This article analyzes self-medication practices common in Russian society, which can be both harmful and beneficial to an individual’s health. Particular attention is paid to the nature and principles of responsible self-medication (RSM). Based on available data from nationwide studies, the article examines the dynamics of self-medication over the past few years, as well as the main reasons and strategies for choosing self-medication tactics in Russians. The complexity of analyzing the phenomenon of self-medication is due to its multifaceted nature, as well as the presence of diverse healthcare interventions (prevention, treatment, rehabilitation, palliative care) and self-care measures (medications, devices and accessories, etc.). The broad interpretation of responsible self-medication contained in international norms and recommendations complicates its study and does not allow for a characterization of the prevalence and dynamics. The article identifies the main self-medication practices of Russians and demonstrates that among Russian citizens who practice self-medication, a relatively high proportion adhere to the principles of responsible self-medication. However, even among these individuals, only partial adherence to its core principles is observed. The author emphasizes that self-medication is not only voluntary but also forced: it is necessary to identify and eliminate the causes of forced choice and to identify the factors that determine it. One of the important tasks remains the development of a methodological basis for a program to improve the health literacy of Russians, as well as the creation of conditions for citizens to practice responsible self-medication.