Substitutes for imported drugs on domestic list. Some Expensive Medicines and Alternatives

Turning to a doctor with his illness and receiving from him an impressive list medicines, the patient rarely questions it. And just knowing the cost necessary drugs, a person wonders if the medicines prescribed by the doctor are so effective, and do they have cheaper analogues? This question, no doubt, interests everyone, and therefore in this article we will answer a number of questions:

what cheap domestic analogues of expensive medicines can be found on the shelves of our pharmacies?
why are these drugs so cheap?
can they provide a therapeutic effect that is not inferior to the original means?

But first things first.

What are generics?

Analogues of expensive medications are called generics all over the world. In fact, these are reproduced "copies" of original drugs for which the patent has expired. Generics have the same active substance as the original drug and the same dosage. They differ only auxiliary components, which means there is no doubt that the therapeutic result of the original and the "copy" is practically the same.

Why are generics so cheap?

The low cost of generics is alarming for many people, because it is completely incomprehensible why a “copy” that is in no way inferior to the original drug costs several times cheaper? In fact big secret there is no. Unlike the original, generic manufacturers do not spend a penny on the development of the active substance, which means they do not include the costs of experiments and tests in the cost. In addition, unlike foreign originals, domestic drugs are not subject to import duties and taxes. All this, in the end, and allows you to form a much more reasonable price.

Other Benefits of Generics

Low price while maintaining a decent therapeutic effect is by no means the only advantage domestic analogues expensive drugs. A huge plus of these drugs is that they are not counterfeited (it is simply unprofitable!). In addition, the assessment of the quality and safety of domestic drugs is growing year by year, which means that the population Russian Federation trusts these funds much more than the same Vietnamese or Chinese medicines.

Disadvantages of generics

Given that generics are still “copies” of the original medicines, they do not fully correspond to the original and this should not be forgotten. We list their shortcomings:

1. Differ in a lower degree of purification, which means big list side effects. Indeed, the cheapness of generics is also explained by the low degree of purification of the drug, which increases the number of side effects. Original drugs in this regard benefit significantly.

2. In comparison with the originals, generics, as a rule, have a "cut down" composition. For example, the original drug can have an anti-inflammatory effect and reduce the temperature in parallel, while its more cheap analogue will only work in one direction.

3. Original products have a high cost, not only because of the high degree of purification and multicomponent composition. Unlike analogues, their action is much longer, and they need to be taken less often.

And yet, given the serious difference in cost and the same therapeutic effect (compare Omez and Omeprazole, Fervex and Paracetamol), modern visitors to polyclinics increasingly prefer domestic analogues of the original foreign drugs. Below is a complete list of these medicines and their substitutes.

List of cheap domestic analogues of expensive drugs

Antispasmodic and analgesic drugs, antipyretics

Cardiac and antihypertensive drugs

Antibacterial, anti-inflammatory and antiviral agents

Antidiarrheals

Antiallergic drugs

Inhalants, cough medicines

Calming agents and drugs that improve cerebral circulation

Gels, ointments and creams for external use

Other medications

Actrapid NM	Humulin NPH
Potassium and magnesium asparaginate	Asparkam
Vinblastine-Teva	Winblastin-Lance
Sermion	Nicergoline
Oftan dexamethasone	Dexamethasone
Timolol	Okumed
Hypothiazide	Hydrochlorodiazide
Vermox	Mebendazole
Iodomarin	Potassium iodide
Troxevasin	Troxerutin
Finlepsin	Carbamazepine
Mezim	Pancreatin
Movalis	Meloxicam

Dear subscribers, today we will talk about analogues of medicines and their prices - or, more precisely, about cheap Russian analogues of expensive imported medicines. As the famous Soviet satirist and humorist Raikin would say: “They are fooling our brother!” But this is true, and often doctors prescribe a more expensive drug, knowing that there is a cheaper option.

And all because they are interested in that. They will also tell the pharmacy where to buy. There is a collusion. I certainly don't want to slander anyone. In addition, sometimes the reception of analogues does not give sustainable result. After all, expensive and cheap medicine is like eating at a restaurant or eatery. The ingredients are the same, but the quality is different ...

Table of cheap analogues of expensive drugs with prices for 2017

However, if you do not want to overpay for packaging and for the name, then look at the tables in which you can find all the main equivalents of expensive drugs. There are also colds and other problems.

Prices in rubles change upward due to inflation, so the tables may contain slightly outdated amounts. But general idea you can get, and the name of the drug does not change from the price. So the information is up to date!

Analogues of drugs - Antipyretics, antispasmodics, pressure, for the brain

Analogues of drugs - Antibiotics, antiviral

The difference in price can be seen without much stress. What to buy is ultimately up to you. In the end, it may not be difficult for someone to give 1000 rubles for a box of medicine.

But we must also remember that the price in no way determines the authenticity of the product. And the temptation is great to fake exactly expensive pills. And no one will bother with cheap ones. There is no benefit.

Drug analogues - Clipping from Rossiyskaya Gazeta

List of expensive and cheap similar drugs

Interchangeable drugs

Affordable analogues of expensive drugs

Some Expensive Medicines and Alternatives

The cost of original drugs and generics

Interchangeable foreign and domestic drugs

It will be useful to learn how to recognize counterfeit medicines

The opinion of doctors is synonymous with expensive drugs, whether to believe the tables on the network

A complete list of expensive drugs and their cheap counterparts - from A to Z

If you didn’t find something in the tables, then you can still go over this list below. If the list does not contain the analogue you need, then ask questions in the comments. I will ask our pharmacist, she has 30 years of experience in pharmacy and she is aware of everything related to the interchangeability of drugs.

B

Dear Belosalik - cheap Akriderm SK

Dear Bepanten - cheap Dexpanthenol

Dear Betaserc - cheap Betahistine

Dear Bystrumgel - cheap Ketoprofen

AT

Dear Voltaren - cheap Diclofenac

G

Expensive Gastrozole - cheap Omeprazole

D

Expensive Detralex - cheap Venarus

Dear Diprosalik - cheap Akriderm SK

Expensive Diflucan - cheap Fluconazole

Dear Fornos - Cheap Rinostop

W

Expensive Zantac - Cheap Ranitidine

Dear Zyrtec - cheap Cetirinax

Expensive Zovirax - cheap Acyclovir

And

Dear Immunal - cheap Echinacea

Expensive Imodium - cheap Loperamide

Y

Expensive Iodomarin - cheap Potassium iodide

To

Dear Cavinton - cheap Vinpocetine

Expensive Claritin - cheap Lorahexal

Expensive Klacid - cheap Clarithromycin

L

Dear Lazolvan - cheap Ambroxol

Expensive Lamisil - cheap Terbinafine

Dear Lyoton-1000 - cheap Heparin-acry gel 1000

Dear Lomilan - cheap Lorahexal

M

Expensive Maxidex - cheap Dexamethasone

Dear Mezim - cheap Pancreatin

Dear Midriacil - cheap Tropicamide.

Dear Miramistin - cheap Chlorhexidine

Dear Movalis - cheap Meloxicam

H

Dear Neuromultivit - cheap Pentovit

Dear No-shpa - cheap Drotaverine

Expensive Normodipin - cheap Amlodipine

Expensive Nurofen - Cheap Ibuprofen

O

Dear Omez - cheap Omeprazole

P

Expensive Panadol - cheap Paracetamol

Dear Panangin - cheap Asparkam

Dear Pantogam - cheap Pantocalcin

R

Expensive Rinonorm - cheap Rinostop

FROM

Dear Sumamed - cheap Azithromycin

T

Dear Trental - cheap Pentoxifylline

Dear Trichopolum - cheap Metronidazole

Expensive Troxevasin - cheap Troxerutin

At

Dear Ultop - cheap Omeprazole

Dear Ursofalk - cheap Ursosan

F

Expensive Fastum-gel - cheap Ketoprofen

Expensive Finlepsin - cheap Carbamazepine

Expensive Flucostat - cheap Fluconazole

Dear Furamag - cheap Furagin

X

Expensive Hemomycin - cheap Azithromycin

E

Dear Enap - cheap Enalapril

Dear Ercefuril - cheap Furazolidone

An extended list of cheap analogues of expensive drugs with a description

Belosalik and analogue Akriderm SK

Active substance:
Indications:

Bepanthen and analogue Dexpanthenol

Active substance: dexpanthenol.
Indications: Prevention and treatment of dry skin in case of violation of the integrity of its integument: care for the mammary glands during the feeding period (treatment of "dryness" of the nipples and painful cracks); prevention and treatment of diaper rash in infants; minor injuries, burns, abrasions, bedsores, aseptic postoperative wounds; cervical erosion.

Betaserc and analogue Betahistine

Active substance: betahistine.
Indications: dropsy of the labyrinth of the inner ear, vestibular and labyrinth disorders: dizziness, noise and pain in the ears, headache, nausea, vomiting, hearing loss; vestibular neuronitis, labyrinthitis, benign positional vertigo(including after neurosurgical operations), Meniere's disease. As part of complex therapy - vertebrobasilar insufficiency, post-traumatic encephalopathy, cerebral atherosclerosis.

Bystrumgel and analogue Ketoprofen

Active substance: ketoprofen.
Indications:

Voltaren and analog Diclofenac

Active substance: diclofenac.
Indications: Inflammatory and inflammation-activated degenerative forms of rheumatism: - chronic polyarthritis; - ankylosing spondylitis (Bekhterev's disease); - arthrosis; - spondylarthrosis; - neuritis and neuralgia, such as cervical syndrome, lumbago (backache), sciatica; — acute attacks gout. Rheumatic lesions soft tissues. Painful swelling or inflammation after injury or surgery.

Gastrozole and analogue Omeprazole

Active substance: omeprazole.
Indications:

Heptral and analogue Heptor

Active substance: Ademetionine.
Indications: Chronic cholecystitis, cholangitis, intrahepatic cholestasis, toxic lesions liver, incl. alcoholic, viral and medicinal origin (antibiotics, antitumor, antituberculosis, antiviral drugs, tricyclic antidepressants, oral contraceptives), fatty degeneration liver, chronic hepatitis, liver cirrhosis, encephalopathy, incl. associated with liver failure (alcoholic, etc.). Depression (including secondary), withdrawal syndrome.

De-nol and an analogue of Gastro-norms

Active substance: Bismuth tripotassium dicitrate
Indications: peptic ulcer and duodenum in the acute phase, incl. associated with Helicobacter pylori; chronic gastritis and gastroduodenitis, incl. associated with Helicobacter pylori, in the acute phase; other gastrointestinal diseases associated with Helicobacter pylori; dyspepsia unrelated to organic diseases gastrointestinal tract; treatment and prevention of gastropathy caused by NSAIDs.

Detralex and analogue Venarus

Active substance: diosmin and hesperidin
Indications: venous insufficiency lower extremities(functional, organic): feeling of heaviness in the legs, pain, cramps, trophic disorders; acute hemorrhoidal attack.

Diprosalik and analogue Akriderm SK

Active substance: betamethasone and salicylic acid.
Indications: psoriasis, eczema (especially chronic), ichthyosis, limited pruritus with severe lichenification, atopic dermatitis, diffuse neurodermatitis; simple and allergic dermatitis; urticaria, erythema multiforme exudative; simple chronic lichen (limited neurodermatitis). Dermatosis not amenable to treatment with other corticosteroids (especially lichen verrucous), red lichen planus, skin dyshidrosis.

Diflucan and analogue Fluconazole

Active substance: fluconazole.
Indications: Systemic lesions caused by Cryptococcus fungi, including meningitis, sepsis, lung and skin infections, both in patients with a normal immune response and in patients with various forms immunosuppression. Generalized candidiasis: candidemia, disseminated candidiasis. Genital candidiasis: vaginal (acute and recurrent), balanitis. Prevention of fungal infections in patients with malignant tumors on the background of chemotherapy or radiation therapy. Mycoses of the skin: feet, body, inguinal region, onychomycosis, pityriasis versicolor, skin candidal infections. Deep endemic mycoses (coccidioidosis, sporotrichosis and histoplasmosis) in patients with normal immunity.

For nose and analog Rinostop

Active substance: xylometazoline.
Indications:

Zantac and analogue Ranitidine

Active substance: ranitidine.
Indications: Treatment and prevention - gastric and duodenal ulcer, NSAID gastropathy, heartburn (associated with hyperchlorhydria), hypersecretion gastric juice, symptomatic ulcers, stress ulcers of the gastrointestinal tract, erosive esophagitis, reflux esophagitis, Zollinger-Ellison syndrome, systemic mastocytosis, polyendocrine adenomatosis; dyspepsia, characterized by epigastric or retrosternal pain associated with eating or disturbing sleep, but not caused by the above conditions; treatment of bleeding from the upper gastrointestinal tract, prevention of relapses stomach bleeding in postoperative period; aspiration pneumonitis, rheumatoid arthritis.

Zyrtec and analogue Cetirinax

Active substance: cetirizine.
Indications: seasonal and year-round allergic rhinitis and conjunctivitis (itching, sneezing, rhinorrhea, lacrimation, conjunctival hyperemia), urticaria (including chronic idiopathic urticaria), hay fever, allergic dermatitis, pruritus, angioedema, atopic bronchial asthma(as part of complex therapy).

Zovirax and analogue Acyclovir

Active substance: acyclovir.
Indications: Cream and ointment for external use - herpes simplex of the skin and mucous membranes, genital herpes (primary and recurrent); localized herpes zoster ( ancillary treatment). Eye ointment - herpetic keratitis.

Immunal and analogue of Echinacea

Active substance: echinacea purpurea extract.
Indications: Immunodeficiency states (including against the background of mental and physical overwork), manifested by acute infectious diseases: “colds”, flu, infectious inflammatory diseases nasopharynx and oral cavity, recurrent infections of the respiratory and urinary tract). Secondary immunodeficiency states after antibiotic therapy, cytostatic, immunosuppressive and radiation therapy.

Imodium and analogue Loperamide

Active substance: loperamide.
Indications: diarrhea (acute and chronic various genesis: allergic, emotional, medicinal, radiation; when changing diet and quality composition food, in violation of metabolism and absorption). Stool regulation in patients with ileostomy. As an auxiliary drug - diarrhea of infectious genesis.

Iodomarin and analogue Potassium iodide

Active substance: potassium iodide.
Indications: endemic goiter. Prevention of diseases caused by iodine deficiency ( endemic goiter, diffuse euthyroid goiter, during pregnancy, condition after goiter resection).

Cavinton and analogue Vinpocetine

Active substance: vinpocetine.
Indications: sharp and chronic disorder cerebral circulation (transient ischemia, progressive stroke, completed stroke, post-stroke condition). Neurological and mental disorders in patients with cerebrovascular insufficiency (memory impairment; dizziness; aphasia, apraxia, movement disorders, headache).

Clacid and analogue Clarithromycin

Active substance: clarithromycin.
Indications: Antibiotic. Bacterial infections caused by susceptible microorganisms: infections of the upper respiratory tract (laryngitis, pharyngitis, tonsillitis, sinusitis), lower divisions respiratory tract (bronchitis, pneumonia, atypical pneumonia), skin and soft tissues (folliculitis, furunculosis, impetigo, wound infection), otitis media; peptic ulcer of the stomach and duodenum, mycobacteriosis, chlamydia.

Claritin and analogue Lorahexal

Active substance: loratadine.
Indications:

Xenical and analogue Orsoten

Active substance: orlistat.
Indications: Obesity (in case only dietary measures have led to a decrease in body weight of at least 2.5 kg in 4 weeks). The action of the drug is based on blocking the work of lipase enzymes, which break down fats to a level where the body can absorb them.

Lazolvan and analogue Ambroxol

Active substance: ambroxol.
Indications: Mucolytic agent, stimulates prenatal development of the lungs (increases the synthesis, secretion of surfactant and blocks its decay). It has a secretomotor, secretolytic and expectorant effect; stimulates the serous cells of the glands of the bronchial mucosa, increases the content of the mucous secretion and the release of a surfactant (surfactant) in the alveoli and bronchi; normalizes the disturbed ratio of serous and mucous components of sputum. By activating hydrolyzing enzymes and increasing the release of lysosomes from Clark cells, it reduces the viscosity of sputum. Raises motor activity ciliated epithelium, increases mucociliary transport.

Lamisil and analogue Terbinafine

Active substance: terbinafine.
Indications: Fungal diseases of the skin and nails (with onychomycosis do not use dosage forms for local application) caused by sensitive pathogens (trichophytosis, microsporia, epidermophytosis, rubrophytosis, candidiasis of the skin and mucous membranes); versicolor versicolor(only dosage forms for local use).

Lioton-1000 and analogue Heparin-acry gel 1000

Active substance: heparin sodium.
Indications: Prevention and treatment of thrombophlebitis of superficial veins, post-injection and post-infusion phlebitis, hemorrhoids (including postpartum), elephantiasis, superficial periphlebitis, lymphangitis, superficial mastitis, localized infiltrates and edema, injuries and bruises (including muscle tissue, tendons, joints), subcutaneous hematoma.

Lomilan and analogue Lorahexal

Active substance: loratadine.
Indications: Allergic rhinitis (seasonal and year-round), conjunctivitis, hay fever, urticaria (including chronic idiopathic), angioedema, pruritic dermatosis; pseudo-allergic reactions caused by the release of histamine; allergic reactions to insect bites.

Maxidex and analogue Dexamethasone

Active substance: dexamethasone.
Indications: Conjunctivitis (non-purulent and allergic), keratitis, keratoconjunctivitis (without damage to the epithelium), blepharitis, scleritis, episcleritis, retinitis, iritis, iridocyclitis and other uveitis of various origins, blepharoconjunctivitis, optic neuritis, retrobulbar neuritis, superficial corneal trauma of various etiologies (after complete corneal epithelization), prevention of inflammation after surgery, sympathetic ophthalmia. Allergic and inflammatory diseases (including microbial) of the ears: otitis.

Mezim and analogue Pancreatin

Active substance: pancreatin.
Indications: Replacement therapy for exocrine pancreatic insufficiency: chronic pancreatitis, pancreatectomy, condition after irradiation, dyspepsia, cystic fibrosis; flatulence, diarrhea of non-infectious genesis. Violation of the assimilation of food (condition after resection of the stomach and small intestine); to improve the digestion of food in persons with normal gastrointestinal function in case of nutritional errors (eating fatty foods, a large number food, irregular meals) and in violation of chewing function, sedentary manner life, prolonged immobilization.

My comment! With regards to this analogue, according to my observations, and according to the reviews of people who underwent therapy with mezim, the results are excellent. But pancreatin, alas, does not give such a clear improvement.

Midriacil and analogue Tropicamide

Active substance: tropicamide.
Indications: diagnostics in ophthalmology (examination of the fundus, determination of refraction by skiascopy), inflammatory processes and adhesions in the chambers of the eye. Drug addicts use it to enhance the effect of heroin and opiates.

Miramistin and analogue Chlorhexidine

Active substance: in the first case - miramistin, in the second - chlorhexidine.
Indications: Antiseptics, as a therapeutic and prophylactic agent for various infections, for antiseptic treatment and disinfection, as well as for the prevention of sexually transmitted infections.

Movalis and analogue Meloxicam

Active substance: meloxicam.
Indications: rheumatoid arthritis; osteoarthritis; ankylosing spondylitis (Bechterew's disease) and other inflammatory and degenerative diseases joints accompanied by pain.

Neuromultivit and analogue Pentovit

Active substance: thiamine chloride (B1), pyridoxine hydrochloride (B6), cyanocobalamin (B12).
Indications: Vitamins. Polyneuropathy; neuritis; neuralgia; trigeminal neuralgia; radicular syndrome caused by degenerative changes in the spine; sciatica; lumbago; plexitis; intercostal neuralgia; paresis of the facial nerve.

No-shpa and analogue Drotaverin

Active substance: drotaverin.
Indications: Prevention and treatment: spasm of smooth muscles internal organs (renal colic, biliary colic, intestinal colic, biliary tract and gallbladder dyskinesia of the hyperkinetic type, cholecystitis, postcholecystectomy syndrome); pyelitis; spastic constipation, spastic colitis, proctitis, tenesmus; pylorospasm, gastroduodenitis, gastric ulcer and duodenal ulcer. Endarteritis, spasm of peripheral, cerebral and coronary arteries. Algodysmenorrhea, threatening miscarriage, threatening premature birth; spasm of the pharynx of the uterus during childbirth, prolonged opening of the pharynx, postpartum contractions. When conducting some instrumental studies, cholecystography.

Normodipin and analogue Amlodipine

Active substance: amlodipine.
Indications: arterial hypertension, exertional angina, vasospastic angina, painless myocardial ischemia, decompensated CHF (as adjuvant therapy).

Nurofen and analogue Ibuprofen

Active substance: ibuprofen.
Indications: Pain syndrome: myalgia, arthralgia, ossalgia, arthritis, sciatica, migraine, headache (including menstrual syndrome) and toothache, at oncological diseases, neuralgia, tendinitis, tendovaginitis, bursitis, neuralgic amyotrophy (Parsonage-Turner disease), post-traumatic and postoperative pain syndrome, accompanied by inflammation.

Omez and analogue Omeprazole

Active substance: omeprazole.
Indications:- peptic ulcer of the stomach and duodenum (including resistant to treatment with other antiulcer drugs); - reflux esophagitis; - erosive and ulcerative lesions of the stomach and duodenum associated with the use of NSAIDs; - peptic ulcers caused by Helicobacter pylori (in combination with antibacterial drugs); - Zollinger-Ellison syndrome; - prevention of acid aspiration (Mendelsohn's syndrome).

Panangin and analogue Asparkam

Active substance: potassium and magnesium aspartate.
Indications: hypokalemia and hypomagnesemia (including those that occurred against the background of vomiting, diarrhea; therapy with saluretics, corticosteroids and laxative drugs), accompanied by arrhythmias (including paroxysmal supraventricular tachycardia, atrial and ventricular extrasystoles) against the background of digitalis intoxication, heart failure or heart attack myocardium.

Pantogam and analogue Pantocalcin

Active substance: hopantenic acid.
Indications: Cerebrovascular insufficiency caused by atherosclerotic changes in cerebral vessels, senile dementia ( initial forms), residual organic brain lesions in individuals middle age and the elderly, cerebral organic insufficiency in patients with schizophrenia, residual effects transferred neuroinfections, post-vaccination encephalitis, TBI (as part of complex therapy).

Panadol and analogue Paracetamol

Active substance: paracetamol.
Indications: Feverish syndrome on the background of infectious diseases; pain syndrome (mild and moderate): arthralgia, myalgia, neuralgia, migraine, toothache and headache, algomenorrhea.

Preductal MB and analogue Trimetazidine MB

Active substance: Trimetazidine. MB - tablets with modified release of trimetazidine.
Indications: Ischemic heart disease: prevention of angina attacks (in complex therapy); treatment of cochleovestibular disorders of ischemic nature (including dizziness, tinnitus, hearing impairment); Cochleovestibular disorders of ischemic nature (tinnitus, hearing impairment), chorioretinal vascular disorders with an ischemic component.

Rinonorm and analogue Rinostop

Active substance: xylometazoline.
Indications: Acute allergic rhinitis, acute respiratory infections with rhinitis, sinusitis, hay fever; otitis media (to reduce swelling of the mucous membrane of the nasopharynx). Preparation of the patient for diagnostic manipulations in the nasal passages.

Sumamed and analogue Azithromycin

Active substance: azithromycin.
Indications:

Taufon and analogue Taurine

Active substance: Taurine.
Indications: Dystrophic lesions retina eyes, incl. hereditary tapetoretinal abiotrophy; corneal dystrophy; senile, diabetic, traumatic and radiation cataracts; corneal injury (as a stimulator of reparative processes).

Trental and analogue Pentoxifylline

Active substance: pentoxifylline.
Indications: Violations peripheral circulation, Raynaud's disease, disorders of tissue trophism; disorders of cerebral circulation: ischemic and post-apoplexy conditions; cerebral atherosclerosis(dizziness, headache, memory impairment, sleep disturbance), dyscirculatory encephalopathy, viral neuroinfection; coronary artery disease, condition after myocardial infarction myocardium; acute disorders circulation in the retina and choroid eyes; otosclerosis, degenerative changes against the background of the pathology of the vessels of the inner ear with gradual decline hearing; COPD, bronchial asthma; impotence of vascular origin.

Trichopolum and analogue Metronidazole

Active substance: metronidazole.
Indications: Antibiotic. Protozoal infections: extraintestinal amoebiasis, including amoebic liver abscess, intestinal amoebiasis, trichomoniasis, giardiasis, balantidiasis, giardiasis, cutaneous leishmaniasis, trichomonas vaginitis, Trichomonas urethritis. Infections caused by Bacteroides: bone and joint infections, CNS infections, incl. meningitis, brain abscess, bacterial endocarditis, pneumonia, empyema and lung abscess, sepsis. Infections caused by Clostridium spp., Peptococcus and Peptostreptococcus species: infections of the abdominal cavity (peritonitis, liver abscess), infections of the pelvic organs (endometritis, abscess fallopian tubes and ovaries, vaginal vault infections). Pseudomembranous colitis (associated with the use of antibiotics). Gastritis or duodenal ulcer associated with Helicobacter pylori.

Triderm and analogue Akriderm GK

Active substance: Gentamicin + Betamethasone + Clotrimazole.
Indications: Simple and allergic dermatitis (especially complicated by secondary infection), atopic dermatitis (including diffuse neurodermatitis), limited neurodermatitis, eczema, dermatomycosis (dermatophytosis, candidiasis, versicolor versicolor), especially when localized in the inguinal region and large folds skin; simple chronic lichen (limited neurodermatitis).

Troxevasin and analogue Troxerutin

Active substance: troxerutin.
Indications: Varicose veins veins, chronic venous insufficiency with such manifestations as static heaviness in the legs, leg ulcers, trophic skin lesions, superficial thrombophlebitis, periphlebitis, phlebothrombosis, leg ulcers, dermatitis, hemorrhoids, post-thrombotic syndrome, diabetic microangiopathy, retinopathy, hemorrhagic diathesis.

Ultop and analogue Omeprazole

Ursofalk and analogue Ursosan

Active substance: Ursodeoxycholic acid.
Indications: uncomplicated cholelithiasis (dissolution of cholesterol gallstones in gallbladder, if it is impossible to remove them surgically or endoscopic methods), chronic opisthorchiasis, primary biliary cirrhosis, primary sclerosing cholangitis, chronic active hepatitis, chronic autoimmune hepatitis ( atypical forms), non-alcoholic steatohepatitis, acute and chronic viral hepatitis, toxic liver damage (alcoholic, drug), atresia of the intrahepatic biliary tract, cholestasis with parenteral nutrition, biliary reflux esophagitis, biliary reflux gastritis, biliary dyskinesia, alcoholic hepatosis, acute hepatitis, chronic active hepatitis with cholestatic syndrome, liver pathology on background of cystic fibrosis, congenital atresia of the bile duct, biliary dyspeptic syndrome(with cholecystopathy and biliary dyskinesia), neonatal cholestasis associated with complete parenteral nutrition. Prevention of liver damage when using hormonal contraceptives and cytostatics, prevention of the formation of gallstones in patients with obesity during rapid loss body weight.

Fastum-gel and analogue Ketoprofen

Active substance: ketoprofen.
Indications: Gel, cream: acute and chronic inflammatory diseases of the musculoskeletal system (rheumatoid arthritis, spondyloarthritis, arthrosis, osteochondrosis); injuries of the musculoskeletal system (including sports), sprains, ruptures of ligaments and tendons of muscles, tendinitis, bruising of muscles and ligaments, edema, phlebitis, lymphangitis, inflammation of the skin. Rinse solution: inflammatory diseases of the oral cavity and pharynx (tonsillitis, pharyngitis, stomatitis, glossitis, gingivitis, periodontitis, periodontal disease, etc.).

Finlepsin and analogue Carbamazepine

Active substance: carbamazepine.
Indications: Epilepsy (excluding absences, myoclonic or flaccid seizures) - partial seizures with complex and simple symptoms, primary and secondary generalized forms of seizures with tonic-clonic convulsions, mixed forms of seizures (monotherapy or in combination with other anticonvulsant drugs). Idiopathic trigeminal neuralgia, trigeminal neuralgia in multiple sclerosis (typical and atypical), idiopathic glossopharyngeal neuralgia. Phase-flowing affective disorders(including bipolar) prevention of exacerbations, weakening of clinical manifestations during exacerbation. Syndrome alcohol withdrawal(anxiety, convulsions, hyperexcitability, sleep disturbances). Diabetic neuropathy with pain syndrome. Diabetes insipidus of central origin.

Flucostat and analogue Fluknazol

Active substance: fluconazole.
Indications: Systemic infections caused by Cryptococcus fungi, including meningitis, sepsis, lung and skin infections. Generalized candidiasis: candidemia, disseminated candidiasis. Genital candidiasis: vaginal (acute and recurrent), balanitis. Prevention of fungal infections in patients with malignant tumors on the background of chemotherapy or radiation therapy. Mycoses of the skin: feet, body, inguinal region, onychomycosis, pityriasis versicolor, skin candidal infections. Deep endemic mycoses (coccidioidosis, sporotrichosis and histoplasmosis) in patients with normal immunity.

Furamag and analogue Furagin

Active substance: furazidin.
Indications: infectious and inflammatory diseases: festering wounds, cystitis, urethritis, pyelonephritis, purulent arthritis; infections of the female genital organs; conjunctivitis, keratitis; burns; prevention of infections during urological operations, cystoscopy, catheterization. For washing cavities: peritonitis, pleural empyema.

Hemomycin and analogue Azithromycin

Active substance: azithromycin.
Indications: Antibiotic. Infections of the upper respiratory tract and ENT organs caused by sensitive pathogens: pharyngitis, tonsillitis, laryngitis, sinusitis, otitis media; scarlet fever; infections of the lower respiratory tract: pneumonia, bronchitis; skin and soft tissue infections: erysipelas, impetigo, secondarily infected dermatoses; urinary tract infections: gonorrheal and non-gonorrheal urethritis, cervicitis, peptic ulcer of the stomach and duodenum associated with Helicobacter pylori.

Enap and analog Enalapril

Active substance: knewadj.
Indications: arterial hypertension (symptomatic, renovascular, including with scleroderma, etc.), CHF I-III stage; prevention of coronary ischemia in patients with LV dysfunction, asymptomatic LV dysfunction.

Ercefuril and analogue Furazolidone

Active substance: nifuroxazide in the first case and furazolidone in the second.
Indications: Diarrhea of infectious origin, dysentery, paratyphoid fever, giardiasis, food poisoning.

What are the tricks in pharmacies

I myself go to pharmacies exclusively to get acquainted with the assortment of herbs. So, I come specifically to write this note to the pharmacy. I'm talking to our pharmacist. For example, I say, what are the drops from the common cold?

She calls me a list of 100 rubles to the top. Well, according to an acquaintance, he gives out more information that, they say, there is, of course, cheaper, for 20 rubles. These are Xilen and Rinostop. Moreover, the active substance in them is the same. This is xylometazoline.

Why sell expensive and cheap do not sell clearly and without comment. So it is important to be able to understand this sea of \u200b\u200bmedicines if you already use them.

The domestic pharmaceutical market presents a wide variety of drugs, at the same time, most of them are very expensive. As an affordable alternative, many people prefer to choose Russian analogues of imported drugs, the list and compliance of which can be obtained from the attending physician or pharmacist at the pharmacy.

Painkillers and antispasmodics

Painkillers (analgesics) are used to relieve pain syndromes various origins. In general, analgesics are divided into 2 groups:

Non-narcotic drugs containing acetylsalicylic acid, analgin, paracetamol, mephinamic acid, piroxicam, ibuprofen, dimexide, etc.
Narcotic drugs that are prescribed in the most extreme and serious cases, such as morphine, promedol, fentanyl, etc.

Antispasmodics (antispasmodics, antispasmodics) are designed to relieve spasms of blood vessels, smooth muscles of internal organs, such as the gastrointestinal tract, urinary and biliary tract, and the female reproductive system.

Cardiac and hypotensive

Cardiac drugs combine several groups of drugs to improve ischemic and cerebral circulation, normalize heart rate, increase the content and transport of oxygen to the heart.

Antihypertensive (antihypertensive) drugs are designed to lower blood pressure. The desired effect can be achieved by different principles drug action:

decrease in the tone of the sympathetic nervous system;
suppression of renin production (a component of the blood pressure regulation system);
vasodilatation;
increased urination (diuretics).

Antibacterial and antiviral

Antibacterial drugs (antibiotics) - medicines that inhibit growth harmful microorganisms or causing their death.

Antiviral agents are drugs that are used to treat viral diseases of various origins. Often they are used to prevent viral diseases and to increase the body's immunity in complex therapy.

Anti-inflammatory and antipyretic

Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) have an anti-inflammatory effect, to which antipyretic and analgesic effects are also added.

Antidiarrheals

Diarrhea (indigestion) is common symptom various diseases Gastrointestinal tract, other internal organs, intoxication. Antidiarrheals reduce intestinal peristalsis, increase the tone of sphincters. This group also includes eubiotics (enzymes and bacteria that regulate the microflora of the gastrointestinal tract) and adsorbents (cleansing the gastrointestinal tract of toxins, allergens).

Name	Active substance	Russian analogue
Imodium	loperamide	Vero-Loperamide diara loperamide
Linex	Lactic acid and bifidobacteria	Bifidumbacterin Bifinorm Lactobacterin Laktonorm
Nifuroxazide	Nifuroxazide	Ecofuril
Smecta	Dioctahedral smectite	Diosmectite Neosmectin
Sorbex	Activated carbon	Activated carbon

Antiulcer

Action antiulcer drugs It is aimed at eliminating ulcerative manifestations on the mucous surface of the stomach and duodenum. They reduce the excess secretion of gastric secretion, reduce the activity of pepsin (the main enzyme of gastric juice), destroy Helicobacter pylori in the gastrointestinal tract, and normalize the motility of the upper sections. digestive tract.

Antiallergic

Allergy medications (antihistamines) work in the body to block histamine receptors, a neurotransmitter that affects Airways, skin, gastrointestinal tract, blood vessels, smooth muscles and causes manifestations of an allergic reaction.

Inhalants and cough medicines

Inhalation is a method of introducing drugs into the body by inhaling steam, gas or smoke. For its implementation, nebulizer devices (inhalers, nebulizers) are used, which are filled with gaseous, liquid or volatile substances.

Mucolytics are cough medicines that loosen mucus in the lungs and make it easier to clear and reduce inflammation in the airways.

soothing

Sedatives (sedatives, psycholeptics) are a group of drugs that cause calm or reduce emotional stress without a hypnotic effect, and at the same time facilitate the process of falling asleep, improve the quality of sleep.

Preparations for external use

The group of drugs for external (topical) use combines a huge number of drugs in the form of ointments, gels, creams, solutions, powders, etc. Depending on the composition, they have antibacterial, disinfectant, analgesic, anti-inflammatory, antihistamine and other effects.

Import substitution in pharma: domestic VS imported

At present the Russian pharmaceutical industry is developing in accordance with the plan of the state program of the Russian Federation "Development of the pharmaceutical and medical industry for 2013-2020", adopted in 2011 and finalized in 2014. According to the developers of the program, by 2020 Russian drugs will occupy 50% of the market of all medicines. And the drugs from the list of Vital and Essential Drugs (“Vital and essential drugs”) - 90% at all. And this is not due to the release of cheap low-quality generics, but thanks to modern technologies that make it possible to produce drugs that are not inferior in quality to foreign ones.

However, so far, no matter how Russia strives to completely get rid of the presence of imported drugs in its pharmacies, today even in the 2015 Vital and Essential Drug List, which includes 608 INN positions (international nonproprietary name), about a third of the list (32%, i.e. 195 drugs) are occupied by drugs manufactured outside of Russia.

Import substitution: who does it affect

In Russia, patients receive medicines in two ways:

free of charge in the process of hospitalization under a medical policy or within the framework of state programs for preferential drug provision;
buy them in pharmacies on their own.

In both options, there are fundamentally different mechanisms for the receipt of drugs in the institution, from where they then disperse to individual citizens.

In the first case medical institutions purchase medicines based on the predicted need of the population for them. They do not plan to profit from their distribution. But at the same time, the same hospitals are forced to save the budget as much as possible, since there are many nuances in covering the costs incurred by the hospital in the treatment of patients by insurers.

Since February 2015, state medical institutions are obliged to announce a tender for the supply of medicines under the new rules. If at least 2 domestic registered generics participate in the tender, imported drugs cannot participate in the auction. As a result, the same hospital, which knows perfectly well which drugs are best for its patients, is forced to buy Russian drugs, having little choice.

Pharmacies buy their goods themselves - and medicines are exclusively goods for them! - at wholesale intermediaries. The goal of pharmacies is to make money, while not violating the requirements of the state for prices and assortment. Therefore, pharmacies buy what will be sold and what they can find on the market. Therefore, direct import substitution for retail sales medication has no effect.

That is, any citizen can still come to the pharmacy and buy there the drug that suits him: cheap or expensive, domestic or imported, dubious generic or original drug with proven effectiveness. Unless of course the desired medicine is on sale. And here import substitution indirectly determines the availability of medicines in pharmacies, as well as their quality.

Cheap analogues of expensive drugs

So, the goal of import substitution is to force imported medicines out of the Russian market. How will this affect patients? To do this, let's ask ourselves the question: what does an ordinary modern pill consist of? This is an active substance in a strictly defined dosage, mixed with an inert carrier substance and packaged in a shell that has certain specified properties - for example, it is designed to transport the active substance through the aggressive acidic environment of the stomach into the intestines. Without such a shell, the drug simply will not work, because it will be neutralized on the outskirts of the target.

We can talk about the following key points that determine the quality of the drug:

raw materials;
technology;
research.

Raw material. In the production of a generic, even with strict adherence to the dosage of the active substance, you can save on the quality of the carrier and shell. But this can significantly affect the speed, degree of absorption and excretion of the active substance, that is, its pharmacokinetics. In addition, impurities in a poorly purified vehicle may cause unintended side effects or increase those of the drug itself. In Russia, the main problem with generics is that they are legally required to be chemically identical to the original, but not pharmacokinetically.

So, the first problem is raw materials for the production of medicines. Now it costs more to produce Russia's own substances than to bring them from its neighbors. Raw materials are initially purchased not of the best quality, and given that the problem of drug purification is quite acute at domestic enterprises, the quality of purchased substances does not improve much during production.

By the way, recently 16 large pharmaceutical companies in Russia stopped producing a number of cheap and popular drugs. The reason is the increase in the cost of substances in dollars against the background of the lack of their production in Russia.

“There is one very unpleasant question: what kind of drugs can be considered Russian? Unfortunately, the vast majority of the so-called "Russian preparations" are Indian substances "compressed" on a Chinese machine. That is, many “Russian” medicines are in fact simply not Russian.”

Technology. Given the current state of the Russian economy pharmaceutical companies difficult to modernize existing facilities. In most cases, we are talking about outdated and often worn-out equipment in which no one has invested for a long time. Wherein Russian production there is practically no such equipment, that is, again, we are talking about its purchases abroad. In times of crisis and fluctuations in the dollar and euro, modernization is not beneficial for pharmaceutical companies.

We also add that the transition of Russian enterprises to GMP (Good Manufacturing Practice) standards should have been completed on January 1, 2014, but so far this has not happened. To date, according to experts, only half of the 450 pharmaceutical industries involved in the production of medicines comply with GMP standards.

Expert commentary: Yaroslav Shulga, head of the consulting company "Shulga Consulting Group"

“Let's be frank - if we talk about the GMP standard on a national scale, and not a single demonstrative enterprise, then so far we have only begun to move in a positive direction. Unfortunately, it is not yet possible to state full compliance with the specified standard. ”

“The quality of a drug depends on many factors. On the one hand, these are the features of its production: the type of raw material, the degree of purification, ballast substances. The higher the quality of the drug, the more effective it is, but at the same time, its cost also increases. Due to the peculiarities of production, domestic drugs often lose quality to foreign ones, but at the same time, the price Russian medicines substantially lower."

“Firstly, the production of original drugs is carried out only at factories that have a confirmation of compliance with the principles of good manufacturing practice (GMP). The GMP certificate means that the medicine is produced in strict accordance with the required chemical composition, production conditions do not allow the ingress of third-party substances, and the products are packaged in such a way that guarantees the preservation of all properties throughout the shelf life. The World Health Organization emphasizes that generics should also be produced only in GMP-accredited factories, but in practice this requirement is far from always observed.

Secondly, the quality, efficacy and safety of generics will always be lower. This is due to the fact that the drug development company indicates in the patent only a general production scheme, and carefully guards the “secrets”. Additional substances, additives, shell components - all this the company producing the generic chooses at its own discretion.

Research. Does Russia have its own medicines - proven and produced using its own technologies? There is. But not enough. Because besides raw materials and modern technologies, there is another important factor: conducting clinical trials.

In order for a drug to enter the market, it must undergo a series of clinical trials that would prove its effectiveness and safety. Such tests are being carried out, but we do not yet have a well-established system, as in developed countries. In the pre-crisis period, domestic pharmaceuticals spent no more than 1-2% of their revenue on research and development. In the current conditions, even this figure is a luxury. Moreover, as soon as the manufacturer is forced to increase research costs, the price of his drugs will immediately increase.

Expert commentary: Yaroslav Shulga, head of the consulting company "Shulga Consulting Group"

“If we are talking about Russian generic drugs, we must admit that not all of them are fully equivalent to the original products. There are a lot of “weak links” with the definition of equivalence.

Obviously, under such conditions, it is not entirely correct to discuss that a Russian generic drug is better, for example, than an original Western European drug. It is even more difficult to compare Russian and foreign preparations created on the basis of different active substances, but used for the treatment of one nosological form.

Expert commentary: Olga Zhogoleva, allergist-immunologist at SM-Clinic (St. Petersburg), candidate of medical sciences, member of the European Academy of Allergy and Clinical Immunology (EAACI) .

“An important factor determining the quality of a drug is its pharmacodynamics - the effect of the drug, its effect on the human body. There is a world standard for modern evidence-based medicine- double-blind, randomized, placebo-controlled trials. This is the only type of drug study that guarantees its effectiveness. In connection with high cost of this type of research, they are, as a rule, more often carried out by foreign manufacturers, in contrast to domestic ones.

Another important factor is the formula of the drug, namely, whether it is the original drug or its copy, called a generic. The original drug, as a rule, is a drug made from high-quality raw materials of a high degree of purification, for which evidence-based studies have been carried out. A generic is a copy that only matches the original chemical structure active substance. Raw materials, ballast substances often have more low quality, evidence-based research and comparative studies efficacy and pharmacodynamics with the original drug is a rarity. Unfortunately, most Russian drugs are generics.”

Kondratova Natalya Vladimirovna, chief physician of the hospital of JSC "Medicine", candidate of medical sciences, associate professor

Kovernichenko Natalya Nikolaevna, director of the purchasing service of the clinic of JSC "Medicina"

“When prescribing a drug, the doctor is guided by the data that were obtained in clinical trials of original drugs. But for most generics, there are no preclinical and clinical studies. Questions about the safety of generics remain open. If studies are carried out for some drugs, then they are short in time and do not meet strict international standards.

Finally, for a number of drugs, comparative studies show that the effect of one tablet of the original drug can be 2-4 times higher than the effect of the generic drug, and dose fluctuations can lead to serious adverse reactions. This means that in order to obtain the desired effect, the patient must take either 1 tablet of the original drug, or 4 tablets of the generic. And the manual says they are the same!

Formally, in order to register any generic drug, the manufacturer must confirm its equivalence to the original drug, but this evidence differs significantly from the real one. clinical situation faced by the doctor. For example, these data are obtained on healthy volunteers, and not on patients with the disease for which the drug is intended to treat.

In Russia, a huge number of generics are registered, which leads to the emergence of tens and hundreds of drugs with the same active ingredients. For example, the original anti-inflammatory drug Voltaren has more than 200 generics.

The patient is faced with a difficult choice and often does not know what is best to take. In the end, take what is cheaper. But, of course, loses in quality.

Imported drugs: advantages and disadvantages

As a result, we can talk about the following advantages of imported drugs compared to domestic ones:

A higher degree of purification, which means side effects are less pronounced and less likely to occur.
More pronounced therapeutic effect at the same doses compared to cheap analogues of expensive drugs. Moreover, sometimes because of this, the patient needs a lower dose. imported drug which also reduces the risk of side effects.

The main disadvantage of imported medicines is their price. And also the fact that as part of the implementation of the import substitution program, they become less accessible even to those people who are willing to pay an increased price for reducing the risk of side effects and a stronger effect.

Internet disservice

The most popular and almost bottomless storehouse of information is, of course, the Internet. We fearlessly plunge into the World Wide Web, naively believing that the mind will help distinguish lies from truth. But, alas and ah, this is not always the case.

Millions of Russian citizens, in an effort to save money, are studying lists of domestic analogues of expensive imported drugs that have flooded the Web. Tomorrow they will go to the pharmacy and with unconcealed pleasure they will buy a penny domestic “substitute” instead of the original drug. And then the story can have a different continuation, and it depends on the anonymous person with an unknown education who posted the information, and on His Majesty Chance.

Behind this careless trust lies an invisible tragedy. When I, a pharmacist with many years of experience, open such a “list of substitutes”, I can hardly contain my emotions. Unnamed authors strongly advise replacing the Mercedes with a VAZ, arguing that domestic cars also have four wheels. And sometimes they offer a scooter under the sauce of a car!

My pharmaceutical consciousness boils, having noticed in the list of "analogues" several pairs of absolutely different drugs. For example, miramistin is not chlorhexidine, and ersefuril has only one relation to furazolidone: both drugs belong to the group of nitrofurans. And this is just a drop in the ocean. Moreover, even quite correct at first glance, replacements can be far from harmless.

Original drug and analogue

The original drug is a drug that was first synthesized by the manufacturer. When buying an original, or, as pharmacists often say, a brand drug, we pay for many years of drug substance development, for, for registration, and so on. The manufacturer includes all these huge costs in the price, so original drugs are a priori much more expensive than generics (from the English generic), or analogues.

Manufacturers of analogues only synthesize a substance according to a well-known algorithm, prepare from it dosage form and pack. Their costs are minimal, and this most favorably affects the price of the final product. Ideally, analogues should correspond to the brand drug in all respects, including effectiveness. But in fact?

The drug substance is the basis of the drug, its "core". The effectiveness of the future drug depends on how well it is synthesized, how well all technological requirements are met. In addition, the composition of the drug includes a lot excipients, which also affect bioavailability, absorbability and other indicators, and hence the final result.

In order to "comb" all manufacturers under one quality comb, in 1968, with the participation of WHO, uniform standards for the production of medicines and dietary supplements GMP (Good manufacturing practice - Good Manufacturing Practice) were adopted. The GMP system regulates all aspects of the production of medicines: from raw materials, the condition of premises and equipment, to personal hygiene and staff training. By the way, not everyone switched to GMP rails. Russian enterprises, and this gives one more reason for reflection.

But even if all the requirements and standards are met, the generic may differ from the original. In 2000, American scientists published data from an independent study. After comparing the properties of the original clacid drug and forty of its generics produced in 13 countries around the world, scientists came to a disappointing conclusion. No analogue has been recognized as equivalent to the original! And this despite the fact that all drugs were produced in accordance with GMP requirements.

We save correctly

And yet experience shows what to cook good ear from cheap fish you can, if you follow all the rules of cooking. First you need to decisively click the mouse to remove sites with ill-fated lists from your bookmarks. Well, fluconazole of unknown production cannot work in the same way as the famous Diflucan, purified, standardized and verified to thousandths of a milligram!

Do not expect the same effect that the unique Creon enzyme gives from domestic pancreatin. Yes, they have the same active ingredients - the Internet did not deceive in this. But to make an enzyme that does not break down in the stomach and intestines, but is absorbed and, most importantly, begins to act like one's own, is a whole art. And while it is not available to domestic enterprises.

Of course, an engineer or a teacher cannot and should not know pharmaceutical subtleties. Moreover, even a pharmacist has no right to interfere with prescriptions and change one drug for another. But the doctor who leads hundreds of patients sees perfectly how the original and the generic work, and knows exactly the difference between voltaren and diclofenac. Therefore, the decision to replace should be made only by the doctor.

Let go of false embarrassment and let your doctor know if you can't afford an expensive brand name drug. The choice on the modern drug market allows you to replace the original drug with a high-quality and more economical analogue that is not inferior to the progenitor in efficiency. And sites that offer to change the awl for soap, be sure to close it so that you never open it again.

Marina Pozdeeva

Photo by Alina Trout