Registered with the Ministry of Justice of the Russian Federation on January 16, 2006.
Registration N 7353

In accordance with Article 32 Federal Law dated June 22, 1998 N 86-FZ "On medicines ah" (Collection of legislation Russian Federation, 1998, N 26, art. 3006; 2003, N 27, art. 2700; 2004, N 35, art. 3607) I order:

1. Approve the attached Procedure for dispensing medicines.

2. Recognize Appendix 3 “List of Medicines Subject to Subject-Quantitative Accounting in Pharmacy Institutions/Organizations and Enterprises” as no longer in force wholesale trade medicines, medical institutions and private practitioners**" and Appendix 4 "Procedure for the dispensing of medicines in pharmacies/organizations", approved by order of the Ministry of Health of the Russian Federation dated August 23, 1999 N 328 "On the rational prescription of medicines, rules writing prescriptions for them and the procedure for their dispensing by pharmacies (organizations)" (registered with the Ministry of Justice of the Russian Federation on October 21, 1999 N 1944), with amendments and additions made by order of the Ministry of Health of the Russian Federation dated May 16, 2003 N 206 ( registered with the Ministry of Justice of the Russian Federation on June 5, 2003 N 4641) and by order of the Ministry of Health and social development Russian Federation dated March 16, 2005 N 216 (registered with the Ministry of Justice of the Russian Federation on April 8, 2005 N 6490).

Minister M. Zurabov

Procedure for dispensing medicines

I. General provisions

1.1. This Procedure determines the requirements for the dispensing of medicines by pharmacies (organizations)*, regardless of their organizational and legal form, form of ownership and departmental affiliation.

1.2. Medicines, including narcotic drugs, psychotropic, potent and toxic substances, registered in the Russian Federation in accordance with the established procedure.

1.3. Medicines are dispensed with a doctor's prescription and without a doctor's prescription by pharmacies (organizations) licensed for pharmaceutical activities.

1.4. Medicines prescribed by doctor are subject to dispensing by pharmacies and pharmacy points.

Medicines in accordance with the List of medicines dispensed without a doctor's prescription, approved by order of the Ministry of Health and Social Development of the Russian Federation dated September 13, 2005 N 578 (registered with the Ministry of Justice of the Russian Federation on September 29, 2005 N 7053) (hereinafter referred to as the List medicines dispensed without a doctor's prescription) are subject to sale by all pharmacies (organizations)*.

1.5. For uninterrupted supply population with medicines, pharmacies (organizations) are required to have in stock a minimum range of medicines necessary to provide medical care, approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 29, 2005 N 312.

II. General requirements for dispensing medicines

2.1. All medicines, with the exception of those included in the List of medicines dispensed without a doctor's prescription, must be dispensed by pharmacies (organizations) only according to prescriptions filled out in the prescribed manner on prescription forms of the relevant accounting forms.

2.2. According to prescriptions written on prescription forms, the forms of which are approved by order of the Ministry of Health of the Russian Federation of August 23, 1999 N 328 (registered with the Ministry of Justice of the Russian Federation on October 21, 1999 N 1944), pharmacies (organizations) dispense:

Narcotic drugs and psychotropic substances included in List II of the List narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, approved by Decree of the Government of the Russian Federation of June 30, 1998 N 681 (Collected Legislation of the Russian Federation, 1998, N 27, Art. 3198; 2004, N 8, Art. 663; N 47, Art. 4666) (hereinafter referred to as the List), written out on special prescription forms for narcotic drugs;

Psychotropic substances included in List III of the List, prescribed on prescription forms, form N 148-1/u-88;

Medicines subject to subject-quantitative accounting in pharmacies (organizations), drug wholesale trade organizations, medical institutions and private practitioners, the List of which is provided in Appendix No. 1 to this Procedure (hereinafter referred to as medicines subject to subject-quantitative accounting) , written out on prescription forms, form N 148-1/u-88;

Medicines included in the List of medicines dispensed on prescription from a doctor (paramedic) when providing additional free medical care to certain categories of citizens entitled to receive state social assistance, approved by order of the Ministry of Health and Social Development of the Russian Federation dated September 28, 2005 N 601 (registered with the Ministry of Justice of the Russian Federation on September 29, 2005 N 7052) (hereinafter referred to as medicines included in the List of medicines dispensed by prescription ( paramedic), as well as other medicines dispensed free of charge or at a discount, prescribed on prescription forms of form N 148-1/u-04 (l);

Anabolic steroids prescribed on prescription forms, form N 148-1/u-88;

Other medicines not included in the List of medicines dispensed without a doctor's prescription, prescribed on prescription forms, form N 107/u.

2.3. Prescriptions for narcotic drugs and psychotropic substances included in List II of the List are valid for five days.

Prescriptions for psychotropic substances included in List III of the List; medicines subject to subject-quantitative accounting; anabolic steroids are valid for ten days.

Prescriptions for medicines included in the List of medicines dispensed by prescription from a doctor (paramedic), as well as other medicines dispensed free of charge or at a discount, with the exception of prescriptions for narcotic drugs and psychotropic substances included in List II of the List, for psychotropic substances , included in List III of the List, for medicines subject to subject-quantitative registration, for anabolic steroids are valid for one month.

Prescriptions for other medicines are valid for two months from the date of issuance of the prescription and up to one year in accordance with paragraph 2.19 of the Instructions on the procedure for prescribing medicines and writing prescriptions for them, approved by order of the Ministry of Health of the Russian Federation dated August 23, 1999 N 328 ( further - Instructions).

2.4. Pharmacy establishments (organizations) are prohibited from dispensing drugs on expired prescriptions, with the exception of drugs on prescriptions that expired while the prescriptions were on deferred service.

2.5. Medicines are dispensed by pharmacies (organizations) in the quantities specified in the prescription, with the exception of medicines, the dispensing rates of which are specified in Appendices 1 and 3 to the Instructions.

2.6. When dispensing medicines according to a doctor's prescription, an employee of a pharmacy institution (organization) makes a note on the prescription about the dispensing of the drug (name or number of the pharmacy institution (organization), name and dosage of the drug, quantity dispensed, signature of the dispenser and date of dispensing).

2.7. If there are medicines in a pharmacy institution (organization) with a dosage different from the dosage prescribed in the doctor’s prescription, the employee of the pharmacy institution (organization) may decide to dispense the available medicines to the patient if the dosage of the drug less dosage specified in the doctor’s prescription, taking into account the recalculation for the course dose.

If the dosage of a medicinal product available in a pharmacy institution (organization) exceeds the dosage specified in the doctor’s prescription, the decision to dispense the medicinal product to the patient is made by the doctor who wrote the prescription.

The patient is provided with information about changing the single dose of the drug.

2.8. In exceptional cases, if it is impossible for a pharmacy institution (organization) to fulfill the doctor’s (paramedic’s) prescription, violation of the secondary factory packaging is allowed.

In this case, the medicinal product must be dispensed in a pharmacy package with the obligatory indication of the name, factory batch, expiration date of the medicinal product, series and date according to the laboratory packaging register and providing the patient with other necessary information (instructions, package insert, etc.).

Tampering with the original factory packaging of medicines is not allowed.

2.9. When dispensing medicines according to a doctor’s prescription valid for one year, the prescription is returned to the patient indicating on the back the name or number of the pharmacy institution (organization), the signature of the employee of the pharmacy institution (organization), the quantity of the drug dispensed and the date of dispensing.

When the patient next contacts a pharmacy institution (organization), notes on the previous receipt of the medicine are taken into account. Upon expiration of the validity period, the prescription is canceled with the stamp “Prescription is invalid” and left at the pharmacy institution (organization).

2.10. In exceptional cases (a patient leaving the city, the inability to regularly visit a pharmacy institution (organization), etc.), pharmaceutical workers of a pharmacy institution (organization) are allowed to make a one-time dispensing of a medicine prescribed by a doctor according to prescriptions valid for one year, in an amount equal to necessary for treatment for two months, with the exception of medicines subject to subject-quantitative accounting.

2.11. If a pharmacy institution (organization) does not have a medicinal product prescribed by a doctor, with the exception of a medicinal product included in the List of Medicines Dispensed on the Prescription of a Doctor (Paramedic), as well as other medicinal products dispensed free of charge or at a discount, the employee of the pharmacy institution (organization) ) can carry out its synonymous replacement with the consent of the patient.

When dispensing a medicinal product included in the List of Medicines Dispensed on the Prescription of a Doctor (Paramedic), as well as another medicinal product dispensed free of charge or at a discount, an employee of a pharmacy institution (organization) can make a synonymous replacement of the medicinal product in agreement with the doctor who wrote the prescription. .

2.12. Prescriptions for medicines marked “statim” (immediately) are processed within a period not exceeding one working day from the moment the patient contacts the pharmacy institution (organization).

Prescriptions for medicines marked “cito” (urgent) are processed within a period not exceeding two working days from the moment the patient contacts the pharmacy institution (organization).

Prescriptions for medicines included in the minimum range of medicines are processed within a period not exceeding five working days from the moment the patient contacts the pharmacy institution (organization).

2.13. Prescriptions for medicines included in the List of medicines dispensed by prescription from a doctor (paramedic) and not included in the minimum range of medicines are serviced within a period not exceeding ten working days from the moment the patient contacts the pharmacy institution (organization).

Prescriptions for medicines prescribed by decision of a medical commission approved by the chief physician of a medical institution are processed within a period not exceeding fifteen working days from the moment the patient contacts the pharmacy institution (organization).

2.14. Prescriptions for medicines subject to subject-quantitative accounting; medicines included in the List of medicines dispensed on prescription from a doctor (paramedic), as well as other medicines sold free of charge or at a discount; anabolic steroids remain in the pharmacy institution (organization) for subsequent separate storage and destruction after the expiration of the storage period.

2.15. The pharmacy institution (organization) must ensure conditions for the safety of prescriptions left for storage for medicines that are subject to subject-quantitative accounting; medicines included in the List of medicines dispensed on prescription from a doctor (paramedic), as well as other medicines sold free of charge or at a discount; anabolic steroid.

2.16. The shelf life of prescriptions in a pharmacy institution (organization) is:

For medicines included in the List of Medicines dispensed on prescription from a doctor (paramedic), as well as other medicines dispensed free of charge or at a discount - five years;

For narcotic drugs and psychotropic substances included in List II of the List, and psychotropic substances included in List III of the List - ten years;

For medicines subject to subject-quantitative registration, with the exception of narcotic drugs and psychotropic substances included in List II of the List, and psychotropic substances included in List III of the List; anabolic steroids - three years.

After the expiration of the storage period, the recipes are subject to destruction in the presence of the commission, about which acts are drawn up, the form of which is provided for in Appendices No. 2 and No. 3 to this Procedure.

The procedure for destroying prescriptions left in a pharmacy institution (organization) after the established storage period has expired, and the composition of the commission for their destruction may be determined by the health care or pharmaceutical authorities of the constituent entity of the Russian Federation.

2.17. Medicines of good quality purchased by citizens are not subject to return or exchange in accordance with the List of non-food products of good quality that cannot be returned or exchanged for a similar product of a different size, shape, size, style, color or configuration, approved by the Decree of the Government of the Russian Federation dated January 19, 1998 No. 55 (Collection of Legislation of the Russian Federation, 1998, No. 4, Art. 482; No. 43, Art. 5357; 1999, No. 41, Art. 4923; 2002, No. 6, Art. 584; 2003, No. 29, Art. . 2998; 2005, N 7, art.

It is not permitted to re-dispense (sell) medicines recognized as goods of inadequate quality and returned by citizens for this reason.

2.18. Prescriptions for tranquilizers that are not subject to subject-quantitative accounting; antidepressants, neuroleptics; alcohol-containing medicines industrial production are canceled with the stamp of the pharmacy institution (organization) “Medicine dispensed” and returned to the patient’s hands.

To re-dispense the drug, the patient must consult a doctor for a new prescription.

2.19. Incorrectly written prescriptions remain in the pharmacy institution (organization), are canceled with the stamp “Prescription is invalid” and are registered in a journal, the form of which is provided in Appendix No. 4 to this Procedure, and are returned to the patient.

Information about all incorrectly prescribed prescriptions is brought to the attention of the head of the relevant medical institution.

2.20. Pharmacy institutions (organizations) carry out separate accounting of medicines included in the List of medicines dispensed according to prescriptions of a doctor (paramedic), dispensed to citizens living in the territory of the corresponding subject of the Russian Federation, and to citizens temporarily staying in the territory of this subject of the Russian Federation.

III. Requirements for the supply of narcotic drugs and psychotropic substances; medicines subject to subject-quantitative accounting; anabolic steroids

3.1. Narcotic drugs and psychotropic substances included in List II of the List, and psychotropic substances included in List III of the List are subject to dispensing by pharmacies (organizations).

3.2. The right to work with narcotic drugs and psychotropic substances included in List II of the List, and psychotropic substances included in List III of the List, has only pharmacy institutions (organizations) that have received the appropriate licenses in established by law Russian Federation is ok.

3.3. Dispensing narcotic drugs and psychotropic substances to patients. included in List II of the List, and psychotropic substances included in List III of the List, are carried out by pharmaceutical workers of pharmacy institutions (organizations) who have the right to do so in accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated May 13, 2005 N 330 (registered in the Ministry of Justice of the Russian Federation on June 10, 2005 N 6711).

3.4. In a pharmacy institution (organization), the dispensing of narcotic drugs and psychotropic substances included in List II of the List is carried out by patients assigned to a specific outpatient clinic, which is assigned to the pharmacy institution (organization).

The assignment of an outpatient clinic to a pharmacy institution (organization) can be carried out by the health care or pharmaceutical management body of a constituent entity of the Russian Federation in agreement with the territorial body for control over the circulation of narcotic drugs and psychotropic substances.

3.5. Narcotic drugs and psychotropic substances included in List II of the List prescribed by a doctor are dispensed to the patient or the person representing him upon presentation of an identity document issued in the prescribed manner.

3.6. Narcotic drugs and psychotropic substances included in List II of the List and included in the List of medicines dispensed by prescription from a doctor (paramedic), as well as those dispensed free of charge or at a discount, are dispensed upon presentation of a prescription written out on a special prescription form for a narcotic medicine, and prescription written out on prescription form form N 148-1/u-04 (l).

Psychotropic substances included in List III of the List, medicines subject to subject-quantitative recording, anabolic steroids included in the List of medicines dispensed by prescription from a doctor (paramedic), as well as those dispensed free of charge or at a discount, are dispensed upon presentation of a prescription written on a prescription card. form N 148-1/у-88, and a prescription written out on the prescription form form N 148-1/у-04 (l).

3.7. Pharmacy institutions (organizations) are prohibited from dispensing narcotic drugs and psychotropic substances included in List II of the List; psychotropic substances included in List III of the List; medicines subject to subject-quantitative accounting; anabolic steroids according to veterinary prescriptions medical organizations for treating animals.

3.8. Separate dispensing of medicinal products subject to subject-quantitative accounting and other medicinal products included in the composition of a combination medicinal product manufactured according to an individual prescription (hereinafter referred to as an extemporaneous medicinal product) is not allowed.

3.9. Pharmaceutical worker of a pharmacy institution (organization) upon receipt of a prescription for a medicinal prescription custom made is obliged to dispense a medicinal product subject to subject-quantitative recording in half the highest single dose if the doctor fails to comply with the established rules for filling out a prescription or if the doctor prescribes drugs in a dose exceeding the highest single dose.

3.10. In the manufacture of extemporaneous medicinal products containing medicinal products subject to subject-quantitative recording, in accordance with prescriptions prescribed by a doctor, the pharmacist of the pharmacy institution (organization) signs on the prescription for issuance, and the pharmacist of the pharmacy institution (organization) signs for the receipt of the required quantity of medicinal products .

3.11. Ethyl alcohol is released:

According to prescriptions written by doctors with the inscription “For application of compresses” (indicating required dilution with water) or “For leather treatment” - up to 50 grams in pure form;

According to prescriptions written by doctors for individually prepared medicinal prescriptions - up to 50 grams in the mixture;

According to prescriptions written by doctors for individually prepared medicinal prescriptions, with the inscription “For special purposes”, separately certified by the doctor’s signature and the seal of the medical institution “For prescriptions”, for patients with chronic course diseases - up to 100 grams in the mixture.

3.12. When dispensing narcotic drugs and psychotropic substances included in List II of the List; psychotropic substances included in List III of the List; extemporaneous medicinal products containing medicinal products subject to subject-quantitative accounting, instead of a prescription, patients are given a signature with a yellow stripe at the top and the inscription “Signature” in black font on it, the form of which is provided for in Appendix No. 5 to this Procedure.

IV. Control over the dispensing of medicines by pharmacies (organizations)

4.1. Internal control over compliance by employees of a pharmacy institution (organization) with the procedure for dispensing medicines (including those subject to subject-quantitative accounting; medicines included in the List of medicines dispensed according to prescriptions of a doctor (paramedic), as well as other medicines dispensed free of charge or at a discount ) is carried out by the head (deputy head) of a pharmacy institution (organization) or a pharmaceutical employee of a pharmacy institution (organization) authorized by him.

4.2. External control of compliance by pharmacies (organizations) with the procedure for dispensing medicines is carried out by the Federal Service for Surveillance in Healthcare and Social Development and authorities for control of the circulation of narcotic drugs and psychotropic substances within their competence.

________________

* Pharmacies, pharmacy points, pharmacy kiosks, pharmacy stores.

After the order of the Ministry of Health on new rules for dispensing medicines came into force, pharmacies became stricter. For example, they do not sell antibiotics without a prescription. Elena Nevolina, executive director of the Pharmacy Guild, told RG what else is possible and what is not allowed under the new order.

1. Why is it now impossible to buy an antibiotic freely?

Antibiotics have always been prescription drugs that should only be used as prescribed by a doctor. In our country, they often treat any cold, just “just in case.” The results of this uncontrolled intake deplorable. Strains of pathogens have appeared in the world serious illnesses, for example, tuberculosis, which do not respond to known antibiotics. There is simply no cure for such diseases! At the beginning of October, the Strategy for preventing the spread of antimicrobial resistance in Russia was approved. One of the principles: bring the use of antibiotics under strict control. At the pharmacy you must present a prescription written on a form. Yes, it is inconvenient, unusual, and takes time. But we must understand: the uncontrolled use of antibiotics does more harm than good.

2. Are there any restrictions on the dispensing of medications containing alcohol?

There are no “two bottles of hawthorn in one hand” conditions. Alcohol-containing drops, which are classified as over-the-counter medications (this is indicated by the manufacturer in the instructions), for example, the same hawthorn tinctures, drops such as Corvalol are sold without any restrictions. True, soon such tinctures will no longer be sold in bottles larger than 25 ml. But many manufacturers already fulfill this condition.

3. Is it true that mild sedatives are now also strictly prescribed?

The situation here is the same as with antibiotics. If the manufacturer has indicated in the instructions for the drug that it is available with a prescription, the pharmacy is obliged to ask the buyer for a prescription. Therefore, drugs such as amitriptyline, phenibut, grandoxin should still be prescribed by a doctor. A regular form is sufficient. And the pharmacist, dispensing the medicine, must “cancel” the prescription with a stamp.

4. Prescription medications, such as statins, often take a long time. Will you have to visit the doctor constantly now?

If the doctor is sure that the patient needs long-term permanent treatment, the doctor has the right to write a prescription, indicating its validity period - up to 1 year. Only the prescription must indicate how often and in what dose the patient can receive the medicine. Each time a note is made on the prescription that the medicine is dispensed. And after a year, the prescription with all the notes is confiscated from the patient and remains in the pharmacy for storage. The shelf life of used prescriptions depends on what medicine was prescribed - it can be stored for three months or five years if we are talking about drugs and other strictly controlled drugs.

For selling prescription drugs without a prescription, a pharmacist can be fined five thousand or more rubles. And the pharmacy will be closed completely for three months. Antibiotics, a number of painkillers, cardiovascular and other drugs disappeared from “free sale.” Supervisory authorities claim that this was done for the sake of the health of patients, while many refer to foreign experience. Why are patients not happy with such care?

In fact, the ban on the free sale of prescription drugs has existed for a long time; Order No. 785 “On the procedure for dispensing medicines” has been in effect since December 14, 2005. But neither pharmacists nor their clients were in a hurry to implement it. And the doctors continued to scribble prescriptions on scraps of paper. Unless medicines from special lists, subject to strict accounting, were dispensed and purchased strictly according to a prescription.

The Ministry of Health and Rospotrebnadzor decided to take the violators seriously. Pharmacists were last in line. If a pharmacy employee sells a prescription drug without a doctor’s prescription, he may be fined at least five thousand rubles. And that's not all. The fine for the pharmacy itself can be one hundred thousand rubles; the supervisory authority has the right to even close the outlet for up to three months. Medicines marked “dispensed only by prescription” are now prohibited from even being displayed on display.

Moreover, the doctor must formalize the prescription accordingly: not on a piece of paper, not on a card, but on an official prescription form with the seal of the medical institution (form 148/u or No. 107/u, depending on the drugs), certified by the personal signature and seal of the doctor. The recipe indicates the international nonproprietary name, as well as the dosage and frequency of use. The issued prescription is valid for 60 days; for chronic patients, it can be issued for a year, indicating the frequency of purchase of the medicine.

About 70% of everything falls under restrictions pharmacy assortment. These are not only psychotropic and narcotic drugs, but also all antibiotics, hormonal agents(including contraceptives), potent painkillers, ampoule dosage forms, a number cardiovascular drugs, medications for diabetics, etc.

The most unpleasant thing is that there is still no exact and full list medicines that cannot be commercially available. The list should have been approved by the Ministry of Health back in January, it was proposed to find it via this link. But try to find it there yourself! Today, pharmacists are asked to follow the instructions; if it contains the entry “dispensed with a doctor’s prescription,” it means that it cannot be dispensed just like that.

Walking through Stary Oskol pharmacies, you can see that local pharmacists do not have a consensus on what can be sold and what cannot be sold.

“Our management has ordered the sale of antibiotics and drugs in ampoules by prescription,” said one of the pharmacies. – There are no changes for other medications.

“We can sell herbs, ointments, antipyretics, some antivirals and nasal drops without a prescription,” said another. – Pentalgin, ketorol, papaverine, festal – only by prescription!

- What kind of papaverine and no-spa do you need? – clarified in the third. – Tablet forms are dispensed freely, in ampoules – according to prescription. Ketonal is similar: we will sell a cream or gel for external use, but if you need other forms of release, contact your doctor.

“I don’t think there is any reason to panic,” explained the pharmacist at the fourth point. “And before, many drugs were sold by prescription. Those same diabetics knew this very well. There are painkillers, stomach and heart medications, the same drugs for diabetics, which have been and remain on the market. Anything more potent is a no. This, I think, is justified: serious drugs also have more serious ones. side effects. Also, if you need strong drugs, which means you need serious treatment and go to the doctor.

In general, if you are going to the pharmacy, at least look on the Internet and look at the instructions for the medicine you are going to buy. It may be prescription only, in which case you will need to see a doctor first.

If you need this or that drug, but have neither the time nor the desire to sit in a long-hour queue, but it is possible to pay for consultations with a doctor in a private medical center, in most cases you can get a prescription there too. Doctor private clinic has the right to write prescriptions for medicines, with the exception of medicines included in Lists II and III of the “List of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation.”

Other innovations:

• Now pharmacists are required to inform customers about all analogues of medicines. It's about about medications with the same international generic name. The client can choose: purchase expensive medicine, or his cheap analogue. If a pharmacy employee does not provide such information, he may be fined.
• In addition, pharmacists and pharmacists cannot refuse customers to familiarize themselves with the accompanying documentation for drugs and medical products(certificates and declarations of conformity).
• At the client's request, the pharmacist must tell in detail about the dosage, method of administration, and interaction of the drug with other medications. In general, the pharmacist was required by law to do everything that he actually does today.
• Pharmacies that are open to visitors 24 hours a day must have a lighted sign with information about night hours.

Opinion. Why do Russians prefer self-medication?

This state of affairs can only surprise those who are not familiar with the reality of the Russian hinterland. The fact that pharmacies need revenue and don’t want to lose customers is just the tip of the iceberg. Main problem– inaccessibility of fast and high-quality medical care. Try standing in line for hours at the doctor's office in the midst of a flu epidemic! Or suffer without pain medication for several weeks until your appointment with a neurologist comes up. So people run to the nearest pharmacy, tearfully begging: give me at least something! Well, doctors, although they dissuade citizens from self-medication and “on camera” ardently support the slogan “medicines are strictly according to prescription,” deep down in their hearts they are glad that patients do not run to them for papers for every trifling reason. In conditions of a shortage of medical personnel (according to the same Ministry of Health, the shortage of therapists in the country is 27%), they sometimes have to serve patients much more than what is required according to the norms: therapists and pediatricians are sometimes assigned two or three positions. If you still have to spend time writing out prescriptions for basic analgins, papaverines, and pentalgins, there will be absolutely no time left for examining patients.

Without boring you with listing examples from personal practice (everyone has their own sad experience), I will say that not many doctors in practice thoughtfully select a drug for a patient, based on the results of tests, examinations and examinations. They make mistakes when prescribing dosages and dosage regimens, and selecting combined drugs. Without this, patients would not think that the best adviser is the Internet.

In many cities, the innovation caused violent outrage. People call the ban on over-the-counter drugs a “quest for survival.” Citizens collect signatures for petitions in various organs with a request to maintain “the previous procedure for dispensing medications.”

In the forties of the last century, humanity received powerful weapons against many deadly dangerous infections. Antibiotics were sold without prescriptions and made it possible to treat diseases that previously inevitably led to fatal outcome revolutionizing medicine. As a result, mortality has decreased significantly, life expectancy has increased, and its quality itself has improved.

Antimicrobial drugs began to be used everywhere, and many scientists predicted the complete disappearance infectious diseases. But it turned out completely differently, and today about 700,000 people die every year from pathogen resistance to drugs.

Antibiotics without prescriptions

For a long time, this is how they were sold, which led to widespread uncontrolled self-medication. Patients independently, without medical consultation, “prescribed” medicine for themselves at the first sign of malaise. But the fact is that ABPs help cope only with diseases caused by bacteria, protozoa or fungi, and against viruses, which are the most common cause colds, they are powerless. In addition, each drug is effective against a certain range of pathogens, and an incorrectly selected drug does not have a therapeutic effect.

As a result of such “treatment,” the disease worsens, a secondary, more severe infection occurs, and pathogenic strains become resistant to the drug.
The sale of antibiotics without prescriptions has created a threatening situation in medicine, where ordinary pneumonia cannot be cured by any modern medicines.

In addition, it became more common to experience serious complications diseases caused by viruses. Doctors all over the world began to declare the need government regulation sales of ABP to consumers.

Why are antibiotics sold only by prescription?

For a long time, no attention was paid to the problem, since science did not stand still and antimicrobial drugs were constantly being improved. The range of pharmacies expanded, and doctors had the opportunity to prescribe alternative antibiotic therapy if the main one did not produce results. However, it soon became obvious that pathogenic microorganisms began to adapt to new conditions faster and faster, and the growth of resistance reached very high rates.

In America and European countries, they treated the situation with full responsibility and have not sold antibiotics without prescriptions for a long time. There, to purchase medicine, you will definitely have to go to the doctor, even if you need the most safe drug with a minimum of contraindications. In the territory of the post-Soviet space, in particular in Russia, only in 2005 did the state listen to doctors and try to legislatively regulate the issue. A list has been compiled antimicrobial agents, which can be purchased freely, but pharmacy chains continued to operate as before.

Finally, in 2016, it came out new law, regulating the rules for dispensing antibiotics from pharmacies, where penalties for non-compliance have become significantly tougher. A very limited number of antibiotics can now be purchased without a prescription, mainly for external use. And organizations implementing antibacterial drugs in violation of the law, are subject to significant fines or are closed for up to 3 months. What drugs are not banned?

List of antibiotics without prescriptions

Detailed information about all legal documents regulating the healthcare sector is available on the website of the relevant ministry. There is also a list of drugs that are sold freely in pharmacy chains. Antimicrobial drugs include:

• Gramicidin S ®
• Nitrofural ®
• Nifuroxazide ®
• Sulfadiazine ®
• Sulfanilamide ®
• Sulfacetamide ®
• Ciclopirox ®
• Econazole ®
• Erythromycin+zinc acetate ®

All of these antibiotics, with the exception of Furazolidone ® , Fluconazole ® and Gramicidin S ® , are sold in the form dosage forms for outdoor and local application– ointments (including eye ones), solutions, creams, suppositories, etc. Any other antibiotics are sold according to a prescription written by a doctor on a special form.

Since the end of September, new rules for the dispensing of pharmaceutical products have come into force - established by Order of the Ministry of Health of the Russian Federation dated July 11, 2017 No. 403n “On approval of the rules for dispensing drugs,” which determines the process of dispensing these drugs by Russian pharmacies. It left neither consumers nor pharmacists indifferent, creating a kind of confusion regarding one point or another of the order. In order to clarify compliance with the new rules for dispensing drugs from pharmacies (order 2017) and eliminate gossip and discrepancies, we will formulate a number of popular questions about the new law on dispensing drugs (September 2017) and answer them.

Do the new dispensing rules classify all types of drugs as prescription drugs?

Of course not. The rules for dispensing prescription drugs have been partially updated and apply only to the dispensing of a clearly defined range of drugs. As for popular medications that do not require a prescription, there are no restrictions on dispensing, as before.

And after this order, you can just buy a medicine, although it requires a prescription?

As is known, the over-the-counter supply of medicines that require a doctor's prescription was prohibited. For violations, pharmacy personnel were subject to a hefty fine, and the pharmacy lost its license. However, to be honest, absolute law-abidingness is not observed by all citizens and institutions, not excluding pharmacies. Nevertheless, the adoption of a new law on the dispensing of drugs also has psychological impact on the unconscious part of our citizens, clients of pharmacies. Moreover, pharmacy workers had to become more attentive and strict regarding the prohibited over-the-counter dispensing of drugs.

How do you know if you need a prescription for a particular drug?

Firstly, whether a prescription is actually required is reflected in the attached instructions for use of any drug.

Secondly, there is no longer any need to rack your brains in despair if you accidentally lost the instructions - visit or call the doctor who prescribed this medication for you. By the way, approximately 70% of all registered Russian drugs have prescription status. Prescriptions are written out on special forms, most often drawn up in accordance with form No. 107-1/u.

Thirdly, you can solve this problem yourself, through the online store of our pharmacy at the address (if you have a computer in the house and know the name of the medicine). If the right drug is marked on our website with the label “dispensing drugs by prescription”, which means that the problem of needing a prescription for it has been solved, but an appointment with a doctor cannot be avoided. If there is no such mark, then over-the-counter dispensing of medicines is permitted.

How do you understand: “The prescription remains at the pharmacy”?

With regard to changes in the rules for the dispensing of drugs according to doctor’s prescriptions, the following is noted here. If medications are included in the list of narcotic or psychotropic drugs that require strict accounting, then prescriptions for them are not returned to the patient and remain in pharmacies to control their sale. Control is carried out by both Roszdravnadzor and the Ministry of Internal Affairs.

According to the new law on the dispensing of drugs (September 2017), this list has been expanded by a number of drugs:

• antidepressants,
• sleeping pills,
• neuroleptics,
• tranquilizers,
• alcohol-containing medications with an alcohol content of more than 15%.

“Alcohol-containing medicines”?.. It turns out that now you need a prescription for valerian or Corvalol?

No. According to the new order, as mentioned above, not all alcohol-containing drugs require a prescription. or no less popular, like a large number of other well-known elixirs and tinctures, has been given the status of over-the-counter medications. The proportion of alcohol in them is small, and, accordingly, in the instructions for use there is no note about the need for a prescription.

So, let’s say that there is a prescription, but several drugs are prescribed at once, and the name of one of them is marked “remains in the pharmacy.” However, at the moment, as a patient, I only need one medicine. Will they take my prescription?

Yes. Exceptions include only annual prescriptions, provided that you do not need all the medications listed at once, but only need one package of one of them. In this case, the pharmacy is deprived of the right to pick up this long-term prescription. The seller will only record the quantity purchased remedy, and will return the recipe.

Is it possible to receive medications if the prescription is written for a recipient other than the patient?

Yes. The dispensing of medicines according to a doctor's prescription is permitted to any holder of a prescription. In fact, all drugs are dispensed without problems - whether it is the patient himself, his relatives, friends or acquaintances. All you need to do is present a prescription.

Only narcotic or psychotropic medications fall under the exception. The prescription for them is written out on a specially designed sheet No. 107/u-NP pink color. To receive such drugs in a pharmacy, a power of attorney is required from the patient (including in handwritten form, without notarized confirmation) with a mandatory indication of the date of its preparation and a passport confirming the identity of the recipient.

What else is new in the distribution of medicines and pharmaceutical products?

When selling, pharmacies are now required to stamp “ Medicine released”, so their reuse is excluded. Keep in mind that if you want to refill the same medication, you will need to fill a new prescription.

Regardless of the fact that the drug received has instructions for use, the pharmacy employee is obliged to inform the buyer:

• about how to properly store the medicine;
• on compatibility with other medications;
• about methods and doses of administration;
• about the availability of cheaper analogues of this medicine in the pharmacy.

True, all this was already spelled out earlier in the law “On the Fundamentals of Protecting Citizens’ Health” and “Rules of Good Pharmacy Practice”, but on at the moment the provision on mandatory informing of consumers by pharmacists began to apply to the procedure for dispensing medicines.

This is important!

1. The new order No. 403n canceled the effect of order No. 785, concerning the dispensing of narcotics and psychotropics only by an attached pharmacy. The pharmacy is now obliged to service prescriptions for such drugs prescribed in a clinic in any region of the Russian Federation.
2. According to the new order No. 403n, the standard for dispensing (no more than two packages) of over-the-counter drugs has now been abolished.