Obat peringkat Merk NAMA OBAT

1.1 Morfin 1 MST 10MG TABLET ****

MST 15MG TAB****
2 MORPHINE HCL INJEKSI ****
Fentanyl 1 DUROGESIC 25MU ***
Petidin 2 PETHIDIN HCL INJEKSI *******###

1.2 Asam Mefenamat 1 ASAM MEFENAMAT 500MG TABLET

ASAM MEFENAMAT 500MG (ASKES)
2 MEFINAL 500MG TABLET
MEFINAL 250MG TABLET
3 PONSTAN 500MG TABLET
4 PONDEX SYRUP
5 MEFINTER 500MG TABLET
Asam Traneksamat 1 ASAM TRANEKSAMAT 250 INJ
ASAM TRANEKSAMAT 500 INJ
ASAM TREXAMANAT TAB ASKES
Asetilsalisilat 1 APTOR TABLET
Baklofen 1 LIORESAL 10MG TABLET
Celecoxib 1 CELEBREX 200 TABLET
CELEBREX 100 TABLET
Ca Karbonat 1 DUMOCALCIN MINT/CHOCO TABLET
Ca Phenylbutazone 1 NEUROFENAK PLUS CAP
2 NEW SKELAN
Diaserin 1 ARTRODAR
Dexketorofen 1 KETOPROFEN 100MG
KETOPROFEN 2ML INJEKSI
KETOPROFEN 50MG TAB
(+ketoprofen) KETESE TABLET
KETESE INJEKSI"
Etodolak 1 LONENE 200MG TABLET
LONENE 300MG TABLET
Etoricoxib 1 ARCOXIA 60MG
ARCOXIA 90MG
ARCOXIA 120MG
Fentanyl 1 FENTANYL 2ML/AMPUL
FENTANYL INJEKSI / MILI ****
Fucoidan FUCOHELIX 100 MG TAB
Ibuprofen 1 PRORIS 200MG KAPLET
PRORIS SUSP 60ML
2 BUFECT FORTE SUSP.
BUFECT SUSPENSI 60ML SYRUP
3 IBUPROFEN 200 SY
IBUPROFEN 200MG TABLET
 IBUPROFEN 400MG TABLET
IBUPROFEN SUS 100MG/5ML 60ML
K Diklofenak 1 EFLAGEN 25MG TABLET
EFLAGEN 50MG TABLET
2 KALIUM DIKOFENAK 50MG
KALIUM DIKOFENAK 25MG
Leflunomide 1 ARAVA 20MG TABLET
Ketoprofen 1 KALTROFEN EC 50MG TABLET
KALTROFEN EC 100MG TABLET
KALTROFEN SUPP.
KALTROFEN INJEKSI
KALTROFEN GEL
2 ALTOFEN 50MG AMP
Ketorolac 1 Ketorolac 10mg tab
KETOROLAC 30MG INJEKSI
KETOROLAC 30MG INJ (ASKES)
2 TORASIC 10 TAB
TORASIC 30MG INJEKSI
3 SCELTO 30MG INJEKSI
SCELTO 30MG INJ (ASKES)
SCELTO 10MG INJEKSI
4 RATIVOL INJ
5 KETROBAT 30 MG inj
6 REMOPAIN 3% INJEKSI
7 KETOPAIN 30 INJ
8 TERANOL 30 MG/1 ML INJ
TORADOL 30MG INJ
Metampiron 1 ANTALGIDON INJ
Meloxicam 1 MELOXICAM 15MG TABLET
Meloxicam 15mg tab askes
MELOXICAM 7,5MG TABLET
MELOXICAM 7,5MG TAB (ASKES)
2 OSTELOX 15 MG TAB
OSTELOX 7,5 TABLET
3 MEXPHARM 15MG TABLET
MEXPHARTM 7,5MG TABLET
4 MOBIFLEX 15 TAB
5 ARTRILOX 15MG TABLET
6 MOXAM SUPOSITORIA
7 ARTRILOX 7,5MG TABLET
8 MELOXIN 7,5MG TABLET
Mesalazine 1 SALOFALK 250MG TABLET
SALOFALK ENEMA 50ML
 SALOFALK 500 MGTABLET
Metamizolen 1 PRONEURON TABLET ****
2 NOVALGIN SYRUP
NOVALGIN TABLET
Metampiron + diazepam 1 ANALSIK TABLET ****
2 DANALGIN TAB ***
NOVALGIN 2ML INJEKSI
NA Diklofenak 1 NATRIUM DIKLOFENAK 25MG TABLET
NATRIUM DICLOFENAC 50MG TABLET
2 FLAMAR 25MG TABLET
FLAMAR 50MG TABLET
3 DEFLAMAT 100MG CR TABLET
DEFLAMAT CR 75MG CAP
(+ vit B1, vit B6) 4 DOLOFENAC TABLET
Nabumetason 1 GOFLEX TABLET
Piroxicam 1 PIROXICAM 20MG TABLET
PIROXICAM 10MG TABLET
2 FELDEN FLASH 20MG TAB
Seratiopeptidase 1 NUTRIFLAM KAPSUL
tramadol 1 TRAMADOL 50MG TABLET
TRAMADOL 100ML INJ
TRAMADOL 50MG TAB (ASKES)
TRAMADOL 100MG/2ML INJ (ASKES)
TRAMADOL 50 ML INJEKSI
2 TRADOSIK CAPSUL
TRADOSIK INJEKSI
3 TRAMAL 50 MG INJEKSI
TRAMAL SUPP
TRAMAL 100MG INJEKSI
TRAMAL RETARD 100MG TABLET
Tiroridin 1 NONFLAMIN TABLET
NONFLAMIN CAPSUL (ASKES)

Parecoxin Na 1 DYNACAST 4/DELTA LIFE 4

DYNASTAT INJEKSI
Parasetamol 1 SANMOL TABLET
SANMOL 500 EFF
SANMOL DROP
SANMOL INF
SANMOL SYRUP
2 Paracetamol 500mg tab
PARACETAMOL 15ML DROP
Paracetamol 60ml syr(ogb)
 PARACETAMOL DROPS ASKES
PARACETAMOL SYRUP
(+Tramadol) 3 ZALDIAR TAB
(+Tramadol) 4 TRAMIFEN TAB
(+ ibuprofen, kafein) 5 NEURALGIN TABLET
(Asetilsistein) 6 SISTENOL TABLET
7 SUMAGESIC TABLET
8 PANADOL TABLET
9 NAPREX 250 MG SYR
10 NAFREX TST RITE 250 MG SYR
NAPREX TST RITE 250MG/60ML SYR
11 DUMIN 125MG/2.5 ML SUPP.
DUMIN RECTAL 250MG/2,5ML SUPP
12 OTTOPAN DROP
OTTOPAN SYRUP
13 PRAXION 1205MLSUSP
PRAXION 250/5ML SUSP
(+Tramadol) 14 TOPSY CREAM
15 BIOGESIC TABLET
16 FARMADOL INFUS
17 PAMOL 60ML SYRUP
PAMOL TABLET
18 PRIMADOL KAPLET
(+Tramadol) 19 ACETRAM TABLET

1.3 allopurinol 1 ALLOPURINOL 100MG TABLET

ALLOPURINOL 300MG TAB
ALLOPURINOL 100MG TAB (ASKES)
ALLOPURINOL 300MG TAB (ASKES)
2 PURICEMIA TABLET
3 ZYLORIC 300MG TABLET
ZYLORIC 100MG TABLET
Recolfar RECOLFAR TABLET
Probenesid PROBENID TAB 500MG
KOMPOSISI KETERANGAN GOL. FARMAKOLOGI
morfin sulfat 10mg 1 1.1
morfin sulfat 15mg 1 1.1
morphine 1 1.1
fentanyl 1 1.1
petidin 50mg/ml 1 1.1

asam mefenamat 500 mg 1 1.2

asam mefenamat 500 mg 1 1.2
asam mefenamat 500mg 1 1.2
asam mefenamat 250mg 1 1.2
asam mefenamat 500mg 1 1.2
asam mefenamat 1 1.2
asam mefenamat 1 1.2
asam traneksamat 1 1.2
asam traneksamat 1 1.2
asam trexamanat 1 1.2
asam asetilsalisilat 1-10 1.2 10.2
Baklofen 1 1.2
celecoxib 200mg 1 1.2
celecoxib 100mg 1 1.2
kalsium karbonat 500 mg 1 1.2
1 1.2
Ca phenylbutazone 200 mg, carisoprodol 125 mg 1 1.2
diaserin 1 1.2
dexketoprofen trometamol 1 1.2
dexketoprofen trometamol 1 1.2
dexketoprofen trometamol 1 1.2
ketoprofen, dexketoprofen 1 1.2
ketoprofen, dexketoprofen 1 1.2
etodolak 1 1.2
etodolak 1 1.2
etoricoxib 1 1.2
etoricoxib 1 1.2
etoricoxib 1 1.2
fentanyl 50 g / ml 1 1.1
fentanyl 50 g / ml 1 1.1
Fucoidan 1 1.2
ibuprofen 1 1.2
ibuprofen 1 1.2
ibuprofen 200mg/5ml 1 1.2
ibuprofen 100mg/5ml 1 1.2
ibuprofen 1 1.2
ibuprofen 1 1.2
ibuprofen 1 1.2
ibuprofen 1 1.2
diklofenak K 25 mg 1 1.2
diklofenak K 50 mg 1 1.2
1 1.2
1 1.2
leflunomide 1 1.2
ketoprofen 1 1.2
ketoprofen 1 1.2
ketoprofen 1 1.2
ketoprofen 1 1.2
ketoprofen 1 1.2
ketoprofen 1 1.2
1 1.2
ketorolac tromethamine 1 1.2
1 1.2
ketorolac tromethamine ketorolac 1 1.2
ketorolac tromethamine ketorolac 1 1.2
ketorolak 30mg/ml 1 1.2
ketorolak 30mg/ml 1 1.2
ketorolak 10mg/ml 1 1.2
ketorolac 1 1.2
1 1.2
ketorolac 1 1.2
ketorolac tromethamine 1 1.2
ketorolac tromethamine 1 1.2
ketorolactromethamine 1 1.2
metampiron 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloksikam 15mg 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
meloxicam 1 1.2
mesalazine 1 1.2
mesalazine 1 1.2
mesalazine 1 1.2
metamizolen 1 1.2
metamizolen sodium 1 1.2
metamizolen sodium 1 1.2
methampyrone, diazepam 1 1.2
methampiron 500 mg, diazepam 2 mg 1 1.2
metamizolen sodium 1 1.2
natium diclofenac 1 1.2
natium diclofenac 1 1.2
diklofenak Na 1 1.2
diklofenak Na 1 1.2
natrium diclofenac 1 1.2
natrium diclofenac 1 1.2
diklofenak Na, vit B1, vit B6 1 1.2
nabumetone 1 1.2
piroxicam 1 1.2
piroxicam 1 1.2
piroksikam 1 1.2
seratiopeptidase 1 1.2
tramadol tramadol 1 1.2
tramadol tramadol 1 1.2
tramadol tramadol 1 1.2
tramadol tramadol 1 1.2
tramadol tramadol 1 1.2
tramadol 50 mg tramadol 1 1.2
tramadol 50 mg tramadol 1 1.2
tramadol tramadol 1 1.2
tramadol tramadol 1 1.2
tramadol tramadol 1 1.2
tramadol 1 1.2
tinoridin 1 1.2
tinoridin 1 1.2

parecoxib natrium 1 1.2

parecoxib natrium 1 1.2
parasetamol 500 mg 1 1.2
1 1.2
parasetamol 100mg/ml 1 1.2
1 1.2
parasetamol 120mg/5ml 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
tramadol, paracetamol tramadol (+paracetamol) 1 1.2
tramadol (+paracetamol) tramadol (+paracetamol) 1 1.2
paracetaol, ibuprofen, kafein 1 1.2
asetilsistein 200mg + parasetamol 500mg 1 1.2
parasetamol 500 mg 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
micronized paracetamol 1 1.2
micronized paracetamol 1 1.2
tramadol (+paracetamol) 1 1.2
paracetamol 1 1.2
paracetamol 1 1.2
1 1.2
paracetamol 1 1.2
parasetamol 1 1.2
tramadol, paracetamol 1 1.2

allopurinol 1 1.3
allopurinol 1 1.3
allopurinol 1 1.3
allopurinol 1 1.3
allopurinol 1 1.3
1 1.3
Allopurinol 1 1.3
kolkisin 1 1.3
probenesid 1 1.3
FORMULARIUM GENERIK JAN FEB MAR APR MEI JUN
2 0 10 10 0 11 0 0
2 0 0 0 0 0 0 0
2 1 4 2 2 4 2 2
2 0 1 1 0 1 0 0
2 1 10 2 3 5 7 6

2 1 552 547 594 490 722 430

2 1 6 25 15 10 8 50
2 0 1225 1222 1182 1633 1164 1056
2 0 66 70 30 40 40 76
2 0 56 32 43 67 57 28
0 0 0 0 0 0 0
0 0 0 0 0 0 0
2 1 0 0 0 1 3 1
2 1 20 15 0 0 0 0
2 1 0 0 0 20 20 0
2 0 20 0 0 0 0 17
0 0 0 0 0 0 0
2 0 264 238 325 976 523 403
2 0 33 76 236 0 0 0
0 25 8 20 0 0 0
0 233 82 130 236 233 193
0 0 0 0 0 0 0
2 0 60 119 105 138 259 65
2 1 0 0 0 0 0 0
2 1 0 0 0 0 0 1
2 1 15 16 20 0 0 22
0 225 218 119 69 272 167
0 0 0 0 0 0 0
0 0 6 10 62 105 8
0 35 0 50 125 72 40
0 247 148 194 258 120 50
0 49 29 83 106 101 0
0 0 42 98 108 68 3
2 1 0 1 1 20 20 0
2 1 0 0 0 15 0 0
0 0 0 0 125 52 198
2 0 86 77 66 66 100 54
2 0 0 0 1 0 0 0
2 0 91 110 84 76 68 28
2 0 0 0 0 0 0 0
2 1 1 4 5 71 30 11
2 1 120 70 24 0 0 0
2 1 10 10 0 16 10 13
2 1 2 2 2 4 7 5
2 0 43 60 116 490 722 430
2 0 151 40 118 10 8 50
2 1 10 10 40 19 10 10
2 0 0 20 0 0 0 0
0 40 5 15 15 0 26
2 0 130 137 68 139 52 133
2 0 45 0 30 42 26 56
2 0 15 4 13 9 17 19
2 0 0 0 1 6 1 3
2 0 0 0 0 0 2 1
2 0 0 0 0 0 0 0
2 1 181 55 0 5 6 0
2 1 17 8 9 7 30 9
2 1 4 0 8 3 2 0
2 0 17 0 16 20 33 21
2 0 1 0 0 0 0 0
2 0 9 26 3 19 24 13
2 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
0 4 9 11 21 2 3
0 1 7 1 0 9 6
0 0 10 0 0 0 0
2 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0
0 0 0 0 0 0 0
2 0 0 0 0 0 5 0
2 1 379 399 386 617 550 416
2 1 30 3 25 28 20 5
2 1 124 135 78 99 278 113
2 1 0 5 0 0 0 0
2 0 483 479 395 561 337 216
2 0 92 50 60 71 67 52
0 14 6 5 56 109 84
0 0 0 0 0 0 0
2 0 20 12 0 5 0 0
0 0 0 0 0 0 0
2 0 1 2 0 0 1 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 21 15 0 10 0 30
0 1 0 0 0 0 0
 0 0 0 0 0 0 0
0 856 363 982 1026 607 513
2 0 2 1 4 4 3 0
2 0 15 0 0 0 0 0
2 0 892 994 637 976 523 403
0 0 0 0 0 10 0
2 0 6 0 8 6 0 1
2 1 50 80 122 60 210 70
2 1 179 125 116 90 88 55
2 0 26 72 40 76 68 28
2 0 55 0 42 0 0 0
2 0 6 157 164 0 5 0
2 0 88 78 40 0 0 17
2 0 0 0 0 258 120 50
2 0 8 112 128 362 340 45
2 1 140 12 0 47 15 12
2 1 0 40 0 24 0 10
2 0 7 0 0 0 0 0
2 0 538 473 364 436 429 264
2 1 181 142 119 140 137 252
2 1 12 29 25 13 30 37
2 1 0 30 36 1 20 0
2 1 0 0 0 0 0 0
2 1 0 0 0 0 0 0
2 0 0 35 10 15 41 31
2 0 0 0 0 0 0 0
2 0 32 4 21 4 20 3
2 0 8 6 6 21 15 0
2 0 1 2 2 2 0 4
2 0 0 10 5 0 0 0
2 0 529 513 563 459 342 264
2 0 12 10 10 47 0 0

2 0 0 0 0 0 0 0
2 0 0 1 0 138 259 65
2 0 4320 3140 3455 2898 2486 1607
2 0 0 0 0 0 20 15
2 0 20 36 32 25 34 47
2 0 5 0 6 3 19 20
2 0 88 69 132 78 73 47
2 1 435 591 398 446 1417 327
2 1 1 0 1 2 1 1
2 1 2 1 4 1 5 1
2 1 0 0 0 0 2 1
2 1 5 7 8 17 29 7
2 0 627 542 554 569 527 446
2 0 311 294 343 273 373 142
0 310 180 237 220 180 178
0 180 132 236 85 247 144
0 167 70 150 98 170 78
0 30 33 71 32 45 53
0 41 23 22 37 38 65
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 10 14 11 106 101 0
0 5 0 0 108 68 3
2 0 18 10 29 21 22 8
2 0 0 0 1 1 0 0
0 0 0 0 0 0 0
0 17 13 17 8 21 1
0 3 1 0 5 1 2
0 0 0 0 15 0 0
0 0 7 0 1 3 1
2 0 0 0 2 0 0 1
2 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

2 1 330 315 447 365 509 158

2 1 35 10 95 65 40 70
2 1 0 0 0 0 0 15
2 1 0 0 0 0 0 0
2 0 45 10 0 7 0 10
2 0 0 0 10 29 0 0
2 0 0 0 0 30 0 0
2 0 50 190 204 222 117 103
2 0 0 100 0 0 0 0
JUL AGS SEP OKT NOV DES TOTAL
0 15 0 37 5 0 88
0 0 0 0 0 0 0
2 0 2 0 0 1 21
0 2 0 0 1 1 7
4 0 0 0 8 6 51

623 140 290 236 256 453 5333 5333

60 25 16 35 10 50 310 310
1265 211 270 437 345 1134 11144 11144
141 10 0 51 55 146 725 725
28 19 15 20 31 61 457 457
0 1 2 0 0 0 3 0
0 0 0 0 0 0 0 3
1 0 3 0 0 0 9 9
0 0 0 0 2 3 40 40
0 0 0 0 10 25 75 75
17 0 0 0 0 0 54 54
0 0 0 0 0 0 0 0
493 127 121 168 177 707 6218 4522
0 0 0 0 0 0 0 345
0 0 15 0 0 0 15 68
232 40 175 115 100 332 2101 2101
0 0 0 8 0 0 8 8
102 14 50 0 44 150 1106 1106
0 0 0 0 0 0 0
0 0 0 0 0 6 7 7
38 0 0 16 0 20 147 147
195 23 18 55 32 167 1560 1560
0 0 0 0 0 0 0 0
30 0 5 0 0 0 226 226
40 0 0 20 0 40 422 422
65 10 76 80 118 103 1469 1469
0 0 0 0 101 0 469 469
32 0 2 30 38 8 429 429
0 0 0 0 10 25 75 77
0 0 0 0 0 0 15 15
220 10 75 75 40 188 1328 983
148 15 10 5 18 45 690 690
0 0 0 0 0 0 1 1
39 13 15 22 31 55 632 345
0 0 0 0 0 0 214 214
21 15 20 22 50 95 662 192
0 0 0 0 0 0 44 44
 35 10 45 0 3 40 192
7 3 0 4 4 4 44 0
623 140 290 236 256 453 5333 3859
60 25 16 35 10 50 310 573
10 27 10 13 10 71 240 240
0 0 20 0 0 0 40 40
26 30 0 0 0 0 157 157
249 40 62 131 110 377 1628 1628
32 20 10 30 20 80 391 391
25 3 4 23 7 10 149 149
0 0 0 0 0 6 17 17
2 0 0 0 1 0 6 6
0 0 0 0 0 0 0 0
0 0 0 6 0 100 353 353
17 0 1 15 20 19 152 152
0 4 16 6 0 3 46 46
31 0 0 10 30 0 178 178
0 0 0 3 0 0 4 4
28 2 2 0 0 9 135 135
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
10 1 1 4 1 22 89 89
0 0 1 0 2 15 42 42
0 0 0 0 0 7 17 17
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
2 3 1 10 0 0 21 21
744 218 301 402 181 440 5033 5033
10 20 15 26 5 35 222 222
182 20 45 94 203 152 1523 1523
0 0 0 0 0 90 95 95
286 100 82 258 174 360 3731 3731
102 12 30 71 45 180 832 832
93 0 50 0 10 22 449 449
0 0 0 0 0 0 0 0
0 0 0 0 0 6 43 43
0 0 15 0 0 0 15 15
0 0 0 0 0 0 4 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
30 0 0 0 0 0 106 106
0 0 0 0 0 0 1 1
 0 0 0 0 0 0 0 0
663 212 368 471 442 1156 7659 7659
2 0 2 1 3 2 24 24
6 0 0 0 0 5 26 26
493 127 121 168 177 707 6218 6218
0 10 10 0 0 30 60 60
1 0 0 0 0 1 23 23
85 10 70 175 160 197 1289 1289
100 72 65 20 150 75 1135 1135
39 13 15 22 31 55 632 485
0 0 0 0 0 0 0 97
2 3 1 10 0 0 21 348
17 0 0 0 0 0 54 240
65 10 76 80 118 103 1469 880
149 4 69 112 180 283 2371 1792
24 0 0 24 20 0 294 294
10 0 0 12 0 24 120 120
0 0 0 0 2 3 12 12
378 105 136 434 464 966 4987 4987
287 56 42 95 183 83 1717 1717
29 0 0 3 8 22 208 208
0 8 22 30 10 15 172 172
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
46 5 0 25 30 0 238 238
0 0 0 0 0 0 0 0
3 0 4 3 3 0 97 97
0 3 0 0 1 8 68 68
7 0 0 0 2 15 35 35
0 0 0 0 0 0 15 15
400 125 106 160 235 413 4109 4109
0 0 10 5 10 0 104 104

0 0 0 0 0 0 0 0
102 14 50 0 44 150 1106 823
2202 505 489 872 1246 3147 26367 26367
14 0 0 0 0 0 49 49
58 9 1 9 18 18 307 307
15 1 0 4 1 4 78 78
59 13 17 32 34 62 704 704
501 133 232 247 374 441 5542 5542
3 0 0 0 0 0 9 9
2 1 4 7 9 4 41 41
 1 0 0 0 0 1 5 5
24 5 5 7 4 5 123 123
561 116 108 166 263 770 5249 5249
156 79 30 78 99 202 2380 2380
254 140 111 166 151 175 2302 2302
225 100 110 65 50 222 1796 1796
142 125 143 106 124 102 1475 1475
103 40 1 0 30 84 522 522
75 9 15 0 0 54 379 379
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 101 0 469 343
32 0 2 30 38 8 429 294
7 7 7 10 9 25 173 173
0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0
2 2 7 2 2 3 95 95
2 1 1 1 0 0 17 17
0 0 0 0 0 0 15 15
1 0 3 0 0 0 9 16
1 0 0 0 0 0 4 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

183 219 55 135 248 273 3237

100 46 75 0 66 90 692
15 0 0 21 23 10 84
0 0 0 0 0 0 0
20 30 40 0 15 25 202
15 0 0 0 0 0 54
0 0 0 0 0 5 35
217 45 46 111 78 35 1418
0 100 0 0 0 0 200
 ANTIALERGI DAN OBAT UNTUK ANAFILAKSIS

ZAT AKTIF NAMA OBAT KOMPOSIS KETERANGAN

1 CETIRIZINECETIRIZINE 10 TABLET cetirizin 3
CETIRIZINE 50 TABLET cetirizin 3
CETIRIZINE 12ML DROP cetirizin 3
CETIRIZINE 5MG/5ML 60ML SYRUP cetirizin 3
2 CETINAL 10MG cetirizin 3
3 HISTRIN TABLET cetirizin HCl 3
HISTRIN 60ML SYRUP cetirizin HCl 3
HISTRINE DROP cetirizin HCl 3
HISTRINE FT 5MG TAB cetirizin HCl 3
4 OZEN SYRUP 60ML cetirizine 3
OZEN DROP 12ML cetirizine 3
OZEN 10MG TAB 3
5 RYZEN TABLET setirizin HCl 10 ml 3
1 CHLORPHECTM 4MG TABLET klorfeniramin maleat 3
1 CYPROHEPT
HEPTASAN TABLET cyproheptadin HCl 3
1 DEXCHLORDEXTAMINE TABLET Dexamethasone 3
DEXTAMINE SYR 60ML Dexamethasone 3
2 CELESTAMIN TABLET Per tab / 5 ml betam 3
CELESTAMIN 30ML SYRUP dexchlorpheramine m3
CELESTAMIN 60ML SYRUP dexchlorpheramine m3
3 OCUSON TABLET Betamethasone/Betam 3
4 DEXON 3/0 20 Dexamethasone 3
5 COLERGIS SYRUP betametason, deksklo3
1 DESLORATAAERIUS 5MG TABLET desloratadin 3
1 DIMENHYDDRAMAMINE TABLET dimenhidrinat 3-23
2 DRAMASINE TABLET dimenhidrinat, vit B6 3-23
1 DIPHENHYIKADRYL INJEKSI diphenhidramine HCl,3
2 IPHADRYL INJ dipenhidramin Hcl 3
1 DIMENTHI FENISTIL DROP dimetindene maleate 3
1 FEXOFENATELFAST PLUS TABLET feksofenadin HCl 3
2 TELFAST HD 180MG TABLET Feksofenadin HCl 3
3 TELFAST OD 120MG TABLET feksofenadin HCl 12 3
1 HOMOCHLO HOMOCLOMIN TAB homochlorcyclizine hc3
1 LEVOCETIRIXYZAL 5MG TABLET levocetirizine 3
1 LORATADINALDISA SR KAPSUL loratadine 5mg, pseu3
2 CLARITIN TABLET loratadin 3
3 ALLORIST TABLET loratadine 3
ALLORIS SYRUP 60ML loratadine 3
4 LORATADIN 10MG loratadine 3
5 CLARINASE TABLET loratadin 3
1 MEBHYDROL
INTERHISTIN 60ML SYRUP mebhydrolin napadisil3
INTERHISTIN TABLET mebhydrolin napadisil3
1 VERNACEL ED/TRIP nafazolin HCl, phenir 3
GOL. FARMAKOLOGI FORMULARIUM
GENERIK JAN FEB MAR APR MEI
3 2 1 680 535 922 951 682
3 2 1 0 0 0 0 0
3 2 1 1 1 0 0 0
3 2 1 7 7 7 6 14
3 2 0 394 242 443 395 277
3 0 120 80 90 40 10
3 0 5 4 4 8 7
3 0 0 0 0 0 0
3 0 0 0 0 0 0
3 2 0 34 36 35 50 19
3 2 0 18 24 25 16 17
3 2 0 0 0 0 0 0
3 0 0 0 0 0 0
3 2 1 208 302 163 172 415
3 2 0 54 77 10 81 16
3 2 0 109 105 40 56 50
3 2 0 7 1 4 2 3
3 2 0 10 4 11 22 15
3 2 0 8 5 7 6 6
3 2 0 0 0 0 0 0
3 2 0 0 8 0 0 0
3 0 0 0 1 0 0
3 0 0 0 0 0 0
3 2 0 5 0 0 0 0
3 23.2 2 0 10 0 35 0 38
3 23.2 2 0 0 0 0 4 0
3 2 0 0 0 0 0 0
3 2 0 0 0 1 1 0
3 2 0 8 8 11 2 5
3 2 0 163 72 178 134 38
3 2 0 10 0 0 0 10
3 2 0 81 49 60 73 60
3 2 0 0 0 10 7 0
3 2 0 0 0 61 30 60
3 2 0 482 469 653 106 199
3 2 0 121 100 59 108 80
3 2 0 21 46 0 7 0
3 2 1 0 0 0 0 0
3 2 1 0 0 0 0 0
3 2 0 4 0 0 27 0
3 2 0 0 0 0 0 0
3 2 0 86 40 40 43 25
3 0 1 2 0 0 1
JUN JUL AGS SEP OKT NOV DES TOTAL
773 1209 303 343 449 459 1079 8385
0 0 0 0 0 0 0 0
1 0 1 0 0 0 2 6
9 8 5 9 9 3 3 87
283 372 35 56 148 109 345 3099
0 0 10 0 0 0 0 350
3 2 3 1 0 0 5 42
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
25 28 13 11 9 20 50 330
18 23 6 2 9 14 21 193
2 1 0 1 0 0 0 4
0 0 0 0 0 0 0 0
165 239 24 109 96 102 151 2146
0 0 0 0 20 10 70 338
81 106 31 25 50 64 112 829
2 5 1 0 1 2 1 29
25 55 20 0 0 0 30 192
1 3 1 0 0 2 6 45
0 0 0 0 0 0 0 0
0 0 0 0 20 0 0 28
0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 5
0 11 20 31 20 4 36 205
0 0 0 0 0 0 28 32
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2
2 7 2 1 4 3 4 57
30 50 14 22 20 20 46 787
0 10 0 13 0 7 0 50
75 80 18 47 85 5 26 659
0 0 0 15 0 0 10 42
0 0 10 0 20 0 10 191
40 143 54 10 26 40 139 2361
75 111 40 50 39 122 167 1072
14 41 15 10 10 1 7 172
0 0 0 0 0 0 0 0
0 0 0 0 67 23 0 90
0 0 0 0 0 0 0 31
0 0 0 0 0 0 0 0
81 146 10 35 125 104 87 822
0 0 0 0 0 0 0 4
 Obat perin NAMA OBAT KOMPOSISI KETERANGOL. FARMAKO FORMULARIUM
6.1 Pirantel Pam 1 COMBANTRIN SY pirantel pamoat 6 6.1
Antuhelmint Antihelmit(+ mebenda 2 TRIVEXA mebendazol 61

6.2 Antiaprotozoa
6.2.1 metronidazo 1 METRONIDAZOLE 5metronidazole 6 6.2.1
Antiamoeba dan antigiaMETRONIDAZOL 100metronidazole 6 6.2.1
METRONIDAZOL 100metronidazole 6 6.2.1
METRONIDAZOL 100metronidazole 6 6.2.1
METRONIDAZOL 100metronidazole 6 6.2.1
METRONIDAZOLE 250MG TABLET 6 6.2.1
METRONIDAZOLE 50metronidazole 6 6.2.1
2 TROGYL 60ML SUS metronidazole 6 6.2.1
3 NOVAMET INJ 100 Mmetronidazole 6 6.2.1

6.2.2 Choloroqui 1 CHLOROQUIN TABLklorokuin 6 6.2.2

Antimalaria CHLOROQUIN 150Mklorokuin 6 6.2.2
1 PRIMAQUIN TABLE primaquin 6 6.2.2
sulfadoksin, 1 FANSIDAR TABLET sulfadoksin, pirimetamina 6 6.2.2
pirimetamin 1 PRIMET pirimetamin 6 6.2.2

6.4 Antifungi
nystatin 1 NYMIKO SUSP. DROnistatin 100.000 UI/ml 6 6.4
2 CANDISTIN ORAL S nystatin 6 6.4
3 MYCOSTATIN ORAL nystatin 6 6.4
4 KANDISTATIN DROPnystatin 6 6.4
flukonazol 1 DIFLUCAN 50MG TAflukonazol 50 mg 6 6.4
DIFLUCAN 150 MG flukonazol 150 mg 6 6.4
2 GOVAZOL 150MG TAflukonazol 6 6.4
3 FLUCORAL 150MG flukonazol 6 6.4
4 FLUCONAZOLE 150 flukonazol 6 6.4
Ketoconazol 1 KETOCENAZOL 200 ketokonazol 6 6.4
2 FORMYCO 200MG Tketoconazole 6 6.4
griseofulvin 1 FULCIN 500MG TAB griseofulvin 6 6.4
2 GRISEOVULFIN TABgriseovulfin 6 6.4
fluosinolon 1 GENTASOLON 5GR fluosinolon asetonida, gentamisin 6 6.4
Itraconazole 1 SPYROCON KAPSULItraconazole 6 6.4
2 ITRACONAZOLE 10 itraconanazol 6 6.4
3 SPORACID CAPSULItraconazole 6 6.4
zeaxanthyne 1 ZEMYC 50MG TABLEzeaxanthyne 6 6.4
ZEMYC 150 MG TABLEzeaxanthyne 6 6.4
ZEMYC IV INFUSIONzeaxanthyne flucon6 6.4

6.5 AntiTB
 etambutol 1 ETHAMBUTOL 500MEthambutol 500 mg 6 6.5
ETHAMBUTOL 500MG Ethambutol 500 mg 6 6.5
Etambutol. I 1 PULNA FORTE TABLetambutol 250 mg, INH 100mg, vit B6 6 6 6.5
PULNA TABLET etambutol, INH, piridoxin HCL 6 6.5
2 SANTIBI 500MG TABetambutol 250mg; INH 100mg; vit B6 6m6 6.5
SANTIBI PLUS TABLetambutol 250mg; INH 100mg; vit B6 6m6 6.5
3 BACBUTHIN FORTE ethambutol hcl 500mg, isoniazid 100mg,6 6.5
Isoniazide 1 ISONIAZIDE 100 MGisoniazid 6 6.5
INH, B6 ISONIAZIDE 300 MGisoniazid 6 6.5
2 INH CIBA 300MG TA isoniazid, vit B6 6 6.5
INH CIBA 400 MG TAisoniazid, vit B6 6 6.5
3 PEHADOXIN FORTEisoniazid 400mg, vit B6 10 6 6.5
4 TB VIT TAB Isoniazid dan Pyridoxine HCl 6 6.5
TB VIT B6 225 ML Isoniazid dan Pyridoxine HCl 6 6.5
5 PYRAVIT 225ML SY INH, vit B6 6 6.5
6 PEHADOXIN 100MG isoniazid , vit B6 6 6.5
Pirazinamid 1 PYRAZINAMIDE 500pirazinamid 500 mg 6 6.5
2 SANAZET TABLET pirazinamid 500 mg 6 6.5
Rifampicin 1 RIFAMPICIN 450MG rifampicin 6 6.5
RIFAMPICIN 300MG rifampicin 6 6.5
RIFAMPICIN 450MG rifampicin 6 6.5
RIFAMPICIN 600MG rifampicin 6 6.5
RIFAMPICIN 600MG rifampicin 6 6.5
2 RIFAMTIBI 600MG Crifampicin 6 6.5
RIFAMTIBI 450MG T rifampicin 6 6.5
3 RIMACTANE 100ML Rifampicin 6 6.5
RIMACTANE 600MG Rifampicin 6 6.5
rifampisin, 1 RIMACTAZID PAED 75rifampisin, INH 6 6.5
RIMACTACID 450M/3rifampisin 450 mg; INH 300 mg rimact6 6.5
RIMACTAZID PAED 7rifampisin 75 mg; INH 50 mg 6 6.5
rifampisin, 1 RIMCURE PAED TAB rifampisin 75 mg; INH 50 mg; pirazinam 6 6.5
RIMCURE 3-FDC rifampisin, INH, pirazinamid 6 6.5
RIMCURE PAED 75/50rifampisin 75 mg; INH 50 mg; pirazinam 6 6.5
2 RIMSTAR 4-FDC rifampisin 150 mg; INH 75 mg; pir -4-fd 6 6.5

6.6 acyclovir 1 ACYCLOVIR 400MG acyclovir acyclo 6 6.6

Antivirus ACYCLOVIR 200MG acyclovir acyclo 6 6.6
ACYCLOVIR 400MG acyclovir acyclo6 6.6
2 ZOTER 400MG TABLacyclovir 6 6.6

6.7 ofloxacin 1 AKILEN 200MG TABofloxacin 6 6.7

Quinolon AKILEN 400 MG TABofloxacin 6 6.7
moxifloxacin 1 AVELOX 400MG FC Moxifloxacin HCl 6 6.7
AVELOX INFUS 250 Moxifloxacin HCl 6 6.7
 cifrofloxacin 1 BAQUINOR 500MG TCiprofloxacin 500 mg 6 6.7
BAQUINOR 250MG TCiprofloxacin 250 mg 6 6.7
BAQUINOR 100ML ICiprofloxacin 200 mg/100ml 6 6.7
siprofloksasi 1 CIPROFLOXACIN 50Siprofloksasin 6 6.7
CIPROFLOXACIN 50Siprofloksasin 6 6.7
CIPROFLOXACIN 20Siprofloksasin 6 6.7
CIPROFLOXACIN INSiprofloksasin 6 6.7
CIPROFLOXACIN 25Siprofloksasin 6 6.7
CIPROXIN XR 1000 Siprofloksasin 6 6.7
CIPROXIN 500MG T Siprofloksasin 6 6.7.
CIPROXIN XR 500 Siprofloksasin 6 6.7
levofloxacin 1 LEVOFLOXACIN TABlevofloxacin 6 6.7
LEVOCIN 500MG TA levofloxacin 500 mg 6 6.7
LEVOFLOXACIN 500levofloxacin 6 6.7
LEVOFLOXACIN INFlevofloxacin 6 6.7
LEVOFLOXACIN 100Mlevofloxacin 6 6.7
2 NISLEV 500MG TAB levofloxacin 500 mg 6 6.7
NISLEV INFUS levofloxacin 6 6.7
ciprofloxac s 1 VIOQUIN 500MG TA ciprofloxacin sipro 6 6.7

6.8 Sulfonamida
Cotrimoxazo 1 SANPRIMA F TAB sulfometoksazol 800 mg; trimetoprim 16 6 6.8
SANPRIMA 60ML SYper 5 ml sulfometoksazol 200 mg; trime 6 6.8
SANPRIMA TAB sulfometoksazol 400 mg; trimetoprim 80 6 6.8
2 COTRIMOXAZOLE 4Sulfametoksazole, Trimetoprim 6 6.8
COTRIMOXAZOLE SSulfametoksazole, Trimetoprim 6 6.8
Sulfasalazin 1 SULCOLON TABLETSulfasalazine 6-236.8
FORMULARIUM
GENERIK JAN FEB MAR APR MEI JUN JUL AGS
0 2 4 7 4 4 4 3 7
6.1.1 2 0 0 0 0 0 0

2 1 180 120 135 156 185 177 219 45

2 1 0 6 0 6 1 15 24 4
2 1 27 37 34 67 107 38 46 1
2 1 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0
2 1 0 0 0 12 0 0 10 0
2 1 0 0 20 10 0 8 23 10
0 10 7 6 9 10 14 16 3
0 0 0 0 0 0 0 0 0

2 1 713 323 289 647 252 261 321 150

2 1 0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 0 0
2 0 0 0 0 0 6 0 0 0
0 0 0 0 0 0 0 0 0

2 0 4 0 2 8 5 7 10 2
0 10 5 5 10 2 6 5 0
2 0 0 4 2 2 0 1 2 0
2 0 0 0 0 0 0 1 1 0
2 0 2 0 0 1 0 0 1 0
2 0 0 1 0 2 0 0 0 1
2 0 0 1 0 1 1 1 1 0
0 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0
2 1 15 0 0 0 30 62 68 20
2 0 6 35 10 8 4 29 24 10
2 0 7 36 35 69 29 42 42 14
2 1 0 0 105 0 56 24 24 0
2 0 0 0 0 0 0 0 0 0
2 0 70 40 32 78 28 7 7 0
2 1 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0
2 0 14 2 0 6 4 0 0 21
2 0 2 3 2 0 0 0 0 0
2 0 0 2 0 0 0 0 0 0
 1 250 300 670 250 240 257 407 0
1 0 30 0 0 0 25 25 0
2 0 80 28 30 148 60 60 60 0
0 0 0 32 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0
2 0 90 90 0 75 0 0 0 20
0 0 0 0 0 0 0 0 0
2 1 195 90 195 150 0 40 64 12
2 1 244 225 235 356 91 260 241 94
2 0 120 45 146 135 60 60 161 102
2 0 23 25 91 0 45 0 0 0
2 0 54 30 120 72 124 91 110 45
2 0 0 0 52 0 30 45 45 0
2 0 5 5 8 2 5 0 0 0
2 0 0 0 1 0 1 4 5 1
0 0 0 0 0 0 0 0 0
2 1 20 165 434 220 40 194 264 70
2 0 0 0 0 50 30 0 0 76
2 1 92 120 244 184 109 63 192 22
2 1 78 0 60 63 121 146 116 120
2 1 0 0 0 0 0 30 20 42
2 1 0 0 0 0 14 10 10 7
2 1 185 96 106 248 31 99 102 65
2 0 0 30 60 45 30 30 30 0
2 0 0 0 0 0 0 0 0 30
2 0 1 0 0 0 1 3 2 0
2 0 23 25 15 0 0 0 0 0
2 0 0 0 0 0 90 90 90 0
0 0 40 63 15 25 90 90 0
2 0 0 0 0 0 0 0 0 0
2 0 595 642 1170 1475 591 0 0 60
2 0 0 93 120 180 60 0 0 0
2 0 0 0 0 0 0 282 417 90
2 0 141 289 159 309 95 0 0 0

2 1 210 370 363 369 336 120 170 90

2 1 0 0 0 0 0 0 0 0
2 1 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0

2 0 0 0 9 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0
2 0 73 48 26 24 29 23 52 6
2 0 0 0 0 6 0 0 0 0
2 0 1085 1133 711 1153 869 678 841 174
2 0 0 20 5 0 0 0 0 0
2 0 4 0 0 0 0 0 0 0
2 1 686 441 557 531 545 353 550 170
2 1 44 10 10 30 25 10 20 24
2 1 2 0 0 0 0 0 0 0
2 1 2 0 3 0 0 9 17 0
2 1 0 10 0 0 0 0 0 0
0 0 15 0 0 0 0 7 0
2 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 10 10 0
2 1 406 430 527 441 311 190 297 139
2 0 122 113 104 83 154 95 164 28
2 1 17 5 17 15 15 3 13 18
2 1 17 14 10 22 11 16 38 4
2 1 7 0 0 5 2 18 15 7
2 0 105 62 67 62 40 13 18 5
2 0 11 5 9 2 0 10 13 1
0 0 41 25 0 62 28 28 0

2 0 72 20 30 49 5 0 4 10
2 0 0 0 5 7 3 1 2 3
2 0 0 0 0 10 0 0 0 0
2 1 0 0 0 11 40 0 10 0
2 1 0 0 0 0 0 0 0 0
2 0 20 10 0 0 0 0 20 0
SEP OKT NOV DES TOTAL
1 2 5 4 47
0 0 0 0 0 0 0 0

0 55 110 229 1611

19 9 21 7 112
8 10 13 37 425
0 0 0 0 0
0 0 0 0 0
0 0 0 0 22
15 35 15 3 139
2 6 7 7 97
0 0 0 0 0

225 187 512 613 4493

0 0 0 0 0
0 0 0 0 0
0 0 0 0 6
0 0 0 0 0

3 5 6 11 63
2 0 0 2 47
0 5 0 2 18
0 0 1 0 3
12 0 0 2 18
0 0 0 0 4
0 0 0 0 5
0 0 0 1 1
0 0 0 0 0
5 5 25 25 255
2 1 0 15 144
15 0 20 47 356
20 0 0 0 229
0 2 0 2 4
7 14 28 21 332
0 0 0 0 0
0 0 0 0 0
41 0 0 0 88
0 0 1 3 11
0 0 0 0 2
210 90 45 203 2922
0 0 0 10 90
90 120 60 0 736
0 0 0 0 32
0 0 15 30 45
20 20 0 90 405
0 0 0 0 0
60 0 12 90 908
109 85 226 224 2390
110 30 100 184 1253
0 0 0 30 214
15 0 12 15 688
0 0 0 0 172
0 0 1 2 28
0 0 1 0 13
0 0 0 0 0
340 0 60 47 1854
0 60 0 0 216
182 40 182 285 1715
30 42 0 0 776
10 0 31 54 187
0 30 31 30 132
60 65 94 78 1229
0 0 40 30 295
0 0 12 0 42
0 0 0 0 7
0 0 0 30 93
90 0 90 90 540
22 73 12 22 452
0 0 0 0 0
0 0 0 0 4533
0 0 0 0 453
0 30 0 454 1273
0 0 0 0 993

235 169 399 390 3221

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 9
0 0 0 0 0
62 66 24 17 450
4 0 0 0 10
144 441 370 1114 8713
0 0 0 0 25
0 0 0 0 4
280 266 340 622 5341
22 40 80 85 400
0 9 16 25 52
1 0 0 5 37
0 10 16 0 36
2 0 0 0 24
5 0 0 0 5
0 0 0 2 22
194 199 181 546 3861
21 31 12 70 997
0 0 7 84 194
5 3 10 31 181
7 0 9 19 89
15 12 10 43 452
3 2 0 1 57
0 0 20 31 235

0 10 10 17 227
5 3 3 7 39
0 0 0 0 10
0 50 59 30 200
0 0 0 0 0
7 0 0 0 57