, seem large-scale, if not catastrophic.

What about today?

Extensive medical practice and uncontrolled use of antibiotics from the list without a prescription (and with prescriptions too, if the average person manages to buy such a drug just like that) has led to the fact that about 700,000 people die from infection during the year. This forces us to look for new approaches to regulating the market. The economy is good, the profits of pharmaceutical companies are also good, but the health of future generations is more important.

So what should I do?

Instead of expanding the list of over-the-counter antibiotics, authorities decided to take a different route: limiting the sale of the drugs as severely as possible to force people to visit a doctor before starting treatment. It is currently assumed that state enterprises will gradually begin to take over the sector of private medical clinics. A mechanism for cooperation between authorities and non-budgetary institutions is being developed.

This is possible, since in many state clinics not all space is used, while maintenance costs are calculated from everything that is available. That is, the conclusion of contracts will allow you to recoup expenses for housing and communal services, security, give sick people the opportunity to choose, lower costs for private services and a chance to get to the doctor on time without a long line.

Antibiotics: which ones are sold without a prescription?

At the beginning of the material, a list of drugs that can be freely purchased at present is already listed. Most of what is mentioned are medications intended for external use, that is, gels and ointments, suppositories. Among them there are those developed for ophthalmic use. The exceptions are:

"Furazolidone".
"Gramicidin S".
"Fluconazole".

To buy any other items, you will have to provide the pharmacist with a prescription drawn up in a special form.

Against the law: what will happen?

If it is possible to identify a violation of established regulations, the pharmacist will be issued a fine of 5,000 rubles or more. The enterprise itself may be closed for a period of three months.

In addition to antibiotics, similar strict restrictions are imposed on painkillers intended for blood vessels and the heart, affecting the psyche and some other special groups. As the responsible authorities explain, this practice was introduced based on the successful experience of foreign colleagues, where the normalization of the sale of medicines led to improved medical results: resistance at the sources of pathology is developed much less frequently.

It is important

A ban on the sale of prescription drugs without presenting the appropriate permission from a doctor has been introduced on the territory of the state since 2005, however, it was observed rather conditionally. In addition to the Ministry of Health, Rospotrebnadzor has now taken charge of normalizing sales. Now it is not only prohibited to sell prescription medications without the appropriate paper, but even to place them on display. A pharmacy can be fined for a violation in the amount of 100,000 rubles or more.

The prescription must be on official letterhead, sealed by the doctor and the institution, and signed by the doctor. The name indicated in the recipe is non-proprietary. Be sure to prescribe the dose and frequency of administration. The prescription can be used for up to two months, but for chronic patients it is extended for a year, indicating how often the drugs can be purchased.

Buy something?

Currently, the ban is imposed on 70% of all pharmaceutical products. In addition to antibiotics, this includes hormonal drugs, medications in ampoules, diabetic medications, narcotic, psychotropic active substances. And here full list items approved for sale without a prescription were never released. They officially promised to publish it at the beginning of this year on the website of the Ministry of Health, but they never bothered with it. Officials require pharmacists to “follow the instructions.” If it states that a prescription is needed, it means that selling the drug without the official permission of a doctor is unacceptable.

What happens in practice?

Managers of pharmaceutical sales points have different attitudes to the new rules. Somewhere they require pharmacists to strictly adhere to established rules, and on the open market there are only nasal drops, ointments, herbs and a couple of types of medicines to stop the virus and lower the temperature. Other enterprises are ready to sell both antibiotics and painkillers, but only in the form of gels and ointments. You can buy pills somewhere, but you won’t be able to buy ampoules, and some people don’t pay attention to the prohibitions at all.

Before going to the pharmacy, as experts recommend, you should first read the instructions on the Internet. necessary medication. If it does not indicate sale strictly according to a prescription, you can safely purchase such a drug. If there is such a phrase, you should first read side effects and carefully weigh for yourself what is more important: immediate benefit and possible danger in the future or discomfort associated with visiting a doctor who will definitely choose suitable medicine and tell you how to use it.

No. 55 “On appeal medical supplies", the rules for the sale of prescription drugs in pharmacies have been approved for their use in hospitals and clinics that are licensed to engage in pharmaceutical activities.

Basic provisions

Regulations on licensing activities in the field of pharmaceuticals No. 1081 dated December 22, 2011 is a key document that defines the list of requirements, as well as conditions imposed by the state on licensees. The licensees are legal entities who carry out retail trade drugs intended for medical use, For example, pharmacy chains and individual entrepreneurs who have the right to engage in this activity. There is a specific list of prescription drugs.

What are the consequences of a violation?

All listed persons must comply with the rules for dispensing these products, which are intended for medical use. The same provision defines the concept gross violation licensing conditions and requirements, which include issues related to the dispensing of medicines. In the event that the established rules for the dispensing of drugs are violated, regulatory authorities have the right to regard the detected crime as gross with all the ensuing consequences, ranging from serious penalties to suspension of the licensee’s activities.

So, how do you properly dispense a prescription drug?

Legal regulation of the rules for dispensing drugs

Federal Law No. 55 “On the Circulation of Medicines” provides rules for the dispensing of drugs for medical use by pharmacies, as well as individual entrepreneurs.

In addition to this law, the following regulatory documents have been approved that regulate the procedure for dispensing medications:

Law No. 323 “On the Fundamentals of Health Care”.
Law No. 2300 “On the Protection of Consumer Rights”.
Order of the Ministry of Health No. 647 "On approval of the rules of pharmacy practice of medicinal products."
A number of departmental regulations.

Who is responsible?

The prescription drug dispensing process involves close interaction between medical and pharmaceutical workers. Physicians are responsible for prescribing medications within the framework of compliance with the necessary requirements. Pharmacy workers must conduct a pharmaceutical examination before dispensing a prescription. Therefore, an important requirement is the presence feedback between medical and pharmaceutical structures. That is, regulatory requirements require regular sending of information about all incorrectly written prescriptions to a medical institution. This regular feedback process ensures that questions regarding prescription drug violations do not arise.

Who, according to the rules, has the right to write prescriptions?

Currently, five forms of prescription forms are valid. At the beginning of 2016, some changes were made to prescription forms. In order to use stocks of prescription forms purchased long ago for their intended purpose, it was allowed to use the old sample until Order No. 385 of the Russian Ministry of Health came into force. Now pharmacy workers are required to demand those versions of forms, the structure of which has been changed in accordance with the current regulatory documents.

Government Order No. 1175 introduced a lot of new things into the procedure for prescribing and prescribing medications. An important place in the significance of changes should be given directly to the paradigm of prescribing medications. Previously, a health worker had the right to use any name of the product, that is, group or trade. But in connection with the entry into force of Order No. 1175, priority is now given to prescribing drugs according to international generic name. In the case where it is absent, the group option should be used. If both names are missing, then by trade type.

Who has been added to the list?

The list of those who have the right to prescribe and issue prescriptions now includes workers with average medical education, these in particular include midwives and paramedics, but only if such powers are assigned to them by the relevant decree of the head medical institution. U individual entrepreneurs Traditionally, people also have the right to prescribe medications and write prescriptions, albeit under certain restrictions. For example, the nuances are related to the fact that these entrepreneurs who carry out private medical practice, cannot prescribe psychotropic and narcotic drugs from pharmaceutical lists"2" and "3". There are also cases where prescription drugs are dispensed without a prescription.

What about a prescription that comes under a trade name? Is it possible to reject it or is it considered to have been issued correctly? An explanation of this issue is found in the order of the Ministry of Health No. 1175. The bottom line is that the medical employee has the right to use upon discharge trade name subject to individual intolerance or according to health indications. However, such a decision must be approved by a medical commission, which is confirmed by the presence of a stamp on the back of the prescription.

Rules for dispensing prescription drugs and differences in forms

What is the difference between the forms and how should they be formatted correctly? medical workers to avoid incorrect pharmaceutical examination? And what are the basic rules when dispensing drugs? Prescription forms can be distinguished by the purpose of use, their structure and composition of details, as well as by the period of validity and storage. Let us give an example of several options for prescription forms.

Special prescription form

It is the most complex in terms of the composition of the details, as well as the structure. However, from the point of view of use, there is only one case in which a health care worker should use it. This form strict accounting has protection and is intended for prescribing psychotropic and narcotic drugs. Any such prescription must be certified by the doctor’s personal signature and seal. The form must necessarily indicate the last name, first name and patronymic of the authorized specialist, who can be the head or deputy of the medical institution. This person can also be the one who certifies the forms. In addition, certification with a seal is required medical organization. Next on the prescription form there is a note from the pharmacy structure about the dispensing of the medicine. If the pharmacy employee is satisfied with everything in terms of filling out the prescription, then he indicates information about what is dispensed, what is the dosage and packaging of the medicine. The recipe is certified by the indication full name, date of issue, as well as the seal of the pharmacy.

Prescription form No. 107

It is a simplified form compared to the special form described above. According to regulatory documents, this option can be used when prescribing, as well as prescribing a list of prescription drugs that contain small doses of psychotropic and narcotic substances. This form must have the stamp of the medical organization, its full name along with the address, telephone number and date. In addition, a mark is placed on the patient’s age category: children or adults. The name of the patient and the name of the drug are also indicated. Latin by international nonproprietary name along with packaging and dosing. You can enter up to three types of medications into this prescription form, which cannot be done in other options. On the form, among other things, a personal signature is placed with the seal of the attending physician. Such a prescription is considered valid for up to sixty days, and for patients with chronic diseases extension up to one year is permitted. What other rules are involved in the dispensing of prescription drugs?

Additional rules

The legislation provides the following rules:

What drugs are prescription?

This list is fixed by order of the Ministry of Health No. 403 dated July 11, 2017.

Combination products are available by prescription medications with content:

ergotamine hydrotartrate in an amount of up to five mg;
ephedrine hydrochloride up to 100 mg;
pseudoephedrine hydrochloride 30 mg, 10 mg;
dextromethorphan hydrobromide 10 mg;
codeine or its salts 20 mg;
pseudoephedrine hydrochloride 30 mg;
pseudoephedrine hydrochloride from 30 mg to 60 mg, dextromethorphan hydrobromide in the amount of 10 mg;
dextromethorphan hydrobromide 200 mg;
ephedrine hydrochloride 100 mg;
phenylpropanolamine 75 mg.

A person should spend a third of his life sleeping - a lot. After good sleep The charge of vigor and efficiency lasts for a long time. At the same time, intermittent, superficial sleep and poor sleep can become a real torment, especially on the eve of an important day.

The most potent sleeping pills They are limited-release drugs and require a prescription to purchase them. Such drugs, for example, include old and well-known barbiturates: etaminal - sodium, barbamyl, phenobarbital. To acquire such modern and soft active drugs, like Imovan (zopiclone) and zolpidem, also need a prescription.

At the same time, there is a large group of over-the-counter drugs that have hypnotic effect. They are commercially available because their psychoactive inhibitory effect on the central nervous system nervous system significantly lower, and overdose does not cause serious side effects. However, they can help you fall asleep in most cases of mild sleep disorders.

We present these drugs in descending order of hypnotic effect.

Melaxen

Photo: img.zzweb.ru

Cost 650 rubles (0.003 g No. 24)

In humans, melatonin regulates sleep-wake cycles and is the “sleep hormone.” Its task is to cause a drowsiness effect, which increases the chances of falling asleep. In addition, melatonin has a moderate sedative (calming) effect.

Advantages: an overdose of the drug is impossible due to its very rapid disintegration. Good dream continues after the drug is eliminated from the body, so sleep can be considered physiological. Melaxen works on the “done and gone” principle. The medicine does not change the course natural cycle and sleep structure, does not cause nightmares, does not affect awakening. After using the drug there is no feeling of drowsiness, you can drive a car.

Flaws:

possible manifestations allergic reactions, the occurrence of peripheral edema;
relatively high cost.

Conclusions: The drug can be recommended for mild and moderate forms of insomnia, in complex therapy functional disorders, accompanied by sleep disturbances, and also as a means for more rapid adaptation to rapid changes in time zones.

From reviews of Melaxen: “I had absolutely no side effects, I was healthy and strong, normal sleep, in the morning there was not a bit of drowsiness, and at night I saw beautiful colorful dreams. I took it one tablet in 30 minutes. before sleep. After drinking the entire package, no addiction developed. One of the best means for insomnia, I recommend it!"

Donormil

( doxylamine succinate, 15 mg in effervescent and regular tablets). Also released under the name Sungmil.

Photo: otravlen.ru

Cost 350 rubles (30 tablets).

Prescription drug.

It is a blocker of H1 histamine receptors, and, essentially, an antihistamine. But it is not intended for treatment allergic diseases, but is used only for sleep disorders and insomnia. This is one of the best sleeping pills for relieving attacks of insomnia in young, healthy people who do not need to drive a car the next day.

Advantages: effervescent tablet provides fast action, the drug reduces the time it takes to fall asleep and increases sleep time.

Flaws: the drug has side effects characteristic of antihistamines: dry mouth, difficulty waking up, possible daytime sleepiness. In addition, the drug is not indicated for patients with disorders renal function outflow of urine, as well as breathing problems during sleep.

From reviews of Donormil:“The medicine turned out to be wonderful. I didn’t read the instructions and on the first day I took two tablets at once. Ten minutes later I was already asleep. Having slept all night, I felt drowsy for the first half of the day. next night took one tablet according to the instructions. I fell asleep half an hour later, my sleep was calm, my awakening was refreshing."

Corvalol (Valocordin)

Contains phenobarbital (tablets - 7.5 mg, 1.826 g per 100 ml).

Photo: irecommend.ru

Photo: www.farmshop.ru

Cost of drops (50 ml) - 40 tablets (No. 20) - 150

Corvalol (valocordin) is the only over-the-counter drug containing the barbiturate phenobarbital. This immediately puts this drug on a par with more serious competitors, and its low cost makes it very attractive to a wide segment of the population. It is recommended to take from 10 to 40 drops per dose.

Advantages: the drug has a characteristic odor; valerian and mint potentiate the effect of phenobarbital. Can be used as a distraction for pain in the heart area instead of validol; drops can be used in different, individual dosages. The drug has a mild antispasmodic effect on the smooth muscles of internal organs and is indicated for tachycardia (palpitations) and psychomotor agitation.

Flaws:

The characteristic smell of the medicine can permeate an entire apartment with frequent use.
Many people have a prejudice that Corvalol is a “medicine for the poor” - this is completely untrue.
Not recommended during breastfeeding.

From reviews:“Corvalol is the best sleeping pill. I’ve been taking it all my life. Both my mother and grandmother. In addition to helping with insomnia and palpitations, I apply it to my face in the summer - the medicine wonderfully repels mosquitoes, and does not contain terrible chemicals. A solid five!”

Novo - Passit

Herbal preparation (valerian, lemon balm, elderberry, passionflower, St. John's wort, hawthorn, hops, guaifenzin). Available in tablet and syrup form.

Photo: novo-passit.com

The cost of tablets No. 30 is 600 rubles, syrup (200 ml) is 330 rubles.

Combined herbal preparation with a pronounced sedative effect. Guaifenzine has an additional anti-anxiety effect, which in total allows the drug to be used for the treatment of sleep disorders.

Advantages: has quick effect. For insomnia disorders, it is recommended to use syrup, which acts even faster. The drug can be used without a course of treatment: the effect of the first dose is quite pronounced.

Flaws:

Daytime drowsiness and a feeling of depression may develop, especially with an overdose.
Contraindicated for children.
Not recommended for use in patients with chronic alcoholism.

From reviews of Novo-Passit:"It's very good that the drug natural origin. A pleasant surprise It turned out that in addition to improving sleep, Novo-Passit helped eliminate anxiety, some kind of nervousness, and alleviated headaches caused by sitting at the computer."

Persen - Forte

Combined drug (melissa, mint, valerian).

Photo: europharma.kz

The cost of a package of 20 capsules is 350 rubles.

The drug has a mild sedative and hypnotic effect, insomnia is mentioned in the indications. Has a mild antispasmodic effect. Unlike Novo-Passit, it does not contain guaifenzine, and unlike Corvalol, it does not have an intrusive odor.

Advantages: The “night” variety of Persen is specially designed for night use. Helps well to fall asleep if insomnia is caused nervous excitability, that is, a changed mood background.

Flaws: there is no liquid dosage form. Usually liquid form renders faster required action. The drug is not recommended for people with biliary tract diseases, as well as for children under 12 years of age. At long-term use may cause constipation.

From reviews of Persen:“It seems to me that only a course of treatment has a good effect, and a one-time dose does not improve sleep. But if you drink it for at least a week, your mood becomes even and it becomes easier to fall asleep.”

Phytosedan

(herbal infusions for brewing in the form of filter bags)

Photo: www.piluli.ru

The cost of packaging (20 filter bags) is 50 rubles.

Phytosedan is available in several varieties of preparations (No. 2, No. 3), which differ in slight changes in the recipe. The basis of the composition is herbs: motherwort, thyme, oregano, sweet clover and valerian. One package is poured with boiling water, left for 15 minutes, then drunk at night.

Advantages: has a mild, natural effect, makes it easier to fall asleep, is able to eliminate spasms of the smooth muscles of the gastrointestinal tract, and is used in the complex therapy of vegetative-vascular dystonia

Flaws:

Not indicated during pregnancy and breastfeeding.
The infusion is prepared immediately before use, can be stored for no more than a day, and is best consumed warm, which, unlike tablets, is more difficult.

From reviews of Fitosedan:"Herbs for 50 rubles turned out to be much more effective than many expensive funds. I bought it at the pharmacy and brewed it. It is a little bitter, but has a pleasant, calm smell. Already on the second day of use, I realized that it does its job perfectly: it does not cause fatigue during the day, and sleep comes softly and easily."

Glycine

Photo: otravlenym.ru

Cost No. 50 - 49 rubles.

Glycine is a simple amino acid; its role is to regulate inhibitory processes in the cerebral cortex. The effect of glycine is complex and complex: it should be used not only for sleep disorders. To improve sleep, it dissolves under the tongue, since absorption into the sublingual vessels avoids passage through portal system liver, which accelerates the effect.

Advantages: Since glycine (aminoacetic acid) is found in sufficient quantities in the human body, an overdose of glycine is hardly possible before reaching serious complications. In addition, the drug has an anti-anxiety effect and simultaneously improves memory and memorization processes. It is used in therapy, neurology, and is widely prescribed to school-age children.

Flaws: special hypnotic effect glycine has not been studied separately. The effect of the drug is reduced to restoring the imbalance between the transmitters of the sympathetic and parasympathetic parts of the autonomic nervous system.

From reviews of Glycine:“I started using glycine on the advice of friends during a session, since I had previously abused coffee in order to remember a large amount of information. I started having breakdowns, memory impairment, irritability and bad dream. A week after starting to take glycine, we managed to get rid of all discomfort. Improved sleep and memory."

What you need to know:

This list of the best remedies for insomnia that can be bought without a prescription is far from complete. Everyone can add new agents or swap them, since the effectiveness of the drug is largely determined by individual reaction.

Many "doubles" are not listed. So, the drug " Dormiplant"just like the described "Persen" contains lemon balm, mint and valerian. Not described homeopathic medicines, since they do not have a definable effective dose, and cannot be considered from the point of view of evidence-based medicine.

In conclusion, attention should be paid to situations in which insomnia becomes a symptom dangerous diseases . Thus, insomnia may indicate the following health problems:

hyperthyroidism. Arises low-grade fever, weight loss, short temper and irritability;
stress, depression. Such insomnia can be persistent and chronic;
sleep apnea;
Parkinson's disease;
vascular diseases brain, consequences of strokes, dementia.

If it was not possible to stop unpleasant symptoms sleep disturbances for several days, then do not look further potent drugs, but you should definitely consult a doctor.

Attention! There are contraindications, consultation with a specialist is required

You can buy antibiotics at a pharmacy only if they have been prescribed to a citizen. They banned uncontrolled sales by introducing new legislation that began to regulate both how often antibiotics are sold and what dosages people take.

Law on the sale of antibiotics by prescription

Antibiotics are a special group of drugs, the sale of which must be regulated at the legislative level. It is necessary to study in more detail the regulations governing the sale of prescription drugs in Russia.

The sale of medicines is regulated by the following regulatory legal acts:

Order of the Ministry of Health No. 785 “On the procedure for dispensing medicines.”
Order of the Ministry of Health No. 647n “On approval of the Rules of Good Pharmacy Practice for Medicinal Products for Medical Use.”
Federal Law No. 61 “On the Circulation of Medicines”, etc.

A new law in 2017 stipulated that most antibiotics can only be dispensed with a prescription.

This is due to a certain number of factors. For example, the global health community is largely concerned about the fact that citizens of many countries have begun to use antibiotics uncontrollably. This promotes habituation and development immune system citizen in the sense that antibiotics simply cease to act and perform their direct function. Among other things, antibiotics interfere with the functioning of various organs in the human body and adversely affect the liver, kidneys and stomach.

Changes in the law and why antibiotics are sold only by prescription

A new development in legislation was the introduction of amendments to certain regulatory legal acts in March 2017. It stipulates that a separate list of drugs belonging to the group of antibiotics is accepted, which are dispensed in pharmacies only on the recommendation of a doctor. A pharmacist has no right to dispense such drugs without a prescription.

As noted above, these innovations came into effect for a reason. The state has identified the fact of uncontrolled use of these drugs, which significantly damages the health of the population.

Pharmacies are also subject to control in this area. Authorities of the Ministry of Health and Rospotrebnadzor check the availability of prescriptions for certain drugs dispensed in pharmacies.

Rules for dispensing antibiotics from pharmacies

At pharmacies, all drugs received are subject to accounting and control. Prescription drugs are separate category and their accounting is kept more strictly. If it is necessary to sell a particular prescription drug, the pharmacist must warn the buyer that this drug belongs to a special category and a prescription must be presented for it.

Once the prescription has been presented in the proper form, the pharmacist has the right to sell the medicine. The relevant information is entered into a special reporting journal of the pharmacy, and the prescription itself is saved and attached to the reporting.

In a situation where a citizen was sold a prescription drug without presenting the appropriate document, he has the right to write a complaint to the appropriate department and hold the pharmacy accountable.

What tablets are antibiotics?

The Ministry of Health Decree defines a list of medications that are classified as antibiotics:

The list of antibiotics is very long. Talking about general formulation, it is worth noting that these are drugs that are aimed at preventing the proliferation of bacterial microorganisms or their complete death. All antibiotics are divided into groups depending on their spectrum of action.

All antibiotics: list

Today they are recognized and allowed for sale in the territory Russian Federation the following types antibiotics:

Penicillins.

Tetracyclines.

Erythromycin.

Quinolones.

Metronidazole.

Vancomycin.

Imipenem.

Aminoglycoside.

Levomycetin (chloramphenicol).

Neomycin.

Monomycin.

Rifamcin.

Cephalosporins.

Kanamycin.

Streptomycin.

Ampicillin.

Azithromycin.

Cefaclor.

Cefamandole.

Unidox Solutab.

Cefuroxime.

Rulid.

Amoxiclav.

Cefroxitin.

Lincomycin.

Cefoperazone.

Ceftazidime.

Cefotaxime.

Latamoxef.

Cefixime.

Cefpodoxime.

Spiramycin.

Rovamycin.

Clarithromycin.

Roxithromycin.

Klacid.

Sumamed.

Fuzidin.

Avelox.

Moxifloxacin.

Ciprofloxacin.

It is almost impossible to list the entire list of antibiotics, since today there are a huge number of them with different spectrum of action, at different times actions and side effects. They can be divided into both drugs for adults and drugs for children.

Over-the-counter antibiotics: list

Gramicidin S.
Ketoconazole.
Clindamycin.
Clotrimazole.
Metronidazole.
Natamycin.
Nitrofural.
Nifuroxazide.
Sulfadiazine.
Sulfanilamide.
Sulfacetamide.
Terbinafine.
Tetracycline (for local application- ointment).
Fluconazole.
Furazolidone.
Chloramphenicol.
Ciclopirox.
Econazole
Erythromycin + zinc acetate.

You can download all antibacterial drugs that do not require a prescription. ⇐

Antibiotics sold by prescription only: list

How and where to buy antibiotics without a doctor's prescription

You can buy antibiotics without a doctor's prescription in absolutely any pharmacy in Moscow or any other region of the Russian Federation. No restrictions on selling medical drug in this case no. Last time wide use received so-called online pharmacies. This is where you can choose necessary drug without leaving home and order it. It will be delivered to the pharmacy closest to the person’s home.

Home delivery of medications is not allowed!

How to write a prescription for an antibiotic

It is impossible to obtain such a prescription by the will of a citizen alone. This happens solely at the discretion of the doctor and in a situation where a citizen really needs antibiotics.

To obtain a prescription, you must visit your primary care physician. It is he who has the right to draw up this type of document.

The prescription is certified by the seal of the medical organization and the personal seal of the doctor himself. Not only doctors have the right to issue prescriptions government agencies, but also specialists from private medical accredited clinics.

What should the recipe look like?

A recipe is, in essence, a certificate that has such structural elements as:

Name of the medical institution.
The name of the document itself.
List of prescription drugs that a citizen needs.
Doctor's signature and date of issue of the certificate.
The seal of the medical organization and the personal seal of the doctor himself.

Prescription forms are approved by the Ministry of Health and are the same for all state budget clinics.

Antibiotic prescription: form

You can download the form and recipe form . ⇐

The full text of the law on the sale of antibiotics by prescription, as amended

You can download the full text of the law with amendments and additions. ⇐

Finally.

As we can see, from January and March 2017, changes were made to certain legislative acts regulating the sale of medicines. You can no longer buy antibiotics without a prescription. When pharmacies sell drugs contrary to the rules, administrative liability is provided in the form of a fine. In this way, the normal dosage of antibiotics is regulated and the fact of self-medication is eliminated.