Medications can be dispensed with or without a prescription, prescribed by a doctor.

The medications that you can purchase only by presenting a regular prescription prescribed by a doctor are:

• Class A medications: free, as they are fully covered by the National Health Service. However, sometimes a co-payment may be required on the package or prescription, at the discretion of the Regions. These are essential medications for care in the essential levels of healthcare, but this category also includes those prescribed only for the treatment of specific diseases with special AIFA notes;

• Class C medications: paid, fully at the citizen's expense. They are not considered essential;

• Class H medications: free only if provided or used by hospital healthcare facilities.

The medications that you can purchase without a medical prescription are paid and at full price because the National Health Service does not participate in the expense. Only war pensioners who have a direct lifelong pension can obtain them for free if the doctor confirms the necessity of these medications.

They are divided into:

• Over-the-counter medications (OTC) are medications that have been on the market for several years and are therefore considered safe. They can be used for self-medication for mild ailments. Advertising to the public is authorized for this category of medications;

• Medications without a prescription requirement (SOP) recommended by the pharmacist when necessary. Improper use can cause undesirable and harmful effects, especially of an allergic or toxic nature. Advertising for these medications has not been authorized, and the external packaging must clearly state "Medication without a medical prescription requirement".

Equivalent drugs are copies of advertised medicines, essentially the same but sold at lower prices. They are also called generic drugs.

Equivalent medicines have, compared to reference medicines:

• the same active ingredient, which performs the therapeutic function;

• the same amount of active substance;

• the same pharmaceutical form (tablets, pills, powders, etc.).

In equivalent drugs, the following changes occur:

• the name of the medicine;

• the price;

• any excipients, which should be checked before taking.

An equivalent medicine may contain excipients different from those of the reference medicine.

Some excipients may have repercussions on certain categories of patients: this information is provided in detail in the package leaflet.

For example, drugs containing sucrose must be administered with caution to patients with diabetes.

Equivalent drugs have a lower price compared to reference medicines.

Every new drug has a patent that generally lasts 10 years, after which other pharmaceutical companies can replicate it and market it. All equivalent drugs must still be authorized by the Italian Medicines Agency (AIFA) or the European Medicines Agency (EMA).

All equivalent drugs state on the box: Equivalent Medicine.

AIFA (Italian Medicines Agency) updates the list of equivalent drugs marketed monthly, reporting for each drug the maximum reimbursement amount covered by the health service.

Antibiotics fight bacterial infections, for example, pneumonia caused by pneumococci or staphylococcal infections.

Only a doctor can confirm the need to take antibiotics and prescribes them to their patient, who must use them responsibly.

A particular antibiotic may be effective against only one type or multiple types of bacteria, but there is no antibiotic effective against all types of bacteria.

Correct use of antibiotics

• use antibiotics only if specifically prescribed by a doctor, not those left over from a previous treatment or obtained without a prescription;

• follow the doctor's instructions on how to use them (timing, days, etc.);

• do not keep unused antibiotics after the treatment cycle;

• do not take them in the case of viruses, such as for colds or flu. They provide no benefit;

• if possible, prevent infections through vaccinations.

Even if tested and authorized for sale, drugs can sometimes cause adverse reactions in specific cases.

Pharmacovigilance is an activity of monitoring the effects of drugs, which can also be carried out by individual citizens, through a system of spontaneous reporting.

The information received is collected, monitored, validated, and studied in order to identify new potential risks associated with drugs and to prevent harm to the population.

You can report any suspected adverse reaction to a medicine (serious and non-serious, known and unknown), resulting from therapeutic error, abuse, misuse, overdose, and occupational exposure.

To do this, you need to fill out the reporting form and send it:

• by e-mail to the Pharmacovigilance Officer of your ASL;

• by e-mail to the holder of the Marketing Authorization (AIC) of the medicine suspected of causing the adverse reaction;

• online on the AIFA website.

Reporting forms for suspected adverse drug reactions: