High-quality medicine from Russian manufacturers. Furamag and analogue Furagin

We present you the top ten Russian pharmaceutical manufacturers of substandard medicines with the largest volume of products rejected by Roszdravnadzor.

Claims were brought against medicines manufactured by the Tula pharmaceutical company on the following points: the weight of the contents of the package, description and pH. Roszdravnadzor rejected 5 batches of 3 trade names.

9. ZAO Vifitech

The company, founded in 1992, produces both finished dosage forms and substances of plant origin (Mukaltin, Aloe Dry Extract, and others). Violations identified during the inspection of its products related to the weight of the contents in the package, loss on drying and quantitation. Defective are 6 series of 2 trade names.

8. OJSC "Biosintez"

This Russian enterprise is one of the largest drug manufacturing companies. Complaints about the drugs released by Biosynthesis concerned the uniformity of dosing, dissolution and quantification. According to the results of the check, 7 series of 3 trade names were rejected.

7. JSC "Tatkhimfarmpreparaty"

Roszdravnadzor was dissatisfied with: the incorrect description of some drugs produced by Tatkhimfarmpreparaty, their labeling, quantification and packaging, as well as the average weight of tablets. In total, 7 defective batches of 4 trade names were found in this joint-stock company.

6. OOO "Lekar"

9 series of 1 trade name were culled. The reasons are the discrepancy between the authenticity and the volume of the contents of the package with the declared parameters.

5. OAO NPK Eskom

This research and production concern is one of the main Russian manufacturers of infusion solutions. Mechanical inclusions were found in the company's products, there are complaints about labeling and packaging. Roszdravnadzor rejected 9 batches of 5 trade names.

4. JSC SPC "Biogen"

The microbiological purity and authenticity of some of the preparations produced by Biogen did not meet the standards. Based on the results of the audit, Roszdravnadzor considered 10 batches of 2 trade names to be defective.

3. JSC "Tver Pharmaceutical Factory"

The company entered the top 3 Russian manufacturers of low-quality medicines due to inaccurate descriptions of various medicines, the mass of the contents of the package and the package itself. 11 series of medicines of 4 trade names turned out to be of poor quality.

2. Ozon LLC

One of the leaders of the Russian market in the production of generics (generic) - "copies" of the original patented drugs. The rejected products of Ozon LLC included 14 series of 3 trade names. They were found to have dissolution problems and dosing inhomogeneity.

1. JSC "Murom Instrument-Making Plant"

The production of medicines is carried out under its own trademark "VerbaPharm". The company became the leader in the ranking of the worst drug manufacturers due to 29 rejected batches of two names. The inspections revealed shortcomings in the quantitative determination of pharmaceuticals produced at the Murom Instrument-Making Plant.

I.V.Sudarev, V.G.Gandel, Department of Industrial Pharmacy, SEI MARTIT

Pharmaceutical terminology of recent times is replete with a number of interesting innovations that make you strain your brain and try to somehow understand their meaning and content in categories familiar to a specialist. Here, for example, the term "pharmaceutics", introduced into circulation mainly by representatives of the media, who for the most part still pronounce, understand (and often write!) The word "pharmacy" as "formation" or "pharmacy" with an emphasis in the first case on the second syllable, and in the second - on the penultimate one, and for which the term "pharmaceuticals" is socially closer. What it should mean, this term, is not clear. A familiar journalist once said that "... it's all about drugs." That's it, simple and nice. The term “cosmeceuticals” is already on the way, and soon “production” will probably follow ... Or another pearl - “pharmaceutical industry”. Who will explain what it is?

All this could be easily experienced, realizing that it is not so easy for non-specialists to understand these complex pharmaceutical (and pharmacological!) intricacies. But not so long ago, a term was introduced into circulation that cannot be attributed to this casuistry, and it was introduced precisely by specialists. This term is called "domestic medicines". The term is not simple and by no means safe. Let's figure it out.

In the USSR, domestic medicines (drugs, preparations) were called everything that was developed, researched and produced by domestic researchers and manufacturers from domestic raw materials on mainly domestic equipment and on the territory, of course, of the USSR. It was clear and no one raised questions. Today, the term "domestic medicines" is interpreted by many in their own way, putting into it a very diverse content.

So, for example, manufacturers (mainly the owners and top management of most enterprises) call domestic those medicines that are produced abroad and are just packaged in consumer packaging on the territory of Russia and provided with a leaflet in Russian. Moreover, they proudly call the widespread transition to the production of generics after the 1998 crisis "import substitution", bribing many pharmaceutical officials with this term, who happily reported to the country's leadership about the victory over imports. Well, tell me, who would think of calling the Ford Focus assembled in Vsevolozhsk a domestic car: this can only happen if any serious manufacturing defects are found in it. Even the VAZ "penny", assembled almost entirely from domestic parts and components, few people called a domestic car. Domestic were Moskvich, Pobeda, Volga, ZiS, ZiL, ZiM, IzhAvto, etc.

Developers of original medicines, and there are literally few of them left in the country, classify only those developed by them or their Russian colleagues as domestic medicines. But what the population understands by this term, one can only guess.

If we turn to the statements of responsible officials in the sphere of drug circulation of the last decade, we will hear many calls to increase the share of "domestic drugs" in the pharmaceutical market. The most ambitious plans were announced recently in Zelenograd, where the prime minister gave an unsatisfactory assessment of the domestic pharmaceutical industry, calling for a decade to radically change the situation with the drug supply of the country's population in favor of domestic drugs, regaining at least half of the market and ensuring the production of 85% of the most important medicines . It remains, however, not entirely clear how an industry rated at a "deuce" can cope with such a difficult task.

“The floors are parquet, and the doctors are profiled,” this is how the medical staff of the “Kremlin” hospital was called, not without humor. But there were also "Kremlin" pharmacists - specialists responsible for the drug supply of the country's leadership with the necessary drugs. So, these specialists, literate and respected people, constantly strived to reduce the share of domestic drugs in the range of drugs of the "Kremlin pharmacy" in the direction of more modern and effective drugs that came from imports, especially from capitalist countries, and above all the United States, Switzerland , France, Great Britain, Germany, Italy, Japan, seeking appropriate funding for these purchases from the budget. And there is no need to talk about the preparations of the CMEA countries and Yugoslavia: they have always been a desired and sought-after remedy for the Kremlin and the medical and sanitary departments of the Union republics. And today, as we believe, the persons responsible for the health of the nomenklatura adhere to the same concept. Moreover, there are cases when persons from among the nomenklatura, bohemians and businessmen, who have such an opportunity, fundamentally give birth, receive treatment and buy medicines exclusively abroad, even if they can be purchased in Russia.

So why is it today that the question of the prevalence of "domestic" drugs among the means of drug therapy is so persistently raised? And is it possible in principle?

To answer these questions, it is necessary, first of all, to give a clear, unambiguous definition that does not allow for various interpretations of what should be understood as domestic drugs. But first, it is necessary to make a small historical digression, so that it is more clear what, in fact, we are talking about.

After the Second World War, the population of the United States experienced an acute allergy to German-made products, including drugs that circulated on the American pharmaceutical market, were considered very effective and were characterized by the corresponding (German) quality. The population preferred to be treated with “domestic”, American drugs, and pharmaceutical companies, which had already gained power, immediately responded to the consumer’s challenge, which is generally typical for American business, including pharmaceuticals. Large corporations independently, as well as through cooperation with universities and other scientific centers of the country, have carried out the most powerful screening of many synthetic and natural chemical compounds, having made a serious scientific, technical and innovative breakthrough and having carried out an active pharmacological reserve for many years to come. This is what allowed the United States in the mid-sixties to make a real revolution in the pharmaceutical business, to attract dozens of prominent scientists, including Nobel laureates, to the development of new generation drugs, to open a new direction in the development and production of drugs - biopharmacy, which has become the main way of studying and ensuring bioavailability. , without an evaluation of which no drug can enter the market, start translating the main stages of the drug development life cycle into the format of good practices - GLP, GCP, GMP, etc. In the same period, the theoretical and scientific and technical prerequisites for the creation of fundamentally new generations of medicines were laid, which were based on the total chemical synthesis of analogues of natural biologically active substances, their derivatives, fundamentally new classes of organic compounds, as well as advanced technologies for the isolation and purification of target products. This is how semi-synthetic penicillins, cephalosporin antibiotics, prostaglandin biosynthesis blockers - non-steroidal anti-inflammatory drugs, cholesterol biosynthesis blockers - statins, and a number of other chemical structures arose, many of which are still blockbusters of the pharmaceutical market.

The foregoing can be fully applied to some other developed countries - global manufacturers of medicines. So, for example, the Japanese, after experiencing a nuclear attack in 1945, refused to use the most effective American drugs, which did not even have close analogues in Japan, only because they were created in the country of the Yankees. The inhabitants of Japan wanted to be treated with "domestic" means: thus, over time, a powerful Japanese pharmaceutical industry and R&D were created with an emphasis on biotechnology and the use of natural organic compounds, especially biologically active substances of aquatic organisms (marine organisms) as the basis for anticancer drugs, diabetes therapy, cardio - vascular pathologies and infectious diseases.

How is an American (or Japanese, German, French, etc.) "domestic" drug being created today?

First of all, it must be emphasized that the creation of a truly fundamentally new drug can only be done by a powerful, self-sufficient and innovatively motivated structure that has the ability to initiate fundamental research and use its fruits. This is achieved mainly through the participation of large pharmaceutical firms and transnational corporations in the form of a public-private partnership in financing university research through the provision of national and international grants, the total amount of which reaches tens of billions of dollars. But even this is not enough. It is necessary that the process of developing such a drug be led by a recognized scientific school that has proven its leadership in the chosen direction of pharmacological research and pharmaceutical production for a sufficiently long time. For example, the "pharmacy of the world", the German pharmaceutical company Bayer, is a world leader in the development and production of anti-atherosclerotic, anti-inflammatory and antimicrobial drugs; American Merck (in other countries Merck, Sharp and Dome) - means of combating atherosclerosis and its manifestations based on statins; Elly Lily, Novo Nordisk and Ayinomoto for human genetically engineered insulin and parenteral nutrition; Pfizer - anticancer drugs, for example, an effective agent of marine genesis cytosar (cytarabine, arabinoside cytosine) from sea sponges, etc. etc.

The listed companies also produce a number of other equally significant drugs: in the period of globalization and harmonization of the world pharmaceutical economy, the explosive development of science and technology, barriers to research and development are being eliminated everywhere. The only effective regulator of the global innovative pharmaceutical expansion of the 21st century is patent law, which reliably protects the intellectual and industrial property of developers.

The creation of a new drug begins, as a rule, with a “design”, which is based on the previous accumulated experience in the pharmacotherapy of a certain group or groups of diseases. But there are exceptions. So, for example, the Nobel laureate in physics Linus Pauling proposed to fight viral diseases with overdoses of ascorbic acid without any previous experience, only on the basis of inferences. But this is more the exception than the rule. The main path of innovation in pharmaceutical science is the already accumulated scientific and technological baggage, as well as deep knowledge of international law in the field of drug circulation.

The development of an active pharmaceutical ingredient (substance), on the basis of which the corresponding dosage forms are then created, takes about five to seven years, the same amount for the GLP and GCP stages. Moreover, the longer the stage of clinical trials, the more information is accumulated about the long-term consequences and possible side effects of the use of the developed drug. So, for example, stage V of clinical trials, which accompanies the already approved use of a medicinal product, can continue within the framework of pharmacovigilance for 15 years or more.

Further, the substance, in respect of which the declared pharmacological activity has been proven, must be presented in such a dosage form, which most of all corresponds to the intended use. This is achieved by the use of appropriate auxiliary, mostly inert substances, and here biopharmacy comes into play - the science of the influence of pharmaceutical factors on the pharmacological activity of medicinal substances. This is a relatively young branch of pharmaceutical science, which, not without problems and resistance, was introduced into the practice of domestic drug science in the 70s of the last century. The use of biopharmaceutical techniques and technologies achieves such a composition of the dosage form (solid, soft, liquid, gaseous, etc.), in which the excipients not only do not interfere, but, on the contrary, contribute to the maximum manifestation of the therapeutic effect of the substance with a minimum of undesirable side effects. With the participation of excipients, it is possible not only to create the dosage form itself, but also to set certain properties for it: prolong (prolong) the therapeutic effect, protect the substance from the action of gastric juice when the drug is taken orally, dissolve “insoluble” substances, improve or mask an unpleasant taste or smell drug, etc. In other words, the developer (designer) must ensure the optimal bioavailability of the drug: make it work there, then and as much, where, when and as far as it is necessary to exert a pharmacotherapeutic effect on the course of the pathological process.

Given these circumstances, the quality of excipients is subject to the same international law requirements as for active pharmaceutical ingredients: they must be produced and controlled under the same conditions, i.e. in accordance with the requirements of GMP rules, no more and no less. Therefore, the enterprises for the production of substances and the production of excipients must comply with GMP requirements to the same extent as the enterprises for the production of finished medicinal products.

So, what is a "domestic" medicine in the understanding of a European, American or Japanese layman?

This is undoubtedly a drug developed and produced by "domestic" scientists at a "domestic" company from "domestic" substances using "domestic" excipients and on "domestic" pharmaceutical technological equipment. We believe that a foreign specialist will give a similar or similar explanation. As for the territory in which the medicinal product is produced, today it can be any territory recognized by the world pharmaceutical community as suitable for this kind of business.

So what should be understood by the term "domestic" medicine for us Russians?

Domestic substances are practically not produced in the country, and if they are produced anywhere, then, as a rule, using imported chemical components (synthons, catalysts, etc.) and by no means in accordance with GMP standards. The same fully applies to auxiliary substances. Validated domestic pharmaceutical processing equipment can be counted on the fingers of one hand. According to our estimates, there are no more than 10 pharmaceutical enterprises that comply with GMP in the country, and these are mainly enterprises with foreign capital. The remaining 340 (no one knows exactly how many drug manufacturers actually operate in Russia) do not meet these requirements. First, the President of the Russian Federation (August 13, 2003), then twice the Prime Minister (June 19, 2008 and October 9, 2009) unsuccessfully called on the domestic pharmaceutical industry to switch to the GMP standard, first from January 1, 2005, then from January 1, 2010 and, finally, from January 1
2011, and things are still there.

But it is not enough to produce a medicinal product: in order for it to reach the market, its quality must be adequately controlled. The means of pharmaceutical quality control today are as follows: control, testing, analytical and auxiliary equipment, instruments, materials, reagents, reference samples, standards, columns, media, etc. etc. - this is all, as a rule, imports!

The desire at any cost to increase the proportion of "domestic" drugs, especially those produced at enterprises that do not meet modern requirements, to the detriment of funds received through imports, is fraught with serious consequences, especially given the zeal with which the official rushes to execute the master's decree. Having cut imports, the country at one fine moment may face a shortage of the most important modern drugs for the treatment of diabetes, oncological, cardiovascular, and infectious diseases. And, in fact, why do we need to produce 85% of the drugs from the Vital and Essential Drugs list? Are we going to be in blockade for a long time as a howling side? For consumers, the main thing is that this list should include really modern, really effective and safe drugs, then the diseases in our country, which go off scale in almost all serious nosologies, may be on the wane.

We have already become a “generic” power, i.e. a classic country of the third medicinal world, and generics, as you know, are “old men” and “old women” of a very advanced age and their possibilities are very limited.

Thus, if it turns out that we are not able, as in the automotive industry, to organize modern production on our own, and without such production, the development of medicines does not seem relevant, we should develop outsourcing pharmaceutical production with those who are masters of this business, i.e. e. with foreign firms or with the participation of foreign capital, which, in fact, is already happening in fact.

From this follows the conclusion: medicines registered in Russia, produced in accordance with GOST R 52249-2004 and taxes on which, in accordance with Russian legislation, have been paid to our treasury, will have to be called domestic. Then the figure of 85% in the list of essential drugs will not cause serious concern. And by default, let's not forget that substances, excipients, most primary and secondary packaging materials, process equipment and controls are purchased abroad and that we should maintain friendly relations with their manufacturers and countries of registration so that one fine moment they do not refuse from supplies.

We are all used to the fact that each drug has its own analogues or generics. It is often possible to find a replacement for an expensive imported drug among many domestic drugs or medicines manufactured in "third world countries". Interchangeable drugs (table attached) are, in fact, drugs that are based on one active substance.

Why are originals so expensive?

Often, when buying a common cold remedy at a pharmacy, you have to spend a rather large amount. So the question arises: "Are there any interchangeable drugs? What are we paying big money for?"

But not everything is so simple. There is a fairly convincing rationale for setting prices for many drugs. Of course, not all of them are completely effective, but they deserve preference compared to their counterparts.

What's the matter? There is such a phrase in "Do you want those that are, or those that are being treated?" Of course, analogue drugs are not placebos. Many of them improve the quality of life and help improve the health of people who are not able to spend on this fortune. However, it happens that medicines made from cheap raw materials do not bring the expected effect. It all depends on the manufacturer and his integrity.

The principle of pricing expensive and cheap drugs

If you go into details, explaining the difference in the action of drugs with the same active substance, then it is worth noting the very essence for analogy. Not every flour can be used to bake a bun! It seems to be wheat flour, and only pancakes come out of one, and any muffin comes out of the other.

So, in the composition of cheap raw materials used for the production of inexpensive drugs of local manufacture (or in the countries of the "third world"), in addition to the main active substance, there are some impurities. Poorly purified chemical raw materials can eventually give a small negative result, which most often affects as a side effect or an allergic reaction.

Expensive refined raw materials are used for the production of medicines with a higher pricing policy.

Import substitution

Now the question of import substitution often arises. However, not every original medical product can be replaced by an analog one. Alas, a number of drugs have no equal in treatment. For example, drugs for the treatment of oncological diseases, hereditary diseases and diseases of the joints are unparalleled among analogues, such as Alflutop.

There is a so-called Vyshkovsky index, which determines the degree of benefit of drugs and their popularity. Guided by this index, you can determine for yourself the choice of the necessary drug from the entire mass of analogues. It sometimes happens that an analogue is more popular and more effective than its original "brother".

What is an analog drug?

Analogues or generics are drugs that do not have a patent that do not differ in composition from the patented development. However, all these drugs differ from the original drugs in the qualitative and quantitative composition of additional substances.

An analogue is a kind of copy, but not a fake! After the expiration of the license for original medicines, manufacturers quickly copy the composition of the drug, replacing some of the ingredients with cheaper ones. As a result, pharmacies in abundance offer their customers cheaper drugs. And the companies that developed the original, did a lot of work on testing and research, end up losing. Big turnover from sales of analogs brings fabulous incomes, but at the same time helps people with low incomes survive in a cruel market.

It is this fact that forced the manufacturers of original medicines to start manufacturing analogues themselves in countries with cheap ones. At the same time, companies monitor the quality of all products. Conflict situations from the use of analogues should not adversely affect the reputation of the original. Therefore, analogues produced at eminent pharmaceutical factories are preferable.

Copies and fakes

In addition to analogues, there are also copies of drugs that are truly real. Thus, in Belarus they tried to launch an analogue of Tamiflu into production, while raw materials of dubious quality were purchased in China. The result was that the produced drug does not have any therapeutic effect.

The most dangerous drugs for health are fakes (these are not interchangeable drugs at all, the table of which is in the article)! These drugs are produced at local pharmaceutical plants, outside school hours, but more often this is done in unsanitary conditions and without observing elementary hygiene rules and standards, in basements and sheds. "Medications" come by detour to pharmacies, get to sick people and cause irreparable harm to health. It is these drugs that are a threat to the doctor's reputation and a huge damage to the industry.

Below is a table of foreign drugs of original production, taking into account the Vyshkovsky index, in conjunction with their analog, cheaper "brothers". These are more than 48 pairs of interchangeable drugs that are frequently prescribed.

Interchangeable drugs

Before you are interchangeable drugs (table).

Purpose, quantity	Original	Cost in rubles	Index	Analog	Cost in rubles	Index
anti-influenza,	"TeraFlu"	330	0,0331	"Flucomp"	195	0,0077
anti-cold, tablets, 10	"Nurofen"	109	1,0231	"Ibuprofen"	38	0,9
antibiotic tablets,6	"Sumamed"	500	3,1332	"Z-factor"	228	0,1906
anti-influenza, tablets, 10	"Coldrex"	150	0,6943	"Influnet"	100	0,0065
antispasmodic, tablets, 10	"No-shpa"	140	2,355	"Drotaverine"	40	0,0323
antifungal, liquid, 15 milliliters	"Exoderil"	616	0,625	"Naftifin hydrochloride"	330	0,0816
antipyretic, rectal suppositories,	"Panadol"	75	0,3476	"Cefekon D"	51	0,3897
antispasmodic, tablets	"Spazmalgon"	150	0,6777	"Renalgan"	88	0,005
antispasmodic, injections	"Spazmalgon"	285	0,6777	"Geomag"	122	0,044
antihistamines, tablets, 10	"Erius"	1000	0,8003	"Desloratadine"	330	0,0273
antifungal anti-candidiasis, tablets, 1	"Diflucan"	500	1,0307	"Fluconazole"	130	0,8797
antipyretic tablets, 10	"Aspirin"	139	0,5482	"Acetylsalicylic acid"	8	0,0592
antifungal,	"Clotrimazole"	72	0,8676	"Canison"	57	0,391
antifungal, vaginal tablets	"Candide"	85	0,8676	"Clotrimazole"	55	0,3489
from diarrhea tablets, 6	"Imodium"	240	0,3179	"Loperamide"	58	0,0102
antirheumatic painkiller pills, 10	"Movalis"	550	1,6515	"Meloxicam"	45	0,7007
bone metabolism corrector, 10	"DONA"	1350	0,9476	"Glucosamine maximum"	470	0,391
enzyme remedy tablets, 20	"Mezim forte"	270	1,5264	"Pancreatin"	28	0,6564
enzyme agent, 10	"Festal"	107	1,5732	"Normoenzyme"	40	0,044
antidiabetic pills,30	"Diabeton MV"	280	0,6647	"Gliclazide MV"	128	0,0527
for the treatment of erectile dysfunction, tablets, 3	"Viagra"	1500	0,7319	"Dynamico"	395	0,3941
immunostimulating,	"Immunal"	285	0,6658	"Echinacea Vilar"	178	0,0109
venoprotective	"Detralex"	1460	1,7879	"Venarus"	650	1,0866
antihistamine tablets, 10	"Claritin"	188	0,7079	"Loratadine"	12	0,1017
antidepressant	"Heptral"	1800	2,1899	"Heptor"	950	0,643
antiviral tablets	"Zovirax"	850	0,7329	"Cyclovir"	72	0,1117
antibacterial, tablets, 10	"Trichopol"	65	0,7738	"Metronidazole"	19	0,7432
tablets, 10	"Capoten"	155	1,5296	"Captopril"	9	0,5245
PN inhibitor tablets, 30	"Omez"	200	2,5697	"Omeprazole"	55	0,7745
antihistamine tablets	"Zyrtec"	236	1,5075	"Cetirizine"	80	0,0503
secretolytic, syrup	"Lazolvan"	230	1,864	"Ambroxol"	132	0,0141
anti-inflammatory pills, 20	"Voltaren"	320	0,4561	"Ortofen"	11	0,0726
contraceptive pills, 21	"Janine"	870	0,307	"Silhouette"	650	0,1476
antiseptic, liquid	"Miramistin"	330	1,6511	"Hexicon"	116	0,9029
B vitamins, injections	"Milgamma"	1100	2,808	"Trigamma"	99	0,0334
antacid, tablets	"Zantac"	300	0,2345	"Histak"	41	0,0293
antifungal, cream	"Lamisil"	700	0,7227	"Terbinox"	63	0,012
improving blood microcirculation, tablets	"Trental"	300	1,55	"Pentilin"	136	0,0366
hepatoprotector capsules, 30	"Essentiale Forte N"	555	2,2309	"Phosfonciale"	435	0,0943
diuretic tablets, 30	"Lasix"	50	0,6781	"Furasemide"	28	0,0148
antiemetic solution for injection	"Cerucal"	250	1,1001	"Methocopramide"	71	0,2674
antimicrobial antibiotic ointment	"Levomekol"	97	0,8167	"Levomitil"	45	0,0268
anti-inflammatory pain reliever, gel	"Fastum Gel"	460	0,2459	"Ketoprofen"	97	0,0221
anticoagulant, gel	"Lyoton 1000"	800	0,2965	"Heparin-Akrigel"	210	0,0657
nasal drops	"Otrivin"	178	0,2831	"Tizin Xylo"	111	0,0751
immunomodulators tablets, 20	"Groprinosin"	1400	0,5692	"Inoprinosine"	1200	2,917
tissue regeneration stimulator	"Bepanthen"	370	0,7003	"Pantoderm"	240	0,1216
sedative drops	"Valocordin"	281	0,3382	"Korvaldin"	144	0,0318
antibiotics tablets, 16	"Flemoxin Salutab"	490	3,4917	"Ospamox"	200	0,107

This is the so-called list of interchangeable drugs. It is not complete, of course, since new analogues are constantly appearing, old medicines that have become irrelevant disappear. In principle, each large pharmacy has its own table - analogues of expensive drugs.

Prescribing medications

When prescribing medications for treatment, the doctor should, first of all, start from the social status and income of the patient. Rich people are used to paying for the speed of results, for the quality of treatment, for the brand. The rest combine the quality of drugs with their cost. You can not drive the patient into a corner by prescribing an expensive original - he will not buy it anyway.

Treatment is carried out by "grandmother's advice" or not carried out at all. If an inexpensive analogue is prescribed to such a patient, there is a possibility that the appointment will be fulfilled. This will happen because the cost of drugs will not frighten the patient to the extent that the price of an expensive original will frighten him. That is why the table "Analogues of expensive drugs" will be very useful.

I would like to add to all of the above: never buy drugs from your hands. In this case, there are no guarantees that this is a medicine, and not a poison or a "dummy". In a pharmacy, to confirm the quality of medicines, you can ask the pharmacist to provide supporting documents if there is any doubt about their production, as well as get acquainted with the available analogues or substitutes. "Interchangeable drugs: table" here will just come in handy.

Blacklist of Roszdravnadzor

Roszdravnadzor has defined a black list That is, their interchangeable drugs (table), which are analogues of well-known world brands, should not be used in treatment. It has been established by testing that the medical preparations produced at these factories are of dubious quality. Among them: "Belmedpreparaty", "Tatfarmkhimpreparaty", "Biochemist", "Herbion Pakistan", "Farmak", "Sagmel Inc", "Dalkhimfarm", "Biosintez" and others.

In conclusion, I would like to add that before purchasing a medicine, you should read the attached instructions for it, which indicates all its advantages in treatment and a number of side effects. For this there is a table of foreign drugs. When choosing an analogue, you should consult with your doctor.

The choice of medicine is the choice of the patient. Be healthy!