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NATIONAL LIST of ESSENTIAL MEDICINES 2008
n
NATIONAL
LIST of
ESSENTIAL
MEDICINES
2008
DEPARTEMEN KESEHATAN R.I.
MINISTRY of HEALTH
REPUBLIC of INDONESIA
1
Ministry of Health of The Republic of Indonesia.
Cataloging in Publication Data.
615.1
Ind Indonesia. Ministry of Health Republic of Indonesia.
n National list of essential medicines 2008.--
Jakarta : Ministry of Health of The Republic of
Indonesia, 2008.
1. Judul 1. DRUGS
2
CONTENT
Page
Foreword i
Content ii
The decree of The Ministry of Health regarding National List of Essential Medicines iii
2008
Chapter I INTRODUCTION 1
Chapter II National List of Essential Medicines 2008 19
Chapter III Restricted Medicine List for Public Health Center 2008 63
APPENDICES
Appendix I Changes of National List of Essential Medicines 2005 88
Appendix II The Decree of Ministry of Health Number 239/MENKES/ 100
SK/III/2008, 5 March 2008, regarding The Establishment of
National Committee on Revision of The NLEM 2008
Appendix III List of Participants of Technical Meetings and Plenary Session 105
of National List of Essential Medicines 2008
Appendix IV Statement of Compliance 108
Appendix V Conflict of Interest Statement 109
Appendix VI Assessment Form 110
Index 112
National List of Essential Medicines 2008 ii
THE MINISTER OF HEALTH OF THE REPUBLIC OF INDONESIA
THE DECREE OF THE MINISTER OF HEALTH
OF THE REPUBLIC OF INDONESIA
NUMBER : 791/MENKES/SK/VIII/2008
REGARDING
THE NATIONAL LIST OF ESSENTIAL MEDICINES 2008
THE MINISTER OF HEALTH OF THE REPUBLIC OF INDONESIA
Considers : a. 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 is therefore, the National List of Essential
Medicines should be revised;
b. the National List of Essential Medicines which mentioned in the Decree
of the Minister of Health No. 497/Menkes/SK/VII/2006 has to be
revised according to progress of medical sciences, health technology,
disease pattern and the health program respectively;
c. Considering point (a) and (b), it is necessary to redetermine the
National List of Essential Medicines by the Ministerial Decree;
Refers to : 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 Papers of the Republic of Indonesia
No. 4431);
3. Law No. 32 year 2004 regarding the Regional Government
Administration (State Paper year 2004 No. 125, Additional to State
Paper No. 4437) as lastly changed by Regulation No. 12 year 2008
regarding the second changing on the Regulation No. 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
the pharmaceutical product and Medical Devices (State Paper year
1998 No. 138, Additional to State Paper No. 3781);
6. Government regulation No. 38 year 2007 regarding Division of
governing administration of central government, Provincial
Government, and local government in Municipality/District (State paper
Year 2007 No. 82, Additional State Paper NO. 4737);
National List of Essential Medicines 2008 iii
7. Presidential Regulation No. 9 year 2005 regarding the authority,
function, Organizational Structure and duty of States Ministries of the
Republic of Indonesia;
8. Presidential Regulation No. 10 Year 2005 regarding Organization Unit
and duty of the First Rank Officers of the States Ministries;
9. The Regulation of Ministry of Health No. 085/Menkes/Per/I/ 1989
regarding the Compulsory of Generic products prescribing at public
health facilities;
10. The decree of the Minister of Health of the Republic of Indonesia no.
1575/Menkes/Per/XI/2005 regarding Organization and Management of
the Ministry of Health as has been changed by the Regulation of the
Minister of Health No. 1295/Menkes/Per/XII/2007;
11. The decree of the Minister of Health No. 189/Menkes/SK/III/ 2006
regarding the National Medicines Policy;
12. The decree of the Minister of Health No. 239/Menkes/SK/III/ 2008
regarding The Establishment of The National Committee on Revision
of The National List of The Essential Medicines 2008.
Has decided
To Stipulate :
The First : THE DECREE OF THE MINISTER OF HEALTH REGARDING
NATIONAL LIST OF ESSENTIAL MEDICINES 2008.
The Second : The National List of Essential Medicines 2008 as mentioned in the first
dictum is attached in the Appendix hereto.
The Third : The National List of Essential Medicines (NLEM) is the list of the selected
medicines that satisfy the priority health care needs of the population and
are intended to be available within the context of functioning health
systems.
The Fourth : The implementation of NLEM is to increase the appropriateness, safety,
rationalization of the medicine use and management and also increase
the effectiveness and efficiency of the available budget in order to
expand, to distribute evenly and to increase the quality of health services
for all community levels.
The Fifth : The implementation of NLEM should be consistent and continuously in
level of Health Service Units.
The Sixth : 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.
National List of Essential Medicines 2008 iv
The Seventh : This decree shall be effective as of the date of stipulation.
Stipulated in : Jakarta
On Date : August 21, 2008.
Minister of Health
Dr. dr. SITI FADILAH SUPARI, Sp.JP (K)
National List of Essential Medicines 2008 v
FOREWORD
The National Medicines Policy (2006) mandates the enforcement to enhance the quality of health
services; to ensure the availability of safe, efficacious and good quality medicines in sufficient
amount and type, affordability and accessibility of medicine particularly essential medicine for the
whole community, to be government’s responsibility.
Essential medicine is selected medicine that mostly needed for health service, including diagnosis,
prevention, therapy and rehabilitation, which enforced to be provided in health care units,
according to their function and level.
This revision’s renewal applied a new approach, whereas the process of addition and deletion
preceded with re-evaluation of existing list of previous National List of Essential Medicines (NLEM)
by The National Committee of NLEM, therefore there were deletion of obsolete medicines and
addition of new medicines in consequence of science improvement. It needs the transparency of
evaluating process which utilize scientific evidence and consider the pediatric formulation.
NLEM revised regularly every three years; the last revision carried out in 2005. Current revision is
conducted by The National Committee of NLEM, which legalized through The Decree of Minister of
Health.
Hopefully, by the prevailing of NLEM 2008, mandate of The National Medicines Policy could be
applied better.
A great thankfulness is given to all parties involved in the process of revision and formulation of
NLEM 2008.
Jakarta, August 2008
Director General
Pharmaceutical Services and Medical Devices
Dra. Kustantinah, Apt. MAppSc.
NIP. 140 100 965
National List of Essential Medicines 2008 i
CHAPTER I
INTRODUCTION
The concept of Essential Medicine in Indonesia was first introduced with the publication of The
National List of Essential Medicines (NLEM) in 1978, followed by the National Medicines Policy
document in 1983. The National List of Essential Medicines, named DOEN (NLEM) is revised
periodically every 3-4 years. DOEN 2008 is a revised edition. The Government’s commitment to do
periodic revisions is a reputation of its own.
In the year 2007, the World Health Organization (WHO) has carried out the first phase of Good
Governance on Medicines (GGM) program in Indonesia by conducting a survey on transparency of
five pharmaceutical functions. One of them is the selection process of essential medicines, which
from the aspect of transparency process is valued to be insufficient. From the meeting of the 30th
WHO Essential Medicine List in Sri Lanka (2007), it was reiterated that the importance of
transparency of the selection process both by expert panel members who do revisions, revision
process, and revision methods which have got to be more rely on evidence based medicine (EBM),
and the importance of the conflict of interest statement from expert panel members.
Recalling some of the above mentioned issues, this year’s (2008) revision has been geared into its
betterment. Because of it, the revision process this time is rather different from the earlier revision
process, some of these improvements are as follows:
1. The selection of expert panel members has been tightly scrutinized, including valuation
against conflict of interest.
2. Since the beginning of discussion, program managers who use medicines in the
environment of the Ministry of Health have been included, not only during the plenary
meeting. This endeavor is hoped to be a re-learning process to the internal of the
Ministry of Health to fully understand the concept of essential medicines.
3. Besides the opinion and experiences of expert panel members in this revision team, the
utilization of evidence based medicine (EBM) data are important considerations.
4. The entire discussion process gives great attention to medicines for children, including
its formulation. The WHO essential medicines list for children has been used as one of
the guidelines. The siding with the individual rights of children is also shown by electing
pediatricians into the expert panel that numbered to 4 (four) persons.
5. Revision of the medicines list has been holistic and total, meaning weighing all
medicines listed in the NLEM 2005 including notes which may no longer be deemed fit.
Earlier revisions were more in the evaluation of medicines which are suggested to be
added on in the previous list.
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National List of Essential Medicines 2008
6. Transparency is also displayed with descriptions of arguments why a medicine must be
deleted or be added from the NLEM 2005, or even be change of dosage form.
A. National Essential Medicines
Essential medicines are chosen medicines which are most needed to cater to the diagnoses,
prophylaxis, therapy, and rehabilitation, which are made available to the health service units
in accordance to its functions and tiers.
1. Criteria of National Essential Medicines
a. Selection Criteria
Selection of essential medicines is based on these criteria:
(1) Having got the most beneficial risk-benefit ratio.
(2) Guaranteed of quality, including stability and bio-availability.
(3) Practicality in storage and distribution.
(4) Practical in use and delivery, which are adjusted to man power and
health services facilities.
(5) Advantageous in compliance and reception by patients.
(6) Having got the highest benefit-cost ratio based on direct and indirect
expenses for the patient.
(7) If there is more than one choice which have the same therapeutic
effects, then preference is made for:
- medicines with effects which are known to have scientific data;
- medicines with pharmacokinetic data which are known to be most
beneficial;
- medicines with better stability;
- easily obtainable;
- medicines that are most familiar.
(8) Fixed combination medicines have to follow the following criteria:
- the compounded medicine is useful in the form of that
combination only;
- combination medicines have got to show higher efficacy and
safety than each individual component;
- ratio of the components of patent combination medicines are
ratios which are fixed for a large number of patients who need
those combination medicines;
- combination medicines have got to increase the benefit-cost ratio;
- combination antibiotics it must also prevent or lessen the
occurrences of resistance or other disadvantageous effects.
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National List of Essential Medicines 2008
b. Criteria of Additions and Deletions
1. When addition of new medicines are considered, the existing old
medicines with the same indications which may be obsolete should be
taken into account, unless there is a strong reason to keep both of them.
2. Medicines used in special program(s) are suggested by the program
manager and will be assessed by general EM selection criteria.
3. In the revision process, the entire medicine list in the NLEM (2005) is
evaluated by the National Revisions Committee. Deletion of medicines
which are seen as no longer effective may here be decided upon or a
substitution may be done when another better medicine has been
available.
c. Guidance on Evidence and Recommendation
Proof of evidence and recommendations are adopted from the US Agency for
Health Care Policy and Research. The type of study should rely on scientific
data, such as depicted in the list below, but the recommendation should depend
on the overall judgement of all available data. Testimonials are not considered
for assessment.
STATEMENTS OF EVIDENCE
Ia Data are obtained from meta-analysis of randomized, controlled clinical
trials.
Ib Data are obtained from at least one randomized, controlled clinical trial.
IIa Data are obtained from at least one non-randomized and well designed
clinical trial.
IIb Data are obtained from at least one quasi-experiment of another type of
study that is well designed.
III Data are obtained from descriptive study that is well designed, like
comparative study, correlation study, and case study.
IV Data are obtained from reports or opinion of expert panels.
2. Application of Concept of Essential Medicines
Essential medicines are the most basic medicines which are needed to cater for health
services. If other than listed NLEM medicines are needed, a (Hospital) Formulary or
another limited medicine list may be instituted.
The NLEM may also be expanded into other documents as the needs arise.
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National List of Essential Medicines 2008
a. National List of Essential Medicines (NLEM)
National List of Essential Medicines consists of selected, most needed medicines
and made to be available at health services units in accordance with its
functionality and its levels. NLEM are a national minimum standard to health
services.
Implementation of NLEM is meant to increase the efficacy, safety, rational use,
and medicine management which altogether increase efficiency of available cost,
which in turn extends coverage and increase average quality of medicine
prescriptions. Application of this National Essential Medicines Policy must be done
consistently, and continuously at all levels of health services units.
Medicine dosage-form and strength, such as tablets, syrups, injections, and other
forms, unit strength, dose, and size of package indicated in the NLEM are binding,
in order to create standards. Sizes of packaging for each health service unit are
based on logistics efficiency while distribution is related with common usage.
b. Therapeutic Guidelines
Medication Guidelines should be systematically structured to help physicians to
make a correct diagnosis and optimal medication for a certain kind of disease.
Guidelines of medication should be suited for every level of health services units,
such as guidelines in basic medication at Public Health Center and guidelines in
diagnosis and therapy at local hospitals.
Medication Guidelines consist of information about all kinds of diseases, especially
sicknesses which are occurring frequently - with their respective complaints - and
information about dosage form, unit strength, dose of medicines and length of time
of medication.
c. Hospital Formulary
A hospital formulary is a list of medicines which have been agreed upon by key
hospital physicians and their inherent (medicine) information which are used in the
hospital concerned. A national hospital formulary is written by the Medicine and
Therapeutic Committee based on NLEM and elaborated upon by taking into
account other medicines proven effective which are needed by specialties in the
concerned hospitals. The creation of a hospital formulary has to be based on
therapeutic guidelines. The implementation of a hospital formulary must be
monitored and its report be used to carry out evaluation and revision so as to keep
up with advancements of scientific knowledge and medical science.
d. Specialists’ Formulary
Specialists’ formularies are books which are consist of comprehensive complete
information on medicines needed by certain specialists of a hospital, to be used for
patient care with special disease indications.
Specialists’ formularies are written to increase compliance of hospital specialists
towards their hospital formulary, that has been ranked very low until today. Certain
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National List of Essential Medicines 2008
specializations may have many sub-specializations, for example the field of
obstetrics and gynecology as a specialization that has got many sub-
specializations, that special essential medicines list can be made for Obstetrics
and Gynecology. The writings of a specialists’ formulary involve specialist
professional association with its many sub-branches. With the involvement and
active participation of specialists it is expected that they will feel that they are part
of the association, so that rational medicine use can be positively applied.
e. National Indonesian Medicine Information
National medicine information consists of medicines which are on the market and
are presented briefly, are relevant to physicians’ needs, pharmacists, and other
health services workers. The National Indonesian Medicine Information is
published by the Ministry of Health to guarantee objectivity, completeness, and
unconfounding. Information on medicines that are covers indications, side-effects,
dosages, how to use, and other important information which are most important for
patients. The development of this book was based on more scientific data, related
to benefits and actual medicine use.
3. Management and Medicine Use
To improve rational medicine use, the use of essential medicines at health service units
should follow treatment guidelines and proper medicine management be instituted.
Effective medicine management is required to guarantee medicine availability in the
right kinds and quantities while fulfilling quality standards. Important aspects of medicine
management are as follows:
- Limitation of numbers and kinds of medicines based on an Essential Medicines
List, using generic names, with a correct selection process;
- Bulk purchasing should be applied;
- Competitive, transparent purchases;
- Audit system and reporting from management report.
Application of Government Regulation Number 38 year 2007 on the coordination of the
governance between the Central Government and the Provincial Government and other
regional governments in order to synchronize its health management in the country. So,
as with medicine management organizations, each state/city has got organizational
structures and their own medicine management policies. This would open up basic
differences in each state/city in carrying out medicine management.
The cycle of medicine distribution is started at the time a medicine is delivered from the
factory or distributor, and it ends at the time medicine consumption reports are handed
in to the logistics unit. Effective medicine distribution should have a system design and
sound management such as: constant medicine supply, taking care of the quality of
medicines at the time of distribution process, minimizing medicines which are unused
because of spoilage or being expired, with correct planning in accordance with each
province’s medicine needs, use of inventory records which are accurate, rationalization
of medicine depots, and supply of information to estimate medicine needs.
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National List of Essential Medicines 2008
With decentralization in place it is hoped that state government or city or provinces can
sufficiently supply respective individual medicine needs. The central government, in this
matter, the Ministry of Health only lends back-up support when state/city or province
cannot fully supply the medicine needs. The NLEM is a base for planning and supply or
logistics of medicines in local (district/province/city) and central government.
Management and use of specialists’ medicines for certain situations, the government
c.q. Directorate General of Pharmaceutical Services and Medical Devices, Ministry of
Health can provide these through special channels (special access scheme) in
accordance with The Decree of Minister of Health Number: 1379.A/Menkes/SK/XI/2002.
4. Communication, Information, and Education(CIE)
CIE on essential medicines are a pre-requisite to improve the use of medicines and
rational prescribing by health providers. CIE for health providers and the public in
general to increase rational use of medicines and be maintained continuously should
use the following links:
a. Governmental organizations/private institutions.
b. Related professional organization.
c. Curriculum of education for health providers.
d. Other possible channels.
Every listed medicine in NLEM must be accompanied by accurate information that is
objective and understandable by health providers. This information covers indication,
contraindication, dose, how to use, caution remarks, side-effects, medicine interaction,
and dosage forms of preparations.
5. Research and Development
Research and development should be done to support the selection process and
improvement of the NLEM. Research and development are done in line with medical
science and technology in the subjects of medicine, pharmacy, epidemiology, and
education. The outcome or result of research and development are utilized as inputs in
the revision process and improvement of NLEM periodically.
6. Monitoring and Evaluation
Monitoring and evaluation are done to support the success of the application of the
NLEM through mechanism and output evaluation of potential underlying problems and
its effective solutions. This can be achieved through co-ordination, supervision,
monitoring and evaluation of application of the NLEM by the Ministry of Health.
Monitoring and evaluation are done gradually fitting to functions and levels.
7. NLEM Revisions
NLEM has to be revised and perfected periodically. Revisions are not only for keeping
up with the advancement of knowledge, but also for practical reasons in the use and
dispensing which fits health providers and the health service facilities.
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National List of Essential Medicines 2008
Perfection of NLEM is done continuously with input of suggestions from health service
units and health research, whether governmental or private, conveyed to the Directorate
General of Pharmaceutical Services and Medical Devices, Ministry of Health, Republic
of Indonesia. NLEM revisions are done periodically every 3 (three) years.
8. Quality Control
Total medicine quality control covers the phases of product development, good
manufacturing practices, monitoring of medicine quality in the distribution chain and
their use, are important elements in applying the essential medicines concept.
9. Antibiotics Resistance
Antibiotic resistance will increase, especially with first-line essential antibiotics, which
are relatively inexpensive. This condition is dangerous, because ultimately the public
will lose sensitive antibiotics that are potential in fighting infectious diseases which are
newly occurring or recurring. The reason is because of irrational use of antibiotics by
both of health providers or patients.
In overcoming the problem of antibiotic resistance it takes the following efforts:
a. Conducting surveillance of microbe resistance so that antibiotics resistance
patterns are obtained.
b. Surveillance of antibiotic use
Surveillance of antibiotic use is done by research institutions, hospitals, and public
health centers, province or district health offices and other health, education and
research institutions.
c. Containing antibiotic use by health providers by applying antibiotic prescription
policy gradually, fitting to the conditions of patients and disease patterns, using
first-choice antibiotics from the start, and reserving other antibiotics of subsequent
choice for limited use.
d. To provide communication, information and education towards all parties using
antibiotics whether they be health workers, patients or the public in general about
how to use antibiotics rationally and the danger, caused by irrational use of
medicines.
10. Donated Medicines
Donations in the form of money or medicines from another country, private
organizations, or other international bodies can support the public health services in a
country that needs it. In its operation, medicines donation must fulfill the requirements
as described in WHO Guidelines for Medicines Donations 1999. Health services being
used must fulfill a certain existing applicable guidelines/standards. This guideline covers
general principles about selection of medicines, quality of medicines, shelf life,
packaging and labeling, information and management.
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National List of Essential Medicines 2008
Four main principles of donated medicines are:
• Donated medicines must provide maximum usefulness to recipient country.
• Understand the needs and respecting the authority of recipient country.
• Does not use double standards for the quality of donated medicines.
• Effective communication between donor country and recipient country.
Donated medicines are best received when they are in accordance with NLEM. In order
for medicines supply and health logistics can help the operations of health workers, the
types of medicines and health logistics must coincide with the disease patterns in
Indonesia.
For medicines which are not marketed in Indonesia acceptance must follow a special
channel (special access scheme), in accordance with the existing applicable rule.
B. Terminologies
1. Contents and Format of NLEM
a. The National Essential Medicine list is used as the basis for all units of
(governmental) health services.
b. One type if medicines can be used in several forms of preparations and one form
of preparation can consist of a few dosage forms.
c. In the NLEM, medicines are categorized according to class, subclass and
sometimes sub-subclass therapy, which are in alphabetical order.
2. Nomenclature
a. Medicine names are written according to the last edition of Indonesian
Pharmacopoeia. If it does not appear in the Indonesian Pharmacopoeia then
generic names are used.
b. Medicines which are commonly used and do not have an INN (International Non-
proprietary Name) are written with common names, for example ‘oral rehydration
salt’.
c. Combination medicines which do not have a generic name are given agreed
names which are generic names for combinations and each is written with the
effective ingredients, followed with dosage of each component.
d. For some items which need a synonym are written within brackets.
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National List of Essential Medicines 2008
3. Explanatory Notes
a. Keywords
(1) Dosage Forms
Dosage forms or preparations are forms of medicines according to the
production process in the form of usage, for example: capsule, enteric
coated tablet, intravenous injection etc.
(2) Dosage strength
Strength of preparation is the content or percentage of effective
components in ready made preparations. For dosage strength in the form
of salt or its esther, salt or esther are written down within brackets, for
example ethambutol tablet 250 mg (hydrochloride). As for dosages of
effective components, the names of salts or esther (which are written
within brackets) would be priored by the word ‘as’, for example:
chloroquine tablet 150 mg (as phosphate).
(3) Packaging
Packaging is the smallest container that contains the medicine.
(4) Package Size
Package Size is the total number of preparation units or the smallest
container in one standard packaging, for example 100 vials.
b. Other Notes
(1) Information in restricted columns are meant for medicines with certain
restrictive notes:
(a) Monitoring of side-effects.
(b) Limitation of indications.
(c) Only for certain cases.
(d) Tight screening is required or medical expert considerations needed.
(e) Nature or medicine mechanism of action requires attention.
(f) Special treatment required.
(g) Special facilities needed.
(h) Combination with other medicine needed.
(i) Required for certain areas, like endemic areas.
(j) Uses in accordance with existing health program.
(2) Writing of technical terms or foreign language words are written in italics.
(3) National Medicines Lists are medicine lists that are used by hospitals.
(4) NLEM for Public Health Center (primary health service units) in red
colored paper.
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National List of Essential Medicines 2008
c. Abbreviations
i.a. injection : intraartherial injections
i.c. injection : intracutaneous injection
infiltr inj : infiltrated injection
infusion sol : infusion solution
inj : injection
i.m. injection : intramuscular injection
IU : international unit
i.v. injection : intravenous injection
liq : liquid
p.v. injection : paravertebral injection
rectal sol : rectal solution
s.c. injection : subcutaneous injection
sacch : sacchets/bags/pouches
sol : solution
supp : suppository
C. Renewal of Revision Process
Discussions were not conducted only limited to incoming requests, but revaluating the whole
NLEM of 2005. This was done because the list was only updated during previous years and
some old medicines have become obsolete or new and better medicines have become
available. Also some uses of older medicines have been renewed and some have made
other restrictions.
Expert teams and consultants work together in the discussion that is divided into several
groups based on therapeutic class. Consultants are responsible for EBM data in accordance
with his/her competence. Besides information from consultants and expert team, the
secretariat supported fully with among others, information from Cochrane review and WHO
Library. From this process, although EBM information is not always totally accepted, but
discussions are no longer based on level-4 evidence or expert team opinion only.
Understanding the concept of essential medicines has to be re-socialized. Seemingly, the
understanding of the essential medicines is withering and explanation about this concept is
appreciated. ‘Essential Medicine is a floor not a ceiling’ (WHO TRS 946), it is a minimum for
health care. A medicine is essential when you can’t do without it. The difference of essential
medicines and program medicines will result in the availability of a specific medicine. This
problem is overcome by socialization and special policies by the Ministry of Health relating to
essential medicines and program medicines.
In the revision process, from the start it has been planned to give attention to medicines for
children. This policy is not only meant for harmony with the global policy, but Indonesia is
consistently aiming at decreasing mortality of babies and children, so that it needs this
emphasis. The involvement of four pediatricians, give sufficient contributions for this problem.
Also the involvement of the Directorate of Child Health and other directorates are very
intensive. The addition of medicines for children with dosage forms especially for children,
like carbamazepine, is provided in the form of syrup.
In the final discussion of the Plenary Meeting it has been agreed that 78 medicines has been
deleted from NLEM 2005 and 48 were added to the new list of 2008. Changes in formulations
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National List of Essential Medicines 2008
(forms of preparations, dosages, packaging) was agreed for 21 medicines. It was found that
33 medicines were given short notes as important to be provided or supplied by the
government through ways fitting with the existing applicable policies. The total number of
medicines in the NLEM 2008 is 323 medicine items.
1. Revision Process
Revision processes started by sending letters to government health services institutions
(hospital types A, B, C, public health center) as well as several chosen private parties,
special programs in the Ministry of Health and professional organizations. Three months
later, from 114 installations to whom letters were sent to, 25 had responded. From those
responses three had ”no suggestion”, 22 were responding with “request for additions to
the list”, and there was no one responding to delete medicines from the old list.
Although in the letter sent, it has been informed that suggestion has got to come
together with supporting data and functions, only 10 installations were sending
supporting data. Besides suggestions from the installations, the expert team and
consultants, may give suggestions with supportive data.
This process is a yardstick in carrying out the assessment, it is needed to build
transparency process and accountability in the future. The process consists of creation
of a committee, criteria of recruitment of expert team members, tasks and obligations of
expert team members, revision processes, holding discussion meetings and
socialization of NLEM.
2. Committee Members
a. Organization
(1) Organizational structure is a National Committee consisting of:
(a) Expert team
(b) Consultants
(c) Program manager and
(d) Operational Secretariat
(2) Membership of National Committee lasts until a next committee is formed
for the next NLEM revision meeting. The Committee is legalized by the
Minister of Health by a Decree wherein its duties are stated.
(3) Names of expert team members and selected consultants are indexed
without titles, only differentiated into MDs, general practitioner, specialists,
or pharmacists.
(4) Not all therapeutic classes need to be represented as a member or
consultant in the Committee.
(5) If an expert in a special field is needed, he/she can be invited to become a
resource person to give an expert opinion in the revision process. They
will not become a part of the expert team and also do not take part in
decision making.
(6) Duties of expert team members and consultants listed in the Ministerial
Decree are:
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National List of Essential Medicines 2008
(a) Expert Team members are evaluating medicines listed in NLEM
2005 and also evaluate suggested medicines which are applied for
deletion or inclusion in the new list.
(b) Consultants are joining the discussions and may give scientific or
practical inputs which may be needed to be useful to be taken into
consideration by the expert team members.
(c) Expert team members and consultants together give
technical/scientific justification to Ministry of Health through
Directorate of Pharmaceutical Services and Medical Devices to
accept the new NLEM 2008 nationally, while assisting the
Directorate of Rational Medicine Use in practicing its concept.
(7) Program manager is a representative of a directorate in the Ministry of
Health who owns special therapeutic programs and manages the logistics
of medicines.
(8) The Operational Secretariat are Directorate of Rational Medicines Use,
Directorate General of Pharmaceutical Services and Medical Devices.
b. The selection process of Expert Team and Consultants
(1) Pre-requisites of Expert Team and Consultants
(a) Have integrity and a high professional standard.
(b) Expert team members and consultants are clinicians from several
fields of specialization, Clinical Pharmacology, Dentistry,
Pharmacists, physicians/health service units (public health center).
(c) In order to get professional expert team members who are impartial,
he or she must not represent professional associations, hospital
departments, or other jobs which are potential in creating conflicts.
(d) Signing a letter of consent, acceptance and availability.
(e) Willing to sign a conflict of interest statement. But somebody who
has a conflict of interest can still be considered to become a member
of the expert team, if integrity can be maintained. He/she may then
not participate in a voting process.
(2) 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
the commencement of the Meeting.
(b) He or she must submit the filled-in form 1 (one) week after receiving,
together with 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.
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National List of Essential Medicines 2008
3. Revision Methods
a. Submission of medicines
Revision processes is started by sending submission forms to several health
service units (University Hospitals, Special Hospitals, chosen State Hospitals,
Provincial Hospitals, Military/Police Hospitals, chosen Private Hospitals, Regional
Hospitals, Public Health Center with beds). Provincial Health Units representative,
public health center, and program managers (in the directorate of Ministry of
Health). Submission Request Forms are sent 3 (three) months before the first
Meeting.
b. Compilation of Submissions
Compiled submissions are categorized or grouped in therapeutic classes.
c. Material of Revisions
Material of Revisions are put in a matrix, which is put side by side with the WHO
List 2007 and the latest NLEM 2005 edition. It is followed with the submitted
medicines. Revised Materials will be handed to expert team members 1 (one)
week before technical discussion meeting.
d. Discussion Criteria
Submissions to be discussed are suggestions which come with arguments and
accompanied with scientific evidence.
e. Methods of Revision Materials
(1) 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 and adding essential medicines whether from requests or
from expert team member’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).
• Implementation of NLEM (in relation with program medicines,
guideline for procurement of PKD Medicines, DPHO- AsKes
and others).
• NLEM Revision Procedure.
• Procedure in technical discussion (preparation of NLEM
revision draft) and plenary meetings.
• Attendance: expert team, consultants, program managers,
operational secretariat.
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National List of Essential Medicines 2008
(b) Technical discussion meetings
• Discussion meetings of the pro and contra whether to accept or
refute a submission.
• Discussion on benefit-risk of additions or deletions of essential
medicines which are on the old list.
• Putting in focus those medicines which are submitted, but were
not included in the WHO list. These were specially scrutinized.
• Suggestion to put food supplements into NLEM will not be
considered.
• If the Expert Team fails to make a decision on some choices, a
resource person outside the expert team members will be
invited.
• Attendance for the meeting are:
o Expert team
o Consultants
o Related program managers of Ministry of Health
o Related resource persons.
• Result of technical discussion meetings is NLEM revision draft.
(c) Plenary Meeting
• Aims at making agreements, formalizing, and socializing
revised draft of the NLEM.
• Meeting Chairman is the head of the expert team.
• Formalization of NLEM draft to become the new revision is the
Directorate of Pharmaceutical Services and Medical Devices
task or someone who is appointed by the institute.
• When the result of plenary meeting has been legalized it may
not be altered, except editorial revisions.
• Plenary meeting members should be responsible as part of the
decision making process and are also expected in the active
participation to deploy the new NLEM.
• Plenary meeting attendees are:
o Those who attended the preliminary meeting and
technical discussions;
o Medical Committees of University Hospitals,
Military/Police Hospitals, chosen Private Hospitals and
other hospitals and medal schools who submitted
suggestions for revision;
o Attendees from Faculty of Medicine
o Attendees from Faculty of Pharmacy;
o Attendees from School of Nursery;
o Provincial Health Office submitting revision suggestion(s);
14
National List of Essential Medicines 2008
o Professional organizations (IBI, IDI, PPNI, ISFI,
specialists’ associations);
o Pharmaceutical Industries (BUMN and Pharmaceutical
Wholesalers Association)
4. Explanation of changes made
Medicine changes made in NLEM 2008 whether generic names or their formulations,
based on therapeutic classes are as follows:
1. Analgesics, Antipyretics, Non-steroidal Anti-inflammatory Medicines,
Medicines used to treat gout
1.1 Opioid Analgesics
Sufentanyl in the form of citrate 50 mcg/ml, was taken out from the list,
because of poor availability in the market.
1.2 Non-opioid Analgesics
Methampyron i.m. inj. 250 mg/ml was taken out from the list for safety
reason, where in the form of injection may cause anaphylactic shock.
Suggestion to add ketoprofen supp. 100 mg and paracetamol supp. 120
mg and 240 mg were accepted, recalling that ketoprofen supp. is used for
post-surgical patients who cannot yet receive oral medicine forms, while it
is non-irritant to the stomach. While paracetamol supp. is needed to
prevent febrile convulsion cases, post-surgery in children, in line with
pediatric procedures. Availability and procurement of paracetamol supp.,
are limited to district level hospitals.
1.3 Anti-gout
Colchicine tablets 500 mcg has been listed in NLEMs from the start. But
with the availability of many NSAIDs, its efficacy is valued not much
different from other NSAID medicines, while their safety is lower than
colchicine. Thus colchicine was taken out from the list. The WHO Model
List 2007 did not contain colchicines either.
2. Anesthetics
2.1 Local Anesthetics
Lidocaine inj 5% + glucose 7.5% 2 ml amp was suggested to be added,
especially for spinal anesthesia, in areas where bupivacaine are difficult to
get. Besides, toxic effects against the heart is smaller. Lidocaine inj. 1%
(HCl) + epinefrin 1 : 200,000 in packaging of 20 and 30 ml were deleted
from the list, because the packaging is seen to be too large, so it would
cause spoilage if not finished.
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National List of Essential Medicines 2008
2.2 General Anesthetics and Oxygen
Suggested liquid isoflurane liq. 3 – 3.5 % 250 ml are accepted, because of
advantages to the heart and are used for patients with specific certain
conditions. Midazolam inj. i.v. 1 mcg/ml and i.v. inj. 5 mg/ml are choice
medicine for patients with fragile vital signs, as sedative, hypnotic, and
pre-anaesthetics. While liquid enflurane ih., btl 250 ml was taken out of
the list with the reason being less advantageous if compared with
isoflurane and halothane. While Thiopental powder. inj. i.v. 1,000 mg/ml
was taken out from the list because of safety consideration.
5. Antiepileptic-Anticonvulsants
Suggestion of addition in the dosage form of syrup and chewable tablet for
pediatric patients are accepted. So, in this class were listed: fenitoin syrup 50
mcg/5 ml, carbamazepin 100 mg/ml bottle 120 ml, chewable tablets 100 mg.
Phenobarbital tab 50 mg was added, because it was still effective and cheap.
6. Anti-infective
In several previous revisions of NLEMs, cephalosporines were always suggested
to be added, but only this time the National Committee, gave way to cephazolin
with limitation to special use of surgery prophylaxis inj. 1 g/vial. Cephazolin is a
chosen medicine for surgery prophylaxis to prevent surgical wounds infection. The
same thing happens to Ceftriaxone inj. 1 g/vial, that is a chosen medicine for
meningitis and is used for resistant cases of typhoid fever with chloramphenicol
and cyprofloxacin. The delay of entry of cephalosporine antiinfectives is caused by
the fast growing anti-infective resistance in hospitals, especially.
Expert team agreed to accept the inclusion of vancomycine inj. 500 mg to
overcome MRSA (methicillin resistant S. aureus) infection, a serious nasocomial
infection. Amphotericine*) inj. i.v. vial 50 mg was requested and accepted for
inclusion, because it is the only systemic antifungal, mainly for pulmonary fungal
infection. In the list it was marked *) that means “needing special expertise in its
use”.
For anti-amoebic diloxanide furoate tab 500 mg was included, recalling the
importance of treatment of cysts that does not show physical symptoms. In the
anti-malarial case arthesunate inj. i.v. 60 mg/ml was added, that was valued to be
having better efficacy compared to artemether inj., although from the side of usage
artemether is more practical for public health center (primary health service units).
In the antiviral protease inhibitor group lopinavir were added because they were
needed for HIV/AIDS, although their prices are higher. In anti-tuberculosis
medicines, besides a few single medicines are provided, listed were some
combination medicines for use by program needs. But in the case of dosage
forms, it was left to program needs, whether they be in the form of FDC (fixed
dose combination), or combipack. Single preparations are maintained for use in
health services which are not yet able to carry out direct observed treatment
shortcourse (DOTS) program.
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National List of Essential Medicines 2008
8. Antineoplastic, Immunosuppressive and Medicines used in Palliative Care
Chlormetin and levamisol were taken out of the list, because they were no longer
in use as anticancer medicines, because of their efficacy and safety. Addition of
daunorubicin HCl powder inj. was suggested and accepted by expert team, as well
as chlorambucil tablet 2 mg and melfalan tablet 2 mg. Daunorubicin is a main
medication in Acute Lymphocyte Leukemia that is often found in children.
Chlorambucil is low priced, registered in Indonesia and is in accordance with the
WHO Model List. Melfalan is a cheap medicine and is needed in the treatment of
multiple myeloma.
14. Dental Medication and Oral Health
From this therapeutic class many are evaluated as obsolete, even their uses are
no longer being taught by Dental Schools, for example sulpha cones preparation
and iodoform paste. There are some which are causing environmental damage,
like the use of amalgam, because of that it is agreed upon that composite be used.
17. Cardiovascular Medicines
In this therapeutic category a few changes in subclass or deletions of medicines
were applied because they are no longer in production and are no longer available
in the market like procainamide, reserpine, quinidine. In the subclass of
antiarrythmic added were amiodarone and digoxin. In the antihypertension class
sodium nitroprusid inj. was added to be used for its specific efficacy in surgery
needing hypotension technique and septic shock.
18. Dermatological Medicines
Many medicines were deleted because of obsolescence, for example gentian
violet, liver oil ointment. These liquids like lotio kummerfeldi, if needed, can be
entered into a hospital formulary.
New additions which are accepted are permethrine as an antiscabicide that is less
toxic to children, in place of Gamexan. Other addition is Liquor Veilli (diluted
salicylic acid), a simple effective medicine for wet dermatitis.
20. Electrolytes and Nutrients
Oral rehydration salt in 1000 ml sacchets are deleted from the list, because the
packaging is too large, inefficient to store and it does not maintain freshness for
long time. Only 200 ml sachets are available.
In the case of parenteral nutrition liquid namely liquid nutrients i.v. all of them were
deleted from the list. The National Committee, especially expert team and
consultants, are well aware of the importance of this preparation, but compositions
which are available in the market vary and were too many, with uses which may
be different.
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National List of Essential Medicines 2008
For children use and neonates in this therapeutic class liquid nutrients were
added: glucose 4% + NaCl 0.18% infusion, and sodium bicarbonate inj. 1.4%
isotonic.
23. Psychotherapeutic Medicines
Alprazolam was deleted because valued to be non-essential and tend to cause
overuse and dependence. In subclass therapy antidepression and antimania it
was suggested addition of fluoxetine, sertraline and paroxetine. Fluoxetine
cap/tab10 mg and cap/tab 20 mg were accepted as choice medicines for category
SSRI.
In the antipsychotic subclass racemic methylphenidat addition was suggested in
the form of regular release and extended release to be used for Attention Deficit
Hyperactive Disorder (ADHD). Although evidence has not fully supported, but all
these times it has been a choice medicine for ADHD. Addition of chlozapine was
accepted because it is a selected medicine for other resistant antipsychotic
medicines. This medicine is effective but it is necessary to watch for
agranulocytosis side effect. Periodic leucocytes counts must be taken.
28. Ear treatment, Nose, and Throat
Important changes took place in looking at ear treatment, nose, and throat.
Experts considered that treatment of ear infection does not need to use antibiotics
or corticosteroids. Other than that antibiotic preparations in the form of nose or ear
drops are not listed in the WHO Model List.
D. Socialization of NLEM 2008
In applying essential medicines concept, NLEM 2008 must be spread to health service
facilities in the entire Indonesia. Socialization can be in the form of printed books which are
delivered to all health service units and publicized in electronic form.
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National List of Essential Medicines 2008
CHAPTER II
NATIONAL LIST OF ESSENTIAL MEDICINES
2008
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
1. ANALGESICS, ANTIPYRETICS, NON-STEROIDAL ANTI-INFLAMMATORY MEDICINES,
MEDICINES USED TO TREAT GOUT
1.1 OPIOID ANALGESICS
codeine tablet 10 mg,
bottle 250 tablets
fentanyl injection i.m./i.v. 0.05 mg/ml Authority required :
(citrate), Anesthetist
box 5 ampoules @ 2 ml
morphine injection i.m./s.c./i.v. 10
mg/ml (HCl/sulfate),
box 10 ampoules @ 1 ml
tablet 10 mg (HCl/sulfate),
bottle 30 tablets
pethidine injection i.m./s.c./slow
released i.v 50 mg/ml
(HCl),
box 10 ampoules @ 2 ml
sufentanyl injection 5 mcg/ml (citrate),
box 5 vials @ 10 ml
1.2 NON-OPIOID ANALGESICS
acetylsalicylic acid (acetosal) tablet 100 mg, box 10 blisters
@10 tablets
tablet 500 mg, box 10 blisters
@10 tablets
ibuprofen tablet 200 mg,
bottle 100 tablets
tablet 400 mg,
bottle 100 tablets
ketoprofen suppositoria 100 mg Restricted use :
Post operative patients
National List of Essential Medicines 2008 19
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
methampyrone tablet 500 mg, Restricted use :
bottle 1000 tablets To reduce agranulocytosis
paracetamol tablet 100 mg,
bottle 1000 tablets
tablet 500 mg,
bottle 1000 tablets
syrup 120 mg/5 ml,bottle 60 ml
suppositoria 120 mg
suppositoria 240 mg
phenylbutazone coated tablet 200 mg, Restricted use :
bottle 100/1000 tablets Only for acute arthritis, to be
taken after meals, for one
week and to be followed by
other safer NSAID as
needed.
sodium diclofenac tablet 25 mg, box 10 stripes
@ 10 tablets
tablet 50 mg, box 10 stripes
@ 10 tablets
1.3. MEDICINES USED TO TREAT GOUT
allopurinol tablet 100 mg, bottle Note :
100/1000 tablets - Blocks uric acid production
(in 35% of cases)
- Not for acute attack
probenecid tablet 500 mg, bottle 100/1000 Note :
tablets - Increases uric acid renal
excretion (in 65% of cases)
- Dosage 2 X ½ tablet,
increase water intake
- Not for acute attack
2. ANESTHETICS
2.1 LOCAL ANESTHETICS
bupivacaine p.v. injection 0.50% (HCl), Restricted use :
box 5 vials @ 20 ml Only for spinal anesthesia
injection 0.5% (HCl) +
glukosa 7.5%, box 5
ampoules @ 4 ml
National List of Essential Medicines 2008 20
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
ethyl chloride spray, bottle 100 ml Note :
Air tight package
lidocaine infiltr injection 1% (HCl),
box 100 amps @ 2 ml
p.v. injection 2% (HCl),
box 100 ampoules @ 2ml
gel 2%, tube 10 g
spray 4%, bottle 50 ml
injection 5% + glukosa 7,5 %, Restricted use :
ampoule 2 ml Only for spinal anesthesia
2.2 GENERAL ANESTHETICS and OXYGEN
halothane inhalation liquid,
bottle 50/250 ml
isoflurane inhalation liquid,
bottle 250 ml
ketamine i.v. injection 10 mg/ml (as
HCl), box 10 vial @ 20 ml
i.v. injection 50 mg/ml (as
HCl), box 10 vial @ 20 ml
midazolam i.v. injection 1 mg/ml Restricted use :
i.v .injection 5 mg/ml Only for special conditions
nitrous oxide inhalation, gas in tube
oxygen inhalation, gas in tube
propofol injection 10%,
box 5 ampoules @ 20 ml
thiopental i.v. powder for injection 500
mg/ampoule (as sodium
salt) (for dissolved in 20 ml
WFI), box 25 ampoules
2.3 MEDICINES USED FOR PREOPERATIVE MEDICATION PROCEDURES
atropine injection 1 mg/ml (sulfate),
box 50 ampoules @ 1 ml
National List of Essential Medicines 2008 21
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
diazepam tablet 5 mg,
bottle 1000 tablet
injection 5 mg/ml,
box 100 ampoules @ 2 ml
morphine i.m./s.k./i.v. injection 10
mg/ml (HCl/sulfate),
box 10 ampoules @ 1 ml
3 ANTIALLERGICS and MEDICINES USED IN ANAPHYLAXIS
chlorpheniramine tablet 4 mg ( maleate),
bottle1000 tablets
injection 5 mg/ml (maleate),
box 100 ampoules @ 1 ml
dexamethasone injection 5 mg/ml (as sodium
phosphate), box 100
ampoules @ 1 ml
diphenhydramine i.m. injection 10 mg/ml (HCl),
box 100 ampoules @ 1 ml
epinephrine (adrenaline) s.c./i.m. injection 0,1% Note :
(HCl/bitartrate), - Drug of choice for
box 100 ampoules @ 1 ml anaphylactic reaction
- Dosage 0,3 mg – 0,5 mg
i.m., may be repeated
4. ANTIDOTES and OTHER SUBSTANCES USED IN POISONING
4.1 SPECIFIC
atropine i.m./i.v./s.c injection 1 mg/ml Restricted use :
(sulfate), Caution on package: “only for
box 10 ampoules @ 2 ml antidotes (large dose)”.
calcium folinic (leucovorin, Ca) tablet 1 mg, bottle 100 tablets
tablet 15 mg, bottle 10 tablets
injection 3 mg/ml,
box 10 ampoules @ 1 ml
calcium gluconate injection 100 mg/ml,
box 24 ampoules @ 10 ml
National List of Essential Medicines 2008 22
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
deferoxamine powder for injection 500
mg/ml (mesilate),
box 10 vials @ 10 ml
methylthioninium chloride injection i.v. 10 mg/ml (as
(methylene blue) dihydrate),
box 10 ampoules @ 10 ml
naloxone injection 0.02 mg/ml (HCl),
box 10 ampoules @ 2 ml
injection 0.4 mg/ml (HCl),
box 5 ampoules @ 2 ml
protamine sulfate i.m. injection 10 mg/ml,
box 10 vials @ 5 ml
sodium bicarbonate tablet 500 mg,
bottle 1000 tablets
sodium thiosulfate i.v. injection 25%,
box 10 ampoules @10 ml
4.2 NON-SPESIFIC
active carbon activated powder, sacch 0.5 kg
apomorphine s.c. injection 5 mg/ml (HCl),
box 10 ampoules @ 1 ml
magnesium sulfate powder, sacch 30 g
5. ANTIEPILEPTICS – ANTICONVULSANTS
carbamazepine tablet 200 mg,
bottle 100/1000 tablets
chewable tablet 100 mg
syrup 100 mg/5 ml,
bottle 120 ml
diazepam i.m./i.v. injection 5 mg/ml,
box 100 ampoule @ 2 ml
rectal sol 4 mg/ml, tube 2.5 ml
magnesium sulfate i.v. injection 20%,
ampoule 25 ml
i.v. injection 40%,
ampoule 25 ml
National List of Essential Medicines 2008 23
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
phenobarbital tablet 30 mg,
bottle 1000 tablets
tablet 50 mg,
bottle 1000 tablets
tablet 100 mg,
bottle 1000 tablets
i.m injection 50 mg/ml,
box 100 ampoules @ 2 ml
i.v.injection 50 mg/ml (as
sodium salt),
box 100 ampoules @ 2 ml
phenytoin capsule 30 mg (as sodium
salt), bottle 250 capsules
capsule 100 mg (as sodium
salt), bottle 250 capsules
injection 50 mg/ml (as sodium
salt),
box 10 ampoules @ 2 ml
syrup 50 mg/5 ml,bottle 120 ml
valproate tablet 250 mg (as sodium
salt), bottle 50 tablets
tablet 500 mg (as sodium
salt), bottle 50 tablets
syrup 250 mg/5 ml (as
sodium salt), bottle 120 ml
6. ANTI-INFECTIVE MEDICINES
6.1 ANTHELMINTHICS
6.1.1 Intestinal Anthelminthics
albendazole tablet 400 mg, Note :
box 5 stripes @ 6 tablets - For strongiloides.
- Pediatric dose : 20
mg/kgBW
mebendazole tablet 100 mg,
bottle 100 tablets
syrup 100 mg/5 ml,bottle 30 ml
National List of Essential Medicines 2008 24
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
praziquantel scored tablet 300 mg,
bottle 100/1000 tablets
pyrantel scored tablet 250 mg
(pamoate),
bottle 250 tablets
suspension 125 mg/5 ml
(pamoate), bottle 30 ml
6.1.2 Antifilarials
diethylcarbamazine scored tablet 100 mg (citrate), Note :
bottle 1000 tablets For endemic area
6.1.3 Antischistosomals
praziquantel tablet 600 mg, Restricted use :
bottle 100 tablets - Only for Central Sulawesi
- Only for South Kalimantan,
for Fasciolopsis buski
treatment
6.2 ANTIBACTERIALS
6.2.1 Beta Lactam medicines
amoxicillin trihydrate scored tablet 500 mg,
box 10 stripes @ 10 tablets
dry syrup 125 mg/5 ml,
bottle 60 ml
ampicillin i.m./i.v. powder for injection
250 mg/vial (as sodium
salt), box 10 vials
i.m./i.v. powder for injection
500 mg/vial (as sodium
salt), box 10 vials
benzathine benzylpenicillin i.m. injection 1.2 millions
IU/ml, box 25 vials @ 4 ml
i.m. injection 2.4 millions
IU/ml, box 25 vials @ 10 ml
benzylpenicillin crystal i.m./i.v. injection 10 millions
IU/vial, box 25 vials
National List of Essential Medicines 2008 25
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
cefazolin powder for injection 1 g / vial, Note :
box 2 vials Prophylactics, to prevent
operation wound infection
ceftriaxone powder injection 1 g / vial,
box 2 vials
dicloxacillin capsule 250 mg (as sodium
salt), box 25 stripes @ 4
capsules
scored tablet 500 mg (as
sodium salt)
syrup 62.5 mg/5 ml (as
sodium salt), bottle 60 ml
i.m./i.v. powder for injection
500 mg/vial (as sodium
salt) (soluble in 5 ml WFI),
box 20 vials
phenoxymethylpenicillin tablet 500 mg (as potassium
(penicillin V) salt), bottle 1000 tablets
tablet 250 mg (as potassium
salt), box 10 stripes @ 10
tablets
dry syrup 250 mg/5 ml
(as potassium salt),
bottle 60 ml
procaine benzylpenicillin powder for injection i.m. 3
millions IU/vial,
box 100 vials
powder for injection i.m. 1
million IU/vial,
box 100 vials
6.2.2 Other antibacterials
6.2.2.1 Tetracycline
doxycycline capsule 100 mg(hyclate/HCl), Note :
box 10 stripes @ 10 May be used for renal
capsules patients
National List of Essential Medicines 2008 26
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
oxytetracycline i.v. injection 250 mg/3 ml
(HCl), box 10 ampoules
@ 3 ml
i.v. injection 50 mg/ml (HCl),
box 10 vials @ 10 ml
tetracycline capsule 250 mg (HCl),
bottle 1000 capsules
capsule 500 mg (HCl),
box 10 stripes @ 10
capsules
6.2.2.2 Chloramphenicol
chloramphenicol capsule 250 mg,
bottle 1000 capsules
suspension 125 mg/5 ml (as
palmitate), bottle 60 ml
i.v. powder for injection 100
mg/ml (as succinate
sodium),
box 10 vials @ 10 ml
6.2.2.3 Sulfa-Trimethoprim
NLEM co-trimoxazole I (adult) tablet, box 10 stripes @ 10
combination of : tablets
sulfamethoxazole 400 mg
trimethoprim 80 mg
NLEM co-trimoxazole II tablet, bottle 100 tablets
(paediatric) combination of:
sulfamethoxazole 100 mg
trimethoprim 20 mg
NLEM co-trimoxazole III i.v. injection, box 5 ampoules Note :
combination of : @ 5 ml, box 5 vials @ 10 ml Minimized use
sulfamethoxazole 80 mg/ml
trimethoprim 16 mg/ml
sulfadiazine tablet 500 mg, bottle100
tablets
trimethoprim scored tablet 200 mg,
bottle 100 tablets
National List of Essential Medicines 2008 27
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
6.2.2.4 Macrolides
clindamycin injection 150 mg/ml (as Note :
phosphate), box 100 Benefit for bone infections
ampoules @ 2 ml
erythromycin capsule 250 mg (as
stearate),
bottle 100 capsules
syrup 200 mg/5 ml (as ethyl
succinate), bottle 60 ml
6.2.2.5 Aminoglycosides
gentamicin injection 10 mg/ml (as
sulfate) @ 2 ml
injection 40 mg/ml (as
sulfate),
box 10 ampoules @ 2 ml
6.2.2.6 Quinolones
ciprofloxacin scored tablet 500 mg (as HCl), Caution :
box 10 blister @ 10 tablets Not for fist line treatment on
gram possitive bacteria
infection
vancomycin powder injection 500 mg/vial, Restricted use :
box 1 vial Benefit for MRSA infection
6.2.2.7 Specific Use
metronidazole tablet 250 mg,
bottle 100/1000 tabs
tablet 500 mg,
bottle 100/1000 tabs
suppositoria 500 mg,
box 6 suppositoria
infusion solution 5 mg/ml,
bottle 100 ml
sulfasalazine tablet 500 mg, Restricted use :
bottle 500 tablets Specific for ulcerative colitis
National List of Essential Medicines 2008 28
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
6.3 SPECIFIC ANTI-INFECTIVE MEDICINES
6.3.1 Antileprosy medicines
clofazimine, micronized oily capsule 100 mg,
bottle 100 capsules
dapsone scored tablet 100 mg,
bottle 1000 tablets
rifampicin capsule 300 mg, box 10 Restricted use :
stripes @ 10 capsules Only for tuberculosis and
leprosy
6.3.2 Antituberculosis medicines
ethambutol tablet 250 mg (HCl),
bottle 100 tablets
tablet 500 mg (HCl),
bottle 100 tablets
isoniazid tablet 100 mg,
bottle 1000 tablets
tablet 300 mg,
bottle 1000 tablets
pyrazinamide tablet 500 mg,
bottle 100 tablets
rifampicin scored tablet 300 mg, Restricted use :
box 10 stripes @10 tablets Only for tuberculosis and
tablet 450 mg, leprosy
box 10 stripes @10 tablets
tablet 600 mg,
box 10 stripes @10 tablets
streptomycin powder for injection 1000
mg/vial (as sulfate),
box 100 vials
combination of : Note :
rifampicin caplet 150 mg; 75 mg Dosage form and usage
isoniazid tablet 150 mg; 50 mg according to National
Tuberculosis Program
National List of Essential Medicines 2008 29
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
combination of : Note :
rifampicin capl 150 mg Dosage form and usage
isoniazid tablet 150 mg according to National
ethambutol tablet 400 mg tuberculosis program.
combination of : Note :
rifampicin capl 150 mg; 75 mg;450 mg Dosage form and usage
isoniazid tablet 75 mg; 50 mg; 300 mg according to National
pyrazinamide tablet 400 mg; 150 mg; tuberculosis program.
500mg
combination of : Note :
rifampicin capl 150 mg; 450 mg Dosage form and usage
isoniazid tablet 75 mg; 300 mg according to National
pyrazinamide tablet 400 mg; 500 mg tuberculosis program
ethambutol tablet 275 mg; 250 mg;
500mg
6.3.3 Urinary Antiseptics
NLEM co-trimoxazole I (adult) tablet, box 10 stripes @ 10
combination : tablets
sulfamethoxazole 400 mg
trimethoprim 80 mg
methenamine mandelate enteric coated tablet 500 mg,
(hexamine mandelat) bottle 100/1000 tablets
nitrofurantoine scored tablet 100 mg,
bottle 100 tablets
trimethoprim scored tablet 200 mg,
bottle 100 tablets
6.4 ANTIFUNGAL MEDICINES
6.4.1 Systemic
amphotericin ∗ ) i.v injection vial 50 mg/10 ml,
vials @ 10 ml
griseofulvin, micronized scored tablet 250 mg,
bottle 100 tablets
∗
Complementary list
National List of Essential Medicines 2008 30
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
ketoconazole tablet 200 mg, bottle 100 Restricted use :
tablet Only for cronic mucocuta-
neous candidiasis, which are
not responsive to nystatin
and other fungicides,
systemic mycosis infection
(candidiasis, parakoksidioido-
mikosis etc)
nystatin coated tablet 500,000
IU/tablet,
bottle 100/1000 tablets
suspension 100,000 IU/ml,
bottle 12 ml
6.4.2. Topical
NLEM antifungal medicines ointment, pot 30 g
combination of:
benzoic acid 6%
salicylic acid 3%
miconazole powder,2% (nitrate),sacch 20 g
cream, 2% (nitrate), tube 10g
nystatin vaginal tablet 100,000
IU/tablet,
box 10 stripes @10 tablets
sodium thiosulfate liquid 25%, bottle 30 ml
6.5 ANTIPROTOZOAL MEDICINES
6.5.1 Antiamoebic and antigiardiasis medicines
diloxanide tablet 500 mg (furoate)
metronidazole tablet 250 mg,
bottle 100 tablets
tablet 500 mg,
bottle 100 tablets
National List of Essential Medicines 2008 31
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
6.5.2 Antimalarial medicines
6.5.2.1 For prophylaxis
chloroquine tablet 150 mg (as phosphate),
bottle 1000 tablets
6.5.2.2 For curative treatment
NLEM antimalarial medicines tablet, bottle 500 tablets Restricted use :
combination of : For specific area which
pyrimethamine 25 mg already resistent to
sulfadoxine 500 mg chloroquin (decided by
District Health Offices)
artemether injection 80 mg/ml,
box 6 ampoules @ 1 ml
artesunate injection i.v./i.m. 60 mg/ml,
box 8 vials @ 1 ml
combination of :
artesunate 50 mg tablet, box 2 blisters @ 12
amodiaquin 200 mg tablets (combipack)
box 3 blisters @ 8 tablets
chloroquine tablet 150 mg(as phosphate),
bottle 1000 tablets
syrup 50 mg/5ml, bottle 60 ml
primaquine tablet 15 mg (as phosphate),
bottle 1000 tablets
quinine tablet 222 mg (bisulfate), Restricted use :
bottle 1000 tablets Only for severe malaria
i.v. injection 25% (as HCl),
box 100 ampoules @ 2 ml
6.6 ANTIVIRAL MEDICINES
6.6.1 Antiherpes medicines
aciclovir scored tablet 200 mg
scored tablet 400 mg
National List of Essential Medicines 2008 32
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
6.6.2. Antiretrovirals
6.6.2.1. Nucleoside reverse transcriptase inhibitor (NRTI)
lamivudine (3TC) tablet 150 mg
stavudine tablet 30 mg, bottle 60 tablets
tablet 40 mg, bottle 60 tablets
zidovudine tablet 300 mg,
bottle 60 tablets
tablet 100 mg,
bottle 100 tablets
syrup 50 mg/5 ml, bottle 10ml
i.v. infusion solution 200
mg/10 ml
6.6.2.2 Non-nucleoside reverse transcriptase inhibitors (NNRTI)
efavirenz tablet 200 mg,
bottle 90 tablets
tablet 600 mg,
bottle 30 tablets
nevirapine tablet 200 mg,
box 6 blisters @ 10 tablets
6.6.2.3 Protease inhibitors
lopinavir tablet
7. ANTIMIGRAINE MEDICINES
7.1 FOR PROPHYLAXIS
dihydroergotamine tablet 2.5 mg (as mesilate),
box 10 stripes @ 10
tablets
propranolol scored tablet 40 mg (HCl)
bottle 100 tablets
7.2 FOR TREATMENT OF ACUTE ATTACK
ergotamine tablet 1 mg (tartrate),
bottle 100 tablets
National List of Essential Medicines 2008 33
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
combination of : tablet, box 30/100 tablets
ergotamine 1 mg
caffeine 50 mg
8. ANTINEOPLASTIC, IMMUNOSUPPRESSIVES and MEDICINES USED IN PALLIATIVE
CARE
8.1 HORMONES AND ANTIHORMONES
medroxyprogesterone tablet 250 mg,
acetate bottle 50 tablets
injection 200 mg/ml,
box 1 vial 2.5 ml
tamoxifen tablet 20 mg (citrate),
bottle 30 tablets
testosterone soft capsule 40 mg
(undecanoate),
box 5 stripes @ 4 capsules
8.2. IMMUNOSUPPRESSIVE MEDICINES
azathioprine tablet 50 mg,
bottle 100 tablets
ciclosporin soft capsule 25 mg,
bottle 50 capsules
injection 50 mg/ml,
box 10 ampoules @ 5 ml
8.3 CYTOTOXIC MEDICINES
asparaginase powder for injection
10,000IU/vial, box 1 vial
bleomycin powder for injection 15
mg/ampoule (as HCl),
box 1 ampoule
busulfan coated tablet 2 mg,
bottle 100 tablets
calcium folinate (leucovorin, tablet 15 mg, bottle 10 tablets
Ca) injection 3 mg/ml,
box 5 ampoules @ 1/10 ml
National List of Essential Medicines 2008 34
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
chlorambucyl tablet 2 mg
cyclophosphamide coated tablet 50 mg,
bottle 28 tablets
i.v. powder injection 200
mg/vial, box 1 vial
i.v. powder for injection 500
mg/vial, box 1 vial
i.v. powder injection 1000
mg/vial, box 1 vial
cysplatin powder for injection 10
mg/vial, box 10 vial
powder for injection 50
mg/vial, box 100 vial
cytarabine i.m./i.v./s.c powder injection
100 mg/vial, box 5 vials
dacarbazine powder for injection 100
mg/vial, box 1 vial
dactinomycin i.v. injection 0.5 mg/vial,
box 1 vial 0.5 mg
daunorubicin powder injection 20 mg/vial
(HCl), box 1 vial @ 4 ml
doxorubicin i.v. powder for injection 10
mg/vial (HCl),
box 1 vial @ 5 ml
i.v. powder for injection 50
mg/vial (HCl),
box 1 vial @ 25 ml
etoposide injection 20 mg/ml,
box 10 ampoules @ 5 ml
capsule 100 mg,
bottle 10 capsules
fluorouracyl i.v. injection 50 mg/ml,
box 10 ampoules @ 5 ml
National List of Essential Medicines 2008 35
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
melphalan tablet 2 mg Note :
Storage at 2-8oC
mercaptopurine tablet 50 mg, bottle 25 tablets
methotrexate tablet 2.5 mg (as sodium salt),
bottle 100 tablets
powder for injection 50 mg/vial
(as sodium salt), box 1 vial
i.v./i.m./i.t. powder for injection
5 mg/vial (as sodium salt),
box 1 vial
procarbazine capsule 50 mg (as HCl),
bottle 100 capsules
vinblastine powder for injection 10
mg/vial (sulfate), box 1 vial
vincristine i.v. powder for injection 1 Caution :
mg/vial (sulfate), box 1 vial - Not for intrathecal use
- Storage at 2-8oC
8.4 MEDICINES FOR PALLIATIVE TREATMENT
morphine tablet 10 mg (sulfate), Restricted use :
bottle 30 tablets Palliative Care Hospital
9. ANTIPARKINSONISM MEDICINES
NLEM antiparkinsonism tablet, bottle 100 tablets
medicines
combination of :
benserazide 25 mg
levodopa 100 mg
trihexyphenidyl tablet 2 mg (HCl),
bottle 250 tablets
10. MEDICINES AFFECTING THE BLOOD
10.1 ANTIANAEMIA MEDICINES
cyanocobalamine injection 500 mcg/ml,
box 100 ampoules @ 1 ml
National List of Essential Medicines 2008 36
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
fe (II) sulfate 7 H20 coated tablet 300 mg,
bottle 1000 tablets
syrup, bottle 60 ml
drops, bottle
folic acid tablet 1 mg,
bottle 1000 tablets
tablet 5 mg,
bottle 1000 tablets
10.2 MEDICINES AFFECTING COAGULATION
heparin sodium i.v./s.c. injection 5000 IU/ml,
box 1 vial 5 ml
phytomenadione (vitamin K1) coated tablet 10 mg,
bottle 1000 tablets
injection 10 mg/ml,
box 100 ampoules @ 1 ml
i.m injection 2 mg/ml, Dose :
ampoule 1 ml - New born baby dose 1 mg
- Premature baby dose 0,5
mg
protamine sulfate injection 10 mg/ml, Authority required
box 10 vial @ 5 ml
warfarin tablet 2 mg (as sodium/
potassium salt),
bottle 100 tablets
11. BLOOD PRODUCTS and PLASMA SUBSTITUTES
11.1 BLOOD PRODUCTS
factor VIII (consentrate) powder for injection 250 IU/vial Authority required :
+ solvent 10 ml, box 1 vial Used for the treatment of
haemophilia A
factor IX complex powder for injection 1000 Authority required :
IU/vial + solvent 25 ml, Used for the treatment of
box 1 vial haemophilia B
powder for injection 500 IU/vial
+ solvent 10 ml, box 1 vial
National List of Essential Medicines 2008 37
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
protein plasma fraction Authority required :
Right procedures needed
11.2 PLASMA SUBSTITUTES and PLASMA EXPANDERS
hydroxy ethyl starch infusion solution 6%,
bottle 500 ml
infusion solution 10%,
bottle 500 ml
NLEM plasma substitutes infusion solution, Restricted use :
combination of: bottle 500 ml - Only for special cases
polygeline (equivalent 0.63 - Need special facility and
g nitrogen) 17.5 g skill
sodium chloride 4.25 g - Various combination in
potassium chloride 0.19 g market could be used
calcium (bound at
polypeptide) 0.125 g
pyrogen free sterile water
to 500 ml
12. DIAGNOSTIC AGENTS
12.1 RADIOCONTRAST MEDIA
12.1.1 Angiography
meglumine amidotrizoate injection 65%,
box 1 vial @ 50 ml
12.1.2 Billigraphy
sodium iopodate capsule 500 mg,
bottle 6 capsules
12.1.3 Histerosalpingography
meglumine sodium injection 76%,
amidotrizoate box 1 ampoule 20 ml
12.1.4 Myelography
iohexole injection 240 mg I/ml,
box 1 vial 10 ml
injection 300 mg I/ml,
box 1 vial 10 ml
injection 350 mg I/ml,
box 1 vial 20 ml
National List of Essential Medicines 2008 38
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
iopamidol injection 0.408 g/ml,
box 10 ampoule @ 10 ml
injection 0.612 g/ml,
box 10 ampoule @ 20 ml
iophendilate injection consist of 30.5 %
iodium,
box 1 ampoule @ 3 ml
12.1.5 Metabolism
NLEM media contrast granule, sacch, with anhydric
substance acetic acid 10%
combination of :
sodium bicarbonate 1.25 g
simethicone 0.042 g
barium sulfate powder, sacch 200 g
suspension 2.2%,
bottle 250/450 ml
suspension 55%, bottle 2 l
suspension 65%,
bottle 500 ml
meglumine sodium sol 59.7 %, bottle 120 ml
amidotrizoate
12.1.6 Urograph
iopamidole injection 0.612 g/ml,
box 10 ampoules @ 20 ml
injection 0.755 g/ml,
box 10 ampoules @ 20 ml
meglumine sodium i.v. injection 76%,
amidotrizoate box 1 ampoule @ 20 ml
12.2 FUNCTION TEST
12.2.1 Renal
sodium aminohypurate i.v. injection 200 mg/ml,
box 1 ampoule 10 ml
National List of Essential Medicines 2008 39
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
12.2.2 Liver
sodium bromsulphtalein i.v. injection 5%,
box 1 ampoule 3 ml
12.2.3 Miscellaneous
fluorescein eye drops 1% (sodium salt),
bottle 5 ml
eye drops 2% (sodium salt),
bottle 5 ml
injection 10%,
box 1 ampoule @ 5 ml
injection 20%,
box 1 ampoule @ 5 ml
12.3 SKIN TEST
tuberculin protein purified i.c. injection 1:10,
derivative box 1 vial 2 ml
13. ANTISEPTICS dan DISINFECTANTS
13.1 ANTISEPTICS
chlorhexidine sol 5.0% (gluconate), For diluted
bottle 2.5 l
hydrogen peroxyde concentrate solution, Storage :
bottle 1000 ml - Storage in glass bottle with
glass cap, air tight, saved
from light.
- For diluted until 3%.
policresulen (metacresol liquid, bottle 10 ml / 50 ml
sulphonate and methanal
condensate)
povidone-iodine solution 10%, bottle 1000 ml
13.2 DISINFECTANTS
calcium hypochlorite powder, sacch 20 g ‘Samijaga’ program
chlorine base compound powder (for 0.1% sol),
bottle 100 g
ethanol 70% sol, bottle 100 ml /1000 ml
National List of Essential Medicines 2008 40
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
paraformaldehyde tablet 1 g, bottle 100 tablets
sol 5%, bottle 1000 ml
saponificated cresol 50% liquid, bottle 1000 ml
(lysol)
14. MEDICINES and DENTAL MATERIAL USED FOR ORAL HEALTH
14.1 MEDICINES USED FOR DENTAL and ORAL HEALTH,
NLEM dental anesthetics injection, box 20/50/100
combination of: ampoules @ 2 ml
lidocaine HCl 2%
epinephrine 1 : 80,000
calcium hydroxide paste, box 2 tubes
chlorhexidine liquid 0,2% (gluconate) Note :
For making dilutions
chlorphenol camphor menthol liquid, bottle 10 ml
ethyl chloride spray 0.05-0.2 ml,
bottle 100 ml
eugenol liquid, bottle 10 ml
fluorine tablet 0.5 mg,
bottle 100 tablets
lidocaine injection 2% (HCl), box 100
ampoules @ 2 ml
paste 5% (HCl), tube 10 g
spray 15% (HCl), bottle 60 ml
nystatin suspension 100,000 UI/ml,
bottle 12 ml
sodium hypochlorite concentrate liquid 5%, Note :
bottle 10 ml For making dilutions
14.2 DENTAL MATERIAL USED FOR ORAL HEALTH
gelatin sponge cubicles 1x1x1 cm, tin 50 pcs
National List of Essential Medicines 2008 41
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
glass ionomer ART powder bottle10 g
(Atraumatic Restorative sol, bottle 6 g (4.8 ml)
Treatment) cocoa butter 5 g
gutta percha points box 120 sticks
resin composite set
root canal filling paste, bottle
surgical ginggival pack set
temporary filling sol and powder, bottle 100 g
15. DIURETICS
furosemide tablet 40 mg,
bottle 250 tablets
i.v./i.m. injection 10 mg/ml,
box 25 ampoules @ 2 ml
hydrochlorothiazide tablet 25 mg,
bottle 1000 tablets
mannitol infusion liquid 20%,
bottle 500 ml
spironolactone tablet 25 mg,
box 10 stripes @10 tablets
tablet 100 mg,
box 10 stripes @10 tablets
16. HORMONES, OTHER ENDOCRINE MEDICINES and CONTRACEPTIVES
16.1 ANTIDIURETIC HORMONES
desmopressin spray
vasopressin i.m./s.c. injection 20 IU/ml,
box 10 ampoules @ 1 ml
National List of Essential Medicines 2008 42
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
16.2 ANTIDIABETIC
16.2.1 Oral Antidiabetic
glibenclamide tablet 2.5 mg,
bottle 100 tablets
tablet 5 mg, bottle 100 tablets
glipizide tablet 5 mg,
box 5 blisters @ 20 tablets
metformin tablet 500 mg,
bottle 100 tablets
16.2.2 Injectable Antidiabetic
intermediate insulin injection 100 IU/ml,
box 1 vial @ 10 ml
regular insulin injection 100 IU/ml,
box 1 vial @ 10 ml
regular insulin : intermediate injection 100 IU/ml,
insulin (30 : 70) box 1 vial @ 10 ml
16.3 SEX HORMONE and FERTILITY RELATED MEDICINES
16.3.1 Androgens
testosterone oil injection 200 mg/ml
(enantate), box 1 vial @1 ml
16.3.2 Estrogens
conjugated estrogens tablet 0.625 mg,
box stripes 28 tablets
ethinylestradiol tablet 0.05 mg,
bottle 100 tablets
tablet 0.5 mg,
bottle 100 tablets
16.3.3 Progestogens
hydroxy progesterones i.m. injection 125 mg/ml,
box 1 ampoule 2 ml
National List of Essential Medicines 2008 43
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
norethisterone tablet 5 mg, bottle 30 tablets
16.3.4 Contraceptives Note :
According to National Family
16.3.4.1 Oral Hormonal Contraceptives Planning Program
combination : pill coordinated by National
levonorgestrel 150 mcg Family Planning Coordination
ethinylestradiol 30 mcg Board (BKKBN)
16.3.4.2 Injectable Hormonal Contraceptives
medroxyprogesterone depot injection 150 mg
acetate
16.3.4.3 Intra-uterine Devices
copper - containing device set / pcs
16.3.4.4 Implantable Contraceptives
levonorgestrel implant 2 rods (3-4 years)
16.4 THYROID and ANTITHYROID HORMONES
lugol solution bottle 30 ml Note :
Dilute before use
propylthiouracyl scored tablet 100 mg,
bottle 1000 tablets
thyroxine sodium tablet 0.1 mg, bottle 50 tablets
16.5 CORTICOSTEROID HORMONES
dexamethasone tablet 0.5 mg,
bottle 1000 tablets
injection 5 mg/ml (as sodium
phosphate), box 100
ampoule @ 1 ml
hydrocortisone tablet 10 mg
powder for injection 100
mg/vial (sodium succinate),
box 100 vial @ 2 ml
prednisone tablet 5 mg,
bottle 1000 tablets
National List of Essential Medicines 2008 44
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
17. CARDIOVASCULAR MEDICINES
17.1 ANTI-ANGINAL MEDICINES
atenolol tablet 50 mg, box 10 stripes
@ 10 tablets
diltiazem HCl tablet 30 mg, box 10 stripes
@ 10 tablets
isosorbide dinitrate sublingual tablet 5 mg,
bottle 60 tablets
nitroglycerine sublingual tablet 0.5 mg,
bottle100/1000 tablets
17.2 ANTIARRHYTHMIC MEDICINES
amiodarone tablet 200 mg, box 30 tablets
injection 150 mg/3 ml,
box 6 ampoule @ 3 ml
digoxin tablet 0.0625 mg, Pediatric dose :
bottle 100 tablets Tablet 0,0625 mg for
tablet 0.25 mg, pediatrics
bottle 100 tablets
injection 0.25 mg/ml,
box 1 ampoule @ 2 ml
disopyramide capsule 100 mg (phosphate),
bottle 100 capsules
epinephrine (adrenaline) injection 0.1% (as bitartrate), Note :
box 100 ampoules @ 1 ml For intracardial or resusitation
lidocaine i.v. injection 2% (HCl),
box 100 ampoules @ 2 ml
propranolol tablet 10 mg (HCl),
bottle 100 tablets
i.v. injection 1 mg/ml (HCl),
box 10 ampoules @ 1ml
National List of Essential Medicines 2008 45
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
verapamil tablet 40 mg (HCl), Special use :
bottle 30 tablets For supraventricular
injection 2.5 mg/ml (HCl), arrhythmia.
box 10 ampoules @ 2 ml
17.3 ANTIHYPERTENSIVE MEDICINES
atenolol tablet 50 mg, bottle 50 tablets
captopril scored tablet 12.5 mg, Caution :
box 10 stripes @ 6 tablets - Not for pregnant women
scored tablet 25 mg, box 10 - Having cough side effect
stripes @ 6 or 10 tablets
clonidine ∗ ) i.m. injection 0.15 mg/ml Note :
(HCl), box 1 ampoule 1 ml For severe hypertension
hydrochlorothiazide tablet 25 mg,
bottle 100 tablets
lisinopril tablet 5 mg,
box 3 stripes @ 10 tablets
tablet 10 mg,
box 3 stripes @ 10 tablets
tablet 20 mg, CD
box 3 stripes @ 10 tablets
methyldopa coated tablet 250 mg,
bottle 100 or 1000 tablets
nifedipine tablet 10 mg
sodium nitroprusside *) injection, vial
17.4 PLATELET ANTIAGGREGATION
acetylsalicylic acid (acetosal) tablet 80 mg, box 10 blisters
@ 10 tablets
∗
Complementary list
National List of Essential Medicines 2008 46
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
17.5 ANTI THROMBOTIC MEDICINES
streptokinase injection 750,000 IU/vial Restricted use :
injection 1,500,000 IU/vial - Authority required
- Need special facility and
skill
17.6 MEDICINES USED IN HEART FAILURE
captopril scored tablet 12.5 mg, Caution :
box 10 stripes @10 scored - Not for pregnant women
tablets - Having cough side effect
scored tablet 25 mg,
box 10 stripes @ 10
scored tablets
digoxin tablet 0.0625 mg, Pediatric dose :
bottle 100 tablets Tablet 0,0625 mg for
tablet 0.25 mg, pediatrics
bottle 100 or 1000 tablets
injection 0.25 mg/ml,
box 1 ampoule @ 2 ml
furosemide tablet 40 mg,
box 20 stripes@ 10 tablets
injection i.v./i.m. 10 mg/ml,
box 25 ampoules @ 2 ml
17.7 MEDICINES USED for SHOCK ATTACK
17.7.1 Medicines used for Cardiogenic Shock
dobutamine injection 50 mg/ml; vial 5 ml
injection 25 mg/ml;
ampoule 10 ml
dopamine injection 40 mg/ml (HCl),
box 5 ampoules @ 5 ml
epinephrine (adrenaline) injection i.v. 0.1 %
(as HCl/ bitartrate),
box 100 ampoules @ 1 ml
National List of Essential Medicines 2008 47
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
17.7.2 Medicines used for Anaesthetic Shock
ephedrine injection 50 mg/ml (HCl), Note :
box 100 ampoules @ 1 ml Used as long acting
vasopressor
norepinephrine injection 4 mg/ml,
ampoule 2 ml
17.8 LIPID-LOWERING AGENTS
simvastatin scored tablet 10 mg,
box 30 tablets
18. DERMATOLOGICAL MEDICINES
18.1 ANTIACNE MEDICINES
retinoic acid cream 0.05%, tube 20 g
18.2 ANTI-INFECTIVE MEDICINES
silver sulfadiazine cream 1%, pot 500 g Special use :
Large area burn wounds
NLEM anti-infective medicines ointment, tube 5 g
combination of :
bacitracin 500 IU/g
polymixin B 10,000 IU/g
18.3 ANTIFUNGAL MEDICINES
NLEM antifungal medicines ointment, pot 30 g Note :
combination of : General antifungal ointment
benzoic acid 6%
salicylic acid 3%
miconazole powder 2% (nitrate),
sacch 20 g
cream 2% (nitrate), tube 10 g
sodium thiosulfate liquid 25%, bottle 30 ml
18.4 ANTI-INFLAMMATORY and ANTIPRURITIC MEDICINES
betamethasone ointment 0.1% (as valerate),
tube 5 g
cream 0.1% (as valerate),
tube 5 g
National List of Essential Medicines 2008 48
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
hydrocortisone cream 2.5% (acetate),
tube 5 g
liquor veilli (salicylic acid solution Note :
solution 0,1 %) - Fresh prepared (r.p.=
combination of : recentus paratus)
salicylic acid 0.1 % - For wet dermatitis
boric acid 0.5 %
glycerine 10 %
18.5 SCABICIDES and PEDICULICIDES
permethrin cream 5 %, tube
2-4 ointment, ointment, pot 30 g
combination of :
salicylic acid 2%
sulfur precipitate 4 %
18.6 CAUSTIC MEDICINES
silver nitrate sol 20%, bottle 10 ml Note :
For hypergranulation
18.7 MEDICINES AFFECTING SKIN DIFFERENTIATION and PROLIFERATION
coal tar sol 5 %, bottle 100 ml
podophyllum resin alcoholic sol 25 %, Authority required :
bottle 30 ml - Should be applicated by
practitioners
- Should be cleaned 1-4
hours after used, make
sure that no residues
- Only for severe thickening,
causing danger of
absorptions
- Not for pregnant women
because of terratogenic
effect
- Not for use by patients
- Not for take away home
salicylic acid ointment 2%, pot 30 g
ointment 5%, pot 30 g
ointment 10%, pot 30 g
National List of Essential Medicines 2008 49
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
urea cream 10 %, tube 40 g
18.8 MISCELLANEOUS
liquor carbonis detergents suspension 2%, bottle 30 ml
suspension 5%, bottle 30 ml
liquor faberi liquid
salicyl powder powder 2%, box 100 g
19. PERITONEAL DIALYSIS SOLUTIONS
NLEM haemodialysis solution sol, bottle 1 gallon
NLEM peritoneal dialysis infusion sol,
solution 24 bottle @ 1000 ml
20. ELECTROLYTE, NUTRITION SOLUTIONS, and OTHERS
20.1 ORAL
oral rehydration salts powder, 100 sacch - Drink slowly to prevent
combination of : each sacch for 200 ml vomiting
sodium chloride 0.52 g water - 1 sacchet to be dissolved
potassium chloride 0.30 g in 200 ml water
trisodium citrate
dihydrate 0.58 g
anhydric glucose 2.70 g
potassium chloride ready-to-dissolve tablet 300 - Dissolve before use
mg, air tight tube 10 tablets - Storage in air tight
container
sodium bicarbonate tablet 500 mg, ottle 1000
tablets
20.2 PARENTERAL
calcium gluconate i.v. injection 10%,
box 24 ampoules @ 10 ml
darrow glucose ana (DG ana) infusion sol, bottle 500 ml
dextrose infusion sol 5 %, bottle 500 ml
National List of Essential Medicines 2008 50
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
glucose infusion sol 5%, bottle 500 ml
infusion sol 10%,
bottle 500 ml
infusion sol 40%, bottle 25 ml
half strength darrow glucose infusion sol, bottle
intralipid liquid infusion sol 10%, Restricted use :
bottle 100/500 ml - Only for special cases
infusion sol 20%, - Need special facility and
bottle 100/500 ml skill
mannitol infusion sol 20 %,
bottle 500 ml
NLEM nutritious solution infusion sol, bottle 500 ml Note :
combination of : For pediatric use
glucose 5%
sodium chloride 0.225 %
nutritious solution infusion sol, bottle 500 ml
combination of :
glucose 4%
sodium chloride 0.18 %
potassium chloride i.v. injection 1 meq/ml,
box 1 ampoule 10 ml
ringer lactate infusion sol, bottle 500 ml
sodium bicarbonate i.v. injection 8.4%, Note :
bottle 25 ml Need to check blood gas
injection 1.4% isotonik, bottle level
sodium chloride infusion sol 0,9%, Note :
bottle 500 ml Need to check sodium level.
infusion sol 3%, bottle 500 ml
injection 15%, vial 50 ml
20.3 MISCELLANEOUS
water for injections box, ampoule/vial @ 10
ml/20 ml
National List of Essential Medicines 2008 51
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
21. OPHTHALMOLOGICAL PREPARATION
21.1. LOCAL ANESTHETICS
bupivacaine injection 0.5% (HCl),
box 5 ampoules @ 20 ml
tetracaine eye drops 0.5% (HCl),
bottle 5 ml
21.2 ANTI-INFECTIVE AGENTS
amphotericin eye ointment 3%, tube 3.5 g
gentamicin eye ointment 0,3%, tube 3.5 g
eye drops 0.3%, bottle 5 ml
idoxuridine eye drops 0.1%, bottle 5 ml
eye ointment 0.5%, tube 4 g
oxytetracycline eye ointment 1% (HCl),
tube 3.5 g
sulfacetamide eye drops 15% (sodium),
bottle 5 ml
21.3 ANTI-INFLAMMATORY AGENTS
betamethasone eye drops 1 mg/ml (sodium),
bottle 5 ml
21.4 MYDRIATICS
atropine eye drops 0.5% (sulfate),
bottle 5 ml
eye drops 1% (sulfate),
bottle 5 ml
homatropine eye drops 2% (as hydro
bromide), bottle 15 ml
21.5 MIOTICS and ANTIGLAUCOMA MEDICINES
acetazolamide tablet 250 mg,
bottle 100 tablets
i.m/i.v. powder for injection
500 mg/vial (as sodium
salt), box 10 vials + 10
ampoules WFI @ 5 ml
National List of Essential Medicines 2008 52
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
pilocarpine eye drops 2% (HCl/nitrate),
bottle 5 ml
eye drops 4% (HCl/nitrate),
bottle 5 ml
timolol eye drops 0.25% (maleate),
bottle 5 ml
eye drops 0.5% (maleate),
bottle 5 ml
21.6 MISCELLANEOUS
combination of : sol 2%, bottle 5 ml Note :
hydroxypropyl For dry eyes syndrome
methylcellulose 5 mg
dextran (70) 1 mg
glycerine 2 mg
benzalkonium
chloride 0.01% w/v
sodium chromoglycate eye drops 2%, bottle 15 ml
22. OXYTOCICS and UTERIC RELAXANTS
22.1 OXYTOCICS
methyl ergometrine coated tablet 0.125 mg
(maleate),
bottle 100 tablets
injection 0.200 mg/ml,
box 100 ampoules @ 1 ml
oxytocin injection 10 IU/ml,
box 100 ampoules @ 1 ml
22.2 UTERIC RELAXANTS
magnesium sulfate injection 20%,
box 10 vials @ 20 ml
injection 40%,
box 10 vials @ 20 ml
National List of Essential Medicines 2008 53
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
23. PSYCHOTHERAPEUTIC MEDICINES
23.1 MEDICINES USED in GENERALIZED ANXIETY and SLEEP DISORDERS
diazepam tablet 2 mg,
bottle 1000 tablets
tablet 5 mg,
bottle 1000 tablets
i.m. injection 5 mg/ml,
box 100 ampoules @ 2 ml
23.2 MEDICINES USED in DEPRESSIVE DISORDERS
amitriptyline coated tablet 25 mg (HCl),
box 10 blisters @ 10
tablets
fluoxetine capsule/tablet 10 mg,
box 30 tablets
capsule/tablet 20 mg,
box 30 tablets
lithium carbonate tablet 200 mg, box 10 stripes Caution :
@ 10 tablets - If possible, need to check
blood concentration level
- Safety windows is 0,8-1,2
mmol eq/l
23.3 MEDICINES USED for OBSESSIVE COMPULSIVE DISORDERS
clomipramine tablet 25 mg (HCl),
bottle 1000 tablets
23.4 MEDICINES USED in PSYCHOTIC DISORDERS
chlorpromazine coated tablet 25 mg (HCl),
bottle 1000 tablets
coated tablet 100 mg (HCl),
bottle 1000 tablets
i.m. injection 25 mg/ml (HCl),
box 100 ampoules @ 1 ml
National List of Essential Medicines 2008 54
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
clozapine ∗ ) tablet 25 mg, box 50 tablets Caution :
tablet 50 mg, box 50 tablets - Need to check blood
leucocyte regularly
(agranulocytosis)
- Drug of choice in psychotic
disorder treatment which
already resistent to other
antipsychotics.
fluphenazine tablet 2.5 mg (HCl),
bottle 100 tablets
i.m. injection 25 mg/ml
(decanoate),
box 10 vials @ 1 ml
haloperidol tablet 0.5 mg, Note :
bottle 100/1000 tablets Second generation
tablet 1.5 mg, antipsychotic
bottle 100/1000 tablets
tablet 2 mg, box 100 tablets
tablet 5 mg,
bottle 100/1000 tablets
drops 2 mg/ml,
bottle 15 ml/100 ml
i.m. injection 2 mg/ml (HCl)
box 5 ampoules @ 1 ml
i.m. injection 5 mg/ml (HCl)
box 5 ampoules @ 1 ml
injection 50 mg/ml (as
decanoate)
box 5 ampoules @ 1 ml
(long acting)
risperidone tablet 1 mg, box 5 stripes @
10 tablets
tablet 2 mg, box 5 stripes @
10 tablets
23.5. MEDICINES USED for ADHD
(dl) methylphenidate*) regular release tablet 10 mg, Authority required :
box 30 tablets Need special skill
extended release tablet 20 mg,
box 30 tablets
∗
Complementary list
National List of Essential Medicines 2008 55
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
24. MUSCLE RELAXANTS (PERIPHERALLY-ACTING) and CHOLINESTERASE
INHIBITORS
24.1 NEUROMUSCULAR INHIBITORS
atracurium injection 25 mg/2,5 ml,
ampoule 2.5 ml
rocuronium i.v injection 10 mg/ml;
vial 5 ml
succinylcholine powder i.v./i.m. injection 100 Authority required :
mg/ vial (chloride), - Restricted use (only for
box 10 vials special cases)
- Need special facillities and
skill
24.2 MEDICINES USED for MIASTENIA GRAVIS
neostigmine ∗ ) injection 0.5 mg/ml (methyl
sulfate),
box 50 ampoules @ 1 ml
pyridostigmine tablet 60 mg (bromide),
box 10 stripes/blisters @
10 tablets
25. GASTROINTESTINAL MEDICINES
25.1 ANTACIDS and OTHER ANTIULCER MEDICINES
NLEM antacid I chewable tablet, bottle 1000
combination of: tablets
aluminium hydroxide 200 mg
magnesium hydroxide 200 mg
NLEM antacid II suspension, bottle 60 ml
combination of :
aluminium
hydroxide 200 mg/5 ml
magnesium
hydroxide 200 mg/5 ml
∗
Complementary list
National List of Essential Medicines 2008 56
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
ranitidine tablet 150 mg,
box 3 stripes @10 tablets
25.2 ANTIEMETIC MEDICINES
chlorpromazine coated tablet 25 mg (HCl),
bottle 1000 tablets
i.m. injection 25 mg/ml (HCl),
box 100 ampoules @ 1 ml
i.m injection 5 mg/ml (HCl),
box 100 ampoules @ 2 ml
dimenhydrinate tablet 50 mg, bottle 1000 Note :
tablets - Adult dose : ½ - 1 tablet
- Use ½ - 1 hour before
meals to get better efficacy
metoclopramide tablet 10 mg (as HCl),
bottle 100 tablets
injection 5 mg/ml (as HCl),
box 10 ampoules @ 2 ml
syrup 5 mg/5 ml, bottle 50 ml
drops 0.1 mg/drop,
bottle 10 ml
25.3 ANTIHAEMORRHOID MEDICINES
NLEM antihaemorrhoid suppositoria, box 100 supps
combination of :
bismuth subgallate 150 mg
hexachlorophene 2.5 mg
lidocaine 10 mg
zinc oxide 120 mg
supp to 2 g
25.4 ANTISPASMODIC MEDICINES
atropine tablet 1 mg (sulfate),
tin 100 tablets
i.m./i.v./s.c. injection 0.25
mg/ml (sulfate),
box 100 ampoules @ 1 ml
i.m./i.v./s.c. injection 1 mg/ml
(sulfate),
box 50 ampoules @ 1 ml
National List of Essential Medicines 2008 57
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
belladonna extract tablet 10 mg,
bottle 100/1000 tablets
25.5 MEDICINES USED IN DIARRHOEA
oral rehydration salts powder, 100 sacchs, - Drink slowly to prevent
combination of : each sacch for 200 ml of vomitting
sodium chloride 0.52 g water - 1 sachet to be dissolved in
potassium chloride 0.30 g 200 ml of water
trisodium citrate
dihydrate 0.58 g
anhydric glucose 2.70 g
25.6 CATARTIC MEDICINES
bisacodyl suppositoria 5 mg, box 6
suppositoria
suppositoria 10 mg, box 6
suppositoria
glycerine liquid, bottle 100 ml
25.7 ANTI-INFLAMMATORY MEDICINES
sulfasalazine tablet 500 mg, box 10 stripes
@ 10 tablets
26. MEDICINES ACTING ON RESPIRATORY TRACT
26.1 ANTIASTHMATIC
aminophylline scored tablet 200 mg,
bottle 1000 tablets
injection 24 mg/ml,
box 100 ampoules @10 ml
budesonide aerosol 100 mcg/puff,
canister 15 ml
aerosol 200 mcg/puff,
canister 15 ml
dexamethasone tablet 0.5 mg,
bottle 1000 tablets
i.v. injection 5 mg/ml (as
sodium phosphate),
box 100 ampoules @ 1 ml
National List of Essential Medicines 2008 58
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
ephedrine tablet 25 mg (HCl),
bottle 1000 tablets
epinephrine (adrenaline) injection 0.1 % (as
HCl/bitartrate), box 100
ampoules @ 1 ml
salbutamol tablet 2 mg (as sulfate),
bottle 100/1000 tablets
tablet 4 mg (as sulfate),
bottle 100/1000 tablets
ih liquid 0.5 % , bottle 10 ml Note :
ih/aerosol 100 mcg/dose (as For intermittent inhalation and
sulfate), tube 200/400 first accute attack.
doses
injection 50 mcg/ml (as
sulfate), box 100
ampoules @ 1 ml
respirator liquid for nebulizer
2.5 mg/2.5 ml NaCl,
box 4x5 nebules
26.2 ANTITUSSIVES
codeine tablet 10 ml (HCl/phosphate),
bottle 250 tablets
dextromethorphan tablet 15 mg (HBr),
bottle 1000 tablets
syrup 10 mg/5 ml (HBr),
bottle 60 ml
26.3 EXPECTORANT
glyceryl guaiacolate syrup 25 mg/5 ml,bottle 60 ml
tablet 100 mg,
bottle 1000 tablets
obat batuk hitam (OBH) liquid, bottle 200 ml
concentrate liquid,
bottle 1000 ml
National List of Essential Medicines 2008 59
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
27. IMMUNOLOGICALS
27.1 SERA and IMMUNOGLOBULINS
antitetanus immunoglobulin i.m. injection 500 IU, vial Note :
(human) - Storage at 2-8º C
antidiphtheria sera (A.D.S) i.m. injection 10,000 IU/vial, Note :
box 10 vials @ 5 ml - Storage at 2-8º C
i.m. injection 20,000 IU/vial,
box 10 vials @ 10 ml
antirabies sera i.m. injection 100 IU/ml, Indication :
box 10 vial @ 20 ml - For post-exposure treatment
in rabies area
- Storage at 2-8º C
antitetanus sera (A.T.S) for prophylaxis : Note :
i.m. injection 1500 IU/ampoule, - Storage at 2-8º C
box 10 ampoules @ 1 ml
for curative treatment :
i.m./i.v. injection 10,000
IU/ampoule,
box 10 ampoules @ 2 ml
i.m./i.v injection 20,000
IU/vial, box 10 vials@ 4 ml
immunoglobulin sera injection i.m., Note :
box 10 vial @ 10 ml - Storage at 2-8º C
snake antivenom sera i.m./i.v. injection, box 10 vial Note :
snake antivenom special @ 5 ml - Only for specific area
for snake from outside - Storage at 2-8º C.
papua
snake antivenom special
for papua snake
27.2 VACCINES
BCG vaccine i.c. injection, Note :
box 5 ampoules @ 2 ml - Storage below 5º C
i.c. injection,
box 5 ampoules @ 4 ml
National List of Essential Medicines 2008 60
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
diphtheria, pertusis and i.m injection, Note :
tetanus adsorbed vaccine box 10 vial @ 5 ml - Storage at 2-8º C
(DPT)
hepatitis B vaccine injection 20 mcg/ml, Note :
(recombinant) box 1 vial 0.5; 1 ml - Storage at 2-8º C
measles vaccine s.c injection, box 10 vials (10 Note :
doses) @ 5 ml - Storage at 2-8º C
poliomyelitis vaccine drops, box vial 10/20 doses Note :
- Storage at 2-8º C
rabies vaccine (human) s.k./i.c. powder for injection, Indication :
box 7 vial @ 1 dose + 7 - Storage at 2-8º C
ampoules solvent @ 2 ml - Used for pre-exposure and
booster : box 5 ampoules @ post-exposure treatment in
1 dose + 5 ampoules rabies area
solvent @ 4 ml
tetanus adsorbed vaccine i.m.injection, box 1 vial 5 ml Note :
(tetanus adsorbed toxoid) - Storage at 2-8º C
tetanus and diphteria i.m. injection, Note :
adsorbed vaccine (TD) box 10 vial @ 5 ml - Storage at 2-8º C
28. MEDICINES USED FOR EAR, NOSE and THROAT
carboglycerine ear drops 10 %, bottle 5 ml
hydrogen peroxide concentrate liquid, bottle Note :
1000 ml - Storage in glass bottle with
glass cap, air tight, save
from light
- For making dilution until
3%
lidocaine spray liquid 4% (HCl),
bottle 50 ml
oxymetazoline nasal drops 0.025% (HCl),
bottle 15 ml
nasal drops 0.050 % (HCl),
bottle 10 ml
National List of Essential Medicines 2008 61
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
29. VITAMINS and MINERALS
ascorbic acid tablet 50 mg,
bottle 1000 tablets
calcium gluconate injection 100 mg/ml,
box 24 ampoules @ 10 ml
calcium lactate tablet 500 mg,
bottle 1000 tablets
ergocalciferol capsule 50,000 IU, Note :
bottle 100 capsules Therapeutic use for
suspension 10.000 IU/ml, hypocalcemia (seldom
bottle 60 ml needed in tropical countries)
iodine soft capsule 200 mg,
bottle 1500 capsules
nicotinamide tablet 100 mg
pyridoxine tablet 10 mg (HCl),
bottle1000 tablets
tablet 25 mg (HCl),
bottle 1000 tablets
retinol tablet 5000 IU,
bottle 1000 tablets
soft capsule 50,000 IU,
bottle 50 capsules
soft capsule 100,000 IU,
bottle 50 capsules
soft capsule 200,000 IU (as
palmitate),
bottle 50 capsules
thiamine tablet 50 mg (HCl),
bottle 1000 tablets
vitamin B complex tablet, bottle 1000 tablets
National List of Essential Medicines 2008 62
CHAPTER III
RESTRICTED MEDICINE LIST
FOR PUBLIC HEALTH CENTER
2008
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
1. ANALGESICS, ANTIPYRETICS, NON-STEROIDAL ANTI-INFLAMMATORY MEDICINES,
MEDICINES USED TO TREAT GOUT
1.1 OPIOID ANALGESICS
pethidine injection i.m./s.c./slow Authority required :
released i.v 50 mg/ml Used only for nursing Public
(HCl), Health Center (PHC)
box 10 ampoules @ 2 ml
1.2 NON-OPIOID ANALGESICS
acetylsalicylic acid (acetosal) tablet 100 mg,
box 10 blisters@10 tablets
tablet 500 mg,
box 10 blisters@10 tablets
ibuprofen tablet 200 mg,
bottle 100 tablets
tablet 400 mg,
bottle 100 tablets
methampyrone tablet 500 mg, Restricted use :
bottle 1000 tablets To reduce agranulocytosis
paracetamol tablet 100 mg,
bottle 1000 tablets
tablet 500 mg,
bottle 1000 tablets
syrup 120 mg/5 ml,bottle 60 ml
suppositoria 120 mg
suppositoria 240 mg
sodium diclofenac tablet 25 mg, box 10 stripes
@ 10 tablets
tablet 50 mg, box 10 stripes
@ 10 tablets
National List of Essential Medicines 2008 63
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
1.3. MEDICINES USED TO TREAT GOUT
allopurinol tablet 100 mg, Note :
bottle 100/1000 tablets - Blocks uric acid production
(in 35% of cases)
- Not for acute attack
probenecid tablet 500 mg, Note :
bottle 100/1000 tablets - Increases uric acid renal
excretion (in 35% patients)
- Dosage 2 X ½ tablet,
increase water intake
- Not for acute attack
2. ANESTHETICS
2.1 LOCAL ANESTHETICS
ethyl chloride spray, bottle 100 ml Note :
Air tight package
lidocaine infiltr injection 1% (HCl),
box 100 amps @ 2 ml
p.v. injection 2% (HCl),
box 100 ampoules @ 2ml
gel 2%, tube 10 g
spray 4%, bottle 50 ml
2.2 GENERAL ANESTHETICS and OXYGEN
ketamine i.v. injection 10 mg/ml (as Authority required :
HCl), box 10 vial @ 20 ml Used only for nursing PHC
i.v. injection 50 mg/ml (as
HCl), box 10 vial @ 20 ml
oxygen inhalation, gas in tube
thiopental i.v. powder for injection 500 Authority required :
mg/ampoule (as sodium Used only for nursing PHC
salt) (for dissolved in 20 ml
WFI), box 25 ampoules
2.3 MEDICINES USED FOR PREOPERATIVE MEDICATION PROCEDURES
atropine injection 1 mg/ml (sulfate),
box 50 ampoules @ 1 ml
National List of Essential Medicines 2008 64
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
diazepam tablet 5 mg,
bottle 1000 tablet
injection 5 mg/ml,
box 100 ampoules @ 2 ml
morphine i.m./s.k./i.v. injection 10
mg/ml (HCl/sulfate),
box 10 ampoules @ 1 ml
3. ANTIALLERGICS and MEDICINES USED IN ANAPHYLAXIS
chlorpheniramine tablet 4 mg ( maleate),
bottle1000 tablets
injection 5 mg/ml (maleate),
box 100 ampoules @ 1 ml
dexamethasone injection 5 mg/ml (as sodium
phosphate), box 100
ampoules @ 1 ml
diphenhydramine i.m. injection 10 mg/ml (HCl),
box 100 ampoules @ 1 ml
epinephrine (adrenaline) s.c./i.m. injection 0,1% Note :
(HCl/bitartrate), - Drug of choice for
box 100 ampoules @ 1 ml anaphylactic reaction
- Dosage 0,3 mg – 0,5 mg
i.m. may be repeated
4. ANTIDOTES and OTHER SUBSTANCES USED IN POISONING
4.1 SPECIFIC
atropine i.m./i.v./s.c injection 1 mg/ml Restricted use :
(sulfate), - Caution on package: “only
box 10 ampoules @ 2 ml for antidotes (large dose)”
- Used only for nursing PHC
calcium folinic (leucovorin, Ca) tablet 1 mg, bottle 100 tablets
sodium bicarbonate tablet 500 mg,
bottle 1000 tablets
sodium thiosulfate i.v. injection 25%,
box 10 ampoules @ 10 ml
National List of Essential Medicines 2008 65
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
4.2 NON-SPESIFIC
active carbon activated powder, sacch 0,5 kg
magnesium sulfate powder, sacch 30 g
5. ANTIEPILEPTICS – ANTICONVULSANTS
diazepam i.m./i.v. injection 5 mg/ml,
box 100 ampoules @ 2 ml
rectal sol 4 mg/ml, tube 2,5 ml
phenobarbital tablet 30 mg,
bottle 1000 tablets
tablet 50 mg,
bottle 1000 tablets
tablet 100 mg,
bottle 1000 tablets
i.m injection 50 mg/ml,
box 100 ampoules @ 2 ml
i.v.injection 50 mg/ml (as
sodium salt), box 100
ampoules @ 2 ml
phenytoin capsule 30 mg (as sodium Restricted used :
salt), bottle 250 capsules Specific for continued
capsule 100 mg (as sodium treatment for patient who
salt), bottle 250 capsules referred back to PHC
injection 50 mg/ml (as sodium
salt), box 10 ampoules
@ 2 ml
6. ANTI-INFECTIVE MEDICINES
6.1 ANTHELMINTHICS
6.1.1 Intestinal Anthelminthics
mebendazole tablet 100 mg,
bottle 100 tablets
syrup 100 mg/5 ml,
bottle 30 ml
pyrantel scored tablet 250 mg
(pamoate),
bottle 250 tablets
suspension 125 mg/5 ml
(pamoate), bottle 30 ml
National List of Essential Medicines 2008 66
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
6.1.2 Antifilarials
diethylcarbamazine scored tablet 100 mg (citrate), Note :
bottle 1000 tablets For endemic area
6.2 ANTIBACTERIALS
6.2.1 Beta lactam medicines
amoxicillin trihydrate scored tablet 500 mg,
box 10 stripes @ 10 tablets
dry syrup 125 mg/5 ml,
bottle 60 ml
ampicillin i.m./i.v. powder for injection
250 mg/vial (as sodium
salt), box 10 vials
i.m./i.v. powder for injection
500 mg/vial (as sodium
salt), box 10 vials
benzathine benzylpenicillin i.m. injection 1,2 millions
IU/ml, box 25 vials @ 4 ml
i.m. injection 2.4 millions
IU/ml, box 25 vials @ 10 ml
benzylpenicillin crystal i.m./i.v. injection 10 millions
IU/vial, box 25 vials
phenoxymethylpenicillin tablet 500 mg (as potassium Restricted used :
(penicillin V) salt), bottle 1000 tablets Not used for severe infection
tablet 250 mg (as potassium
salt), box 10 stripes
@ 10 tablets
dry syrup 250 mg/5 ml
(as potassium salt),
bottle 60 ml
procaine benzylpenicillin powder for injection i.m. 3
millions IU/vial,
box 100 vials
powder for injection i.m. 1
million IU/vial,
box 100 vials
National List of Essential Medicines 2008 67
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
6.2.2 Other antibacterials
6.2.2.1 Tetracycline
oxytetracycline i.v. injection 250 mg/3 ml
(HCl), box 10 ampoules
@ 3 ml
i.v. injection 50 mg/ml (HCl),
box 10 vials @ 10 ml
tetracycline capsule 250 mg (HCl),
bottle 1000 capsules
capsule 500 mg (HCl),
box 10 stripes @ 10
capsules
6.2.2.2 Chloramphenicol
chloramphenicol capsule 250 mg,
bottle 1000 capsules
suspension 125 mg/5 ml (as
palmitate), bottle 60 ml
6.2.2.3 Sulfa-Trimethoprim
NLEM co-trimoxazole I (adult) tablet, box 10 stripes
combination of : @ 10 tablets
sulfamethoxazole 400 mg
trimethoprim 80 mg
NLEM co-trimoxazole II tablet, bottle 100 tablets
(paediatric) combination of:
sulfamethoxazole 100 mg
trimethoprim 20 mg
sulfadiazine tablet 500 mg, bottle100
tablets
trimethoprim scored tablet 200 mg,
bottle 100 tablets
6.2.2.4 Macrolides
erythromycin capsule 250 mg (as stearate),
bottle 100 capsules
syrup 200 mg/5 ml (as ethyl
succinate), bottle 60 ml
National List of Essential Medicines 2008 68
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
6.2.2.7 Specific Use
metronidazole tablet 250 mg,
bottle 100/1000 tabs
tablet 500 mg,
bottle 100/1000 tabs
6.3 SPECIFIC ANTI-INFECTIVE MEDICINES
6.3.1 Antileprosy medicines
clofazimine, micronized oily capsule 100 mg,
bottle 100 capsules
dapsone scored tablet 100 mg,
bottle 1000 tablets
6.3.2 Antituberculosis medicines
ethambutol tablet 250 mg (HCl),
bottle 100 tablets
tablet 500 mg (HCl),
bottle 100 tablets
isoniazid tablet 100 mg,
bottle 1000 tablets
tablet 300 mg,
bottle 1000 tablets
pyrazinamide tablet 500 mg,
bottle 100 tablets
rifampicin scored tablet 300 mg, Restricted use :
box 10 stripes @10 tablets Only for tuberculosis and
tablet 450 mg, leprosy
box 10 stripes @10 tablets
tablet 600 mg,
box 10 stripes @10 tablets
streptomycin powder for injection 1000 Note :
mg/vial (as sulfate), Special packaging
box 100 vials
National List of Essential Medicines 2008 69
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
combination of : Note :
rifampicin caplet 150 mg; 75 mg Dosage form and usage
isoniazid tablet 150 mg; 50 mg according to National
Tuberculosis Program
combination of : Note :
rifampicin capl 150 mg Dosage form and usage
isoniazid tablet 150 mg according to National
ethambutol tablet 400 mg tuberculosis program.
combination of : Note :
rifampicin capl 150 mg; 75 mg;450 mg Dosage form and usage
isoniazid tablet 75 mg; 50 mg; 300 mg according to National
pyrazinamide tablet 400 mg; 150 mg; tuberculosis program.
500mg
combination of : Note :
rifampicin capl 150 mg; 450 mg Dosage form and usage
isoniazid tablet 75 mg; 300 mg according to National
pyrazinamide tablet 400 mg; 500 mg tuberculosis program.
ethambutol tablet 275 mg; 250 mg;
500mg
6.3.3 Urinary Antiseptics
NLEM co-trimoxazole I (adult) tablet, box 10 stripes
combination : @ 10 tablets
sulfamethoxazole 400 mg
trimethoprim 80 mg
nitrofurantoine scored tablet 100 mg,
bottle 100 tablets
trimethoprim scored tablet 200 mg,
bottle 100 tablets
6.4 ANTIFUNGAL MEDICINES
6.4.1 Systemic
griseofulvin, micronized scored tablet 250 mg,
bottle 100 scored tablets
nystatin coated tablet 500,000 IU/tablet,
bottle 100/1000 tablets
suspension 100,000 IU/ml,
bottle 12 ml
National List of Essential Medicines 2008 70
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
6.4.2. Topical
NLEM antifungal medicines ointment, pot 30 g
combination of:
benzoic acid 6%
salicylic acid 3%
nystatin vaginal tablet 100,000
IU/tablet, box 10 stripes
@ 10 tablets
6.5 ANTIPROTOZOAL MEDICINES
6.5.1 Antiamoebic and antigiardiasis medicines
metronidazole tablet 250 mg,
bottle 100 tablets
tablet 500 mg,
bottle 100 tablets
6.5.2 Antimalarial medicines
6.5.2.1 For prophylaxis
chloroquine tablet 150 mg(as phosphate),
bottle 1000 tablets
6.5.2.2 For curative treatment
NLEM antimalarial medicines tablet, bottle 500 tablets Restricted use :
combination of : For specific area which
pyrimethamine 25 mg already resistent to
sulfadoxine 500 mg chloroquine (decided by
District/Municipality Health
Offices)
artemether injection 80 mg/ml,
box 6 ampoules @ 1 ml
artesunate injection i.v./i.m. 60 mg/ml,
box 8 vials @ 1 ml
National List of Essential Medicines 2008 71
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
combination of :
artesunate 50 mg tablet, box 2 blisters @ 12
amodiaquin 200 mg tablets (combipack)
box 3 blisters @ 8 tablets
chloroquine tablet 150 mg(as phosphate),
bottle 1000 tablets
syrup 50 mg/5ml, bottle 60 ml
primaquine tablet 15 mg (as phosphate),
bottle 1000 tablets
quinine tablet 222 mg (bisulfate), Restricted use :
bottle 1000 tablets - Only for severe malaria
i.v. injection 25% (as HCl), - Used only for nursing PHC
box 100 ampoules @ 2 ml
7. ANTIMIGRAINE MEDICINES
7.1 FOR PROPHYLAXIS
dihydroergotamine tablet 2.5 mg (as mesilate),
box 10 stripes@ 10 tablets
7.2 FOR TREATMENT OF ACUTE ATTACK
ergotamine tablet 1 mg (tartrate),
bottle 100 tablets
combination of : tablet, box 30/100 tablets
ergotamine 1 mg
caffeine 50 mg
9. ANTIPARKINSONISM MEDICINES
NLEM antiparkinsonism tablet, bottle 100 tablets Authority required :
medicines Parkinsonism diagnostic has
combination of : to be ensured
benserazide 25 mg
levodopa 100 mg
trihexyphenidyl tablet 2 mg (HCl), bottle 250 Authority required :
tablets Parkinsonism diagnostic has
to be ensured
National List of Essential Medicines 2008 72
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
10. MEDICINES AFFECTING THE BLOOD
10.1 ANTIANAEMIA MEDICINES
cyanocobalamine injection 500 mcg/ml,
(vitamin B12) box 100 ampoules @ 1 ml
fe (II) sulfate 7 H20 coated tablet 300 mg,
bottle 1000 tablets
syrup, bottle 60 ml
drops, bottle
folic acid tablet 1 mg,
bottle 1000 tablets
tablet 5 mg,
bottle 1000 tablets
10.2 MEDICINES AFFECTING COAGULATION
phytomenadione (vitamin K1) coated tablet 10 mg,
bottle 1000 tablets
injection 10 mg/ml,
box 100 ampoules @ 1 ml
i.m injection 2 mg/ml, Dose :
ampoule 1 ml - New born baby dose 1 mg
- Premature baby dose 0,5 mg
12. DIAGNOSTIC AGENTS
12.2 FUNCTION TEST
12.2.3 Miscellaneous
fluorescein eye drops 1% (sodium salt),
bottle 5 ml
eye drops 2% (sodium salt),
bottle 5 ml
injection 10%,
box 1 ampoule @ 5 ml
injection 20%,
box 1 ampoule @ 5 ml
12.3 SKIN TEST
tuberculin protein (purified i.c. injection 1:10,
derivative) box 1 vial 2 ml
National List of Essential Medicines 2008 73
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
13. ANTISEPTICS dan DISINFECTANTS
13.1 ANTISEPTICS
hydrogen peroxyde concentrate solution, Storage :
bottle 1000 ml - Storage in glass bottle with
glass cap, air tight, saved
from light
- For diluted until 3%
povidone-iodine sol 10%, bottle 1000 ml
13.2 DISINFECTANTS
calcium hypochlorite powder, sacch 20 g ‘Samijaga’ program
ethanol 70% sol, bottle 100 ml /1000 ml
paraformaldehyde tablet 1 g, bottle 100 tablets
sol 5%, bottle 1000 ml
saponificated cresol 50% liquid, bottle 1000 ml
(lysol)
14. MEDICINES and DENTAL MATERIAL USED FOR ORAL HEALTH
14.1 MEDICINES USED FOR DENTAL and ORAL HEALTH,
NLEM dental anesthetics injection, box 20/50/100
combination of: ampoules @ 2 ml
lidocaine HCl 2%
epinephrine 1 : 80,000
calcium hydroxide paste, box 2 tubes
chlorphenol camphor menthol liquid, bottle 10 ml
ethyl chloride spray 0,05-0,2 ml, Note :
bottle 100 ml Air tight package
eugenol liquid, bottle 10 ml
fluorine tablet 0,5 mg, Authority required :
bottle 100 tablets For PHC in specific area
National List of Essential Medicines 2008 74
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
lidocaine injection 2% (HCl),
box 100 ampoules @ 2 ml
paste 5% (HCl), tube 10 g
spray 15% (HCl), bottle 60 ml
nystatin suspension 100.000 UI/ml,
bottle 12 ml
14.2 DENTAL MATERIAL USED FOR ORAL HEALTH
gelatin sponge cubicles 1x1x1 cm, tin 50 pcs
glass ionomer ART powder bottle10 g
(Atraumatic Restorative sol, bottle 6 g (4,8 ml)
Treatment) cocoa butter 5 g
gutta percha points box 120 sticks
resin composite set
root canal filling paste, bottle
temporary filling sol and powder, bottle 100 g
15. DIURETICS
furosemide tablet 40 mg,
bottle 250 tablets
i.v./i.m. injection 10 mg/ml,
box 25 ampoules @ 2 ml
16. HORMONES, OTHER ENDOCRINE MEDICINES and CONTRACEPTIVES
16.2 ANTIDIABETIC
16.2.1 Oral Antidiabetic
glibenclamide tablet 2,5 mg, bottle 100
tablets
tablet 5 mg, bottle 100 tablets
metformin tablet 500 mg, bottle 100
tablets
National List of Essential Medicines 2008 75
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
16.3 SEX HORMONE and FERTILITY RELATED MEDICINES
16.3.4 Contraceptives Note :
According to National Family
16.3.4.1 Oral Hormonal Contraceptives Planning Program
coordinated by BKKBN
combination : pill
levonorgestrel 150 mcg
ethinylestradiol 30 mcg
16.3.4.2 Injectable Hormonal Contraceptives
medroxyprogesterone depot injection 150 mg
acetate
16.3.4.3 Intra-uterine Devices
Copper - containing device set / pcs
16.4 THYROID and ANTITHYROID HORMONES
lugol solution bottle 30 ml Note :
Dilute before use
propylthiouracyl scored tablet 100 mg,
bottle 1000 tablets
16.5 CORTICOSTEROID HORMONES
dexamethasone tablet 0,5 mg,
bottle 1000 tablets
injection 5 mg/ml (as sodium
phosphate),
box 100 ampoule @ 1 ml
hydrocortisone tablet 10 mg
powder for injection 100
mg/vial (sodium succinate),
box 100 vial @ 2 ml
prednisone tablet 5 mg, Note :
bottle 1000 tablets Second line used after
dexamethasone
National List of Essential Medicines 2008 76
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
17. CARDIOVASCULAR MEDICINES
17.1 ANTI-ANGINAL MEDICINES
atenolol tablet 50 mg, box 10 stripes
@ 10 tablets
isosorbide dinitrate sublingual tablet 5 mg,
bottle 60 tablets
17.2 ANTIARRHYTHMIC MEDICINES
propranolol tablet 10 mg (HCl),
bottle 100 tablets
i.v. injection 1 mg/ml (HCl),
box 10 ampoules @ 1ml
17.3 ANTIHYPERTENSIVE MEDICINES
captopril scored tablet 12.5 mg, Caution :
box 10 stripes @ 6 tablets - Not for pregnant women
scored tablet 25 mg, box 10 - Having cough side effect
stripes @ 6 or 10 tablets
hydrochlorothiazide tablet 25 mg,
bottle 100 tablets
17.4 PLATELET ANTIAGGREGATION
acetylsalicylic acid (acetosal) tablet 80 mg, box 10 blisters
@ 10 tablets
17.6 MEDICINES USED IN HEART FAILURE
captopril scored tablet 12.5 mg, box 10 Caution :
stripes @ 10 scored tablets - Not for pregnant women
scored tablet 25 mg, box 10 - Having cough side effect
stripes @ 10 scored tablets
digoxin tablet 0.0625 mg, Pediatric dose :
bottle 100 tablets Tablet 0,0625 mg for
tablet 0.25 mg, pediatrics
bottle 100 or 1000 tablets
injection 0.25 mg/ml,
box 1 ampoule @ 2 ml
National List of Essential Medicines 2008 77
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
furosemide tablet 40 mg, box 20 stripes
@ 10 tablets
injection i.v./i.m. 10 mg/ml,
box 25 ampoules @ 2 ml
17.7 MEDICINES USED for SHOCK ATTACK,
17.7.1 Medicines used for cardiogenic shock
epinephrine (adrenaline) injection i.v. 0,1 %
(as HCl/ bitartrate),
box 100 ampoules @ 1 ml
17.8 LIPID-LOWERING AGENTS
simvastatin scored tablet 10 mg,
box 30 scored tablets
18. DERMATOLOGICAL MEDICINES
18.2 ANTI-INFECTIVE MEDICINES
NLEM anti-infective medicines ointment, tube 5 g
combination of :
bacitracin 500 IU/g
polymixin B 10,000 IU/g
18.3 ANTIFUNGAL MEDICINES
NLEM antifungal medicines ointment, pot 30 g Note :
combination of : General antifungal ointment
benzoic acid 6%
salicylic acid 3%
sodium thiosulfate liquid 25%, bottle 30 ml
18.4 ANTI-INFLAMMATORY and ANTIPRURITIC MEDICINES
betamethasone ointment 0.1% (as valerate),
tube 5 g
cream 0.1% (as valerate),
tube 5 g
hydrocortisone cream 2.5% (acetate),
tube 5 g
National List of Essential Medicines 2008 78
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
18.5 SCABICIDES and PEDICULICIDES
2-4 ointment, ointment, pot 30 g
combination of :
salicylic acid 2%
sulfur precipitate 4 %
18.6 CAUSTIC MEDICINES
silver nitrate sol 20%, bottle 10 ml Note :
For hypergranulation
18.7 MEDICINES AFFECTING SKIN DIFFERENTIATION and PROLIFERATION
coal tar sol 5 %, bottle 100 ml
podophyllum resin alcoholic sol 25 %, Authority required :
bottle 30 ml - Should be applicated by
practitioners
- Should be cleaned 1-4
hours after used, make
sure that no residues
- Only for severe thickening,
causing danger of
absorptions
- Not for pregnant women
because of terratogenic
effect
- Not for use by patients
- Not for take away home
salicylic acid ointment 2%, pot 30 g
ointment 5%, pot 30 g
ointment 10%, pot 30 g
18.8 MISCELLANEOUS
liquor carbonis detergents suspension 2%, bottle 30 ml
suspension 5%, bottle 30 ml
liquor faberi liquid
salicyl powder powder 2%, box 100 g
National List of Essential Medicines 2008 79
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
20. ELECTROLYTE, NUTRITION SOLUTIONS, and OTHERS
20.1 ORAL
oral rehydration salts powder, 100 sacch - Drink slowly to prevent
combination of : each sacch for 200 ml vomiting
sodium chloride 0.52 g water - 1 sacchet to be dissolved
potassium chloride 0.30 g in 200 ml water
trisodium citrate
dihydrate 0.58 g
anhydric glucose 2.70 g
sodium bicarbonate tablet 500 mg, bottle 1000
tablets
20.2 PARENTERAL
glucose infusion sol 5%, bottle 500 ml
infusion sol 10%,
bottle 500 ml
infusion sol 40%, bottle 25 ml
ringer lactate infusion sol, bottle 500 ml
sodium chloride infusion sol 0.9%, Note :
bottle 500 ml - Need to check sodium
infusion sol 3%, bottle 500 ml level
injection 15%, vial 50 ml - Used only for nursing PHC
20.3 MISCELLANEOUS
water for injections box, ampoule/vial @ 10
ml/20 ml
21. OPHTHALMOLOGICAL PREPARATION
21.1. LOCAL ANESTHETICS
tetracaine eye drops 0.5% (HCl),
bottle 5 ml
21.2 ANTI-INFECTIVE AGENTS
oxytetracycline eye ointment 1% (HCl),
tube 3.5 g
sulfacetamide eye drops 15% (sodium),
bottle 5 ml
National List of Essential Medicines 2008 80
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
21.4 MYDRIATICS
atropine eye drops 0.5% (sulfate),
bottle 5 ml
eye drops 1% (sulfate),
bottle 5 ml
21.5 MIOTICS and ANTIGLAUCOMA MEDICINES
pilocarpine eye drops 2% (HCl/nitrate),
bottle 5 ml
eye drops 4% (HCl/nitrate),
bottle 5 ml
22. OXYTOCICS and UTERIC RELAXANTS
22.1 OXYTOCICS
methyl ergometrine coated tablet 0.125 mg
(maleate), bottle 100 tablets
injection 0.200 mg/ml,
box 100 ampoules @ 1 ml
oxytocin injection 10 IU/ml,
box 100 ampoules @ 1 ml
23. PSYCHOTHERAPEUTIC MEDICINES
23.1 MEDICINES USED in GENERALIZED ANXIETY and SLEEP DISORDERS
diazepam tablet 2 mg,
bottle 1000 tablets
tablet 5 mg,
bottle 1000 tablets
i.m. injection 5 mg/ml,
box 100 ampoules @ 2 ml
23.2 MEDICINES USED in DEPRESSIVE DISORDERS
amitriptyline coated tablet 25 mg (HCl),
box 10 blisters@10 tablets
23.3 MEDICINES USED for OBSESSIVE COMPULSIVE DISORDERS
clomipramine tablet 25 mg (HCl),
bottle 1000 tablets
National List of Essential Medicines 2008 81
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
23.4 MEDICINES USED in PSYCHOTIC DISORDERS
chlorpromazine coated tablet 25 mg (HCl),
bottle 1000 tablets
coated tablet 100 mg (HCl),
bottle 1000 tablets
i.m. injection 25 mg/ml (HCl),
box 100 ampoules @ 1 ml
haloperidol tablet 0.5 mg, Note :
bottle 100/1000 tablets - Second generation
tablet 1.5 mg, antipsychotic
bottle 100/1000 tablets - Specific for PHC which
tablet 2 mg, box 100 tablets integrated to mental health
tablet 5 mg, care
bottle 100/1000 tablets
drops 2 mg/ml,
bottle 15 ml/100 ml
i.m. injection 2 mg/ml (HCl),
box 5 ampoules @ 1 ml
i.m. injection 5 mg/ml (HCl),
box 5 ampoules @ 1 ml
injection 50 mg/ml (as
decanoate),
box 5 ampoules @ 1 ml
(long acting)
25. GASTROINTESTINAL MEDICINES
25.1 ANTACIDS and OTHER ANTIULCER MEDICINES
NLEM antacid I chewable tablet,
combination of: bottle 1000 tablets
aluminium hydroxide 200 mg
magnesium hydroxide 200 mg
NLEM antacid II suspension, bottle 60 ml
combination of :
aluminium
hydroxide 200 mg/5 ml
magnesium
hydroxide 200 mg/5 ml
National List of Essential Medicines 2008 82
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
25.2 ANTIEMETIC MEDICINES
chlorpromazine coated tablet 25 mg (HCl),
bottle 1000 tablets
i.m. injection 25 mg/ml (HCl),
box 100 ampoules @ 1 ml
i.m injection 5 mg/ml (HCl),
box 100 ampoules @ 2 ml
dimenhydrinate tablet 50 mg, bottle 1000 Note :
tablets - Adult dose : ½ - 1 tablet
- Use ½ - 1 hour before
meals to get better efficacy
25.3 ANTIHAEMORRHOID MEDICINES
NLEM antihaemorrhoid suppositoria, box 100 supp
combination of :
bismuth subgallate 150 mg
hexachlorophene 2.5mg
lidocaine 10 mg
zinc oxide 120 mg
supp to 2 g
25.4 ANTISPASMODIC MEDICINES
atropine tablet 1 mg (sulfate),
tin 100 tablets
i.m./i.v./s.c. injection 0.25
mg/ml (sulfate),
box 100 ampoules @ 1 ml
i.m./i.v./s.c. injection 1 mg/ml
(sulfate),
box 50 ampoules @ 1 ml
belladonna extract tablet 10 mg,
bottle 100/1000 tablets
25.5 MEDICINES USED IN DIARRHOEA
oral rehydration salts powder, 100 sacchs, - Drink slowly to prevent
combination of : each sacch for 200 ml of vomiting
sodium chloride 0.52 g water - 1 sachet to be dissolved in
potassium chloride 0.30 g 200 ml of water
trisodium citrate
dihydrate 0.58 g
anhydric glucose 2.70 g
National List of Essential Medicines 2008 83
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
25.6 CATARTIC MEDICINES
glycerine liquid, bottle 100 ml
26. MEDICINES ACTING ON RESPIRATORY TRACT
26.1 ANTIASTHMATIC
dexamethasone tablet 0.5 mg,
bottle 1000 tablets
i.v. injection 5 mg/ml (as
sodium phosphate),
box 100 ampoules @ 1 ml
ephedrine tablet 25 mg (HCl),
bottle 1000 tablets
epinephrine (adrenaline) injection 0.1 % (as
HCl/bitartrate), box 100
ampoules @ 1 ml
salbutamol tablet 2 mg (as sulfate),
bottle 100/1000 tablets
tablet 4 mg (as sulfate),
bottle 100/1000 tablets
26.2 ANTITUSSIVES
codeine tablet 10 mg (HCl/phosphate),
bottle 250 tablets
dextromethorphan tablet 15 mg (HBr),
bottle 1000 tablets
syrup 10 mg/5 ml (HBr),
bottle 60 ml
26.3 EXPECTORANT
glyceryl guaiacolate syrup 25 mg/5 ml,bottle 60 ml
tablet 100 mg,
bottle 1000 tablets
obat batuk hitam (OBH) liquid, bottle 200 ml
concentrate liquid,
bottle 1000 ml
National List of Essential Medicines 2008 84
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
27. IMMUNOLOGICALS
27.1 SERA and IMMUNOGLOBULINS
antidiphtheria sera (A.D.S) i.m. injection 10,000 IU/vial, Note :
box 10 vials @ 5 ml - Storage at 2-8º C
i.m. injection 20.000 IU/vial,
box 10 vials @ 10 ml
antirabies sera i.m. injection 100 IU/ml, Indication :
box 10 vial @ 20 ml - For post-exposure treatment
in rabies area
- Storage at 2-8º C
antitetanus sera (A.T.S) for prophylaxis : Note :
i.m. injection 1500 - Storage at 2-8º C
IU/ampoule
box 10 ampoules @ 1 ml
for curative treatment :
i.m./i.v. injection 10,000
IU/ampoule,
box 10 ampoules @ 2 ml
i.m./i.v injection 20,000
IU/vial, box 10 vials@ 4 ml
snake antivenom sera i.m./i.v. injection, box 10 vial Note :
snake antivenom special @ 5 ml - Only for specific area
for snake from outside - Storage at 2-8º C.
papua
snake antivenom special
for papua snake
27.2 VACCINES
BCG vaccine i.c. injection, Note :
box 5 ampoules @ 2 ml - Storage below 5º C
i.c. injection,
box 5 ampoules @ 4 ml
diphtheria, pertusis and i.m injection, Note :
tetanus adsorbed vaccine box 10 vial @ 5 ml - Storage at 2-8º C
(DPT)
hepatitis B vaccine injection 20 mcg/ml, Note :
(recombinant) box 1 vial 0.5; 1 ml - Storage at 2-8º C
National List of Essential Medicines 2008 85
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
measles vaccine s.c. injection, box 10 vials Note :
(10 doses) @ 5 ml - Storage at 2-8º C
poliomyelitis vaccine drops, box vial 10/20 doses Note :
- Storage at 2-8º C
rabies vaccine (human) s.c./i.c. powder for injection, Indication :
box 7 vial @ 1 dose + 7 - Storage at 2-8º C
ampoules solvent @ 2 ml - Use for pre-exposure and
booster : box 5 ampoules @ post-exposure treatment in
1 dose + 5 ampoules rabies area
solvent @ 4 ml
tetanus adsorbed vaccine i.m. injection, box 1 vial 5 ml Note :
(tetanus adsorbed toxoid) - Storage at 2-8º C
tetanus and diphteria i.m. injection, Note :
adsorbed vaccine (TD) box 10 vial @ 5 ml - Storage at 2-8º C
28. MEDICINES USED FOR EAR, NOSE and THROAT
carboglycerine ear drops 10 %, bottle 5 ml
29. VITAMINS and MINERALS
ascorbic acid tablet 50 mg,
bottle 1000 tablets
calcium lactate tablet 500 mg,
bottle 1000 tablets
pyridoxine tablet 10 mg (HCl),
bottle1000 tablets
tablet 25 mg (HCl),
bottle 1000 tablets
retinol tablet 5000 IU,
bottle 1000 tablets
soft capsule 50,000 IU,
bottle 50 capsules
soft capsule 100,000 IU,
bottle 50 capsules
soft capsule 200,000 IU (as
palmitate),
bottle 50 capsules
National List of Essential Medicines 2008 86
THERAPEUTIC
CLASS, GENERIC DOSAGE FORM RESTRICTION
NAME (INN)
thiamine tablet 50 mg (HCl),
bottle 1000 tablets
vitamin B complex tablet, bottle 1000 tablets
Minister of Health
Dr. dr. SITI FADILAH SUPARI, SpJP (K)
National List of Essential Medicines 2008 87
CHANGES OF NLEM 2005
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
1 acetazolamide tablet 250 mg, bottle 100 tablets Moved to other
i.m/i.v. powder for injection, 500 therapeutic sub-
mg/vial (as sodium salt), class
box 10 vials + 10 ampoules
water for injection @ 5 ml
2 active carbon activated powder, sacch 0.5 kg Change of generic
name
3 alprazolam tablet 0.25 mg, −
box 10 stripes @ 10 tablets
tablet 0.5 mg,
box 10 stripes @ 10 tablets
4 amiloride tablet 5 mg (HCl), −
bottle 100 tablets
5 amiodarone tablet 200 mg, box 30 tablets +
injection 150 mg/3 ml,
box 6 ampoules @ 3 ml
6 amphotericin *) i.v injection vial 50 mg/10 ml, +
vials @ 10 ml
7 antitetanus i.m. injection 500 UI, vial +
immunoglobulin (human)
8 artesunate i.v/i.m injection 60 mg/ml, +
box 8 vials @ 1 ml
9 atracurium injection 25 mg/2,5 ml, +
ampoule 2,5 ml
10 benzoil peroxyde gel 2.5%, tube 5 g −
gel 5%, tube 5 g
National List of Essential Medicine 2008
88
88
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
11 benzylpenicilin eye ointment 1.000 IU/g, tube 5 g −
12 betamethasone eye drop 1 mg/ml (sodium), +
bottle 5 ml
13 bupivacaine infiltrate injection 0.25% (HCl), −
box 5 vial @ 20 ml
14 carbamazepine chewable tablet 100 mg +
syrup 100 mg/5 ml, bottle 120 ml
15 cefazolin powder for injection 1 g / vial, +
box 2 vials
16 ceftriaxone powder injection 1 g / vial, +
box 2 vials
17 chlorambucyl tablet 2 mg +
18 chloramphenicol ear drop 3 %, bottle 5 ml −
19 chlorhexidine sol 1.5 % (gluconate), bottle 2.5 l −
sol 4.0 % (gluconate), bottle 2.5 l
20 chlorhexidine sol 5.0% (gluconate), bottle 2.5 l +
21 chlormethine powder injection 10 mg/vial −
(HCl), box 1 vial
22 clomiphen tablet 50 mg (citrate), −
bottle 10 tablets
23 clomipramine tablet 10 mg (HCl), −
bottle 250 tablets
24 clozapine ∗ ) tablet 25 mg, box 50 tablets +
tablet 50 mg, box 50 tablets
∗
Complementary list
National List of Essential Medicine 2008
89
89
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
25 codeine tablet 10 mg (phosphate), Change of dosage
bottle 250 tablet strength and
packaging
26 colchicine tablet 500 mcg, −
box 3 stripes @ 10 tablets
27 combination of: tablet, box 30/100 tablets +
ergotamine 1 mg
caffeine 50 mg
28 combination of: capsule −
extr. apii herba 92 mg
extr. ortosiphonis folium
28 mg
29 compound thymi syrup liquid, bottle 100 ml −
30 copper –containing device set / pcs +
31 daunorubicin powder injection 20 mg/vial +
(HCl), box 1 vial @ 4 ml
32 desmopressin spray Change of dosage
form
33 devitalization paste (non paste, bottle −
arsen)
34 dextran 70 Infus sol 6%, bottle 500 ml −
35 dextrose infusion solution 5 %, +
bottle 500 ml
36 diethylcarbamazine scored tablet 100 mg (citrate), Change of dosage
bottle 1000 tablet strength
37 digoxin tablet 0.0625 mg, +
bottle 100 tablets
tablet 0.25 mg,
bottle 100 tablets
injection 0.25 mg/ml;
box 1 ampoule 2 ml
National List of Essential Medicine 2008
90
90
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
38 diloxanide tablet 500 mg (furoate) +
39 disodium edetate eye drop 0.35%, bottle 5 ml −
40 dobutamine injection 50 mg/ml, vial 5 ml +
injection 25 mg/ml, ampoule
10 ml
41 edrofonium injection i.v. 10 mg/ml (chloride), −
box 10 vial @ 10 ml
42 efavirenz tablet 200 mg, bottle 90 tablets Change of
tablet 600 mg, bottle 30 tablets therapeutic sub-class
and dosage form
43 enflurane inhalation liquid, bottle 250 ml −
44 etacridine (rivanol) solutio 0.1 %, bottle 300 ml −
powder, bottle 100 g
45 ethosuccimide capsule 250 mg, −
bottle 100/1000 capsules
syrup 250 mg/5 ml, bottle 60 ml
46 ethyl ester from oleum i.a./i.v. injection 1 ml −
iodized papaveris consist of 0,96 ml
(iodized oil) (equivalent with 0.48 g iodine),
box 1 ampoule 10 ml
47 etonogestrel implant 1 rods (3 yrs) −
48 fe (II) sulfate 7H2O syrup, bottle 60 ml +
49 fentanyl i.m./i.v. injection 0.05 mg/ml Change of
(citrate), packaging
box 5 ampoules @ 2 ml
50 fluoxetine capsule/tablet 10 mg, +
box 30 tablets
capsule/tablet 20 mg,
box 30 tablets
National List of Essential Medicine 2008
91
91
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
51 framicetin sterile kassa 1% (sulfate), −
box 10 pieces
52 gamexan cream 1%, bottle 30 ml −
53 gelatin spons layer 5 x 7 x 1 cm −
54 gentian violet sol 1%, bottle 10 ml −
55 haloperidol i.m. injection 2 mg/ml (HCl) Change of salt form
box 5 ampoules @ 1 ml
i.m. injection 5 mg/ml (HCl)
box 5 ampoules @ 1 ml
56 hydrochlorothiazide tablet 25 mg, bottle 1000 tablets +
57 hydrocortisone tablet 10 mg +
58 hydrocortisone cream 1% (acetate), tube 5 g −
59 hydrocortisone acetate eye drop 1%, bottle 5 ml −
60 intermediate insulin injection 40 IU/ml, −
box 1 vial 10 ml
61 iodine injection 480 mg/ml, −
box 1 ampoule 10 ml
62 iodoform paste paste −
63 isoflurane inhalation liquid, bottle 250 ml +
64 isoprenaline injection 1mg/ml (HCl), −
box 1 ampoule 2 ml
65 ketoprofen suppositoria 100 mg +
66 levamisole tablet 50 mg (HCl), −
box 4 bls @ 9 tablets
National List of Essential Medicine 2008
92
92
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
67 levertrane ointment 5% −
68 levonorgestrel pill 75 mcg, 150 mcg −
69 levonorgestrel implant 6 rods (5 yrs) −
70 lidocaine injection 5% + glucose 7.5 %, +
ampoule 2 ml
71 lidocaine injection 1% (HCl) + epinephrine −
1 : 200,000,
box 10 vials @ 30 ml
injection 2% (HCl) + epinephrine
1 : 200,000,
box 10 vials @ 20 ml
72 liquor faberi liquor with menthol 0,1% −
liquor with menthol 0,5%
73 liquor veilli (salicylic acid solution +
solution 0.1 %)
combination of :
salicylic acid 0.1 %
boric acid 0.5 %
glycerine 10 %
74 lisinopril tablet 5 mg, −
box 3 stripes @ 10 tablets
tablet 10 mg,
box 3 stripes @ 10 tablets
tablet 20 mg,
box 3 stripes @ 10 tablets
75 lithium carbonate tablet 200 mg, Change of dosage
box 10 stripes @ 10 tablets strength
76 lopinavir tablet +
77 lotio kummerfeldi liquid, packaging as needed −
National List of Essential Medicine 2008
93
93
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
78 mannitol infusion sol 20%, bottle 500 ml −
79 melphalan tablet 2 mg +
80 meningococcus powder injection, −
polysaccharide A + C box 10 vials @ 10 dosage +
vaccine 10 ampoules solvent @ 5 ml
81 methampyrone i.m. injection 250 mg/ml, −
box 25 vials @ 10 ml
box 100 ampoules @ 2 ml
82 methyl cellulose, sol 2 %, bottle 5 ml Change of
changed to be therapeutic sub-
combination of class and the
hydroxypropyl methyl- composition is
cellulose 5 mg written completely
dextran (70) 1 mg
glycerine 2 mg
benzalkonium chloride
0.01% w/v
83 (dl) methylphenidate ∗ ) regular release tablet 10 mg, +
box 30 tablets
extended release tablet 20 mg,
box 30 tablets
84 methyl prednisolone tablet 4 mg, bottle 100 tablets −
85 metoclopramide syrup 5 mg/5 ml, bottle 50 ml +
drop 0.1 mg/drop, bottle 10 ml
86 midazolam i.v. injection 1 mg/ml +
i.v. injection 5 mg/ml
87 NLEM nutritious solution I infusion sol, bottle 500 ml −
88 NLEM nutritious solution II infusion sol, bottle 500 ml −
∗
Complementary list
National List of Essential Medicine 2008
94
94
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
89 NLEM nutritious solution III infusion sel, bottle 500 ml −
90 NLEM nutritious solution IV infusion sel, bottle 500 ml −
91 NLEM nutritious solution V infusion sel, bottle 500 ml −
92 NLEM otic medicine ear drop, bottle 5 ml −
combination of:
neomycin sulfate 500 mg
polymixin B sulfate
1.000.000 IU/100 ml
93 neomycin tablet 500 mg, bottle 100 tablets −
94 nicotinamide tablet 100 mg +
95 norepinephrine injection 4 mg/ml, ampoule 2 ml +
96 nutritious solution infusion sol, bottle 500 ml +
combination of :
glucose 4%
sodium chloride 0.18 %
97 oral rehydration salts powder, 100 sacch, each sacch −
for 1000 ml of water
98 pancuronium i.v. injection 2 mg/ml (bromide), −
box 10 ampoules @ 2 ml
99 paracetamol suppositoria 120 mg +
suppositoria 240 mg
100 patent blue V s.c. injection 2.5%, −
box 1 ampoule 2 ml
101 permethrin cream 5%, tube +
102 perphenazin tablet 4 mg (HCl), −
bottle 100/1000 tablets
tablet 16 mg (HCl),
bottle 100/1000 tablets
National List of Essential Medicine 2008
95
95
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
103 phenobarbital tablet 50 mg, bottle 1000 tablets +
104 phenol liquid bottle 10 ml −
105 phenytoin syrup 50 mg/5 ml, bottle120 ml +
106 phytomenadione i.m injection 2mg/ml, +
ampoule 1 ml
107 piridostigmine tablet 10 mg (bromide), −
box 10 stripes/bls @ 10 tablets
108 policresulen (metacresol liquid, bottle 10 ml / 50 ml Moved to other
sulphonate & methanal therapeutic class
condensate)
109 prednisolon eye drop 0,5%, bottle 5 ml −
eye ointment 1%, tube 3,5 g
110 procainamide injection 100 mg/ml (HCl) −
111 propranolol scored tablet 40 mg (HCl), +
bottle 100 tablets
112 propyliodone injection in oil 500-600 mg/ml, −
box 1 ampoule 20 ml
113 propylthiouracyl tablet 100 mg, bottle 1000 tablets Change of dosage
strength
114 propranolol tablet 10 mg, box 100 tablets −
tablet 40 mg, box 100 tablets
115 protein plasma fraction Dosage form and
(including fibrinogen) strength are deleted
116 quinidine tablet 200 mg (sulfate), −
bottle 100/1000 tablets
117 reserpin tablet 0,10 mg, bottle 1000 tablets −
tablet 0,25 mg, bottle 1000 tablets
National List of Essential Medicine 2008
96
96
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
118 resin composite set +
119 retinol tablet 5000 UI, bottle 50 tablet +
soft capsule 100,000 UI,
bottle 50 soft capsules
120 retinol injection 100,000 IU/ ampoule, −
box 100 ampoules @ 1 ml
oily injection 100,000
IU/ampoule (as palmitate),
box 100 ampoules @ 2 ml
121 regular insulin injection 40 IU/ml, −
box 1 vial 10 ml
122 regular insulin : injection 100 IU/ml, +
intermediate insulin (30 box 1 vial 10 ml
: 70)
123 rocuronium i.v. injection 10 mg/ml, vial 5 ml +
124 silver amalgam powder 65 - 75%, bottle 1 oz −
125 silver nitrate sol 40%, bottle 10 ml −
126 sodium bicarbonate injection 1,4% isotonic +
127 sodium fucidic cream 20 mg/g, tube 5 g −
128 sodium nitroprusside *) injection, vial +
129 stavudin tablet 30 mg, bottle 60 tablets Change of
tablet 40 mg, bottle 60 tablets therapeutic sub-class
and dosage form
130 succinyl choline iv/i.m powder injection 500 Change of generic
mg/vial (chloride), box 10 vial name
131 sufentanyl injection 50 mcg/ml (citrate), −
box 5 vial @ 5 ml
National List of Essential Medicine 2008
97
97
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
132 sulfonic preparation cones, bottle 100 butir −
133 sulpirid capsule 50 mg, −
box 10 stripes @ 10 capsules
tablet 200 mg,
box 2 stripes @ 10 tablets
134 suxamethonium iv/i.m powder injection 500 −
mg/vial (chlorida), box 10 vial
135 thiamine injection 100 mg/ml, −
box 100 ampoules 1 ml
136 thiopental i.v. powder for injection 500 −
mg/ampoule (as sodium salt)
(for dissolved in 20 ml WFI),
box 25 ampoules
137 trichloracetic acid crystal, sacch −
138 tropicamide eye drop 1%, bottle 5 ml −
139 tuberkulin protein i.c. injection 1:10, −
(purified derivative) box 1 vial 25 ml
140 valproate tablet 250 mg (as sodium salt), Change of dosage
bottle 50 tablets form and strength
tablet 500 mg (as sodium salt),
bottle 50 tablets
syrup 250 mg/5 ml (as sodium
salt), bottle 120 ml
141 vancomycin powder injection 500 mg/vial, +
box 1 vial
142 vecuronium powder injection 10 mg/vial −
(bromide), box 20 vials
143 warfarin tablet 2 mg (potassium salt), bottle Change of dosage
100 tablets strength
National List of Essential Medicine 2008
98
98
ADDITION (+),
DELETION (-),
GENERIC NAME
NO DOSAGE FORM CHANGE OF
(INN)
DOSAGE
FORM
144 zidovudine tablet 100 mg, bottle 100 tablets Change of
therapeutic sub-class
and dosage form
145 zinc phosphate cement Powder and liquid, −
set 30 g bottle 1 set
National List of Essential Medicine 2008
99
99
THE MINISTER OF HEALTH OF THE REPUBLIC OF INDONESIA
THE DECREE OF THE MINISTER OF HEALTH
OF THE REPUBLIC OF INDONESIA
NUMBER: 239/MENKES/SK/III/2008
REGARDING
THE ESTABLISHMENT OF NATIONAL COMMITTEE ON REVISION
OF THE NATIONAL LIST OF ESSENTIAL MEDICINES 2008
THE MINISTER OF HEALTH OF THE REPUBLIC OF INDONESIA
Considers : a. in order to enhance the quality of health services, the availability of a
good quality, safe, effective and sufficient quantity of essential
medicines is the responsibility of the government as authorized in the
National Medicines Policy;
b. as according to the point (a) above, it is necessary to support the
implementation of rational use of medicines;
c. as according to the progress of the medical sciences and health
technology, disease pattern, health program and the improvement of
public health status as a result of the currently health development, it
is therefore, the National list of Essential Medicines should be revised;
d. in order to revise the National List of Essential Medicines (NLEM), it is
necessary to establish The National Committee On Revision of the
National List of Essential Medicines 2008 by Ministerial decree.
Refers to : 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 of
Pharmaceutical Products and Medical Devices (State Paper year 1998
No. 138, Additional to State Papers of the Republic of Indonesia No.
3781);
3. Government Regulation No. 38 year 2007 regarding Division of
Municipality/District Administrative (State of the Republic of
Indonesian Paper year 2007 No. 82);
4. The Regulation of the President of the Republic of Indonesia No. 9
year 2005 regarding the locality, duty, function, structure of the
organization and the job description of the States Ministries of the
Republic of Indonesia;
5. The Regulation of the President of the Republic of Indonesia No. 10
year 2005 regarding Organization Unit and duty of the First Rank
Officers of the States Ministries of the Republic of Indonesia;
6. The Regulation of the Minister of Health of the Republic of Indonesia
No. 1575/Menkes/Per/XI/2005 regarding the Organization and Ethical
Task of the Health Department of the Republic of Indonesia;
7. The Decree of the Minister of Health of the Republic of Indonesia No.
189/MENKES/SK/III/2006 regarding The National Medicines Policy.
National List of Essential Medicines 2008 100
Has decided
To stipulate : THE DECREE OF THE MINISTER OF HEALTH REGARDING
THE ESTABLISMENT OF THE NATIONAL COMMITTEE ON
REVISION OF THE NATIONAL LIST OF ESSENTIAL
MECICINES 2008
The First : To establish The National Committee on Revision of National
List of Essential Medicines 2008 with organization structure as
set forth in the appendix hereto;
The Second : The responsibilities of National Committee of NLEM are as
follows:
a. The Steering Committee
The Steering Committee is responsible to provide advice
and direction of the revision according to prevailing laws
and regulations;
b. The Expert Team
The Expert Team is responsible to evaluate the
medicines in NLEM 2005 and to analyze the proposed
medicines to be added to or deleted from the NLEM
2008.
c. The Consultant
The consultant is responsible to provide the technical
support or scientific findings needed by the expert team.
d. The Expert Team and The Consultant jointly provide the
technical and the scientific support to the Ministry of
Health vide Directorate General of Pharmaceutical
Services and Medical Devices on implementing NLEM
nationwide and to assist the Directorate of Rational Use
of Medicine to execute its policy.
e. The Members
The Members are responsible to provide input needed
for evaluation of NLEM 2005 and to analyze the
proposed medicines to be added to or deleted from
NLEM 2008.
f. The Organizing Committee
The Organizing Committee are responsible in recording,
documentation and supplying the data, preparing the
procedures and guidelines, and preparing the
recommended draft of NLEM 2008, arranging the
technical meetings and plenary session, preparing the
draft documentations, and finalizing NLEM 2008 and its
dissemination.
The Third : The Revision of NLEM should be conducted during 2008;
The Fourth : On implementing the duties of The National Committee of
Revision of NLEM are responsible to the Ministry of Health vide
Directorate General of Pharmaceutical Services and Medical
Devices; and report the activities at least 1 (one) month after the
termination of their task.
National List of Essential Medicines 2008 101
The Fifth : The duty period of The National Committee of Revision of NLEM
started since the stipulation date of this decree and terminated
at the end of 2008.
The Sixth : The budget of The National Committee of Revision of NLEM and
activities is under Annual National Budget of Directorate of
Rational Use of Medicine in the year of 2008;
The Seventh : This decree shall be effective as of the date of stipulation, and
there will be reconsideration or amendment as required if there
are shortcomings of mistakes in the stipulation.
Stipulated in : Jakarta
On Date : March 5, 2008.
Minister of Health
Dr. dr. SITI FADILAH SUPARI, Sp.JP (K)
Circulation to:
1. The Coordinator Minister of the Public Welfare
2. The Minister of Home Affair
3. The Head of National Planning and Development Board
4. The Head of National Agency of Drug and Food Control
5. The First Ranks officers in the Ministry of Health.
6. The Head of Province Health Office all over the Republic of Indonesia.
7. The Directors of all Teaching Hospitals and Vertical Hospitals within the Ministry of Health all
over the Republic of Indonesia.
8. The Head of Municipality or District Health Office all over the Republic of Indonesia.
9. Whom it may concern, to be implemented as required.
National List of Essential Medicines 2008 102
APPENDIX :
THE DECREE OF THE MINISTER OF HEALTH
OF THE REPUBLIC OF INDONESIA
NUMBER : 239/MENKES/SK/III/2008
DATE : MARCH 5, 2008
THE ESTABLISHMENT OF NATIONAL COMMITTEE ON REVISION
OF THE NATIONAL LIST OF ESSENTIAL MEDICINES 2008
Steering Committee :
1. Director General of Pharmaceutical Services and Medical Devices
2. Head of National Agency of Food and Drug Control
3. Director General of Medical Services
4. Director General of Diseases Control and Sanitation
5. Deputy 1 of National Agency of Food and Drug Control
Head of Authority : Director General of Pharmaceutical Services and Medical devices
Expert Team :
Chairman : 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)
Counsultant :
1. 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)
7. Nani Sukasediati (Pharmacist)
8. Pinky F. Riawan (General Practitioner)
9. Sri Suryawati (Pharmacist)
National List of Essential Medicines 2008 103
Organizing Committee :
Head : Director of Rational Use of Medicines
Secretary : Zorni Fadia (General Practitioner)
Seecretary I : Dita Novianti (Pharmacist)
Members :
1. Secretary to Director General of Pharmaceutical Services and
Medical devices
2. Director of Public Medicines and Medical Supply
3. Director of Maternal Health
4. Director of Child Health
5. Director of Direct Communicable Diseases Control
6. Director of Animal Sourced Diseases Elimination
7. Director of Non-Communicable Diseases
8. Director of Epidemiologic Surveillance, Immunization and
Dimension Health
9. Head of Sub Directorate of Standardization and Technical
Assistance, Rational Use Medicines Directorate
10. Head of Sub Directorate of Promotion, Rational Use Medicines
Directorate
Secretariat :
1. Erie Gusnellyanti
2. Liza Fetrisiani
3. Prihadi Mulyono
4. Anwar Wahyudi
5. Nofiyanti
6. Mulyati
Stipulated in : Jakarta
On Date : March 5, 2008.
Minister of Health
Dr. dr. SITI FADILAH SUPARI, Sp.JP (K)
National List of Essential Medicines 2008 104
LIST OF PARTICIPANTS OF TECHNICAL
MEETINGS AND PLENARY SESSION
NATIONAL LIST OF ESSENTIAL MEDICINES
2008
1 Director General of Pharmaceutical Services and Medical Devices
2 Head of National Agency of Food and Drug Control
3 Director General of Medical Services
4 Director General of Diseases Control and Sanitation
5 Deputy I of National Agency of Food and Drug Control
6 Secretary to Director General of Pharmaceutical Services and Medical Devices
7 Director of Rational Use of Medicine
8 Director of Public Medicines and Medical Supply
9 Director of Maternal Health
10 Director of Child Health
11 Director of Direct Communicable Diseases Control
12 Director of Non-Communicable Diseases Control
13 Director of Animal Sourced Diseases Elimination
14 Director of Epidemiologic Surveillance, Immunization and Dimension Health
15 Director of Public Nutrition
16 Director of Mental Health Services
17 Director of Primary Medical Services
18 Director of Specialist Medical Services
19 Director of Public Hospital Dr. M Yunus Bengkulu
20 Director of Public Hospital DR. M. Djamil Padang
21 Director of Public Hospital Ulin Banjarmasin
22 Director of National Public Hospital RS Cipto Mangunkusumo
23 Director of Central Public Hospital Hasan Sadikin Bandung
24 Director of Central Public Hospital Muh. Hussein Palembang
25 Director of Public Hospital dr. Moewardi, Solo
26 Director of Public Hospital dr. Sardjito, Yogyakarta
27 Director of Central Public Hospital Wahidin Sudirohusodo, Makasar
28 Director of Public Hospital Dr. Karyadi, Semarang
29 Director of Public Cardiovascular Hospital Harapan Kita
30 Director of Mental Hospital Cimahi
31 Director of Provincial Public Hospital Wahidin Sudirohusodo Mojokerto-East Java
32 Director of Provincial Public Hospital dr. Soetomo, Surabaya
33 Director of Public Hospital Kab. Tangerang
34 Director of Provincial Public Hospital Arifin Achmad, Pekanbaru
35 Director of Central Public Hospital Sanglah - Denpasar
36 Director of Siloam Karawaci Hospital, Banten
37 Director of Sumber Waras Hospital, Jakarta
38 Director of Husada Hospital, Jakarta
39 Director of Public Hospital Yos Sudarso, Padang
40 Director of PT. Indofarma
41 Director of PT. Kimia Farma
42 Director of PT. Phapros
43 Health Directorate of National Army - POLRI
National List of Essential Medicines 2008
105
44 Head of Provincial Health Office in Nangroe Aceh Darusalam
45 Head of Provincial Health Office in South Sulawesi
46 Head of Provincial Health Office in DKI Jakarta
47 Head of Provincial Health Office in West Java
48 Head of Provincial Health Office in Central Java
49 Head of Provincial Health Office in East Java
50 Head of Provincial Health Office in West Kalimantan
51 Head of Provincial Health Office in Central Kalimantan
52 Head of Provincial Health Office in Western Southeast Nusa Tenggara
53 Head of Provincial Health Office in Eastern Southeast Nusa Tenggara
54 Head of Provincial Health Office in Papua
55 Head of Provincial Health Office in Central Sulawesi
56 Head of Provincial Health Office in North Sulawesi
57 Head of Provincial Health Office in West Sumatera
58 Head of Provincial Health Office in North Sumatera
59 Head of District Health Office in Karang Anyar
60 Head of District Health Office in Sleman
61 Head of District Health Office in Surakarta
62 Head of Public Health Center of Pajang, Surakarta
63 Head of Public Health Center of Tebet, Jakarta
64 Chairman of Indonesian Medical Doctors Association
65 Chairman of Indonesian Midwives Association
66 Chairman of Indonesian Pharmacologist Association
67 Chairman of Indonesian Nursery Association
68 Chairman of Indonesian Pharmacist Association
69 Chairman of Indonesian Anesthesiologist and Reanimation Specialist Association
70 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 Sutanto
77 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, SpKGA
89 DR. Atie W. Soekandar, Sp.FK.
90 DR. Sri Suryawati
91 dr. Kartono Muhammad
92 dr. Pinky F. Riawan
93 Dra. Engko Sosialine, M. Biomed
94 dr. Zorni Fadia
95 dr. Abdullah Akhmad
96 Dra. Detty Yuliati, Apt.
National List of Essential Medicines 2008
106
97 Dita Novianti, S.Si, Apt, MM
98 Erie Gusnellyanti, S.Si, Apt.
99 dr. Djentot Fibihanindyo Putro
100 Dra. Dara Amelia, Apt.
101 Dra. Ema Viaza, Apt.
102 Rohayati Rahafat, S.Si, Apt.
103 Drs. Suhata
104 Awan Yurianto
105 Suprihandoyo
106 Prihadi Mulyono
107 Anwar Wahyudi
108 Nofiyanti
109 Mulyati
-----------
National List of Essential Medicines 2008
107
STATEMENT OF COMPLIANCE
CHAIRMAN/VICE CHAIRMAN/
EXPERT/CONSULTANT*)
I, as undersigned below
Name :
Address :
declare as follows:
1. Disposed to be the Chairman/Vice Chairman/Expert/Consultant*) of The National
Committee of NLEM (National List of Essential Medicines) 2008.
2. Disposed to attend Technical Discussion Meeting of NLEM Revision.
3. Disposed to sign Conflict of Interest Statement.
Jakarta, .......................................
( )
*) Strike out the unnecessary statement
National List of Essential Medicines 2008
108
CONFLICT OF INTEREST STATEMENT
Indonesian National Essential Medicines Committee (2008)
For the evaluation of the Selection of Essential Medicines an evaluation committee is needed that
would guarantee that its members are impartial and free from conflicts of interest that would biased
the outcome of their choice(s) of medicines. Therefore all individuals chosen as National
Committee Members are required to sign a statement as below, as consented:
1. No direct family members, including self, have important positions in or have stakes in
the drug business so as to bias his/her selection.
2. Committee Members, including Chairman and Consultants, should not solicit or receive
money or gratuities that clearly indicate a form of bribery.
3. Committee Members should refrain from presenting faked data in the form of
publications or statements of dubious nature.
4. In its deliberations members should use their intellectual judgment, instead of stating
mere opinions without support of scientific data.
5. When in the discussion of a subject, a member feels that he/she might have a conflict of
judgment, he/she must acknowledge the chairman of the nature of its possible conflict.
In the case of a serious conflict of interest, he/she will not be allowed to participate in a
voting procedure.
6. Committee Members may not deliberately leak important confidential issues of decision
to a third party.
I, the undersigned below:
Name: .........................................
Function: Chairman / Vice Chairman / Member / Consultant
Declares that he/she understood the above statement and will obey the written rules above.
---------------------------------------- ----------------------
Committee Member Date
National List of Essential Medicines 2008
109
ASSESSMENT FORM
APPLICATION FOR ADDITION / DELETION OF
NATIONAL LIST OF ESSENTIAL MEDICINES
2008
NO SUBJECT
1 Summary
2 Reason of deletion
3 Public relation
4 Comparation with similar medicine on the list
5 Pharmacological characteristic
6 Effectiveness evidence
7 Safety evidence
8 Benefit – cost ratio
9 Formulation
10 The using of the medicine by international guidance
11 Prevailing laws and regulatiuon which is supporting to delete the medicine
12 Recommendation
13 References
National List of Essential Medicines 2008
110
RECAPITULATION OF APPLICATION
FOR NLEM REVISION
2008
Application from
Name of Institution :
Address :
Phone No/Facs :
CHANGE
GENERIC
THERAPEUTIC DOSAGE SUPPORTING
NO NAME PACKAGING
CLASS FORM EBM *)
(INN)
ADDITION DELETION
Explanation : ………………….200..
*) Based on trusted literature / reference Stamp / signature
*) Enclose the related literature / reference
Name _____
NIP.
National List of Essential Medicines 2008
111
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