What antibiotics are sold without a prescription in Belarus. The Ministry of Health proposes a new list of over-the-counter drugs

The Ministry of Health proposes to discuss a new list of medicines that can be bought at pharmacies without a prescription. The new list of drugs is posted on the department's website.

The picture is used as an illustration. Photo: Reuters

“The project has been updated taking into account the presence or absence of registration of medicines and has not changed significantly in comparison with the current one,” commented in Ministry of Health. “Our specialists look forward to suggestions and comments from specialists, including practitioners and suppliers.

TUT.BY compared two lists of over-the-counter drugs - the current one and the new one, which the Ministry of Health proposes to discuss.

The draft new list contains medicines under international non-proprietary names (if any), i.e. all medicines with such INN in the forms specified in the decree, regardless of their trade names, will be sold without a prescription.

So, for example, as before without a prescription, pharmacies offer to sell powders that are used for colds, gels and tablets for heartburn, anesthetics. Without prescriptions, antiviral drugs will continue to be sold - Groprinosin, Arbidol, Arpetol. But Oseltamivir, the Ministry of Health, offers to release according to prescriptions.

- Doctors assumed that all systemic antibiotics - those taken orally or by injection - would be removed from the new list of over-the-counter drugs. However, only one was withdrawn, - comments Tatyana Erofeeva, doctor-therapist of the medical center "Lode". I think everything should have been removed. Still, our people tend to self-prescribe antibacterial drugs. Often in insufficiently substantiated cases for this.

For example, the interlocutor says, a person has a cold or a runny nose, and he immediately takes an antibiotic. Although it is not inefficient to do this early or at all. Such self-medication leads to resistance of the body to these drugs.

The specialist also notes that two drugs that are used for high blood pressure and heart disease have been removed from the new list.

“That's right, because modern drugs are much more effective, but for some reason they were prescription,” the therapist continues. - And these old ones, with a lot of side effects - without it.

The fact that the list of drugs that can be bought without a doctor's prescription can become shorter, the doctor notes many pluses. By this, she says, we are approaching European standards.

“Drugs with serious side effects should not be sold just like that. As, in fact, drugs, from diseases that require the supervision of a doctor, she explains her position. “Suppose hypertension, which needs to be observed at least twice a year. In Europe, the same "Captopril" can be bought only on prescription.

Tatyana Erofeeva believes that such a situation disciplines people.

A new list of drugs that will be sold without a prescription can be viewed, or on the website of the Ministry of Health in the "Drug Policy" section.

Comments and suggestions on the draft resolution are proposed to be sent to the Department of Pharmaceutical Inspection and Organization of Drug Provision of the Ministry of Health to the email address [email protected]. Letters are accepted until June 16, 2017.

advice from consultants in Vitebsk pharmacies

September 15, 1928 microbiologist Alexander Fleming isolated penicillin, the world's first antibiotic. The invention of a talented Englishman revolutionized medicine. In those years, most infectious diseases such as pneumonia, sepsis, tuberculosis, gangrene, and typhoid fever were considered incurable.

Penicillin helped save millions of lives both in peacetime and during World War II, when the first antibiotic was commercialized in the United States in 1943. By the way, in the USSR in 1942, for the first time, penicillin was isolated by professor Zinaida Ermolyeva. The material for obtaining was a colony of mold fungi taken from the wall of a Moscow bomb shelter. The antibiotic helped to heal a huge number of seriously wounded soldiers who suffered from purulent lesions caused by staphylococci and streptococci.

From such a colony, penicillin can be isolated. Source: vistanews.ru

Today, they sell mainly drugs of the penicillin group, obtained synthetically. And to get them, you need a doctor. But what if for some reason there is no way to contact a specialist? Will antibiotics be sold without a prescription?

Will sell. The list, which are freely sold in the pharmacy network of Belarus, includes amoxicillin, oxacillin, doxycycline, ampicillin. You can get them freely.

We go to the duty room of LLC "VITVAR" on Moskovsky Prospekt. You can go here at any time of the day, and this is a definite plus: if a cold has already taken by the throat late in the evening, when there is no way to see a doctor, then it is better to ask a loved one to go to the nearest “duty room”. Amoxicillin-500 of Belarusian production will cost 4 rubles 37 kopecks for ten capsules. Plus, they can still offer a ten percent discount on (only domestic) disabled people, pensioners, mothers of large families and those who have children under 3 years old. Do not trust the Belarusian drug, take Ospamox of the same dosage from Sandoz. Price up: 6 rubles 14 kopecks.

At Itera-med, a smiling consultant Ludmila suggests not to get involved in antibiotics, and at the first manifestations of a cold, take powders with paracetamol or Grippomix containing rimantadine.

Many people are now self-medicating.- the pharmacist sighs, - and I am sure that you need to take only with the permission of a doctor. Especially things like antibiotics. Yes, amoxicillin (at the pharmacy, the drug costs 4 rubles 30 kopecks, and this is the lowest price in the city!) I will sell. But if you have the means, get better its analogue - Amoklav-1000 (14 tablets) from Pharmland for 14 rubles 26 kopecks. It is believed that when taking this drug, about 96% of the amoxicillin, which is part of it, is absorbed. And it will not affect the microflora of the gastrointestinal tract in any way.

I will also give advice: please do not abuse various painkillers like citramone and analgin, do not thoughtlessly drink aspirin, trying to bring down the temperature with a cold. You will only get a stomach ulcer.

There are many antibiotics in the pharmacy network. Photo by Evgeny Moskvin

There are also discounts at Itera-med - 5% for pensioners and those who buy medicines for children under the age of 3.

In the Pharmacy network, domestic-made amoxicillin will cost more: 4 rubles 77 kopecks for a pack of 10 capsules. Slightly more expensive than amoxicillin in Planet Health: 4 rubles 79 kopecks. recommend paying attention to its British counterpart Clavomed, which due to its composition (amoxicillin plus clavulanic acid) is better absorbed by the body. For 10 tablets you have to lay out 19 rubles 95 kopecks.

In the Energofarm pharmacy, amoxicillin is 4 rubles 72 kopecks. Pharmacist Olga explains that the cheapest antibiotic is ampicillin at a dosage of 250 mg. Give for 20 tablets 1 ruble 79 kopecks. It is necessary to take medicines for 5-7 days, two tablets 4 times a day.

I understand that there are times when it is not possible to call a doctor and get the desired prescription, Olga says, then amoxicillin will help out. Let's say a person came to Belarus from another country and caught a bacterial infection. And on weekends and holidays, you don’t run into doctors. Although on the other hand, it is impossible to do without making the correct diagnosis. And if you were overtaken by a disease caused by a virus, the same flu? Against him, the antibiotic will be useless. Just waste your money.

Let's take a look at the ADEL pharmacy. Here amoxicillin is the most expensive in the city: 4 rubles 86 kopecks. The pharmacist Lyudmila explains that the medicine must be taken in combination: it is also necessary to take probiotics and hepatoprotectors (means that protect the liver and gastrointestinal tract) with it. So therapy is expensive! Get ready to splurge.

In order to avoid disagreements in the order of dispensing "by prescription / without a prescription" of medicines from pharmacies in Belarus, we suggest using the following information. You can be guided by it when determining the procedure for dispensing a drug from a pharmacy in disputable situations.

Controversial situations on prescription medicines from pharmacies in Belarus have recently arisen more and more:
— Why Metronidazole prescription pills, and Trichopolum without?
- Why did Broncho-munal "suddenly" become prescription?
— What's the story with Dexatobrom and Tobradex?
Etc.

There is even a whole page on the website of the Ministry of Health of Belarus dedicated to this problem.

Now a pharmacy employee, in addition to the range, regulatory documents and cash procedures, constantly needs to keep in mind a “list of prescription exceptions”, which somehow contradict the Decree of the Ministry of Health of the Republic of Belarus dated 05.06.2012 No. 55 “On establishing a list of medicines sold without a doctor’s prescription ".

Recently, the regulator gave an explanation that clarifies what is happening:

“If for a medicinal product during state registration (confirmation of state registration) the procedure for dispensing “without a prescription” is established, the value of the ATC code does not affect the procedure for dispensing, regardless of its inclusion in the list of medicines sold without a doctor’s prescription, approved by a decree of the Ministry of Health of the Republic Belarus dated 05.06.2012 No. 55 “On the establishment of a list of medicines sold without a doctor’s prescription” (hereinafter referred to as the list). Such a drug will be sold from pharmacies without a doctor's prescription.
In the case when for a medicinal product during state registration (confirmation of state registration) the procedure for dispensing “by prescription” is determined, one should be guided by the ATC code under which it is indicated in the list.

For instance:
Medicines Methyluracil rectal suppositories 500 mg № 10 currently registered with a prescription order and ATC code A14B.
The international non-proprietary name (hereinafter referred to as INN) "methyluracil" is listed in the following ATC groups:
С05 Angioprotectors;
D03A Wound healing agents;
L03 Immunostimulants.
Given the above, the above medicines with the international non-proprietary name "methyluracil" in the form of rectal suppositories sold from pharmacies by prescription.

The situation is similar with pharmaceuticals. "Broncho-munal" capsules 7mg No. 10 and "Broncho-munal P" capsules 3.5 mg No. 10.
Currently, these medicines are registered under the prescription order and ATC code L03AX.
In the list, these trade names of medicines are listed in the group R07 Other medicines for the treatment of diseases of the respiratory system and are not listed in the group L03 Immunostimulants, therefore, these medicines sold by prescription.

Thus, we propose to be guided by the current value of the ATC code, as well as the procedure for dispensing the medicinal product determined during state registration (confirmation of state registration).

If the list of medicines under the INN is indicated, the over-the-counter dispensing procedure will apply to all trade names of this INN, if the medicine is indicated in the list under a specific trade name, the over-the-counter dispensing procedure will apply only to the medicine under this trade name.”

In the last paragraph, let's analyze the situation with Tobradex and Dexatobrom:

Dexatobrom is dispensed without a doctor's prescription, tk. is present in Decree No. 55 precisely under the trade name - DEXATOBROM. There are no Tobradex eye drops in the list, so we look at the state register:
Therefore, Tobradex is dispensed by prescription.

Let's analyze the main part of this letter using the example of Metronidazole and Trichopolum in detail:

"Metronidazole tablets for internal use"
We open resolution No. 55, we find that Metronidazole is located in the group. We open the instructions for medical use (or the state register of medicines):
Pharmacotherapeutic group: Antimicrobial agents for systemic use. imidazole derivatives. Code ATX-J01XD01
Group does not match, then we check the order of vacation according to the state register:

Therefore, metronidazole must be sold from pharmacies by prescription (due to the absence of metronidazole with the ATX-J01XD01 group in the list).

"Trichopol tablets for internal use"
We open resolution No. 55. We find: P01A Amoebiasis and other protozoal infections. We open the instructions for medical use (or the state register of medicines): Pharmacotherapeutic group: Antiprotozoal drugs. ATX code P01A. Group matches, which means that it can be dispensed from pharmacies without a doctor's prescription.

Therefore, metronidazole is subject to sale from pharmacies by prescription (due to the absence of metronidazole with the ATC-J01XD01 group in the list), and Trichopol without a prescription. For the same reasons, methyluracil suppositories are classified as prescription drugs.

Just in case, we offer you the following algorithm for determining the release of medicines from a pharmacy: