Duphaston analogues are cheap. What are duphaston analogues? Choosing the Right Tool

Name:

Duphaston (Duphaston)

Pharmacological
action:

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

After oral intake rapidly 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 the urine (56-79%). 72 hours after a single dose, it is completely eliminated from the body. It does not accumulate, there is no increase in the concentration of dydrogesterone in patients with renal insufficiency.

Indications for
application:

Confirmed deficiency of endogenous progesterone(endometriosis, luteal insufficiency, recurrent fetal loss or threatened abortion, premenstrual syndrome, violations menstrual cycle, secondary amenorrhea, dysmenorrhea).
Hormone Replacement Therapy (surgical castration, including with a preserved uterus; menopausal syndrome - is used if 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 consider Clinical signs diseases and phases of the natural menstrual cycle. Daily dosage divided into several doses, preferably at regular intervals.

At endometriosis apply 10 mg of dydrogesterone 2-3 r / s (without interruptions or from the 5th to the 25th day of the menstrual cycle).

At infertility progesterone genesis 20 mg / day (in 2 doses) from the 11th to the 25th day of the 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 allows you to adjust cytological examination vaginal epithelium (colpocytology).

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

With threatened abortion apply 40 mg of dydrogesterone as a starting dose 1 time, then - 10 mg every 8 hours for 1 week. After that, the dosage is gradually reduced. However, with the resumption of signs of threatened abortion, it is possible to increase the dose again. Can be used up to 12-20 weeks of pregnancy.

With the usual miscarriage therapy is started when planning pregnancy: 10 mg 2 r / s from the 11th to the 25th day of the menstrual cycle. If conception has occurred, therapy is carried out at the same dose constantly, 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.

With premenstrual syndrome(PMS) - 10 mg from the 11th to the 25th day of the menstrual cycle. The duration of therapy is 3-6 months.

With 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 a short luteal phase, 20 mg / day is used, in 2 divided doses from the 11th to the 25th day of the cycle.

In the treatment of amenorrhea used in combination with estrogen. Apply 10 mg of dydrogesterone 2 times a day from the 11th to the 25th day of the menstrual cycle while taking 0.05 ethinylestradiol from the 1st to the 25th day of the cycle. The duration of treatment is 3 or more menstrual cycles.

For dysfunctional bleeding used at 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 prevention, 10 mg of dydrogesterone 2 r / s is used from the 11th to the 25th day of the menstrual cycle, combined with 0.05 ethinylestradiol 1 r / s.

As HRT used only in combination with estrogen.
With continuous therapy, 10 mg is used for 14 days each menstrual cycle. With cyclic use - only in the last 12-14 days of estrogens, 10 mg 1 r / s. If necessary (insufficient secretory transformation 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 hypersensitivity to the drug.

Contraindications:

Undiagnosed vaginal bleeding;
- existing severe liver disease or the presence of serious illnesses liver in the past, if liver function indicators 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 using the drug Duphaston. Reviews of site visitors - consumers are presented this medicine, as well as the opinions of medical specialists on the use of Duphaston in their practice. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications were observed and side effects, possibly not declared by the manufacturer in the annotation. Duphaston analogues, if available structural analogues. Use for the treatment of endometriosis, infertility in women, as well as during pregnancy, its planning and breastfeeding.

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

Dydrogesterone does not have estrogenic, androgenic, anabolic, glucocorticoid and thermogenic activity. Does not render 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 estrogens. It is indicated in all cases of endogenous progesterone deficiency.

The drug has no contraceptive action.

When treated with dydrogesterone therapeutic effect achieved without suppression of ovulation or disruption menstrual function. Dydrogesterone does possible conception and maintenance of pregnancy during treatment.

Pharmacokinetics

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

Indications

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

Release form

Tablets of 10 mg.

Instructions for use and dosing regimen

The drug is taken orally.

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

With infertility (due to 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. Treatment is recommended to continue in the first months of pregnancy as recommended for habitual abortion.

With a threatened miscarriage, 40 mg is prescribed once, then 10 mg every 8 hours until the symptoms disappear.

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

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

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

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

With amenorrhea, estrogens are prescribed 1 time per day from the 1st to the 25th day of the cycle, together with Duphaston - 10 mg 2 times from the 11th to the 25th day of the cycle.

To stop dysfunctional uterine bleeding, Dufaston 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.

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

If a biopsy or ultrasonography testify to inadequate response 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);
increased sensitivity of the mammary glands is possible;
minor liver dysfunction, sometimes accompanied by weakness or malaise, jaundice or pain in the abdomen;
hemolytic anemia;
skin rash, itching;
urticaria, angioedema;
peripheral edema.

Contraindications

hypersensitivity to the components of the drug.

With caution, the drug should be prescribed with instructions in the anamnesis for pruritus during a previous pregnancy.

Use during pregnancy and lactation

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

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

special instructions

In the case of the appointment of dydrogesterone in combination with estrogens (for example, for replacement therapy hormones) should take into account the contraindications and warnings associated with the use of estrogens.

Before starting hormone replacement therapy (HRT), a complete history should be taken. During treatment, it is recommended to periodically monitor individual tolerance HRT. The patient should be informed about any changes in the mammary glands she should report to the doctor. Investigations involving mammography should be performed in accordance with conventional 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, you should study the cause, make an endometrial biopsy in order to exclude malignant changes in the endometrium.

Careful clinical examination when indicating a history of a progesterone-dependent tumor (for example, meningioma), as well as in case of its progression during pregnancy or during previous hormone therapy.

Currently, there are no data on the negative effect of dydrogesterone in chronic renal failure.

Do not prescribe Duphaston tablets to patients with genetically determined galactose intolerance, lactase deficiency or malabsorption syndrome.

Influence on the ability to drive vehicles and control mechanisms

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

drug interaction

At simultaneous application 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 for the active substance:

Iprozhin;
Crinon;
Prajisan;
Progesterone;
Progestogel;
Utrozhestan.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases that the corresponding drug helps with and see 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. In the treatment of this disease, in some cases, the question arises of what can replace Duphaston, but what is the reason for this?

The essence of the problem

Before talking about correction hormonal regimen treatment, it is necessary to recall that Duphaston has practically 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 practice, obstetrics 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 efficiency requires immediate correction.

If the problem is ovulation or her total absence, That female body needs additional progesterone, which is produced in not enough. That is why it is required to additionally take Duphaston or another analogue for the timely regulation of the hormonal background, 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 drug has a similar composition, pharmacological effects to the site of pathology. But what is known about this medical preparation? Unlike Duphaston, progesterone in chemical formula not synthesized, but presented in in kind which increases the chances of successful conception.

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

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

Contraindications and side effects

Utrozhestan gently acts in the female body, and among the contraindications, the instructions indicate hypersensitivity and lactation. It is also not recommended to take the drug with a tendency to uterine bleeding, if suspected malignant neoplasms, as well as in the case of impaired blood clotting. This is where the list of restrictions ends, but side effects are quite common, and on numerous sites on the network, patients reflect in detail all their dissatisfaction with such an appointment.

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

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

If there are characteristic anomalies, you should not rush to stop the drug, perhaps a dose adjustment is enough to achieve positive dynamics of the disease. Otherwise, a replacement will be required, and the effect of a new analogue in the body is the most unpredictable.

Dosage and administration

the medical preparation available in the form of capsules intended for oral and vaginal application. One pill contains 100 mg of natural progesterone, but the method of application is discussed individually by the attending gynecologist.

In order to prevent this or that diagnosis, the specialist recommends internal intake of the hormone, and it is very important to maintain the prescribed daily standards. If this is a treatment for diagnosed infertility, then doctors also stop at oral administration of Utrozhestan. But to maintain pregnancy with a threat of miscarriage, it is preferable vaginal use capsules, but internal intake in the complex also does not hurt.

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

It is very important that the drug corresponds to the expiration date, and was prescribed by a doctor, and not by a girlfriend 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, according to the indications, Duphaston is suitable, 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 clinical pictures. But what kind of drugs are we talking about?

Most often these are such names as Utrozhestan and Prajistan, which are considered a worthy alternative to enough synthetic progesterone, necessary for the correction of the menstrual cycle, hormonal levels and providing successful conception. These preparations 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 medical drug Duphaston is not suitable, the patient should not engage in superficial self-medication, since the positive dynamics of the underlying disease will still not wait. First of all, you need to contact a specialist, and that clinically will select the most effective replacement, a worthy analogue. There is no complete analogue of the characteristic medicines, and it is important not to forget about this when correcting the treatment regimen.

It remains only to add that all the presented medicines have a hormonal basis, that is, they have a direct effect on hormonal background. That is why one should not exclude such anomalies as unexpected weight gain, increased vegetation on the body. It is important to note this question in order to keep the form, presentable appearance. However, such cases are very rare, so the patient may not worry about common fears in terms of taking "hormones".

If absolutely contraindicated for use hormonal drug Duphaston, what can replace such an appointment will only be prompted by the attending physician - a gynecologist. If such a replacement is required when carrying a fetus to preserve its viability, then this should definitely be the Utrozhestan medication, which is dispensed without an additional prescription. The characteristic preparation can be taken orally and vaginally, which will markedly enhance the desired therapeutic effect.

IN Lately more and more problems associated with pregnancy began to arise, it becomes more difficult for women not only to become pregnant, but also to bear a child. Perhaps this is related to big amount abortions, or maybe our ecology is to blame. To solve these problems, such a tool as Utrozhestan, an analogue of Duphaston, is often used. Both of these drugs are hormonal, and often their appointment causes concern in women. So why are these drugs needed?

hormonal drugs

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

Description of the drug "Dufaston"

This remedy is hormonal and in its action is very similar to the action natural hormone progesterone. "Dufaston" seems to make up for the missing amount of progesterone in a woman's body. The drug is synthetic, due to which its absorption occurs in digestive tract. The drug does not disrupt the functioning of the liver, the treatment does not change the level of sugar in the blood of a woman and is not violated. early dates use Duphaston. The doctors' comments about him are positive, and this is not surprising, because during treatment he 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" (drug) - another one that has the same purpose as "Dufaston", although there are between these medicines 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 "Dufaston" is good to use if the body contains increased amount since this medicine can significantly reduce them negative impact. Both of these drugs do not negative impact ovulation and do not have contraceptive properties. There is only one contraindication for the presented drugs - intolerance to the components of the drug, but if the patient has it, then you need to be extremely careful. Do not forget that both drugs are medicines that should be used only as prescribed by the attending physician.

On the modern pharmacological market there are many various medicines. Some of them are interchangeable, there are analogues and generics. When it comes to such a drug as Duphaston, then there are several analogues here. 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 when following states observed in women:

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

It is also often prescribed to pregnant women who have threatened abortion. Progesterone contributes to the normal course of pregnancy.

It creates conditions for normal education gestational sac, secure attachment to the wall of the uterus, its nutrition, and also prevents miscarriages during the first trimester, when the hormonal background is still unstable. With a lack of progesterone, the body cannot properly respond 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 most effectively absorbed when internal reception drug. The most important advantage of such funds is their origin. Unlike most synthetic hormones, the substances contained in the preparation are not derived from testosterone, which eliminates the occurrence of many side effects:

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

Duphaston has practically no contraindications. The only reason 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 pass mandatory inspection and consult with an experienced specialist. It has successfully established itself in modern gynecology and is widely used for the treatment and prevention of many conditions.

Choosing the Right Tool

Duphaston is an expensive drug that must be taken for long period time. Often, such expenses can become unbearable 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 be followed when choosing?

by 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, a list of conditions in which the medicine is used should match as much as possible. The funds do not have to be completely identical when it comes to composition. Some drugs may have the same active substance, similar to it, or completely differ in composition, but have an almost identical effect on the body. Therefore, all analogues can be divided into two main groups:

identical;
drugs with a similar effect.

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

Identical composition

Completely coincide in composition, therefore, in all therapeutic characteristics of 2 drugs: Dufaston 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 means.

1. Dufaston.

Dufaston is a generic known drug. As you know, the generic is completely identical drug, which has a different name since the original was developed by another company that patented it. Dufaston was released another 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 network of pharmacies, the place of sale and the country of origin.

2. Dydrogesterone.

Dydrogesterone, in turn, is slightly different in 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. Additional ingredients indicated in the composition are only necessary to create a dosage form and do not affect the effect of the drug in any way. Since production requires minimum costs, then the cost of Dydrogesterone is an order of magnitude lower than that of other funds from this series. The main difficulty of its use is the 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 a small population.

Similar action

The second group of drugs includes drugs that have a different composition, but have the same therapeutic characteristics and evidence 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. Morning.

The most popular and well-known analogue is considered to be 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 he received it 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 contraindications:

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

That is why the use of Utrozhestan should be agreed with the doctor and prescribed only after an examination and tests that exclude the possibility of manifestation negative consequences from drinking medicinal product. The most important test is a test 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 worthy replacement Duphaston.

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

2. Progesterone.

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

The main reason for replacing Duphaston with any of its analogues is the cost. original drug. Almost all analogues have a price several times lower, which makes them affordable for everyone. Most often, the price is determined by the country of manufacture, 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 medicines.