Medication Errors Associated with Zantac and Zyrtec

Problem: Medication errors have occurred over the last three years with Zantac and Zyrtec in the pediatric population where Zantac syrup was prescribed but Zyrtec syrup was dispensed. Zantac is an h3-Blocker and Zyrtec is an antihistamine. They do not have overlapping dosage strengths, but they are both available in the syrup dosage form, Zantac as 150 mg/10 mL and Zyrtec as 5 mg/5 mL. Glaxo Wellcome manufactures Zantac and Pfizer manufactures Zyrtec and the container labels do not appear similar. Both are available in 1-pint amber glass bottles; Zyrtec is also available in a 120 mL bottle. The proprietary names look alike and sound alike to each other. Such similarities between Zantac and Zyrtec increase the potential for medication errors.

The medication error reports are summarized in the following table.

Postmarketing Safety Reports of Medication Errors Associated with Zantac and Zyrtec

The seven errors that have been reported to the FDA were mostly in pediatric patients ranging in ages from 7 days to 15 months. The causes, when specified, were due to dispensing errors, where the incorrect stock bottle of the syrup was chosen from the shelf. The outcomes of the medication errors were not serious. In one case, a 12 month-old male patient was prescribed 120 mL of Zantac syrup but was given 120 mL of Zyrtec. The error occurred when the incorrect stock bottle of Zyrtec syrup was chosen by the technician and poured into the dispensing bottle labeled as Zantac. The mother noticed that the baby became “violently ill” but the doctor did not find anything serious. In another case, a 15 month-old patient was dosed incorrectly with Zyrtec instead of Zantac for 6 weeks prior to discovery of the error. The outcome of the error was a continuation of the patient’s reflux-induced sinusitis. Other cases noted outcomes of sleep disturbance, increased thirst, decreased appetite, diarrhea, vomiting, and decreased weight.

Recommendation: Separate the stock bottles of Zantac and Zyrtec syrups on the shelves. One of the two medications may be placed in a “fast-mover” section of the pharmacy. Also, inclusion of the indication on the prescription order may serve as a reminder to select the correct medication as well as reduce errors due to poor handwriting.

9/20/00

• Content current as of:

  08/13/2015

Treating Hives Effectively | Everyday Health

Q1. My daughter has had hives covering her body on and off for several months. The doctor said that hives usually last for a couple of weeks to a few months. My daughter has never had any allergies to food or anything else. What could have caused this, and what is the most effective treatment for hives?

— Laurie, Florida

Hives (known in the medical community as urticaria) are very itchy spots, pink to red, that appear on the skin, feel raised up from the surrounding skin, and then disappear without a trace (unless the person has scratched and damaged the skin). An individual hive can range from the size of a pencil eraser to the size of a dinner plate. Hives are not rare, and most people experience a brief bout of them at least once in their lives. They typically last a few days or a week and then go away as suddenly as they came. This can happen after someone has a mild infection, including everyday viruses, or in association with taking antibiotics. Hives can also be part of a more serious allergic reaction, such as a reaction to a food, medicine, or insect sting. Anyone who develops hives plus other symptoms — such as difficulty breathing, dizziness or light-headedness, throat tightness, nausea or vomiting, or passing out — should be seen by a health care provider immediately.

Sometimes outbreaks of hives keep happening for weeks or months, as you describe in the case of your daughter. This condition is called chronic hives, or chronic urticaria, and it’s characterized by the presence of hives on most days of the week for six weeks or more. This disorder, less common than short-lived hives, affects about one in 100 people. It is very distressing to the person who has it because it is uncomfortable, unpredictable, and interferes with sleep, school, and work. However, it is almost never related to a more serious medical problem or to an allergy.

Researchers do not know with certainty what causes chronic urticaria, but there are a couple of leading theories. One is that chronic hives are caused by changes in white blood cells called basophils. Another is that some people begin to make antibodies (proteins that normally fight infections) that cause cells (mast cells) to release natural chemicals. These mast cells are in the skin, and the chemicals cause swelling in the skin around the cells, creating hives. It isn’t clear, according to this theory, what starts the process, but the good news is that the problem eventually corrects itself in most people after a period of time — a few months to as much as a year is typical. However, a small number of unfortunate people have chronic hives for years on end.

Many people with hives notice that the symptoms seem to be related to diet in some way, but testing for food allergy usually shows that a person with hives is not allergic to any food. This is because while some foods contain natural chemicals that aggravate hives, there are so many foods that do this that avoiding enough of them to make a real difference in the symptoms would be difficult and impractical.

People with hives almost always require antihistamines to control the symptoms. Antihistamines are considered the safest and most effective initial treatment. Certain antihistamines, such as cetirizine (Zyrtec), fexofenadine (Allegra), and loratadine (Claritin), cause less drowsiness and dry mouth than others, such as diphenhydramine (Benadryl) and chlorpheniramine. Doctors often need to combine different types of antihistamines or double the dose of one medicine. To figure out the right medication or combination of medications for your daughter, you’ll need to discuss with her doctor her age and how well she responds to the various medications. If hives are still not controlled on full doses of two or more antihistamines, many doctors will add a medicine called montelukast (Singulair) for a month or so, and some patients then improve. Every patient is different, though, and it can take weeks to find a set of medicines that work. The process can be frustrating, so be patient.

Q2. I have had chronic hives for the past six months. The only thing that controls them temporarily is prednisone. As soon as I am off of it, they come back with a vengeance within 24 hours or less. Is there anything else that might help? I already take Zyrtec and Zantac. I am desperate and would appreciate any suggestions.

— Gail, Massachusetts

Hives are raised, intensely itchy spots or patches that appear in crops, last for a few hours, and then resolve without leaving any residual marks on the skin. They can range in size from as big as a pencil eraser to the size of a dinner plate. Hives can appear anywhere on the body, although the legs, arms, abdomen, armpits, and neck are the areas where they most commonly surface. Most people will develop hives at least once in their lives, and the trigger is often not obvious.

“Chronic hives” are hives that occur in episodes, daily or nearly every day, for more than six weeks. For a benign condition, hives certainly cause a lot of suffering for those that have them. As your doctor has probably mentioned, there is no identifiable allergy or underlying medical condition to explain chronic hives in about 85 percent of those who suffer from them.

If you visit the message boards on this site, you will find plenty of people writing in under the thread titled, “Crazy Itching.” Just reading through what others have posted, you can get a sense of how exasperating this problem can get. Also, you can see that different treatments work for different people, and what seems to be a miracle treatment for one person has minimal effect on another.

The bottom line is this: There are no magic cures for hives. Most of the time, people try various medications until they find some combination that works for them.

The combination of Zantac (ranitidine) and Zyrtec (cetirizine) helps many people, although you may need to double the regular Zyrtec dose to 10 mg twice a day for decent relief. The Zantac you take should be at least 150 mg twice a day.

In addition to this, some people benefit from 10 to 20 mg of doxepin before bed. Doxepin is an antidepressant when taken at higher doses, but at lower doses acts as a strong antihistamine. It is very sedating however, and some people feel groggy in the morning. Another antihistamine that can be helpful is hydroxyzine, taken at a dosage of 25 mg every six to eight hours if needed, although it is also sedating.

Prednisone will calm down hives in most cases, but it can have severe side effects if taken continuously for months or years. Dramatic and sudden changes in medication often cause the hives to flare again, so sometimes I have success lowering the prednisone dose very, very slowly. For example, once you get down to 10 mg, try dropping one milligram every four days or so: in other words, 9 mg a day for four days; 8 mg a day for the next four days, etc. Once you reach 4 or 5 mg, try changing to taking prednisone every other day for a week, and then stop. When lowering and stopping the prednisone, you also have to keep the antihistamines going at full strength, and if you’re lucky, they will offer enough relief by themselves.

Make sure you are not inadvertently doing anything that could be aggravating the hives. Things that seem to aggravate hives and itching in most everyone include:

• Dramatic temperature changes (hot showers, cooling down after a workout)
• Alcohol
• Medications like aspirin and other over-the-counter pain medications. (Acetaminophen — Tylenol or generic — is usually fine.)
• Stress
• Poor sleep
• Dramatic changes in diet (rich restaurant meals, very spicy foods)
• Nighttime. Hives and itching often worsen at night because that’s when the body’s natural anti-itch chemicals are at their lowest.

This list is just good to keep in mind if you have an itching problem, even if you can’t control many of the things on it. Try to keep your eating and sleeping patterns as regular as possible.

Q3. I get hives after exercise. Is this some kind of allergic reaction? If it is, what can I do to treat or prevent it?

There are many people who get hives and other allergic symptoms after exercising, a condition known as exercise-induced urticaria. If you see hives developing, it’s best to stop exercising for five to 10 minutes and see if they fade.

However, this doesn’t mean you have to give up exercise entirely. Talk to your doctor about this condition, and he or she may recommend a quick-acting, non-sedating antihistamine that you can take prior to exercise. Also, it may be worthwhile to work out with a buddy just in case the symptoms become more extensive than hives (shortness of breath, dizziness). Some patients with this condition carry auto-injectable adrenaline in case of a life-threatening allergic reaction.

Learn more in the Everyday Health Allergy Center.

Solutions to Problem Itching – The Arthritis Connection

by MedMaven updated 10/2021

Many individuals with autoimmune and rheumatoid conditions suffer from Aquagenic Pruritus, a fancy clinical term for itching. There are few treatments for itching that are highly effective and provide consistent relief but the Z and P or T combination appears to work well for many individuals.

Itching occurs in many autoimmune, rheumatologic, and even blood disorders and may be caused or worsened by exposure to water without observable skin lesions. The symptoms may be felt immediately after contact with water and may last an hour or longer. It generally occurs in the trunk and nearby extremities. Most patients describe itching, but others report a tingling, burning or stinging sensation.

The Z and P or T combo (Zyrtec and Pepcid (famotidine) or Tagamet (cimetidine) is a simple solution for itching that is widely used by individuals with polycythemia vera and is reported to provide great success. It should be noted that generic versions Cetirizine Hydrochloride (Zyrtec) and Pepcid (famotidine) or Tagamet (cimetidine)  can be purchased from Costco or Walmart for a considerable discount from the branded versions.

The Z and P or T combo’s effectiveness in Mast Cell disorders is confirmed in William Alford’s article:

“Patients with urticaria (hives) and mast cell disease are typically treated with various combinations of antihistamines which block histamine receptor sites on cells, with a fine tuning of both dosage levels and drug choice often being very specific to the patient. A very successful choice is the well-known combo of Zyrtec and Pepcid (famotidine) or Tagamet (cimetidine) since this combination blocks both the h2 and h3 histamine receptors. Other antihistamines include ChlorTrimeton, Benadryl, Dramamine, Claritin, and Tavist.”

Note: Before taking any medications, even OTC, be sure to check with your doctor or pharmacist.

More Strategies to Beat Itching

Mast Cell Disease and the Release of Histamines

Mast cells have long been known to contribute to the discomforts of mankind by releasing histamine and producing the miseries of allergies. However, patients with mast cell disease may also present with a multitude of disparate symptoms such as arthritis, GERD, constipation, malabsorption, cramping, severe abdominal bloating, short term memory problems, headache, nausea, bone pain, heart palpitations, changes in cognitive function and mood and more. Sound familiar?….nearly identical to the symptoms we experience as MPN patients. Mastocytosis, one of the myriad of mast cell diseases are classified as an MPN, so no surprise there!

Mast cell diseases are histamine disorders (be sure to click on the preceding link and scroll down midway for the excellent graphic, Histamine Intolerance & Mast Cell Activation) that come in many flavors – mast cell activation syndrome (MCAS), mast cell activation disorder (MCAD) and mastocytosis (numerous types) among others. Other conditions with a link to histamine/mast cell include: Fibromyalgia, Cancer, Multiple Sclerosis, Narcolepsy, IBS, Crohn’s, Parkinson’s, Alzheimer’s and heart disease.

Mast cell activation syndrome is a fancy way of saying the immune system is freaking out and dumping inflammation into the body, sometimes chronically.

While mast cells present throughout the body, all body tissues that come in direct contact with the outside world have mast cells and they are concentrated in the skin, gut, nasal passages, lung, urinary tract and other mucus membranes.

With MPNs, we suffer with excess histamine due to basophil breakdown (a type of white blood cell). Histamine is one of the inflammatory players released by mast cells, along with heparin and serotonin. They also contain cytokines, interleukin, leukotrienes, prostaglandins and other inflammatory agents. The release of these proinflammatory agents results in the classic allergy symptoms which most of us are familiar with.

However, the principle chemical mediator of mast cells is histamine which can cause tissue swelling, itching, flushing and other noxious skin responses. It is what causes the itching and swelling of the mosquito bite and the itch of healing wounds with the rapid growth of new tissue. But it can also cause systemic responses such as headache, nausea, dizziness, diarrhea and can be involved in other GI disease such as gastric ulcer and IBS.

References

1. William Alford, “Mast Cells and GI Motility Disease, 2005” – Permission is granted by the author for anyone to copy and distribute this document to any other part so long as the author’s name and the copyright notice is retained on all copies or sections of the document.
2. Wikipedia, mast cell.
3. Indian Journal of Dermatology, Aquagenic Pruritis: Beneath Water “Lies,” 2011
4. The Low Histamine Chef, Yasmina Ykelenstam, “Natural Mast Cell Stabilizers for Histamine,” 2016.

Zyrtec vs. Zantac: Your soundalike drug stories

This morning, we reported on the dangers of look-alike, sound-alike drugs — a serious problem that can lead to injuries or, in some cases, deaths. You wrote in with your own stories of the trouble with drug names that sound too similar; here are some of the best submissions.

When my son was four months old, he was prescribed a low dosage of the antihistamine Zyrtec for his severe allergies. When my husband picked up the prescription from our local chain pharmacy, he asked for a consultation because he was concerned about using the drug on an infant.  The pharmacist who gave the consultation said the drug was a heartburn medication and proceeded to provide instructions for the use of Zantac. My husband told the pharmacist that he was mistaken, and the pharmacist became very annoyed and insisted that he was the professional and knew for a fact that Zyrtec was a heartburn medication.

— Anonymous

I was accidentally given a Rx for patients with heart failure. I was looking at the pills when I got out in the parking lot. I thought, well, maybe they changed manufacturers (because that HAS happened with one of medications before). Then I started reading the information that was stapled on the bag, and promptly went back in with the pills.

— Paula King, Ripley, N.Y.

Some years ago, I was given Toprol instead of Topamax. Fortunately, I am a nurse, and knew the difference between the drugs. It could have been much worse.

— Anonymous

I was prescribed Tapazole for a thyroid problem, rapid heartbeats and fever at the dosage of .05 milligrams 5 times a day. The pharmacy misread the prescription and gave me Trazodone, a controlled substance narcotic, which is unavailable in .05 dosage, so they ‘thought’ the doctor must have meant .50. I took this and got very sick, couldn’t drive, and was not getting well. My doctor dropped the ball and thought I wasn’t taking my medication, because I was not getting better. I finally told the doctor I would not take Trazodone anymore it is killing me, and she said ‘where did you get Trazodone?’ (after 2 refills!) She called the pharmacy and they figured it out. I started getting well after 2 weeks on the right med, but should not have been driving on the narcotic, also the dosage was enough to sedate an elephant — I am small, and would take the pill, walk into the next room and collapse on the floor asleep. then wake up and do it again. We sued, and won $12,000 — wow, I almost died and the store’s defense was, it was an honest mistake and happens millions of times a year, since I didn’t die or have permanent damage, I didn’t deserve more.

— Anonymous

I was given an anti-depressant medication incorrectly dispensed by the pharmacist. Fortunately, the medication was in the same classification of anti-depressants and it did not cause any harm. My doctor phoned the pharmacist immediately and addressed the issue. I was later contacted by a representative of the drug store chain who was very apologetic.

— Anonymous

The pharmacist incorrectly labeled my mother’s perscription. She caught her error, which was labeling Mom’s with another customer’s. She phoned asking that I return to the pharmacy, bring the medication. She said she also asked ther other person to do the same. We were all fortunate that neither of them had taken any of the medication.

Another incident occurred when my mom was hospitalized. She told the dispensing nurse that the medication she was trying to give my mother was not correct. She refussed to take it. It was actually the medication for the other patient in the bed next to her. That patient died during the night. We do not know if there was an investigation, probably not since my mom was never questioned. The dispensing nurse was very agressive toward us for questioning her about the medication.

— Carolyn Keene, Cortez, Colo.

When I was released from the hospital after a heart attack they gave me a bag full of different pills and told me not to stop until they were all used. That night I broke into a sweat and fell down in the bathroom so dizzy I could not get up. My wife called the doctor and he wanted to know what I was taking. When he heard some of the names of the stuff he told my wife to throw them away and get me back to the hospital asap. I survived this little episode but I don’t trust them anymore.

— Anonymous

When my son was about 2, the drug store labeled the antibiotic as the cough syrup and the cough syrup as the antibiotic. My son wasn’t getting any better after a day, so I called the doctor, and he was smart enough to ask me the color of the medications. That’s when we found out they had been marked incorrectly. I called the drug store and told them what had happened — they could have cared less. Needless to say, I don’t shop there anymore, and I do let my friends and family know which store it is. You don’t mess with a mother hen’s chick!

— Anonymous

Yes. I recognized that the pills did not look like the drug I had been taking. I called the pharmacy. They corrected it immediately. Fortunately it was a refill, so I knew what pill to look for. I always check a pill before I take it to see for myself if it is the pill I recognize.

— Anonymous

I am a renal transplant and I take the drug Imuran as an anti-rejection medication. I had my perscription refilled at the same drug store that I used for along time. After returning home from this drug store with my perscription refill I noticed that the tablets were capsules. I called the drug store immediately and talked with a pharmacist who asked me to bring the Imuran back to the store. A pharmacist had used the wrong medication. If I had not known to check on the difference of pills I don’t know what would have happened.

— Barbara, Alabama

I was prescibed Sarafem for PMDD (premenstrual dysphoric disorder). I went to pick up the prescription, which was called in, and the pharmacist told me how to take it. I thought her directions were vastly different from how my GYN told me to take it, so I questioned it. The pharmacist made a comment about trying to conceive and when I assured her I wasn’t (I was only 20) she looked at the prescription she had filled for Serophene (a fertility drug!!!). They sure do sound similar, and both would come from an OB/GYN. I’m glad I asked. I also immediately changed pharmacies as they should have noticed that I was on birth control that had recently been refilled (by them!).

— Anonymous

Several years ago I was given ranitidine (which is for stomach acid) instead of rimantidine (which is for the flu! which I had at the time) Fortunately, I knew what ranitidine was and was able to get the correct drug from a very embarassed pharmacy.

— Anonymous

My kid, who was 12 at the time, received a shipment of Toporol (high blood pressure med) instead of Topamax (anti-seizure med), from mail order meds mandated by insurance company. Had to pay $120 for emergency scrip for Topamax, as kid was running out of pills, no time to wait for mail order correction. What really shocked us, the drugs were shipped in an unremarkable package, addressed to the KID, the 12-year-old KID, not to the responsible adults. Package looked like something the kid could have sent away for by collecting cereal box tops. Meds to a kid under 18 should ALWAYS be sent to responsible adults “in care of” a kid, not TO the kid. BTW, insurance company dropped that mail order place, uses a different one.

— Anonymous

Your Treatment Options for Hives

With time, chronic hives (your doctor may call them chronic idiopathic urticaria – CIU, or chronic spontaneous urticaria – CSU) usually go away on their own. There’s no medication to cure them, but treatments can help ease your pain and discomfort.

Talk to your doctor about these options:

Antihistamines

These medications block something called histamine. That’s a chemical in the skin that can cause allergy symptoms like hives. The meds come in different forms:

Non-drowsy: Your doctor will probably want you to try over-the-counter options like cetirizine (Zyrtec), fexofenadine (Allegra), and loratadine (Claritin) first. They won’t make you sleepy. They usually only cause mild side effects, like dry mouth and eyes.

It’s important to take these every day, not just when you have a breakout.

Nighttime: If your hives are severe, your doctor may point you toward diphenhydramine (Benadryl) or a similar medicine. Because it can make you drowsy, your doctor will probably tell you to take it at night.

h3 blockers: You may be told to take more than one type of antihistamine at a time for your hives. Medicines like cimetidine (Tagamet) or famotidine (Pepcid) can be used together with other treatments. These drugs also ease heartburn. For your hives, they narrow blood vessels. That calms redness.

These may cause side effects like diarrhea, dizziness, and headaches.

Steroids

If antihistamines don’t help, your doctor might prescribe a corticosteroid. These drugs calm the immune system. That can make your hives less severe.

You can get them in a shot or a pill. They can cause side effects like:

• High blood pressure
• Weight gain
• Sleep problems
• Bone density problems
• Blurred vision
• The need to pee a lot
• Increased thirst
• Fluid retention
• Psychological effects

Because of the chance of these side effects, doctors usually give them at low doses and only for short periods of time.

If you take these for a while, you could have other side effects, including:

• Cataracts
• High blood sugar
• Higher risk of infection
• Osteoporosis (thinning bones)
• Bruising

Other Options

Chronic hives can be difficult to treat. If there’s an underlying cause like a thyroid issue, taking care of that may ease the hives. Often, though, the cause of your reaction can’t be found.

When antihistamines and steroids don’t work, there are a few more treatments that your doctor might suggest.

Asthma medications like montelukast (Singulair) or zafirlukast (Accolate) can help hives, including those made worse by aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).

These medications can have side effects, so check with your doctor.

Omalizumab (Xolair) is approved for those who don’t get relief from antihistamines. Your doctor injects it under your skin. Experts think it blocks a different chemical in your immune system that contributes to hives.

Side effects of this medication include:

• Headache
• Upset stomach
• A slightly higher chance of heart disease or a stroke
• Rarely, a severe allergic reaction called anaphylaxis

If those drugs don’t work, your doctor may try anti-inflammatory medications or something called an immunosuppressant, which curbs your immune system.

Together, you and your doctor can decide the best treatment plan for your chronic hives.

Chronic hives – Diagnosis and treatment

Diagnosis

Your doctor will do a physical exam and ask you a number of questions to try to understand what might be causing your signs and symptoms. He or she may also ask you to keep a diary to keep track of:

• Your activities
• Any medications, herbal remedies or supplements you take
• What you eat and drink
• Where hives appear and how long it takes a welt to fade
• Whether your hives come with painful swelling

If your physical exam and medical history suggest your hives are caused by an underlying problem, your doctor may have you undergo testing, such as blood tests or skin tests.

Treatment

Your doctor will likely recommend you treat your symptoms with home remedies, such as over-the-counter antihistamines. If self-care steps don’t help, talk with your doctor about finding the prescription medication or combination of drugs that works best for you. Usually, an effective treatment can be found.

Antihistamines

Taking nondrowsy antihistamine pills daily helps block the symptom-producing release of histamine. They have few side effects. Examples include:

• Loratadine (Claritin)
• Fexofenadine (Allegra)
• Cetirizine (Zyrtec)
• Desloratadine (Clarinex)

If the nondrowsy antihistamines don’t help you, your doctor may increase the dose or have you try the type that tends to make people drowsy and is taken at bedtime. Examples include hydroxyzine pamoate (Vistaril) and doxepin (Zonalon).

Check with your doctor before taking any of these medications if you are pregnant or breast-feeding, have a chronic medical condition, or are taking other medications.

Other medications

If antihistamines alone don’t relieve your symptoms, other drugs may help. For example:

• Histamine (H-2) blockers. These medications, also called H-2 receptor antagonists, are injected or taken orally. Examples include cimetidine (Tagamet HB) and famotidine (Pepcid).
• Anti-inflammation medications. Oral corticosteroids, such as prednisone, can help lessen swelling, redness and itching. These are generally for short-term control of severe hives or angioedema because they can cause serious side effects if taken for a long time.
• Antidepressants. The tricyclic antidepressant doxepin (Zonalon), used in cream form, can help relieve itching. This drug may cause dizziness and drowsiness.
• Asthma drugs with antihistamines. Medications that interfere with the action of leukotriene modifiers may be helpful when used with antihistamines. Examples are montelukast (Singulair) and zafirlukast (Accolate).
• Man-made (monoclonal) antibodies. The drug omalizumab (Xolair) is very effective against a type of difficult-to-treat chronic hives. It’s an injectable medicine that’s usually given once a month.
• Immune-suppressing drugs. Options include cyclosporine (Gengraf, Neoral, others) and tacrolimus (Astagraft XL, Prograf, Protopic).

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

Chronic hives can go on for months and years. They can interfere with sleep, work and other activities. The following precautions may help prevent or soothe the recurring skin reactions of chronic hives:

• Wear loose, light clothing.
• Avoid scratching or using harsh soaps.
• Soothe the affected area with a bath, fan, cool cloth, lotion or anti-itch cream.
• Keep a diary of when and where hives occur, what you were doing, what you were eating, and so on. This may help you and your doctor identify triggers.
• Avoid known triggers.
• Apply sunscreen before going outside.

Preparing for your appointment

You’ll probably first visit your primary care doctor. He or she may refer you to a doctor who specializes in skin diseases (dermatologist) or to an allergy specialist.

For chronic hives, some basic questions to ask your doctor include:

• What is likely causing my symptoms?
• How long will these hives last?
• What kinds of tests do I need? Do these tests require any special preparation?
• What treatments are available, and which do you recommend?
• Do these treatments have any side effects?
• Do I need prescription medication, or can I use over-the-counter medications to treat the condition?
• Does the medicine you’re prescribing have a generic version?
• I have other health problems. Is the treatment you recommend compatible with those conditions?

What to expect from your doctor

Your doctor is likely to ask you questions such as:

• What symptoms do you have, and when did you first begin experiencing them?
• Do you have tightness in your chest or throat, nausea, or difficulty breathing?
• Have you had any viral or bacterial infections recently?
• What medications, herbal remedies and supplements do you take?
• Have you tried any new foods recently?
• Have you traveled to a new place?
• Do you have a family history of hives or angioedema?
• What, if anything, appears to improve or worsen your symptoms?

Zantac May Contain Cancer-Linked Chemical, FDA Warns

(Photo Credit: Amy Lutz/Shutterstock)

UPDATE: The Zantac Recall Lawsuit Investigation is now open! If you take Zantac, submit your information here for a free case review.

Drugs made of ranitidine, including the brand name Zantac, may have been contaminated with a possible cancer-causing chemical, the U.S. Food and Drug Administration reports.

This report and subsequent series of recalls comes after news of contamination by the same chemical in the case of other drugs, including other heartburn and some blood pressure medications.

Ranitidine is a drug used to treat heartburn and acid indigestion. It is available both via prescription and over-the-counter. It is a histamine-2 blocker, which helps to treat acid indigestion and heartburn by decreasing the amount of acid that the stomach produces.

However, the drug may pose some dangers, due to a possible contamination. According to the FDA, laboratory tests revealed the drug may have been contaminated with NDMA (N-nitrosodimethylamine). NDMA was reportedly discovered in low levels in the drug, but it could be concerning because NDMA may be able to cause cancer.

The FDA explains that NDMA is an environmental contaminant, and is found in water and foods. Reportedly, it has been found in meats, dairy products, and vegetables. Unfortunately, the contaminant has been found in drugs, as well. NDMA can form as a byproduct of certain industrial processes, according to the Environmental Protection Agency (EPA).

The FDA says that NDMA, as well as other contaminants, have been found in other heartburn medications known as Angiotensin II Receptor Blockers, also reportedly as a result of manufacturing. Last year, dozens of prescription blood pressure drugs were recalled over concerns that they had been contaminated with NDMA, according to ABC News. One of the drugs involved in the recall was valsartan.

The recalled drugs had unacceptably high levels of NDMA, reports ABC, whereas Zantac had much lower reported levels.

The FDA’s Director for the Center of Drug Evaluation and Research says that the levels of NDMA were just slightly higher than the levels present in foods like cured and grilled meats, per USA Today.

Because of the possible contamination, worldwide distribution of Zantac was halted, per ABC. This applied to both brand-name and generic forms of the drug. Reportedly, Novartis, the makers of a generic Zantac, halted production of the drugs as a cautionary measure.

Distribution halted until there was “further clarification” about the contaminant problem, reported USA Today, as the company conducted an internal investigation into the issue.

In April 2020, the FDA officially requested the removal of all ranitidine products from the market, including the brand name Zantac, and manufacturers began issuing voluntary recalls for their various ranitidine products.

Both patients and medical professionals are invited to report adverse events related to ranitidine use to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program, to help experts better understand the scope of the problem and possible side effects.

If you or someone you love has taken Zantac and has been diagnosed with cancer after exposure to Zantac, you may be able to file a lawsuit and pursue compensation. Filing a lawsuit cannot take away the pain and suffering caused by a cancer diagnosis, nor can it bring a loved one back to life, but it can at least help to alleviate the financial burden incurred by medical expenses, lost wages, and more.

Filing a lawsuit can be a daunting prospect, so Top Class Actions has laid the groundwork for you by connecting you with an experienced attorney. Consulting an attorney can help you determine if you have a claim, navigate the complexities of litigation, and maximize your potential compensation.

Do you currently take Zantac? How will this report impact you? Tell us your story in the comment section below.

90,000 Lessons in economy – expensive drugs and their cheap analogues

14:02
07/15/2014

Is it worth buying an expensive medicine just because it is imported, or is it still worth replacing it with an analogue of domestic production, which, moreover, costs several times less? Especially now, when prices, especially for medicines, are growing by leaps and bounds. Why do drugs with the same formulation cost differently?

Huge amounts of money are spent on the invention of a new drug, preparation of a chemical formula, production and testing.Further, the pharmaceutical company patents its product and delivers it for sale, while the price is formed in such a way as to recoup the investment. After the patent has expired, any company can release this drug, but naturally it will cost much less. Such cheap analogs of expensive drugs are called generics.

The original differs from the generic in the degree of purification and side effects. The new generation drugs have a higher degree of purification, and the side effects after their use are less pronounced, but the therapeutic effect of the original and the generic is the same, since the same active ingredient is used.Besides the low price, generics have another important advantage – they are not counterfeited. Not economically viable.

Below is a list of expensive medicines and their cheap analogues

Rinonorm – Rinostop
Sumamed – Azithromycin
Trental – Pentoxifylline
Trichopolum – Metronidazole
Troxevasin – Troxerutin
Ultratop – Omeprazole
Fastum gel – Ketoprofen
Finlepsin – 1111 Phyllucicione Enalapril
Ersefuril – Furazolidone
Zantac – Ranitidine
Zyrtec – Cetirinax
Zovirax – Acyclovir
Immunal – Echinacea extract
Imodium – Loperamide
Iodomarine – Potassium iodide
Cavanitin11 Clambroxol
Clambriexidol
Lazyronexidine Terbinafine
Lioton-1000 – Heparin-Acrygel 1000
Lomilan – Lorahexal
Maxidex – Dexamethasone
Mezim – Pancreatin
Midriacil – Tropicamide
Miramistin – Chlorhexidine
Movalis – Meloxicamridativa-11 11 Nurofen – Ibuprofen
Omez – Omeprazole
Panadol – Paracetamol
Panangin – Asparkam
Pantogam – Pantocalcin

90,000 Will Russians Survive on Russian Medicines? | Latest News of Omsk and Omsk Region

Deputy Chairman of the State Duma for Health Protection Nikolai Gerasimenko said that by 2018 Russia will produce 90% of essential drugs (now this figure is 65%) – so as not to depend on the Western market.The remaining 10%, according to the head of the Ministry of Healthcare Veronica Skvortsova, can borrow drugs from Belarus. Physicians and patients alike were alarmed by this promise of .

The fact that due to “political uncertainty” fashionable Western boutiques are leaving the trading floors of Russia is one thing. But the fact that the shelves of pharmacies by 2018 may be occupied mainly by domestic and Belarusian medicines is completely different. Nice clothes and health are completely different things. And if the intentions of legislators and officials really include the replacement of foreign medicines with domestic ones in such a short (three-year) period, the consequences can be unpredictable.

“If the emergence of new domestic drugs begins to take place in the form of free competition, and not“ twisting hands, ”it will not be worse,” believes the chief physician of the Omsk Central Clinical Hospital, Associate Professor Nikolai Nikolaev. – After all, now budget clinics and hospitals give priority to domestic drugs. The main problem: many of them are inferior to imported ones in quality. It’s like with cars: it’s all about the details. And these details are not only the level of synthesis of the chemical purity of the drug, but also the characteristics of the carrier of the active substance of the drug.The modern tablet is often a very complex therapeutic system that allows the drug to be released evenly over, for example, 24 hours. Such a tablet is superior to many computers in terms of the accumulation of high technologies. Most of the components of her system are protected by individual patents and, since they are not drugs themselves, no one is going to disclose them and will not. This, for example, is what distinguishes the original imported trimetazidine (preductal MB) or indapamide (arifon retard) from analogues.

At the same time, we have excellent domestic drugs that fully correspond to analogues (for example, betahistine, drotaverine, piracetam), but there are also those that I, as a specialist, will not use (I am not satisfied with the quality of Russian lisinopril, amlodipine, trimetazidine, etc. many others).

Now about the time of the appearance of new drugs. That high-tech that we do not produce, in the coming years and will not be able to produce (these are the majority of modern antibiotics, antifungal and anticancer drugs, monoclonal antibodies, genetically engineered drugs).Yes, it will take us decades to develop the necessary technologies! So if it is promised, then it is just eyewash. And there is nothing to replace these drugs – I think, as they were purchased abroad, they will continue to be purchased. The drug market is very competitive, and not a single import manufacturer will voluntarily leave it. And if, nevertheless, reliable Russian or Belarusian counterparts appear, this can only be welcomed.

The owner of two Omsk clinics Sergey Popov agrees with his colleague:
– Comparing other domestic tablets with branded imported ones is the same as comparing Russian and Japanese TVs.There is, for example, the domestic drug atorvastatin, which is desirable after 55 years of age to take for the prevention of heart attacks and strokes. And there is its analogue Liprimar (produced in Germany, Ireland, USA). In the first, side effects (of which there are 35 in the instructions) are often manifested, in the second, they are extremely rare. Therefore, in terms of the general effect on the body, drugs differ like heaven and earth. Many effective anticancer drugs are of foreign origin. And then the question immediately arises: when will the new Russian drugs have time to pass clinical trials? It takes at least seven years to bring a drug to the market (and only three years remain from 2015 to 2018).Last year, domestic drugs worth about $ 92 million were sold on the Belarusian market, or 20.4 percent of the capacity of the entire drug market. The rest, as far as I know, the Belarusian citizens spent on the purchase of imported drugs.

… When in 2013 there was no imported anticancer drug leukeran in Russian pharmacies for several months (the license was not renewed), there was nothing to replace it with. Doctors developed treatment regimens with other drugs, but the patients became worse, not all of them survived.I would very much like this situation – only on a much larger scale – not to repeat itself …

Natalia Gergert

90,000 48 pairs of drugs with identical composition, but very different prices – a step-by-step recipe with a photo. The author of the recipe is Natalie.

48 pairs of drugs with identical composition, but very different prices 1. Nurofen (120 rubles) = Ibuprofen (10 rubles) 2. Mezim (300 rubles) = Pancreatin (30 rubles) 3. No-spa (150 rubles) = Drotaverine hydrochloride (30 rubles) 4. Panadol (50 rubles) = Paracetamol (5 rubles) 5.Belosalik (380 rubles) = Akriderm SK (40 rubles) 6. Bepanten (250 rubles) = Dexpanthenol (100 rubles) 7. Betaserk (600 rubles) = Betahistin (250 rubles) 8. Bystrumgel (180 rubles) = Ketoprofen (60 rubles) 9. Voltaren (300 rubles) = Diclofenac (40 rubles) 10. Gastrozole (120 rubles) = Omeprazole (50 rubles) 11. Detralex (580 rubles) = Venarus (300 rubles) 12. Diflucan (400 rubles) = Fluconazole (30 rubles) 13. Fornos (100 rubles) = Rinostop (30 rubles) 14. Zantac (280 rubles) = Ranitidine (30 rubles) 15. Zyrtec (220 rubles) = Cetirinax (80 rubles) 16. Zovirax (240 rubles) = Acyclovir (40 rubles) 17.Immunal (200 rubles) = Echinacea extract (50 rubles) 18. Imodium (300 rubles) = Loperamide (20 rubles) 19. Iodomarin (220 rubles) = Potassium iodide (100 rubles) 20. Cavinton (580 rubles) = Vinpocetine (200 rubles) 21. Claritin (180 rubles ) = Lorahexal (60 rubles) 22. Klacid (600 rubles) = Clarithromycin (180 rubles) 23. Lazolvan (320 rubles) = Ambroxol (20 rubles) 24. Lamisil (400 rubles) = Terbinafine (100 rubles) 25. Lioton-1000 (350 rubles) = Heparin- acrygel 1000 (120 rubles) 26. Lomilan (150 rubles) = Lorahexal (50 rubles) 27. Maxidex (120 rubles) = Dexamethasone (40 rubles) 28.Midriacil (360 rubles) = Tropicamide (120 rubles) 29. Miramistin (200 rubles) = Chlorhexidine (10 rubles) 30. Movalis (410 rubles) = Meloxicam (80 rubles) 31. Neuromultivitis (250 rubles) = Pentovit (50 rubles) 32. Normodipine (620 rubles) = Amlodipine (40 rubles) 33. Omez (180 rubles) = Omeprazole (50 rubles) 34. Panangin (140 rubles) = Asparkam (10 rubles) 35. Pantogam (350 rubles) = Pantocalcin (230 rubles) 36. Rinonorm (50 rubles) = Rinostop (20 rubles) 37. Sumamed (450 rubles) = Azithromycin (90 rubles) 38. Trental (200 rubles) = Pentoxifylline (50 rubles) 39. Trichopolum (90 rubles) = Metronidazole (10 rubles) 40.Troxevasin (220 rubles) = Troxerutin (110 rubles) 41. Ultop (270 rubles) = Omeprazole (50 rubles) 42. Fastum-gel (250 rubles) = Ketoprofen (70 rubles) 43. Finlepsin (280 rubles) = Carbamazepine (50 rubles) 44. Flucostat (200 rubles) = Fluconazole (20 rubles) 45. Furamag (380 rubles) = Furagin (40 rubles) 46. Hemomycin (300 rubles) = Azithromycin (100 rubles) 47. Enap (150 rubles) = Enalapril (70 rubles) 48. Ersefuril (400 rubles) = Furazolidone (40 rubles)

Medicines prices rise in Smolensk – “Readovka67.ru”

We are switching from cool European medicines to plantain

According to “Rabochy Put”, in January the price of medicines increased by 20-25 percent.But, judging by the opinion of experts, in the near future the rise in price will be up to 70 percent. Smolensk pharmacists believe that prices for vital and essential medicines of domestic production will rise by no more than a percentage of inflation. And the cost of imported goods is strictly fixed in rubles in 2010, and only the Government of the Russian Federation can revise it. By the way, there are already 608 items on the VED list itself. It is clear that the cost of pills and injections is growing due to the exchange rate. Indeed, as experts note, many domestic drugs are made from imported components.And, as reported by the federal media, work is underway to replace them with Russian ones. Domestic technologies have already been developed for obtaining 10 substances for medicines. Head of the Department of Economic Development, Investments, Foreign Economic Activity and Entrepreneurship of the Smolensk Region, Viktor Kozhevnikov, in an interview with Rabochy Put, encourages Smolensk: “ We constantly monitor the prices of medicines included in the VED list. The rest of the segment is subject only to market regulation.I would like to note that pharmacies in Smolensk, due to their large number and the prevailing tough competition, as a rule, do not apply maximum markups. People living in small settlements, where there is one pharmacy per regional center and adjacent villages, were especially vulnerable in terms of the rise in prices for pharmaceuticals. This is where prices should not be dictated. To do this, we go to places with scheduled and, according to applications from the field, unscheduled inspections. I think that vital drugs will not rise in price by more than the inflation rate of ”.But what about those resin people whose medicinal preferences are not included in the “lucky” list? Heart patients and chronic patients with other diagnoses will probably have to switch from European medicines to the cheapest Indian or Russian counterparts: Nurofen – Ibuprofen; Mezim – Pancreatin; No-shpa – Drotaverina hydrochloride; Panadol – Paracetamol; Belosalik – Akriderm SK; Bepanten – Dexpanthenol; Betaserk – Betagistin; Bystrumgel – Ketoprofen; Voltaren – Diclofenac; Gastrozole – Omeprazole; Detralex – Venarus; Dlyanos – Rinostop; Zantac – Ranitidine; Zyrtek – Cetirinax; Zovirax – Acyclovir; Immunal – Echinacea extract; Imodium – Loperamide; Iodomarin – Potassium iodide; Cavinton – Vinpocetine; Claritin – Lorahexal; Lazolvan – Ambroxol; Lamisil – Terbinafine; Lomilan – Loragexal; Midriacil – Tropicamide; Miramistin – Chlorhexidine; Movalis – Meloxicam; Neuromultivitis – Pentovit; Normodipine – Amlodipine; Omez – Omeprazole; Panangin – Asparkam; Pantogam – Pantocalcin; Rinonorm – Rinostop; Trental – Pentoxifylline; Troxevasin – Troxerutin; Ultop – Omeprazole; Fastum gel – Ketoprofen; Furamag – Furagin; Enap – Enalapril; Ersefuril – Furazolidone.

48 pairs of drugs with the same composition, but different prices

1. Nurofen (120 rubles) = Ibuprofen (10 rubles)
2. Mezim (300 rubles) = Pancreatin (30 rubles)
3. No-spa (150 rubles) = Drotaverine hydrochloride (30 rubles)
4. Panadol (50 rubles) = Paracetamol (5 rubles)
5. Belosalik (380 rubles) = Akriderm SK (40 rubles)
6. Bepanten (250 rubles) = Dexpanthenol (100 rubles)
7. Betaserc (600 rubles) = Betahistin ( 250 rubles)
8. Bystrumgel (180 rubles) = Ketoprofen (60 rubles)
9. Voltaren (300 rubles) = Diclofenac (40 rubles)
10.Gastrozole (120 rubles) = Omeprazole (50 rubles)
11. Detralex (580 rubles) = Venarus (300 rubles)
12. Diflucan (400 rubles) = Fluconazole (30 rubles)
13. Fornos (100 rubles) = Rinostop (30 rubles)
14. Zantac ( 280 rubles) = Ranitidine (30 rubles)
15. Zirtec (220 rubles) = Cetirinax (80 rubles)
16. Zovirax (240 rubles) = Acyclovir (40 rubles)
17. Immunal (200 rubles) = Echinacea extract (50 rubles)
18. Imodium (300 rubles) ) = Loperamide (20 rubles)
19. Iodomarin (220 rubles) = Potassium iodide (100 rubles)
20. Cavinton (580 rubles) = Vinpocetine (200 rubles)
21.Claritin (180 rubles) = Lorahexal (60 rubles)
22. Klacid (600 rubles) = Clarithromycin (180 rubles)
23. Lazolvan (320 rubles) = Ambroxol (20 rubles)
24. Lamisil (400 rubles) = Terbinafine (100 rubles)
25. Lioton- 1000 (350 rubles) = Heparin-acrygel 1000 (120 rubles)
26. Lomilan (150 rubles) = Lorahexal (50 rubles)
27. Maxidex (120 rubles) = Dexamethasone (40 rubles)
28. Mydriacil (360 rubles) = Tropikamide (120 rubles)
29 Miramistin (200 rubles) = Chlorhexidine (10 rubles)
30. Movalis (410 rubles) = Meloxicam (80 rubles)
31.Neuromultivitis (250 rubles) = Pentovit (50 rubles)
32. Normodipin (620 rubles) = Amlodipine (40 rubles)
33. Omez (180 rubles) = Omeprazole (50 rubles)
34. Panangin (140 rubles) = Asparkam (10 rubles)
35. Pantogam ( 350 rubles) = Pantocalcin (230 rubles)
36. Rinonorm (50 rubles) = Rinostop (20 rubles)
37. Sumamed (450 rubles) = Azithromycin (90 rubles)
38. Trental (200 rubles) = Pentoxifylline (50 rubles)
39. Trichopolum (90 rubles) = Metronidazole (10 rubles)
40. Troxevasin (220 rubles) = Troxerutin (110 rubles)
41. Utop (270 rubles) = Omeprazole (50 rubles)
42.Fastum gel (250 rubles) = Ketoprofen (70 rubles)
43. Finlepsin (280 rubles) = Carbamazepine (50 rubles)
44. Flucostat (200 rubles) = Fluconazole (20 rubles)
45. Furamag (380 rubles) = Furagin (40 rubles)
46. Hemomycin (300 rubles) = Azithromycin (100 rubles)
47. Enap (150 rubles) = Enalapril (70 rubles)
48. Ersefuril (400 rubles) = Furazolidone (40 rubles)
Source

First aid kit

Expensive medicines may not always be available, but they may be cheap!

• Nurofen (120 rubles) and Ibuprofen (10 rubles)
• Mezim (300 rubles) and Pancreatin (30 rubles)
• No-shpa (150 rubles) and Drotaverina hydrochloride (30 rubles)
• Panadol (50 rubles) and Paracetamol (5 rubles)
• Belosalik (380 rubles) and Akriderm SK (40 rubles)
• Bepanten (250 rubles) and Dexpanthenol (100 rubles)
• Betaserk (600 rubles) and Betagistin (250 rubles)
• Bystrumgel (180 rubles) and Ketoprofen (60 rubles)
• Voltaren (300 rubles) and Diclofenac (40 rubles)
• Gastrozole (120 rubles) and Omeprazole (50 rubles)
• Detralex (580 rubles) and Venarus (300 rubles)
• Diflucan (400 rubles) and Fluconazole (30 rubles)
• For nose (100 rubles) and Rinostop (30 rubles)
• Zantak (280 rubles) and Ranitidine (30 rubles)
• Zyrtec (220 rubles) and Cetirinax (80 rubles)
• Zovirax (240 rubles) and Acyclovir (40 rubles)
• Immunal (200 rubles) and Echinacea extract (50 rubles)
• Imodium (300 rubles) and Loperamide (20 rubles)
• Iodomarin (220 rubles) and Potassium iodide (100 rubles)
• Cavinton (580 rubles) and Vinpocetine (200 rubles)
• Claritin (180 rubles) and Lorahexal (60 rubles)
• Klacid (600 rubles) and Clarithromycin (180 rubles)
• Lazolvan (320 rubles) and Ambroxol (20 rubles)
• Lamisil (400 rubles) and Terbinafine (100 rubles)
• Lioton-1000 (350 rubles) and Heparin-akrigel 1000 (120 rubles)
• Lomilan (150 rubles) and Loragexal (50 rubles)
• Maxidex (120 rubles) and Dexamethasone (40 rubles)
• Midriacil (360 rubles) and Tropicamide (120 rubles)
• Miramistin (200 rubles) and Chlorhexidine (10 rubles)
• Movalis (410 rubles) and Meloxicam (80 rubles)
• Neuromultivit (250 rubles) and Pentovit (50 rubles)
• Normodipine (620 rubles) and Amlodipine (40 rubles)
• Omez (180 rubles) and Omeprazole (50 rubles)
• Panangin (140 rubles) and Asparkam (10 rubles)
• Pantogam (350 rubles) and Pantocalcin (230 rubles)
• Rinonorm (50 rubles) and Rinostop (20 rubles)
• Sumamed (450 rubles) and Azithromycin (90 rubles)
• Trental (200 rubles) and Pentoxifylline (50 rubles)
• Trichopolum (90 rubles) and Metronidazole (10 rubles)
• Troxevasin (220 rubles) and Troxerutin (110 rubles)
• Ultratop (270 rubles) and Omeprazole (50 rubles)
• Fastum-gel (250 rubles) and Ketoprofen (70 rubles)
• Finlepsin (280 rubles) and Carbamazepine (50 rubles)
• Flucostat (200 rubles) and Fluconazole (20 rubles)
• Furamag (380 rubles) and Furagin (40 rubles)
• Hemomycin (300 rubles) and Azithromycin (100 rubles)
• Enap (150 rubles) and Enalapril (70 rubles)
• Ersefuril (400 rubles) and Furazolidone (40 rubles)

By the way, yes…: yuvikom – LiveJournal

this should be remembered. I make a special note to myself. And I share with my friends, of course.

Replacement of expensive drugs with analogues.

WHEN RUB 10 = RUB 200?

Belosalik (380 rubles) and Akriderm SK (40 rubles)
Bepanten (250 rubles) and Dexpanthenol (100 rubles)
Betaserk (600 rubles) and Betagistin (250 rubles)
Bystrumgel (180 rubles) and Ketoprofen (60 rubles)
Voltaren (300frub) and Dik 40 RUB)
Gastrozole (120 RUB) and Omeprazole (50 RUB)
Detralex (580 RUB) and Venarus (300 RUB)
Diflucan (400 RUB) and Fluconazole (30 RUB)
Dlyanos (100 RUB) and Rinostop (30 RUB)
Zantac (280 RUB) and Ranitidine ( 30 RUB)
Zyrtec (220 RUB) and Cetirinax (80 RUB)
Zovirax (240 RUB) and Acyclovir (40 RUB)
Immunal (200 RUB) and Echinacea extract (50 RUB)
Imodium (300 RUB) and Loperamide (20 RUB)
Iodomarin (220 RUB) and Potassium iodide (100 rubles)
Cavinton (580 rubles) and Vinpocetine (200 rubles)
Claritin (180 rubles) and Lorahexal (60 rubles)
Clacid (600 rubles) and Clarithromycin (180 rubles)
Lazolvan (320 rubles) and Ambroxol (20 rubles)
Lamisil (400 rubles) and Terbinafin (100 rubles)
Lioton-1000 (350 rubles) and Heparin-akrigel 1000 (120 rubles)
Lomilan (150 rubles) and Lo rahexal (50 rubles)
Maxidex (120 rubles) and Dexamethasone (40 rubles)
Mezim (300 rubles) and Pancreatin (30 rubles)
Midriacil (360 rubles) and Tropicamide (120 rubles)
Miramistin (200 rubles) and Chlorhexidine (10 rubles)
Movalis (410 rubles) Meloxicam (80 rubles)
Neuromultivit (250 rubles) and Pentovit (50 rubles)
No-shpa (150 rubles) and Drotaverine hydrochloride (30 rubles)
Normodipin (620 rubles) and Amlodipine (40 rubles)
Nurofen (120 rubles) and Ibuprofen (10 rubles)
Omez ( 180 RUB) and Omeprazole (50 RUB)
Panadol (50 RUB) and Paracetamol (5 RUB)
Panangin (140 RUB) and Asparkam (10 RUB)
Pantogam (350 RUB) and Pantocalcin (230 RUB)
Rinonorm (50 RUB) and Rinostop (20 RUB)
Sumamed ( 450 rubles) and Azithromycin (90 rubles)
Trental (200 rubles) and Pentoxifylline (50 rubles)
Trichopol (90 rubles) and Metronidazole (10 rubles)
Troxevasin (220 rubles) and Troxerutin (110 rubles)
Ultop (270 rubles) and Omeprazole (50-)
F gel (250 rubles) and Ketoprofen (70 rubles)
Finlepsin (280 rubles) and Carbamazepin (50 rubles)
Flucostat (20 0 RUB) and Fluconazole (20 RUB)
Furamag (380 RUB) and Furagin (40 RUB)
Hemomycin (300 RUB) and Azithromycin (100 RUB)
Enap (150 RUB) and Enalapril (70 RUB)
Ersefuril (400 RUB) and Furazolidone (40 RUB)

source

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