Ministry of Health of the Republic of Armenia Feb 2013.
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Transcript of Ministry of Health of the Republic of Armenia Feb 2013.
Availability of Opioids in Armenia
Ministry of Health of the Republic of ArmeniaFeb 2013
Opioid analgesics registered in the Republic of ArmeniaName Dosage,
Prescription Form
Producing country, Company
Registration Date
Valid to
1. Morphine hydrochloride 1% solution for infusion
10 mg/ml; (100/20x5/) 1 ml ampoule
“Zdorovye narodu” OJSC, Ukraine 05.12.2011 05.12.2016
2. Omnopon-ZN (Morphine hydrochloride, papaverine hydrochloride, codeine, noscapine, tebaine)
11,5 mg/ml + 0,72 mg/ml +1,44 mg/ml + 5,4 mg/ml + 0,1 mg/ml ; (100/20x5/) 1 ml ampoule
“Zdorovye narodu” OJSC, Ukraine
07.09.2012 05.12.20163. Fentanyl 0.005%,
solution for infusion0,05 mg/ml ; (100/20x5/) 2 ml ampoule
“Zdorovye narodu” OJSC, Ukraine
05.12.2011 05.12.20164. Promedol-
ZN(trimetoperidine hydrochloride)
20 mg/ml (100/20x5/) 1 ml ampoule
“Zdorovye narodu” OJSC, Ukraine 07.09.2012 05.12.2016
Name Dosage, Prescription Form
Producing country, Company
Registration Date
Valid to
5.
Durogesic Matrix
25mcg/h TDTS, 4,2 mg, 5 in a box
Alza Ireland Ltd, Janssen Pharmaceutical N.V 08.06.2009 08.06.2014
Durogesic Matrix
50 mcg/h TDTS, 8,4 mg, 5 in a box
Alza Ireland Ltd, Janssen Pharmaceutical N.V 08.06.2009 08.06.2014
6. Methadose™ Oral Tablets (methadone hydrochloride) Tablets, USP
5 mg, bottles of 100 tablets
Mallinckrodt Inc., USA 17.12.2008 04.12.2013
Methadose™ Oral Tablets (methadone hydrochloride) Tablets, USP
10 mg; bottles of 100 tablets
Mallinckrodt Inc., USA 17.12.2008 04.12.2013
Methadose™ Oral Tablets (methadone hydrochloride) Tablets, USP
40 mg; bottles of 100 tablets
Mallinckrodt Inc., USA 17.12.2008 04.12.2013
Opioid analgesics registered in the Republic of Armenia
Name Dosage, Prescription Form
Producing country, Company
Registration Date
Valid to
6 Tramadol, solution for injection
100 mg /2 ml; (5) ampoules 2 ml
CRCA, Novo Mesto, Slovenia
27.03.2012
27.03.2017
Tramadol, capsules
50 mg (20/2x10/) blisters
CRCA, Novo Mesto, Slovenia
27.03.2012
27.03.2017
Tramadol-M
50 mg/ml (1 ml);1 ml ampoules (10)
“Zororvye narodu” OJSC, Ukraine
08.10.2008
02.10.2013
Tramadol-M50 mg/ml (2ml) 2 ml ampoules (5)
“Zororvye narodu” OJSC, Ukraine
08.10.2008
02.10.2013
Tramadol, solution for injection
100 mg/2 ml; (5) ampoules 2մլ
Hemopharm AD - Serbia
14.09.2011
14.09.2016
Tramadol
50մ mg (20/2x10/) blisters
Hemopharm AD - Serbia
14.03.2011
14.03.2016
Tramadol Alcaloid, capsules
50 mg; (20) in bottles Alcaloid AD - Skopje
13.12.2012
19.11.2017
Tramadol Alcaloid, solution for injection
50մգ/մլ; (5) ampoules 2 ml Alcaloid AD - Skopje
13.12.2012
19.11.2017
Opioid analgesics registered in the Republic of Armenia
Armenia is not a major drug-producing country and because of conservative social mores domestic abuse of drugs is relatively modest;
Some use (secondary route) as a transit country for drug trafficking;
Opiates, are the second most abused drug group (after hashish and cannabis) ;
In 2009 Armenia implemented new legislation towards EU standards , decriminalization of the use of illegal drugs (emphasizing prevention & treatment of drug users) and adopted a three year national drug strategy;
In 2011 the Monitoring Centre for Narcotic Drugs and Drug Addiction was established under the National Institute of Health;
Armenia is a party to the 1988 UN Drug Convention .
Regulation of Drug Circulation In Armenia
Regulation of Drug Circulation In Armenia International treaties
- UN Single Convention on Narcotic Drugs of 1961- UN Convention on Psychotropic substances of 1971- UN Convention against Illicit traffic in Narcotic Drugs and
Psychotropic Substances f 1988
Domestic Regulatory documents
- The Law of the Republic of Armenia on the Narcotic & Psychotropic Substances (Dec 26, 2002) , The Law on Pharmaceuticals
- Decrees of the Government on licensing of agencies on drugs importation, exportation, production, warehousing, and distribution: on lists of controlled drugs and their precursors and on the order of their circulation, decree of the MoH on prescriptions, etc
Regulation of Drug Circulation In ArmeniaAgencies involved
- The Government of Armenia (approves the lists of controlled drugs and their precursors, their circulation order and annual quotes for the Armenia)
- Ministry of Health of Armenia (responsible for registration and licensing)
- Police Department at the Government of Armenia- Customs Service- National Security Service- Prosecutor’s Office
Testing and registration, importation, warehousing, distribution, storage, prescribing, dispensing, monitoring of prescription usage
Testing and registration of narcotic drugs is not different from other pharmaceuticals.
- Testing is done at the laboratory of the Drug Expertise Center of the MoH
- Registration is done by the MoH- Activities of importation, warehousing, distribution of narcotics
should be licensed by the Ministry of Health (special condition requirements). Currently only one organization “Armpharmacia” JSC, holds the license for importation and warehousing of narcotics.
- Dispensing of narcotics is done through prescriptions by the order of prescriptions and distribution of pharmaceuticals approved by the Ministerial decree #100 of Feb 26, 2002 on the order using prescription form #1 approved by the Government of Armenia (forms 2 and 4 are used for psychotropic substances).
- Monitoring of narcotic drugs dispensing and usage in pharmacies and health care institutions is done by the Ministry of Health.
- Annual reports on narcotics circulation are submitted to the MoH and Police Dept by institutions licensed for circulation of narcotic drugs.
Restrictions on prescribing, i.e. route of administration, dose, length of prescription?The acting Law on narcotics does not stipulate a special procedure and condition of the use of narcotics/psychotropic substances for medical purposes.
Only One opioid or psychotropic substance may be prescribed at each prescription form
Prescription of narcotics in out-patient facilities is only available to cancer patients (morphine injectable form only)
Prescriptions of narcotic drugs are issued for 2 days (Prescriptions of narcotic and psychotropic drugs is valid for 20 days).
The process of prescription is cumbersome (through a decision of a committee, each prescription to be validated by signature and personal stamp of the prescribing physician, the prescription stamp, the signature and stamp of the director or deputy director and round seal of the facility).
Main activities carried out in Armenia in 2011-2012 towards development of palliative care (in cooperation
with the GF and OSF)Situational analysis, draft guidelines in pain
management and national guidelines on palliative care developed
Pilot testing of different models of palliative care in four sites implemented and in progress
- 132 patients included- 3692 home visits, 1388 out-patient vists and 4697
emergency calls served. - Regulated by Ministerial decree the patients
enrolled in pilots receive methadone procured under the GF funded HSS project.
Expert assessment of the oral morphine requirement for Armenia
Assumptions:- Current usage of morphine is 1.327 Kg for
injectable only- Oral morphine will replace 75% of the injectable
and we need more mg for oral than injectable- Estimated 25% increase annually due to education
and pilot projectsEstimates:- 2013- 3.3 kg (2.475 kg oral, 0.825 inj.)- 2014- 4.15 kg (3.11 kg oral, 1.04 kg inj.)- 2015- 5.19 (3.89 kg oral, 1.3 kg inj.)
What is the projected need for morphine in the country by dosage form (IR, SR, and injectable)
The quotes of narcotic and psychotropic medication to be produced, imported to or exported from the Republic of Armenia are implemented by the Government of RA.
Quotes of 2013:- Morphine (all forms)- 4500 g- Codeine – 3000 g- Phentanyl (all forms)-21 g- Methadone (all forms)- 10000g- Tebaine --10g, Trimetoperidine-- 650 g
Activities foreseen for 2013
Registration of oral morphine (included in the list of essential medicines of low demand) is underway
Pilot projects continue, evaluation expected end of 2013
Comprehensive review of legislation on narcotic drugs aimed at improved conditions and increased availability of opioid analgesics for patients in need in Armenia.
THANK YOU!!!