Formularium_obat_1

TAHUN 2018 GOLONGAN ANTIBIOTIK

NO

1

2 3 4

NAMA GENERIK Amoxicillin 500 mg kapsul

NAMA DAGANG Topcillin 500mg

Amoxicillin 1 gram injeksi Amoxicillin 125mg/5ml syrup Amoxicillin 250mg/5ml syrup Amoxicilliin 100mg/ml drop Ampicillin 1 gram Ampicillin 500mg tablet Azythromycin 500mg tablet Ciprofloksasin 500mg tablet Ciprofloksasin 200mg/100ml infus Thiamfenicol 500 mg kapsul

Amoxicillin inj Yusimox syr

5 Thiamfenicol 125mg/5ml syrup Cefadroxyl 500 mg kapsul

PABRIKAN

Supramox drop Sagestam inj Azytromicin tab Floxifar Ciprofloxacin Dionicol 500 kapsul Dionicol sirup Thiamfilex sirup Cefadroxil 500mg kapsul

6 7

8

9

Cefadroxyl 150mg/1ml Cefadroxyl 125mg/5ml syrup Cefadroxyl 250 mg/5ml syrup Cefrixime 100mg kapsul

Lapicef drop Lostacef Sirup

Cefixime 100mg/5ml syrup

Cefila Sirup Helixim sirup

Cefotaxim 1 gram injeksi Ceftriaxon 1 gram injeksi

10 Chloramphenicol TM 11

12

Maxpro 100mg

Chloramphenicol TT Co amoxiclav 500mg kapsul

Cefxon inj Infibiotic inj Broadced inj Reco TM Colme TM Erla tm Erlamicetin TT Duazat kaplet 1

13 14 15 16 17 18

Co amoxiclav 500mg sirup Clindamycin 150 mg kapsul Clindamycin 300mg kapsul Colistin 1,5jt IU tablet Doxycyclin 100mg kapsul Erythromicin 500mg tablet Erythromicin 200mg Erythromicin syrup

19 20

Ethambutol 500mg tablet Metronidazol 500 mg tablet Metronidazol 500mg/100ml infus

21

Metronidazol Supp Metronidazol 500 mg/ml syrup

22

Gentamicin 40mg/ml injeksi Gentamicin cream

23

Amikasin 125 mg/ml injeksi

24

25

26 27 28 31 32 33

34

INH 100 mg tablet INH 300 mg tablet INH 400 mg tablet INH + Piridoksin Levofloxacin 500 mg tablet Levofloxacin 500 mg/ 100 ml infus Meropenem 0,5 gr injeksi Meropenem 1 gr injeksi Mupirosin krim Neomycin salep Oxy Tetracyclin salep mata Pyrazinamide 500 mg tablet Rifampicin 300 mg kapsul Rifampicin 450 mg kapsul Rifampicin 600 mg kapsul Cotrimoxazole 240 mg tablet Cotrimoxazole 480 mg tablet

Aclam Kaplet Aclam Sirup

Dohixat kapsul Eryra kaplet Erysanbe 200 Chewable tab Eryra sirup

Molazol Kaplet Nulagyl infus 500 mg/100 ml Fiondazol 500 mg/100 ml Provagin 1 gr supp Vagizol 500 mg ovula Metrolet sirup Farizol Sirup Ottogenta inj Genoint cream Genoint Salep Mata Mikaject 250 inj Mikasin 250 inj TB Vit 6 tablet TB Vit 6 sirup

Pibaksin Nebacetin TB Zet Tablet

Bactoprim Sisoprim Bactoprim Forte Sisoprim Forte Infatrim Forte 2

35

Cotrimoxazole 120 mg/5 ml syrup Asam pipemidat 400mg/kapsul

Bactoprim sirup Urinter

GOLONGAN ANTI FUNGI 1

2

3 4

Miconazole nitrate 2% Ketoconazole 200 mg tablet

Solinfec tablet

Ketoconazole 2% cream

Solinfec Salep

Flukonazole 50 mg kapsul Nystatin 100.000IU/ml

Kiflusol Nyndia drop Kandistatin drop Cazetin drop

GOLONGAN ANTI ALERGI 1

2

Loratadine 10 mg tablet Loratadine sirup Cetirizine 10 mg tablet

Winantin Lorihis Lerzin

Cetirizine 5 mg/ 5 ml syrup

Ritez sirup Lerzin sirup Ryvell drop Ritez drop Interhistin Pronicy Alleron Mexon Prodex

Cetirizine 10 mg/ml drops 3 4 5

Mebhydrolin 50 mg tablet Ciproheptadin 4mg tablet CTM 4mg tablet

6

CTM plus betametason

GOLONGAN ANTI ASMA

1

2 3

Salbutamol 2 mg tablet Salbutamol 4 mg tablet Salbutamol 2,5 mg Nebul

Ipratrium br 21 mcg, salb 120mcg Fluticasone Nebule Terbutaline 2.5 mg tablet Terbutaline injeksi

Lasal Pritasma Ventolin Suprasma Februlin Combiven Flixotide Neosma Nairet inj 3

4 5 6

Theophylin 300mg + salbutamol Ketotifen 1 mg tablet epedrin inj Aminophyllin 24mg/ml injeksi

Teosal Intifen vasodrin inj

GOLONGAN NASAL DEKONGESTAN, ANTITUSIF DAN INFLUENZA 1

2 3 4 5 6 7 8 9

Tripolidine 2,5 mg tablet + Pseudoefedrine 60 mg tablet

Tremenza tablet Valved Alerfed tablet

Loratadine 5 mg tablet + Pseudoefedrine 120 mg tablet Paracetamol 500mg, PPA 12,5mg, CTM 2mg, DMP 15mg Paracetamol 125mg, PPA 3,125mg, CTM 0,5mg, DMP 3,75mg Paracetamol 500mg, PPA 12,5mg, CTM 2mg, DMP 10mg, GG 50mg, PPA 12,5mg,CTM 1mg Diphenhidramine 12,5mg, Amm klorida 100mg DMP 10mg, diphenhidramin,amm klorida Tripolidine + pseudoephedrin syrup Pseudoefedrin hcl 7.5 mg drop

Alpara tablet Alpara syrup Molexflu tablet Dextral tablet Sanadryl exp syrup Sanadryl DMP syrup Rhinofed sirup Rhinos Neo drop Alco drob

GOLONGAN NSAID 1

2 3

4 5 6 7

Natrium Diclofenac 50 mg tablet Kalium Diclofenac 50 mg tablet Meloxicam 7,5 mg tablet Meloxicam 15 mg tablet Methampyron 500 mg, Vit B1 50 mg, Vit B6 100 mg, Vit B12 100 mcg tablet Natrium Diclofenac 50 mg, Vit B1 50 mg, Vit B6 50 mg, Vit B12 1 mg tablet Ketorolac Tromethamine 30 mg/ml Ketorolac Tromethamine 10 mg tablet

Voltadex Diclofam Kaditic

Velcox Flasicox Neuralgin

Teranol Inj Teranol tablet 4

8

9

Ketoprofen 100 mg tablet Ketoprofen 100 mg supp Piroxicam 20 mg kapsul Tramadol 37,5 mg + Paracetamol 325 mg

Protofen supp kaltropen supp Wiros patral tab Analtram tablet

GOLONGAN KORTIKOSTEROID 1

2

Mometasone Furoate 0,1% cream 5 gr Methylprednisolone 4 mg tablet Methylprednisolone 8 mg tablet Methylprednisolone 16 mg tablet Methylprednisolone 125 mg injeksi Methylprednisolone 500 mg injeksi Dexamethasone 0,5 mg

4

5 6 7

Dexamethasone 5 mg/ml Betamethasone cream Desoximethasone cream Diflucortolone 1 mg/gr

Elox cream mofacord cream Rhemafar tablet

Stenirol injeksi Indexon tablet Carbidu kalmetason

Dexocort krim

GOLONGAN ANTIBIOTIK + KORTIKOSTEROID TOPIKAL 1 2 3

Betamethasone + Neomycin cream Betamethasone + Gentemycin cream Desonid + Neomycin

Denomix salep Digenta krim

GOLONGAN ANTI VIRUS 1 2

Acyclovir 200 mg tablet Acyclovir 400 mg tablet Acyclovir cream Methisoprinol tablet Metisoprinol sirup

Laprosin tablet Maxprinol sirup pronovir sirup

GOLONGAN ANTIPIRETIK/ANALGESIK Paracetamol 500 mg tablet Paracetamol 120 mg/5 ml 1

Paracetamol 250mg sirup

Sanmol tablet Maganol tablet Sanmol syrup fasidol sirup Cupanol syrup praxion sirup kamolas Forte sirup 5

Paracetamol 60 mg/0,6 ml drops

Paracetamol 100 mg/100 ml infus Asam Mefenamat 500 mg 2

3

Ibuprofen 200 mg tablet Ibuprofen 400 mg tablet Ibuprofen 100 mg/5 ml suspensi

Metamizole 500 mg tablet Metamizole 500 mg/ml injeksi 4 Metamizole 500 mg/5 ml syrup

Sanmol drops kamolas drop alpamol drop Fioramol infus Mefinter ponsamic Mefentan opistan lexaprofen Iprox Suspensi farsifen sirup Termofen Suspensi Antrain tablet Antrain injeksi ginifar tab Norages injeksi Norages syrup

GOLONGAN ANTI MUAL DAN MUNTAH 1

Metoclopramide 10 mg tablet Metoclopramide 5 mg/ml injeksi metoclorpramid 10mg/5ml Ondansetron 4 mg tablet Ondansetron 8 mg tablet Ondansetron 4 mg/ 2 ml injeksi

Nilatika tablet sotatic inj norvom sirup

Ondansetron 8 mg/ 4 ml injeksi Ondansetron 4 mg/5 ml syrup

Ondane injeksi Ondane syrup

Domperidone 10 mg tablet Domperidone 5 mg/5ml syrup

Vesperum Tablet Vometa sirup vesperum sirup lexadon sirup Vometa drop Vomil B6 tablet Mediamer

2

3

4

Domperidone 5 mg/ml drops Pyrathiazine Theoclate + Pyridoxine

GOLONGAN ANTI ULKUS PEPTIKUM 1 2

Omeprazole 20 mg kapsul Omeprazole 40 mg injeksi Pantoprazole 40 mg injeksi

OPM Norsec inj

6

3

4 5

6 7 8 9 10 12 13 14 15 16 17

Ranitidin 25 mg/ml injeksi Ranitidin 150 mg tablet Sucralfate 500 mg/5ml syrup Magnesium Hydroxide, Magnesium, Simethicone tablet Magnesium Hydroxide, Magnesium, Simethicone syrup Dimetilpolisiloksan Misoprostol Famotidin 20 mg tablet Simetidin 200 mg tablet Clidinium bromide 2,5mg, klordiazepoksid 5mg Hiosine 10 mg tablet Hiosine + paracetamol 500mg Hiosine njeksi Fucoidon 100mg kapsul Fucoidon 100mg/15ml syrup DLBS2411 250mg lansoprazol

Molafat sirup lexacrol lexacrol sirup plantacid sirup Gastrucid sirup Disflatyl Proster

Melidox tablet Gitas tablet Scopma plus tablet Gitas injkesi Fucobac Redacid

GOLONGAN CEREBROVASKULER 1 2 7 8 9 10 11 12 13 14

Flunarizine 5 mg tablet Flunarizine 10 mg tablet Piracetam 1 gr injeksi Piracetam 3 gr injeksi Piracetam 800 mg tablet Piracetam 1200 mg tablet Donepezil Citicoline 500 mg tablet

Unalium 5 mg Unalium 10 mg

Incelin

Citicoline 250 mg injeksi Citicoline 500 mg injeksi

GOLONGAN NEUROTROPIK VITAMIN 1 2 3 4

Vit B1 100 mg, B6 200 mg, B12 200 mcg Vit B1 100 mg, B6 200 mg, B12 5000 mcg Mecobalamin 500 mcg Mecobalamin 500 mcg injeksi

Neurodex probion neurohax Lapibal

7

Lapibal Ethigobal

GOLONGAN SUPLEMEN DAN VITAMIN DAN OBAT LAIN 1

2 3 4 5

Echinacea Purpurea 500 mg, Pink Rock Rose 50 mg, Zink Picolinate 10 mg, Selenium 15 mcg kaplet Echinacea Purpurea 250 mg, Pink Rock Rose 50 mg, Zink Picolinate 5 mg syrup Co-enzym Q10 30 mg

12

Diosmin 450 mg + Hesperidine 50 mg Lysine 25 mg + Vit A, D, B1, B2, B6, B12 Dekspantenol, Vit A, Vit D, Vit B1, Vit B6 dll

14

Omega 3 64,5 mg, EPA/DHA 48,5/12,5 MG Asam Folat 400 mcg dan vit lain

16 17 18 19 20 21 22 23

Nuzym

Natural Asthaxantine 4 mg tablet Kalsium Karbonat 1250mg Calcuim Lactate, Vit B6, Vit C, Vit D3 Calcium, Isoflavone, Vit D, K, Magnesium Curcumae tablet Curcumae + Vit lain syrup

15

Nufit syrup

Co-enzym Q10 100 mg

6 7 9 10 11

13

Nufit kaplet

Vitamin E 200 mcg Vitamin E 400 mcg Zinc Sulphate 20 mg/5 ml syrup Zinc Sulphate 20 mg tablet Essential Keto acid

Xidane Osteocal Elkana syr Cal 95 Curcuma Vitacur sirup veridin tablet Apialys syrup Apialys drops Sim-DHA sirup supralysin sirup San-B-Plex drops supralysin drop Promavit Folamil Genio Folavit

Lecithin 150mg dll

Santa E Santa E Interzinc Interzinc Keto-G tablet Aminefron Heparsan

Sericocalyx folium dll

Renax

GOLONGAN ANTI ANEMIA 8

1 2

Fe Fumarate 250 mg, dll

Inbion Etabion

Fe Fumarate 360 mg, dll

GOLONGAN ANTIKOAGULAN, ANTI PLATELET DAN TROMBOLITIK 1 2 3 4 5 6 7 8

Silostazol 100mg tablet Asam asetilsalisilat 80mg

pletaal aspilet cartylo

Klopidogrel 75 mg Karbazokrom 10mg /tablet Karbazokrom 5mg/5ml inj Asam traneksamat 500mg tablet Asam traneksamat 50mg/ml inj Vitamin K 5mg/ml Vitamin K 2mg/ml Fondaparinuks 2,5 mg/0,5ml

adrome Crome

phyfion Diviti

GOLONGAN PRODUK DARAH DAN PENGGANTI PLASMA 1 2

Human Albumin 20% 50 ml Human Albumin 20% 100 ml HES 130

Widahes

3

GOLONGAN MUKOLITIK 1 2 3 4

Ambroxol 30 mg tablet Ambroxol 15 mg/5 ml syrup Ambroxol 15 mg/ml drops Erdostein 300 mg

5 6 7

Bromhexine 8 mg Bromhexine 4 mg/5 ml N. Acetylsistein 200 mg kapsul

roverton Mucos syrup Mucos drops Vectrin

GOLONGAN ANTI DIARE dan PROBIOTIK 1

Attapulgite

2 3 4

Loperamide Dioctahedral Smectite 30mg Lactobacillus Reuteri

5

Lactobacillus Acidophillus, L.lactis

Diagit Molagit Inamid smecta Interlac tablet interlac drop Interlac Sachet L-Bio sachet 9

kaolin + pectin sirup nifuroxazide sirup furazolidone

lacto b sachet L-bio kapsul guanistrep sirup nifudiar sirup neoprodiar sirup

GOLONGAN TRANQUILIZER + PSIKOFARMAKA 1 2

3 4

5 6 7 8 9

Alprazolam 0,25 mg tablet Alprazolam 0,5 mg tablet Haloperidol 0,5 mg Haloperidol 1 mg Haloperidol 5 mg tablet Clobazam 10 mg tablet Diazepam 2 mg tablet Diazepam 5 mg tablet Diazepam 5 mg/ml injeksi Diazepam 5 mg supp Midazolam 5 mg/5 ml injeksi Amitriptiline 25mg tablet Fluoxetin 20 mg tablet Klorpromazine 100mg tablet Klorpromazine 25mg/ml injeksi Trifluoperazin 5 mg tablet

Alganax 0,5 mg

Stesolid rectal Miloz

GOLONGAN RELAKSAN OTOT PERIFER DAN PENGHAMBAT KOLINESTERASE 1

Atrakurium besilat 25mg/2,5ml inj notrixum

2

Eperison 50mg tablet

3

Neostigmin 0,5mg/ampul

Neostigmin

GOLONGAN ANTI EPILEPSI + ANTIPARKINSON 1 2 3 3 4 5 6 7

Carbamazepin 200mg tablet Trihexyphenidyl 2mg Asam valproat 500mg tablet Asam valproat 50mg/ml syrup Penitoin 100mg tablet Penitoin 50mg /ml injeksi Gabapentin 100 mg Gabapentin 300 mg Pregabalin 75 mg Phenobarbital 30 mg tablet Phenobarbital 200mg/2mlinj Levodopa 100mg, benserazide HCl 25mg

Bamgetol depakote Depakene sirup Kutoin Kutoin Gabasant

Sibital inj levazide 10

8

Pramipeksol 0,375 mg Pramipeksol 0,250 mg

PGB

GOLONGAN ANTIDIABETIK ORAL 1

Metformin 500 mg tablet

2

Glimepiride 1 mg tablet Glimepiride 2 mg tablet Glimepiride 3 mg tablet Glimepiride 4 mg tablet Glibenclamide 5 mg tablet Gliclazide 80mg tablet Gliquidon 30mg tablet Pioglitazone 15 mg tablet Acarbose 50mg tablet Acarbose 100mg tablet

3 4 5 6 7

Glumin XR Glikos

Renabetic Glucodex

GOLONGAN INSULIN 1

Insulin aspart 100 iu/ml

2

insulin lispromix 100 ui/ml

3 4

Insulin detemir 100 iu/ml Insulin glargine 100 iu/ml

Novorapid flexpen

Levemir flexpen

GOLONGAN ANASTESI UMUM 1 2 3 4 5

Ketamin HCl 100 mg/ ml Bupivacain 5mg/ml Lidocain2%, ephineprin Lidocain2% injeksi Propofol 10mg/ml injeksi

6 7

Halothan Isofluran

KTM injeksi Regivell Pehacain inj Nupovell

GOLONGAN KARDIOVASKULER 1

2 3

Nifedipin 10mg tablet Nifedipin 20mg tablet SR Nifedipin 30mg tablet SR Nitrogliserin inj ISDN 5mg tablet

Farmalat 10mg tablet Adalat oros NTG farsorbid 11

4 5 5 6

7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

ISDN 1mg/ml Diltiazem 30mg tablet Diltiazem 50mg/ml injeksi Amiodaron 200 mg/tablet Amiodaron 50 mg/ml injeksi Kaptopril 12,5 mg tablet Kaptopril 25 mgtablet Ramipril 2,5 mgtablet Ramipril 5mg tablet Ramipril 10 mg tablet Lisinopril 5mg tablet Lisinopril 10mg tablet Valsartan 80 mg tablet Valsartan 160 mg tablet Bisoprolol 5mg tablet Bisoprolol 2,5mg tablet Propanolol 10mg tablet Propanolol 40mg tablet Amlodipin 5mg tablet Amlodipin 10mg tablet Nimodipin 30mg tablet Nimodipin 0,2mg /ml injeksi Nicardipin 1mg/ml

farsorbid inj

Terazosin 1 mg tablet Irbersartan 150mg tablet Irbersartan 3000mg tablet Candesartan 80mg tablet Candesartan 160mg tablet Telmisartan 40 mg tablet Telmisartan 80 mg tablet Metyldopa 250mg tablet Digoxin 0,25mg tablet Digoxin injeksi Dopamin 10mg/ml Dobutamin 50mg/ml

Hytrin

Tyarit Tyarit

nimotop

Dopamet Fargoxin

Dobutamin Giulini 22

24

ephinephrin1mg/ml inj Norephineprin 1mg/ml Atorvastatin 20mg tablet Atorvastatin 40mg tablet Simvastatin 10mg tablet

25

Simvastatin 20mg tablet Pravastatin 10 mg

23

N-epi

SVT 10

12

27 28 29

Gemfibrosil 300 mg kapsul Fenofibrate 100mg kapsul Fenofibrate 300mg kapsul Trimetazidine diHCl

Evotyl Angintriz

GOLONGAN DIURETIK 1 2 3 4 5 6

Furosemid 40mg tablet Furosemid 10mg/2ml inj Spironolacton 25mg tablet Spironolacton 100mg tablet HCT 25mg tablet Manitol Otsu Manitol Harnal Ocas Inkurin tablet

Tamsulosin 0.4mg Ekstrak Cucurbita semen

GOLONGAN ANTIPIRAI 1 2

Allopurinol 100mg tablet Allopurinol 300mg tablet Kolsisin 0,5mg tablet

GOLONGAN UTEROTONIK, RELAKSAN UTERUS DAN OBAT GYNEKOLOG LAIN 1

Metylergometrin 125mcg

2 3 4

Metylergometrin 200mcg/ml Oksitosin 0,2mg/ml Isoksuprin hcl 20mg/tablet

6 7

Isoksuprin hcl injeksi Progesteron 100mg Progesteron 200mg Lactobacillus rhamnosus Clomiphen Sitrat 50mg

8 9 10

Siproteron 2mg Allylestrenol 5 mg Noretisteron 5mg

11 12

Etynilestradiol 0,03mg Medroksiprogesteron asetat 50mg, estradiol sipionat 10mg/ml inj Medroksiprogesteron asetat 150mg/ml

5

13

Bledstop Myotonic tablet myotonic Protocin inj hystolan tab Duvadilan tab Duvadilan inj Uterogeston Uterogeston Floragyn clovertil Diane premaston Norelut Primolut Microgynon cyclogeston Depo Neo triclofem 13

14 15 16

Levonorgestrel IUD Drospirenon 3 mg, etinilestradiol 0,03mg

Andalan

GOLONGAN NARKOTIK 1

Codein 10mg tablet

Codicaf 10

Kimia Farma

2 3 4 5

Morphine 10 mg tablet Pethidin 50mg/ml injeksi Fentanyl 2.1 mg per transdermal patches Fentanyl 0,05mg /ml inj

MST clopedin

Mundipharma Janssen

USULAN/TAMBAHAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

14