1. azithromycin 2. ambroxol 3. amlodipine 4. amoxicillin + clavulanic acid 5. articaine 6. atorvastatin 7. acyclovir 8. bisacodyl 9. bromocriptine 10. verapamil In accordance with the current rules, fill out a prescription form for the medicinal product based on the model of its commercial packaging. 2. Name the pharmacological group to which the drug prescribed in the prescription belongs, as well as the main indications for its use. 3. Replace the drug prescribed in the prescription with another drug - an analogue in terms of the main pharmacological action (justify your choice). 4. List other (possible) forms of release of the prescribed drug and propose, taking into account its international nonproprietary name, an alternative drug - a synonym.

Asking for Preferences

Reading File

Finding Sources

Searching the Web

Russian prescription form RF-107 rules 2024 filling rules drug prescription blank

I have enough information to compile a thorough answer for all 10 drugs. Given this is a Russian pharmacology curriculum task (the format, drug list, and task structure are characteristic of Russian medical school pharmacology practicals), I'll use the standard Russian prescription format (Form 107-1/u for non-controlled drugs, in Russian academic style rendered in English).

Here is the complete answer for all 10 drugs:

Prescription Task - All 10 Drugs

Format Notes

Russian outpatient prescriptions use Form 107-1/u. Required fields:

Date, patient name, age, physician name, stamp
Rp.: (Recipe) - drug name in Latin (genitive case), dose, quantity
D.S.: (Dentur. Signetur) - dispensing and patient instructions in Russian
Physician signature + personal seal

1. AZITHROMYCIN

Prescription (based on commercial packaging - Azithromycin 500 mg tablets, pack of 3)

Date: 07.06.2026

Patient: Ivanov Ivan Ivanovich, age 32

Rp.: Azithromycini 0,5
D.t.d. N. 3 in tab.
S.: Take 1 tablet once daily, 1 hour before meals, for 3 days.

Physician: _____________ /signature/  Stamp

Pharmacological Group & Indications

Group: Macrolide antibiotic (15-membered azalide subclass).

Main indications:

Community-acquired pneumonia (atypical pathogens: Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella)
Acute bacterial exacerbations of chronic bronchitis
Pharyngitis/tonsillitis (beta-hemolytic streptococcus, as alternative to penicillins)
Skin and soft tissue infections
Urogenital infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae
Otitis media in children
Prevention and treatment of Mycobacterium avium complex (MAC) infections in HIV patients

Analogue (same pharmacological action - macrolide antibiotic)

Clarithromycin (Klacid) - also a macrolide antibiotic, same mechanism (reversibly binds to 50S ribosomal subunit, inhibits bacterial protein synthesis). Clarithromycin has a broader spectrum including H. pylori and better tissue penetration in some infections (e.g., sinusitis). Available as 250 mg and 500 mg tablets, prescribed twice daily (unlike azithromycin's once-daily regimen).

Other Release Forms & Synonym

Other forms of azithromycin:

Capsules 250 mg (pack of 6)
Powder for oral suspension 100 mg/5 ml and 200 mg/5 ml (for pediatric use)
Lyophilisate for IV infusion 500 mg/vial (hospital use)
Eye drops 1% (ophthalmic, e.g., Azyter)

Synonym (same INN): Sumamed (Pliva/Teva) - the original brand; also Zitrolid, Hemomycin, AzitRus, Azitrox. All contain the same active substance - azithromycin.

2. AMBROXOL

Prescription (based on commercial packaging - Ambroxol 30 mg tablets, pack of 20)

Date: 07.06.2026

Patient: Petrova Anna Sergeevna, age 28

Rp.: Ambroxoli 0,03
D.t.d. N. 20 in tab.
S.: Take 1 tablet 3 times daily after meals for 5 days, then 1 tablet twice daily.

Physician: _____________ /signature/  Stamp

Pharmacological Group & Indications

Group: Mucoactive agent; secretomotor / mucolytic (bromhexine metabolite).

Main indications:

Acute and chronic bronchitis with viscous sputum
Pneumonia (adjunct to antibiotic therapy)
Bronchial asthma with impaired mucus clearance
Bronchiectasis
COPD with sputum production
Respiratory distress syndrome in newborns (stimulates surfactant synthesis - administered to premature infants)
Pre- and postoperative airway clearance

Analogue (same pharmacological action - mucolytic)

Acetylcysteine (ACC, N-acetylcysteine) - mucolytic that directly breaks disulfide bonds in mucus glycoproteins, reducing sputum viscosity. Effective for the same indications (bronchitis, COPD). Mechanism differs from ambroxol (ambroxol stimulates Clara cells to produce surfactant and enhances ciliary activity; acetylcysteine is a direct mucolytic and antioxidant). Choice of ACC is justified when rapid, powerful mucolysis is needed.

Other Release Forms & Synonym

Other forms of ambroxol:

Syrup 15 mg/5 ml and 30 mg/5 ml (100 ml bottles, pediatric and adult)
Solution for oral use/inhalation 7.5 mg/ml
Lozenges 15 mg
Solution for injection 15 mg/2 ml (IV/IM/SC for hospital use)
Extended-release capsules 75 mg (Ambroxol retard)

Synonym: Lazolvan (Boehringer Ingelheim) - original brand; also Ambrobene, Flavamed, Halixol. All contain ambroxol hydrochloride as the active substance.

3. AMLODIPINE

Prescription (based on commercial packaging - Amlodipine 5 mg tablets, pack of 30)

Date: 07.06.2026

Patient: Sidorov Petr Nikolaevich, age 55

Rp.: Amlodipini 0,005
D.t.d. N. 30 in tab.
S.: Take 1 tablet once daily, at any time of day, regardless of meals.

Physician: _____________ /signature/  Stamp

Pharmacological Group & Indications

Group: Calcium channel blocker (CCB), dihydropyridine subclass; antihypertensive and antianginal agent.

Main indications:

Arterial hypertension (monotherapy or in combination)
Stable angina pectoris (exertional)
Vasospastic angina (Prinzmetal angina)
Chronic coronary artery disease (including angiographically confirmed CAD without heart failure)

Analogue (same pharmacological action - dihydropyridine CCB)

Nifedipine (Corinfar, Adalat) - same subclass (dihydropyridine CCB), blocks L-type Ca²⁺ channels in vascular smooth muscle causing vasodilation. However, nifedipine has shorter half-life (requires 2-3 doses/day for IR form) and causes more reflex tachycardia compared to amlodipine's long half-life (~35-50 h) allowing once-daily dosing. Felodipine (Plendil) or lercanidipine are closer analogues with similar once-daily profiles.

Other Release Forms & Synonym

Other forms of amlodipine:

Tablets 2.5 mg, 5 mg, 10 mg (most common forms)
Fixed-dose combination tablets: Amlodipine + Atorvastatin (Caduet), Amlodipine + Valsartan (Exforge), Amlodipine + Perindopril (Prestalia/Dalneva), Amlodipine + Bisoprolol (Concor AM)

Synonym: Norvasc (Pfizer) - original brand; also Amlovas, Stamlo, Tenox, Amlotop. All contain amlodipine besylate (or amlodipine maleate - same active moiety).

4. AMOXICILLIN + CLAVULANIC ACID

Prescription (based on commercial packaging - Amoxicillin 500 mg + Clavulanic acid 125 mg tablets, pack of 14)

Date: 07.06.2026

Patient: Kozlova Maria Ivanovna, age 40

Rp.: Amoxicillini 0,5 + Acidi clavulanici 0,125
D.t.d. N. 14 in tab.
S.: Take 1 tablet 3 times daily with meals for 5-7 days.

Physician: _____________ /signature/  Stamp

(Note: Also commonly available as 875 mg/125 mg - pack of 14, dosed twice daily)

Pharmacological Group & Indications

Group: Beta-lactam antibiotic (aminopenicillin) combined with a beta-lactamase inhibitor; broad-spectrum antibacterial agent.

Main indications:

Community-acquired pneumonia
Acute sinusitis, otitis media
Acute exacerbations of chronic bronchitis
Urinary tract infections (cystitis, pyelonephritis)
Skin and soft tissue infections
Intra-abdominal infections
Diabetic foot infections
Bite wounds (animal/human)
Dental infections

Analogue (same pharmacological action - protected penicillin / beta-lactam + inhibitor)

Ampicillin + Sulbactam (Unasyn) - another beta-lactamase inhibitor combination. Sulbactam irreversibly inhibits beta-lactamases and also has intrinsic antibacterial activity against Acinetobacter. Justified as an alternative when Acinetobacter infections are suspected or in hospital settings. For outpatient use, Piperacillin + Tazobactam (Tazocin) is an alternative for more severe infections.

Other Release Forms & Synonym

Other forms of amoxicillin + clavulanate:

Tablets 250 mg/125 mg, 500 mg/125 mg, 875 mg/125 mg
Powder for oral suspension (125 mg/31.25 mg per 5 ml; 200 mg/28.5 mg per 5 ml; 400 mg/57 mg per 5 ml)
Powder for IV solution 1000 mg/200 mg, 500 mg/100 mg (hospital use)

Synonym: Augmentin (GSK) - original brand; also Amoxiclav, Flemoclav, Panklav, Ranklav. All contain the fixed amoxicillin/clavulanate combination.

5. ARTICAINE

Prescription (based on commercial packaging - Articaine 4% solution with epinephrine 1:100,000, 1.7 ml dental cartridge, pack of 50)

Date: 07.06.2026

Patient: Novikova Elena Aleksandrovna, age 35

Rp.: Sol. Articaini 4% - 1,7 ml
     (cum Epinephrino 1:100 000)
D.t.d. N. 10 in cartulis.
S.: For infiltration or conduction dental anesthesia, 1.7 ml per injection site. Administer by dentist only.

Physician-dentist: _____________ /signature/  Stamp

(Note: In practice, articaine is predominantly prescribed/administered in dental settings from cartridges; may also be in ampoule form for hospital use)

Pharmacological Group & Indications

Group: Local anesthetic, amide type; contains both an ester and amide group (thiophene ring structure). Often classified as amide-class local anesthetic.

Main indications:

Infiltration anesthesia in dentistry
Conduction (nerve block) anesthesia in dentistry
Intraoral soft tissue and bone surgery anesthesia
Tooth extraction, pulpotomy, cavity preparation
Periodontal procedures
Implantology
Also used in maxillofacial surgery and minor outpatient surgical procedures

Analogue (same pharmacological action - amide local anesthetic)

Lidocaine (Lidocaini) - the classic amide local anesthetic, also blocks voltage-gated Na⁺ channels. Lidocaine 2% is widely used in dentistry (though articaine 4% has superior tissue penetration and can achieve adequate anesthesia even through bone). Lidocaine is also used for topical, infiltration, spinal, and epidural anesthesia. Justified as alternative when articaine is unavailable or in patients with articaine hypersensitivity.

Other Release Forms & Synonym

Other forms of articaine:

Solution for injection 4% (1.7 ml dental cartridges) - with epinephrine 1:100,000 or 1:200,000
Solution for injection 4% without vasoconstrictor (for patients with contraindications to epinephrine)
Ampoules 1% and 2% for larger volume infiltration (less common)

Synonym: Ubistesine (3M ESPE), Septanest (Septodont), Alfacaine, Ultracain DS - all contain articaine as the active substance (with or without epinephrine/adrenaline).

6. ATORVASTATIN

Prescription (based on commercial packaging - Atorvastatin 20 mg tablets, pack of 30)

Date: 07.06.2026

Patient: Morozov Alexei Viktorovich, age 58

Rp.: Atorvastatini 0,02
D.t.d. N. 30 in tab.
S.: Take 1 tablet once daily in the evening, regardless of meals.

Physician: _____________ /signature/  Stamp

Pharmacological Group & Indications

Group: HMG-CoA reductase inhibitor (statin); hypolipidemic agent.

Main indications:

Primary hypercholesterolemia (Fredrickson Type IIa and IIb)
Mixed dyslipidemia
Homozygous familial hypercholesterolemia (high-dose atorvastatin)
Primary prevention of cardiovascular events in patients with multiple risk factors (including type 2 diabetes)
Secondary prevention: reduction of MI, stroke, revascularization, and angina hospitalizations in patients with established CAD
Reduction of non-fatal MI and fatal/non-fatal stroke risk

Analogue (same pharmacological action - statin)

Rosuvastatin (Crestor) - also an HMG-CoA reductase inhibitor, but more potent on a mg-for-mg basis (rosuvastatin 10 mg ≈ atorvastatin 20 mg in LDL-lowering). Rosuvastatin is hydrophilic (less hepatic first-pass), does not undergo significant CYP3A4 metabolism (less drug-drug interaction compared to atorvastatin), and is preferred when stronger LDL reduction is needed or when CYP3A4 interactions with atorvastatin are problematic (e.g., in patients taking clarithromycin or verapamil).

Other Release Forms & Synonym

Other forms of atorvastatin:

Tablets 10 mg, 20 mg, 40 mg, 80 mg
Fixed-dose combinations: Atorvastatin + Amlodipine (Caduet/Liptonorm Plus), Atorvastatin + Ezetimibe (Liptruzet)

Synonym: Lipitor (Pfizer) - original brand; also Torvacard, Tulip, Atomax, Liprimar. All contain atorvastatin calcium as the active substance.

7. ACYCLOVIR

Prescription (based on commercial packaging - Acyclovir 200 mg tablets, pack of 20)

Date: 07.06.2026

Patient: Volkova Natalia Dmitrievna, age 26

Rp.: Acycloviri 0,2
D.t.d. N. 20 in tab.
S.: Take 1 tablet 5 times daily (every 4 hours, omitting the night dose) for 5 days.

Physician: _____________ /signature/  Stamp

(For herpes zoster, higher dose: Acyclovir 0,8 tab., 5 times daily x 7 days; or 400 mg tabs pack of 30 for suppressive therapy)

Pharmacological Group & Indications

Group: Antiviral agent; nucleoside analogue (guanosine analogue); selectively activated by viral thymidine kinase.

Main indications:

Herpes simplex virus (HSV-1 and HSV-2) infections: orolabial herpes, genital herpes (primary and recurrent episodes), herpetic keratitis
Herpes zoster (shingles) - VZV infection
Chickenpox (varicella) in immunocompromised patients or severe cases
HSV encephalitis (IV form)
Prevention of CMV and HSV in immunocompromised patients (organ transplant, HIV)
Neonatal herpes (IV form)

Analogue (same pharmacological action - antiviral/nucleoside analogue active against herpesviruses)

Valacyclovir (Valtrex) - prodrug of acyclovir (L-valyl ester), with ~3-5x higher oral bioavailability than acyclovir (55% vs 15-30%). This allows less frequent dosing: 500-1000 mg twice daily instead of 5 times/day. For recurrent genital herpes: valacyclovir 500 mg x 2/day x 5 days vs acyclovir 200 mg x 5/day. Higher peak plasma levels also improve efficacy for herpes zoster. Justified as a more convenient analogue.

Other Release Forms & Synonym

Other forms of acyclovir:

Tablets 200 mg, 400 mg, 800 mg
Powder/concentrate for IV infusion 250 mg/vial, 500 mg/vial (for severe/systemic infections, encephalitis)
Cream 5% (tubes 2 g, 5 g) for topical application to orolabial/genital lesions
Ophthalmic ointment 3% (for herpetic keratitis)

Synonym: Zovirax (GSK) - original brand; also Aciclovir-AKOS, Viroleks, Gerperax, Atsik. All contain acyclovir (aciclovir) as the active substance.

8. BISACODYL

Prescription (based on commercial packaging - Bisacodyl 5 mg enteric-coated tablets, pack of 30)

Date: 07.06.2026

Patient: Frolova Galina Petrovna, age 62

Rp.: Bisacodyli 0,005
D.t.d. N. 30 in tab. obductis (enterosolventibus)
S.: Take 1-2 tablets once daily at bedtime. Do not crush or chew. Do not take with milk or antacids.

Physician: _____________ /signature/  Stamp

Pharmacological Group & Indications

Group: Contact (stimulant) laxative; diphenylmethane derivative. Acts on colonic mucosa.

Main indications:

Constipation (acute and symptomatic, short-term)
Preparation of the bowel before colonoscopy, radiological examination, or surgical procedures
Post-operative constipation
Constipation in bedridden patients
Facilitation of defecation in patients with hemorrhoids, anal fissures

Analogue (same pharmacological action - stimulant/contact laxative)

Sodium picosulfate (Guttalax, Regulax) - also a stimulant laxative of the same diphenylmethane chemical class. Converted by colonic bacteria to the same active metabolite (bis-(p-hydroxyphenyl)-pyridyl-2-methane, BHPM) as bisacodyl. Acts locally in the colon, stimulating peristalsis and reducing water/electrolyte absorption. Produces similar onset of action (6-12 hours). Justified as a pharmacological equivalent available as drops (convenient for dose titration).

Other Release Forms & Synonym

Other forms of bisacodyl:

Enteric-coated tablets 5 mg (most common)
Rectal suppositories 10 mg (onset 15-60 min; used when faster effect is needed)
Solution for rectal use (enema)
Powder for oral solution (combined bowel prep formulations)

Synonym: Dulcolax (Sanofi) - original brand; also Bisacodyl-Nycomed, Laxatin, Pedicol (suppositories). All contain bisacodyl as the active substance.

9. BROMOCRIPTINE

Prescription (based on commercial packaging - Bromocriptine 2.5 mg tablets, pack of 30)

Date: 07.06.2026

Patient: Nikitin Sergei Alexandrovich, age 63

Rp.: Bromocriptini 0,0025
D.t.d. N. 30 in tab.
S.: Take 1/2 tablet twice daily with meals for 1 week, then increase to 1 tablet (2.5 mg) 2-3 times daily as directed by physician.

Physician: _____________ /signature/  Stamp

(Dose titration is important; starting with low doses reduces nausea)

Pharmacological Group & Indications

Group: Dopamine receptor agonist (D2 predominant); ergot alkaloid derivative; also inhibits prolactin secretion (antiprolactinemic agent).

Main indications:

Hyperprolactinemia (prolactinomas, drug-induced hyperprolactinemia)
Female infertility due to hyperprolactinemia (restoration of ovulation)
Galactorrhea
Acromegaly (adjunct treatment - inhibits GH in some patients)
Parkinson's disease (as dopamine agonist, often as adjunct to levodopa)
Inhibition of postpartum lactation
Premenstrual syndrome with mastodynia
Type 2 diabetes mellitus (Cycloset formulation - fast-release bromocriptine approved in USA)

Analogue (same pharmacological action - dopamine agonist / antiprolactinemic)

Cabergoline (Dostinex) - also a dopamine agonist (D2 receptor) ergot derivative, used for hyperprolactinemia and Parkinson's disease. Cabergoline has a much longer half-life (~63-68 hours vs ~3-6 hours for bromocriptine), allowing once or twice-weekly dosing (0.5 mg 1-2x/week vs bromocriptine 2.5 mg 2-3x/day). Cabergoline is better tolerated (less nausea/vomiting) and more effective for prolactinoma size reduction. Justified as a preferred analogue for prolactinoma management.

Other Release Forms & Synonym

Other forms of bromocriptine:

Tablets 2.5 mg (standard)
Capsules 5 mg (less common, some markets)
Fast-release capsules 0.8 mg (Cycloset - for type 2 diabetes, US-specific)

Synonym: Parlodel (Novartis) - original brand; also Bromergon, Abergin, Serocryptin. All contain bromocriptine mesylate as the active substance.

10. VERAPAMIL

Prescription (based on commercial packaging - Verapamil 80 mg tablets, pack of 50)

Date: 07.06.2026

Patient: Zaitseva Olga Nikolaevna, age 67

Rp.: Verapamili hydrochloridi 0,08
D.t.d. N. 50 in tab.
S.: Take 1 tablet 3 times daily with meals. Do not crush extended-release tablets if prescribed in that form.

Physician: _____________ /signature/  Stamp

Pharmacological Group & Indications

Group: Calcium channel blocker (CCB), phenylalkylamine subclass; antiarrhythmic (Class IV, Vaughan-Williams), antihypertensive, antianginal agent.

Main indications:

Supraventricular tachyarrhythmias: paroxysmal SVT (including AVNRT), atrial flutter, atrial fibrillation (rate control)
Angina pectoris: stable angina, vasospastic (Prinzmetal) angina
Arterial hypertension
Hypertrophic obstructive cardiomyopathy (HOCM) - reduces outflow tract obstruction
Migraine prophylaxis
Cluster headache prophylaxis

Analogue (same pharmacological action - non-dihydropyridine CCB / Class IV antiarrhythmic)

Diltiazem (Cardizem) - benzothiazepine CCB, same Class IV antiarrhythmic classification. Like verapamil, diltiazem depresses SA and AV node conduction and has negative chronotropic effects, making it useful for rate control in AF and SVT termination. Diltiazem generally causes less negative inotropic effect than verapamil, so it is preferred in patients with mildly reduced LV function. Both are contraindicated in heart failure with reduced EF and in combination with beta-blockers (risk of complete AV block).

Other Release Forms & Synonym

Other forms of verapamil:

Tablets 40 mg, 80 mg, 120 mg (immediate release)
Extended-release tablets/capsules 120 mg, 180 mg, 240 mg, 360 mg (Isoptin SR, Verelan PM) - once daily dosing
Solution for IV injection 2.5 mg/ml in 2 ml ampoules (for acute arrhythmia management)

Synonym: Isoptin (Abbott/Knoll) - original brand; also Finoptin, Lekoptin, Verahexal, Calan. All contain verapamil hydrochloride as the active substance.

Summary Table

#	Drug	Group	Key Indications	Analogue	Synonym (Trade Name)
1	Azithromycin	Macrolide antibiotic	Respiratory, STI, skin infections	Clarithromycin	Sumamed
2	Ambroxol	Mucolytic/secretomotor	Bronchitis, COPD, pneumonia adjunct	Acetylcysteine (ACC)	Lazolvan
3	Amlodipine	Dihydropyridine CCB	Hypertension, angina	Nifedipine	Norvasc
4	Amoxicillin + Clavulanate	Protected penicillin	Respiratory, UTI, skin, dental infections	Ampicillin + Sulbactam	Augmentin
5	Articaine	Amide local anesthetic	Dental/local infiltration anesthesia	Lidocaine	Ubistesine / Ultracain
6	Atorvastatin	HMG-CoA reductase inhibitor (statin)	Dyslipidemia, CV prevention	Rosuvastatin	Lipitor
7	Acyclovir	Nucleoside analogue antiviral	HSV, VZV infections	Valacyclovir	Zovirax
8	Bisacodyl	Stimulant laxative	Constipation, bowel prep	Sodium picosulfate	Dulcolax
9	Bromocriptine	Dopamine agonist (D2)	Hyperprolactinemia, Parkinson's	Cabergoline	Parlodel
10	Verapamil	Phenylalkylamine CCB / Class IV antiarrhythmic	SVT, AF rate control, angina, HTN	Diltiazem	Isoptin

Notes on Prescription Format:

All prescriptions above follow the Russian Form 107-1/u structure for outpatient non-controlled substances
Doses are written in grams (e.g., 0.5 = 500 mg; 0.005 = 5 mg) per Russian convention
"D.t.d. N." = "Detur tales doses numero" (give such doses, quantity N)
Articaine and IV preparations (acyclovir, verapamil ampoules) would require the appropriate institutional/specialist prescription forms
Bromocriptine is a Schedule III prescription drug in Russia requiring Form 148-1/u-04 in some regions due to potential for misuse

bismuth subcitrate 12. hydrochlorothiazide 13. glibenclamide 14. low molecular weight heparins 15. diazepam 16. diclofenac 17. doxycycline 18. iron supplements 19. short- and long-acting human insulin 20. ketorolac 21. clemastine 22. co-trimoxazole 23. levothyroxine sodium 24. levofloxacin 25. lincomycin 26. lisinopril 27. losartan 28. maprotiline 29. mebendazole 30. mercazolil 31. metoclopramide 32. metoprolol 33. metformin 34. nandrolone 35. nitroglycerin 36. oxymetazoline 37. omeprazole 38. oseltamivir 39. pancreatin 40. piracetam 41. prednisolone 42. salbutamol 43. theophylline 44. tramadol 45. fentanyl 46. fluconazole 47. fluticasone 48. cefotaxime 49. cyanocobalamin 50. ethinyl estradiol + desogestrel Same above for this drugs

I'll complete all 40 drugs using the same Russian prescription format (Form 107-1/u). This is a large set - I'll work through them systematically from my pharmacological knowledge base.

Prescription Task - Drugs 11–50

Format Reminder

Russian outpatient Rx Form 107-1/u structure:

Rp.: drug name (Latin, genitive), dose
D.t.d. N. quantity and form
S.: patient instructions
Doses in grams per Russian convention

11. BISMUTH SUBCITRATE

Prescription (De-Nol 120 mg tablets, pack of 112)

Rp.: Bismuthi subcitras 0,12
D.t.d. N. 112 in tab.
S.: Take 1 tablet 4 times daily (30 min before each meal and at
    bedtime), with water. Do not take with milk or antacids.
    Course: 28 days.

Pharmacological Group & Indications

Group: Gastroprotective agent; colloidal bismuth compound; anti-Helicobacter pylori agent.

Indications:

Peptic ulcer disease (gastric and duodenal ulcer) - as part of H. pylori eradication regimens (bismuth quadruple therapy)
H. pylori eradication (first-line and rescue therapy)
Chronic gastritis associated with H. pylori
Functional dyspepsia
Irritable bowel syndrome (limited use)
Traveler's diarrhea (bismuth subsalicylate in some countries)

Analogue

Bismuth subsalicylate (Pepto-Bismol) - another colloidal bismuth compound with similar gastroprotective and anti-H. pylori properties. Both coat the ulcer base forming a protective barrier, inhibit pepsin activity, stimulate mucus/bicarbonate secretion, and have direct antibacterial activity against H. pylori. Justified as analogue when bismuth subcitrate is unavailable.

Other Forms & Synonym

Other forms: Tablets 120 mg; oral suspension (less common); in combination packs (Pylera capsules: bismuth subcitrate + metronidazole + tetracycline, all-in-one for quadruple therapy).

Synonym: De-Nol (Astellas) - original brand; also Ventrisol, Gaviskon-Bismut, Ulcavis. All contain colloidal bismuth subcitrate (tripotassium dicitratobismuthate).

12. HYDROCHLOROTHIAZIDE

Prescription (Hydrochlorothiazide 25 mg tablets, pack of 20)

Rp.: Hydrochlorothiazidi 0,025
D.t.d. N. 20 in tab.
S.: Take 1 tablet once daily in the morning after meals.

Pharmacological Group & Indications

Group: Thiazide diuretic; antihypertensive agent. Inhibits Na⁺/Cl⁻ cotransporter in the distal convoluted tubule.

Indications:

Arterial hypertension (first-line, often in combination)
Edematous states: chronic heart failure, nephrotic syndrome, liver cirrhosis
Diabetes insipidus (nephrogenic) - paradoxical antidiuretic effect
Hypercalciuria with nephrolithiasis (reduces urinary Ca²⁺)
Idiopathic hypercalciuria

Analogue

Indapamide (Arifon) - sulfonamide thiazide-like diuretic, primarily acts on distal tubule. At low doses (1.5 mg SR) acts mainly as a vasodilator; at higher doses also has diuretic effect. Indapamide has a more favorable metabolic profile (less hypokalemia, less effect on glucose/lipids) and is preferred in hypertension management. Justified as a metabolically safer thiazide-class analogue.

Other Forms & Synonym

Other forms: Tablets 12.5 mg, 25 mg, 50 mg; fixed-dose combinations with ACE inhibitors (e.g., Captopril + HCT: Co-Zestril; Lisinopril + HCT: Iruzid; Enalapril + HCT: Enap-H), with ARBs (Losartan + HCT: Gizaar), with beta-blockers (Bisoprolol + HCT: Lodoz).

Synonym: Hypothiazide (Chinoin) - original brand widely used in CIS; also Esidrix, Oretic, HydroDIURIL. Active substance: hydrochlorothiazide.

13. GLIBENCLAMIDE

Prescription (Glibenclamide 5 mg tablets, pack of 30)

Rp.: Glibenclamidi 0,005
D.t.d. N. 30 in tab.
S.: Take 1 tablet (5 mg) once daily 30 minutes before breakfast.
    Dose may be increased to 2 tablets (10 mg) as directed.

Pharmacological Group & Indications

Group: Second-generation sulfonylurea; oral hypoglycemic agent. Stimulates insulin secretion by blocking ATP-sensitive K⁺ channels on pancreatic beta cells.

Indications:

Type 2 diabetes mellitus (when diet/exercise + metformin insufficient, or metformin contraindicated)
Not used in type 1 DM or diabetic ketoacidosis

Analogue

Gliclazide (Diabeton MR) - second-generation sulfonylurea with same mechanism (K_ATP channel block on beta cells). Gliclazide has additional antioxidant properties and a more physiological insulin secretion profile with lower risk of hypoglycemia vs glibenclamide (especially the MR formulation). In elderly patients, gliclazide MR is strongly preferred over glibenclamide due to glibenclamide's long half-life and active metabolites causing prolonged hypoglycemia.

Other Forms & Synonym

Other forms: Tablets 1.75 mg (micronized = Glibenclamide Mite), 5 mg. Fixed-dose combinations with metformin (Glucovance: Glibenclamide 2.5 mg or 5 mg + Metformin 500 mg).

Synonym: Maninil (Berlin-Chemie) - widely used brand in CIS; also Daonil, Euglucon, Glyburide (USA name). Active substance: glibenclamide (glyburide).

14. LOW MOLECULAR WEIGHT HEPARINS (LMWH)

Prescription (Enoxaparin 40 mg/0.4 ml prefilled syringe, pack of 10) — representative LMWH

Rp.: Sol. Enoxaparini natrii 4000 anti-Xa IU (40 mg) - 0,4 ml
D.t.d. N. 10 in syringis praeparatis.
S.: Inject 0.4 ml subcutaneously once daily into the abdominal
    wall. Rotate injection sites. Course: 10 days.

(For therapeutic dosing: Enoxaparin 1 mg/kg SC q12h; for prophylaxis: 20-40 mg SC once daily)

Pharmacological Group & Indications

Group: Anticoagulant; low molecular weight heparin (LMWH); indirect thrombin inhibitor (predominantly anti-Xa activity, some anti-IIa). Activates antithrombin III.

Indications:

Prophylaxis of venous thromboembolism (VTE) in surgical patients, immobilized medical patients
Treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE)
Acute coronary syndrome (NSTEMI, STEMI) - as bridge/adjunct to PCI
Prevention of thrombus formation in extracorporeal circuits (hemodialysis)
Bridging anticoagulation during VKA initiation or in perioperative period
Treatment of VTE in pregnancy (preferred over warfarin)

Analogue

Fondaparinux (Arixtra) - synthetic selective factor Xa inhibitor (pentasaccharide), also activates antithrombin III but has no anti-IIa activity. Longer half-life than LMWH (17-21 h, once-daily SC). Less risk of heparin-induced thrombocytopenia (HIT) since it does not interact with PF4. Justified as analogue for VTE prophylaxis/treatment, particularly when HIT has occurred or is a concern.

Other Forms & Synonym

Other LMWHs available (all LMWH class, slight differences in anti-Xa/IIa ratio):

Enoxaparin (Clexane/Lovenox) - most widely studied
Dalteparin (Fragmin) - prefilled syringes 2500, 5000, 7500, 10000, 12500 IU
Nadroparin (Fraxiparine) - syringes 0.3, 0.4, 0.6, 0.8, 1.0 ml
Bemiparin (Hibor) - second-generation, longer half-life
Tinzaparin (Innohep)

Synonym (for enoxaparin): Clexane (Sanofi) = Lovenox (US); also Anfibra, Hemapaxane. All contain enoxaparin sodium.

15. DIAZEPAM

Prescription (Diazepam 5 mg tablets, pack of 20) — Strict prescription (Form 148-1/u-04, Schedule III)

Special prescription form (Form 148-1/u-04)

Rp.: Diazepami 0,005
D.t.d. N. 20 in tab.
S.: Take 1 tablet (5 mg) 2-3 times daily.
    Course: no more than 2-4 weeks without reassessment.

[Physician personal stamp, seal of institution required]

Pharmacological Group & Indications

Group: Benzodiazepine; anxiolytic, sedative-hypnotic, anticonvulsant, muscle relaxant, amnestic. Positive allosteric modulator of GABA-A receptors.

Indications:

Anxiety disorders, generalized anxiety
Acute alcohol withdrawal (delirium tremens prevention and treatment)
Seizure disorders: status epilepticus (IV), febrile seizures
Pre-medication before surgery/procedures (sedation)
Muscle spasm (centrally acting)
Insomnia (short-term)
Eclampsia/pre-eclampsia (IV)
Tetanus (muscle spasm control)

Analogue

Lorazepam (Ativan) - intermediate-acting benzodiazepine, same GABA-A potentiation mechanism. Lorazepam lacks active metabolites (unlike diazepam which forms desmethyldiazepam and oxazepam), making it safer in hepatic impairment and elderly. For status epilepticus IV lorazepam is considered first-line in many guidelines. For anxiety: shorter duration requires more frequent dosing but less accumulation.

Other Forms & Synonym

Other forms: Tablets 2 mg, 5 mg, 10 mg; Solution for IV/IM injection 5 mg/ml (ampoules 2 ml = 10 mg); Rectal solution/gel (Stesolid, Diazepam Desitin) 5 mg/2.5 ml, 10 mg/2.5 ml (for febrile/epileptic seizures in children).

Synonym: Valium (Roche) - original brand; also Relanium, Seduxen, Sibazon. Active substance: diazepam.

16. DICLOFENAC

Prescription (Diclofenac 50 mg enteric-coated tablets, pack of 20)

Rp.: Diclofenaci natrii 0,05
D.t.d. N. 20 in tab. enterosolventibus
S.: Take 1 tablet 2-3 times daily with meals.
    Maximum daily dose: 150 mg. Course: up to 5-7 days for acute pain.

Pharmacological Group & Indications

Group: Non-selective NSAID (COX-1 and COX-2 inhibitor); analgesic, anti-inflammatory, antipyretic. Phenylacetic acid derivative.

Indications:

Pain syndromes: musculoskeletal pain, postoperative pain, dental pain, headache
Inflammatory arthropathies: rheumatoid arthritis, osteoarthritis, ankylosing spondylitis
Gout (acute attack)
Dysmenorrhea (primary and secondary)
Renal/biliary colic (in combination with antispasmodics)
Fever (antipyretic)
Ocular inflammation (eye drops form)

Analogue

Ibuprofen (Nurofen) - propionic acid NSAID, also non-selective COX inhibitor. Similar anti-inflammatory and analgesic efficacy to diclofenac at equipotent doses. Ibuprofen generally has better GI tolerability profile and is available OTC in many countries. Preferred in mild-moderate pain, fever, dysmenorrhea. At higher doses (800 mg TID) provides anti-inflammatory effect comparable to diclofenac 150 mg/day.

Other Forms & Synonym

Other forms:

Enteric-coated tablets 25 mg, 50 mg, 75 mg; SR tablets 100 mg (once daily)
Solution for IM injection 75 mg/3 ml ampoules
Suppositories 50 mg, 100 mg (rectal)
Gel 1%, 5% for topical application (Voltaren Emulgel)
Eye drops 0.1% (Voltaren Ophta) - for ocular inflammation, post-cataract surgery
Transdermal patches 140 mg

Synonym: Voltaren (Novartis) - original brand; also Ortofen, Diklofenak, Naklofen. Active substance: diclofenac sodium.

17. DOXYCYCLINE

Prescription (Doxycycline 100 mg capsules, pack of 10)

Rp.: Doxycyclini hydrochloridi 0,1
D.t.d. N. 10 in caps.
S.: Take 1 capsule twice daily with plenty of water, with or
    after meals. Do not lie down for 30 minutes after taking.
    Course: 5-7 days (respiratory infections) or as directed.

Pharmacological Group & Indications

Group: Tetracycline antibiotic (second-generation, semi-synthetic). Inhibits bacterial protein synthesis by binding to 30S ribosomal subunit.

Indications:

Respiratory infections: community-acquired pneumonia (atypical pathogens), bronchitis, sinusitis
Sexually transmitted infections: chlamydia, gonorrhea (non-penicillinase-producing), syphilis (alternative), lymphogranuloma venereum
Lyme disease (Borrelia burgdorferi)
Rickettsial infections (Rocky Mountain spotted fever, typhus)
Brucellosis (combined with rifampicin)
Malaria prophylaxis and treatment (combined with quinine)
Acne vulgaris (anti-inflammatory + antibacterial)
Periodontal disease
Anthrax (Bacillus anthracis) prophylaxis and treatment
Cholera

Analogue

Minocycline (Minocin) - second-generation tetracycline, same 30S ribosomal inhibition mechanism. Superior lipid solubility gives better tissue penetration, activity against some tetracycline-resistant strains, and additional anti-inflammatory properties useful in acne. Longer half-life than doxycycline. Can cause vestibular side effects (dizziness). Preferred for acne and some resistant infections.

Other Forms & Synonym

Other forms: Capsules 50 mg, 100 mg; Tablets 100 mg; Powder for oral suspension; Powder for IV infusion 100 mg/vial (hospital use); Periodontal gel 8.5% (Atridox - local delivery for periodontitis).

Synonym: Unidox Solutab (Astellas) - popular brand in CIS (dispersible tablets); also Vibramycin, Doxylin, Doxal. Active substance: doxycycline monohydrate or hydrochloride.

18. IRON SUPPLEMENTS

Prescription (Ferrous sulfate [Sorbifer Durules] 100 mg elemental Fe tablets, pack of 30) — representative oral iron

Rp.: Ferrosi sulfatis 0,32 (= Ferri 0,1)
D.t.d. N. 30 in tab. obductis (retard)
S.: Take 1 tablet twice daily 30-60 minutes before meals.
    Swallow whole, do not crush. Avoid milk, tea, antacids
    within 1-2 hours.

(Sorbifer Durules = Ferrous sulfate 320 mg + Ascorbic acid 60 mg; provides ~100 mg elemental iron)

Pharmacological Group & Indications

Group: Iron preparation; antianemic agent. Ferrous (Fe²⁺) salts are better absorbed than ferric (Fe³⁺).

Indications:

Iron deficiency anemia (treatment)
Prevention of iron deficiency: pregnancy, lactation, prematurity, rapid growth periods
Chronic blood loss (GI bleeding, menorrhagia - treatment of resulting anemia)
Post-gastrectomy states (reduced gastric acid impairs iron absorption)
Restless legs syndrome (iron deficiency-related)

Analogue

Iron (III) hydroxide polymaltose complex (Maltofer, Ferrum Lek) - ferric iron complex. Does not cause oxidative GI irritation seen with ferrous salts (less nausea, constipation, dark stools for some patients). Absorbed by active transport, cannot cause overdose by passive absorption. Preferred in GI-intolerant patients and children. Slightly slower onset of Hb response compared to ferrous salts.

Other Forms & Synonym

Other oral iron preparations:

Ferrous sulfate: Tardyferon 80 mg, Sorbifer Durules 100 mg
Ferrous gluconate: Totem solution (ferrous gluconate + manganese + copper)
Ferrous fumarate: Ferretab, Heferol
Iron (III) polymaltose: Maltofer (chewable tabs, syrup, drops, solution)
IV preparations: Iron sucrose (Venofer) 20 mg/ml ampoules; Ferric carboxymaltose (Ferinject); Iron dextran (Cosmofer) - for IV use in severe deficiency, GI intolerance, or malabsorption

Synonym: Sorbifer Durules (EGIS) and Tardyferon (Pierre Fabre) for ferrous sulfate; Ferrum Lek (Lek) for polymaltose complex.

19. SHORT- AND LONG-ACTING HUMAN INSULIN

Prescription A - Short-acting (Regular Human Insulin 100 IU/ml, 10 ml vial)

Rp.: Insulini humani solubilis 100 IU/ml - 10 ml
D.t.d. N. 5 in flac.
S.: Inject subcutaneously 15-30 minutes before meals as directed
    by physician. Dose individualized. May also be given IV
    (hospital use, diluted). Store at 2-8°C unopened;
    opened vial at room temperature, use within 28 days.

Prescription B - Long-acting (Insulin glargine 100 IU/ml, 3 ml SoloStar pen cartridge)

Rp.: Insulini glargini 100 IU/ml - 3 ml
D.t.d. N. 5 in pen-syringis (SoloStar).
S.: Inject subcutaneously once daily at the same time each day.
    Dose individualized by physician. Do not mix with other
    insulins. Store at 2-8°C; in use pen at room temperature,
    discard after 28 days.

Pharmacological Group & Indications

Group: Hormone; pancreatic hormone analogue; antidiabetic agent. Binds insulin receptors, promotes glucose uptake, inhibits gluconeogenesis and glycogenolysis.

Indications:

Type 1 diabetes mellitus (absolute indication)
Type 2 diabetes mellitus uncontrolled by oral agents
Diabetic ketoacidosis (DKA) - IV regular insulin
Hyperglycemic hyperosmolar state
Gestational diabetes mellitus (preferred over oral agents)
Hyperkalemia treatment (insulin + dextrose, drives K⁺ into cells)
Stress hyperglycemia in critically ill patients (hospital)

Analogue

Rapid-acting insulin analogues (for short-acting): Insulin lispro (Humalog), insulin aspart (NovoRapid), insulin glulisine (Apidra) - modified to dissociate faster from hexamers, giving faster onset (5-15 min) and shorter duration (3-5 h) vs regular human insulin (30 min onset, 6-8 h duration). Administered immediately before or after meals; more flexible dosing with less postprandial hyperglycemia and less late hypoglycemia.

Ultra-long-acting analogues (for long-acting): Insulin degludec (Tresiba, 100 or 200 IU/ml) - half-life ~25 h, once daily, less night hypoglycemia than glargine U100. Insulin glargine U300 (Toujeo) - more concentrated, flatter profile.

Other Forms & Synonym

Short-acting: Humulin R (Lilly), Actrapid (Novo Nordisk), Insuman Rapid (Sanofi) - all regular human insulin 100 IU/ml; also in 10 ml vials and 3 ml cartridges/pens.

Long-acting (basal): Lantus = Basaglar (glargine U100); Toujeo (glargine U300); Tresiba (degludec); Levemir (detemir 100 IU/ml) - all basal insulins with different duration profiles.

Premixed formulations: Humulin M3 (30% regular + 70% NPH), Mixtard 30, NovoMix 30 (30% aspart + 70% protamine-aspart).

20. KETOROLAC

Prescription (Ketorolac 10 mg tablets, pack of 20)

Rp.: Ketorolaci trometamoli 0,01
D.t.d. N. 20 in tab.
S.: Take 1 tablet every 4-6 hours as needed for pain.
    Maximum 40 mg/day orally. Maximum course: 5 days.
    Take with food or milk to reduce GI irritation.

Pharmacological Group & Indications

Group: NSAID (non-selective COX inhibitor); potent analgesic; acetic acid derivative (pyrrolizine carboxylic acid). One of the most potent oral/IM NSAIDs for pain.

Indications:

Moderate to severe acute pain: postoperative pain, trauma, musculoskeletal pain, renal/biliary colic
Short-term pain management (maximum 5 days oral, 2 days IM/IV)
Dental pain
Gynecological pain (dysmenorrhea, post-procedure)
Eye drops form: allergic conjunctivitis, post-cataract surgery inflammation/pain
NOT for chronic use (high GI/renal toxicity risk)

Analogue

Lornoxicam (Xefocam) - oxicam class NSAID, similarly potent analgesic effect. Lornoxicam provides comparable pain relief to ketorolac IM with potentially better tolerability. Also used for postoperative and acute musculoskeletal pain. Available as tablets and IM/IV injection. Justified as analogue for acute moderate-severe pain management.

Other Forms & Synonym

Other forms: Tablets 10 mg; Solution for IM/IV injection 30 mg/ml (1 ml ampoules); Eye drops 0.5% (Acular) - for post-cataract and allergic eye use.

Synonym: Ketorol (Dr. Reddy's) - widely used in CIS; also Ketanov, Toradol (US), Dolac. Active substance: ketorolac tromethamine.

21. CLEMASTINE

Prescription (Clemastine 1 mg tablets, pack of 20)

Rp.: Clemastini 0,001
D.t.d. N. 20 in tab.
S.: Take 1 tablet twice daily (morning and evening).
    Avoid driving and operating machinery. Avoid alcohol.

Pharmacological Group & Indications

Group: First-generation H₁-antihistamine (antiallergic agent); ethanolamine derivative. Crosses the blood-brain barrier (sedating).

Indications:

Allergic rhinitis (seasonal and perennial)
Urticaria (acute and chronic)
Allergic dermatoses: atopic dermatitis, contact dermatitis, pruritus
Angioedema
Insect bite reactions
Anaphylactic reactions (adjunct, after epinephrine)
Allergic conjunctivitis

Analogue

Cetirizine (Zyrtec) - second-generation H₁-antihistamine. Same receptor target (H₁ block) but highly selective, minimal BBB penetration, non-sedating at standard doses. Once-daily dosing (10 mg). Superior profile for daytime use, driving, and in patients requiring cognitive clarity. Preferred for chronic allergic conditions over sedating first-generation agents.

Other Forms & Synonym

Other forms: Tablets 1 mg; Solution for IV/IM injection 0.1% (1 mg/ml, 2 ml ampoules) - for severe allergic reactions, urticaria; Syrup 0.1 mg/ml (pediatric use).

Synonym: Tavegil (Novartis) - original widely used brand in CIS; also Rivtagil. Active substance: clemastine hydrogen fumarate.

22. CO-TRIMOXAZOLE

Prescription (Co-trimoxazole 480 mg [400 mg sulfamethoxazole + 80 mg trimethoprim] tablets, pack of 20)

Rp.: Co-trimoxazoli 0,48 (Sulfamethoxazoli 0,4 + Trimethoprim 0,08)
D.t.d. N. 20 in tab.
S.: Take 2 tablets twice daily (morning and evening) with meals
    and plenty of fluids. Course: 5-7 days.

(For standard dosing: 960 mg = 2 x 480 mg tablets twice daily; children use 120 mg or 240 mg tablets)

Pharmacological Group & Indications

Group: Combined antibacterial agent; sulfonamide + dihydrofolate reductase inhibitor (diaminopyrimidine). Acts at two sequential steps in bacterial folate synthesis (sequential blockade = synergy).

Indications:

Urinary tract infections (cystitis, pyelonephritis - E. coli, Proteus)
Pneumocystis jirovecii pneumonia (PCP) - treatment and prophylaxis in HIV/immunosuppressed (high dose)
Toxoplasmosis (alternative)
Nocardiosis
Traveler's diarrhea, Shigellosis
Respiratory tract infections (bronchitis, otitis media)
Skin and soft tissue infections (MRSA-active - trimethoprim-sulfamethoxazole active against community-acquired MRSA)
Stenotrophomonas maltophilia infections (drug of choice)

Analogue

Trimethoprim alone (Trimopan) - in UTI treatment, trimethoprim monotherapy (200 mg twice daily) provides equivalent efficacy to co-trimoxazole with fewer adverse effects (avoids sulfonamide component's adverse reactions: rash, Stevens-Johnson syndrome, myelosuppression). Preferred for uncomplicated UTI in patients with sulfonamide allergy or intolerance.

Other Forms & Synonym

Other forms: Tablets 120 mg (pediatric), 240 mg, 480 mg, 960 mg; Oral suspension 240 mg/5 ml (pediatric); Solution for IV infusion (concentrate 80 mg/ml in 5 ml ampoules, dilute before use) - for PCP treatment (high dose IV).

Synonym: Biseptol (Polfa) - most widely known brand in CIS/Eastern Europe; also Bactrim, Septrin. Active substance: sulfamethoxazole + trimethoprim (5:1 ratio).

23. LEVOTHYROXINE SODIUM

Prescription (L-Thyroxine 50 mcg tablets, pack of 50; or 100 mcg pack of 50)

Rp.: Levothyroxini natrii 0,0001 (100 mcg)
D.t.d. N. 50 in tab.
S.: Take 1 tablet once daily, 30-60 minutes before breakfast,
    with water only. Do not take with calcium, iron, antacids
    within 4 hours.

Pharmacological Group & Indications

Group: Thyroid hormone preparation (synthetic L-thyroxine = T4). Converted peripherally to active T3 (triiodothyronine). Regulates metabolism, growth, and development.

Indications:

Hypothyroidism (all causes: autoimmune/Hashimoto, post-thyroidectomy, post-radioiodine, iodine deficiency, congenital)
Thyroid hormone replacement after total/partial thyroidectomy
TSH suppression therapy in differentiated thyroid cancer
Euthyroid goiter (multinodular, colloid goiter)
Myxedema coma (IV high-dose)
Congenital hypothyroidism (critical to start within 2 weeks of birth)

Analogue

Liothyronine (T3, Cytomel) - synthetic triiodothyronine, the biologically active form. Faster onset and shorter half-life (~1 day vs ~7 days for T4). Used in myxedema coma (IV), in combination with T4 in hypothyroid patients with persistent symptoms on T4 alone, and during thyroid cancer staging (short washout period vs levothyroxine). Most patients do well on T4 monotherapy.

Other Forms & Synonym

Other forms: Tablets 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg, 112 mcg, 125 mcg, 150 mcg, 175 mcg, 200 mcg; Solution for IV injection 100 mcg/ml (for myxedema coma); Combination preparations: T4+T3 (Thyreocomb, Thyreotom).

Synonym: Eutirox (Merck) and L-Thyroxin Berlin-Chemie - leading brands in CIS; also Synthroid (US, AbbVie), Levothroid, Euthyrox. Active substance: levothyroxine sodium.

24. LEVOFLOXACIN

Prescription (Levofloxacin 500 mg tablets, pack of 10)

Rp.: Levofloxacini 0,5
D.t.d. N. 10 in tab.
S.: Take 1 tablet once daily, with or without food.
    Take with plenty of water. Avoid antacids, calcium,
    iron within 2 hours. Course: 7-14 days (RTI) or
    as directed. Avoid sun exposure.

Pharmacological Group & Indications

Group: Fluoroquinolone antibiotic (third-generation / respiratory fluoroquinolone). Inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV.

Indications:

Community-acquired pneumonia (including drug-resistant strains)
Healthcare-associated pneumonia (HCAP)
Acute exacerbation of chronic bronchitis (second-line)
Acute bacterial sinusitis (when first-line fails)
Complicated UTI, pyelonephritis
Complicated skin and soft tissue infections
Complicated intra-abdominal infections (combined)
Prostatitis (excellent prostate penetration)
Tuberculosis (second-line, in MDR-TB regimens)
Anthrax exposure prophylaxis

Analogue

Moxifloxacin (Avelox) - fourth-generation respiratory fluoroquinolone. Enhanced Gram-positive (including pneumococcus) and anaerobic coverage compared to levofloxacin; no renal dose adjustment needed (hepatic elimination). However, no urinary tract indication (low urinary concentration). Preferred for respiratory infections, especially when pneumococcal resistance is a concern. Both have similar QT-prolongation risk.

Other Forms & Synonym

Other forms: Tablets 250 mg, 500 mg, 750 mg; Solution for IV infusion 5 mg/ml (100 ml bags) - for hospitalized patients, bioequivalent to oral; Eye drops 0.5% (Oftaquix) - for bacterial conjunctivitis, corneal ulcer.

Synonym: Tavanic (Sanofi) - original brand; also Floracid, Levolet, Lebel, Glevo. Active substance: levofloxacin.

25. LINCOMYCIN

Prescription (Lincomycin 500 mg capsules, pack of 20)

Rp.: Lincomycini hydrochloridi 0,5
D.t.d. N. 20 in caps.
S.: Take 1 capsule 3-4 times daily, 1-2 hours before or
    after meals. Course: 7-14 days.

Pharmacological Group & Indications

Group: Lincosamide antibiotic. Inhibits bacterial protein synthesis by binding to 50S ribosomal subunit (same target as macrolides, but different binding site). Active mainly against Gram-positive bacteria and anaerobes.

Indications:

Bone and joint infections (osteomyelitis, septic arthritis) - excellent bone penetration
Dental infections, periostitis, jaw osteomyelitis
Septicemia caused by susceptible Gram-positive organisms
Skin and soft tissue infections
Respiratory infections (pneumonia, empyema) - second-line
Alternative in penicillin-allergic patients
Anaerobic infections

Analogue

Clindamycin (Dalacin C) - semi-synthetic lincosamide, structurally related to lincomycin but with superior pharmacokinetics (better oral bioavailability ~90% vs ~30% for lincomycin), broader spectrum (especially anaerobes), and is preferred over lincomycin in most guidelines. Used for same indications plus bacterial vaginosis, toxoplasmosis (combined with pyrimethamine in AIDS), and malaria (combined with quinine). Clindamycin has largely replaced lincomycin in Western medicine; lincomycin remains commonly used in CIS countries.

Other Forms & Synonym

Other forms of lincomycin: Capsules 250 mg, 500 mg; Solution for IM/IV injection 300 mg/ml (1 ml and 2 ml ampoules) - for osteomyelitis and severe infections; Liniment/ointment (external, less common).

Synonym: Lincocin (Pfizer) - original brand; also Lincomycin-AKOS, Neolincomycin. Active substance: lincomycin hydrochloride.

26. LISINOPRIL

Prescription (Lisinopril 10 mg tablets, pack of 30)

Rp.: Lisinoprilum 0,01
D.t.d. N. 30 in tab.
S.: Take 1 tablet once daily at the same time each day,
    regardless of meals. Starting dose may be 5 mg.

Pharmacological Group & Indications

Group: ACE inhibitor (angiotensin-converting enzyme inhibitor); antihypertensive, cardioprotective. Not a prodrug (unlike enalapril) - directly active.

Indications:

Arterial hypertension
Heart failure with reduced ejection fraction (HFrEF) - reduces mortality
Post-MI (started within 24 h, reduces remodeling and mortality)
Diabetic nephropathy (reduces proteinuria, slows progression)
Non-diabetic CKD with proteinuria
Left ventricular dysfunction (asymptomatic, post-MI)

Analogue

Ramipril (Tritace) - ACE inhibitor, prodrug converted to ramiprilat. Has the most robust evidence base among ACE inhibitors for cardiovascular risk reduction (HOPE trial). Longer half-life than lisinopril. Lisinopril and ramipril are pharmacologically equivalent (same mechanism - ACE inhibition, kinin accumulation), differing mainly in pharmacokinetics and evidence base. Enalapril (Renitec) is another common analogue (prodrug, 2x/day dosing).

Other Forms & Synonym

Other forms: Tablets 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg; Fixed combinations with HCT: Iruzid (Lisinopril 10/20 mg + HCT 12.5/25 mg); with amlodipine: Equacard, Ekvator.

Synonym: Diroton (Gedeon Richter) - widely used in CIS; also Lisinopril-Teva, Prinivil, Zestril. Active substance: lisinopril dihydrate.

27. LOSARTAN

Prescription (Losartan 50 mg tablets, pack of 30)

Rp.: Losartanum kalicum 0,05
D.t.d. N. 30 in tab.
S.: Take 1 tablet once daily, with or without food.
    May increase to 100 mg once daily if needed.

Pharmacological Group & Indications

Group: Angiotensin II receptor blocker (ARB / sartан); antihypertensive, nephroprotective. Selective AT₁ receptor antagonist.

Indications:

Arterial hypertension
Diabetic nephropathy in type 2 DM with proteinuria (LIFE, RENAAL trials)
Heart failure with reduced EF (HFrEF) - when ACE inhibitor not tolerated
Prevention of stroke in hypertensive patients with LV hypertrophy
Reduction of cardiovascular morbidity in hypertension (LIFE trial)
Uric acid lowering (unique among ARBs - losartan has uricosuric effect, useful in hypertensive patients with gout)

Analogue

Valsartan (Diovan) - another ARB, also selective AT₁ blocker. Strong evidence in HFrEF (Val-HeFT trial) and post-MI (VALIANT). No uricosuric effect. Irbesartan (Aprovel) and telmisartan are other analogues with once-daily dosing; telmisartan has the longest half-life (~24 h) and has some PPAR-γ agonist activity potentially benefiting insulin sensitivity.

Other Forms & Synonym

Other forms: Tablets 25 mg, 50 mg, 100 mg; Fixed combinations with HCT: Gizaar/Lozap Plus (Losartan 50 mg + HCT 12.5 mg), Lozap Plus 100/25.

Synonym: Cozaar (MSD) - original brand; also Lozap, Lorista, Losartan-Teva, Presartan. Active substance: losartan potassium.

28. MAPROTILINE

Prescription (Maprotiline 25 mg tablets, pack of 30)

Rp.: Maprotilini hydrochloridi 0,025
D.t.d. N. 30 in tab.
S.: Take 1 tablet 2-3 times daily with meals.
    Dose adjusted gradually. Avoid abrupt discontinuation.
    Maximum dose: 150 mg/day. Takes 2-4 weeks for effect.

Pharmacological Group & Indications

Group: Tetracyclic antidepressant (TeCA); norepinephrine reuptake inhibitor (NRI); also has antihistamine (H₁) and anticholinergic properties. Closely related to tricyclic antidepressants.

Indications:

Major depressive disorder (endogenous, reactive, atypical)
Anxiety with depression
Insomnia associated with depression
Enuresis in children (off-label, similar to TCAs)
Neuropathic pain (adjunct)

Analogue

Amitriptyline - tricyclic antidepressant (TCA), inhibits both serotonin and norepinephrine reuptake. Stronger serotoninergic effect than maprotiline. Greater anticholinergic and sedative effects. Equally effective for depression but more adverse effects (dry mouth, constipation, urinary retention, cardiotoxicity in overdose). Preferred for neuropathic pain and migraine prophylaxis. Maprotiline may have slightly better cardiac safety than amitriptyline.

Other Forms & Synonym

Other forms: Tablets 10 mg, 25 mg, 50 mg, 75 mg; Solution for IV/IM infusion 25 mg/5 ml (hospital use for severe depression).

Synonym: Ludiomil (Novartis) - original brand; also Maprotibene, Psymion. Active substance: maprotiline hydrochloride.

29. MEBENDAZOLE

Prescription (Mebendazole 100 mg tablets, pack of 6)

Rp.: Mebendazoli 0,1
D.t.d. N. 6 in tab.
S.: For enterobiasis (pinworm): Take 1 tablet as a single dose.
    Repeat after 2-3 weeks. Treat all family members
    simultaneously.
    For ascariasis, hookworm, whipworm: 1 tablet twice daily
    for 3 consecutive days.

Pharmacological Group & Indications

Group: Anthelmintic (benzimidazole class). Inhibits tubulin polymerization in helminths, impairing glucose uptake and causing autolysis of intestinal cells in the worm.

Indications:

Enterobiasis (pinworm, Enterobius vermicularis)
Ascariasis (Ascaris lumbricoides)
Trichuriasis (whipworm, Trichuris trichiura)
Hookworm (Ancylostoma duodenale, Necator americanus)
Mixed intestinal helminthiasis
Strongyloidiasis (second-line)
Trichinellosis (high doses)
Hydatid disease (Echinococcus) - high dose, prolonged (adjunct to surgery)

Analogue

Albendazole (Zentel) - also a benzimidazole anthelmintic, same mechanism. Broader spectrum than mebendazole: effective against systemic helminthiases (hydatid cysts, cysticercosis, filariasis) due to better systemic absorption (mebendazole has very poor oral bioavailability, ~1-5%, limiting it to intestinal parasites). For intestinal helminths: single-dose albendazole 400 mg is equivalent to mebendazole 3-day course for many species. Albendazole is preferred for tissue-invasive infections.

Other Forms & Synonym

Other forms: Tablets 100 mg; Suspension/syrup 100 mg/5 ml (pediatric use - useful since children may not swallow tablets easily).

Synonym: Vermox (Janssen) - original brand; also Vormin, Vermo, Mebex. Active substance: mebendazole.

30. MERCAZOLIL (THIAMAZOLE)

Prescription (Thiamazole 5 mg tablets, pack of 50)

Rp.: Thiamazoli 0,005
D.t.d. N. 50 in tab.
S.: Take as directed by physician (initial dose typically
    20-40 mg/day in 2-4 divided doses; maintenance 5-15 mg/day).
    Regular blood count monitoring required.

(Note: "Mercazolil" is the Russian/CIS trade name for thiamazole/methimazole)

Pharmacological Group & Indications

Group: Antithyroid agent (thionamide class). Inhibits thyroid peroxidase, blocking oxidation of iodide and coupling of iodotyrosines - thereby preventing thyroid hormone (T3, T4) synthesis.

Indications:

Hyperthyroidism (Graves' disease, toxic multinodular goiter, toxic adenoma)
Thyrotoxicosis - preoperative preparation before thyroidectomy
Preparation for radioiodine therapy
Long-term management when surgery and radioiodine declined
Thyroid storm (high dose, combined with iodine, beta-blocker, corticosteroids)
Neonatal hyperthyroidism (from maternal TSH-receptor antibodies)

Analogue

Propylthiouracil (PTU) - another thionamide antithyroid drug. Same mechanism (inhibits thyroid peroxidase) plus additionally inhibits peripheral conversion of T4 to T3 (at high doses). PTU is preferred over thiamazole in: first trimester of pregnancy (thiamazole has teratogenic risk - aplasia cutis, choanal atresia), thyroid storm (faster T4→T3 blockade), and some cases of thiamazole agranulocytosis. Thiamazole/mercazolil is generally preferred over PTU for most other indications due to once-daily dosing and less hepatotoxicity risk.

Other Forms & Synonym

Other forms: Tablets 5 mg, 10 mg (some markets 20 mg).

Synonym: Tyrozol (EGIS) - modern brand used in CIS; also Tapazole (US), Favistan (Germany), Strumazol. Active substance: thiamazole (= methimazole in US nomenclature; mercazolil is Russian INN).

31. METOCLOPRAMIDE

Prescription (Metoclopramide 10 mg tablets, pack of 50)

Rp.: Metoclopramidi hydrochloridi 0,01
D.t.d. N. 50 in tab.
S.: Take 1 tablet 3 times daily, 30 minutes before meals.
    Maximum daily dose: 30 mg. Maximum course: 5 days
    (longer only under physician supervision).
    Avoid in children under 1 year.

Pharmacological Group & Indications

Group: Prokinetic agent and antiemetic. Central and peripheral D₂ receptor antagonist; also 5-HT₄ agonist and 5-HT₃ antagonist (at high doses). Enhances GI motility and blocks chemoreceptor trigger zone (CTZ).

Indications:

Nausea and vomiting (drug-induced, postoperative, pregnancy-related - with caution)
Gastroparesis (diabetic, post-surgical)
GERD (short-term, as adjunct)
Functional dyspepsia
Hiccups (intractable)
Enhancement of contrast medium transit during GI procedures
Adjunct to analgesics for migraine (improves absorption, antiemetic)
Prevention of chemotherapy-induced nausea (now largely replaced by ondansetron)

Analogue

Domperidone (Motilium) - peripheral D₂ antagonist only (does not cross BBB significantly), so lacks central side effects of metoclopramide (extrapyramidal reactions, tardive dyskinesia, sedation). Acts on stomach and duodenum to enhance gastric emptying, relaxes pylorus. Preferred prokinetic for gastroparesis and functional dyspepsia, especially in elderly, due to better safety profile. However: risk of QT prolongation (similar to metoclopramide).

Other Forms & Synonym

Other forms: Tablets 10 mg; Solution for IM/IV injection 5 mg/ml (2 ml ampoules) - for acute nausea, pre-medication; Syrup 1 mg/ml (pediatric - but EPS risk means very limited pediatric use); Suppositories 20 mg.

Synonym: Cerucal (AWD Pharma) - most widely used brand in CIS; also Reglan (US), Primperan. Active substance: metoclopramide hydrochloride.

32. METOPROLOL

Prescription (Metoprolol succinate SR 50 mg tablets, pack of 30)

Rp.: Metoprololi succinatis 0,05
D.t.d. N. 30 in tab. retard (SR)
S.: Take 1 tablet once daily with or after a meal.
    Swallow whole, do not crush. Do not stop abruptly
    (taper over 1-2 weeks). Monitor heart rate.

Pharmacological Group & Indications

Group: Cardioselective beta-1 adrenergic receptor blocker (beta-blocker, group II antiarrhythmic). Selective at low doses; loses selectivity at high doses.

Indications:

Arterial hypertension
Angina pectoris (stable)
Heart failure with reduced EF (HFrEF) - reduces mortality (MERIT-HF trial)
Post-MI - reduces reinfarction and mortality
Tachyarrhythmias: sinus tachycardia, SVT, rate control in atrial fibrillation/flutter
Hypertrophic cardiomyopathy
Migraine prophylaxis
Essential tremor
Hyperthyroidism (symptomatic control - palpitations, tremor)
Prevention of perioperative cardiovascular events

Analogue

Bisoprolol (Concor) - cardioselective beta-1 blocker with highest beta-1 selectivity among beta-blockers. Once-daily dosing. Similar evidence base for HFrEF (CIBIS-II trial). Generally preferred over metoprolol tartrate (IR) due to once-daily dosing. Comparable to metoprolol succinate (SR) in clinical practice.

Other Forms & Synonym

Other forms: Metoprolol tartrate: IR tablets 25 mg, 50 mg, 100 mg (twice daily); Metoprolol succinate: SR/XL tablets 25 mg, 50 mg, 100 mg, 200 mg (once daily); Solution for IV injection 1 mg/ml (5 ml ampoules) for acute arrhythmias.

Synonym: Betaloc (AstraZeneca) - widely used in CIS (Betaloc ZOK = succinate SR); also Metocard, Egilok, Corvitol. Active substance: metoprolol succinate or tartrate.

33. METFORMIN

Prescription (Metformin 500 mg tablets, pack of 60)

Rp.: Metformini hydrochloridi 0,5
D.t.d. N. 60 in tab.
S.: Take 1 tablet 2-3 times daily with meals or immediately
    after. Start with 500 mg once daily; increase gradually
    over 2-4 weeks to reduce GI side effects.
    Standard dose: 1000 mg twice daily.

Pharmacological Group & Indications

Group: Biguanide; oral antidiabetic / antihyperglycemic agent. Primarily activates AMPK, reduces hepatic gluconeogenesis, improves peripheral insulin sensitivity. Does NOT cause hypoglycemia as monotherapy.

Indications:

Type 2 diabetes mellitus: first-line pharmacotherapy (unless contraindicated)
Polycystic ovary syndrome (PCOS) - improves insulin sensitivity, restores ovulation
Prevention of type 2 diabetes in pre-diabetic patients (IGT, IFG)
Metabolic syndrome
Adjunct in type 1 DM (reduces insulin dose and weight)
Cancer risk reduction (observational data, not approved indication)
Weight management in DM (weight-neutral/slight weight loss)

Contraindications: eGFR < 30 ml/min (risk of lactic acidosis); hold 48 h before contrast procedures.

Analogue

Empagliflozin (Jardiance) - SGLT-2 inhibitor, different mechanism (inhibits renal glucose reabsorption, glucosuria). Also first-line alongside metformin with proven cardiovascular and renal benefits in T2DM (EMPA-REG OUTCOME trial). Not directly interchangeable but serves as analogue/complementary drug when metformin is contraindicated (renal impairment: empagliflozin down to eGFR 20 mL/min/1.73m² for heart failure indication).

Other Forms & Synonym

Other forms: Tablets 500 mg, 850 mg, 1000 mg (IR); Extended-release (XR/SR) tablets 500 mg, 750 mg, 1000 mg (once or twice daily, better GI tolerability); Oral solution 500 mg/5 ml. Fixed combinations with glibenclamide (Glucovance), sitagliptin (Janumet), vildagliptin (Galvusmet), empagliflozin (Synjardy).

Synonym: Glucophage (Merck) - original brand; also Siofor, Metforal, Bagomet. Active substance: metformin hydrochloride.

34. NANDROLONE

Prescription (Nandrolone decanoate 50 mg/ml solution for IM injection, 1 ml ampoules, pack of 1) — Controlled substance (anabolic steroid)

Special prescription form (Form 148-1/u-04)

Rp.: Sol. Nandroloni decanoatis oleosae 5% - 1 ml
D.t.d. N. 4 in amp.
S.: Inject 50 mg intramuscularly once every 3 weeks.
    [Physician stamp + institutional seal required]

Pharmacological Group & Indications

Group: Anabolic steroid; 19-nortestosterone derivative. Androgen receptor agonist with high anabolic:androgenic ratio (~10:1). Stimulates protein synthesis, erythropoiesis (via EPO stimulation), nitrogen retention, and bone mineralization.

Indications (clinical/legitimate):

Anemia associated with renal failure (before erythropoiesis-stimulating agents era; now rarely used)
Aplastic anemia (adjunct)
Cachexia and muscle wasting (cancer, HIV/AIDS, severe burns)
Osteoporosis (adjunct in postmenopausal women, historically)
Severe protein deficiency states

Analogue

Testosterone enanthate (Testoviron Depot) - long-acting testosterone ester, also anabolic steroid with androgen receptor agonism. Higher androgenic activity than nandrolone. Used for androgen replacement therapy (hypogonadism), delayed puberty, and (historically) for similar anabolic indications. Modern replacement for nandrolone in anemia = erythropoiesis-stimulating agents (EPO, darbepoetin alfa).

Other Forms & Synonym

Other forms: Nandrolone phenylpropionate (Durabolin) 25 mg/ml, 50 mg/ml - shorter acting, IM injection every 1-2 weeks; Nandrolone decanoate (Deca-Durabolin) 25 mg/ml, 50 mg/ml, 100 mg/ml - long-acting, IM every 2-4 weeks.

Synonym: Retabolil (original CIS brand for nandrolone decanoate 50 mg/ml in 1 ml ampoules) - historically the standard brand in Soviet/Russian medicine; Deca-Durabolin (Organon) internationally. Active substance: nandrolone decanoate.

35. NITROGLYCERIN

Prescription (Nitroglycerin 0.5 mg sublingual tablets, pack of 40)

Rp.: Nitroglycerini 0,0005
D.t.d. N. 40 in tab. sublingualibus
S.: Place 1 tablet under the tongue at the onset of angina
    attack. May repeat after 5 minutes if no relief.
    If no relief after 3 tablets (15 min), call emergency
    services immediately (suspect MI).
    Store in dark, tightly closed original container.

Pharmacological Group & Indications

Group: Organic nitrate; antianginal agent; vasodilator. Releases NO (nitric oxide), activates guanylate cyclase, increases cGMP, causes smooth muscle relaxation and vasodilation (predominantly venous at low doses).

Indications:

Acute angina attack (sublingual - first choice for relief)
Angina prophylaxis (transdermal, oral prolonged-release)
Unstable angina (IV infusion in hospital)
Acute MI (IV - reduces preload/afterload, limits infarct size)
Acute decompensated heart failure (IV - reduces preload)
Hypertensive crisis with cardiac involvement (IV)
Esophageal spasm
Achalasia (sublingual, off-label)
Anal fissure (topical ointment 0.2-0.4%)

Analogue

Isosorbide dinitrate (Cardiket, Isordil) and Isosorbide mononitrate (Monocinque, Olicard) - long-acting organic nitrates used for angina prophylaxis. Both release NO by the same mechanism. Isosorbide mononitrate does not require hepatic conversion to active form (unlike ISDN), has better bioavailability, and is preferred for maintenance therapy. SR formulations allow once-daily dosing and require nitrate-free interval to prevent tolerance.

Other Forms & Synonym

Other forms:

Sublingual tablets 0.5 mg (quick relief)
Sublingual spray (Nitromint, Nitrospray) 0.4 mg/dose - more stable shelf-life
Transdermal patches (Nitroderm TTS, Deponit) 5 mg/24h, 10 mg/24h
Prolonged-release capsules/tablets (Nitrosorbide, Sustak) for prophylaxis
Solution for IV infusion 0.1%, 0.1 mg/ml (hospital use, ACS/HF)
Ointment 2% (topical for anal fissure)

Synonym: Nitromint (EGIS) - sublingual tablets/spray popular in CIS; Perlinganit (IV solution); Nitroglycerin-Ratiopharm. Active substance: nitroglycerin (glyceryl trinitrate).

36. OXYMETAZOLINE

Prescription (Oxymetazoline 0.1% nasal drops/spray, 10 ml bottle) — OTC in most countries, but Rx example shown

Rp.: Sol. Oxymetazolini hydrochloridi 0,1% - 10 ml
D.t.d. N. 1 in flac. cum nebulizatore.
S.: Adults and children >6 years: spray 2-3 times into
    each nostril 2-3 times daily. Maximum use: 3-5 days.
    Do not exceed recommended dose or duration.

(Children 2-6 years use 0.025-0.05% solution; infants use 0.01-0.025%)

Pharmacological Group & Indications

Group: Alpha-2 adrenergic agonist (imidazoline derivative); nasal decongestant; vasoconstrictor. Applied topically to nasal mucosa.

Indications:

Nasal congestion due to acute rhinitis (cold), allergic rhinitis, sinusitis
Relief of nasal obstruction before nasal examination
Adjunct in otitis media (to improve Eustachian tube patency)
Before nasal procedures (hemostasis)
Ophthalmic solution (0.025-0.05%): conjunctival redness (vasoconstrictor)

Key limitation: Maximum 3-5 days use to avoid rebound congestion (rhinitis medicamentosa).

Analogue

Xylometazoline (Otrivin, Galazolin) - another imidazoline alpha-agonist nasal decongestant with the same mechanism. Very similar pharmacological profile; oxymetazoline has slightly longer duration of action (8-12 h vs 6-8 h for xylometazoline). Both are used identically for nasal decongestion with same 3-5 day maximum duration. Choice is largely preference/availability.

Other Forms & Synonym

Other forms: Nasal drops 0.025%, 0.05%, 0.1%; Nasal spray 0.05%, 0.1% (metered-dose); Ophthalmic solution 0.025% (Visine, Clear Eyes); Combined nasal sprays with ipratropium (for rhinorrhea + congestion).

Synonym: Nazivin (Merck) - original widely used brand in CIS; also Knoxin, Noxivine, Sanorin-Mono, Afrin (US). Active substance: oxymetazoline hydrochloride.

37. OMEPRAZOLE

Prescription (Omeprazole 20 mg capsules, pack of 28)

Rp.: Omeprazoli 0,02
D.t.d. N. 28 in caps.
S.: Take 1 capsule once daily before breakfast.
    Swallow whole. Course: 4 weeks (duodenal ulcer),
    8 weeks (gastric ulcer, GERD). For H. pylori eradication:
    combine with antibiotics as prescribed.

Pharmacological Group & Indications

Group: Proton pump inhibitor (PPI). Irreversibly inhibits H⁺/K⁺-ATPase (the "proton pump") in gastric parietal cells, blocking acid secretion.

Indications:

Gastroesophageal reflux disease (GERD) - treatment and maintenance
Erosive esophagitis
Peptic ulcer disease (gastric and duodenal ulcer)
H. pylori eradication (triple/quadruple therapy partner)
NSAID-associated gastropathy (treatment and prophylaxis)
Zollinger-Ellison syndrome
Stress ulcer prophylaxis (IV form in ICU)
Upper GI bleeding (IV form, post-endoscopic hemostasis)

Analogue

Pantoprazole (Nolpaza, Controloc) - PPI with same irreversible H⁺/K⁺-ATPase inhibition. More selective for the gastric proton pump (less CYP2C19 interaction than omeprazole/esomeprazole), fewer drug-drug interactions (relevant for patients on clopidogrel - pantoprazole/rabeprazole preferred over omeprazole). Available as IV formulation for hospital use. Esomeprazole (S-isomer of omeprazole, Nexium) provides higher plasma levels with less inter-patient variability.

Other Forms & Synonym

Other forms: Capsules 10 mg, 20 mg, 40 mg; Enteric-coated tablets (Losec MUPS); Powder for IV injection/infusion 40 mg/vial (for upper GI bleeding, hospital use).

Synonym: Losec (AstraZeneca) - original brand; also Ultop, Omez, Gastrozol, Romesec. Active substance: omeprazole (magnesium or sodium salt).

38. OSELTAMIVIR

Prescription (Oseltamivir 75 mg capsules, pack of 10)

Rp.: Oseltamiviri phosphatis 0,075
D.t.d. N. 10 in caps.
S.: Take 1 capsule twice daily for 5 days.
    Start as early as possible, ideally within 48 hours
    of symptom onset. Take with food to reduce nausea.

Pharmacological Group & Indications

Group: Antiviral agent; neuraminidase inhibitor. Inhibits influenza virus neuraminidase, preventing release of new viral particles from infected cells and reducing viral spread.

Indications:

Treatment of influenza A and B in adults and children (start within 48 h of symptoms)
Post-exposure prophylaxis of influenza (75 mg once daily x 10 days)
Pre-exposure prophylaxis during influenza outbreaks (immunocompromised, elderly)
High-risk patients: elderly, immunocompromised, chronic cardiorespiratory disease
Hospitalized patients with severe influenza
Novel influenza strains (H5N1, H1N1 pandemic)

Analogue

Zanamivir (Relenza) - also a neuraminidase inhibitor, same mechanism. Administered by oral inhalation (Diskhaler, 10 mg twice daily x 5 days). Cannot be given orally (poor bioavailability). Preferred when oseltamivir-resistant influenza strains are suspected (some H1N1 resistant strains remain zanamivir-sensitive). Baloxavir marboxil (Xofluza) - newer single-dose oral antiviral (cap-dependent endonuclease inhibitor, different mechanism) approved 2018.

Other Forms & Synonym

Other forms: Capsules 30 mg, 45 mg, 75 mg; Powder for oral suspension 6 mg/ml (pediatric, 30 ml bottle); IV form (peramivir - different drug, but same class for severe hospitalized cases).

Synonym: Tamiflu (Roche) - original brand; also Oseltamivir-Teva, Nomides, Influnet. Active substance: oseltamivir phosphate.

39. PANCREATIN

Prescription (Pancreatin/Creon 25,000 IU lipase capsules, pack of 50)

Rp.: Pancreatinum 0,25 (25 000 IU lipasae)
D.t.d. N. 50 in caps. enterosolventibus.
S.: Take 1-2 capsules with each main meal and 1 capsule
    with snacks. Swallow whole with water (do not crush
    or chew). Take during or immediately after meals.

(Dosing is in FIP/IU units of lipase activity; packages contain 10,000; 25,000; or 40,000 IU)

Pharmacological Group & Indications

Group: Enzyme preparation; digestive enzymes (pancreatic enzyme replacement). Contains lipase, protease (trypsin, chymotrypsin), and amylase from porcine pancreatic extract.

Indications:

Exocrine pancreatic insufficiency (EPI): chronic pancreatitis, post-pancreatectomy, pancreatic cancer
Cystic fibrosis (major indication - CF-related EPI)
Post-gastrectomy maldigestion
Steatorrhea of any cause (bile acid deficiency, short bowel syndrome)
Functional dyspepsia (low-dose, as digestive aid)
Diagnostic use: secretin stimulation test

Analogue

Mezim forte (Berlin-Chemie) - also pancreatin preparation (porcine) with similar enzyme composition. Mezim forte 10,000 is equivalent to Pancreatin 10,000. Creon (Solvay/Abbott) is the gold-standard brand with enteric-coated microspheres for superior enzyme activity. All contain pancreatin; differences are in formulation (mini-microspheres vs powder tablets) affecting enzyme release and efficacy.

Other Forms & Synonym

Other forms: Enteric-coated tablets (Pancreatin regular); Enteric-coated capsules containing mini-microspheres (Creon 10,000; 25,000; 40,000) - preferred modern form; Powder (for tube feeding); Combined preparations with bile acids and hemicellulase (Festal, Digestal).

Synonym: Creon (AbbVie) - reference brand; also Mezim forte, Panzinorm, Ermital, Pangrol. Active substance: pancreatin (standardized by lipase units).

40. PIRACETAM

Prescription (Piracetam 400 mg capsules, pack of 60)

Rp.: Piracetami 0,4
D.t.d. N. 60 in caps.
S.: Take 2 capsules (800 mg) 3 times daily before meals.
    Course: 4-8 weeks. May take 2.4-4.8 g/day as directed.

Pharmacological Group & Indications

Group: Nootropic agent; cyclic GABA derivative (2-oxo-pyrrolidine acetamide). Modulates AMPA receptors, improves neuronal membrane fluidity, enhances cerebral blood flow. Note: Regulatory status varies - not approved by FDA/EMA as a drug; widely used in CIS and Eastern Europe.

Indications (per CIS/Russian prescribing):

Cognitive impairment (age-related, post-stroke, post-TBI)
Dementia (adjunct)
Dyslexia (in children)
Myoclonus (high-dose, especially cortical myoclonus)
Sickle cell anemia (reduces sickling)
Alcoholism withdrawal (adjunct)
Post-concussion syndrome
Vertigo of central origin

Analogue

Citicoline (Ceraxon, Somazina) - nootropic/neuroprotective agent; precursor for phosphatidylcholine synthesis, enhances ACh synthesis, reduces neuronal membrane breakdown. More evidence base than piracetam for stroke rehabilitation and TBI. Aniracetam, phenylpiracetam are other racetam analogues with similar (or stronger) effects.

Other Forms & Synonym

Other forms: Capsules 400 mg; Tablets 200 mg, 400 mg, 800 mg, 1200 mg; Solution for IV/IM injection 200 mg/ml (5 ml, 20 ml ampoules) - for acute stroke, myoclonus; Oral solution 333 mg/ml; Combination: Piracetam + Cinnarizine (Fezam capsules) - widely used in CIS.

Synonym: Nootropil (UCB) - original brand; also Lucetam, Memotropil, Piratropil. Active substance: piracetam.

41. PREDNISOLONE

Prescription (Prednisolone 5 mg tablets, pack of 100)

Rp.: Prednisoloni 0,005
D.t.d. N. 100 in tab.
S.: Take as directed by physician (dose individualized).
    Example: 40 mg/day in morning = 8 tablets with breakfast.
    Do not stop abruptly (taper gradually).
    Take with food.

Pharmacological Group & Indications

Group: Synthetic glucocorticoid (corticosteroid). Binds glucocorticoid receptors; anti-inflammatory, immunosuppressive, antiallergic; mineralocorticoid activity moderate.

Indications:

Asthma (exacerbations, severe persistent - systemic; maintenance - inhaled preferred)
COPD exacerbations
Inflammatory bowel disease (Crohn's disease, ulcerative colitis)
Rheumatic diseases: RA, SLE, vasculitis, polymyalgia rheumatica, temporal arteritis
Allergic conditions: severe urticaria, angioedema, anaphylaxis (adjunct)
Dermatological conditions: pemphigus, severe eczema
Autoimmune conditions: ITP, AIHA, myasthenia gravis
Organ transplant rejection prophylaxis
Cerebral edema (dexamethasone preferred; prednisolone used in some protocols)
Adrenal insufficiency (replacement therapy)
Croup (single dose)

Analogue

Dexamethasone - fluorinated glucocorticoid, ~25-30x more potent than prednisolone (weight basis). No mineralocorticoid activity. Preferred for: cerebral edema, meningitis (anti-inflammatory adjunct), croup (single dose), anti-emesis in chemotherapy, ARDS (COVID-19), preterm labor (fetal lung maturation), adrenal suppression testing (DST). For anti-inflammatory/immunosuppressive purposes: methylprednisolone (Medrol) is intermediate potency (4x prednisolone, no mineralocorticoid effect).

Other Forms & Synonym

Other forms: Tablets 1 mg, 5 mg; Solution for IV/IM injection 30 mg/ml (1 ml, 3 ml ampoules) - IV for acute emergencies; Eye drops/ointment 0.5%, 1%; Ear drops; Topical cream/ointment 0.25%, 0.5%; Nasal spray; Rectal enema/foam (for IBD).

Synonym: Prednisolone-Nycomed, Decortin (Germany); also Deltacortril. Active substance: prednisolone. (Prednisone - the prodrug, converted to prednisolone in liver, is the standard US formulation; Prednisolone = active form, preferred in liver disease.)

42. SALBUTAMOL

Prescription (Salbutamol 100 mcg/dose metered-dose inhaler, 200 doses)

Rp.: Salbutamoli 0,0001 in dosi (100 mcg/dosi)
D.t.d. N. 1 inhalatio dosimeter (200 dosium)
S.: Inhale 1-2 puffs as needed for bronchospasm
    (maximum 4 times daily at regular intervals, or up
    to every 4-6 hours). Shake well before use.
    For exercise-induced bronchospasm: 2 puffs 15-30
    min before exercise.

Pharmacological Group & Indications

Group: Short-acting beta-2 adrenergic agonist (SABA); bronchodilator. Stimulates beta-2 receptors in bronchial smooth muscle causing relaxation and bronchodilation.

Indications:

Acute bronchospasm relief in asthma (reliever/"rescue" inhaler)
Exercise-induced bronchoconstriction (prophylaxis)
Acute COPD exacerbation (bronchodilator)
Bronchospasm during anesthesia
Nebulizer solution for acute severe asthma (hospital)
IV/SC: management of severe asthma exacerbation (hospital)
Tocolysis (IV infusion - to relax uterine smooth muscle in premature labor)
Hyperkalemia treatment (nebulized - drives K⁺ into cells)

Analogue

Fenoterol (Berotec) - also SABA, beta-2 agonist, used by inhalation. Slightly longer duration than salbutamol. Historical concerns about cardiac safety at high doses (especially from high-dose pressurized MDI - withdrawn in some markets). Terbutaline (Bricanyl) - another SABA also used for tocolysis. For long-acting beta-2 agonists (LABA, not SABAs): formoterol (Foradil) and salmeterol (Serevent) are analogues in class but different duration.

Other Forms & Synonym

Other forms: MDI inhaler 100 mcg/dose; Dry powder inhaler (DPI - Ventolin Rotacaps); Nebulizer solution 2.5 mg/2.5 ml, 5 mg/2.5 ml unit-dose vials; Solution for IV infusion 1 mg/ml (for acute severe asthma, premature labor); Oral tablets 2 mg, 4 mg (rare use); Syrup 2 mg/5 ml (pediatric).

Synonym: Ventolin (GSK) - original brand; also Salamol, Salbuvent, AsthmaHaler. Active substance: salbutamol (= albuterol in US nomenclature).

43. THEOPHYLLINE

Prescription (Theophylline SR 300 mg tablets, pack of 30)

Rp.: Theophyllini 0,3
D.t.d. N. 30 in tab. retard (SR)
S.: Take 1 tablet twice daily (every 12 hours).
    Take with food at regular times. Do not crush.
    Dose individualized by serum level monitoring
    (target: 8-12 mcg/ml). Avoid caffeine.

Pharmacological Group & Indications

Group: Methylxanthine; phosphodiesterase (PDE) inhibitor; adenosine receptor antagonist; bronchodilator and respiratory stimulant. Increases cAMP in bronchial smooth muscle cells.

Indications:

Asthma (add-on therapy when ICS ± LABA insufficient - third-line)
COPD (maintenance bronchodilation - third-line after LABA/LAMA)
Apnea of prematurity (aminophylline/theophylline - IV)
Acute severe asthma (IV aminophylline - adjunct in hospital when beta-2 agonists fail)
Anti-inflammatory effect at low doses (emerging evidence)

Narrow therapeutic index: therapeutic range 8-12 mcg/ml; toxic >20 mcg/ml.

Analogue

Aminophylline (Eufillin) - theophylline ethylenediamine complex (80% theophylline by weight). More water-soluble, available for IV use. Used interchangeably with theophylline. IV aminophylline is standard in Russian/CIS hospitals for acute bronchospasm, severe asthma, cardiac asthma, and pulmonary edema. Oral SR theophylline and IV aminophylline are the two key forms of the same pharmacologically active compound.

Other Forms & Synonym

Other forms: SR/XR tablets 100 mg, 200 mg, 300 mg, 400 mg (Theo-Dur, Theodur retard); Aminophylline solution for IV 2.4% (24 mg/ml, 10 ml ampoules) - hospital use; Aminophylline suppositories; Theophylline oral solution (pediatric).

Synonym: Theo-Dur (Schering-Plough) - SR brand; Euphyllin CR, Theolong; Aminophylline = Eufillin in CIS for IV form. Active substance: theophylline.

44. TRAMADOL

Prescription (Tramadol 50 mg capsules, pack of 20) — Controlled substance (opioid analgesic) - special prescription form

Special prescription form (Form 148-1/u-04)

Rp.: Tramadoli hydrochloridi 0,05
D.t.d. N. 20 in caps.
S.: Take 1-2 capsules every 4-6 hours as needed for pain.
    Maximum dose: 400 mg/day (8 capsules).
    [Physician personal stamp + institutional seal required]

Pharmacological Group & Indications

Group: Opioid analgesic (mu-opioid receptor agonist, weak); also inhibits serotonin and norepinephrine reuptake (dual mechanism). Schedule IV controlled substance in Russia.

Indications:

Moderate to severe pain when non-opioid analgesics are insufficient
Chronic cancer pain (as part of WHO analgesic ladder, step 2-3)
Postoperative pain
Neuropathic pain (SNRI component contributes)
Procedural pain (IV/IM)

Analogue

Ketorolac IM (for acute moderate-severe pain, non-opioid alternative) or Tapentadol (Palexia) - opioid analgesic combining mu-receptor agonism with norepinephrine reuptake inhibition (like tramadol but no serotonin component), stronger mu-agonism, fewer serotonin-related side effects. Codeine + paracetamol is a weaker opioid analgesic alternative. For moderate cancer pain: morphine (sustained-release) is the step-3 WHO ladder drug.

Other Forms & Synonym

Other forms: Capsules 50 mg; SR tablets 100 mg, 150 mg, 200 mg (once or twice daily, for chronic pain); Solution for IM/IV/SC injection 50 mg/ml (1 ml, 2 ml ampoules); Suppositories 100 mg; Oral drops 100 mg/ml. Fixed combination with paracetamol: Zaldiar (Tramadol 37.5 mg + Paracetamol 325 mg).

Synonym: Tramal (Gruenenthal) - original brand; also Tramundal, Ultram (US), Crispin. Active substance: tramadol hydrochloride.

45. FENTANYL

Prescription (Fentanyl transdermal patch 25 mcg/h, pack of 5) — Narcotic analgesic - Form 107/u-NP (strict narcotic prescription)

Narcotic prescription form (Form 107/u-NP)

Rp.: Fentanyli systematis transdermi 25 mcg/h
D.t.d. N. 5 (quinque) in systematis (patch)
S.: Apply 1 patch to intact, dry, non-irritated flat skin
    (chest, back, upper arm). Replace every 72 hours.
    Fold used patch inward and dispose safely.
    NOT for opioid-naive patients.

[Two-layer seal, physician name, personal stamp, institutional
stamp, patient identity required]

Pharmacological Group & Indications

Group: Potent synthetic opioid analgesic; pure mu-opioid receptor agonist. 100x more potent than morphine (weight basis). Schedule II/Narcotic List I in Russia.

Indications:

Severe chronic pain requiring continuous opioid analgesia (cancer pain, step 3 WHO ladder)
Breakthrough cancer pain (transmucosal/sublingual/nasal rapid-onset forms)
Intraoperative and postoperative analgesia (IV/IM - anesthesia)
Epidural and intrathecal analgesia
Procedural sedation/analgesia (IV)
Palliative care pain management

Analogue

Buprenorphine (Norspan, Butrans) - partial mu-opioid agonist, also available as transdermal patch (5, 10, 20 mcg/h; changed weekly). Ceiling effect on respiratory depression makes it safer in some patients. Available as sublingual tablets (suboxone = buprenorphine + naloxone for opioid use disorder treatment). Morphine (sustained-release oral: MST Continus) is the gold-standard WHO step-3 opioid by oral route.

Other Forms & Synonym

Other forms: Transdermal patches 12, 25, 50, 75, 100 mcg/h (72-h patches); Solution for IV/IM injection 0.05 mg/ml (50 mcg/ml), 2 ml ampoules (for anesthesia); Transmucosal/sublingual tablets (Actiq lozenges, Abstral sublingual) for breakthrough pain; Nasal spray (Instanyl, PecFent) for breakthrough pain; Buccal film (Onsolis).

Synonym: Durogesic (Janssen) - original transdermal patch brand; also Fentanyl-TTS, Fendivia. For IV: Fentanyl-Janssen. Active substance: fentanyl (free base or citrate).

46. FLUCONAZOLE

Prescription (Fluconazole 150 mg capsules, pack of 1 or 4)

Rp.: Fluconazoli 0,15
D.t.d. N. 1 in caps.
S.: Take 1 capsule as a single dose for vaginal candidiasis.
    For oropharyngeal candidiasis: 50-100 mg once daily
    for 7-14 days (require pack of 14).

Pharmacological Group & Indications

Group: Triazole antifungal agent. Inhibits fungal cytochrome P450 14α-demethylase (CYP51), blocking ergosterol synthesis - disrupting fungal cell membrane integrity.

Indications:

Vulvovaginal candidiasis (single oral dose 150 mg)
Oropharyngeal and esophageal candidiasis (HIV, immunosuppressed)
Systemic/invasive candidiasis (higher doses, IV)
Cryptococcal meningitis (treatment and maintenance prophylaxis in HIV)
Coccidioidomycosis
Dermatophytoses (onychomycosis - 150 mg weekly x 3-6 months)
Prevention of fungal infections in immunocompromised patients

Analogue

Itraconazole (Orungal) - also triazole antifungal, same ergosterol biosynthesis inhibition. Broader spectrum: active against Aspergillus (fluconazole is NOT active), dermatophytes, dimorphic fungi. Preferred for aspergillosis, onychomycosis (pulse therapy), and non-meningeal histoplasmosis. Fluconazole is preferred for Candida and cryptococcal infections due to better CNS penetration and bioavailability.

Other Forms & Synonym

Other forms: Capsules 50 mg, 100 mg, 150 mg, 200 mg; Solution for IV infusion 2 mg/ml (50 ml, 100 ml bags) - for severe systemic infections; Oral suspension 10 mg/ml, 40 mg/ml (pediatric use); Vaginal tablets/cream (local formulations).

Synonym: Diflucan (Pfizer) - original brand; also Flucostat, Mikosist, Diflazon, Mycomax. Active substance: fluconazole.

47. FLUTICASONE

Prescription (Fluticasone propionate 125 mcg/dose MDI inhaler, 60 doses)

Rp.: Fluticasoni propionatis 0,000125 in dosi (125 mcg/dosi)
D.t.d. N. 1 inhalatio dosimeter (60 dosium)
S.: Inhale 1-2 puffs twice daily. Rinse mouth and throat
    with water after each use (prevent oral candidiasis).
    Regular use only - not for acute attacks.
    Use spacer device for best delivery.

Pharmacological Group & Indications

Group: Inhaled corticosteroid (ICS); synthetic glucocorticoid for inhalation. High topical anti-inflammatory potency, minimal systemic absorption (high first-pass hepatic metabolism).

Indications:

Asthma (persistent mild-to-severe) - controller/maintenance therapy (first-line ICS)
COPD (moderate-severe, combined with LABA - in GOLD group E)
Allergic rhinitis (nasal spray - Flixonase/Avamys) - seasonal and perennial
Nasal polyps (nasal spray, high dose)
Eosinophilic esophagitis (swallowed off-label)

Analogue

Budesonide (Pulmicort) - also ICS, similar mechanism. Broad evidence base in asthma and COPD. Available as nebulizer suspension (Pulmicort Respules) - preferred for young children (<4 years) who cannot use MDI. Equivalent anti-asthmatic efficacy to fluticasone at approximately 2:1 dose ratio (fluticasone 100 mcg ≈ budesonide 200 mcg). Beclomethasone dipropionate (QVAR) - older ICS, still widely used and economical.

Other Forms & Synonym

Other forms of fluticasone: MDI 50 mcg, 125 mcg, 250 mcg/dose; DPI (Diskus/Accuhaler) 100 mcg, 250 mcg, 500 mcg/dose; Nasal spray 50 mcg/dose (Flixonase for allergic rhinitis); Topical cream/ointment 0.05%, 0.005% (for skin conditions). Fixed combinations: Fluticasone + Salmeterol (Seretide/Advair MDI and DPI) - widely used ICS/LABA combination; Fluticasone + Vilanterol (Relvar Ellipta) - once-daily DPI.

Synonym: Flixotide (GSK) - original inhaler brand; Flisonase/Flonase (nasal). Active substance: fluticasone propionate (or furoate in Relvar/Arnuity).

48. CEFOTAXIME

Prescription (Cefotaxime 1 g powder for injection, pack of 5 vials)

Rp.: Cefotaximi 1,0 (pro injectione)
D.t.d. N. 5 in flac.
S.: Dissolve contents of 1 vial in 3-4 ml water for injection
    (IM) or 10 ml (IV bolus) or dilute in 50-100 ml NaCl
    0.9% for IV infusion.
    Administer 1 g every 8-12 hours (IM or IV) as directed.
    Course: 5-10 days.

Pharmacological Group & Indications

Group: Third-generation cephalosporin antibiotic. Inhibits bacterial cell wall synthesis (penicillin-binding proteins); broad spectrum (Gram-positive and especially Gram-negative); beta-lactamase stable.

Indications:

Meningitis (bacterial - drug of choice in combination with ampicillin for neonates)
Septicemia/bacteremia
Community-acquired and hospital-acquired pneumonia
Complicated urinary tract infections
Intra-abdominal infections (peritonitis, in combination)
Bone and joint infections
Skin and soft tissue infections (severe)
Gonococcal infections
Typhoid fever
Prophylaxis in surgery (GI, orthopedic)

Analogue

Ceftriaxone (Rocephin) - also third-generation cephalosporin, same mechanism and similar spectrum. Key advantage: once-daily dosing (long half-life ~8 h vs cefotaxime ~1 h) - single IM/IV injection per day. Ceftriaxone penetrates CSF well (meningitis treatment). Preferred over cefotaxime in outpatient parenteral therapy, Lyme disease, and single-dose gonorrhea treatment. Note: ceftriaxone should not be mixed with calcium-containing solutions (precipitation risk, especially in neonates).

Other Forms & Synonym

Other forms: Powder for IM/IV injection 0.5 g, 1 g, 2 g vials. (No oral form - all cephalosporins of generation 3+ are parenteral, except cefdinir/cefixime/cefpodoxime which are oral 3rd-gen).

Synonym: Claforan (Sanofi-Aventis) - original brand; also Cefabol, Oritaxim, Talcef, Cefotaxime-AKOS. Active substance: cefotaxime sodium.

49. CYANOCOBALAMIN (VITAMIN B12)

Prescription (Cyanocobalamin 500 mcg/ml solution for IM injection, 1 ml ampoules, pack of 10)

Rp.: Sol. Cyanocobalamini 0,05% (500 mcg/ml) - 1 ml
D.t.d. N. 10 in amp.
S.: Inject 1 ml (500 mcg) intramuscularly once daily for
    10 days (initial treatment of B12 deficiency/pernicious
    anemia), then 1 ml once monthly for maintenance.
    (For neurological involvement: higher initial frequency
    as directed by physician.)

Pharmacological Group & Indications

Group: Water-soluble vitamin (B12); cobalamin. Cofactor for methionine synthase (homocysteine → methionine) and methylmalonyl-CoA mutase. Essential for DNA synthesis, myelin formation, and erythropoiesis.

Indications:

Vitamin B12 deficiency (pernicious anemia, dietary deficiency in vegans/vegetarians, gastrectomy, malabsorption)
Megaloblastic anemia due to B12 deficiency
Subacute combined degeneration of the spinal cord (neurological B12 deficiency)
Funicular myelosis
Peripheral neuropathy (diabetic, alcoholic - adjunct)
Elevated homocysteine
After prolonged metformin use (metformin reduces B12 absorption)
Cyanide poisoning (hydroxocobalamin = different form, IV)

Analogue

Hydroxocobalamin (Cyanokit, Neo-Cytamen) - another form of vitamin B12 (OH group instead of CN). Superior to cyanocobalamin: longer-lasting depot effect (monthly IM injection vs monthly cyanocobalamin); better cellular retention; preferred for cyanide poisoning treatment (IV hydroxocobalamin, Cyanokit). Methylcobalamin - the neurologically active coenzyme form, used in peripheral neuropathy and as oral supplement (better oral absorption in some patients without intrinsic factor).

Other Forms & Synonym

Other forms: Solution for IM/SC injection 200 mcg/ml, 500 mcg/ml (1 ml ampoules); Tablets 50-500 mcg (for dietary supplementation, NOT for pernicious anemia - requires injections due to absent intrinsic factor); Sublingual tablets 1000 mcg (bypass intrinsic factor); Nasal gel/spray (Nascobal). Combined B-vitamin preparations (Neurobion: B1+B6+B12 IM injection; Milgamma).

Synonym: Cyanocobalamin-Nycomed; also Bedoce, Vibisone. Active substance: cyanocobalamin.

50. ETHINYL ESTRADIOL + DESOGESTREL

Prescription (Ethinylestradiol 20 mcg + Desogestrel 150 mcg tablets, pack of 21 [Mercilon] or 28 [Marvelon])

Rp.: Ethinylestradiolum 0,00002 + Desogestrelum 0,00015
D.t.d. N. 21 in tab. obductis
S.: Take 1 tablet daily at the same time each day for 21
    consecutive days, starting on the 1st day of menstrual
    cycle. Follow with a 7-day tablet-free interval, then
    start new pack. Take in order as marked on blister.

Pharmacological Group & Indications

Group: Combined oral contraceptive (COC); monophasic. Synthetic estrogen (ethinyl estradiol) + third-generation progestogen (desogestrel). Inhibits ovulation (suppresses LH surge via hypothalamic-pituitary feedback), thickens cervical mucus, alters endometrium.

Indications:

Contraception (primary indication)
Dysmenorrhea (secondary/primary)
Endometriosis-related pain (continuous use)
Menorrhagia (heavy menstrual bleeding)
Polycystic ovary syndrome (PCOS) - cycle regulation, acne, hirsutism
Premenstrual dysphoric disorder (PMDD)
Functional ovarian cysts (suppression)
Acne vulgaris (estrogen+progestogen with anti-androgenic activity - e.g., cyproterone acetate-based COCs are stronger but desogestrel has low androgenicity)

Analogue

Ethinylestradiol 30 mcg + Levonorgestrel 150 mcg (Microgynon, Rigevidon) - COC with second-generation progestogen. Similar contraceptive efficacy. Levonorgestrel has more androgenic activity than desogestrel, so EE/desogestrel preparations are preferred for acne and PCOS. Ethinylestradiol + Drospirenone (Yaz 20/3 mg, Yasmin 30/3 mg) - drospirenone has antimineralocorticoid and antiandrogenic activity, useful for PMDD, water retention, and acne.

Other Forms & Synonym

Other forms of EE+Desogestrel:

Mercilon (EE 20 mcg + Desogestrel 150 mcg) - 21 tablets
Marvelon (EE 30 mcg + Desogestrel 150 mcg) - 21 or 28 tablets
Other COC delivery: Vaginal ring (NuvaRing - etonogestrel + EE); Transdermal patch (Evra - norelgestromin + EE); Extended-cycle/continuous use pills (84-day, 365-day regimens).

Synonym: Mercilon/Marvelon (MSD) - widely known brands; also Regulon (Gedeon Richter, EE 30 mcg + desogestrel 150 mcg), Novynette (EE 20 mcg + desogestrel 150 mcg). Active substances: ethinyl estradiol + desogestrel.

Summary Table - Drugs 11-50

#	Drug	Group	Key Indications	Analogue	Synonym
11	Bismuth subcitrate	Gastroprotective / anti-H.pylori	PUD, H. pylori eradication	Bismuth subsalicylate	De-Nol
12	Hydrochlorothiazide	Thiazide diuretic	Hypertension, edema	Indapamide	Hypothiazide
13	Glibenclamide	Sulfonylurea	Type 2 DM	Gliclazide	Maninil
14	LMWHs (Enoxaparin)	Anticoagulant (LMWH)	VTE prophylaxis/treatment, ACS	Fondaparinux	Clexane
15	Diazepam	Benzodiazepine	Anxiety, seizures, alcohol withdrawal	Lorazepam	Valium / Seduxen
16	Diclofenac	NSAID (non-selective COX inhibitor)	Pain, arthritis, dysmenorrhea	Ibuprofen	Voltaren
17	Doxycycline	Tetracycline antibiotic	Respiratory, STI, Lyme, rickettsial	Minocycline	Unidox Solutab
18	Iron supplements	Antianemic - iron preparation	Iron deficiency anemia	Iron polymaltose (Maltofer)	Sorbifer Durules
19	Human insulin (short+long)	Pancreatic hormone / antidiabetic	DM1, DM2, DKA	Rapid/ultra-long analogues	Actrapid / Lantus
20	Ketorolac	NSAID - potent analgesic	Acute moderate-severe pain	Lornoxicam	Ketorol / Ketanov
21	Clemastine	First-gen H₁ antihistamine	Allergy, urticaria	Cetirizine	Tavegil
22	Co-trimoxazole	Sulfonamide + DHFR inhibitor	UTI, PCP, MRSA skin	Trimethoprim	Biseptol
23	Levothyroxine Na	Thyroid hormone (T4)	Hypothyroidism, goiter	Liothyronine (T3)	Eutirox
24	Levofloxacin	Fluoroquinolone	Pneumonia, UTI, prostatitis	Moxifloxacin	Tavanic
25	Lincomycin	Lincosamide antibiotic	Osteomyelitis, dental, Gram+	Clindamycin	Lincocin
26	Lisinopril	ACE inhibitor	Hypertension, HFrEF, post-MI	Ramipril	Diroton
27	Losartan	ARB (sartан)	Hypertension, DN, HFrEF	Valsartan	Cozaar / Lozap
28	Maprotiline	Tetracyclic antidepressant	Depression, anxiety-depression	Amitriptyline	Ludiomil
29	Mebendazole	Anthelmintic (benzimidazole)	Enterobiasis, ascariasis	Albendazole	Vermox
30	Mercazolil (thiamazole)	Antithyroid (thionamide)	Hyperthyroidism, thyrotoxicosis	Propylthiouracil	Tyrozol
31	Metoclopramide	Prokinetic / antiemetic (D₂ blocker)	Nausea, gastroparesis	Domperidone	Cerucal
32	Metoprolol	Cardioselective beta-blocker	HTN, angina, HFrEF, arrhythmia	Bisoprolol	Betaloc ZOK
33	Metformin	Biguanide antidiabetic	Type 2 DM, PCOS	Empagliflozin	Glucophage / Siofor
34	Nandrolone	Anabolic steroid	Anemia, cachexia, wasting	Testosterone enanthate	Retabolil
35	Nitroglycerin	Organic nitrate / vasodilator	Acute angina, ACS, HF	Isosorbide mononitrate	Nitromint
36	Oxymetazoline	Alpha-2 agonist / nasal decongestant	Nasal congestion, rhinitis	Xylometazoline	Nazivin
37	Omeprazole	Proton pump inhibitor	GERD, PUD, H. pylori	Pantoprazole	Losec / Omez
38	Oseltamivir	Neuraminidase inhibitor / antiviral	Influenza A/B	Zanamivir	Tamiflu
39	Pancreatin	Digestive enzyme preparation	Pancreatic exocrine insufficiency	Mezim forte	Creon
40	Piracetam	Nootropic	Cognitive impairment, myoclonus	Citicoline	Nootropil
41	Prednisolone	Glucocorticoid	Asthma, IBD, rheumatic, allergy	Dexamethasone	Decortin
42	Salbutamol	SABA (beta-2 agonist)	Acute bronchospasm, asthma	Fenoterol	Ventolin
43	Theophylline	Methylxanthine bronchodilator	Asthma, COPD (add-on)	Aminophylline (IV)	Theo-Dur / Eufillin
44	Tramadol	Opioid analgesic (weak mu-agonist + SNRI)	Moderate-severe pain	Tapentadol	Tramal
45	Fentanyl	Potent opioid analgesic	Severe cancer pain, anesthesia	Buprenorphine	Durogesic
46	Fluconazole	Triazole antifungal	Candidiasis, cryptococcosis	Itraconazole	Diflucan
47	Fluticasone	Inhaled corticosteroid (ICS)	Asthma, COPD, allergic rhinitis	Budesonide	Flixotide
48	Cefotaxime	3rd-gen cephalosporin	Meningitis, sepsis, pneumonia	Ceftriaxone	Claforan
49	Cyanocobalamin	Vitamin B12	B12 deficiency, megaloblastic anemia	Hydroxocobalamin	Cyanocobalamin-Nycomed
50	EE + Desogestrel	Combined oral contraceptive	Contraception, PCOS, dysmenorrhea	EE + Levonorgestrel	Mercilon / Regulon

Special prescription notes for controlled substances:

Diazepam (15), Tramadol (44): Form 148-1/u-04 (Russia) - special strict accounting prescription, validity 5 days, no repeats
Fentanyl (45): Form 107/u-NP (narcotic) - requires two-layer seal, patient ID, 5-day validity, strict dispensing records
Nandrolone (34): Form 148-1/u-04 as anabolic steroid (Schedule III)
All other drugs above: Standard Form 107-1/u, validity 60 days (chronic conditions) or 10 days (acute)

Create a comparison table of all 50 drugs by therapeutic category

Reading File

Running Command

Writing File

Running Command

Editing File

Running Command

Editing File

Your credits are exhausted. Your daily credits reset tomorrow, or you can purchase a top-up for more.

This is a shared conversation. Sign in to Orris to start your own chat.