Usually we do not think about the cost-effectiveness of the treatment prescribed by the attending physician until the amount exceeds some threshold amount. We do not choose medicines, but doctors, pharmacists, marketers of drug manufacturers decide for us which medicines to use.
In order to become an active participant in your own treatment, you need to know that almost all drugs have synonyms (containing the same active chemicals) and analogues (containing different active substances, but intended to treat the same diseases). The price for analogues and synonyms differs very much, and the number of such analogues sometimes reaches several tens. More expensive drugs are distinguished by a greater degree of purification, the presence of additional additives that affect the duration of the action of the main substance, and the absence of certain side effects. The price of expensive drugs includes advertising, a patent component, a more complex manufacturing technology and the manufacturer's profit. But cheaper medicines are not counterfeited, because it is not profitable. In addition, all analogues and synonyms also undergo rigorous testing and application tests, and only then receive a brand name and their own name for the drug. So at the doctor's appointment you should ask about the analogues, the active substance of the drug.
The following table lists analogues and synonyms for many expensive drugs. Prices are very approximate as they are constantly rising, but the difference in prices is noticeable.
Table of analogues and synonyms of expensive drugs
| Expensive medicine | Cheaper equivalent or synonym | Approximate price (prices are constantly changing, but the difference remains) | Prescribing the drug | |
| Coldrex | 371 ruble | Prostudox | 73 rubles | Antipyretic, immunomodulatory |
| Azimed | 484 rubles | Azithromycin | 96 rubles | Antibiotic |
| Ambrobene | 3,5$ | Ambroxol | 1.75$ | For bronchitis |
| Amlotop | 170 rubles | Amlodipine | 45 rubles | Hypotensive, antianginal |
| Antigrippin | 90-210 rubles | Antigrippin SARS / Agri (Antigrinnip) | 90/37 rubles | For flu and colds |
| Arifon | 370 rubles | Indap/Indapamide | 63/90 rubles | |
| Aspirin, Aspirin Upsa | 97 rubles | Acetylsalicylic acid | 4 rubles | For flu and colds |
| Aspirin cardio | 135 rubles | cardiask | 35 rubles | Non-steroidal anti-inflammatory drug |
| Atsik | 2,5$ | Acyclovir | 1$ | For herpes |
| ACC (acetylcysteine) | 150-200 rubles | 8/20-55/35/20 rubles | From cough | |
| Belosalik | 380 rubles | Akriderm SK | 40 rubles | |
| Bepanthen | 230 rubles | Dexpanthenol | 83 rubles | |
| Betaserc | 520 rubles | Betahistine | 220 rubles | |
| Bronchosan (Bromhexine) | 120 rubles | Solvin / Mukaltin (Marshmallow medicinal root) / Marshmallow root / Marshmallow syrup / Oregano herb | 40-60/8/20-55/35/20 rubles | From cough |
| Brufen retard | 135 rubles | ibuprofen | 12 rubles | |
| Bystrumgel | 150 rubles | Ketoprofen | 60 rubles | |
| Valocordin | 34 rubles | Corvalol / Corvaldin | 8 rubles | sedative |
| Viagra | 1500 rubles | Sildenafil | 540 rubles | For the treatment of erectile dysfunction |
| Voltaren | 284 rubles | Diclofenac | 33 rubles | |
| Gastrosol | 120 rubles | Omeprazole | 50 rubles | |
| Gedelix (ivy leaf extract) | 170 rubles | Mukaltin (Marshmallow medicinal root) / Marshmallow root / Marshmallow syrup / Oregano herb | 8/20-55/35/20 rubles | From cough |
| Heptral | 1902 rubles | Heptor | 878 rubles | Antidepressant |
| De-nol | 950 rubles | Gastro norms | 220 rubles | |
| Detralex | 642 rubles | Venarus | 329 rubles | For the treatment of varicose veins |
| Diprosalik | 280 rubles | Akriderm | 180 rubles | |
| Diflucan | 480 rubles | Fluconazole | 20 rubles | For the treatment of thrush |
| For the nose | 80 rubles | Rinostop/Xilen | 17/19 rubles | From a cold |
| Zantac | 280 rubles | Ranitidine | 50 rubles | |
| Zyrtec | 220 rubles | Cetirinax | 80 rubles | |
| Zovirax (cream) | 370 rubles | Acyclovir | 19 rubles | |
| Immunal | 202 rubles | Echinacea (drops) | 40 rubles | Immunostimulating |
| Imodium | 248 rubles | loperamide | 57 rubles | for diarrhea |
| Imunotice | 46 rubles | Echinacea extract | 3 rubles | |
| Iodomarin | 236 rubles | Potassium iodite | 69 rubles | |
| Cavinton | 600 rubles | Vinpacetin | 225 rubles | |
| Kapoten | 190 rubles | Captopril | 11 rubles | |
| Ketoprofen | 290 rubles | ibuprofen | 12 rubles | Antipyretic and anti-inflammatory |
| Claritin | 212 rubles | Clarotadine | 95 rubles | From allergies |
| Klacid | 615 rubles | Clarithromycin | 175 rubles | |
| Koldakt | 105 rubles | Paracetamol | 5 rubles | Antipyretic and anti-inflammatory |
| Cordipin | 41 rubles 10 tablets | Cordaflex | 58 rubles 100 tablets | Lowering blood pressure and heart |
| Creon | 263 rubles | Pancreatin | 36 rubles | Digestive enzymes |
| Xenical | 2024 rubles | Orsoten | 1161 rubles | For weight loss |
| Lazolvan (ambroxol) | 222 rubles | Ambroxol | 16 rubles | Bronchitis, pneumonia |
| Lamisil | 390 rubles | Terbinafine | 282 rubles | from fungal diseases |
| Lyoton | 7,5$ | Trombless | 5$ | Vascular obstruction |
| Lyoton 1000 | 360 rubles | Heparin-acry gel 1000 | 95 rubles | |
| Lomilan | 140 rubles | Lorahexal | 48 rubles | |
| Losek maps | 1120 rubles | Omez | 177 rubles | |
| Maxidex | 110 rubles | Dexamethasone | 40 rubles | |
| Mezim, Mezim-Forte | 71 ruble | Pancreatin | 36 rubles | Digestive enzymes |
| Midriacil | 350 rubles | Tropicamide | 100 rubles | |
| Miramistin | 225 rubles | Chlorhexidine | 12 rubles | |
| Movalis | 691 rubles | Meloxicam | 145 rubles | for arthritis |
| Motilium | 10$ | Motilac | 5,2$ | Nausea, heaviness in the stomach |
| Nazivin | 100 rubles | Rinostop/Xilen | 17/19 rubles | From a cold |
| Naklofen | 3,5$ | Diclofenac | 1$ | Arthritis, rheumatism |
| Neuromultivitis | 100 rubles | Pentovit | 40 rubles | |
| Nootropil 400 mg | 169 rubles | Piracetam 400 mg | 21 ruble | |
| Normodipin | 650 rubles | Amlodipine | 40 rubles | |
| notta | 154 rubles | Novo-passit | 65 rubles | soothing |
| No-shpa | 106 rubles | Drotaverine / spasmol | 10/35 rubles | Antispasmodic |
| Nurofen | 68 rubles | ibuprofen | 6 rubles | Pain reliever |
| Omez | 190 rubles | Omeprazole | 26 rubles | |
| Otrivin | 190 rubles | Rinostop | 20 rubles | |
| Panadol | 54 rubles | Paracetamol | 24 rubles | Antipyretic |
| Panangin | 156 rubles | Asparkam | 11 rubles | Heart arythmy |
| Pantogam | 320 rubles | Calcium Hopantenate/Pantocalcin | 139/250 rubles | Improving brain activity |
| Pair-plus from lice | 400 rubles | hellebore water | 25 rubles | |
| Pentalgin-N | 79 rubles | Spazgan | 14.5 rubles | Antispasmodics and analgesics |
| Plavix | 2770 rubles | Sylt | 900 rubles | |
| Preductal | 11$ | Triductan | 5,5$ | Cardiology |
| Preductal MV | 850 rubles | Deprenorm MV | 300 rubles | |
| Rhinonorm | 45 rubles | Rinostop/Xilen | 17/19 rubles | From a cold |
| Sanorin | 100 rubles | Naphthyzin | 7 rubles | |
| Sumamed | 450 rubles | Azithromycin | 90 rubles | Antibiotic (for sore throat, pneumonia) |
| TeraFlu | 266 rubles | Influnorm | 145 rubles | For flu and colds |
| Traflu extra for flu and colds | 250 rubles | Paracetamol + ascorbic acid | 6-45 rubles + 5-20 rubles | For flu and colds |
| Tiberal | 347 rubles | Metronidazole | 4 rubles | Antiviral and anti-infective |
| Trental | 220 rubles | Pentoxifylline | 50 rubles | |
| Triderm | 650 rubles | Akriderm GK | 300 rubles | |
| Trichopolum | 80 rubles | Metronidazole | 10 rubles | Antiviral and anti-infective |
| Troxevasin | 210 rubles | Troxerutin | 120 rubles | |
| Ultop | 270 rubles | Omeprazole | 50 rubles | |
| Ultra adsorb | 247 rubles | Activated carbon | 18 rubles | |
| Ursofalk | 210 rubles | Ursosan | 165 rubles | |
| Fastum-gel | 179 rubles | Ortofen | 25 rubles | Muscle pain, sprains |
| Fastum-gel | 240 rubles | Ketoprofen | 60 rubles | Muscle pain, sprains |
| Phenotropil 100 mg | 711 rubles | Piracetam 200 mg | 11 rubles | Improving brain activity |
| Fervex | 83 rubles | Paracetamol | 1 ruble | Antipyretic and anti-inflammatory |
| Finlepsin | 250 rubles | Carbamazepine | 40 rubles | |
| Flemoxin Solutab | 95 rubles | Amoxicillin | 11 rubles | Antibiotic |
| Flucostat | 135 rubles 1 capsule | Fluconazole/Diflucan | 20 rubles / 298 rubles 7 capsules | Antibiotic |
| Forkan | 319 rubles 4 capsules | Diflucan | 298 rubles 7 capsules | Antibiotic |
| Furamag | 350 rubles | Furagin | 40 rubles | |
| Hemomycin | 270 rubles | Azithromycin | 100 rubles | |
| Echinacea extract Dr. Theis | 150 rubles | Echinacea extract. Russian variant | 23 rubles | Immunostimulating |
| Enap | 130 rubles | Enalapril | 80 rubles | Lowering blood pressure and heart |
| Ercefuril | 390 rubles | Furazolidone | 12 rubles |
It is worth recalling that both the originals and analogues with synonyms have side effects. Therefore, before use, you need to carefully study the instructions.
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 a fortune on this. However, it happens that drugs 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 its 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 prices. 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 analogue, 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 accompanying 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 determined 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 you buy a medicine, you should read the attached instructions for it, where all its advantages in treatment and a number of side effects are indicated. 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!
The life of any drug begins with a name, which can be several - chemical, trade, national generic, generic or international non-proprietary name of the drug (abbreviated as INN). The latter is considered especially important for all medical and pharmaceutical workers. This name is assigned to the active substance of the drug, has worldwide recognition and is considered public property.
Some historical facts about INN
The beginning of the system of international generic names was laid by the resolution of the World Health Assembly in the fiftieth year. The first list of INNs was published three years later.
Since that time, the system has been working. Currently, this organization constantly publishes a directory of international generic names of medicines and a journal containing a list of INNs. The essence of the system is to help healthcare professionals, using an exclusive and at the same time common name all over the world, to establish each pharmaceutical substance. An international range of such substances in INN form is needed to:
- international information exchange between medical and pharmaceutical workers, as well as scientists;
- safe prescribing and dispensing to patients;
- identification of drugs.
Tasks of the INN system
The international non-proprietary name of medicines is unique and should not be consonant with other names so that it cannot be confused with other commonly used names. In order to be used worldwide, these names are non-proprietary, i.e. they can be used without restrictions to identify pharmaceutical substances. One of the features of the INN system is that due to the use of common elements of words in the names of substances that are similar in pharmacological properties, their relationship can be traced.
As a result, any specialist in the field of pharmacy or medicine understands that substances belong to a certain group with similar activity.
Use of INN
INNs belonging to the same pharmacological group have similar properties. names of medicines are used:
- when marking;
- in advertising publications;
- in scientific literature;
- in regulatory documents;
- in information about the drug;
- in pharmacopoeias.
Their application is provided for by international or national legislation. To avoid confusion and in order to exclude a threat to the health of individuals, it is forbidden to borrow trade names from the INN. There are countries where a special font size is defined that is allowed to print the generic name under an advertisement or brand name.
Why assign INN?
International non-proprietary names of medicines are assigned by a specially created commission of the World Health Organization (WHO) in accordance with a certain procedure. The generic name helps specialists understand the many drugs that appear on the pharmaceutical market after the expiration of the patent for the original drug. Many drugs with the same INN have different trade names. For example, a drug called "Ciprofloxacin" - this INN has about thirty-eight trade names, "Diclofenac" - fifty-two, and the well-known "Paracetamol" - thirty-three. Many drugs are made on the basis of one substance, for example:
- 55 drugs are made from penicillin;
- from nitroglycerin - 25;
- from diclofenac - 205.
Every year the total number of INNs increases by more than a hundred items. Currently, there are more than eight and a half thousand.
How is the list of international generic names of medicines selected and published?
The INN is assigned only to those substances that can be characterized by a chemical formula or nomenclature. In accordance with the policy followed by WHO, names are not selected for herbal preparations and homeopathic preparations, as well as mixtures. In addition, names are not selected for substances used for a long period of time for medical purposes under specific names and for some common chemical names, for example, acetic acid. The selection process itself is quite long, and lasts more than two years. After notification of the submitter, all names are printed by WHO in a special magazine. During the year, since 1997, the following lists of titles have been issued:
- proposed;
- recommended.
Moreover, they are compiled in Spanish, English, French, and also contain the Latin name of each INN. In addition, a complete list of international generic drug names is printed. It is subject to regular updates. It lists the names in six different languages, including Latin.
Application of INN
The growth in the number of generic names expands the scope of their application. Due to the global recognition and active use of the INN system in practical medicine, most pharmaceutical substances are designated using the international non-proprietary name. When filling out clinical documents or conducting various studies, INN is used quite widely and has already become quite commonplace. In addition, the importance of INN is increasingly increasing as a result of the active use of generic names for pharmaceutical products.
Use of INN in practical medicine
What is the international non-proprietary name of medicines? In the Federal Law "On the Circulation of Medicines" this concept is deciphered as follows - this is the name of the pharmaceutical substance proposed by WHO. As mentioned above, the INN system was invented to classify and record the names of active substances and their free use in the medical and pharmaceutical community. Starting from 2012, in practical medicine, all prescriptions and prescribing of medicines are carried out according to the INN, and in their absence, according to the grouping names. When choosing a drug, doctors need to distinguish between such concepts as:
- the name of the active substance;
- trade name of a medicine containing a pharmacologically active, i.e. active substance.
On the pharmaceutical market, there are a huge number of trade names for drugs that are manufactured by different manufacturers, but have the same active ingredient. In all official instructions for the medical use of the drug, as well as on the packages, there is an international non-proprietary name of the drug. Knowing and using the INN enables doctors to prescribe drugs efficiently and rationally, as well as to use limited financial resources economically.
Search for analogues and synonyms
Analogues are drugs that have a similar pharmacological effect and mechanism of action. Such drugs may belong to different pharmacological groups, have different therapeutic effects, have different contraindications and side effects. For example, "Remantadin", "Kagocel", "Ingavirin" are similar means. Synonyms are drugs with different trade names, but having the same INN. Consider a few examples of drugs-synonyms. Listed below are drugs with the international non-proprietary name "Drotaverine" and "Paracetamol".
The first includes "No-shpa", "Spazmol", "Spakovin", "Spazmoverin", the second - "Kalpol", "Ifimol", "Prohodol". Many people confuse these two concepts and often look for cheap analogues in pharmacies. It is important to understand that analogues are not synonymous, and only a doctor can choose them correctly. And any patient is able to choose a synonymous drug on their own, depending on the preferences of a particular trade name and country of origin of the drug.
To save money on medicines, you need to clearly understand what exactly you need to look for. To do this, you need to understand the terminology and what the doctor writes in the prescription.
This is very important because confusion about terms can result in you choosing a drug that is not the one your doctor prescribed.
Patients often seek similar expensive cheap medicines, not understanding the meaning of the terms "analogue", "synonym", "generic". Therefore, before you start looking for a cheap drug, let's understand the terminology.
Since July 1, 2013, the order of the Ministry of Health of the Russian Federation No. 1175n obliged doctors to indicate in the prescription not the commercial name of the drug, but the international non-proprietary name (INN), that is, the active substance.
Fig. 2 - What the doctor writes in the prescription.
This means that physicians should not prescribe drugs to patients under their trade name, that is, certain manufacturers who could pay physicians for this remuneration. Now doctors are required to indicate the active substance in the prescription, according to which the patient can choose a drug from the trade names available in the pharmacy.
INN, original, generic, synonym, analogue - terminology
You may hear or already know the following terms and phrases in relation to medicines:
- international non-proprietary name (INN),
- original (brand) medicine,
- generic,
- synonym,
- analogue (analogous medicine).
International non-proprietary name (INN)
International non-proprietary name (INN) is the unique name of the active substance of the medicinal product. Each drug must have one or more active ingredients and there may be several additional and auxiliary substances.
It is the active substances that have the main therapeutic effect on a particular disease. This is the active substance and the doctor should indicate in the prescription.
Original (brand name) medicine
Huge amounts of money are spent on the creation of a new drug - from several hundred million dollars to a billion, and it also takes a long period of time - up to 10-15 years. In addition to developing a formula for an active substance, it is necessary to determine its effectiveness and side effects, starting with tests on cells, mice and ending with volunteers, develop a technology for its production, and conduct an expensive advertising campaign.
On average, the term of a patent is about 25 years, and for the remaining 10-15 years, the manufacturer must recover its costs for the development and launch of the original drug on the market and make a profit, so the cost of patented drugs is very high, but the quality is guaranteed.
Generic
Generic is a medicinal product with the same active substance as the drug with a patented name.
Generics are sold under an international non-proprietary name or under a proprietary name that differs from the brand name of the drug developer. Generic drugs are usually called medicines, the active substance of which has expired patent protection. As a rule, generic drugs do not differ in their effectiveness from the original drugs, but they are much cheaper.
A generic drug is much cheaper for the manufacturer, since there is no need to spend money on expensive and ten-year drug development, clinical trials, and development of production technology. In addition, during the time that patent protection lasts, some side effects and complications are revealed, and generic manufacturers can only take them into account in the instructions for use, without spending money on research. Therefore, generics are cheaper than branded drugs, and sold out much faster. Generic is actually a fake, but of high quality and legal. A generic manufacturer legally registers its brand, and in order to avoid accusations of copyright infringement, replaces one or two letters in the name of the drug or gives it a different name.
Generics have the same medicinal properties, since they contain the same active ingredients as the original. The side effects of generics and the brand are also the same. Generics are bought more often than originals, even in such prosperous countries as the United States or Sweden.
One originator drug may have several generics that differ significantly in price both from the originator drug and from each other.
The cheapest generics are presented in my table, and you can find all the rest yourself using the method that will be described below.
Generic is not always the cheapest drug containing this active ingredient, so in my table drugs are not divided into generics and originals, but into expensive and cheap drugs.
Synonym
This term can be used by doctors in relation to generics. Therefore, everything that is written about generics also applies to synonyms. If the doctor in a conversation with you uses the term "synonym", ask him if he means the generic in this case or puts some other meaning into the term "synonym".
Analogue or similar medicine
This term is most often associated with confusion in concepts. Sometimes this term is erroneously used in relation to generics, and this is a serious mistake.
Similar to the original medicine- it is most often not a generic. A similar medicine (analogue) often contains a completely different active substance.
Usually, analogues mean drugs belonging to the same group, for example, antihistamines, and these are drugs that are completely different in terms of the active substance, and they do not have the same effect on the patient.
You can choose a generic drug yourself according to the active ingredient indicated in the prescription by your doctor, or you can consult a pharmacist who, based on this prescription, will suggest a medicine with the active ingredient you need. It will be legal and safe for your health.
Analogue (similar drug) only a doctor can prescribe you. You cannot independently completely safely and competently replace a medicine with one active substance with an analogue of this medicine, that is, with a completely different medicine with a different active substance, but with a similar effect. And a pharmacist cannot legally give you that advice.
A similar medicine can be qualified only by a doctor at the reception. And you can find and choose a generic of the original medicine yourself, and I will teach you this.
On the Internet, the concepts of “analogue”, “analogous medicine” are often used, but it is meant by this “ analogue of the active substance”, “a drug similar in active substance” or generic. That is why it is so important to first understand the terminology in order to clearly understand whether we are talking about analogue of the drug according to the active substance!
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When we come for a drug prescribed by a doctor, we may encounter its absence not only in the pharmacy itself, but also in the warehouse. And it is not always possible to order a medicine, for example, from a manufacturer. In this case, the pharmacist or pharmacist offers a replacement for the missing drug - synonym or analogue. The words seem to be well-known and often used in everyday life, but as a rule, not everyone correctly understands their meaning. So what is a synonym and analogue of a drug? And we will also figure out whether it is possible to trust the advice of a pharmacist to replace the missing drug.
Drug Synonyms
For a better understanding, consider such concepts as the international non-proprietary name and the trade name of the drug.
Any drug in its composition contains an active or active substance, which has a pharmaceutical (therapeutic) effect on the body. The active substance of the drug is international non-proprietary name(INN). INN can be seen on the package of the drug. It has a smaller font and is placed under trade name- the name under which the drug is sold in the pharmacy.
For example, in the absence of Nurofen Forte in pharmacies, a pharmacist or pharmacist may suggest replacing Iburofen-Hemofarm, Faspik or Mig 400 with drugs.
The drugs have the same form of release - film-coated tablets at a dosage of 400 mg, and the same active ingredient - ibuprofen. These drugs differ in cost: Nurofen Forte costs about 100 rubles, Iburofen-Hemofarm - 75 rubles, Faspik - 110 rubles, Mig 400 - 150 rubles. These drugs are synonymous and completely interchangeable with each other.
You can also give illustrative examples of some popular drugs. Voltaren solution for injection costs about 300 rubles, its synonym Diclofenac - 58 rubles, Panangin - 140 rubles, Asparkam's synonym - 50 rubles, Ketanov - 118 rubles, its synonym Ketorolac - 65 rubles.
The advantage of synonyms is their diversity in the pharmaceutical market and the difference in the price range, reaching hundreds of rubles in some cases. A synonymous drug can be selected at the lowest price.
You can choose a synonym using a specialized directory by contacting a doctor or pharmacist. Also, with this replacement, it is necessary to make sure that the dosage of the active substance for the medicines matches.
Not all drugs have synonyms.
Analogues of medicines
Analogues of medicines- drugs that contain different active substances in their composition, but are used to treat the same diseases. These drugs have a different therapeutic effect, indications and contraindications for use can be very different.
For example, antiviral drugs Arbidol and Kagocel are analogues to each other. These drugs have different active ingredients, but belong to the same pharmacological group and are used for influenza.
If you need a similar replacement of the drug, you should always consult with your doctor for greater effectiveness of therapy. The attending physician will take into account your comorbidities and characteristics of the body to prevent the development of adverse side effects.
