Liste positive des médicaments valable au 1er octobre 2011 ... - CNS

Numéro national
Liste positive des médicaments valable au 1er octobre 2011
Cette liste se base sur des données qui sont de la compétence de la Division de la
Pharmacie et des Médicaments et du Ministère de la sécurité sociale.
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
A01AA01 sodium fluoride
0045694 FLUOR SMB GTTS 30 ML 0 0
2,72 80
0131307 ZYMAFLUOR 0,25 MG 250 CPR 0 0
4,59 80
0131324 ZYMAFLUOR 1 MG 250 CPR 0 0
6,91 80
A01AB03 chlorhexidine
0207727 CORSODYL SOL 200 ML 0 0
4,71 40
A01AB09 miconazole
0027634 DAKTARIN GEL ORAL 40 G 17392 0 0
7,44 80
A01AB12 hexetidine
0053603 HEXTRIL COLLU LIQ 200 ML 0 0
5,10 40
A02AA01 magnesium carbonate
0368602 MAG 2 100 MG 60 CPR 0 0
4,85 80
A02AD01 ordinary salt combinations
0300279 GELOX 30 SACH 0 0
5,68 80
0209381 MAALOX 100 CPR 0 0
9,13 80
0068699 MAALOX 40 CPR 0 0
4,57 80
0068721 MAALOX FORTE SUSP 20 SACH MND 10 ML 0 0
10,01 80
0145401 MAALOX FORTE SUSP 355 ML 0 0
13,02 80
0068718 MAALOX SUSP 20 SACH MND 10 ML 0 0
7,38 80
0145381 MAALOX SUSP 355 ML 0 0
8,07 80
0176245 MAGLID 48 CPR A SUCER 0 0
4,76 80
0177127 REGLA PH FORTE 40 CPR 0 0
5,64 80
A02AD02 magaldrate
0255299 GASTRICALM 50 CPR A CROQUER 0 0
5,93 80
0100197 RIOPAN SUSP 800 MG 20 SACH 10 ML 0 0
8,70 80
0511791 RIOPAN SUSP 800 MG 50 SACH 10 ML 0 0
17,39 80
A02AD04 hydrotalcite
0253862 TALIDAT 100 CPR 0 0
13,19 80
0253845 TALIDAT 20 CPR 0 0
3,48 80
0253859 TALIDAT 50 CPR 0 0
7,91 80
A02AX Antacids, other combinations
0074813 MUTHESA 50 CPR 0 0
3,73 80
0074827 MUTHESA SIR 170 ML 0 0
4,97 80
0156595 SYNGEL SIR 300 ML 0 0
11,17 80
A02BA01 cimetidine
0183561 CIMEHEXAL 200 MG 10 AMP 2 ML IV 0 0
9,72 80
0178951 CIMEHEXAL 800 MG 100 CPR 0 0
17,44 80
0178947 CIMEHEXAL 800 MG 50 CPR 0 0
12,99 80
0301195 CIMETIDINE EG 200 MG 100 CPR 0 0
14,29 80
0301178 CIMETIDINE EG 200 MG 20 CPR 0 0
6,34 80
0301201 CIMETIDINE EG 400 MG 56 CPR 0 0
17,21 80
0301214 CIMETIDINE EG 800 MG 28 CPR 0 0
17,21 80
0182435 H2 BLOCKER RATIO 200 MG 10 AMP INJ 2 ML 0 0
9,72 80
0182404 H2 BLOCKER RATIO 400 MG 100 CPR PELLIC 0 0
18,40 80
0182385 H2 BLOCKER RATIO 400 MG 20 CPR PELLIC 0 0
4,07 80
0182399 H2 BLOCKER RATIO 400 MG 50 CPR PELLIC 0 0
9,66 80
0182418 H2 BLOCKER RATIO 800 MG 20 CPR PELLIC 0 0
7,34 80
0182421 H2 BLOCKER RATIO 800 MG 50 CPR PELLIC 0 0
16,88 80
0174349 NUARDIN 200 MG 20 CPR EFF 0 0
11,76 80
0174352 NUARDIN 200 MG 60 CPR EFF 0 0
31,30 80
A02BA02 ranitidine
0283049 DOCRANITI 150 MG 112 CPR 0 0
12,49 80
0283021 DOCRANITI 150 MG 28 CPR 0 0
7,18 80
0283035 DOCRANITI 150 MG 56 CPR 0 0
9,22 80
0283052 DOCRANITI 300 MG 28 CPR 0 0
8,64 80
0283066 DOCRANITI 300 MG 56 CPR 0 0
9,40 80
0218555 RANITIC 150 MG 100 CPR 0 0
9,00 80
Page 1 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0218538 RANITIC 150 MG 20 CPR 0 0
3,40 80
0218541 RANITIC 150 MG 50 CPR 0 0
6,50 80
0218524 RANITIC 300 MG 100 CPR 0 0
13,00 80
0218507 RANITIC 300 MG 20 CPR 0 0
5,00 80
0218511 RANITIC 300 MG 50 CPR 0 0
6,50 80
0446628 RANITIDINE EG 150 MG 112 CPR 0 0
10,30 80
0543926 RANITIDINE EG 150 MG 112 CPR EFF (TUBE) 0 0
18,80 80
0286314 RANITIDINE EG 150 MG 56 CPR 0 0
9,22 80
0286328 RANITIDINE EG 300 MG 28 CPR 0 0
8,64 80
0544047 RANITIDINE EG 300 MG 28 CPR EFF (TUBE) 0 0
15,23 80
0446631 RANITIDINE EG 300 MG 56 CPR 0 0
8,27 80
0544064 RANITIDINE EG 300 MG 56 CPR EFF (TUBE) 0 0
18,80 80
0130828 ZANTAC 150 MG 56 CPR 0 0
9,22 80
0154167 ZANTAC 150 MG/10 ML SIR 2*280 ML 0 0
15,50 80
0130831 ZANTAC 300 MG 28 CPR 0 0
8,64 80
0130845 ZANTAC 50 MG 5 AMP 2 ML IV UD 0 0
8,13 80
0418511 ZANTAC SOLUBLE 150 MG 4*14 CPR EFF 0 0
15,50 80
0419293 ZANTAC SOLUBLE 300 MG 2*14 CPR EFF 0 0
15,50 80
A02BB01 misoprostol
0027262 CYTOTEC 200 MCG 112 CPR 0 0
36,90 80
A02BC01 omeprazole
0350995 DOCOMEPRA 20 MG 28 CAPS BLIST 0 0
13,27 80
0351037 DOCOMEPRA 20 MG 56 CAPS BLIST 0 0
26,53 80
0279077 LOSEC MUPS 10 MG 28 CPR 0 0
16,99 80
0279081 LOSEC MUPS 10 MG 56 CPR 0 0
24,56 80
0279113 LOSEC MUPS 20 MG 28 CPR 0 0
25,61 80
0409543 LOSEC MUPS 20 MG 56 CPR 0 0
37,22 80
0279144 LOSEC MUPS 40 MG 28 CPR 0 0
42,84 80
0285981 OMEP 20 MG 15 CAPS 0 0
9,00 80
0285995 OMEP 20 MG 30 CAPS 0 0
14,40 80
0286023 OMEP 20 MG 60 CAPS 0 0
19,20 80
0378545 OMEPRAZOLE EG 10 MG 28 CAPS 0 0
11,43 80
0378576 OMEPRAZOLE EG 10 MG 56 CAPS 0 0
18,15 80
0421498 OMEPRAZOLE EG 20 MG 100 CAPS 0 0
40,05 80
0421288 OMEPRAZOLE EG 20 MG 14 CAPS BLIST 0 0
13,37 80
0421307 OMEPRAZOLE EG 20 MG 28 CAPS BLIST 0 0
18,95 80
0315661 OMEPRAZOLE EG 20 MG 28 CPR 0 0
12,73 80
0421471 OMEPRAZOLE EG 20 MG 56 CAPS 0 0
27,32 80
0315691 OMEPRAZOLE EG 20 MG 56 CPR 0 0
28,55 80
0421744 OMEPRAZOLE EG 40 MG 100 CAPS 0 0
77,23 80
0421551 OMEPRAZOLE EG 40 MG 28 CAPS BLIST 0 0
31,19 80
0421727 OMEPRAZOLE EG 40 MG 56 CAPS 0 0
46,12 80
0421582 OMEPRAZOLE EG 40 MG 56 CAPS BLIST 0 0
52,70 80
0321895 OMEPRAZOLE FAR 20 MG 28 CPR 0 0
23,30 80
0321928 OMEPRAZOLE FAR 20 MG 56 CPR 0 0
31,93 80
0395921 OMEPRAZOLE RATIO 10 MG 28 CAPS 0 0
10,74 80
0395952 OMEPRAZOLE RATIO 10 MG 56 CAPS 0 0
18,15 80
0354736 OMEPRAZOLE RATIO 20 MG 14 CAPS 0 0
8,88 80
0354753 OMEPRAZOLE RATIO 20 MG 28 CAPS 0 0
13,26 80
0354767 OMEPRAZOLE RATIO 20 MG 56 CAPS 0 0
17,77 80
0396056 OMEPRAZOLE RATIO 40 MG 28 CAPS 0 0
18,41 80
0396091 OMEPRAZOLE RATIO 40 MG 56 CAPS 0 0
34,75 80
0370919 SEDACID 10 MG 14 CPR 0 0
9,56 80
0370922 SEDACID 10 MG 28 CPR 0 0
12,87 80
0370936 SEDACID 10 MG 56 CPR 0 0
18,15 80
0482073 SEDACID 20 MG 100 CPR 0 0
31,31 80
0370953 SEDACID 20 MG 14 CPR 0 0
13,37 80
0370967 SEDACID 20 MG 28 CPR 0 0
18,27 80
0370971 SEDACID 20 MG 56 CPR 0 0
25,76 80
A02BC02 pantoprazole
0489723 PANTOMED 20 MG 28 CPR 0 0
13,19 80
0489754 PANTOMED 20 MG 56 CPR 0 0
18,67 80
0489771 PANTOMED 20 MG 84 CPR 0 0
37,52 80
0489978 PANTOMED 40 MG 28 CPR 0 0
20,28 80
0490013 PANTOMED 40 MG 56 CPR 0 0
29,22 80
0490031 PANTOMED 40 MG 84 CPR 0 0
61,53 80
Page 2 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0490996 PANTOPRAZOL HEXAL 20 MG 30 CPR 0 0
11,90 80
0491024 PANTOPRAZOL HEXAL 20 MG 60 CPR 0 0
19,20 80
0490741 PANTOPRAZOL HEXAL 40 MG 30 CPR 0 0
15,00 80
0490772 PANTOPRAZOL HEXAL 40 MG 60 CPR 0 0
24,00 80
0494009 PANTOPRAZOL RATIO 20 MG 30 CPR GR BLIST 0 0
11,86 80
0494026 PANTOPRAZOL RATIO 20 MG 60 CPR GR BLIST 0 0
19,22 80
0493788 PANTOPRAZOL RATIO 40 MG 30 CPR GR BLIST 0 0
14,89 80
0519626 PANTOPRAZOLE EG 20 MG 28 CPR 0 0
12,82 80
0519643 PANTOPRAZOLE EG 20 MG 56 CPR 0 0
18,08 80
0529636 PANTOPRAZOLE EG 20 MG 98 CPR BLIST 0 0
23,01 80
0519691 PANTOPRAZOLE EG 40 MG 28 CPR 0 0
19,62 80
0519707 PANTOPRAZOLE EG 40 MG 56 CPR 0 0
27,88 80
0529975 PANTOPRAZOLE EG 40 MG 98 CPR BLIST 0 0
37,59 80
0272451 PANTOZOL 20 MG 28 CPR BLIST 0 0
20,55 80
0272465 PANTOZOL 20 MG 56 CPR BLIST 0 0
29,62 80
0218121 PANTOZOL 40 MG 28 CPR 0 0
32,20 80
A02BC03 lansoprazole
0240122 DAKAR 15 MG 56 CAPS 0 0
22,11 80
0204837 DAKAR 30 MG 28 CAPS 0 0
23,99 80
0453071 DOCLANSOPRAZOLE 30 MG 28 CAPS 0 0
20,02 80
0453099 DOCLANSOPRAZOLE 30 MG 56 CAPS 0 0
28,28 80
0453197 LANSOPRAZOL DOC 15 MG 28 CAPS 0 0
10,53 80
0453216 LANSOPRAZOL DOC 15 MG 56 CAPS 0 0
17,13 80
0397411 LANSOPRAZOL RATIO 15 MG 14 CAPS 0 0
5,16 80
0397439 LANSOPRAZOL RATIO 15 MG 28 CAPS 0 0
9,82 80
0397473 LANSOPRAZOL RATIO 15 MG 56 CAPS 0 0
18,68 80
0397716 LANSOPRAZOL RATIO 30 MG 14 CAPS 0 0
12,13 80
0397747 LANSOPRAZOL RATIO 30 MG 28 CAPS 0 0
17,08 80
0397778 LANSOPRAZOL RATIO 30 MG 56 CAPS 0 0
28,45 80
0410186 LANSOPRAZOLE EG 15 MG 28 CAPS 0 0
11,72 80
0410205 LANSOPRAZOLE EG 15 MG 56 CAPS 0 0
18,42 80
0410236 LANSOPRAZOLE EG 30 MG 28 CAPS 0 0
20,02 80
0410253 LANSOPRAZOLE EG 30 MG 56 CAPS 0 0
28,86 80
0410267 LANSOPRAZOLE EG 30 MG 98 CAPS 0 0
40,83 80
A02BC04 rabeprazole
0256587 PARIET 10 MG 28 CPR 0 0
25,55 80
0256591 PARIET 10 MG 56 CPR 96110 0 0
42,27 80
0256671 PARIET 20 MG 28 CPR 96114 0 0
42,27 80
0256685 PARIET 20 MG 4*14 CPR 0 0
73,55 80
A02BC05 esomeprazole
0284158 NEXIAM 20 MG 14 CPR BLIST 0 0
8,75 80
0284161 NEXIAM 20 MG 28 CPR BLIST 0 0
13,42 80
0284175 NEXIAM 20 MG 56 CPR BLIST 0 0
18,95 80
0284189 NEXIAM 20 MG 98 CPR BLIST 0 0
29,31 80
0284242 NEXIAM 40 MG 28 CPR BLIST 0 0
18,49 80
A02BX02 sucralfate
0139157 KEAL 1 G 30 CPR 0 0
8,03 80
0150185 KEAL 1 G 30 SACH 0 0
8,03 80
0190163 KEAL 2 G 15 SACH 0 0
7,71 80
0122275 ULCOGANT 1 G/5 ML SUSP 250 ML 0 0
18,02 80
0122261 ULCOGANT 1 G/5 ML SUSP 50 SACH 0 0
18,02 80
A02BX13 alginic acid
0282851 GAVISCON ADVANCE SUSP 500 ML 0 0
16,22 80
0048391 GAVISCON PDR 50 G 0 0
9,13 80
0258984 GAVISCON SUSP 500 ML (ANIS) 0 0
13,82 80
0118174 TOPAAL 42 CPR 0 0
3,41 80
A03AA04 mebeverine
0195481 DUSPATALIN 135 MG 120 DRG 0 0
13,60 80
0037434 DUSPATALIN 135 MG 40 DRG 0 0
9,15 80
0238687 MEBEVERINE EG 135 MG 120 CPR 0 0
9,37 80
0255738 MEBEVERINE EG 135 MG 40 CPR 0 0
6,65 80
A03AB06 otilonium bromide
0151523 SPASMOMEN 40 MG 30 CPR 0 0
11,29 80
0206845 SPASMOMEN 40 MG 60 CPR 0 0
15,61 80
A03AX08 alverine
Page 3 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0285799 SPASMINE 60 MG 40 CAPS 0 0
12,14 80
0348935 SPASMINE FORTE 120 MG 40 CAPS 0 0
19,83 80
A03BA01 atropine
0009152 ATROPINSULFAT BRN 0,5 MG 10 AMP 1 ML V 0 0
2,23 80
A03BB01 butylscopolamine
0016451 BUSCOPAN 10 MG 50 DRG 0 0
7,99 80
0016482 BUSCOPAN 10 MG 6 SUPP 0 0
3,38 80
0016465 BUSCOPAN 20 MG 6 AMP 1 ML IMIVSC 0 0
4,38 80
A03DB04 butylscopolamine and analgesics
0016532 BUSCOPAN COMP 3 AMP 5 ML IMIV 0 0
5,98 80
A03FA01 metoclopramide
0031783 DIBERTIL 10 MG 30 CAPS 0 0
6,60 80
0031802 DIBERTIL 5 MG 30 CAPS 0 0
3,64 80
0047931 GASTRONERTON 20 CPR 0 0
2,47 80
0047945 GASTRONERTON 50 CPR 0 0
6,00 80
0048004 GASTRONERTON GTTS 20 ML 0 0
1,42 80
0048018 GASTRONERTON GTTS 50 ML 0 0
3,32 80
0235654 MCP HEXAL 0.4% GTTS 100 ML 0 0
5,73 80
0235641 MCP HEXAL 0.4% GTTS 30 ML 0 0
1,91 80
0235668 MCP HEXAL 10 MG 20 CPR 0 0
2,45 80
0235637 MCP HEXAL INJEKT 10 MG 5 AMP 2 ML 0 0
1,30 80
0070036 MCP RATIO 10 MG 20 CPR 0 0
2,47 80
0137068 MCP RATIO 10 MG 5 SUPP 0 0
1,32 80
0070053 MCP RATIO 10 MG 50 CPR 0 0
5,94 80
0070070 MCP RATIO GTTS 100 ML 0 0
5,72 80
0070067 MCP RATIO GTTS 30 ML 0 0
1,92 80
0136995 MCP RATIO RET 30 MG 10 CAPS 0 0
3,34 80
0137006 MCP RATIO RET 30 MG 50 CAPS 0 0
12,67 80
0173372 MCP RATIO SF 10 MG 5 AMP 2 ML IMIVSC 0 0
1,35 80
0178317 METOCLOPRAMIDE EG 10 MG 30 CAPS 0 0
5,89 80
0152131 PRIMPERAN 10 MG 30 CPR 0 0
7,61 80
0093724 PRIMPERAN 10 MG 6 AMP 2 ML IMIV 0 0
5,69 80
0093755 PRIMPERAN 10 MG 6 SUPP ENF 0 0
5,50 80
0093741 PRIMPERAN 20 MG 6 SUPP AD 0 0
6,46 80
0152145 PRIMPERAN 5 MG/5 ML SIR 200 ML 0 0
6,38 80
0182564 PROKINYL LP 15 MG 30 CAPS 0 0
2,83 80
A03FA03 domperidone
0457747 DOMPERIDONE EG 10 MG 30 CPR 0 0
6,73 80
0560931 DOMPERIDONE EG 10 MG 30 CPR ORODISP 0 0
8,78 80
0073685 MOTILIUM 1 MG/ML SIR 200 ML 17482 0 0
5,82 80
0073640 MOTILIUM 10 MG 30 CPR 17473 0 0
8,54 80
0073699 MOTILIUM 10 MG 6 SUPP BB 17483 0 0
2,96 80
0073704 MOTILIUM 30 MG 6 SUPP ENF 17484 0 0
4,59 80
0073718 MOTILIUM 60 MG 6 SUPP AD 17485 0 0
7,76 80
0158251 MOTILIUM GRAN EFF 20 SACH 63051 0 0
9,04 80
0482266 MOTILIUM INSTANT 10 MG 20 CPR FONDANTS 0 0
10,20 80
0482283 MOTILIUM INSTANT 10 MG 30 CPR FONDANTS 0 0
10,98 80
0235591 MOTILIUM PED 1 MG/ML SOL 100 ML 63138 0 0
4,65 80
0509633 OROPERIDYS 10 MG 30 CPR 0 0
8,75 80
A03FA05 alizapride
0066632 LITICAN 50 MG 20 CPR 0 0
9,21 80
0066663 LITICAN 50 MG 6 AMP 2 ML 0 0
7,13 80
A04A ANTIEMETICS AND ANTINAUSEANTS
0451435 EMESAN K 20 MG 10 SUPP 0 0
5,69 40
0451421 EMESAN K 20 MG 5 SUPP 0 0
3,40 40
A04AA01 ondansetron
0230806 ZOFRAN 16 MG 5 SUPP 0 0
58,04 100
0275677 ZOFRAN ZYDIS 8 MG 10 LYO 0 0
69,08 100
A04AA02 granisetron
0220781 KYTRIL 1 MG 10 CPR 0 0
58,54 100
A04AA03 tropisetron
0185583 NAVOBAN 5 MG 5 CAPS 0 0
91,36 100
A05AA02 ursodeoxycholic acid
0139773 URSOCHOL 150 MG 50 CPR 0 0
21,84 80
Page 4 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0228311 URSOCHOL 300 MG 100 CPR 0 0
56,61 80
0293076 URSOFALK 250 MG 100 CAPS 0 0
46,79 80
0123823 URSOFALK 250 MG 50 CAPS 0 0
27,22 80
A05AX02 hymecromone
0018344 CANTABILINE 30 CAPS 0 0
6,10 40
0018358 CANTABILINE 90 CAPS 0 0
14,88 40
A05BA03 silymarin
0301018 CEFASILYMARIN 105 MG 100 CPR 0 0
39,58 40
0301004 CEFASILYMARIN 105 MG 60 CPR 0 0
24,26 40
0064820 LEGALON FORTE 140 MG 60 CAPS 0 0
43,07 40
A05BA06 ornithine oxoglurate
0052735 HEPAMERZ 10 AMP 10 ML PERF 0 0
85,55 40
0246093 HEPAMERZ GRAN 3000 30 SACH 5 G 0 0
44,82 40
0052718 HEPAMERZ GRAN 3000 50 SACH 5 G 0 0
69,74 40
A06AA01 liquid paraffin
0269151 LANSOYL PARAFFINE GELEE 225 G 0 0
5,08 40
A06AB02 bisacodyl
0245664 DULCOLAX BISACODYL 10 MG 10 SUPP 0 0
6,49 40
0245647 DULCOLAX BISACODYL 5 MG 40 DRG 0 0
4,85 40
0207677 LAXANS RATIO 10 MG 10 SUPP 0 0
3,30 40
0207663 LAXANS RATIO 10 MG 5 SUPP 0 0
1,71 40
0216712 LAXANS RATIO 5 MG 30 CPR 0 0
2,03 40
0197151 PURGO PIL NF 10 MG 30 DRG 0 0
5,83 40
0382355 TEMPOLAX FORTE 7,5 MG 42 DRG 0 0
4,95 40
A06AB06 senna glycosides
0462246 SENOKOT 7,5 MG 40 CPR 0 0
5,07 40
A06AB08 sodium picosulfate
0064266 LAXOBERON 0,75% GTTS 15 ML 0 0
5,64 40
A06AB09 bisoxatin
0130134 WYLAXINE 20 CPR 0 0
4,29 40
A06AB20 contact laxatives in combination
0169241 PREPACOL SET 4 CPR + SOL 30 ML 0 0
7,44 40
0179183 SOFTENE 30 CPR 0 0
3,74 40
A06AB56 senna glycosides, combinations
0281934 AGIOLAX GRAN 100 G 0 0
5,64 40
0158152 AGIOLAX GRAN 250 G 0 0
9,45 40
0137443 DARLIN 40 DRG 0 0
6,82 40
0095195 PRUNASINE SIR 200 ML 0 0
7,52 40
A06AB57 cascara, combinations
0036146 REX 40 DRG 0 0
6,28 40
A06AC01 ispaghula (psylla seeds)
0175976 AGIOCUR GRAN 250 G 0 0
17,20 40
0182578 PSYLIA PDR 20 SACH 0 0
3,53 40
A06AC03 sterculia
0225421 NORMACOL GRAN 30 SACH 10 G 0 0
10,48 40
0079921 NORMACOL GRAN 375 G 0 0
10,48 40
A06AC51 ispaghula, combinations
0374161 PARAPSYLLIUM PDR 10 SACH 0 0
3,57 40
A06AD11 lactulose
0013317 BIFITERAL 500 ML 0 0
9,08 40
0203888 DUPHALAC DRY PDR 20 SACH 0 0
11,79 40
0203907 DUPHALAC DRY PDR 350 G 0 0
16,47 40
0398064 DUPHALAC FRUIT 10 G 20 SACH 15 ML 0 0
10,04 40
0156127 DUPHALAC SIR 20 SACH 15 ML 0 0
10,04 40
0037059 DUPHALAC SIR 300 ML 0 0
8,00 40
0037062 DUPHALAC SIR 500 ML 0 0
11,47 40
0235171 LACTULOSE EG 670 MG/ML SIR 300 ML 0 0
6,40 40
0235184 LACTULOSE EG 670 MG/ML SIR 500 ML 0 0
9,17 40
0216757 LACTULOSE RATIO SIR 1000 ML 0 0
15,66 40
0216726 LACTULOSE RATIO SIR 200 ML 0 0
4,22 40
0216743 LACTULOSE RATIO SIR 500 ML 0 0
8,94 40
A06AD12 lactitol
Page 5 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0143423 IMPORTAL PDR 20 SACH 10 G 0 0
14,45 40
A06AD15 macrogol
0297125 FORLAX 20 SACH 10 G 0 0
13,51 40
A06AD17 sodium phosphate
0511581 FLEET PHOSPHO SODA SOL 45 ML 0 0
7,85 40
A06AD65 macrogol, combinations
0344273 COLOFORT 4 SACH 0 0
13,60 40
0154007 COLOPEG PDR 1 SACH 0 0
3,58 40
0399769 ENDOFALK 6 SACH 0 0
12,42 40
0184958 KLEAN PREP SHAKER 4 SACH 0 0
16,15 40
0498821 LAXIDO NATURAL PDR 20 SACH 0 0
10,00 40
0498848 LAXIDO NATURAL PDR 50 SACH 0 0
22,79 40
0498767 LAXIDO ORANGE PDR 20 SACH 0 0
10,00 40
0498784 LAXIDO ORANGE PDR 50 SACH 0 0
22,79 40
0578398 MOLAXOLE PDR 20 SACH 0 0
9,70 40
0233663 MOVICOL 20 SACH 0 0
13,46 40
0516462 MOVICOL CHOCOLATE 20 SACH 0 0
13,46 40
0445861 MOVICOL JR NEUTRAL 30 SACH 0 0
13,46 40
0516266 MOVICOL NEUTRAL 20 SACH 0 0
13,46 40
0453295 MOVIPREP PDR 4 SACH 0 0
16,93 40
0279872 TRANSIPEG 2,95 30 SACH 0 0
9,00 40
0285575 TRANSIPEG PDR 20 SACH 5,9 G 0 0
9,14 40
A06AG01 sodium phosphate
0045081 FLEET ENEMA AD SOL 133 ML 0 0
2,50 80
0045095 FLEET ENEMA ENF SOL 66,6 ML 0 0
2,32 80
0229366 LAVEMENT AU PHOSPHATE NORGINE 130 ML 0 0
2,74 80
0092694 PRACTOCLYSS 1 LAV 120 ML 0 0
1,69 80
A06AG04 glycerol
0240721 BABYLAX GEL 2*3 TUBES 0 0
7,70 40
0240718 BABYLAX GEL 3 TUBES 0 0
4,26 40
A06AG10 docusate sodium, incl. combinations
0163765 NORGALAX SOL 6 TUBES 10 G 0 0
6,40 80
A06AH01 methylnaltrexone bromide
0486928 RELISTOR 12 MG 1 FL 0,6 ML SC 0 0
41,62 80
0486945 RELISTOR 12 MG 7 FL 0,6 ML+7 SRG+14 TAMP 0 0
191,22 80
A06AX02 carbon dioxide producing drugs
0182547 EDUCTYL 12 SUPP AD 0 0
2,16 40
0182533 EDUCTYL 12 SUPP ENF 0 0
1,24 40
A07AA02 nystatin
0017977 CANDIO HERMAL SUSP BUV 24 ML 0 0
5,86 80
0078745 NILSTAT GTTS OR 30 ML 0 0
4,53 80
0081205 NYSTATINE SUSP LIQ 24 D 0 0
6,82 80
A07AA06 paromomycin
0047380 GABBRORAL 250 MG 16 CAPS 0 0
9,10 80
A07AX03 nifuroxazide
0231848 BACIFURANE 200 MG 16 CAPS 0 0
4,00 80
0141673 NIFUROXAZIDE EURGN 200 MG 16 CAPS 0 0
3,37 80
0180363 NIFUROXAZIDE EURGN 200 MG 28 CAPS 0 0
5,13 80
0182595 PANFUREX 200 MG 28 CAPS 0 0
3,38 80
0182601 PANFUREX GE 4% SUSP 90 ML 0 0
2,83 80
A07BA01 medicinal charcoal
0290253 KOHLE COMPRETTEN 250 MG 30 CPR 0 0
7,34 80
0290267 KOHLE COMPRETTEN 250 MG 60 CPR 0 0
12,11 80
0079899 NORIT 200 MG 30 CAPS 0 0
5,81 80
A07BA51 medicinal charcoal, combinations
0018540 CARBOBEL SIMPLEX 30 CPR 0 0
5,53 80
0018554 CARBOBEL SIMPLEX GRAN 70 G 0 0
6,33 80
0018604 CARBOLACTANOSE 30 CAPS 0 0
6,71 40
0134178 CARBOSYLANE 24 D 48 CAPS 0 0
4,15 80
0134164 CARBOSYLANE 48 D 96 CAPS 0 0
6,75 80
A07BC04 attapulgite
0000482 ACTAPULGITE 30 SACH 0 0
2,56 80
A07BC05 diosmectite
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0105632 SMECTA 30 SACH 0 0
5,63 80
A07CA Oral rehydration salt formulations
0038736 ELOTRANS 10 SACH 3660851 0 0
4,07 80
0203938 ORALPAEDON 240 10 BTL 3550521 0 0
4,07 80
0229383 ORALPAEDON 240 ERDBEERE 10 SACH 3552521 0 0
4,07 80
A07DA03 loperamide
0224888 DYSPAGON 2 MG 6 CAPS 0 0
3,20 80
0056135 IMODIUM 2 MG 20 CAPS 17469 0 0
7,38 80
0056149 IMODIUM 2 MG 60 CAPS 17471 0 0
11,89 80
0233968 IMODIUM INSTANT 2 MG 20 CPR 140829 0 0
8,65 80
0233971 IMODIUM INSTANT 2 MG 60 CPR 140831 0 0
16,23 80
0056166 IMODIUM SOL BUV 100 ML 27231 0 0
6,69 80
0176309 LOPEDIUM 2 MG 10 CAPS 0 0
1,90 80
0197571 LOPEDIUM 2 MG 20 CAPS 0 0
3,80 80
0176312 LOPEDIUM 2 MG 50 CAPS 0 0
7,11 80
0187512 LOPEDIUM 2 MG/ML SOL 10 ML 0 0
3,87 80
0187526 LOPEDIUM 2 MG/ML SOL 20 ML 0 0
6,99 80
0182497 LOPERAMID RATIO 2 MG 10 CPR PELLIC 0 0
3,08 80
0182502 LOPERAMID RATIO 2 MG 20 CPR PELLIC 0 0
5,43 80
0182516 LOPERAMID RATIO 2 MG 50 CPR PELLIC 0 0
9,52 80
0259799 LOPERAMID RATIO AKUT 2 MG 10 CPR 0 0
2,57 80
0205168 LOPERAMIDE EG 2 MG 20 CAPS 0 0
5,91 80
0205171 LOPERAMIDE EG 2 MG 60 CAPS 0 0
8,31 80
A07EA06 budesonide
0286278 BUDENOFALK 3 MG 100 CAPS 0 0
87,16 80
0286264 BUDENOFALK 3 MG 50 CAPS 0 0
57,19 80
0227991 ENTOCORT 3 MG 100 CAPS 0 0
84,73 80
0190213 ENTOCORT ENEMA LAVT 7 CPR + 7 FL P 0 0
45,48 80
A07EC01 sulfasalazine
0101776 SALAZOPYRINE 500 MG 100 CPR 0 0
12,14 100
0101809 SALAZOPYRINE EC 500 MG 100 DRG 0 0
13,58 100
0101812 SALAZOPYRINE EC 500 MG 300 DRG 0 0
29,75 100
A07EC02 mesalazine
0022865 CLAVERSAL 250 MG 100 CPR 0 0
19,79 100
0022896 CLAVERSAL 250 MG 120 SUPP 0 0
38,62 100
0022882 CLAVERSAL 250 MG 30 SUPP 0 0
14,76 100
0151281 CLAVERSAL 250 MG 300 CPR 0 0
39,15 100
0296985 CLAVERSAL 500 MG 100 CPR 0 0
35,13 100
0150771 CLAVERSAL 500 MG 15 SUPP 0 0
16,68 100
0296999 CLAVERSAL 500 MG 300 CPR 0 0
70,08 100
0150784 CLAVERSAL 500 MG 60 SUPP 0 0
46,43 100
0210817 CLAVERSAL FOAM MOUSSE US RECT 1 FL 14 D 0 0
36,31 100
0023974 COLITOFALK 250 MG 100 CPR 0 0
19,53 100
0024002 COLITOFALK 250 MG 120 SUPP 0 0
45,65 100
0023991 COLITOFALK 250 MG 30 SUPP 0 0
16,44 100
0168051 COLITOFALK 500 MG 10 SUPP 0 0
12,32 100
0168101 COLITOFALK 500 MG 100 CPR 0 0
30,05 100
0168081 COLITOFALK 500 MG 120 SUPP 0 0
76,10 100
0189503 COLITOFALK 500 MG 20 CPR 0 0
10,87 100
0168064 COLITOFALK 500 MG 30 SUPP 0 0
25,98 100
0189517 COLITOFALK 500 MG 300 DRG 0 0
62,33 100
0176925 COLITOFALK SUSP 2 G 7 LAV 60 G 0 0
30,07 100
0136852 COLITOFALK SUSP 4 G 7 LAV 60 G 0 0
35,88 100
0206988 PENTASA 1 G 14 SUPP 0 0
29,70 100
0298525 PENTASA 1 G 150 SACH 0 0
130,04 100
0298511 PENTASA 1 G 50 SACH 0 0
55,57 100
0149198 PENTASA 10 MG/ML 7 LAVT 100 ML 0 0
28,70 100
0557001 PENTASA 2 G 120 SACH 0 0
196,95 100
0181262 PENTASA 500 MG 300 CPR 0 0
118,33 100
0181245 PENTASA 500 MG 90 CPR 0 0
34,50 100
A07FA01 lactic acid producing organisms
0211554 LACTEOL 20 CAPS 0 0
8,07 40
A07FA02 saccharomyces boulardii
0428812 ENTEROL 250 MG 10 CAPS 0 0
8,70 40
0428861 ENTEROL 250 MG 10 SACH 0 0
8,70 40
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0428826 ENTEROL 250 MG 20 CAPS 0 0
16,03 40
0428874 ENTEROL 250 MG 20 SACH 0 0
16,03 40
0428843 ENTEROL 250 MG 50 CAPS 0 0
34,93 40
A09AA Enzyme preparations
0044344 FERMENTO DUODENAL 50 CAPS 0 0
25,93 80
A09AA02 multienzymes (lipase, protease etc.)
0024369 COMBIZYM 100 DRG 0 0
22,48 80
0024355 COMBIZYM 50 DRG 0 0
13,39 80
0277539 CREON 150 MG 100 CAPS 0 0
19,79 80
0298296 CREON FORTE 300 MG 100 CAPS 0 0
44,28 80
0167876 PANZYTRAT 10000 100 CAPS 0 0
23,23 80
0167751 PANZYTRAT 10000 50 CAPS 0 0
12,79 80
0251286 PANZYTRAT 25000 U 100 CAPS 0 0
48,93 80
0251272 PANZYTRAT 25000 U 50 CAPS 0 0
26,92 80
A10AB01 insulin (human)
0147016 HUMULINE REGULAR 100 U 1*10 ML 0 0
21,83 100
0202474 HUMULINE REGULAR 100 U 5*3 ML CRT 0 0
32,17 100
0365032 INSUL ACTRAPID 100 U 1*10 ML 0 0
17,68 100
0365046 INSUL ACTRAPID PF 100 U 5*3 ML 0 0
32,07 100
A10AB04 insulin lispro
0221869 HUMALOG 100 U 1*10 ML 0 0
24,53 100
0221872 HUMALOG 100 U 5*1,5 ML CRT 0 0
24,06 100
0235265 HUMALOG 100 U 5*3 ML CRT 0 0
38,16 100
A10AB05 insulin aspart
0268946 INSUL NOVORAPID 100 U 1*10 ML 0 0
24,53 100
0291474 INSUL NOVORAPID FLEXPEN 100U 5STYLOS 3ML 0 0
41,27 100
0268977 INSUL NOVORAPID PF 100 U 5*3 ML 0 0
38,16 100
A10AB06 insulin glulisine
0388801 APIDRA 100 U/ML 1 FL 10 ML SC 0 0
23,67 100
0388881 APIDRA 100 U/ML 5 CRT 3 ML SC 0 0
36,62 100
0470928 APIDRA 100 U/ML 5 STYLOS SOLOSTAR 3ML SC 0 0
39,59 100
A10AC01 insulin (human)
0146974 HUMULINE NPH 100 U 1*10 ML 0 0
21,83 100
0202491 HUMULINE NPH 100 U 5*3 ML CRT 0 0
32,17 100
0336711 INSUL INSULATARD 100 U 1*10 ML 0 0
17,68 100
0336769 INSUL INSULATARD PF 100 U 5*3 ML 0 0
32,07 100
A10AD01 insulin (human)
0146795 HUMULINE 30/70 100 U 1*10 ML 0 0
21,83 100
0202538 HUMULINE 30/70 100 U 5*3 ML CRT 0 0
32,17 100
0365077 INSUL MIXTARD 30 100 U 1*10 ML 0 0
18,87 100
0365113 INSUL MIXTARD 30 PF 100 U 5*3 ML 0 0
34,34 100
A10AD04 Insulin lispro
0511953 HUMALOG KWIKPEN 100 U 5*3 ML 0 0
41,27 100
0259639 HUMALOG MIX 25 100 U 5*3 ML CRT 0 0
38,16 100
0511971 HUMALOG MIX 25 KWIKPEN 100 U 5*3 ML 0 0
41,27 100
0259656 HUMALOG MIX 50 100 U 5*3 ML CRT 0 0
38,16 100
0511998 HUMALOG MIX 50 KWIKPEN 100 U 5*3 ML 0 0
41,27 100
A10AD05 insulin aspart
0291426 INSUL NOVOMIX 30 FLEXPEN 100U 5*3 ML 0 0
41,27 100
0287678 INSUL NOVOMIX 30 PF 100U 5*3 ML 0 0
38,16 100
0468348 INSUL NOVOMIX 50 FLEXPEN 100U 5*3 ML 0 0
41,27 100
0468334 INSUL NOVOMIX 50 PF 100U 5*3 ML 0 0
38,16 100
0468365 INSUL NOVOMIX 70 FLEXPEN 100U 5*3 ML 0 0
41,27 100
0468351 INSUL NOVOMIX 70 PF 100U 5*3 ML 0 0
38,16 100
A10AE04 insulin glargine
0282167 LANTUS 100 U/ML 5 CRT 3 ML SC 0 0
57,86 100
0441408 LANTUS 100U/ML 5CRT SOLOSTAR 3ML+5STYLOS 0 0
57,86 100
A10AE05 insulin detemir
0382386 LEVEMIR 100 U/ML 5 CRT PF 3 ML SC 0 0
64,04 100
0382422 LEVEMIR 100 U/ML 5 STYLOS PRER FLEX 3ML 0 0
66,84 100
A10BA02 metformin
0194484 GLUCOPHAGE 500 MG 60 CPR 0 0
6,20 100
0194498 GLUCOPHAGE 850 MG 100 CPR 0 0
8,11 100
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0289297 METFORMAX 850 MG 120 CPR 0 0
9,03 100
0289283 METFORMAX 850 MG 40 CPR 0 0
6,23 100
A10BB01 glibenclamide
0027892 DAONIL 5 MG 100 CPR 0 0
16,27 100
0027889 DAONIL 5 MG 30 CPR 0 0
8,64 100
0042370 EUGLUCON 5 100 CPR 0 0
19,05 100
A10BB07 glipizide
0049614 GLIBENESE 5 MG 100 CPR 0 0
15,22 100
0072450 MINIDIAB 5 MG 90 CPR 0 0
14,09 100
A10BB08 gliquidone
0154069 GLURENORM 30 MG 100 CPR 0 0
14,36 100
0154055 GLURENORM 30 MG 40 CPR 0 0
9,23 100
A10BB09 gliclazide
0569841 DIAMICRON 60 MG 30 CPR 0 0
11,43 100
0569886 DIAMICRON 60 MG 90 CPR 0 0
32,34 100
0031444 DIAMICRON 80 MG 60 CPR 0 0
18,96 100
0290592 DIAMICRON MR 30 MG 60 CPR MODIF RELEASE 0 0
18,98 100
A10BB12 glimepiride
0244636 AMARYLLE 2 MG 30 CPR 0 0
8,64 100
0244653 AMARYLLE 2 MG 90 CPR 0 0
17,68 100
0351233 AMARYLLE 3 MG 30 CPR 0 0
10,93 100
0351328 AMARYLLE 4 MG 30 CPR 0 0
13,21 100
0416937 GLIMEPIRID HEXAL 1 MG 120 CPR 0 0
11,67 100
0416891 GLIMEPIRID HEXAL 1 MG 30 CPR 0 0
4,80 100
0416985 GLIMEPIRID HEXAL 2 MG 120 CPR 0 0
17,18 100
0416954 GLIMEPIRID HEXAL 2 MG 30 CPR 0 0
6,60 100
0417044 GLIMEPIRID HEXAL 3 MG 120 CPR 0 0
23,96 100
0417013 GLIMEPIRID HEXAL 3 MG 30 CPR 0 0
9,00 100
0417092 GLIMEPIRID HEXAL 4 MG 120 CPR 0 0
29,68 100
0417061 GLIMEPIRID HEXAL 4 MG 30 CPR 0 0
12,34 100
0417142 GLIMEPIRID HEXAL 6 MG 120 CPR 0 0
44,10 100
0417111 GLIMEPIRID HEXAL 6 MG 30 CPR 0 0
15,64 100
A10BD02 metformin and sulfonamides
0474961 EUCREAS 50/1000 MG 180 CPR BLIST 0 0
130,40 100
0474944 EUCREAS 50/1000 MG 60 CPR BLIST 0 0
53,89 100
0474863 EUCREAS 50/850 MG 180 CPR BLIST 0 0
130,40 100
0474832 EUCREAS 50/850 MG 60 CPR BLIST 0 0
53,89 100
0325748 GLUCOVANCE 500/2,5 MG 120 CPR 0 0
16,84 100
0325877 GLUCOVANCE 500/5 MG 120 CPR 0 0
16,84 100
A10BD07 metformin and sitagliptin
0488161 JANUMET 50/1000 MG 196 CPR 0 0
141,28 100
0488131 JANUMET 50/1000 MG 56 CPR 0 0
50,78 100
0488081 JANUMET 50/850 MG 196 CPR 0 0
141,28 100
0488046 JANUMET 50/850 MG 56 CPR 0 0
50,78 100
A10BF01 acarbose
0173114 GLUCOBAY 100 MG 60 CPR 0 0
19,30 100
0173101 GLUCOBAY 50 MG 120 CPR 0 0
25,73 100
A10BG03 pioglitazone
0287809 ACTOS 15 MG 28 CPR 0 0
34,34 100
0287826 ACTOS 15 MG 98 CPR 0 0
86,19 100
0287843 ACTOS 30 MG 28 CPR 0 0
50,81 100
0287861 ACTOS 30 MG 98 CPR 0 0
130,35 100
A10BH01 sitagliptin
0453636 JANUVIA 100 MG 28 CPR 0 0
45,76 100
0453671 JANUVIA 100 MG 98 CPR 0 0
141,73 100
A10BH02 vildagliptin
0470363 GALVUS 50 MG 180 CPR 0 0
130,05 100
0470329 GALVUS 50 MG 60 CPR 0 0
53,89 100
A10BH03 saxagliptin
0528897 ONGLYZA 5 MG 28 CPR 0 0
46,99 100
0528916 ONGLYZA 5 MG 98 CPR 0 0
127,51 100
A10BX02 repaglinide
0256381 NOVONORM 0,5 MG 120 CPR 0 0
25,36 100
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0256461 NOVONORM 1 MG 120 CPR 0 0
25,36 100
0256539 NOVONORM 2 MG 120 CPR 0 0
25,36 100
A10BX03 nateglinide
0297836 STARLIX 120 MG 120 CPR 0 0
58,94 100
0297805 STARLIX 120 MG 30 CPR 0 0
21,08 100
0297755 STARLIX 60 MG 120 CPR 0 0
58,94 100
0297724 STARLIX 60 MG 30 CPR 0 0
21,08 100
A10BX04 exenatide
0454163 BYETTA 10 MCG 1 STYLO 2,4 ML SC 0 0
102,51 100
0454132 BYETTA 5 MCG 1 STYLO 1,2 ML SC 0 0
101,65 100
A10BX07 liraglutide
0533852 VICTOZA 6 MG/ML 2 STYLOS 3 ML SC 0 0
102,63 100
A11CC03 alfacalcidol
0258953 1 ALPHA LEO 0,25 MCG 30 CAPS 0 0
8,72 80
0258967 1 ALPHA LEO 0,25 MCG 50 CAPS 0 0
11,30 80
0258971 1 ALPHA LEO 1 MCG 50 CAPS BLIST 0 0
29,15 80
0559876 1 ALPHA LEO 2 MCG/ML 10 AMP 0,5 ML 0 0
45,60 80
0559893 1 ALPHA LEO 2 MCG/ML 10 AMP 1 ML 0 0
106,37 80
0559909 1 ALPHA LEO 2 MCG/ML GTTS 1 FL 10 ML 0 0
16,00 80
A11CC04 calcitriol
0330202 ROCALTROL 0,25 MCG 30 CAPS BLIST 0 0
11,22 80
0330216 ROCALTROL 0,5 MCG 30 CAPS BLIST 0 0
15,60 80
A11CC05 colecalciferol
0233341 D CURE 25000 U/ML 4 AMP 0 0
3,89 80
0176729 D CURE GTTS 10 ML 0 0
2,96 80
0193683 UVEDOSE 100000 U 1 AMP BUV 2 ML 0 0
1,78 80
0127562 VIGANTOLETTEN 1000 U 90 CPR 0 0
6,20 80
0127576 VIGANTOLETTEN 500 U 90 CPR 0 0
5,30 80
0241617 VITAM D3 B.O.N. 200000 U 1 AMP 1 ML 0 0
1,84 80
A11CC20 combinations
0045713 FLUOR VIGANTOLETTEN 1000 90 CPR 0 0
6,10 80
0045727 FLUOR VIGANTOLETTEN 500 90 CPR 0 0
5,02 80
A11DA01 thiamine (vit B1)
0011987 BENERVA 300 MG 20 CPR 0 0
3,50 80
0012760 BETAMINE 500 MG 50 DRG 0 0
7,13 80
A11DB Vitamin B1 in combination with vitamin B6 and/or vitamin B12
0269281 BEFACT FORTE B1 B2 B6 B12 100 DRG 0 0
19,40 80
0226561 BEFACT FORTE B1 B2 B6 B12 30 DRG 0 0
7,66 80
0078048 NEUROBION 3 AMP 3 ML 0 0
7,77 80
0172666 NEUROBION N FORTE 100 DRG 0 0
21,61 80
0172327 NEUROBION N FORTE 50 DRG 0 0
12,54 80
0205512 NEUROTRAT S FORTE 60 DRG 0 0
10,51 80
0107086 SOPALAMIN PDR 6 FL + S 2 ML IM 0 0
6,98 80
A11HA01 nicotinamide
0166073 UCEMINE PP 100 MG 50 CPR 0 0
4,62 80
A11HA02 pyridoxine (vit B6)
0096046 PYRIDOXINE 250 MG 20 CPR 0 0
4,91 80
A11HA04 riboflavin (vit B2)
0145302 BERIVINE 50 MG 40 DRG 0 0
5,05 80
0099647 RIBON 10 A 50 CPR 0 0
2,33 80
A12AA04 calcium carbonate
0211473 CALCICHEW 500 MG 100 CPR (FL) 0 0
23,52 80
0241696 CALPEROS 500 MG 60 CPR 0 0
7,90 80
A12AA12 calcium acetate anhydrous
0428907 CALCIUMACETAT NEFRO 500 MG 100 CPR 0 0
8,58 80
0428911 CALCIUMACETAT NEFRO 500 MG 200 CPR 0 0
15,62 80
0428938 CALCIUMACETAT NEFRO 700 MG 100 CPR 0 0
10,71 80
0428941 CALCIUMACETAT NEFRO 700 MG 200 CPR 0 0
19,51 80
A12AA20 calcium (different salts in combination)
0134151 CALCIFORTE 500 MG 30 AMP BUV 10 ML 0 0
6,79 80
0017087 CALCIPOT 200 CPR 0 0
12,76 80
0017073 CALCIPOT 50 CPR 0 0
4,36 80
0017400 CALCIUM SDZ FORT 1000 MG 20 CPR EFF 0 0
8,40 80
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A12AX Calcium, combinations with other drugs
0219048 CACIT VIT D3 1 G/880 U GRAN 30 SACH 0 0
18,06 80
0219021 CACIT VIT D3 500 MG/440 U GRAN 30 SACH 0 0
9,04 80
0421257 CAD 1000 MG 880 U CITROEN 30 SACH 0 0
15,65 80
0421243 CAD 500 MG 440 U CITROEN 30 SACH 0 0
8,91 80
0380106 CALCIFORTE VIT D3 500 MG 400 U 60 CPR 0 0
8,10 80
0525671 CALCIGEN D FORTE 1000MG 880U 20 CPR EFF 0 0
10,71 80
0525685 CALCIGEN D FORTE 1000MG 880U 40 CPR EFF 0 0
18,95 80
0241648 CALPEROS D3 60 CPR A SUCER 0 0
8,04 80
0252798 D VITAL 500/440 GRAN EFF 30 SACH 0 0
10,20 80
0252803 D VITAL FORTE 1000/880 GRAN EFF 30 SACH 0 0
16,03 80
0462666 D VITAL FORTE 1000/880 GRAN EFF 90 SACH 0 0
38,43 80
0435011 EPTAVIT 1000 MG 880 U 30 CPR EFF 0 0
8,04 80
0450831 EPTAVIT 1000 MG 880 U 90 CPR EFF 0 0
23,00 80
0554897 STEOVIT D3 CITRON 1000MG/800U 28 CPR BLI 0 0
14,67 80
0554933 STEOVIT D3 CITRON 1000MG/800U 84 CPR 0 0
35,47 80
0505147 STEOVIT D3 ORANGE 1000MG/880U 2*15CPR EF 0 0
15,72 80
0505164 STEOVIT D3 ORANGE 1000MG/880U 6*15CPR EF 0 0
35,61 80
A12BA01 potassium chloride
0021384 CHLOROPOTASSURYL 1 G 10 AMP BUV 0 0
4,47 80
0060947 KALINOR RET P 600 MG 50 CAPS 0 0
7,41 80
0203861 KALITRANS RET 600 MG 50 CAPS 3501501 0 0
6,72 80
A12BA04 potassium hydrogencarbonate
0060883 KALINOR 15 CPR EFF 0 0
7,47 80
0060897 KALINOR 30 CPR EFF 0 0
14,20 80
A12BA05 potassium gluconate
0122552 ULTRA K SOL 200 ML 0 0
4,45 80
A12CC02 magnesium sulfate
0107976 SPASMAG 30 AMP BUV 5 ML 0 0
5,50 80
0107962 SPASMAG 60 CAPS 0 0
5,50 80
A12CC03 magnesium gluconate
0122700 ULTRA MAGNESIUM 162 MG 40 SACH 0 0
13,83 80
A12CC05 magnesium aspartate
0215195 MAGIUM 20 CPR A MACHER 0 0
3,30 80
0272238 MAGNEROT A 100 MG 20 SACH 0 0
5,48 80
0272241 MAGNEROT A 100 MG 50 SACH 0 0
12,15 80
0272269 MAGNEROT A 300 MG 20 SACH 0 0
8,75 80
0272272 MAGNEROT A 300 MG 50 SACH 0 0
20,25 80
0272305 MAGNEROT A 500 MG 20 SACH 0 0
16,68 80
0272319 MAGNEROT A 500 MG 50 SACH 0 0
36,04 80
0210137 MAGNESIUM SDZ 20 CPR EFF 02610 0 0
5,73 80
A12CC08 magnesium pidolate
0068931 MAG 2 12 AMP 10 ML IV 0 0
4,21 80
0215794 MAG 2 184 MG 30 SACH 0 0
3,99 80
0068914 MAG 2 30 AMP BUV 0 0
6,92 80
0415084 MAG 2 SANS SUCRE 30 AMP BUV 10 ML 0 0
6,92 80
A12CC10 magnesium oxide
0335324 MAGNOSANOL 50 CAPS 0 0
8,58 80
A12CC30 magnesium (different salts in combination)
0013799 BIOMAGNESIN 100 CPR 0 0
6,88 80
A12CD01 sodium fluoride
0137881 NATRIUMFLUORID BAER 25 MG 100 DRG 0 0
5,79 80
0075953 NATRIUMFLUORID BAER 25 MG 50 DRG 0 0
3,17 80
A14AB01 nandrolone
0028449 DECA DURABOLIN 50 MG 1 ORGAJECT 1 ML IM 0 0
9,00 80
0028452 DECA DURABOLIN 50 MG 2 ORGAJECT 1 ML IM 0 0
14,41 80
A16AX02 anethole trithione
0111335 SULFARLEM S25 60 DRG 0 0
4,79 40
B01AA Vitamin K antagonists
0218295 PREVISCAN 20 MG 30 CPR 0 0
4,55 100
B01AA03 warfarin
0069620 MAREVANE 5 MG 25 CPR 0 0
6,05 100
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B01AA04 phenprocoumon
0069603 MARCOUMAR 3 MG 25 CPR 0 0
5,77 100
B01AA07 acenocoumarol
0252624 SINTROM 1 MG 100 CPR 102241 0 0
6,24 100
0105291 SINTROM 4 MG 20 CPR 0 0
5,79 100
B01AB01 heparin
0156645 HEPARIN CA RATIO 12500 U 5 AMP 0,5 ML IV 0 0
11,08 80
0154833 HEPARIN CA RATIO 5000 U 10 SRG 0,2 ML IV 0 0
14,97 80
0154816 HEPARIN CA RATIO 5000 U 20 AMP 0,2ML IVS 0 0
17,74 80
0154802 HEPARIN CA RATIO 5000 U 5 AMP 0,2 ML IVS 0 0
5,13 80
0053018 HEPARIN LEO 25000 U 1 AMP 5 ML 0 0
3,73 80
0053021 HEPARIN NA BRN 25000 U 10 FL 5 ML IVSC 0 0
2,38 80
0053035 HEPARIN NA BRN 5000 U 10 AMP 0,5 ML IVSC 0 0
2,03 80
0173968 HEPARIN NA RATIO 25000 U 5 FL 5 ML IVSC 0 0
21,97 80
0154508 HEPARIN NA RATIO 5000 U 10 SRG 0,2 ML IV 0 0
14,97 80
0154492 HEPARIN NA RATIO 5000 U 20 AMP 0,2 ML 0 0
15,56 80
0154489 HEPARIN NA RATIO 5000 U 5 AMP 0,2 ML IVS 0 0
4,33 80
0164518 MONO EMBOLEX 3000 IE 10 SRG 0,3 ML 0 0
43,67 80
0164485 MONO EMBOLEX NM 20 AMP 0,5 ML SC 0 0
79,56 80
B01AB04 dalteparin
0206523 FRAGMIN 10000 U 10 SRG 1 ML IV 0 0
73,40 80
0261914 FRAGMIN 12500 U 5 SRG 0,5 ML SC 0 0
47,36 80
0261931 FRAGMIN 15000 U 5 SRG 0,6 ML SC 0 0
54,18 80
0261959 FRAGMIN 18000 U 5 SRG 0,72 ML SC 0 0
63,63 80
0191742 FRAGMIN 2500 U 10 SRG 0,2 ML SC 0 0
25,18 80
0191756 FRAGMIN 5000 U 10 SRG 0,2 ML SC 0 0
39,88 80
0219972 FRAGMIN 7500 U 10 SRG 0,75 ML SC 0 0
54,18 80
B01AB05 enoxaparin
0190485 CLEXANE 100 MG 10 SRG 1 ML IVSC 0 0
56,08 80
0316492 CLEXANE 120 MG 10 SRG 0,8 ML SCIV 0 0
77,21 80
0316489 CLEXANE 150 MG 10 SRG 1 ML SCIV 0 0
80,63 80
0173128 CLEXANE 20 MG 10 SRG 0,2 ML IVSCVI 0 0
23,57 80
0173145 CLEXANE 40 MG 10 SRG 0,4 ML IVSCVI 0 0
37,73 80
0267613 CLEXANE 60 MG 10 SRG 0,6 ML IVSC 0 0
43,85 80
0190454 CLEXANE 80 MG 10 SRG 0,8 ML IVSC 0 0
49,95 80
B01AB06 nadroparin
0163829 FRAXIPARINE 10000U 10 SRG 0,4 ML SC 0 0
30,49 80
0046531 FRAXIPARINE 15000U 10 SRG 0,6 ML SC 0 0
39,07 80
0163846 FRAXIPARINE 20000 U 10 SRG 0,8 ML SC 0 0
49,94 80
0217741 FRAXIPARINE 25000 U 10 SRG 1 ML SC 0 0
60,89 80
0046609 FRAXIPARINE 7500U 10 SRG 0,3 ML SC 0 0
24,70 80
0300637 FRAXODI 19000 U/ML 10 AMP SRG 0,6 ML 0 0
86,60 80
0300641 FRAXODI 19000 U/ML 10 AMP SRG 0,8 ML 0 0
112,56 80
0300654 FRAXODI 19000 U/ML 10 AMP SRG 1 ML 0 0
138,49 80
B01AB10 tinzaparin
0243978 INNOHEP 10000 U 10 SRG 0.5 ML SC 0 0
71,82 80
0243981 INNOHEP 14000 U 10 SRG 0.7 ML SC 0 0
97,03 80
0243995 INNOHEP 18000 U 10 SRG 0.9 ML SC 0 0
122,29 80
0243916 INNOHEP 2500 U 10 SRG 0,25 ML SC 0 0
24,71 80
0243947 INNOHEP 3500 U 10 SRG 0.35 ML SC 0 0
30,77 80
0243964 INNOHEP 4500 U 10 SRG 0.45 ML SC 0 0
36,16 80
B01AC04 clopidogrel
0541837 CLOPIDOGREL DOC 75 MG 28 CPR 0 0
13,05 80
0541868 CLOPIDOGREL DOC 75 MG 84 CPR 0 0
29,13 80
0560488 CLOPIDOGREL EG 75 MG 28 CPR 0 0
29,35 80
0560524 CLOPIDOGREL EG 75 MG 84 CPR 0 0
41,67 80
0537316 CLOPIDOGREL RATIO GMBH 75 MG 100 CPR 0 0
49,16 80
0537252 CLOPIDOGREL RATIO GMBH 75 MG 28 CPR 0 0
24,49 80
0253117 PLAVIX 75 MG 28 CPR 0 0
30,73 80
0253134 PLAVIX 75 MG 84 CPR 0 0
64,97 80
B01AC05 ticlopidine
0116829 TICLID 250 MG 30 DRG 0 0
15,69 80
0171218 TICLID 250 MG 60 DRG 0 0
23,66 80
0451354 TICLOPIDINE EG 250 MG 30 CPR 0 0
15,69 80
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0451368 TICLOPIDINE EG 250 MG 60 CPR 0 0
18,95 80
0451371 TICLOPIDINE EG 250 MG 90 CPR 0 0
30,50 80
B01AC06 acetylsalicylic acid
0169271 ASAFLOW 160 MG 56 CPR 0 0
9,31 80
0251952 ASAFLOW 80 MG 56 CPR ENTEROSOL 0 0
5,94 80
0207128 CARDEGIC 160 PDR 30 SACH 0 0
4,09 80
0207131 CARDEGIC 300 PDR 30 SACH 0 0
4,51 80
0517456 CARDIOASPIRINE 100 MG 28 CPR 0 0
3,60 80
0244667 CARDIOASPIRINE 100 MG 30 CPR 0 0
3,95 80
0517487 CARDIOASPIRINE 100 MG 56 CPR 0 0
6,08 80
0311791 CARDIOASPIRINE 100 MG 60 CPR 0 0
6,69 80
0517506 CARDIOASPIRINE 100 MG 84 CPR 0 0
9,12 80
0189405 HERZ ASS RATIO 100 MG 100 CPR 0 0
3,08 80
0189386 HERZ ASS RATIO 100 MG 50 CPR 0 0
1,85 80
B01AC07 dipyridamole
0134648 DIPYRIDAMOLE EG 75 MG 100 DRG 0 0
6,75 80
0088934 PERSANTINE 75 MG 100 DRG 0 0
9,17 80
0088982 PERSANTINE RET 200 MG 60 CAPS 0 0
12,53 80
0135208 PERSANTINE RET GE 150 MG 60 CAPS 0 0
9,96 80
B01AC22 prasugrel
0516977 EFIENT 10 MG 28 CPR 1 1
55,64 80
0517005 EFIENT 10 MG 84 CPR 1 1
151,23 80
0516641 EFIENT 5 MG 28 CPR 1 1
55,64 80
0516672 EFIENT 5 MG 84 CPR 1 1
151,23 80
B01AC30 combinations
0289008 AGGRENOX 60 CAPS 0 0
16,49 80
B01AE07 dabigatran etexilate
0481871 PRADAXA 110 MG 10 CAPS 1 13
26,88 80
0481899 PRADAXA 110 MG 60 CAPS 1 13
127,94 80
0481837 PRADAXA 75 MG 10 CAPS 1 13
26,88 80
0481854 PRADAXA 75 MG 60 CAPS 1 13
127,94 80
B01AX06 rivaroxaban
0494253 XARELTO 10 MG 10 CPR 1 13
57,61 80
0494267 XARELTO 10 MG 30 CPR 1 13
128,01 80
B02AA02 tranexamic acid
0043378 EXACYL 10 AMP BUV 10 ML 0 0
12,76 80
0043350 EXACYL 250 MG 100 CPR 0 0
18,99 80
0218301 EXACYL 250 MG 50 CPR 0 0
12,89 80
0173825 EXACYL 500 MG 20 CPR 0 0
12,28 80
0043381 EXACYL 500 MG 5 AMP 5 ML IV 0 0
10,18 80
B02BA01 phytomenadione
0234254 KONAKION PED 2 MG 5 AMP 0,2 ML IMIVPO 0 0
10,99 80
B02BC02 oxidized cellulose
0084269 OUATE HEMOSTATIQUE QUALIPHAR 10 G 0 0
7,29 80
B02BX01 etamsylate
0032357 DICYNONE 20 CPR 0 0
3,86 80
0032360 DICYNONE 50 CPR 0 0
8,62 80
0032374 DICYNONE 6 AMP 2 ML IMIV 0 0
2,42 80
B02BX04 romiplostim
0547956 NPLATE 250 MCG PDR 1 FL + KIT SC 1 5
647,35 100
0547973 NPLATE 500 MCG PDR 1 FL + KIT SC 1 5
1.285,93 100
B03AA01 ferrous glycine sulfate
0410155 FERROSANOL 30 MG/ML GTTS 30 ML 0 0
3,70 80
0044599 FERROSANOL DUODENAL 50 CAPS 0 0
12,72 80
0272613 FERROSANOL GYN 50 CAPS 0 0
11,16 80
B03AA03 ferrous gluconate
0180959 LOSFERRON 80 MG 60 CPR EFF 0 0
17,78 80
B03AA07 ferrous sulfate
0044537 FEROGRAD 500 (525 MG) 30 CPR 0 0
7,57 80
0044540 FEROGRAD 500 (525 MG) 60 CPR 0 0
14,37 80
0044361 FEROGRADUMET 30 CPR 0 0
4,04 80
0044375 FEROGRADUMET 60 CPR 0 0
7,82 80
0196489 TARDYFERON 80 MG 30 CPR 0 0
3,49 80
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B03AB02 saccharated iron oxide
0191581 FERRICURE 150 MG 28 CAPS 0 0
10,11 80
0273865 FERRICURE 150 MG 56 CAPS 0 0
16,57 80
0355411 FERRICURE GTTS 200 ML 0 0
20,70 80
0196041 FERRICURE GTTS 60 ML 0 0
8,85 80
B03AD03 ferrous sulfate
0198774 TARDYFERON B 9 30 CPR 0 0
3,67 80
B03BB01 folic acid
0309002 FOLAVIT 4 MG 40 CPR 0 0
7,42 80
B03XA01 erythropoietin
0226333 EPREX 1000 U 6 SRG 0,5 ML SC 1 5
72,64 100
0226378 EPREX 10000 U 6 SRG 1 ML SC 1 5
619,01 100
0226347 EPREX 2000 U 6 SRG 0,5 ML SC 1 5
136,62 100
0449391 EPREX 20000 U 1 SRG 0,5 ML SCIV 1 5
213,76 100
0226351 EPREX 3000 U 6 SRG 0,3 ML SC 1 5
193,22 100
0226364 EPREX 4000 U 6 SRG 0,4 ML SC 1 5
252,86 100
0449356 EPREX 40000 U 1 SRG 1 ML SCIV 1 5
372,10 100
0293434 EPREX 5000 U 6 SRG 0,5 ML 1 5
313,90 100
0293448 EPREX 6000 U 6 SRG 0,6 ML 1 5
374,94 100
0293465 EPREX 8000 U 6 SRG 0,8 ML 1 5
496,98 100
0248943 NEORECORMON 10000 U 6 SRG 0,6 ML SCIV 1 5
529,20 100
0237516 NEORECORMON 10000 U PDR 1 CRT SC 1 5
103,98 100
0237502 NEORECORMON 100000 U PDR 1 FL MTD+S SCIV 1 5
980,91 100
0248862 NEORECORMON 2000 U 6 SRG 0,3 ML SCIV 1 5
117,81 100
0248961 NEORECORMON 20000 U 6 SRG 0,6 ML SCIV 1 5
1.049,63 100
0237547 NEORECORMON 20000 U PDR 1 CRT SC 1 5
198,70 100
0248845 NEORECORMON 3000 U 6 SRG 0,3 ML SCIV 1 5
172,32 100
0364536 NEORECORMON 30000 U PDR 4 SRG 0,6ML IVSC 1 5
1.049,63 100
0279368 NEORECORMON 4000 U PDR 6 SRG SC 1 5
216,95 100
0248912 NEORECORMON 500 U 6 SRG 0,3 ML SCIV 1 5
34,60 100
0248828 NEORECORMON 5000 U 6 SRG 0,3 ML SCIV 1 5
269,00 100
0279341 NEORECORMON 6000 U PDR 6 SRG SC 1 5
321,03 100
0279306 NEORECORMON 60000 U PDR 1 CRT SC 1 5
629,61 100
0476756 RETACRIT 1000 U 6 SRG 0,3 ML SCIV 1 5
53,08 100
0476918 RETACRIT 10000 U 6 SRG 1 ML SCIV 1 5
439,09 100
0476787 RETACRIT 2000 U 6 SRG 0,6 ML SCIV 1 5
98,93 100
0476921 RETACRIT 20000 U 1 SRG 0,5 ML SCIV 1 5
152,23 100
0476806 RETACRIT 3000 U 6 SRG 0,9 ML SCIV 1 5
137,86 100
0476935 RETACRIT 30000 U 1 SRG 0,75 ML SCIV 1 5
224,01 100
0476837 RETACRIT 4000 U 6 SRG 0,4 ML SCIV 1 5
180,90 100
0476949 RETACRIT 40000 U 1 SRG 1 ML SCIV 1 5
265,47 100
0476854 RETACRIT 5000 U 6 SRG 0,5 ML SCIV 1 5
223,93 100
0476871 RETACRIT 6000 U 6 SRG 0,6 ML SCIV 1 5
266,96 100
0476899 RETACRIT 8000 U 6 SRG 0,8 ML SCIV 1 5
353,04 100
B03XA02 darbepoetin alfa
0302551 ARANESP 10 MCG 1 STYLO 0,4 ML (SURCLIC) 1 5
34,83 100
0302564 ARANESP 10 MCG 4 SRG 0,4 ML SCIV 1 5
108,82 100
0302726 ARANESP 100 MCG 1 STYLO 0,5 ML (SURCLIC) 1 5
253,76 100
0302743 ARANESP 100 MCG 4 SRG 0,5 ML SCIV 1 5
1.014,78 100
0530394 ARANESP 100 MCG 4 SRG SECURISEES SC 1 5
1.009,43 100
0302578 ARANESP 15 MCG 1 STYLO 0,375 ML (SURCLIC 1 5
47,87 100
0302757 ARANESP 150 MCG 1 STYLO 0,3 ML (SURCLIC) 1 5
375,76 100
0302761 ARANESP 150 MCG 4 SRG 0,3 ML SCIV 1 5
1.438,29 100
0530444 ARANESP 150 MCG 4 SRG SECURISEES SC 1 5
1.430,96 100
0302601 ARANESP 20 MCG 4 SRG 0,5 ML SCIV 1 5
207,25 100
0530265 ARANESP 20 MCG 4 SRG SECURISEES SC 1 5
205,64 100
0302614 ARANESP 30 MCG 1 STYLO 0,3 ML (SURCLIC) 1 5
85,91 100
0302628 ARANESP 30 MCG 4 SRG 0,3 ML SCIV 1 5
320,07 100
0530282 ARANESP 30 MCG 4 SRG SECURISEES SC 1 5
317,94 100
0432331 ARANESP 300 MCG 1 SRG PREREMPLIE SCIV 1 5
716,30 100
0530458 ARANESP 300 MCG 1 SRG SECURISEE SC 1 5
712,32 100
0302774 ARANESP 300 MCG 1 STYLO 0,6 ML (SURCLIC) 1 5
716,30 100
0302631 ARANESP 40 MCG 1 STYLO 0,4 ML (SURCLIC) 1 5
108,14 100
0302645 ARANESP 40 MCG 4 SRG 0,4 ML SCIV 1 5
404,91 100
0530301 ARANESP 40 MCG 4 SRG SECURISEES SC 1 5
402,37 100
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Numéro national
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0302659 ARANESP 50 MCG 1 STYLO 0,5 ML (SURCLIC) 1 5
136,14 100
0302662 ARANESP 50 MCG 4 SRG 0,5 ML SCIV 1 5
527,18 100
0530329 ARANESP 50 MCG 4 SRG SECURISEES SC 1 5
524,09 100
0432359 ARANESP 500 MCG 1 SRG PREREMPLIE SCIV 1 5
1.142,17 100
0530475 ARANESP 500 MCG 1 SRG SECURISEE SC 1 5
1.136,23 100
0368441 ARANESP 500 MCG 1 STYLO 1 ML (SURCLIC) 1 5
1.142,17 100
0302676 ARANESP 60 MCG 1 STYLO 0,3 ML (SURCLIC) 1 5
157,19 100
0302693 ARANESP 60 MCG 4 SRG 0,3 ML SCIV 1 5
630,73 100
0530346 ARANESP 60 MCG 4 SRG SECURISEES SC 1 5
627,14 100
0302709 ARANESP 80 MCG 1 STYLO 0,4 ML (SURCLIC) 1 5
205,85 100
0302712 ARANESP 80 MCG 4 SRG 0,4 ML SCIV 1 5
837,84 100
0530377 ARANESP 80 MCG 4 SRG SECURISEES SC 1 5
833,29 100
B03XA03 methoxy polyethylene glycol-epoetin beta
0459674 MIRCERA 100 MCG/ML 1 SRG 0,3 ML IVSC 1 5
319,27 100
0488385 MIRCERA 120 MCG 1 SRG 0,3 ML IVSC 1 5
381,25 100
0459688 MIRCERA 150 MCG 1 SRG 0,3 ML IVSC 1 5
474,20 100
0459691 MIRCERA 200 MCG/ML 1 SRG 0,3 ML IVSC 1 5
629,13 100
0459707 MIRCERA 250 MCG 1 SRG 0,3 ML IVSC 1 5
784,06 100
0488354 MIRCERA 30 MCG 1 SRG 0,3 ML IVSC 1 5
102,36 100
0459657 MIRCERA 50 MCG/ML 1 SRG 0,3 ML IVSC 1 5
164,33 100
0459661 MIRCERA 75 MCG/ML 1 SRG 0,3 ML IVSC 1 5
241,81 100
B05BA03 carbohydrates
0162155 GLUCOSE 5% BRN 1 FL 250 ML V 0 0
1,74 80
0162169 GLUCOSE 5% BRN 1 FL 500 ML V 0 0
2,50 80
0050288 GLUCOSE 5% BRN 10 AMP 10 ML P 0 0
7,11 80
0154976 GLUCOSTERIL 5% 100 ML FREKA INJ-FLASCHE 0 0
1,78 80
0154959 GLUCOSTERIL 5% 100 ML GLAS-INF 2700031 0 0
2,49 80
0182081 GLUCOSTERIL 5% 1000 ML P 2700231 0 0
4,32 80
0154962 GLUCOSTERIL 5% 250 ML GLAS INF 2700061 0 0
2,58 80
0182094 GLUCOSTERIL 5% 250 ML KABIPAC PK042E025 0 0
2,15 80
0155049 GLUCOSTERIL 5% 500 ML G 2700091 0 0
2,86 80
0179748 GLUCOSTERIL 5% 500 ML P 2700221 0 0
2,74 80
B05BB01 electrolytes
0182127 KOCHSALZLSG ISOT 10 ML 20 AMP P B314085 0 0
8,79 80
0275159 KOCHSALZLSG ISOT 100 ML FREEFLEX B248361 0 0
2,58 80
0165322 KOCHSALZLSG ISOT 100 ML INF G 1310031 0 0
1,84 80
0165238 KOCHSALZLSG ISOT 100 ML INJ G (1310021) 0 0
2,03 80
0165451 KOCHSALZLSG ISOT 1000 ML G 1310141 0 0
4,19 80
0165465 KOCHSALZLSG ISOT 1000 ML GS 1310151 0 0
4,45 80
0165479 KOCHSALZLSG ISOT 1000 ML P 1310231 0 0
3,85 80
0165482 KOCHSALZLSG ISOT 1000ML PS PLASTIPUR 0 0
3,87 80
0165211 KOCHSALZLSG ISOT 20 ML 20 AMP P B314405 0 0
9,59 80
0165367 KOCHSALZLSG ISOT 250 ML G 1310061 0 0
2,38 80
0165371 KOCHSALZLSG ISOT 250 ML KABIPAC (P) 0 0
2,01 80
0165403 KOCHSALZLSG ISOT 500 ML G 1310091 0 0
2,57 80
0165417 KOCHSALZLSG ISOT 500 ML GS 1310101 0 0
2,75 80
0165421 KOCHSALZLSG ISOT 500 ML KABIPAC 1310221 0 0
2,46 80
0165417 KOCHSALZLSG ISOT 500 ML PLASTIPUR 0 0
2,75 80
0217284 MINIBAG PLUS NACL 0,9% 1 PP VFLX 50 ML 0 0
5,42 80
0075922 NA CHLORID 0,9% BRN 10 AMP 10 ML P 0 0
7,06 80
0075936 NA CHLORID 0,9% BRN 10 AMP 20 ML P 0 0
7,31 80
0075855 NA CHLORID 0,9% BRN 100 ML 0 0
1,36 80
0075841 NA CHLORID 0,9% BRN 50 ML 0 0
1,29 80
0062700 NACL BRN 0,9% 1 FL 250 ML V 0 0
2,11 80
0062714 NACL BRN 0,9% 1 FL 500 ML V 0 0
2,26 80
0177497 NACL BRN 0,9% 1 MINIFL 100 ML 0 0
2,13 80
0142099 RINGERINFUSLSG BRN 1 FL 1 L G 0 0
4,29 80
0142085 RINGERINFUSLSG BRN 1 FL 500 ML G 0 0
2,26 80
0145946 RINGERLACTATINFUSLSG BRN 1000 ML V 0 0
3,89 80
0145977 RINGERLACTATINFUSLSG BRN 500 ML P 0 0
3,47 80
0149458 RINGERLOESUNG 1000 ML GS 2600151 0 0
9,69 80
0149444 RINGERLOESUNG 1000 ML P 2600231 0 0
9,69 80
0149511 RINGERLOESUNG 250 ML G 2600061 0 0
6,49 80
0149475 RINGERLOESUNG 500 ML G 2600091 0 0
6,69 80
0149492 RINGERLOESUNG 500 ML GS 2600101 0 0
3,64 80
0149508 RINGERLOESUNG 500 ML P 2600221 0 0
6,69 80
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0149475 RINGERLOESUNG 500 ML PLASTIPUR B231552 0 0
6,69 80
B05CA02 chlorhexidine
0145834 UROTAINER CHLORHEXIDINE 10*100 ML 0 0
27,22 80
B05CA06 mandelic acid
0145817 UROTAINER AC,MANDEL 1% 10*100 ML PP 0 0
27,22 80
B05XA31 electrolytes in combination with other drugs
0274281 NONAN NOVUM 1 FL 40 ML PERF 0 0
2,80 80
0249498 TRACITRANS PLUS 10 ML 10 AMP G 0 0
30,00 80
C01AA05 digoxin
0063451 LANOXINE 0,125 MG 60 CPR 0 0
5,84 100
0063482 LANOXINE 0,250 MG 120 CPR 0 0
6,96 100
0063479 LANOXINE 0,250 MG 60 CPR 0 0
6,01 100
0192087 LANOXINE 0,5 MG 5 AMP 2 ML UD IMIV 0 0
4,84 100
0063515 LANOXINE PG ELIXIR PED 60 ML 0 0
6,92 100
C01AA08 metildigoxin
0063367 LANITOP 0,1 MG 50 CPR 0 0
2,36 100
C01BA03 disopyramide
0203308 RYTHMODAN 100 MG 120 CAPS 0 0
13,53 100
0201544 RYTHMODAN LA 250 MG 40 CPR 0 0
13,72 100
C01BB01 lidocaine
0207856 XYLOCARD 100 MG 2% 5 AMP 5 ML IMIV 0 0
9,82 100
C01BC03 propafenone
0101681 RYTMONORM 150 MG 100 CPR 0 0
19,03 100
0101678 RYTMONORM 150 MG 50 CPR 0 0
11,70 100
0101700 RYTMONORM 300 MG 100 CPR 0 0
29,05 100
0101695 RYTMONORM 300 MG 50 CPR 0 0
19,45 100
C01BC04 flecainide
0363851 APOCARD RET 100 MG 60 CAPS 0 0
26,61 100
0363914 APOCARD RET 150 MG 60 CAPS 0 0
36,43 100
0363881 APOCARD RET 200 MG 60 CAPS 0 0
45,94 100
0465668 FLECAINIDE EG 100 MG 100 CPR BLIST 0 0
29,63 100
0113276 TAMBOCOR 100 MG 100 CPR 0 0
39,61 100
0113262 TAMBOCOR 100 MG 40 CPR 0 0
20,74 100
0113293 TAMBOCOR 150 MG 5 AMP 15 ML IV 0 0
31,07 100
C01BD01 amiodarone
0153559 AMIODARONE EG 200 MG 60 CPR 0 0
9,77 100
0024999 CORDARONE 200 MG 20 CPR 0 0
8,80 100
0025013
C01BD07
CORDARONE 200 MG 60 CPR 0 0
14,03 100
0539311 MULTAQ 400 MG 60 CPR 1 1
89,27 100
C01BG07 cibenzoline
0158149 CIPRALAN 130 MG 100 CPR 0 0
27,31 100
0158135 CIPRALAN 130 MG 40 CPR 0 0
15,96 100
C01CA01 etilefrine
0038199 EFFORTIL 0,75% GTTS 50 ML 0 0
13,57 80
0038185 EFFORTIL 5 MG 50 CPR 0 0
8,43 80
C01CA02 isoprenaline
0060351 ISUPREL 0,2 MG 5 AMP 1 ML PERF 0 0
9,54 80
C01CA03 norepinephrine
0065263 LEVOPHED 8 MG 10 AMP 4 ML IV 0 0
21,39 80
C01CA24 epinephrine
0164244 FASTJEKT IM AUTO-INJECTEUR A 1 0 0
70,15 80
C01DA02 glyceryl trinitrate
0268401 DEPONIT NT 10 100 PATCH 0 0
83,16 80
0268395 DEPONIT NT 10 30 PATCH 0 0
34,97 80
0268378 DEPONIT NT 5 100 PATCH 0 0
65,57 80
0268364 DEPONIT NT 5 30 PATCH 0 0
25,66 80
0190955 MINITRAN 10 MG 30 PATCH 0 0
25,82 80
0190969 MINITRAN 15 MG 30 PATCH 0 0
34,99 80
0190941 MINITRAN 5 MG 30 PATCH 0 0
18,41 80
0253747 NATISPRAY 0,3 MG/D SPRAY BU 18 ML 0 0
6,57 100
0236388 NITRODERM TTS 10 10 PATCH 0 0
17,45 80
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0236391 NITRODERM TTS 10 100 PATCH 0 0
83,36 80
0078910 NITRODERM TTS 10 30 PATCH 0 0
33,52 80
0236357 NITRODERM TTS 5 10 PATCH 0 0
15,95 80
0236361 NITRODERM TTS 5 100 PATCH 0 0
69,02 80
0078924 NITRODERM TTS 5 30 PATCH 0 0
29,10 80
0368485 NITROLINGUAL PUMPSPRAY 0,4 MG 250 D SL 0 0
9,62 100
0223426 TRINIPATCH 10 30 PATCH 0 0
25,82 80
0223457 TRINIPATCH 15 30 PATCH 0 0
34,41 80
0223409 TRINIPATCH 5 30 PATCH 0 0
18,42 80
0129990 WILL LONG 2,5 MG 100 CAPS 0 0
7,18 100
0130005 WILL LONG 7,5 MG 100 CAPS 0 0
5,43 100
C01DA08 isosorbide dinitrate
0019565 CEDOCARD 5 MG 180 CPR 0 0
8,78 100
0019551 CEDOCARD 5 MG 60 CPR 0 0
6,15 100
0248635 ISOKET 10 MG 60 CPR 0 0
6,15 100
0314758 ISOKET 10 MG 98 CPR 0 0
9,13 100
0248974 ISOKET 5 MG 60 CPR 0 0
4,61 100
0314744 ISOKET 5 MG 98 CPR 0 0
6,88 100
0234965 ISOKET RET 120 MG 60 CAPS 0 0
22,33 100
0314808 ISOKET RET 120 MG 98 CAPS 0 0
28,97 100
0248649 ISOKET RET 20 MG 60 CPR 0 0
5,69 100
0314761 ISOKET RET 20 MG 98 CPR 0 0
9,29 100
0248652 ISOKET RET 40 MG 60 CPR 0 0
9,78 100
0314775 ISOKET RET 40 MG 98 CPR 0 0
14,23 100
0059302 ISOKET RET 60 MG 100 CPR 0 0
25,33 100
0248666 ISOKET RET 60 MG 60 CPR 0 0
12,29 100
0314789 ISOKET RET 60 MG 98 CPR 0 0
23,55 100
0248683 ISOKET RET 80 MG 60 CPR 0 0
15,19 100
0314792 ISOKET RET 80 MG 98 CPR 0 0
28,71 100
0170045 ISOKET SPRAY 300 D 15 ML 0 0
22,05 100
C01DA14 isosorbide mononitrate
0038400 ELANTAN LONG 50 MG 100 CAPS 0 0
47,54 100
C01DX12 molsidomine
0335291 CORUNO 16 MG 28 CPR 0 0
32,67 80
0355649 CORUNO 16 MG 42 CPR 0 0
41,93 80
0156452 CORVATON 2 MG 100 CPR 0 0
16,79 80
0025822 CORVATON 2 MG 50 CPR 0 0
10,82 80
0025853 CORVATON 4 MG 120 CPR 0 0
37,65 80
0025836 CORVATON 4 MG 60 CPR 0 0
25,08 80
0337234 MOLSIKET RET 8 MG 98 CPR 0 0
18,41 80
C01EB17 ivabradine
0423797 PROCORALAN 5 MG 56 CPR 1 1
57,64 80
0423878 PROCORALAN 7,5 MG 56 CPR 1 1
57,64 80
C02AC01 clonidine
0217883 CATAPRESSAN 150 0,15 MG 100 CPR 0 0
12,65 100
0019193 CATAPRESSAN 150 0,15 MG 5 AMP IMIVSC 0 0
6,63 100
C02AC05 moxonidine
0285396 MOXON 0,2 MG 28 CPR 0 0
10,96 100
0285432 MOXON 0,4 MG 28 CPR 0 0
14,57 100
0374949 MOXONIDINE EG 0,2 MG 28 CPR 0 0
8,55 100
0455921 MOXONIDINE EG 0,2 MG 56 CPR 0 0
12,98 100
0375154 MOXONIDINE EG 0,4 MG 28 CPR 0 0
11,23 100
0455935 MOXONIDINE EG 0,4 MG 56 CPR 0 0
18,90 100
C02AC06 rilmenidine
0136951 HYPERIUM 1 MG 30 CPR 0 0
15,47 100
C02CA01 prazosin
0072500 MINIPRESS 1 MG 100 CPR 0 0
11,22 100
0072528 MINIPRESS 2 MG 100 CPR 0 0
16,06 100
0072545 MINIPRESS 5 MG 100 CPR 0 0
28,33 100
C02LA51 reserpine and diuretics, combinations with other drugs
0203342 BRISERIN N 100 DRG 0 0
40,15 80
0203339 BRISERIN N 60 DRG 0 0
29,30 80
C03AA03 hydrochlorothiazide
0236228 ESIDRIX 25 MG 100 CPR 0 0
16,69 80
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0236214 ESIDRIX 25 MG 20 CPR 0 0
10,49 80
0237015 ESIDRIX 25 MG 50 CPR 0 0
13,10 80
C03BA04 chlortalidone
0236617 HYGROTON 50 MG 20 CPR 02478 0 0
8,78 80
0236621 HYGROTON 50 MG 50 CPR 02479 0 0
12,89 80
C03BA11 indapamide
0224485 FLUDEX 1,5 MG 30 CPR LP 0 0
12,79 80
0045565 FLUDEX 2,5 MG 30 CPR 0 0
12,79 80
0585781 INDAPAMIDE DOC 2,5 MG 60 CPR 0 0
8,46 80
0205185 INDAPAMIDE EG 2,5 MG 20 DRG 0 0
6,05 80
0205199 INDAPAMIDE EG 2,5 MG 60 DRG 0 0
8,54 80
C03BX03 cicletanine
0136012 TENSTATEN 50 MG 30 CAPS 0 0
16,76 80
C03CA01 furosemide
0304832 DOCFUROSE 40 MG 50 CPR 0 0
6,71 80
0170417 FURORESE 20 MG 5 AMP 2 ML IMIV 0 0
2,58 80
0047265 FURORESE 40 MG 20 CPR 0 0
1,94 80
0136172 FUROSEMID RATIO 20 MG 5 AMP 2 ML IMIV 0 0
2,59 80
0136219 FUROSEMID RATIO 250 MG 5 AMP 25 ML PERF 0 0
20,84 80
0156029 FUROSEMID RATIO 40 MG 100 CPR 0 0
10,54 80
0047296 FUROSEMID RATIO 40 MG 20 CPR 0 0
2,75 80
0047301 FUROSEMID RATIO 40 MG 50 CPR 0 0
6,21 80
0136947 FUROSEMIDE EG 40 MG 50 CPR SEC 0 0
6,80 80
0063935 LASIX 20 MG 5 AMP 2 ML IMIV 0 0
6,08 80
0063899 LASIX 40 MG 12 CPR 0 0
5,88 80
0063904 LASIX 40 MG 50 CPR 0 0
9,37 80
0063921 LASIX 500 MG 20 CPR 0 0
22,27 80
0064039 LASIX P 30 MG 30 CAPS 0 0
7,78 80
C03CA02 bumetanide
0248568 BURINEX 1 MG 30 CPR 0 0
7,85 80
0160571 BURINEX 2 MG 5 AMP 4 ML IMIV 0 0
9,15 80
0160553 BURINEX 5 MG 20 CPR 0 0
12,73 80
C03CA04 torasemide
0268574 TORREM 10 MG 20 CPR 0 0
10,81 80
0275758 TORREM 2,5 MG 56 CPR 0 0
9,10 80
C03DA01 spironolactone
0002554 ALDACTONE 100 MG 30 CPR 0 0
13,17 80
0002568 ALDACTONE 100 MG 50 CPR 0 0
17,42 80
0002599 ALDACTONE 25 MG 50 CPR 0 0
8,68 80
0229593 ALDACTONE 50 MG 30 CPR 0 0
9,58 80
0292759 DOCSPIRONO 100 MG 50 CPR 0 0
15,80 80
0292745 DOCSPIRONO 25 MG 50 CPR 0 0
9,50 80
0156046 SPIRONOLACTON RATIO 100 MG 100 CPR 0 0
29,75 80
0108908 SPIRONOLACTON RATIO 100 MG 20 CPR 0 0
13,01 80
0108911 SPIRONOLACTON RATIO 100 MG 50 CPR 0 0
19,53 80
0178271 SPIRONOLACTONE EG 100 MG 30 CPR 0 0
11,30 80
0202393 SPIRONOLACTONE EG 100 MG 50 CPR 0 0
15,59 80
0178298 SPIRONOLACTONE EG 25 MG 50 CPR 0 0
7,73 80
C03DA02 potassium canrenoate
0018294 CANRENOL 100 MG 50 CPR 0 0
15,55 80
0018313 CANRENOL 50 MG 50 CPR 0 0
10,22 80
0106142 SOLDACTONE 200 MG 6 AMP 0 0
12,93 80
C03DA04 eplerenone
0385245 INSPRA 25 MG 30 CPR 1 6
71,71 80
C03DB02 triamterene
0350219 DYTAC 50 MG 28 CAPS 0 0
8,29 80
C03EA Low-ceiling diuretics and potassium-sparing agents
0195464 DEHYDROSANOL TRI 30 DRG 0 0
11,34 80
0028855 DEHYDROSANOL TRI 50 DRG 0 0
17,01 80
0317679 DEHYDROSANOL TRI MITE 50 DRG 0 0
13,51 80
C03EA01 hydrochlorothiazide and potassium-sparing agents
0004321 AMILORETIK 100 CPR 0 0
4,00 80
0225594 AMILORETIK 30 CPR 0 0
1,00 80
0004318 AMILORETIK 50 CPR 0 0
2,00 80
Page 18 of 85

Numéro national
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0037787 DYTENZIDE 112 CPR 0 0
18,39 80
0037773 DYTENZIDE 28 CPR 0 0
8,48 80
0073170 MODURETIC 112 CPR (EMB CALENDRIER) 0 0
7,31 80
0073167 MODURETIC 56 CPR (EMB CALENDRIER) 0 0
5,83 80
0292731 SPIRONOLACTON HCTZ DOC 56 CPR 0 0
10,34 80
C03EA03 epitizide and potassium-sparing agents
0037742 DYTA URESE 28 CAPS 0 0
8,51 80
0037756 DYTA URESE 56 CAPS 0 0
11,20 80
C03EA04 altizide and potassium-sparing agents
0002537 ALDACTAZINE 28 CPR 0 0
8,72 80
0002540 ALDACTAZINE 98 CPR 0 0
17,07 80
C03EB01 furosemide and potassium-sparing agents
0142328 FRUSAMIL 28 CPR 0 0
8,22 80
0150526 FRUSAMIL 56 CPR 0 0
10,72 80
0108780 SPIRO COMP FORTE RATIO 100 CPR 0 0
39,24 80
0108763 SPIRO COMP FORTE RATIO 20 CPR 0 0
15,17 80
0108777 SPIRO COMP FORTE RATIO 50 CPR 0 0
24,50 80
0193961 SPIRO COMP RATIO 20 CPR 0 0
12,38 80
0194193 SPIRO COMP RATIO 50 CPR 0 0
17,93 80
C05AA Corticosteroids
0119929 TRIANAL 10 SUPP 0 0
6,90 80
0119915 TRIANAL POM 20 G 0 0
8,60 80
C05AA04 prednisolone
0052556 HEMOSEDAN POM 30 G 0 0
7,19 80
0102689 SCHERIPROCT POM 30 G 0 0
8,26 80
C05AA08 fluocortolone
0122728 ULTRAPROCT POM 30 GR 0 0
6,22 80
C05AD Local anesthetics
0059123 ISOCHINOL SALBE 30 G 0 0
5,18 80
C05AX03 other preparations, combinations
0288756 COSE ANAL 15 SUPP 0 0
9,17 80
0288773 COSE ANAL POM 20 G 0 0
6,56 80
C07AA02 oxprenolol
0236651 TRASICOR 80 MG 100 CPR 0 0
38,53 100
C07AA03 pindolol
0128461 VISKEN 15 MG 100 CPR 0 0
58,42 100
0128489 VISKEN 5 MG 100 CPR 0 0
27,00 100
0128556 VISKEN RET 20 MG 100 CPR 0 0
71,35 100
C07AA05 propranolol
0056474 INDERAL 10 MG 50 CPR 0 0
5,80 100
0056507 INDERAL 40 MG 100 CPR 0 0
8,64 100
0056569 INDERAL RET 160 MG 56 CAPS 0 0
14,03 100
0056572 INDERAL RET MITIS 80 MG 42 CAPS 0 0
9,64 100
0167961 PROPRANOLOL EG 40 MG 100 CPR 0 0
7,56 100
0167957 PROPRANOLOL RET EG 160 MG 56 CAPS 0 0
11,71 100
C07AA07 sotalol
0530203 SOTALEX 160 MG 50 CPR 0 0
10,74 100
C07AA16 tertatolol
0138678 ARTEX 5 MG 30 CPR 0 0
13,49 100
C07AB02 metoprolol
0067612 LOPRESOR 100 MG 100 CPR 0 0
17,22 100
0211974 METOHEXAL 100 MG 30 CPR 0 0
5,40 100
0167281 METOHEXAL 100 MG 50 CPR 0 0
7,50 100
0208451 METOHEXAL 50 MG 30 CPR 0 0
4,31 100
0167263 METOHEXAL 50 MG 50 CPR 0 0
4,50 100
0204336 METOHEXAL RET 200 MG 100 CPR 0 0
17,83 100
0208464 METOHEXAL RET 200 MG 30 CPR 0 0
9,90 100
0204322 METOHEXAL RET 200 MG 50 CPR 0 0
12,00 100
0401576 METOHEXAL SUCC 142,5 MG 100 CPR BLIST 0 0
19,97 100
0401559 METOHEXAL SUCC 142,5 MG 30 CPR BLIST 0 0
12,00 100
0401562 METOHEXAL SUCC 142,5 MG 50 CPR BLIST 0 0
15,00 100
0401711 METOHEXAL SUCC 190 MG 100 CPR BLIST 0 0
21,27 100
0401691 METOHEXAL SUCC 190 MG 30 CPR BLIST 0 0
12,00 100
Page 19 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0401707 METOHEXAL SUCC 190 MG 50 CPR BLIST 0 0
15,74 100
0401173 METOHEXAL SUCC 23,75 MG 100 CPR BLIST 0 0
13,00 100
0401142 METOHEXAL SUCC 23,75 MG 30 CPR BLIST 0 0
6,30 100
0401156 METOHEXAL SUCC 23,75 MG 50 CPR BLIST 0 0
9,00 100
0401304 METOHEXAL SUCC 47,5 MG 100 CPR BLIST 0 0
15,00 100
0401285 METOHEXAL SUCC 47,5 MG 30 CPR BLIST 0 0
6,30 100
0401299 METOHEXAL SUCC 47,5 MG 50 CPR BLIST 0 0
10,00 100
0401451 METOHEXAL SUCC 95 MG 100 CPR BLIST 0 0
16,50 100
0401433 METOHEXAL SUCC 95 MG 30 CPR BLIST 0 0
9,60 100
0401447 METOHEXAL SUCC 95 MG 50 CPR BLIST 0 0
13,00 100
0527581 METOPROLOL EG 100 MG 28 CPR 0 0
8,04 100
0527614 METOPROLOL EG 100 MG 56 CPR 0 0
10,71 100
0527631 METOPROLOL EG 200 MG 28 CPR 0 0
9,85 100
0527662 METOPROLOL EG 200 MG 56 CPR 0 0
13,35 100
0213111 METOPROLOL RATIO 100 MG 100 CPR 0 0
15,09 100
0213092 METOPROLOL RATIO 100 MG 30 CPR 0 0
6,27 100
0213108 METOPROLOL RATIO 100 MG 50 CPR 0 0
10,52 100
0213142 METOPROLOL RATIO 50 MG 100 CPR 0 0
9,30 100
0213125 METOPROLOL RATIO 50 MG 30 CPR 0 0
4,30 100
0213139 METOPROLOL RATIO 50 MG 50 CPR 0 0
6,93 100
0237046 PRELIS 200 MG 100 CPR 02191 0 0
34,47 100
0236942 PRELIS 200 MG 30 CPR 02947 0 0
22,34 100
0236956 PRELIS 200 MG 50 CPR 02163 0 0
15,99 100
0103560 SELOKEN 100 MG 100 CPR 0 0
15,83 100
0103607 SELOKEN 5 MG 5 AMP 5 ML IV 0 0
9,20 100
0152193 SELOZOK 100 (95 MG) 28 CPR 0 0
10,05 100
0135726 SELOZOK 200 (190 MG) 28 CPR 0 0
13,01 100
0404971 SELOZOK 25 MG 28 CPR 0 0
8,56 100
C07AB03 atenolol
0155617 ATEHEXAL 100 MG 100 CPR 0 0
18,86 100
0208304 ATEHEXAL 100 MG 30 CPR 0 0
9,84 100
0155603 ATEHEXAL 100 MG 50 CPR 0 0
11,00 100
0237967 ATENOLOL EG 100 MG 28 CPR 0 0
9,85 100
0237971 ATENOLOL EG 100 MG 56 CPR 0 0
15,62 100
0237998 ATENOLOL EG 25 MG 28 CPR 0 0
5,90 100
0238009 ATENOLOL EG 25 MG 56 CPR 0 0
7,43 100
0238026 ATENOLOL EG 50 MG 28 CPR 0 0
7,29 100
0238043 ATENOLOL EG 50 MG 56 CPR 0 0
10,08 100
0191269 ATENOLOL VON CT 50 MG 100 CPR PELLIC 0 0
16,51 100
0191241 ATENOLOL VON CT 50 MG 30 CPR PELLIC 0 0
6,25 100
0299018 DOCATENO 100 MG 56 CPR 0 0
12,19 100
0298993 DOCATENO 50 MG 56 CPR 0 0
9,30 100
0215844 TENORMIN 100 MG 56 CPR 0 0
18,85 100
0219695 TENORMIN MINOR 25 MG 56 CPR 0 0
8,39 100
0215827 TENORMIN MITIS 50 MG 56 CPR 0 0
12,28 100
C07AB04 acebutolol
0102966 SECTRAL 400 MG 28 CPR 0 0
12,38 100
0102983 SECTRAL 400 MG 70 CPR 0 0
19,71 100
0150378 SECTRAL GE 200 MG 28 CPR 0 0
9,14 100
0150381 SECTRAL GE 200 MG 56 CPR 0 0
11,56 100
C07AB05 betaxolol
0204742 KERLON 20 MG 28 CPR 0 0
12,02 100
0204756 KERLON 20 MG 56 CPR 0 0
16,79 100
C07AB07 bisoprolol
0301584 BISOPROLOL EG 10 MG 28 CPR 0 0
11,03 100
0301598 BISOPROLOL EG 10 MG 56 CPR 0 0
11,82 100
0301567 BISOPROLOL EG 5 MG 28 CPR 0 0
7,94 100
0301571 BISOPROLOL EG 5 MG 56 CPR 0 0
8,32 100
0024579 CONCOR 10 MG 100 CPR 0 0
24,78 100
0024551 CONCOR 10 MG 30 CPR 0 0
11,00 100
0024601 CONCOR 5 MG 100 CPR 0 0
18,95 100
0024582 CONCOR 5 MG 30 CPR 0 0
7,30 100
0273588 CONCOR COR 2,5 MG 100 CPR 0 0
14,67 100
0273561 CONCOR COR 2,5 MG 30 CPR 0 0
5,30 100
C07AB08 celiprolol
Page 20 of 85

Numéro national
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0137099 SELECTOL 200 MG 28 CPR 0 0
8,88 100
0137104 SELECTOL 200 MG 56 CPR 0 0
11,79 100
0226297 SELECTOL 400 MG 28 CPR 0 0
11,79 100
C07AB12 nebivolol
0486539 NEBIVOLOL EG 5 MG 28 CPR 0 0
12,30 100
0486573 NEBIVOLOL EG 5 MG 56 CPR 0 0
14,71 100
0495264 NEBIVOLOL HEXAL 5 MG 100 CPR 0 0
12,85 100
0495183 NEBIVOLOL HEXAL 5 MG 30 CPR 0 0
10,05 100
0495197 NEBIVOLOL HEXAL 5 MG 50 CPR 0 0
10,95 100
0530508 NOBITEN 5 MG 100 CPR 0 0
28,00 100
0306482 NOBITEN 5 MG 28 CPR 0 0
12,68 100
0306496 NOBITEN 5 MG 56 CPR 0 0
17,83 100
C07AG01 labetalol
0118725 TRANDATE 100 MG 75 CPR 0 0
12,21 100
0118739 TRANDATE 200 MG 75 CPR 0 0
17,11 100
C07AG02 carvedilol
0396249 CARVEDILOL EG 25 MG 56 CPR 0 0
16,25 100
0395093 CARVEDILOL EG 6,25 MG 56 CPR 0 0
8,05 100
0356436 CARVEDILOL RATIO 25 MG 60 CPR 0 0
20,73 100
0356209 CARVEDILOL RATIO 6,25 MG 14 CPR SEC 0 0
2,06 100
0356261 CARVEDILOL RATIO 6,25 MG 60 CPR 0 0
8,06 100
0171669 DIMITONE 25 MG 56 CPR 0 0
18,99 100
0376781 DOCCARVEDILOL 25 MG 56 CPR 0 0
18,99 100
0376604 DOCCARVEDILOL 6,25 MG 56 CPR 0 0
7,35 100
0234092 KREDEX 12,5 MG 14 CPR 0 0
6,55 100
0164549 KREDEX 25 MG 56 CPR 0 0
18,99 100
0234089 KREDEX 6,25 MG 56 CPR 0 0
8,93 100
C07BB Beta blocking agents, selective, and thiazides
0522831 NOBIRETIC 5/12,5 MG 28 CPR 0 0
19,45 100
0522859 NOBIRETIC 5/12,5 MG 56 CPR 0 0
28,04 100
0522862 NOBIRETIC 5/12,5 MG 90 CPR 0 0
41,26 100
0522909 NOBIRETIC 5/25 MG 28 CPR 0 0
19,45 100
0522926 NOBIRETIC 5/25 MG 56 CPR 0 0
28,04 100
0522943 NOBIRETIC 5/25 MG 90 CPR 0 0
41,26 100
C07BB02 metoprolol and thiazides
0193281 METOHEXAL COMP 100 CPR 0 0
17,20 100
0193263 METOHEXAL COMP 30 CPR 0 0
8,10 100
0193277 METOHEXAL COMP 50 CPR 0 0
11,72 100
0206121 ZOKZID 28 CPR 0 0
9,65 100
C07BB04 acebutolol and thiazides
0102997 SECTRAZIDE 28 CPR 0 0
13,76 100
0103008 SECTRAZIDE 70 CPR 0 0
23,10 100
C07BB07 bisoprolol and thiazides
0348272 COBISOPROLOL EG 10/25 MG 28 CPR 0 0
9,96 100
0348319 COBISOPROLOL EG 10/25 MG 56 CPR 0 0
11,79 100
0348031 COBISOPROLOL EG 5/12,5 MG 28 CPR 0 0
7,78 100
0348062 COBISOPROLOL EG 5/12,5 MG 56 CPR 0 0
8,34 100
0194968 CONCOR 10 PLUS 30 CPR 0 0
17,21 100
0194937 CONCOR 5 PLUS 30 CPR 0 0
10,38 100
C07CB02 metoprolol and other diuretics
0237032 PRELIS COMP 100 CPR 02206 0 0
131,20 80
0236746 PRELIS COMP 30 CPR 02949 0 0
51,59 80
0236763 PRELIS COMP 50 CPR 02203 0 0
73,37 80
C07CB03 atenolol and other diuretics
0238061 ATENOLOL/CHLORTALIDONE EG 28 CPR 0 0
10,13 100
0238074 ATENOLOL/CHLORTALIDONE EG 56 CPR 0 0
16,20 100
0218622 TENORETIC 100/25 56 CPR 0 0
19,91 100
0218653 TENORETIC MITIS 50/12,5 56 CPR 0 0
12,93 100
C07FB02 metoprolol and other antihypertensives
0209007 LOGIMAT 10 MG 28 CPR PL 0 0
9,43 100
0208996 LOGIMAT 5 MG 28 CPR PL 0 0
7,40 100
C07FB03 atenolol and other antihypertensives
0154394 TENIF 28 CAPS 0 0
14,36 100
C08CA01 amlodipine
Page 21 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0445309 AMLODIPIN HEXAL 10 MG 100 CPR BLIST 0 0
14,02 100
0445245 AMLODIPIN HEXAL 10 MG 20 CPR BLIST 0 0
9,58 100
0445276 AMLODIPIN HEXAL 10 MG 50 CPR BLIST 0 0
11,47 100
0445696 AMLODIPIN HEXAL 5 MG 100 CPR BLIST 0 0
12,40 100
0445648 AMLODIPIN HEXAL 5 MG 20 CPR BLIST 0 0
8,00 100
0445679 AMLODIPIN HEXAL 5 MG 50 CPR BLIST 0 0
10,67 100
0445505 AMLODIPIN HEXAL 7,5 MG 100 CPR BLIST 0 0
13,63 100
0445441 AMLODIPIN HEXAL 7,5 MG 20 CPR BLIST 0 0
9,50 100
0445472 AMLODIPIN HEXAL 7,5 MG 50 CPR BLIST 0 0
11,10 100
0491508 AMLODIPIN N RATIO 10 MG 100 CPR 0 0
13,99 100
0491427 AMLODIPIN N RATIO 10 MG 20 CPR 0 0
9,57 100
0491458 AMLODIPIN N RATIO 10 MG 50 CPR 0 0
11,27 100
0491329 AMLODIPIN N RATIO 5 MG 100 CPR 0 0
12,11 100
0491248 AMLODIPIN N RATIO 5 MG 20 CPR 0 0
8,00 100
0491279 AMLODIPIN N RATIO 5 MG 50 CPR 0 0
10,42 100
0466732 AMLODIPINE BESILATE EG 10 MG 100 CPR 0 0
30,84 100
0466679 AMLODIPINE BESILATE EG 10 MG 30 CPR 0 0
12,14 100
0466536 AMLODIPINE BESILATE EG 5 MG 28 CPR 0 0
12,03 100
0466571 AMLODIPINE BESILATE EG 5 MG 56 CPR 0 0
12,71 100
0466598 AMLODIPINE BESILATE EG 5 MG 98 CPR 0 0
23,35 100
0590019 AMLOR 10 MG 100 CAPS 0 0
36,56 100
0158314 AMLOR 10 MG 30 CAPS 0 0
16,90 100
0158301 AMLOR 5 MG 28 CAPS 0 0
11,54 100
0589991 AMLOR 5 MG 56 CAPS 0 0
16,04 100
C08CA02 felodipine
0325409 FELODIPIN RATIO 10 MG 20 CPR PL 0 0
9,32 100
0325412 FELODIPIN RATIO 10 MG 50 CPR PL 0 0
22,78 100
0325362 FELODIPIN RATIO 5 MG 20 CPR PL 0 0
5,91 100
0325376 FELODIPIN RATIO 5 MG 50 CPR PL 0 0
14,57 100
0333333 FELODIPINE EG 10 MG 28 CPR PL 0 0
13,03 100
0333171 FELODIPINE EG 5 MG 28 CPR PL 0 0
9,47 100
0239931 PLENDIL RET 10 MG 28 CPR 0 0
15,96 100
0239894 PLENDIL RET 5 MG 28 CPR 0 0
11,48 100
C08CA03 isradipine
0165563 LOMIR 2,5 MG 100 CPR 0 0
40,57 100
0184931 LOMIR SRO 5 MG 100 CAPS 0 0
48,45 100
0184927 LOMIR SRO 5 MG 50 CAPS 0 0
30,15 100
0187283 LOMIR SRO MITE 2,5 MG 100 CAPS 0 0
37,82 100
0187266 LOMIR SRO MITE 2,5 MG 50 CAPS 0 0
24,69 100
C08CA04 nicardipine
0181151 RYDENE RET 45 MG 60 CAPS 0 0
22,39 100
C08CA05 nifedipine
0183544 ADALAT OROS 30 MG 28 CPR 0 0
12,36 100
0380141 ADALAT OROS 60 MG 56 CPR 0 0
28,94 100
0000787 ADALAT RET 20 MG 30 CPR 0 0
10,46 100
0139871 APRICAL 2% GTTS 30 ML 0 0
8,09 100
0139868 APRICAL RET 20 MG 100 CAPS 0 0
21,99 100
0260755 HYPAN 40 MG 28 CPR 0 0
14,61 100
0260769 HYPAN 40 MG 56 CPR 0 0
20,75 100
0078633 NIFEDIPIN RATIO 10 MG 100 CAPS 0 0
12,09 100
0078602 NIFEDIPIN RATIO 10 MG 30 CAPS 0 0
6,00 100
0078616 NIFEDIPIN RATIO 10 MG 50 CAPS 0 0
7,99 100
0135953 NIFEDIPIN RATIO 20 MG/ML GTTS 30 ML 0 0
8,12 100
0156032 NIFEDIPIN RATIO GTTS 100 ML 0 0
22,26 100
C08CA07 nisoldipine
0237824 SULAR 10 MG 28 CPR 0 0
16,19 100
0246001 SULAR 10 MG 56 CPR 0 0
23,44 100
0237838 SULAR 20 MG 28 CPR 0 0
23,44 100
0246014 SULAR 20 MG 56 CPR 0 0
33,72 100
0231011 SYSCOR 10 MG 28 CPR PL 0 0
16,19 100
0231025 SYSCOR 20 MG 28 CPR PL 0 0
23,44 100
C08CA08 nitrendipine
0011116 BAYPRESS 20 MG 14 CPR 0 0
12,19 100
0011133 BAYPRESS MITIS 10 MG 28 CPR 0 0
12,19 100
C08CA09 lacidipine
Page 22 of 85

Numéro national
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0181696 MOTENS 4 MG 28 CPR 0 0
17,36 100
C08CA12 barnidipine
0288675 VASEXTEN 10 MG 28 CAPS 0 0
20,50 100
0288689 VASEXTEN 10 MG 56 CAPS 0 0
29,52 100
0288692 VASEXTEN 20 MG 28 CAPS 0 0
29,70 100
0288708 VASEXTEN 20 MG 56 CAPS 0 0
43,78 100
C08CA13 lercanidipine
0566948 LERCANIDIPINE EG 10 MG 28 CPR 0 0
11,22 100
0566996 LERCANIDIPINE EG 10 MG 98 CPR 0 0
21,77 100
0567055 LERCANIDIPINE EG 20 MG 28 CPR 0 0
17,03 100
0567119 LERCANIDIPINE EG 20 MG 98 CPR 0 0
30,85 100
0228941 ZANIDIP 10 MG 28 CPR 0 0
12,09 100
0524853 ZANIDIP 10 MG 56 CPR 0 0
18,33 100
0376845 ZANIDIP 20 MG 28 CPR 0 0
17,61 100
0524867 ZANIDIP 20 MG 56 CPR 0 0
25,42 100
C08DA01 verapamil
0059817 ISOPTIN 120 MG 100 DRG 0 0
15,59 100
0059803 ISOPTIN 120 MG 50 DRG 0 0
8,94 100
0059834 ISOPTIN 80 MG 100 DRG 0 0
9,71 100
0059820 ISOPTIN 80 MG 50 DRG 0 0
5,86 100
0182971 ISOPTIN KHK RET 120 MG 100 CPR 0 0
19,91 100
0182967 ISOPTIN KHK RET 120 MG 50 CPR 0 0
11,91 100
0059882 ISOPTIN MITE 40 MG 100 DRG 0 0
5,91 100
0059879 ISOPTIN MITE 40 MG 50 DRG 0 0
3,51 100
0059896 ISOPTIN RR RET 240 MG 50 CPR 0 0
18,45 100
0328753 ISOPTIN RR RET 240 MG 98 CPR 0 0
29,92 100
C08DA51 verapamil, combinations
0392317 TARKA 180/2 MG 28 CPR 0 0
26,76 100
0392334 TARKA 180/2 MG 98 CPR 0 0
66,21 100
C08DB01 diltiazem
0191501 DILTAHEXAL RET 90 MG 100 CPR 0 0
21,10 100
0225613 DILTAHEXAL RET 90 MG 30 CPR 0 0
8,25 100
0191496 DILTAHEXAL RET 90 MG 50 CPR 0 0
12,14 100
0253151 PROGOR 120 MG 28 CAPS 0 0
8,50 100
0253165 PROGOR 180 MG 28 CAPS 0 0
10,31 100
0364567 PROGOR 180 MG 56 CAPS 0 0
12,28 100
0253179 PROGOR 240 MG 28 CAPS 0 0
11,64 100
0488578 PROGOR 240 MG 56 CAPS 0 0
16,18 100
0231333 PROGOR 300 MG 28 CAPS PL 0 0
12,34 100
0364553 PROGOR 300 MG 56 CAPS 0 0
17,63 100
0253182 PROGOR 360 MG 28 CAPS 0 0
13,37 100
0116992 TILDIEM 60 MG 100 CPR 0 0
13,07 100
0116989 TILDIEM 60 MG 50 CPR 0 0
10,07 100
0231896 TILDIEM RET 200 MG 28 CAPS 0 0
14,07 100
0180641 TILDIEM RET 300 MG 28 CAPS 0 0
16,14 100
0241522 VIAZEM 120 MG 30 CAPS 0 0
12,88 100
0241536 VIAZEM 180 MG 30 CAPS 0 0
18,10 100
0241553 VIAZEM 240 MG 30 CAPS 0 0
21,94 100
0241567 VIAZEM 300 MG 30 CAPS 0 0
24,94 100
0241571 VIAZEM 360 MG 30 CAPS 0 0
26,92 100
C09AA01 captopril
0230577 CAPOTEN 25 MG 60 CPR 0 0
18,21 100
0230581 CAPOTEN 50 MG 60 CPR 0 0
26,02 100
0214184 CAPTOHEXAL 25 MG 100 CPR 0 0
10,61 100
0214167 CAPTOHEXAL 25 MG 20 CPR 0 0
4,21 100
0214171 CAPTOHEXAL 25 MG 50 CPR 0 0
6,22 100
0214217 CAPTOHEXAL 50 MG 100 CPR 0 0
11,76 100
0214198 CAPTOHEXAL 50 MG 20 CPR 0 0
5,40 100
0214203 CAPTOHEXAL 50 MG 50 CPR 0 0
9,84 100
0214248 CAPTOHEXAL COR 12,5 MG 100 CPR 0 0
7,31 100
0214221 CAPTOHEXAL COR 12,5 MG 20 CPR 0 0
2,95 100
0214234 CAPTOHEXAL COR 12,5 MG 50 CPR 0 0
4,24 100
0451385 CAPTOPRIL EG 100 MG 30 CPR 0 0
18,68 100
0451404 CAPTOPRIL EG 100 MG 60 CPR 0 0
27,00 100
0455949 CAPTOPRIL EG 25 MG 60 CPR 0 0
12,55 100
Page 23 of 85

Numéro national
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0482414 CAPTOPRIL EG 50 MG 60 CPR 0 0
17,37 100
0298851 DOCCAPTOPRI 100 MG 30 CPR 0 0
8,96 100
0298864 DOCCAPTOPRI 100 MG 60 CPR 0 0
22,86 100
0298816 DOCCAPTOPRI 25 MG 60 CPR 0 0
10,31 100
0298847 DOCCAPTOPRI 50 MG 60 CPR 0 0
14,50 100
C09AA02 enalapril
0098233 RENITEC 20 MG 28 CPR 0 0
10,24 100
0229917 RENITEC 20 MG 56 CPR 0 0
13,96 100
0252851 RENITEC 20 MG 98 CPR 0 0
21,30 100
0098247 RENITEC 5 MG 28 CPR 0 0
6,23 100
C09AA03 lisinopril
0358606 DOCLISINOPRIL 20 MG 56 CPR 0 0
15,28 100
0351829 LISINOPRIL EG 20 MG 28 CPR 0 0
11,39 100
0351863 LISINOPRIL EG 20 MG 56 CPR 0 0
16,52 100
0351881 LISINOPRIL EG 20 MG 98 CPR 0 0
28,96 100
0351671 LISINOPRIL EG 5 MG 28 CPR 0 0
6,41 100
0351703 LISINOPRIL EG 5 MG 56 CPR 0 0
8,02 100
0309274 LISINOPRIL RATIO 20 MG 100 CPR 0 0
13,43 100
0309257 LISINOPRIL RATIO 20 MG 30 CPR 0 0
10,30 100
0309261 LISINOPRIL RATIO 20 MG 50 CPR 0 0
11,27 100
0309338 LISINOPRIL RATIO 5 MG 100 CPR 0 0
10,90 100
0309311 LISINOPRIL RATIO 5 MG 30 CPR 0 0
3,48 100
0309324 LISINOPRIL RATIO 5 MG 50 CPR 0 0
5,72 100
0146201 ZESTRIL 20 MG 28 CPR 0 0
11,82 100
0211571 ZESTRIL 20 MG 56 CPR 0 0
19,57 100
0146196 ZESTRIL 5 MG 28 CPR 0 0
6,54 100
C09AA04 perindopril
0406278 COVERSYL 10 MG 60 CPR 0 0
34,50 100
0406281 COVERSYL 10 MG 90 CPR 0 0
45,15 100
0406121 COVERSYL 5 MG 30 CPR 0 0
13,10 100
0406152 COVERSYL 5 MG 90 CPR 0 0
25,82 100
C09AA05 ramipril
0365922 TRITACE 10 MG 28 CPR BLIST 0 0
18,47 100
0196928 TRITACE 2,5 MG 28 CPR 0 0
8,57 100
0196931 TRITACE 5 MG 28 CPR 0 0
12,06 100
C09AA06 quinapril
0163881 ACCUPRIL 20 MG 28 CPR 0 0
10,69 100
0273087 ACCUPRIL 40 MG 56 CPR 0 0
27,61 100
0163877 ACCUPRIL 5 MG 28 CPR 0 0
6,23 100
0412499 QUINAPRIL EG 20 MG 28 CPR 0 0
10,69 100
0412521 QUINAPRIL EG 20 MG 56 CPR 0 0
15,69 100
0412275 QUINAPRIL EG 5 MG 28 CPR 0 0
6,23 100
0412308 QUINAPRIL EG 5 MG 56 CPR 0 0
7,70 100
C09AA07 benazepril
0215181 CIBACEN 10 MG 28 CPR 0 0
10,58 100
0236567 CIBACEN 10 MG 42 CPR 0 0
11,54 100
0236571 CIBACEN 10 MG 98 CPR 0 0
15,08 100
0254811 CIBACEN 20 MG 28 CPR 0 0
11,47 100
0254825 CIBACEN 20 MG 42 CPR 0 0
12,82 100
0257116 CIBACEN 20 MG 98 CPR 0 0
17,74 100
0215178 CIBACEN 5 MG 28 CPR 0 0
9,90 100
0236181 CIBACEN 5 MG 42 CPR 0 0
10,56 100
0236195 CIBACEN 5 MG 98 CPR 0 0
13,05 100
C09AA08 cilazapril
0523582 INHIBACE 0,5 MG 30 CPR SEC 0 0
6,49 100
0182192 INHIBACE 5 MG 28 CPR SEC 0 0
16,64 100
C09AA09 fosinopril
0185021 FOSINIL 20 MG 28 CPR 0 0
20,95 100
C09AA10 trandolapril
0425953 UDRIK 2 MG 100 CAPS 0 0
24,24 100
0425922 UDRIK 2 MG 20 CAPS 0 0
10,40 100
C09BA02 enalapril and diuretics
0247963 CO RENITEC 56 CPR 0 0
14,25 100
0252834 CO RENITEC 98 CPR 0 0
21,91 100
Page 24 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
C09BA03 lisinopril and diuretics
0420053 COLISINOPRIL EG 20/12,5 MG 28 CPR 0 0
12,17 100
0420098 COLISINOPRIL EG 20/12,5 MG 56 CPR 0 0
14,89 100
0358153 LISINOPRIL RATIO COMP 10/12,5 MG 30 CPR 0 0
6,95 100
0358167 LISINOPRIL RATIO COMP 10/12,5 MG 50 CPR 0 0
13,44 100
0358024 LISINOPRIL RATIO COMP 20/12,5 MG 30 CPR 0 0
11,58 100
0358038 LISINOPRIL RATIO COMP 20/12,5 MG 50 CPR 0 0
14,12 100
0166798 ZESTORETIC 28 CPR 0 0
12,19 100
0248084 ZESTORETIC 56 CPR 0 0
20,35 100
C09BA04 perindopril and diuretics
0471987 COVERSYL PLUS 2,5/0,625 MG 30 CPR 0 0
18,12 100
0472029 COVERSYL PLUS 2,5/0,625 MG 90 CPR 0 0
36,20 100
0436568 COVERSYL PLUS 4/1,25 MG 30 CPR 0 0
18,12 100
0471875 COVERSYL PLUS 5/1,25 MG 30 CPR 0 0
17,66 100
0471911 COVERSYL PLUS 5/1,25 MG 90 CPR 0 0
35,13 100
0252445 PRETERAX 2/0,625 MG 30 CPR SEC 0 0
16,87 80
C09BA05 ramipril and diuretics
0209038 TRITAZIDE 28 CPR 0 0
12,71 100
0230627 TRITAZIDE 56 CPR 0 0
17,88 100
C09BA06 quinapril and diuretics
0197201 ACCURETIC 10/12,5 28 CPR 0 0
9,79 80
0197214 ACCURETIC 20/12,5 28 CPR 0 0
11,48 100
0419763 COQUINAPRIL 20/12,5 MG 28 CPR 0 0
11,48 100
0419813 COQUINAPRIL 20/12,5 MG 56 CPR 0 0
16,74 100
C09BA07 benazepril and diuretics
0254842 CIBADREX 10/12,5 MG 28 CPR 0 0
12,22 100
0254856 CIBADREX 10/12,5 MG 42 CPR 0 0
14,42 100
0254873 CIBADREX 10/12,5 MG 98 CPR 0 0
23,83 100
C09BA08 cilazapril and diuretics
0206408 CO INHIBACE 28 CPR 0 0
22,93 100
C09BB02 enalapril and lercanidipine
0505228 ZANICOMBO 10/10 MG 28 CPR 0 0
20,05 100
0505276 ZANICOMBO 10/10 MG 56 CPR 0 0
28,89 100
0505357 ZANICOMBO 20/10 MG 28 CPR 0 0
20,05 100
0505407 ZANICOMBO 20/10 MG 56 CPR 0 0
28,89 100
C09BB04 perindopril and amlodipine
0500252 COVERAM 10/10 MG 60 CPR 0 0
62,60 100
0500266 COVERAM 10/10 MG 90 CPR 0 0
90,06 100
0500722 COVERAM 10/5 MG 60 CPR 0 0
55,76 100
0500736 COVERAM 10/5 MG 90 CPR 0 0
80,18 100
0500381 COVERAM 5/10 MG 30 CPR 0 0
28,90 100
0500428 COVERAM 5/10 MG 90 CPR 0 0
60,57 100
0500543 COVERAM 5/5 MG 30 CPR 0 0
22,95 100
0500588 COVERAM 5/5 MG 90 CPR 0 0
46,34 100
C09BB05 ramipril and felodipine
0446595 TAZKO 5/5 MG 28 CPR 0 0
19,19 100
0444427 TAZKO 5/5 MG 98 CPR 0 0
43,75 100
C09CA01 losartan
0329683 COZAAR 100 MG 28 CPR 0 0
42,06 100
0329702 COZAAR 100 MG 98 CPR 0 0
69,92 100
0209171 COZAAR 50 MG 28 CPR 0 0
17,71 100
0209184 COZAAR 50 MG 56 CPR 0 0
27,82 100
0249646 COZAAR 50 MG 98 CPR 0 0
43,97 100
0345284 LOORTAN 100 MG 98 CPR 0 0
38,57 100
0252915 LOORTAN 50 MG 98 CPR 0 0
37,78 100
0562112 LOSARTAN EG 100 MG 98 CPR 0 0
29,31 100
0562059 LOSARTAN EG 50 MG 28 CPR 0 0
15,47 100
0562062 LOSARTAN EG 50 MG 56 CPR 0 0
24,27 100
0562076 LOSARTAN EG 50 MG 98 CPR 0 0
29,31 100
0508295 LOSARTAN RATIO 100 MG 28 CPR 0 0
22,13 100
0479758 LOSARTAN RATIO 100 MG 56 CPR 0 0
35,58 100
0479761 LOSARTAN RATIO 100 MG 98 CPR 0 0
50,32 100
0508278 LOSARTAN RATIO 50 MG 28 CPR 0 0
13,83 100
0479873 LOSARTAN RATIO 50 MG 56 CPR 0 0
21,73 100
Page 25 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0479887 LOSARTAN RATIO 50 MG 98 CPR 0 0
34,48 100
C09CA02 eprosartan
0281643 TEVETEN 600 MG 28 CPR 0 0
26,55 100
0328705 TEVETEN 600 MG 98 CPR 0 0
63,01 100
C09CA03 valsartan
0310938 DIOVAN 80 MG 28 CPR 0 0
27,84 100
0311255 DIOVAN 80 MG 56 CPR 0 0
45,76 100
0310941 DIOVAN 80 MG 98 CPR 0 0
71,66 100
0452544 DIOVAN FORTE 320 MG 28 CPR 0 0
37,65 100
0452558 DIOVAN FORTE 320 MG 56 CPR 0 0
64,58 100
0452561 DIOVAN FORTE 320 MG 98 CPR 0 0
103,51 100
0310972 DIOVAN PROTECT 160 MG 28 CPR 0 0
31,67 100
0310986 DIOVAN PROTECT 160 MG 56 CPR 0 0
53,12 100
0311001 DIOVAN PROTECT 160 MG 98 CPR 0 0
84,11 100
C09CA04 irbesartan
0240959 APROVEL 150 MG 28 CPR 0 0
26,34 100
0240993 APROVEL 300 MG 28 CPR 0 0
38,37 100
0241018 APROVEL 300 MG 98 CPR 0 0
95,24 100
C09CA06 candesartan
0245096 ATACAND 16 MG 28 CPR 0 0
30,66 100
0272112 ATACAND 16 MG 56 CPR 0 0
45,25 100
0319432 ATACAND 16 MG 98 CPR 0 0
74,39 100
0382209 ATACAND 32 MG 98 CPR 0 0
91,87 100
0245082 ATACAND 8 MG 28 CPR 0 0
25,92 100
0272093 ATACAND 8 MG 56 CPR 0 0
37,73 100
0342525 ATACAND 8 MG 98 CPR 0 0
61,32 100
C09CA07 telmisartan
0353353 KINZALMONO 40 MG 28 CPR 0 0
27,36 100
0353398 KINZALMONO 80 MG 28 CPR 0 0
40,05 100
0353403 KINZALMONO 80 MG 56 CPR 0 0
60,25 100
0353417 KINZALMONO 80 MG 98 CPR 0 0
90,61 100
0260965 MICARDIS 40 MG 28 CPR 0 0
27,30 100
0261007 MICARDIS 80 MG 28 CPR 0 0
40,00 100
0261011 MICARDIS 80 MG 56 CPR 0 0
60,20 100
0261024 MICARDIS 80 MG 98 CPR 0 0
90,54 100
C09CA08 olmesartan medoxomil
0359701 BELSAR 10 MG 28 CPR 0 0
22,66 100
0359763 BELSAR 20 MG 28 CPR 0 0
25,92 100
0359781 BELSAR 20 MG 98 CPR 0 0
61,28 100
0359827 BELSAR 40 MG 28 CPR 0 0
30,51 100
0359844 BELSAR 40 MG 98 CPR 0 0
74,06 100
0357268 OLMETEC 10 MG 28 CPR 0 0
22,66 100
0357318 OLMETEC 20 MG 28 CPR 0 0
25,92 100
0357335 OLMETEC 20 MG 98 CPR 0 0
61,28 100
0357366 OLMETEC 40 MG 28 CPR 0 0
30,51 100
0357397 OLMETEC 40 MG 98 CPR 0 0
74,06 100
C09D ANGIOTENSIN II ANTAGONISTS, COMBINATIONS
0447351 EXFORGE 10/160 MG 28 CPR 0 0
41,77 100
0447379 EXFORGE 10/160 MG 56 CPR 0 0
68,38 100
0447396 EXFORGE 10/160 MG 98 CPR 0 0
108,75 100
C09DA01 losartan and diuretics
0539954 COZAAR PLUS 100/12,5 MG 98 CPR 0 0
69,92 100
0244345 COZAAR PLUS 28 CPR 0 0
18,39 100
0244359 COZAAR PLUS 56 CPR 0 0
27,82 100
0249632 COZAAR PLUS 98 CPR 0 0
43,97 100
0315545 COZAAR PLUS FORTE 100/25 MG 28 CPR 0 0
42,07 100
0315562 COZAAR PLUS FORTE 100/25 MG 98 CPR 0 0
69,92 100
0264589 LOORTAN PLUS 50/12,5 MG 98 CPR 0 0
37,78 100
0322991 LOORTAN PLUS FORTE 100/25 MG 98 CPR 0 0
38,57 100
0562157 LOSARTAN PLUS EG 50/12,5 MG 28 CPR 0 0
15,47 100
0562174 LOSARTAN PLUS EG 50/12,5 MG 56 CPR 0 0
24,27 100
0562207 LOSARTAN PLUS EG 50/12,5 MG 98 CPR 0 0
29,31 100
0562417 LOSARTAN PLUS FORTE EG 100/25 MG 98 CPR 0 0
29,31 100
C09DA02 eprosartan and diuretics
Page 26 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0389681 TEVETEN PLUS 600/12,5 MG 28 CPR 0 0
27,05 100
0389701 TEVETEN PLUS 600/12,5 MG 98 CPR 0 0
64,38 100
C09DA03 valsartan and diuretics
0353841 CODIOVAN 160/12,5 MG 28 CPR 0 0
33,56 100
0353854 CODIOVAN 160/12,5 MG 56 CPR 0 0
56,08 100
0353868 CODIOVAN 160/12,5 MG 98 CPR 0 0
88,21 100
0474653 CODIOVAN 320/12,5 MG 28 CPR 0 0
39,38 100
0474667 CODIOVAN 320/12,5 MG 56 CPR 0 0
67,08 100
0474671 CODIOVAN 320/12,5 MG 98 CPR 0 0
106,61 100
0253523 CODIOVAN 80/12,5 MG 28 CPR 0 0
29,87 100
0253537 CODIOVAN 80/12,5 MG 56 CPR 0 0
49,09 100
0253541 CODIOVAN 80/12,5 MG 98 CPR 0 0
76,52 100
0389731 CODIOVAN FORTE 160/25 MG 28 CPR 0 0
37,66 100
0389745 CODIOVAN FORTE 160/25 MG 56 CPR 0 0
63,81 100
0389759 CODIOVAN FORTE 160/25 MG 98 CPR 0 0
101,13 100
0474748 CODIOVAN FORTE 320/25 MG 28 CPR 0 0
42,65 100
0474751 CODIOVAN FORTE 320/25 MG 56 CPR 0 0
73,24 100
0474765 CODIOVAN FORTE 320/25 MG 98 CPR 0 0
116,92 100
C09DA04 irbesartan and diuretics
0258273 COAPROVEL 150/12,5 28 CPR 0 0
27,31 100
0258306 COAPROVEL 300/12,5 28 CPR 0 0
38,37 100
0258337 COAPROVEL 300/12,5 98 CPR 0 0
95,24 100
0441491 COAPROVEL 300/25 28 CPR 0 0
38,37 100
0441537 COAPROVEL 300/25 98 CPR 0 0
95,24 100
C09DA06 candesartan and diuretics
0278621 ATACAND PLUS 16/12,5 28 CPR 0 0
30,90 100
0278634 ATACAND PLUS 16/12,5 56 CPR 0 0
46,90 100
0278648 ATACAND PLUS 16/12,5 98 CPR 0 0
75,11 100
C09DA07 telmisartan and diuretics
0353286 KINZALKOMB 40/12,5 MG 28 CPR 0 0
28,39 100
0353238 KINZALKOMB 80/12,5 MG 28 CPR 0 0
40,05 100
0353241 KINZALKOMB 80/12,5 MG 56 CPR 0 0
55,94 100
0353255 KINZALKOMB 80/12,5 MG 98 CPR 0 0
92,08 100
0492696 KINZALKOMB 80/25 MG 28 CPR 0 0
40,05 100
0492679 KINZALKOMB 80/25 MG 56 CPR 0 0
56,00 100
0492682 KINZALKOMB 80/25 MG 98 CPR 0 0
92,15 100
0319951 MICARDIS PLUS 40/12,5 28 CPR 0 0
28,33 100
0320027 MICARDIS PLUS 80/12,5 28 CPR 0 0
40,00 100
0320013 MICARDIS PLUS 80/12,5 56 CPR 0 0
60,20 100
0319995 MICARDIS PLUS 80/12,5 98 CPR 0 0
92,08 100
0482123 MICARDIS PLUS 80/25 28 CPR 0 0
40,00 100
0482154 MICARDIS PLUS 80/25 56 CPR 0 0
55,94 100
0482171 MICARDIS PLUS 80/25 98 CPR 0 0
92,08 100
C09DA08 olmesartan medoxomil and diuretics
0422528 BELSAR PLUS 20/12,5 MG 28 CPR 0 0
25,92 100
0422545 BELSAR PLUS 20/12,5 MG 98 CPR 0 0
61,28 100
0422478 BELSAR PLUS 20/25 MG 28 CPR 0 0
25,92 100
0422495 BELSAR PLUS 20/25 MG 98 CPR 0 0
61,28 100
0569581 BELSAR PLUS 40/12,5 MG 28 CPR 0 0
30,44 100
0569601 BELSAR PLUS 40/12,5 MG 98 CPR 0 0
74,00 100
0569631 BELSAR PLUS 40/25 MG 28 CPR 0 0
30,44 100
0569659 BELSAR PLUS 40/25 MG 98 CPR 0 0
74,00 100
0422755 OLMETEC PLUS 20/12,5 MG 28 CPR 0 0
25,92 100
0422772 OLMETEC PLUS 20/12,5 MG 98 CPR 0 0
61,28 100
0422707 OLMETEC PLUS 20/25 MG 28 CPR 0 0
25,92 100
0422724 OLMETEC PLUS 20/25 MG 98 CPR 0 0
61,28 100
0570288 OLMETEC PLUS 40/12,5 MG 28 CPR 0 0
30,44 100
0570307 OLMETEC PLUS 40/12,5 MG 98 CPR 0 0
74,00 100
0570338 OLMETEC PLUS 40/25 MG 28 CPR 0 0
30,44 100
0570355 OLMETEC PLUS 40/25 MG 98 CPR 0 0
74,00 100
C09DB01 valsartan and amlodipine
0447284 EXFORGE 5/160 MG 28 CPR 0 0
41,14 100
0447303 EXFORGE 5/160 MG 56 CPR 0 0
67,12 100
0447321 EXFORGE 5/160 MG 98 CPR 0 0
107,06 100
0447172 EXFORGE 5/80 MG 28 CPR 0 0
34,20 100
Page 27 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0447205 EXFORGE 5/80 MG 56 CPR 0 0
57,11 100
0447222 EXFORGE 5/80 MG 98 CPR 0 0
90,20 100
C09DB02 olmesartan medoxomil and amlodipine
0497191 FORZATEN 20/5 MG 28 CPR 0 0
29,83 100
0497211 FORZATEN 20/5 MG 98 CPR 0 0
72,30 100
0497305 FORZATEN 40/10 MG 28 CPR 0 0
42,12 100
0497322 FORZATEN 40/10 MG 98 CPR 0 0
105,33 100
0497241 FORZATEN 40/5 MG 28 CPR 0 0
38,69 100
0497269 FORZATEN 40/5 MG 98 CPR 0 0
96,07 100
0495961 SEVIKAR 20/5 MG 28 CPR 0 0
29,83 100
0495989 SEVIKAR 20/5 MG 98 CPR 0 0
72,30 100
0496065 SEVIKAR 40/10 MG 28 CPR 0 0
42,12 100
0496082 SEVIKAR 40/10 MG 98 CPR 0 0
105,33 100
0496017 SEVIKAR 40/5 MG 28 CPR 0 0
38,69 100
0496034 SEVIKAR 40/5 MG 98 CPR 0 0
96,07 100
C09DB04 telmisartan and amlodipine
0575964 TWYNSTA 40/10 MG 28 CPR 0 0
33,32 100
0576006 TWYNSTA 40/10 MG 98 CPR 0 0
81,64 100
0575883 TWYNSTA 40/5 MG 28 CPR 0 0
30,87 100
0575933 TWYNSTA 40/5 MG 98 CPR 0 0
75,02 100
0576118 TWYNSTA 80/10 MG 28 CPR 0 0
44,51 100
0576152 TWYNSTA 80/10 MG 98 CPR 0 0
108,02 100
0576041 TWYNSTA 80/5 MG 28 CPR 0 0
42,06 100
0576085 TWYNSTA 80/5 MG 98 CPR 0 0
99,84 100
C09XA02 aliskiren
0468043 RASILEZ 150 MG 28 CPR 0 0
34,05 80
0468074 RASILEZ 150 MG 56 CPR 0 0
59,31 80
0468107 RASILEZ 150 MG 98 CPR 0 0
97,57 80
0468141 RASILEZ 300 MG 28 CPR 0 0
38,90 80
0468172 RASILEZ 300 MG 56 CPR 0 0
69,51 80
0468219 RASILEZ 300 MG 98 CPR 0 0
115,44 80
C09XA52 aliskiren and hydrochlorothiazide
0502579 RASILEZ HCT 150/12,5 MG 28 CPR PELLIC 0 0
34,05 80
0502582 RASILEZ HCT 150/12,5 MG 56 CPR PELLIC 0 0
59,31 80
0502596 RASILEZ HCT 150/12,5 MG 98 CPR PELLIC 0 0
97,57 80
0502629 RASILEZ HCT 150/25 MG 28 CPR PELLIC 0 0
34,05 80
0502632 RASILEZ HCT 150/25 MG 56 CPR PELLIC 0 0
59,31 80
0502646 RASILEZ HCT 150/25 MG 98 CPR PELLIC 0 0
97,57 80
0502681 RASILEZ HCT 300/12,5 MG 28 CPR PELLIC 0 0
38,90 80
0502694 RASILEZ HCT 300/12,5 MG 56 CPR PELLIC 0 0
69,51 80
0502713 RASILEZ HCT 300/12,5 MG 98 CPR PELLIC 0 0
115,44 80
0512964 RASILEZ HCT 300/25 MG 28 CPR PELLIC 0 0
38,90 80
0513006 RASILEZ HCT 300/25 MG 56 CPR PELLIC 0 0
69,51 80
0513037 RASILEZ HCT 300/25 MG 98 CPR PELLIC 0 0
115,44 80
C10AA01 simvastatin
0310776 SIMVAHEXAL 10 MG 100 CPR 0 0
14,35 80
0310745 SIMVAHEXAL 10 MG 30 CPR 0 0
9,87 80
0310762 SIMVAHEXAL 10 MG 50 CPR 0 0
11,10 80
0310695 SIMVAHEXAL 20 MG 100 CPR 0 0
20,00 80
0310664 SIMVAHEXAL 20 MG 30 CPR 0 0
7,80 80
0310681 SIMVAHEXAL 20 MG 50 CPR 0 0
12,50 80
0310566 SIMVAHEXAL 30 MG 30 CPR 0 0
12,60 80
0310597 SIMVAHEXAL 30 MG 50 CPR 0 0
15,91 80
0310521 SIMVAHEXAL 40 MG 100 CPR 0 0
24,00 80
0310485 SIMVAHEXAL 40 MG 30 CPR 0 0
5,80 80
0310504 SIMVAHEXAL 40 MG 50 CPR 0 0
10,00 80
0310874 SIMVAHEXAL 5 MG 100 CPR 0 0
12,61 80
0310843 SIMVAHEXAL 5 MG 30 CPR 0 0
9,42 80
0310861 SIMVAHEXAL 5 MG 50 CPR 0 0
10,30 80
0324771 SIMVASTATIN RATIO 10 MG 100 CPR 0 0
14,30 80
0324723 SIMVASTATIN RATIO 10 MG 30 CPR 0 0
9,84 80
0324737 SIMVASTATIN RATIO 10 MG 50 CPR 0 0
11,06 80
0324463 SIMVASTATIN RATIO 20 MG 100 CPR 0 0
20,17 80
0324401 SIMVASTATIN RATIO 20 MG 30 CPR 0 0
7,80 80
0324415 SIMVASTATIN RATIO 20 MG 50 CPR 0 0
12,50 80
Page 28 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0324284 SIMVASTATIN RATIO 40 MG 100 CPR 0 0
24,00 80
0324222 SIMVASTATIN RATIO 40 MG 30 CPR 0 0
11,40 80
0324236 SIMVASTATIN RATIO 40 MG 50 CPR 0 0
15,50 80
0324589 SIMVASTATIN RATIO 5 MG 100 CPR 0 0
12,57 80
0328431 SIMVASTATIN RATIO 5 MG 30 CPR 0 0
9,39 80
0328445 SIMVASTATIN RATIO 5 MG 50 CPR 0 0
10,28 80
0494303 SIMVASTATINE DOC 20 MG 28 CPR 0 0
9,44 80
0494321 SIMVASTATINE DOC 20 MG 84 CPR 0 0
18,31 80
0494365 SIMVASTATINE DOC 40 MG 56 CPR 0 0
11,25 80
0494379 SIMVASTATINE DOC 40 MG 98 CPR 0 0
26,64 80
0158541 ZOCOR 20 MG 28 CPR 0 0
10,37 80
0223152 ZOCOR 20 MG 84 CPR 0 0
19,18 80
0249534 ZOCOR 40 MG 28 CPR 0 0
12,47 80
0252879 ZOCOR 40 MG 98 CPR 0 0
27,08 80
C10AA02 lovastatin
0328669 LOVAHEXAL 10 MG 100 CPR 0 0
15,99 80
0328624 LOVAHEXAL 10 MG 30 CPR 0 0
10,30 80
0328638 LOVAHEXAL 10 MG 50 CPR 0 0
11,84 80
0325099 LOVAHEXAL 20 MG 100 CPR 0 0
21,99 80
0325054 LOVAHEXAL 20 MG 30 CPR 0 0
11,87 80
0325068 LOVAHEXAL 20 MG 50 CPR 0 0
14,61 80
0325202 LOVAHEXAL 40 MG 100 CPR 0 0
31,41 80
0325152 LOVAHEXAL 40 MG 30 CPR 0 0
14,33 80
0325166 LOVAHEXAL 40 MG 50 CPR 0 0
18,97 80
C10AA03 pravastatin
0385777 DOCPRAVASTATINE 20 MG 28 CPR 0 0
7,93 80
0385813 DOCPRAVASTATINE 20 MG 98 CPR 0 0
28,53 80
0385844 DOCPRAVASTATINE 40 MG 28 CPR 0 0
17,78 80
0385875 DOCPRAVASTATINE 40 MG 98 CPR 0 0
41,79 80
0516574 PRAREDUCT 20 MG 28 CPR 0 0
14,21 80
0516588 PRAREDUCT 20 MG 98 CPR 0 0
31,42 80
0516607 PRAREDUCT 40 MG 28 CPR 0 0
20,30 80
0516611 PRAREDUCT 40 MG 98 CPR 0 0
46,51 80
0180119 PRAVASINE 20 MG 28 CPR 0 0
22,03 80
0253005 PRAVASINE 20 MG 98 CPR 0 0
52,00 80
0259531 PRAVASINE 40 MG 28 CPR 0 0
31,96 80
0259835 PRAVASINE 40 MG 98 CPR 0 0
79,12 80
0367149 PRAVASTATIN HEXAL 20 MG 100 CPR 0 0
20,56 80
0367041 PRAVASTATIN HEXAL 20 MG 20 CPR 0 0
5,80 80
0367071 PRAVASTATIN HEXAL 20 MG 50 CPR 0 0
13,96 80
0367328 PRAVASTATIN HEXAL 30 MG 100 CPR 0 0
26,15 80
0367202 PRAVASTATIN HEXAL 30 MG 20 CPR 0 0
11,26 80
0367247 PRAVASTATIN HEXAL 30 MG 50 CPR 0 0
16,53 80
0367507 PRAVASTATIN HEXAL 40 MG 100 CPR 0 0
30,11 80
0367376 PRAVASTATIN HEXAL 40 MG 20 CPR 0 0
11,92 80
0367412 PRAVASTATIN HEXAL 40 MG 50 CPR 0 0
18,37 80
0413207 PRAVASTATINE EG 20 MG 28 CPR 0 0
9,40 80
0413241 PRAVASTATINE EG 20 MG 98 CPR 0 0
28,53 80
0413305 PRAVASTATINE EG 40 MG 28 CPR 0 0
18,46 80
0413353 PRAVASTATINE EG 40 MG 98 CPR 0 0
38,64 80
C10AA04 fluvastatin
0259771 LOCOL 20 MG 100 CAPS 0 0
14,35 80
0258998 LOCOL 20 MG 30 CAPS 0 0
9,87 80
0211019 LOCOL 20 MG 50 CAPS 0 0
11,10 80
0259785 LOCOL 40 MG 100 CAPS 0 0
20,56 80
0259009 LOCOL 40 MG 30 CAPS 0 0
11,49 80
0211053 LOCOL 40 MG 50 CAPS 0 0
13,96 80
0309761 LOCOL 80 MG 100 CPR 0 0
30,11 80
0309744 LOCOL 80 MG 30 CPR 0 0
14,00 80
0309758 LOCOL 80 MG 50 CPR 0 0
18,37 80
C10AA05 atorvastatin
0233713 LIPITOR 10 MG 28 CPR 0 0
31,65 80
0241925 LIPITOR 10 MG 84 CPR 0 0
74,67 80
0233731 LIPITOR 20 MG 28 CPR 0 0
46,01 80
0241939 LIPITOR 20 MG 84 CPR 0 0
111,94 80
0241942 LIPITOR 40 MG 84 CPR 0 0
184,19 80
Page 29 of 85

Numéro national
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0312896 LIPITOR 80 MG 98 CPR 0 0
213,40 80
C10AA07 rosuvastatin
0346636 CRESTOR 10 MG 28 CPR 0 0
31,65 80
0346717 CRESTOR 10 MG 98 CPR 0 0
83,98 80
0346796 CRESTOR 20 MG 28 CPR 0 0
46,01 80
0346877 CRESTOR 20 MG 98 CPR 0 0
129,10 80
0346975 CRESTOR 40 MG 28 CPR 0 0
77,53 80
0347048 CRESTOR 40 MG 98 CPR 0 0
201,32 80
C10AB02 bezafibrate
0389373 BEZAFIBRAT HEXAL RET 400 MG 100 CPR 0 0
22,00 80
0389356 BEZAFIBRAT HEXAL RET 400 MG 30 CPR 0 0
8,10 80
0268591 CEDUR 200 MG 60 CPR 0 0
9,90 80
0268588 EULITOP 400 MG 30 CPR 0 0
9,90 80
C10AB05 fenofibrate
0336061 FEGENOR 200 MG 30 CAPS 0 0
10,75 80
0301097 FENOGAL 200 MG LIDOSE 30 CAPS 0 0
8,57 80
0301102 FENOGAL 200 MG LIDOSE 98 CAPS 0 0
13,68 80
0400422 FENOGAL 267 MG LIDOSE 30 CAPS 0 0
8,80 80
0400471 FENOGAL 267 MG LIDOSE 90 CAPS 0 0
18,47 80
0192994 LIPANTHYL MICRON 200 MG 30 CAPS 0 0
11,37 80
0270667 LIPANTHYL MICRON 267 MG 30 CAPS 0 0
12,64 80
0270671 LIPANTHYL MICRON 267 MG 90 CAPS 0 0
23,22 80
0270619 LIPANTHYL MICRON 67 MG 30 CAPS 0 0
7,08 80
0270622 LIPANTHYL MICRON 67 MG 90 CAPS 0 0
10,65 80
0430144 LIPANTHYL NANO 145 MG 30 CPR 0 0
11,37 80
0430175 LIPANTHYL NANO 145 MG 90 CPR 0 0
21,57 80
C10AB08 ciprofibrate
0055253 HYPERLIPEN 100 MG 30 CAPS 0 0
11,78 80
C10AC01 colestyramine
0096337 QUESTRAN 50 SACH 4 G 0 0
24,92 80
C10AC02 colestipol
0023652 COLESTID PDR 50 SACH 5 G 0 0
23,55 80
C10AC04 colesevelam
0371061 CHOLESTAGEL 625 MG 180 CPR 0 0
135,42 80
C10AD06 acipimox
0209458 OLBETAM 250 MG 90 CAPS 0 0
23,15 80
C10AD52 nicotinic acid, combinations
0488242 TREDAPTIVE 1000/20 MG 196 CPR 0 0
133,37 80
0488192 TREDAPTIVE 1000/20 MG 28 CPR 0 0
30,89 80
C10AX09 ezetimibe
0348515 EZETROL 10 MG 98 CPR 0 0
133,43 80
C10BA02 simvastatin and ezetimibe
0390035 INEGY 10/20 MG 98 CPR 0 0
164,59 80
0390195 INEGY 10/40 MG 98 CPR 0 0
190,55 80
0390343 INEGY 10/80 MG 98 CPR 0 0
200,93 80
D01AA01 nystatin
0017915 CANDIO HERMAL CREME 20 G 0 0
6,16 80
D01AC01 clotrimazole
0183267 ANTIFUNGOL 1% 1 FL DOS 30 ML 0 0
3,93 80
0152517 FUNGIZID RATIO 1% SPRAY 40 ML 0 0
5,29 80
D01AC02 miconazole
0027620 DAKTARIN CREME 30 G 17398 0 0
6,17 80
0027651 DAKTARIN PDR 20 G 17397 0 0
6,20 80
0347911 DAKTARIN SPRAY 2%/D 1 FL 8 G 0 0
7,08 80
0027679 DAKTARIN TEINTURE 30 ML 17395 0 0
6,02 80
D01AC03 econazole
0269215 DERMAZOL 1% PDR 30 G 0 0
5,68 80
0256167 DERMAZOL 1% SOL 30 G 0 0
3,92 80
0256136 DERMAZOL GE 1% CREME 30 G 0 0
3,07 80
0256153 DERMAZOL GE 1% EMULSION 30 G 0 0
3,35 80
0089427 PEVARYL LAIT DERMATO 30 ML 191589 0 0
3,92 80
0180217 PEVARYL SPRAY SOLUTIO 30 ML 192619 0 0
7,85 80
Page 30 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
D01AC05 isoconazole
0119350 TRAVOGENE CREME 20 G 0 0
6,34 80
D01AC08 ketoconazole
0503092 NIZORAL 2% CREME 30 G 0 0
7,27 80
D01AC09 sulconazole
0043431 MYK 1 1% CREME 30 G 0 0
7,34 80
0180122 MYK 1 1% SOL 20 ML 0 0
4,24 80
D01AC10 bifonazole
0385147 CANESTENE DERM BIFONAZOLE 1% CREME 15 G 0 0
9,44 80
D01AC20 combinations
0027584 DAKTACORT CREME 15 G 17396 0 0
6,42 80
0027598 DAKTACORT CREME 30 G 27332 0 0
7,75 80
0089461 PEVISONE 15 G CREME 191216 0 0
6,16 80
D01AC52 miconazole, combinations
0177631 DAKTOZIN 0,25% PATE 90 G 52490 0 0
7,96 80
D01AE12 salicylic acid
0104599 SICOMBYL GRAN 10 G 0 0
4,37 80
D01AE14 ciclopirox
0154381 MYCOSTER 1% CREME 30 G 0 0
4,97 80
0247381 MYCOSTER 1% PDR 30 G 0 0
4,88 80
0154363 MYCOSTER 1% SOL 30 ML 0 0
4,98 80
0214346 MYCOSTER 8% SOL 3 ML 0 0
14,97 80
D01AE15 terbinafine
0174237 LAMISIL 1% CREME 15 G 03337 0 0
9,17 80
0468236 LAMISIL 1% SPRAY 15 ML 0 0
10,36 80
0262312 LAMISIL DERMGEL 1% GEL 15 G 0 0
9,95 80
D01AE16 amorolfine
0205087 LOCERYL 5% VERNIS 5 ML 0 0
41,89 80
D01BA02 terbinafine
0457022 DOCTERBINAFINE 250 MG 14 CPR 0 0
20,80 80
0457053 DOCTERBINAFINE 250 MG 56 CPR 0 0
53,79 80
0174156 LAMISIL 250 MG 14 CPR 0 0
71,12 80
0174173 LAMISIL 250 MG 28 CPR 0 0
130,88 80
0400503 MYCONORMIN 250 MG 14 CPR 0 0
19,75 80
0400517 MYCONORMIN 250 MG 28 CPR 0 0
31,66 80
0409378 MYCONORMIN 250 MG 42 CPR 0 0
43,74 80
0435848 TERBINAFINE TEVA 250 MG 14 CPR 0 0
23,82 80
D02AB Zinc products
0258341 CALAMINE GEL 50 ML 0 0
6,00 80
0257097 INOTYOL POM 90 G 0 0
7,09 80
0270023 MITOSYL POM 150 G 0 0
7,56 80
0230305 MITOSYL POM 65 G 0 0
4,47 80
D02AX Other emollients and protectives
0076706 NEOCUTIGENOL POM 100 G 0 0
5,93 80
0076690 NEOCUTIGENOL POM 50 G 0 0
3,69 80
D02BB01 betacarotene
0019002 CAROTABEN 100 CAPS 0 0
33,97 80
D03AA Cod-liver oil ointments
0122924 UNGUENTOLAN POM 100 G 0 0
9,22 80
0122907 UNGUENTOLAN POM 20 G 0 0
3,47 80
0122910 UNGUENTOLAN POM 50 G 0 0
5,91 80
0292065 VITAMURUINE 445000 U POM 45 G 0 0
5,07 80
D03BA52 collagenase, combinations
0283391 IRUXOL POM 30 G 0 0
23,47 80
D04AA13 dimetindene
0151179 FENISTIL 0,1% GEL 20 G 0 0
4,25 40
0151182 FENISTIL 0,1% GEL 50 G 0 0
8,58 40
D04AA15 bamipine
0394387 SOVENTOL 2% GEL 20 G 0 0
4,22 40
0394391 SOVENTOL 2% GEL 50 G 0 0
8,58 40
D04AA32 diphenhydramine
0016921 CALADRYL CREME 42 G 0 0
4,05 40
Page 31 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0016935 CALADRYL LOT 100 ML 0 0
4,37 40
D04AA34 chlorphenoxamine
0112783 SYSTRAL CREME 20 G 0 0
3,83 40
0112766 SYSTRAL GEL 20 G 0 0
3,40 40
D04AB01 lidocaine
0179586 XYLOCAINE ASTRA 2% GEL 10 SRG 10 G 0 0
15,97 80
0130442 XYLOCAINE ASTRA 2% GEL 30 ML 0 0
5,66 80
0130487 XYLOCAINE ASTRA 5% POM 35 G 0 0
6,34 80
0130568 XYLOCAINE ASTRA SPRAY 10% 1 FL PULV 50ML 0 0
23,70 80
D05AX02 calcipotriol
0488337 DAIVONEX 50 MCG/G CREME 100 G 0 0
36,59 80
0488323 DAIVONEX 50 MCG/G CREME 30 G 0 0
15,80 80
D05AX52 calcipotriol, combinations
0313375 DOVOBET POM 60 G 0 0
46,66 80
0500803 XAMIOL 50 MCG/G 0,5 MG/G GEL 60 G 0 0
46,66 80
D05BB02 acitretin
0147999 NEOTIGASON 10 MG 30 CAPS 0 0
26,33 80
0148013 NEOTIGASON 25 MG 30 CAPS 0 0
46,46 80
D06AA03 oxytetracycline
0076429 NEOBACITRACINE POM 20 G 0 0
5,46 80
0180685 TERRAMYCINE POM 15 G 0 0
5,59 80
D06AA04 tetracycline
0140032 IMEX 3% POM 20 G 0 0
18,71 80
D06AX01 fusidic acid
0154248 FUCIDIN 2% CREME 15 G 0 0
8,50 80
0144692 FUCIDIN POM 15 G (ONGUENT) 0 0
8,50 80
0154413 FUCITHALMIC 1% GEL 5 G 0 0
6,63 80
D06AX07 gentamicin
0048911 GEOMYCINE CREME 15 G 0 0
5,03 80
0048925 GEOMYCINE POM 15 G 0 0
5,03 80
D06AX08 tyrothricin
0281559 TYROSUR GEL 5 G 0 0
3,79 80
0122079 TYROSUR PDR 5 G 0 0
4,54 80
D06AX09 mupirocin
0485139 BACTROBAN 2% POM 15 G 0 0
9,16 80
D06BA Sulfonamides
0006388 ANTEBOR SOLUTION 200 ML 0 0
8,86 80
0092128 POLYSEPTOL POM 22 G 0 0
6,80 80
D06BA01 silver sulfadiazine
0045002 FLAMMAZINE CREME 50 G 0 0
7,58 80
D06BB02 tromantadine
0128203 VIRU MERZ SEROL 5 G 0 0
9,22 80
D06BB03 aciclovir
0214525 SUPRAVIRAN 5 % CREME 2 G 0 0
4,07 80
D06BB06 penciclovir
0228891 VECTAVIR 1% CREME 2 G 141062 0 0
8,32 80
D06BB07 lysozyme
0074682 MURAZYME 2% POM 25 G 0 0
5,62 80
D06BB10 imiquimod
0256749 ALDARA 5% CREME 12 SACH 250 MG 0 0
74,15 80
D06BX01 metronidazole
0389034 ROSACED 0,75% CREME 30 G 0 0
7,53 80
0247039 ROZEX 0,75% CREME 30 G 0 0
8,00 80
0275548 ROZEX 0,75% EMULS 30 G TUBE 0 0
8,00 80
0194873 ROZEX 0,75% GEL 30 G 0 0
8,00 80
D07AA02 hydrocortisone
0278201 PANNOCORT 1% CREME 5 G 0 0
1,59 80
D07AB01 clobetasone
0042515 EUMOVATE CREME 30 G 0 0
8,52 80
0042529 EUMOVATE ONG 30 G 0 0
8,52 80
D07AB02 hydrocortisone butyrate
Page 32 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0212131 LOCOID CRELO 0,1% EMUL 100 G 0 0
13,31 80
0203924 LOCOID CRELO 0,1% EMUL 30 G 0 0
7,53 80
0067027 LOCOID CREME 30 G 0 0
7,53 80
0067030 LOCOID LIPOCREME 30 G 0 0
7,53 80
0067044 LOCOID LOT 0,1% 30 ML 0 0
7,53 80
0067058 LOCOID ONG DERM 30 G 0 0
7,53 80
D07AB07 fluprednidene
0028547 DECODERM CREME 20 G 0 0
11,88 80
0028550 DECODERM CREME 50 G 0 0
16,26 80
0028564 DECODERM SALBE 20 G 0 0
13,02 80
D07AB08 desonide
0243897 LOCAPRED 0,1% CREME 15 G 0 0
2,61 80
0243852 LOCATOP 0,1 % CREME 30 G 0 0
3,11 80
D07AB09 triamcinolone
0028984 DELPHI 0,1% CREME 30 G 0 0
10,17 80
D07AC01 betamethasone
0012886 BETNELAN V 0,1% CREME 30 G 0 0
6,53 80
0012919 BETNELAN V 0,1% LOTION 30 ML 0 0
6,53 80
0012936 BETNELAN V 0,1% ONG 30 G 0 0
6,53 80
0033337 DIPROLENE 0,05% CREME 30 G 0 0
7,52 80
0033340 DIPROLENE 0,05% ONG 30 G 0 0
7,52 80
0033418 DIPROSONE CREME 30 G 0 0
7,52 80
0033421 DIPROSONE LOTION 30 ML 0 0
7,52 80
0033435 DIPROSONE POM 30 G 0 0
7,52 80
D07AC06 diflucortolone
0077605 NERISONA CREME 15 G 0 0
6,10 80
0077619 NERISONA CREME 30 G 0 0
7,11 80
0077636 NERISONA POM 30 G 0 0
7,11 80
0077667 NERISONA POM GRASSE 30 G 0 0
7,11 80
D07AC11 amcinonide
0004299 AMICLA CREME 30 G 0 0
7,29 80
D07AC13 mometasone
0182872 ELOCOM 0,1% CREME 20 G 0 0
7,43 80
0182905 ELOCOM 0,1% LOT 20 ML 0 0
7,43 80
0182886 ELOCOM 0,1% ONG 20 G 0 0
7,43 80
D07AC14 methylprednisolone aceponate
0186059 ADVANTAN 0,1% CREME 15 G 0 0
6,51 80
0186031 ADVANTAN 0,1% POM 15 G 0 0
6,51 80
0186045 ADVANTAN 0,1% POM GRASSE 15 G 0 0
6,51 80
D07AC17 fluticasone
0192767 CUTIVATE 0,005% POM 30 G 0 0
7,74 80
0192736 CUTIVATE 0,05% CREME 30 G 0 0
7,74 80
D07AD01 clobetasol
0426186 CLARELUX 0,05% MOUSSE 100 G 0 0
21,50 80
0457599 CLOBEX 500 MCG/G SHAMP 125 ML 0 0
20,03 80
0030268 DERMOVATE 0,05% CREME 30 G 0 0
7,89 80
0030271 DERMOVATE 0,05% LOTION 30 ML 0 0
7,89 80
0030299 DERMOVATE 0,05% ONG 30 G 0 0
7,89 80
D07CA01 hydrocortisone and antibiotics
0253666 FUCIDIN HYDROCORTISONE CREME 15 G 0 0
8,55 80
0180671 TERRACORTRIL POM 15 G 0 0
8,28 80
D07CB02 fluprednidene and antibiotics
0028600 DECODERM COMP CREME 20 G 0 0
20,11 80
0028614 DECODERM COMP CREME 50 G 0 0
34,19 80
0028631 DECODERM COMP SALBE 20 G 0 0
20,11 80
0028645 DECODERM COMP SALBE 50 G 0 0
34,19 80
D07CC01 betamethasone and antibiotics
0158281 FUCICORT CREME 15 G 0 0
8,90 80
D07XB03 fluprednidene
0192137 DECODERM TRI CREME 50 G 0 0
30,90 80
D07XC01 betamethasone
0033399 DIPROSALIC LOTION 30 ML 0 0
7,83 80
0033404 DIPROSALIC ONG 30 G 0 0
7,83 80
Page 33 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0067898 LOTRIDERM CREME 30 G 0 0
8,16 80
D08AC02 chlorhexidine
0137412 ASTREXINE PDR 30 G 0 0
3,60 80
0212159 HIBIDIL 0,05% SOL 10*15 ML UD 0 0
6,75 80
0212193 HIBIDIL 0,05% SOL 8*50 ML UD 0 0
16,20 80
0053701 HIBIGUARD 0,5% SOL 500 ML 0 0
6,39 80
0258886 HIBISCRUB 4% 4 FL UD 25 ML 0 0
5,29 80
0053729 HIBISCRUB 4% SOL 250 ML 0 0
5,84 80
0133752 HIBITANE 5% SOL 10 SACH 15 ML 0 0
7,05 80
0053813 HIBITANE 5% SOL 250 ML 0 0
5,86 80
0053830 HIBITANE ANTISEPT LUBRIF 250 ML 0 0
4,88 80
0183321 MEFREN INCOLORE SOL 50 ML 0 0
4,65 80
0139286 SEPTEAL 0,5 % SOL 250 ML 0 0
3,67 80
D08AC04 hexamidine
0053598 HEXOMEDINE TRANSCUT SOL 45 ML 0 0
5,20 80
D08AC52 chlorhexidine, combinations
0182211 CETAVLEX CREME 60 G 0 0
4,23 80
0027164 CYTEAL SOL ANTISEPTIQUE 250 ML 0 0
3,78 80
0027178 CYTEAL SOL ANTISEPTIQUE 500 ML 0 0
6,80 80
0051402 HAC SOL 250 ML 0 0
5,18 80
D08AG02 povidone-iodine
0014944 BRAUNODERM 1/100 G SOL 1000 ML 0 0
11,70 80
0014927 BRAUNODERM 1/100 G SOL 150 ML 0 0
2,83 80
0014992 BRAUNOL 7,5/100 G SOL 1000 ML 0 0
8,30 80
0014989 BRAUNOL 7,5/100 G SOL 250 ML 0 0
6,42 80
0186594 BRAUNOL 7,5/100 G SOL 30 ML 0 0
2,12 80
0015065 BRAUNOVIDON 10% 10*20 CM 10 GAZES 0 0
35,05 80
0015048 BRAUNOVIDON 10% 7,5*10 CM 10 GAZES 0 0
23,80 80
0015115 BRAUNOVIDON POM 100 G 0 0
10,31 80
0015101 BRAUNOVIDON POM 20 G 0 0
3,97 80
0174657 IODEX DERMAL 10% 1 FL 30 ML 0 0
4,47 80
0058384 IODEX SIMPLE POM 23 G 0 0
6,61 80
0269943 ISOBETADINE 10% GEL 100 G 0 0
8,03 80
0404466 ISOBETADINE DERM 10% SOL 10*5 ML UD 0 0
5,31 80
0194727 ISOBETADINE DERM 10% SOL 125 ML 0 0
5,44 80
0393636 ISOBETADINE HYDROALCOOLIQUE 5% 125 ML 0 0
5,91 80
0059025 ISOBETADINE SAV GERM 7,5% 500 ML 0 0
9,86 80
0059090 ISOBETADINE TULLE 10% 10*10 CM 10 COMPR 0 0
11,52 80
0241746 ISOBETADINE UNIWASH 7,5% 10 FL UD 10 ML 0 0
7,62 80
D08AX04 tosylchloramide sodium
0020860 CHLORAMINE PURA 250 MG 60 CPR 0 0
3,55 80
0021241 CHLORAZOL 500 MG 20 CPR 0 0
4,57 80
D08AX07 sodium hypochlorite
0181276 DAKIN COOPER STABILISE 250 ML 0 0
5,34 80
D09AA02 fusidic acid
0046982 FUCIDIN INTERTULLE COMPR 10*10 0 0
10,98 80
0046996 FUCIDIN INTERTULLE COMPR 10*30 0 0
13,24 80
D10AD01 tretinoin
0066856 LOCACID CREME 30 G 0 0
5,75 80
0066873 LOCACID LOT 15 ML 0 0
5,35 80
0153545 TRETINOINE KEFRANE GEL 30 G 0 0
5,15 80
D10AD03 adapalene
0252025 DIFFERIN 0,1% CREME 30 G 0 0
9,83 80
0380459 DIFFERIN 0,1% CREME 60 G 0 0
17,68 80
0217169 DIFFERIN 0,1% GEL 30 G 0 0
9,83 80
0380462 DIFFERIN 0,1% GEL 60 G 0 0
17,68 80
D10AD04 isotretinoin
0197858 ISOTREX 0,05% GEL 50 G 0 0
20,11 80
D10AD51 tretinoin, combinations
0181486 WIDMER CARBAMID VAS CREME 30 G 0 0
10,59 80
D10AD54 isotretinoin, combinations
0260867 ISOTREXIN 0,05/2% GEL 50 G 0 0
18,96 80
D10AE01 benzoyl peroxide
Page 34 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0001980 AKNEROXID 100 MG/G GEL 50 G 0 0
7,44 80
0001994 AKNEROXID 50 MG/G GEL 50 G 0 0
6,74 80
0183107 BENZAC 10% GEL 40 G 0 0
6,38 80
0183111 BENZAC 5% GEL 40 G 0 0
6,14 80
0038042 ECLARAN 10 GEL 45 G 0 0
3,22 80
0038056 ECLARAN 5 GEL 45 G 0 0
3,22 80
0102708 SCHEROGEL 10% GEL 30 G 0 0
3,76 80
0102711 SCHEROGEL 5% GEL 30 G 0 0
3,61 80
D10AE51 benzoyl peroxide, combinations
0269277 ACNEPLUS CREME 30 G 0 0
8,51 80
D10AF01 clindamycin
0239748 DALACIN TOPICAL 1% LOTIO 30 ML 0 0
11,85 80
0343648 ZINDACLIN 1% GEL 30 G 0 0
16,82 80
D10AF02 erythromycin
0196279 ACNERYNE 4% GEL 30 G 0 0
14,33 80
0001977 AKNEMYCIN 2% SOL 25 ML 0 0
11,56 80
0146473 AKNEMYCIN 2000 POM 2% 25 G 0 0
11,56 80
0001963 AKNEMYCIN EMULSION 25 G 0 0
14,41 80
0040913 ERYFLUID LOTION 100 ML 0 0
7,73 80
0259107 ERYTHROMYCINE BAILLEUL 4% SOL 100 ML 0 0
4,56 80
0559862 STIMYCINE 0,2 G/10 ML 1 FL 25 ML 0 0
6,54 80
D10AF03 chloramphenicol
0254503 CHLORAMPHENICOL ERFA 1% CREME 20 G 0 0
4,03 80
D10AF52 erythromycin, combinations
0523579 BENZADERMINE GEL 1 POT + S 0 0
24,05 80
0131128 ZINERYT LOT 30 ML 0 0
18,86 80
D10AX03 azelaic acid
0163071 SKINOREN 20% CREME 30 G 0 0
11,47 80
D10BA01 isotretinoin
0472984 CURACNE 40 MG 30 CAPS 0 0
49,47 80
0427927 CURACNE GE 10 MG 30 CAPS MOLLES 0 0
16,56 80
0427975 CURACNE GE 20 MG 30 CAPS MOLLES 0 0
28,29 80
0427863 CURACNE GE 5 MG 30 CAPS MOLLES 0 0
10,02 80
0100393 ROACCUTANE 10 MG 30 CAPS 0 0
17,84 80
0100409 ROACCUTANE 20 MG 30 CAPS 0 0
27,40 80
D11AF Wart and anti-corn preparations
0178785 DUOFILM SOL 15 G 0 0
6,79 80
0444221 VERRUMAL 14 ML 0 0
18,79 80
D11AH01 tacrolimus
0317004 PROTOPIC 0,03% POM 30 G 0 0
32,77 80
0317018 PROTOPIC 0,03% POM 60 G 0 0
53,26 80
0317021 PROTOPIC 0,1% POM 30 G 0 0
35,39 80
0317035 PROTOPIC 0,1% POM 60 G 0 0
58,68 80
D11AH02 pimecrolimus
0334439 ELIDEL 1% CREME 15 G 0 0
25,63 80
0334442 ELIDEL 1% CREME 30 G 0 0
39,14 80
D11AX19 alitretinoin
0501974 TOCTINO 10 MG 30 CAPS MOLLES 0 0
483,41 80
0501988 TOCTINO 30 MG 30 CAPS 0 0
483,41 80
G01AA10 clindamycin
0203289 DALACIN VAG 2% CREME 40 G 0 0
25,23 80
G01AD01 lactic acid
0063112 LACTAGYNECOGEL POM 60 G + APPL 0 0
7,72 80
G01AF01 metronidazole
0044926 FLAGYL 500 MG 10 OV 0 0
6,17 80
G01AF02 clotrimazole
0051223 CANESTENE GYN CLOTRIMAZ 2% CR 20G +3APPL 0 0
7,92 80
0051187 CANESTENE GYN CLOTRIMAZOLE 100 MG 6 CPR 0 0
7,88 80
0146294 FUNGIZID RATIO 1% CREME 20 G 0 0
3,27 80
0146313 FUNGIZID RATIO 1% CREME 50 G 0 0
6,97 80
0217155 FUNGIZID RATIO 1% CREME VAG 35 G + APPL 0 0
5,51 80
0146246 FUNGIZID RATIO 100 MG 6 CPR VAG + APPL 0 0
5,91 80
0146277 FUNGIZID RATIO 200 MG 3 CPR VAG + APPL 0 0
5,52 80
Page 35 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0169237 FUNGIZID RATIO KOMBI 3 CPR+CR 20 G+APPL 0 0
6,57 80
G01AF04 miconazole
0051240 GYNODAKTARIN 1200 MG 1 OV 34198 0 0
8,54 80
0051254 GYNODAKTARIN 200 MG 7 OV 17442 0 0
10,10 80
0051237 GYNODAKTARIN CREME VAG 78 G 17399 0 0
10,79 80
G01AF12 fenticonazole
0431091 GYNOXIN 2% CREME 35 G 0 0
8,55 80
0431088 GYNOXIN 200 MG 3 OV 0 0
7,29 80
0431074 GYNOXIN 600 MG 1 OV 0 0
5,49 80
G01AF15 butoconazole
0199253 GYNOMYK 100 MG 3 OV 0 0
7,99 80
0199267 GYNOMYK 2% CREME VAG 20 G + 3 APPL 0 0
8,24 80
G01AX11 povidone-iodine
0391953 ISOBETADINE GYN 10% SOL 500 ML P 0 0
10,43 80
0217012 ISOBETADINE UNIGYN SOL VAG 5 FL UD 10 ML 0 0
10,97 80
G01AX14 lactobacillus fermentum
0235539 GYNOFLOR 12 CPR VAG 0 0
13,88 80
G02AB01 methylergometrine
0071677 METHERGIN 0,2 MG 5 AMP 1 ML 0 0
5,15 80
0071663 METHERGIN GTTS 10 ML 0 0
15,78 80
G02CB01 bromocriptine
0086392 PRAVIDEL 2,5 MG 10 CPR 0 0
13,29 80
0086411 PRAVIDEL 2,5 MG 100 CPR 0 0
54,59 100
0086408 PRAVIDEL 2,5 MG 30 CPR 0 0
22,75 80
G02CB03 cabergoline
0191319 DOSTINEX 0,5 MG 2 CPR 0 0
28,67 80
0235766 SOSTILAR 0,5 MG 8 CPR 0 0
38,61 80
G02CB04 quinagolide
0205039 NORPROLAC 150 MCG 30 CPR 001786 0 0
111,92 80
0205025 NORPROLAC 25/50 MCG 3 + 3 CPR 001789 0 0
8,37 80
0205042 NORPROLAC 75 MCG 30 CPR 001783 0 0
36,75 80
G03BA03 testosterone
0456981 NEBIDO 250 MG/ML 1 AMP 4 ML IM 0 0
112,91 80
0482428 SUSTANON 250 MG 1 AMP 1 ML 0 0
9,94 80
0314681 SUSTANON 250 MG 6 AMP 1 ML 0 0
37,61 80
0338411 TESTOCAPS 40 MG 60 CAPS 0 0
31,50 80
G03BB01 mesterolone
0095164 PROVIRON 25 MG 50 CPR 0 0
10,19 80
G03BB02 androstanolone
0143969 ANDRACTIM 2,5% GEL 80 G 0 0
16,46 80
G03CA03 estradiol
0260447 CLIMARA 50 12 PATCH 0 0
28,59 80
0220729 CLIMARA 50 4 PATCH 0 0
12,98 80
0226168 DERMESTRIL 100 8 PATCH 0 0
6,60 80
0350321 DERMESTRIL 25 26 PATCH 0 0
22,30 80
0350334 DERMESTRIL 50 26 PATCH 0 0
28,69 80
0269071 DERMESTRIL SEPTEM 25 12 PATCH 0 0
18,91 80
0269098 DERMESTRIL SEPTEM 50 12 PATCH 0 0
25,80 80
0145171 ESTRADERM TTS 100 6 PATCH 0 0
15,36 80
0236441 ESTRADERM TTS 25 18 PATCH 0 0
16,93 80
0256928 ESTRAMON 100 8 MG 6 PATCH 0 0
8,25 80
0256864 ESTRAMON 25 2 MG 6 PATCH 0 0
5,10 80
0256895 ESTRAMON 50 4 MG 6 PATCH 0 0
6,60 80
0262505 ESTREVA 0,1 % GEL 50 G 0 0
7,04 80
0238575 ESTROFEM 1 MG 3*28 CPR 0 0
26,77 80
0176438 ESTROFEM 2 MG 3*28 CPR 0 0
26,77 80
0032987 MENO IMPLANT 1 CPR IMPL 0 0
49,19 80
0444346 OESTROGEL 0,06% GEL 2*100 G 0 0
12,72 80
0081513 OESTROGEL 0,06% GEL 80 G 0 0
6,88 80
0328462 PROGYNOVA 1 MG 3*28 DRG 0 0
9,14 80
0328476 PROGYNOVA 2 MG 3*28 DRG 0 0
10,43 80
0539341 SYSTEN TTS 3,2 MG 24 PATCH 0 0
30,80 80
0226591 SYSTEN TTS 3,2 MG 26 PATCH 0 0
33,39 80
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Numéro national
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0157625 VAGIFEM 25 MCG 15 CPR VAG + APPL 0 0
19,35 80
0183754 ZUMENON 2 MG 3*28 CPR 0 0
25,60 80
G03CA04 estriol
0000112 AACIFEMINE 0,5 MG 15 OV 0 0
6,41 80
0000076 AACIFEMINE 2 MG 30 CPR 0 0
8,31 80
0000109 AACIFEMINE CREME 15 G 0 0
10,26 80
0186689 ORTHOGYNEST DEPOT 6 OV 193552 0 0
9,33 80
G03DA02 medroxyprogesterone
0095116 PROVERA 10 MG 30 CPR 0 0
9,78 80
0139496 PROVERA 5 MG 24 CPR 0 0
6,91 80
G03DA04 progesterone
0094251 PROGESTOGEL GEL 80 G 0 0
5,53 80
0123966 UTROGESTAN 100 MG 30 CAPS 0 0
9,57 80
0123983 UTROGESTAN 100 MG 90 CAPS 0 0
20,48 80
0262441 UTROGESTAN 100 MG 90 CAPS VAG 0 0
20,48 80
0461879 UTROGESTAN 200 MG 45 CAPS 0 0
20,48 80
G03DB01 dydrogesterone
0171624 DUPHASTON 10 MG 42 CPR 0 0
16,21 80
G03DB04 nomegestrol
0309999 LUTENYL 5 MG 30 CPR 0 0
15,44 80
0525279 LUTENYL 5 MG 90 CPR 0 0
30,26 80
0497921 NOGEST 5 MG 30 CPR 0 0
15,12 80
0497949 NOGEST 5 MG 60 CPR 0 0
21,79 80
0497966 NOGEST 5 MG 90 CPR 0 0
29,80 80
G03DC02 norethisterone
0093674 PRIMOLUT NOR FORTE 10 MG 30 CPR 0 0
8,62 80
G03DC03 lynestrenol
0083289 ORGAMETRIL 5 MG 30 CPR 0 0
6,60 80
G03FA01 norethisterone and estrogen
0252543 ACTIVELLE 3*28 CPR 0 0
36,88 80
0200533 KLIOGEST 3*28 CPR 0 0
41,03 80
0233842 MERIGEST 2/0,7 MG 28 CPR 0 0
15,96 80
0233856 MERIGEST 3*28 CPR 0 0
29,62 80
G03FA14 dydrogesterone and estrogen
0293062 FEMOSTON CONTI 3*28 CPR 0 0
41,18 80
0569967 FEMOSTON LOW 0,5/2,5 MG 84 CPR 0 0
41,18 80
G03FA15 dienogest and estrogen
0308473 CLIMODIEN 2/2 3*28 CPR 0 0
36,88 80
G03FB01 norgestrel and estrogen
0026864 CYCLOCUR 3*21 DRG 0 0
10,81 80
G03FB05 norethisterone and estrogen
0233521 MERICOMBI 1 MG 28 CPR 0 0
14,10 80
0233534 MERICOMBI 1 MG 3*28 CPR 0 0
25,27 80
0232439 MERICOMBI 2 MG 28 CPR 0 0
14,10 80
0232442 MERICOMBI 2 MG 3*28 CPR 0 0
25,27 80
0255805 TRISEQUENS 2 MG 3*28 CPR 0 0
15,32 80
G03FB06 medroxyprogesterone and estrogen
0250258 DIVIPLUS 3*28 CPR 0 0
13,20 80
0173811 DIVIVA 3*21 CPR 0 0
11,34 80
G03FB08 dydrogesterone and estrogen
0305471 FEMOSTON 1/10 3*28 CPR 0 0
30,80 80
0229921 FEMOSTON 2/10 3*28 CPR 0 0
30,80 80
G03GA01 chorionic gonadotrophin
0093206 PREGNYL 1500 U 3 AMP + S 1 ML IM 0 0
9,77 80
0511761 PREGNYL 5000 U 1 AMP + S 1 ML IM 0 0
8,96 80
0093237 PREGNYL 5000 U 3 AMP + S 1 ML IM 0 0
14,95 80
G03GA02 human menopausal gonadotrophin
0330913 MENOPUR FERRING 75 U PDR 10 FL + S IMSC 0 0
189,15 80
G03GA04 urofollitropin
0434001 FOSTIMON 150 U/ML PDR 1 FL + S IMSC 0 0
44,41 80
0434028 FOSTIMON 150 U/ML PDR 10 FL + S IMSC 0 0
360,90 80
0433969 FOSTIMON 75 U/ML PDR 1 FL + S IMSC 0 0
22,75 80
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Numéro national
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0433986 FOSTIMON 75 U/ML PDR 10 FL + S IMSC 0 0
184,97 80
G03GA05 follitropin alfa
0365239 GONAL F 300 U 1 STYLO 0,5 ML + 5 AIG 0 0
119,60 80
0365242 GONAL F 450 U 1 STYLO 0,75 ML + 7 AIG 0 0
173,88 80
0215231 GONAL F 75 U PDR 1 AMP+S 1 ML SC 0 0
35,78 80
0365256 GONAL F 900 U 1 STYLO 1,5 ML + 14 AIG 0 0
335,44 80
G03GA06 follitropin beta
0279435 PUREGON 300 U 1 CRT 0,36 ML SC 0 0
125,46 80
0279449 PUREGON 600 U 1 CRT 0,72 ML SC 0 0
230,44 80
0389082 PUREGON 900 U 1 CRT 1,23 ML + AIG 0 0
341,20 80
G03GA09 corifollitropin alfa
0555815 ELONVA 100 MG 1 SRG 0,5 ML + 1 AIG SC 0 0
570,79 80
0558767 ELONVA 150 MG 1 SRG 0,5 ML + 1 AIG SC 0 0
570,79 80
G03GA30 combinations
0462733 PERGOVERIS 150 U PDR 10 FL + S 1 ML SC 0 0
756,04 80
G03GB02 clomifene
0023070 CLOMID 50 MG 10 CPR 0 0
8,86 80
0088481 PERGOTIME 50 MG 5 CPR 0 0
9,17 80
G03HA01 cyproterone
0006049 ANDROCUR 10 MG 45 CPR 0 0
19,51 80
0006035 ANDROCUR 50 MG 50 CPR 0 0
29,67 80
G03HB01 cyproterone and estrogen
0186093 CLIMEN 3*21 DRG 0 0
29,51 80
0381281 DAPHNE 2 MG 3*21 CPR 0 0
13,35 80
0409137 DAPHNE 2 MG 6*21 CPR 0 0
19,36 80
0139997 DIANE 35 3*21 DRG 0 0
23,35 80
G03XC01 raloxifene
0254033 EVISTA 60 MG 14 CPR 0 0
25,94 80
0254051 EVISTA 60 MG 84 CPR 0 0
90,79 80
G04BC Urinary concrement solvents
0366804 BLANEL 48 CPR EFF 0 0
22,06 80
0366818 BLANEL 96 CPR EFF 0 0
39,69 80
0335016 URALYT U GRAN 280 G 0 0
46,19 80
G04BD02 flavoxate
0123319 URISPAS 200 MG 100 DRG 0 0
14,35 80
0141835 URISPAS 200 MG 40 DRG 0 0
9,22 80
G04BD04 oxybutynin
0134522 DITROPAN 5 MG 100 CPR 0 0
12,44 80
0134519 DITROPAN 5 MG 30 CPR 0 0
7,66 80
0134505 DITROPAN 5 MG/5 ML SIR 473 ML 0 0
12,48 80
0400257 KENTERA 36 MG 8 PATCH 0 0
44,51 80
0395532 OXYBUTYNINE EG 5 MG 100 CPR 0 0
8,62 80
0395482 OXYBUTYNINE EG 5 MG 30 CPR 0 0
5,93 80
G04BD07 tolterodine
0244474 DETRUSITOL 2 MG 56 CPR 0 0
46,11 80
0303706 DETRUSITOL RET 4 MG 28 CAPS 0 0
49,45 80
G04BD08 solifenacin
0386306 VESICARE 5 MG 30 CPR 0 0
53,17 80
0386341 VESICARE 5 MG 90 CPR 0 0
113,70 80
G04BD09 trospium
0234903 SPASMEX 15 MG 30 CPR 0 0
22,70 80
0234934 SPASMEX 5 MG 30 CPR 0 0
20,16 80
0197889 SPASMO URGENIN TC 100 DRG 0 0
40,85 80
0197875 SPASMO URGENIN TC 50 DRG 0 0
26,25 80
0224861 SPASMOLYT 20 MG 100 DRG 0 0
48,95 80
0224857 SPASMOLYT 20 MG 50 DRG 0 0
30,92 80
0523534 URIVESC 60 MG 28 CAPS 0 0
24,95 80
0523551 URIVESC 60 MG 84 CAPS 0 0
54,04 80
G04BD11 fesoterodine
0467922 TOVIAZ 4 MG 28 CPR 0 0
48,55 80
0477817 TOVIAZ 4 MG 84 CPR 0 0
106,71 80
0467984 TOVIAZ 8 MG 28 CPR 0 0
53,76 80
0477821 TOVIAZ 8 MG 84 CPR 0 0
118,46 80
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Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
G04CA01 alfuzosin
0225398 XATRAL RET 5 MG 56 CPR 0 0
34,86 80
0304961 XATRAL UNO 10 MG 30 CPR 0 0
36,66 80
G04CA02 tamsulosin
0437095 DOCTAMSULOSINE 0,4 MG 30 CAPS 0 0
18,71 80
0437131 DOCTAMSULOSINE 0,4 MG 90 CAPS 0 0
36,81 80
0410995 OMIC OCAS 0,4 MG 30 CPR 0 0
39,31 80
0411041 OMIC OCAS 0,4 MG 90 CPR 0 0
88,31 80
0414493 TAMSULOSIN EG 0,4 MG 30 CAPS 0 0
18,95 80
0414543 TAMSULOSIN EG 0,4 MG 90 CAPS 0 0
37,31 80
0414817 TAMSULOSIN HEXAL 0,4 MG 100 CAPS 0 0
25,00 80
0414736 TAMSULOSIN HEXAL 0,4 MG 20 CAPS 0 0
12,60 80
0414771 TAMSULOSIN HEXAL 0,4 MG 50 CAPS 0 0
17,00 80
0433423 TAMSULOSINE HCL YAMA-PH 0,4 MG 30 CAPS 0 0
22,35 80
0433454 TAMSULOSINE HCL YAMA-PH 0,4 MG 90 CAPS 0 0
48,10 80
0433809 TAMSULOSINE RATIO 0,4 MG 100 CAPS 0 0
25,00 80
0433762 TAMSULOSINE RATIO 0,4 MG 20 CAPS 0 0
12,60 80
0433793 TAMSULOSINE RATIO 0,4 MG 50 CAPS 0 0
17,00 80
G04CA03 terazosin
0055480 HYTRIN 1 MG 10 CPR 0 0
6,01 80
0055494 HYTRIN 10 MG 28 CPR 0 0
26,39 80
0055513 HYTRIN 2 MG 28 CPR 0 0
11,84 80
0055527 HYTRIN 5 MG 28 CPR 0 0
19,33 80
0296923 TERAZOSAB 1 MG 10 CPR 0 0
2,35 80
0296954 TERAZOSAB 10 MG 28 CPR 0 0
27,77 80
0296937 TERAZOSAB 2 MG 28 CPR 0 0
11,38 80
0296941 TERAZOSAB 5 MG 28 CPR 0 0
21,66 80
G04CA52 tamsulosin and dutasteride
0569081 COMBODART 0,5/0,4 MG 30 CAPS (FL) 0 0
43,56 80
0569094 COMBODART 0,5/0,4 MG 90 CAPS (FL) 0 0
90,67 80
G04CB01 finasteride
0467046 FINASTERID RATIO 5 MG 100 CPR 0 0
64,39 80
0467015 FINASTERID RATIO 5 MG 30 CPR 0 0
25,38 80
0467029 FINASTERID RATIO 5 MG 50 CPR 0 0
36,43 80
0460255 FINASTERIDE EG 5 MG 100 CPR 0 0
57,62 80
0460211 FINASTERIDE EG 5 MG 30 CPR 0 0
27,73 80
0460238 FINASTERIDE EG 5 MG 60 CPR 0 0
38,48 80
0187882 PROSCAR 5 MG 28 CPR 0 0
37,00 80
G04CB02 dutasteride
0343438 AVODART 0,5 MG 30 CAPS 0 0
39,65 80
G04CX02 serenoa repens
0183933 PERMIXON 160 MG 60 CAPS 0 0
31,98 80
0219244 PROSTA URGENIN UNO 320 MG 120 CAPS 0 0
36,04 80
0219231 PROSTA URGENIN UNO 320 MG 60 CAPS 0 0
20,39 80
0233095 PROSTASERENE 320 MG 30 CAPS 0 0
17,78 80
H01AA02 tetracosactide
0112377 SYNACTHEN 0,25 MG 1 AMP 0 0
5,72 80
0112394 SYNACTHEN DEP 1 MG 1 AMP 0 0
6,05 80
H01AC01 somatropin
0180136 GENOTONORM 12 MG PDR 1 FL 2 CPT SC P PEN 1 5
304,52 100
0164311 GENOTONORM 5,3 MG PDR 1 FL 2CPT SC P PEN 1 5
154,78 100
0198208 HUMATROPE 12 MG PDR 1 CRT+SRG S IMSC 1 5
248,09 100
0198192 HUMATROPE 6 MG PDR 1 CRT + SRG S IMSC 1 5
138,08 100
0274196 NORDITROPIN SPXX 10 MG 3 CRT 1,5 ML SC 1 5
829,85 100
0274179 NORDITROPIN SPXX 5 MG 3 CRT 1,5 ML SC 1 5
419,32 100
0364889 NUTROPIN AQ 10 MG 1 CRT 2 ML SC 1 5
268,72 100
0364892 NUTROPIN AQ 10 MG 3 CRT 2 ML SC 1 5
788,64 100
0455631 OMNITROPE 3,3 MG SOL INJ 5 CRT 1,5 ML SC 1 5
543,52 100
0575849 OMNITROPE 6,7 MG SOL INJ 5 CRT 1,5 ML SC 1 5
1.078,28 100
0194517 ZOMACTON 4 MG PDR 12 U 1 FL + S 3,5 ML 1 5
118,28 100
H01BA02 desmopressin
0459559 DESMOPRESSING FERRING 0,2 MG 100 CPR 0 0
83,95 80
0459531 DESMOPRESSING FERRING 0,2 MG 15 CPR 0 0
19,16 80
0209069 MINIRIN 0,1 MG/ML 1 FL 2,5 ML IN 0 0
19,99 80
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Numéro national
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0192821 MINIRIN SPRAY 0,1 MG/ML 1 FL 2,5 ML IN 0 0
19,75 80
H01CA Gonadotropin-releasing hormones
0285205 DECAPEPTYL 0,1 MG PDR 7 FL + S SC 0 0
40,95 80
H01CA01 gonadorelin
0062891 KRYPTOCUR 0,2 MG/D 2*10 G SPRAY IN 0 0
153,54 80
H01CA03 histrelin
0554754 VANTASSE 50 MG 1 IMPLANT + 1 DISPO 0 0
1.310,71 100
H01CB02 octreotide
0182824 SANDOSTATIN 100 MCG 5 AMP 1 ML SC 0 0
75,75 100
0182841 SANDOSTATIN 1000 MCG 1 AMP 5 ML SC 0 0
140,86 100
0182811 SANDOSTATIN 50 MCG 5 AMP 1 ML SC 0 0
43,59 100
0182838 SANDOSTATIN 500 MCG 5 AMP 1 ML SC 0 0
342,17 100
0246255 SANDOSTATIN LAR 10 MG 1 FL+SRG 2,5 ML(C) 0 0
1.229,47 100
0246241 SANDOSTATIN LAR 20 MG 1 FL+SRG 2 ML(C) 0 0
2.022,63 100
0246272 SANDOSTATIN LAR 30 MG 1 FL+SRG 2 ML(C) 0 0
2.574,97 100
H01CB03 lanreotide
0340811 SOMATULINE AUTOGEL 120 MG 1 SRG 0,5ML SC 0 0
1.335,93 100
0340792 SOMATULINE AUTOGEL 60 MG 1 SRG 0,3 ML SC 0 0
876,59 100
0340808 SOMATULINE AUTOGEL 90 MG 1 SRG 0,3 ML SC 0 0
1.048,73 100
0314467 SOMATULINE PR 40 MG PDR 1 COFFERT 1 FL 0 0
442,65 100
H01CC01 ganirelix
0282184 ORGALUTRAN 0,25 MG 1 SRG 0,5 ML SC 0 0
48,92 80
0282198 ORGALUTRAN 0,25 MG 5 SRG 0,5 ML SC 0 0
204,88 80
H01CC02 cetrorelix
0264981 CETROTIDE 0,25 MG 7 FL + 7 SRG SC 0 0
252,15 80
0264978 CETROTIDE 0,25 MG PDR 1 FL + SRG SC 0 0
52,03 80
H02AA02 fludrocortisone
0195772 ASTONIN H 50 CPR 0 0
33,44 80
H02AB01 betamethasone
0019873 CELESTONE 0,5 MG 30 CPR 0 0
5,66 80
0019890 CELESTONE 0,5 MG/ML GTTS 30 ML 0 0
6,16 80
0019906 CELESTONE 1 AMP 4 MG 1 ML IMIV 0 0
5,34 80
0019923 CELESTONE CHRONODOSE 1 FL 1 ML IM M.D. 0 0
7,93 80
0033371 DIPROPHOS DS 2MG+5MG 1 SRG 1 ML IMIAID 0 0
7,97 80
0033385 DIPROPHOS DS 4MG+10MG 1 SRG 2 ML IMIAID 0 0
10,18 80
H02AB02 dexamethasone
0311384 AACIDEXAM 5 MG 1 AMP 1 ML IMIV 0 0
6,22 80
0197391 FORTECORTIN 0,5 MG 20 CPR 0 0
4,86 80
0197411 FORTECORTIN 4 MG 20 CPR 0 0
21,48 80
0235038 FORTECORTIN 8 MG 20 CPR 0 0
29,83 80
0046139 FORTECORTIN INJEKT 100MG 10ML FERTIGSPR 0 0
43,27 80
0046173 FORTECORTIN INJEKT 40 MG 5ML 1 FERTIGSPR 0 0
23,39 80
0046142 FORTECORTIN INJEKT 4MG 3 AMP 1ML 0 0
3,73 80
0046187 FORTECORTIN INJEKT 8 MG 3 AMP 2 ML 0 0
5,30 80
H02AB04 methylprednisolone
0029611 DEPO MEDROL 200 MG 1 AMP 5 ML IMTO 0 0
23,00 80
0029589 DEPO MEDROL 40 MG 1 AMP 1 ML IMTO 0 0
9,06 80
0029639 DEPO MEDROL 40 MG 1 SRG 1 ML IMTO 0 0
9,06 80
0029592 DEPO MEDROL 40 MG 3 AMP 1 ML IMTO 0 0
17,47 80
0029625 DEPO MEDROL 40 MG 3 SRG 1 ML IMTO 0 0
17,47 80
0029608 DEPO MEDROL 80 MG 1 AMP 2 ML IMTO 0 0
13,55 80
0029642 DEPO MEDROL 80 MG 1 SRG 2 ML IMTO 0 0
13,55 80
0029673 DEPO MEDROL LIDO 40 MG 1 FL 1 ML IMTO 0 0
9,19 80
0029690 DEPO MEDROL LIDO 40 MG 3 FL 1 ML IMTO 0 0
17,81 80
0029687 DEPO MEDROL LIDO 80 MG 1 FL 2 ML IMTO 0 0
13,78 80
0070280 MEDROL 32 MG 20 CPR 0 0
20,74 80
0070313 MEDROL 4 MG 30 CPR 0 0
7,71 80
0070330 MEDROL A 16 MG 14 CPR 0 0
10,53 80
0070344 MEDROL A 16 MG 50 CPR 0 0
22,56 80
0070361 MEDROL PACK 4 MG 21 CPR 0 0
6,80 80
0106576 SOLUMEDROL 1 G PDR + S 16 ML IV 0 0
68,68 80
0134858 SOLUMEDROL 125 MG 1 MIX 2 ML IMIV 0 0
14,93 80
0106609 SOLUMEDROL 40 MG 1 MIX 1 ML IMIV 0 0
8,61 80
0106612 SOLUMEDROL 40 MG 3 MIX 1 ML IMIV 0 0
15,73 80
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0106626 SOLUMEDROL 500 MG PDR 1 FL + S 8 ML IV 0 0
40,97 80
0106531 SOLUMEDROL SAB 125 MG PDR 1 FL + S 2 ML 0 0
14,93 80
0106562 SOLUMEDROL SAB 40 MG 3 MIX 1 ML IMIV 0 0
15,73 80
0106559 SOLUMEDROL SAB 40 MG PDR 1 FL + S 1 ML 0 0
8,61 80
H02AB06 prednisolone
0106321 SOLUDECORTIN H 25 MG 3 AMP IMIVSC 0 0
6,80 80
0106352 SOLUDECORTIN H 50 MG 3 AMP IMIVSC 0 0
13,16 80
H02AB08 triamcinolone
0002201 ALBICORT 10 MG 1 FL 5 ML IM 0 0
9,40 80
0061961 KENACORT A 10 50 MG 1 FL 5 ML IAID 0 0
8,79 80
H02AB09 hydrocortisone
0288577 HYDROCORTISONE ERFA 20 MG 20 CPR 0 0
7,50 80
0106285 SOLUCORTEF 100 MG 1 FL 2 ML IMIV 0 0
6,59 80
0106304 SOLUCORTEF 250 MG 1 FL 2 ML IMIV 0 0
9,44 80
H02AB13 deflazacort
0063546 CALCORT 30 MG 10 CPR 0 0
30,46 80
0156063 CALCORT 30 MG 20 CPR 0 0
57,87 80
0063563 CALCORT 6 MG 20 CPR 0 0
15,24 80
0154749 CALCORT 6 MG 60 CPR 0 0
43,46 80
H03AA01 levothyroxine sodium
0038803 ELTHYRONE 100 MCG 100 CPR 0 0
6,42 80
0150414 ELTHYRONE 150 MCG 100 CPR SEC 0 0
7,14 80
0038820 ELTHYRONE 200 MCG 100 CPR 0 0
7,80 80
0150428 ELTHYRONE 25 MCG 100 CPR SEC 0 0
5,33 80
0038784 ELTHYRONE 50 MCG 100 CPR 0 0
5,66 80
0192025 EUTHYROX 100 MCG 100 DRG 0 0
7,83 80
0192039 EUTHYROX 125 MCG 100 CPR 0 0
9,53 80
0192042 EUTHYROX 150 MCG 100 DRG 0 0
10,26 80
0300671 EUTHYROX 175 MCG 100 CPR 0 0
11,40 80
0192056 EUTHYROX 200 MCG 100 CPR 0 0
12,38 80
0192851 EUTHYROX 25 MCG 100 CPR 0 0
3,87 80
0192008 EUTHYROX 50 MCG 100 DRG 0 0
5,56 80
0192011 EUTHYROX 75 MCG 100 CPR 0 0
7,23 80
0195451 JODTHYROX 100 MCG 100 CPR 0 0
12,57 80
0277847 L THYROXINE CHRST 100 MCG 112 CPR 0 0
8,82 80
0277851 L THYROXINE CHRST 125 MCG 112 CPR 0 0
9,65 80
0277864 L THYROXINE CHRST 150 MCG 112 CPR 0 0
10,48 80
0366382 L THYROXINE CHRST 175 MCG 112 CPR 0 0
11,51 80
0277878 L THYROXINE CHRST 200 MCG 112 CPR 0 0
11,87 80
0277816 L THYROXINE CHRST 25 MCG 112 CPR 0 0
6,34 80
0277833 L THYROXINE CHRST 50 MCG 112 CPR 0 0
7,02 80
0366379 L THYROXINE CHRST 75 MCG 112 CPR 0 0
8,10 80
0080645 NOVOTHYRAL 100 MCG 100 CPR 0 0
22,97 80
H03AA03 combinations of levothyroxine and liothyronine
0192981 NOVOTHYRAL 75 MCG 100 CPR 0 0
20,21 80
H03BA02 propylthiouracil
0094718 PROPYLTHIOURACIL CHRST 50 MG 60 CPR 0 0
7,73 80
H03BB02 thiamazole
0110646 STRUMAZOL 10 MG 100 CPR 0 0
8,97 80
0192915 THYROZOL 10 MG 50 CPR 0 0
6,04 80
0192932 THYROZOL 20 MG 20 CPR 0 0
3,45 80
0192946 THYROZOL 20 MG 50 CPR 0 0
7,44 80
0192882 THYROZOL 5 MG 50 CPR 0 0
5,03 80
H03CA Iodine therapy
0140341 JODID MERCK 100 MCG 100 CPR 0 0
3,73 80
0244832 JODID MERCK 200 MCG 100 CPR 0 0
5,78 80
H04AA01 glucagon
0225496 GLUCAGEN HYPOKIT 1 MG PDR + SRG IMIVSC 0 0
21,90 80
H05AA02 teriparatide
0350429 FORSTEO 20 MCG/D 1 STYLO SC 0 0
375,22 80
H05BX01 cinacalcet
0386709 MIMPARA 30 MG 28 CPR 0 0
188,95 100
0386757 MIMPARA 60 MG 28 CPR 0 0
345,81 100
0386791 MIMPARA 90 MG 28 CPR 0 0
492,58 100
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J01AA Tetracyclines
0167635 AMBRODOXY 10 CAPS 0 0
4,88 80
0167649 AMBRODOXY 20 CAPS 0 0
8,58 80
J01AA02 doxycycline
0304815 DOCDOXYCY DISPERS 100 MG 10 CPR 0 0
6,25 80
0304801 DOCDOXYCY DISPERS 200 MG 10 CPR 0 0
8,49 80
0169805 DOXY M RATIO 100 MG 10 CPR 0 0
7,47 80
0169819 DOXY M RATIO 100 MG 20 CPR 0 0
9,71 80
0169822 DOXY M RATIO 200 MG 10 CPR 0 0
9,13 80
0245101 DOXY M RATIO 200 MG 20 CPR 0 0
10,75 80
0185843 DOXYCYCLIN RATIO SF 2 AMP 5 ML IV 0 0
13,57 80
0185857 DOXYCYCLIN RATIO SF 5 AMP 5 ML IV 0 0
20,70 80
0238091 DOXYCYCLINE EG 100 MG 10 CPR 0 0
7,27 80
0238088 DOXYCYCLINE EG 200 MG 10 CPR 0 0
10,93 80
0191353 DOXYHEXAL SF SULFITFREI 100 MG 2 AMP 5ML 0 0
9,49 80
0191367 DOXYHEXAL SF SULFITFREI 100 MG 5 AMP 5ML 0 0
20,65 80
0170384 DOXYHEXAL TABS 100 MG 10 CPR 0 0
2,21 80
0170398 DOXYHEXAL TABS 100 MG 20 CPR 0 0
4,20 80
0170367 DOXYHEXAL TABS 200 MG 10 CPR 0 0
4,46 80
0170371 DOXYHEXAL TABS 200 MG 20 CPR 0 0
9,00 80
0036034 DOXYLETS 100 MG 10 CAPS 0 0
8,23 80
0036048 DOXYLETS 200 MG 10 CAPS 0 0
10,69 80
0176083 DOXYTAB 100 MG 10 CAPS 0 0
8,67 80
0127271 VIBRATAB 100 MG 10 CPR 0 0
8,40 80
J01AA04 lymecycline
0302435 TETRALYSAL 300 MG 28 CAPS 0 0
19,61 80
0223931 TETRALYSAL 300 MG 56 CAPS 0 0
28,28 80
J01AA08 minocycline
0248331 KLINOTAB 100 MG 30 CPR 0 0
18,75 80
0072626 MINO 50 MG 20 CPR 0 0
9,88 80
0191899 MINO 50 MG 42 CPR 0 0
14,77 80
0251305 MINOCIN 100 MG 10 CAPS MICROGRAN 0 0
10,77 80
0251319 MINOCIN 100 MG 20 CAPS MICROGRAN 0 0
23,58 80
0457331 MINOCYCLINE EG 50 MG 20 CAPS 0 0
8,62 80
0457344 MINOCYCLINE EG 50 MG 42 CAPS 0 0
12,67 80
0145624 MINOTAB 100 MG 10 CPR 0 0
10,77 80
J01BA02 thiamphenicol
0123238 URFAMYCINE 500 MG PDR 3 AMP IMIV 0 0
8,24 80
0123210 URFAMYCINE 750 MG PDR 3 AMP IMIV 0 0
10,36 80
J01CA01 ampicillin
0139451 PENTREXYL 2 G 1 AMP IV 0 0
6,90 80
J01CA04 amoxicillin
0149573 AMOXICILLIN 250 TS RATIO GRAN 100G=200ML 0 0
8,65 80
0005105 AMOXICILLIN 250 TS RATIO GRAN 50G=100ML 0 0
4,49 80
0267255 AMOXICILLIN RATIO 1 G 14 CPR 0 0
11,47 80
0005086 AMOXICILLIN RATIO 1 G 20 CPR PELLIC 0 0
12,40 80
0218216 AMOXICILLIN RATIO 1 G 30 CPR 0 0
16,37 80
0005122 AMOXICILLIN RATIO 500 MG 20 CPR PELLIC 0 0
11,64 80
0005153 AMOXICILLIN RATIO 750 MG 20 CPR PELLIC 0 0
12,52 80
0249985 AMOXICILLIN RATIO 750 MG 30 CPR PELLIC 0 0
15,12 80
0458632 AMOXICILLINE EG 1 G 20 CPR EFF 0 0
14,50 80
0237936 AMOXICILLINE EG 1 G 8 CPR 0 0
8,90 80
0458629 AMOXICILLINE EG 1 G 8 CPR EFF 0 0
9,28 80
0475701 AMOXICILLINE EG 250 MG/5 ML PDR 100 ML 0 0
7,39 80
0158586 AMOXICILLINE EG 250 MG/5 ML PDR 80 ML 0 0
4,41 80
0146134 AMOXICILLINE EG 500 MG 16 CAPS 0 0
8,90 80
0459304 AMOXICILLINE EG 500 MG 30 CAPS 0 0
14,12 80
0005167 AMOXIHEXAL 1000 MG 10 CPR PELLIC 0 0
8,50 80
0005170 AMOXIHEXAL 1000 MG 20 CPR PELLIC 0 0
12,40 80
0139823 AMOXIHEXAL 250 MG/5 ML SIR 100 ML 0 0
4,45 80
0197682 AMOXIHEXAL 250 MG/5 ML SIR 2*100 ML 0 0
8,50 80
0005203 AMOXIHEXAL 500 MG 10 CPR PELLIC 0 0
1,70 80
0162351 AMOXIHEXAL 500 MG 20 CPR PELLIC 0 0
3,20 80
0005217 AMOXIHEXAL 750 MG 10 CPR 0 0
6,50 80
0005220 AMOXIHEXAL 750 MG 20 CPR 0 0
10,93 80
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0157741 AMOXYPEN 250 MG/5 ML SIR 80 ML 0 0
4,69 80
0157723 AMOXYPEN 500 MG 16 CAPS 0 0
8,18 80
0022705 CLAMOXYL 125 MG/5 ML SIR 80 ML 0 0
5,82 80
0140466 CLAMOXYL 250 MG/5 ML SIR 80 ML 0 0
6,84 80
0022624 CLAMOXYL 500 MG 16 CAPS 0 0
8,90 80
0022722 CLAMOXYL 500 MG 16 SACH 0 0
8,94 80
0022784 CLAMOXYL 500 MG PDR 6 FL + S IMIV 0 0
8,23 80
0385049 CLAMOXYL TABS 1 G 24 CPR 0 0
15,67 80
0196623 CLAMOXYL TABS 1 G 8 CPR 0 0
8,90 80
0389292 FLEMOXIN 250 MG/5 ML SUSP 100 ML 0 0
6,83 80
0193702 FLEMOXIN 250 MG/ML SIR 80 ML 0 0
4,89 80
0331678 FLEMOXIN SOLUTAB 1 G 20 CPR 0 0
21,34 80
0459271 FLEMOXIN SOLUTAB 1 G 24 CPR 0 0
16,14 80
0341661 FLEMOXIN SOLUTAB 500 MG 30 CPR 0 0
13,22 80
0242158 GRAMIDIL 1 G PDR 14 SACH 0 0
5,54 80
0242144 GRAMIDIL 1 G PDR 6 SACH 0 0
2,70 80
0050744 GRAMIDIL 500 MG 12 CAPS 0 0
2,07 80
0141589 GRAMIDIL 500 MG/5 ML PDR SIR 60 ML 0 0
2,49 80
0050758 GRAMIDIL PDR 125 MG/5 ML SIR 60 ML 0 0
1,88 80
0050761 GRAMIDIL PDR SUSP 250 MG 60 ML 0 0
2,01 80
J01CE01 benzylpenicillin
0087212 PENADUR LA 1,2 MIO U PDR 1 FL+S 5 ML I 0 0
4,37 80
J01CE02 phenoxymethylpenicillin
0215777 MEGACILLIN 1 MIO U 10 CPR 0 0
4,04 80
0215781 MEGACILLIN 1 MIO U 30 CPR 0 0
9,05 80
0172411 MEGACILLIN 300000 U/5 ML SIR 100 ML 0 0
6,82 80
0206893 MEGACILLIN 300000 U/5 ML SIR 2*100 ML 0 0
11,58 80
0215746 MEGACILLIN MEGA 1,5 MIO U 10 CPR 0 0
5,18 80
0215763 MEGACILLIN MEGA 1,5 MIO U 20 CPR 0 0
8,50 80
0211991 PENHEXAL MEGA 1 MIO U 30 CPR 0 0
8,97 80
0087663 PENI ORAL 1 MIO U 15 CPR 0 0
7,94 80
J01CE07 clometocillin
0100376 RIXAPEN 500 MG 16 CPR 0 0
9,60 80
J01CF05 flucloxacillin
0193801 FLOXAPEN 500 MG 16 CAPS 0 0
14,18 80
0174416 STAPHYCID 250 MG/5 ML SIR 1 FL 80 ML 0 0
9,86 80
0109306 STAPHYCID 500 MG 16 CAPS 0 0
13,77 80
J01CR02 amoxicillin and enzyme inhibitor
0462294 AMOCLANE 125/31,25 MG PDR SUSP OR 100 ML 0 0
6,90 80
0462277 AMOCLANE 250/62,5 MG PDR 100 ML 0 0
9,04 80
0388121 AMOCLANE 500/125 MG 16 CPR 0 0
11,10 80
0459254 AMOCLANE 500/125 MG 32 CPR 0 0
17,24 80
0378416 AMOCLANE 875/125 MG 10 CPR BLIST 0 0
10,76 80
0378451 AMOCLANE 875/125 MG 20 CPR BLIST 0 0
17,45 80
0009300 AUGMENTIN 125/31,25 MG/5 ML SIR 80 ML 0 0
6,28 80
0009314 AUGMENTIN 250/62,5 MG/5 ML SIR 80 ML 0 0
7,89 80
0009328 AUGMENTIN 500/125 MG 16 CPR 0 0
11,04 80
0187834 AUGMENTIN 500/125 MG 16 SACH 0 0
11,04 80
0265569 AUGMENTIN 875/125 MG 10 CPR 0 0
10,61 80
0311773 AUGMENTIN 875/125 MG 20 CPR 0 0
17,15 80
0340033 AUGMENTIN RET 1 G/62,5 MG 28 CPR 0 0
17,77 80
0340047 AUGMENTIN RET 1 G/62,5 MG 40 CPR 0 0
23,22 80
0340471 CLAVUCID SOLUTAB 500/125 MG 20 CPR 0 0
11,95 80
0376036 CLAVUCID SOLUTAB 875/125 MG 20 CPR 0 0
15,92 80
0311062 DOCAMOCLAF 500/125 MG 16 CPR 0 0
10,22 80
J01DB01 cefalexin
0061734 KEFORAL 500 MG 16 CPR 0 0
11,15 80
J01DB04 cefazolin
0061832 KEFZOL 1 G PDR 3 AMP IM 0 0
12,31 80
J01DB05 cefadroxil
0037286 DURACEF 500 MG 16 CAPS 0 0
11,27 80
0217608 DURACEF 500 MG/5 ML PDR SIR 80 ML 0 0
10,69 80
0037322 DURACEF HD 250 MG/5 ML SIR 80 ML 0 0
8,60 80
J01DB09 cefradine
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0265829 ZEEFRA GE 500 MG 12 CAPS 0 0
5,13 80
J01DC02 cefuroxime
0394454 DOCCEFUROXIME 250 MG 10 CPR 0 0
7,49 80
0394485 DOCCEFUROXIME 250 MG 24 CPR 0 0
12,29 80
0394521 DOCCEFUROXIME 500 MG 10 CPR 0 0
11,11 80
0394552 DOCCEFUROXIME 500 MG 24 CPR 0 0
19,27 80
0211121 ZINACEF BOLUS 1,5 G 1 FL UD IV 0 0
8,90 80
0513345 ZINACEF BOLUS 750 MG PDR 1 FL IMIV 0 0
6,55 80
0211151 ZINACEF PERF 1,5 G PDR 1 FL UD IV 0 0
8,90 80
0154301 ZINNAT 250 MG 10 CPR 0 0
7,49 80
0238804 ZINNAT 250 MG/5 ML SIR 100 ML 0 0
11,11 80
0157771 ZINNAT 500 MG 10 CPR 0 0
11,11 80
0274974 ZINNAT 500 MG 20 CPR 0 0
16,74 80
J01DC03 cefamandole
0069407 MANDOL 1 G PDR 3 FL 10 ML MTD PERF 0 0
18,00 80
J01DC04 cefaclor
0220066 CEC 125 MG/5 ML GRAN 1 FL 100 ML 0 0
5,96 80
0220083 CEC FORTE 250 MG/5 ML GRAN 1 FL 100 ML 0 0
6,95 80
0496843 DOCCEFACLO 500 MG 15 CAPS 0 0
11,99 80
J01DD01 cefotaxime
0206716 CLAFORAN 1000 MG PDR 1 FL + S IMIV 0 0
10,63 80
0206733 CLAFORAN 2000 MG PDR 1 FL + S IV 0 0
15,61 80
J01DD02 ceftazidime
0211201 GLAZIDIM BOLUS 1 G PDR 1 FL IMIV 0 0
13,26 80
0211215 GLAZIDIM BOLUS 2 G PDR 1 FL IV 0 0
22,22 80
0211196 GLAZIDIM BOLUS 500 MG PDR 1 FL IMIV 0 0
8,79 80
0211179 GLAZIDIM PERF 1 G PDR 1 FL UD IMIV 0 0
13,26 80
0211182 GLAZIDIM PERF 2 G PDR 1 FL UD IV 0 0
22,22 80
J01DD04 ceftriaxone
0100622 ROCEPHINE 1 G PDR 1 FL + S 10 ML IV 0 0
10,08 80
0100619 ROCEPHINE 1 G PDR 1 FL + S 3,5 ML IM 0 0
10,08 80
0100636 ROCEPHINE 2 G PDR 1 FL PERF 0 0
15,96 80
J01DE01 cefepime
0200757 MAXIPIME 1 G 3 FL IMIV 0 0
30,42 80
0200761 MAXIPIME 2 G 3 FL IMIV 0 0
54,04 80
J01DH02 meropenem
0206764 MERONEM 1 G PDR 1 FL IV 0 0
21,66 80
0206781 MERONEM 500 MG PDR 1 FL IV 0 0
13,85 80
J01EE01 sulfamethoxazole and trimethoprim
0010346 BACTRIM FORTE 10 CPR 0 0
6,71 80
0010315 BACTRIM SIR 100 ML 0 0
6,04 80
0025996 COTRIM FORTE RATIO 10 CPR 0 0
1,92 80
0026007 COTRIM FORTE RATIO 20 CPR 0 0
3,69 80
0203504 COTRIM HEXAL FORTE 10 CPR 0 0
1,90 80
0203518 COTRIM HEXAL FORTE 20 CPR 0 0
3,60 80
0149895 COTRIMOXAZOLE EG 160/800 MG 10 CPR 0 0
5,68 80
0149901 COTRIMOXAZOLE EG 160/800 MG 30 CPR 0 0
7,18 80
0042966 EUSAPRIM 20 CPR AD 0 0
6,69 80
0042983 EUSAPRIM 50 CPR AD 0 0
9,02 80
0043056 EUSAPRIM FORTE 10 CPR 0 0
6,69 80
0043073 EUSAPRIM FORTE 30 CPR 0 0
9,31 80
0043025 EUSAPRIM SIR PED 100 ML 0 0
6,03 80
J01FA01 erythromycin
0040832 ERY 125 MG 24 SACH 0 0
3,40 80
0040846 ERY 250 MG 24 SACH 0 0
3,40 80
0040863 ERY 500 MG 20 CPR SEC 0 0
4,04 80
0183236 ERYHEXAL 1000 MG 12 SACH 0 0
14,39 80
0183253 ERYHEXAL 1000 MG 20 SACH 0 0
18,82 80
0140001 ERYHEXAL 200 MG/5 ML GRAN P SIR 100 ML 0 0
7,10 80
0187221 ERYHEXAL 200 MG/5 ML GRAN P SIR 2*100 ML 0 0
12,33 80
0167232 ERYHEXAL 500 MG 10 CPR 0 0
3,00 80
0198001 ERYHEXAL 500 MG 20 CPR 0 0
4,00 80
0208352 ERYHEXAL 500 MG 30 CPR 0 0
5,70 80
0198015 ERYHEXAL 500 MG 50 CPR 0 0
9,00 80
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0041020 ERYTHROCINE 1 G PDR 1 FL + S 20 ML IV 0 0
12,69 80
0252963 ERYTHROCINE 250 MG/5 ML SIR 80 ML 0 0
7,24 80
0169447 ERYTHROFORTE 1000 MG 10 SACH 0 0
13,18 80
0041101 ERYTHROFORTE 500 MG 16 CPR 0 0
10,31 80
0041115 ERYTHROFORTE 500 MG 16 SACH 0 0
10,31 80
0167974 ERYTHROMYCINE RATIO 1000 DB 12 SACH 0 0
14,39 80
0167988 ERYTHROMYCINE RATIO 1000 DB 20 SACH 0 0
18,82 80
0168016 ERYTHROMYCINE RATIO 250 DB 20 SACH 0 0
5,21 80
0167991 ERYTHROMYCINE RATIO 500 DB 10 SACH 0 0
10,55 80
0168002 ERYTHROMYCINE RATIO 500 DB 20 SACH 0 0
12,67 80
0163099 MONOMYCIN 200 MG/5 ML SIR 100 ML 0 0
7,96 80
0163104 MONOMYCIN 200 MG/5 ML SIR 2*100 ML 0 0
13,63 80
0163085 MONOMYCIN 200 MG/5 ML SIR 60 ML 0 0
5,33 80
J01FA02 spiramycin
0101194 ROVAMYCINE 1,5 MIO U 16 CPR 0 0
9,07 80
J01FA06 roxithromycin
0315402 ROXITHROMYCINE EG 150 MG 10 CPR 0 0
8,78 80
0183981 RULID 100 MG 10 CPR 0 0
10,70 80
0199691 RULID 150 MG 10 CPR 0 0
12,65 80
J01FA09 clarithromycin
0205509 BICLAR 125 BEBE SIR 60 ML 0 0
10,15 80
0225465 BICLAR 125 JR SIR 120 ML 0 0
13,25 80
0171154 BICLAR 250 MG 10 CPR 0 0
9,98 80
0221323 BICLAR 500 MG PDR 1 FL IV 0 0
14,68 80
0221337 BICLAR FORTE 500 MG 10 CPR 0 0
14,73 80
0289395 BICLAR KIDS 250 MG/5 ML GRAN SUSP 80 ML 0 0
15,95 80
0409509 BICLAR UNO 500 MG 10 CPR 0 0
14,73 80
0409512 BICLAR UNO 500 MG 20 CPR 0 0
21,45 80
0378853 CLARITHROMYCIN HEXAL 250 MG 10 CPR 0 0
9,10 80
0378867 CLARITHROMYCIN HEXAL 250 MG 12 CPR 0 0
10,70 80
0378903 CLARITHROMYCIN HEXAL 250 MG 20 CPR 0 0
12,97 80
0378979 CLARITHROMYCIN HEXAL 500 MG 14 CPR 0 0
14,17 80
0379007 CLARITHROMYCIN HEXAL 500 MG 20 CPR 0 0
16,06 80
0375347 CLARITHROMYCIN RATIO 250 MG 10 CPR 0 0
9,10 80
0375395 CLARITHROMYCIN RATIO 250 MG 20 CPR 0 0
12,92 80
0375607 CLARITHROMYCIN RATIO 500 MG 14 CPR 0 0
14,12 80
0375638 CLARITHROMYCIN RATIO 500 MG 20 CPR 0 0
15,99 80
0400341 CLARITHROMYCINE ABBOTT UNO 500 MG 10 CPR 0 0
13,15 80
0400355 CLARITHROMYCINE ABBOTT UNO 500 MG 20 CPR 0 0
21,45 80
0398114 CLARITHROMYCINE EG 250 MG 10 CPR 0 0
8,78 80
0398324 CLARITHROMYCINE EG 500 MG 10 CPR 0 0
12,12 80
0398369 CLARITHROMYCINE EG 500 MG 21 CPR 0 0
26,09 80
0221291 HELICLAR 500 MG 21 CPR 0 0
29,84 80
0221306 HELICLAR 500 MG 42 CPR 0 0
82,79 80
J01FA10 azithromycin
0461235 AZITHROMYCIN HEXAL 200MG/5ML PDR 15 ML 0 0
6,00 80
0461266 AZITHROMYCIN HEXAL 200MG/5ML PDR 30 ML 0 0
12,00 80
0461283 AZITHROMYCIN HEXAL 200MG/5ML PDR 37,5 ML 0 0
12,65 80
0366107 AZITHROMYCIN HEXAL 250 MG 6 CPR 0 0
9,64 80
0366155 AZITHROMYCIN HEXAL 500 MG 3 CPR 0 0
9,64 80
0420571 AZITHROMYCIN RATIO 250 MG 6 CPR 0 0
9,70 80
0420604 AZITHROMYCIN RATIO 500 MG 3 CPR 0 0
9,70 80
0483246 AZITHROMYCINE EG 250 MG 6 CPR 0 0
9,64 80
0483327 AZITHROMYCINE EG 500 MG 3 CPR 0 0
9,64 80
0305504 ZITROMAX 1500 MG PDR SUSP 37,5 ML 0 0
12,07 80
0252297 ZITROMAX 250 MG 6 CPR 0 0
10,89 80
0252333 ZITROMAX 500 MG 3 CPR SEC 0 0
10,89 80
0206165 ZITROMAX 600 MG PDR SUSP 15 ML 0 0
7,24 80
0206179 ZITROMAX 900 MG PDR SUSP 22,5 ML 0 0
8,87 80
J01FA11 miocamycin
0230126 MERCED 500 MG/10 ML GRAN SUSP 120 ML 0 0
7,49 80
0230059 MERCED 600 MG 14 CPR 0 0
8,82 80
J01FA15 telithromycin
0306711 KETEK 400 MG 10 CPR 0 0
16,93 80
0306739 KETEK 400 MG 20 CPR 0 0
29,02 80
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J01FF01 clindamycin
0027763 DALACIN C 150 MG 16 CAPS 0 0
12,22 80
0027780 DALACIN C 300 MG 16 CAPS 0 0
18,57 80
0155991 DALACIN C 300 MG 3 AMP 2 ML 0 0
14,31 80
0156001 DALACIN C 600 MG 3 AMP 4 ML 0 0
22,84 80
0156015 DALACIN C 900 MG 3 AMP 6 ML 0 0
29,12 80
0027794 DALACIN C SIR 80 ML 0 0
10,71 80
J01FF02 lincomycin
0065781 LINCOCIN 500 MG 16 CAPS 0 0
13,10 80
0139398 LINCOCIN 600 MG 6 SRG 2 ML IM 0 0
18,42 80
J01GB01 tobramycin
0081284 OBRACIN 80 MG 3 FL 2 ML 0 0
12,23 80
0287549 TOBI 300 MG 4*14 AMP UD 5 ML IH 0 0
2.403,79 80
J01GB06 amikacin
0224731 AMUKIN 1 G 2 FL 4 ML IMIV 0 0
46,24 80
0005573 AMUKIN 100 MG 2 FL 2 ML IMIV 0 0
9,48 80
0005590 AMUKIN 500 MG 2 FL 2 ML IMIV 0 0
26,29 80
J01GB09 dibekacin
0028239 DEBEKACYL 75 MG 1 SRG 1,5 ML IMIVSC 0 0
3,17 80
J01MA01 ofloxacin
0321234 DOCOFLOXACINE 400 MG 10 CPR 0 0
14,30 80
0369918 OFLOXACINE EG 200 MG 10 CPR 0 0
9,75 80
0369773 OFLOXACINE EG 400 MG 10 CPR 0 0
15,59 80
0369742 OFLOXACINE EG 400 MG 5 CPR 0 0
9,75 80
0113486 TARIVID 200 MG 10 CPR 0 0
13,81 80
0258936 TARIVID 400 MG 10 CPR SEC 0 0
20,74 80
0217531 TARIVID 400 MG 5 CPR 0 0
13,81 80
J01MA02 ciprofloxacin
0316881 CIPROFLOXACIN RATIO 250 MG 10 CPR 0 0
8,45 80
0316895 CIPROFLOXACIN RATIO 250 MG 20 CPR 0 0
13,43 80
0316851 CIPROFLOXACIN RATIO 500 MG 10 CPR 0 0
13,43 80
0316864 CIPROFLOXACIN RATIO 500 MG 20 CPR 0 0
17,63 80
0316816 CIPROFLOXACIN RATIO 750 MG 10 CPR 0 0
15,56 80
0316833 CIPROFLOXACIN RATIO 750 MG 20 CPR 0 0
37,35 80
0358959 CIPROFLOXACINE EG 250 MG 10 CPR 0 0
10,28 80
0359083 CIPROFLOXACINE EG 500 MG 20 CPR 0 0
22,51 80
0359178 CIPROFLOXACINE EG 750 MG 20 CPR 0 0
30,75 80
0316928 CIPROHEXAL 250 MG 10 CPR 0 0
8,50 80
0316539 CIPROHEXAL 250 MG 20 CPR 0 0
13,48 80
0316591 CIPROHEXAL 500 MG 10 CPR 0 0
13,40 80
0316637 CIPROHEXAL 500 MG 20 CPR 0 0
17,60 80
0316704 CIPROHEXAL 750 MG 10 CPR 0 0
15,62 80
0316735 CIPROHEXAL 750 MG 20 CPR 0 0
22,19 80
0135645 CIPROXIN 250 MG 10 CPR 0 0
10,28 80
0135709 CIPROXIN 500 MG 20 CPR 0 0
22,51 80
0321282 CIPROXINE 5% 2 FL MICROCPS + S 0 0
27,01 80
0327384 DOCCIPROFLO 250 MG 10 CPR 0 0
8,98 80
0327465 DOCCIPROFLO 500 MG 20 CPR 0 0
22,51 80
0327336 DOCCIPROFLO 750 MG 20 CPR 0 0
30,75 80
J01MA04 enoxacin
0195545 ENOXOR 200 MG 10 CPR 0 0
9,12 80
J01MA06 norfloxacin
0286202 NORFLOXACINE EG 400 MG 20 CPR 0 0
6,73 80
0286183 NORFLOXACINE EG 400 MG 6 CPR 0 0
5,29 80
0131193 ZOROXIN 400 MG 20 CPR 0 0
7,07 80
0131176 ZOROXIN 400 MG 6 CPR 0 0
5,39 80
J01MA12 levofloxacin
0247087 TAVANIC 250 MG 10 CPR 0 0
28,82 80
0247137 TAVANIC 500 MG 10 CPR 0 0
42,36 80
J01MA14 moxifloxacin
0281075 AVELOX 400 MG 10 CPR 0 0
42,21 80
0292924 AVELOX 400 MG 5 CPR 0 0
24,23 80
0288868 PROFLOX 400 MG 10 CPR 0 0
40,72 80
0288854 PROFLOX 400 MG 5 CPR 0 0
23,47 80
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J01XA02 teicoplanin
0158461 TARGOCID 200 MG PDR 1 FL+S 3,2 ML IMIV 0 0
19,11 80
0158474 TARGOCID 400 MG PDR 1 FL+S 3,2ML IMIV 0 0
31,64 80
J01XB01 colistin
0023831 COLIMYCINE 1 MIO U PDR 1 FL IM 0 0
22,99 80
0023800 COLIMYCINE 1,5 MIO U 10 CPR 0 0
4,39 80
J01XD01 metronidazole
0044912 FLAGYL 500 MG 20 CPR 0 0
7,18 80
J01XD02 tinidazole
0043896 FASIGYN 500 MG 4 CPR 0 0
7,40 80
J01XD03 ornidazole
0171204 TIBERAL 500 MG 10 CPR 0 0
10,03 80
0116751 TIBERAL 500 MG 3 CPR 0 0
3,43 80
J01XE01 nitrofurantoin
0047198 FURADANTINE MC 100 MG 50 CAPS 0 0
9,73 80
0047203 FURADANTINE MC 50 MG 50 CAPS 0 0
7,37 80
0078986 NITROFURANTOIN RATIO RET 100 MG 50 CAPS 0 0
12,98 80
J01XE02 nifurtoinol
0123191 URFADYN 100 MG 50 CAPS PL 0 0
10,46 80
J01XX01 fosfomycin
0219258 MONURIL 3 G PDR 1 SACH 0 0
9,10 80
J01XX04 spectinomycin
0120981 TROBICIN 2 G 1 FL 3,2 ML IM 0 0
13,58 80
J02AB02 ketoconazole
0079255 NIZORAL 200 MG 10 CPR 22958 0 0
12,14 80
0079269 NIZORAL 200 MG 30 CPR 27335 0 0
23,40 80
J02AC01 fluconazole
0434161 CANDIZOLE 150 MG 1 CAPS 0 0
6,77 80
0434143 CANDIZOLE 200 MG 10 CAPS 0 0
53,21 80
0434157 CANDIZOLE 200 MG 20 CAPS 0 0
94,07 80
0434188 CANDIZOLE 50 MG 10 CAPS 0 0
18,71 80
0163068 DIFLUCAN 150 MG 1 CAPS 0 0
9,04 80
0178222 DIFLUCAN 200 MG 10 CAPS 0 0
53,21 80
0178236 DIFLUCAN 200 MG 20 CAPS 0 0
95,47 80
0244703 DIFLUCAN 200 MG/5 ML PDR SIR 1 FL 35 ML 0 0
39,12 80
0165918 DIFLUCAN 50 MG 10 CAPS 0 0
19,76 80
0244717 DIFLUCAN 50 MG/5 ML PDR SIR 1 FL 35 ML 0 0
15,06 80
0353997 FLUCONAZOL HEXAL 100 MG 20 CAPS 0 0
75,09 80
0418637 FLUCONAZOL HEXAL 100 MG 50 CAPS 0 0
171,61 80
0377209 FLUCONAZOL HEXAL 150 MG 1 CAPS 0 0
5,78 80
0377261 FLUCONAZOL HEXAL 200 MG 20 CAPS 0 0
91,20 80
0377288 FLUCONAZOL HEXAL 200 MG 50 CAPS 0 0
220,00 80
0353921 FLUCONAZOL HEXAL 50 MG 20 CAPS 0 0
38,80 80
0353949 FLUCONAZOL HEXAL 50 MG 50 CAPS 0 0
92,67 80
0335341 FLUCONAZOL RATIO 150 MG 1 CAPS 0 0
5,80 80
0335484 FLUCONAZOL RATIO 200 MG 20 CAPS 0 0
92,48 80
0335372 FLUCONAZOL RATIO 50 MG 14 CAPS 0 0
30,43 80
0449096 FLUCONAZOLE EG 150 MG 1 CAPS 0 0
8,21 80
0438661 FLUCONAZOLE TEVA 150 MG 1 CAPS 0 0
5,78 80
0438738 FLUCONAZOLE TEVA 200 MG 10 CAPS 0 0
55,29 80
0438755 FLUCONAZOLE TEVA 200 MG 20 CAPS 0 0
91,29 80
0438576 FLUCONAZOLE TEVA 50 MG 10 CAPS 0 0
19,39 80
J02AC02 itraconazole
0431365 ITRACONAZOLE EG 100 MG 15 CAPS 0 0
16,80 80
0431396 ITRACONAZOLE EG 100 MG 28 CAPS 0 0
23,18 80
0431317 ITRACONAZOLE EG 100 MG 4 CAPS 0 0
8,30 80
0431429 ITRACONAZOLE EG 100 MG 60 CAPS 0 0
51,34 80
0246899 SPORANOX 1% SOL 150 ML 87572 0 0
63,65 80
0151229 SPORANOX 100 MG 15 CAPS 52083 0 0
16,80 80
0225532 SPORANOX 100 MG 28 CAPS 87578 0 0
27,30 80
0151201 SPORANOX 100 MG 4 CAPS 52082 0 0
8,30 80
0239671 SPORANOX 100 MG 60 CAPS 0 0
51,34 80
J04AB02 rifampicin
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0099745 RIFADINE 150 MG 100 CAPS 0 0
30,94 100
0201091 RIFADINE 300 MG 50 CAPS 0 0
30,94 100
J04AB03 rifamycin
0099857 RIFOCINE 500 MG 2 AMP 10 ML IV 0 0
8,68 100
J04AB04 rifabutin
0225899 MYCOBUTIN 150 MG 100 CAPS 0 0
229,08 100
J04AC01 isoniazid
0358461 NICOTIBINE 300 MG 30 CAPS 0 0
8,57 100
J04AK01 pyrazinamide
0113729 TEBRAZID 500 MG 100 CPR 0 0
15,43 100
J04AK02 ethambutol
0074861 MYAMBUTOL 400 MG 100 CPR 0 0
30,25 100
J05AB01 aciclovir
0301438 ACICLOVIR EG 200 MG 25 CPR 0 0
18,16 80
0301469 ACICLOVIR EG 800 MG 35 CPR 0 0
71,15 80
0539517 ACICLOVIR RATIO 800 MG 35 CPR 0 0
22,04 80
0217642 ACICLOVIR VON CT 200 MG 25 CPR 0 0
11,54 80
0217673 ACICLOVIR VON CT 800 MG 35 CPR 0 0
22,47 80
0298878 DOCACICLO 200 MG 25 CPR 0 0
11,86 80
0298881 DOCACICLO 800 MG 35 CPR 0 0
21,38 80
0444431 ZOVIRAX 200 MG 25 CPR 0 0
20,76 80
0190731 ZOVIRAX 400 MG/5 ML SIR 100 ML 0 0
21,94 80
0444444 ZOVIRAX 800 MG 35 CPR 0 0
71,15 80
J05AB04 ribavirin
0336612 COPEGUS 200 MG 168 CPR 0 0
632,63 100
0445925 COPEGUS 400 MG 56 CPR 0 0
421,63 100
0264544 REBETOL 200 MG 140 CAPS 0 0
555,04 100
0264558 REBETOL 200 MG 168 CAPS 0 0
568,07 100
0264531 REBETOL 200 MG 84 CAPS 0 0
336,78 100
J05AB09 famciclovir
0242371 FAMVIR 125 MG 10 CPR 0 0
43,56 80
0289154 FAMVIR 250 MG 15 CPR 0 0
142,31 80
J05AB11 valaciclovir
0220357 ZELITREX 500 MG 10 CPR 0 0
38,06 80
0218703 ZELITREX 500 MG 42 CPR 0 0
78,46 80
J05AB14 valganciclovir
0321072 VALCYTE 450 MG 60 CPR 0 0
1.518,49 80
J05AB15 brivudine
0316203 ZERPEX 125 MG 7 CPR 0 0
82,79 80
J05AE01 saquinavir
0402234 INVIRASE 500 MG 120 CPR 0 0
333,04 100
J05AE02 indinavir
0226526 CRIXIVAN 200 MG 360 CAPS 0 0
254,92 100
0226557 CRIXIVAN 400 MG 180 CAPS 0 0
254,92 100
J05AE03 ritonavir
0568942 NORVIR 100 MG 3*30 CPR (FL) 0 0
80,28 100
0481949 NORVIR 100 MG 84 CAPS MOLLES 0 0
75,51 100
0226185 NORVIR 80 MG/ML SOL 5 FL 90 ML 0 0
307,32 100
J05AE06 lopinavir
0299178 KALETRA 2*90 CAPS (FL) 0 0
422,08 100
0436604 KALETRA 200/50 MG 120 CPR 0 0
419,48 100
0299195 KALETRA 5 FL 60 ML + 5 SRG 0 0
419,54 100
J05AE07 fosamprenavir
0377971 TELZIR 50 MG/ML SUSP BUV 225ML + SRG DOS 0 0
97,78 100
0377968 TELZIR 700 MG 60 CPR 0 0
353,80 100
J05AE08 atazanavir
0364942 REYATAZ 150 MG 60 CAPS 0 0
390,43 100
0364973 REYATAZ 200 MG 60 CAPS 0 0
390,43 100
0481983 REYATAZ 300 MG 30 CAPS 0 0
390,43 100
J05AE09 tipranavir
0416842 APTIVUS 250 MG 120 CAPS 0 0
740,03 100
J05AE10 darunavir
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0524089 PREZISTA 150 MG 240 CPR (FL) 0 0
708,29 100
0450571 PREZISTA 300 MG 120 CPR 0 0
708,29 100
0508393 PREZISTA 400 MG 60 CPR 0 0
475,23 100
0508409 PREZISTA 600 MG 60 CPR 0 0
708,29 100
0524075 PREZISTA 75 MG 480 CPR (FL) 0 0
708,29 100
J05AF01 zidovudine
0172165 RETROVIR 10 MG/ML SIR 200 ML + SRG 10 ML 0 0
31,75 100
0133671 RETROVIR 100 MG 100 CAPS 0 0
131,16 100
0134892 RETROVIR 250 MG 40 CAPS 0 0
131,16 100
0219406 RETROVIR 300 MG 60 CPR 0 0
207,04 100
J05AF02 didanosine
0178141 VIDEX 2 G PDR P SOL OR 1 FL 0 0
34,05 100
0287745 VIDEX EC 125 MG 30 CAPS 0 0
58,37 100
0287759 VIDEX EC 200 MG 30 CAPS 0 0
88,96 100
0287762 VIDEX EC 250 MG 30 CAPS 0 0
109,01 100
0287776 VIDEX EC 400 MG 30 CAPS 0 0
169,13 100
J05AF04 stavudine
0221824 ZERIT 1 MG/ML SOL 200 ML 0 0
21,90 100
0221791 ZERIT 30 MG 56 CAPS BLIST 0 0
136,07 100
0221811 ZERIT 40 MG 56 CAPS BLIST 0 0
144,54 100
J05AF05 lamivudine
0224292 EPIVIR 10 MG/ML GTTS 240 ML 0 0
52,80 100
0224308 EPIVIR 150 MG 60 CPR 0 0
152,65 100
0309372 EPIVIR 300 MG 30 CPR 0 0
152,65 100
0266874 ZEFFIX 100 MG 84 CPR 0 0
138,06 100
0266888 ZEFFIX 5 MG/ML SIR 240 ML 0 0
30,28 100
J05AF06 abacavir
0266793 ZIAGEN 20 MG/ML SIR 1 FL 240 ML 0 0
79,59 100
0266776 ZIAGEN 300 MG 60 CPR 0 0
247,52 100
J05AF07 tenofovir disoproxil
0330314 VIREAD 245 MG 30 CPR 0 0
399,43 100
J05AF08 adefovir dipivoxil
0342508 HEPSERA 10 MG 30 CPR 0 0
455,03 100
J05AF09 emtricitabine
0355988 EMTRIVA 200 MG 30 CAPS 0 0
199,72 100
J05AF10 entecavir
0437162 BARACLUDE 0,5 MG 30 CPR 0 0
422,80 100
0437193 BARACLUDE 1 MG 30 CPR 0 0
495,85 100
J05AG01 nevirapine
0547987 VIRAMUNE 200 MG 14 CPR 0 0
66,45 100
0247154 VIRAMUNE 200 MG 60 CPR 0 0
257,13 100
0265152 VIRAMUNE 50 MG/5 ML SIR 240 ML 0 0
57,88 100
J05AG03 efavirenz
0266597 STOCRIN 100 MG 30 CAPS 0 0
54,61 100
0517067 STOCRIN 200 MG 90 CPR 0 0
284,56 100
0266583 STOCRIN 50 MG 30 CAPS 0 0
31,75 100
0333591 STOCRIN 600 MG 30 CPR (FL) 0 0
284,56 100
J05AG04 etravirine
0488341 INTELENCE 100 MG 120 CPR 0 0
419,50 100
J05AR01 zidovudine and lamivudine
0252753 COMBIVIR 150 MG 60 CPR BLIST 0 0
397,58 100
J05AR02 lamivudine and abacavir
0391838 KIVEXA 600/300 MG 30 CPR BLIST 0 0
397,52 100
J05AR03 tenofovir disoproxil and emtricitabine
0396624 TRUVADA 200/245 MG 30 CPR 0 0
555,48 100
J05AR04 zidovudine, lamivudine and abacavir
0293935 TRIZIVIR 60 CPR BLIST 0 0
660,71 100
J05AR06 emtricitabine, tenofovir disoproxil and efavirenz
0476353 ATRIPLA 30 CPR 0 0
831,28 100
J05AX05 inosine pranobex
0059798 ISOPRINOSINE 500 MG 40 CPR 0 0
16,84 80
J05AX07 enfuvirtide
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0347714 FUZEON 90 MG/ML PDR 60 FL + S + 60 SRG 0 0
1.757,50 100
J05AX08 raltegravir
0472676 ISENTRESS 400 MG 60 CPR 0 0
867,27 100
J05AX09 maraviroc
0467113 CELSENTRI 150 MG 60 CPR 0 0
899,06 100
0467161 CELSENTRI 300 MG 60 CPR 0 0
899,06 100
J06BB01 anti-D (rh) immunoglobulin
0268771 RHOGAM ULTRA FILTERED 300 MCG 1FL 1ML IM 0 0
40,90 80
J06BB02 tetanus immunoglobulin
0399738 TETABULINE S/D 250 U 1 SRG 1 ML IM 0 0
20,60 80
J07BB02 influenza, inactivated, split virus or surface antigen
0152727 ALPHA RIX 1 SRG 0,5 ML IMSC 1 3
8,79 100
0057146 INFLUVAC S 1 SRG 0,5 ML UD IMSC 1 3
8,79 100
0125361 VAXIGRIP 1 SRG 0,5 ML IMSC 1 3
8,79 100
J07BM01 papillomavirus (human types 6, 11, 16, 18)
0441263 GARDASIL 1 SRG 0,5 ML + 1 DISPO + 2 AIG 1 12
120,65 100
J07BM02 papillomavirus (human types 16, 18)
0467483 CERVARIX 20/20 MCG 1 SRG 0,5 ML + 1 AIG 1 12
120,70 100
L01AA01 cyclophosphamide
0039246 ENDOXAN 50 MG 50 DRG 0 0
16,84 100
L01AA02 chlorambucil
0316086 LEUKERAN 2 MG 50 CPR 0 0
9,38 100
L01AA03 melphalan
0003050 ALKERAN 2 MG 25 CPR 0 0
9,95 100
L01AB01 busulfan
0075046 MYLERAN 2 MG 100 CPR 0 0
14,39 100
L01AX03 temozolomide
0264401 TEMODAL 100 MG 5 CAPS 0 0
333,01 100
0512138 TEMODAL 100 MG 5 CAPS UD 0 0
333,01 100
0512155 TEMODAL 140 MG 5 CAPS UD 0 0
455,79 100
0512172 TEMODAL 180 MG 5 CAPS UD 0 0
574,98 100
0264396 TEMODAL 20 MG 20 CAPS 0 0
297,56 100
0512124 TEMODAL 20 MG 20 CAPS UD 0 0
297,56 100
0264382 TEMODAL 20 MG 5 CAPS 0 0
80,99 100
0512111 TEMODAL 20 MG 5 CAPS UD 0 0
80,99 100
0264429 TEMODAL 250 MG 5 CAPS 0 0
773,39 100
0512205 TEMODAL 250 MG 5 CAPS UD 0 0
773,39 100
0264379 TEMODAL 5 MG 20 CAPS 0 0
85,51 100
0524576 TEMODAL 5 MG 20 CAPS UD 0 0
85,51 100
0264365 TEMODAL 5 MG 5 CAPS 0 0
26,22 100
0524562 TEMODAL 5 MG 5 CAPS UD 0 0
26,22 100
L01BA01 methotrexate
0341643 LEDERTREXATE 2,5 MG 30 CPR 0 0
7,50 100
0283102 LEDERTREXATE 5 MG 1 FL 2 ML 0 0
6,57 100
0064672 LEDERTREXATE SOD 5 MG PDR 12 FL IV 0 0
32,29 100
L01BB02 mercaptopurine
0095679 PURI NETHOL 25 CPR 0 0
13,09 100
L01BB05 fludarabine
0321458 FLUDARA ORAL 10 MG 15 CPR 0 0
403,93 100
0321461 FLUDARA ORAL 10 MG 20 CPR 0 0
535,81 100
L01BC02 fluorouracil
0038266 EFUDIX ONG 20 G 0 0
23,30 80
L01BC06 capecitabine
0297092 XELODA 150 MG 60 CPR 0 0
68,36 100
0297108 XELODA 500 MG 120 CPR 0 0
405,58 100
L01CB01 etoposide
0126419 VEPESID 100 MG 10 CPR 0 0
68,69 100
L01DB06 idarubicin
0233016 ZAVEDOS 5 MG 1 CAPS 0 0
39,59 100
L01XE01 imatinib
0359617 GLIVEC 100 MG 20 CPR 1 5
517,23 100
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0359621 GLIVEC 100 MG 60 CPR 1 5
1.597,50 100
0359634 GLIVEC 400 MG 10 CPR 1 5
977,60 100
0359648 GLIVEC 400 MG 30 CPR 1 5
2.966,35 100
L01XE03 erlotinib
0409459 TARCEVA 100 MG 30 CPR 1 5
1.914,36 100
0409462 TARCEVA 150 MG 30 CPR 1 5
2.356,33 100
0409445 TARCEVA 25 MG 30 CPR 1 5
539,33 100
L01XE04 sunitinib
0441067 SUTENT 12,5 MG 30 CAPS 0 0
1.414,97 100
0441071 SUTENT 25 MG 30 CAPS 0 0
2.820,52 100
0441084 SUTENT 50 MG 30 CAPS 0 0
5.631,63 100
L01XE05 sorafenib
0439671 NEXAVAR 200 MG 112 CPR 1 5
3.800,92 100
L01XX05 hydroxycarbamide
0054810 HYDREA 500 MG 20 CAPS 0 0
8,65 100
L01XX11 estramustine
0041681 ESTRACYT 140 MG 100 CAPS 0 0
126,70 100
L01XX14 tretinoin
0226073 VESANOID 10 MG 100 CAPS 0 0
195,76 100
L01XX35 anagrelide
0389441 XAGRID 0,5 MG 100 CAPS 1 5
493,12 100
L02AA02 polyestradiol phosphate
0041728 ESTRADURINE 80 MG PDR 1 FL + S 2 ML IM 0 0
8,79 100
L02AB01 megestrol
0141186 MEGACE 160 MG 30 CPR 0 0
41,35 100
L02AB02 medroxyprogesterone
0029866 DEPO PROVERA 500 MG 1 AMP 3,3 ML IM 0 0
14,43 100
0095133 PROVERA 100 MG 50 CPR 0 0
24,57 100
0095147 PROVERA 250 MG 40 CPR 0 0
39,18 100
0144403 PROVERA 400 MG 25 CPR 0 0
36,18 100
0450925 PROVERA 500 MG 30 CPR 0 0
50,16 100
0144899 PROVERA 500 MG/5 ML SIR 100 ML 0 0
45,65 100
L02AE01 buserelin
0158197 SUPREFACT NASAL 0,1 MG/D 1 FL 100 D 0 0
41,00 100
0111870 SUPREFACT NASAL 0,1 MG/D 4 FL 100 D 0 0
143,11 100
L02AE02 leuprorelin
0393099 DEPO ELIGARD 22,5 MG PDR 1 SRG + S SC 0 0
260,13 100
0470461 DEPO ELIGARD 45 MG PDR 1 SRG + S SC 0 0
511,50 100
0393118 DEPO ELIGARD 7,5 MG PDR 1 SRG + S SC 0 0
126,27 100
0554835 LUCRIN DEPOT 11,25 MG 1 SRG PREREMPLIE 0 0
289,04 100
0400159 LUCRIN DEPOT 3,75 MG 1 SRG PREREMPLIE 0 0
140,32 100
L02AE03 goserelin
0141818 ZOLADEX DEPOT 3,6 MG 1 SRG SC 0 0
130,66 100
0216841 ZOLADEX LA 10,8 MG 1 SRG SC 0 0
322,56 100
L02AE04 triptorelin
0299956 DECAPEPTYL SR 11,25 MG 1 SRG + S 2 ML 0 0
282,40 100
0591517 DECAPEPTYL SR 22,5 MG 1 FL + S 0 0
511,50 100
0299942 DECAPEPTYL SR 3,75 MG 1 SRG + S 2 ML 0 0
129,37 100
L02BA01 tamoxifen
0217768 NOLVADEX 10 MG 98 CPR 0 0
21,46 100
0217771 NOLVADEX D 20 MG 56 CPR 0 0
26,09 100
0172604 TAMIZAM 20 MG 60 CPR 0 0
29,28 100
0209508 TAMIZAM 20 MG 90 CPR 0 0
38,34 100
L02BA02 toremifene
0257214 FARESTON 60 MG 100 CPR 0 0
85,36 100
L02BA03 fulvestrant
0368325 FASLODEX 250 MG 1 SRG 5 ML IM 0 0
443,32 100
0568939 FASLODEX 250 MG 2 SRG PRER 5 ML + 2 AIG 0 0
522,82 100
L02BB01 flutamide
0290835 EULEXIN 250 MG 84 CPR 0 0
51,37 100
0325006 FLUTAMIDE EG 250 MG 100 CPR 0 0
59,96 100
0242354 FLUTAPLEX 250 MG 100 CPR 0 0
58,13 100
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0242368 FLUTAPLEX 250 MG 200 CPR 0 0
104,05 100
L02BB03 bicalutamide
0461333 BICALUTAMID RATIO 50 MG 30 CPR 0 0
58,35 100
0461364 BICALUTAMID RATIO 50 MG 90 CPR 0 0
153,34 100
0519965 BICALUTAMIDE EG 50 MG 100 CPR 0 0
260,46 100
0519948 BICALUTAMIDE EG 50 MG 28 CPR 0 0
84,57 100
0466102 BICALUTAMIDE TEVA 50 MG 28 CPR 0 0
105,59 100
0466151 BICALUTAMIDE TEVA 50 MG 56 CPR 0 0
163,31 100
0329751 CASODEX 150 MG 28 CPR 0 0
199,75 100
0216211 CASODEX 50 MG 28 CPR 0 0
84,57 100
L02BG03 anastrozole
0495801 ANASTROZOL RATIO 1 MG 100 CPR 0 0
137,63 100
0495765 ANASTROZOL RATIO 1 MG 30 CPR 0 0
47,31 100
0565713 ANASTROZOLE EG 1 MG 28 CPR 0 0
71,69 100
0565758 ANASTROZOLE EG 1 MG 98 CPR 0 0
184,96 100
0215151 ARIMIDEX 1 MG 28 CPR 0 0
71,69 100
0330927 ARIMIDEX 1 MG 84 CPR 0 0
159,79 100
L02BG04 letrozole
0231351 FEMARA 2,5 MG 100 CPR 0 0
519,51 100
0231347 FEMARA 2,5 MG 30 CPR 0 0
169,89 100
L02BG06 exemestane
0271485 AROMASIN 25 MG 30 CPR 0 0
129,43 100
L03AA02 filgrastim
0169031 NEUPOGEN 30 MIO U 5 AMP 1 ML IVSC 0 0
407,05 100
0314372 NEUPOGEN 30 MIO U 5 SRG PREREMPL 0,5 ML 0 0
407,05 100
0314386 NEUPOGEN 48 MIO U 5 SRG PREREMPL 0,5 ML 0 0
569,63 100
0506354 RATIOGRASTIM 30 MIO U PERF 5 SRG 0,5 ML 0 0
386,92 100
0506399 RATIOGRASTIM 48 MIO U PERF 5 SRG 0,8 ML 0 0
541,36 100
L03AA10 lenograstim
0246417 GRANOCYTE 33,6 MIO U PDR 5 FL+SRG 1 ML 0 0
408,88 100
L03AA13 pegfilgrastim
0341451 NEULASTA 6 MG 1 SRG (1) 0,6 ML SC 0 0
1.261,19 100
0529359 NEULASTA 6 MG 1 SRG SECURISEE 0,6 ML SC 0 0
1.261,19 100
0416209 NEULASTA 6 MG 1 STYLO 0,6 ML SC 0 0
1.289,97 100
L03AB03 interferon gamma
0185356 IMMUKINE 2 MIO U 6 FL 0,5 ML SC 0 0
626,59 100
L03AB04 interferon alfa-2a
0284905 ROFERON A 18 MIO U 6 CRT 0,6 ML SC 0 0
560,78 100
0274022 ROFERON A 3 MIO U 6 SRG 0,5 ML IMSC 0 0
105,78 100
0277444 ROFERON A 4,5 MIO U 6 SRG 0,5 ML IMSC 0 0
147,74 100
0274067 ROFERON A 6 MIO U 6 SRG 0,5 ML IMSC 0 0
194,18 100
0274084 ROFERON A 9 MIO U 6 SRG 0,5 ML IMSC 0 0
286,78 100
L03AB05 interferon alfa-2b
0208724 INTRON A 10 MIO U PDR 1 FL+S IMSC 0 0
76,31 100
0175508 INTRON A 10 MIO U PDR 6 FL+S IMIVSC 0 0
396,34 100
0278052 INTRON A ALB FREE 25 MIO U 2 FL 2,5 ML 0 0
325,90 100
0243415 INTRON A PEN 18 MIO U 1 STYLO MTD 1,2 ML 0 0
114,30 100
0243429 INTRON A PEN 30 MIO U 1 STYLO MTD 1,2 ML 0 0
206,16 100
0243432 INTRON A PEN 60 MIO U 1 STYLO MTD 1,2 ML 0 0
389,33 100
L03AB07 interferon beta-1a
0233629 AVONEX 30 MCG (6MIO) PDR 4 FL UD 3 ML IM 0 0
807,35 100
0355375 AVONEX 30 MCG 4 SRG 0,5 ML + 4 AIG IM 0 0
964,34 100
0265216 REBIF 12 MIO U/0,5 ML (44MCG) 12 SRG SC 0 0
1.143,52 100
0513118 REBIF 12 MIO U/0,5ML (44MCG) 4 CRT 1,5ML 0 0
1.143,47 100
0249971 REBIF 6 MIO U/0,5 ML (22MCG) 12 SRG SC 0 0
856,22 100
0513104 REBIF 6 MIO U/0,5 ML (22MCG) 4 CRT 1,5ML 0 0
856,15 100
L03AB08 interferon beta-1b
0274957 BETAFERON 8 MIO U PDR 15 FL + 15 SRG SC 0 0
891,72 100
0217138 BETAFERON 8 MIO U PDR 15 FL + S 2 ML SC 0 0
901,01 100
0441456 BETAFERON 8 MIO U PDR 15FL+15SRG+15ADAPT 0 0
737,74 100
L03AB10 peginterferon alfa-2b
0282591 PEGINTRON 100 MCG PDR 1 FL + S + 1 SRG 0 0
204,24 100
0320139 PEGINTRON 100 MCG PDR 1 STYLO + 1 AIG 0 0
197,87 100
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0320142 PEGINTRON 100 MCG PDR 4 STYLOS + 4 AIG 0 0
765,09 100
0282654 PEGINTRON 120 MCG PDR 1 FL + S + 1 SRG 0 0
243,19 100
0320187 PEGINTRON 120 MCG PDR 1 STYLO + 1 AIG 0 0
235,67 100
0320191 PEGINTRON 120 MCG PDR 4 STYLOS + 4 AIG 0 0
916,31 100
0282704 PEGINTRON 150 MCG PDR 1 FL + S + 1 SRG 0 0
301,67 100
0320237 PEGINTRON 150 MCG PDR 1 STYLO + 1 AIG 0 0
292,41 100
0320241 PEGINTRON 150 MCG PDR 4 STYLOS + 4 AIG 0 0
1.143,31 100
0282489 PEGINTRON 50 MCG PDR 1 FL + S + 1 SRG 0 0
106,82 100
0320058 PEGINTRON 50 MCG PDR 1 STYLO + 1 AIG 0 0
103,31 100
0320061 PEGINTRON 50 MCG PDR 4 STYLOS + 4 AIG 0 0
386,91 100
0282539 PEGINTRON 80 MCG PDR 1 FL + S + 1 SRG 0 0
165,29 100
0320092 PEGINTRON 80 MCG PDR 1 STYLO + 1 AIG 0 0
160,06 100
0320108 PEGINTRON 80 MCG PDR 4 STYLOS + 4 AIG 0 0
613,89 100
L03AB11 peginterferon alfa-2a
0323578 PEGASYS 135 MCG 4 SRG 0,5 ML SC 0 0
766,00 100
0323595 PEGASYS 180 MCG 4 SRG 0,5 ML SC 0 0
886,47 100
L03AX03 BCG vaccine
0340873 IMMUCYST 81 MG SUSP 1 FL + S 3 ML VE 0 0
66,14 100
0375803 ONCOTICE PDR 1 FL VI 0 0
57,99 100
L03AX13 glatiramer acetate
0370291 COPAXONE 20 MG/ML 28 SRG PRERPL SC 0 0
846,21 100
L04AA06 mycophenolic acid
0264111 CELLCEPT 1 G/5 ML PDR 110 G 0 0
94,92 100
0224566 CELLCEPT 250 MG 3*100 CAPS 0 0
189,72 100
0224552 CELLCEPT 500 MG 3*50 CPR 0 0
189,72 100
L04AA10 sirolimus
0317424 RAPAMUNE 1 MG 100 CPR 0 0
434,84 100
0344483 RAPAMUNE 2 MG 30 CPR 0 0
264,42 100
0301228 RAPAMUNE 60 MG 1 FL 60 ML + 1 SET 0 0
264,42 100
L04AA13 leflunomide
0270832 ARAVA 10 MG 100 CPR 0 0
170,96 100
0270829 ARAVA 10 MG 30 CPR 0 0
69,50 100
0285382 ARAVA 100 MG 3 CPR 0 0
41,43 100
0270881 ARAVA 20 MG 100 CPR 0 0
195,84 100
0270877 ARAVA 20 MG 30 CPR 0 0
78,92 100
L04AB01 etanercept
0443951 ENBREL 25 MG PDR 4 SRG PREREMPL 0,5 ML 0 0
547,20 100
0462263 ENBREL 25 MG PDR 4FL+4SRG+20AIG+4ADAPT 0 0
547,20 100
0524903 ENBREL 50 MG PDR 4 MYCLIC 1 ML + 8 TAMP 0 0
1.085,63 100
0443996 ENBREL 50 MG PDR 4 SRG PREREMPL 1 ML 0 0
1.085,63 100
0440199 ENBREL PED 25 MG 4 SRG PREREMPL 1 ML 0 0
563,87 100
L04AB04 adalimumab
0353001 HUMIRA 40 MG 2 SRG 0,8 ML SC 0 0
1.056,43 100
0444301 HUMIRA 40 MG 2 STYLOS 0,8 ML + 2 TAMP 0 0
1.056,43 100
L04AB05 certolizumab pegol
0541272 CIMZIA 200 MG 2 SRG 1 ML SC 0 0
1.011,78 100
L04AB06 golimumab
0528978 SIMPONI 50 MG 1 STYLO 0,5 ML 0 0
1.150,67 100
L04AC05 ustekinumab
0567976 STELARA 45 MG 1 SRG PREREMPL 0,5 ML SC 0 0
3.188,38 100
0567993 STELARA 90 MG 1 SRG PREREMPL 1 ML SC 0 0
3.612,34 100
L04AD01 ciclosporin
0170661 SANDIMMUN 100 MG 50 CAPS 0 0
207,40 100
0102238 SANDIMMUN 100 MG/ML GTTS 50 ML 0 0
207,40 100
0170644 SANDIMMUN 25 MG 50 CAPS 0 0
62,97 100
0306563 SANDIMMUN INF 250 MG 10 AMP 5 ML PERF 0 0
160,44 100
0266051 SANDIMMUN OPTORAL 10 MG 100 CAPS 0 0
52,26 100
0317164 SANDIMMUN OPTORAL 100 MG 50 CAPS 0 0
225,91 100
0317097 SANDIMMUN OPTORAL 25 MG 50 CAPS 0 0
60,82 100
0317133 SANDIMMUN OPTORAL 50 MG 50 CAPS 0 0
115,20 100
0198131 SANDIMMUN OPTORAL GTTS 50 ML 0 0
225,91 100
L04AD02 tacrolimus
0477798 ADVAGRAF 0,5 MG 100 CAPS 0 0
91,14 100
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0477719 ADVAGRAF 0,5 MG 50 CAPS 0 0
52,75 100
0477767 ADVAGRAF 1 MG 100 CAPS 0 0
147,46 100
0555149 ADVAGRAF 3 MG 100 CAPS 0 0
413,90 100
0477803 ADVAGRAF 5 MG 100 CAPS 0 0
665,82 100
0477784 ADVAGRAF 5 MG 50 CAPS 0 0
337,30 100
0308926 PROGRAFT 0,5 MG 100 CAPS 0 0
91,14 100
0308912 PROGRAFT 0,5 MG 50 CAPS 0 0
52,75 100
0250518 PROGRAFT 1 MG 100 CAPS 0 0
147,46 100
0250504 PROGRAFT 1 MG 50 CAPS 0 0
78,11 100
0250549 PROGRAFT 5 MG 100 CAPS 0 0
665,82 100
0250535 PROGRAFT 5 MG 50 CAPS 0 0
337,30 100
L04AX01 azathioprine
0056443 IMURAN 50 MG 100 CPR 0 0
26,59 100
0168114 IMURAN MITIS 25 MG 100 CPR 0 0
17,05 100
M01AB01 indometacin
0034530 DOLCIDIUM 100 MG 12 SUPP 0 0
7,83 80
0034544 DOLCIDIUM GE 50 MG 12 SUPP 0 0
6,47 80
0185911 INDOMET RATIO 100 MG 10 SUPP 0 0
4,17 80
0185924 INDOMET RATIO 100 MG 50 SUPP 0 0
18,24 80
0056877 INDOMET RATIO 25 MG 100 CAPS 0 0
6,95 80
0056846 INDOMET RATIO 25 MG 20 CAPS 0 0
2,03 80
0056863 INDOMET RATIO 25 MG 50 CAPS 0 0
4,68 80
0056913 INDOMET RATIO 50 MG 100 CAPS 0 0
9,80 80
0056880 INDOMET RATIO 50 MG 20 CAPS 0 0
2,36 80
0056894 INDOMET RATIO 50 MG 50 CAPS 0 0
5,30 80
0056927 INDOMET RATIO RET 75 MG 20 CAPS RET 0 0
4,50 80
0056930 INDOMET RATIO RET 75 MG 50 CAPS RET 0 0
9,09 80
M01AB05 diclofenac
0154525 CATAFLAM 50 MG 30 DRG 0 0
9,81 80
0031895 DICLAC 100 MG 10 SUPP 0 0
3,47 80
0031928 DICLAC 25 MG 100 CPR 0 0
5,45 80
0162365 DICLAC 25 MG 20 CPR 0 0
1,49 80
0031914 DICLAC 25 MG 50 CPR 0 0
2,98 80
0031959 DICLAC 50 MG 10 SUPP 0 0
1,93 80
0031945 DICLAC 50 MG 100 CPR 0 0
9,11 80
0162379 DICLAC 50 MG 20 CPR 0 0
1,86 80
0208335 DICLAC 50 MG 30 SUPP 0 0
4,88 80
0031931 DICLAC 50 MG 50 CPR 0 0
4,88 80
0031878 DICLAC 75 MG 1 AMP 3 ML IM 0 0
0,77 80
0031881 DICLAC 75 MG 5 AMP 3 ML IM 0 0
2,93 80
0155519 DICLAC RET 100 MG 100 CPR 0 0
14,00 80
0155486 DICLAC RET 100 MG 20 CPR 0 0
3,09 80
0155505 DICLAC RET 100 MG 50 CPR 0 0
7,50 80
0451886 DICLOFENAC EG 100 MG 12 SUPP 0 0
6,16 80
0451872 DICLOFENAC EG 100 MG 30 CPR 0 0
9,44 80
0182662 DICLOFENAC EG 25 MG 100 CPR 0 0
8,52 80
0182659 DICLOFENAC EG 25 MG 30 CPR 0 0
5,87 80
0182676 DICLOFENAC EG 50 MG 50 CPR 0 0
8,52 80
0451841 DICLOFENAC EG 75 MG 6 AMP 3 ML IVIM 0 0
6,21 80
0451869 DICLOFENAC EG 75 MG 60 CPR 0 0
11,31 80
0032021 DICLOFENAC RATIO 100 MG 10 SUPP 0 0
5,52 80
0032035 DICLOFENAC RATIO 100 MG 50 SUPP 0 0
16,52 80
0032083 DICLOFENAC RATIO 25 MG 10 SUPP 0 0
4,45 80
0032066 DICLOFENAC RATIO 25 MG 100 CPR PELLIC 0 0
10,31 80
0032049 DICLOFENAC RATIO 25 MG 20 CPR PELLIC 0 0
2,79 80
0032052 DICLOFENAC RATIO 25 MG 50 CPR PELLIC 0 0
6,20 80
0032097 DICLOFENAC RATIO 25 MG 50 SUPP 0 0
11,43 80
0032147 DICLOFENAC RATIO 50 MG 10 SUPP 0 0
9,04 80
0032133 DICLOFENAC RATIO 50 MG 100 CPR PELLIC 0 0
11,75 80
0032102 DICLOFENAC RATIO 50 MG 20 CPR PELLIC 0 0
4,19 80
0032116 DICLOFENAC RATIO 50 MG 50 CPR PELLIC 0 0
8,83 80
0032150 DICLOFENAC RATIO 50 MG 50 SUPP 0 0
12,24 80
0173405 DICLOFENAC RATIO SF 75 MG 1 AMP 2 ML IM 0 0
1,35 80
0267269 DICLOFENAC RATIO SF 75 MG 10 AMP 2 ML 0 0
10,99 80
0173422 DICLOFENAC RATIO SF 75 MG 30 AMP 2 ML IM 0 0
13,65 80
0032228 DICLOFENAC RET RATIO 100 MG 100 CAPS RET 0 0
13,51 80
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0032200 DICLOFENAC RET RATIO 100 MG 20 CAPS RET 0 0
7,30 80
0032214 DICLOFENAC RET RATIO 100 MG 50 CAPS RET 0 0
10,67 80
0304796 DOCDICLOFE 100 MG 30 CPR 0 0
8,68 80
0304782 DOCDICLOFE 75 MG 60 CPR 0 0
13,17 80
0345531 MOTIFENE 75 MG 28 CAPS RET 0 0
12,00 80
0235011 MOTIFENE 75 MG 56 CAPS RET 0 0
15,68 80
0176147 POLYFLAM 50 MG 50 CPR 0 0
10,78 80
0236858 VOLTAREN 100 MG 10 SUPP 0 0
7,26 80
0236469 VOLTAREN 25 MG 20 DRG 0 0
4,08 80
0237189 VOLTAREN 25 MG 50 DRG 0 0
7,69 80
0237242 VOLTAREN 50 MG 100 DRG 0 0
25,15 80
0237239 VOLTAREN 50 MG 20 DRG 0 0
5,74 80
0236939 VOLTAREN 50 MG 50 DRG 0 0
13,58 80
0264317 VOLTAREN DISPERS 46,5 MG 20 CPR 0 0
2,00 80
0264321 VOLTAREN DISPERS 46,5 MG 50 CPR 0 0
4,67 80
0269182 VOLTAREN INJEKT 75 MG 1 AMP 3 ML IM 0 0
1,86 80
0337945 VOLTAREN RESINAT 100 CAPS 0 0
8,83 80
0337928 VOLTAREN RESINAT 20 CAPS 0 0
1,55 80
0337931 VOLTAREN RESINAT 50 CAPS 0 0
4,10 80
0237158 VOLTAREN RET 100 MG 100 DRG 0 0
42,69 80
0236729 VOLTAREN RET 100 MG 20 DRG 0 0
11,63 80
0237144 VOLTAREN RET 100 MG 50 DRG 0 0
24,95 80
M01AB11 acemetacin
0096693 RANTUDIL FORTE 60 MG 20 CAPS 0 0
11,20 80
0096709 RANTUDIL FORTE 60 MG 50 CAPS 0 0
14,97 80
0096712 RANTUDIL RET 90 MG 20 CAPS 0 0
19,33 80
0096726 RANTUDIL RET 90 MG 50 CAPS 0 0
36,13 80
M01AB14 proglumetacin
0157348 TOLINDOL 150 MG 60 CAPS 0 0
11,69 80
M01AB15 ketorolac
0176991 TARADYL 10 MG 5 AMP 1 ML IM 0 0
7,47 80
M01AB16 aceclofenac
0523291 ACECLOFENAC EG 100 MG 20 CPR 0 0
7,74 80
0523324 ACECLOFENAC EG 100 MG 60 CPR 0 0
12,93 80
0228471 AIRTAL 100 MG 20 CPR 0 0
9,89 80
0228484 AIRTAL 100 MG 60 CPR 0 0
16,95 80
0228341 BIOFENAC 100 MG 20 CPR 0 0
9,89 80
0228355 BIOFENAC 100 MG 60 CPR 0 0
16,95 80
M01AB55 diclofenac, combinations
0241861 ARTHROTEC 75 30 CPR 0 0
24,34 80
M01AC01 piroxicam
0177662 BREXINE 20 MG 30 CPR 0 0
15,16 80
0177645 BREXINE 20 MG 30 SACH DBL 0 0
15,16 80
0267627 BREXINE DRYFIZ 20 MG 30 CPR EFF 0 0
15,16 80
0304958 DOCPIROXI DISPERS 20 MG 30 CPR 0 0
10,54 80
0134201 FELDENE 10 MG 30 CAPS 0 0
8,39 80
0044019 FELDENE 20 MG 12 SUPP 0 0
7,86 80
0134195 FELDENE 20 MG 30 CAPS 0 0
12,28 80
0142622 FELDENE 20 MG 6 AMP 1 ML IM 0 0
7,57 80
0136481 FELDENE DIS 20 MG 30 CPR 0 0
12,28 80
0212503 FELDENE LYOTABS 20 MG 30 CPR 0 0
15,35 80
0457358 PIROXICAM EG 20 MG 30 CAPS 0 0
10,61 80
0457375 PIROXICAM EG 20 MG 30 CPR 0 0
10,61 80
0457361 PIROXICAM EG 20 MG 6 AMP 1 ML IM 0 0
6,88 80
0205641 PIROXICAM HEXAL 10 MG TABS 20 CPR 0 0
3,99 80
0205655 PIROXICAM HEXAL 10 MG TABS 50 CPR 0 0
9,45 80
0205719 PIROXICAM HEXAL 20 MG TABS 100 CPR 0 0
19,28 80
0205686 PIROXICAM HEXAL 20 MG TABS 20 CPR 0 0
6,83 80
0205705 PIROXICAM HEXAL 20 MG TABS 50 CPR 0 0
13,82 80
0190809 PIROXICAM RATIO 10 MG TABS 20 CPR 0 0
3,99 80
0190812 PIROXICAM RATIO 10 MG TABS 50 CPR 0 0
9,45 80
0190759 PIROXICAM RATIO 20 MG 10 SUPP 0 0
6,80 80
0190762 PIROXICAM RATIO 20 MG 50 SUPP 0 0
38,81 80
0190776 PIROXICAM RATIO 20 MG TABS 20 CPR 0 0
6,83 80
0190793 PIROXICAM RATIO 20 MG TABS 50 CPR 0 0
13,78 80
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0411071 PIROXICAM TEVA 20 MG 30 CPR 0 0
13,43 80
0260349 SOLICAM 20 MG 14 CAPS 0 0
7,90 80
0243804 SOLICAM 20 MG 28 CAPS 0 0
11,72 80
0243818 SOLICAM 20 MG 56 CAPS 0 0
19,40 80
M01AC02 tenoxicam
0140239 TILCOTIL 20 MG 30 CPR 0 0
10,86 80
0158183 TILCOTIL 20 MG 60 CPR 0 0
14,97 80
M01AC06 meloxicam
0461771 MELOXICAM EG 15 MG 30 CPR 0 0
11,31 80
0417903 MELOXICAM HEXAL 15 MG 20 CPR 0 0
9,20 80
0417836 MELOXICAM HEXAL 7,5 MG 10 CPR 0 0
2,30 80
0417853 MELOXICAM HEXAL 7,5 MG 20 CPR 0 0
4,40 80
0216256 MOBIC 15 MG 30 CPR 0 0
11,63 80
0305356 MOBIC 15 MG 5 AMP 1,5 ML IM 0 0
8,46 80
M01AE01 ibuprofen
0016109 BRUFEN 400 MG 100 DRG 0 0
11,32 80
0016126 BRUFEN FORTE 600 MG 30 CPR 0 0
8,65 80
0512057 BRUFEN FORTE 600 MG 60 CPR 0 0
10,79 80
0180718 BRUFEN RET 800 MG 28 CPR 0 0
9,31 80
0201978 BRUFEN RET 800 MG 60 CPR 0 0
13,18 80
0174741 DOLGIT 600 MG 100 DRG 0 0
18,51 80
0174724 DOLGIT 600 MG 20 DRG 0 0
4,41 80
0174738 DOLGIT 600 MG 50 DRG 0 0
10,47 80
0170627 DOLGIT 800 MG 20 CPR 0 0
5,35 80
0170631 DOLGIT 800 MG 50 CPR 0 0
13,73 80
0202782 DOLOFIN 400 MG 100 DRG 0 0
7,09 80
0202779 DOLOFIN 400 MG 30 DRG 0 0
2,69 80
0457751 IBU RATIO 2% SIR 100 ML 0 0
2,86 80
0463792 IBU RATIO 200 MG 100 CPR 0 0
7,50 80
0463775 IBU RATIO 200 MG 20 CPR 0 0
1,72 80
0463789 IBU RATIO 200 MG 50 CPR 0 0
7,04 80
0454339 IBU RATIO 400 MG 100 CPR 0 0
7,19 80
0454311 IBU RATIO 400 MG 20 CPR 0 0
2,06 80
0454325 IBU RATIO 400 MG 50 CPR 0 0
4,50 80
0454373 IBU RATIO 600 MG 100 CPR 0 0
14,00 80
0454342 IBU RATIO 600 MG 20 CPR 0 0
3,20 80
0454356 IBU RATIO 600 MG 50 CPR 0 0
7,70 80
0454406 IBU RATIO 800 MG 100 CPR 0 0
17,13 80
0454387 IBU RATIO 800 MG 20 CPR 0 0
5,00 80
0454391 IBU RATIO 800 MG 50 CPR 0 0
11,20 80
0155679 IBUHEXAL 400 MG 100 CPR 0 0
7,19 80
0155651 IBUHEXAL 400 MG 20 CPR 0 0
2,06 80
0155665 IBUHEXAL 400 MG 50 CPR 0 0
4,50 80
0155648 IBUHEXAL 600 MG 100 CPR 0 0
14,00 80
0155621 IBUHEXAL 600 MG 20 CPR 0 0
3,20 80
0155634 IBUHEXAL 600 MG 50 CPR 0 0
7,70 80
0200855 IBUHEXAL 800 MG 100 CPR 0 0
17,20 80
0200838 IBUHEXAL 800 MG 20 CPR 0 0
5,00 80
0200841 IBUHEXAL 800 MG 50 CPR 0 0
11,00 80
0176519 IBUHEXAL RET 800 MG 100 CPR 0 0
17,20 80
0176486 IBUHEXAL RET 800 MG 20 CPR 0 0
5,00 80
0176505 IBUHEXAL RET 800 MG 50 CPR 0 0
11,20 80
0386497 IBUPROFEN CT 500 MG 10 SUPP 0 0
3,10 80
0386581 IBUPROFEN RET CT 400 MG 20 CAPS 0 0
5,70 80
0136964 IBUPROFENE EG 400 MG 100 DRG 0 0
8,04 80
0202216 IBUPROFENE EG 400 MG 30 DRG 0 0
5,90 80
0213501 MALAFENE 100 MG/5 ML SIR 100 ML 0 0
3,73 80
0211957 NUROFEN 200 MG 48 DRG 0 0
7,73 80
0345334 NUROFEN ENF 200 MG 24 CPR 0 0
4,12 80
0253702 NUROFEN ENF SS SUCRE 100MG/5ML SIR 200ML 0 0
8,47 80
0521624 NUROFEN ENF SS SUCRE ROUGE 2% SIR 200 ML 0 0
8,47 80
0525086 NUROFEN FASTTAPS 400 MG 24 CPR PELLIC 0 0
6,61 80
0198029 SCHMERZDOLGIT 400 MG 30 CAPS 0 0
6,23 80
0300221 SPIDIFEN 200 MG 24 SACH 0 0
3,99 80
0339953 SPIDIFEN 400 MG 24 CPR 0 0
6,57 80
M01AE02 naproxen
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0284421 ALEVE 220 MG 30 CPR 0 0
6,75 80
0007158 APRANAX 275 MG 30 CPR 0 0
8,94 80
0169433 APRANAX 550 MG 30 CPR 0 0
11,37 80
0314422 NAPROFLAM 500 MG 30 CPR 0 0
11,20 80
0176262 NAPROSYNE EC 250 MG 50 CPR 0 0
11,02 80
0176276 NAPROSYNE EC 500 MG 30 CPR 0 0
12,23 80
0148447 NAPROXENE EG 250 MG 50 CPR 0 0
8,11 80
0148464 NAPROXENE EG 500 MG 12 SUPP 0 0
7,23 80
0148451 NAPROXENE EG 500 MG 30 CPR 0 0
8,94 80
M01AE03 ketoprofen
0140693 BIROFENID 150 MG 30 CPR 0 0
10,20 80
0100751 ROFENID 100 MG 12 SUPP 0 0
6,54 80
0197973 ROFENID LA 200 MG 28 CAPS 0 0
11,53 80
0100748 ROFENID READY MIX 100 MG 6 AMP 2 ML IM 0 0
9,29 80
M01AE09 flurbiprofen
0046836 FROBEN 100 MG 60 DRG 0 0
10,30 80
M01AE16 alminoprofen
0185861 MINALFENE 300 MG 15 CPR 0 0
4,72 80
M01AG Fenamates
0168873 RHEUMON IM 1 AMP 2 ML IM 0 0
2,60 80
M01AH01 celecoxib
0281108 CELEBREX 100 MG 60 CAPS 0 0
28,25 80
0298011 CELEBREX 200 MG 10 CAPS 0 0
18,42 80
0281125 CELEBREX 200 MG 30 CAPS 0 0
28,25 80
M01AH05 etoricoxib
0332837 ARCOXIA 120 MG 14 CPR 0 0
25,37 80
0332854 ARCOXIA 120 MG 28 CPR 0 0
40,85 80
0476367 ARCOXIA 30 MG 28 CPR 0 0
24,71 80
0332532 ARCOXIA 60 MG 28 CPR 0 0
40,85 80
0332692 ARCOXIA 90 MG 28 CPR 0 0
39,36 80
M01AX01 nabumetone
0472712 GAMBARAN 500 MG 60 CPR 0 0
12,23 80
M01CC01 penicillamine
0139403 METALCAPTASE 300 MG 20 CPR 0 0
16,03 100
M02AA Antiinflammatory preparations, non-steroids for topical use
0073024 MOBILISIN CREME 100 G 0 0
12,35 40
0180928 MOBILISIN CREME 50 G 0 0
7,72 40
M02AA06 etofenamate
0098989 RHEUMON CREME 100 G 0 0
8,62 40
0161161 RHEUMON LOTIO 100 G 0 0
8,62 40
0199592 THERMORHEUMON CREME 100 G 0 0
9,98 40
0119235 TRAUMON 10% GEL 100 G 0 0
8,62 40
0199608 TRAUMON 10% GEL 50 G 0 0
5,06 40
0364598 TRAUMON 5% GEL 100 G 0 0
8,53 40
M02AA07 piroxicam
0136169 FELDENE GEL 0,5% 25 G 0 0
4,77 40
0164861 FELDENE GEL 0,5% 50 G 0 0
8,11 40
M02AA08 felbinac
0181911 FLEXFREE GEL 100 G 0 0
14,38 40
0173534 FLEXFREE GEL 50 G 0 0
8,39 40
0197066 FLEXFREE MOUSSE SPRAY 100 G 0 0
12,78 40
M02AA10 ketoprofen
0239734 FASTUM 2,5% DISP 120 G 0 0
16,82 40
0195707 FASTUM 2,5% GEL 60 G 0 0
9,96 40
M02AA13 ibuprofen
0034592 DOLGIT 5% CREME 100 G 0 0
9,47 40
0034589 DOLGIT 5% CREME 50 G 0 0
5,27 40
0236004 DOLGIT MIKROGEL 5% GEL 100 G 0 0
10,88 40
0237001 DOLGIT MIKROGEL 5% GEL 50 G 0 0
5,96 40
0223622 DOLOFIN 5% GEL 50 G 0 0
6,82 40
0223779 IBUTOP 5% GEL 100 G 0 0
13,14 40
0223765 IBUTOP 5% GEL 50 G 0 0
8,31 40
M02AA15 diclofenac
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0189548 VOLTAREN EMULGEL 1% 100 G 0 0
5,15 40
0129777 VOLTAREN EMULGEL 1% 50 G 0 0
3,13 40
M02AA23 indometacin
0136253 INDOMET RATIO 1% GEL 100 G 0 0
6,58 40
0136236 INDOMET RATIO 1% GEL 50 G 0 0
4,17 40
0469068 SPORTFLEX 1% SPRAY 100 ML 0 0
14,77 40
0469054 SPORTFLEX 1% SPRAY 50 ML 0 0
9,67 40
M02AC Preparations with salicylic acid derivatives
0274859 ALGESAL CREME 100 G 0 0
5,82 40
0138888 ALGESAL MOUSSE 100 G 0 0
11,97 40
0002828 ALGESAL MOUSSE 50 G 0 0
6,84 40
0002909 ALGIPAN POM 140 G 0 0
8,84 40
0002893 ALGIPAN POM 80 G 0 0
5,73 40
0289364 DOLAL LINIMENT 50 G 0 0
6,12 40
0199124 STILENE 180 ML 0 0
6,32 40
M02AX10 various
0015504 SRILANE CREME 50 G 0 0
8,95 40
M03BX01 baclofen
0066050 LIORESAL 10 MG 50 CPR 0 0
9,64 80
0066064 LIORESAL 25 MG 50 CPR 0 0
15,61 80
M03BX02 tizanidine
0105436 SIRDALUD 2 MG 100 CPR 0 0
18,99 80
0105422 SIRDALUD 2 MG 50 CPR 0 0
13,79 80
0105467 SIRDALUD 4 MG 100 CPR 0 0
27,28 80
0105453 SIRDALUD 4 MG 50 CPR 0 0
18,05 80
0152629 SIRDALUD 6 MG 100 CPR 0 0
35,49 80
M03BX07 tetrazepam
0366205 EPSIPAM 50 MG 20 CPR 0 0
4,94 40
0218832 MYOLASTAN 50 MG 20 CPR 0 0
5,23 40
M04AA01 allopurinol
0136804 ALLOPURINOL EG 300 MG 90 CPR 0 0
13,41 80
0576301 ALLOPURINOL RATIO 100 MG 100 CPR 0 0
7,53 80
0576295 ALLOPURINOL RATIO 100 MG 50 CPR 0 0
6,41 80
0149606 ALLOPURINOL RATIO 300 MG 100 CPR 0 0
12,01 80
0149587 ALLOPURINOL RATIO 300 MG 20 CPR 0 0
3,41 80
0149591 ALLOPURINOL RATIO 300 MG 50 CPR 0 0
7,88 80
0219874 ALPURIC 300 MG 90 CAPS 0 0
12,21 80
0131288 ZYLORIC 100 MG 100 CPR 0 0
8,14 80
0131291 ZYLORIC 300 MG 30 CPR 0 0
7,83 80
0139644 ZYLORIC 300 MG 90 CPR 0 0
12,73 80
M04AC01 colchicine
0362397 COLCHICINE OPOCALCIUM 1 MG 20 CPR 0 0
4,86 80
M05BA02 clodronic acid
0244538 BONEFOS 800 MG 50 CPR 0 0
153,22 80
M05BA04 alendronic acid
0463839 ALENDRON HEXAL 70 MG 12 CPR 0 0
23,97 80
0463811 ALENDRON HEXAL 70 MG 4 CPR 0 0
14,74 80
0409719 ALENDRONSAEURE RATIO 70 MG 12 CPR 0 0
26,75 80
0409686 ALENDRONSAEURE RATIO 70 MG 4 CPR 0 0
14,74 80
0486797 BEENOS 70 MG 12 CPR 0 0
28,76 80
0486783 BEENOS 70 MG 4 CPR 0 0
14,65 80
0212808 FOSAMAX 10 MG 28 CPR 0 0
20,28 80
0252669 FOSAMAX 10 MG 98 CPR 0 0
78,88 80
0303481 FOSAMAX 70 MG HEBDOMADAIRE 12 CPR 0 0
49,27 80
0303463 FOSAMAX 70 MG HEBDOMADAIRE 4 CPR 0 0
20,28 80
0565632 OSTACID 70 MG 12 CPR 0 0
23,97 80
M05BA05 tiludronic acid
0214458 SKELID 200 MG 28 CPR 0 0
101,31 80
M05BA06 ibandronic acid
0355716 BONDRONAT 50 MG 84 CPR 0 0
855,09 80
0409414 BONVIVA 150 MG 3 CPR 0 0
99,34 80
0432247 BONVIVA 3 MG PERF 1 SRG 3 ML IV 0 0
99,34 80
M05BA07 risedronic acid
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0280761 ACTONEL 30 MG 28 CPR 0 0
126,23 80
0283083 ACTONEL 5 MG 84 CPR 0 0
54,48 80
0338621 ACTONEL HEBDO 35 MG 12 CPR 0 0
54,48 80
M05BA08 zoledronic acid
0405608 ACLASTA 5 MG 1 FL 100 ML PERF 0 0
371,90 80
M05BB02 risedronic acid and calcium, sequential
0480857 ACTONEL COMBI D 12 CPR + 72 SACH 0 0
64,50 80
M05BB03 alendronic acid and colecalciferol
0471133 FOSAVANCE 70 MG/5600 U 12 CPR 0 0
63,34 80
M05BX03 strontium ranelate
0388779 PROTELOS 2 G 84 SACH 0 0
106,64 80
M05BX04 denosumab
0569015 PROLIA 60 MG 1 SRG 1 ML SC 0 0
208,14 80
N01BB01 bupivacaine
0286717 MARCAINE 0,5% 5 FL 20 ML + 5 BOUCHONS 0 0
26,94 80
N01BB02 lidocaine
0065649 LIDOCAIN BRN 2% 10 AMP 5 ML V 0 0
3,79 80
0478491 VERSATIS 5% 10 EMPLATRES 0 0
37,84 80
0478537 VERSATIS 5% 30 EMPLATRES 0 0
99,89 80
0286765 XYLOCAINE ASTRA 1% 1 FL 20ML + 1 BOUCHON 0 0
3,47 80
0286703 XYLOCAINE ASTRA 2% 1 FL 20ML + 1 BOUCHON 0 0
3,63 80
N01BB03 mepivacaine
0286734 SCANDICAINE 1% 5 FL 20 ML + 5 BOUCHONS 0 0
14,33 80
0286748 SCANDICAINE 2% 5 FL 20 ML + 5 BOUCHONS 0 0
15,27 80
N01BB20 combinations
0057437 INSTILLAGEL 10*11 ML 0 0
19,09 80
0057406 INSTILLAGEL 10*6 ML 0 0
15,10 80
0057423 INSTILLAGEL 11 ML 0 0
3,54 80
0057390 INSTILLAGEL 6 ML 0 0
3,02 80
N01BB52 lidocaine, combinations
0227859 EMLA 5 % 2 PATCH 0 0
5,54 80
0157754 EMLA 5% CREME 5 G + 2 PANSEM 0 0
5,47 80
0130408 XYLOCAINE ADREN ASTRA 1% 1 FL 20 ML IMSC 0 0
3,63 80
0130425 XYLOCAINE ADREN ASTRA 2% 1 FL 20 ML IMSC 0 0
3,63 80
N02AA01 morphine
0575706 MORPHINE HCL 10 MG 10 AMP 1 ML STRP 0 0
7,35 80
0249789 MS CONTIN 10 MG 30 CPR 0 0
9,89 80
0249811 MS CONTIN 100 MG 30 CPR 0 0
41,26 80
0204675 MS CONTIN 200 MG 14 CPR 0 0
39,31 80
0249792 MS CONTIN 30 MG 30 CPR 1 11
17,19 80
0073928 MS CONTIN 30 MG 56 CPR 1 11
25,13 80
0249808 MS CONTIN 60 MG 30 CPR 1 11
29,01 80
0073945 MS CONTIN 60 MG 56 CPR 1 11
42,99 80
0270376 MS DIRECT 10 MG 56 CPR 0 0
18,13 80
N02AA03 hydromorphone
0366222 PALLADONE IR 1,3 MG 28 CAPS 0 0
9,44 80
0366271 PALLADONE IR 2,6 MG 28 CAPS 0 0
14,80 80
0334893 PALLADONE SR 16 MG 30 CAPS 0 0
68,05 80
0334912 PALLADONE SR 24 MG 30 CAPS 0 0
84,35 80
0334845 PALLADONE SR 4 MG 30 CAPS 0 0
22,70 80
0334862 PALLADONE SR 8 MG 30 CAPS 0 0
38,89 80
N02AA05 oxycodone
0354302 OXYCONTIN 10 MG 30 CPR 0 0
17,15 80
0354395 OXYCONTIN 20 MG 30 CPR 0 0
28,42 80
0354476 OXYCONTIN 40 MG 30 CPR 0 0
47,59 80
0415554 OXYCONTIN 5 MG 30 CPR 0 0
11,91 80
0354574 OXYCONTIN 80 MG 30 CPR 0 0
80,01 80
0495721 OXYNORM INSTANT 10 MG 28 CPR ORODISP 0 0
14,81 80
0495667 OXYNORM INSTANT 20 MG 28 CPR ORODISP 0 0
25,28 80
0495698 OXYNORM INSTANT 5 MG 28 CPR ORODISP 0 0
9,44 80
N02AA59 codeine, combinations excl. psycholeptics
0211439 ALGISEDAL 16 CPR 0 0
2,48 80
0281089 COMBAREN 20 CPR 0 0
19,55 80
Page 59 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0277072 DAFALGAN CODEINE 30 CPR 0 0
5,83 80
0138485 DAFALGAN CODEINE 32 CPR EFF 0 0
7,43 80
0299147 DOCPARACOD 500 MG/30 MG 30 CPR 0 0
4,83 80
0364603 DOLVIRAN N 20 CPR 0 0
14,92 40
0076186 NEDOLON P 20 CPR 0 0
4,02 80
0185759 PANADOL CODEINE 20 CPR 0 0
4,07 80
0266003 TALVOSILEN FORTE 10 SUPP 0 0
3,68 80
N02AB02 pethidine
0034429 DOLANTINE 100 MG 5 AMP 2 ML IMIVSC 0 0
5,80 80
N02AB03 fentanyl
0227943 DUROGESIC 100 MCG/H (16,8 MG) 5 PATCH 0 0
63,97 80
0409798 DUROGESIC 12 MCG/H (2,1 MG) 5 PATCH 0 0
17,71 80
0227909 DUROGESIC 25 MCG/H (4,2 MG) 5 PATCH 0 0
22,67 80
0227912 DUROGESIC 50 MCG/H (8,4 MG) 5 PATCH 0 0
37,99 80
0227926 DUROGESIC 75 MCG/H (12,6 MG) 5 PATCH 0 0
51,70 80
0472337 MATRIFEN 100 (11 MG) 5 PATCH 0 0
63,97 80
0477204 MATRIFEN 12 (1,38 MG) 2 PATCH 0 0
9,51 80
0472113 MATRIFEN 12 (1,38 MG) 5 PATCH 0 0
17,71 80
0477235 MATRIFEN 25 (2,75 MG) 2 PATCH 0 0
11,50 80
0472161 MATRIFEN 25 (2,75 MG) 5 PATCH 0 0
22,67 80
0472211 MATRIFEN 50 (5,5 MG) 5 PATCH 0 0
37,99 80
0472273 MATRIFEN 75 (8,25 MG) 5 PATCH 0 0
51,70 80
N02AC03 piritramide
0033239 DIPIDOLOR 20 MG 5 AMP 2 ML IMSC 0 0
6,52 80
N02AD01 pentazocine
0045985 FORTAL 30 MG 10 AMP 1 ML IMIVSC 0 0
8,99 80
0045968 FORTAL 50 MG 100 CPR 0 0
15,17 80
0045954 FORTAL 50 MG 30 CPR 0 0
8,22 80
N02AE01 buprenorphine
0114211 TEMGESIC SL 0,2 MG 50 CPR 0 0
15,00 80
0314856 TRANSTEC 35 (20 MG) 5 PATCH 0 0
36,73 80
0314891 TRANSTEC 52,5 (30 MG) 5 PATCH 0 0
50,67 80
0314937 TRANSTEC 70 (40 MG) 5 PATCH 0 0
65,03 80
N02AX Other opioids
0135291 VALTRAN GTTS 10 ML 0 0
6,29 80
0135306 VALTRAN GTTS 20 ML 0 0
7,93 80
0269121 VALTRAN GTTS 60 ML 0 0
14,26 80
0284614 VALTRAN RET 100/8 MG 30 CPR 0 0
16,81 80
0284645 VALTRAN RET 150/12 MG 30 CPR 0 0
21,66 80
0284581 VALTRAN RET 50/4 MG 30 CPR 0 0
11,28 80
N02AX02 tramadol
0481448 CONTRAMAL UNO 100 MG 30 CPR 0 0
12,92 80
0481529 CONTRAMAL UNO 200 MG 30 CPR 0 0
20,84 80
0481613 CONTRAMAL UNO 300 MG 30 CPR 0 0
28,74 80
0501148 DOCTRAMADO 100 MG 30 CPR 0 0
9,63 80
0501151 DOCTRAMADO 100 MG 60 CPR 0 0
13,12 80
0508507 DOCTRAMADO 150 MG 20 CPR 0 0
9,63 80
0508511 DOCTRAMADO 150 MG 60 CPR 0 0
20,74 80
0508524 DOCTRAMADO 200 MG 20 CPR 0 0
10,77 80
0508538 DOCTRAMADO 200 MG 60 CPR 0 0
23,95 80
0212906 DOLZAM 100 MG 10 AMP 2 ML 0 0
11,19 80
0212891 DOLZAM 100 MG 5 AMP 2 ML 0 0
8,50 80
0212856 DOLZAM 100 MG/ML GTTS 10 ML 0 0
8,22 80
0212873 DOLZAM 100 MG/ML GTTS 3*10 ML 0 0
13,69 80
0245261 DOLZAM 100 MG/ML GTTS 5*10 ML 0 0
17,83 80
0220441 DOLZAM 50 MG 30 CAPS 0 0
9,86 80
0212842 DOLZAM 50 MG 60 CAPS 0 0
13,69 80
0371317 DOLZAM RET 100 MG 56 CPR 0 0
19,54 80
0371284 DOLZAM RET 150 MG 56 CPR 0 0
25,57 80
0371253 DOLZAM RET 200 MG 56 CPR 0 0
30,59 80
0371348 DOLZAM RET 75 MG 56 CPR 0 0
16,12 80
0279712 DOLZAM UNO 150 MG 28 CPR 0 0
16,12 80
0279726 DOLZAM UNO 200 MG 28 CPR 0 0
18,25 80
0272188 DOLZAM UNO 300 MG 14 CPR 0 0
16,12 80
0272191 DOLZAM UNO 400 MG 14 CPR 0 0
18,25 80
Page 60 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0230949 TRADONAL 100 MG 10 AMP 2 ML IMIV 0 0
9,33 80
0230899 TRADONAL 100 MG/ML GTTS 10 ML 0 0
6,67 80
0230904 TRADONAL 100 MG/ML GTTS 30 ML 0 0
10,99 80
0230918 TRADONAL 50 MG 30 CAPS 0 0
7,91 80
0290284 TRADONAL 50 MG 30 CPR EFF 0 0
9,86 80
0230921 TRADONAL 50 MG 60 CAPS 0 0
10,99 80
0385942 TRADONAL ODIS 50 MG 30 CPR 0 0
7,57 80
0248411 TRADONAL RET 100 MG 60 CAPS 0 0
20,65 80
0248425 TRADONAL RET 150 MG 60 CAPS 0 0
27,20 80
0248442 TRADONAL RET 200 MG 60 CAPS 0 0
32,37 80
0248392 TRADONAL RET 50 MG 60 CAPS 0 0
13,72 80
0485724 TRAMADOL RET EG 100 MG 30 CPR 0 0
9,72 80
0485741 TRAMADOL RET EG 100 MG 60 CPR 0 0
13,93 80
0486171 TRAMADOL RET EG 150 MG 20 CPR 0 0
9,72 80
0486203 TRAMADOL RET EG 150 MG 60 CPR 0 0
20,74 80
0485948 TRAMADOL RET EG 200 MG 20 CPR 0 0
10,84 80
0485979 TRAMADOL RET EG 200 MG 60 CPR 0 0
23,95 80
0149542 TRAMAL 100 MG 10 AMP 2 ML IMIVSC 0 0
10,29 80
0216628 TRAMAL 100 MG 10 SUPP 0 0
6,57 80
0216631 TRAMAL 100 MG 20 SUPP 0 0
11,85 80
0144367 TRAMAL 100 MG 5 AMP 2 ML IMIVSC 0 0
5,75 80
0211697 TRAMAL 100 MG/ML GTTS 1 FL DOS 100 ML 0 0
34,18 80
0211795 TRAMAL 100 MG/ML GTTS 1 FL DOS 50 ML 0 0
20,72 80
0144336 TRAMAL 100 MG/ML GTTS 10 ML 0 0
6,54 80
0149539 TRAMAL 100 MG/ML GTTS 30 ML 0 0
17,38 80
0144353 TRAMAL 50 MG 10 CAPS 0 0
3,00 80
0206859 TRAMAL 50 MG 30 CAPS 0 0
8,11 80
0207887 TRAMAL 50 MG 50 CAPS 0 0
12,82 80
0216595 TRAMAL LONG 100 MG 10 CPR 0 0
8,80 80
0216601 TRAMAL LONG 100 MG 30 CPR 0 0
22,53 80
0216614 TRAMAL LONG 100 MG 50 CPR 0 0
27,96 80
0232506 TRAMAL LONG 150 MG 10 CPR 0 0
13,19 80
0232523 TRAMAL LONG 150 MG 30 CPR 0 0
33,79 80
0235721 TRAMAL LONG 150 MG 50 CPR 0 0
39,69 80
0232537 TRAMAL LONG 200 MG 10 CPR 0 0
17,58 80
0232541 TRAMAL LONG 200 MG 30 CPR 0 0
45,04 80
0232554 TRAMAL LONG 200 MG 50 CPR 0 0
51,61 80
0349414 TRAMIUM 100 MG 30 CAPS 0 0
10,99 80
0349459 TRAMIUM 150 MG 30 CAPS 0 0
14,45 80
0349509 TRAMIUM 200 MG 30 CAPS 0 0
16,68 80
N02AX52 tramadol, combinations
0337993 ZALDIAR 37,5/325 MG 20 CPR 0 0
9,23 80
0502422 ZALDIAR 37,5/325 MG 20 CPR EFF BLIST 0 0
9,23 80
0338018 ZALDIAR 37,5/325 MG 40 CPR 0 0
14,41 80
0502453 ZALDIAR 37,5/325 MG 40 CPR EFF BLIST 0 0
14,41 80
0338035 ZALDIAR 37,5/325 MG 60 CPR 0 0
18,90 80
0502471 ZALDIAR 37,5/325 MG 60 CPR EFF BLIST 0 0
18,90 80
N02BA01 acetylsalicylic acid
0131419 ACENTERINE 500 MG 100 CPR 0 0
7,33 80
0285481 ASPEGIC 100 30 SACH BB 0 0
4,57 80
0008351 ASPEGIC 1000 20 SACH 0 0
7,53 80
0285494 ASPEGIC 250 30 SACH ENF 0 0
5,34 80
0008382 ASPEGIC 500 20 SACH 0 0
3,26 80
0285513 ASPEGIC 500 30 SACH 0 0
5,83 80
0008334 ASPEGIC 6 AMP 5 ML IMIV 0 0
7,04 80
0033922 DISPRIL 300 MG 24 CPR DISP 0 0
2,35 80
0318998 SEDERGINE FORTE 1 G 20 CPR EFF 0 0
6,52 80
N02BA51 acetylsalicylic acid, combinations excl. psycholeptics
0147291 ASS + C RATIO 10 CPR EFF 0 0
3,40 40
0147355 ASS + C RATIO 20 CPR EFF 0 0
5,38 40
0218958 MIGPRIV PDR 6 SACH 0 0
11,51 40
0092114 POLYPIRINE 20 CAPS LHL 0 0
4,61 40
N02BB02 metamizole sodium
0080239 NOVALGINE 1 G 10 AMP 2 ML IMIV 0 0
7,88 80
0080208 NOVALGINE 500 MG 20 CPR 0 0
3,49 80
0235847 NOVALGINE GTTS 20 ML 0 0
3,44 80
Page 61 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
N02BE01 paracetamol
0334814 ALGOSTASE MONO 1000 MG 20 CPR EFF 0 0
5,34 80
0362173 ALGOSTASE MONO 1000 MG 40 CPR EFF 0 0
9,23 80
0341674 ALGOSTASE MONO 500 MG 32 CPR EFF 0 0
4,62 80
0400176 ALGOSTASE MONO 500 MG 32 SACH 0 0
3,74 80
0259155 BENURON 1 G 10 SUPP 0 0
2,39 80
0259111 BENURON 125 MG 10 SUPP 0 0
1,29 80
0262486 BENURON 200 MG/5 ML SIR 100 ML 0 0
3,22 80
0259124 BENURON 250 MG 10 SUPP 0 0
1,51 80
0259138 BENURON 500 MG 10 SUPP 0 0
1,76 80
0259141 BENURON 500 MG 20 CPR 0 0
1,69 80
0156601 CROIX BLANCHE MONO 500 MG 20 SACH 0 0
2,38 80
0027312 DAFALGAN 500 MG 30 CPR 0 0
4,30 80
0138132 DAFALGAN 500 MG 32 CPR EFF 0 0
5,61 80
0298198 DAFALGAN AD 600 MG 12 SUPP 0 0
3,32 80
0298167 DAFALGAN BB 80 MG 12 SUPP 0 0
2,02 80
0380073 DAFALGAN FORTE 1 G 16 CPR 0 0
4,67 80
0311627 DAFALGAN FORTE 1 G 16 CPR EFF 0 0
6,14 80
0380087 DAFALGAN FORTE 1 G 32 CPR 0 0
8,41 80
0311631 DAFALGAN FORTE 1 G 32 CPR EFF 0 0
10,97 80
0380091 DAFALGAN FORTE 1 G 50 CPR 0 0
11,41 80
0298184 DAFALGAN GD ENF 300 MG 12 SUPP 0 0
2,60 80
0298171 DAFALGAN J ENF 150 MG 12 SUPP 0 0
2,34 80
0277735 DAFALGAN ODIS 500 MG 16 CPR 0 0
3,76 80
0298203 DAFALGAN PED 3% 90 ML 0 0
2,52 80
0344113 DOLOL INSTANT 500 MG 20 CPR DISP 0 0
4,08 80
0205381 DOLPRONE 500 MG 16 CPR 0 0
2,95 80
0260674 ENELFA 125 MG 10 SUPP 0 0
1,17 80
0260688 ENELFA 250 MG 10 SUPP 0 0
1,37 80
0260691 ENELFA 500 MG 10 SUPP 0 0
1,58 80
0039389 ENELFA SIR 100 ML 0 0
2,86 80
0167523 LEMSIP 650 MG 12 SACH 0 0
6,04 80
0276917 PANADOL 1 G 20 CPR 0 0
5,54 80
0276921 PANADOL 1 G 50 CPR 0 0
11,08 80
0143258 PANADOL 500 MG 20 CPR 0 0
3,40 80
0085574 PANADOL 500 MG 30 CPR 0 0
4,21 80
0143261 PANADOL 500 MG 60 CPR 0 0
7,16 80
0460367 PARACETAMOL EG 500 MG 30 CPR 0 0
3,44 80
0170241 PARACETAMOL RATIO 1 G 10 SUPP 0 0
2,16 80
0086005 PARACETAMOL RATIO 125 MG 10 SUPP 0 0
1,04 80
0086019 PARACETAMOL RATIO 250 MG 10 SUPP 0 0
1,26 80
0086036 PARACETAMOL RATIO 500 MG 10 SUPP 0 0
1,51 80
0482526 PARACETAMOL RATIO 500 MG 20 CPR 0 0
1,46 80
0086022 PARACETAMOL RATIO 500 MG 30 CPR 0 0
1,89 80
0150171 PARACETAMOL RATIO LOESUNG 100 ML 0 0
2,70 80
0333817 PERDOLAN 500 MG 20 CPR EFF 0 0
4,18 80
0290852 PERDOLAN AD 500 MG 12 SUPP 96147 0 0
4,57 80
0297514 PERDOLAN AD 500 MG 30 CPR 96157 0 0
4,71 80
0290883 PERDOLAN BB 100 MG 12 SUPP 96153 0 0
3,16 80
0311451 PERDOLAN ENF 32 MG/ML SIR 200 ML 96145 0 0
6,90 80
0290866 PERDOLAN ENF 350 MG 12 SUPP 96149 0 0
4,23 80
0297495 PERDOLAN J ENF 200 MG 12 SUPP 0 0
3,69 80
N02BE51 paracetamol, combinations excl. psycholeptics
0131758 AFEBRYL 16 CPR EFF 0 0
3,45 40
0364911 AFEBRYL 32 CPR EFF 0 0
6,07 40
0242046 ALGOSTASE 30 CAPS 0 0
4,81 40
0193196 ALGOSTASE 32 CPR EFF 0 0
5,83 40
0368583 ALGOSTASE PDR 32 SACH 0 0
3,89 40
0174545 CROIX BLANCHE 20 CPR 0 0
2,19 40
0152101 CROIX BLANCHE 20 SACH 0 0
2,81 40
0429546 GRIPPAL + C RATIO 10 CPR EFF 0 0
2,62 40
0429563 GRIPPAL + C RATIO 20 CPR EFF 0 0
4,47 40
0067321 LONARID N 30 CPR 0 0
5,41 40
0191837 MELABON K 20 CPR 0 0
4,28 40
0309579 PERDOLAN COMP 20 CPR 0 0
3,40 40
0309596 PERDOLAN COMP AD 12 SUPP 0 0
5,30 40
Page 62 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
N02BG06 nefopam
0000661 ACUPAN 30 MG 30 CPR 0 0
8,39 80
N02CA01 dihydroergotamine
0030707 DETMS GTTS 100 ML 0 0
21,79 80
0030688 DETMS RET 50 CAPS 0 0
13,34 80
0055740 IKARAN GE GTTS 50 ML 0 0
3,21 80
0224082 IKARAN LP 5 MG 30 CPR 0 0
9,26 80
N02CC01 sumatriptan
0248537 IMITREX 10 MG SPRAY 6 FL 0,1 ML IN 1 7
43,52 80
0229271 IMITREX 20 MG SPRAY 6 FL 0,1 ML IN 1 7
65,49 80
0172215 IMITREX 6 MG 2 SRG 0,5 ML SC 1 7
42,03 80
0205351 IMITREX 6 MG 4 SRG 0,5 ML SC 1 7
79,16 80
0427197 IMITREX INSTANT 100 MG 6 CPR 1 7
65,02 80
0427166 IMITREX INSTANT 50 MG 12 CPR 1 7
65,02 80
N02CC02 naratriptan
0250115 NARAMIG 2,5 MG 12 CPR 1 7
58,24 80
N02CC03 zolmitriptan
0279967 ZOMIG INSTANT 2,5 MG 12 CPR ORODISP 1 7
65,06 80
0279936 ZOMIG INSTANT 2,5 MG 2 CPR ORODISP 1 7
19,20 80
0279953 ZOMIG INSTANT 2,5 MG 6 CPR ORODISP 1 7
40,95 80
0240024 ZOMIG ORAL 2,5 MG 12 CPR 1 7
65,06 80
0240007 ZOMIG ORAL 2,5 MG 3 CPR 1 7
27,17 80
N02CC04 rizatriptan
0253327 MAXALT LYO 10 MG 3 CPR 1 7
27,12 80
0253331 MAXALT LYO 10 MG 6 CPR 1 7
44,35 80
N02CC05 almotriptan
0441053 ALMOGRAN 12,5 MG 12 CPR 1 7
60,83 80
0285897 ALMOGRAN 12,5 MG 3 CPR 1 7
26,24 80
N02CC06 eletriptan
0308621 RELERT 40 MG 6 CPR 1 7
40,92 80
N02CX02 clonidine
0136741 DIXARIT 0,025 MG 100 DRG 0 0
15,78 80
N02CX06 oxetorone
0079482 NOCERTONE 60 MG 30 CPR 0 0
8,86 80
N03AA02 phenobarbital
0047833 GARDENAL 100 MG 20 CPR 0 0
1,30 80
N03AA03 primidone
0238981 MYSOLINE 250 MG 90 CPR 0 0
20,53 80
N03AB02 phenytoin
0033189 DIPHANTOINE 100 MG 100 CPR 0 0
10,13 100
0033211 DIPHANTOINE 250 MG 5 AMP IV 0 0
13,03 100
0039991 EPANUTIN 100 MG 100 CAPS 0 0
11,40 100
0040006 EPANUTIN SIR 80 ML 0 0
12,29 100
N03AB52 phenytoin, combinations
0126999 VETHOINE 100 CPR 0 0
11,55 100
N03AD01 ethosuximide
0254579 ZARONTIN 250 MG/5 ML SIR 200 ML 0 0
6,36 100
N03AE01 clonazepam
0100328 RIVOTRIL 0,5 MG 150 CPR 0 0
10,79 100
0100314 RIVOTRIL 0,5 MG 50 CPR 0 0
4,00 100
0100345 RIVOTRIL 2 MG 100 CPR 0 0
14,68 100
0100331 RIVOTRIL 2 MG 30 CPR 0 0
5,62 100
0100359 RIVOTRIL 2,5 MG/ML GTTS 10 ML 0 0
3,94 100
N03AF01 carbamazepine
0236536 TEGRETAL 2% SIR 250 ML 0 0
15,56 80
0236831 TEGRETAL 200 MG 50 CPR 0 0
7,88 80
0236908 TEGRETAL RET 200 MG 100 CPR 0 0
20,50 80
0236892 TEGRETAL RET 200 MG 50 CPR 0 0
14,70 80
0236911 TEGRETAL RET 400 MG 50 CPR 0 0
19,53 80
N03AF02 oxcarbazepine
0279385 TRILEPTAL 150 MG 100 CPR 0 0
33,97 100
0281223 TRILEPTAL 150 MG 200 CPR 0 0
57,84 100
Page 63 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0279371 TRILEPTAL 150 MG 50 CPR 0 0
21,84 100
0281241 TRILEPTAL 300 MG 200 CPR 0 0
102,68 100
0279399 TRILEPTAL 300 MG 50 CPR 0 0
33,44 100
0279421 TRILEPTAL 600 MG 100 CPR 0 0
102,68 100
0281268 TRILEPTAL 600 MG 200 CPR 0 0
193,27 100
0279418 TRILEPTAL 600 MG 50 CPR 0 0
56,43 100
N03AG01 valproic acid
0024937 CONVULEX 300 MG 100 CAPS 0 0
12,17 100
0024940 CONVULEX 500 MG 100 CAPS 0 0
18,10 100
0029317 DEPAKINE 30% GTTS 60 ML 0 0
10,68 100
0029320 DEPAKINE 6% SIR 300 ML 0 0
9,93 100
0210611 DEPAKINE CHRONO 300 MG 50 CPR 0 0
9,57 100
0210686 DEPAKINE CHRONO 500 MG 50 CPR 0 0
13,32 100
0029334 DEPAKINE EC 150 MG 100 DRG 0 0
8,86 100
0145297 DEPAKINE EC 300 MG 100 CPR 0 0
11,15 100
0029348 DEPAKINE EC 500 MG 100 CPR 0 0
16,45 100
N03AG04 vigabatrin
0172778 SABRIL 500 MG 100 CPR 0 0
57,10 100
N03AG06 tiagabine
0233937 GABITRIL 10 MG 100 CPR 0 0
93,70 100
0233954 GABITRIL 15 MG 100 CPR 0 0
140,73 100
0233891 GABITRIL 5 MG 50 CPR 0 0
38,87 100
N03AX09 lamotrigine
0390603 LAMBIPOL 100 MG 60 CPR DISP 0 0
40,54 80
0390651 LAMBIPOL 200 MG 60 CPR DISP 0 0
74,69 80
0390519 LAMBIPOL 25 MG 60 CPR DISP 0 0
16,18 80
0390553 LAMBIPOL 50 MG 60 CPR DISP 0 0
23,42 80
0390522 LAMBIPOL STARTER PACK 25 MG 42 CPR DISP 0 0
12,54 80
0218765 LAMICTAL 100 MG 90 CPR DISP 0 0
50,12 100
0312543 LAMICTAL 2 MG 30 CPR DISP 0 0
6,89 100
0228887 LAMICTAL 200 MG 30 CPR DISP 0 0
40,54 100
0218751 LAMICTAL 25 MG 30 CPR DISP 0 0
10,12 100
0511824 LAMICTAL 25 MG STARTERPACK ADD-ON 21 CPR 0 0
8,30 100
0511838 LAMICTAL 25 MG STARTERPACK MONO 42 CPR 0 0
12,54 100
0218748 LAMICTAL 5 MG 30 CPR DISP 0 0
6,89 100
0229285 LAMICTAL 50 MG 90 CPR DISP 0 0
31,98 100
0511841 LAMICTAL 50 MG STARTERPACK ADD-ON 42 CPR 0 0
17,36 100
0407826 LAMOTRIGIN CT 100 MG 100 CPR 0 0
60,00 100
0407776 LAMOTRIGIN CT 100 MG 50 CPR 0 0
28,01 100
0408001 LAMOTRIGIN CT 200 MG 100 CPR 0 0
112,86 100
0407437 LAMOTRIGIN CT 25 MG 50 CPR 0 0
9,74 100
0407651 LAMOTRIGIN CT 50 MG 100 CPR 0 0
31,70 100
0407602 LAMOTRIGIN CT 50 MG 50 CPR 0 0
15,87 100
N03AX10 felbamate
0219485 TALOXA 600 MG/5 ML SIR 230 ML 0 0
68,50 100
0218992 TALOXA TABS 600 MG 100 CPR 0 0
128,52 100
N03AX11 topiramate
0242497 TOPAMAX 100 MG 60 CPR 140602 0 0
42,43 80
0273221 TOPAMAX 15 MG 60 CAPS 140381 0 0
12,89 80
0273235 TOPAMAX 25 MG 60 CAPS 140379 0 0
17,40 80
0242404 TOPAMAX 25 MG 60 CPR 140600 0 0
17,40 80
0273249 TOPAMAX 50 MG 60 CAPS 140380 0 0
25,73 80
0242449 TOPAMAX 50 MG 60 CPR 140601 0 0
25,73 80
N03AX12 gabapentin
0234501 NEURONTIN 100 MG 90 CAPS 0 0
13,34 80
0234481 NEURONTIN 300 MG 90 CAPS 0 0
25,03 80
0234464 NEURONTIN 400 MG 90 CAPS 0 0
31,23 80
0296128 NEURONTIN 600 MG 90 CPR 0 0
44,71 80
0296159 NEURONTIN 800 MG 90 CPR 0 0
57,04 80
N03AX14 levetiracetam
0525363 KEPPRA 100 MG/ML 1 FL 150 ML + SRG 1 ML 0 0
41,71 100
0525346 KEPPRA 100 MG/ML 1 FL 150 ML + SRG 3 ML 0 0
41,71 100
0341688 KEPPRA 100 MG/ML 1 FL 300 ML + SRG 0 0
72,73 100
0288482 KEPPRA 1000 MG 100 CPR 0 0
222,15 100
0288272 KEPPRA 250 MG 100 CPR 0 0
61,67 100
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0288353 KEPPRA 500 MG 100 CPR 0 0
115,44 100
0290091 KEPPRA 750 MG 100 CPR 0 0
168,78 100
N03AX15 zonisamide
0434272 ZONEGRAN 100 MG 56 CAPS 0 0
81,94 100
0434336 ZONEGRAN 100 MG 98 CAPS 0 0
136,37 100
0434305 ZONEGRAN 25 MG 28 CAPS 0 0
21,06 100
0434319 ZONEGRAN 50 MG 28 CAPS 0 0
30,96 100
N03AX16 pregabalin
0377825 LYRICA 150 MG 56 CAPS 0 0
81,89 80
0377891 LYRICA 300 MG 56 CAPS 0 0
121,24 80
0377761 LYRICA 75 MG 56 CAPS 0 0
48,48 80
N03AX18 lacosamide
0493601 VIMPAT 100 MG 56 CPR 0 0
84,39 100
0493709 VIMPAT 15 MG/ML SIR 200 ML 0 0
48,36 100
0493631 VIMPAT 150 MG 56 CPR 0 0
122,24 100
0493662 VIMPAT 200 MG 56 CPR 0 0
160,07 100
0493502 VIMPAT 50 MG 56 CPR 0 0
45,54 100
N04AA01 trihexyphenidyl
0007886 ARTANE 2 MG 50 CPR 0 0
2,71 100
0007919 ARTANE 5 MG 50 CPR 0 0
5,50 100
N04AA02 biperiden
0205462 AKINETON 2 MG 60 CPR 0 0
7,46 100
N04AA04 procyclidine
0061913 KEMADRIN 5 MG 100 CPR 0 0
7,89 100
N04BA02 levodopa and decarboxylase inhibitor
0094461 PROLOPA 125 MG 100 CAPS 0 0
13,42 100
0094489 PROLOPA 250 MG 100 CPR SEC 0 0
20,08 100
0094475 PROLOPA 250 MG 30 CPR SEC 0 0
9,68 100
0235962 PROLOPA DISP 125 MG 100 CPR SEC 0 0
13,42 100
0166771 PROLOPA HBS 125 MG 100 CAPS 0 0
13,42 100
0105100 SINEMET 25/250 MG 100 CPR 0 0
11,94 100
0180752 SINEMET CONTROL 50/200 MG 100 CPR 0 0
14,52 100
N04BB01 amantadine
0171199 PK MERZ 100FILMTABL 0 0
21,46 100
0091215 PK MERZ INFUSIONSLSG 10*500 ML 0 0
177,04 100
0218359 PK MERZ INFUSIONSLSG 500 ML 0 0
23,15 100
N04BC01 bromocriptine
0086439 PRAVIDEL 10 MG 100 CAPS 0 0
219,40 100
0086425 PRAVIDEL 10 MG 30 CAPS 0 0
74,21 100
0086442 PRAVIDEL 5 MG 100 CAPS 0 0
107,14 100
N04BC02 pergolide
0173727 PERMAX 0,05 MG 30 CPR 0 0
7,26 100
0173744 PERMAX 0,25 MG 100 CPR 0 0
26,43 100
0173775 PERMAX 1 MG 100 CPR 0 0
72,45 100
N04BC04 ropinirole
0229108 REQUIP 1 MG 84 CPR 0 0
29,01 100
0229559 REQUIP 2 MG 84 CPR 0 0
42,50 100
0229111 REQUIP 5 MG 84 CPR 0 0
88,18 100
0483084 REQUIP MODUTAB 2 MG 28 CPR 0 0
17,71 100
0483148 REQUIP MODUTAB 4 MG 84 CPR 0 0
72,29 100
0483067 REQUIP MODUTAB 8 MG 84 CPR 0 0
135,82 100
N04BC05 pramipexole
0248196 MIRAPEXIN 0,18 MG 30 CPR 0 0
16,79 100
0248215 MIRAPEXIN 0,7 MG 100 CPR 0 0
93,78 100
0529183 MIRAPEXIN LP 0,26 MG 30 CPR 0 0
21,49 100
0529264 MIRAPEXIN LP 1,05 MG 100 CPR 0 0
127,53 100
0529251 MIRAPEXIN LP 1,05 MG 30 CPR 0 0
58,88 100
0529295 MIRAPEXIN LP 2,10 MG 100 CPR 0 0
235,94 100
0529281 MIRAPEXIN LP 2,10 MG 30 CPR 0 0
100,43 100
0529328 MIRAPEXIN LP 3,15 MG 100 CPR 0 0
344,37 100
N04BD01 selegiline
0300699 ELDEPRYL 10 MG 30 CPR 0 0
46,56 100
0237709 ELDEPRYL 5 MG 100 CPR 0 0
86,47 100
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0237693 ELDEPRYL 5 MG 30 CPR 0 0
31,36 100
0237791 ELDEPRYL 5 MG 60 CPR 0 0
46,56 100
N04BD02 rasagiline
0396561 AZILECT 1 MG 28 CPR 0 0
102,14 100
N04BX01 tolcapone
0240878 TASMAR 100 MG 100 CPR 0 0
138,57 100
N04BX02 entacapone
0255657 COMTAN 200 MG 100 CPR (FL) 0 0
94,18 100
N05AA02 levomepromazine
0080712 NOZINAN 100 MG 20 CPR 0 0
6,94 80
0080743 NOZINAN 25 MG 20 CPR 0 0
5,39 80
0080760 NOZINAN 4% GTTS 30 ML 0 0
5,91 80
N05AD01 haloperidol
0051786 HALDOL 10 MG/ML GTTS 30 ML 38114 0 0
17,02 80
0051724 HALDOL 2 MG 25 CPR 38109 0 0
6,74 80
0051805 HALDOL 2 MG/ML GTTS 15 ML 17449 0 0
5,76 80
0051819 HALDOL 2 MG/ML GTTS 30 ML 17454 0 0
6,85 80
0051741 HALDOL 20 MG 20 CPR 38112 0 0
21,89 80
0051769 HALDOL 5 MG 25 CPR 17455 0 0
10,19 80
0051853 HALDOL 5 MG 5 AMP 1 ML IMIV 17448 0 0
7,23 80
0051870 HALDOL DEC 100 MG 1 AMP 1 ML 30135 0 0
14,87 80
0051898 HALDOL DEC 150 MG 1 AMP 3 ML 22952 0 0
20,19 80
0051917 HALDOL DEC 50 MG 1 AMP 1 ML 22951 0 0
10,81 80
N05AD03 melperone
0259271 BURONIL 25 MG 50 DRG 0 0
4,64 80
N05AD05 pipamperone
0033290 DIPIPERON 4% GTTS 60 ML 17425 0 0
7,93 80
0033256 DIPIPERON 40 MG 20 CPR 17421 0 0
5,93 80
0033273 DIPIPERON 40 MG 60 CPR 17424 0 0
8,22 80
N05AD07 benperidol
0046688 FRENACTIL GTTS 15 ML 17438 0 0
5,68 80
0056362 IMPROMEN 0,2% GTTS 30 ML 22890 0 0
8,21 80
0056412 IMPROMEN DEC 50 MG 1 AMP 1 ML 34199 0 0
11,83 80
N05AE03 sertindole
0237855 SERDOLECT 12 MG 28 CPR 1 1
113,09 80
0237869 SERDOLECT 16 MG 28 CPR 1 1
113,09 80
0237872 SERDOLECT 20 MG 28 CPR 1 1
113,09 80
0237841 SERDOLECT 4 MG 30 CPR 1 1
35,25 80
N05AF01 flupentixol
0045386 FLUANXOL 0,5 MG 30 DRG 0 0
2,04 80
0045405 FLUANXOL 0,5 MG 50 DRG 0 0
6,38 80
0045419 FLUANXOL 1 MG 50 DRG 0 0
7,29 80
0045422 FLUANXOL 3 MG 50 DRG 0 0
9,19 80
0045467 FLUANXOL DEPOT 100 MG 1 AMP 1 ML IM 0 0
13,80 80
0045484 FLUANXOL DEPOT 20 MG 1 AMP 1 ML IM 0 0
7,03 80
0045520 FLUANXOL DEPOT 40 MG 1 AMP 2 ML IM 0 0
6,41 80
N05AF05 zuclopenthixol
0023117 CLOPIXOL 10 MG 100 CPR 0 0
13,38 80
0023098 CLOPIXOL 2 MG 100 CPR 0 0
6,48 80
0023151 CLOPIXOL 2% GTTS 20 ML 0 0
10,00 80
0023134 CLOPIXOL 25 MG 100 CPR 0 0
22,41 80
0023120 CLOPIXOL 25 MG 30 CPR 0 0
9,59 80
0166008 CLOPIXOL ACUTARD 100 MG 1 AMP 2 ML IM 0 0
20,69 80
0165997 CLOPIXOL ACUTARD 50 MG 1 AMP 1 ML IM 0 0
11,06 80
0023179 CLOPIXOL DEPOT 200 MG 1 AMP 1 ML IM 0 0
8,27 80
N05AG01 fluspirilene
0056023 IMAP 12 MG 1 FL 6 ML IM 17463 0 0
15,26 80
N05AG02 pimozide
0083051 ORAP 1 MG 75 CPR 17495 0 0
10,79 80
0083082 ORAP FORTE 4 MG 20 CPR 17499 0 0
10,79 80
N05AG03 penfluridol
0103669 SEMAP 20 MG 12 CPR 17554 0 0
8,82 80
N05AH02 clozapine
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0212727 LEPONEX 100 MG 20 CPR 0 0
18,80 80
0212731 LEPONEX 100 MG 50 CPR 0 0
32,93 80
0212677 LEPONEX 25 MG 20 CPR 0 0
11,33 80
0212681 LEPONEX 25 MG 50 CPR 0 0
15,37 80
N05AH03 olanzapine
0226462 ZYPREXA 10 MG 28 CPR 0 0
120,40 80
0585439 ZYPREXA 10 MG 70 CPR 0 0
232,16 80
0585442 ZYPREXA 10 MG 98 CPR 0 0
321,52 80
0226414 ZYPREXA 5 MG 28 CPR 0 0
64,24 80
0585411 ZYPREXA 5 MG 70 CPR 0 0
120,43 80
0585425 ZYPREXA 5 MG 98 CPR 0 0
165,09 80
0226431 ZYPREXA 7,5 MG 56 CPR 0 0
168,27 80
0277251 ZYPREXA VELOTAB 10 MG 28 CPR DISP 0 0
120,40 80
0459156 ZYPREXA VELOTAB 10 MG 70 CPR DISP 0 0
232,16 80
0585408 ZYPREXA VELOTAB 10 MG 98 CPR DISP 0 0
321,52 80
0277248 ZYPREXA VELOTAB 5 MG 28 CPR DISP 0 0
64,24 80
0459139 ZYPREXA VELOTAB 5 MG 70 CPR DISP 0 0
120,43 80
0585392 ZYPREXA VELOTAB 5 MG 98 CPR DISP 0 0
165,09 80
N05AH04 quetiapine
0277542 SEROQUEL 100 MG 60 CPR 0 0
82,87 80
0277556 SEROQUEL 200 MG 60 CPR 0 0
117,30 80
0323824 SEROQUEL 300 MG 60 CPR 0 0
167,51 80
0479565 SEROQUEL XR 200 MG 100 CPR 0 0
153,48 80
0479551 SEROQUEL XR 200 MG 60 CPR 0 0
117,30 80
0479615 SEROQUEL XR 300 MG 100 CPR 0 0
225,85 80
0479601 SEROQUEL XR 300 MG 60 CPR 0 0
167,51 80
0479677 SEROQUEL XR 400 MG 100 CPR 0 0
298,19 80
0479663 SEROQUEL XR 400 MG 60 CPR 0 0
225,84 80
N05AL01 sulpiride
0034379 DOGMATIL 100 MG 6 AMP 2 ML IM 0 0
6,59 80
0034365 DOGMATIL 25 MG/5 ML SIR 200 ML 0 0
5,67 80
0034351 DOGMATIL 50 MG 30 CAPS 0 0
8,41 80
0034348 DOGMATIL FORTE 200 MG 12 CPR 0 0
9,90 80
0180704 MERESA FORTE 200 MG 100 CPR 0 0
44,98 80
0071114 MERESA FORTE 200 MG 20 CPR 0 0
16,99 80
0071128 MERESA FORTE 200 MG 50 CPR 0 0
28,03 80
0502789 MERESASUL 50 MG 100 CAPS 0 0
23,59 80
0502792 MERESASUL 50 MG 20 CAPS 0 0
6,17 80
0502808 MERESASUL 50 MG 50 CAPS 0 0
13,25 80
0134603 SULPIRIDE EG 200 MG 12 CPR 0 0
7,06 80
N05AL03 tiapride
0116748 TIAPRIDAL 100 MG 12 AMP 2 ML IMIV 0 0
7,38 80
0116720 TIAPRIDAL 100 MG 20 CPR 0 0
9,22 80
0116734 TIAPRIDAL 100 MG 60 CPR 0 0
16,43 80
0233002 TIAPRIDAL GTTS 30 ML 0 0
13,73 80
N05AL05 amisulpride
0335985 SOLIAN 100 MG 60 CPR 0 0
35,77 80
0265846 SOLIAN 200 MG 120 CPR 0 0
108,61 80
0265832 SOLIAN 200 MG 30 CPR 0 0
35,77 80
0336031 SOLIAN 400 MG 60 CPR 0 0
108,61 80
0265863 SOLIAN 50 MG 30 CPR 0 0
12,19 80
N05AN01 lithium
0140726 CAMCOLIT 400 MG 100 CPR 0 0
8,64 80
0069438 MANIPREX 250 MG 100 DRG 0 0
10,86 80
0093478 PRIADEL 100 CPR 0 0
10,62 80
N05AX07 prothipendyl
0035331 DOMINAL 40 MG 20 DRG 0 0
6,99 80
0035359 DOMINAL FORTE 80 MG 50 CPR 0 0
10,68 80
N05AX08 risperidone
0439895 RISPERDAL 1 MG 100 CPR 0 0
36,17 80
0439864 RISPERDAL 1 MG 20 CPR 0 0
11,63 80
0204434 RISPERDAL 1 MG 6 CPR 72249 0 0
6,41 80
0245616 RISPERDAL 1 MG 60 CPR 63122 0 0
24,20 80
0238916 RISPERDAL 1 MG/ML GTTS 100 ML 87530 0 0
36,17 80
0306322 RISPERDAL 1 MG/ML GTTS 30 ML 96471 0 0
15,46 80
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0439945 RISPERDAL 2 MG 100 CPR 0 0
66,04 80
0204448 RISPERDAL 2 MG 20 CPR 82196 0 0
19,28 80
0204451 RISPERDAL 2 MG 60 CPR 63125 0 0
42,13 80
0440008 RISPERDAL 3 MG 100 CPR 0 0
95,02 80
0204479 RISPERDAL 3 MG 20 CPR 82197 0 0
26,19 80
0204482 RISPERDAL 3 MG 60 CPR 63128 0 0
60,05 80
0440056 RISPERDAL 4 MG 100 CPR 0 0
123,75 80
0204515 RISPERDAL 4 MG 60 CPR 0 0
77,76 80
0440137 RISPERDAL 6 MG 60 CPR 0 0
112,27 80
0360425 RISPERDAL CONSTA 25 MG PDR 1 FL + S IM 0 0
123,97 80
0360439 RISPERDAL CONSTA 37,5 MG PDR 1 FL + S IM 0 0
164,28 80
0360442 RISPERDAL CONSTA 50 MG PDR 1 FL + S IM 0 0
193,09 80
0347213 RISPERDAL INSTASOLV 1 MG 28 CPR 0 0
16,30 80
0347231 RISPERDAL INSTASOLV 2 MG 28 CPR 0 0
27,87 80
N05AX12 aripiprazole
0375882 ABILIFY 10 MG 28 CPR 0 0
118,13 80
0375932 ABILIFY 15 MG 28 CPR 0 0
118,13 80
0375994 ABILIFY 30 MG 28 CPR 0 0
136,76 80
N05AX13 paliperidone
0462747 INVEGA 3 MG 28 CPR 0 0
99,93 80
0462778 INVEGA 3 MG 56 CPR 0 0
191,07 80
0462814 INVEGA 6 MG 28 CPR 0 0
107,35 80
0462845 INVEGA 6 MG 56 CPR 0 0
205,92 80
0462893 INVEGA 9 MG 28 CPR 0 0
107,35 80
0462926 INVEGA 9 MG 56 CPR 0 0
205,92 80
N05BA01 diazepam
0171185 DIAZEPAM EG 10 MG 100 CPR 0 0
12,10 40
0154542 DIAZEPAM EG 10 MG 25 CPR 0 0
3,70 40
0031606 DIAZEPAM RATIO 10 MG 10 CPR 0 0
0,71 40
0031623 DIAZEPAM RATIO 10 MG 20 CPR 0 0
1,19 40
0214038 DIAZEPAM RATIO 10 MG 5 AMP 2 ML IMIV 0 0
2,47 40
0031637 DIAZEPAM RATIO 10 MG 50 CPR 0 0
2,65 40
0206201 DIAZEPAM RATIO 10 MG GTTS 25 ML 0 0
1,54 40
0031640 DIAZEPAM RATIO 2 MG 10 CPR 0 0
0,31 40
0031654 DIAZEPAM RATIO 2 MG 20 CPR 0 0
0,53 40
0031668 DIAZEPAM RATIO 2 MG 50 CPR 0 0
1,27 40
0031671 DIAZEPAM RATIO 5 MG 10 CPR 0 0
0,53 40
0031685 DIAZEPAM RATIO 5 MG 20 CPR 0 0
0,88 40
0031699 DIAZEPAM RATIO 5 MG 50 CPR 0 0
1,94 40
0124574 VALIUM 10 MG 100 CPR 0 0
20,29 40
0246045 VALIUM 10 MG 30 CPR 0 0
7,43 40
0124655 VALIUM 10 MG 6 AMP 2 ML IMIV 0 0
7,00 40
0124624 VALIUM 5 MG 100 CPR 0 0
13,24 40
0246031 VALIUM 5 MG 30 CPR 0 0
5,37 40
N05BA04 oxazepam
0084580 OXAZEPAM EG 15 MG 50 CPR 0 0
3,76 40
N05BA05 potassium clorazepate
0118935 TRANXENE 10 MG 30 CAPS 0 0
4,70 40
0118983 TRANXENE 20 MG PDR 5 FL + S IMIV 0 0
9,33 40
0118966 TRANXENE 5 MG 100 CAPS 0 0
9,54 40
0118952 TRANXENE 5 MG 30 CAPS 0 0
3,84 40
0118997 TRANXENE 50 MG PDR 5 FL + S IMIV 0 0
12,63 40
0123014 UNI TRANXENE 15 MG 30 CAPS 0 0
7,51 40
N05BA06 lorazepam
0304877 DOCLORAZE 1 MG 50 CPR 0 0
2,63 40
0187901 LAURACALM 1 MG 30 CPR 0 0
3,32 40
0187932 LAURACALM 2,5 MG 30 CPR 0 0
5,52 40
0304894 LORAZEPAM DOC 2,5 MG 50 CPR 0 0
4,67 40
0067822 LORAZEPAM EG 1 MG 50 CPR 0 0
3,77 40
0067819 LORAZEPAM EG 2,5 MG 50 CPR 0 0
6,79 40
0067853 LORIDEM 2,5 MG 50 CPR 0 0
6,72 40
0104148 SERENASE 1 MG 20 CPR 0 0
2,32 40
0104151 SERENASE 1 MG 50 CPR 0 0
4,93 40
0104179 SERENASE 2,5 MG 50 CPR 0 0
8,34 40
0114032 TEMESTA 1 MG 20 CPR 0 0
2,05 40
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0114046 TEMESTA 1 MG 50 CPR 0 0
4,26 40
0114063 TEMESTA 2,5 MG 20 CPR 0 0
3,42 40
0114077 TEMESTA 2,5 MG 50 CPR 0 0
7,28 40
0114080 TEMESTA 4 MG 10 AMP 1 ML IMIV 0 0
11,90 40
0114127 TEMESTA EXPIDET 1 MG 50 CPR 0 0
6,43 40
0114161 TEMESTA EXPIDET 2,5 MG 50 CPR 0 0
10,47 40
N05BA08 bromazepam
0015583 BROMAZEPAM EG 12 MG 50 CPR 0 0
9,71 40
0015597 BROMAZEPAM EG 6 MG 50 CPR 0 0
5,24 40
0015633 BROMIDEM 12 MG 50 CPR 0 0
8,94 40
0015647 BROMIDEM 6 MG 50 CPR 0 0
4,97 40
0065330 LEXOTAN 3 MG 50 CPR 0 0
5,86 40
0065358 LEXOTAN 6 MG 20 CPR 0 0
4,66 40
0065361 LEXOTAN 6 MG 50 CPR 0 0
9,82 40
N05BA09 clobazam
0046755 FRISIUM 10 MG 20 CPR 0 0
5,25 40
0046769 FRISIUM 10 MG 50 CPR 0 0
10,96 40
0046805 FRISIUM 20 MG 50 CPR 0 0
18,90 40
N05BA11 prazepam
0068511 LYSANXIA 10 MG 20 CPR 0 0
5,03 40
0068525 LYSANXIA 10 MG 50 CPR 0 0
10,02 40
0068542 LYSANXIA 20 MG 50 CPR BISEC 0 0
15,78 40
0231929 LYSANXIA GTTS 15 MG/ML 20 ML 0 0
11,50 40
0540874 PRAZEPAM EG 10 MG 20 CPR 0 0
4,02 40
0540907 PRAZEPAM EG 10 MG 50 CPR 0 0
8,02 40
0540924 PRAZEPAM EG 20 MG 50 CPR 0 0
12,62 40
0540938 PRAZEPAM EG GTTS 15 MG/ML 1 FL 20 ML 0 0
8,37 40
N05BA12 alprazolam
0206263 ALPRAZ 0,5 MG 14 CPR 0 0
3,61 40
0206277 ALPRAZ 0,5 MG 28 CPR 0 0
5,42 40
0488581 ALPRAZ 0,5 MG 56 CPR 0 0
8,65 40
0206281 ALPRAZ 1 MG 14 CPR 0 0
5,06 40
0206294 ALPRAZ 1 MG 28 CPR 0 0
8,09 40
0298901 ALPRAZOLAM DOC 1 MG 50 CPR 0 0
14,82 40
0457389 ALPRAZOLAM EG 0,25 MG 20 CPR 0 0
2,70 40
0457392 ALPRAZOLAM EG 0,25 MG 50 CPR 0 0
5,42 40
0457408 ALPRAZOLAM EG 0,5 MG 20 CPR 0 0
4,56 40
0457411 ALPRAZOLAM EG 0,5 MG 50 CPR 0 0
8,65 40
0457425 ALPRAZOLAM EG 1 MG 20 CPR 0 0
6,96 40
0457439 ALPRAZOLAM EG 1 MG 50 CPR 0 0
14,43 40
0457442 ALPRAZOLAM EG 2 MG 20 CPR 0 0
12,51 40
0457456 ALPRAZOLAM EG 2 MG 50 CPR 0 0
24,76 40
0298962 DOCALPRAZO 0,25 MG 50 CPR 0 0
4,71 40
0298945 DOCALPRAZO 0,5 MG 50 CPR 0 0
8,58 40
0130277 XANAX 0,25 MG 50 CPR 0 0
7,38 40
0130294 XANAX 0,5 MG 50 CPR 0 0
12,00 40
0244555 XANAX 0,75 MG/ML GTTS 20 ML 0 0
8,81 40
0130327 XANAX 1 MG 50 CPR 0 0
20,72 40
0154041 XANAX 2 MG 50 CPR 0 0
32,33 40
0221189 XANAX RET 0,5 MG 30 CPR 0 0
8,62 40
0221208 XANAX RET 1 MG 30 CPR 0 0
14,69 40
0221225 XANAX RET 2 MG 30 CPR 0 0
25,34 40
N05BA16 nordazepam
0201723 CALMDAY 10 MG 30 DRG 0 0
7,04 40
0204174 CALMDAY 10 MG 60 DRG 0 0
11,13 40
0017476 CALMDAY 5 MG 30 DRG 0 0
5,30 40
0017493 CALMDAY 5 MG 60 DRG 0 0
8,89 40
0500042 NORDAZ 15 MG 30 CPR 0 0
4,30 40
N05BA18 ethyl loflazepate
0127447 VICTAN 2 MG 30 CPR 0 0
5,58 40
N05BA21 clotiazepam
0023232 CLOZAN 10 MG 50 CPR 0 0
10,20 40
0023246 CLOZAN 5 MG 20 CPR 0 0
3,73 40
0023263 CLOZAN 5 MG 50 CPR 0 0
8,18 40
N05BA22 cloxazolam
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0150591 AKTON 1 MG 50 CPR 0 0
9,24 40
0081608 AKTON 2 MG 20 CPR 0 0
7,42 40
0150588 AKTON 2 MG 50 CPR 0 0
18,63 40
N05BB01 hydroxyzine
0008897 ATARAX 25 MG 50 CPR 0 0
7,31 40
0008916 ATARAX SIR 200 ML 0 0
4,63 40
N05BX03 etifoxine
0272434 STRESAM 50 MG 60 CAPS 0 0
6,54 40
N05CD01 flurazepam
0109418 STAURODORM NEU 20 CPR 0 0
9,30 40
N05CD02 nitrazepam
0241991 MOGADON 5 MG 30 CPR 0 0
3,61 40
N05CD03 flunitrazepam
0233825 FLUNITRAZEPAM EG 1 MG 10 CPR 0 0
1,29 40
0143471 ROHYPNOL 1 MG 10 CPR 0 0
1,90 40
N05CD05 triazolam
0178494 HALCION 0,125 MG 10 CPR 0 0
3,02 40
0178513 HALCION 0,250 MG 10 CPR 0 0
3,77 40
N05CD06 lormetazepam
0067660 LORAMET 1 MG 30 CPR 0 0
5,73 40
0067674 LORAMET 2 MG 30 CPR 0 0
9,00 40
0210401 LORANKA 2 MG 28 CPR 0 0
7,87 40
0152016 LORMETAZEPAM EG 1 MG 30 CPR 0 0
5,25 40
0152033 LORMETAZEPAM EG 2 MG 30 CPR 0 0
8,51 40
0304913 LORMETAZEPAM MYLAN 2 MG 30 CPR 0 0
7,08 40
0189839 NOCTAMID 1 MG 30 CPR 0 0
7,66 40
0189842 NOCTAMID 2 MG 30 CPR 0 0
12,02 40
0152051 STILAZE 2 MG 30 CPR 0 0
9,86 40
N05CD09 brotizolam
0064932 LENDORMIN 0,25 MG 30 CPR 0 0
12,93 40
N05CD11 loprazolam
0199513 DORMONOCT 1 MG 30 CPR 0 0
10,53 40
0199527 DORMONOCT 2 MG 30 CPR 0 0
17,71 40
N05CF01 zopiclone
0056197 IMOVANE 7,5 MG 30 CPR 0 0
13,85 40
0269912 ZOPICLONE EG 7,5 MG 30 CPR 0 0
9,01 40
N05CF02 zolpidem
0149217 STILNOCT 10 MG 30 CPR 0 0
12,72 40
0326003 ZOLPIDEM EG 10 MG 30 CPR BLIST 0 0
9,62 40
N05CF03 zaleplon
0262939 SONATA 10 MG 14 CAPS 0 0
8,11 40
0262908 SONATA 5 MG 14 CAPS 0 0
5,08 40
N05CM09 valerian
0243673 RELAXINE 500 MG 15 CPR 0 0
6,99 40
0243687 RELAXINE 500 MG 30 CPR 0 0
11,44 40
0228338 VALERIAL 500 MG 30 CPR 0 0
11,32 40
N06AA02 imipramine
0288949 TOFRANIL 25 MG 100 DRG 10366 0 0
21,48 80
0288921 TOFRANIL 25 MG 20 DRG 10364 0 0
4,85 80
0288935 TOFRANIL 25 MG 50 DRG 10165 0 0
10,82 80
N06AA04 clomipramine
0236262 ANAFRANIL 10 MG 100 DRG 10351 0 0
9,64 80
0236245 ANAFRANIL 10 MG 20 DRG 10349 0 0
2,39 80
0236259 ANAFRANIL 10 MG 50 DRG 10350 0 0
5,20 80
0236519 ANAFRANIL 25 MG 100 DRG 10355 0 0
20,22 80
0236486 ANAFRANIL 25 MG 20 DRG 10353 0 0
4,85 80
0236505 ANAFRANIL 25 MG 50 DRG 10354 0 0
11,83 80
0236293 ANAFRANIL RET 75 MG 20 CPR 10604 0 0
17,41 80
0236309 ANAFRANIL RET 75 MG 50 CPR 10602 0 0
23,70 80
N06AA09 amitriptyline
0097382 REDOMEX 1% 1 FL 10 ML M.D. IMIV 0 0
1,74 80
0097351 REDOMEX 10 MG 100 CPR 0 0
6,42 80
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Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0097379 REDOMEX 25 MG 100 CPR 0 0
8,40 80
0097365 REDOMEX 25 MG 30 CPR 0 0
2,18 80
0097396 REDOMEX DIFFUCAPS 25 MG 40 CAPS 0 0
7,34 80
0097415 REDOMEX DIFFUCAPS 50 MG 40 CAPS 0 0
9,48 80
0097432 REDOMEX DIFFUCAPS 75 MG 20 CAPS 0 0
7,97 80
N06AA10 nortriptyline
0080094 NORTRILEN 25 MG 50 CPR 0 0
7,26 80
N06AA12 doxepin
0105145 SINEQUAN 25 MG 100 CAPS 0 0
11,50 80
0105162 SINEQUAN 50 MG 100 CAPS 0 0
17,09 80
N06AA16 dosulepin
0095035 PROTHIADEN 25 MG 100 CAPS 0 0
7,64 80
0177341 PROTHIADEN 25 MG 30 CAPS 0 0
2,84 80
0095021 PROTHIADEN 75 MG 28 DRG 0 0
6,50 80
N06AB03 fluoxetine
0293532 DOCFLUOXETINE 20 MG 28 CAPS 0 0
8,74 80
0293546 DOCFLUOXETINE 20 MG 60 CAPS 0 0
16,87 80
0323273 FLUOXONE DIVULE 20 MG 100 CPR 0 0
36,38 80
0323256 FLUOXONE DIVULE 20 MG 30 CPR 0 0
18,10 80
0281481 FONTEX 20 MG 28 PULV 0 0
22,82 80
0293191 FONTEX DISP 20 MG 28 CPR 0 0
23,19 80
0203373 PROZAC 20 MG 28 CAPS 0 0
22,82 80
0519501 PROZAC DISP 20 MG 28 CPR SEC 0 0
22,82 80
N06AB04 citalopram
0164065 CIPRAMIL 20 MG 28 CPR 0 0
20,21 80
0164129 CIPRAMIL 40 MG PERF 10 AMP 1 ML 0 0
69,66 80
0421941 CITALOPRAM EG 20 MG 28 CPR 0 0
15,43 80
0421971 CITALOPRAM EG 20 MG 56 CPR 0 0
26,99 80
0426799 CITALOPRAM HEXAL 20 MG 100 CPR BLIST 0 0
24,12 80
0426706 CITALOPRAM HEXAL 20 MG 20 CPR BLIST 0 0
11,60 80
0426768 CITALOPRAM HEXAL 20 MG 50 CPR BLIST 0 0
16,37 80
0426964 CITALOPRAM HEXAL 30 MG 100 CPR BLIST 0 0
35,97 80
0339094 CITALOPRAM HEXAL 30 MG 20 CPR 0 0
14,10 80
0426866 CITALOPRAM HEXAL 30 MG 20 CPR BLIST 0 0
14,10 80
0426933 CITALOPRAM HEXAL 30 MG 50 CPR BLIST 0 0
22,42 80
0427104 CITALOPRAM HEXAL 40 MG 100 CPR BLIST 0 0
45,99 80
0339189 CITALOPRAM HEXAL 40 MG 20 CPR 0 0
16,21 80
0427037 CITALOPRAM HEXAL 40 MG 20 CPR BLIST 0 0
16,21 80
0427071 CITALOPRAM HEXAL 40 MG 50 CPR BLIST 0 0
27,54 80
0432619 CITALOPRAM HEXAL 60 MG 100 CPR BLIST 0 0
67,07 80
0338875 CITALOPRAM HEXAL 60 MG 20 CPR 0 0
20,63 80
0432524 CITALOPRAM HEXAL 60 MG 20 CPR BLIST 0 0
20,63 80
0432569 CITALOPRAM HEXAL 60 MG 50 CPR BLIST 0 0
38,29 80
0367829 CITALOPRAM VON CT 20 MG 100 CPR 0 0
39,14 80
0367765 CITALOPRAM VON CT 20 MG 20 CPR 0 0
13,38 80
0367796 CITALOPRAM VON CT 20 MG 50 CPR 0 0
23,18 80
0367961 CITALOPRAM VON CT 40 MG 100 CPR 0 0
65,18 80
0367894 CITALOPRAM VON CT 40 MG 20 CPR 0 0
17,76 80
0367931 CITALOPRAM VON CT 40 MG 50 CPR 0 0
38,65 80
N06AB05 paroxetine
0354221 PAROXETINE EG 20 MG 28 CPR PELLIC 0 0
17,93 80
0354235 PAROXETINE EG 20 MG 56 CPR PELLIC 0 0
20,45 80
0563771 PAROXETINE EG 30 MG 56 CPR 0 0
34,00 80
0563865 PAROXETINE EG 40 MG 28 CPR 0 0
26,01 80
0563915 PAROXETINE EG 40 MG 98 CPR 0 0
69,54 80
0352244 PAROXETINE RATIO 20 MG 28 CPR 0 0
14,77 80
0352275 PAROXETINE RATIO 20 MG 56 CPR 0 0
24,72 80
0187137 SEROXAT 20 MG 28 CPR 0 0
17,93 80
0330474 SEROXAT 20 MG 56 CPR 0 0
25,92 80
0319401 SEROXAT 20 MG/10 ML SUSP 150 ML 0 0
11,50 80
0309632 SEROXAT 30 MG 28 CPR 0 0
20,72 80
N06AB06 sertraline
0405351 DOCSERTRALINE 100 MG 30 CPR 0 0
17,03 80
0405284 DOCSERTRALINE 50 MG 30 CPR 0 0
14,53 80
0342251 SERLAIN 100 MG 30 CPR 0 0
17,03 80
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Numéro national
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0307722 SERLAIN 20 MG/ML GTTS 60 ML 0 0
14,26 80
0244183 SERLAIN 50 MG 30 CPR SEC 0 0
15,14 80
0392818 SERTRALIN HEXAL 100 MG 100 CPR BLIST 0 0
49,74 80
0392741 SERTRALIN HEXAL 100 MG 20 CPR 0 0
14,20 80
0392771 SERTRALIN HEXAL 100 MG 50 CPR BLIST 0 0
26,50 80
0393006 SERTRALIN HEXAL 50 MG 100 CPR BLIST 0 0
30,00 80
0392933 SERTRALIN HEXAL 50 MG 20 CPR 0 0
10,69 80
0392964 SERTRALIN HEXAL 50 MG 50 CPR BLIST 0 0
15,50 80
0408644 SERTRALIN RATIO 100 MG 20 CPR 0 0
14,20 80
0408675 SERTRALIN RATIO 100 MG 50 CPR 0 0
26,50 80
0408434 SERTRALIN RATIO 50 MG 20 CPR 0 0
10,69 80
0408465 SERTRALIN RATIO 50 MG 50 CPR 0 0
20,50 80
0415442 SERTRALINE EG 100 MG 30 CPR 0 0
17,03 80
0415487 SERTRALINE EG 100 MG 60 CPR 0 0
31,16 80
0415331 SERTRALINE EG 50 MG 30 CPR 0 0
14,59 80
0415361 SERTRALINE EG 50 MG 60 CPR 0 0
18,13 80
N06AB08 fluvoxamine
0228579 FLOXYFRAL 100 MG 30 CPR SEC 0 0
18,37 80
0395631 FLUVOXAMINE EG 100 MG 30 CPR 0 0
13,75 80
N06AB10 escitalopram
0327661 SIPRALEXA 10 MG 28 CPR 0 0
26,78 80
0327675 SIPRALEXA 10 MG 56 CPR 0 0
39,07 80
0327997 SIPRALEXA 20 MG 28 CPR BLIST CLAIR 0 0
39,07 80
0328008 SIPRALEXA 20 MG 56 CPR 0 0
65,23 80
N06AF03 phenelzine
0075600 NARDELZINE 100 DRG 0 0
32,52 80
N06AG02 moclobemide
0170448 AURORIX 150 MG 100 CPR 0 0
33,08 80
N06AX03 mianserin
0065070 LERIVON 10 MG 90 CPR 0 0
10,20 80
0487066 LERIVON 30 MG 30 CPR 0 0
8,03 80
0192073 LERIVON 30 MG 50 CPR 0 0
13,43 80
0162981 LERIVON 60 MG 30 CPR 0 0
15,13 80
N06AX05 trazodone
0119428 TRAZOLAN 100 MG 30 CPR 0 0
8,13 80
0119445 TRAZOLAN 100 MG 90 CPR 0 0
13,89 80
N06AX11 mirtazapine
0389065 MIRTAZAPIN RATIO 15 MG 10 CPR 0 0
5,10 80
0387401 MIRTAZAPIN RATIO 15 MG 50 CPR 0 0
15,23 80
0387561 MIRTAZAPIN RATIO 30 MG 20 CPR 0 0
13,11 80
0387608 MIRTAZAPIN RATIO 30 MG 50 CPR 0 0
23,49 80
0387785 MIRTAZAPIN RATIO 45 MG 20 CPR 0 0
16,26 80
0387821 MIRTAZAPIN RATIO 45 MG 50 CPR 0 0
32,39 80
0398954 MIRTAZAPINE EG 15 MG 30 CPR 0 0
14,77 80
0398985 MIRTAZAPINE EG 15 MG 60 CPR 0 0
21,51 80
0399142 MIRTAZAPINE EG 30 MG 30 CPR 0 0
21,18 80
0399402 MIRTAZAPINE EG 45 MG 100 CPR 0 0
42,36 80
0399366 MIRTAZAPINE EG 45 MG 50 CPR 0 0
29,15 80
0485254 MIRTAZAPINE RATIO 15 MG 48 CPR ORODISP 0 0
14,88 80
0485223 MIRTAZAPINE RATIO 15 MG 6 CPR ORODISP 0 0
3,12 80
0485299 MIRTAZAPINE RATIO 30 MG 18 CPR ORODISP 0 0
12,71 80
0485318 MIRTAZAPINE RATIO 30 MG 48 CPR ORODISP 0 0
22,77 80
0485352 MIRTAZAPINE RATIO 45 MG 18 CPR ORODISP 0 0
15,30 80
0485383 MIRTAZAPINE RATIO 45 MG 48 CPR ORODISP 0 0
31,21 80
0290236 REMERGON 15 MG/ML GTTS 1 FL 66 ML 0 0
23,07 80
0329991 REMERGON SOLTAB 15 MG 5*6 CPR 0 0
15,92 80
0330041 REMERGON SOLTAB 30 MG 5*6 CPR 0 0
23,04 80
0330085 REMERGON SOLTAB 45 MG 5*6 CPR 0 0
26,43 80
N06AX12 bupropion
0463887 WELLBUTRIN XR 150 MG 30 CPR 0 0
32,52 80
0463891 WELLBUTRIN XR 150 MG 90 CPR 0 0
69,28 80
0463923 WELLBUTRIN XR 300 MG 30 CPR 0 0
53,53 80
0463937 WELLBUTRIN XR 300 MG 90 CPR 0 0
117,88 80
N06AX14 tianeptine
Page 72 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0139319 STABLON 12,5 MG 30 CPR ENR 0 0
11,38 80
N06AX16 venlafaxine
0525539 DOCVENLAFAXINE 150 MG 100 CAPS 0 0
54,55 80
0525511 DOCVENLAFAXINE 150 MG 30 CAPS 0 0
19,64 80
0525525 DOCVENLAFAXINE 150 MG 50 CAPS 0 0
29,18 80
0525492 DOCVENLAFAXINE 75 MG 100 CAPS 0 0
34,09 80
0512429 DOCVENLAFAXINE 75 MG 30 CAPS 0 0
10,47 80
0525489 DOCVENLAFAXINE 75 MG 50 CAPS 0 0
17,21 80
0258127 EFEXOR EXEL 150 MG 28 CAPS 0 0
32,49 80
0409476 EFEXOR EXEL 37,5 MG 7 CAPS 0 0
6,64 80
0258077 EFEXOR EXEL 75 MG 28 CAPS 0 0
20,64 80
0528558 VENLAFAXINE EG 150 MG 28 CAPS 0 0
20,29 80
0529426 VENLAFAXINE EG 150 MG 56 CAPS 0 0
35,26 80
0529362 VENLAFAXINE EG 37,5 MG 14 CAPS 0 0
8,21 80
0528379 VENLAFAXINE EG 37,5 MG 28 CAPS 0 0
12,35 80
0528463 VENLAFAXINE EG 75 MG 28 CAPS 0 0
10,52 80
N06AX17 milnacipran
0306451 IXEL 25 MG 56 CAPS BLIST 0 0
16,73 80
0261475 IXEL 50 MG 56 CAPS BLIST 0 0
29,65 80
N06AX21 duloxetine
0394602 CYMBALTA 60 MG 28 CAPS 0 0
41,43 80
0380185 YENTREVE 20 MG 56 CAPS 1 5
56,06 80
0380204 YENTREVE 40 MG 56 CAPS 1 5
56,06 80
N06BA04 methylphenidate
0450035 MEDIKINET RET 10 MG 50 CAPS 1 1
27,20 80
0450049 MEDIKINET RET 20 MG 50 CAPS 1 1
50,07 80
0450052 MEDIKINET RET 30 MG 50 CAPS 1 1
75,15 80
0450066 MEDIKINET RET 40 MG 50 CAPS 1 1
101,28 80
0553399 RILATINE MR 20 MG 30 CAPS 1 1
28,27 80
0553418 RILATINE MR 30 MG 30 CAPS 1 1
34,31 80
0236889 RITALIN 10 MG 20 CPR 1 1
6,92 80
N06BA07 modafinil
0264741 PROVIGIL 100 MG 90 CPR 1 5
128,98 80
N06CA Antidepressants in combination with psycholeptics
0028208 DEANXIT 30 DRG 0 0
5,37 80
N06DA02 donepezil
0238897 ARICEPT 10 MG 28 CPR 1 1
92,93 80
0238902 ARICEPT 10 MG 56 CPR 1 1
165,31 80
0459871 ARICEPT 10 MG 56 CPR ORODISP 1 1
165,31 80
0435638 ARICEPT 5 MG 28 CPR 1 1
81,16 80
N06DA03 rivastigmine
0267515 EXELON 0,2 % SOL 120 ML 1 1
119,66 80
0249941 EXELON 1,5 MG 112 CAPS 1 1
197,49 80
0249923 EXELON 1,5 MG 28 CAPS 1 1
49,23 80
0249937 EXELON 1,5 MG 56 CAPS 1 1
102,83 80
0250163 EXELON 3 MG 112 CAPS 1 1
197,49 80
0250132 EXELON 3 MG 28 CAPS 1 1
51,46 80
0250146 EXELON 3 MG 56 CAPS 1 1
102,83 80
0250194 EXELON 4,5 MG 112 CAPS 1 1
197,49 80
0250177 EXELON 4,5 MG 28 CAPS 1 1
51,46 80
0250181 EXELON 4,5 MG 56 CAPS 1 1
102,83 80
0468267 EXELON 4,6 MG 30 PATCH 1 1
106,53 80
0468271 EXELON 4,6 MG 60 PATCH 1 1
204,77 80
0250231 EXELON 6 MG 112 CAPS 1 1
197,49 80
0250213 EXELON 6 MG 28 CAPS 1 1
54,39 80
0250227 EXELON 6 MG 56 CAPS 1 1
102,83 80
0468303 EXELON 9,5 MG 30 PATCH 1 1
106,53 80
0468317 EXELON 9,5 MG 60 PATCH 1 1
204,77 80
0468321 EXELON 9,5 MG 90 PATCH 1 1
303,00 80
N06DA04 galantamine
0292793 REMINYL 4 MG 56 CPR 96472 1 1
63,96 80
0286135 REMINYL 4 MG/ML SOL 100 ML 96131 1 1
79,11 80
0394701 REMINYL RET 16 MG 28 CAPS 1 1
88,65 80
0394728 REMINYL RET 16 MG 84 CAPS 1 1
241,53 80
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Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0394745 REMINYL RET 24 MG 28 CAPS 1 1
97,58 80
0394762 REMINYL RET 24 MG 84 CAPS 1 1
260,61 80
0394681 REMINYL RET 8 MG 28 CAPS 1 1
63,96 80
N06DX01 memantine
0320285 AXURA 10 MG 50 CPR 1 1
84,93 80
0320318 AXURA 10 MG/G 1 FL 50 G 1 1
84,93 80
0487469 AXURA 20 MG 42 CPR 1 1
142,68 80
0492343 AXURA 20 MG 98 CPR UD 1 1
322,86 80
0487519 AXURA STARTERPACK 4*7 CPR 1 1
60,21 80
N07AA02 pyridostigmine
0071419 MESTINON 10 MG 50 CPR 0 0
7,65 80
0071453 MESTINON 60 MG 150 DRG 0 0
37,29 80
N07AA51 neostigmine, combinations
0184961 ROBINUL NEOSTIGMINE 10 AMP 1 ML IV 0 0
39,32 80
N07AB02 bethanechol
0408093 MYOCHOLINE GLENWOOD 10 MG 50 CPR 0 0
16,29 80
N07BB01 disulfiram
0006312 ANTABUSE 400 MG 50 CPR 0 0
6,63 80
N07BB03 acamprosate
0328719 CAMPRAL 333 MG 168 CPR 0 0
54,97 80
0215438 CAMPRAL 333 MG 84 CPR 0 0
31,94 80
N07BB04 naltrexone
0281965 NALOREX 50 MG 28 CPR 0 0
69,69 80
N07BC01 buprenorphine
0251211 SUBUTEX 2 MG 7 CPR 1 11
10,65 80
0251224 SUBUTEX 8 MG 7 CPR 1 11
24,08 80
N07BC02 methadone
0436361 MEPHENON 5 MG 30 CPR 1 11
5,24 100
0277153 METHADDICT 5 MG 100 CPR 1 11
11,16 100
0277122 METHADDICT 5 MG 20 CPR 1 11
2,23 100
0277136 METHADDICT 5 MG 50 CPR 1 11
5,58 100
N07BC51 buprenorphine, combinations
0445973 SUBOXONE 2/0,5 MG 28 CPR 1 11
30,90 80
0445956 SUBOXONE 2/0,5 MG 7 CPR 1 11
10,98 80
0445991 SUBOXONE 8/2 MG 28 CPR 1 11
84,97 80
0445987 SUBOXONE 8/2 MG 7 CPR 1 11
26,03 80
N07CA01 betahistine
0136818 BETAHISTINE EG 6 MG 100 CPR 0 0
8,26 80
0162947 BETASERC 16 MG 42 CPR SEC 0 0
11,59 80
0176781 BETASERC 16 MG 84 CPR SEC 0 0
15,50 80
0012807 BETASERC 8 MG 100 CPR 0 0
12,06 80
0333771 DOCBETAHI 16 MG 42 CPR 0 0
8,16 80
0333803 DOCBETAHI 16 MG 84 CPR 0 0
10,62 80
0333736 DOCBETAHI 8 MG 100 CPR 0 0
8,92 80
0278424 LECTIL 16 MG 45 CPR 0 0
8,38 80
0499568 LECTIL 24 MG 60 CPR 0 0
14,08 80
0251529 LECTIL 8 MG 30 CPR 0 0
2,78 80
0251515 LECTIL 8 MG 90 CPR 0 0
7,53 80
N07CA03 flunarizine
0104568 SIBELIUM 10 MG 28 CPR 38101 0 0
19,35 80
N07XX02 riluzole
0223913 RILUTEK 50 MG 56 CPR 0 0
251,70 100
P01BA01 chloroquine
0079238 NIVAQUIN 100 MG 100 CPR 1 8
4,53 80
0079224 NIVAQUIN 100 MG 20 CPR 1 8
5,11 80
P01BA02 hydroxychloroquine
0091344 PLAQUENIL 200 MG 100 DRG 1 8
14,00 80
P01BB51 proguanil, combinations
0235511 MALARONE 12 CPR 1 8
42,89 80
0340521 MALARONE JR 62,5/25 MG 12 CPR 1 8
17,96 80
P01BC02 mefloquine
0186658 LARIAM 250 MG 8 CPR 1 8
33,29 80
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Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
P01BD01 pyrimethamine
0027939 DARAPRIM 25 MG 30 CPR 1 8
4,33 80
P01CX01 pentamidine isethionate
0146229 PENTACARINAT 300 MG 5 FL 0 0
103,24 80
P02CA01 mebendazole
0304931 DOCMEBENDA 100 MG 10 CPR 0 0
4,43 80
0126663 VERMOX 100 MG 6 CPR 17604 0 0
4,66 80
0133895 VERMOX 500 MG 50 CPR 37095 0 0
44,17 80
0126694 VERMOX SIR 30 ML 17606 0 0
5,31 80
P02DA01 niclosamide
0130750 YOMESAN 500 MG 4 CPR 0 0
6,12 80
P03AC04 permethrin
0190728 ZALVOR 5% CREME 30 G 0 0
13,11 80
R01AC01 cromoglicic acid
0187235 CROMOHEXAL KOMB 2% SPRAY 15 ML + COLLY 0 0
8,68 40
0267708 CROMOHEXAL SANFT NASENSPRAY 15 ML 0 0
5,45 40
0267711 CROMOHEXAL SANFT NASENSPRAY 30 ML 0 0
9,50 40
0215729 LOMUSOL 2% GTTS 13,5 ML IN 0 0
8,22 40
0216291 LOMUSOL FORTE 4% SPRAY 15 ML IN 0 0
8,69 40
R01AC02 levocabastine
0173985 LIVOSTIN 0,05% SPRAY 1 FL 10 ML 52017 0 0
11,51 40
R01AC03 azelastine
0188716 ALLERGODIL SPRAY 10 ML 0 0
11,17 40
R01AC51 cromoglicic acid, combinations
0151568 VIVIDRIN SPRAY 15 ML 241 0 0
6,86 40
R01AD04 flunisolide
0112637 SYNTHARIS NEB NAS 24 ML 0 0
9,23 40
R01AD05 budesonide
0298539 RHINOCORT AQUA 64 MCG/D 120 D 0 0
11,62 40
R01AD08 fluticasone
0251791 FLIXONASE AQUA 50 MCG/D SPRAY 150 D 0 0
14,53 40
R01AD09 mometasone
0253439 NASONEX 50 MCG/D SPRAY 18 G 0 0
16,11 40
R01AD12 fluticasone furoate
0475759 AVAMYS 27,5 MCG SPRAY 120 D 0 0
14,39 40
R01AX03 ipratropium bromide
0226106 ATRONASE 0,3 MG/ML MICRODOS 1 FL 15 ML 0 0
13,21 40
R01AX08 framycetin
0105761 SOFRAMYCINE SIMPLE GTTS NAS 15 ML 0 0
4,40 40
0105789 SOFRAMYCINE SPRAY MICRODOSEUR 15 ML 0 0
4,86 40
R01AX10 various
0337315 PHYSIOLOGICA 10*5 ML 0 0
3,01 40
0255318 PHYSIOLOGICA 16 AMP 0 0
4,69 40
0337332 PHYSIOLOGICA 30*5 ML 0 0
7,25 40
0255321 PHYSIOLOGICA 32 AMP 0 0
7,95 40
0209122 PHYSIORHINE 0.9% SOL IN 18 UD 5 ML 0 0
4,85 40
R02AA15 povidone-iodine
0174612 IODEX BUCCAL 1% COLLU 200 ML 0 0
4,66 40
0058966 ISOBETADINE BUCCAL 1% SOL 200 ML 0 0
5,31 40
R02AA20 various
0030108 DEQUONAL SOL 200 ML 0 0
6,36 40
R03AC02 salbutamol
0210641 AIROMIR 100 MCG AER 200 D 0 0
7,44 100
0409141 NOVOLIZER SALBUT 100 MCG 1 CRT 200D RECH 0 0
5,19 100
0405687 NOVOLIZER SALBUT 100 MCG 1 INH+CRT 200 D 0 0
11,56 100
0126307 VENTOLIN 0,5% SOL P NEB 10 ML 0 0
6,71 100
0265511 VENTOLIN 100 MCG/D 200 D SPRAY SS CFC 0 0
6,47 100
0220827 VENTOLIN DISKUS 200 MCG 60 BLIST 0 0
9,59 100
0263662 VENTOLIN NEBULES 1 MG/ML 20 AMP 2,5 ML 0 0
9,51 100
R03AC03 terbutaline
0161791 BRICANYL TURBOHALER 0,5 MG/D PDR IH 200D 0 0
14,69 100
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Numéro national
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R03AC12 salmeterol
0214024 SEREVENT DISKUS 50 MCG 1 DISQ 60 BL 0 0
27,39 100
0458615 SEREVENT EVOHALER 25 MCG/D SUSP 120 D IH 0 0
27,39 100
R03AC13 formoterol
0449485 NOVOLIZER FORMOTEROL 12 MCG 1 CRT 60 D 0 0
27,39 100
0232621 OXIS TURBOHALER 4,5 MCG/D 60 D IH 0 0
24,76 100
0232635 OXIS TURBOHALER 9 MCG/D 60 D IH 0 0
23,71 100
R03AC18 indacaterol
0558834 ONBREZ BREEZHALER 150 MCG 30 CAPS + INH 0 0
38,00 100
0558865 ONBREZ BREEZHALER 300 MCG 30 CAPS + INH 0 0
38,00 100
R03AK03 fenoterol and other drugs for obstructive airway diseases
0305499 DUOVENT HFA 200 D 10 ML INH 0 0
11,14 100
0213187 DUOVENT SOL INH 20 FL UD 0 0
13,15 100
R03AK04 salbutamol and other drugs for obstructive airway diseases
0306806 COMBIVENT 60 FL UD INH 0 0
23,65 100
0250701 COMBIVENT SOL 20 FL UD INH 0 0
11,96 100
R03AK06 salmeterol and other drugs for obstructive airway diseases
0296291 SERETIDE 25/125 AER 120 D 0 0
47,40 100
0296307 SERETIDE 25/250 AER 120 D 0 0
61,98 100
0296288 SERETIDE 25/50 AER 120 D 0 0
37,37 100
0261041 SERETIDE 50/100 DISKUS 60 D 0 0
37,30 100
0261072 SERETIDE 50/250 DISKUS 60 D 0 0
47,40 100
0261119 SERETIDE 50/500 DISKUS 60 D 0 0
61,98 100
R03AK07 formoterol and other drugs for obstructive airway diseases
0472967 INUVAIR 100/6 MCG SOL INH 120 D 0 0
45,89 100
0339404 SYMBICORT FORTE TURBO 320/9 MCG 1*60 D 0 0
48,14 100
0294672 SYMBICORT TURBOHALER 1*120 D 0 0
48,14 100
0294624 SYMBICORT TURBOHALER 1*60 D 0 0
34,37 100
R03BA01 beclometasone
0286931 QVAR AUTOHALER 100 MCG/D 200D IH 0 0
26,27 100
0286927 QVAR AUTOHALER 50 MCG/D 200 D IH 0 0
17,87 100
R03BA02 budesonide
0398002 NOVOLIZER BUDESONIDE 200MCG/D INH+200 D 0 0
21,51 100
0162706 PULMICORT SUSP 0,5 MG/ML 20 UD 2 ML 0 0
43,56 100
0416243 PULMICORT TURBOHALER 200 MCG PDR 100 D 0 0
15,97 100
R03BA05 fluticasone
0257035 FLIXOTIDE 250 MCG/D AER SS CFC 120 D 0 0
35,85 100
0275632 FLIXOTIDE 50 MCG/D AER SS CFC 120 D 0 0
12,43 100
0216811 FLIXOTIDE DISKUS 100 MCG 60 D 0 0
12,43 100
0216824 FLIXOTIDE DISKUS 250 MCG 60 D 0 0
22,66 100
0216838 FLIXOTIDE DISKUS 500 MCG 60 D 0 0
35,85 100
0270068 FLIXOTIDE NEBULES 0,5 MG 10 AMP 2 ML INH 0 0
14,42 100
0270054 FLIXOTIDE NEBULES 2 MG 10 AMP 2 ML INH 0 0
21,71 100
R03BB01 ipratropium bromide
0214556 ATROVENT 0,25 MG 20 FL 2 ML UD IH 0 0
9,60 100
0306787 ATROVENT 0,25 MG 60 FL 2 ML UD IH 0 0
17,96 100
0214573 ATROVENT 0,5 MG 20 FL 2 ML UD IH 0 0
12,72 100
0345222 ATROVENT HFA 20 MCG/D AER 10 ML 0 0
9,99 100
R03BB04 tiotropium bromide
0316041 SPIRIVA 18 MCG 30 CAPS + HANDIHALER 0 0
48,60 100
R03BC01 cromoglicic acid
0170791 CROMOHEXAL 1% 20 MG 50 AMP 2 ML 0 0
14,50 80
0256315 LOMUDAL INHAL CFC-FREE 5MG/D AER 12 ML 0 0
11,92 80
0067254 LOMUDAL SOL NEB 20 MG 48 AMP 2 ML V IH 0 0
13,26 80
R03CC02 salbutamol
0126288 VENTOLIN 2 MG 100 CPR 0 0
6,76 100
0126310 VENTOLIN 2 MG/5 ML SIR 150 ML 0 0
5,53 100
0126291 VENTOLIN 4 MG 50 CPR 0 0
6,71 100
0126338 VENTOLIN 500 MCG 3 AMP 1 ML IMSC 0 0
6,42 100
R03DA04 theophylline
0115754 THEOLAIR LA 250 MG 100 CPR 0 0
9,42 100
0115771 THEOLAIR LA 350 MG 100 CPR 0 0
11,08 100
0115964 THEOSTAT 300 MG 30 CPR LP 0 0
3,31 100
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0160617 XANTHIUM 200 MG 60 CAPS 0 0
7,38 100
0182551 XANTHIUM 300 MG 60 CAPS 0 0
8,58 100
0160603 XANTHIUM 400 MG 60 CAPS 0 0
9,42 100
R03DA05 aminophylline
0222382 EUPHYLLIN 200 MG 5 AMP 10 ML IV 0 0
5,25 100
R03DC01 zafirlukast
0228744 ACCOLATE 20 MG 56 CPR 0 0
21,99 80
0251823 RESMA 20 MG 56 CPR 0 0
21,99 80
R03DC03 montelukast
0246904 SINGULAIR 10 MG 28 CPR 0 0
41,50 80
0246918 SINGULAIR 10 MG 56 CPR 0 0
79,88 80
0433292 SINGULAIR 4 MG 28 CPR CROQ 0 0
41,50 80
0512706 SINGULAIR 4 MG 28 SACH 0 0
41,50 80
0246935 SINGULAIR 5 MG 28 CPR CROQ 0 0
41,50 80
R05CB01 acetylcysteine
0148383 ACC 100 MG 100 SACH 0 0
10,51 40
0195108 ACC 100 MG 20 CPR EFF 0 0
2,60 40
0197763 ACC 100 MG 20 SACH 0 0
2,60 40
0195111 ACC 100 MG 50 CPR EFF 0 0
5,82 40
0197777 ACC 100 MG 50 SACH 0 0
5,82 40
0204353 ACC 100 MG TABS 20 CPR 0 0
2,43 40
0175637 ACC 200 MG 100 CPR EFF 0 0
13,26 40
0148402 ACC 200 MG 100 SACH 0 0
13,26 40
0195531 ACC 200 MG 20 CPR EFF 0 0
3,76 40
0197781 ACC 200 MG 20 SACH 0 0
3,76 40
0166915 ACC 200 MG 50 CPR EFF 0 0
7,58 40
0197794 ACC 200 MG 50 SACH 0 0
7,58 40
0204403 ACC 200 MG TABS 100 CPR 0 0
13,26 40
0204384 ACC 200 MG TABS 20 CPR 0 0
3,17 40
0204398 ACC 200 MG TABS 50 CPR 0 0
7,21 40
0204417 ACC 600 MG TABS 20 CPR 0 0
5,00 40
0204421 ACC 600 MG TABS 50 CPR 0 0
11,00 40
0208268 ACC AKUT 600 MG 6 CPR EFF 0 0
2,65 40
0166977 ACC INJEKT 300 MG 5 AMP 3 ML IMIV 0 0
1,70 80
0462599 ACC KINDERSAFT GRAN 20 MG/ML 100 ML 0 0
3,79 40
0468379 ACC KINDERSAFT GRAN 20 MG/ML 200 ML 0 0
6,70 40
0175668 ACC LONG 600 MG 10 CPR EFF 0 0
3,76 40
0197813 ACC LONG 600 MG 100 CPR EFF 0 0
17,53 40
0166946 ACC LONG 600 MG 20 CPR EFF 0 0
5,00 40
0166963 ACC LONG 600 MG 50 CPR EFF 0 0
11,00 40
0136799 ACETYLCYSTEINE EG 200 MG 30 CAPS 0 0
5,85 40
0240461 ACETYLCYSTEINE EG 600 MG 30 CPR EFF 0 0
7,56 40
0455904 ACETYLCYSTEINE EG 600 MG 60 CPR EFF 0 0
11,32 40
0455918 ACETYLCYSTEINE EG 600 MG 60 SACH 0 0
11,32 40
0347518 DOCACETYL 600 MG 30 SACH 0 0
9,82 40
0173839 EXOMUC 200 MG 30 SACH 0 0
4,35 40
0068637 LYSOMUCIL 200 MG 30 CAPS 0 0
7,85 40
0068623 LYSOMUCIL 200 MG 30 CPR EFF 0 0
5,78 40
0068654 LYSOMUCIL 300 MG 20 AMP 3 ML IMIVIH 0 0
8,58 80
0378013 LYSOMUCIL 4% SOL BUV 150 ML 0 0
6,56 40
0277591 LYSOMUCIL 600 MG 14 CPR EFF 0 0
7,75 40
0265586 LYSOMUCIL 600 MG 14 SACH 0 0
7,75 40
0187686 LYSOMUCIL 600 MG 30 CPR EFF 0 0
10,54 40
0265605 LYSOMUCIL 600 MG 30 SACH 0 0
10,54 40
0235993 LYSOMUCIL GRAN 200 MG 30 SACH 0 0
7,29 40
0305227 LYSOMUCIL JR 2% SIR 150 ML 0 0
6,32 40
0296162 LYSOX 2% SIR 180 ML 0 0
6,90 40
0187008 LYSOX 200 MG 30 SACH 0 0
7,00 40
0188019 LYSOX 200 MG/15 G SOL 30 FL 0 0
7,85 40
0222169 LYSOX 400 MG 30 SACH 0 0
8,80 40
0251001 LYSOX 600 MG 30 SACH 0 0
10,69 40
0230613 LYSOX JR 100 MG 30 SACH 0 0
4,84 40
0193568 NAC RATIO 200 MG 20 BRAUSETABL 0 0
3,88 40
0193523 NAC RATIO 200 MG 20 SACH 2 G 0 0
3,88 40
0190888 NAC RATIO 200 MG 20 TRINKTABL 0 0
3,88 40
0206571 NAC RATIO 200 MG 30 SACH 0 0
6,35 40
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0193571 NAC RATIO 200 MG 50 BRAUSETABL 0 0
7,81 40
0193537 NAC RATIO 200 MG 50 SACH 0 0
7,81 40
0190891 NAC RATIO 200 MG 50 TRINKTABL 0 0
7,81 40
0193585 NAC RATIO 600 MG 10 BRAUSETABL 0 0
4,03 40
0193599 NAC RATIO 600 MG 20 BRAUSETABL 0 0
7,33 40
0190911 NAC RATIO 600 MG 20 TRINKTABL 0 0
7,28 40
0193604 NAC RATIO 600 MG 50 BRAUSETABL 0 0
13,22 40
0190924 NAC RATIO 600 MG 50 TRINKTABL 0 0
14,56 40
0197147 PECTOMUCIL 200 MG GRAN 30 SACH 0 0
5,44 40
R05CB02 bromhexine
0014328 BISOLVON 0,2% SOL INH 100 ML 0 0
6,80 80
0162687 BISOLVON 0,2% SOL OR 100 ML 0 0
6,80 40
0014295 BISOLVON 8 MG 50 CPR 0 0
8,73 40
0014314 BISOLVON 8 MG/5ML SIR 250 ML 0 0
8,61 40
0197178 BROMEX 5 MG/ML 1 FL 180 ML 0 0
7,97 40
0136821 BROMHEXINE EG 8 MG 50 CPR 0 0
6,02 40
R05CB03 carbocisteine
0105565 SIROXYL 5 % SIR 250 ML 0 0
7,24 40
0143082 SIROXYL GRAN 14 SACH 0 0
7,91 40
R05CB05 mesna
0157804 MISTABRON 600 MG 30 AMP 3 ML INH 0 0
30,84 80
0072870 MISTABRON 600 MG 6 AMP 3 ML INH 0 0
10,17 80
R05CB06 ambroxol
0004058 AMBROHEXAL 15 MG 5 AMP 2 ML IMIVSC 0 0
3,69 80
0004030 AMBROHEXAL 15 MG/5 ML SIR ENF 100 ML 0 0
2,14 40
0004044 AMBROHEXAL 15 MG/5 ML SIR ENF 250 ML 0 0
4,59 40
0003999 AMBROHEXAL 30 MG 100 CPR 0 0
9,56 40
0175699 AMBROHEXAL 30 MG 20 CPR 0 0
2,21 40
0003985 AMBROHEXAL 30 MG 50 CPR 0 0
5,40 40
0004027 AMBROHEXAL 7,5 MG/ML GTTS 100 ML 0 0
3,98 40
0004013 AMBROHEXAL 7,5 MG/ML GTTS 50 ML 0 0
2,37 40
0184538 AMBROHEXAL RET 75 MG 10 CAPS 0 0
3,64 40
0004092 AMBROHEXAL RET 75 MG 100 CAPS 0 0
22,67 40
0175704 AMBROHEXAL RET 75 MG 20 CAPS 0 0
6,24 40
0004089 AMBROHEXAL RET 75 MG 50 CAPS 0 0
12,99 40
0208951 AMBROHEXAL S 60 MG 20 CPR EFF 0 0
5,43 40
0135967 AMBROXOL RATIO 15 MG 10 AMP 2 ML IMIVSC 0 0
13,26 80
0267014 AMBROXOL RATIO HL 30 MG 100 CPR 0 0
10,06 40
0266986 AMBROXOL RATIO HL 30 MG 20 CPR 0 0
2,57 40
0267001 AMBROXOL RATIO HL 30 MG 50 CPR 0 0
6,09 40
0266972 AMBROXOL RATIO HL RET 75 MG 100 CAPS 0 0
22,67 40
0266955 AMBROXOL RATIO HL RET 75 MG 20 CAPS 0 0
6,20 40
0266969 AMBROXOL RATIO HL RET 75 MG 50 CAPS 0 0
12,96 40
0264754 AMBROXOL RATIO HUSTENSAFT 100 ML 0 0
2,13 40
0264768 AMBROXOL RATIO HUSTENSAFT 250 ML 0 0
4,25 40
0264785 AMBROXOL RATIO HUSTENTROPFEN 100 ML 0 0
3,98 40
0264771 AMBROXOL RATIO HUSTENTROPFEN 50 ML 0 0
2,37 40
0161905 MUXOL 30 MG 30 CPR 0 0
4,83 40
0152596 MUXOL SOL BUV 180 ML 0 0
4,42 40
0144001 SURBRONC 30 MG/5 ML SIR 250 ML 0 0
13,60 40
0144371 SURBRONC 60 MG 20 CPR SEC 0 0
10,58 40
0162978 SURBRONC 60 MG 20 SACH 0 0
8,65 40
R05CB10 combinations
0139367 FLUIMUCIL ANTIBIOTIC 1 FL+S INTO 0 0
4,81 40
0045596 FLUIMUCIL ANTIBIOTIC 3 FL+S INTO 0 0
9,67 40
R05CB13 dornase alfa (desoxyribonuclease)
0203082 PULMOZYME 1 MG 30 AMP 2,5 ML INH 0 0
660,05 80
R05CB15 erdosteine
0249503 MUCODOX 300 MG 14 CPR 0 0
5,49 40
0249517 MUCODOX 300 MG 56 CPR 0 0
14,26 40
0249503 MUCOTHERA 300 MG 14 CAPS 0 0
5,49 40
0249517 MUCOTHERA 300 MG 56 CAPS 0 0
14,26 40
R05DA01 ethylmorphine
0288563 CODETHYLINE ERFA 5 MG 50 CPR 0 0
5,32 40
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R05DA04 codeine
0219163 GLOTTYL SIR 300 ML 0 0
6,95 40
0076530 NEOCODION 20 CPR 0 0
2,51 40
0076589 NEOCODION AD SIR 180 ML 0 0
2,67 40
0076592 NEOCODION ENF SIR 125 ML 0 0
1,88 40
R05DA07 noscapine
0306448 NOSCA MEREPRINE 15 MG 24 CPR 0 0
5,44 40
R05DA09 dextromethorphan
0262522 DEXIR 15 MG/5 ML SIR AD 120 ML 0 0
5,22 40
0262536 DEXIR 7,5 MG/5 ML SIR ENF 125 ML 0 0
4,68 40
0317052 HUMEX ANTITUSSIV 13,3MG/10ML SIR 200 ML 0 0
5,01 40
0317066 HUMEX ANTITUSSIV JR 5 MG/5 ML SIR 125 ML 0 0
4,02 40
0213285 TOUXIUM ANTITUSSIVUM 30 MG 20 CAPS 0 0
6,80 40
0197164 TUSSIPECT 1,5 MG/ML 180 ML 0 0
6,69 40
R05DA10 thebacon
0137605 ACEDICONE 5 MG 20 CPR 0 0
6,13 40
R05DB Other cough suppressants
0462327 COTRANE PHOLCODINE 1,2 MG/ML SIR 200 ML 0 0
6,37 40
R05DB05 pentoxyverine
0443769 BALSOCLASE ANTITUSSIVUM ENF 12 SUPP 0 0
4,96 40
0443819 BALSOCLASE ANTITUSSIVUM GTTS 30 ML 0 0
6,60 40
0443755 BALSOCLASE ANTITUSSIVUM J ENF 12 SUPP 0 0
4,85 40
0443772 BALSOCLASE ANTITUSSIVUM SIR 200 ML 0 0
6,90 40
0443786 BALSOCLASE ANTITUSSIVUM SS SUCRE SIR 200 0 0
6,75 40
0121538 TUCLASE SIR 200 ML 0 0
4,14 40
R05DB13 butamirate
0467225 SINECOD AD 7,5 MG/5 ML SIR 125 ML 0 0
6,80 40
R05DB21 cloperastine
0345639 LYSOTOSSIL 0,354 G/ML SIR 200 ML 0 0
6,32 40
0419505 LYSOTOSSIL 10 MG 30 DRG 0 0
4,66 40
R05FA02 opium derivatives and expectorants
0278228 BAUME PULMONAIRE SIR AD 250 ML 0 0
6,31 40
0056460 INALPIN SIR 180 ML 0 0
7,68 40
0245048 TROPHIRES SIR AD 200 ML 0 0
4,69 40
0121099 TROPHIRES SIR ENF 125 ML 0 0
2,48 40
R05FB02 cough suppressants and expectorants
0090235 PHYTOTUX SIR 250 ML 0 0
6,91 40
R06AA02 diphenhydramine
0446645 EMESAN 50 MG 10 CPR 0 0
1,72 40
0438867 EMESAN 50 MG 20 CPR 0 0
3,00 40
0438871 EMESAN 50 MG 50 CPR 0 0
6,20 40
R06AB02 dexchlorpheniramine
0091862 POLARAMINE 2 MG/5 ML SIR 100 ML 0 0
5,68 80
0091909 POLARAMINE REPETABS 6 MG 20 CPR ENR 0 0
5,95 80
R06AB03 dimetindene
0044148 FENISTIL 1 MG 20 DRG 0 0
5,68 80
0268252 FENISTIL 24 STD 4 MG 20 CAPS 0 0
12,17 80
0268266 FENISTIL 24 STD 4 MG 50 CAPS 0 0
26,30 80
0044179 FENISTIL GTTS 20 ML 0 0
5,69 80
R06AB54 chlorphenamine, combinations
0099275 RHINOFEBRYL 20 CAPS 0 0
5,60 40
R06AD01 alimemazine
0116085 THERALENE 10 MG 50 CPR 0 0
2,34 80
0116104 THERALENE 4% GTTS 30 ML 0 0
3,07 80
R06AD02 promethazine
0089704 PHENERGAN 50 MG 5 AMP 2 ML 0 0
5,41 80
R06AD07 mequitazine
0251885 QUITADRILL 5 MG 14 CPR 0 0
4,51 80
R06AE07 cetirizine
0321346 CETIRIZINE EG 10 MG 20 CPR 0 0
7,38 80
0321377 CETIRIZINE EG 10 MG 50 CPR 0 0
13,79 80
0339547 CETIRIZINE HEXAL 10 MG 20 CPR 0 0
5,69 80
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0339564 CETIRIZINE HEXAL 10 MG 50 CPR 0 0
13,10 80
0339516 CETIRIZINE HEXAL 10 MG 7 CPR 0 0
2,60 80
0325314 CETIRIZINE RATIO 10 MG 20 CPR 0 0
6,64 80
0177094 ZYRTEC 1 MG/ML SIR 200 ML 0 0
10,28 80
0138566 ZYRTEC 10 MG 20 CPR 0 0
10,28 80
0167666 ZYRTEC 10 MG/ML GTTS 20 ML 0 0
10,28 80
R06AE09 levocetirizine
0543506 LEVOCETIRIZINE EG 5 MG 100 CPR 0 0
22,20 80
0543389 LEVOCETIRIZINE EG 5 MG 20 CPR 0 0
8,42 80
0543439 LEVOCETIRIZINE EG 5 MG 40 CPR 0 0
12,04 80
0543473 LEVOCETIRIZINE EG 5 MG 60 CPR 0 0
14,95 80
0465122 XYZALL 0,5 MG/ML GTTS 200 ML 0 0
11,56 80
0307817 XYZALL 5 MG 20 CPR 0 0
10,38 80
0307851 XYZALL 5 MG 40 CPR 0 0
15,05 80
0429211 XYZALL 5 MG/ML GTTS 20 ML 0 0
11,56 80
R06AX13 loratadine
0409364 CLARITINE 1 MG/ML SIR 100 ML 0 0
7,83 80
0148191 CLARITINE 10 MG 21 CPR 0 0
10,38 80
0374126 LORANO AKUT 10 MG 14 CPR 0 0
4,95 80
0374112 LORANO AKUT 10 MG 7 CPR 0 0
2,60 80
0370998 RUPTON 10 MG 10 CPR 0 0
4,03 80
0371026 RUPTON 10 MG 100 CPR 0 0
20,92 80
R06AX17 ketotifen
0130800 ZADITEN SIR 200 ML 0 0
17,20 80
R06AX22 ebastine
0223054 ESTIVAN 10 MG 20 CPR 0 0
10,65 80
0348918 ESTIVAN 20 MG 20 CPR 0 0
15,25 80
R06AX25 mizolastine
0246238 MIZOLLEN 20 CPR 0 0
11,19 80
R06AX26 fexofenadine
0244301 TELFAST 120 MG 20 CPR 0 0
10,65 80
0244328 TELFAST 180 MG 20 CPR 0 0
14,35 80
R06AX27 desloratadine
0455496 AERIUS 0,5 MG/ML SOL BUV 150 ML 0 0
9,28 80
0291989 AERIUS 5 MG 30 CPR 0 0
14,21 80
0291992 AERIUS 5 MG 50 CPR 0 0
19,58 80
R06AX28 rupatadine
0477574 RUPATALL 10 MG 30 CPR 0 0
16,08 80
S01AA01 chloramphenicol
0021109 CHLORAMPHENICOL BRNV 0,4% COLLY 10 ML 0 0
5,56 80
0254517 CHLORAMPHENICOL ERFA 0,5% COLLY 5 ML 0 0
4,88 80
0254521 CHLORAMPHENICOL ERFA 1% POM OPH 2,5 G 0 0
5,55 80
S01AA02 chlortetracycline
0009491 AUREOMYCINE LEDERLE 1% POM OPHT 5 G 0 0
5,44 80
S01AA11 gentamicin
0048844 GENTAMYTREX COLLY + POM OPHT 743 0 0
5,60 80
0048858 GENTAMYTREX COLLY 5 ML 741 0 0
3,79 80
0048830 GENTAMYTREX POM OPHT 3 G 742 0 0
2,69 80
S01AA12 tobramycin
0398792 TOBRAVISC 0,3% COLLY 5 ML 0 0
8,27 80
0117518 TOBREX COLLY 5 ML 0 0
8,27 80
0117521 TOBREX ONG OPHT 3,5 G 0 0
7,24 80
S01AA26 azithromycin
0477073 AZYTER 0,015% COLLY 6 UD 0 0
6,97 80
S01AA30 combinations of different antibiotics
0114967 TERRAMYCINE POM OPHT 3,5 G 0 0
5,69 80
S01AD02 trifluridine
0204725 TRIFLUMANN COLLY 5 ML 0 0
19,61 80
S01AD03 aciclovir
0131257 ZOVIRAX 3% ONG OPHT 4,5 G 0 0
14,07 80
S01AD09 ganciclovir
0435821 VIRGAN 0,15% GEL 5 G 0 0
14,59 80
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Numéro national
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S01AX07 sodium borate
0002523 ALCASOL COLLY 9 ML 0 0
6,07 80
S01AX08 hexamidine
0082443 OPHTAMEDINE SOL 10 ML 0 0
5,57 80
S01AX13 ciprofloxacin
0197181 CILOXAN 0,3% COLLY 5 ML 0 0
6,87 80
S01BA01 dexamethasone
0069956 MAXIDEX COLLY 5 ML 0 0
7,85 80
0108536 SPERSADEX 0,1% DISP COLLY 0 0
10,28 80
S01BA04 prednisolone
0092923 PRED FORTE COLLY 5 ML 0 0
7,70 80
0122535 ULTRACORTENOL POM OPHT 5 G 0 0
11,12 80
S01BA07 fluorometholone
0408076 FLUACORT 0,1% COLLY 5 ML 0 0
6,52 80
0045551 FLUCON 1 MG/ML COLLY 5 ML 0 0
8,70 80
0045792 FML LIQUIFILM 0,1% COLLY 5 ML 0 0
6,81 80
S01BA13 rimexolone
0247882 VEXOLON 1% COLLY 1 FL CPT-GTTS 5 ML 0 0
8,57 80
S01BB Corticosteroids and mydriatics in combination
0038140 EFEMOLINE COLLY 5 ML 0 0
11,12 80
S01BC01 indometacin
0286815 INDOCOLLYRE 0,1% SOL 5 ML 0 0
7,88 80
S01BC03 diclofenac
0458694 DICLOABAK 0,1% COLLY 10 ML 0 0
9,57 80
0187091 VOLTAREN OPHTA SINE COLLY 20*0,3 ML 0 0
24,01 80
S01BC05 ketorolac
0238205 ACULARE 0,5% COLLY 10 ML 0 0
8,32 80
S01BC09 pranoprofen
0170918 PRANOX 0,1% COLLY 1 FL 5 ML 0 0
7,42 80
S01CA01 dexamethasone and antiinfectives
0279807 DEXAGENTA POS 5 MG COLLY 5 ML 0 0
6,77 80
0243639 DEXAGRANE COLLY 5 ML 0 0
2,50 80
0030934 DEXAMYTREX COLLY 5 ML 555 0 0
7,44 80
0030948 DEXAMYTREX POM OPHT 3 G 556 0 0
5,72 80
0265698 FRAKIDEX COLLY 1 FL 5 ML 0 0
5,41 80
0172814 FRAKIDEX POM 5 G 0 0
5,41 80
0070019 MAXITROL COLLY 5 ML 0 0
8,21 80
0070022 MAXITROL POM OPHT 3,5 G 0 0
7,15 80
0156872 TOBRADEX POM OPH 3,5 G 0 0
7,15 80
0156869 TOBRADEX SUSP 5 ML 0 0
8,39 80
S01CA02 prednisolone and antiinfectives
0092940 PREDMYCINE P LIQUIFILM 5 ML 0 0
7,04 80
S01CA03 hydrocortisone and antiinfectives
0114726 TERRACORTRIL POM OPHT 3,5 G 0 0
6,10 80
0114743 TERRACORTRIL SUSP OPHT 5 ML 0 0
6,62 80
S01EA02 dipivefrine
0156659 PROPINE 0,1% COLLY 5 ML 0 0
7,25 80
S01EA03 apraclonidine
0204899 IOPIDINE 0,5% COLLY 5 ML 0 0
13,08 80
S01EA05 brimonidine
0250471 ALPHAGAN 0,2% COLLY 5 ML 0 0
18,31 80
S01EB01 pilocarpine
0059929 ISOPTO CARPINE 1% COLLY 15 ML 0 0
5,50 80
0059932 ISOPTO CARPINE 2% COLLY 15 ML 0 0
5,89 80
0108438 SPERSACARPIN 0,5% COLLY 10 ML 0 0
2,38 80
S01EB09 acetylcholine
0213643 MIOCHOL E COLLY 20 MG 1 FL 0 0
35,47 80
S01EB51 pilocarpine, combinations
0157111 NORMOGLAUCON COLLY 10 ML 582 0 0
19,35 80
S01EC01 acetazolamide
0138101 DIAMOX 250 MG 25 CPR 0 0
8,06 80
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Numéro national
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0031458 DIAMOX 500 MG PDR 1 FL IV 0 0
7,93 80
S01EC03 dorzolamide
0273932 TRUSOPT 2% COLLY 1 OCUMETER PLUS 5 ML 0 0
14,68 80
S01EC04 brinzolamide
0278343 AZOPT 1% COLLY 5 ML 0 0
14,68 80
S01ED01 timolol
0213996 DISPATIM SINE 0,25% COLLY 120*0,4 ML UD 0 0
28,28 80
0214011 DISPATIM SINE 0,5% COLLY 120*0,4 ML UD 0 0
28,42 80
0500154 GELTIM 0,1% GEL 90*0,4 ML UD 0 0
21,10 80
0289561 TIMABAK 0,25% COLLY 5 ML 0 0
8,97 80
0289574 TIMABAK 0,5% COLLY 5 ML 0 0
9,31 80
0195501 TIMOHEXAL 0,25% COLLY 3*5 ML 0 0
10,00 80
0167196 TIMOHEXAL 0,25% COLLY 5 ML 0 0
2,40 80
0195514 TIMOHEXAL 0,5% COLLY 3*5 ML 0 0
10,00 80
0167182 TIMOHEXAL 0,5% COLLY 5 ML 0 0
2,55 80
0241908 TIMOLOL FALCON 0,25% COLLY 5 ML 0 0
5,76 80
0241889 TIMOLOL FALCON 0,5% COLLY 5 ML 0 0
5,85 80
0322746 TIMOPOS 0,25% COLLY 10 ML 0 0
7,13 80
0322763 TIMOPOS 0,5% COLLY 10 ML 0 0
10,19 80
0311465 TIMOPTOL 0,25% COLLY 1 FL OCUM PLUS 5 ML 0 0
5,76 80
0311479 TIMOPTOL 0,5% COLLY 1 FL OCUM PLUS 5 ML 0 0
5,85 80
0338505 TIMOPTOLGEL 0,5% 1 FL OCUM PLUS 2,5 ML 0 0
7,65 80
S01ED02 betaxolol
0013088 BETOPTIC 0,5% COLLY 5 ML 0 0
7,85 80
0193666 BETOPTIC S 0,25% COLLY 5 ML 0 0
8,87 80
S01ED03 levobunolol
0158023 BETAGAN 0,25% COLLY 5 ML 0 0
8,70 80
0142586 BETAGAN 0,5% COLLY 5 ML 0 0
8,70 80
S01ED04 metipranolol
0012712 BETAMANN 0,1% COLLY 5 ML 0 0
5,79 80
0012726 BETAMANN 0,3% COLLY 5 ML 0 0
5,85 80
0218183 BETAMANN 0,3% EDO SINE COLLY 60*0,5 ML 0 0
20,36 80
0012743 BETAMANN 0,6% COLLY 5 ML 0 0
5,89 80
S01ED05 carteolol
0376541 ARTEOPTIC LA 1% COLLY 3 ML 0 0
10,48 80
0376554 ARTEOPTIC LA 2% COLLY 3 ML 0 0
10,48 80
0399786 ARTEOPTIC LA 2% COLLY 3*3 ML 0 0
19,34 80
0150431 CARTEOL 1% COLLY 5 ML 0 0
10,15 80
0472953 CARTEOL 2% COLLY 3*5 ML 0 0
19,77 80
0150445 CARTEOL 2% COLLY 5 ML 0 0
10,62 80
S01ED51 timolol, combinations
0502288 AZARGA 10 MG/ML 5 MG/ML COLLY 3*5 ML 0 0
49,98 80
0436862 COMBIGAN 0,2/0,5% COLLY 3*5 ML 0 0
41,94 80
0274801 COSOPT COLLY 1 OCUMETER PLUS 5 ML 0 0
27,12 80
0297593 COSOPT COLLY 3 OCUMETER PLUS 5 ML 0 0
49,98 80
0457621 COSOPT UD COLLY 20MG/ML 5MG/ML 60*0,2 ML 0 0
25,40 80
0434983 DUOTRAV 40 MCG/ML 5 MG/ML COLLY 2,5 ML 0 0
32,66 80
0434997 DUOTRAV 40 MCG/ML 5 MG/ML COLLY 3*2,5 ML 0 0
69,65 80
0303379 XALACOM COLLY 2,5 ML 0 0
34,80 80
0303382 XALACOM COLLY 3*2,5 ML 0 0
74,33 80
S01EE01 latanoprost
0240783 XALATAN 0,005% COLLY 2,5 ML 0 0
29,36 80
0251868 XALATAN 0,005% COLLY 3*2,5 ML 0 0
56,94 80
S01EE03 bimatoprost
0565498 LUMIGAN 0,3 MG/ML COLLY 3 ML 0 0
27,93 80
0565484 LUMIGAN 0,3 MG/ML COLLY 3*3 ML 0 0
52,55 80
S01EE04 travoprost
0314663 TRAVATAN 40 MCG/ML COLLY 1 FL 2,5 ML 0 0
27,94 80
0314677 TRAVATAN 40 MCG/ML COLLY 3 FL 2,5 ML 0 0
52,55 80
S01FA04 cyclopentolate
0535986 MINIMS CYCLOPENTOLATE HCL 0,5% COLLY A20 0 0
16,79 80
0183091 ZYKLOLAT EDO SINE COLLY 20 X 0,5 ML 0 0
9,27 80
S01FA06 tropicamide
Page 82 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0121281 TROPICOL 0,5% COLLY 10 ML 0 0
4,90 80
S01FB01 phenylephrine
0089797 PHENYLEPHRIN BRNV 10% COLLY 10 ML 0 0
3,96 80
0219292 PHENYLEPHRIN CHLORH CHVN 10% 20 MIN 0 0
16,79 80
S01GA02 tetryzoline
0193361 BERBERIL N COLLY 10 ML 0 0
4,04 80
0277007 BERBERIL N EDO COLLY 10*0,5 ML 0 0
5,29 80
0277011 BERBERIL N EDO COLLY 20*0,5 ML 0 0
8,52 80
S01GA51 naphazoline, combinations
0299892 COLLYRE BLEU LAITER COLLY 10 ML 0 0
5,42 80
0072433 MINHAVEZ COLLY 0 0
4,90 80
S01GX01 cromoglicic acid
0364571 CROMABAK 20 MG/ML COLLY 10 ML 0 0
9,87 80
0170403 CROMOHEXAL 2% COLLY 10 ML 0 0
3,78 80
0176553 CROMOHEXAL UD COLLY 20*0,5 ML 0 0
3,98 80
0195528 CROMOHEXAL UD COLLY 50*0,5 ML 0 0
9,85 80
0164003 DISPACROMIL COLLY 10 ML 0 0
4,00 80
0163992 DISPACROMIL SINE COLLY 20*0,5 ML 0 0
4,00 80
0082619 OPTICROM 2% COLLY 10 ML 0 0
10,56 80
0151571 VIVIDRIN COLLY 10 ML 240 0 0
5,38 80
S01GX02 levocabastine
0173971 LIVOSTIN 0,05% COLLY 1 FL 4 ML 52349 0 0
12,53 80
S01GX05 lodoxamide
0170689 ALOMIDE 1 MG/ML COLLY 5 ML 0 0
5,68 80
S01GX06 emedastine
0263855 EMADINE 0,5 MG/ML COLLY 5 ML 0 0
13,42 80
S01GX07 azelastine
0257553 ALLERGODIL COLLY 6 ML 0 0
12,17 80
S01GX08 ketotifen
0576314 ALTRIABAK 0,25 MG/ML COLLY 5 ML 0 0
13,49 80
0303544 ZADITEN OPHTA COLLY 5 ML 0 0
13,47 80
0298721 ZADITEN OPHTA SINE 0,025% COLLY 20FL UD 0 0
16,67 80
0298749 ZADITEN OPHTA SINE 0,025% COLLY 50FL UD 0 0
33,53 80
S01GX09 olopatadine
0341871 OPATANOL 0,1% COLLY 1 FL 5 ML 0 0
13,41 80
S01HA02 oxybuprocaine
0278259 MONOFREE OXYBUPROCAINE 0,4% COLLY 20*0,4 0 0
11,77 80
0033788 NOVESINE 0,4% DISPERSA COLLY 10 ML 0 0
4,29 80
0219275 OXYBUPROCAINE HCL CHVN 0,4% COLLY 20 MIN 0 0
16,79 80
0084725 UNICAINE 0,4 % COLLY 10 ML 0 0
5,68 80
S01HA03 tetracaine
0219311 TETRACAIN CHLORH CHVN 1% COLLY 20 MIN 0 0
16,79 80
S01JA01 fluorescein
0220343 FLUORESCEINE SOD CHVN 2% COLLY 20 MIN 0 0
16,53 80
S01XA02 retinol
0081351 OCULOTECT COLLY 10 ML 0 0
4,75 80
0233261 OCULOTECT COLLY 3*10 ML 0 0
9,87 80
S01XA12 dexpanthenol
0187561 CORNEREGEL 10 G 0 0
4,47 80
S01XA20 artificial tears and other indifferent preparations
0223782 ALCON EYE GEL 10 G 0 0
6,50 40
0182341 ARTELAC COLLY 1 FL 10 ML 450 0 0
4,18 40
0225451 ARTELAC EDO COLLY 120 * 0,6 ML 0 0
31,83 40
0225434 ARTELAC EDO COLLY 30 * 0,6 ML 0 0
11,57 40
0225448 ARTELAC EDO COLLY 60 * 0,6 ML 0 0
19,70 40
0164017 DISPATENOL COLLY 10 ML 0 0
4,45 40
0233226 DISPATENOL COLLY 3*10 ML 0 0
6,40 40
0160746 ISOPTO TEARS COLLY 15 ML 0 0
4,09 40
0066596 LIQUIFILM TEARS 15 ML 0 0
4,95 40
0294168 OCUGEL 0,25% GEL 10 G 0 0
7,77 40
0419469 PVP AUGENTROPFEN DR MANN 10 ML 0 0
2,95 40
0224681 SICCAGENT 2 % COLLY 10 ML 0 0
4,82 40
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Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0166851 TEARS NATURAL 15 ML 0 0
4,67 40
0222186 THILO TEARS GEL OPHT 10 G 0 0
6,50 40
0279273 VIDISIC EDO GEL 120*0,6 ML 0 0
31,83 40
0279242 VIDISIC EDO GEL 30*0,6 ML 0 0
11,57 40
0279256 VIDISIC EDO GEL 60*0,6 ML 0 0
19,70 40
0140273 VIDISIC GEL 10 G 431 0 0
4,18 40
0140287 VIDISIC GEL 3*10 G 432 0 0
8,52 40
S02AA Antiinfectives
0144448 OTOFA GTTS 200000 U 1 FL 10 ML 0 0
3,51 80
S02AA30 antiinfectives, combinations
0076432 NEOBACITRACINE INSTILLATION 0 0
6,54 80
S02CA06 dexamethasone and antiinfectives
0092050 POLYDEXA GTTS AURICUL 10 ML 0 0
2,44 80
S02DA01 lidocaine
0084112 OTIPAX 16 G 0 0
2,63 80
S02DC Indifferent preparations
0020308 CERULYX GTTS 10 ML 0 0
5,75 80
0130375 XERUMENEX GTTES AURICUL 0 0
4,28 80
V01AA20 various
0213206 ALLERGOVIT 1 FL B (ENTRETIEN) 1*3 ML 0 0
221,76 80
0213191 ALLERGOVIT ST A+B / 2*3 ML 0 0
242,64 80
0536059 NOVO-HELISEN DEPOT EB ST 1-3 3*4,5 ML 0 0
115,78 80
0536031 NOVO-HELISEN DEPOT FL ENTRETIEN 1*4,5 ML 0 0
69,37 80
0536045 NOVO-HELISEN DEPOT FL ENTRETIEN 2*4,5 ML 0 0
120,16 80
V03AB Antidotes
0147101 LEGALON SIL 350 MG PDR 4 FL+S 5 ML IV 0 0
615,59 80
V03AB14 protamine
0246028 PROTAMINE 1000 ROCHE 5000 U 5 AMP 5 ML 0 0
9,87 80
0536112 PROTAMINE SULF LEO 1400 U/ML 1 FL 5 ML 0 0
6,89 80
V03AC01 deferoxamine
0030545 DESFERAL 500 MG PDR 10 FL+S 0 0
39,51 100
V03AC02 deferiprone
0269487 FERRIPROX 500 MG 100 CPR 0 0
240,88 100
V03AC03 deferasirox
0441991 EXJADE 125 MG 84 CPR 1 5
694,50 100
0442016 EXJADE 250 MG 84 CPR 1 5
1.380,70 100
0442047 EXJADE 500 MG 84 CPR 1 5
2.683,10 100
V03AE01 polystyrene sulfonate
0061622 KAYEXALATE CALCIUM PDR 300 G 0 0
21,27 100
0061636 KAYEXALATE SODIUM PDR 450 G 0 0
24,55 100
0107170 SORBISTERIT CA PDRE 500G 3400711 0 0
41,50 100
V03AE02 sevelamer
0319379 RENAGEL 800 MG 180 CPR 0 0
191,25 100
0519593 RENVELA 2,4 G PDR 60 SACH 0 0
181,92 100
0519545 RENVELA 800 MG 180 CPR (FL) 0 0
181,92 100
V03AE03 lanthanum carbonate
0403522 FOSRENOL 500 MG 90 CPR A CROQ 0 0
194,37 100
0403603 FOSRENOL 750 MG 90 CPR A CROQ 0 0
240,74 100
V03AF03 calcium folinate
0438898 RESCUVOLIN 15 MG 10 CPR 0 0
39,14 100
0438903 RESCUVOLIN 15 MG 50 CPR 0 0
115,55 100
V03AF04 calcium levofolinate
0213531 ELVORINE 7,5 MG 10 CPR 0 0
28,21 100
V03AN01 oxygen
0243155 OXYGENE MEDICAL BT 100 L 0 0
5,60 80
0243205 OXYGENE MEDICAL BT 1000 L 0 0
5,60 80
0243236 OXYGENE MEDICAL BT 10500 L 0 0
55,26 80
0243169 OXYGENE MEDICAL BT 200 L 0 0
5,60 80
0243219 OXYGENE MEDICAL BT 2100 L 0 0
11,80 80
0243172 OXYGENE MEDICAL BT 300 L 0 0
5,60 80
0243186 OXYGENE MEDICAL BT 400 L 0 0
5,60 80
0243222 OXYGENE MEDICAL BT 4200 L 0 0
23,60 80
Page 84 of 85

Numéro national
Dénomination abrégée Prise en charge conditionnelle Prix public Taux
0243141 OXYGENE MEDICAL BT 74 L 0 0
5,60 80
V07AB Solvents and diluting agents, incl. irrigating solutions
0007340 AQUA AD INJ BRN 10 AMP 20 ML P 0 0
7,46 80
0007337 AQUA AD INJ BRN 10 MINI PL 10 ML 0 0
7,06 80
0007256
YY
AQUA AD INJ BRN 100 ML V 0 0
1,39 80
0303107 BALDRIPARAN N STARK BERUHIGUNG 100 DRG 0 0
21,49 40
Page 85 of 85