NATIONAL LIST of ESSENTIAL MEDICINES 2008

651.1IndPNATIONAL LIST of ESSENTIAL MEDICINES 2008NATIONALLIST ofESSENTIALMEDICINES2008NLEMMINISTRY of HEALTHREPUBLIC of INDONESIA

MINISTRY of HEAREPUBLIC of INDONNATIONALLIST ofESSENTIALMEDICINES2008inistry of Health of The Republic of Indonesia.taloging in Publication Data.donesia. Ministry of Health Republic of Indonesia.tional list of essential medicines 2008.--karta : Ministry of Health of The Republic ofdonesia, 2008.Judul 1. DRUGS

MINISTRY of HEALTHREPUBLIC of INDONESIACONTENTFOREWORDines Policy (2006) mandates the enforcement to enhance the quality of health services; toility of safe, efficacious and good quality medicines in sufficient amount and type,ccessibility of medicine particularly essential medicine for the whole community, to beonsibility.is selected medicine that mostly needed for health service, including diagnosis,and rehabilitation, which enforced to be provided in health care units, according to theirwal applied a new approach, whereas the process of addition and deletion preceded withxisting list of previous National List of Essential Medicines (NLEM) by The NationalM, therefore there were deletion of obsolete medicines and addition of new medicines inience improvement. It needs the transparency of evaluating process which utilize scientificider the pediatric formulation.larly every three years, the last revision carried out in 2005. Current revision is conductedmmittee of NLEM, which legalized through The Decree of Minister of Health.evailing of NLEM 2008, mandate of The National Medicines Policy could be applied better.s is given to all parties involved in the process of revision and formulation of NLEM 2008.ForewordContentThe decree of The Ministry of Health regarding National List of EMedicines 2008Chapter IINTRODUCTIONChapter II National List of Essential Medicines 2008Chapter IIIAPPENDICESAppendix IRestricted Medicine List for Public Health CChanges of National List of Essential MediAppendix II The Decree of Ministry of Health Number 2SK/III/2008, 5 March 2008, regarding The Eof National Committee on Revision of TheJakarta, August 2008Director GeneralPharmaceutical Services and Medical DevicesDra. Kustantinah, Apt. MAppSc.NIP. 140 100 965Appendix IIIAppendix IVAppendix VAppendix VIList of Participants of Technical Meetings aSession of National List of Essential MedicStatement of ComplianceConflict of Interest StatementAssessment Form Application for Addition/Dof National List of Essential Medicines 200Indextial Medicines 2008iii

DECREE OF THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIAUMBER : 791/MENKES/SK/VIII/2008

THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIATHE DECREE OF THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIANUMBER : 791/MENKES/SK/VIII/2008REGARDINGTHE NATIONAL LIST OF ESSENTIAL MEDICINES 2008THE MINISTER OF HEALTH OF THE REPUBLIC OF INDONESIAa. in order to increase the quality of health services and to ensure the availability,equity, affordability of the essential medicines to the community at all levels, it istherefore, the National List of Essential Medicines should be revised;b. the National List of Essential Medicines which mentioned in the Decree of theMinister of Health No. 497/Menkes/SK/VII/2006 has to be revised according toprogress of medical sciences, health technology, disease pattern and the healthprogram respectively;c. Considering point (a) and (b), it is necessary to redetermine the National List ofEssential Medicines by the Ministerial Decree;1. Law No. 23 Year 1992 regarding Health (States Paper Year 1992 No. 100,Additional to States Paper No. 3495);2. Law No. 29 Year 2004 regarding Medical Practice (State Paper Year 2004 No. 116,Additional to State Paper of the Republic of Indonesia No. 4431);3. Law No. 32 Year 2004 regarding the Regional Government Administration (StatePaper Year 2004 No. 125, Additional to State Paper No. 4437) as lastly changedby Regulation No. 12 Year 2008 regarding the Second Changing on the RegulationNo. 32 Year 2004 regarding Regional Government (State Paper Year 2008 No. 59,Additional State Paper No. 4844);4. Government Regulation No. 32 Year 1996 regarding Health Human Resource/Health Personnel (State Paper Year 1996 No. 49, Additional to State Paper No.3637);5. Government Regulation No. 72 Year 1998 regarding the Security of thePharmaceutical Product and Medical Devices (State Paper Year 1998 No. 138,Additional to State Paper No. 3781);To Stipulate :THE MINISTER OF HEALTOF THE REPUBLIC OF INDONESI6. Government Regulation No. 38 YearAdministration of Central GovernmenGovernment in Municipality/District (StaState Paper NO. 4737);7. Presidential Regulation No. 9 Year 2Organizational Structure and duty ofIndonesia;8. Presidential Regulation No. 10 Year 200the First Rank Officers of the States Minis9. The Regulation of Ministry of Health NoCompulsory of Generic Products Prescri10. The Decree of the Minister of Hea1575/Menkes/Per/XI/2005 regarding OMinistry of Health as has been changed bNo. 1295/Menkes/Per/XII/2007;11. The Decree of the Minister of Health NoNational Medicines Policy;12. The Decree of the Minister of Health NoEstablishment of The National CommitEssential Medicines 2008.HAS DECIDEDThe First : THE DECREE OF THE MINISTER OF HOF ESSENTIAL MEDICINES 2008.The Second : The National List of Essential Medicinesattached in the Appendix hereto.The Third : The National List of Essential Medicinmedicines that satisfy the priority healtintended to be available within the contextial Medicines 2008iiiiv

THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIA: The implementation of NLEM is to increase the appropriateness, safety,rationalization of the medicine use and management and also increase theeffectiveness and efficiency of the available budget in order to expand, to distributeevenly and to increase the quality of health services for all community levels.: The implementation of NLEM should be consistent and continuously in every levelof Health Service Units.: With approval of this decree, therefore the Decree of Minister of Health No.497/Menkes/SK/VII/2006 regarding the National List of Essential Medicines 2005,hereby cancelled and believed not to be applicable any more.: This decree shall be effective as of the date of stipulation.Stipulated in JakartaOn Date : August 21, 2008.MINISTER OF HEALTH,IDr. dr. SITI FADILAH SUPARI, Sp.JP (K)tial Medicines 2008v

CHAPTER IINTRODUCTION

CHAPTER IINTRODUCTIONential Medicine in Indonesia was first introduced with the publication of The National Listines (NLEM) in 1980, followed by the National Medicines Policy document in 1983. Thesential Medicines, named DOEN (NLEM) is revised periodically every 3-4 years. DOENdition. The Government's commitment to do periodic revisions is a reputation of its own.e World Health Organization (WHO) has carried out the first phase of Good GovernanceM) program in Indonesia by conducting a survey on transparency of five pharmaceuticalthem is the selection process of essential medicines, which from the aspect ofthess is valued to be insufficient. From the meeting of the 30 WHO Essential Medicine List), it was reiterated that the importance of transparency of the selection process both byers who do revisions, revision process, and revision methods which have got to be moresed medicine (EBM), and the importance of the conflict of interest statement from expertf the above mentioned issues, this year's (2008) revision has been geared into itsse of it, the revision process this time is rather different from the earlier revision process,ovements are as follows:lection of expert panel members has been tightly scrutinized, including valuation againstt of interest.he beginning of discussion, program managers who use medicines in the environment ofistry of Health have been included, not only during the plenary meeting. This endeavor isto be a re-learning process to the internal of the Ministry of Health to fully understand thet of essential medicines.s the opinion and experiences of expert panel members in this revision team, theion of evidence based medicine (EBM) data are important considerations.tire discussion process gives great attention to medicines for children, including itsation. The WHO essential medicines list for children has been used as one of thenes. The siding with the individual rights of children is also shown by electing pediatriciansexpert panel that numbered to 4 (four) persons.n of the medicines list has been holistic and total, meaning weighing all medicines listedLEM 2005 including notes which may no longer be deemed fit. Earlier revisions werethe evaluation of medicines which are suggested to be added in the previous list.arency is also displayed with descriptions of arguments why a medicine must be deleteddded, or even be change of dosage form.ential Medicinesedicines are chosen medicines which are most needed to cater to the diagnoses,therapy, and rehabilitation, which are made available to the health service units ino its functions and tiers.1. Criteria of National Essential Medicinesa. Selection CriteriaSelection of essential medicines is based on these(1) Having got the most beneficial risk-benefit ra(2) Guaranteed of quality, including stability and(3) Practicality in storage and distribution.(4) Practical in use and delivery, which are adfacilities.(5) Advantageous in compliance and reception(6) Having got the highest benefit-cost ratio baspatient.(7) If there is more than one choice which hpreference is made for:- medicines with effects which are know- medicines with pharmacokinetic data- medicines with better stability;- easily obtainable;- medicines that are most familiar.(8) Fixed combination medicines have to follow- the compounded medicine is useful in- combination medicines have got to sindividual component;- ratio of the components of patent comfixed for a large number of patients wh- combination medicines have got to inc- combination antibiotics it must alsoresistance or other disadvantageous eb. Criteria of Additions and Deletions1. When addition of new medicines are considsame indications which may be obsolete sha strong reason to keep both of them.2. Medicines used in special program(s) arewill be assessed by general EM selection cr3. In the revision process, the entire medicineNational Revisions Committee. Deletion oeffective may here be decided upon or abetter medicine has been available.c. Guidance on Evidence and RecommendationProof of evidence and recommendations are adoPolicy and Research. The type of study should rethe list below, but the recommendation shouldavailable data. Testimonials are not considered fotial Medicines 200812

TATEMENTS OF EVIDENCEc. Hospital FormularyabData are obtained from meta-analysis of randomized, controlled clinical trials.Data are obtained from at least one randomized, controlled clinical trial.Data are obtained from at least one non-randomized and well designed clinical trial.Data are obtained from at least one quasi-experiment of another type of study that iswell designed.A Hospital Formulary is a list of medicines whicphysicians and their inherent (medicine) inforconcerned. A National Hospital Formulary is wCommittee based on NLEM and elaborated upoproven effective which are needed by specialtiesof a Hospital Formulary has to be based on therapHospital Formulary must be monitored and its rerevision so as to keep up with advancements of scIData are obtained from descriptive study that is well designed, like comparative study,correlation study, and case study.Data are obtained from reports or opinion of expert panels.ation of Concept of Essential Medicinesial medicines are the most basic medicines which are needed to cater for health services.r than listed NLEM medicines are needed, a (Hospital) Formulary or another limitede list may be instituted.EM may also be expanded into other documents as the needs arise.ational List of Essential Medicines (NLEM)ational List of Essential Medicines consists of selected, most needed medicines andade to be available at health services units in accordance with its functionality and itsvels. NLEM are a national minimum standard to health services.plementation of NLEM is meant to increase the efficacy, safety, rational use, andedicine management which altogether increase efficiency of available cost, which in turnxtends coverage and increase average quality of medicine prescriptions. Application ofis National Essential Medicines Policy must be done consistently, and continuously at allvels of health services units.edicine dosage-form and strength, such as tablets, syrups, injections, and other forms,nit strength, dose, and size of package indicated in the NLEM are binding, in order toreate standards. Sizes of packaging for each health service unit are based on logisticsfficiency while distribution is related with common usage.herapeutic Guidelinesherapeutic Guidelines should be systematically structured to help physicians to make aorrect diagnosis and optimal medication for a certain kind of disease. Guidelines ofedication should be suited for every level of health services units, such as guidelines inasic medication at Public Health Center and guidelines in diagnosis and therapy at localospitals.herapeutic Guidelines consist of information about all kinds of diseases, especiallyicknesses which are occurring frequently - with their respective complaints - andformation about dosage form, unit strength, dose of medicines and length of time ofedication.d. Specialists' FormularySpecialists' Formularies are books which arinformation on medicines needed by certain speccare with special disease indications.Specialists' Formularies are written to increase ctheir hospital formulary, that has been ranked vemay have many sub-specializations, for examplea specialization that has got many sub-specializacan be made for Obstetrics and Gynecology. Tinvolve specialist professional association winvolvement and active participation of specialistare part of the association, so that rational medicine. Indonesian National Medicine InformationNational medicine information consists of medipresented briefly, are relevant to physicians' needworkers. The National Indonesian Medicine InfHealth to guarantee objectivity, completenesmedicines that are covers indications, side-efimportant information which are most important fwas based on more scientific data, related to bene3. Management and Medicine UseTo improve rational medicine use, the use of essentialfollow treatment guidelines and proper medicine managEffective medicine management is required to guarantand quantities while fulfilling quality standards. Importaas follows:- Limitation of numbers and kinds of medicines basgeneric names, with a correct selection process;- Bulk purchasing should be applied;- Competitive, transparent purchases;- Audit system and reporting from management reptial Medicines 200834

tion of Government Regulation Number 38 year 2007 on the coordination of theance between the Central Government and the Provincial Government and other regionalments in order to synchronize its health management in the country. So, as with medicineement organizations, each city has got organizational structures and their own medicineement policies. This would open up basic differences in each city in carrying out medicineement.cle of medicine distribution is started at the time a medicine is delivered from the factory ortor, and it ends at the time medicine consumption reports are handed in to the logisticsfective medicine distribution should have a system design and sound management suchstant medicine supply, taking care of the quality of medicines at the time of distributions, minimizing medicines which are unused because of spoilage or being expired, withplanning in accordance with each province's medicine needs, use of inventory recordsare accurate, rationalization of medicine depots, and supply of information to estimatee needs.ecentralization in place it is hoped that state government or city or provinces canntly supply respective individual medicine needs. The central government, in this matter,istry of Health only lends back-up support when city or province cannot fully supply thee needs. The NLEM is a base for planning and supply or logistics of medicines in locality/province) and central government.ement and use of specialists' medicines for certain situations, the government c.q.rate General of Pharmaceutical Services and Medical Devices, Ministry of Health canthese through special channels (special access scheme) in accordance with The Decreeter of Health Number: 1379.A/Menkes/SK/XI/2002.unication, Information and Education (CIE)essential medicines are a pre-requisite to improve the use of medicines and rationalbing by health providers. CIE for health providers and the public in general to increasel use of medicines and be maintained continuously should use the following links:overnmental organizations/private institutions.elated professional organization.urriculum of education for health providers.ther possible channels.isted medicine in NLEM must be accompanied by accurate information that is objectivederstandable by health providers. This information covers indication, contraindication,ow to use, caution remarks, side-effects, medicine interaction, and dosage forms oftions.rch and Developmentch and development should be done to support the selection process and improvement ofEM. Research and development are done in line with medical science and technology injects of medicine, pharmacy, epidemiology, and education. The outcome or result ofh and development are utilized as inputs in the revision process and improvement ofperiodically.6. Monitoring and EvaluationMonitoring and evaluation are done to support the sthrough mechanism and output evaluation of potentisolutions. This can be achieved through co-ordination,application of the NLEM by the Ministry of Health. Monfitting to functions and levels.7. NLEM RevisionsNLEM has to be revised and perfected periodically. Revadvancement of knowledge, but also for practical reashealth providers and the health service facilities.Perfection of NLEM is done continuously with input of shealth research, whether governmental or private, cPharmaceutical Services and Medical Devices, Ministrrevisions are done periodically every 3 (three) years.8. Quality ControlTotal medicine quality control covers the phases of prpractices, monitoring of medicine quality in the distribelements in applying the essential medicines concept.9. Antibiotics ResistanceAntibiotic resistance will increase, especially with frelatively inexpensive. This condition is dangerous,sensitive antibiotics that are potential in fighting infectiorecurring. The reason is because of irrational use of apatients.In overcoming the problem of antibiotic resistance it takea. Conducting surveillance of microbe resistance sobtained.b. Surveillance of antibiotic useSurveillance of antibiotic use is done by researchcenters, province or district health offices andinstitutions.c. Containing antibiotic use by health providers bgradually, fitting to the conditions of patients aantibiotics from the start, and reserving other anuse.d. To provide communication, information and educwhether they be health workers, patients or tantibiotics rationally and the danger, caused by irrtial Medicines 200856

d Medicinesns in the form of money or medicines from another country, private organizations, or othertional bodies can support the public health services in a country that needs it. In itson, medicines donation must fulfill the requirements as described in WHO Guidelines fores Donations 1999. Health services being used must fulfill a certain existing applicablees/standards. This guideline covers general principles about selection of medicines,of medicines, shelf life, packaging and labeling, information and management.ain principles of donated medicines are:onated medicines must provide maximum usefulness to recipient country.nderstand the needs and respecting the authority of recipient country.oes not use double standards for the quality of donated medicines.ffective communication between donor country and recipient country.d medicines are best received when they are in accordance with NLEM. In order fores supply and health logistics can help the operations of health workers, the types ofes and health logistics must coincide with the disease patterns in Indonesia.dicines which are not marketed in Indonesia acceptance must follow a special channell access scheme), in accordance with the existing applicable rule.sts and Format of NLEMhe National Essential Medicine list is used as the basis for all units of (governmental)ealth services.ne type if medicines can be used in several forms of preparations and one form ofreparation can consist of a few dosage forms.the NLEM, medicines are categorized according to class, subclass and sometimes sububclasstherapy, which are in alphabetical order.clatureedicine names are written according to the last edition of Indonesian Pharmacopoeia. If itoes not appear in the Indonesian Pharmacopoeia then generic names are used.edicines which are commonly used and do not have an INN (International NonroprietaryName) are written with common names, for example 'oral rehydration salt'.ombination medicines which do not have a generic name are given agreed names whichre generic names for combinations and each is written with the effective ingredients,llowed with dosage of each component.or some items which need a synonym are written within brackets.atory Noteseywords) Dosage FormsDosage forms or preparations are forms of medicines according to the productionprocess in the form of usage, for example: capsule, enteric coated tablet, intravenousinjection etc.7tial Medicines 20088(2) Dosage strengthStrength of preparation is the content or permade preparations. For dosage strength inare written down within brackets, for(hydrochloride). As for dosages of effective(which are written within brackets) would bchloroquine tablet 150 mg (as phosphate).(3) PackagingPackaging is the smallest container that con(4) Package Sizeb. Other NotesPackage Size is the total number of preparastandard packaging, for example 100 vials.(1) Information in restricted columns are meanotes:(a) Monitoring of side-effects.(b) Limitation of indications.(c) Only for certain cases.(d) Tight screening is required or medical(e) Nature or medicine mechanism of acti(f) Special treatment required.(g) Special facilities needed.(h) Combination with other medicine need(i) Required for certain areas, like endem(j) Uses in accordance with existing heal(2) Writing of technical terms or foreign languag(3) National Medicines Lists are medicine lists t(4) NLEM for Public Health Center (primary heac. Abbreviationscap : capsulecapl : capletg : grami.a. injection/inj : intraartherial injectionsi.c. injection/inj : intracutaneous injectioninfiltr injection/inj : infiltrated injectioninfusion sol : infusion solutioninj : injectioni.m. injection/inj : intramuscular injectioni.t. injection/inj : intrathecal injectionIU : international uniti.v. injection/inj : intravenous injectionliq : liquidmcg : microgrammg : miligram

.v. injection/inj : paravertebral injectionctal sol : rectal solution.c. injection/inj : subcutaneous injectionacch : sacchets/bags/pouchesol : solutionupp : suppositoryb : tabletFI : water for injectionevision Processwere not conducted only limited to incoming requests, but revaluating the whole NLEM ofas done because the list was only updated during previous years and some old medicinesobsolete or new and better medicines have become available. Also some uses of olderve been renewed and some have made other restrictions.and consultants work together in the discussion that is divided into several groups basedtic class. Consultants are responsible for EBM data in accordance with his/herBesides information from consultants and expert team, the secretariat supported fullythers, information from Cochrane review and WHO Library. From this process, althoughtion is not always totally accepted, but discussions are no longer based on level-4xpert team opinion only.g the concept of essential medicines has to be re-socialized. Seemingly, theg of the essential medicines is withering and explanation about this concept is'Essential Medicine is a floor not a ceiling' (WHO TRS 946), it is a minimum for health care.essential when you can't do without it. The difference of essential medicines and programll result in the availability of a specific medicine. This problem is overcome by socializationolicies by the Ministry of Health relating to essential medicines and program medicines.n process, from the start it has been planned to give attention to medicines for children.not only meant for harmony with the global policy, but Indonesia is consistently aiming atortality of babies and children, so that it needs this emphasis. The involvement of four, give sufficient contributions for this problem. Also the involvement of the Directorate ofand other directorates are very intensive. The addition of medicines for children withespecially for children, like carbamazepine, is provided in the form of syrup.scussion of the Plenary Meeting it has been agreed that 78 medicines has been deleted2005 and 48 were added to the new list of 2008. Changes in formulations (forms of, dosages, packaging) was agreed for 21 medicines. It was found that 33 medicines wereotes as important to be provided or supplied by the government through ways fitting withpplicable policies. The total number of medicines in the NLEM 2008 is 323 medicine items.on Processn processes started by sending letters to government health services institutions (hospital, B, C, public health center) as well as several chosen private parties, special programs inistry of Health and professional organizations. Three months later, from 114 installationsm letters were sent to, 25 had responded. From those responses three had ”notion”, 22 were responding with “request for additions to the list”, and there was no oneding to delete medicines from the old list. Although in the letter sent, it has been informedgestion has got to come together with supporting data and functions, only 10 installationsending supporting data. Besides suggestions from the installations, the expert team andants, may give suggestions with supportive data.This process is a yardstick in carrying out the assessprocess and accountability in the future. The process coof recruitment of expert team members, tasks and obligprocesses, holding discussion meetings and socializati2. Committee Membersa. Organization(1) Organizational structure is a National Comm(a) Expert team(b) Consultants(c) Program manager and(d) Operational Secretariat(2) Membership of National Committee lasts unNLEM revision meeting. The Committee isDecree wherein its duties are stated.(3) Names of expert team members and selectonly differentiated into MDs, general practiti(4) Not all therapeutic classes need to be repreCommittee.(5) If an expert in a special field is needed, he/person to give an expert opinion in the revisof the expert team and also do not take part(6) Duties of expert team members and consult(a) Expert Team members are evaluatingevaluate suggested medicines whichnew list.(b) Consultants are joining the discussiinputs which may be needed to be usexpert team members.(c) Expert team members and consujustification to Ministry of HealthServices and Medical Devices to accassisting the Directorate of Rational M(7) Program manager is a representative of aowns special therapeutic programs and ma(8) The Operational Secretariat are DirectoratGeneral of Pharmaceutical Services and Mespecialization, clinical pharmphysicians/health service units (publicmust not represent professional assjobs which are potential in creating cob. The selection process of Expert Team and Consul(1) Pre-requisites of Expert Team and Consulta(a) Have integrity and a high professional(b) Expert team members and consulta(c) In order to get professional expert teatial Medicines 2008910

(d)(e)Signing a letter of consent, acceptance and availability.Willing to sign a conflict of interest statement. But somebody who has a conflictof interest can still be considered to become a member of the expert team, ifintegrity can be maintained. He/she may then not participate in a votingprocess.) Recruitment processes of Expert Team and Consultants:(a) The Secretariat sends a form of written availability and willingness,accompanied by his/her superior permission, 1 (one) month prior to thecommencement of the Meeting.(b) He or she must submit the filled-in form 1 (one) week after receiving, togetherwith a conflict of interest statement.(c) An acceptance and statement of willingness letter consists of:Explanation of job description of expert team.Schedule of material of discussion which have to be attended.on Methodsubmission of medicinesevision processes is started by sending submission forms to several health service unitsUniversity Hospitals, Special Hospitals, chosen State Hospitals, Provincial Hospitals,ilitary/Police Hospitals, chosen Private Hospitals, Regional Hospitals, Public Healthenter with beds). Provincial Health Units representative, public health center, androgram managers (in the directorate of Ministry of Health). Submission Request Formsre sent 3 (three) months before the first Meeting.ompilation of Submissionsompiled submissions are categorized or grouped in therapeutic classes.aterial of Revisionsaterial of Revisions are put in a matrix, which is put side by side with the WHO List 2007nd the latest NLEM 2005 edition. It is followed with the submitted medicines. Revisedaterials will be handed to expert team members 1 (one) week before technical discussioneeting.iscussion Criteriaubmissions to be discussed are suggestions which come with arguments andccompanied with scientific evidence.ethods of Revision Materials1) Revision can be the whole assessment or one of the following processes:(a) Only assessment of submission requests. Deleting or accepting submissions.(b) Taking into account the whole NLEM and incoming requests. Deleting andadding essential medicines whether from requests or from expert teammember's and consultants' opinion.2) Types of discussions meeting:(a) Preliminary Meeting consists of• Information about the understanding of essential medicines (definitions,criteria, (approximate) number of essential medicines in NLEM etc).(b)(c)• Implementation of NLEM (in refor procurement of PKD Medicin• NLEM Revision Procedure.• Procedure in technical discussand plenary meetings.• Attendance: expert team, conssecretariat.Technical discussion meetings• Discussion meetings of the prosubmission.• Discussion on benefit-risk of addwhich are on the old list.• Putting in focus those medicinincluded in the WHO list. These• Suggestion to put food supplem• If the Expert Team fails to makeperson outside the expert team m• Attendance for the meeting are:o Expert teamo Consultantso Related program manageo Related resource persons• Result of technical discussion mPlenary Meeting• Aims at making agreements, fothe NLEM.• Meeting Chairman is the head o• Formalization of NLEM draftDirectorate of Pharmaceuticalsomeone who is appointed by th• When the result of plenary mealtered, except editorial revision• Plenary meeting members shoumaking process and are alsodeploy the new NLEM.• Plenary meeting attendees are:o Those who attended thdiscussions;o Medical Committees oHospitals, chosen Privateschools who submitted suo Attendees from Faculty ofo Attendees from Faculty ofo Attendees from School ofo Provincial Health Office suo Professional organizatioassociations);o Pharmaceutical IndusWholesalers Association)tial Medicines 20081112

ation of changes madee changes made in NLEM 2008 whether generic names or their formulations, based onutic classes are as follows:nalgesics, Antipyretics, Non-steroidal Anti-inflammatory Medicines, Medicinessed to treat gout.1 Opioid AnalgesicsSufentanyl in the form of citrate 50 mcg/ml, was taken out from the list, because ofpoor availability in the market..2 Non-opioid AnalgesicsMethampyron i.m. inj. 250 mg/ml was taken out from the list for safety reason, wherein the form of injection may cause anaphylactic shock. Suggestion to add ketoprofensupp 100 mg and paracetamol supp 120 mg and 240 mg were accepted, recallingthat ketoprofen supp is used for post-surgical patients who cannot yet receive oralmedicine forms, while it is non-irritant to the stomach. While paracetamol supp isneeded to prevent febrile convulsion cases, post-surgery in children, in line withpediatric procedures. Availability and procurement of paracetamol supp, are limitedto district level hospitals..3 Anti-goutColchicine tablets 500 mcg has been listed in NLEMs from the start. But with theavailability of many NSAIDs, its efficacy is valued not much different from otherNSAID medicines, while their safety is lower than colchicine. Thus colchicine wastaken out from the list. The WHO Model List 2007 did not contain colchicines either.nesthetics.1 Local AnestheticsLidocaine inj 5% + glucose 7.5% 2 ml amp was suggested to be added, especially forspinal anesthesia, in areas where bupivacaine are difficult to get. Besides, toxiceffects against the heart is smaller. Lidocaine inj 1% (HCl) + epinefrin 1 : 200,000 inpackaging of 20 and 30 ml were deleted from the list, because the packaging is seento be too large, so it would cause spoilage if not finished..2 General Anesthetics and OxygenSuggested liquid isoflurane liq 3 - 3.5 % 250 ml are accepted, because of advantagesto the heart and are used for patients with specific certain conditions. Midazolam inji.v. 1 mcg/ml and i.v. inj 5 mg/ml are choice medicine for patients with fragile vitalsigns, as sedative, hypnotic, and pre-anaesthetics. While liquid enflurane ih btl 250ml was taken out of the list with the reason being less advantageous if compared withisoflurane and halothane. While Thiopental i.v. powder inj 1000 mg/ml was taken outfrom the list because of safety consideration.ileptic-Anticonvulsantstion of addition in the dosage form of syrup and chewable tablet for pediatric patients areed. So, in this class were listed: fenitoin syrup 50 mcg/5 ml, carbamazepin 100 mg/ml20 ml, chewable tablets 100 mg. Phenobarbital tab 50 mg was added, because it was stille and cheap.6. Anti-infectiveIn several previous revisions of NLEMs, cephalosporinbut only this time the National Committee, gave way to csurgery prophylaxis inj 1 g/vial. Cephazolin is a choprevent surgical wounds infection. The same thing hachosen medicine for meningitis and is used forchloramphenicol and cyprofloxacin. The delay of entry oby the fast growing anti-infective resistance in hospitalsExpert team agreed to accept the inclusion of vanco(methicillin resistant S. aureus) infection, a serious nasvial 50 mg was requested and accepted for inclusion, bmainly for pulmonary fungal infection. In the list it wasexpertise in its use”.For anti-amoebic diloxanide furoate tab 500 mg watreatment of cysts that does not show physical symptoi.v. inj 60 mg/ml was added, that was valued to be havininj although from the side of usage artemether is morehealth service units).In the antiviral protease inhibitor group lopinavir werHIV/AIDS, although their prices are higher. In anti-tubemedicines are provided, listed were some combinationin the case of dosage forms, it was left to program ne(fixed dose combination), or combipack. Single prepaservices which are not yet able to carry out direct oprogram.8. Antineoplastic, Immunosuppressive and MedicinesChlormetin and levamisol were taken out of the list,anticancer medicines, because of their efficacy and sainj was suggested and accepted by expert team, as weltablet 2 mg. Daunorubicin is a main medication in Acutefound in children. Chlorambucil is low priced, registerethe WHO Model List. Melfalan is a cheap medicine anmyeloma.14. Dental Medication and Oral HealthFrom this therapeutic class many are evaluated as obstaught by Dental Schools, for example sulpha cones psome which are causing environmental damage, likeagreed upon that composite be used.17. Cardiovascular MedicinesIn this therapeutic category a few changes in subclasbecause they are no longer in production and areprocainamide, reserpine and quinidine. In the subclassand digoxin. In the antihypertension class sodium nitrspecific efficacy in surgery needing hypotension techniqtial Medicines 20081314

tological Medicinesedicines were deleted because of obsolescence, for example gentian violet, liver oilnt. These liquids like lotio kummerfeldi, if needed, can be entered into a hospital formulary.dditions which are accepted are permethrine as an antiscabicide that is less toxic ton, in place of Gamexan. Other addition is Liquor Veilli (diluted salicylic acid), a simplee medicine for wet dermatitis.lytes and Nutrientshydration salt in 1000 ml sacchets are deleted from the list, because the packaging is toonefficient to store and it does not maintain freshness for long time. Only 200 ml sachets arele.ase of parenteral nutrition liquid namely liquid nutrients i.v. all of them were deleted from. The National Committee, especially expert team and consultants, are well aware of thence of this preparation, but compositions which are available in the market vary and wereny, with uses which may be different.ldren use and neonates in this therapeutic class liquid nutrients were added: glucose 4% +.18% infusion, and sodium bicarbonate inj 1.4% isotonic.otherapeutic Medicineslam was deleted because valued to be non-essential and tend to cause overuse andence. In subclass therapy antidepression and antimania it was suggested addition ofine, sertraline and paroxetine. Fluoxetine cap/tab10 mg and cap/tab 20 mg were acceptedice medicines for category SSRI.antipsychotic subclass racemic methylphenidat addition was suggested in the form ofrelease and extended release to be used for Attention Deficit Hyperactive Disorder). Although evidence has not fully supported, but all these times it has been a choicene for ADHD. Addition of chlozapine was accepted because it is a selected medicine foresistant antipsychotic medicines. This medicine is effective but it is necessary to watch forlocytosis side effect. Periodic leucocytes counts must be taken.atment, Nose, and Throatnt changes took place in looking at ear treatment, nose and throat. Experts consideredatment of ear infection does not need to use antibiotics or corticosteroids. Other than thattic preparations in the form of nose or ear drops are not listed in the WHO Model List.of NLEM 2008sential medicines concept, NLEM 2008 must be spread to health service facilities in thesia. Socialization can be in the form of printed books which are delivered to all healthnd publicized in electronic form.tial Medicines 200815

CHAPTER IIIONAL LIST OF ESSENTIAL MEDICINES2008

CHAPTER IIAL LIST OF ESSENTIAL MEDICINES2008EUTICNERICINN)ALGESICSDOSAGE FORMtablet 10 mg,bottle 250 tabletsi.m./i.v. injection 0.05 mg/ml(citrate),box 5 ampoules @ 2 mli.m./s.c./i.v. injection 10mg/ml (HCl/sulfate),box 10 ampoules @ 1 mltablet 10 mg (HCl/sulfate),bottle 30 tabletsi.m./s.c./slowreleased i.v. injection 50 mg/ml(HCl),box 10 ampoules @ 2 mlinjection 5 mcg/ml (citrate),box 5 vials @ 10 mlRESTRICTIONS, ANTIPYRETICS, NON-STEROIDAL ANTI-INFLAMMATORY MEDICINES,USED TO TREAT GOUTAuthority required :AnesthetistTHERAPEUTICCLASS, GENERICNAME (INN)methampyroneparacetamolphenylbutazonesodium diclofenac1.3. MEDICINES USED TO TREAT GOUTallopurinolDOSAGE FORMtablet 500 mg,bottle 1000 tabletstablet 100 mg,bottle 1000 tabletstablet 500 mg,bottle 1000 tabletssyrup 120 mg/5 ml,bottlesuppositoria 120 mgsuppositoria 240 mgcoated tablet 200 mg,bottle 100/1000 tabletstablet 25 mg, box 10 strip@ 10 tabletstablet 50 mg, box 10 strip@ 10 tabletstablet 100 mg, bottle100/1000 tabletsprobenecid tablet 500 mg, bottle 100tabletsD ANALGESICSid (acetosal)tablet 100 mg, box 10 blisters@10 tabletstablet 500 mg, box 10 blisters@10 tabletstablet 200 mg,bottle 100 tabletstablet 400 mg,bottle 100 tabletssuppositoria 100 mg Restricted use :Post operative patients2. ANESTHETICS2.1 LOCAL ANESTHETICSbupivacaineethyl chloridep.v. injection 0.50% (HCl)box 5 vials @ 20 mlinjection 0.5% (HCl)+glukosa 7.5%, box 5ampoules @ 4 mlspray, bottle 100 mltial Medicines 20081718

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMeinfiltr injection 1% (HCl),box 100 amps @ 2 mlinfiltr injection 1% (HCl),box 100 amps @ 2 mlp.v. injection 2% (HCl),box 100 ampoules @ 2mlgel 2%, tube 10 gspray 4%, bottle 50 mlinjection 5% + glukosa 7.5 %,ampoule 2 mlAL ANESTHETICS and OXYGENinhalation liquid,bottle 50/250 mlinhalation liquid,bottle 250 mli.v. injection 10 mg/ml (asHCl), box 10 vial @ 20 mli.v. injection 50 mg/ml (asHCl), box 10 vial @ 20 mli.v. injection 1 mg/mli.v. injection 5 mg/mlinhalation, gas in tubeinhalation, gas in tubeinjection 10%,box 5 ampoules @ 20 mli.v. powder for injection 500mg/ampoule (as sodiumsalt) (for dissolved in 20 mlWFI), box 25 ampoulesRestricted use :Only for spinalanesthesiaCINES USED FOR PREOPERATIVE MEDICATION PROCEDURESinjection 1 mg/ml (sulfate),box 50 ampoules @ 1 mldiazepamepinephrine (adrenaline) s.c./i.m. injection 0,1%(HCl/bitartrate),box 100 ampoules @4. ANTIDOTES and OTHER SUBSTANCES USED IN POI4.1 SPECIFICatropinecalcium folinate (leucovorin, Ca)tablet 5 mg,bottle 1000 tabletinjection 5 mg/ml,box 100 ampoules @morphine i.m./s.c./i.v. injection 10mg/ml (HCl/sulfate),box 10 ampoules @ 13 ANTIALLERGICS and MEDICINES USED IN ANAchlorpheniraminedexamethasonetablet 4 mg ( maleate),bottle1000 tabletsinjection 5 mg/ml (maleabox 100 ampoules @injection 5 mg/ml (as sodphosphate), box 100ampoules @ 1 mldiphenhydramine i.m. injection 10 mg/ml (Hbox 100 ampoules @i.m./i.v./s.c injection 1 mg(sulfate),box 10 ampoules @ 2tablet 1 mg, bottle 100 tatablet 15 mg, bottle 10 tainjection 3 mg/ml,box 10 ampoules @ 1tial Medicines 20081920

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMtechlorideue)atetIFICteactivated powder, sacch 0.5 kgs.c. injection 5 mg/ml (HCl),box 10 ampoules @ 1 mlpowder, sacch 30 gICS ANTI CONVULSANTSinjection 100 mg/ml,box 24 ampoules @ 10 mlpowder for injection 500mg/ml (mesilate),box 10 vials @ 10 mlinjection i.v. 10 mg/ml (asdihydrate),box 10 ampoules @ 10 mlinjection 0.02 mg/ml (HCl),box 10 ampoules @ 2 mlinjection 0.4 mg/ml (HCl),box 5 ampoules @ 2 mli.m. injection 10 mg/ml,box 10 vials @ 5 mltablet 500 mg,bottle 1000 tabletsi.v. injection 25%,box 10 ampoules @10 mltablet 200 mg,bottle 100/1000 tabletschewable tablet 100 mgsyrup 100 mg/5 ml,bottle 120 mlphenobarbitalphenytoinvalproate6. ANTI-INFECTIVE MEDICINES6.1 ANTHELMINTHICS6.1.1 Intestinal Anthelminthicsalbendazoletablet 30 mg,bottle 1000 tabletstablet 50 mg,bottle 1000 tabletstablet 100 mg,bottle 1000 tabletsi.m injection 50 mg/ml,box 100 ampoules @i.v.injection 50 mg/ml (assodium salt),box 100 ampoules @capsule 30 mg (as sodiumsalt), bottle 250 capsucapsule 100 mg (as sodiusalt), bottle 250 capsuinjection 50 mg/ml (as sosalt),box 10 ampoules @ 2syrup 50 mg/5 ml,bottle 1tablet 250 mg (as sodiumsalt), bottle 50 tabletstablet 500 mg (as sodiumsalt), bottle 50 tabletssyrup 250 mg/5 ml (as sosalt), bottle 120 mltablet 400 mg,box 5 stripes @ 6 tabletstial Medicines 2008i.m./i.v. injection 5 mg/ml,box 100 ampoule @ 2 mlrectal sol 4 mg/ml, tube 2.5 mlte i.v. injection 20%,ampoule 25 mli.v. injection 40%,ampoule 25 ml21mebendazolepraziquantel22tablet 100 mg,bottle 100 tabletssyrup 100 mg/5 ml,bottlescored tablet 300 mg,bottle 100/1000 tablets

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMlsinetosomalsRIALSam medicinesrateylpenicillinrystalscored tablet 250 mg (pamoate),bottle 250 tabletssuspension 125 mg/5 ml(pamoate), bottle 30 mlscored tablet 100 mg (citrate),bottle 1000 tabletstablet 600 mg,bottle 100 tabletsscored tablet 500 mg,box 10 stripes @ 10 tabletsdry syrup 125 mg/5 ml,bottle 60 mli.m./i.v. powder forinjection 250 mg/vial (assodium salt), box 10 vialsi.m./i.v. powder forinjection 500 mg/vial (assodium salt), box 10 vialsi.m. injection 1.2 millionsIU/ml, box 25 vials @ 4 mli.m. injection 2.4 millionsIU/ml, box 25 vials @ 10 mli.m./i.v. injection 10 millionsIU/vial, box 25 vialspowder for injection1 g / vial, box 2 vialspowder injection1 g / vial, box 2 vialsNote :For endemic areaRestricted use :-Only for Central Sulawesi-Only for South Kalimantan,for Fasciolopsis buski treatmentNote :Prophylactics, to preventoperation wound infectiondicloxacillinphenoxymethylpenicillin(penicillin V)procaine benzylpenicillin6.2.2 Other antibacterials6.2.2.1 Tetracyclinedoxycyclineoxytetracyclinetetracyclinecapsule 250 mg (as sodiubox 25 stripes @ 4 cascored tablet 500 mg(as sodium salt)syrup 62.5 mg/5 ml(as sodium salt), bottlei.m./i.v.powder for injectio500 mg/vial (as sodium(soluble in 5 ml WFI),box 20 vialstablet 500 mg (as potassibottle 1000 tabletstablet 250 mg (as potassibox 10 stripes @ 10 tadry syrup 250 mg/5 ml(as potassium salt),bottle 60 mli.m. powder for injection3 millions IU/vial, boxi.m. powder for injection1 million IU/vial, box 1capsule 100 mg(hyclate/box 10 stripes @ 10 ci.v. injection 250 mg/3 mlbox 10 ampoules @ 3i.v. injection 50 mg/ml (Hbox 10 vials @ 10 mlcapsule 250 mg (HCl),bottle 1000 capsulesbox 10 capsule 500 mg (stripes @ 10 capsules23tial Medicines 200824

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMphenicolcapsule 250 mg,bottle 1000 capsulessuspension 125/5 ml(as palmitate),bottle 60 mli.v. powder for injection100 mg/ml(as succinate sodium),box 10 vials @ 10 ml6.2.2.5 Aminoglycosidesgentamicin6.2.2.6 Quinolonesciprofloxacininjection 10 mg/ml (assulfate) @ 2 mlinjection 40 mg/ml (assulfate),box 10 ampoules @ 2scored tablet 500 mg (asbox 10 blister @ 10 taimethoprimzole I (adult)400 mg80 mgtablet, box 10 stripes@ 10 tabletsvancomycin6.2.2.7 Specific Usepowder injection 500 mgbox 1 vialzole IIination of :100 mg20 mgzole IIIe 80 mg/ml16 mg/mltablet, bottle 100 tabletsi.v. injection, box 5 ampoules@ 5 ml,box 5 vials @10 mltablet 500 mg,bottle100 tabletsNote :Minimized usemetronidazolesulfasalazinetablet 250 mg,bottle 100/1000 tabstablet 500 mg,bottle 100/1000 tabssuppositoria 500 mg,box 6 suppositoriainfusion solution 5 mg/mbottle 100 mltablet 500 mg,bottle 500 tabletsdesscored tablet 200 mg,bottle 100 tabletsinjection 150 mg/ml (asphosphate), box 100ampoules @ 2 mlcapsule 250 mg (asstearate),bottle 100 capsulessyrup 200 mg/5 ml (as ethylsuccinate), bottle 60 mlNote :Benefit for bone infections6.3 SPECIFIC ANTI-INFECTIVE MEDICINES6.3.1 Antileprosy medicinesclofazimine, micronizeddapsoneoily capsule 100 mg,bottle 100 capsulesscored tablet 100 mg,bottle 1000 tabletsrifampicin capsule 300 mg, box 10stripes @ 10 capsulestial Medicines 20082526

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMrculosis medicinestablet 250 mg (HCl),bottle 100 tabletstablet 500 mg (HCl),bottle 100 tabletstablet 100 mg,bottle 1000 tabletstablet 300 mg,bottle 1000 tabletstablet 500 mg,bottle 100 tabletsscored tablet 300 mg,box 10 stripes @10 tabletstablet 450 mg,box 10 stripes @10 tabletstablet 600 mg,box 10 stripes @10 tabletspowder for injection 1000mg/vial (as sulfate),box 100 vialscaplet 150 mg; 75 mgtablet 150 mg; 50 mgcaplet 150 mgtablet 150 mgtablet 400 mgRestricted use :Only for tuberculosisand leprosyNote :Dosage form and usageaccording to NationalTuberculosis ProgramNote :Dosage form and usageaccording to NationalTuberculosis Program.combination of :rifampicinisoniazidpyrazinamideethambutol6.3.3 Urinary AntisepticsNLEM co-trimoxazole I (adult)combination of :sulfamethoxazole 400 mgtrimethoprim 80 mgmethenamine mandelate(hexamine mandelate)nitrofurantoinetrimethoprim6.4 ANTIFUNGAL MEDICINES6.4.1 Systemicamphotericin *)griseofulvin, micronizedcaplet 150 mg; 450 mgtablet 75 mg; 300 mgtablet 400 mg; 500 mgtablet 275 mg; 250 mg;500 mgtablet, box 10 stripes@ 10 tabletsenteric coated tablet 500bottle 100/1000 tabletscored tablet 100 mg,bottle 100 tabletsscored tablet 200 mg,bottle 100 tabletsi.v injection vial 50 mg/10vials @ 10 mlscored tablet 250 mg,bottle 100 tabletsketoconazole tablet 200 mg, bottle 100tabletcapl 150 mg; 75 mg; 450 mgtablet 75 mg; 50 mg; 300 mgtablet 400 mg; 150 mg;500mgNote :Dosage form and usageaccording to NationalTuberculosis Program Complementary listtial Medicines 20082728

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMal medicinesof:6%3%teOZOAL MEDICINESrial medicinesphylaxisrative treatmentrial medicinesof :ne 25 mg500 mgcoated tablet 500,000 IU/tablet,bottle 100/1000 tabletssuspension 100,000 IU/ml,bottle 12 mlointment, pot 30 gpowder, 2% (nitrate),sacch 20 gcream, 2% (nitrate), tube 10gvaginal tablet 100,000IU/tablet,box 10 stripes @10 tabletsliquid 25%, bottle 30 mlebic and antigiardiasis medicinestablet 500 mg (furoate)tablet 250 mg,bottle 100 tabletstablet 500 mg,bottle 100 tabletstablet 150 mg (as phosphate),bottle 1000 tabletstablet, bottle 500 tablets Restricted use :For specific area whichalready resistent tochloroquine (decided byDistrict Health Offices)artemetherartesunatecombination of :artesunate 50 mgamodiaquin 200 mgchloroquineprimaquinequinine6.6 ANTIVIRAL MEDICINES6.6.1 Antiherpes medicinesacyclovir6.6.2. Antiretroviralsinjection 80 mg/ml,box 6 ampoules @ 1i.v./i.m. injection 60 mgbox 8 vials @ 1 mltablet, box 2 blisters @tablets (combipack)box 3 blisters @ 8 tabltablet 150 mg (as phosbottle 1000 tabletssyrup 50 mg/5ml, bottltablet 15 mg (as phospbottle 1000 tabletstablet 222 mg (bisulfatebottle 1000 tabletsi.v. injection 25% (as Hbox 100 ampoules @scored tablet 200 mgscored tablet 400 mg6.6.2.1. Nucleoside reverse transcriptase inhibitorlamivudine (3TC)tablet 150 mgstavudine tablet 30 mg, bottle 60tablet 40 mg, bottle 60zidovudinetablet 300 mg,bottle 60 tabletstablet 100 mg,bottle 100 tabletssyrup 50 mg/5 ml, bottli.v. infusion solution 20mg/10 mltial Medicines 20082930

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMucleoside reverse transcriptase inhibitors (NNRTI)tablet 200 mg,bottle 90 tabletstablet 600 mg,bottle 30 tabletsse inhibitorsNE MEDICINESYLAXISetial Medicines 2008tablet 200 mg,box 6 blisters @ 10 tabletstabletMENT OF ACUTE ATTACK1 mg50 mgtablet 2.5 mg (as mesilate),box 10 stripes @ 10tabletsscored tablet 40 mg (HCl)bottle 100 tabletstablet 1 mg (tartrate),bottle 100 tabletstablet, box 30/100 tabletsSTIC, IMMUNOSUPPRESSIVES and MEDICINES USED IN PALLIATIVES AND ANTIHORMONESronetablet 250 mg,bottle 50 tabletsinjection 200 mg/ml,box 1 vial 2.5 mltablet 20 mg (citrate),bottle 30 tabletssoft capsule 40 mg(undecanoate),box 5 stripes @ 4 capsules318.2. IMMUNOSUPPRESSIVE MEDICINESazathioprineciclosporin8.3 CYTOTOXIC MEDICINESasparaginase32tablet 50 mg,bottle 100 tabletssoft capsule 25 mg,bottle 50 capsulesinjection 50 mg/ml,box 10 ampoules @ 5powder for injection10,000 IU/vial, box 1 vbleomycin powder for injection 15mg/ampoule (as HCI),box 1 ampoulebusulfancalcium folinate (leucovorin,Ca)chlorambucylcyclophosphamidecoated tablet 2 mg,bottle 100 tabletstablet 15 mg, bottle 10 tainjection 3 mg/ml,box 5 ampoules @ 1/tablet 2 mgcoated tablet 50 mg,bottle 28 tabletsi.v. powder injection 200mg/vial, box 1 viali.v. powder for injection 50mg/vial, box 1 viali.v. powder injection 1000mg/vial, box 1 vialcysplatin powder for injection 10mg/vial, box 10 vialspowder for injection 50mg/vial, box 100 vialscytarabinei.m./i.v./s.c powder injecti100 mg/vial, box 5 viadacarbazine powder for injection 100mg/vial, box 1 vial

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMi.v. injection 0.5 mg/vial,box 1 vial 0.5 mgpowder injection 20 mg/vial(HCl), box 1 vial @ 4 mli.v. powder for injection 10mg/vial (HCl),box 1 vial @ 5 mli.v. powder for injection 50mg/vial (HCl),box 1 vial @ 25 mlinjection 20 mg/ml,box 10 ampoules @ 5 mlcapsule 100 mg,bottle 10 capsulesi.v. injection 50 mg/ml,box 10 ampoules @ 5 mltablet 2 mg Note :Storage at 2-8 o Ctablet 50 mg, bottle 25 tabletstablet 2.5 mg (as sodium salt),bottle 100 tabletspowder for injection 50 mg/vial(as sodium salt), box 1 viali.v./i.m./i.t. powder for injection5 mg/vial (as sodium salt),box 1 vialcapsule 50 mg (as HCl),bottle 100 capsulespowder for injection 10mg/vial (sulfate), box 1 viali.v. powder for injection 1mg/vial (sulfate), box 1 vialCaution :- Not for intrathecal use- Storage at 2-8 o C8.4 MEDICINES FOR PAL LIATIVE TREATMENTmorphine9. ANTIPARKINSONISM MEDICINESNLEM antiparkinsonismmedicinescombination of :benserazide 25 mglevodopa 100 mgtrihexyphenidyltablet 10 mg (sulfate),bottle 30 tabletstablet, bottle 100 tabletstablet 2 mg (HCl),bottle 250 tablets10. MEDICINES AFFECTING THE BLOOD10.1 ANTIANAEMIA MEDICINEScyanocobalaminefe (II) sulfate 7 H 2 0folic acidinjection 500 mcg/ml,box 100 ampoules @ 1coated tablet 300 mg,bottle 1000 tabletssyrup, bottle 60 mldrops, bottletablet 1 mg,bottle 1000 tabletstablet 5 mg,bottle 1000 tablets10.2 MEDICINES AFFECTING COAGULATIONheparin sodiumphytomenadione (vitamin K1)i.v./s.c. injection 5000 IU/box 1 vial 5 mlcoated tablet 10 mg,bottle 1000 tabletsinjection 10 mg/ml,box 100 ampoules @ 1i.m. injection 2 mg/ml,ampoule 1 mltial Medicines 20083334

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMDUCTS and PLASMA SUBSTITUTESODUCTSntrate)injection 10 mg/ml,box 10 vial @ 5 mltablet 2 mg (as sodium/potassium salt),bottle 100 tabletspowder for injection 250 IU/vial+ solvent 10 ml, box 1 vialx powder for injection 1000IU/vial + solvent 25 ml,box 1 vialpowder for injection 500 IU/vial+ solvent 10 ml, box 1 vialAuthority required :Used for the treatment ofhaemophilia AAuthority required :Used for the treatment ofhaemophilia Braction Authority required :Right procedures neededUBSTITUTES and PLASMA EXPANDERSrch infusion solution 6%,bottle 500 mlinfusion solution 10%,bottle 500 mlbstitutesf:uivalent ton) 17.5 ge 4.25 goride 0.19 gd at) 0.125 gterile water500 mlinfusion solution,bottle 500 mlAuthority requiredRestricted use :- Only for special cases- Need special facility andskill- Various combination inmarket could be used12. DIAGNOSTIC AGENTS12.1 RADIOCONTRAST MEDIA12.1.1 Angiographymeglumine amidotrizoate injection 65%,box 1 vial @ 50 ml12.1.2 Billigraphysodium iopodate12.1.3 Histerosalpingographymeglumine sodiumamidotrizoate12.1.4 Myelographyiohexoleiopamidolinjection 76%,box 1 ampoule 20 mlinjection 240 mg I/ml,box 1 vial 10 mlinjection 300 mg I/ml,box 1 vial 10 mlinjection 350 mg I/ml,box 1 vial 20 mlinjection 0.408 g/ml,box 10 ampoule @ 10injection 0.612 g/ml,box 10 ampoule @ 20iophendilate injection consist of 30.5 %iodium,box 1 ampoule @ 3 m12.1.5 MetabolismNLEM media contrastsubstancecombination of :sodium bicarbonate 1.25 gsimethicone 0.042 gcapsule 500 mg,bottle 6 capsulesgranule, sacch, with anhyacetic acid 10%tial Medicines 20083536

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMmpowder, sacch 200 gsuspension 2.2%,bottle 250/450 mlsuspension 55%, bottle 2 lsuspension 65%,bottle 500 mlsol 59.7 %, bottle 120 ml13. ANTISEPTICS dan DISINFECTANTS13.1 ANTISEPTICSchlorhexidinehydrogen peroxydesol 5% (gluconate),bottle 2.5 lconcentrate solution,bottle 1000 mlTESTuratei.v. injection 200 mg/ml,box 1 ampoule 10 mlhtalein i.v. injection 5%,box 1 ampoule 3 mleousinjection 0.612 g/ml,box 10 ampoules @ 20 mlinjection 0.755 g/ml,box 10 ampoules @ 20 mlm i.v. injection 76%,box 1 ampoule @ 20 mleye drops 1% (sodium salt),bottle 5 mleye drops 2% (sodium salt),bottle 5 mlinjection 10%,box 1 ampoule @ 5 mlinjection 20%,box 1 ampoule @ 5 mlpolicresulen (metacresolsulphonate and methanal13.2 DISINFECTANTScalcium hypochloritechlorine base compoundethanol 70%paraformaldehydesaponificated cresol 50%(lysol)powder, sacch 20 gpowder (for 0.1% sol),bottle 100 gsol, bottle 100 ml /1000 mtablet 1 g, bottle 100 tablesol 5%, bottle 1000 mlliquid, bottle 1000 ml14. MEDICINES and DENTAL MATERIAL USED FOR OR14.1 MEDICINES USED FOR DENTAL and ORAL HEALTNLEM dental anestheticscombination of:lidocaine HCl 2%epinephrine 1 : 80,000liquid, bottle 10 ml / 50 mlpovidone-iodine solution 10%, bottle 1000injection, box 20/50/100ampoules @ 2 mlpurified i.c. injection 1:10,box 1 vial 2 mlcalcium hydroxidepaste, box 2 tubestial Medicines 20083738

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMhor mentholTERIAL USED FOR ORAL HEALTHTstorativetsl packliquid 0.2% (gluconate)liquid, bottle 10 mlspray 0.05-0.2 ml,bottle 100 mlliquid, bottle 10 mltablet 0.5 mg,bottle 100 tabletsinjection 2% (HCl), box 100ampoules @ 2 mlpaste 5% (HCl), tube 10 gspray 15% (HCl), bottle 60 mlsuspension 100,000 IU/ml,bottle 12 mlrite concentrate solution 5%,bottle 10 mlcubicles 1x1x1 cm, tin 50 pcspowder bottle10 gsol, bottle 6 g (4.8 ml)cocoa butter 5 gbox 120 stickssetpaste, bottlesetAir tight containerNote :For dilutedhydrochlorothiazidespironolactone16.2 ANTIDIABETIC16.2.1 Oral Antidiabeticglibenclamide tablet 2.5 mg, bottle 100tablet 5 mg, bottle 100 taglipizidemetformin16.2.2 Injectable Antidiabeticintermediate insulinregular insulintablet 25 mg,box 10 stripes @10 tatablet 100 mg,box 10 stripes @10 ta16. HORMONES, OTHER ENDOCRINE MEDICINES and16.1 ANTIDIURETIC HORMONESdesmopressinvasopressintablet 25 mg,bottle 1000 tabletsmannitol infusion liquid 20%,bottle 500 mlsprayi.m./s.c. injection 20 IU/mbox 10 ampoules @ 1tablet 5 mg, box 5 blistetabletstablet 500 mg,bottle 100 tabletsinjection 100 IU/ml,box 1 vial @ 10 mlinjection 100 IU/ml,box 1 vial @ 10 mlsol and powder, bottle 100 gregular insulin : intermediateinsulin (30 : 70)injection 100 IU/ml,box 1 vial @ 10 mltablet 40 mg,bottle 250 tabletsi.v./i.m. injection 10 mg/ml,box 25 ampoules @ 2 ml16.3 SEX HORMONE and FERTILITY RELATED MEDIC16.3.1 Androgenstestosteroneoily injection 200 mg/ml(enantate), box1 vialtial Medicines 20083940

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMnsgensogenseroneseptives Note :According to National FamilyPlanning Programcoordinated by NationalFamily Planning CoordinationBoard (BKKBN)ormonal Contraceptiveslol150 mcg30 mcgpillble Hormonal Contraceptiveseroneterine Devicesing devicetable Contraceptivestablet 0.625 mg,box stripes 28 tabletstablet 0.05 mg,bottle 100 tabletstablet 0.5 mg,bottle 100 tabletsi.m. injection 125 mg/ml,box 1 ampoule 2 mltablet 5 mg, bottle 30 tabletsdepot injection 150 mgset / pcsimplant 2 rods (3-4 years)and ANTITHYROID HORMONESbottle 30 ml Note :Dilute before usescored tablet 100 mg,bottle 1000 tabletstablet 0.1 mg, bottle 50 tablets16.5 CORTICOSTEROID HORMONESdexamethasonetablet 0.5 mg,bottle 1000 tabletsinjection 5 mg/ml (as sodphosphate), box 100ampoule @ 1 mlhydrocortisoneprednisone17. CARDIOVASCULAR MEDICINES17.1 ANTI-ANGINAL MEDICINESatenololdiltiazem HClisosorbide dinitratenitroglycerine17.2 ANTIARRHYTHMIC MEDICINESamiodaronetablet 30 mg, box 10 strip@ 10 tabletssublingual tablet 5 mg,bottle 60 tabletssublingual tablet 0.5 mg,bottle100/1000 tabletstablet 200 mg, box 30 tainjection 150 mg/3 ml,box 6 ampoule @ 3 mdigoxin tablet 0.0625 mg,bottle 100 tabletstablet 0.25 mg,bottle 100 tabletsinjection 0.25 mg/ml,box 1 ampoule @ 2 mdisopyramidetablet 10 mgpowder for injection 100mg/vial (sodium succibox 100 vial @ 2 mltablet 5 mg,bottle 1000 tabletstablet 50 mg, box 10 strip@ 10 tabletscapsule 100 mg (phosphbottle 100 capsulestial Medicines 20084142

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMnaline)injection 0.1% (as bitartrate),box 100 ampoules @ 1 mli.v. injection 2% (HCl),box 100 ampoules @ 2 mltablet 10 mg (HCl),bottle 100 tabletsi.v. injection 1 mg/ml (HCl),box 10 ampoules @ 1mlNote :For intracardial orresusitation17.4 PLATELET ANTIAGGREGATIONacetylsalicylic acid (acetosal)17.5 ANTI THROMBOTIC MEDICINESstreptokinasetablet 80 mg, box 10 blister@ 10 tabletsinjection 750,000 IU/vialinjection 1,500,000 IU/viaRTENSIVE MEDICINEStablet 40 mg (HCl),bottle 30 tabletsinjection 2.5 mg/ml (HCl),box 10 ampoules @ 2 mltablet 50 mg, bottle 50 tabletsscored tablet 12.5 mg,box 10 stripes @ 6 tabletsscored tablet 25 mg, box 10stripes @ 6 or 10 tabletsi.m. injection 0.15 mg/ml(HCl), box 1 ampoule 1 mlSpecial use :For supraventriculararrhythmia.Caution :- Not for pregnant women- Having cough side effectNote :For severe hypertension17.6 MEDICINES USED IN HEART FAILUREcaptoprildigoxinscored tablet 12.5 mg,box 10 stripes @10 sctabletsscored tablet 25 mg,box 10 stripes @ 10scored tabletstablet 0.0625 mg,bottle 100 tabletstablet 0.25 mg,bottle 100 or 1000 tablinjection 0.25 mg/ml,box 1 ampoule @ 2 midetablet 25 mg,bottle 100 tabletstablet 5 mg,box 3 stripes @ 10 tabletstablet 10 mg,box 3 stripes @ 10 tabletstablet 20 mg,box 3 stripes @ 10 tabletscoated tablet 250 mg,bottle 100 or 1000 tabletsNote :Every 4 hoursfurosemidetablet 40 mg,box 20 stripes @ 10 tai.v./i.m. injection 10 mg/mbox 25 ampoules @ 217.7 MEDICINES USED for SHOCK ATTACK17.7.1 Medicines used for Cardiogenic Shockdobutamine injection 50 mg/ml; vial 5injection 25 mg/ml;ampoule 10 mlside *)ttablet 10 mginjection, vialdopamineinjection 40 mg/ml (HCl),box 5 ampoules @ 5 mepinephrine (adrenaline) i.v. injection 0.1 %(as HCl/ bitartrate),box 100 ampoules @tial Medicines 20084344

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMs used for Anaesthetic Shockinjection 50 mg/ml (HCl),box 100 ampoules @ 1 mlERING AGENTSOGICAL MEDICINESMEDICINESTIVE MEDICINESve medicinesf :500 IU/g0,000 IU/gAL MEDICINESmedicinesf :6%3%injection 4 mg/ml,ampoule 2 mlscored tablet 10 mg,box 30 tabletscream 0.05%, tube 20 gointment, pot 30 g Note :General antifungal ointmentpowder 2% (nitrate),sacch 20 gcream 2% (nitrate), tube 10 gNote :Used as long actingvasopressorcream 1%, pot 500 g Special use :Large area burn woundsointment, tube 5 ghydrocortisoneliquor veilli (salicylic acidsolution 0.1 %)combination of :salicylic acid 0.1 %boric acid 0.5 %glycerine 10 %cream 2.5% (acetate),tube 5 gsolution18.5 SCABICIDES and PEDICULICIDESpermethrin2-4 ointment,combination of :salicylic acid 2 %sulfur precipitate 4 %18.6 CAUSTIC MEDICINESsilver nitrateointment, pot 30 gsol 20%, bottle 10 ml18.7 MEDICINES AFFECTING SKIN DIFFERENTIATION acoal tarcream 5 %, tubesol 5 %, bottle 100 mlpodophyllum resin alcoholic sol 25 %,bottle 30 mleliquid 25%, bottle 30 mlAMMATORY and ANTIPRURITIC MEDICINEStial Medicines 2008ointment 0.1% (as valerate),tube 5 gcream 0.1% (as valerate),tube 5 g4546

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMNEOUSetergentse ready-to-dissolve tablet 300mg, air tight tube 10 tabletsate tablet 500 mg, ottle 1000tabletsALe i.v. injection 10%,box 24 ampoules @ 10 mlna (DG ana)ointment 2%, pot 30 gointment 5%, pot 30 gointment 10%, pot 30 gcream 10 %, tube 40 gsuspension 2%, bottle 30 mlsuspension 5%, bottle 30 mlliquidAL DIALYSIS SOLUTIONSlysis solutionl dialysispowder 2%, box 100 gYTE, NUTRITION SOLUTIONS, and OTHERSalts:ridee0.52 g0.30 g0.58 g2.70 gsol, bottle 1 galloninfusion sol,24 bottle @ 1000 mlpowder, 100 saccheach sacch for 200 mlwaterinfusion sol, bottle 500 mlNote :- Drink slowly to preventvomiting- 1 sacchet to be dissolvedin 200 ml waterNote :- Dissolve before use- Storage in air tightcontainerdextrose infusion sol 5 %, bottle 5glucose infusion sol 5%, bottle 50infusion sol 10%,bottle 500 mlinfusion sol 40%, bottle 2half strength darrow glucosemannitol infusion sol 20 %,bottle 500 mlNLEM nutritious solutioncombination of :glucose 5 %sodium chloride 0.225 %nutritious solutioncombination of :glucose 4 %sodium chloride 0.18 %potassium chlorideringer lactatesodium bicarbonate i.v. injection 8.4%,bottle 25 mlinjection 1.4% isotonik, bsodium chloride infusion sol 0.9%,bottle 500 mlinfusion sol 3%, bottle 50injection 15%, vial 50 ml20.3 MISCELLANEOUSinfusion sol, bottleintralipid liquid infusion sol 10%,bottle 100/500 mlinfusion sol 20%,bottle 100/500 mlinfusion sol, bottle 500 minfusion sol, bottle 500 mi.v. injection 1 meq/ml,box 1 ampoule 10 mlinfusion sol, bottle 500 mwater for injections box, ampoule/vial @ 10ml/20 mltial Medicines 20084748

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMOLOGICAL PREPARATIONNESTHETICSCTIVE AGENTSICSinjection 0.5% (HCl),box 5 ampoules @ 20 mleye drops 0.5% (HCl),bottle 5 mleye ointment 3%, tube 3.5 geye ointment 0.3%, tube 3.5 geye drops 0.3%, bottle 5 mleye drops 0.1%, bottle 5 mleye ointment 0.5%, tube 4 geye ointment 1% (HCl),tube 3.5 geye drops 15% (sodium),bottle 5 mlLAMMATORY AGENTSeye drops 1 mg/ml (sodium),bottle 5 mleye drops 0.5% (sulfate),bottle 5 mleye drops 1% (sulfate),bottle 5 mleye drops 2% (as hydrobromide), bottle 15 mland ANTIGLAUCOMA MEDICINEStablet 250 mg,bottle 100 tabletsi.m/i.v. powder for injection500 mg/vial (as sodiumsalt), box 10 vials + 10ampoules WFI @ 5 mlpilocarpinetimolol21.6 MISCELLANEOUScombination of :hydroxypropylmethylcellulosedextran (70)glycerinebenzalkoniumchloride 0.01% w/v22. OXYTOCICS and UTERIC RELAXANTS22.1 OXYTOCICSmethyl ergometrineoxytocin5 mg1 mg2 mg22.2 UTERIC RELAXANTSeye drops 2% (HCl/nitrbottle 5 mleye drops 4% (HCl/nitrbottle 5 mleye drops 0.25% (malebottle 5 mleye drops 0.5% (maleabottle 5 mlsol 2%, bottle 5 mlsodium chromoglycate eye drops 2%, bottle 1coated tablet 0.125 mg(maleate),bottle 100 tabletsinjection 0.2 mg/ml,box 100 ampoules @injection 10 IU/ml,box 100 ampoules @magnesium sulfate injection 20%,box 10 vials @ 20 mlinjection 40%,box 10 vials @ 20 mltial Medicines 20084950

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMERAPEUTIC MEDICINESS USED in GENERALIZED ANXIETY and SLEEP DISORDERStablet 2 mg,bottle 1000 tabletstablet 5 mg,bottle 1000 tabletsi.m. injection 5 mg/ml,box 100 ampoules @ 2 mlS USED in DEPRESSIVE DISORDERScoated tablet 25 mg (HCl),box 10 blisters @ 10tabletscapsule/tablet 10 mg,box 30 tabletscapsule/tablet 20 mg,box 30 tabletstablet 200 mg, box 10 stripes@ 10 tabletsUSED for OBSESSIVE COMPULSIVE DISORDERStablet 25 mg (HCl),bottle 1000 tabletsUSED in PSYCHOTIC DISORDERScoated tablet 25 mg (HCl),bottle 1000 tabletscoated tablet 100 mg (HCl),bottle 1000 tabletsi.m. injection 25 mg/ml (HCl) ,box 100 ampoules @ 1 mlCaution :- If possible, need to checkblood concentration level- Safety window is 0.8-1.2mmol eq/lclozapine )fluphenazinehaloperidolrisperidonetablet 25 mg, box 50 tabtablet 50 mg, box 50 tabtablet 2.5 mg (HCl),bottle 100 tabletsi.m. injection 25 mg/ml(decanoate),box 10 vials @ 1 mltablet 0.5 mg,bottle 100/1000 tabletstablet 1.5 mg,bottle 100/1000 tabletstablet 2 mg, box 100 tabletablet 5 mg,bottle 100/1000 tabletsdrops 2 mg/ml,bottle 15 ml/100 mli.m. injection 2 mg/ml (HCbox 5 ampoules @ 1 mi.m. injection 5 mg/ml (HCbox 5 ampoules @ 1 minjection 50 mg/ml (asdecanoate)box 5 ampoules @ 1 m(long acting)tablet 1 mg, box 5 stripes10 tabletstablet 2 mg, box 5 stripes10 tablets Complementary listtial Medicines 20085152

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMS USED for ADHDate*)regular release tablet 10 mg,box 30 tabletsextended release tablet 20 mg,box 30 tabletsAuthority required :Need special skillNLEM antacid IIcombination of :aluminiumhydroxide 200 mg/5 mlmagnesiumhydroxide 200 mg/5 mlsuspension, bottle 60 mlELAXANTS (PERIPHERALLY-ACTING) and CHOLINESTERASESCULAR INHIBITORSinjection 25 mg/2.5 ml,S USED for MIASTENIA GRAVISTESTINAL MEDICINESinjection 0.5 mg/ml (methylsulfate),box 50 ampoules @ 1 mltablet 60 mg (bromide),box 10 stripes/blisters @10 tabletsand OTHER ANTIULCER MEDICINESoxide 200 mgroxide 200 mgi.v. injection 10 mg/ml vial 5 mli.v./i.m. powder for injection100 mg/ vial (chloride),box 10 vialschewable tablet, bottle 1000tabletsAuthority required :- Restricted use (only forspecial cases)- Need special facillitiesand skillranitidine25.2 ANTIEMETIC MEDICINESchlorpromazinemetoclopramide25.3 ANTIHAEMORRHOID MEDICINESNLEM antihaemorrhoidcombination of :bismuth subgallate 150 mghexachlorophene 2,5 mglidocaine 10 mgzinc oxide 120 mgsupp to 2 gtablet 150 mg,box 3 stripes @10 tabcoated tablet 25 mg (HCl)bottle 1000 tabletsi.m. injection 25 mg/ml (Hbox 100 ampoules @ 1i.m injection 5 mg/ml (HCbox 100 ampoules @ 2dimenhydrinate tablet 50 mg, bottle 1000tablet 10 mg (as HCl),bottle 100 tabletsinjection 5 mg/ml (as HClbox 10 ampoules @ 2syrup 5 mg/5 ml, bottle 50drops 0.1 mg/drop,bottle 10 mlsuppositoria, box 100 supttial Medicines 20085354

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMMODIC MEDICINEStablet 1 mg (sulfate),tin 100 tabletsi.m./i.v./s.c. injection 0,25mg/ml (sulfate),box 100 ampoules @ 1 mli.m./i.v./s.c. injection 1 mg/ml(sulfate),box 50 ampoules @ 1 mlctS USED IN DIARRHOEAsalts:ridee0.52 g0.30 g0.58 g2.70 gMEDICINEStablet 10 mg,bottle 100/1000 tabletspowder, 100 sacchs,each sacch for 200 ml ofwatersuppositoria 5 mg, box 6suppositoriasuppositoria 10 mg, box 6suppositorialiquid, bottle 100 mlAMMATORY MEDICINEStablet 500 mg, box 10 stripes@ 10 tabletsACTING ON RESPIRATORY TRACTMATICscored tablet 200 mg,bottle 1000 tabletsinjection 24 mg/ml,box 100 ampoules @10 mlNote :- Drink slowly to preventvomitting- 1 sacchet to be dissolved in200 ml of waterbudesonidedexamethasoneephedrineepinephrine (adrenaline)salbutamol26.2 ANTITUSSIVEScodeinedextromethorphanaerosol 100 mcg/puff,canister 15 mlaerosol 200 mcg/puff,canister 15 mltablet 0.5 mg,bottle 1000 tabletsi.v. injection 5 mg/ml (assodium phosphate),box 100 ampoules @tablet 25 mg (HCl),bottle 1000 tabletsinjection 0.1 % (asHCl/bitartrate), box 10ampoules @ 1 mltablet 2 mg (as sulfate),bottle 100/1000 tablettablet 4 mg (as sulfate),bottle 100/1000 tabletih liquid 0.5 % , bottle 10ih/aerosol 100 mcg/dosesulfate), tube 200/400dosesinjection 50 mcg/ml (assulfate), box 100ampoules @ 1 mlrespirator liquid for nebu2.5 mg/2.5 ml NaCl,box 4x5 nebulestablet 10 ml (HCl/phosphbottle 250 tabletstablet 15 mg (HBr),bottle 1000 tabletssyrup 10 mg/5 ml (HBr),bottle 60 mltial Medicines 20085556

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMRANTate(OBH)GICALSIMMUNOGLOBULINSnoglobulin i.m. injection 500 IU, vial Note :- Storage at 2-8 Cra (A.D.S)syrup 25 mg/5 ml,bottle 60 mltablet 100 mg,bottle 1000 tabletsliquid, bottle 200 mlconcentrate liquid,bottle 1000 mli.m. injection 10,000 IU/vial,box 10 vials @ 5 mli.m. injection 20,000 IU/vial,box 10 vials @ 10 ml(A.T.S) for prophylaxis :i.m. injection 1500 IU/ampoule,box 10 ampoules @ 1 mlfor curative treatment :i.m./i.v. injection 10,000IU/ampoule,box 10 ampoules @ 2 mli.m./i.v injection 20,000IU/vial, box 10 vials@ 4 mleraseram specialoutsideI)m specialake (ABU II)i.m. injection 100 IU/ml,box 10 vial @ 20 mli.m. injectionbox 10 vial @ 10 mli.m./i.v. injection, box 10 vial@ 5 mlNote :- Storage at 2-8 oCIndication :- For post-exposuretreatment in rabies area- Storage at 2-8 oCNote :- Storage at 2-8 oCNote :- Storage at 2-8 CNote :- Only for specific area- Storage at 2-8 Coo27.2 VACCINESBCG vaccinediphtheria, pertusis andtetanus adsorbed vaccine(DPT)hepatitis B vaccine(recombinant)measles vaccinepoliomyelitis vaccinerabies vaccine (human)tetanus adsorbed vaccine(tetanus adsorbed toxoid)tetanus and diphteriaadsorbed vaccine (TD)lidocaines.c./i.c. powder for injectiobox 7 vial @ 1 dose +ampoules solvent @ 2booster : box 5 ampoules1 dose + 5 ampoulessolvent @ 4 mli.m.injection, box 1 vial 5i.m. injection,box 10 vial @ 5 ml28. MEDICINES USED FOR EAR, NOSE and THROATcarboglycerinehydrogen peroxidei.c. injection,box 5 ampoules @ 2i.c. injection,box 5 ampoules @ 4i.m injection,box 10 vial @ 5 mlinjection 20 mcg/ml,box 1 vial 0.5; 1 mls.c injection, box 10 vialsdoses) @ 5 mldrops, box vial 10/20 dosear drops 10 %, bottle 5 mconcentrate liquid, bottle1000 mlspray liquid 4% (HCl),bottle 50 mltial Medicines 20085758

EUTICNERICINN)DOSAGE FORMRESTRICTIONend MINERALSxnasal drops 0.025% (HCl),bottle 15 mlnasal drops 0.05% (HCl),bottle 10 mltablet 50 mg,bottle 1000 tabletsinjection 100 mg/ml,box 24 ampoules @ 10 mltablet 500 mg,bottle 1000 tabletscapsule 50,000 IU,bottle 100 capsulessuspension 10,000 IU/ml,bottle 60 mlsoft capsule 200 mg,bottle 1500 capsulestablet 100 mgtablet 10 mg (HCl),bottle1000 tabletstablet 25 mg (HCl),bottle 1000 tabletstablet 5000 IU,bottle 1000 tabletssoft capsule 50,000 IU,bottle 50 capsulessoft capsule 100,000 IU,bottle 50 capsulessoft capsule 200,000 IU (aspalmitate),bottle 50 capsulestablet 50 mg (HCl),bottle 1000 tabletstablet, bottle 1000 tabletsNote :Therapeutic use forhypocalcemia (seldomneeded in tropicalcountries)tial Medicines 200859

CHAPTER IIIRESTRICTED MEDICINE LISTOR PUBLIC HEALTH CENTER2008

CHAPTER IIIRESTRICTED MEDICINE LISTOR PUBLIC HEALTH CENTER2008UTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)1.3. MEDICINES USED TO TREAT GOUTallopurinolDOSAGE FORMtablet 100 mg,bottle 100/1000 tabletS, ANTIPYRETICS, NON-STEROIDAL ANTI-INFLAMMATORY MEDICINES,USED TO TREAT GOUTALGESICSi.m./s.c./slow released i.v.injection 50 mg/ml (HCl),box 10 ampoules @ 2 mlAuthority required :Used only for nursing PublicHealth Center (PHC)probenecidtablet 500 mg,bottle 100/1000 tabletD ANALGESICSid (acetosal)ctablet 100 mg,box 10 blisters@10 tabletstablet 500 mg,box 10 blisters@10 tabletstablet 200 mg,bottle 100 tabletstablet 400 mg,bottle 100 tabletstablet 500 mg,bottle 1000 tabletstablet 100 mg,bottle 1000 tabletstablet 500 mg,bottle 1000 tabletssyrup 120 mg/5 ml,bottle 60 mltablet 25 mg, box 10 stripes@ 10 tabletstablet 50 mg, box 10 stripes@ 10 tabletsRestricted use :To reduce agranulocytosis2. ANESTHETICS2.1 LOCAL ANESTHETICSethyl chloridelidocainespray, bottle 100 mlinfiltr injection 1% (HCl),box 100 amps @ 2 mlp.v. injection 2% (HCl),box 100 ampoules @gel 2%, tube 10 gspray 4%, bottle 50 ml2.2 GENERAL ANESTHETICS and OXYGENketamineoxygeni.v. injection 10 mg/ml (asHCl), box 10 vial @ 20i.v. injection 50 mg/ml (asHCl), box 10 vial @ 20inhalation, gas in tubethiopental i.v. powder for injection 5mg/ampoule (as sodiusalt) (for dissolved in 2WFI), box 25 ampouletial Medicines 20086162

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMUSED FOR PREOPERATIVE MEDICATION PROCEDUREStial Medicines 2008i.m. injection 10 mg/ml (HCl),box 100 ampoules @ 1 mlnaline) s.c./i.m. injection 0.1%(HCl/bitartrate),box 100 ampoules @ 1 mland OTHER SUBSTANCES USED IN POISONINGucovorin, Ca)teinjection 1 mg/ml (sulfate),box 50 ampoules @ 1 mltablet 5 mg,bottle 1000 tabletinjection 5 mg/ml,box 100 ampoules @ 2 mli.m./s.c./i.v. injection 10mg/ml (HCl/sulfate),box 10 ampoules @ 1 mlICS and MEDICINES USED IN ANAPHYLAXIStablet 4 mg ( maleate),bottle1000 tabletsinjection 5 mg/ml (maleate),box 100 ampoules @ 1 mlinjection 5 mg/ml (as sodiumphosphate), box 100ampoules @ 1 mli.m./i.v./s.c injection 1 mg/ml(sulfate),box 10 ampoules @ 2 mltablet 1 mg, bottle 100 tabletstablet 500 mg,bottle 1000 tabletsNote :- Drug of choice foranaphylactic reaction- Dosage 0.3 - 0.5 mgi.m. may be repeatedRestricted use :- Caution on package: onlyfor antidotes (large dose)- Used only for nursing PHC63sodium thiosulfate i.v. injection 25%,box 10 ampoules @ 14.2 NON-SPESIFICactive carbonmagnesium sulfatephenytoin6. ANTI-INFECTIVE MEDICINES6.1 ANTHELMINTHICS6.1.1 Intestinal Anthelminthicsmebendazole64activated powder, sacchpowder, sacch 30 g5. ANTIEPILEPTICS ANTICONVULSANTSdiazepamphenobarbitali.m./i.v. injection 5 mg/mbox 100 ampoules @rectal sol 4 mg/ml, tube 2tablet 30 mg,bottle 1000 tabletstablet 50 mg,bottle 1000 tabletstablet 100 mg,bottle 1000 tabletsi.m injection 50 mg/ml,box 100 ampoules @i.v.injection 50 mg/ml (assodium salt), box 100ampoules @ 2 mlcapsule 30 mg (as sodiusalt), bottle 250 capsucapsule 100 mg (as sodsalt), bottle 250 capsuinjection 50 mg/ml (as sosalt), box 10 ampoule@ 2 mltablet 100 mg,bottle 100 tabletssyrup 100 mg/5 ml,bottle 30 ml

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMlsneRIALSm medicinesatelpenicillinrystalscored tablet 250 mg(pamoate),bottle 250 tabletssuspension 125 mg/5 ml(pamoate), bottle 30 mlscored tablet 100 mg (citrate),bottle 1000 tabletsscored tablet 500 mg,box 10 stripes @ 10 tabletsdry syrup 125 mg/5 ml,bottle 60 mli.m./i.v. powder for injection250 mg/vial (as sodiumsalt), box 10 vialsi.m./i.v. powder for injection500 mg/vial (as sodiumsalt), box 10 vialsi.m. injection 1.2 millionsIU/ml, box 25 vials @ 4 mli.m. injection 2.4 millionsIU/ml, box 25 vials @ 10 mli.m./i.v. injection 10 millionsIU/vial, box 25 vialsNote :For endemic areaprocaine benzylpenicillin6.2.2 Other antibacterials6.2.2.1 Tetracyclineoxytetracyclinetetracycline6.2.2.2 Chloramphenicolchloramphenicol6.2.2.3 Sulfa-TrimethoprimNLEM co-trimoxazole I (adult)combination of :sulfamethoxazole 400 mgtrimethoprim 80 mgi.m. powder for injection3 millions IU/vial,box 100 vialsi.m. powder for injection1 million IU/vial,box 100 vialsi.v. injection 250 mg/3 m(HCl), box 10 ampoul@ 3 mli.v. injection 50 mg/ml (Hbox 10 vials @ 10 mlcapsule 250 mg (HCl),bottle 1000 capsulescapsule 500 mg (HCl),box 10 stripes @ 10capsulescapsule 250 mg,bottle 1000 capsulessuspension 125 mg/5 mpalmitate), bottle 60 mtablet, box 10 stripes@ 10 tabletsenicillintablet 500 mg (as potassiumsalt), bottle 1000 tabletstablet 250 mg (as potassiumsalt), box 10 stripes@ 10 tabletsdry syrup 250 mg/5 ml(as potassium salt),bottle 60 mlRestricted used :Not used for severe infectionNLEM co-trimoxazole II(paediatric) combination of:sulfamethoxazole 100 mgtrimethoprim 20 mgsulfadiazinetrimethoprimtablet, bottle 100 tabletstablet 500 mg, bottle10tabletsscored tablet 200 mg,bottle 100 tabletstial Medicines 20086566

EUTICNERICINN)idesc UseDOSAGE FORMtablet 250 mg,bottle 100/1000 tabletstablet 500 mg,bottle 100/1000 tabletsANTI-INFECTIVE MEDICINESsy medicinesronizedrculosis medicinestial Medicines 2008capsule 250 mg (as stearate),bottle 100 capsulessyrup 200 mg/5 ml (as ethylsuccinate), bottle 60 mloily capsule 100 mg,bottle 100 capsulesscored tablet 100 mg,bottle 1000 tabletstablet 250 mg (HCl),bottle 100 tabletstablet 500 mg (HCl),bottle 100 tabletstablet 100 mg,bottle 1000 tabletstablet 300 mg,bottle 1000 tabletstablet 500 mg,bottle 100 tabletsscored tablet 300 mg,box 10 stripes @10 tabletstablet 450 mg,box 10 stripes @10 tabletstablet 600 mg,box 10 stripes @10 tabletspowder for injection 1000mg/vial (as sulfate),box 100 vialsRESTRICTIONRestricted use :Only for tuberculosis andleprosyNote :Special packaging67THERAPEUTICCLASS, GENERICNAME (INN)combination of :rifampicinisoniazidethambutolcombination of :rifampicinisoniazidpyrazinamidecombination of :rifampicinisoniazidpyrazinamideethambutol6.3.3 Urinary AntisepticsNLEM co-trimoxazole I (adult)combination of :sulfamethoxazole 400 mgtrimethoprim 80 mgnitrofurantoinetrimethoprim6.4 ANTIFUNGAL MEDICINES6.4.1 Systemicgriseofulvin, micronizednystatinDOSAGE FORMcaplet 150 mgtablet 150 mgtablet 400 mg6.4.2. TopicalNLEM antifungal medicines ointment, pot 30 gcombination of:benzoic acid 6%salicylic acid 3%nystatin vaginal tablet 100,000IU/tablet, box 10 strip@ 10 tablets68caplet 150 mg; 75 mg;tablet 75 mg; 50 mg; 30tablet 400 mg; 150 mg;500mgcaplet 150 mg; 450 mgtablet 75 mg; 300 mgtablet 400 mg; 500 mgtablet 275 mg; 250 mg;500 mgtablet, box 10 stripes@ 10 tabletsscored tablet 100 mg,bottle 100 tabletsscored tablet 200 mg,bottle 100 tabletsscored tablet 250 mg,bottle 100 scored tabcoated tablet 500,000 Ibottle 100/1000 tablesuspension 100,000 IUbottle 12 ml

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMOZOAL MEDICINESbic and antigiardiasis medicinesrial medicinesphylaxisative treatmential medicinesf :e 25 mg500 mg:50 mg200 mgtablet 250 mg,bottle 100 tabletstablet 500 mg,bottle 100 tabletstablet 150 mg(as phosphate),bottle 1000 tabletstablet, bottle 500 tabletsinjection 80 mg/ml,box 6 ampoules @ 1 mli.v./i.m. injection 60 mg/ml,box 8 vials @ 1 mltablet, box 2 blisters @ 12tablets (combipack)box 3 blisters @ 8 tabletstablet 150 mg(as phosphate),bottle 1000 tabletssyrup 50 mg/5ml, bottle 60 mltablet 15 mg (as phosphate),bottle 1000 tabletstablet 222 mg (bisulfate),bottle 1000 tabletsi.v. injection 25% (as HCl),box 100 ampoules @ 2 mlRestricted use :For specific area whichalready resistent tochloroquine (decided byDistrict/Municipality HealthOffices)Restricted use :- Only for severe malaria- Used only for nursing PHC7. ANTIMIGRAINE MEDICINES7.1 FOR PROPHYLAXISdihydroergotamine7.2 FOR TREATMENT OF ACUTE ATTACKergotaminecombination of :ergotaminecaffeine1 mg50 mg9. ANTIPARKINSONISM MEDICINESNLEM antiparkinsonismmedicinescombination of :benserazide 25 mglevodopa 100 mgtrihexyphenidyl10. MEDICINES AFFECTING THE BLOOD10.1 ANTIANAEMIA MEDICINEScyanocobalamine(vitamin B12)fe (II) sulfate 7 H20folic acidtablet 2.5 mg (as mesilabox 10 stripes@ 10 tatablet 1 mg (tartrate),bottle 100 tabletstablet, box 30/100 tablettablet, bottle 100 tabletstablet 2 mg (HCl), bottletabletsinjection 500 mcg/ml,box 100 ampoules @coated tablet 300 mg,bottle 1000 tabletssyrup, bottle 60 mldrops, bottletablet 1 mg,bottle 1000 tabletstablet 5 mg,bottle 1000 tabletstial Medicines 20086970

UTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMIC AGENTSTESTeouseye drops 1% (sodium salt),bottle 5 mleye drops 2% (sodium salt),bottle 5 mlinjection 10%,box 1 ampoule @ 5 mlinjection 20%,box 1 ampoule @ 5 ml(purified i.c. injection 1:10,box 1 vial 2 mlCS dan DISINFECTANTSICSdeAFFECTING COAGULATION(vitamin K1)ANTScoated tablet 10 mg,bottle 1000 tabletsinjection 10 mg/ml,box 100 ampoules @ 1 mli.m. injection 2 mg/ml,ampoule 1 mlconcentrate solution,bottle 1000 mlsol 10%, bottle 1000 mlStorage :- Storage in glass bottle withglass cap, air tight, savedfrom light- For diluted until 3%rite powder, sacch 20 g ”Samijaga” Programsol, bottle 100 ml /1000 mlDose :- New born baby dose 1 mg- Premature baby dose0.5 mgsaponificated cresol 50%(lysol)14. MEDICINES and DENTAL MATERIAL USED FOR OR14.1 MEDICINES USED FOR DENTAL and ORAL HEALTNLEM dental anestheticscombination of:lidocaine HCl 2%epinephrine 1 : 80,000calcium hydroxidechlorphenol camphor mentholethyl chlorideeugenolfluorinelidocainenystatininjection, box 20/50/100ampoules @ 2 mlpaste, box 2 tubesliquid, bottle 10 mlspray 0.05-0.2 ml,bottle 100 mlliquid, bottle 10 mltablet 0.5 mg,bottle 100 tabletsinjection 2% (HCl),box 100 ampoules @paste 5% (HCl), tube 10spray 15% (HCl), bottle 6suspension 100,000 IU/mbottle 12 ml14.2 DENTAL MATERIAL USED FOR ORAL HEALTHgelatin sponge cubicles 1x1x1 cm, tin 50glass ionomer ART(Atraumatic RestorativeTreatment)gutta percha pointsresin compositeroot canal fillingliquid, bottle 1000 mlpowder bottle10 gsol, bottle 6 g (4.8 ml)cocoa butter 5 gbox 120 stickssetpaste, bottleetablet 1 g, bottle 100 tabletssol 5%, bottle 1000 mltemporary filling sol and powder bottle 10tial Medicines 20087172

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMtablet 40 mg,bottle 250 tabletsi.v./i.m. injection 10 mg/ml,box 25 ampoules @ 2 ml16.5 CORTICOSTEROID HORMONESdexamethasonetablet 0.5 mg,bottle 1000 tabletsinjection 5 mg/ml (as sodphosphate),box 100 ampoule @ 1S, OTHER ENDOCRINE MEDICINES and CONTRACEPTIVESTICdiabetictablet 2.5 mg, bottle 100tabletstablet 5 mg, bottle 100 tabletshydrocortisoneprednisonetablet 10 mgpowder for injection 100mg/vial (sodium succinbox 100 vial @ 2 mltablet 5 mg,bottle 1000 tabletstablet 500 mg, bottle 100tabletsONE and FERTILITY RELATED MEDICINESptivesrmonal Contraceptivesl150 mcg30 mcgpillle Hormonal Contraceptivesroneerine Devicesdevicedepot injection 150 mgset / pcsNote :According to National FamilyPlanning Programcoordinated by BKKBNnd ANTITHYROID HORMONESbottle 30 ml Note :Dilute before usescored tablet 100 mg,bottle 1000 tablets17. CARDIOVASCULAR MEDICINES17.1 ANTI-ANGINAL MEDICINESatenololisosorbide dinitrate17.2 ANTIARRHYTHMIC MEDICINESpropranololtablet 50 mg, box 10 stri@ 10 tabletssublingual tablet 5 mg,bottle 60 tabletstablet 10 mg (HCl),bottle 100 tabletsi.v. injection 1 mg/ml (HCbox 10 ampoules @ 117.3 ANTIHYPERTENSIVE MEDICINEScaptoprilscored tablet 12.5 mg,box 10 stripes @ 6 tascored tablet 25 mg, boxstripes @ 6 or 10 tablhydrochlorothiazide17.4 PLATELET ANTIAGGREGATIONacetylsalicylic acid (acetosal)tablet 25 mg,bottle 100 tabletstablet 80 mg, box 10 blis@ 10 tabletstial Medicines 20087374

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMS USED IN HEART FAILURES USED for SHOCK ATTACK,s used for cardiogenic shocktablet 0.0625 mg,bottle 100 tabletstablet 0.25 mg,bottle 100 or 1000 tabletsinjection 0.25 mg/ml,box 1 ampoule @ 2 mltablet 40 mg, box 20 stripes@ 10 tabletsi.v./i.m. injection 10 mg/ml,box 25 ampoules @ 2 mlnaline) i.v. injection 0.1 %(as HCl/ bitartrate),box 100 ampoules @ 1 mlERING AGENTSLOGICAL MEDICINESCTIVE MEDICINESive medicinesf :500 IU/g0,000 IU/gscored tablet 12.5 mg, box 10stripes @ 10 scored tabletsscored tablet 25 mg, box 10stripes @ 10 scored tabletsscored tablet 10 mg,box 30 scored tabletsointment, tube 5 gCaution :- Not for pregnant women- Having cough side effectPediatric dose :Tablet 0.0625 mg forpediatrics18.4 ANTI-INFLAMMATORY and ANTIPRURITIC MEDICINbetamethasone18.5 SCABICIDES and PEDICULICIDES2-4 ointment,combination of :salicylic acid 2 %sulfur precipitate 4 %18.6 CAUSTIC MEDICINESsilver nitrateointment pot 30 gsol 20%, bottle 10 ml18.7 MEDICINES AFFECTING SKIN DIFFERENTIATIONcoal tarointment 0.1% (as valeratube 5 gcream 0.1% (as valeratetube 5 ghydrocortisone cream 2.5% (acetate), tusol 5 %, bottle 100 mlpodophyllum resin alcoholic sol 25 %,bottle 30 mlAL MEDICINESmedicinesf :6%3%ointment, pot 30 g Note :General antifungal ointmentsalicylic acidointment 2%, pot 30 gointment 5%, pot 30 gointment 10%, pot 30 geliquid 25%, bottle 30 mltial Medicines 20087576

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMNEOUSetergentsYTE, NUTRITION SOLUTIONS, and OTHERSalts:ridee0.52 g0.30 g0.58 g2.70 gtial Medicines 2008powder, 100 saccheach sacch for 200 mlwaterate tablet 500 mg, bottle 1000tabletsALNEOUSinfusion sol 5%, bottle 500 mlinfusion sol 10%,bottle 500 mlinfusion sol 40%, bottle 25 mlinfusion sol, bottle 500 mlinfusion sol 0.9%,bottle 500 mlinfusion sol 3%, bottle 500 mlinjection 15%, vial 50 mls box, ampoule/vial @ 10ml/20 mlOLOGICAL PREPARATIONESTHETICSsuspension 2%, bottle 30 mlsuspension 5%, bottle 30 mlliquidpowder 2%, box 100 geye drops 0.5% (HCl),bottle 5 ml- Drink slowly to preventvomiting- 1 sacchet to be dissolvedin 200 ml waterNote :- Need to check sodiumlevel- Used only for nursing PHC7721.2 ANTI-INFECTIVE AGENTSoxytetracyclinesulfacetamide21.4 MYDRIATICSatropine21.5 MIOTICS and ANTIGLAUCOMA MEDICINESpilocarpine22. OXYTOCICS and UTERIC RELAXANTS22.1 OXYTOCICSmethyl ergometrineoxytocin23. PSYCHOTHERAPEUTIC MEDICINES78eye drops 2% (HCl/nitratebottle 5 mleye drops 4% (HCl/nitratebottle 5 mlcoated tablet 0.125 mg(maleate), bottle 100 tainjection 0.200 mg/ml,box 100 ampoules @ 1injection 10 IU/ml,box 100 ampoules @ 123.1 MEDICINES USED in GENERALIZED ANXIETY anddiazepamtablet 2 mg,bottle 1000 tabletstablet 5 mg,bottle 1000 tabletsi.m. injection 5 mg/ml,box 100 ampoules @ 223.2 MEDICINES USED in DEPRESSIVE DISORDERSamitriptylineeye ointment 1% (HCl),tube 3.5 geye drops 15% (sodium),bottle 5 mleye drops 0.5% (sulfate),bottle 5 mleye drops 1% (sulfate),coated tablet 25 mg (HClbox 10 blisters@10 tab

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMS USED for OBSESSIVE COMPULSIVE DISORDERSTESTINAL MEDICINEStablet 0.5 mg,bottle 100/1000 tabletstablet 1.5 mg,bottle 100/1000 tabletstablet 2 mg, box 100 tabletstablet 5 mg,bottle 100/1000 tabletsdrops 2 mg/ml,bottle 15 ml/100 mli.m. injection 2 mg/ml (HCl),box 5 ampoules @ 1 mli.m. injection 5 mg/ml (HCl),box 5 ampoules @ 1 mlinjection 50 mg/ml (asdecanoate),box 5 ampoules @ 1 ml(long acting)and OTHER ANTIULCER MEDICINESxide 200 mgroxide 200 mgtablet 25 mg (HCl),bottle 1000 tabletsS USED in PSYCHOTIC DISORDERScoated tablet 25 mg (HCl),bottle 1000 tabletscoated tablet 100 mg (HCl),bottle 1000 tabletsi.m. injection 25 mg/ml (HCl),box 100 ampoules @ 1 mlchewable tablet,bottle 1000 tabletsNote :- Second generationantipsychotic- Specific for PHC whichintegrated to mental healthcareNLEM antacid IIcombination of :aluminiumhydroxide 200 mg/5 mlmagnesiumhydroxide 200 mg/5 ml25.2 ANTIEMETIC MEDICINESchlorpromazinesuspension, bottle 60 mlcoated tablet 25 mg (HCbottle 1000 tabletsi.m. injection 25 mg/ml (Hbox 100 ampoules @i.m injection 5 mg/ml (HCbox 100 ampoules @dimenhydrinate tablet 50 mg, bottle 1000tablets25.3 ANTIHAEMORRHOID MEDICINESNLEM antihaemorrhoidcombination of :bismuth subgallate 150 mghexachlorophene 2.5 mglidocaine 10 mgzinc oxide 120 mgsupp to 2 gsuppositoria, box 100 s25.4 ANTISPASMODIC MEDICINESatropinetablet 1 mg (sulfate),tin 100 tabletsi.m./i.v./s.c. injection 0.25mg/ml (sulfate),box 100 ampoules @i.m./i.v./s.c. injection 1 m(sulfate),box 50 ampoules @ 1belladonna extracttablet 10 mg,bottle 100/1000 tablettial Medicines 20087980

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMalts:IVESnUSED IN DIARRHOEAideeACTING ON RESPIRATORY TRACTMATICnaline)ANTate0.52 g0.30 g0.58 g2.70 gMEDICINEStial Medicines 2008powder, 100 sacchs,each sacch for 200 ml ofwaterliquid, bottle 100 mltablet 0.5 mg,bottle 1000 tabletsi.v. injection 5 mg/ml (assodium phosphate),box 100 ampoules @ 1 mltablet 25 mg (HCl),bottle 1000 tabletsinjection 0.1 % (asHCl/bitartrate), box 100ampoules @ 1 mltablet 2 mg (as sulfate),bottle 100/1000 tabletstablet 4 mg (as sulfate),bottle 100/1000 tabletstablet 10 mg (HCl/phosphate),bottle 250 tabletstablet 15 mg (HBr),bottle 1000 tabletssyrup 10 mg/5 ml (HBr),bottle 60 mlsyrup 25 mg/5 ml,bottle 60 mltablet 100 mg,bottle 1000 tabletsNote :- Drink slowly to preventvomiting- 1 sachet to be dissolved in200 ml of water81obat batuk hitam (OBH)27. IMMUNOLOGICALS27.1 SERA and IMMUNOGLOBULINSantidiphtheria sera (A.D.S)antirabies sera27.2 VACCINESBCG vaccinediphtheria, pertusis andtetanus adsorbed vaccine(DPT)i.m. injection 10,000 IU/vbox 10 vials @ 5 mli.m. injection 20,000 IU/vbox 10 vials @ 10 mli.m. injection 100 IU/ml,box 10 vial @ 20 mlantitetanus sera (A.T.S) for prophylaxis :i.m. injection 1500IU/ampoulebox 10 ampoules @ 1for curative treatment :i.m./i.v. injection 10,000IU/ampoule,box 10 ampoules @ 2i.m./i.v injection 20,000IU/vial, box 10 vials@snake antivenom serasnake antivenom specialfor snake from outsidepapua (ABU I)snake antivenom specialfor papua snake (ABU II)82liquid, bottle 200 mlconcentrate liquid,bottle 1000 mli.m./i.v. injection, box 10@ 5 mli.c. injection,box 5 ampoules @ 2 mi.c. injection,box 5 ampoules @ 4 mi.m injection,box 10 vial @ 5 ml

EUTICNERICINN)DOSAGE FORMRESTRICTIONTHERAPEUTICCLASS, GENERICNAME (INN)DOSAGE FORMeinjection 20 mcg/ml,box 1 vial 0.5; 1 mls.c. injection, box 10 vials(10 doses) @ 5 mlNote :- Storage at 2 - 8 CNote :- Storage at 2 - 8 Cine drops, box vial 10/20 doses Note :- Storage at - 20 Cuman)s.c./i.c. powder for injection,box 7 vial @ 1 dose + 7ampoules solvent @ 2 mlbooster : box 5 ampoules @1 dose + 5 ampoulessolvent @ 4 mlIndication :- Storage at 2 - 8 C- Use for pre-exposure andpost-exposure treatment inrabies areaooooretinoltablet 5000 IU,bottle 1000 tabletssoft capsule 50,000 IU,bottle 50 capsulessoft capsule 100,000 IUbottle 50 capsulessoft capsule 200,000 IUpalmitate),bottle 50 capsulesthiamine tablet 50 mg (HCl),bottle 1000 tabletsvitamin B complextablet, bottle 1000 tabletvaccinebed toxoid)i.m. injection, box 1 vial 5 ml Note :- Storage at 2 - 8 Coeriaine (TD)i.m. injection,box 10 vial @ 5 mlNote :- Storage at 2 - 8 CoMINISTUSED FOR EAR, NOSE and THROATnd MINERALSear drops 10 %, bottle 5 mltablet 50 mg,bottle 1000 tabletstablet 500 mg,bottle 1000 tabletstablet 10 mg (HCl),bottle1000 tabletstablet 25 mg (HCl),bottle 1000 tabletsIDr. dr. SITI FADHtial Medicines 20088384

APPENDIX ICHANGES OF NLEM 2005

CHANGES OF NLEM 2005ERIC NAME(INN)DOSAGE FORMADDITION (+),DELETION (-),CHANGE OFDOSAGEFORMNOGENERIC NAME(INN)DOSAGE FO11 benzylpenicilin eye ointment 1000 IUolamidetablet 250 mg, bottle 100 tabletsi.m/i.v. powder for injection, 500mg/vial (as sodium salt),box 10 vials + 10 ampouleswater for injection @ 5 mlMoved to othertherapeutic subclass12 betamethasone eye drop 1 mg/ml (sobottle 5 ml13 bupivacaine infiltrate injection 0.25box 5 vial @ 20 mlcarbon activated powder, sacch 0,5 kg Change of genericname14 carbamazepine chewable tablet 100syrup 100 mg/5 ml, bolamidetablet 0.25 mg,box 10 stripes @ 10 tabletstablet 0.5 mg,box 10 stripes @ 10 tabletstablet 5 mg (HCl),bottle 100 tablets--15 cefazolin powder for injection 1box 2 vials16 ceftriaxone powder injection 1 gbox 2 vials17 chlorambucyl tablet 2 mgaronetericin *)tablet 200 mg, box 30 tabletsinjection 150 mg/3 ml,box 6 ampoules @ 3 mli.v injection vial 50 mg/10 ml,vials @ 10 ml++18 chloramphenicol ear drop 3 %, bottle 519 chlorhexidine sol 1.5 % (gluconate)sol 4.0 % (gluconate)20 chlorhexidine sol 5.0% (gluconate),anusunoglobulin (human)i.m. injection 500 UI, vial +21 chlormethine powder injection 10 m(HCl), box 1 vialnatei.v/i.m injection 60 mg/ml,box 8 vials @ 1 ml+22 clomiphen tablet 50 mg (citrate)bottle 10 tabletsriuminjection 25 mg/2.5 ml,ampoule 2.5 ml+23 clomipramine tablet 10 mg (HCl),bottle 250 tabletsil peroxydegel 2.5%, tube 5 ggel 5%, tube 5 g-24 clozapine ) tablet 25 mg, box 50tablet 50 mg, box 50tial Medicines 20088586

ERIC NAME(INN)DOSAGE FORMADDITION (+),DELETION (-),CHANGE OFDOSAGEFORMNOGENERIC NAME(INN)DOSAGE FOeinenation of:tamineeine1 mg50 mgnation of:. apii herba 92 mg. ortosiphonis folium28 mgund thymi syruptablet 10 mg (phosphate),bottle 250 tablettablet 500 mcg,box 3 stripes @ 10 tabletsChange of dosagestrength andpackagingtablet, box 30/100 tablets +capsuleliquid, bottle 100 ml---38 diloxanide tablet 500 mg (furoat39 disodium edetate eye drop 0.35%, bottinjection 25 mg/ml, am40 dobutamine injection 50 mg/ml, vi10 ml41 edrofonium injection i.v. 10 mg/mbox 10 vial @ 10 m42 efavirenz tablet 200 mg, bottletablet 600 mg, bottle43 enflurane inhalation liquid, bottr containing device set / pcs +rubicinpowder injection 20 mg/vial(HCl), box 1 vial @ 4 mlpressin spray Change of dosageformlization paste (nonn)n 70paste, bottleInfus sol 6%, bottle 500 mlse infusion solution 5 %,bottle 500 mllcarbamazinenscored tablet 100 mg (citrate),bottle 1000 tablettablet 0.0625 mg,bottle 100 tabletstablet 0.25 mg,bottle 100 tabletsinjection 0.25 mg/ml;box 1 ampoule 2 ml+--+Change of dosagestrength+44 etacridine (rivanol) solution 0.1 %, bottlepowder, bottle 100 g45 ethosuccimide capsule 250 mg,bottle 100/1000 capsyrup 250 mg/5 ml, b46 ethyl ester from oleumiodized papaveris(iodized oil)i.a./i.v. injection 1 mlconsist of 0.96 ml(equivalent with 0.4box 1 ampoule 10 m47 etonogestrel implant 1 rods (3 yrs)48 fe (II) sulfate 7H2O syrup, bottle 60 mlbox 5 ampoules @49 fentanyl i.m./i.v. injection 0.05(citrate),capsule/tablet 20 mg50 fluoxetine capsule/tablet 10 mgbox 30 tabletsbox 30 tabletstial Medicines 20088788

ERIC NAME(INN)DOSAGE FORMADDITION (+),DELETION (-),CHANGE OFDOSAGEFORMNOGENERIC NAME(INN)DOSAGE FOetinanspongen violetridolsterile kassa 1% (sulfate),box 10 piecescream 1%, bottle 30 mllayer 5 x 7 x 1 cmsol 1%, bottle 10 mli.m. injection 2 mg/ml (HCl)box 5 ampoules @ 1 mli.m. injection 5 mg/ml (HCl)box 5 ampoules @ 1 mlChange of salt formhlorothiazide tablet 25 mg, bottle 1000 tablets +ortisone tablet 10 mg +ortisoneortisone acetateediate insulinrm pastecream 1% (acetate), tube 5 geye drop 1%, bottle 5 mlinjection 40 IU/ml,box 1 vial 10 mlinjection 480 mg/ml,box 1 ampoule 10 mlpasteane inhalation liquid, bottle 250 ml +nalineinjection 1mg/ml (HCl),box 1 ampoule 2 mlofen suppositoria 100 mg +isoletablet 50 mg (HCl),box 4 bls @ 9 tablets------+----67 levertrane ointment 5%68 levonorgestrel pill 75 mcg, 150 mcg69 levonorgestrel implant 6 rods (5 yrs)70 lidocaine injection 5% + glucosampoule 2 ml1 : 200,000, box 10injection 2% (HCl) + e1 : 200,000, box 1071 lidocaine injection 1% (HCl) + evials @ 30 mlvials @ 20 ml72 liquor faberi liquor with menthol 0liquor with menthol 073 liquor veilli (salicylic acidsolution 0.1 %)combination of :salicylic acid 0.1 %boric acid 0.5 %glycerine 10 %solutionbox 3 stripes @ 10box 3 stripes @ 10box 3 stripes @ 1074 lisinopril tablet 5 mg,tablet 10 mg,tablet 20 mg,75 lithium carbonate tablet 200 mg,box 10 stripes @ 176 lopinavir tablet77 lotio kummerfeldi liquid, packaging as ntial Medicines 20088990

ERIC NAME(INN)tolinfusion sol 20%, bottle 500 mlalan tablet 2 mg +gococcussaccharide A + Cinempyronel cellulose,ged to benation ofoxypropyl methyllose5 mgran (70) 1 mgrine 2 mgalkonium chloride% w/vthylphenidate )l prednisolonelopramideolamnutritious solution Inutritious solution IIDOSAGE FORMpowder injection,box 10 vials @ 10 dosage +10 ampoules solvent @ 5 mli.m. injection 250 mg/ml,box 25 vials @ 10 mlbox 100 ampoules @ 2 mlsol 2 %, bottle 5 mlregular release tablet 10 mg,box 30 tabletsextended release tablet 20 mg,box 30 tabletstablet 4 mg, bottle 100 tabletssyrup 5 mg/5 ml, bottle 50 mldrop 0.1 mg/drop, bottle 10 mli.v. injection 1 mg/mli.v. injection 5 mg/mlinfusion sol, bottle 500 mlinfusion sol, bottle 500 mlADDITION (+),DELETION (-),CHANGE OFDOSAGEFORM---Change oftherapeutic subclassand thecomposition iswritten completely+-++--NOGENERIC NAME(INN)89 NLEM nutritious solution III infusion sel, bottle 5090 NLEM nutritious solution IV infusion sel, bottle 5091 NLEM nutritious solution V infusion sel, bottle 5092 NLEM otic medicinecombination of:neomycin sulfate 500 mgpolymixin B sulfate1,000,000 IU/100 mlear drop, bottle 5 ml93 neomycin tablet 500 mg, bottle94 nicotinamide tablet 100 mg95 norepinephrine injection 4 mg/ml, am96 nutritious solutioncombination of :glucose 4 %sodium chloride 0.18 %DOSAGE FOinfusion sol, bottle 5097 oral rehydration salts powder, 100 sacch, efor 1000 ml of wate98 pancuronium i.v. injection 2 mg/mlbox 10 ampoules @99 paracetamol suppositoria 120 mgsuppositoria 240 mg100 patent blue V s.c. injection 2.5%,box 1 ampoule 2 m101 permethrin cream 5%, tubebottle 100/1000 tabbottle 100/1000 table102 perphenazin tablet 4 mg (HCl),tablet 16 mg (HCl),tial Medicines 20089192

ERIC NAME(INN)DOSAGE FORMADDITION (+),DELETION (-),CHANGE OFDOSAGEFORMNOGENERIC NAME(INN)DOSAGE FObarbital tablet 50 mg, bottle 1000 tablets +l liquidbottle 10 mltoin syrup 50 mg/5 ml, bottle120 ml +118 resin composite set119 retinol tablet 5000 IU, bottlesoft capsule 100,000bottle 50 soft capsuenadionetigminei.m injection 2 mg/ml,ampoule 1 mltablet 10 mg (bromide),box 10 stripes/bls @ 10 tablets+-120 retinol injection 100,000 IU/box 100 ampoulesoily injection 100,000IU/ampoule (as palbox 100 ampoulessulen (metacresolhonate & methanaldensate)solonnamidenololliquid, bottle 10 ml / 50 mleye drop 0.5%, bottle 5 mleye ointment 1%, tube 3.5 ginjection 100 mg/ml (HCl)scored tablet 40 mg (HCl),bottle 100 tabletsMoved to othertherapeutic class--+121 regular insulin injection 40 IU/ml,box 1 vial 10 ml122 regular insulin :intermediate insulin (30: 70)injection 100 IU/ml,box 1 vial 10 ml123 rocuronium i.v. injection 10 mg/m124 silver amalgam powder 65 - 75%, bo125 silver nitrate sol 40%, bottle 10 mliodoneoily injection 500 - 600 mg/ml,box 1 ampoule 20 mlthiouracyl tablet 100 mg, bottle 1000 tablets Change of dosagestrength-126 sodium bicarbonate injection 1.4% isoton127 sodium fucidic cream 20 mg/g, tube128 sodium nitroprusside *) injection, vialnololplasma fractioning fibrinogen)ineintablet 10 mg, box 100 tabletstablet 40 mg, box 100 tabletstablet 200 mg (sulfate),bottle 100/1000 tabletstablet 0.10 mg, bottle 1000 tabletstablet 0.25 mg, bottle 1000 tablets-Dosage form andstrength are deleted--129 stavudin tablet 30 mg, bottle 6tablet 40 mg, bottle 6130 succinyl choline iv/i.m powder injectiomg/vial (chloride), b131 sufentanyl injection 50 mcg/ml (cbox 5 vial @ 5 mltial Medicines 20089394

ERIC NAME(INN)DOSAGE FORMADDITION (+),DELETION (-),CHANGE OFDOSAGEFORMNOGENERIC NAME(INN)DOSAGE FOic preparationcones, bottle 100 butir-144 zidovudine tablet 100 mg, bottlecapsule 50 mg,box 10 stripes @ 10 capsulestablet 200 mg,box 2 stripes @ 10 tablets-145 zinc phosphate cement powder and liquid, sebottle 1 setethonium i.v./i.m. powder injection 500mg/vial (chlorida), box 10 vial-neinjection 100 mg/ml,box 100 ampoules 1 ml-ntal i.v. powder for injection 500mg/ampoule (as sodium salt)(for dissolved in 20 ml WFI),box 25 ampoules-racetic acidmideulin proteinified derivative)atemycinniumincrystal, saccheye drop 1%, bottle 5 mli.c. injection 1:10,box 1 vial 25 mltablet 250 mg (as sodium salt),bottle 50 tabletstablet 500 mg (as sodium salt),bottle 50 tabletssyrup 250 mg/5 ml (as sodiumsalt), bottle 120 mlpowder injection 500 mg/vial,box 1 vialpowder injection 10 mg/vial(bromide), box 20 vialstablet 2 mg (potassium salt), bottle100 tablets---Change of dosageform and strength++Change of dosagestrengthtial Medicines 20089596

APPENDIX IIDECREE OF THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIANUMBER: 239/MENKES/SK/III/2008

THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIATHE MINISTER OF HEAOF THE REPUBLIC OF INDONTHE DECREE OF THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIANUMBER: 239/MENKES/SK/III/2008REGARDINGE ESTABLISHMENT OF NATIONAL COMMITTEE ON REVISIONOF THE NATIONAL LIST OF ESSENTIAL MEDICINES 2008HE MINISTER OF HEALTH OF THE REPUBLIC OF INDONESIA: a. in order to enhance the quality of health services, the availability of agood quality, safe, effective and sufficient quantity of essentialmedicines is the responsibility of the government as authorized inthe National Medicines Policy;b. as according to the point (a) above, it is necessary to support theimplementation of rational use of medicines;c. as according to the progress of the medical sciences and healthtechnology, disease pattern, health program and the improvementof public health status as a result of the currently healthdevelopment, it is therefore, the National list of Essential Medicinesshould be revised;d. in order to revise the National List of Essential Medicines (NLEM), itis necessary to establish The National Committee On Revision ofthe National List of Essential Medicines 2008 by Ministerial decree.: 1. Law No. 23 year 1992 regarding Health (State Paper year 1992 No.100, additional to State Paper No. 4431);2. Government Regulation No. 27 year 1998 regarding Safety ofPharmaceutical Products and Medical Devices (State Paper year1998 No. 138, Additional to State Papers of the Republic ofIndonesia No. 3781);3. Government Regulation No. 38 year 2007 regarding Division ofMunicipality/District Administrative (State of the Republic ofIndonesian Paper year 2007 No. 82);4. The Regulation of the Presidyear 2005 regarding the loorganization and the job desRepublic of Indonesia;5. The Regulation of the Presidyear 2005 regarding OrganiOfficers of the States Ministri6. The Regulation of the MinisteNo. 1575/Menkes/Per/XI/20Ethical Task of the Health De7. The Decree of the MinisterNo. 189/MENKES/SK/III/20Policy.OF THE NATIONAL LIST OF ESHas decidedTo stipulate : THE DECREE OF THE MINISTESTABLISMENT OF THE NATThe First : To establish The National ComEssential Medicines 2008 with oappendix hereto;The Second : The responsibilities of National Ca. The Steering CommitteeThe Steering Committee isdirection of the revisionregulations;b. The Expert TeamThe Expert Team is respons2005 and to analyze the prdeleted from the NLEM 2008c. The ConsultantThe consultant is responsibscientific findings needed bytial Medicines 20089798

THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIATHE MINISTER OF HEAOF THE REPUBLIC OF INDONd. The Expert Team and The Consultant jointly provide the technicaland the scientific support to the Ministry of Health vide DirectorateGeneral of Pharmaceutical Services and Medical Devices onimplementing NLEM nationwide and to assist the Directorate ofRational Use of Medicine to execute its policy.e. The MembersThe Members are responsible to provide input needed forevaluation of NLEM 2005 and to analyze the proposed medicines tobe added to or deleted from NLEM 2008.IDr.f. The Organizing CommitteeThe Organizing Committee are responsible in recording,documentation and supplying the data, preparing the proceduresand guidelines, and preparing the recommended draft of NLEM2008, arranging the technical meetings and plenary session,preparing the draft documentations, and finalizing NLEM 2008 andits dissemination.: The Revision of NLEM should be conducted during 2008;: On implementing the duties of The National Committee of Revision ofNLEM are responsible to the Ministry of Health vide Directorate Generalof Pharmaceutical Services and Medical Devices; and report theactivities at least 1 (one) month after the termination of their task.Circulation to:1. The Coordinator Minister of the Public Welfare2. The Minister of Home Affair3. The Head of National Planning and Development Board4. The Head of National Agency of Drug and Food Control5. The First Ranks officers in the Ministry of Health.6. The Head of Province Health Office all over the Republic of I7. The Directors of all Teaching Hospitals and Vertical Hospitthe Republic of Indonesia.8. The Head of Municipality or District Health Office all over the9. Whom it may concern, to be implemented as required.: The duty period of The National Committee of Revision of NLEM startedsince the stipulation date of this decree and terminated at the end of2008.: The budget of The National Committee of Revision of NLEM andactivities is under Annual National Budget of Directorate of Rational Useof Medicine in the year of 2008;: This decree shall be effective as of the date of stipulation, and there willbe reconsideration or amendment as required if there are shortcomingsof mistakes in the stipulation.tial Medicines 200899100

THE MINISTER OF HEALTHOF THE REPUBLIC OF INDONESIATHE MINISTER OF HEAOF THE REPUBLIC OF INDONAPPENDIX :THE DECREE OF THE MINISTER OF HEALTH OFTHE REPUBLIC OF INDONESIANUMBER : 239/MENKES/SK/III/2008DATE : MARCH 5, 2008E ESTABLISHMENT OF NATIONAL COMMITTEE ON REVISIONOF THE NATIONAL LIST OF ESSENTIAL MEDICINES 2008tee :1. Director General of Pharmaceutical Services and Medical Devices2. Head of National Agency of Food and Drug Control3. Director General of Medical Services4. Director General of Diseases Control and Sanitation5. Deputy 1 of National Agency of Food and Drug Control: Director General of Pharmaceutical Services and Medical devicesChairman : Iwan Darmansjah (General Practitioner)Vice Chairman : Rianto Setiabudy (General Practitioner)Members :1. Abdul Muthalib (General Practitioner)2. Asril Aminullah (General Practitioner)3. Bambang Sudarmanto (Specialist)4. Dede Gunawan (Specialist)5. Djakaria (Specialist)6. Gunawan (Specialist)7. Hanafi Trisnohadi (Specialist)8. Inge Sutanto (General Practitioner)9. Nugroho Kampono (Specialist)10. Omo Abdul Madjid (Specialist)11. Robert Reverger (Specialist)12. Sarwono Waspadji (specialist)13. Silvia Desiree Fadiel (Dentist)14. Sri Rezeki S. Hadinegoro (Specialist)7. Nani Sukasedi8. Pinky F. Riawa9. Sri Suryawati (Organizing Committee :Head : Director of RationaSecretary : Zorni Fadia (GeneSeecretary I : Dita Novianti (PharMembers :1. Secretary toServices and M2. Director of Pub3. Director of Mat4. Director of Chil5. Director of Dire6. Director of Anim7. Director of Non8. Director of Epiand Dimension9. Head of SubTechnical AsDirectorateSecretariat :1. Erie Gusnellya2. Liza Fetrisiani (3. Prihadi Mulyon4. Anwar Wahyud5. Nofiyanti6. Mulyatitial Medicines 20081. Arini Setiawati ((Pharmacist)2. Atie W. Soekandar (General Practitioner)3. Engko Sosialine (Pharmacist)4. Irawan Mangunatmaja (Specialist)5. Iwan Dwiprahasto (General Practitioner)6. Kartono Muhammad (General Practitioner)101102IDr.

APPENDIX IIIPARTICIPANTS OF TECHNICAL MEETINGSAND PLENARY SESSIONIONAL LIST OF ESSENTIAL MEDICINES2008

PARTICIPANTS OF TECHNICAL MEETINGSAND PLENARY SESSIONIONAL LIST OF ESSENTIAL MEDICINES2008eral of Pharmaceutical Services and Medical Devicesional Agency of Food and Drug Controleral of Medical Serviceseral of Diseases Control and Sanitationational Agency of Food and Drug ControlDirector General of Pharmaceutical Services and Medical Devicesational Use of Medicineublic Medicines and Medical Supplyaternal Healthhild Healthirect Communicable Diseases Controlon-Communicable Diseases Controlnimal Sourced Diseases Eliminationpidemiologic Surveillance, Immunization and Dimension Healthublic Nutritionental Health Servicesrimary Medical Servicespecialist Medical Servicesublic Hospital Dr. M Yunus Bengkuluublic Hospital DR. M. Djamil Padangublic Hospital Ulin Banjarmasinational Public Hospital RS Cipto Mangunkusumoentral Public Hospital Hasan Sadikin Bandungentral Public Hospital Muh. Hussein Palembangublic Hospital dr. Moewardi, Soloublic Hospital dr. Sardjito, Yogyakartaentral Public Hospital Wahidin Sudirohusodo, Makasarublic Hospital Dr. Karyadi, Semarangublic Cardiovascular Hospital Harapan Kitaental Hospital Cimahirovincial Public Hospital Wahidin Sudirohusodo Mojokerto-East Javarovincial Public Hospital dr. Soetomo, Surabayaublic Hospital Kab. Tangerangrovincial Public Hospital Arifin Achmad, Pekanbaruentral Public Hospital Sanglah - Denpasariloam Karawaci Hospital, Bantenumber Waras Hospital, Jakartausada Hospital, Jakartaublic Hospital Yos Sudarso, PadangT. IndofarmaT. Kimia FarmaT. Phaprostorate of National Army - POLRI44 Head of Provincial Health Office in Nangroe Aceh Darusala45 Head of Provincial Health Office in South Sulawesi46 Head of Provincial Health Office in DKI Jakarta47 Head of Provincial Health Office in West Java48 Head of Provincial Health Office in Central Java49 Head of Provincial Health Office in East Java50 Head of Provincial Health Office in West Kalimantan51 Head of Provincial Health Office in Central Kalimantan52 Head of Provincial Health Office in Western Southeast Nus53 Head of Provincial Health Office in Eastern Southeast Nusa54 Head of Provincial Health Office in Papua55 Head of Provincial Health Office in Central Sulawesi56 Head of Provincial Health Office in North Sulawesi57 Head of Provincial Health Office in West Sumatera58 Head of Provincial Health Office in North Sumatera59 Head of District Health Office in Karang Anyar60 Head of District Health Office in Sleman61 Head of District Health Office in Surakarta62 Head of Public Health Center of Pajang, Surakarta63 Head of Public Health Center of Tebet, Jakarta64 Chairman of Indonesian Medical Doctors Association65 Chairman of Indonesian Midwives Association66 Chairman of Indonesian Pharmacologist Association67 Chairman of Indonesian Nursery Association68 Chairman of Indonesian Pharmacist Association69 Chairman of Indonesian Anesthesiologist and Reanimation70 Prof. dr. Iwan Darmansjah, SpFK.71 Prof. dr. Rianto Setiabudy, SpFK.72 Prof. dr. Abdul Muthalib, SpPD (K).73 Prof. dr. Djakaria, SpRad (K).74 Prof. dr. Nugroho Kampono, SpOG.75 Prof. Dr. dr. Hanafi Trisnohadi, SpKJ(K)76 Prof. Dr. dr. Inge Sutanto77 Prof. Dr. dr. Sarwono Waspadji, SpPD (K)78 Prof. Dr. dr. Sri Rezeki S. Hadinegoro,SpA (K)79 Prof. Dr. Arini Setiawati,PhD.80 Prof. dr. Iwan Dwiprahasto, M.MedSc, PhD.81 Prof. dr. Asril Aminullah, Sp.A (K)82 dr. Omo Abdul Madjid, SpOG.83 dr. Bambang Sudarmanto, Sp.A.84 dr. Dede Gunawan, SpS (K)85 dr. Robert Reverger, SpKJ (K)86 dr. Gunawan Darmansjah, SpAn.87 dr. Irawan Mangunatmadja , SpA.(K)88 drg. Silvia Desiree, SpKGA89 DR. Atie W. Soekandar, Sp.FK.90 DR. Sri Suryawati91 dr. Kartono Muhammad92 dr. Pinky F. Riawan93 Dra. Engko Sosialine, M. Biomedtial Medicines 2008103104

iaAkhmaduliati, Apt.i, S.Si, Apt, MMyanti, S.Si, Apt.ibihanindyo Putroelia, Apt.aza, Apt.hafat, S.Si, Apt.tooonouditial Medicines 2008105

APPENDIX IVSTATEMENT OF COMPLIANCE

::STATEMENT OF COMPLIANCEHAIRMAN/VICE CHAIRMAN/ EXPERT/CONSULTANT*)d below,s:ed to be the Chairman/Vice Chairman/Expert/Consultant*) of The Nationalittee of NLEM (National List of Essential Medicines) 2008.ed to attend Technical Discussion Meeting of NLEM Revision.ed to sign Conflict of Interest Statement.Jakarta, .......................................( )nnecessary statementtial Medicines 2008107

APPENDIX VONFLICT OF INTEREST STATEMENT

CONFLICT OF INTEREST STATEMENTndonesian National Essential Medicines Committee (2008)ion of the Selection of Essential Medicines an evaluation committee isuld guarantee that its members are impartial and free from conflicts ofuld biased the outcome of their choice(s) of medicines. Therefore allen as National Committee Members are required to sign a statement asnted:irect family members, including self, have important positions in or haves in the drug business so as to bias his/her selection.mittee Members, including Chairman and Consultants, should not solicit orve money or gratuities that clearly indicate a form of bribery.mittee Members should refrain from presenting faked data in the form ofcations or statements of dubious nature.deliberations members should use their intellectual judgment, instead ofg mere opinions without support of scientific data.n in the discussion of a subject, a member feels that he/she might have aict of judgment, he/she must acknowledge the chairman of the nature of itsible conflict. In the case of a serious conflict of interest, he/she will not beed to participate in a voting procedure.mittee Members may not deliberately leak important confidential issues ofion to a third party.d below:....................................airman / Vice Chairman / Member / Consultant/she understood the above statement and will obey the written rules above.------------------- ----------------------berDatetial Medicines 2008109

APPENDIX VIASSESSMENT FORM APPLICATIONFOR ADDITION/DELETION OFIONAL LIST OF ESSENTIAL MEDICINES2008

yASSESSMENT FORM APPLICATIONFOR ADDITION / DELETION OFNATIONAL LIST OF ESSENTIAL MEDICINES2008of deletionrelationSUBJECTration with similar medicine on the listacological characteristiceness evidenceevidenceationcost ratioing of the medicine by international guidanceing laws and regulatiuon which is supporting to delete the medicinemendationncesApplication fromName of Institution :Address :Phone No/Facs :NOTHERAPEUTICCLASSRECAPITULATION OF APPLFOR NLEM REVISIO2008GENERICNAME(INN)DOSAGEFORMPACKAGINGExplanation :*) Based on trusted literature / reference*) Enclose the related literature / referencetial Medicines 2008111112

INDEX

DRUG INDEX1, 74, see acetosal64, 43, 44, 56, 63, 72, 75, 81de, 53, 54, 79, 8080, 69te, 23, 654947, 55, 77, 81, see A.D.S, 82oglobulin (human), 57ee A.T.S8349, 55, 63, 78, 8082t, 55, 800ride, 50penicillin, 23, 6545, 68, 75ystal, 23, 655, 49, 76bismuth subgallate, 54, 80bleomycin, 32boric acid, 46budesonide, 56bupivacaine, 18, 49busulfan, 32Ccaffeine, 31, 70calcium, 35calcium folinic, 20, 32, 63calcium gluconate, 21, 47, 59calcium hydroxide, 38, 72calcium hypochlorite, 38, 71calcium lactate, 59, 83captopril, 43, 44, 74, 75carbamazepine, 21carboglycerine, 58, 83cefazolin, 23ceftriaxon, 23chlorambucyl, 32chloramphenicol, 25, 66chlorhexidine, 38, 39chlorine base compound, 38chloroquine, 29, 30, 69chlorpheniramine, 20, 63chlorphenol camphor menthol, 39, 72chlorpromazine, 51, 54, 79, 80clozapine, 52ciclosporin, 32ciprofloxacin, 26clindamycin, 25clofazimine, micronized, 26, 67clomipramine, 51, 79clonidine, 43coal tar, 46, 76codeine, 17, 56, 81conjugated estrogen, 41copper-containing device, 41, 73cyanocobalamine, 34, 70cyclophosphamide, 32cysplatin, 32cytarabine, 32DDG ana, 47DPT, 58, 82dacarbazine, 32dactinomycin, 33dapsone, 26, 67darrow glucose ana, see DG ana,daunorubicin, 33deferoxamine, 21desmopressin, 40dexamethasone, 20, 42, 56, 63, 74, 81dextran, 50dextromethorphan, 56, 81dextrose, 48diazepam, 20, 21, 51, 63, 64, 78dicloxacillin, 24diethylcarbamazine, 23, 65digoxin, 42, 44, 75dihydroergotamine, 31, 70diloxanide, 29diltiazem HCl, 42dimenhydrinate, 54, 80diphenhydramine, 20, 63diphtheria pertusis and tetanus adsorbedvaccine, see DTPdisopyramide, 42dobutamine, 44dopamine, 44doxorubicin, 33doxycycline, 24Eefavirenz, 31ephedrine, 45, 56, 81epinephrine, see adrenalinergocalciferol, 59ergotamine, 31, 70erythromycin, 25, 67ethambutol, 27, 28, 67, 68ethanol 70%, 38, 71ethinylestradiol, 41, 73ethyl chloride, 18, 39, 62, 72etoposide, 33eugenol, 39, 72Ffactor IX complex, 35factor VIII (concentrate), 35fe (II)sulfate 7 H 2 O, 34, 70fentanyl, 17fluorine, 39, 72fluorescein, 37, 71fluorouracyl, 33fluoxefluphefolic afurosGgelatigentaglassTreatglibenglipizglucoglyceglycegriseoguttaHhalf shalophalothhepahexachexamhepahomahydrohydrohydrohydrohydrohydroIibupridoxuimmuintermintraliiodineiohexiopamiopheisofluisoniaisosotial Medicines 2008113114

, see calcium folinic, 7339, 43, 54, 58, 62, 72, 80ergents, 47, 7775173, 21, 50, 64xide, 53, 54, 79, 8058, 8364rone acetate, 31, 41, 73rizoate, 36amidotrizoate, 36, 373nate, see policresulenate, see policresulendelate, see hexamine mandelate8, 61e, 50, 78hloride, 21e methylthioninium chloride5354, 29, 67, 69534, 63NNLEM antacid I, 53, 79NLEM antacid II, 54, 80NLEM antifungal medicines, 29, 45, 68, 75NLEM antihaemorrhoid, 54, 80NLEM anti-infective medicines, 45, 75NLEM antimalarial medicines, 29, 69NLEM antiparkinsonism medicines, 34, 70NLEM co-trimoxazole I, 25, 28, 66, 68NLEM co-trimoxazole II, 25, 66NLEM co-trimoxazole III, 25NLEM dental anaesthetics, 38, 72NLEM haemodialysis solution, 47NLEM media contrast substance, 36NLEM nutritious solution, 48NLEM plasma substitutes, 35NLEM peritoneal dialysis solution, 47naloxone, 21neostigmine, 53nevirapine, 31nicotinamide, 59nifedipine, 43nitrofurantoine, 28, 68nitroglycerine, 42nitrous oxide, 19norepinephrine, 45norethisterone, 41nystatin, 29, 39, 68, 72nutritious solution, 48O2-4 ointment, 46, 76OBH, 57, 82oral rehydration salts, 47, 55, 77, 81oxymetazoline, 59oxytetracycline, 24, 49, 66, 78oxygen, 19, 62oxytocin, 50, 78Pparaformaldehyde, 38, 71paracetamol, 18, 61permethrin, 46pethidine, 17, 61penicillin V, 24, 65phenobarbital, 22, 64phenoxymethylpenicillin, see penicillin Vphenylbutazone, 18phenytoin, 22, 64phytomenadione, 34, 71pilocarpine, 50, 78podophyllum resin, 46, 76policresulen, 38poliomyelitis vaccine, 58, 83polygeline, 35polymixin B, 45, 75potassium chloride, 35, 47, 48, 55, 77, 81povidone-iodine, 38, 71praziquantel, 22, 23prednisone, 42, 74primaquine, 30, 69probenecid, 18, 62procaine benzylpenicillin, 24, 66procarbazine, 33propofol, 19propranolol, 31, 43, 74propylthiouracyl, 41, 73protamine sulfate, 21, 35protein plasma fraction, 35pyrantel, 23, 65pyrazinamide, 27, 28, 67, 68pyridostigmine, 53pyridoxine, 59, 83pyrimethamine, 29, 69pyrogen free sterile water, 35Qquinine, 30, 69Rrabies vaccine (human), 58, 83ranitidine, 54regular insulin, 40resin composite, 39, 72retinoic acid, 45retinol, 59, 84rifampicin, 26, 27, 28, 67, 68ringer lactate, 48, 77risperidone, 52rocuronium, 53root canal filling, 39, 72Ssalbutamol, 56, 81salicylic acid, 29, 45, 46, 47, 68, 75, 76salicylic acid solution 0,1%, see liquor veillisalicyl psaponificsilver nitrsilver sulsimethicosimvastasnake ansodium asodium bsodium bsodium csodium csodium dsodium hsodium iosodium nsodium tspironolastavudinestreptokistreptomsuccinylcsufentansulfacetasulfadiazsulfadoxisulfametsulfasalasulfur presurgical gTTD, 58,tamoxifetestostertemporartetanus atetanus atoxoidtetanus atetracaintetracyclithiaminethiopentathyroxinetimolol, 5trihexyphtrimethoptrisodiumtuberculitial Medicines 2008115116

X-Y-Z, 59, 84zidovudine, 30zinc oxide, 54, 80, 48, 77tial Medicines 2008117