Draf Frs 2012

1

Nama generik Bentuk Sediaan Kekuatan Nama Dagang Produsen

1 ANALGESIK, ANTIPIRETIK, ANTIINFLAMASI NON STEROID DAN ANTIPIRAI1.1. ANALGESIK NARKOTIK

1 Codein tab 10 mg,20 mg tab Codein KF

2 Codein + phenyltoloxamine kap, sir Codipront KF

3 Codein, paracetamol tab Coditam KF

4 kap, sir Codipront cum exp KF

5 Fentanyl inj, patch Fentanyl 12,5 mg, 25 mg dan 50 mg inj Durogesic JanFentanyl Jan

6 Sufentanyl inj Sufenta KF

7 Morfin inj, tab inj 10 mg/ml, tab 10 dan 30mg Morfin KFMST continus tab MBF

8 Pethidin inj 50 mg/ml Pethidin KF

1.2. ANALGESIK NON NARKOTIK1.2.1. ANALGESIK ANTIPIRETIK

1 Acetosal tab 80 mg, 160 mg Ascardia PharAspilet MediCardio aspirin ScheMiniaspi Mer

No Kelas Terapi

No Urut Obat

Codein 11,11 mg, phenyltoloxamine 3,67 mg syr

Codeine, phenyltoloxamine, guaifenesin.

Codeine 30 mg, phenyltoloxamine 10 mg, guaifenesin 100 mg.

2


2 Ketorolac inj, tab 10mg/ml dan 30 mg/ml inj Ketorolac OGB10 dan 30 mg tab Remopain Dex

scelto Pharfarpain Fah

3 Metamizol inj, sir, tab 1 g inj, sir 250mg/5 ml, tab 500mg Norages MeprNovalgin SAAntalgin OGB

4 Metamizol + diazepam tab 500 mg + 2 mg Cetalgin SohoDanalgin KalNeurodial Pha

5 Paracetamol tab 250 mg, 500 mg, 600 mg Dumin Actsir 120 mg/5ml, supp 125 mg Paracetamol OGBdrop 100 mg/ml, infus 10 mg/ml Sanmol San

Pamol IntTempra TaishoFarmadol infus FahPyrex infus NvlTamoliv Kal

6 Paracetamol + kafein tab 500 mg + 65 mg Panadol extra Ster

7 Paracetamol + N acetylcistein tab 500 mg + 200 mg Sistenol Dex

8 Paracetamol + Tramadol tab 325 mg + 37,5 mg Acetram tab PharTramifen tab OttoUltracet Jan

No Kelas Terapi

No Urut Obat

tab, sir, supp, drop, infus

3

tramset Fah


9 Parasetamol + ibuprofen + caffeine tab 500mg Neuralgin Kal

10 Parasetamol + vit B6 + vit B1 + Vit B12 tab 00 + 10 mg + 50 mg + 100 mcg Dolo-Neurobion Merck

11 Tramadol tab, inj, supp inj 50 mg/ml, 100 mg/2 ml; Tramadol OGB50 mg tab, 100 mg supp Tramal Phar

trasik FahDolana Com

1.2.2. ANTIINFLAMASI NON STEROID, ANTIPIRAI1 Allopurinol tab 100 mg dan 300 mg Allopurinol OGB

Zyloric GSK

2 Asam Mefenamat tab 500 mg Asam mefenamat OGBMefinal SanPonstan PfiLapistan Lapi

3 Celecoxib tab 100 mg, 200 mg Celebrex Pfi

4 Dexketoprofen trometamol tab 25 mg Ketesse Fer

5 Diclofenac resinate drop 5 mg/ml Cataflam Nov

6 Etoricoxib tab 60 mg, 90 mg Arcoxia MSD

7 Glucosamin HCL tab 250 mg, 500 mg Fitbon tab Soho

No Kelas Terapi

No Urut Obat

4

Osmin tab Hex


8 Glucosamine + chondroitin + vit tab, sach Oste SohoGerac LandOsmetin NvlViostin Phar

9 Ibuprofen tab, sir, supp tab 200 mg, 400 mg; sir 100mg/5 ml Ibuprofen OGB125 mg supp Proris Phar

Ibufenz Kal

10 Kalium diklofenak tab 25 mg, 50 mg Kalium diklofenak OGBCataflam NovCataflam D NovAclonac Phar

11 Ketoprofen tab, supp, inj tab 50 mg, 100 mg; supp 100 mg Ketoprofen OGBinj 10 mg/ml Kaltrofen Kal

Pronalges DexProfenid SA

12 Ketorolac 10 mg tab tab, inj 10mg, 30 mg Ketorolac OGBTorasic KalFarfain FahRemopain DexScelto Phar

13 Meloxicam tab 7,5 mg, 15 mg tab Meloxicam OGBMexpharm Kal

No Kelas Terapi

No Urut Obat

5

Moxam PharMobiflex Soho


14 Na Diklofenak tab, tab SR 25 mg, 50 mg, 75 mg (SR) tab Natrium diklofenak OGBRenadinac FahVoltadex DexVoltaren Nov

15 tab 50 mg + 50 mg + 50 mg Dolofenac tab Merck

16 Parecoxib Na inj 40 mg Dynastat Pfi

17 Piroxicam tab 10 mg, 20 mg Piroxicam OGBFeldene PfiPirofel SanScandene ?

18 Probenecid tab 500 mg Probenid Dex

19 Sulfasalazine tab 500 mg Sulcolon Ber

20 Tinoridine HCL kap 50 mg Nonflamin Tak

2 ANESTETIK2.1. ANESTETIK LOKAL

1 Bupivacaine inj 0,5 % Marcain dan Marcain heavAZDecain DexBuvanest Kal

No Kelas Terapi

No Urut Obat

Na-Diklofenak + Thiamine nitrate + pyridoxolHCL

6

Bunascan Fah

2 Etil klorida spray Chlorethyl spray DrH


3 Lidocain + prilocain krim 25 mg + 25 mg Emla 5% AZEstesia PhmTopsy Gal

4 Lidocain + epinefrin inj 20 mg + 12,5 mg Lidocain comp OGBPehacain Phap

5 Lidocain inj, jelly, spray 2% inj Lidocain inj KFCathejell BSFXylocain jelly, spray AZXylocain inj AZ

2.2. ANESTETIK UMUM DAN OKSIGEN1 Enfluran Compound Fah

2 Halotan Halotan Dex

3 Isoflurane Isoflurane DexAerane KalTerrel Fah

4 Ketamin HCl Ketalar EthKetamin Hamelin Com

5 Midazolam inj 5 mg, 15 mg Hipnoz Phar

No Kelas Terapi

No Urut Obat

7

Miloz NvlFortanes KalSedacum Dex

6 Oksigen Oxycan Aneka Gas


7 Propofol Propofol Lipuro BBRecofol DexDiprivan AZ

8 Sevoflurane 250 ml Sevoflurane KalSojourn FahSevodex Dex

3 ANTIALERGI DAN OBAT UNTUK ANAFILAKSIS1 Bepotastine besilate 10 mg Talion Tan

2 tab, sir 0,25 mg + 2 mg Celestamin ScheOcuson SanCollergis DexMeclovel Nvl

3 Cetirizine HCl tab, sir, drop 10 mg tab, 5 mg/5 ml syr Cetirizine HCL OGB10 mg/ml drops Ozen Phar

Ritez DexRyvel Nvl

4 Ciproheptadine HCl tab 4 mg Heptasan tab CapPronicy tab Kal

No Kelas Terapi

No Urut Obat

Betametasone + dexchlorpheniramine maleat

8

5 Pseudoehedrin + chlorpheniramin maleatsir 15 mg + 1 mg Rhinos junior Dex

6 Desloratadin tab 5 mg Aerius tab Sche


7 Dexametason tab, inj 0,5 mg tab, 5 mg/ml inj Cortidex SanDexametasone OGBKalmethasone HexOradexon Organon

8 tab 0,5 mg + 2 mg Dextafen OttoDextamine Phap

9 Difenhydramin, ammonium cl dll sir Ikadryl Ika

10 Difenhydramine inj 2 mg/ml Diphenhydramine OGB-PharIkadryl Ika

11 Pseudoephedrin + Fexofenadin tab 120 mg + 60 mg Fexofed Kal

12 Fexofenadine tab Telfast SA

13 Homochlorcyclizin 10 mg tab tab 10 mg Homoclomin Eis

14 Hydroxyzine 25 mg tab tab, sir tab 25 mg; sir 10 mg/5 ml Bestalin Lapi

15 Isothipendyl, pct, phenylefrin drop Nipe Tran

No Kelas Terapi

No Urut Obat

Dexamethason + Dexchlorpheniramin maleat

9

16 Ketotifen tab, sir tab 1 mg; sir 0,2 mg/ml Intifen IntProfilas Kal

17 Levocetirizine tab Xyzal SA

18 Loratadin tab, sir tab 10 mg; sir 5 mg/5ml Alloris San


Claritin ScheLoran GPSohotin Soho

19 Pseudoephedrin - loratadin tab, sir tab 60 mg + 5 mg, 5 mg /120 mg Rhinos SR Dex

20 Mebhidrolin tab 50 mg Histapan SanInterhistin Int

21 Methylprednisolon tab, inj 4 mg, 8 mg, 16 mg tab Medixon Fer125 mg, 500 mg inj Metrison Dex

Somerol SohoDepo-Medrol inj PfiSolumedrol inj PfiMethylprednisolon OGB

22 Norepinefrin inj 1mg/ml Raivas DexVascon Fah

23 Phenylpropanolamin, CTM tab Nalgestan Medi

24 Pseudoephedrin + tripolidin sir, tab 30 mg + 1,25 mg/ 5 ml Actifed GSK

No Kelas Terapi

No Urut Obat

10

tab 60 mg + 2,5 mg Tremenza San

25 Pseudoephedrin + terfenadine tab, sir 30 mg + 40 mg tab; Rhinofed Dex15 mg + 20 mg / 5 ml syr

4 ANTIDOT DAN OBAT LAIN UNTUK KERACUNAN4.1. KHUSUS

1 Atropin sulfat inj 1 mg/ml Atropin sulfas OGB


2 Metiltionin klorida inj Metilen blue inj RSCM

3 Nalokson HCL inj 0,02 mg/ml Nokoba Fah

4 Natrium bicarbonat tab, inj 500 mg tab; 84mg/ml inj Natrium bicarbonat tab OGBMeylon inj Ots

5 Ca Polystirene sulfonate serbuk 5 g Kalitake sach Dipa

6 Acetylsistein inf 200 mg/ml Hidonac inf Zam

4.2. UMUM1 Carbon aktif tab Norit KF

2 Magnesium sulfat serbuk, inj 30 g; 40% inj MGSO4 BraMGSO4 Ots

3 Attapulgit tab 600 mg Biodiar SdzNew Diatab Medi

5 ANTIEPILEPSI, ANTIKONVULSI

No Kelas Terapi

No Urut Obat

11

1 Asam valproat sir 250 mg/5ml Depakene Abb

2 Carbamazepine tab 200 mg Tegretol NovCarbamazepin OGB

3 Diazepam inj, tab, supp inj 2 ml; tab 2mg, 5 mg Stesolid Actsupp 5mg,10 mg ValiSan San

Diazepam OGBValium Roc


trazep tube Fah

4 Divalproex Na tab 250 mg, 500 mg tab Depakote, Depakote ER Abb

5 Fenitoin kap, inj kap 100 mg; Dilantin Pfiinj 100 mg/2 ml, 250 mg/5 ml Fenitoin Ika

Kutoin MerZentropil Ika

6 Fenobarbital inj; tab 200 mg/ 2 ml; tab 30 mg Sibital inj MerPental ComLuminal ?

7 Gabapentin kap 100 mg, 300 mg Nepatic cap Kalrepligen PharNeurontin PfiAlpentin Act

8 Oxcarbazepine tab 300 mg Trileptal NovProlepsi Mer

No Kelas Terapi

No Urut Obat

12

6 PSIKOFARMAKA6.1. TRANKUILISER MINOR

1 Alprazolam tab 0,25 mg, 0,5 mg, 1 mg Alprazolam OGBFrixitas NvlXanax PfiZypras Kal

2 Clobazam tab 10 mg Clobazam OGBFrisium SA


3 Diazepam tab, inj, supp tab 2 mg dan 5 mg; inj 2 ml Diazepam KFsupp 5 mg dan 10 mg Stesolid Act

ValiSan San

4 Escitalopram tab Cipralex Lun

5 Estazolam tab 1 mg dan 2 mg Esilgan TakEstalin Nvl

6 Klonazepam tab 2 mg Riklona Mer

7 Lorazepam tab 0,5 mg, 1 mg dan 2 mg Ativan SSMerlopam Mer

6.2. TRANKUILISER MAYOR1 Zolpidem tartrat tab 10 mg Zolmia Fah

2 Chlorpromazine tab 25 mg, 100 mg Chlorpromazine OGBCepezet Mer

No Kelas Terapi

No Urut Obat

13

3 Clozapine tab 25 mg dan 100 mg Clozaril NovLuften Phar

4 Haloperidol tab, inj 0,5 mg, 1 mg dan 5 mg tab Haloperidol OGBLodomer MerSerenace SohoHaldol Jan

5 Risperidone tab 2 mg Neripros PharPersidal Mer


Zofredal Kal

6 Trifluoperazone tab 5 mg Stelazine Phar

6.3. ANTIDEPRESAN1 Fluoxetin tab 10 mg dan 20 mg Antiprestin Phar

Kalxetin Kal

2 Imipramine tab 25 mg Tofranil Nov

3 Amitriptilin tab 25 mg Amitriptilin OGB

6.4. NEUROTONIK DAN NOOTROPIK1 Alfa lipoic acid, cyanocobalamin Mecola Lapi

2 Atomoxetine Xenocy Kal

3 choline citrate, cytidine monophospat dllkap Neulin PS Fer

No Kelas Terapi

No Urut Obat

14

4 Citicholin inj, tab 100 mg, 250 mg, 500 mg dan 1000 mg Brainact KalCholinaar NvlCiticolin Generik OGBLancolin LandSoholin Soho

5 DI-alpha tecopheryl nicotinate kap Enico Eis

6 Isoxsuprine HCL tab Duvadilan KF

7 Mecobalamin tab, inj tab 250 mg dan 500 mg Kalmeco Kal


inj 500 mg Lanabal LandMecobalamin OGBMeconeuro NvlMethycobal EisMagerik Phar

8 Nimodipine inj 0,2 mg/ml Ceremax Kal

9 Piracetam tab, inj, inf 400 mg, 800 mg dan 1200 mg tab Neurotam Kal3 g inj; 12 g inf Nootropil GSK

Piracetam OGBcetoros PharPirabrain Int

10 Sulbutamin tab 200 mg Arcalion Ser

6.5. ANTIEMETIK DAN ANTIVERTIGO

No Kelas Terapi

No Urut Obat

15

1 Domperidon tab, sir, drop 10 mg tab; 5 mg/ml siyr Domperidon OGB5 mg/ml drops Vometa Dex

Vomitas KalDominal drop Act

2 Metoklopramide tab, inj 10 mg tab; 5 mg/ml inj Clopramel NvlPrimperan SohoMetoklopramid OGB

3 Ondansentron tab, inj, sir 4 mg dan 8 mg Invomit Int4 mg/5 ml syr Narfoz Phar

Ondansentron OGBOndavell Nvl


Vomceran Kal

4 Tropisetron inj 5 mg/ml Cetrovel Nvl

5 Granisentron inj granon DexGramet Phar

6.6. ANTIVERTIGO1 Betahistin tab 8 mg dan 24 mg Betaserc Abb

Merislon EisMertigo DexVastigo Dex

2 Cinnarizine tab 25 mg Stugeron Jan cillag

3 Dimenhydrinate tab 50 mg Dramamine Soho

No Kelas Terapi

No Urut Obat

16

4 Flunarizine tab 5, 10 mg Dizzine PharSibelium JanFrego KalUnalium GP

6.7. ANTIMIGREN1 Ergotamin + coffein tab 1 mg + 100 mg Cafergot Nov

2 Flunarizine tab 5 mg dan 10 mg Unalium GPFrego Kal

3 Belladona + ergotamin + phenobarbital tab Bellapheen Soho


4 Pizotifen tab 0,5 mg Lysagor Kal

7 ANTIPARKINSON1 Bromocriptine tab 2,5 mg Parlodel Nov

2 Levodopa + benzerazide tab Levazide PyrMadopar RocLeparson Dex

3 Pramipexole hydrochloride tab dan ER tab 0,125 mg dan 0,175 Sifrol BoehSifrol ER Boeh

4 Sulpirid tab 50 mg Dogmatil Soho

5 Trihexylphenidyl tab 2 mg Hexymer Mer

No Kelas Terapi

No Urut Obat

17

Arkine PyrArtane Lederle

8 RELAKSAN OTOT PERIFER DAN PENGHAMBAT KOLINESETERASE8.1. PENGHAMBAT NEUROMUSKULER

1 Baclofen tab 10 mg Lioresal Nov

2 Chlorzoxazone tab 200 mg Solaxin Eis

3 Eperisone tab 50 mg Forres KalMyonal EisRizonax NvlEpsonal Pyr

4 Na hyaluronat inj 2ml inj Hyalgan pref Comguardix Dex


5 Tizanidine tab 2 mg Sirdalud NovZitanid Nvlphardex Phar

6 Vecuronium Bromida inj 4 mg dan 10 mg Ecron Phar

7 Atracurium besylate inj 50 mg/5 ml Tramus Dexfarelax Fah

8 Rocuronium inj Roculax Fah

8.2. MIASTENIA GRAVIS1 Pyridostigmin tab 60 mg Mestinon Tran

No Kelas Terapi

No Urut Obat

18

2 Neostigmin metilsulfat inj 0,5 mg/ml Prostigmin Com

9 ANTIINFEKSI9.1. ANTELMINTIK

1 Pirantel Pamoat tab, sir tab 125 mg, 250 mg Combantrin Pfisir : 125 mg/5 ml

9.2. ANTIBAKTERI9.2.1 GOLONGAN PENISILIN

1 Amoxicillin tab, sir, inj, drop 250 mg dan 500 mg tab Amoxicillin OGB125 mg/5 ml , 250 mg/5 ml Amoxsan San1 g inj; 100 mg/ml drop Lapimox Lapi

Kalmoxillin Kal


2 Amoxicyllin + as. Klavulanat tab, sir, inj 250 mg + 125 mg; 500 mg + 125 mg Aclam LapiSir : 125 mg + 31,25 mg/ 5 ml Clavamox Kalsir forte: 250 mg + 31,25 / 5 ml Co Amoxiclav OGB-INFinj: 1 g + 200 mg Augmentin GSK

Clamixin Otto

3 Ampicillin + sulbactam tab, inj tab Bactesyn Kalinj 1 g + 0,5 mg Cinam San

Picyn BerViccyllin-SX Mei

4 Piperacillin + tazobactam + Edetic acid inj 4 mg + 500 mg + 1 mg Tazocine Pfi

5 Procain benzylpenicillin inj 3.000.000 Unit Procain penicillin Mei

No Kelas Terapi

No Urut Obat

19

6 Sulbenicillin inj 1 g Kedacillin Tak

9.2.2 GOLONGAN AMINOGLIKOSIDA1 Amikasin inj 250 mg dan 500 mg inj Amikasin OGB

Amikin BMSAmiosin DexMikasin Kal

2 Gentamisin inj 40 mg/ml Ethigen EthGentamisin OGBSalticin Int

3 Netilmicin sulfat inj inj 150 mg/1,5 ml dan 300mg/1,5 ml Hypobhac Phap


4 Dibekasin sulfat inj 50 mg/ml Dibekasin Mei

9.2.3 GOLONGAN SEFALOSPORIN1 Cefaclor tab 500 mg Capabiotic Fah

Cloracef Eth

2 Cefadroxil tab, sir 250 mg dan 500 mg tab Cefat San125 mg/5 ml, 250 mg/5 ml sir Longcef Kal

Cefadroxil OGBrenasistin Fah

3 Cefazolin inj 1 g Cefazolin OGB

4 Cefditoren tab 200 mg Meiact Mei

No Kelas Terapi

No Urut Obat

20

5 Cefepime inj 1 g Cefepime Hex OGBDaryancef DarMaxicef PharSopime SOHO

6 Cefixim tab, sir 100 mg dan 200 mg tab Cefixim OGBGol C : hrs dg rekomendasi Mikro Klin/PPRA 100 mg/ml syr Cefspan Kal

Lanfix LandSofix Soho

7 Cefoperazon inj I g Bifotik SanStabixin Fahcephopar Phar

8 Cefoperazon + sulbactam inj 500 mg + 500 mg Cefoperazon + sulbactam Kal


Cefratam DexSoperam Sohostabactam Fah

9 Cefotaxim inj 1 g Cefotaxim OGBKalfoxim KalTaxegram Sanclatax Fah

10 Cefotiam tab 200 mg Ceradolan Tak

11 Cefpirom inj 1 g Cefnos PharCefpirome Hex

No Kelas Terapi

No Urut Obat

21

Sopirom SohoXenoprom Nvl

12 Cefpodoxime proxetil tab 100 mg dan 200 mg Banadoz Sdz

13 Cefprozil tab 500 mg Lizor Phar

14 Ceftazidim inj 1 g Ceftazidim OGBCeftum FerPharodim PharThidim inj Kal

15 Ceftizoxime inj 1 g Ceftizoxime NvlChromagen PharCefizox Kal


16 Ceftriakson inj 1 g Broadcet KalCeftriaxon OGBSocef SohoActaxon Act

17 Cefuroxime tab, inj 500 mg tab; 750 mg dan 1 g inj Anbacim SanSharox FahZinnat GSK

9.2.4 GOLONGAN KLORAMFENIKOL1 Kloramfenikol tab, inj, sir 250 mg tab, 1 g inj Chloramphenicol OGB

sir: 125 mg/5 ml Colsancetine San

No Kelas Terapi

No Urut Obat

22

2 Thiamphenicol tab, sir 500 mg tab; Biothicol Sansir: 125 mg/5 ml, 250 mg/5 ml Thiamycin Int

9.2.5 GOLONGAN MAKROLIDA1 Azitromicin tab, sir, inj 250 mg dan 500 mg tab Azitromisin OGB

sir: 200 mg/5 ml Azomax Dexinj Binozyd Sdz

Zitromax Pfi

2 Claritromycin tab, sir 250 mg, 500 mg tab Comtro Com125 mg/5 ml, 250 mg/5 ml syr Abbotic Abb

3 Erytromicin tab 200 mg, 250 mg dan 500 mg ErySan SanErythromycin OGB

4 Spiramisin tab 500 mg Spiramisin tab OGB


9.2.6 GOLONGAN KUINOLON1 Ciprofloxacin tab, inf 500 mg tab; 200 mg inf Baquinor San

Ciprofloxacin OGBQuinobiotic PharTequinol OTTOStarquin Dex

2 Levofloxacin tab, inf 250 mg, 500 mg tab Cravox Lapi500 mg, 750 mg inf Levofloxacin OGB

Mosardal SohoLevoxal SdzVolequin Dex

No Kelas Terapi

No Urut Obat

23

3 Moxifloxacin tab, inf inf: 400 mg / 250 ml; 400 mg tab Avelox Bay

4 Ofloxacin tab 200 mg, 400 mg tab Ofloxacin OGBDanaflox KalLapiflox Lapi

9.2.7 GOLONGAN TETRASIKLIN1 Doxycyclin tab tab 50 mg, 100 mg Doxycyclin OGB

Interdoxin IntVibramycin Pfi

2 Tetrasiklin kap 250 mg Tetrasiklin OGBSanlin San

9.2.8 GOLONGAN BETALAKTAM LAIN1 Doripenem inj 500 mg inj Doribax Jan


2 Imipenem + Cilastazin inj 500 mg + 500 mg Pelastin inj SanTienam inj MerckXerxes inj Phar

3 Meropenem inj 0,5 g, 1 g Ronem FahGol C : hrs rekomendasi Mikroklin Merofen Kal

Meronem AZMeropenem OGB

9.2.9 ANTISEPTIK SALURAN KEMIH1 Asam pipemidat kap Impresial Zam

Urotractin San

No Kelas Terapi

No Urut Obat

24

2 Cotrimoxazol tab, sir 400 mg, 800 mg Sanprima Sansir: 200 mg/ 5 ml Cotrimoxazol OGB

Bactrim Roc

3 Phenazopyridine tab 100 mg Urogetix tab Tran9.2.10 ANTIBAKTERI LAIN

1 colistin tab tab 250 000 iu, 1.500.000 iu Colistin tab Act

2 Fosfomicin inj, sach 1 g, 2 g inj; 3 g sach Fosmicin MeiFosmidex DexMonuril Zam

3 Gramicidin + Neomycin tab hisap FG Troches Mei

4 Klindamisin tab 150 mg, 300 mg tab Anerocid FerClimadan KalClindamycin OGB


Dalacin C PfiProlic San

5 Linezolid inf 600 mg Zyvox Pfi

6 Linkomisin kap 500 mg Lincocin PfiLincophar PharLinkomisin OGBPercocyn Land

7 Tygecycline inj 50 mg/5 ml Tygacil Pfi

No Kelas Terapi

No Urut Obat

25

8 Vancomisin inj 0,5 g Vancep Fah

9.2.11 ANTILEPRA1 Rifampisin tab 300 mg, 450 mg , 600 mg Rimactane Sdz

Rifampisin OGBRif Arm

9.2.12 ANTITUBERKULOSIS1 Etambutol tab 500 mg Etambutol OGB

Etibi Santibi SanTibitol Mer

2 Etambutol + INH + Vit B6 tab 250 mg + 100 mg + 5 mg Bacbutinh Armtab forte: 500 mg + 200 mg + 10 mg

3 INH + vit B6 tab, sir 300 mg, 400 mg INH CIBA Sdz100 mg + 10 mg/5 ml syr Suprazid Arm

Pyravit Gal


4 Pirazinamid tab 500 mg Prazina Arm Pirazinamid OGBPezeta Sdz

5 Rifampisin tab 300 mg, 450 mg , 600 mg Rimactane SdzRifampisin OGBRif Arm

6 tab 150 mg + 75 mg + 275 mg + 400 mg Rimstar 4-FDC Adult SdzRifastar INF

Pem/Rocella Lab

No Kelas Terapi

No Urut Obat

Rifampisin + INH + Ethambutol + Pyrazinamid

26

7 Rifampisin + INH + PZA tab Paed tab : 75 mg + 75 mg + 150 mg Rimcure Sdz3-FDC : 150 mg + 75 mg + 400 mg

8 Ripampisin + INH tab tab: 75/50mg, paed: 450/300mg Rimactazide Sdz

9.3. ANTIFUNGI1 Anidulafungin tab Ecalta Pfi

2 Clotrimazol tab 0,5 mg Canesten Bay

3 Fluconazole tab, inf tab: 50 mg, 150 mg Diflucan Pfiinf: 200 mg/100 ml Flucoral Kal

Kifluzol KFZemyc Pharcryptal Fah

4 Griseofulvin tab 500 mg Fungistop Ber


5 Itraconazole kap 100 mg Sporacid FerSporanox JanSporax Inm

6 Ketoconazol tab 200 mg Interzol tab IntKetoconazol tab OGBZoloral tab IkaFungoral KF

7 metronidazole inf, supp fladex Dex

No Kelas Terapi

No Urut Obat

27

8 Metronidazole + nystatin ovula 500 mg + 100.000 IU Fladystin DexFlagystatin SANeo Gynoxa KalTrichostatic Phar

9 Micafungin inj 50 mg Mycamine Ast

10 Nistatin drop 100.000 IU Candistin PharEnystin KalNymiko San

11 Voriconazole inj 200 mg Vfend Pfi

12 Amphotericin B inj Amphotericin B OGB

9.4. ANTIVIRAL1 Aciclovir tab, inj 200 mg, 400 mg Aciclovir OGB

inj: 250 mg/5 ml Zoter IntZovirax inj GSK


2 Valaciclovir Tab 500mg Valvir SohoInclovir Int

3 Metisoprinol tab, sir tab 500 mg; 250 mg/5 ml sir Isoprinosine MediIsprinol Nvl

4 Lamivudin + Zidofudin tab 150 mg + 300 mg Duviral KF

5 Nevirapin tab 200 mg Neviral KF

No Kelas Terapi

No Urut Obat

28

6 Stavudin tab 30 mg Staviral KF

7 Zidovudin tab 100 mg Reviral KF

8 Efavirenz tab 600 mg Efapirenz Stri

9 Lamivudin tab 150 mg Hiviral KF

10 Tenofovir tab 300 mg Tevir Ran

9.5. ANTIPROTOZOA9.5.1 ANTIAMUBA DAN ANTIGIARDIASIS

1 Metronidazol tab, inf, supp 500 mg Metronidazol tab OGBFlagyl tab SAFladystin Dex Diazole inf BBTrichodazol infus Sanfarnat Fahfladex Dex


9.5.2 ANTIMALARIA9.5.2.1 UNTUK PENCEGAHAN

1 Klorokuin Resochin BayRiboquin Dex

9.5.2.2 UNTUK PENGOBATAN1 Klorokuin Resochin Bay

Riboquin Dex

No Kelas Terapi

No Urut Obat

29

10 ANTINEOPLASTIK, IMUNOSUPRESOR DAN OBAT UNTUK TERAPI PALIATIF10.1. ANTIHORMON

1 Clomiphene citrat tab 50 mg Profertil Kal

2 Letrozole tab 2,5 mg Femara Nov

3 Tamoxifen tab 1 mg, 20 mg Tamofen Kal

4 Nomegretol acetat tab 5 mg Lutenyl Merck

5 Allylestrenol tab 5 mg Premaston Kalpregtenol Fah

10.2. IMUNOSUPRESAN

10.3. SITOTOKSIK1 Lenogastrim Granocyte SA

2 5 Fluorouracil inj 250 mg/5 ml 5 Fluorouracil Ebewe FerCuracil Kal

3 Bleomicyn inj 15 mg Bleocyn Kal


4 Capecitabine tab 500 mg Xeloda Roc

5 Carboplatin inj 150 mg/15 ml, 450 mg/45 ml Actoplatin ActCarboplatin KalDBL Carboplatin TSP

6 Cisplatin inj 10 mg/20 ml, 50 mg/100 ml Cisplatin Ebewe Fer

No Kelas Terapi

No Urut Obat

30

Cisplatin Kal

7 Cyclophospamide tab, inj 50 mg tab; 200 mg, 500 mg, 1 g inj Cyclophospamide Kal

8 Docetaxel inj 20 mg, 80 mg Taxotere SABrexel Kal Docetere Fer

9 Doxorubicin inj 10 mg, 50 mg Adricin inj NvlDoxorubicin Kal

10 Etoposyd inj 100 mg/5 ml Etopul Nvl

11 Gemcitabin inj 1 g Gemtavis ActCytogem FerGemzar Eli

12 Ifosfamid inj 2 g Holoxan Tran

13 Methrotexat tab 2,5 mg Methotrexate Kal

14 oxaliplatin tab 50 dan 100 mg Eloxatin SA


15 Paclitaxel inj 100 mg, 300 mg Paxus KalSindaxel ActAnzatax TSP

16 Vinblastine inj 2mg/2ml, 10mg/10 ml Vinblastine Nvl

17 Vincristine inj 1 mg/ml Vincristine Nvl

No Kelas Terapi

No Urut Obat

31

18 Vinorelbine inj 50 mg, 100 mg Navelbine inj Tran

19 Leucovorin Ca inj 50 mg/5 ml Leucovorin inj Kal

20 Mesna inf 400 mg Uromitexan TMI

10.3. TERAPI TARGETING1 Bevacizumab inj 25 mg/ml Avastin Roc

2 Erlotinib tab 25, 100 dan 150 mg Tarceva Roc

3 Gefitinib tab 250 mg Iressa AZ

4 Imatinib tab 100 mg, 400 mg Glivec Nov

5 Irinotekan inj 40 mg/2 ml; 100 mg/5 ml Irnocam Ferron

6 Lapatinib tab 250 mg Tykerb GSK

7 Pemetrexed inj 100 mg; 500 mg Alimta Eli


8 Rituximab inj 100 mg, 500 mg MabThera Roc

9 Temozolanide kap 20 mg; 100 mg; 250 mg Temodal Sche

10 Trastuzumab inj 440 mg Herceptin Roc

11 KARDIOVASKULER11.1. ANTIARITMIA

No Kelas Terapi

No Urut Obat

32

1 Amiodarone tab, inj tab 200 mg ; inj 150 mg/3 ml Cordarone SAKendaron DarTiaryt Fah

2 Dopamine inj 40 mg/ml Dopac KalDopamin KFUdopa Dipaindop Fah

3 Dobutamin inj 250 mg/5ml Dobuject DexDominic KalInodex Dexinotrop Fah

4 Milrinon inj 1 mg/ml Inovad Fah

11.2. ANTIANGINA1 Amiodarone tab, inj tab 200 mg; inj 150 mg/3 ml Cordarone SA

Kendaron DarTiaryt tab Fah


2 ISDN tab, inj 5 mg, 10 mg, 20 mg Cedocard Dar1mg/ml inj Farsorbid Fah

ISDN OGBIsoket PharIsorbid Phar

3 Trimetazidine tab Trizedon MR Sermiozidine Fah

No Kelas Terapi

No Urut Obat

33

11.3. GLIKOSIDA JANTUNG1 Digoxin tab, inj 0,25 mg tab; 0,5 mg/2 ml inj Digoxin OGB

Fargoxin FahLanoxin GSK

11.4. ANTIHIPERTENSI11.4.1. PENGHAMBAT ACE

1 Aliskiren tab 150 mg Rasilez Nov

2 Captopril tab 12,5 mg, 25 mg, 50 mg Captopril OGBAcepress Ber

3 Imidapril tab 5 mg, 10 mg Tanapress Tan

4 Lisinopril tab 5 mg, 10 mg Interpril IntNoperten DexOdace Dar

5 Ramipril tab 2,5 mg, 5 mg Cardace SA Triatec SA


11.4.2. PENGHAMBAT BETA1 Atenolol tab 50 mg Betablok Hex

Tenormin AZ

2 Bisoprolol tab 2,5 mg, 5 mg Betaone HexConcor MerckHapsen PharMaintate Tan

No Kelas Terapi

No Urut Obat

34

3 Carvedilol tab 6,25 mg Dilbloc RocVbloc Kalblorec Fah

4 Metoprolol tab Metoprolol OGB

11.4.3. ANTAGONIS KALSIUM1 Amlodipin tab 5 mg, 10 mg Amlodipin OGB

Divask KalTensivask DexNorvask Pfi

2 Amlodipin + Atorvastatin tab 5 mg + 10 mg; 10 mg + 10 mg Caduet Pfi

3 Atenolol + Nifedipin kap Niften AZ

4 Diltiazem tab, inj 30 mg, 60 mg, 180 mg Cordila SR Dex100 mg, 200 mg tab CD Diltiazem HCl OGB5 mg/ml inj trazep Fah


Herbesser CD TanFarmabes Fah

5 Nicardipine tab, inj 10 mg/10 ml inj Perdipine Asttensilo Fah

6 Nifedipin tab, tab oros tab 10 mg, 20 mg, tab oros 30 mg Adalat oros BayAdalat BayCalcigard retard TorretNifedipin OGB

No Kelas Terapi

No Urut Obat

35

7 Verapamil tab Isoptin SR Knoll11.4.5. Angiotensin Reseptor Bloker

1 Amlodipin + Irbesartan tab 5/80; 10/160; 5/160 Exforge 5/80 Nov

2 Candesartan tab 8 mg, 16 mg Blopress TakCanderin Dex

3 Irbesartan tab 150 mg, 300 mg Irbedox SdzIrvask KalIrvebal SA Tensira Land

4 Losartan tab 50 mg, 100 mg Acetensa FahAngioten Kal

5 Telmisartan tab 40 mg, 80 mg Micardis Boeh


6 Valsartan tab 80 mg, 160 mg Diovan NovValsartan Dex

11.4.4. ANTIHIPERTENSI LAIN1 tab 0,075 mg , 0,15 mg Clonidine OGB

Catapres Boeh

2 Doxazocin tab 2 mg Cardura Pfi

3 Methyldopa tab 250 mg Dopamet Act

4 Terazosin tab 1 mg, 2 mg Hytrin Abb

No Kelas Terapi

No Urut Obat

36

5 Dexmedetomidine Precedex Hosp

11.5. OBAT KARDIOVASKULER LAIN1 Adenosin triphosphate tab, inj ATP Kal

Bio ATP Phap

2 Co enzym Q 10 tab Cor-Q PharQ ten NvlUbiforce MrpTonicard Esc

3 Coenzim Q10 dll tab Q 10 plus NutCar Q Kal


11.6. VASODILATOR PERIFER DAN AKTIVATOR SEREBRAL1 Citicolin tab, inj tab 500 mg; 250 mg inj Brainact Kal

Cholinaar NvlCiticolin OGB-BerLancolin Land

2 Finasteride tab 5 mg Prostide Phar

3 Naftidrofuryl oxalate tab 100 mg Vascuprax Fah

4 Nicergoline tab 10 mg, 30 mg Seroline Kal

No Kelas Terapi

No Urut Obat

37

5 Norepinefrin inj 1 mg/ml Vascon Fah

12 DIURETIK1 Furosemid tab, inj tab 40 mg; 20 mg/2 ml inj Furosemid OGB

Farsix FahLasix SARoxemid NvlSilax Eth

2 Hidroclorotiazid + bisoprolol tab 6,25 mg + 2,5 mg Lodoz Phar

3 Spirinolactone tab 25 mg, 100 mg Aldactone Soho

Spirinolactone OGBSpirola Kal

4 Spironolacton + thiabutazid tab 25 mg + 2,5 mg Aldazide Soho


13 DARAH, OBAT YANG MEMPENGARUHI13.1. HEMOSTATIK

1 Asam traneksamat tab, inj tab 250 mg, 500 mg; inj 50 mg/ml Asam traneksamat OGBKalnex KalRonex PharTransamin OTTOTranexid Dex

2 Carbazochrome Na Sulfonate tab, inj 10 mg tab; 50 mg/10 ml inj Adona AC 17 TanAdona TanCrome Fer

No Kelas Terapi

No Urut Obat

38

3 Ethamsylate tab, inj 500 mg tab; 250 mg inj Dicynone Cor

13.2. ANTIKOAGULAN, ANTITROMBOTIK DAN FIBRINOLITIK1 Fondaparinux inj 2,5 mg/0,5 ml Arixtra GSK

2 Acetosal tab 80 mg, 160 mg Ascardia PharCardio aspirin ScheMiniaspi Merfarmasal Fah

3 Beraprost Na tab Dorner Ast

4 Cilostazol tab 50 mg, 100 mg Citaz KalIlos tab PharPletaal tab OtsCilostazol tab OGB


5 Clopidogrel tab 75 mg Copidrel LandCPG KalPlavix SAVaclo DexClopidogrel OGB

6 Enoxaparin inj 20 mg/0,2 ml Lovenox SA

7 Heparin inj 5.000 IU/ml Inviclot Fah

8 Heparin, Nicotinic Acid jeli, salep Thrombophob TIA

No Kelas Terapi

No Urut Obat

39

9 human antithrombine 3 kybernin Dex

10 Lumbrokinase tab Disolf Dex

11 Nadropin inj 0,4 ml Fraxiparine GSK

12 Warfarin tab 2 mg Simarc Fah

13 Dabigatran tab 75, 110, dan 150 mg Pradaxa Boeh

14 Streptokinase inj Streptase Dex

15 Rivaroxaban tab 10 mg Xarelto Bay

13.3. OBAT HEMOROLOGI1 Bencyclane tab 100 mg Fludilat Sche


2 Flavonoid hydrosmin kap 200 mg Venosmil Kalrhodium Fahardium Ser

3 Pentoxifylline tab 400 mg Reotal / SR Kal

13.4. ANTIANEMI1 Fe dll tab, drop Maltofer Com

Nonemi LapiHemobion MerckFerlin Medi

2 Asam folat tab 1 mg Folavit San

No Kelas Terapi

No Urut Obat

40

Folic acid OGBStarfolat Dex

3 Asam Folat + Fe dll tab Folamil genio DexEmineton KalPromavit LapiFetavita Esc

4 Sianokobalamin dll kap Farbion FahGlucobion Merck

5 Eritropoetin (epoetin alfa) inj 2000 unit, 4000 unit, 10.000 unit Epotrex NP Nvl3000 unit, 10.000 unit Hemapo Kal

6 Eritropoetin (epoetin beta) inj 2000, 5000, 10.000 dan 30.000 unit Recormon Roc


13.5. HEMATOPOETIC1 Filgastrim inj 300 mcg/ml Leucogen Kal

Leukokine NvlNeupogen Roc

2 Lenogastrim inj 263 mcg/ml Granocyte SA

14 SALURAN NAPAS, OBAT UNTUK:14.1. ANTIASMA

1 Teofilin tab Euphyllin Retard PharEuphyllin Retard mite PharBronchophylin Dar

No Kelas Terapi

No Urut Obat

41

2 Budenoside formoterol inh, swinghaler, tubuhaler Symbicort AZObucort OtsPulmicort AZ

3 Ephedrin tab, inj 25 mg Ephedrin HCl KF

4 Fenoterol HBR MDI, sol, Nebs Berotec Boeh

5 Fluticasone nebs, sol Flixotide GSKAvamys GSK

6 GG, salbutamol sir Lasal exp Lapi75 mg + 2 mg Glitaven Nvl

7 Indacaterol maleat inh 150 mcg dan 300 mcg Onbrez Breezhaler Nov

8 Ipatropium sol Atrovent sol Boeh


9 Ipratropium + Salbutamol nebs udt Boeh Farbivent nebules Fah

10 Ipratropium + Fenoterol MDI Berodual MDI Boeh

11 Procaterol tab, sir, inh, sol, inj Atarox NvlMeptin Ots

12 Pseudoepherin drop, sir 7,5 mg/0,8 ml Alco IntAlco plus IntRhinos neo DexDisudrin Medi

No Kelas Terapi

No Urut Obat

42

13 Salbutamol sulfat tab, inh, nebs 2 mg tab; nebules 2,5 mg Ventolin GSKsalbutamol OGB

14 Salbutamol sulfat , guafenisin sir Ventolin expect GSK

15 Salbutamol sulfat, Teofilin anhidrat tab Teosal Dex

16 Salmeterol, Fluticasone diskus, inh, MDI 100,250 dan 500 Seretide GSK

17 Terbutalin sulfat tab, inj, MDI, Respule 2,5 mg tab Bricasma AZ

18 Tiotropium Bromide inh Spiriva Boeh14.2. ANTITUSIF

1 Dextromethorpan tab, sir tab 15 mg; sir 10 mg/5 ml Dextromethorphan OGB

2 Dextromephorpan dll sir Sanadryl DMP SanCodecon Erl


3 Levodropropizin sir Levopront Com

4 Oxomemazine, GG sir Comtusi Com

5 Oxomemazine, GG, PCT sir Toplexil SA

6 Pseudoephedrin, DMP sir Alco DMP Int

7 Pseudoephedrin, tripolidin, DMP sir Actifed supressan GSK

14.3. EKSPEKTORAN

18 µg

No Kelas Terapi

No Urut Obat

43

1 Pseudoephedrin, tripolidin, Guafenisin sir Actifed Exp GSK

2 Bromhexin tab, drop, inj, sir Bisolvon BoehBisolvon kid BoehFarmavon FahMucohexin San

3 GG, salbutamol sir Fartolin exp Fah

4 Obat batuk hitam sir OBH IFRSOBH Combi ComOBH Ika IkaOBH Nelco Nelco

5 Pipazethate, isothipendhyl, GG, liquorice sir, balsam Transpulmin TMI

6 Pseudoephedrin, Bromhexin sir Alco plus Int


14.4. MUKOLITIK1 Acetylsistein tab, efferves, granul, injtab 200 mg; 100 mg, 200 mg granul Sistenol tab Nov

600 mg effervescent Fluimucyl tab Zam300 mg/3 ml inj; 100 mg/5 ml sir N-ace Fah

Acetylsistein OGB

2 Ambroxol tab, sir, drop tab 30 mg; 15 mg/5 ml syr Ambroxol OGB15 mg/ml drop Epexol San

Mucopect BoehTransbroncho Kal

No Kelas Terapi

No Urut Obat

44

Mucos Mepr

3 Carbosistein sir 125 mg/5 ml, 250 mg/5 ml Broncholit NicRhinatiol Phc

4 Carbosistein +prometazine sir Rhinatiol + prometazine Phc

5 Erdostein tab, sir tab 300 mg; 175 mg/5 ml sir Recustein LandVectrin DexVestein Kal

6 Pseudoefedrin + Chlorpheniramin sir 15 mg + 1 mg /5 ml Triaminic Pilek Nov

7 Pseudoefedrin + dextromethorphan sir, drop 15 mg + 5 mg/5 ml Triaminic batuk Nov

8 Pseudoefedrin + Guaifenesin sir 15 mg + 50 mg/5 ml Triaminic expect Nov

14.5. LAIN-LAIN OBAT SALURAN NAFAS1 Pelargonium sidoides tab 20 mg Kaloba Phap


15 OBAT SALURAN CERNA15.1. ANTASIDA DAN ANTI ULSERASI

1 Antasida Doen tab, sir Dexnta DexMylanta BayPlantacid KalPolysilane PharFarmacrol forte Fah

2 Antasida + Famotidin tab Magard FA SOHO

No Kelas Terapi

No Urut Obat

45

3 Esomeprazol tab, inj 20 mg, 40 mg; 40 mg inj Nexium AZ

4 Famotidin tab 40 mg Faberdin BerRenapepsa Fah

5 Lansoprazol tab, inj tab 30 mg; 30 mg inj Lancid KalLanprazid PharLaz DexProsogan TakInacid INF

6 Misoprostol tab 200 mcg Gastrul FahInflesco Phb/EscInvitec KalNoprostol Nvl

7 Na rebeprazole tab 10 mg, 20 mg Pariet Esai

8 Omeprazol tab, sir, inj tab 40 mg; 40 mg inj Omeprazol OGBOMZ Fer


Ozid DarSocid SOHOStomacer SdzGastrofer Dex

9 Pantoprazol kap, inj kap 30 mg; 40 mg inj Pantozol PharPumpisel SanPanso SOHO

No Kelas Terapi

No Urut Obat

46

Pranza KalVomizole DexPantozol Phar

10 Polymigel tab 400 mg Strocain P Eis

11 Ranitidin tab, inj tab 150 mg; inj 50 mg/ml Rantin KalWiacid LandRanitidin OGBrenatac FahAcran San

12 Rebamipide tab 100 mg Becantex PharMucosta Otssysmuko Fah

13 Sukralfat sir 500 mg/5ml Inpepsa FahNeciblok KalTaxilan PharUlsidex Dex


15.2. REGULATOR, ANTIEMETIK, ANTIFLATULEN1 Amylase, protease dll tab Enzyplex Medi

Excelase-E Mei

2 Pancreatin, Simeticone tab Tripanzym San

3 Budesonide kap 3 mg Chenofalk Dar

No Kelas Terapi

No Urut Obat

47

4 Cisapride tab 5 mg Acpulsif Dex

5 Dimethylpolysiloxane tab 40 mg Disflatyl Phar

6 Domperidone tab, drop, sir tab 5 mg, 10 mg; drop 5 mg/ml Motilium Jansir 5 mg/5 ml Vometa FT Dex

Vomitas FDT KalDomperidon OGBDometa IkaVomidone PharDominal Act

7 Granisetron inj 1 mg, 3 mg Gramet PharGranon Dex

8 Mesalazine tab 500 mg Midodrine Pharsalofalk Dar

9 Metoclopramide tab, sir, inj tab 10 mg; 5 mg/5ml sir Primperan Soho10 mg/2 ml inj Metoclopramide OGB

Clopramel Nvl


10 Ondansentron tab, inj, sir tab dan inj 4 mg, 8 mg; Cedantron Sohosir 4 mg/5 ml Narfoz Phar

Ondansentron OGBVomceran KalVometraz Dexonetic Fah

No Kelas Terapi

No Urut Obat

48

Ondavell Nvl

11 Tropisetron inj 5 mg/ml Cetrovel Nvl

12 Pancreotin dll tab Benozym Ber

15.3. ANTISPASMODIK1 Chlordiazepoxide + Clinidium tab 5 mg + 2,5 mg Librax Tran

Braxidin San

2 Extract belladon tab 10 mg Extract belladon OGB

3 Hyoscine tab, inj tab 10 mg; inj 20 mg/ml Stomica PharBuscopan Boeh

4 Atropin sulfat inj 1 mg/ml Atropin sulfas OGB

5 Hyosin N butil bromida, paracetamol tab Buscopan plus Boeh

6 Methampyrone, Papaverine, Extr Bellad tab Spasminal Hex

7 tabSpasmium

SOHO


8 Otilonium Bromide tab Spasmomen Dex

9 irbosid tab mebeferin Fah

15.4. HEPATOPROTEKTOR

Methlordiazepoxide, Phenylpropiylethylamine

No Kelas Terapi

No Urut Obat

49

1 kap Hepa-Q Pyr

2 As.amino, methionine,phenylalanine dll Comafusin Hepar Kal

3 kap, sir Curliv plus Soho

4 Curcuma longa rhizoma dll kap Biocurlam SohoBiocurliv Soho

5 Curcuma roots tab Curcuma Soho

6 Fructus schisandra chinensis dll kap Hepa balance PhbHP Pro BLM

7 L ornithin, L Aspartate serb 4 g Hepatosol Lola KalForhepa Kal

8 silibinin, vit B1, B2, B6 dll tab Livercare Dar

9 Ursodeoxycholic acid Estazor FahLofibra Pharurdafalk Dar


10 Pure lecithin dll tab 250 mg Lesichol Land

11 Methionin dll tab Methioson Soho

Extract Silybum marianum, Extract Curcuma Xanthorrhizae

Choline bitartrate, curcuma xanthoriza, dll

No Kelas Terapi

No Urut Obat

50

12 Selenium dll tab Proliva Gra

13 Palecatechu, lecitin dll tab Rejuvit Nut

14 tab Hepamax Kal

15 Glycyrhizin, amino acid inj SNMC Dex

15.5. ANTIHEMOROID1 Fluocortolone pivalate, lidokain HCL supp, salep Ultraproct Tran

2 Lidocain dll salep Haemocaine Gal

3 Lithospermin radix dll supp Borraginol N TakBorraginol S Tak

4 Plavonoid tab Ardium Serrhodium Fah

5 Policresulen + cinchocaine supp, salep Faktu Phar

6 Purified soya bean dll kap Lanaven Land

15.6. OBAT DIARE1 Attalpugite + pectine tab 600 mg + 50 mg Diagit tab Int


2 Active charcoal tab Bekarbon KF

3 Attapulgit tab 630 mg Biodiar Sdz

PPC 95%, silymarin phytosome, schizandra, a tokoferol

No Kelas Terapi

No Urut Obat

51

New Diatab Medi

4 Diosmectite sach serbuk Smecta Nvl

5 Karbon aktif tab Norit Eagle Indopharma

6 Lactobacillus serbuk, kap Lacto B NvlLacidofil DexBIO-gi FahLiprolac Kal

7 Loperamid tab 2 mg Rhomuz PharImodium Jan

8 serbuk Trolit Kal

9 Nifuroxazide sir Nifural Medi

10 Zinc tab, sir 20 mg tab Zinc INFOrezinc NvlZincare Kal

15.7. LAKSANSIA1 Bisacodyl tab, supp 5 mg tab; 10 mg supp Dulcolax Boeh

2 Lactulose sir 3,335 mg/5ml Dulcolactol BoehLactulac Ika


3 Na laurylsulfat dll supp Microlax supp Phar

Monascus purpureus, psidii, vitamin, elektrolit

No Kelas Terapi

No Urut Obat

52

4 NaPO4 dll enema Fleet enema ComFleet phospoda Comfosen enema Fah

5 Phenoftalein, parafin liq dll sir Laxadine syrup Gal

6 Sorbitol sir 67,50 ml/botol Yal Tri

7 peg niflec Mei

16 HORMON, OBAT ENDOKRIN LAIN DAN KONTRASEPTIK16.1. ANTIDIABETIK ORAL

1 Acarbose tab 50 mg dan 100 mg Acarbose OGBEclid DexGlucobay Bay

2 Bioactve fraction DLBS3233 inlacin Dex

3 Glibenclamid + metformin tab 2,5 dan 5 mg Glucovance Merck

4 glibenklamid tab 5 mg renabetic Fah

5 Gliclazid tab 80 mg; tab MR 30 mg Glucodex DexPedab OttoDiamicron SerLinodiab PyrDiamicron MR Ser


6 Glimepirid, Metformin tab Amaryl M SA

No Kelas Terapi

No Urut Obat

53

7 Glimepirid tab 1 mg, 2 mg, 3mg, 4 mg Metrix KalParide PharRelide FahGlimepiride OGB

8 Gliquidon tab 30 mg Glurenorm BoehGliquidone OGB

9 Metformin tab 500 mg, 850 mg Glucophage MerckGlucophage XR MerckMetformin OGBNevox XR Kal

10 Pioglitazone tab 15 mg, 30 mg Actos ActDeculin Dexpionix Kal

11 Sitagliptin tab 50 mg, 100 mg Januvia Merck

12 Vildagliptin tab 50 mg tab Galvus Nov

13 linagliptin trajenta Boeh

16.2. ANTIDIABETIK PARENTERAL1 Human insulin inj 100 IU / ml, 10 ml. Humulin N Eli

Humulin R EliNovorapid NovoInsuman basal SA

Nama generik Bentuk Sediaan Kekuatan Nama Dagang ProdusenNo

Kelas Terapi

No Urut Obat

54

2 Human insulin , cartridge inj 100 IU / ml, 3 ml. Humalog cart Eli30/70 cart Humulin R cart Eli

Humulin N cart Eli

3 Human insulin inj. 100 IU / ml, penfill 3 minj 100 IU / ml, 3 ml. Insulatard penfil Novo

4 Basal analog insulin , Solostar Pen inj 100 IU / ml, 3 ml. Lantus solostar SA

5 Basal insulin analog inj. Flexpen inj 100 IU / ml, 3 ml. Levemir flexpen Novo

6 Basal isulin analog Flexpen inj 100 IU / ml, 3 ml. Novorapid flexpen Novo

7 Basal isulin analog , Flexpen inj 100 IU / ml, 3 ml. Humalog mixcart Eli

8 Mix insulin analog , Flexpen inj 100 IU / ml, 3 ml. Novomix 30 Flexpen Novo

16.3. HORMON KEHAMILAN DAN YANG MEMPENGARUHI FERTILITAS16.3.1 ANDROGEN16.3.2 ESTROGEN

1 Ethinyl Estradiol tab 4 mg Novestrol Nvl

2 Ethinyl Estradiol inj Novestrol Nvl

3 Premaston tab Allylestrenol Kal

16.3.3 PROGESTERON1 Dydrogesterone tab 10 mg Duphaston Abb

2 Levonorgestrel tab 0,03 mg Microlut Bay

55


3 Nomegestrel tab 5 mg Lutenyl Merck

4 Noretisteron tab 50 mg primolut N BayNorelut Dex

5 Progesterone tab 200 mg, 400 mg Cygest Act

16.3.4 INDUKTOR INVOLUSI1 Klomifen sitrat tab 50 mg Provula Dex

Profertil Kal

16.4. HORMON KORTIKOSTEROID1 Dexametason tab, inj 0,5 mg tab, 5 mg/ml inj Cortidex San

Deksamethason OGBKalmethasone Hex

2 Methylprednisolon tab, inj tab: 4 mg, 8 mg, 16 mg Hexilon Kal inj: 125 mg, 500 mg Intidrol Int

Medixon FerMedrol PfiMetrison DexSomerol SohoDepo-Medrol PfiSolumedrol Pfi

3 Prednisolon tab 4 mg Tison Land

4 Triamcinolon inj, tab, semprot inj:40 mg/1 ml , tab:4mg, Flamicort Dexsemprot 55 mcgx 120 dosis Amtocort Phar

No Kelas Terapi

No Urut Obat

56

Trilac Nvl


Kenalog TaishoKetricin FerNasacort AQ spray SA

16.5. KONTRASEPSI ORAL

1 tab 2mg + 0,035 mg Diane 35

2 Etynilestradiol + levonorgestrel tab Mycroginon Sche

17 PREPARAT TIROID DAN ANTAGONIS1 Levothyroxine-Na tab 50 mcg, 100 mcg Euthyrox Merck

Thyrax Sche

2 Carbimazole tab 5 mg, 10 mg Neo mercazole Nic

3 Thiamazole tab 5 mg, 10 mg Thyrozol Merck

18 ANTIHIPERLIPIDEMIA Pfi1 Amlodipin + atorvastatin tab 10 mg Caduet

2 Atorvastatin tab 10 mg, 20 mg, 40 mg Atofar FahAtorvastatin OGBLipitor PfiStator Dex

3 Fenofibrat tab 100 mg, 160 mg, 200 mg, 300 mg Fenofibrat OGBLipanthyl supra Abb

No Kelas Terapi

No Urut Obat

Cyproterone acetate + ethinyl estradiol Bay Sche pharma

57

Trolip Dex


4 Gemfibrozil tab 300 mg Gemfibrozil OGBMersikol MerLopid Pfi

5 Lovastatin tab 2 mg tab Lipovas TSPLoxipas TSP

6 Rosuvastatin Ca tab 5 mg, 10 mg, 25 mg Crestor AZ

7 simvastatin tab 5 mg, 10 mg, 25 mg tab Rechol PharSimvastatin OGBVidastat DarCholestat Kal

8 ezetimibe + simvastatin tab 10 mg + 10 mg; 10 mg + 20 mg Vytorin Sche

19 OKSITOSIK DAN RELAKSAN UTERUS1 Methergin tab, inj tab 0,125 mg , inj: 0,2 mg/ ml Metilergometrin Sdz

2 Oksitoxin inj 10 IU/ml inj Induxin KalSyntocynon Nov

3 Magnesium sulfat inj 20% MgSO4 Bra

20 GIGI, OBAT UNTUK

1Bahan tumpatan sementara siap pakai

Caviton

No Kelas Terapi

No Urut Obat

58

2 Gutta percha point Gutta percha


3 Paper point Paper point

4 Kalsium hidroksida Dycal

5 Endomethason Endomethason

6 Putrex pasta Putrex

7 Cresophene Cresophene

8 Bahan tumpatan dasar Elite cement

9 Selluloid str Selluloid

21 MULUT, OBAT TOPIKAL1 Policresulen 10 ml Albothyl Phar

2 60 ml Aloclair Kal

3 Povidon Iodin gargle Betadin MBF

4 Miconazol oral gel Daktarin Jan

5 Nistatin drop 100.000 IU/ml Kandistatin Mes Mycostatin TaishoNymiko San

No Kelas Terapi

No Urut Obat

Aqua, maltodextrin, aloe, propilen glikol, dll

59

6 Triamsinolon salep 0,1 % Kenalog in ora base Taisho


7 Chlorhexidin gluconat gargle 150 ml Minosept Minorod

8 Benzydamides HCL 7,5 mg/5 ml, 60 ml Tantum Lozenges SohoTantum Verde Oral Rinse Soho

22 BAHAN PROTESA1 Bahan cetak prothesa Kromofan

2 Bahan pengisi cetakan Stone biru

3 Gips putih Gips putih

4 Articulating paper Articulating paper

23 KULIT OBAT TOPIKAL23.1. ANTI AKNE

1 Adapalene gel 0,1 % Evalene Fer

2 Azelaic acid krim 20% Zelface Fer

3 Benzyl peroxide krim Benzolac CL SDM

4 Hidroquinon,tretinoin, Flucinolon asetonida Revaquin SDM

5 Hidroquinon 5%, 2%, 4% Mediquin SDMBioquin Ika

No Kelas Terapi

No Urut Obat

60

6 Retinoic acid gel, krim 0,25, 0,01% 20 g, 0,025% 15 g, 0,05% 20 Vitacid SDM

7 Tretinoin krim 0,05%, 0,1% Retin A JansonTrentin Ika


23.2. ANTIBAKTERI1 Erithromycine krim, gel, sol 20 gr Erymed SDM

2 Mupirocin krim, salep 2% Bactoderm crem IkaBactroban oint GSKPirotop SDM

3 Neomicyn sulfate, ekstak placenta gel Beoplacenton Kal

4 Povidone iodine salep, sol, skin clenser 5 gr, 10 gr Betadine MBF

5 Silver sulfadiazide krim Burnazin Dar

6 Kloramfenicol krim Chloramphecort KF

7 Fluocinolone acetonide + neomycin Cinolon N San

8 Framycetine sulfate Daryant tulle Dar

9 krim 10 gr Digenta IntDiprogenta Sche

10 Fusidic acid krim GP

No Kelas Terapi

No Urut Obat

Betametason dipropionate& gentamycine SO4

61

Fusycom ComFucidin DarFutaderm IntAfucid Fer


11 Gentamicin krim, salep 5 gr, 10 gr, 15 gr Garamycin ScheIkagen IkaSagestam San

12 krim 5 gr, 10 gr Gentasolon IkaCinogenta Fer

13 Kloramfenicol salep Ikamicetin SK IkaKalmicetin oint Kal

14 Klindamycin gel, sol, serb. 5 gr Medi klin SDMNebacetine Phar

23.3. ANTIFUNGI1 Bifonazole krim 5 g Mycospore Bay

2 Cotrimoxazole krim Canesten Bay

3 Fluconazole inf Cryptal Fah

4 Ketoconazole krim, sol SS-2% 80ml, 5 g Zoloral IkaKetomed SDMFungoral KF

No Kelas Terapi

No Urut Obat

Gentamycin SO4& Fluocinolone acetonide 0,25

62

5 Miconazole serb, krim 5 g, 15 g, 20 g, 25 g Daktarin Diapers JanDaktarin powder 20 gr JanMycorine GalFungares GP

6 Nistatin dan Zinc oxide salep Myco Z Taisho


23.4. ANTIANTIFLAMASI DAN ANTIPRURITUS1 Beclometason dipropionat krim 0,025% + 10g Cleniderm Soho

2 Betametason krim Benoson Ber

3 Betametason, garamycin krim Benoson G Ber

4 Betametason, miconazole krim Benoson M Ber

5 Betametason, neomicyn krim 10 g Benoson N Ber

6 Betametasone dipropionate krim, salep 5 g, 10 g Diprosone OV Sche

7 Clobetasol krim, salep 5 g, 10 g, Kloderma SDMLotasbat IntHercum Phar

8 Desonide krim, lot Apolar ActDesolex SDM

9 Desonide dan Neomycin sulfat krim Desolex N SDM

10 Desoximetason salep 15 g Esperson

No Kelas Terapi

No Urut Obat

63

Inerson Int

11 Dexmethason, clotrimazole krim Baycuten N Bay

12 Diflucortolone valerat Nerilon sr IntNerisona Sche


13 Diflucortolone valerat + Chlorquinaldol krim 5g +10g Nerisona Combi TMI

14 Fluocinolone acetonide salep, krim 5 g, 10 g, 75 g Dermasolon IkaMediflex Kal

15 Hydrocortison lot 20 ml Locoid Com

16 Hydrocortison &Miconazol krim Thecort Cream GPBrentan Jan

17 Mometasone furoate krim 5 gr, 10 gr Dermovel FerElox GPIflacort PharElocon MSD

18 Terbinafine Termisil FerLamisil Nvl

19 Na Diklofenak emulgel gel 10 g, 20 g, 50 g Voltaren Nov

20 Glucosamine dll krim 10 g Osteor C PyrFitajoint roler ComLocoid Com

No Kelas Terapi

No Urut Obat

64

21 Piroxicam gel 0,5 % Felden flas Pfi

23.5. ANTISKABIES DAN ANTIPEDIKULOSIS1 Permethrin lotion 5% w/v Scabimite Gal

A Scabs HOE2 Selenium sulfida Topisel lotion Gal

Selsun Yellow Abb


23.6. KAUSTIK1 Perak nitrat 20% Ag Nitrat IFRS

23.7. KERATOTOKSIK DAN KERATOPLASTIK

23.8. ANTIVIRUS1 Acyclovir krim 5% Acyclovir OGB

Zovirax GSKScanovir TSPDanovir Kal

23.9. LAIN-LAIN1 Hypoalergic ambiphilic cream Biocream Merck

2 Calamin, Zinc Oxide lot, serb Caladin Gal

3 Calamin dan Pramoxine Caladryl lotion JJ

4 Camphore lot, serb Calamed Promedyc dyna farma

5 Anhydrous lanolin, isopropil myristate krim Decubal Act

No Kelas Terapi

No Urut Obat

65

6 Aqua, PEG, aloe krim Mederma cr skin care Merz

7 Centella asiatica salep, serb, krim Madecassol CorLanakeloid LandTekasol ointment SDM

8 Ethylhexyl methoxycinnamate krim, lot SPF 33 Parasol SDM


9 Hydroactive gel Duoderm Gel Dex

10 Hydroquinone krim Mediquin SDMMelanox SDMBioquin Ika

11 Lactic acid lot Lacticare StieflLactacyd SA

12 Linoleic triglyceride krim Ezerra HOE

13 serb Niflec Mei

14 Polisilokasan, silicon dioxide 6 gr Kelocote Axe

15 Pseudo dermal lipid krim, lot Noroid Soho

16 Pseudo dermal lipid dan Zinc oxide krim Noroid derma rash Soho

No Kelas Terapi

No Urut Obat

Macrogol, Na Sulfat, Hydrogen Carbonat

66

17 Radix scutelriae Mebo oint Bei

18 Selenium sulfida 60 ml, 120 ml Selsun yellow Abb

19 Urea krim, lot Carmed SDMMoisderm Int

20 Zinc oxide, asam salisilat serb Salicyl Ika


23.10. TOPIKAL ANALGESIK DAN ANTIINFLAMASI1 Methylsalisilate 15 gr Counterpain Taisho

2 Piroxicam dll gel Counterpain PXM TaishoFeldene Pfi

24 MATA, OBAT UNTUK24.1. SISTEMIK

1 Azetazolamide tab 250 mg Glaucon Cen

2 Manitol inf 20%, 250 ml Mannitol Ots

24.2. TOPIKAL24.2.1. ANESTETIK LOKAL

1 Tetracain tetes mata 0,5% ED C Pantocain Cen

24.2.2. ANTIMIKROBA1 Natamycin 50 mg/ml C Natacen Cen

2 Amfoterisin salep 1% Fungicid Cen

No Kelas Terapi

No Urut Obat

67

3 Ciprofloxacin tetes mata C Ulcori Cen

4 Dexmethason, Neomisin, Polimiksin tetes mata,salep mata C Xitrol CenC Polydex

5 Dibekacine sulfat tetes mata Dibekacin Mei

6 Fluorometholon, Neomicyn sulfat tetes mata C Polynel Cen


7 Fluorometholon 0,1% Flumetholon Fer

8 Fusidic acid 10 mg Pithalmic Cen

9 Fluconazole tetes mata 2mg/ml Solnazol Cen

10 Gentamicyn sulfat tetes mata, salep 0.30% Gentamicyn Erla

11 Idoksuridin tetes mata 5 ml C Cendrid Cen

12 Kloramfenikol tetes mata,salep mata 0,25% dan 0,5% ED C Fenicol CenIkamicetin Ika

13 Kloramphenicol, Hidrocortison tetes mata,salep mata C Mycos Cen

14 Kloramphenicol, Polimiksin salep C Mycetin Cen

15 Levofloxacin tetes mata LFX CenCravit Fer

No Kelas Terapi

No Urut Obat

68

Levocin San

16 Na sulfacetamide, Prednisolon tetes mata 5 ml C Cetapred Cen

17 Neomisin, Polimiksin tetes mata,salep C Statrol E Cen

18 Ofloxacin tetes mata C Floxa CenTarivid Ophtalmic Fer

19 Oxytetracyclin salep 1% tube 3,5 g Oxytetracyclin Kifa


20 Polimiksin tetes mata,salep mata C Polygran Cen

21 Tobramicyn tetes mata Bralifex San

22 Tobramicyn, Dexmethason tetes mata Bralifex plus SanC Tobroson CenInmatrol Int

23 Moksifloksasin tetes mata 0,5% Vigamox Alc

24.2.3. ANTIVIRAL1 Acyclovir salep mata C Hervis Cen

Zovirax zalf mata GSK

24.2.4. ANTIINFLAMASI1 Na diklofenak tetes mata Flamar San

2 Na diklofenak, vit A C Noncort

No Kelas Terapi

No Urut Obat

69

3 Na hyaluronat tetes mata 0,1% Hialid FerHyaloph San

4 Pemirolast K tetes mata Alegysal Fer

5 Prednisolon tetes mata C P Pred CenC Vosama

24.2.5. ANTIALERGI1 Naphazolin, feniramin maleat tetes mata C Vernacel Cen


2 Natrium Kromoglikat tetes mata C Conver Cen

3 Olopatadine HCl 0,1% Patanol Alc

4 Pheniramin maleat, Naphazolin Hidrochl drop C Conal Cen

24.2.6. MIDRIATIK1 Atropin Sulfas tetes mata 0,5% dan 1% C Tropin Cen

2 Tropikamid tetes mata 0,5% dan 1% C Mydriatyl Cen

3 Homatropin Homatropin 2% Homatropin ?

4 Phenylefrine HCl Phenylefrine HCl 2,5%, 5%, 10% C Efrisel Cen

24.2.7. ADSTRINGENT1 Antazoline + Nephazoline drop C Vasacon A Cen

No Kelas Terapi

No Urut Obat

70

2 Naphazoline tetes mata Naphazoline HCl 1mg/ml C Vasacon Cen

24.2.8. MIOTIK DAN ANTIGLAUKOMA1 Carteolol ED Arteoptic LA Ots

2 Latanopros, Timolol C Glaoplus Cen

3 Latanopros 0,01%,0,005% Glaupen CenXalatan Pfi

4 Pilocarpine HCl tetes mata 1% ,2 %, 4 % C Carpine Cen

5 Timolol tetes mata 0,25% dan 0,5% C Timolol Cen


24.2.9. LAIN-LAIN1 Billberry extract tab Berry vision disp San

Cen berry CenMatovit AX Soho

2 syr,tab Eyevit Lapi

3 Retivit San Retivit plus

4 Betakarotene, Billberry extr, retinol, Vit Etab Matovit Soho

5 CaCl2 dll tetes mata 5 ml dan 10 ml C Asthenof CenC Augentonic

No Kelas Terapi

No Urut Obat

Billberry extract, retinol,lutein, selenium,zinc,

Beta karoten, vit C,E,Cn,Cu,Ze Lutein +lycopen, Zea xantin

71

C Catarlent

7 Na dihidrozapentacene polisulfonate tetes mata C Cenfresh CenC Lyterrs C Lyterrs

8 HPMC, Dextran tetes mata C Eyefresh Cen

9 Sodium Hyaluronate tetes mata C Hyalub Cen

10 Asam hyaluronat, Vit A gel C Oculenta Cen

11 Vit A dll tetes mata C Protagenta Cen


12 Vit A , Aneurin HCl, Calcium 1000 IU/ml Repithel Cen

13 Tetryzoline tetes mata C Vision Cen

14 Natrium Iodida, Kalium Iodida tetes mata C Vitrolenta Cen

15 Fluorometholon 0,1% Flumetholon Fer

17 Pirenoksin tetes mata 5 ml Kary Uni FerLentikular Cen

18 billbery extrak dll tab,syr Lanavision Land

19 Hidroximetil selulosa, dextran dll tetes mata Opthalgon Cen

No Kelas Terapi

No Urut Obat

72

20 Lutein, Lycopene dll tab Optimax Fer

21 Mineral oil, glycerol, tyloxapol, dll Cationorm Kal

25 VITAMIN DAN MINERAL1 Asam folat tab 1 mg , 5 mg tab Acid Folicum OGB

2 Fursultiamine inj 50 mg inj Alinamin Tak

3 Fursultiamine + vit B2 tab 50 mg tab Alinamin Tak

4 Multivitamin pediatric drop,syr Apialys LapiElkana SanCernevit Kal


5 Antioksidan kpl Seloxy kaplet FerNatur E Darvioxy Fahglisodin Kal

6 Vit B komplek dll tab,inj,cap 300 mg dan 600 mg tab,5000 tab, Vit B complek OGB5000 inj Neurobion Merck

Neurochol LandNeurodex Dex

7 Betakarotene dll tab Oxyvit Fer

8 tab Aspar Tan

No Kelas Terapi

No Urut Obat

Bibentiamin, mg aspartat, potassium aspartat

73

9 Calcitriol Kolkatriol Phapostriol Fah

10 Calcium + vitamin tab,syr, 800 tab, Cal 95 LapiCalos FahDumocalcin plus ActOsfit DHA KalOsfit KalCavit D3 MerckOssofit IntEasycal Nvl

11 CaPO4, cyanocobalamin tab Milmor Phar

12 Choline, Vit A, Vit B1, Vit B12, D3 tab Molinfa Land


13 Curcuma Xanthoriza dll Curcuma emulsion SohoCurcuma plus emulsion SohoLikurmin KalVitacur Lapi

14 D-alpha-tocoferol tab 200 mg, 300 mg, 400mg Dalfarol DarEturol Esc

15 Dibasic Ca Phospat sachet Syncore sachet Land

16 Pharmaton vit Boeh

No Kelas Terapi

No Urut Obat

D-Ribose, L-Carnitine Fumarate, Coenzyme Q10, Magnesium Citrate

74

17 Anti anemi, pre/post natal tab,syr,drop Emineton KalNonemi LapiVitamam NvlPromavit LapiFerrokid KalZomivit NvlAnvomer DexFolamil Genio Dex

19 K-L aspartase Lipirol Nvl

20 Lutein dll Reticopen Landrebal plus Fah


21 Vit C dll tab,strip,inj,syr 120 ml Becom zet SanEster C HolExtrace EthVitacimin TakZegase Kal

22 Suplemen/ multivitamin + mineral tab,cap 50 mg cap,50 tab Cernevit KalProvital LandProvital plus LandArdivit plus NvlBion 3 MerckZegavit Kal

26 DESINFEKTAN DAN ANTISEPTIK

No Kelas Terapi

No Urut Obat

75

26.1. ANTISEPTIK1 Policresulen cairan 10 ml Albothyl concentrate Phar

2 Povidon Iodin cairan, salep 1% Betadine MBFForintec iodine Lapi

3 Lactic acid liq 60 ml Lactacyd liquid SA

4 Tetra chlorodeca oxygena nion complex sol Oxoferin sol Phar

5 Triclosan Phisohex Phar

6 Hidrogen peroksida H2O2 Bra

7 Klorhexidin gluconat First aid BSNMicroshild JJ


26.2. DESINFEKTAN1 Etanol 70% Etanol Bra

Bayclin galon Bay

2 Kalsium hipoklorida tab Presept JJ

3 Kresol tersaponifikasi 50% Lysol Bra

4 Paraformaldehide tab,cairan Formalin Bra

5 Cetrimide + Klorheksidin glukonat First aid BSN

6 Glutaraldehid Cidex JJ

No Kelas Terapi

No Urut Obat

76

Cidex OPA JJ

7 Teepol Teepol Bra

27 LARUTAN DIALISIS PERITONEAL1 Kombinasi glukosa , NaCl inf 5% + 0,225% Glucose-NaCl Wid

28 LARUTAN ELEKTROLIT, NUTRISI DAN LAIN-LAIN28.1. ORAL

1 Asam amino, asam amino rantai cabang dserbuk, infus Aminoleban Ots

2 Essential ketoacids tab. Ketosteril Fretonar Sdzprorenal Nvl

3 serb. 185 gr Diabetasol KalEnsure Abb


Nutrican KalPeptisol Kal

4 KCl tab. KSR Merck

5 Garam oralit serbuk, cairan Pedialyte AbbOralit OGBrenalit Fah

6 Cystein, Glycine, Glycyrhizin inj 20 mg + 400 mg + 40 mg Dexinf. glutiven Dex

Carbohidrat + protein + lemak + dll

No Kelas Terapi

No Urut Obat

Stronger Neo Minophagen C

77

7 Kalium aspratat, Mg aspartat Renapar Fah

8 Pure lechitin dll serb. 10 gr Nutricol sac Landlesichol Land

9 KH2PO4 serbuk KH2PO4 Bra

10 Asam amino, vitamin, Selenium serbuk 4,5 g Minowell Nvl

28.2. PARENTERAL1 Glukosa inf 5%, 10 %, 40% Dextrose Ots

25 cc, 100 cc, 250 cc, 500 cc Dextrose Ecosol BB2 Kalsium glukonas inj Ca glukonas Eth

3 Kalium Klorida inj 25 cc KCl 7,46% Ots


4 Natrium Klorida inf 0,9% ; 3 %; 0,45%; 0,225% NaCl 0,9% Wid500 cc, 100 cc NaCl 0,9% Ecosol BB1000 cc Nacl 0,9% Ots

5 Ringer laktat inf 500 cc RL Wid500 cc Ecosol RL ecosol Ots500 cc Ringer Lactat BB

6 Hipertonik Laktat inf 500 cc Totilac Kal

7 Dextrose + NS inf 10% + 1/5NS Dextrose Ots

No Kelas Terapi

No Urut Obat

78

2,5% + 0,45% (2A)5% + 0,45%; 5% + 1/4 (N4)

8 Aqua steril inf 1000 ml Sterile water for irrigation Ots

9 Aqua pro injeksi inf 25 ml Aqua Ots

10 inf KAEN 3A Ots

11 inf KAEN 3B Ots

12 Natrium Bikarbonat inj. 25 ml Meylon Ots

13 inf. Aminofusin L 600 Kal

Aminovel 600 OtsAminoplasmal BB


14 inf. 5 %, 10 % Aminoleban Ots

15 inf Triofusin 500 KalTriofusin E1000

16 inf Tutofusin Ops Kal

NaCl + KCl + Na. Laktat + Dexrose 2,34 gr + 0,75 gr + 2,24 gr + 27 gr

NaCl + KCl + Na. Laktat + Dexrose Anhidrat 1,75 gr + 1,5 gr + 2,24 gr + 27 gr

Asam Amino + D.Sorbitol + Vitamin C + Inositol + Nikotinamida + Vitamin B6 + Riboflavin, Natrium Fosfat + Rutosid (Rutin) + Mineral

50 gr/L + 100 gr/L + 50 gr/L + 0,4 gr/L + 0,5 gr/L + 0,06gr/L + 0,04 gr/L + 2,5 mg/ml + 0,4 gr/L

No Kelas Terapi

No Urut Obat

Asam Amino + Xylitol + Vit. + mineral

Fruktosa + Glukosa + Xylitol 60 gr + 33 gr + 30 gr

Ca + Mg + NA + K + Asetat + Sorbitol4 meq + 6 meq + 100 meq + 18 meq90 meq + Asetat 38 meq + sorbitol 50 gr

79

17inf

Aminofusin hepar Kal

18inf

Kalbamin Kal

19 Nutrisi Lipid MCT/LCT inf Lipofundin BBLinoleic Kal

20 inf Clinimix KalCombiflex peri BB

21 inf Aminofluid Ots

22inf

Asering Ots

23 Maltose inf Maltose Ots


24inf

Aminosteril infant 6% Fre

25 inf KAEN 1B Ots

26 Dextrose + RL inf Dextrose in Ringer OtsGE Dex

27 Nutrisi karbohidrat inf Triofusin 1000 Kal

Asam Amino Rantai Cabang Kadar Tinggi + Asam Amino Aromatik Kadar Rendah + NaCl

Asam Amino + N + NA + Asetat 100 mg + 15,7 mg + 2 m EQ + 120 m EQ

Asam amino + Glukosa + Elektrolit 40 g + 80 gr

Asam amino + Glukosa + Elektrolit + Zn 3% + 7,5%

Na + K + Cl + Ca + Asetat 140 me + 4 m Eq + 109 meq + 3 meq + 28 meq

10% 500 ml

No Kelas Terapi

No Urut Obat

Asam Amino + D sorbitol + Vit C + Inositol + Nikotinamid + Fosfat

50 g/l + 100 g/l + 0,4 g/l + 0,5 g/l + 0,06 g/l + 0,04 g/l + 2,5 mg/l

Glucose + NaCl 5 % + 0,2255

80

Triofusin E 1000 Kal

28 inf KAEN Mg3 Ots

29 Ringer asetat inf Asering Ots

30inf

Amiparen Ots

31inf.

Kabiven Fre

Nutriflex peri BB

32inf

KAEN 4B Ots

33 inf 30 meq/l + 20 meq/l + 10 meq/l + 40 g/lKAEN 4A Ots


34 Amino acids (essential & non-essential) inf Renxamin Kalkidmin Ots

35 inf Tetrahes BB

36

inf.

Ringer fundin BB

NaCl + KCl + Na Laktat + Dekstrosa Anhidrat 1,75 gr + 1,5 gr + 2,24 gr + 100 gr

Total Asam amino : Asam amino esensial + non esensial + rasio E/N + BCCA + totan N + Na + acetat

100 g + 59, 10 g + 40,90 g + 7,2 + 30% w/w + 15,7 g + Na 2 meq + 120 mwq

Glukose + Amino Acids & Electrolyte (Vamin Novum) + Fat Emulsion (Intralipid)

(11 %) + (18) + (20%) , 1440 ml , 1920 ml

Na+ + Cl + K + laktat + dekstrose 30 meq/l + Cl 28 meq/l + 8 meq/l + 10 meq/l + 37,5 g/l

Na+ + Cl + K + laktat + dekstrose

No Kelas Terapi

No Urut Obat

Hydroxyethyl stach + NaCl (130/0.4) 6 g + 0.9 g/ 100 cc

Calcium Chloride Dihydrate + Magnesium Chloride Hexahydrate Malic Acid + Potassium Chloride + Sodium Acetate + Sodium Chloride 0.37 g + 0.2 g + 0.67 g + 0.3 g + 3.27 g +

6.8 g / l

81

38 N (2) L alanyl 1 glutamine inf Glutiven Dex

39 Aquabides inf 500 ml Aquabides Ika

29 LAIN-LAIN1 Alendronate Artrodar Com

2 Lactoferin dll BD Gard MBF

3 Arabinoxylan derivatives tab. Biobron Fer

4 Ibandronic acid inj. Bondronat Roc

5 Hidroxiapeti inj. Bongros-HA Dae

6 Lumbrokinase Disolf Dex

7 500 mg Enercore Soho

8 Syncore Land


9 Rhizoma Pharidis Ewoma Eth

10 Fetavita NCU

11 Donezepil tab. Fordesia Kalalzim Fah

D-ribose + L-Carnitine

D-ribose + L-carnitine + Coenzym Q10 + Mg citrat

No Kelas Terapi

No Urut Obat

suplemen + natural fish oil + vit E + as folat + dll

82

12 tab. Fortibi Soho

13 Glutamic acid Glutrop Tro

14 Guardix sol Dex

15 Hylan G-F20 Synvisc One SA

16 Tamsulosin 0,2 mg AstTamsulosin 0,4 mg Harnal Ast

17 Propiverine HCl tab. 15 mg Mictonorm Phap

18 Hepalance Phb

19 tab. Hepamax Kal

20 Rose hip powd kaps. I-flex Phap

21 Centella asiatica tab. 30 mg Lanakeloid Land

22 tab. Lemocin Nov


23 Astaxanthin dll tab. & sir. Matoflam Soho

24 Phosphatidyl serine tab. Memoran Soho

25 Nephrolit Bin

Extr. Morinda + zingiber

Hyaluronic acid + CMC + Hanmi

Harnal d

Fructus schisandra chinensis + Lechitin + dll

Schizandra chinensis + Silymarin + Vit. E

Tyrotricin + lidocain + cetrimonium

No Kelas Terapi

No Urut Obat

Orthosipon stamineus + dll

83

26 Risedronat Na tab Ristonat Phap150 mg Actonel SA

27 Stobled Land

28 Ginkgo biloba, Ginkgo flavon glicoside Tebokan Special Phap

29 Tonar Phap

30 tribullus terrestris Tribeston Teg

31 naftokinase Trobesco EscUbesco NCU


32 Ursodeoxycholic acid 250 mg Urdafalk Dar250 mg Urdahex Kal

33 Flavoxate HC Urispas INF

34 Solifenaci 5 mg Vesicare Ast

Radix et rhizoma notoginseng + borneolum syntheticum + rhizoma dioscoreae nipponiceae + rhizoma dioscoreae + herba geranii herba erodii + rhizoma menispermi

a-ketoisoleucine + a-ketoleucine + a-ketophenylaianine + a-ketovaline + Dl_-a-hyclroxy methionine + L- lysine acetate + L- threonine + L- tryptophan + L- histidine + L-tyrosine + total nitrogen + total Ca

No Kelas Terapi

No Urut Obat

84

35 Chondroitin sulfat Viostin DS Phar

36 Curcuminoid sir. 100 ml Vitacur Lapi

37 Pumpkin seed oil Vitanorm Lapi

38 Pancreatin, simethicone tab 170 mg + 80 mg Gasflat Fah

39 Amilase, Protease, Lipase, dll tab Vitazym Kal

40 Phylantus niruri extrak Divens Plus Dex

30 PRODUK DARAH DAN PENGGANTI PLASMA30.1. PRODUK DARAH

1 Albumin serum normal 20% 100 ml, 50 ml Albapure Dex25% 100 ml Albuminar Dex20% 100 ml Human albumin biotest Phl20% 50 ml Octalbin Kal25% 100 ml Octalbin Kal20%100 ml, 50 ml; 25%100ml,20 ml;5%5 Plasbumin Dipa

Albumin Behring Behring25% 20ml Plasbumin Dipa


30.2. PENGGANTI PLASMA DAN PLASMA EKSPANDER1 Hidroxyl Ethyl Starch BM 200.000 200, 500 ml FIMA HES Kal

6% 500ml HAES steril Fre

No Kelas Terapi

No Urut Obat

85

2 Koloid HES BM 130.000 inf. 6 % 500 ml Voluven FreWidahes Wid

3 Modified Fluid Gelatine BM 30.000 inf. Gelofusin BBgelofusal Dex

4 inf. Tetraspan BB

5 Ekstrak Ophiocephalus striatus Vipabulmin Muf

31 SISTEM IMUN DAN OBAT YANG MEMPENGARUHI31.1. SERUM DAN IMUNOGLOBULIN

1 Serum anti tetanus inj. 1500 UI , 20.000 UI ATS Bio

2 Immunoglobulin tetanus inj Tetagam Dex

31.2 Immuno modulator1 Astaxanthin kaps, tab 4 mg Astaxanthin Int

Astatin NvlAsthin force SohoAtria Land


2 Beta glukan Glucan 5 EX For

3 Cinnamon tab. 50 mg , 100 mg Inlacin Dex

Hydroxyethyl starch + sodium chloride + potassium chloride + calcium chloride dihydrate + magnesium chloride hexahydrate + sodium acetate trihydrate + malic acid

No Kelas Terapi

No Urut Obat

86

Cinula Soho

4 Echinacea dll tab, sir. Imboost Force SohoImunal plus NvlImunos LapiProza Land

5 Phylantus niruri extr sir. Stimuno DexDex

6 Plasma Ig Gamaraas Com

7 Super Oxide Dismutase ekstrak Melon tab. Glisodin Kal

31.2. VAKSIN1 Vaksin BCG amp serb. @ 2 ml, 4 ml pelarut BCG Bio

2 Vaksin campak amp serb. @ 10 dosis Vaksin campak Bio

3 Vaksin polio vial/20 dosis Vaksin Polio Bio

4 Vaksin serap difteri tetanus pertusis (DTP) 5 mg/5 ml Vaksin DPT Bio0,5 mg/0,5 ml Infanrix GSK

Infanrix HIB GSK

5 Vaksin serap tetanus 5 ml/vial Toxoid Bio


6 Vaksin hepatitis B inj. , vial 20 mcg/ml , 0,5 1ml Hepatitis BioEngerix B GSK

No Kelas Terapi

No Urut Obat

87

inj. 2 ml Engerix GSK

7 Vaksin Influenza tipe B 0,5 ml Hiberinx GSK

8 Vaksin Influenza tipe A dan B 0,5 ml fluaric GSK

9 Vaksin Haemophillus b, Pneumococcal Synflorix GSK

10 Vaksin Hepatitis A Havrix 720 junior GSK11 Purified Protein Derivative inj PPD Bio

32 TELINGA, HIDUNG DAN TENGGOROKAN, OBAT UNTUK:32.1. ANTIBAKTERI TOPIKAL

1 tetes telinga Otopraf Pra

2 Ofloxacin tetes telinga Tarivid Otic 50 lotion Fer

32.2. LAIN-LAIN1 NaCl tetes hidung tetes hidung, spray Breathy Nvl

Breathy Nasal Spray Nvl

2 Oxymetazolin spray 0,025 % , 0,05 % Iliadin Merck

3 Framycetin + Gramicidin + Dexmethason drop Sofradex SA

4 Lemocin lozenges Nov


32.3. NASAL SPRAY KORTIKOSTEROID

Polymixin B Sulfat + Neomicyn sulfat + dll

Tyrothricin + cetrimonium + lidocain

No Kelas Terapi

No Urut Obat

88

1 Triamsinolon acetonide Nasacort SA

2 Mometasone spray Nasonex nasal ScheFluticasone furoate nasal spray Avamys GSK

32.4. BAHAN KONTRAS RADIOLOGI1 Iopamidol 300/50 Iophamiro Bracco2 Barium sulfat 7 gr Microbar PT TIA3 Iohexol Omnipaque GE Healthcare, Inc.4 Iopromide 300 Ultravist Bay

Draf Frs 2012

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Transcript of Draf Frs 2012