Daftar Obat Formularium RSCM Berdasarkan Kelas Terapi

DAFTAR OBAT FORMULARIUM RSCM BERDASARKAN KELAS TERAPI
NO NO
NAMA GENERIK BENTUK KEKUATAN NAMA DAGANG KETR.
KELAS URUT
SEDIAAN
TERAPI OBAT
1 ANALGESIK,
ANTIPIRETIK, ANTI-
REMATIK, ANTIPIRAI
1.1 ANALGESIK
NARKOTIK
1 Fentanil inj; patch inj 0,05 mg/ml; TTS 25 Fentanyl (inj.);
mcg/jam, 50 mcg/jam Durogesic (patch)
2 Kodein HCl tablet 10 mg, 15 mg, 20 mg Codein KF
3 Kodein HCl + tablet 30 mg + 500 mg Coditam
Parasetamol
4 Morfin HCl inj 10 mg/ml Morphine HCl KF
5 Morfin sulfat tab short tab short acting 10 mg; MST
acting; tab tab SR 10 mg, 15 mg, 30
SR mg, 60 mg
6 Petidin HCl inj 50 mg/ml Pethidine HCl KF
7 Sufentanil inj 5 mcg/ml, 50 mcg/ml Sufenta; Sufenta forte
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1.2 ANALGESIK NON
NARKOTIK
1 Antalgin tablet; inj. tab 500 mg; inj. 250 Novalgin (inj.);
mg/ml Antalgin tablet 500
mg (generik)
2 Asam Mefenamat kapsul; kapsul 250 mg; tab 500 Ponstan; Mefinal,
tablet; mg; susp 50 mg/5 ml Asam Mefenamat
suspensi tablet 500 mg
(generik)
3 Asetosal tablet 500 mg Aspirin
4 Deksketoprofen tab; inj 50 mg Ketesse
trometamol
5 Diklofenak tab; emulgel tab 25 mg, 50 mg; tetes; Voltaren; Cataflam;
emulgel 1% 10 g, 20 g Deflamat CR;
Natrium Diklofenak
tablet 50 mg; 25 mg
(generik); Kalium
Diklofenak tablet 25
mg; 50 mg (generik)
6 Etorikoksib tablet 60 mg, 90 mg,120 mg Arcoxia
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 Ibuprofen tab kunyah; tab kunyah 100 mg; tab Proris; Lexaprofen;
tab; sirup; 200 mg, 400mg; sirup Brufen; Ibuprofen
suppos 100 mg/5 ml, 200 mg/ml; tablet 200 mg; 400
supp 125 mg mg (generik)
8 Indometasin kapsul 25 mg, 50 mg, 100 mg Dialon; Indometasin
(generik)
9 Ketoprofen tab; suppos; tab 50 mg, 100 mg; Profenid; Kaltrofen;
inj. supp 100 mg; inj.50 mg/ Pronalges;
ml,100 mg/ml Ketoprofen tablet 50
mg; 100 mg; inj. 50
mg/ml (generik)
10 Ketorolak trometamin tab; inj tab 10 mg; inj10 mg/ml, Toradol; Xevolac;
30 mg/ml Remopain; Ketorolak
inj. 10 mg/ml; 30
mg/ml; tab 10 mg
(generik)
11 Meloksikam tab; suppos; tab 7,5 mg, 15 mg; supp Movi-cox; Rhemacox;
inj. 15 mg Velcox; Meloxicam
tablet 7,5 mg; 15
mg; supp 15 mg; inj
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
12 Parasetamol tab; tab 500 mg, susp 120 Panadol; Tempra;
suspensi; mg/5 ml; supp 125 mg, Dumin; Farmadol
suppos; 250 mg; infus 10 mg/ml infus; Paracetamol
infus tablet 500 mg;
drops; syrup
(generik)
13 Parasetamol + Asetil tablet 500 mg Sistenol
Sistein
14 Parasetamol + tablet 350 mg + 200 mg + Neuralgin
Ibuprofen + Kafein 50 mg
15 Parasetamol + tablet 325 mg + 37,5 mg Ultracet; Zaldiar;
Tramadol Acetram
16 Parasetamol + vit B1 + tablet Dolo Neurobion
vit B6 + vit B12
17 Parekoksib natrium inj 20 mg, 40 mg vial Dynastat
18 Piroksikam kapsul; tab; kaps 10 mg, 20 mg; tab Feldene; Piroxicam
gel 10 mg, 20 mg; gel 5% 15 kapsul 10 mg; 20 mg
g, 25 g (generik)
19 Selekoksib kapsul 10 mg, 20 mg Celebrex
20 Tinoridin HCl kapsul 50 mg Nonflamin
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
21 Tramadol HCl kapsul; tab; kaps 50 mg; tab 100 mg; Tramal; Trasik;
inj; suppos inj 50 mg/ml; 100 mg/ Dolgesik; Tramadol
amp 2ml, 200 mg/amp 2 HCl kapsul 50
ml; supp 100mg mg; inj 50 mg/ml
(generik)
1.3 ANTIREMATIK,
ANTIPIRAI
1 Allopurinol tablet 100, 300 mg Zyloric; Allopurinol
tablet 100 mg; 300
mg (generik)
2 Asam Hyaluronat inj 10 mg/ml syringe 2,5 ml Adant Dispo; Osflex
3 Azatioprin tablet 50 mg Imuran; Azatioprine
PCH; Azathioprine
tablet 50 mg
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
4 Etarnecept inj 50 mg/ml Enbrel Hanya utk
pasien yg
tdk responsif
dgn obat lain.
Diresepkan
hanya oleh
dokter ahli
Reumatologi
5 Kolkisin tablet 0,5 mg Recolfar; Kolkisin

(generik)
6 Leflunomid tablet 10 mg, 20 mg, 100 mg Arava
7 Metotreksat tab; inj tab 2,5 mg; inj 5 mg/ml, Methotrexate Ebewe;
50 mg/5ml, 5 mg/2ml, 50 Emthexate
mg/2ml
8 Mofetil Mikofenolat kapsul 250 mg, 500 mg Cellcept
9 Probenesid tablet 500 mg Probenid; Probenesid
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
10 Siklofosfamid tab; inj tab 50 mg; inj 200 mg, Endoxan - Asta
500 mg, 1000 mg Iyophilisate; Cyclovid;
Cyclophosphamide
Kalbe
11 Sulfasalazin kaplet 500 mg Sulcolon;
Sulfasalazin
(generik)
2 ANESTETIK
2.1 ANESTETIK LOKAL
1 Bupivakain HCl inj 0,5% duofit polyamp 20 Marcain; Regivell;
ml; 0,5% spinal heavy Decain Heavy;
4 ml; 0,5% spinal 4 ml; Buvanest Heavy
0,5% heavy 4 ml 0,5%; Bupivakain inj
5 mg (generik)
2 Etilklorida semprot Ethyl Chloride
(generik)
3 Levobupivakain inj 50 mg amp Chirocaine 0,5%
4 Lidokain (5%)+ inj 50 mg/ml (5%) Lidodex
Dextrose 5%
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
5 Lidokain 2% + inj 20 mg + 0,0125 mg Pehacain
Adrenalin
6 Lidokain HCl inj; gel; inj 1%, 2%, 4%, 5%; gel Xylocain;Lidocaine
spray 10%; spray 10% dlm inj 2% (generik)
50 ml
7 Lidokain HCl 25 mg + krim krim 50 mg Emla cream; Estesia
Prilokain 25 mg
8 Ropivakain HCl inj 7,5 mg/20 ml Naropin
2.2 ANESTETIK UMUM
1 Deksmedetomidin HCl vial 100 mcg/ml Precedex
2 Desfluran cairan 240 ml Suprane
4 Enfluran cairan 250 ml Ethrane; Compound
347
5 Etomidat inj 1% 20 ml Etomidate-Lipuro
6 Halotan cairan 50 ml, 250 ml Fluothane, Halothane
(generik)
7 Isofluran inhalasi cair 250 ml Forane; Aerrane;
Isoflurane (generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
8 Ketamin HCl inj 10 mg/ml Ketalar; Ketamin-
Hameln; Ivanes;
Ketamin HCl
(generik)
9 Midazolam inj 5 mg/5 ml amp, 15 mg/ Dormicum;
3 ml Midazolam-Hameln;
Sedacum
10 Propofol inj 1% dlm 20 ml Diprivan; Fresofol;
Propofol Lipuro
11 Sevofluran cairan 250 ml Sevorane; Sojourn
12 Sodalime pro anestesi serbuk Gallon 4,5 liter Sodalime; Sofnolime;
Intersorb Plus
3 ANTIALERGI DAN
OBAT UNTUK
ANAFILAKSIS
1 Desloratadin tablet 5 mg Aerius
2 Difenhidramin HCl inj, tab 10 mg/ml Decadryl;
Diphenhydramine inj
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Feksofenadin HCl tablet tab BD 60 mg; tab OD Telfast BD, OD, HD
120 mg; tab HD 180 mg
4 Feksofenadin HCl + tablet SR 60 mg + 120 mg Telfast Plus
Pseudoefedrin
5 Feniramin maleat tab, inj tab 25 mg; inj 50 mg/ Avil
amp
6 Hidroksizin tab; sirup tab 25 mg; sir 10 mg/5 Bestalin
ml
7 Homoklorsiklizin tablet 10 mg Homoclomin
8 Klorfeniramin maleat tab; inj tab 4 mg, inj 5 mg/ml Cohistan;
Chlorpheniramine
HCl tablet (generik)
9 Loratadin tab; sirup tab 10mg; sirup 5 mg/ 5 Claritin; Inclarin;
ml botol 60 ml Clatatin; Loratadine
tablet 10 mg
(generik)
10 Loratadin + tablet 5mg + 60mg Rhinos SR
Pseudoefedrin
11 Mebhidrolin Napadisilat tablet 50 mg Interhistin
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
12 Pseudoefedrin drop 7,5 mg Rhinos Neo
13 Pseudoefedrin HCl + sirup 7,5 mg + 1 mg Rhinos Junior
CTM
14 Pseudoefedrin + tab; susp tab 30 mg + 40 mg; susp Rhinofed
Terfenadin 15 mg + 20 mg per 5 ml
15 Setirizin tab; sirup; tab 10 mg; sir 5 mg/ml, Ryzen; Histrine;
drop drop 10 mg/ml Histrine FT; Rytez:
Cetirizine kapsul 10
mg (generik)
16 Siproheptadin HCl kaplet 4 mg Pronicy
4 ANTIDOT DAN
OBAT LAIN UNTUK
KERACUNAN
4.1 KHUSUS
1 Atropin Sulfat tab; inj tab 0,5 mg; inj 1 mg/ml Atropine Sulfate
tablet 0,5 mg; inj 1
mg/ml(generik)
2 Biru Metilen inj 10 mg/ml Methylene Blue
Produksi RSCM
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Buprenorfin dan Tablet Buprenorfin HCl 2 Suboxone
Nalokson Sublingual mg+Naloxon 0,5mg
, Buprenorfin 8
mg+Naloxon 2 mg
4 Deferasiroks tablet 125 mg, 250 mg, 500 mg Exjade
effervescent
5 Deferipron tablet tab 500 mg Ferriprox
6 Deksrazoksan inj 250 mg/vial, 500 mg/vial Zinecard
7 Deferoksamin mesilat serbuk inj 500 mg/vial Desferal
8 Flumazenil inj 0,5 mg/5 ml Anexate
9 Kalsium Folinat tab; inj tab 15 mg; inj 50mg/ Rescuvolin inj 50 mg/
amp, 50 mg/5 ml, 30 amp; Leucovorin DBL;
mg/10 ml (Folcasin) Folcasin; Leucovorin
caps 15 mg (generik)
10 Kalsium glukonat inj 100 mg/ml Calcium Gluconate
10%
11 Kalsium Polistiren serbuk 5g Kalitake
sulfonat
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
12 Mesna inj 200 mg/2 ml, 400 mg/4 Uromitexan
ml
13 N-asetil sistein inj. Hidonac
14 Nalokson HCl inj 0,4 mg/ml Narcan; Nokoba
15 Natrium Bikarbonat tab; inj tab 500 mg; inj 8,4% Meylon 8,4%;
Natrium Bikarbonat
tablet 500 mg
(generik)
4.2 UMUM
1 Karbo Adsorben tablet 500 mg Norit; Bekarbon
5 ANTIEPILEPSI
1 Diazepam tab; inj; lar tab 2 mg, 5 mg; inj 10 Valium; Valdimex;
rektal mg/2ml; lar rektal 5 mg Stesolid; Diazepam
tube 2,5 ml; lar rektal 10 tablet 5 mg (generik)
mg tube 2,5 ml
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Fenitoin natrium tablet; kap 100 mg; inj 100 Dilantin, Kutoin;
kapsul; inj mg/2 ml, 250 mg/5 ml Phenytoin Ika
Pharmindo;
Phenytoin kapsul
100 mg; inj. (generik)
3 Fenobarbital tab; inj tab 30 mg, 50 mg, 100 Sibital; Phental;
mg; inj 50 mg/ml Phenobarbital tablet
30 mg; 100 mg
(generik)
4 Gabapentin kapsul 100 mg, 300 mg Neurontin; Sipentin;
Gabexal
5 Karbamazepin tablet 200 mg Tegretol, Bamgetol,
Carbamazepine
tablet 200 mg
(generik)
6 Lamotrigine tablet 50 mg, 100 mg Lamictal
7 Klonazepam tablet 2 mg Rivotril; Riklona 2
8 Levirasetam tablet 250 mg, 500 mg Keppra
9 Magnesium sulfat inj 20%, 40% Magnesium Sulphate
Otsuka
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
10 Okskarbazepin kaplet 300 mg Trileptal; Prolepsi;
Barzepin
11 Pregabalin kapsul 75 mg, 150 mg Lyrica
12 Topiramat tablet 25 mg, 50 mg, 100 mg Topamax
13 Valproat (dlm btk tab; sirup tab 250 mg, 500 mg; sir Depakene (sirup),
asam/Natrium) 250 mg/5 ml Depakote (tablet);
Ikalep; Asam
Valproat tablet
150 mg; 250 mg
(generik)
14 Zonisamide tablet 100 mg Zonegran
6 ANTIMIKROBA
6.1 ANTELMINTIK
6.1.1 Antelmintik Intestinal
1 Levamisol tablet 25 mg Askamex
2 Mebendazol tablet 500 mg Vermox; Mebendazol
sirup (generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Pirantel pamoat tab; tab 125mg, 250mg; Combantrin; Pirantel
suspensi susp 10ml (125mg/ Pamoat tab 125
5ml,250mg/5ml) mg; 250 mg; sirup
(generik)
6.1.2 Antifilaria
6.2 ANTIBAKTERI
6.2.1 Golongan Penisilin
1 Amoksisilin kapsul; Kaps 250 mg; kapl 500 Amoxil; Amoxsan; A
kaplet; sirup mg; sirup 125 mg/5 ml; Amoxicillin tablet
kering; inj inj 1 g/vial 125 mg; kapsul 250
mg; kaplet 500 mg;
sirup kering 125 mg/
5 ml (generik)
2 Amoksisilin + tab; sirup; inj tab 500 mg + 125 mg; Augmentin; A
Klavulanat sir 125 mg/5 ml; inj 500 Clavamox; Improvox;
mg,1g Amoxicillin-
Clavulanat tablet 625
mg (generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Ampisilin tab; sirup tab 250 mg, 500 mg; Ampicillin inj. 1 g A
kering; inj sirup 125 mg/5 ml; inj (generik)
250 mg/vial, 500 mg/vial,
1g/vial
4 Ampisilin-Sulbaktam inj 750 mg, 1,5 g Unasyn; Bactesyn; A
Picyn
5 Benzatin Benzil inj 1,2 juta IU, 2,4 juta IU Benzatin Benzil A
Penisilin Penisilin 1,2 juta UI;
2,4 juta UI (generik)
6 Fenoksi metil penisilin tablet Fenocin
7 Piperasilin + inj 4,5 g dalam vial Tazocin C; kecuali
Tazobaktam NICU: A
8 Prokain Penisilin G inj 3 juta IU Procaine Penicillin- A
G-Meiji
9 Sulbenisilin inj 1g Kedacillin A
6.2.2 Golongan
Aminoglikosida
1 Amikasin inj 250 mg, 500 mg Amikin; Mikasin B
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Dibekasin inj 50 mg, 100 mg Dibekacin Meiji, A
Dibekacin (generik)
3 Gentamisin inj 20 mg/2ml, 60 mg/1,5 Garamycin; A
ml, 80 mg/2 ml Gentamerck;
Sagestam;
Gentamycin inj. 80
mg (generik)
4 Kanamisin sulfat kapsul, inj. 250 mg,1 g vial Kanamycin inj. 1 g A
(generik)
5 Linkomisin kapsul; sirup kap 250 mg, 500 mg; sir Lincocin; Biolincom; A
250 mg/5 ml Pritalinc; Lincomycin
tablet 500 mg; 250
mg (generik)
6 Netilmicin inj. 300 mg/1,5 ml Hypobhac B
7 Tobramisin inj. 500 mg Tobryne A
6.2.3 Golongan
Kloramfenikol
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Kloramfenikol kapsul; kap 250 mg; susp Chloramex; A
suspensi; inj 125mg/ 5ml; inj 1 g/ml Chloramphenicol
kapsul 250 mg;
suspensi (generik)
2 Tiamfenikol kapsul 250 mg, 500 mg Urfamycin; Thiamycin; A
Thiamphenicol
tablet 500 mg; 250
mg (generik)
6.2.4 Golongan Kuinolon
1 Levofloksasin tab; infus 500 mg Cravit; Levonic; A
Levoxal;
Levofloxacin drip;
tablet 500 mg
(generik)
2 Moksifloksasin tab salut tab salut film 400 mg; Avelox A
film; infus infus 400 mg/250 ml
3 Ofloksasin tablet 200 mg, 400 mg Tarivid; Ofloxacin A
tablet 200 mg; 400
mg (generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
4 Siprofloksasin tab; infus tab 250 mg, 500 mg; tab Ciproxin; Ciproxin A
XR 500 mg, 1 g; infus XR; Civell; Baquinor;
2%, 4% dlm botol 100 ml Ciprofloxacin tablet
250 mg; 500 mg;
infus (generik)
6.2.5 Golongan Makrolid
1 Azitromisin kapsul 250 mg, 500 mg Zithromax; Binozyt; A
Zistic; Azithromycine
tablet 500 mg
(generik)
2 Eritromisin stearat kapsul; tab; kap 250 mg; tab 200 Erythrocin EES; A
tab kunyah; mg, 500 mg; tab kunyah Kalthrocin;
sirup kering; 200 mg; sir botol 60 ml Erythromycin tablet
drop (200 mg/5 ml); drop 100 250 mg; 500 mg;
mg/2,5 ml sirup (generik)
3 Klaritromisin tablet 250 mg, 500mg Abbotic; Bicrolid A
4 Roksitromisin kapsul 150 mg, 300 mg Rulid A
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
5 Spiramisin tab; sirup tab 500 mg, 1,5 MIU, 3 Rovamycin; Spiradan; A
MIU; sir 125 mg/5 ml Vipram; Spiramycin
tablet 500 mg; 250
mg (generik)
6.2.6 Golongan Sefalosporin
1 Sefadroksil kapsul; sirup kap 250, 500 mg; sirup Cefat; Cefadroxil A
kering kering 125 mg/5 ml, 250 kapsul 250 mg; 500
mg/5 ml mg; sirup kering 125
mg/ 5 ml(generik)
2 Sefaklor tablet 250 mg, 500 mg Ceclor; Cloracef; A
Cefaclor (generik)
3 Sefazolin inj 1g Cefazol; Fabiolin; A
Cefazolin inj 1 g
(generik)
4 Sefditoren Pivoksil tablet 200 mg Meiact A
5 Sefepim inj 0,5 g; 1 g Macef; Daryacef; C
Cefepime 1 g
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
6 Sefiksim kapsul, sirup kapsul 50 mg; 100 mg; Cefspan; Tocef; A
kering 200 mg; sirup kering 100 Cefila; Cefixime
mg/ 5 ml kapsul 100 mg;
kaplet 200 mg; sirup
kering 100 mg/ 5
ml(generik)
7 Sefoperazon inj 1g Cefobid; Stabixin; B
Biorazon;
Cefoperazone inj. 1
g (generik)
8 Sefoperazon + inj 500 mg + 500 mg Sulperazon; B
Sulbaktam Stabactam; Sulbacef;
Sefoperazone-
Sulbactam inj 1 g
(generik)
9 Sefotaksim inj 0,5 g; 1 g Claforan; Lapixim; B
Soclaf; Cefotaxime
inj 500 mg; 1 g
(generik)
10 Sefotiam tab; inj tab 200 mg; inj 1 g Ceradolan; Fodiclo B
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
11 Sefpirom inj 1g Cefrom; Cefrin; Pirom; C
Cefpirome inj. 1 g
(generik)
12 Sefpodoksim tablet 100 mg Banan; Banadoz A
13 Sefradin kapsul; sirup kaps 250 mg, 500 mg, 1 Lovecef A
g; sir 125 mg/5 ml
14 Seftazidim inj 500 mg, 1 g Fortum; Ceftum; C
Pharodime;
Ceftazidime 1 g
(generik)
16 Seftizoksim injeksi 0,5 g, 1 g Cefizox; Tizos; B
Ceftizoxime inj. 1 g
(generik)
17 Seftriakson inj 1g Rocephin; Ecotrixon; B
Bioxon; Ceftriaxone
1 g (generik)
18 Sefuroksim (kapsul: kap; inj kap 250 mg, 500 mg; inj Zinnat (kapsul); A
Axetil; inj. Na) 750 mg Kalcef; Sharox;
Cefuroxime inj 750
mg (generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
6.2.7 Golongan Tetrasiklin
1 Doksisiklin kapsul 50 mg, 100 mg Vibramycin; A
Doxicor; Interdoxin;
Doxicycline tablet
100 mg (generik)
3 Oksitetrasiklin kapsul; inj; kaps 250 mg; inj 500 mg/ Terramycin; A
salep kulit; ml; salep kulit 1%; salep Oxytetracycline inj.
salep mata mata 0,5 %, 1% 500 mg/ml (generik)
4 Tetrasiklin kapsul 250 mg, 500 mg Tetracycline HCl A
kapsul 250 mg; 500
mg (generik)
5 Tigesiklin inj 50 mg/ 5 ml vial Tygacil C
6.2.8 Golongan Lain-lain
1 Aztreonam inj 1000 mg Azactam; Vebac C
2 Ertapenem inj. 1g Invanz C
3 Doripenem inj. 1g Doribax C
4 Fosfomisin inj., serbuk 1 g, 2 g, 3 g (sachet) Fosmicin; Fosmidex, A
Monuril (sachet)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
5 Imipenem + Silastatin inj. 500 mg + 500 mg per Tienam; Pelastin; C
120 ml vial Elastyn
6 Klindamisin kapsul 150 mg, 300 mg Dalacin; Anerocid; A
Clinmas;
Clindamycine kapsul
150 mg; 300 mg
(generik)
7 Kolistin tablet 250.000 IU; 1.500.000 IU Colistine A
8 Kotrikmosazol tab; tab 80 mg + 400 mg, 160 Bactrim; Sanprima; A
(TMP+SMZ) suspensi mg+ 800 mg; suspensi Cotrimoxazole tablet
40 mg + 200 mg per 5 ml 480 mg; suspensi
240 mg/ 5 ml
(generik)
9 Linezolid tab; infus tab 600mg; infus 2 mg/ Zyvox C
ml 300 ml
10 Meropenem inj 500 mg, 1 g Meronem; Meropex; C; kecuali
Merofen; Meropenem NICU:A
inj 500 mg; 1 g
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
11 Metronidazol tab; infus; tab 250 mg, 500 mg; Flagyl; Novamet; A
suspensi; infus 500 mg/kolf; susp Supplin;
ovula 125 mg/5 ml; ovula 500 Metronidazole
mg, 1 g tablet 500 mg; drip
(generik)
12 Teikoplanin inj 400 mg Targocid C; kecuali
NICU: A
13 Vankomisin inj 500 mg Vancep; Vancomycin C
HCl inj 500 mg
(generik)
6.3 ANTITUBERKULOSIS
1 Etambutol tablet 250 mg, 500 mg Bacbutol; Tibigon;
Ethambutol tablet
250 mg; 500 mg
(generik)
2 Isoniazid tablet 100 mg, 300 mg Isoniazid tablet
100 mg; 300 mg
(generik)
3 Isoniazid + vit B6 tablet 100 mg, 300 mg INH Ciba; Pehadoxin
Forte
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
4 Pirazinamid tablet 500 mg Pezeta; Prazina;
Pyrazinamide tablet
500 mg (generik)
5 Rifampisin kaplet 300 mg, 450 mg, 600 mg Rimactane; Rifamtibi;
Rifampicin tablet
300 mg; 450 mg; 600
mg (generik)
6 Rifampisin + INH tablet salut 450 mg + 300 mg; Paed Rimactazid 450/300;
selaput : 75 mg + 50 mg Rimactazid Paed
7 Rifampisin + INH + kaplet 150 mg + 75 mg + 400 Rimcure 3 FDC;
Pirazinamid mg; Paed : 75 mg + 50 Rimcure Paed
mg + 150 mg
8 Rifampisin +INH tablet 150 mg + 75 mg + 400 Rimstar 4 FDC
+ Pirazinamid + mg + 275 mg
Ethambutol
9 Streptomisin sulfat inj. 1 g, 5 g Streptomycin
Sulphate Meiji
6.4 ANTILEPROTIK
6.5 ANTIFUNGI
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Flukonazol kapsul; inj kaps 50 mg,150 mg, Diflucan; Cryptal;
200 mg; inj 2 mg/ml 100 Fludis; Flukonazol
ml vial tablet 150 mg;
Flukonazol drip
(generik)
2 Griseofulvin tablet 125 mg, 500 mg Grivin; Griseofulvin
tablet 125 mg; 500
mg (generik)
3 Itrakonazol kapsul 100 mg Sporacid; Trachon;
Itraconazole kapsul
100 mg (generik)
4 Ketokonazol tablet 200 mg Nizoral; Interzol;
Mycoral;
Ketoconazole tablet
200 mg (generik)
5 Metronidazol + Nistatin ovula 500 mg + 10.000 IU Flagystatin, Fladystin
6 Micafungin Natrium inj Mycamine
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 Nistatin tab vagina; tab vagina 100.000 IU; Mycostatin;
susp susp 100.000 IU/ml Kandistatin; Fungatin;
Nystatin tablet
500.000 IU (generik)
8 Terbinafin tablet 250 mg Lamisil; Interbi
9 Vorikonazol tab; inj tab 50 mg, 200 mg; inj Vfend
200 mg vial
6.6 ANTIMALARIA
1 Artemether + tablet 20 mg + 120 mg Coartem
Lumefantrin
2 Klorokuin fosfat/difosfat tablet 250 mg Resochin;
Chloroquine tablet
250 mg (generik)
3 Kuinin diHCl tab; inj tab 222 mg; inj 300 mg/ Quinine HCl
ml amp (generik)
4 Pirimetamin tablet 25 mg Primet;
Pyrimethamine
tablet 25 mg
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
5 Primakuin tablet 15 mg Primakuin (generik)
6 Sulfadoksin + tablet 500 mg + 25 mg Fansidar;
Pirimetamin Sulfadoxine-
Pyrimethamine
(generik)
6.7 ANTIVIRUS
1 Adefovir dipivoksil tablet 10 mg Hepsera
2 Asiklovir tab; inj tab 200 mg, 400 mg; inj Zovirax; Zoter;
250 mg Poviral; Acyclovir
tablet 200 mg;
400mg (generik)
3 Entekavir tab; larutan tab 0,5 mg, 1 mg; larutan Baraclude
0,05 mg/ml
4 Famasiklovir tablet 250 mg Famvir
5 Gansiklovir inj 500 mg Cymevene
6 Hepatitis B inj Hepamun
Imunoglobulin
7 Human Alfa Interferon inj 18 MIU/1 ml, 30 MIU/1,2 Intron-A; Kalferon;
ml, 3 MIU/ml Alfanative
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
8 Interferon Alfa 2a inj 135 mcg, 180 mcg Pegasys
Pegylated
9 Interferon Alfa 2a inj 3 MIU, 4,5 MIU Roferon A
Pegylated
10 Interferon Alfa 2b inj vial; inj 50 mcg, 80 mcg, 100 Peg Intron
Pegylated pen mcg, 120 mcg, 150 mcg
11 Lamivudin tablet 100 mg 3TC-HBV
12 Metisoprinosin tab; sirup tab 500 mg; sir 250 mg/ Isoprinosine
5 ml
13 Oseltamivir tablet 75 mg Tamiflu; Oseltamivir
(generik)
15 Telbivudin tablet 600 mg Sebivo
16 Valasiklovir tablet 500 mg Valtrex; Valvir
17 Valgansiklovir tablet 450 mg Valcyte
6.8 ANTIRETROVIRAL
1 Didanosin tablet 100 mg Dinosin, Videx
2 Efavirenz tablet 200 mg, 600 mg Efavir; Aviranz
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Iopinavir + Ritonavir kapsul Kaletra
4 Lamivudin tab; larutan tab 150 mg 3TC
5 Lamivudin + Zidovudin tablet Duviral; Zidolam
6 Lopinavir + Ritonavir tablet 200 mg + 50 mg Aluvia
7 Nevirapin tablet 200 mg Neviral; Viramun
8 Nevirapin + Lamivudin tablet Nevilast
+ Stavudin
9 Stavudin tablet 30 mg Stvudin; Staviral
10 Stavudin + Lamivudin tablet Coviro-LS; FDC Dual
Pediatric
11 Stavudin + Lamivudin tablet FDC Triple Pediatric
+ Nevirapin
12 Tenofovir tablet 300 mg Viread, Tenofovir
(generik)
13 Zidovudin kapsul 100 mg, 200 mg Retrovir; Avirzid;
Reviral
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 ANTIMIGRAIN /
VERTIGO
7.1. ANTIMIGRAIN
1 Dihidroergotamin tablet 2,5 mg Dihydergot
mesilat
2 Ergotamin + Kafein tablet 1 mg + 100 mg Cafergot; Ericaf
3 Ergotamin + Belladona dragee 0,3 mg + 0,1 mg + 20 mg Bellaphen
alk + Fenobarbital
4 Flunarizin tablet 5 mg, 10 mg Sibelium; Silum;
Frego; Flunarizine
tablet 5 mg (generik)
5 Pizotifen tab 500 mcg Lysagor
6 Sinarizin tablet 25 mg Stugeron; Nariz;
Merron
7 Sumatriptan tablet 100 mg Imitrex; Triptagic
7.2. ANTIVERTIGO
1 Betahistin diHCl tablet 8 mg, 24 mg Betaserc
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Betahistin mesilat tablet 6 mg Merislon; Lexigo;
Versilon; Betahistine
mesilat tablet 6 mg
(generik)
8 ANTINEOPLASTIK,
IMUNOSUPRESAN
DAN OBAT UNTUK
TERAPI PALIATIF
8.1 Antihormon
1 Anastrozol tablet 1 mg Arimidex
2 Eksemestan tablet 25 mg Aromasin
3 Letrozol tablet 2,5 mg Femara
4 Leuprorelin asetat inj. 3,75 mg Lectrum; Tapros;
Endroline
5 Tamoksifen sitrat tablet 10 mg, 20 mg Tamofen; Tamoplex;
Tamoxifen Ebewe 20
8.2. Imunosupresan
1 Asam Mikofenolat tablet 180 mg, 360 mg Myfortic
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Azatioprin tablet 50 mg Imuran; Azathioprine
tablet 50 mg
(generik)
3 Morfetil Mikofenolat kaplet 500 mg Cellcept
4 Siklosporin kapsul; inj; kaps 25 mg, 50 mg, 100 Sandimun Neoral
larutan mg; inj 250 mg/5 ml; lar
100 mg/ml utk 50 ml
Takrolimus 0,5 mg, 1 mg Prograf
8.3 Antineoplastik
1 Asparaginase inj 10.000 IU/vial Leunase
2 5-Fluorourasil inj 250 mg/5 ml vial, 500 Curacil; Fluracedyl
mg/10 ml vial RTUS; 5-Fluorouracil
3 Bevasizumab inj 25 mg/ml vial 4 ml, 16 ml Avastin
4 Bikalutamid tablet 50 mg, 150 mg Casodex
5 Bleomisin inj 15 mg/amp Bleocin; Blenamax
6 Busulfan tab; inj tab 2 mg; inj 60 mg/vial Busulfex
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 Dakarbazin inj 200 mg, 600 mg Dacarbazin DBL;
Dacarbazin Medac
8 Daunorubisin Inj inj 20 mg/vial Daunocin
9 Doksorubisin inj 10 mg/5 ml vial, 50 Doxorubin RTUS;
mg/25 ml vial Doxorubicin Kalbe
10 Dosetaksel inj 20 mg/0,5 ml, 80 mg/2 Taxotere; Docetere;
ml Brexel
11 Epirubisin HCl inj 10 mg/5 ml, 50 mg/25 ml Farmorubicin;
Epirubicin Ebewe;
Epirubicin Kalbe
12 Erlotinib tablet 25 mg, 100 mg, 150 mg Tarceva
13 Etoposid inj 100 mg/5ml amp Etoposid Ebewe;
Posyd RTUS
14 Fludarabin inj 50 mg vial Fludara
15 Flutamid tablet 250 mg Fugerel; Flutapex
16 Gemsitabin inj 200 mg, 1 g Gemzar; Cytogem;
Gemtavis
17 Goserelin asetat inj 3,6 mg, 10,8 mg Zoladex
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
18 Hidroksi Urea kapsul 500 mg Hydrea; Cytodrox;
Hydroxyurea Medac
19 Ifosfamid inj 200 mg, 500mg, 1 g, 2g Holoxan
20 Imatinib kapsul 100 mg Glivec
21 Irinotekan inj 40 mg/2 ml, 100 mg/5 ml Campto
22 Kapesitabin tab salut film 500 mg Xeloda
23 Karboplatin inj 150 mg/15 ml, 450 Carboplatin Kalbe;
mg/45 ml Carbosin RTUS
24 Megestrol asetat tab; tab 40 mg; susp 40 mg/ Megace
suspensi ml 240 ml
25 Melfalan tablet 2 mg, 5 mg Alkeran
26 Merkaptopurin tablet 50 mg Merkapto
27 Metotreksat tab; inj. tab 2,5 mg; inj.5 mg/2 Emthexate RTUS;
ml, 50 mg/2 ml Methotrexate Ebewe
28 Mitomisin-C inj 2 mg, 10 mg Mitomycin-C-Kyowa
29 Oksaliplatin inj 50 mg, 100 mg Eloxatin; Oxaliplatin
Ebewe; Oxaliplatin
Medac
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
30 Paklitaksel inj 6 mg/ml, 30 mg/5 ml; Ebetaxel; Paxus
150 mg/25 ml; 100
mg/16,67 ml, 260
mg/43,33 ml
31 Rituksimab inj 100 mg/10 ml, 500 Mabthera
mg/50 ml
32 Setuksimab inj 2 mg/ml Erbitux
33 Sikofosfamid tab; inj tab 50 mg; inj 200 mg, Endoxan; Cyclovid;
500 mg, 1 g Cyclophosphamide
Kalbe
34 Sisplatin inj 10 mg/10 ml, 50 mg/50 Platosin RTUS;
ml, 10 mg/20 ml, 50 Cisplatin Ebewe
mg/100 ml
35 Sitarabin inj 100 mg/ml, 500 mg/10 Alexan; Cytarabine
ml, 1 g/ 10 ml DBL
36 Sorafenib tablet 200 mg Nexavar
37 Talidomid kapsul 50 mg, 100 mg, 150 mg, Thalomid
200 mg
38 Temozolamid kapsul 5 mg, 20 mg,100 mg, Temodal
250 mg
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
39 Tioguanin-6 tab 40 mg Tabloid
40 Trastuzumab inj 440 mg Herceptin
41 Vinblastin Sulfat inj 10 mg/10 ml VinBLAStine DBL;
VinBLAStine RTUS
42 Vinkristin Sulfat inj 1 mg/1 ml, 2 mg/2 ml VinCRIStine Kalbe;
VinCRIStine RTUS;
VinCRIStine DBL
43 Vinorelbin inj 10 mg/ml, 50 mg/5 ml Navelbine
9 ANTIPARKINSON /
DEMENTIA
9.1 ANTIPARKINSON
1 Bromokriptin tablet 2,5 mg Parlodel; Elkrip
2 Entakapon tablet 200 mg Comtan
3 Levodopa tablet 100 mg Levoben
4 L Dopa + Benserasid tablet 100 mg + 25 mg Madopar; Levazide
5 L Dopa + Benserasid + tablet 100 mg + 25 mg + 200 Stalevo
Entakapon mg
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
6 Pramipeksol tablet 0,125 mg, 0,25 mg Sifrol
7 Selegilin tablet 5 mg Jumex
8 Triheksifenidil HCl tablet 2 mg Artane; Arkine;
Hexymer;
Trihexyphenidyl
9.2 OBAT DEMENTIA
1 Donepezil tablet 5 mg Aricept; Aldomer;
Fordesia
2 Galantamin tablet 4 mg; 8 mg Reminyl
3 Rivastigmin kapsul; lar kaps 1,5 mg, 3 mg, 4,5 Exelon
oral; patch mg, 6 mg; lar oral 2 mg/
ml; patch 9 mg, 18 mg
10 OBAT YANG
MEMPENGARUHI
DARAH
10.1 ANTIANEMIA
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Asam Folat tab 1 mg, 5 mg Folic Acid tablet 1
mg; 5 mg (generik);
Anemolat; Megabion
2 Besi Sukrosa ( Iron tab 100 mg/5ml Venofer; Nefrofer;
Sucrose ) Rinofer
3 Besi (II) dlm bentuk tablet Tab 15 mg, 360 mg; Hemobion; Iberet
garam sulfat, fumarat) drops; kombinasi Folic-500, Sangobion;
Ferizz FM (tab 15
mg); Ferizz (drops);
Ferro sulfat (generik)
4 Kompleks Besi (III) tab kunyah 357 mg + 350 mcg Maltofer Fol
hidroksida polimaltose
(IPC) + Asam Folat
5 Sianokobalamin tab; inj tab 50 mcg,100 mcg; Cyanocobalamine
inj 500 mcg/ml, 1000
mcg/ml
10.2 OBAT YANG
MEMPENGARUHI
DARAH
1 Ateplase inj 50 mg/50 ml Actilyse
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Anti Thrombin III inj 50 IU/ml Kybernin P
3 Asetosal tablet 80 mg, 100 mg, 160 mg Aspilet chewable;
Ascardia; Miniaspi;
Cardio Aspirin (100
mg)
4 Dabigatran Eteksilat tab 75 mg, 110 mg Pradaxa Hanya untuk
thrombosis
vena pasca
bedah
5 Dipiridamol tablet 25 mg, 50 mg, 75 mg Persantin

6 Enoksaparin natrium inj 20 mg/0,2 ml, 40 mg/0,4 Lovenox
ml, 60 mg/0,6 ml
7 Fondaparinux natrium inj 2,5 mg/0,5 ml Arixtra
8 Heparin dialisat gel; salep gel 20 g; salep 15 g Thrombophob
9 Heparin natrium inj 25.000 IU/5ml Inviclot
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
10 Klopidogrel tablet 75 mg Plavix; Vaclo; Plavos;
Clopidogrel tablet 75
mg (generik)
11 Lumbricus kapsul 250 mg Plasmin
12 Nadroparin pre-filled PFS 0.3 ml, 0.4 ml, 0.6 Fraxiparen
syringe; ml; MDV 5 ml
multiple
dose vial
13 Parnaparin natrium inj syringe 0,3 ml, 0,4 ml, 0,6 ml Fluxum
14 Silostazol tablet 50 mg, 100 mg Pletaal; Citaz; Stazol;
Cilostazol 100 mg
(generik)
15 Streptokinase inj 1.500.000 IU Streptase
16 Tiklopidin tablet 250 mg Ticlid; Platidine
17 Tirofiban HCl infus 250 mcg/ml Aggrastat
18 Urokinase inj 500.000 IU Urokinase GCC
19 Warfarin natrium tablet 2 mg Simarc 2
10.3 Hemostatik
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Asam Traneksamat kapsul; tab; kaps 250 mg; tab 500 Transamin; Kalnex;
inj mg; inj 250 mg/ 5ml Tranexid; Asam
amp, 500 mg/ 5ml amp Traneksamat tablet
500 mg; inj. 250 mg;
500 mg (generik)
2 Etamsilat tab; inj tab 500 mg; inj 250 Dicynone
mg/2 ml
3 Fibrinogen + inj 1 ml Beriplast P Combi
Koagulase Faktor
4 Karbazokrom tab; inj tab 10 mg, 30 mg; inj 10 Adona (AC-17);
mg/2ml, 25 mg/5 ml, 50 Crome
mg/10 ml
5 Oktreotid inj 0,1 mg/ml Sandostatin
6 Somatostatin inj 250 mcg, 3.000 mcg Somatostatin-UCB;
Stilamin; Somanovell
7 Vitamin K1 tab; inj tab 10 mg; inj 2 mg/ml Kavita; Neo-K;
Phytomenadione
(generik)
10.4 Hematopoetik
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Eritropoietin alfa pre-filled 2.000 IU/0,5 ml, 4.000 Eprex, Epotrex
syringe IU/0,4 ml, 10.000 IU/ml
2 Eritropoietin beta inj 2.000 IU, 5.000 IU, Recormon Hanya utk
10.000 IU, 30.000 IU indikasi
resque
terapi dgn
keganasan
3 Rekombinan Human inj 500 IU, 2.000 IU, 3.000 rHuEPO; Hemapo
Eritropoetin IU, 4.000 IU, 10.000 IU
4 Filgrastim (GCSF) inj 30 MU/ml, 300 mcg/1,2 Neupogen; Leukokine;
ml, 300 mcg/ml Leucogen
5 Lenograstim inj 33,6 MIU atau 263 Granocyte 34
mcg/ml
11 PRODUK DARAH
DAN PENGGANTI
PLASMA
11.1 FRAKSI PLASMA
UNTUK PEMAKAIAN
KHUSUS
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Albumin (Human inj 20% 50 ml, 20% 100 ml, Albumin Behring;
Albumin) 25% 20 ml, 25% 50 ml, Octalbin; Plasbumin
25% 100 ml
2 Rekombinan Faktor Inj. 1,2 mg setara 50.000 NovoSeven
VIIa unit
3 Faktor pembekuan inj 250 IU-340 IU, 500 IU- Koate-DVI; Kogenate
darah VIII (konsentrat) 560 IU 5 ml / botol dosis FS
tunggal
4 Faktor pembekuan inj 500 IU/vial, 100 IU/vial Cofact; Nonafact
darah II, VII, IX, X
(konsentrat)
11.2 PENGGANTI PLASMA
1 Dekstran 40 infus 10% dlm NaCl Otsutran L
2 Dekstran 70 infus 6% HM Dextran - NS
3 Fraksi Protein Plasma infus kadar protein 5% Plasmanate infusion
(termasuk Fibrinogen)
4 Hidroksietil pati 6% infus 6%, 10% Voluven; Widahes;
(HES) Tetraspan
5 Poligelin infus 3,5% dlm 500 ml, 4% Haemaccel; Gelofusin
dlm 500 ml
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
12 DIAGNOSTIK
12.1 OBAT KONTRAS
1 Barium enema tablet 5 mg Barium enema
2 Barium sulfat suspensi 998% w/w nett 340 g, Liquid Polybar Plus
105% w/v nett 1900 ml
3 EZ Gas II EZ Gas II
4 Gadodiamida larutan Omniscan; Magnevist;
Dotarem; Primovist;
Gadovist
5 Gadobenat dimeglumin inj. 529 mg/ml,10 ml Multihance
6 Iodine larutan 320 mg/ml dalam vial Omnipaque; Iopamiro;
100 ml Ultravist; Optiray 320;
Visipaque
7 Natrium/ Meglumin inj 76% Urografin
amidotrizoat
13 ANTISEPTIK DAN
DESINFEKTAN
13.1 ANTISEPTIK
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Alkohol cairan; swab 70% Alcohol Produksi
RSCM
2 Etakridin Laktat larutan 0,1% Rivanol Produksi
(Rivanol) RSCM
3 Ferakrilum larutan 1% Hemolok
4 Hidrogen Peroksida cairan 3% H2O2 Produksi
RSCM
5 Iodin Povidon larutan; 10% Betadine; Extradine;
salep Braunol (7,5%)
6 Kalium Permanganat larutan; 0,1%; 0,2%; 1%; 2% Kalium Permanganate
serbuk (sediaan segar); serbuk Produksi RSCM
1:5.000, 1: 10.000
7 Kantaridin tingtur 0,7% Canthacur
8 Polikresulen larutan lar kons 360 mg/g 10 ml, Albothyl
konsentrat; 100 ml; gel 50 g; ovula
gel; ovula 90 mg
13.2 DESINFEKTAN
1 Amonium kuarterner larutan Stericide; Soapy
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Deterjen enzimatik larutan Helyzime; Stabimed;
Steryzime
3 Formalin larutan 10% Formalin Produksi
RSCM
4 Glutaraldehid larutan 2,45% Cidex
5 Klorheksidin 7,5% + larutan Savlon; Hibicet HC;
Setrimid 1,5% First Aid
6 Klorheksidin diglukonat larutan 4%, 5% Handscrub: Hibiscrub;
Cutisoft; Microshield;
Handrub: Microshield:
Viorex
7 Lisol cairan 50% Lisol
8 Orto-ftalaldehid cairan 0,55% Cidex-OPA
9 Sublimat cairan 3% Sublimat Produksi
RSCM
14 OBAT UNTUK GIGI
DAN MULUT
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
14.1 OBAT TOPIKAL
UNTUK GIGI DAN
MULUT
1 Benzidamin HCl larutan 7,5 mg/5 ml Tantum Verde Oral
Rinse
2 Boraks Gliserin cairan Borax Glycerin
Produksi RSCM
3 Gargarisma Khan larutan Gargarisma Khan
Produksi RSCM
4 Iodin Povidon larutan; 1% Betadine
salep; obat
kumur
5 Klorheksidin diglukonat larutan Minosep Gargle; Kin
(gel)
6 Maltodextrin, aqua, gargle; gel gargle 60 mL; gel 8 ml Aloclair
propilen glikol, dll
15 DIURETIK
1 Amilorid HCl + tablet 2.5 mg + 25 mg, 5 mg Lorinid-Mite
Hidroklortiazid + 50 mg
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Furosemid tab; inj tab 40 mg; inj 20 mg/2 Lasix; Furosix; Farsix;
ml Furosemide tablet
40 mg; inj. (generik)
3 Gliserol larutan 10% Glycerin
4 Hidroklorotiazid tablet 25 mg, 50 mg Hydrochlorothizide
(generik)
5 Indapamid tablet Natrilix SR
6 Klortalidon tablet 50 mg Hygroton; Thalidone-
50
7 Manitol Inj 20% Manitol; Infusan-M20
8 Spironolakton tablet 25 mg, 100 mg Aldactone; Spirola;
Spironolactone
tablet 25 mg; 100 mg
(generik)
9 Spironolakton + tablet 25 mg + 2.5 mg Aldazide
Tiabutazide
16 HORMON,
ENDOKRIN LAIN
DAN KONTRASEPSI
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
16.1 ANTIDIABETIK
16.1.1 Antidiabetik oral
1 Akarbose tablet 50 mg, 100 mg Glucobay; Eclid
2 Glibenklamid tablet 5 mg Daonil;
Glibenclamide 5 mg
(generik)
3 Gliklazid tablet 30 mg, 80 mg Diamicron MR;
Glucodex
4 Glikuidon tablet 30 mg Glurenorm; Lodem
5 Glimepirid tablet 1 mg, 2 mg, 3 mg, 4 mg Amaryl; Gluvas,
Metrix; Glimepiride
1 mg; 2 mg; 3 mg; 4
mg (generik)
6 Glipizid tablet 5 mg, 10 mg Minidiab; Glucotrol XL
7 Metformin HCl tablet 500 mg, 850 mg Glucophage; Glumin;
Gliformin; Metformin
500 mg; 850 mg
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
8 Metformin HCl + tablet 250 mg + 1,25 mg, 500 Glucovance
Glibenklamid mg + 2,5 mg, 500 mg
+ 5 mg
9 Natelglinid tablet 120 mg Starlix
10 Pioglitazon tablet 15 mg, 30 mg Actos; Deculin; Pionix
11 Repaglinid tablet 0,5 mg, 1 mg, 2 mg Novonorm; Dexanorm
12 Sitagliptin tablet 25 mg, 50 mg, 100 mg Januvia
13 Vildagliptin tablet 50 mg Galvus
16.1.2 Antidiabetik parenteral
1 Insulin Analog Aspart inj 100 IU/ml 3 cc Novorapid flexpen
2 Insulin Analog Campur inj 100 IU/ml 3 cc Novomix flexpen
(Aspart + NPH)
3 Insulin Analog Campur inj 100 IU/ml 3 cc Humalog Mix 25
(Lispro + NPH)
4 Insulin Analog Detemir inj 100 IU/ml 3 cc Levemir flexpen
5 Insulin Analog Glargine inj; penfill inj 100 IU/ml 10 ml; Lantus
penfill 100 IU/ml 3 ml
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
6 Insulin Analog Glulisin inj vial 100 IU/ml 10 ml Apidra
7 Insulin Analog Lispro inj 100 IU/ml 3 cc Humalog
8 Insulin Campur (Insulin inj; penfill inj 100 IU/ml 10 ml; Mixtard 30 HM/
Regular + NPH) penfill 100 IU/ml 3 ml Mixtard HM Penfill;
Mixtard Novolet
9 Insulin Kerja inj; penfill inj 100 IU/ml 10 ml; Insulatard HM/
Menengah (NPH) penfill 100 IU/ml 3 ml Insulatard HM Penfill;
Humulin N; Insulatard
Novolet
10 Insulin Regular inj; penfill inj 100 IU/ml 10 ml; Actrapid HM/Actrapid
penfill 100 IU/ml 3 ml HM Penfill; Humulin
R; Actrapid Novolet
16.2 HORMON KELAMIN
DAN OBAT YANG
MEMPENGARUHI
FERTILITAS
16.2.1 GnRH Analog, FSH/LH
1 Setrorelix inj 0,25 mg Cetrotide
2 Ganirelix inj 500 mcg/ml Orgalutran
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Goserelin asetat inj 3,6 mg, 10,8 mg dlm Zoladex
single dose syringe
4 Ovidrel HCG inj 250 mcg Ovidrel DKSH
5 Rekombinan FSH inj; pen inj 75 IU, 1050 IU/1,75 Gonal F
ml; pen 300 IU, 450 IU,
900 I
6 Testosteron kap; inj kap 40 mg; inj 250 mg Andriol (kapsul);
/amp Sustanon 250 (inj);
Nebido (inj)
16.2.2 Estrogen
1 Estradiol tab salut tab salut film 1 mg, 2 mg; Ovestin; Progynova
film; krim krim 15 g
2 Estradiol hemihidrat gel 0,1% 100 g Estreva
3 Estradiol valerat tablet 2 mg Cyclo-Progynova
4 Etinilestradiol tablet 50 mcg Lynoral
5 Estradiol + tablet 1 mg + 2 mg Angeliq
Drospirenon
16.2.3 Progestogen
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Didrogesteron tablet 10 mg Duphaston
2 Medroksiprogesteron tablet 5 mg Prothyra
3 Noretisteron tablet 5 mg Primolut-N; Norelut
4 Nomegestrol asetat kaplet 5 mg Lutenyl
5 Progesteron pessari 200 mg, 400 mg Cygest
6 Siproteron asetat + tablet 50 mg, 2 mg + 0,035 mg Androcur; Diane 35
etinilestradiol
16.2.4 Kontraseptik
1 Desogestrel tablet 75 mcg Cerazette
2 Kombinasi Drospirenon tablet 3 mg + 0,03 mg, 3 mg + Yasmin; Yaz
+ Etinilestradiol 0,02 mg
3 Levonorgestrel + tablet 150 mcg + 30 mcg Microgynon
Etinilestradiol
4 Levonorgestrel tablet 30 mcg Mirena; Microlut
5 Medroksi Progesteron tab; inj. tab 10 mg, 500 mg; inj Triclofem; Veraplex
asetat depot 150 mg/ml (tab 500 mg)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
6 Medroksi Progesteron inj. depot 0,5 ml Cyclofem
asetat + Estradiol
sipinoat
16.2.5 Induktor ovulasi
1 HCG inj 1500 IU, 5000 IU Pregnyl
2 Follitropin inj 50 IU, 100 IU Puregon
3 Klomifen sitrat tablet 50 mg Clomifen; Provula;
Profertil
4 Lutropin inj 75 IU Luveris
(Rekombinan LH)
16.3 HORMON TIROID
DAN ANTITIROID
1 Karbimazol tablet 5 mg Neo-Mercazol
2 Lugol cairan 30 ml Larutan Lugol
Produksi RSCM
3 Methimazol tablet 5 mg, 10 mg Thyrozol
4 Propiltiourasil tablet 50 mg; 100 mg Propylthiouracil
tablet 100 mg
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
5 L-Tiroksin natrium tablet 0,1 mg Thyrax, Euthyrox;
Levothyroxine tablet
(generik)
16.4 KORTIKOSTEROID
DAN
KORTIKOTROPIN
1 Budesonid kapsul 3 mg Budenofalk
2 Betametason + tab; sirup 60 ml Colergis
desklofeniramin maleat
3 Deksametason tab; inj tab 0,5 mg; inj 4 mg/ Oradexon,
ampul, 5 mg/amp, 20 Kalmethason;
mg/vial Lanadexon;
Dexamethasone
tablet 0,5 mg; 4 mg;
inj. (generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
4 Metil Prednisolon tab; inj 4 mg, 8 mg, 16 mg; inj Tablet: Medrol;
asetat 125 mg/ 2ml, 500 mg/8 Medixon; Thimelon;
ml Methylprednisolone
tablet 4 mg; 8 mg;
16 mg (generik).
Injeksi: Solumedrol;
Depo Medrol
Medixon; Thimelon;
Methylprednisolone
inj. 125 mg (generik)
5 Prednison tablet 5 mg Pehacort; Prednison
6 Triamsinolon asetonid tab; inj; tab 4 mg; inj IA/ID 10 Triamcort (tab);
salep mg/ml vial 5 ml, IM 40 Flamicort Inj;
mg/ml vial 1 ml; salep Flamicort (inj IA/
0,1% 5 g IB/ID/IM); Kenalog
in orabase (salep);
Ketricin (tab, salep)
16.5 HORMON LAIN
1 Bromokriptin tablet 2,5 mg Parlodel; Elkrip
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
16.6 OBAT ANTI OBESITAS
1 Orlistat kapsul 120 mg Xenical
16.7 OBAT METABOLISME
TULANG DAN OTOT
1 Alendronat tablet 10 mg Nichospor; Alovell
2 Alfakalsidol tablet 0,25 mcg, 0,5 mcg, 1 Bone-One
mcg
3 Ibandronat (asam) inj; tab inj: 6 mg ; tab 150 mg Bondronat (inj);
Bonviva (tab)
4 Kalsitonin inj 50 IU/ml, 100 IU/ml Miacalcic
5 Klodronat dinatrium kapsul; tab; kaps 400 mg; tab 800 Bonefos
infus mg; inf 60 mg/ml
6 Risedronat tablet 5 mg, 35 mg Actonel; Osteonate
OD; Retonel
7 Stronsium ranelat granul 2g Protos
8 Zolendronat inj 5 mg/5 ml Zometa; Aclasta
17 OBAT
KARDIOVASKULER
17.1 ANTIANGINA
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Atenolol tablet 50 mg, 100 mg Tenormin; Betablok;
Tenblok
2 Bisoprolol tablet 2,5 mg, 5 mg Concor; Maintate,
Hapsen; Bisoprolol
tablet 2,5 mg; 5 mg
(generik)
3 Diltiazem tab; inj tab 30 mg, 60 mg; inj Herbesser; Cordila;
50 mg Diltiazem tablet 30
mg (generik)
4 Isosorbid dinitrat tab; tab SL; 5 mg, 10 mg, 20 mg; inj Cedocard; Farsorbid;
tab SR; inj 10 mg/10 ml Isosorbide Dinitrate
5 Isosorbid mononitrat tab; tab SR 20 mg, 60 mg (SR) Imdur; Monecto-20;
Cardismo
6 Metoprolol tartrat tab 50 mg; 100 mg Seloken; Lopresor;
Cardiosel
7 Nitrogliserin inj; tablet 10 mg/10 ml Nitrocine;
Glyceryltrinitrat DBL
(inj); Nitrokaf retard
(tablet)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
17.2 ANTIDISRITMIA
1 Adenosin inj 3 mg/ml vial 2 ml Adenocor
2 Amiodaron tab; inj tab 200 mg; inj 150 Cordaron; Tiaryt;
mg/3ml Kendaron
3 Diltiazem tab; inj tab 30 mg, 60 mg; inj Herbesser
50 mg
4 Esmolol inj vial 10 mg/ml Esmolol; Breviblac
5 Disopiramid kapsul 100 mg Norpace; Rythmodan
6 Lidokain HCl inj 2% Xylocard; Scandonest;
Lidokain inj
(generik)
7 Propafenon HCl tablet 150 mg Rytmonorm
8 Propanolol HCl tab salut 10 mg, 40 mg Farmadral;
selaput Propanolol HCl
tablet 10 mg; 40 mg
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
9 Verapamil tab; inj tab 80 mg, 240 mg; inj Isoptin; Cardiover;
2.5 mg/ml Corpamil; Verapamil
tablet 80 mg; inj.
(generik)
17.3 ANTIHIPERTENSI
17.3.1 Golongan ACE
Inhibitor
1 Enalapril tablet 5 mg Renacardon; Tenace
2 Imidapril tablet 5 mg; 10 mg Tanapress
3 Kaptopril tablet 12,5 mg, 25 mg Acepress; Captopril
tablet 12,5 mg; 25
mg (generik)
4 Kaptopril + HCT tablet 25 mg + 12,5 mg Capozide
5 Lisinopril tablet 5 mg, 10 mg, 20 mg Zestril; Noperten
6 Perindopril tablet 4 mg Prexum
7 Ramipril tablet 2,5 mg, 5 mg, 10 mg Triatec; Hyperil;
Ramixal
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
17.3.2 Golongan Beta Blocker
1 Atenolol tablet 50 mg; 100 mg Tenormin; Betablok;
Tenblok
2 Bisoprolol tablet 2,5 mg, 5 mg Concor; Maintate;
Hapsen; Bisoprolol
3 Bisoprolol + HCT tablet 2.5 mg, 5mg Lodoz
4 Karvedilol tablet 6,25 mg, 25 mg Dilbloc, V-bloc
5 Labetalol tab; inj tab 50 mg; inj 100 mg Trandete
6 Metoprolol tartrat tablet 50 mg; 100 mg Seloken; Lopresor;
Cardiosel
7 Propranolol HCl tablet 10 mg; 40 mg Blocard; Farmadral;
Propanolol HCl
tablet 10 mg; 40 mg
(generik)
17.3.3 Golongan Calcium
Channel Blocker
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Amlodipin besilat tablet 5 mg; 10 mg Norvask; Lovask;
Amlogrix; Amlodipine
tablet 5 mg; 10 mg
(generik)
2 Amlodipin + tablet 5 mg + 10 mg, 10 mg + Caduet
Atorvastatin 10 mg, 5 mg + 20 mg, 10
mg + 20 mg
3 Diltiazem tab; kapsul; tab 30 mg, 60 mg; kaps Herbesser; Carditen;
inj 90 mg, 100 mg, 180 mg, Diltiazem (generik)
200 mg; inj 50 mg
4 Felodipin tablet 5 mg Plendil; Nirmadil
6 Nifedipin tablet 5 mg, 10 mg, 20 mg Adalat/ Adalat oros;
(oros/retard), 30 mg Farmalat; Coronipin;
(oros), 60 mg (oros) Nifedipine tablet 10
mg (generik)
7 Nikardipin inj; tab; kap inj 2 mg/2 ml, 10 mg/10 Perdipine (inj); Loxen
ml; tab 20 mg; kap 40 (tablet; kapsul); Blistra
mg
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
8 Nimodipin tab salut tab 30 mg; lar infus 10 Nimotop; Ceremax
selaput; lar mg/50 ml
infus
17.3.4 Golongan Alpha
Blocker
1 Doksazosin tablet 1 mg, 2 mg Cardura; Kaltensif
2 Terazosin HCl tablet 1 mg, 2 mg Hytrin
17.3.5 Golongan Angiotensin
II Antagonist
1 Irbesartan tablet 150 mg, 300 mg Aprovel; Irvask;
Irbedox; Irbesartan
(generik)
2 Irbesartan + HCT tablet 300 mg + 12,5 mg Coaprovel; Irtan Plus;
Co-Irverbal
3 Kandesartan tablet 8 mg, 16 mg Blopress
4 Kandesartan + HCT tablet 16 mg + 12,5 mg Blopress plus
5 Losartan tablet 50 mg Cozaar; Angioten
6 Telmisartan tablet 40 mg, 80 mg Micardis
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 Valsartan tab salut 80 mg, 160 mg Diovan; Valsartan tab
selaput 80 mg (generik)
17.3.6 Golongan Lain-lain
1 Klonidin HCl tab; inj tab 0,075 mg, 0,15 mg; Catapres; Clonidine
inj 0,15 mg/ml HCl tablet 0,15 mg
(generik)
2 Metildopa anhidrat tab salut 250 mg Dopamet
selaput
17.5 GLIKOSIDA JANTUNG
1 Digoksin tab; inj tab 0,25 mg; inj 0.25mg/ Lanoxin; Fargoxin
ml (inj.); Digoxin tablet
0,25 mg (generik)
17.6 OBAT UNTUK SYOK
17.6.1 Inotropik
1 Dobutamin inj 250 mg/20 ml, 250 mg/ Dobutamine Giulini;
vial 5 ml Inotrop; Dobuject
2 Dopamin HCl inj 10 mg/ml; 40 mg/ml Dopamin Giulini;
Indop
3 Milrinone inj Coritrope, Inovad
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
17.6.2. Vasokonstriktor
1 Deksametason natrium inj. tab 0,5 mg; inj 4 mg/ Oradexon;
fosfat ampul, 5 mg/amp, 20 Kalmethason
mg/vial
2 Efedrin HCl tab; inj tab 25 mg; inj 50 mg/ml Ephedrine HCl inj.
50 mg/ml (generik)
3 Epinefrin HCl inj. 1 mg/ml Phinev; Ephinephrine
inj (generik)
4 Fenilefrin HCl inj. 10 mg/ml Phenylephrine HCl
inj (generik)
5 Isoprenalin HCl inj. 0,2 mg/ml Isuprel; Isoprenalin inj
6 Norepinefrin bitartrat inj. 4 mg/ 4 ml Levophed; Vascon;
Raivas
17.7 PENURUN
KOLESTEROL
1 Atorvastatin tab salut 10 mg, 20 mg, 40 mg Lipitor; Stator; Atorsan
selaput
2 Fenofibrat kapsul 100 mg, 200 mg, 300 mg Lipanthyl; Trolip;
Zumafib Micro
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Gemfibrozil kapsul 300 mg, 450 mg, 600 Lopid; Scantipid;
mg, 900 mg Gemfibrozil tablet
300 mg (generik)
4 Pravastatin tablet 10 mg, 20 mg Cholespar; Gravastin
5 Rosuvastatin tablet 10 mg, 20 mg Crestor
6 Simvastatin tablet 10 mg, 20 mg Zocor, Cholestat;
Mersivas;
Simvastatin tablet 10
mg; 20 mg (generik)
17.8 VASODILATOR
1 Flunarizin tablet 5 mg, 10 mg Sibelium; Flunarizin
tab 5 mg (generik)
2 Iloprost lar inhalasi 2 ml Ventavis
3 Naftidrofuril oksalat tablet 100 mg, 200 mg Praxilene; Vascuprax
4 Pentoksifilin tab; inj tab 400 mg; inj 100 mg/5 Trental; Reotal;
ml, 300 mg/15 ml Pentoxifylline
5 Sildenafil sitrat tablet 50 mg, 100 mg Viagra; Emposil
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
6 Sitikolin tab; inj tab 500 mg, 1000 mg; inj Nicholin; Brainact;
250 mg/2 ml, 500 mg/4 Takelin; Citicholine
ml, 1 g/8 ml inj 250 mg (generik)
7 Tadalafil tablet 10 mg, 20 mg Cialis
8 Vardenafil tablet 5 mg, 10 mg, 20 mg Levitra
17.9 LAIN-LAIN
1 Ginko Biloba tablet 40 mg, 80 mg Tebokan; Tanakan
2 Magnesium klorida inj amp 20 ml Cardioplegia DBL
+ Kalium klorida +
Prokain HCl
3 Pirasetam kaplet; sirup; kaplet 400 mg, 800 mg, Nootropil; Neurotam;
inj 1200 mg; sirup 10%; inj Mersitropil; Piracetam
1 g/ 5 ml, 3 g/ 5 ml, 12 tablet 400 mg; 800
g/ 60 ml mg; 1200 mg; inj. 1
g; 3 g; 12 g (generik)
4 Prostaglandin E1 inj 500 mcg/ml Prostin VR Pediatric
18 OBAT TOPIKAL
UNTUK KULIT
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
18.1 ANTIAKNE
1 Adapalen gel 0,1% Evalen
2 Asam Azeleat krim 20% Zelface
3 Belerang sabun 5% x 100 g, 10% x 100 g GF Sulfur
batang
4 Benzoil Peroksid gel 2,5%, 5% Benzolac
5 Isotretinoin kapsul; kapsul 10 mg, 20 mg Roaccutane
tablet
6 Lotio Kummerfeldi lotion - Lotio Kummerfeldi
RSCM
7 Sulphonated sabun - Acne Aid Bar
Surfactant Blend batang
8 Tretinoin larutan; gel; Lar 0,05%; gel 0,025%; Vitacid; Retin A;
krim krim 0,025%, 0,05%, Reticor
0,1%
9 Triklosan emulsi 2% Phisohex
18.2 ANTIBAKTERI
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Eritromisin krim; gel; 2% Erymed
larutan
2 Framisetin sulfat kasa steril 1% Sofratulle; Daryantulle
3 Fusidat krim (asam); 2% Foban; Fucidin;
salep Futaderm
(Natrium)
4 Fusidat (asam) + krim 2% + 0,1% Fucicort
Betametason valerat
5 Klindamisin gel; larutan gel 1%, 1,2%; lar 1,2% Comdacin; Mediklin;
Clinium
6 Kloramfenikol salep; gauze 2% Kemicetine;
Chloramphenicol
salep (generik);
Chloramphenicol
Produksi RSCM
7 Kloramfenikol + krim Chloramphecort
Hidrokortison asetat
8 Mupirosin krim; salep 2% Bactroban; Bactoderm
9 Nadifloksasin krim 10 g Acuatim
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
10 Perak Sulfadiazin krim 1% Dermazin; Burnazin
18.3 ANTIFUNGI
1 Ketokonazol gel; krim; 2% Nizoral; Interzol;
shampoo Ketomed;
Ketoconazole cream
2 % (generik)
2 Klotrimazol krim; larutan 1% Canesten; Candazole
3 Ketokonazol + Tar shampoo Fungitar shampoo
4 Mikonazol Nitrat krim; bubuk 2% Daktarin; Mycorine;
Miconazole cream 2
% (generik)
5 Mikonazol Nitrat + krim 2% + 1% Brentan
Hidrokortison
6 Mikonazol Nitrat + salep 2% + 150 mg Daktarin Diaper
Seng Oksida
7 Nisatin + Seng Oksida salep 100.000 IU + 200 mcg Myco Z
8 Selenium sulfida shampoo 1,8% Selsun
9 Terbinafin krim 1% Lamisil; Termicil
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
10 Tiokonazol krim Trosyd
18.4 ANTIVIRUS
1 Asiklovir krim 5% Zovirax; Clinovir;
Danovir; Acyclovir
cream (generik)
18.5 ANTIINFLAMASI DAN
ANTIPRURITIK
1 Betametason krim; salep krim 0,05%; salep 0,05% Beprosone; Diprosone
dipropionat OV
2 Betametason valerat krim 0,1% Benoson;
Betamethasone
cream 0,1% (generik)
3 Boorschudmixture bedak kocok Boorschudmixture
Produksi RSCM
4 Desoksimetason krim; salep 2,5 mg Esperson; Inerson
5 Desonid krim; salep; 0,05% Apolar; Dermades;
lotio Desolex
6 Diflukortolon valerat krim; salep 0,1% Nerisona; Nerisona
FO
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 Doksepin krim 5% Sagalon
8 Flusinolon asetonid krim; salep 0,025% Dermasolon; Cinolon
9 Flutikason propionat krim 0,05% Medicort
10 Hidrokortison asetat krim 1%; 2,5% Hydrocortisone
cream (generik)
11 Hidrokortison butirat krim; krim 1.00% Locoid
lemak; scalp
lotion
12 Kalamin krim; lotio; krim 10%; lotio 15%; Caladine; Calamed
bedak bedak 10%
13 Klobetasol propionat krim; salep 0,05% Dermovate; Kloderma;
Lotasbat
14 Metil Prednisolon krim; salep 0,1% Advantan; Advantan
aseponat FO
15 Mometason furoat krim; salep; 0,1% Mofacort; Dermovel;
lotio Elocon
16 Prednikarbat krim 2,5 mg/g Dermatop
17 Triamsinolon asetonid krim 0,1% Kenacort-A
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
18.6 ANTISKABIES
1 Asam Salisilat + salep 2% + 4% Salep 2-4 Produksi
Belerang endap RSCM
2 Lindane + Asam Usnat krim 1% Scabicid
3 Permetrin krim 5% Scabimite
18.7 LAIN-LAIN
1 5-Fluorourasil krim Efudix
2 AHA + PHA sabun sabun Glikoderm PHA &
AHA
3 Alium cefa extract gel 10% Mederma; Cicacare
4 Amfibilik basa krim krim 20 g Biocream
hipoalergenik
5 Asam Alfa Hidroksi krim; lotion 8%, 10%, 15% Neostrata; Glycore
6 Asam Alfa Hidroksi larutan 20%, 35%, 50%, 75% Neostrata
peel
7 Asam Salisilat larutan; larutan 1%; salep 2%, Asam Salisilat
salep 5%, 20%, 40%
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
8 Bedak Salisilat serbuk 2% Decyline
9 Cairan pembersih botol Optimal Pre-Peel
peeling Cleanser
10 Centella asiatica + krim Centella asiatica 1% + Lanakeloid-E
vit E vit E 0,2%
11 Dimetikon + vinil gel 15 g Dermatix
dimetikon
12 Eco honey + gliserin + gel 20 g Sanoskin Melladerm
propilen glikol + PEG Plus
4000
13 Ekstrak bebas protein Jelly 10 g Solcoseryl
darah terhemolisa dari
lembu muda
14 Etilheksil- krim; lotion SPF 30, 33, 40 Krim SPF 33; Lotion
metoksisinamat + parasol SPF 30,
Titanium dioksida + Miscol SPF 41
oksibenzon
15 Hidrokuinon krim 4%, 5% Melanox Forte;
Mediquin
16 Karbamida krim 40 mg
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
17 Lanolin anhidrous salep 20 g; 40 g Decubal
18 Metoksalen tinctura 1% Delsoralen
19 Minoksidil larutan 2%, 4% Regrou
20 Minyak Arachis krim 21% Oilatum krim
21 Minyak Bergamot tinctura Oleum Bergamot
22 Minyak Ikan salep 10% Minyak Ikan
23 Minyak Mineral sabun Oilatum Bar
batang
24 Minyak Zaitun + lanolin sabun Oilum soap
+ kolagen batang
25 Natrium kokoil isetionat larutan 1,5% Physiogel liquid 150
cc
26 Neutralizer AHA peel larutan Neostrata
27 Perak Nitrat cairan 20% Argenti Nitrat Produksi
RSCM
28 Pimekrolimus krim 1% Elidel
29 Post peel cream krim Neostrata
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
30 Radix scutellariae + salep 20 g MEBO hanya utk
Phellodendri cortex + kasus luka
Rhizoma coptidis bakar grade
2 dan 3
31 Sabun sabun Oilatum bar
batang
32 Takrolimus salep 0,03%, 0,1% Protopic
33 Urea krim 10%, 20% Carmed
34 Vaselin salep Vaselin Produksi
RSCM
35 Cryptomphalus krim 40 mg/50 ml Radiocare
aspersa secretion
19 LARUTAN DIALISIS
1 Larutan Hemodialisa larutan Renalin 100
2 Cairan Dianeal larutan 25%, 2,5%, 1,5% Cairan Dianeal
20 LARUTAN
ELEKTROLIT,
NUTRISI, DLL
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
20.1 ORAL
1 Asam Amino + Vitamin serbuk sachet @ 53 g, @ 25 g Nutrocid (sachet @ 53
+ Mineral g); Falkamin
2 Kalium klorida tablet siap tab siap larut 600 mg, KSR; KCl puyer
larut; puyer puyer 500 mg (Generik)
3 Oralit serbuk 100 g/sachet Renalyte; Dehidralyte;
Oralit (Generik)
4 Lemak,protein,karbo larutan 500 ml Fresubin
hidrat
20.2 PARENTERAL
1 Aqua pro injeksi larutan 25 ml; 500 ml; 1000 ml WFI Otsuka; WIDA WI
(1000 ml)
2 Asam amino infus berbagai komposisi Aminosteril 5%, 10%;
Aminosteril 8% N
Hepa; Aminosteril
infant 6%, Pan Amin
G; Kidmin; Kalbamin;
Primene 10%;
Aminoplasmal 5%E,
10%E
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Asam amino + infus Nutrisol DBL
Karbohidrat
4 Asam amino + vitamin infus Aminofusin L 600;
+ elektrolit Aminofusin Paed
5 Asam amino 50 g infus Aminovel 600;
+ sorbitol 100 g + Nutrisol-S
elektrolit + vitamin
6 Asam amino bebas infus 250 ml; 500 ml Amiparen
100 g + nitrogen 15,7
g + Na 2 mek + asetat
120 mek
7 Asam amino rantai infus Aminoleban;
cabang (BCAA) infus Aminofusin Hepar;
Comafusin Hepar
8 Glukosa infus 5%, 10%, 40% Otsuka; Widatra;
B.Braun
9 Kalium klorida inj 25 meq/vial Kalium Chloride
10 Kalsium glukonat inj 10% Calcii Gluconas
11 L-alanin + L-glutamin infus 50 ml, 100 ml Dipeptiven; Glutiven
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
12 Larutan elektrolit infus 500 ml Tutofusin OPS
13 Larutan kombinasi infus 250 ml Eas Pfrimmer
(dlm 1 liter): asam
amino esensial,histidin
14 Larutan kombinasi infus 500 ml Triofusin 500
(dlm 1 liter):fruktosa 60
g,glukosa 33 g, xylitol
30 g
15 Larutan kombinasi infus 500 ml Triofusin E 1000
(dlm 1 liter): Fruktosa
120 g, glukosa 66 g,
xylitol 60 g, elektrolit,
vitamin
16 Larutan kombinasi infus 500 ml Triofusin 1600
(dlm 1 liter): Fruktosa
200 g, glukosa 110 g,
xylitol 100 g
17 Larutan kombinasi infus 500 ml KA-EN 1B
(dlm 1 liter): Natrium
38,5 mek, Cl 38,5 mek,
glukosa 37,5 g
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
18 Larutan kombinasi infus 500 ml KA-EN Mg3; Tridex
(dlm 1 liter): Natrium 100
50 mek, K 20 mek, Cl
50 mek, laktat 20 mek,
glukosa 100 g
19 Larutan kombinasi infus 500 ml KA-EN 3B; Tridex 27B
glukosa 27 g
20 Larutan kombinasi infus 500 ml KA-EN 3A
glukosa 27 g
21 Larutan kombinasi: infus 500 ml OTSU D10-0,18 NS
Glukosa 10% &
Natrium klorida 0,9%=
4:1 (N5)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
22 Larutan kombinasi: infus 500 ml OTSU D2,5-1/2 NS
Glukosa 2,5% &
Natrium klorida 0,45%
23 Larutan kombinasi: infus 500 ml OTSU D5-1/4 NS;
Glukosa 5% & Natrium WIDA D5-1/4NS
klorida 0,225%
24 Larutan kombinasi: infus 500 ml OTSU D5-1/2 NS;
Glukosa 5% & Natrium WIDA D5-1/2NS
klorida 0,45%
25 Larutan kombinasi: infus 500 ml OTSU D5 NS; WIDA
Glukosa 5% & Natrium D5-NS
klorida 0,9% = 4:1(N4)
26 Larutan nutrisi + Infus berbagai komposisi Triparen 1; Triparen 2;
elektrolit Clinimix; Combiflex;
Kabiven; Aminofluid;
Nutriflex Lipid
27 Lipid infus 20% Ivelip; Lipofundin
MCT/LCT; Clinoleic
28 Maltose infus 10% 500 ml,1000 ml Martos 10
29 Multivitamin parenteral serbuk infus vial @166 mg Soluvit N
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
30 Multivitamin parenteral inj 10 ml Vitalipid N Adult; MVI
31 Natrium bikarbonat inj 8.4% vial 25 ml Meylon
32 Natrium klorida inj; infus inj 0.9% 25 ml; infus 100 NaCl Otsuka; NaCl
ml, 500 ml, 1000 ml; 3% Widatra; Ecosol
500 ml
33 Natrium laktat infus 250 ml Totilac
hipertonik
34 Ringer Asetat infus Asering; Infusan Ring-
As; Ringerfundin
35 Ringer Asetat + infus 500 ml Asering-5
glukosa 50 g
36 Ringer Laktat infus 500 ml, 1000 ml Ecosol; Wida RL
21 OBAT UNTUK MATA
21.1 SISTEMIK
1 Asetazolamid tab 250 mg Glaucon
2 Gliserin larutan 50% Glycerine
3 Manitol inj 20% Manitol; Manitol Fima
Internasional
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
21.2 TOPIKAL
21.2.1 Antimikroba
1 Amfoterisin salep mata 1% Fungicid
2 Asam Fusidat tetes mata 1% Fucithalmic
3 Asiklovir salep mata 3% Cendo Hervis
4 Dibekasin tetes mata 0,3 % Dibekacine (generik)
5 Gentamisin salep mata; 0,3% Cendo Gentamycin;
tetes mata Gentamycin ED;
Gentamycin salep
0,1% 5 g (generik)
6 Idoksuridin tetes mata 0,1% Cendrid; Isotic Ixodine
7 Kloramfenikol salep mata; salep mata 1%; tetes Cendo Fenicol (ED);
tetes mata mata 0,25%, 5%, 1% Cendomycetin EO;
Ikamicetin 1% EO
8 Kloramfenikol + tetes mata 1% + 0,5% Cendomycos
Hidrokortison asetat
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
9 Kloramfenikol + salep mata; salep mata 10 mg/g; Cendo Mycetine
Polimiksin B Sulfat tetes mata tetes mata (10 mg +
10000 UI)/ ml
10 Levofloksasin tetes mata 0,5% Cravit; Cendo LFX
11 Natamisin tetes mata; Cendo Natacen
salep mata
12 Neomisin + Basitrasin salep mata 5 mg + 250 IU Nebacetin
13 Neomisin + Polimiksin tetes mata; tetes mata 3,5 mg+ Cendo Xitrol
+ Deksametason salep mata 20.000 IU + 1,2 mg;
salep mata 5 mg+ 6.000
IU+1,3 mg; tetes mata
3,5 mg+ 6.000 IU+1 mg
14 Neomisin Sulfat + salep mata, salep mata 3,5 g; tetes Cendo Stratol
Polimiksin B sulfat + tetes mata mata: MD 0,6 ml, 5 ml
Tetrahidrozolin
15 Ofloksasin tetes mata 0,3% Cendo Floxa; Tarivid
16 Oksitetrasiklin salep mata 1% Terramycin Ophth
17 Polimiksin tetes mata 10000 IU/ml Cendo Polygran
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
18 Sulfasetamid salep mata; 10%, 15% Cendo Cetamide;
tetes mata Albuvit
19 Tobramisin vial 80 mg/ml Cendo Tobro
20 Tobramisin + tetes mata (3 mg + 1 mg)/ml MD 0,6 Cendo Tobroson
Deksametason ml, 5 ml, viscous 5 ml
21.2.2 Antiinflamasi
1 Betametason tetes mata 0,1% Cendo Vosama
2 Diklofenak natrium tetes mata 1 mg/ml Cendo Noncort;
Flamar ED
3 Fluorometolon + tetes mata (1 mg + 3,5 mg) /ml 0,6 Cendo Polynel;
Neomisin sulfat ml; 5 ml Flumetholone 0,1
4 Kromoglikat natrium larutan 2%, 4% Cendo Conver; Crom
Opthal
5 Prednisolon asetat tetes mata 10 mg/ml P-Pred
21.2.3 Midriatik
1 Atropin Sulfat tetes mata 0,5% ; 1% btl 5 ml Cendo Tropin
2 Fenilefrin HCl tetes mata 10% Cendo Efrisel
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Homatropin tetes mata 2% Cendo Homatro
hidrobromid
4 Tropikamid tetes mata 1% Cendomydriatyl
21.2.4 Miotik dan
antiglaukoma
1 Adrenalin HCl tetes mata 0.25% Cendo Adrenal
2 Betaksolol HCl tetes mata 0,5% Optibet
3 Brinzolamid tetes mata 1% Azopt
4 Dorzolamid tetes mata 1% - 2% Trusopt
5 Karteolol tetes mata 2% Arteopic
6 Latanoprost tetes mata 0.005% Xalatan
7 Pilokarpin HCl tetes mata 2% Cendo Carpin;
Triacarpin
8 Timolol tetes mata 0,25%, 0,5% Tim Opthal; Isotic
Adretor; Timol
9 Travoprost tetes mata 0.004% Travatan
21.2.5 Lain-lain
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Aneurin HCl + Ca tetes mata 0,5 mg + 5 mg + 1000 UI Rephitel
Pantotenat + Vitamin A
2 Dinatrium Edetat tetes mata 0.35% btl 15 ml EDTA
3 Fluorescein natrium tetes mata 2% dlm botol 5 ml Cendo Flurescein
4 Hidroksi Propil Metil tetes mata 0,3% Tears Naturalle II
Selulosa
5 Hidroksi Propil Metil tetes mata (3 mg + 1 mg)/ml Cendo Eyefresh
Selulosa + Dekstran 70
6 Hidroksi Propil Metil tetes mata 2 mg/ml Cendo Lubricen
Selulosa + Natrium
Hyaluronat
7 Hidroksi Propil tetes mata (5 mg + 0,25 mg + 1000 Augentonic
Metil Selulosa + UI)/ml
Oksimetazolin +
Vitamin A
8 Hyaluronat natrium tetes mata 0,1%, 1,5%, 1,6% Hialid; BBTVISC
1,5%; Occulon HV
1,6%; Cendo Hyalub
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
9 Kalium klorida + tetes mata Cendo Catarlent
Kalium Iodida +
Natrium tiosulfat
10 Karboksimetil selulosa tetes mata Cendo Cenfresh
11 Mitomisin tetes mata 0,4 mg/ml Mytocin
12 Nafazolin tetes mata 0,25 mg/ml Vernacel; Cendo
Vasacon
13 Natrium klorida + tetes mata 8,664 mg+ 1,32 mg Cendolyteers
Kalium klorida
14 Natrium klorida + tetes mata Balanced Salt
Natrium asetat + Solution (BSS)
Natrium sitrat +
Kalsium klorida +
Magnesium klorida +
Kalium klorida
15 Pemirolast kalium tetes mata 0,1% Alegysal
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
16 Polivinil pirolidon + vit tetes mata Cendo Protagent A
A + Na-Hialuronat +
NaCl + Na hidrogen
fosfat + Na dihidrogen
fosfat
17 Tetrahidrozolin HCl tetes mata 0,05% btl 5&10 ml Visine
18 Tetrakain HCl tetes mata 0,5% Pantocain
19 Vaccinium Myrtilllus tetes mata 80 mg/ml Cendo Berry
Extract
20 Vitamin A palmitat salep mata 10 mg/ml Cendo Oculenta
21 Vit A palmitat + gel utk mata 1.000 IU + 3,5 mg Oculotect
karbomer 980
22 UTEROTONIK DAN
RELAKSAN UTERUS
22.1 Uterotonik
1 Metilergometrin maleat tab; inj. 0,125 mg, 0,2 mg/ml Methergin; Pospargin
2 Misoprostol tablet 200 mcg Cytotec; Gastrul
3 Oksitosin inj 10 IU/ml Synthocinon; Induxin
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
22.2 RELAKSAN UTERUS
1 Isoksuprin HCl tab; inj. tab 20 mg; inj. 10 mg/2 Duvadilan
ml amp
2 Magnesium sulfat inj 20%, 40% Magnesium Sulphate
3 Nifedipin tablet 5 mg, 10 mg Adalat; Nifedipin
tablet 10 mg
(generik)
4 Terbutalin sulfat tab; inj; tab 2,5 mg; inj 0,5 mg/ Bricasma
respules; ml; resp 2,5 mg/ml; turb
turbuler 0,25 mg, 0,5 mg
23 PSIKOFARMAKA
23.1 ANTIANSIETAS DAN
ANTIINSOMNIA
1 Alprazolam tablet 0,25 mg, 0,5 mg, 1 mg Xanax; Alganax;
Zypraz; Alprazolam
0,5 mg; 1 mg
(generik)
2 Bromazepam tablet 1,5 mg, 3 mg, 6 mg Lexotan; Lexzepam
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Diazepam tab; inj; lar tab 2 mg, 5 mg; inj 10 Valium; Valdimex;
rektal mg/2ml; lar rektal 5 mg Stesolid; Diazepam
tube 2,5 ml; lar rektal 10 tablet 5 mg (generik)
mg tube 2,5 ml
4 Estazolam kapsul 1 mg, 2 mg Esilgan
5 Klobazam tablet 10 mg Frisium; Clofritis;
Clobazam tablet 10
mg (generik)
6 Lorazepam tablet 0,5 mg; 1 mg; 2 mg Ativan; Merlopam
7 Zolpidem tablet 10 mg Stilnox; Zolmia
23.2 ANTIDEPRESI DAN
ANTIMANIA
1 Agomelatine tablet salut 25 mg Valdoxan
film
2 Amitriptilin HCl tablet 25 mg Amitryptylline
HCl tablet 25 mg
(generik)
3 Duloksetin kapsul 60 mg Cymbalta
4 Escilatopram tablet 10 mg Cipralex
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
5 Fluoksetin kapsul 10 mg, 20 mg Prozac; Lodep;
Kalxetin
6 Imipramin tablet 25 mg Tofranil
7 Maprotilin tablet 10 mg, 25 mg, 50 mg Ludiomil
8 Sertralin tablet 50 mg Zoloft; Fridep; Serlof;
Sertraline tablet 50
mg (generik)
9 Tianeptine tablet 12,5 mg Stablon
10 Venlafaksin HCl kapsul 75 mg, 150 mg Efexor XR
23.3 ANTIOBSESI DAN
ANTIKOMPULSI
23.4 ANTIPSIKOSIS
1 Aripiprazol tab; oral tab 5 mg, 10 mg, 15 mg; Abilify
soln; inj oral soln 1 mg/ml; inj 7,5
mg/ml
2 Haloperidol tablet; inj; tab 0,5 mg, 1,5 mg, 2 Haldol; Serenace;
drops mg, 5 mg; inj 5 mg/ml; Lodomer; Haloperidol
drops 5mg/ml tablet 0,5 mg; 1,5
mg; 5 mg (generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Haloperidol dekanoat inj 50 mg/ml Haldol Decanoas
4 Kloralhidat kapsul 500 mg Chloralhydrat 500
5 Klorpromazin HCl tab salut tab 25 mg, 100 mg; inj Largactil; Promactil;
selaput; inj 25 mg/ml Cepezet-100
6 Klozapin tablet 25 mg, 100 mg Clozaril; Luften;
Clorilex
7 Olanzapin tab; inj tab 5 mg, 10 mg; inj 10 Zyprexa; Olandoz
mg/vial
8 Quetiapin tablet 25 mg, 100 mg, 200 mg; Seroquel; Seroquel
XR 300 mg; XR 400 mg XR
9 Risperidon tab: inj; oral tab 1 mg, 2 mg, 3 mg; inj Risperdal; Zofredal;
sol 25 mg, 37,5 mg, 50 mg; Persidal; Risperdal
oral sol 1 mg/ml Consta; Risperidon
10 Trifluoperazin tablet 1 mg, 2 mg, 5 mg Stelazine; Stelosi
11 Zotepin tablet 25 mg, 50 mg Lodopin
23.5 ANTI ADHD
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Metilfenidat HCl tablet 1 mg, 2 mg, 3 mg, 10 mg Ritalin; Prohiper 10
intermediate release
24 RELAKSAN OTOT
PERIFER DAN
PENGHAMBAT
KOLINESTERASE
24.1 PENGHAMBAT
NEUROMUSKULAR
1 Atrakurium besilat inj 25 mg/2,5 ml, 50 mg/5ml Tracrium; Atracurium
Hameln; Tramus
2 Baklofen tablet 10 mg Lioresal
3 Eperison HCl tab salut 50 mg Myonal; Forres;
selaput Rizonax
4 Pankuronium bromida inj 2 mg/ml Pavulon
5 Rokuronium bromida inj 50 mg Esmeron; Roculax
6 Tizanidin tablet 2 mg Sirdalud; Zitanid
7 Vekuronium bromida inj 4 mg/mL, 10 mg/vial Norcuron; Ecron
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
24.2 OBAT UNTUK
MISTENIA GRAVIS
1 Neostigmin metilsulfat inj. 0,5 mg/ml Prostigmin;
Neostigmin Hameln
2 Piridostigmin bromida tablet 60 mg Mestinon
25 OBAT UNTUK
SALURAN CERNA
25.1 ANTASIDA DAN
ULKUS, ANTIBUSA
1 Antasida DOEN tab; 500 mg Dexanta (suspensi);
suspensi Antasida DOEN
tablet; suspensi
(generik)
2 Alumunium hidroksida tab; Mylanta; Polycrol;
+ Magnesium suspensi Polysilan
hidroksida + Simetikon
3 Esomeprazol tab; inj tab 20 mg, 40 mg; inj 40 Nexium; Nexium IV
mg vial
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
4 Lansoprazol kapsul 15 mg, 30 mg Prosogan FD;
Inhipraz; LAZ;
Lansoprazole kapsul
30 mg (generik)
5 Misoprostol tablet 200 mcg Cytotec; Gastrul
6 Omeprazol kapsul; inj kaps 10 mg, 20 mg, 40 Losec; OMZ; Ozid;
mg; inj 40 mg Omeprazole kapsul
20 mg (generik)
7 Pantoprazol tab; inj tab 20 mg, 40 mg; inj Pantozol; Panso;
40 mg Pantotis
8 Ranitidin tab; inj tab 150 mg, 300 mg; Zantac; Radin;
inj 25 mg/ml; Sirup 75 Ranicare; Ranitidin
mg/5ml tablet 150 mg; inj. 50
mg/2 ml (generik);
Sirup : Ranicare
9 Rebamipid tablet 100 mg Mucosta; Becantex
10 Simetikon tablet 20 mg Simethicone
11 Sukralfat tab; fenolftalein 55 mg; Inpepsa; Ulsicral;
suspensi Paraffin liq 1,2g; gliserin Musin
378 mg
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
12 Teprenon kapsul 50 mg Purubex
25.2 ANTIEMETIK
1 Betahistin mesilat tablet 6 mg Merislon, Betahistine
(generik)
2 Dimenhidrinat tablet 50 mg Dramamine
3 Domperidon tab; sirup; tab 10 mg; sirup 1 mg/ Motilium; Vometa;
drop ml; drop 5 mg/ml Vomecho FM 10;
Domperidone tablet
10 mg (generik)
4 Granisetron inj 1 mg/ml, 3 mg/3 ml Kytril; Granon
5 Metoklopramid HCl tablet; inj; tab 5mg, 10 mg; inj 10 Primperan; Sotatic;
sirup; drop mg/2 ml; sir 5 mg/5 ml; Metoclopramide
drop 1 mg/10 tetes tablet 10 mg; inj. 10
mg/ 2 ml (generik)
6 Ondansetron HCl tab salut tab 4 mg; 8 mg; inj. 4 Zofran; Dantroxal;
selaput; mg/2 ml, 8 mg/4 ml Kliran; Ondansetron
kaplet salut tablet 4 mg; 8 mg;
selaput; inj inj. 4 mg; 8 mg
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 Palonosetron inj 0,25 mg/5 ml Paloxi
8 Piratiasin teoklat + tablet 40 mg + 37,5 mg Mediamer B6; Zomivit
vit B6
9 Tropisetron kapsul; inj kaps 5 mg; inj 5 mg/5 ml Navoban; Setrovel
(inj)
25.3 ANTIHEMORRHOID
1 Bismut subgalat + supp Anti hemoroid supp
lidokain + seng oksida (generik)
+ supositoria
2 Fluokortolon pivalat + krim; suppos krim 1 mg + 20 mg; Ultraproct N
Lidokain suppos 1 mg + 40 mg
3 Hidrosmin kapsul; gel kaps 200 mg; gel 2% Venosmil
4 Diosmin + Hesperidin tablet 450 mg + 50 mg Ardium; Rhodium
5 Polikresulen + suppo; salep 50 mg + 10 mg, 100 mg Faktu
Sinkokain + 2,5 mg
25.4 ANTISPASMODIK
1 Atropin sulfat tab; inj tab 0,5 mg; inj 0,25 mg/ Atropin Sulfat
ml, 1 mg/ml (generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Butropium bromida tablet 5 mg Caliopan
3 Hiosin n-butil bromida tab salut tab 10 mg; inj 20 mg/mL Buscopan; Scopamin;
gula; inj. Stomica
25.5 OBAT UNTUK DIARE
1 Attapulgit tablet 600 mg New Diatab; Biodiar
2 Garam Oralit serbuk NaCl 0,7 g + KCl 0,3 g + Indoralyte; Oralit
trinatrium sitrat dihidrat (generik)
0,58 mg + Glukosa
anhidrat 4g
3 Kaolin + Pektin suspensi 550 mg + 20 mg Kaopectat
4 Loperamid HCl tablet 2 mg Imodium;
Loperamide tablet 2
mg (generik)
5 Smektit serbuk 3g Smecta
6 Seng sulfat tablet tablet dipersible; serbuk Zinkid; Serbuk :
dispersible; : 10 mg; sirup : 20 mg/5 Orezinx; sirup : Zanic
serbuk; sirup ml
25.6 LAKSATIF
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Bisakodil tab; suppos tab 5 mg; supp 5mg, Dulcolax; Dulcolactol
10 mg
2 Gliserin minum larutan Glycerine minum
Produksi RSCM
3 Kombinasi: Natrium enema (45 mg + 450 mg +5 Microlax
lauril sulfoasetat mg + 625 mg + 4465
+ Natrium sitrat + mg)/5 ml
asam sorbat + PEG +
Sorbitol
4 Kombinasi sorbitol, botol YAL
docusat sodium
5 Kombinasi: Makrogol sachet Niflec
+ Natrium sulfat +
Natriium Hidrogen
karbonat + Natrium
klorida + Kalium
Klorida
6 Laktulosa sirup 3,335 g/5 ml Duphalac; Lactulax;
Constipan
7 Magnesium sulfat kristal 30 g Garam Inggris
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
8 Natrium Fosfosoda enema botol 133 ml (Fleet Fleet Enema; Fleet
Enema); botol 45 ml Phosposoda; Fosen
(Fleet Phosposoda)
9 Parafin + Gliserin sirup Fenolftalein 55 mg; Laxadine
Paraffin liq 1,2 g; gliserin
378 mg
25.7 Lain-lain
1 Asam ursodeoksikholat kapsul 250 mg Urdafalk; Estazor;
Lofibra
3 Curcumin tablet 200 mg Curcuma
4 Glicirrhyzin inj 40 mg amp 20 ml Stronger Neo-
Minophagen C
5 HEFC serbuk 300 mg HEFC
6 Kombinasi enzim dragee Enzyplex; Vitazym
saluran cerna
7 Lactobacillus serbuk Lacto B
acidophilus
8 Lactobacillus reuteri tablet Rillus
kunyah
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
9 Lactobacillus kapsul Lacidofil
rhamnosus
10 L-Karnitin + Ubiquinon kapsul lunak Tonicard
+ vit E + asam folat
11 L-Ornitin L-Aspartat sachet; inj sachet 3 g; 5 g/ 10 ml Hepa-Merz; Ornispar;
amp Livola inf
12 Mesalazin tab; enema; tab 250 mg, 500 mg; Salofalk; Sulfitis (tab);
suppos enema 4 g; supp 500 mg Midodrine
13 Enzim pankreatik dragee Pankreoflat;
Enzymfort; Elsazym
14 Schisandrin kapsul 400 mg Hp Pro; Hepamax
26 OBAT UNTUK
SALURAN NAFAS
26.1 ANTIASMA
1 Aminofilin tab scored; tab scored 200 mg; inj Aminophyllin tablet
inj 24 mg/ml 200 mg; inj. (generik)
2 Beklometason inhaler 200 mcg/dosis Becotide; Beclomed
easyhaler
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
3 Budesonid aerosol 100 mcg; 200 mcg/puff Pulmicort; Inflammide
dosis terukur
4 Budesonid + Fomoterol aerosol 80/4,5 mcg, 160/4,5 mcg Symbicort
dosis terukur
5 Deksametason natrium tab; inj tab 0,5 mg; inj 4 mg/ Oradexon;
fosfat ampul, 5 mg/amp, 20 Kalmethason
mg/vial
6 Efedrin HCl inj, tab inj 50 mg/ml; tab 25 mg Ephedrine HCl tablet
25 mg; inj. 50 mg/ml
(generik)
7 Epinefrin inj 0,1 % Epinephrine HCl
8 Fenoterol HBr larutan; lar 0,1 % 40 ml; MDI 100 Berotec
inhaler mcg/puff, 200 mcg/puff
9 Flutikason propionat nebule nebules 0,5 mg/2ml Flixotide
10 Ipratropium bromida inhalasi 20 mcg/spray Atrovent
11 Prokaterol HCl mini tablet; tab 25 mcg, 50 mcg; sir Meptin air inhaler;
hemihidrat tablet; sirup; 25 mcg/5ml; inhaler 10 Ataroc
inhaler mcg/puff
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
12 Salbutamol tab; sir; tab 2 mg, 4 mg; sir 2 Ventolin; Lasal;
inhaler; mg/5 mL; inhaler 100 Salbutamol tablet 2
nebules; mcg/puff; nebules 2,5 mg; 4 mg (generik)
rotacap; mg; rot 200 mcg, 400
rotahaler; mcg; inj 0.5 mg/ml
rotadisk;
diskhaler; inj
13 Salbutamol + UDV, inhaler 2,5 mg + 0,5 mg UDV; Combivent; Farbivent
Ipratropium Bromida MDI 200 puffs
14 Salmoterol 25 mcg + inhaler 50/120 dosis, 125/120 Seretide 50 inhalasi,
Flutikason proprionat dosis Seretide 125 inhalasi
50 mcg / 125 mcg
15 Teofilin kaps lunak; kaps lunak 130 mg; tab Euphyllin R mite;
tab; eliksir; 150 mg, 300 mg; eliksir Bronchopyhllin;
powder 130 mg/15ml; powder Theophyllin tablet
1g 150 mg (generik)
16 Terbutalin Sulfat tab; sir; inj; tab 2,5 mg; sir 0,3 mg/ Bricasma; Nairet;
canister; ml; inj 0,5 mg/ml; can Forasma
turbuhaler; 0,25 mg/puff; turb 0,25
respules mg, 0,5 mg; resp 2,5
mg/ml
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
17 Tiotropium kapsul kaps 18 Spiriva Combo,
mcg+handihaller, 18 Spiriva Refill
mcg refill
26.2 ANTITUSIF
1 Dekstrometorfan HBr tablet, sir tab 15 mg; sir 10 mg/5 Dextromethorphane

ml HBr tablet 15 mg;
sirup 10 mg/ 5 ml
(generik)
2 Kodein HCl tablet 10 mg Codipront
26.3 MUKOLITIK
1 Ambroksol tablet, sirup tab 30 mg, sir 15 mg/5 Mucopect;
ml Transbroncho;
Ambroxol tablet 30
mg; sirup (generik)
2 Bromheksin HCl tablet; tab 8mg; eliksir dan sirup Bisolvon
eliksir; sirup; 4 mg/5ml; lar 8 mg/4ml;
larutan utk inj 4 mg/2ml amp
inhalasi, inj
3 Erdostein kapsul; sirup kaps 300 mg; sir 175 Vectrine; Edotin
mg/5ml (kapsul); Mucotein
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
4 N-asetil Sistein serbuk; sirup serbuk 100 mg, 200 mg; Fluimucyl; Pectocil
sir 150 mg/5 ml
26.4 EKSPEKTORAN
1 Gliseril Guaiakolat tablet 100 mg Glycerilguaiacolate
(generik)
2 Difenhidramin sirup Benadryl CM
HCl+amonium
klorida+natrium
sitrat+mentol+alkohol
3 Obat Batuk Hitam larutan OBH Produksi RSCM
26.5 LAIN-LAIN
1 Beractant inj 25 mg/ml 8 ml vial Survanta
27 OBAT YANG
MEMPENGARUHI
SISTEM IMUN
27.1 SERUM DAN
IMUNOGLOBULIN
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Gama Globulin Imun inj 5% Gammaraas; IG
VENA IV
2 Serum Antibisa Ular inj vial 5 ml ABU Polivalen
3 Serum Antidifteri inj 20.000 IU/vial
4 Serum Antitetanus inj 1.500 IU, 20.000 IU ATS
5 Serum Imun Globulin inj 300 I.U., 0,5 mg/ 0,5 ml Imogam Rabbies;
Human Rabies Verorab
6 Serum Imun Globulin inj 5%, 6%, 10% Gamunex 10%;
Intragam 6%;
Octagam 5%;
7 Tetanus Imun Globulin inj 250 IU Tetagam P
27.2 VAKSIN
1 Vaksin Antipolio inj 40 antigen unit (type 1); Imovax Polio
4 antigen unit (type 2);
32 antigen unit (type 3)
2 Vaksin antirabies inj 0,5 mg/ 0,5 ml Verorab
3 Vaksin BCG inj 2 ml, 4 ml Vaksin BCG
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
4 Vaksin Campak inj 5 ml Vaksin campak
5 Vaksin Difteri dan inj 5 ml amp Infanrix
Tetanus
6 Vaksin Difteri Pertusis inj 5 ml Tripacel
dan Tetanus
7 Vaksin Hemophilus inj 10 mcg/0,5 ml vial Hiberix
influenzae B
8 Vaksin Hepatitis A inj 720 IU/ml, 80 IU/0,5 ml, Havrix 720 junior;
160 IU/0,5 ml Avaxim 80; Avaxim
160
9 Vaksin Hepatitis B inj 100 mcg/0,5 ml, 20 Engerix
mcg/0,5 ml vial
10 Vaksin Hepatitis A inj 1 cc Twinrix
dan B
11 Vaksin HPV inj Gardasil; Cervarix
12 Vaksin IgG Hepatitis B inj 217 IU/ ml Hyperhep-B
13 Vaksin Influenza inj 0,5 ml Fluarix; Vaxigrip
14 Vaksin Kombinasi inj 0,5 ml Infanrix-Hib; Tetra Hib
DPaT-Hib
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
15 Vaksin Kombinasi DPT, inj 0,5 ml Pediacel
Hib, Polio
16 Vaksin Meningitis inj 0,5 ml Mencevax ACWY
meningokokal
17 Vaksin MMR inj 0,5 ml Trimovax; M-M-R II
18 Vaksin Pneumokokus inj 0,5 ml Prevenar (PCV);
Pneumo 23
19 Vaksin PPD inj 2 UT 1,5 ml Vaksin PPD
20 Vaksin Rotavirus inj Rotarix
21 Vaksin Tifoid inj Typhim VI
22 Vaksin TT inj vial 5 ml, 10 ml; uniject Vaksin TT Bio Farma
0,5 ml
23 Vaksin Varisela inj 0,5 ml vial Varilrix; Okavax
28 OBAT UNTUK
TELINGA, HIDUNG,
TENGGOROK
28.1 ANTIBAKTERI
TOPIKAL
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
1 Kloramfenikol tetes telinga 3% Cendo Fenicol
2 Ofloksasin tetes telinga 3 mg/ml dlm 5 ml Tarivid
28.2 LAIN-LAIN
1 Flutikason furoat semprot 27,5 mcg/semprot Avamys
hidung
2 Karbogliserin tetes telinga 10% Waxsol;
Karbogliserin 30 mL;
1 L (generik)
3 Larutan air laut isotonis semprot Sterimar
hidung
4 Mometason furoat semprot 50 mcg/dosis Nasonex
hidung
5 Natrium klorida tetes hidung 6,5 mg/ml Breathy nasal drop
6 Oksimetazolin HCl semprot 0,05%; 0,025% (tetes Afrin; Illiadin
hidung; tetes hidung ped)
hidung dws;
tetes hidung
ped
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 Perak Nitrat larutan 5% - 10% Argenti Nitrat Produksi
RSCM
8 Triamsinolon asetonid Semprot 55 mcg/dosis Nasacort AQ
hidung
29 VITAMIN DAN
MINERAL
1 1,25 di(OH) kapsul lunak 0,25 mcg Kolkatriol;
kolekalsiferol Kolekalsiferol 1,25
DI (OH) (generik)
2 Asam Askorbat tab; inj tab 50 mg, 100 mg; inj Extrace; ; Vitamin
(Vitamin C) 100 mg/ml, 200 mg/ml, C tablet 50 mg; inj.
1g (generik)
3 Kalium aspartat/klorida tablet 750 mg; 300 mcg KSR; Aspar-K; Kalipar
4 Kalsium hidrogen tablet 500 mg Dumocalcin
fosfat
5 Kalsium hidrogen tablet Cavit D3
fosfat + Kolekalsiferol
6 Kalsium glukonat inj 100 mg/ml Calcii gluconas
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
7 Kalsium karbonat tablet 500 mg Osteocal; CaCO3
kapsul 500 mg
(generik)
8 Kalsium laktat/fosfat tablet 500 mg Kalk
9 Kalsium organik suspensi; susp setara kalsium 200 Calnic; Calnic Plus
aquamin kaplet mg/5 ml; kaplet setara
kalsium 400 mg
10 Kombinasi kapl salut Seloxy; Lycoxy; Oxyvit
Betakaroten, Vitamin selaput
C, vitamin E, Zinc,
Selenium
11 Kombinasi vitamin B tablet berbagai komposisi Neurobion; Neurobion
5000; Becombion;
Ferlin
12 Kombinasi kalsium dan tab eff CDR
vitamin
13 L-Arginin inj 4%, 10% dlm vial R-Gene
14 Lesitin + vitamin kapsul Lesifit; Neurochol;
Lesichol
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
15 L-Karnitin + Ubiquinon kaplet (30 mg + 500 mg) Carnico-Q; Car-Q
16 Mekobalamin kapsul, inj kaps 250 mcg, 500 mcg; Methycobal;
inj 500 mcg/ml Kalmeco; Sohobal;
Mecobalamin kapsul
250 mcg; 500 mcg;
inj 500 mcg (generik)
17 Mineral-Mix Produksi RSCM
18 Multivitamin inj. inj vial 5 ml Cernevit
19 Nikotinamid kapsul 500 mg Produksi RSCM
20 Ossein hidroksiapatit tablet Ossoral
21 Piridoksin HCl (vit B6) tab; inj tab 10 mg, 25 mg; inj Pyridoxin HCl /
100 mg/ml Vitamin B6 tablet 10
mg (generik)
22 Thiamin HCl tab; inj tab 50 mg, 100 mg; inj vitamin B1 Soho/
100 mg/ml Ethica; Vitamin
B1 tablet 50 mg
(generik)
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
23 Thiamin tab; inj tab 5 mg; inj 10 mg/2 ml Alinamin/Alinamin-F-
Tetrahidrofurfuril Odorless
Disulfid
24 Trace elements untuk larutan Zn 250 mcg + copper Peditrace
infus 20 mcg + manganese 1
mcg + selenium 2 mcg+
fluoride 57 mcg+ iodide
1 mcg
25 Ubiquinon kapsul lunak 50 mg, 100 mg VQ (50 mg); Ubi-Q;
Q-ten
26 Vitamin A tablet 6.000 IU, 20.000 IU, Vitamin A tablet
50.000 IU 6.000 UI; 20.000 UI;
50.000 UI (generik)
27 Vitamin B12 tablet 50 mcg, 100 mcg Vitamin B12 tablet
50 mcg (generik)
28 Vitamin B12 + Ekstrak dragee 20 mcg + 15 mg Moloco + B12
plasenta
29 Vitamin E (Tokoferol) kaplet 100 IU, 200 IU, 400 IU Evion; Dalfarol;
Naturol
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
30 Vitamin K1 tab; inj tab 10 mg; inj 2 mg/ml Phytomenadione
tablet 10 mg; inj
(generik)
31 Vitamin K3 inj 2 mg/ml Vitamin K3 (generik)
32 Zn Pikolinat + Zn kapsul 50 mg + 50 mg + 8 mg Zinc Pharmacore
glukonat + Cu glukonat
30 OBAT YANG
MEMPENGARUHI
SALURAN KEMIH
30.1 ALPHA BLOCKER
1 Terazosin tablet 1 mg Hytrin
2 Doksazosin tablet 1 mg, 2 mg, 4 mg Cardura
3 Tamsulosin tablet 0,2 mg Harnal
4 Alfuzosin tablet 10 mg Xatral XL
30.2 5 ALPHA-
REDUCTASE
INHIBITOR
1 Finasterid tablet 5 mg Prostacom; Proscar
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
2 Dutasterid tablet 0,5 mg Avodart
30.3 ANTISEPTIK
1 Asam pipemidat kapsul 400 mg Urinter
2 Fenazopiridin Urogetix
30.4 ANTI MUSKARINIK
1 Fesoterodin tablet 4 mg, 8 mg Toviaz
2 Solifenasin tablet 5 mg Vesicare
3 Tolterodin l-tartrat tablet 2 mg Detrusitol
30.5 PARASIMPATOMIMETIK
1 Distigmin bromidum tablet Ubretid
31 LAIN-LAIN
1 Aqua untuk inhalasi botol 340 ml Aquapack
2 Asam keto tablet salut 630 mg Tonar; Ketosteril;
3 Botulinum Toxin inj 100 IU/vial Botox; Lanzox
4 EEG Pasta pot 8 oz Ten 20
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
5 Fosfatidil serin + kapsul 125 mg + 147,5 mg + Neulin PS
kolin sitrat + sitidin 121,5 mg
monofosfat
6 Glukosamin + kapsul; tab kaps 250 mg; tab 500 Flexor; Fitbon; Dioste
Kondroitin mg
7 Hipromelosa drop; gel drop 10 ml; gel 10 g Genteal
8 Ko-dergokrin mesilat tab; inj tab 1 mg, 4,5 mg; inj 0,3 Hydergin; Ergotika
mg/ml
9 Lubricant untuk USG Jelly Aquasonic
10 Lubricant Jelly KY Jelly
11 Monomer n-Butil-2- cairan Histoacryl
Sianoakrilat
12 Natrium botol 25 g Ostomy Powder
Karboksimetilselulosa Colloplast 1907
+ guar gum + xantan
gum
13 Oktafloropropan botol C3F8 Gaz
14 Sulfur heksafluorida 30 ml SF6 Gas Arceole
NO NO
KELAS URUT
SEDIAAN
TERAPI OBAT
15 Vinipirolidon/vinilasetat tube 60 g Colloplast Pasta 2650
cop-polimer

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DAFTAR OBAT FORMULARIUM RSCM BERDASARKAN KELAS TERAPI

5 Kolkisin tablet 0,5 mg Recolfar; Kolkisin

5 Dipiridamol tablet 25 mg, 50 mg, 75 mg Persantin

1 Dekstrometorfan HBr tablet, sir tab 15 mg; sir 10 mg/5 Dextromethorphane

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