DKI JAKARTA

No Nama Generik STATUS

Penyedia Harga
1 Air untuk injeksi 20 ml N/A N/A
2 Akarbose tablet 100 mg Dexa Medica 768
3 Akarbose tablet 50 mg Dexa Medica 551
4 Albendazol tablet/kapsul/kaplet 400 mg Holi Pharma 392
5 Alopurinol tablet/kapsul/kaplet 100 mg Novapharin 110
6 Alopurinol tablet/kapsul/kaplet 300 mg Hexpharm Jaya Laboratories 210

7 Alprazolam tablet/kapsul/kaplet 0,5 mg Mersifarma TM 108

8 Alprazolam tablet/kapsul/kaplet 1 mg Mersifarma TM 143

9 Aminofilin inj 24 mg/ml Phapros, Tbk 2,998

10 Aminofilin tablet/kapsul/kaplet 200 mg Marin Liza Farmasi 91

11 Amitriptilin tablet/kap/salut 25 mg Gagal N/A N/A

12 Amlodipin tablet/kapsul/kaplet 5 mg Pertiwi Agung 85

13 Amlodipin tablet/kapsul/kaplet 10 mg Pharma Laboratories 104

14 Amoksisilin kapsul/kaplet/tablet scored 500 mg Pharma Laboratories 190

15 Amoksisilin sirup kering forte 250 mg/5 ml Holi Pharma 3,519

16 Amoksisilin sirup kering 125 mg/ 5 ml Mersifarma TM 1,881

17 Amoksisilin tablet/kapsul/kaplet 250 mg Novapharin 180

18 Ampisilin serbuk injeksi i.v. 1000 mg Gagal N/A N/A
Antasida DOEN I tablet kunyah, kombinasi:
19 Aluminium Hidroksida 200 mg + Magnesium Mersifarma TM 58
Hidroksida 200 mg
Antasida DOEN II suspensi, kombinasi:
20 Aluminium Hidroksida 200 mg/5 ml + Magnesium Mersifarma TM 1,923
Hidroksida 200 mg/5 ml
Anti Bakteri DOEN salep kombinasi: Basitrasin
21 Indofarma (Persero) Tbk 2,924
500 IU/g + Polimiksin 10.000 IU/g
Antifungi DOEN Salep, Kombinasi: Asam
22 Marin Liza Farmasi 4,323
Benzoat 6% + Asam Salisilat 3%
Antimalaria DOEN kombinasi: Pirimetamin 25
23 N/A N/A
mg + Sulfadoksin 500 mg
Asam asetilsalisilat (asetosal)
24 Marin Liza Farmasi 133
tablet/kapsul/kaplet 100 mg
Asam askorbat (vitamin C) tablet/kapsul/kaplet
25 Kimia Farma (Persero) Tbk, 114
250 mg
26 Asam folat tablet/kapsul/kaplet 1 mg Marin Liza Farmasi 67
27 Asam Mefenamat tablet/kapsul/kaplet 250 mg Gagal N/A N/A

28 Asam Mefenamat tablet/kapsul/kaplet 500 mg Mersifarma TM 100

29 Asam traneksamat injeksi 100 mg/ml Bernofarm 2,190

30 Asam traneksamat injeksi 50 mg/ml Dexa Medica 1,956

31 Asam traneksamat tablet/kapsul/kaplet 500 mg Gagal N/A N/A

 Asam ursodeoksikolat tablet/kapsul/kaplet 250
32 Dexa Medica 2,445
mg
33 Asiklovir tablet/kapsul/kaplet 200 mg Phapros, Tbk 240

34 Asiklovir tablet/kapsul/kaplet 400 mg Phapros, Tbk 365

35 Atorvastatin tablet/kapsul/kaplet 10 mg Gagal N/A N/A
Novell Pharmaceutical
36 Atorvastatin tablet/kapsul/kaplet 20 mg 1,100
Laboratories
37 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ethica Industri Farmasi 1,540
38 Azitromisin serb inj 500 mg Gagal N/A N/A

39 Azitromisin sir kering 200 mg/ 5 mL Dexa Medica 29,898

40 Azitromisin tablet/kapsul/kaplet 500 mg Kimia Farma (Persero) Tbk, 1,888

41 Bedak salisil serbuk 2% Rama Emerald Multi Sukses 1,020
42 Betahistin tablet/kapsul/kaplet 6 mg Mersifarma TM 149
43 Betametason krim 0,1% (sebagai Valerat) Kimia Farma (Persero) Tbk, 1,349
44 Bisakodil tablet/kapsul/kaplet 5 mg Etercon Pharma 300
45 Bisoprolol tablet/kapsul/kaplet 5 mg Hexpharm Jaya Laboratories 260
46 Bupivakain injeksi 0.50% (HCl) + glukosa 8% Gagal N/A N/A
47 Deksametason injeksi i.v./i.m. 5 mg/ml Phapros, Tbk 1,540
Promedrahardjo Farmasi
48 Deksametason tablet/kapsul/kaplet 0,5 mg 41
Industri
49 Diazepam tablet/kapsul/kaplet 2 mg Gagal N/A N/A
50 Diazepam tablet/kapsul/kaplet 5 mg Mersifarma TM 103
51 Dietilkarbamazin tablet scored 100 mg Kimia Farma (Persero) Tbk, 156
52 Difenhidramin injeksi i.v./i.m. 10 mg/ml (HCl) Lucas Djaja 1,062
53 Digoksin tablet/kapsul/kaplet 0,25 mg Yarindo Farmatama 104
54 Diltiazem HCl tablet/kapsul/kaplet 30 mg Kimia Farma (Persero) Tbk, 135
55 Dimenhidrinat tablet/kapsul/kaplet 50 mg Kimia Farma (Persero) Tbk, 99
56 Dobutamin injeksi 50 mg/mL Etercon Pharma 14,300
57 Doksisiklin tablet/kapsul/kaplet 100 mg Indofarma (Persero) Tbk 268
58 Domperidon suspensi/sirup 5 mg/5 ml N/A N/A
59 Domperidon tablet/kapsul/kaplet 10 mg Dexa Medica 95
60 Domperidon tetes 5 mg/mL Gagal N/A N/A
61 Donepezil tablet/kapsul/kaplet 5 mg Guardian Pharmatama 1,980
62 Efedrin Inj 50 mg/ml Ethica Industri Farmasi 9,878
Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml
63 Ethica Industri Farmasi 1,749
(0,1%)
64 Eritromisin tablet/kapsul/kaplet 250 mg Lucas Djaja 557
65 Eritromisin sirup kering 200 mg/ 5 ml Phyto Kemo Agung Farma 6,150
66 Eritromisin tablet/kapsul/kaplet 500 mg Rama Emerald Multi Sukses 730
67 Esomeprazol serbuk Inj. 40 mg Meprofarm 33,389
68 Etambutol tablet/kaplet salut 500 mg (HCl) Bernofarm 505
69 Etambutol tablet/kapsul/kaplet 250 mg (HCl) Kimia Farma (Persero) Tbk, 359

70 Fenitoin injeksi 50 mg/ml (100 mg/2 ml) Phapros, Tbk 4,956

71 Fenobarbital injeksi i.m./i.v. 50 mg/ml Phapros, Tbk 1,740

72 Fenobarbital tablet/kapsul/kaplet 30 mg N/A N/A
Fitomenadion (Vit.K1) tablet/kaplet salut gula 10
73 Phapros, Tbk 686
mg
Novell Pharmaceutical
74 Flukonazol injeksi 2 mg/ml 28,000
Laboratories
75 Furosemid tablet/kapsul/kaplet 40 mg Sampharindo Perdana 80
76 Gabapentin tablet/kapsul/kaplet 300 mg Guardian Pharmatama 1,254
Garam Oralit I serbuk, kombinasi: Natrium
klorida 0,52 g + kalium klorida 0,30 g +
77 Rama Emerald Multi Sukses 260
Trinatrium sitrat dihidrat 0,58 g + Glukosa
Anhidrat 2,70 g
78 Gemfibrozil tablet/kapsul/kaplet 300 mg Indofarma (Persero) Tbk 364
79 Gemfibrozil tablet/kapsul/kaplet 600 mg Indofarma (Persero) Tbk 769
80 Gentamisin injeksi 40 mg/ ml Indofarma (Persero) Tbk 3,386
81 Gentamisin tetes mata 0,3% Erela 4,170
82 Glibenklamid tablet/kapsul/kaplet 5 mg Gagal N/A N/A
83 Glikuidon tablet/kapsul/kaplet 30 mg Dexa Medica 1,055
84 Glimepiride tablet/kapsul/kaplet 1 mg Hexpharm Jaya Laboratories 194
85 Glimepiride tablet/kapsul/kaplet 2 mg Guardian Pharmatama 231
86 Glimepiride tablet/kapsul/kaplet 3 mg Hexpharm Jaya Laboratories 283
87 Glimepiride tablet/kapsul/kaplet 4 mg Indofarma (Persero) Tbk 281
Griseofulvin (micronized) tablet/kapsul/kaplet
88 Kimia Farma (Persero) Tbk, 245
125 mg
89 Haloperidol tablet/kapsul/kaplet 0,5 mg Holi Pharma 56
90 Haloperidol tablet/kapsul/kaplet 5 mg Mersifarma TM 69
91 Haloperidol tablet/kapsul/kaplet 1,5 mg Holi Pharma 61
92 Hidrokortison krim 1% Kalbe Farma 2,803
93 Hidrokortison krim 2,5% Phapros, Tbk 2,639
94 Ibuprofen susp 100 mg/5 ml Rama Emerald Multi Sukses 2,475
95 Ibuprofen susp 200 mg/5 ml Indofarma (Persero) Tbk 4,943
96 Ibuprofen tablet/kapsul/kaplet 200 mg Novapharin 102
97 Ibuprofen tablet/kapsul/kaplet 400 mg Phyto Kemo Agung Farma 111
98 Irbesartan tablet/kapsul/kaplet 150 mg Indofarma (Persero) Tbk 483
99 Irbesartan tablet/kapsul/kaplet 300 mg Indofarma (Persero) Tbk 793
100 Isoniazid tablet/kapsul/kaplet 300 mg Kimia Farma (Persero) Tbk, 170
101 Isoniazid tablet/kapsul/kaplet 100 mg Holi Pharma 74
102 Isosorbid Dinitrat tablet/kaplet sublingual 5 mg Yarindo Farmatama 90
Kalsium Laktat (Kalk) tablet/kapsul/kaplet 500
103 Mersifarma TM 56
mg
Novell Pharmaceutical
104 Kandesartan tablet/kapsul/kaplet 16 mg 1,122
Laboratories
Novell Pharmaceutical
105 Kandesartan tablet/kapsul/kaplet 8 mg 693
Laboratories
106 Kaptopril tablet/kaplet scored 12,5 mg Phapros, Tbk 62

107 Kaptopril tablet/kaplet scored 25 mg Pertiwi Agung 80

108 Kaptopril tablet/kapsul/kaplet 50 mg Hexpharm Jaya Laboratories 119

109 Karbamazepin tablet/kapsul/kaplet 200 mg Mersifarma TM 228
110 Ketokonazol krim 2% Kimia Farma (Persero) Tbk, 2,596
111 Ketokonazol tablet/kapsul/kaplet 200 mg Novapharin 280
112 Ketorolak inj 30 mg/ml Hexpharm Jaya Laboratories 1,100
113 Klindamisin tablet/kapsul/kaplet 150 mg Gagal N/A N/A
114 Klindamisin tablet/kapsul/kaplet 300 mg Mersifarma TM 578
115 Klobazam tablet/kapsul/kaplet 10 mg Dexa Medica 967
Novell Pharmaceutical
116 Klomifen sitrat tablet/kapsul/kaplet 50 mg 1,155
Laboratories
117 Klonidin tablet/kapsul/kaplet 0,15 mg Kimia Farma (Persero) Tbk, 170
118 Klopidogrel tablet/kapsul/kaplet 75 mg Dexa Medica 1,650
119 Kloramfenikol salep mata 1 % Kimia Farma (Persero) Tbk, 1,810
120 Kloramfenikol suspensi 125 mg/ 5 ml Novapharin 4,700
121 Kloramfenikol tablet/kapsul/kaplet 250 mg Gagal N/A N/A
Klorfeniramina Maleat (CTM) tablet/kapsul/kaplet
122 Imfarmind Farmasi Industri 37
4 mg
123 Klorpromazin tablet/kaplet salut 100 mg (HCl) Mersifarma TM 144
124 Klorpromazin injeksi i.m. 25 mg/ml (HCl) Phapros, Tbk 1,205
125 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) Phapros, Tbk 1,456
126 Kodein tablet/kapsul/kaplet 10 mg Kimia Farma (Persero) Tbk, 550
127 Kodein tablet/kapsul/kaplet 15 mg Kimia Farma (Persero) Tbk, 950
128 Kodein tablet/kapsul/kaplet 20 mg Kimia Farma (Persero) Tbk, 1,250
kombinasi: (Sefoperazon 500 mg + Sulbaktam
129 Infion 19,900
500 mg) serb inj 1000 mg
130 kombinasi: ergotamin 1 mg + kafein 50 mg Kimia Farma (Persero) Tbk, 167
kombinasi: ferro fumarat 60 mg + as. Folat 0,4
131 Kimia Farma (Persero) Tbk, 350
mg tablet salut gula (tablet tambah darah)
kombinasi: Levonogestrel 150 mcg +
132 Kimia Farma (Persero) Tbk, 1,350
etinilestradiol 30 mcg
Kotrimoksazol (anak) kombinasi tiap 5 ml
133 suspensi: sulfametoksazol 200 mg + trimetoprim Holi Pharma 2,286
40 mg
Kotrimoksazol (dewasa) kombinasi:
134 Mersifarma TM 129
sulfametoksazol 400 mg + trimetoprim 80 mg
Kotrimoksazol forte kombinasi: sulfametoksazol
135 Bernofarm 321
800 mg + trimetoprim 160 mg
136 Lansoprazol tablet/kapsul/kaplet 30 mg Indofarma (Persero) Tbk 315

137 Levofloksasin inf 5 mg/mL Dexa Medica 22,318

Novell Pharmaceutical
138 Levofloksasin tablet/kapsul/kaplet 500 mg 650
Laboratories
139 Lidokain injeksi 2% (HCL) Phapros, Tbk 1,110
Lidokain injeksi 2% (HCl) + Epinefrin 1: 80.000 -
140 Lucas Djaja 1,937
2 mL
141 Lisinopril tablet/kapsul/kaplet 10 mg Dexa Medica 319
142 Lisinopril tablet/kapsul/kaplet 5 mg Dexa Medica 269
Ifars Pharmaceutical
143 Loperamid tablet/kapsul/kaplet 2 mg 80
Laboratories
144 Loratadin tablet/kapsul/kaplet 10 mg Hexpharm Jaya Laboratories 123
145 Meropenem serb inj 1000 mg Bernofarm 38,990
146 Meropenem serb inj 500 mg Dexa Medica 27,200
147 Metformin HCl tablet/kapsul/kaplet 500 mg Hexpharm Jaya Laboratories 94
148 Metformin HCl tablet/kapsul/kaplet 850 mg Tempo Scan Pacific Tbk 156
149 Metilergometrin inj 0,2 mg/ml Ethica Industri Farmasi 2,849
Metilergometrin Maleat (Metilergometrin)
150 N/A N/A
tablet/kaplet salut 0,125 mg
151 Metilprednisolon inj 125 mg/mL Phapros, Tbk 12,090
152 Metilprednisolon inj 500 mg/vial Bernofarm 64,973
Ifars Pharmaceutical
153 Metilprednisolon tablet/kapsul/kaplet 16 mg 612
Laboratories
154 Metilprednisolon tablet/kapsul/kaplet 4 mg Molex Ayus 150
155 Metilprednisolon tablet/kapsul/kaplet 8 mg Bernofarm 295
156 Metoklopramide tablet/kapsul/kaplet 10 mg Kimia Farma (Persero) Tbk, 87
157 Metoklopramide tablet/kapsul/kaplet 5 mg N/A N/A
Finusolprima Farma
158 Metronidazol infus 5 mg/ ml 8,525
Internasional
159 Metronidazol tablet/kapsul/kaplet 250 mg Phyto Kemo Agung Farma 90
160 Metronidazol tablet/kapsul/kaplet 500 mg Phyto Kemo Agung Farma 113
161 Mikonazol krim/salep 2 % (Nitrat) Gagal N/A N/A
162
163 Mometason furoat krim 0,1% Etercon Pharma 13,000
164 N-asetil sistein tablet/kaplet/kapsul 200 mg Gagal N/A N/A
165 Natrium Bikarbonat tab 500 mg Gagal N/A N/A
166 Natrium diklofenak tablet/kapsul/kaplet 25 mg Phapros, Tbk 132

167 Natrium diklofenak tablet/kapsul/kaplet 50 mg Phapros, Tbk 122

168 Nifedipin tablet/kapsul/kaplet 10 mg Dexa Medica 99

169 Nikardipin inj 10 mg Dexa Medica 25,149
170 Nistatin tablet/kaplet salut 500.000 IU/ g Phapros, Tbk 765
171 Nistatin vaginal tablet 100.000 IU/ g Phapros, Tbk 545
172 Obat Anti Tuberculosis FDC Kategori Anak Indofarma (Persero) Tbk 223,585
173 Obat Anti Tuberculosis FDC Kategori I Kimia Farma (Persero) Tbk, 374,380

174 Obat Anti Tuberculosis FDC Kategori II Phapros, Tbk 1,247,980

175 Obat Anti Tuberculosis FDC Kategori Sisipan Phapros, Tbk 166,380

176 Ofloksasin tablet/kapsul/kaplet 200 mg Indofarma (Persero) Tbk 440

177 Ofloksasin tablet/kapsul/kaplet 400 mg Indofarma (Persero) Tbk 605

178 Omeprazol injeksi 40 mg/ 10 ml Dexa Medica 11,868

179 Omeprazol tablet/kapsul/kaplet 20 mg Novapharin 140

180 Ondansetron inj 2 mg/ml (4 mg/ 2 mL) Soho Industri Pharmasi 1,254
181 Ondansetron tablet/kapsul/kaplet 4 mg Indofarma (Persero) Tbk 455
Novell Pharmaceutical
182 Ondansetron tablet/kapsul/kaplet 8 mg 440
Laboratories
183 Parasetamol drips (infus) 1000 mg/100 mL Natura Laboratoria Prima 12,940
184 Parasetamol sirup 120 mg / 5 ml Mersifarma TM 1,010

185 Parasetamol tablet/kapsul/kaplet 500 mg Mersifarma TM 49

186 Pioglitazon tab 30 mg Gagal N/A N/A

187
188 Pirantel pamoat tablet/kapsul/kaplet 125 mg Holi Pharma 277
189 Pirazinamid tablet/kapsul/kaplet 500 mg Holi Pharma 228
190 Piridoksin (vitamin B6) inj 100 mg/mL N/A N/A
Novell Pharmaceutical
191 Pravastatin tablet/kapsul/kaplet 20 mg 1,980
Laboratories
192 Prednison tablet/kapsul/kaplet 5 mg Holi Pharma 76

193 Prokain Benzilpenisilin serbuk injeksi 3 juta IU Gagal N/A N/A

194 Propiltiourasil tablet/kapsul/kaplet 100 mg Gagal N/A N/A
195 Propranolol tab 40 mg Holi Pharma 75
196 Propranolol tablet/kapsul/kaplet 10 mg Holi Pharma 52
Novell Pharmaceutical
197 Ramipril tablet/kapsul/kaplet 10 mg 770
Laboratories
Novell Pharmaceutical
198 Ramipril tablet/kapsul/kaplet 5 mg 330
Laboratories
199 Ranitidin injeksi 25 mg/ml Natura Laboratoria Prima 1,458
200 Ranitidin tablet/kapsul/kaplet 150 mg Hexpharm Jaya Laboratories 98
201 Retinol (vitamin A) kaps lunak 200.000 UI Lucas Djaja 508
202 Rifampisin tablet/kapsul/kaplet 300 mg Indofarma (Persero) Tbk 747
203 Rifampisin tablet/kapsul/kaplet 450 mg Indofarma (Persero) Tbk 868
204 Rifampisin tablet/kapsul/kaplet 600 mg Indofarma (Persero) Tbk 1,108
205 Risperidon tablet/kapsul/kaplet 1 mg Guardian Pharmatama 308
206 Risperidon tablet/kapsul/kaplet 2 mg Dexa Medica 347
207 Risperidon tablet/kapsul/kaplet 3 mg Dexa Medica 560
Salbutamol tablet/kapsul/kaplet 2 mg (sebagai
208 Phapros, Tbk 78
Sulfat)
Salbutamol tablet/kapsul/kaplet 4 mg (sebagai
209 Phapros, Tbk 95
Sulfat)
Salep 2-4, kombinasi: asam salisilat 2% +
210 Marin Liza Farmasi 2,527
belerang endap 4%
211 Sefadroksil sirup kering 125 mg/5ml Holi Pharma 3,984
212 Sefadroksil sir kering 250 mg/5 ml Holi Pharma 5,255
213 Sefadroksil tablet/kapsul/kaplet 250 mg Gagal N/A N/A
214 Sefadroksil tablet/kapsul/kaplet 500 mg Pharma Laboratories 450
Ifars Pharmaceutical
215 Sefaleksin tablet/kapsul/kaplet 500 mg 669
Laboratories
216 Sefazolin serbuk injeksi 1 g Dexa Medica 16,718

217 Sefepim serb inj 1000 mg Dexa Medica 28,797

218 Sefiksim sirup kering 100 mg/ 5 ml Pharma Laboratories 6,150

219 Sefiksim tablet/kapsul/kaplet 100 mg Hexpharm Jaya Laboratories 750

220 Sefiksim tablet/kapsul/kaplet 200 mg Dexa Medica 2,218

221 Sefoperazon serb inj 1.000 mg Holi Pharma 17,450

222 Sefotaksim serb inj 1.000 mg Dexa Medica 4,663

223 Sefotaksim serb inj 500 mg Holi Pharma 5,830

224 Sefpirom serb inj 1000 mg Etercon Pharma 52,500

225 Seftazidim serb inj 1.000 mg Hexpharm Jaya Laboratories 11,880

226 Seftriakson serb inj 1.000 mg Gagal N/A N/A

227 Sertralin tablet/kapsul/kaplet 50 mg Guardian Pharmatama 1,960
228 Setirizin sirup 5 mg/5 ml Erela 3,150

229 Setirizin tablet/kapsul/kaplet 10 mg Phapros, Tbk 96

230 Sianokobalamin (vitamin B12) injeksi 500 mcg Lucas Djaja 1,087
Sianokobalamin (vitamin B12)
231 Marin Liza Farmasi 51
tablet/kapsul/kaplet 50 mcg
232 Simvastatin tablet/kaplet/salut 10 mg Mersifarma TM 111

233 Simvastatin tablet/kaplet/salut 20 mg Natura Laboratoria Prima 229

234 Siprofloksasin inf 2 mg/ml (2%) Hexpharm Jaya Laboratories 9,911
235 Siprofloksasin tab scored 500 mg Novapharin 240
236 Spiramisin tablet/kapsul/kaplet 500 mg Gagal N/A N/A
237 Spironolakton tablet/kapsul/kaplet 100 mg Dexa Medica 699
238 Spironolakton tablet/kapsul/kaplet 25 mg Dexa Medica 244
239 Sukralfat susp 500 mg/5 mL, 100 ml Meprofarm 8,338
240 Sulfadiazin tablet 500 mg Imfarmind Farmasi Industri 285
241 Tetrasiklin tablet/kapsul/kaplet 500 mg Novapharin 310

242 Tetrasiklin tablet/kapsul/kaplet 250 mg Holi Pharma 168

Tiamin (Vitamin B1) tablet/kapsul/kaplet 50 mg
243 Novapharin 82
(HCl/ Nitrat)
244 Tramadol injeksi 50 mg/ml Mersifarma TM 1,710

245 Trifluoperazin tablet/kaplet/salut 5 mg Mersifarma TM 274

246 Triheksifenidil tablet/kapsul/kaplet 2 mg Holi Pharma 80
247 Valasiklovir tablet/kapsul/kaplet 500 mg Bernofarm 6,659
248 Valproat sirup 250 mg/5 ml Dexa Medica 22,987
249 Verapamil tablet/kapsul/kaplet 80 mg (HCl) Kimia Farma (Persero) Tbk, 303
250 Zinc sir 20 mg/5 ml Meprofarm 4,789
251 Zinc tablet dispersible 20 mg Kimia Farma (Persero) Tbk, 513
252 Furosemid inj 10mg/ml (i.v./i.m) N/A N/A
253 Griseofulvin tablet/kapsul/kaplet 500 mg Gagal N/A N/A
254 Medroksi progesteron asetat injeksi depo 150 mg/ Gagal N/A N/A
255 Metoklopramide inj 5 mg/mL Bernofarm 3,395
256 Nimodipine Infus 0,2 mg/ml (0,02%) Gagal N/A N/A
 Medroksi progesteron asetat injeksi 150 mg/3ml
257 Tunggal Idaman Abdi 5,435
(50 mg/mL)