Duphaston analogues are cheap. What analogues does duphaston have? Choosing the right product

Name:

Duphaston

Pharmacological
action:

Dydrogesterone, which is the active substance of duphaston, - progestogen, an analogue of natural progesterone. It has no estrogenic, androgenic or corticoid effect. Does not change thermogenesis, so the presence of ovulation can be determined by monitoring basal temperature bodies. Does not affect metabolism. There are no side effects associated with the use of synthetic progestins. Effective when used internally. Selectively affects progestin receptors of the uterine mucosa. Causes normal secretory transformations in the endometrium in case of sufficient estrogen saturation. Does not affect follicle ovulation. Does not have a virilizing and/or masculinizing effect (including on the fetus).

After oral administration quickly absorbed from gastrointestinal tract. The maximum concentration in the blood after administration is observed In 2 hours. 97% of dydrogesterone binds to blood proteins. Hydroxylated in liver cells. Elimination of biotransformation products occurs in urine (56-79%). 72 hours after a single dose it is completely eliminated from the body. It does not accumulate and there is no increase in the concentration of dydrogesterone in patients with renal failure.

Indications for
application:

Confirmed endogenous progesterone deficiency(endometriosis, luteal phase deficiency, recurrent fetal loss or threatened abortion, premenstrual syndrome, violations menstrual cycle, amenorrhea of secondary origin, dysmenorrhea).
Hormone replacement therapy (surgical castration, including with a preserved uterus; menopausal syndrome - used when it is necessary to neutralize the proliferative effect of estrogens on the mucous membrane of the uterine cavity when using estrogens for HRT).

Mode of application:

Destination schemes are indicative. For maximum therapeutic effect, it is necessary to take into account Clinical signs diseases and phases of the natural menstrual cycle. Daily dosage divided into several doses, preferably at regular intervals.

At endometriosis use 10 mg of dydrogesterone 2-3 times a day (without breaks or from the 5th to 25th day of the menstrual cycle).

At infertility progesterone genesis 20 mg/day (in 2 doses) from the 11th to 25th day of MC inclusive. The course of treatment is 3-6 months. If the patient becomes pregnant, treatment should be continued at the dose recommended for habitual loss pregnancy. The dose of dydrogesterone can be adjusted cytological examination vaginal epithelium (colpocytology).

Habitual pregnancy loss And threatened abortion– used only in case of evidence of endogenous progesterone deficiency.

In case of threatened abortion use 40 mg of dydrogesterone as a starting dose 1 time, then 10 mg every 8 hours for 1 week. After this, the dosage is gradually reduced. However, if signs of threatened abortion recur, it is possible to increase the dose again. Can be used up to 12-20 weeks of pregnancy.

With the usual miscarriage Therapy begins when planning pregnancy: 10 mg 2 times a day from the 11th to the 25th day of the menstrual cycle. If conception has occurred, therapy is carried out at the same dose continuously; from the 20th week of pregnancy, the dose is gradually reduced. Clarification of the need to increase or decrease the dosage of dydrogesterone is possible after a colpocytological study.

For premenstrual syndrome(PMS) – 10 mg from the 11th to the 25th day of the menstrual cycle. Duration of therapy – 3-6 months.

For dysmenorrhea - 20 mg/s in 2 doses from the 5th to the 25th day of the menstrual cycle, for 3-6 months.

With an irregular menstrual cycle, due to the short luteal phase, use 20 mg/day, in 2 divided doses from the 11th to the 25th day of the cycle.

In the treatment of amenorrhea used in combination with estrogens. Apply 10 mg of dydrogesterone 2 times a day from the 11th to the 25th day of the menstrual cycle while taking 0.05 ethinyl estradiol from the 1st to 25th day of the cycle. Duration of treatment – 3 or more menstrual cycles.

For dysfunctional bleeding used in a dose of 10 mg 2 times a day for 5-7 days in combination with ethinyl estradiol 0.05 mg (this regimen stops bleeding). For prophylaxis, use 10 mg of dydrogesterone 2 times per day from the 11th to 25th day of the menstrual cycle, combined with 0.05 ethinyl estradiol 1 time per day.

As HRT used only in combination with estrogens.
For continuous therapy, 10 mg is used for 14 days each menstrual cycle. When used cyclically - only in the last 12-14 days of estrogen 10 mg 1 r / s. If necessary (insufficient secretory transformations of the endometrium, confirmed by ultrasonography or histologically), the dose is increased to 20 mg/day.

Side effects:

Rarely– breakthrough bleeding. In this case, the dose of dydrogesterone must be increased. Can also be customized increased sensitivity to the drug.

Contraindications:

Undiagnosed vaginal bleeding;
- existing severe liver disease or presence serious illnesses liver in the past, if liver function tests have not returned to normal;
- the use of estrogens in combination with progestogens, such as dydrogesterone;
- established hypersensitivity to active substance or to any other component of the drug;
- established or suspected neoplasms dependent on sex hormones.

Interaction
other medicinal

In this article you can read the instructions for use of the drug Duphaston. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of Duphaston in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications were observed and side effects, perhaps not stated by the manufacturer in the annotation. Analogues of Duphaston if available structural analogues. Use for the treatment of endometriosis, infertility in women, as well as during pregnancy, planning and breastfeeding.

Duphaston- analogue of natural progesterone. Duphaston in his own way molecular structure, chemical and pharmacological properties very close to natural progesterone. Due to the fact that dydrogesterone is not a derivative of testosterone, it does not have the side effects characteristic of most synthetic progestogens, the so-called androgenic progestogens.

Dydrogesterone does not have estrogenic, androgenic, anabolic, glucocorticoid and thermogenic activity. Does not provide negative influence on carbohydrate metabolism and liver function.

Dydrogesterone at oral administration selectively affects the endometrium, thereby preventing increased risk development of endometrial hyperplasia and/or carcinogenesis in conditions of excess estrogen. It is indicated in all cases of endogenous progesterone deficiency.

The drug has no contraceptive effect.

When treated with dydrogesterone therapeutic effect achieved without suppressing ovulation or disrupting menstrual function. Dydrogesterone does possible conception and maintaining pregnancy during treatment.

Pharmacokinetics

After oral administration, Duphaston is quickly absorbed from the gastrointestinal tract. Dydrogesterone is metabolized in the liver. Excreted in urine from 56 to 79%.

Indications

endometriosis;
infertility caused by luteal insufficiency;
threatened or habitual miscarriage (with progesterone deficiency);
premenstrual tension syndrome;
dysmenorrhea, irregular menstrual cycle;
secondary amenorrhea (in complex therapy with estrogens);
dysfunctional uterine bleeding;
to neutralize the proliferative effect of estrogens on the endometrium as part of replacement hormone therapy in women with disorders caused by natural or surgical menopause with an intact uterus.

Release forms

Tablets 10 mg.

Instructions for use and dosage regimen

The drug is taken orally.

For endometriosis, 10 mg is prescribed 2-3 times a day from the 5th to the 25th day of the cycle or continuously.

For infertility (caused by luteal insufficiency) - 10 mg per day from the 14th to the 25th day of the cycle. Treatment should be carried out continuously for at least 6 consecutive cycles. It is recommended to continue treatment in the first months of pregnancy as recommended for routine abortion.

In case of threatened miscarriage, 40 mg is prescribed once, then 10 mg every 8 hours until symptoms disappear.

In case of habitual miscarriage, the drug is prescribed 10 mg 2 times before the 20th week of pregnancy, followed by gradual decline doses.

For premenstrual tension syndrome - 10 mg 2 from the 11th to the 25th day of the cycle.

For dysmenorrhea - 10 mg 2 times a day from the 5th to the 25th day of the cycle.

For irregular menstrual cycles - 10 mg 2 times a day from the 11th to the 25th day of the menstrual cycle.

For amenorrhea, estrogens are prescribed once a day from the 1st to the 25th day of the cycle along with Duphaston - 10 mg 2 from the 11th to the 25th day of the cycle.

To stop dysfunctional uterine bleeding, Duphaston is prescribed 10 mg 2 times a day for 5-7 days.

To prevent dysfunctional uterine bleeding, Duphaston is prescribed 10 mg 2 times a day from the 11th to the 25th day of the cycle.

For hormone replacement therapy in combination with continuous estrogen therapy, Duphaston is prescribed 10 mg once a day for 14 days within a 28-day cycle. With a cyclic regimen of estrogen administration, Duphaston is prescribed at a dose of 10 mg 1 time per day during the last 12-14 days of estrogen intake.

If a biopsy or ultrasonography indicate inadequate reaction for a progestogen drug, daily dose should be increased to 20 mg.

Side effect

headache, migraine;
breakthrough uterine bleeding (which can be prevented by increasing the dose);
possible increased sensitivity of the mammary glands;
minor liver dysfunction, sometimes accompanied by weakness or malaise, jaundice or abdominal pain;
hemolytic anemia;
skin rash, itching;
urticaria, Quincke's edema;
peripheral edema.

Contraindications

hypersensitivity to the components of the drug.

The drug should be prescribed with caution if there is a history of itchy skin in a previous pregnancy.

Use during pregnancy and breastfeeding

It is possible to use Duphaston during pregnancy according to indications.

Dydrogesterone is released from breast milk. Breast-feeding It is not recommended while taking the drug.

special instructions

If dydrogesterone is prescribed in combination with estrogens (for example, for replacement therapy hormones), contraindications and warnings associated with the use of estrogens should be taken into account.

Before starting hormone replacement therapy (HRT), a complete medical history should be obtained. During treatment, it is recommended to periodically monitor individual tolerance HRT. The patient should be informed about what changes in the mammary glands she should report to the doctor. Studies including mammography should be performed in accordance with routine patient screening.

Sometimes, during the first months of treatment, breakthrough uterine bleeding may occur. If breakthrough bleeding occur after a certain period of taking the drug or continue after a course of treatment, the cause should be studied and an endometrial biopsy should be performed to exclude malignant changes in the endometrium.

Requires careful clinical examination if there is a history of a progesterone-dependent tumor (for example, meningioma), as well as if it progresses during pregnancy or during previous hormonal therapy.

Currently, there is no data on the negative effects of dydrogesterone in chronic renal failure.

Duphaston tablets should not be prescribed to patients with genetically determined galactose intolerance, lactase deficiency or malabsorption syndrome.

Impact on the ability to drive vehicles and operate machinery

The drug does not affect the ability to drive Vehicle and control of mechanisms.

Drug interactions

At simultaneous use with Duphaston, inducers of microsomal liver enzymes (such as phenobarbital, rifampicin) can accelerate the metabolism of dydrogesterone and reduce the effectiveness of the drug.

Cases of incompatibility with other drugs are unknown.

Analogues of the drug Duphaston

Structural analogues of the active substance:

Iprozhin;
Crinon;
Prajeesan;
Progesterone;
Progestogel;
Utrozhestan.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Infertility is dangerous diagnosis and a terrible sentence for every woman who sees her future in happy motherhood. When treating this disease, in some cases the question arises, what can replace Duphaston, but what is this connected with?

The essence of the problem

Before we talk about correction hormonal pattern treatment, we need to remind you that Duphaston has virtually no contraindications, and is approved for use by all women with the exception of patients with increased intolerance active ingredients. Such cases are extremely rare, but nevertheless, in obstetric practice they have been recorded more than once. In addition, it is worth noting that this particular drug does not always help in the treatment of infertility; for example, six-month therapy with low effectiveness requires immediate correction.

If the problem is ovulation or its complete absence, That female body needs additional progesterone, which is produced in insufficient quantities. That is why it is necessary to additionally take Duphaston or another analogue for the timely regulation of hormonal levels, the menstrual cycle and successful ovulation.

Worthy analogue

Many patients ask the standard question: is it possible to replace Duphaston with Utrozhestan? Most often, the answer is yes, since the characteristic medication has a similar composition, pharmacological effects to the site of pathology. But what is known about this medicine? Unlike Duphaston, progesterone in chemical formula not synthesized, but presented in in kind, which increases the chances of successful conception.

The use of a typical medication is appropriate not only in obstetrics, but also in modern gynecology, and among the indications are not only diagnosed infertility, but also others no less dangerous diseases. Among these are the following:

threat and prevention of miscarriage;
menopause and climatic syndrome;
mastopathy of the mammary glands;
premenstrual syndrome;
disrupted menstrual cycle;
endometriosis and its prevention;
prevention of uterine fibroids.

Contraindications and side effects

Utrozhestan has a gentle effect on the female body, and among the contraindications in the instructions are hypersensitivity and the lactation period. It is also not recommended to take the drug if you are prone to uterine bleeding, if there is suspicion of malignant neoplasms, as well as in case of impaired blood clotting. This is where the list of restrictions ends, but side effects occur quite often, and on numerous online sites, patients reflect in detail all their dissatisfaction with such a prescription.

Most often, anomalies prevail at the very beginning of use, when the body is just getting used to an additional source of progesterone, and is not always ready for such radical changes. Doctors identify the following anomalies that progress in particularly weakened organic resources:

frequent dizziness, less often - fainting;
increased drowsiness;
nervous excitement;
skin rash;
attacks of headache, migraine;
Quincke's edema;
hemolytic anemia;
hives and itching;
passivity and decline in performance;
absent-minded attention;
signs of dyspepsia;
depressed state.

If characteristic anomalies occur, there is no need to rush to discontinue the drug; perhaps a dose adjustment is sufficient to achieve positive dynamics of the disease. Otherwise, a replacement will be required, and the effect of the new analogue in the body is most unpredictable.

Directions for use and doses

the medical drug is available in the form of capsules intended for oral and vaginal use. One pill contains 100 mg of natural progesterone, but the method of use is determined by the treating gynecologist individually.

In order to prevent one or another diagnosis, the specialist recommends internal administration of the hormone, and it is very important to maintain the prescribed daily standards. If this is the treatment of diagnosed infertility, then doctors also stop at the oral use of Utrozhestan. But to maintain a pregnancy when there is a threat of miscarriage, it is preferable vaginal use capsules, but taking it internally as a complex will also not hurt.

Utrozhestan has a lot of advantages, and such advantages are difficult to deny. For example, in case of early toxicosis of a pregnant woman, it is better to insert capsules vaginally, and the therapeutic effect is identical. Besides, sedative effect has a positive effect on the excited nervous system, and progesterone also helps eliminate stagnation in the female body.

It is very important that the drug corresponds to the expiration date, and is prescribed by a doctor, and not by a friend following her example. The effectiveness is noticeable after 2 - 3 months of regular use, however, each patient has her own individual characteristics treatment.

Other analogues

If the drug Duphaston is suitable according to indications, but contraindications limit its systematic use, then in addition to the hormonal drug Utrozhestan, there are other sensational analogues that are also effective in the presented conditions. clinical pictures. But what kind of medications are we talking about?

Most often these are names such as Utrozhestan and Prajistan, which are considered a worthy alternative with sufficient quantity synthetic progesterone, necessary for the correction of the menstrual cycle, hormonal levels and ensuring successful conception. These drugs are patented in Russia and are widely used in gynecological and obstetric practice, show a stable therapeutic effect even in seemingly hopeless clinical situations.

If the medication Duphaston is not suitable, the patient should not engage in superficial self-medication, since the underlying disease will still not see positive dynamics. First of all, you need to contact a specialist, and then clinically will select the most effective replacement, a worthy analogue. There is no complete analogue of typical medications, and it is important not to forget about this when adjusting the treatment regimen.

It only remains to add that all the medications presented are hormonal based, that is, they have a direct effect on hormonal background. That is why you should not rule out such anomalies as unexpected weight gain or increased body hair. It is important to note this question in order to keep it in shape and presentable. appearance. However, such cases are very rare, so the patient may not worry about common fears in terms of taking “hormones”.

If use is strictly contraindicated hormonal drug Only your attending physician - a gynecologist - can tell you what can replace this prescription with Duphaston. If such a replacement is required during pregnancy to preserve its viability, then it should definitely be the drug Utrozhestan, available without an additional prescription. A typical drug can be taken orally and vaginally, which will significantly enhance the desired therapeutic effect.

IN Lately More and more problems associated with pregnancy have begun to arise; it is becoming more difficult for women not only to become pregnant, but also to carry a child to term. Perhaps this is due to big amount abortions, or maybe our environment is to blame. To solve these problems, a remedy such as Utrozhestan, an analogue of Duphaston, is often used. Both of these drugs are hormonal, and their use often causes concern among women. So why are these drugs needed?

hormonal drugs

The drug "Duphaston" is prescribed to those women whose pregnancy is at risk of termination. This medicine contains a component similar to the natural hormone progesterone, the deficiency of which can lead to miscarriage or infertility. An analogue of Duphaston, Utrozhestan, is also designed to compensate for the lack of progesterone, because if its amount in the body is normal, then pregnancy proceeds normally. Due to the “pregnancy hormone”, the placenta is formed, thanks to it, fetal rejection does not occur, pregnancy develops, the mammary glands undergo changes, and the woman’s body is actively preparing for bearing, giving birth and feeding a baby.

Description of the drug "Duphaston"

This remedy is hormonal and its action is very similar to that of natural hormone progesterone. “Duphaston” seems to replenish the missing amount of progesterone in a woman’s body. The drug is synthetic, due to which its absorption occurs in digestive tract. The medicine does not interfere with the functioning of the liver; during treatment, the woman’s blood sugar level does not change and is not disrupted. Clinical trials passed by the medicine have made it possible to achieve quite early stages use Duphaston. Reviews from doctors about it are positive, and this is not surprising, because during treatment it does not affect the development of the fetus. Reception this tool does not cause drowsiness. Russian analogue Duphaston cannot boast of this, since the domestic drug Utrozhestan has a sedative effect, which means it causes drowsiness, so it is not recommended to drive after taking it.

Analogue of "Duphaston"

"Utrozhestan" (medicine) is another one that has the same purpose as "Duphaston", although there are differences between these medications significant difference. "Duphaston" is a synthetic medicine, and its "brother" contains the natural hormone progesterone, which was obtained from plant materials. The drug "Utrozhestan" is available in tablets or capsules and creates a calming effect. An analogue of the drug "Duphaston" is good to use if the body contains increased amount as this medicine can significantly reduce them negative impact. Both of these drugs do not have negative influence on ovulation and do not have contraceptive properties. The presented drugs have one contraindication - intolerance to the components of the drug, but if the patient has one, then you need to be extremely careful. Do not forget that both drugs are medications that should be used only as prescribed by the attending physician.

The modern pharmacological market offers many various medications. Some of them are interchangeable, there are analogues and generics. If we are talking about a drug like Duphaston, then there are several analogues. It is only important to understand the basic principles of action of each drug and understand the difference.

Duphaston and its analogues

All analogues of Duphaston, like the original drug itself, contain synthetic progesterone, a hormone that is responsible for the course of pregnancy.

They are used for following states observed in women:

menstrual irregularities;
bleeding in the uterus;
acute PMS;
infertility, which occurs due to luteal insufficiency;
endometriosis;
menopause and menopausal syndrome;
mastopathy of the mammary glands.

It is also often prescribed to pregnant women who are found to be at risk of miscarriage. Progesterone contributes to the normal course of pregnancy.

It creates conditions for normal education ovum, reliable attachment to the wall of the uterus, its nutrition, and also prevents miscarriages during the first trimester, when hormonal levels are still unstable. With a lack of progesterone, the body cannot react correctly to the appearance of the fetus, perceives it as a foreign object and rejects it. It is for this reason that frequent miscarriages occur during the first three months of pregnancy.

Duphaston and its analogues are as close as possible in their structure to hormones that naturally are produced by the female body, as a result of which progesterone is absorbed most efficiently when internal reception drug. The most important advantage of such funds is their origin. Unlike most synthetic hormones, the substances contained in the drug are not derivatives of testosterone, which eliminates the occurrence of many side effects:

liver dysfunction;
blood clotting disorder;
manifestation female characteristics in a male fetus;
manifestation male characteristics in female fetuses;
change in glucose concentration;
negative impact on the internal secretion organs.

Duphaston has virtually no contraindications. The only reason why a drug can be excluded is individual intolerance some components, that is, allergies. In order to determine whether this remedy is suitable for treatment or not, it is necessary to undergo mandatory inspection and consult with experienced specialist. It has successfully proven itself in modern gynecology and is widely used for the treatment and prevention of many conditions.

Choosing the right product

Duphaston is an expensive drug that must be taken for long period time. Often, such expenses can become unaffordable for future parents. However, pharmacology offers many replacement options, since there are drugs on the market with similar composition or pharmacological action. So what can replace Duphaston and what criteria should you use when choosing?

The most important indicator when choosing an analogue, it is not the price (although it plays a big role), but therapeutic effect facilities. Indications for use and the list of conditions for which the medicine is used should be as identical as possible. The products do not have to be completely identical when it comes to composition. Some drugs may have the same active ingredients, be similar to it, or differ completely in composition, but have an almost identical effect on the body. Therefore, all analogues can be divided into two main groups:

identical;
drugs with similar effects.

It is very important to understand that before changing a drug, you need to consult with your doctor, who will not only help you choose the right drug, but will also be able to guarantee its maximum effectiveness in each individual case. This is due to the characteristics of the organism to which different drugs can provide different action.

Identical composition

The composition and, therefore, all therapeutic characteristics of the two drugs are completely identical: Duphaston and Dydrogesterone. They can replace Duphaston without any harm to the body. However, despite the identical active substance, they have some differences, which you need to know about before taking each of the described remedies.

1. Duphaston.

Duphaston is a generic drug known drug. As you know, the generic is completely identical medicine, which has a different name because the original was developed by another company that patented it. Duphaston was released differently pharmaceutical company, but its composition is completely identical to its predecessor. The only difference is the price, which can be either higher or lower, depending on the pharmacy chain, place of sale and country of manufacture.

2. Dydrogesterone.

Dydrogesterone, in turn, has a slightly different composition, but has an absolutely identical effect. Its only component is the substance of the same name, which is also the main component of Duphaston - synthetic progesterone. The additional ingredients indicated in the composition are necessary only to create the dosage form and do not in any way affect the action of the medicine. Since production requires minimum costs, then the cost of Dydrogesterone is an order of magnitude lower than that of other products in this series. The main difficulty in its use is its relative rarity on sale. It is produced in limited quantities and rarely appears in pharmacies. This issue is especially acute for regional pharmacies in remote cities, as well as cities with small populations.

Similar action

The second group of drugs includes drugs that have a different composition, but have the same therapeutic characteristics and testimony that Duphaston. They can be used to treat the same diseases for which the original drug is intended, but they are also slightly different. To fully replace one drug with another, you need to consult a specialist.

1. Utrozhestan.

The most popular and well-known analogue is a drug developed in Thailand, known as Utrozhestan. The main component is natural micronized progesterone. It was obtained with the participation of volunteers and also synthesized with the help of animals. Wide use it was obtained precisely because of the naturalness of the active substance, which practically does not cause allergic reactions, unlike artificially created hormone substitutes. Despite all the positive aspects, Utrozhestan has some negative side effects and has contraindications:

often provokes headaches and migraines;
may cause itching, hives, allergic reactions, up to Quincke's edema;
causes increased fatigue, drowsiness and decreased performance;
contraindicated for women who are engaged in active activities;
it is prohibited for women who drive vehicles;
prohibited for use by women who experience bleeding in the birth canal.

That is why the use of Utrozhestan should be agreed with a doctor and prescribed only after an examination and tests that exclude the possibility of manifestations negative consequences from consumption medicine. The most important test is to check for allergic reactions and intolerance to the components of the drug.

It is produced in two dosage forms: in the form of tablets, as well as suppositories, which are used intravaginally.

It is Utrozhestan that is considered the most a worthy replacement Duphaston.

It is most similar to natural hormones, which are produced in the female body, and promote pregnancy, and also fully prepare the endometrium, creating favorable conditions for egg implantation and successful pregnancy early stages. TO positive aspects This remedy can be attributed to the fact that it does not promote weight gain, does not retain fluid in the body, and does not affect blood pressure and metabolic processes.

2. Progesterone.

A drug Russian production Progesterone has the same effect on the female body as Duphaston. Moreover, its main active ingredient is gestagen, which is also known as a hormone corpus luteum. The main difference between the two tools is dosage form. Duphaston is available in tablet form, Progesterone is available only in injection form. Most often it is used for inpatient treatment in hospitals, because independent use can be quite problematic. Its form also allows you to accelerate the effect of the drug on the body, which makes it indispensable in treatment severe forms spontaneous abortion.

The main reason for replacing Duphaston with any of its analogues is cost original drug. Almost all analogs have a price several times lower, which makes them accessible to everyone. Most often, the price is determined by the country of origin, the company that launched the product on the market, and also official representative and a network of pharmacies that sell and set their own price for the medicine.