News and promotions. New rules for dispensing medications: put aside panic Dispensing medications from March 1

Since September 22, antibiotics have not been sold without a prescription in Russia. This is what the order of the Ministry of Health says. But in reality, the sale of such drugs looks different.

Russians are increasingly faced with the fact that some drugs are not sold to them if there is no prescription or it is filled out incorrectly. Pharmacies refer to a new order from the Ministry of Health, which clarifies the procedure for selling such medicines.

True, the Business FM experiment showed that it is still possible to buy medicines without a prescription, even if you should have one. Autumn, rain, colds. Nothing new: this is repeated year after year. Only today it has become difficult to buy drugs to treat this very cold. Since the beginning of October, there have been reports on social networks that pharmacies are requiring prescriptions for antibiotics.
Business FM columnist Ivan Medvedev also encountered this.

Ivan Medvedev Business FM columnist“My wife is sick. She called a doctor to the house. The doctor prescribed antibiotics, in particular the drug Amoxiclav. But the doctor prescribed it simply on hospital letterhead, that is, it is not a full-fledged prescription, which, as I accidentally found out, is now of fundamental importance. I went to the pharmacy, where they told me that from September 22, pharmacies do not have the right to dispense antibiotics without a doctor’s prescription, that is, they can dispense antibiotics only by exchanging them for a prescription.”

Another Business FM columnist had better luck. In another pharmacy they were ready to sell him the same drug just like that, without any prescription.

Mikhail Safonov Business FM columnist“Are you for yourself?” I say yes". She assessed my build and said: “You need 500 milligrams.” I say: “Okay, do you need a recipe?” She looked at me sternly and said: “Actually, I need a recipe!” I say: “But I don’t.” She says: “How do you buy it? What did your doctor tell you?” And I say: “But the doctor didn’t tell me anything, because the doctor is my friend.” She says, “Well, if your friend takes responsibility, then please buy.”

At the pharmacy point in the supermarket, next to the Business FM editorial office, there were also no problems with purchasing antibiotics. No one could explain why pharmacies do not require a prescription when they should. Perhaps they are not afraid of fines, although such violations can even result in a license suspension for three months. However, the fact remains.

In fact, pharmacies previously were not allowed to sell prescription drugs without an official prescription. And the order of the Ministry of Health, which came into force on September 22, simply clarifies the rules for their leave. In particular, the pharmacy now keeps the so-called one-time prescription after it has sold the medicine. Why this is being done, explains the executive director of the Russian Association of Pharmacy Chains, Nelly Ignatieva.

Nelly Ignatieva Executive Director of the Russian Association of Pharmacy Chains“If, according to all the documents, the pharmacy received ten medications, and it has five left - we record this, these are separate accounting documents - therefore, there should be five prescriptions, and correctly written prescriptions. If something is written incorrectly in the prescriptions, again this is a violation. In this system, a doctor, a patient, a pharmacy are involved, and for some reason, responsibility for all violations at the moment is only assigned to the pharmacy. But in fact the problem is completely different. Our doctors have stopped writing prescriptions and, accordingly, have confused all patients, and for some reason patients do not demand their rights to write a prescription.”

The official prescription must be written out on a standard form, stamped, indicating the international nonproprietary name of the drug in Latin. The use of specific trade names is acceptable if the drug has no analogues. David Melik-Guseinov, head of the State Budgetary Institution of the Moscow Healthcare Organization Research Institute, told Business FM why doctors violate these rules.

Director of the State Budgetary Institution Research Institute of Healthcare Organization and Medical Management“Only 10% come with some kind of recommendations and about half of these 10%, that is, only 5% of the population, come with correctly filled out prescriptions. Doctors, of course, tried not to write prescriptions, because any prescription with a stamp and signature is an official document. A document that can be presented in court, a document that can be presented to the executive authorities so that they can carry out the appropriate checks. Therefore, medical workers and doctors very often shied away from the obligation to write an official prescription.”

Pharmacies, by the way, are also unauthorized. They are required to return to customers so-called refillable prescriptions, valid for up to a year, which prescribe medications for the treatment of chronic diseases. In this case, the pharmacy must make a note in such a prescription about the sale of the medicine. But sometimes they also try to confiscate such recipes. The Ministry of Health wanted to put things in order with the sale of prescription drugs. We wanted the best, but it turned out as always.

Lyudmila Lapa therapist “This can’t lead to anything good, because now I prescribed antibiotics, for example, today, but the girl says she doesn’t need a prescription. She didn't even ask because she was told that she would buy it, no problem. That is, she has some kind of pharmacy nearby that dispenses everything. And who is right and who is wrong is very difficult to determine. Confusion actually exists. This is an indisputable fact."

To the question of what to do if you were not sold the medicine, there are currently two answers. Either go to your doctor and ask him to write you an official prescription, or find a pharmacy that doesn't require prescriptions. As our experiment showed, they can still be found.

On September 22, new rules for the sale of medicines in pharmacies came into force. Now it may be difficult or impossible to buy the right drug. Pharmacies require prescriptions and even take them for storage. And they may not sell the medicine to relatives at all: they will ask for a power of attorney.

We've looked at the new rules and will explain how they work. The order of the Ministry of Health is complex and incomprehensible even for pharmacists, so clarifications have already been issued for it. We also studied them.

As it was before?

Prescription drugs have always had to be sold by prescription. Each category has its own sales and accounting rules. Such drugs are marketed under strict federal regulations, but pharmacies have not always complied with them.

Previously, you could take one prescription and use it to buy as much medicine as you wanted. Doctors did not indicate the timing, and pharmacists did not pay attention to this. And they could only collect prescriptions in rare cases and for dangerous drugs.

No one monitored the dosages of conventional sedatives and did not mark on the prescription how much and when it had already been purchased. And often they didn’t ask for the recipe at all.

Even if you previously bought an antibiotic, a sedative, or medicine for your grandmother without a prescription, this does not mean that the drug is actually on sale. Even common medications are on the prescription list, and purchasing them can now be a problem.

As it is now? Where can I buy medicine?

It depends on whether a prescription is needed and what category the drug belongs to. There are several such categories; it makes no sense to study them all in advance, but you need to keep it in mind.

Narcotic and psychotropic drugs can only be sold by pharmacies with special permission. There are limitations for immunobiological preparations: for example, a vaccine for inoculating a child can only be bought at a pharmacy or pharmacy point, and only if there is a thermal container. There are also differences in the prescription forms.

If your doctor has given you a prescription, it is best to find out in advance where you can buy it. And don’t be surprised if some pharmacies don’t sell the drug. This is not their whim, but a requirement of the law.

If you need a prescription for a medicine, what should you do?

You need to get this prescription: otherwise the pharmacy will not sell the drug. Even if the medicine is needed urgently or is taken constantly, and there is no time to go to the doctor, it still won’t sell. Maybe in some cities there are pharmacies that manage to circumvent the rules, but it’s better not to count on this: the law is the law.

If you need a prescription for a medicine, you will have to present it at the pharmacy. And the pharmacy has the right to take away this prescription if required by the new rules. That is, you will not be able to buy this medicine a second time using the same prescription.

Recipes are also divided into several types. There are recipes for one time, urgent, for free holidays and various others. The prescription may last for several days, months or a year. You can buy a prescription medication only while it lasts. The pharmacy can take it away for good or return it with a note: how much and when it was sold, in what dosage and for how long it will last.

Is it possible to buy in reserve? More antibiotics, painkillers and blood pressure pills.

No, now you won’t be able to buy in reserve. According to the rules, the prescription will sell as much of the drug as the doctor prescribed.

Pharmacists should monitor this. Even if you ask the doctor for a prescription with a reserve, the pharmacy will not sell that much, and they will even report a violation.

How do I know how long a prescription lasts?

Not all prescriptions indicate an expiration date. Some doctors don’t pay attention to this, but pharmacists generally didn’t care: the main thing is that there is a prescription.

Pharmacists must monitor deadlines and report violations if they are discovered.

So now the prescription will be taken away? And will you have to go for a new one every time?

The pharmacy is required to pick up and store prescriptions for some drugs. They are listed in clause 14 of the new rules. Read and check the instructions for your medications. Maybe this is your case.

If you or someone in your family takes these medications regularly, you will need to get a new prescription for each batch. Even if these pills are needed constantly - for example, painkillers for a seriously ill person. Or sleeping pills and sedatives for regular use. The situation is the same with alcohol-containing drugs - the prescription will remain in the pharmacy.

Whether it is possible to write out a prescription not for one time, but for a long period, the doctor decides and checks the pharmacies.

If the prescription is issued for a year, will it also be taken away? Will you need to go to the same pharmacy all the time or get a new prescription every time?

No, such a recipe will not be taken away. Although there are rumors that they are taking it away. Don't believe rumors - read the law. They can pick it up only if the prescription was issued before September 22, and then the sales rules for this drug changed.

How to deal with long-term prescriptions is described in paragraph 10 of the new rules.

When a pharmacy fills a prescription that is valid for a year, the pharmacist must note when and how much of the drug was sold. And the recipe is returned. Next time, the required amount of medicine will be sold for this prescription again: past sales will be taken into account and the mark will be marked again.

Once your prescription expires, you will no longer be able to buy the medicine using it. If the prescription is stored, the pharmacy will pick it up. If you don’t need to store it, they’ll give it away, but you still won’t be able to use it.

What are the rules for selling vaccines?

The vaccine for vaccination will be sold only if the buyer has a thermal container. You cannot deliver it to the clinic in an ordinary bag: the vaccine will spoil and the vaccination will be useless.

You can buy the container directly at the pharmacy. These are additional costs that need to be taken into account: you will have to pay extra or bring your own. You cannot buy the vaccine in advance. Such drugs can be stored for a maximum of two days. If you are going to vaccinate your child with a paid vaccine, keep these restrictions in mind.

By the way, you cannot buy the vaccine without a prescription either. You will first have to get a prescription from the doctor, then buy the drug using it and within 48 hours go to the clinic again - this time for vaccination.

Sometimes it’s easier to sign up for a paid clinic: they will conduct an examination, give you a referral, and do all the procedures in one go. Or agree to a free vaccination with a cheap vaccine from the state.

There are 2 types of medicines - those that can be bought without a doctor's prescription and those that can only be prescribed by a doctor. Antibiotics belong to the second type, but this rule was violated everywhere. On March 1, 2017, the rules for the sale of medicines were tightened, as the World Health Organization is concerned about the uncontrolled use of antibiotics by people in all countries. The adopted tightening is intended to solve the problem of developing resistance to antimicrobial drugs (antibiotics).

Changes in the law on the sale of medicines from March 1, 2017

The sale of various drugs is regulated by many laws and standards. One of the main ones is Order of the Ministry of Health No. 785 “On the procedure for dispensing medicines.” You can download the document in the latest valid edition at link.

Another order regulating the sale of medicines, including antibiotics, is Order of the Ministry of Health No. 647n “On approval of the Rules for Good Pharmacy Practice of Medicines for Medical Use.” This law came into force on March 1, 2017 and you can download it here.

There is also Federal Law No. 61 “On the Circulation of Medicines,” which in turn also controls the sale of medicines. The law can be downloaded Here.

Previously, it was impossible to obtain psychotropic, narcotic, strict dosage or custom-made drugs without a prescription. Now, according to the new rules, from March 1, 2017, there is a regulation on the sale of drugs by pharmacies only by prescription, if they are not included in the corresponding list of drugs sold without a prescription. First of all, this included antibiotics, blood pressure medications and hormonal drugs.

Sale of antibiotics legally

The number of people self-medicating exceeds all acceptable standards. This leads to progression of the disease and, in the worst case, death. Not having the necessary knowledge in this area, they choose their own dosage and duration of administration. In this regard, the Ministry of Health decided to tighten control over the sale of antibiotics and make them available only with a doctor’s prescription. After all, uncontrolled and frequent use of antibiotics leads to addiction, and subsequently it stops working.

The law regulating the sale of antibiotics is Order of the Ministry of Health No. 785 “On the procedure for dispensing medicines.” It became operational on December 14, 2005. According to it, all drugs that are not included in the list of drugs that do not require a written prescription from a doctor are subject to sale and distribution to potential buyers only with a prescription. The last changes were made to the document on April 22, 2014.

In addition to the sale of antibiotics by prescription, it will also not be possible to buy syrups and tinctures containing ethyl alcohol more than 15% in a pharmacy without appropriate confirmation, and no more than 2 packages per person. As well as antipsychotic drugs, psychotropic, ampoule, hormonal, blood pressure, some painkillers and others.

For violating the current regulations and selling an antibiotic without a prescription, the following fines are expected:

for individuals- from 5,000 - 10,000 rubles;
for an official- 20,000 - 30,000 rubles;
for a legal entity- 100,000 - 150,000 rubles.

A more serious punishment for selling antibiotics without a prescription form may be suspension of the pharmacy for 3 months.

What antibiotics can be sold without a prescription?

The law on prescription drugs has been amended, according to which the sale of drugs, and most importantly antibiotics, will be carried out only as prescribed by a doctor. This rule has existed for a long time, but no one followed it until recently. Now, according to new rules, prescription drugs are prohibited from being displayed on display.

The prescription form contains the following information - the name of the drug, the recommended dosage and method of administration, full name, position and seal of the doctor. The prescription form is valid from 1 month to 3 months, and in case of chronic disease - up to 1 year.

The reason for the adoption of the law on the sale of prescription pills was the self-medication of the population. The problem lies in long queues at clinics and a shortage of doctors, which forces people to consult pharmacists at the pharmacy to choose the necessary antibiotic, rather than consult a doctor. In the future, the Ministry of Health will draw up a list of medicines, the sale of which will be carried out only if there is an appropriate form from a doctor. At the moment, medications are dispensed without a prescription with a corresponding note in the instructions for use - “dispensed without a prescription.”

Without the appropriate prescription form, you can purchase medications for the treatment of fleeting diseases - antiviral and antipyretic. The percentage of over-the-counter drugs is 30%.

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

In Russia, regulations of the Ministry of Health of the Russian Federation have come into force, tightening liability for the dispensing of prescription drugs without a doctor’s prescription. NI correspondents and experts found out what this threatens Russians with. Let's say right away: the excitement has already begun.

First of all, the innovation threatens with alarming rumors and panic. If in advanced Moscow people are nervous that soon you won’t be able to buy simple brilliant green without a prescription, then in the regions there is a real rush - they are buying antibiotics for future use, Valocardine, unknown to many Reforts, and even Viagra, which, supposedly, is about to disappear from free sale in pharmacies. The list of drugs, now available only with a doctor’s prescription, has been circulating on the Internet for two years. It contained medications with psychotropic effects and good old antibiotics. Some indignation was caused by the fact that the heart medication Valocardine was included in this list. Curantil, so often prescribed to pregnant women, was also there, as well as Nimesil, a well-known painkiller. It is unclear who compiled this list and where it came from, but any user can add “their own prohibited” drug to the initial positions, which makes the horror of horrors even more terrible.

The NI correspondent tried to figure out how it all started and what kind of order the Ministry of Health was, which made life so difficult for already unhealthy Russians.

Rospotrebnadzor has been trying for several years to ban the sale of medicines in Russia without prescriptions. However, if earlier we were talking only about antibiotics (which, by the way, are considered by law to be strictly prescription drugs), then last summer the head of the department, Anna Popova, took the initiative to sell all medicines by prescription - even potent ones, even homeopathic ones and categorically ban the sale of medicines over the Internet.

The position, in general, is understandable. How else to deal with self-medication, which today everyone is addicted to? Moreover, there are no harmless drugs - each has its own side effects, indications and contraindications. And only a doctor can really figure out what a particular patient needs.

By the way, today, if you follow the letter of the law, from 60 to 80% of drugs in our pharmacies must be dispensed with a prescription. And some you really can’t buy without it: narcotic analgesics, potent and psychotropic drugs. Dispensing them without a prescription is a serious crime. The share of over-the-counter drugs on the market is very small. However, Rospotrebnadzor ensured that we could not even buy nasal drops without visiting a doctor.

“It could have been foreseen that the introduction of prescriptions for all medications in conditions of a shortage of doctors and difficulties with making appointments would significantly complicate the lives of patients,” Eduard Gavrilov, head of the Foundation, told NI. — According to the Ministry of Health, the shortage of professional therapists in Russia is almost 27%. And prescribing medications is, first of all, a burden on these primary care specialists. People with illnesses today cannot wait to see a doctor, and if the queue to see him grows due to those who came for a prescription for the simplest drug, then paid clinics can celebrate another victory, their clientele will increase.

However, experts do not argue that the idea of dispensing prescription drugs is not inherently bad and is even correct. “You need to be treated as prescribed and under the supervision of a doctor, but now the availability of medical care is low, and it is impossible to do everything “as it should.” And when there is no doctor in a public clinic, the patient will have to go to a paid clinic, that is, in fact, “buy” a prescription,” says the Health Foundation. There is another problem: in most cases, patients receive oral prescriptions from doctors, at best - the name of the drug is written on a piece of paper. Previously, this filk certificate was accepted at the pharmacy without asking for an official prescription or a stamp signed by a doctor. Now the sick are being turned away. One can imagine what kind of “walking through agony” a patient with a headache or back pain turns into at the clinic. “This creates the preconditions for the growth of the shadow pharmaceutical sector and entails risks to the health of patients,” notes Gavrilov.

However, the revolution started by Rospotrebnadzor did not die out. In August last year, it was “brought to fruition by the Ministry of Health by order No. 647-n. “On approval of the Rules of Good Pharmacy Practice for Medicinal Products for Medical Use.” It must be said that in principle, this order does not contain any rules that in any way change the division of drugs into prescription and over-the-counter drugs: in 2017, all those drugs that were dispensed in 2016 will be dispensed by prescription in Russia. No relaxations have been made in this list, but no new restrictions have been added. And in general, 90% of the information provided in the document is devoted to the organization of pharmacy activities, regulation of the work of management and staff, rules for the acceptance and storage of medicines, and similar technical issues that do not affect ordinary buyers.

It seems that that’s it, there are no reasons for panic and no reasons to urgently stock up on medicines today. Then where do the legs grow from? And here’s where it comes from: on March 1 of this year, new rules for the dispensing of prescription drugs and monitoring compliance with the rules for their sale came into force. Fines for dispensing medications without a prescription have increased: a pharmacist or pharmacist can now be fined 5-10 thousand rubles. (previously 1.5-3 thousand rubles), an official - by 20 - 30 thousand rubles. (previously 5 - 10 thousand rubles), legal entity - by 100-150 thousand rubles. (previously 20-30 thousand) or suspend the pharmacy’s activities for up to 90 days.

For six months, regulatory authorities kept an eye on them, stirred up interest in the work of pharmacies, and by October, some of them got real money, and the hype around prescriptions reached its climax. Consumers, caught between two fires, took the side of pharmacists. Not everyone likes that only the pharmacy is still recognized as a violator; for some reason Rospotrebnadzor has no complaints against doctors who do not write prescriptions as expected.

Other trends have also emerged that may influence the further development of this situation.

— The logic of the regulatory authorities is clear, and in general we support the new requirements for pharmaceutical activities. But the devil, as we know, is in the details. We have already had a case: a buyer has a severe asthma attack, he knows the name of the medicine and its dosage perfectly well, but he does not have a prescription with him. In this case, the choice is small: either refuse the suffocating person, or break the law. Therefore, in this matter, the most important thing is to avoid excesses,” Alexey Kiselev-Romanov, director of external communications at PJSC Pharmacy Chain 36.6, told NI.

According to Boris Gorodetsky, an expert at the “Your Pharmacist” service, increasing fines or introducing additional measures, such as suspension or revocation of a license, will have the effect of increasing prices for all medical products, the prices of which are not regulated by the state.

“Pharmacies will need to compensate for the loss of prescription drug revenue,” he explained. “Pharmacies regularly pay fines, but continue to sell prescription drugs without a prescription because they make up a significant portion of their revenue.”

Marketing Director of the FARM-Liniya pharmacy Rostislav Milenkov believes that tightening the legislation will not lead to fundamental changes in this issue, since it does not address the problem of counterfeit prescriptions at all.

“Enter the query “buy a recipe” into a search engine and you will see for yourself how many sites with offers will pop up,” he advised New Izvestia. There are plenty of offers; some, along with the prescription, immediately impose medicine with home delivery. The price of the issue is tolerable, at least for those who need to receive a prescription in a timely manner, and not sit in the clinic for weeks.

However, Milenkov warns that a forged prescription is dangerous, just like a drug bought second-hand. Experts consider a ban on the sale of prescriptions and medicines on the Internet to be a timely and overdue measure, but the devil is again in the details. “Before introducing such regulations, the following questions must be answered: will all patients be able to receive a prescription in a timely manner? For example, if there is already a queue for appointments with doctors in some specialties under compulsory medical insurance for several weeks in advance, is there any understanding of how the burden on the healthcare system (primarily in compulsory medical insurance) will increase with the introduction of such standards and what measures should be taken to avoid this?"

Some experts are in favor of toughening penalties for dispensing prescription drugs without prescriptions. “In no European country does self-prescription of treatment and choice of medicine on the advice of a pharmacist or on the advice of friends exist - there is only a doctor’s prescription,” reminds the chief physician of the Sfera clinic, Erika Eskin. The general director of the pharmaceutical company “Apteka+”, Alexander Koshkin, calls this situation an extremely positive trend: “Since the entry into force of Order No. 647 of the Ministry of Health of the Russian Federation, the requirements for the sale of prescription drugs have become more stringent. And, in my opinion, only the patient will benefit from this measure.”

According to market participants, the situation related to the dispensing of prescription drugs should change for the better due to the expansion of telemedicine capabilities. The burden on both doctors and pharmacy workers will be relieved by the widespread introduction of electronic prescriptions. These are the main innovations that the pharmacy business is waiting for.

Despite the fact that everyone is reassuring worried consumers and not predicting storms in the pharmaceutical industry, the NI correspondent decided to check what was really happening in the pharmacy closest to home. I came in and asked for Monopril (the kind of tablets for high blood pressure). They gave it easily. Already on the way out I looked at the inscription on the box “Dispensed from pharmacies with a prescription. Use as prescribed by your doctor."

According to the current rules, if there is information about the sale by prescription, the over-the-counter sale of such drugs is prohibited. Pharmacies appear to be ignoring the rule in order to increase revenue.

- What did you just give me without a prescription? – I say reproachfully to the girl.

“You didn’t prescribe it for yourself, did you?” - she answers. - Surely the doctor advised?

Yes, that was about fifteen years ago.

The girl looked through some list - it looked like a prescription list from the Ministry of Health. I didn't find Monopril.

- Not your profile. The list includes only psychotropic and potent drugs. And these harmless ones are from Poland. Drink to your health! This Europe is always playing it safe.

Rules for dispensing medications. The most controversial points of order No. 403n

Order of the Ministry of Health of Russia No. 403 n dated July 11, 2017 “On approval of the rules for dispensing medications...” continues to raise many questions among pharmacy workers.

We continue to reveal the secrets of the Order of the Ministry of Health No. 403n “On approval of the rules for the dispensing of medicines...”.

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

– I would like to know about the standards for dispensing ethyl alcohol in its pure form for external use. In what weight units should it now be sold?

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

Orders of the Ministry of Health dated 02/08/2017 No. 47n and dated 12/21/2016 No. 979n, which are designed to limit the volume of containers of alcohol-containing drugs, do not apply to ethyl alcohol in its pure form, since these orders indicate drugs in the form of tinctures containing alcohol.

Clause 23 of Order No. 403n of the Ministry of Health talks about the dispensing of alcohol specifically for external use, since it is hardly possible for the 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 permissible standards for the dispensing of medicines? Sometimes a patient comes with a prescription where they are exceeded...

– The prescription must contain a doctor’s note explaining why the patient needs more medicine than prescribed. This applies not only to the maximum permissible norm, but also to the recommended amount of drugs per prescription.

If there are no such explanations, the pharmacist dispenses medications within the maximum permissible norm or recommended quantity. He must note this in the recipe. The patient and the medical organization must be warned 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 medications...”, such a prescription is invalid, and the medicine cannot be dispensed with an invalid prescription - the same order No. 1175n says this (if the drug is potent, the pharmacist and pharmacist In general, criminal liability awaits).

From the point of view that if we are talking about the usual form 107, you can dispense the drug and it is enough just to record prescription violations in the journal, I do not agree. And I would like to warn specialists that inspectors may also disagree with this. However, Order No. 403n still allows medications to be dispensed if exceeding the maximum permissible 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 “Medicine dispensed.” In accordance with Order No. 403n, there must be another stamp - “The drug has been released.” Is it necessary to redo the stamp?

– 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, the pharmaceutical worker informs the person purchasing the drug about interactions 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 pharmacist 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 consultation on drug interactions should be based solely on the instructions for the product being purchased.

– Patients choose pharmacy organizations based on specialists who can competently provide pharmaceutical consulting services. This information is partly acquired during training as part of a pharmaceutical chemistry course, and partly learned during training sessions from manufacturing companies. In this case, the pharmaceutical specialist is guided exclusively by the knowledge base that he has been able to accumulate during his career.

– What to do with the dispensing of immunobiological drugs?

– In accordance with clause 8.11.5. “Conditions for transportation and storage of immunobiological medicinal products”, approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation dated 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 Immunobiological medicinal products may be sold at retail if they are delivered to the place of direct use in a thermal container or thermos in compliance with cold chain requirements. That is, retail sales of immunobiological drugs are permitted subject to compliance with the cold chain - this means that if a pharmacy wanted to sell immunobiological drugs, it was obliged to provide the buyer with a thermal container. The resolution is still in effect today. But now, in accordance with Order 403n, the drug is dispensed if the visitor has a thermal container.

– Is this condition feasible, since a sick person is not required to understand the categories of medicines? And should it be interpreted as the pharmacy’s right to refuse dispensing?

– Apparently, the pharmacy organization will look for opportunities to provide the patient with such a container or at least cold elements. For example, dry ice in bags.

– 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 one.

– It is prohibited to dispense drugs with expired prescriptions, unless the period expired while the prescription was on deferred maintenance. In such a situation, the drug is dispensed without renewing the prescription. But often, due to procurement and supply problems, drugs arrive at pharmacies only when the prescription that was on deferred service has expired, and the period of deferred service (10 or 15 days) has also expired. Is it possible to dispense the drug using this prescription without re-issuing the document?

– Indeed, in accordance with paragraph 6 of Order of the Ministry of Health No. 403n, it is prohibited to dispense medications on expired prescriptions, 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 a minimum assortment if there is a persistent defect in it? 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 inspection reveals the absence of a drug, a fine is still issued. Judicial practice is very extensive...

Special Purpose Recipe

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

Antibiotics have always been prescription drugs that should only be used as prescribed by a doctor. In our country, they often treat any cold, just “just in case.” The results of such uncontrolled use are disastrous. Strains of pathogens causing serious diseases, such as tuberculosis, have appeared in the world that do not respond to known antibiotics. There is simply no cure for such diseases! At the beginning of October, the Strategy for preventing the spread of antimicrobial resistance in Russia was approved. One of the principles: bring the use of antibiotics under strict control. At the pharmacy you must present a prescription written on a form. Yes, it is inconvenient, unusual, and takes time. But we must understand: the uncontrolled use of antibiotics does more harm than good.

2. Are there any restrictions on the dispensing of medications containing alcohol?

There are no “two bottles of hawthorn in one hand” conditions. Alcohol-containing drops, which are classified as over-the-counter medications (this is indicated by the manufacturer in the instructions), for example, the same hawthorn tinctures, drops such as Corvalol are sold without any restrictions. True, soon such tinctures will no longer be sold in bottles larger than 25 ml. But many manufacturers already fulfill this condition.

3. Is it true that mild sedatives are now also strictly prescribed?

The situation here is the same as with antibiotics. If the manufacturer has indicated in the instructions for the drug that it is available with a prescription, the pharmacy is obliged to ask the buyer for a prescription. Therefore, drugs such as amitriptyline, phenibut, grandoxin should still be prescribed by a doctor. A regular form is sufficient. And the pharmacist, dispensing the medicine, must “cancel” the prescription with a stamp.

4. Prescription medications, such as statins, often take a long time. Will you have to visit the doctor constantly now?

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

Order of the Ministry of Health No. 403n: new holiday rules

What could be more important for a pharmacy organization than the order in which medications are dispensed. Pharmacists barely had time to return from their summer vacation and look around when a new order of the Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n was published with appendices “On approval of the rules for the dispensing of drugs for medical use, including immunobiological drugs, by pharmacy organizations, individual entrepreneurs with license for pharmaceutical activities." The order was registered with the Ministry of Justice of the Russian Federation on September 8; its validity begins on September 22 of the current year.

The first thing I want to say in this regard is that now forget the number “785”. The new order invalidates the well-known order of the Ministry of Health and Social Development dated December 14, 2005 No. 785 “On the procedure for dispensing medicines,” as well as the orders of the Ministry of Health and Social Development No. 302, No. 109 and No. 521 that amended it. At the same time, many points of the new regulatory legal act repeat - sometimes almost verbatim - the corresponding fragments of the predecessor order. But there are also differences, new provisions, which we will focus on to a greater extent, setting out the first observations and notes in the margins of the freshly issued order No. 403n.

Order of the Ministry of Health of the Russian Federation No. 403n consists of three appendices. The first approves new rules for the dispensing of medicinal products, including immunobiological medicinal products (IBP); the second is the requirements for the dispensing of narcotic and psychotropic drugs, drugs with anabolic activity, and other drugs subject to subject-quantitative accounting (SQR). The third appendix establishes the rules for the dispensing of medicines according to the invoice requirements of medical organizations, as well as individual entrepreneurs (IP) with a license for medical activities.

Under the new order, the dispensing of over-the-counter drugs will be allowed both to pharmacies and pharmacy points, as well as individual entrepreneurs and pharmacy kiosks. Otherwise, if we summarize points 2 and 3 of order No. 403n, the following picture emerges.

The dispensing of narcotic and psychotropic drugs can only be carried out by pharmacies and pharmacy points that have the appropriate license.
The remaining prescription drugs are dispensed by pharmacies, pharmacy points and individual entrepreneurs (of course, those with a license for pharmaceutical activities - this clarification will be further considered accepted by default and omitted).
The dispensing of immunobiological prescription drugs is carried out by pharmacies and pharmacy points. Individual entrepreneurs are not mentioned in this provision of paragraph 3, which means that they cannot dispense drugs of this group, which we advise you to pay special attention to.

In general, in order No. 403n the topic of IBP release is spelled out separately, which is not in order 785. It will be regulated by paragraph 13 of the first mentioned act. This paragraph, in particular, determines that when an IBP is dispensed, the exact time of this same dispensing, in hours and minutes, is indicated on the prescription or prescription counterfoil, which remains with the buyer.

IBLP can be released if two conditions are met. Firstly, if the buyer has a special thermal container in which the required mode of transportation and storage of these thermolabile drugs can be observed. The second condition is an explanation (from the pharmacist to the buyer) of the need to deliver this drug to a medical organization, despite the fact that it can be stored in the mentioned container for no more than 48 hours.

Let us recall in this regard that this topic is also regulated by subclause 8.11.5 of the Sanitary and Epidemiological Rules “Conditions for transportation and storage of immunobiological preparations” (SP 3.3.2.3332–16), which were approved by Resolution of the Chief State Sanitary Inspector of the Russian Federation dated February 17, 2016 No. 19 It obliges the pharmacy employee to instruct the buyer on the need to comply with the “cold chain” when transporting biopharmaceutical products.

The fact of this instruction is recorded with a mark on the drug packaging, prescription or other accompanying document. The mark is certified by the signature of the buyer and the chief clerk (or another representative of the pharmacy organization) and also includes the date and time of dispensing. However, the SanPiN does not specify that the time in this case should be indicated in hours and minutes.

Violation of secondary

With the entry into force of Order No. 403n, new emphasis will appear on the topic of the possibility of violation of secondary (consumer) packaging of medicines. The “retiring” norm of Order No. 785 allows this to be done in exceptional cases, if the pharmacy organization is unable to fulfill the doctor’s prescription.

The order No. 403n that replaced it is in this regard more specific and more in line with modern requirements, medical practice and consumer demands. Paragraph 8 of the order determines that violation of the secondary packaging and dispensing of the medicinal product in the primary packaging is allowed in cases where the amount of the drug indicated in the prescription or required by the consumer (for over-the-counter dispensing) is less than the amount of the drug contained in the secondary packaging.

In this case, the buyer must be provided with instructions for use or a copy thereof, and tampering with the original packaging is prohibited. By the way, the new order does not contain the rule that in case of violation of the secondary order, the drug must be dispensed in pharmaceutical packaging with the obligatory indication of the name, factory batch, expiration date of the drug, series and date according to the laboratory packaging register, which is determined by order No. 785.

What does this mean in practice? Let's assume two situations: first - drug X tablets (or dragees) No. 56, primary packaging - blister; the second is drug N tablets No. 56, in a bottle. And in both cases, the question arises about its release to the patient who has presented the chief of staff with a prescription on which, say, 28 tablets or 42 tablets (dragées) are prescribed.

It is clear that in the first case this is acceptable, since it is possible to dispense 28 or 42 tablets without breaking the primary packaging (blister), and in the second case it is unacceptable, since the primary packaging in this situation is a bottle, and breaking it is strictly prohibited. So, our first capital officials do not have the right to count out tablets or dragees from a bottle, as they do in pharmacies in some foreign countries.

"The medicine has been released"

Clause 4 of Order No. 403n of the Ministry of Health of the Russian Federation regulates the topic of prescription forms and the list of drugs dispensed on them. In particular, narcotic and psychotropic drugs of Schedule II are dispensed using Form No. 107/u-NP, with the exception of narcotic and psychotropic drugs in the form of transdermal therapeutic systems.

According to form No. 148–1/у-88 the following are issued:

Schedule III psychotropic drugs;
narcotic and psychotropic drugs of Schedule II in the form of transdermal therapeutic systems;
drugs included in the list of drugs subject to PCU, with the exception of those drugs that are dispensed in form No. 107/u-NP;
drugs that have anabolic activity and are classified as anabolic steroids according to the anatomical-therapeutic-chemical classification (ATC) recommended by the World Health Organization (code A14A);
drugs specified in paragraph 5 of the “Procedure for dispensing to individuals medicinal products containing, in addition to small quantities of narcotic drugs, psychotropic substances and their precursors, other pharmacological active substances” (order of the Ministry of Health and Social Development of the Russian Federation dated May 17, 2012 No. 562n);
preparations manufactured according to a prescription for a medicinal product and containing a narcotic drug or psychotropic substance included in Schedule II and other pharmacological active substances in a dose not exceeding the highest single dose, and provided that this combined medicinal product is not a narcotic or psychotropic drug Schedule II drug.

The remaining prescription drugs, as is known, are dispensed using forms No. 107-1/u. According to paragraph 22 of the order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1175n “On approval of the procedure for prescribing and prescribing medications, as well as forms of prescription forms...”, prescriptions written on the forms of this form are valid for two months from the date of prescription. However, for patients with chronic diseases, it is allowed to set the validity period of the prescription form No. 107-1/u within up to one year and exceed the recommended amount of the drug for prescribing per prescription, established by Appendix No. 2 of this order.

Such a prescription, which also indicates the periods and quantity of the drug dispensed (in each period), is returned to the buyer, of course, with the required notes on the date of dispensing, dosage and quantity of the drug dispensed. This is prescribed by paragraph 10 of order No. 403n. He also determines that the next time the patient comes to the pharmacy with the same prescription, the chief must take into account the notes on the previous dispensing of the drug.

When the maximum quantity specified in the prescription is purchased, it must be stamped “Dispensed.” And a one-time release of the entire quantity, according to the same paragraph, is allowed only in agreement with the doctor who wrote this prescription.

The prescription remains at the pharmacy

There are some changes on the topic indicated in the title of this chapter. Paragraph 14 of the new order establishes that the retail trade entity retains (with the mark “The medicinal product is dispensed”) and stores:

within 5 years recipes for:

narcotic and psychotropic drugs of Schedule II, psychotropic drugs of List III (according to the outgoing 785th order, they are stored for 10 years);

within 3 years recipes for:

drugs dispensed free of charge or at a discount (according to forms No. 148–1/u-04 (l) or No. 148–1/u-06 (l));
combination drugs containing narcotic drugs or psychotropic substances included in Schedules II and III, manufactured in a pharmacy, drugs with anabolic activity, drugs subject to PCU;

within 3 months recipes for:

drugs in liquid dosage form containing more than 15% ethyl alcohol by volume of the finished product, other drugs classified by ATC as antipsychotics (code N05A), anxiolytics (code N05B), hypnotics and sedatives (code N05C), antidepressants (code N06A ) and not subject to PCU.

Order No. 403n of the Russian Ministry of Health did not come without a cherry on the cake, albeit a dubious one. Paragraph 15 of the order states that prescriptions not specified in the previous 14th paragraph (we listed them just above) are marked with the stamp “The drug has been dispensed” and are returned to the indicator. It seems to follow from this that prescriptions of form No. 107-1/y with a two-month validity period become “disposable”. We advise readers to pay special attention to this new norm.

The topic of combating the abuse of alcohol-containing drugs in pharmacies, which was recently trumpeted by the media, is also reflected in the new order on the rules of dispensing. According to the current procedure, prescriptions for such drugs are returned to the patient (with a “dispensed” stamp); under the new order, they must remain in the pharmacy organization.

To avoid getting caught

The procedure for working with incorrectly written prescriptions is now described in a little more detail (clause 15 of order No. 403n). In particular, when they are registered by a pharmacist in a journal, it is necessary to indicate the identified violations in the execution of the prescription, the full name of the health worker who wrote it, the name of the medical organization in which he works, and the measures taken.

According to this clause, when dispensing a drug, the pharmacist informs the buyer not only about the regimen and doses, but also about the rules for storing it at home and interactions with other drugs.

In theory this means the following. The pharmaceutical inspector can approach the first table in the guise of an ordinary buyer - so to speak, make a test purchase. And if the inspector, when dispensing the medicine, does not inform him, for example, that this medicine must be stored at a temperature no higher than 25 ° C, or does not ask whether he is currently taking other medicines, then the inspector can “throw off the mask” and draw up an act of administrative violation. So the norm in paragraph 16 is serious and fraught. And, of course, it requires that the chief captain be thoroughly versed in the complex and voluminous topic of drug interactions.

Paragraph 17 of Order No. 403n contains the rule that a pharmacist does not have the right to provide false or incomplete information about the availability of drugs in the pharmacy’s assortment - including drugs that have the same INN - and also to hide information about the availability of drugs that have a lower price. Similar provisions are contained in subparagraph 2.4 of Article 74 of the Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” and paragraph 54 of the Rules of Good Pharmacy Practice (Order of the Ministry of Health of the Russian Federation dated August 21, 2016 No. 647n). The only thing new here is that this rule appears for the first time in the order on vacation rules.

This was a review of the order, so to speak, “on fresh trail.” Readers will probably find in it other points and norms that deserve special attention. Write to the editors of Katren-Style magazine about them, and we will address your questions to leading industry experts. We will also ask them about the problem of “disposable” prescriptions with a two-month validity period, which was mentioned above, as well as the dispensing of ethyl alcohol and alcohol-containing drugs in the light of the provisions of the new order No. 403n.

On October 5, a webinar by Larisa Garbuzova, Ph.D. will be held on our website. D., Associate Professor of the Department of Management and Economics of Pharmacy at Northwestern State Medical University (St. Petersburg), dedicated to explaining the new rules for dispensing drugs, and on October 25, Executive Director of the National Pharmaceutical Chamber Elena Nevolina will talk about her point of view on the same topic. Register for both webinars.

Materials about the order of the Ministry of Health No. 403n:

Clarifications on the new rules for dispensing medications

On September 27, the Ministry of Health published the first official explanations of Order 403n on the Rules for the Dispensing of Medicines.

Consequences of the new drug dispensing procedure

In connection with the entry into force of the new order of the Ministry of Health No. 403n, many pharmacies have stopped dispensing narcotic painkillers to relatives of cancer patients without a notarized power of attorney from the patient.

Explanations of the new rules - part 2

Read the recipe for autumn

The order of the Ministry of Health has complicated the purchase of drugs for cancer patients and patients with depression

As experts note, the new order of the Ministry of Health contains vague wording. The document was signed back in July, but almost three months before it came into force, the department did not conduct explanatory work with doctors and pharmacists. As a result, each pharmacy interpreted the new rules to the extent of its fear of the inspectors. Relatives of cancer patients were required to have notarized powers of attorney; patients suffering from depression experienced difficulties in purchasing medications, and some pharmacies seriously doubted whether to ask customers for a prescription for Corvalol and motherwort?

Panic attack

Patients with depression learned about the new rules when they came to the pharmacy for another package of pills. “The pharmacist said: we will only sell it according to a prescription, otherwise we will be fined 40 thousand. I bought the drug at this pharmacy for six months, they already know my face, there was no talk of any prescription before. Why didn’t anyone warn me about the changes?” - asks Saratov resident Elena. She had two tablets of Cipralex left at home; she should take one and a half tablets a day; it is not recommended to suddenly quit the drug.

Elena called the private clinic where she is being monitored; the next appointment with a psychotherapist is in four days. The girl did not dare to urgently look for another clinic and specialist. “I started to panic. I rushed to all the pharmacies in the city and rummaged through old stashes at home. My blood pressure jumped to 180. I prayed to all the saints to make it until Saturday and get to the doctor.” The patient was given a prescription at the clinic, and the pharmacy collected it when purchasing the drug. “Now once every two months I will have to go to the doctor for a new prescription and pay 800 rubles per appointment,” Elena shrugs.

Yulia had a prescription for three drugs - an antidepressant, a sedative and a sleeping pill. Trying to buy them, the girl visited several pharmacies and found out that pharmacists understood the new rules differently. “At the first pharmacy they told me that they would take the prescription in exchange for pills. In the second, they held a whole meeting, after much deliberation, they sold me two drugs for two months and put a stamp on the prescription “medicine dispensed.” The third pharmacy sold another drug I needed for only one month and wrote a handwritten note on the prescription.” According to Yulia, a year and a half ago these drugs were freely sold in any pharmacy.

Everyone has their own point

Order of the Ministry of Health No. 403n, which changed the rules for dispensing medicines, came into force on September 22. Palliative care services were the first to tell journalists about the results of the document: in pharmacies in Moscow, Samara, Kurgan and other cities, relatives of cancer patients were required to have notarized powers of attorney for the right to receive narcotic painkillers. Pharmacists read this requirement in paragraph 20 of Order No. 403n: “Narcotic and psychotropic drugs of List II are dispensed upon presentation of an identification document to the person specified in the prescription, his legal representative or a person who has a power of attorney issued in accordance with the legislation of the Russian Federation obtaining such narcotic and psychotropic drugs." Registration of a notarized power of attorney with a visit to the home of a bedridden patient costs from 3.5 thousand rubles in Saratov and takes time.

A few days after the scandal in the press, the Ministry of Health explained that the new order, on the contrary, should make pain relief more accessible - now not only the patient’s close relatives will be able to get the drug at the pharmacy, but also, for example, friends or neighbors to whom the patient will give a power of attorney (and quite power of attorney in simple written form). It is noteworthy that the order was signed on July 11 and published on September 12, but before it came into force, no one explained the controversial wording to the pharmacies. Pharmacists decided to play it safe, fearing inspections, especially strict in the case of narcotic substances.

“Mom was without pain relief until the last minute, and then she died.” Who, for what and how treats cancer patients in the regions?

The difficulties faced by patients with depression are caused by paragraph 14 regarding the sale of tinctures and sedatives. The document states that pharmacies are required to store for three months “prescriptions for drugs in liquid dosage form containing more than 15% ethyl alcohol of the volume of finished products, other drugs related to anatomical, therapeutic and chemical qualifications as antipsychotic drugs (code N05A), anxiolytics (code N05B), hypnotics and sedatives (code N05C), antidepressants (code N06A) and not subject to quantitative accounting.”

Why not provide a specific list of medicines covered by the order? Why such a “raw” document? Or was everything done on purpose so that it could be pinched during inspection? - pharmacists are indignant on thematic forums.

Pharmacists suggested that even Corvalol, Valocardine, tinctures of motherwort, valerian, peony, etc., related to sleeping pills and sedatives (code N05C), fall under the new rules. But how can you demand a prescription for a bottle with the inscription “Dispensed without a prescription”? “In connection with incoming requests,” the Ministry of Health clarified that it is not encroaching on the favorite drops of domestic pensioners. As the department reminded, drugs are classified as prescription or over-the-counter at the stage of state registration, this is indicated in the instructions for use, and the sales rules do not change anything in this regard. Over-the-counter tinctures will continue to be sold freely under the new order, but control over prescription sedatives has been tightened.

Pyotr Sarukhanov / Novaya Gazeta. Go to the artist's website

Sudden dura lex

Most medications used for depression are stamped on the packaging: “Dispensed with a prescription.” Neither doctors nor patients were warned that this instruction would become mandatory from September 22. This came as a surprise even to employees of government medical institutions. “My colleagues are shocked. Our patients run headlong around the city, looking for where to get drugs. Moreover, these are the most innocent drugs that are not addictive, but, on the contrary, treat addiction,” says one of the doctors, who asked not to be named.

Since 2017, control over the dispensing of prescription drugs from pharmacies has been strengthened. However, there is currently no official list of all medications that must be dispensed strictly according to a prescription. Roszdravnadzor controls everything.

Mikhail Khaustov

Pharmacists themselves should focus primarily on the instructions for medications, which contain instructions for sale with or without a prescription. As a result, antibiotics, antiviral drugs, modern tranquilizers and antidepressants, as well as “harmless”, in the opinion of many consumers, drugs fell into disgrace. Roszdravnadzor controls everything.

1 What really happened?

The Order “On the Procedure for Dispensing Medicines” has been in effect in the Altai Territory for more than 10 years.

But since January 1, 2017, Roszdravnadzor, in connection with changes to the law “On the Protection of Consumer Rights,” has been conducting control purchases in pharmacies and seriously fines those who sell any of these drugs without a prescription. this is due to changes in the federal one. Now any citizen or legal entity can complain that a prescription drug was freely sold to him in a pharmacy.

2 Why are consumers unhappy?

People are particularly dissatisfied with the fact that it will now be difficult to buy popular painkillers, such as Nise, Nimesil and Ketanov (a prescription drug).

3 Why were restrictions introduced?

The official explanation for tightening the requirements for the dispensing of drugs is as follows: the level of self-medication among citizens is extremely high, and uncontrolled use of a number of drugs leads to dire consequences for health.

This is especially true for the ability to freely purchase potent drugs, including antibiotics. Taking them without the supervision of specialists undermines the immune system and leads to a decrease in the effect of drug treatment in general.

4 Are pharmacies ready?

The Ministry of Health of the Altai Territory assured that all state medical institutions currently have the necessary supply of various forms of prescription forms, and doctors are ready to prescribe and prescribe medications.

Colds, flu.

5 Will there be concessions?

for chronic patients, it is allowed to set the validity period of the prescription within up to one year, that is, you will not have to go to the doctor every month for a new prescription. But this is if the course of the disease does not change. However, usually these people are regularly observed by specialists;
contraceptives: first you will have to go to the gynecologist, but the doctor can write a prescription for a quarter or even a year, indicating the frequency of its dispensing.

6 Which medications should be sold by prescription only?

antibiotics;
neuroleptics;
psychotropic substances;
ampoule and hormonal (contraceptives and other) drugs;
means for regulating blood pressure.

Colds, flu. Medicines.

7 What can you buy without a prescription?

All drugs for the treatment of fulminant diseases are antiviral and antipyretic.

There is no complete official list of drugs that must be sold strictly according to a prescription.

8 How to understand: according to the prescription or not?

If a pharmacy refuses to sell you a drug, citing the lack of a prescription, you can immediately double-check the information. Just ask your pharmacist to give you the instructions for the medicine or look it up online.

The instructions for each medicine contain the line “Rules for dispensing from pharmacies” and then indicate: “with a prescription” or “without a prescription”. That's all.

9 What should be on the recipe?

patient information (last name, initials and residential address);
doctor's name;
two seals are affixed - the doctor’s and the medical institution’s;
name of the drug by INN (international nonproprietary name, not trade name);
one recipe can contain up to three items, indicating the frequency of their sale: month, quarter or year.
You are required to accept prescriptions at any pharmacy in any locality; you do not need to present personal documents.

10 How many medications are sold without a prescription?

Only 30% of drugs registered in the Russian Federation can be sold without a prescription. The use of the rest requires supervision by the attending physician and presentation of a prescription form upon purchase.

Sale of antibiotics legally

For violating the current regulations and selling an antibiotic without a prescription, the following fines are expected:

for individuals- from 5,000 - 10,000 rubles;
for an official— 20,000 — 30,000 rubles;
for a legal entity- 100,000 - 150,000 rubles.

A more serious punishment for selling antibiotics without a prescription form may be suspension of the pharmacy for 3 months.

What antibiotics can be sold without a prescription?

Without the appropriate prescription form, you can purchase medications for the treatment of fleeting diseases - antiviral and antipyretic. The percentage of over-the-counter drugs is 30%.