In order to protect the health of patients, some drugs have been exempted from application of general rules of substitution by the pharmacist. Therefore, these professionals are urged to refrain from replacing them in the act of dispensing, without the express authorization of medical prescriber. These drugs are
a) biological drugs (insulin, blood products, vaccines, drugs, biotech ).
b) Drugs containing any active ingredients considered a narrow therapeutic index, except when administered intravenously in warfarin, carbamazepine, cyclosporine, digoxin, phenytoin, levothyroxine, lithium, metildigoxina , tacrolimus, theophylline and warfarin.
c) Medicines containing active ingredients subject to special medical supervision or those that require specific monitoring measures for security reasons: vitamin A derivatives (isotretinoin, acitretin) systemic administration, acetohydroxamic acid, thalidomide, clozapine, pergolide, cabergoline, vigabatrin and sertindole.
d) Drugs for the respiratory system when administered by inhalation.
The reference list of drugs is permanently updated and available at the following address:
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