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At present, the pharmacist is not authorized to substitute a biomedicine by a biosimilar as it does between a chemical drug and its generic. It is up to the doctor to prescribe it. The conditions governing its marketing authorization mean that a biosimilar is in principle usable under the same conditions as the medicinal product to which it refers, with a list of indications sometimes restricted for lack of further studies. The concept of biosimilarity also implies an identity of dosage which the doctor is supposed to ensure. When used as a first line, no other precautions are required for the administration of a biosimilar. In the same patient, however, notes that multiple or frequent changes between similar declared drugs increase the immunogenic risk and make it difficult to monitor adverse effects. http://www.bmpharmacy.net