www.aidsmap.comissue 158 july 2006 why GPs need to be integrated into HIV-positive care page 4 primary care at HIV clinics is your clinic providing GP services? page 14 immunisation guidelines new vaccination guidance for HIV-positive people page 8 does efavirenz cause depression? a new study suggests otherwise page 3 anti-HIV therapy adds thirteen years to post-AIDS survival page 13
Some reviews of clomid noted that the drug can also cause weight gain, hair loss and vision impairment hecticlifehealthygirl.com Before using the product you should consult with a specialist and to get acquainted with the instructions approved by the manufacturer.Cialis ne doit pas être prise à tous. Il est important que cialis en ligne est prescrit par un médecin, bien se familiariser avec les antécédents médicaux du patient. Ich habe Probleme mit schnellen Montage. Lesen Sie Testberichte Nahm wie cialis rezeptfrei 30 Minuten vor dem Sex, ohne Erfolg. Beginn der Arbeiten nach 4 Stunden, links ein Freund ein trauriges Ja, und Schwanz in sich selbst nicht ausstehen, wenn es keinen Wunsch ist.
Korporativais_buklets-grindeks_en_2014.cdrGood to be healthy! JSC "Grindeks", Latvia
Riga, LV-1057, 53 Krustpils St.
Ph: +371 67 083 205; + 371 67 083 500
Fax: + 371 67 083 505
Carrying the name of Latvia into the world and developing national pharmaceutical values, Latvia can be proud of the leading pharmaceutical company in the Baltic States - "Grindeks". The successful operation of the company is not only veriﬁed by its performance, but is also acknowledged by the industry specialists, feedback from patients and received awards. In 2010 "Grindeks" received the title of most exportable company in Latvia, while in 2012 "Grindeks" received the International diamond prize for Excellence in Quality. Award was presented by the European Organisation for Quality Research. In terms of reputation, "Grindeks" is in the forefront of the best companies in Latvia by taking ﬁrst place in the industry for several years. "Grindeks" is also among the best employers of Latvia. Medication and active pharmaceutical ingredients manufactured by the company are highly evaluated in Latvia and abroad.
In the centre of "Grindeks" operation is a human being – patient and his health, therefore the company does everything to ensure the society with the high quality, safe and modern medication. Its activities are vertically integrated – the company has all the necessary resources to perform a complete development cycle of a product, from research and development of medications to registration and sales of the ﬁnal dosage forms. The human characteristic of the pharmaceutical business, as well as the resources and knowledge capacity is a strong driving force of overcoming tough competition obstacles, as well as seeking for new solutions.
In order to promote sustainable growth and global competitiveness, signiﬁcant investments are made for the development of the company, due to these investments, a modern infrastructure with laboratories and manufacturing units up to the world class standards have been established. Latvia – the geographical location of "Grindeks" is yet another advantage – the company is as a bridge between Europe and Asia, by delivering products in both directions. Products of "Grindeks" are exported to more than 50 countries.
We aim to become a significant European We care about human health, as well as the interests and welfare of our employees and shareholders. We are innovation based and friendly company. We are responsible professionals using for the production partners, socially of safe and effective science and research, ecologically clean implementing latest determined goals.
work place safety.
HIGH ADDED VALUE – MODERN INFRASTRUCTURE The business philosophy of the company
AND WORLD-CLASS MANUFACTURING UNITS is closely linked to its values. They
Manufacturing units of "Grindeks" are modern and equipped with the world-class manufacturing stimulate the growth of "Grindeks",
equipment. Investments made over the years guarantee a great advantage – the ability to provide contributing to the competitiveness and
vertically integrated or full chemical-pharmaceutical manufacturing cycle with our own resources – from active pharmaceutical ingredients to ﬁnal dosage forms. Both active pharmaceutical establishing the internal culture of the
ingredients and ﬁnal dosage forms manufacturing units are certiﬁed according to the "Good company. "Grindeks" is a constructive
Manufacturing Practice" requirements and quality standards of ISO, thus, guaranteeing patients safety, eﬃciency and quality of medication.
cooperation oriented company that
Within the oﬀer of "Grindeks" ﬁnal dosage forms there is a wide range of diﬀerent forms – tablets, believes that the high level of business
capsules, ointments, gels and syrups. Modern and powerful technological equipment of "Grindeks" ethics principles is important not only
ﬁnal dosage forms provides a convenient, safe, eﬀective and environmentally friendly manufacturing. The total area of "Grindeks" ﬁnal dosage forms manufacturing unit is 5,500 m² and from the drug manufacturers point of
its manufacturing capacity is 1.5 billion tablets, 500 million capsules and 20 million tubes per year.
view, but also from all of the
Manufacturing unit of "Grindeks" active pharmaceutical ingredients is located in the area of pharmaceutical market participants.
approximately 10,000 m². Active ingredients are developed and manufactured in 11 manufacturing units, in diﬀerent capacities – from 10 to 6,000 litres – reactors. Maximum manufacturing capacity of active pharmaceutical ingredients is 200-250 tons per year.
FINAL DOSAGE FORMS Caring for health and life quality of patients, the company annually expands its product range and oﬀers medications that, in terms of quality and safety, are in line with the high "Good Manufacturing Practice" and ISO standard requirements. Within the "Grindeks" product range there are brand products, generics and active pharmaceutical ingredients. The company is proud of its brand products – Mildronate®, PRODUCTS
Mildronate® GX, Ftorafur®, as well as unique ointments Capsicam® and Viprosal B®.
The main therapeutic groups: • heart and cardiovascular medication AND SERVICES
• anti-cancer medication• central nervous system aﬀecting medication However, the company is also focusing on other therapeutic directions cold and pain r medication, as well as gastrointestinal agents; "Grindeks" also oﬀers antibacterial medication.
LIFE QUALITY OF PATIENTS MOST DEMANDED PRESCRIPTION MEDICATION Cytostatic medication for the treatment of alimentary canal tumours as Heart and cardiovascular disease treatment
well as for the treatment of breast cancer Mildronate® is an original, antiischemic agent of a metabolic action, used for the Selective aromatase inhibitor for the treatment of breast cancer treatment of angina pectoris, chronic heart failure and brain circulation disorders. It is recommended in cases of reduced work capacity, physical and psycho-emotional overloads Antiandrogen for the treatment of prostate cancer Cardiac glycoside, used to treat congestive heart failure and supraventricular arrhythmias MOST DEMANDED OVER-THE-COUNTER MEDICATION Alpha-and-beta-adrenoreceptor blockator for the treatment of essential hypertension, chronic stable angina pectoris and chronic heart failure Indications: Used topically as an analgesic in cases of joint and muscle pain.
Viprosal B® ointment
Description: The main active ingredient of the Viprosal B® ointment is venom Antithrombotic agent for prevention of formation and treatment of of viper (Vipera berus). thromboembolism (blood clot) packaging of 30g and 50g Viprosal B® ointment irritates the nerve endings of sensory receptors, causing the local irritation and palliative eﬀect. Lisinopril -Grindeks Angiotensin converting enzyme (ACE) inhibitor for treatment of hypertension, heart
failure, myocardial infarction and diabetic nephropathy Indications: Analgesic and warming remedy for muscle and joint pain relief.
Description: Capsicam® ointment contains substances that by penetrating skin provide heat, thus expanding the blood vessels and irritates the sensory packaging of 30g and 50g nerve endings receptors. By feeling the heat, muscle tension and pain Central nervous system aﬀecting medication
sensation is reduced.
Sleep medication from the group of cyclopyrrolone derivatives for use in Indications: Sulfargin® is a topical ointment with antimicrobial activity.
patients with recurring insomnia and poor sleeping habits · infected burn treatment and prevention of infection, · as an aid in case of infected trophic ulcers and bedsores, · infection prevention for skin graft donors and patients with an array of skin Antiparkinsonian agent for correcting extrapyramidal disorders packaging of 50g and 500g Description: The main active substance of Sulfargin® ointment is sulfadiazine silver salt, which has an antimicrobial activity against bacteria and fungi.
Healing agent activity is determined by silver ion release in the wound, thus Antipsychotic medication for the treatment of schizophrenia and bipolar aﬀective disorders achieving long-lasting antimicrobial eﬀect, which is enhanced by sulfadiazine Atypical neuroleptic agent of the group of benzamides for the treatment Indications: For the treatment of scalp skin infections (dandruﬀ, seborrheic dermatitis of the scalp).
Description: By using Mikanisal® shampoo, whose main active ingredient is ketoconazole, itchy skin, a symptom that is often accompanied by packaging of 60g and 100g Anxiolytics for the treatment of anxiety and panic disorder dermatophytes and yeast infections, disappears quickly, as well as improves skin appearance.
MOST DEMANDED DIETARY SUPPLEMENTS APILAK-GRINDEKS contains lyophilised bee royal jelly. It is a biologically active complex that promotes faster recovery and strengthens immunity after illness, as 10 mg, 25 tablets well as raises the tone. It is widely used for women in the postpartum period for lactation purposes, as well as for appetite promotion for children.
Product form – capsules – it provides a convenient and safe use. Sorbex® meets all Pellet activated charcoal the requirements of modern activated charcoal: high eﬃciency, fast-acting, safe and (Carbo activatus) 300mg / 900mg easy to use.
Each Lactobex® sachet contains not less than 1.0 billion (1x109) lactic acid and biﬁdobacteria colonies formed by L. Complex of lactic acid and biﬁdobacteria acidophilus, B. longum, S. thermophilus – protected by a 10 sachets of 1.0 g unique patented technology Duolac .
Duolac improves stability of bacterial culture and entrance into the intestinal tract, protecting them from the negative Complex of lactic acid and biﬁdobacteria eﬀects of the external environment, as well as the stomach for children with vitamins B1, B2, B6 10 sachets of 1.0 g Latvian Association of Dieticians has assessed Lactobex® products with a sign of Valuable Product.
GRITAMIN® FOR WOMEN
Vitamin series for the whole family.
Gritamin® for Women and Gritamin® for Men is a special vitamin GRITAMIN® FOR MEN
complex of natural products for maintaining health.
Gritamin® for Adults provides human body with vitamins and minerals GRITAMIN® FOR ADULTS
essential for functioning of the body, therefore it is particularly GRITAMIN® B complex
recommended in case of a poor daily diet.
Gritamin® B complex contains all the necessary vitamins of group B. ACTIVE PHARMACEUTICAL INGREDIENTS Various services oﬀered by "Grindeks" to other pharmaceutical The most demanded API's of "Grindeks" are zopiclone, oxytocin, ftorafur (tegafur), UDCA companies have become more common. The best known (ursodeoxycholic acid), droperidol, as well as veterinary products – detomidine hydrochloride, services of "Grindeks" are contract manufacturing and contract medetomidine chloride, atipamezole hydrochloride and xylazine hydrochloride.
development of generic medication.
Contract development of generic medication is conducted in API'S FOR HUMAN USE: API'S FOR VETERINARY USE: two ways: fulﬁlling clients order on the product development and oﬀering contract manufacturing of the respective product, DESAMINOOXYTOCIN ATIPAMEZOLE HYDROCHLORIDE as well as cooperating in the development, licensing and sales of DEXMEDETOMIDINE HYDROCHLORIDE DETOMIDINE HYDROCHLORIDE generic medication.
DEXMEDETOMIDINE HYDROCHLORIDE Because of the newly established Quality Control Laboratory, the FTORAFUR (TEGAFUR) company also oﬀers pharmaceutical product analysis, analytical IMATINIB MESYLATE MEDETOMODINE HYDROCHLORIDE method development and validation.
XYLAZINE HYDROCHLORIDE "Grindeks" provides a control and release of pharmaceutical product series in EU and CIS markets. Product release in these markets has speciﬁc requirement of the "Good Manufacturing ANTAZOLINE PHOSPHATE Practice" standard, which includes product analysis, control and MILNACIPRAN HYDROCHLORIDE audit of manufacturing documentation.
RILMENIDINE DIHYDROGEN PHOSPHATE URSODEOXYCHOLIC ACID MILDRONATE MELDONIUM PHOSPHATE
IN MORE THAN 50
For many years, "Grindeks" business strategy is focused on strengthening positions in both local – Latvian and export markets, increasingly creating new solutions to stimulate demand. Products of "Grindeks" are exported to more than 50 countries worldwide and comprise 95% of total turnover.
The main markets for ﬁnal dosage forms of "Grindeks" are Russia and other CIS countries, as well as the Baltic States. To secure "Grindeks" position strengthening and availability of medications, the company established an expanded network of representative oﬃces. There are representative oﬃces in 13 countries cooperating with local state drug institutions, performing wholesale and retail of pharmaceutical and medical products, as well as ensuring drug registration and marketing activities.
The main markets for active pharmaceutical ingredients are European Union, USA and Japan.
The assignment of "Grindeks" is to develop, manufacture and provide eﬀective medication to patients; therefore, proceeding along this path, the company annually invests in the development of manufacturing, infrastructure and research. Since 2002, the company has carried through many considerable investment projects by investing in development more than 70 million euros over this time.
Comprehensive investments are an important contribution to the development of the company and are increasing the competitiveness of "Grindeks" in European and global markets. Yet it is also a signiﬁcant contribution to the economy of Latvia, where the industrial manufacturing is therefore developing, the state competitiveness and export is increasing.
MOST SIGNIFICANT INVESTMENT PROJECTS OF "GRINDEKS" Million EUR
Ointments Ursodeoxycholic International
ENVIRONMENTAL PROTECTION OBJECTIVES OF "GRINDEKS" FOR 2014-2015 QUALITY.
MANUFACTURING AND INNOVATION of the Quality and Environmental Management responsible manufacturing spheres, as it is related Environmental Management systems are systems, the company has implemented LVS EN to life and health of a human being, therefore the introduced in "Grindeks", which cover all areas of ISO 14001:2004 and LVS EN ISO 9001:2008 pharmaceutical industry is facing very high operations of the company. This enables quality requirements. "Grindeks" complies with continuous improvement of business processes, Environmental pollution reduction measures are the "Good Manufacturing Practice" standards, to provide clients and patients with high quality becoming increasingly important to the world, which serves as a guarantee that the company and safe medication, as well as the regular update operates in accordance with the European Union and improvement of manufactured product including Latvia. "Grindeks" is a "green minded" and global requirements. This is also reﬂected by assortment. The management anticipates company, which is constantly looking for new the fact that "Grindeks" manufacturing units are systematic market and new product research and and innovative solutions for improving the implemented environmental protection system pharmaceutical inspections from all over the and service is essential to increase sales, as well as and resource saving, per forming regular world, as well as cooperation partners, providing a means of obtaining client feedback. By environmental protection measures. When strategic decisions are made, "Grindeks" is always international quality standards.
Environmental Management systems and regular taking into account the potential environmental According to the international and Latvian reports on the performance and improvements PROFESSIONAL
Employees it is a constant, one of the most important values o f the company, therefore "Grindeks" ensures work environment that THE GREATEST VALUE OF "GRINDEKS" stimulates both individual growth and achievement of the company's business goals. Employees of "Grindeks" are professional, high qualiﬁed specialists, who perform their work duties and take care of the company's sustainable development.
Through the Personnel management the company eﬀectuates employment, manufacturing relations, raise of qualiﬁcation and training, wages, and social policy, providing social guarantees, beneﬁts, employee health and accident insurance, as well as a variety of advantages partial compensation for the catering at the company's canteen, transport for conveyance of employees and paid holidays.
The company has implemented evaluation of work quality and development planning system.
As a proof of successfully performed Personnel policy and good employers reputation is a decreasing staﬀ turnover and increasing demand for work and internships at the company.
THE AVERAGE THE AVERAGE "Grindeks" is aware of the needs of society to be more purposefully involved in its development, in CORPORATE
the dialogue with patients and healthcare professionals. Being responsible for the health of consumers and quality of its product, "Grindeks" SOCIAL RESPONSIBILITY
adheres to the principles of Corporate Social Responsibility by providing quality manufacturing FOR THE DEVELOPMENT OF SOCIETY in an environmentally friendly way. As one of the ﬁrst companies in Latvia, in 2002 "Grindeks" responded to the invitation of UN General Secretary Koﬁ Annan to join the UN Global Compact which unites socially responsible business companies from all over the world. Therefore "Grindeks" Corporate Social Responsibility is closely in line with the ten principles of the UN Global Compact that are related to human rights, labour rights and the environment. Taking into account the UN Global Compact principles, Corporate Social Responsibility in "Grindeks" is focus on ﬁve main areas: patient, society, employee, business environment, quality and environmental protection.
"Grindeks" is an active member or supporter of several industry organisations, including, Latvian Pharmacist Association, the Latvian Medical Association, Latvian Chemical and Pharmaceutical Industry Association, the Employers' Confederation of Trade and Industry Chamber, the Latvian Quality Association.
Today, knowledge and information has become one of the most important business resources, innovation – a signiﬁcant competitive advantage, "Grindeks" is particularly pleased by signiﬁcant investments in education and science. "Grindeks" set up a fund "For the Support of Science and Education" in 2006, which is one of the biggest private funds in Latvia. It supports the young professionals of natural sciences, awards gratuities and scholarships not only to students and scientists, but also to educational institutions and training staﬀ.
For many years now "Grindeks" is the general sponsor of the Latvian national ice hockey team, as well as a patron of the Latvian National Opera.
Management of the company strongly believes that successful, ﬁnancially stable and positively oriented companies have an obligation to provide support to the society, and this concept is one of the basic assumptions of the "Grindeks"
LE THERMALISME PSYCHIATRIQUE UNE ALTERNATIVE THÉRAPEUTIQUE DANS LES TROUBLES ANXIEUX Dr Olivier DUBOIS, Saujon Pr Jean Pierre OLIÉ, SHU Sainte Anne ParisPr Roger SALAMON, ISPED Bordeaux II Dr Christiane VAUGEOIS, Ussat I - CrénothérapIe, thermalIsme : ques et de vasodilatation. L'activité antalgique de la crénothé- de quoI s'agIt-Il ? rapie a été largement démontrée. El e est sans doute favorisée par l'inhibition de la transmission de la douleur au niveau médul-