B.

DAFTAR OBAT YANG TIDAK ADA DI FORMULARIUM NASIONAL

KELAS SUB KELAS TERAPI/NAMA GENERIK/SEDIAAN/KEKUATAN DAN RESTRIKSI

TERAPI PENGGUNAAN
1. OBAT SUSUNAN SARAF
1.1 Analgetik-Antipiretik, Anti Inflamasi, Anti Pirai
1.1.1 Analgetik-Antipiretik
Asam Mefenamat
1
1 PONDEX 50MG/ML SUSPENSION
Parasetamol 500 mg, n-asetilsistein 200 mg
2
1 SISTENOL CAPLET
Methampyrone
3
1 ANTALGIN 500 MG TABLET
Methampyrone 500 mg, diazepam 2 mg
4
1 ANALSIK 500 MG TABLET
paracetamol 325 mg, tramadol 37.5 mg
1 PATRAL KAPLET
5
2 ULTRACET TABLET
3 ANALTRAM CAPLET
Tramadol
6 1 TRAMADOL 50 MG
2 TRASIK 50 MG CAPSULE
Parasetamol
1 DUMIN RECTAL 125 MG
7 2 PAMOL 125 MG SUPPOSITORY
3 PAMOL 250 MG SUPPOSITORY
4 PRAXION FORTE 250 MG/5 ML 60 ML SYRUP
1.1.2 Anti Inflamasi Non Steroid, Anti Pirai
Celecoxib
1 1 CELEBREX 200 MG TABLET
2 CELEBREX Kaps 100 mg
Dexketoprofen Trometamol
1 DEXKETOPROFEN 25 MG TABLET
2 2 DEXKETOPROFEN 25 MG/ML INJECTION
3 KETESSE 25 MG TABLET
4 KETESSE 50 MG INJECTION
Natrium Diklofenak
3 1 VOLTAREN RETARD 100 MG TABLET, SUSTAINED RELEASE, FILM COATED
2 VOLTADEX 1% 20 GM GEL
Ibuprofen
4
1 PRORIS SUPPOSITORIA 125 MG
Kalium diklofenak
1 KALIUM DIKLOFENAK 50 MG TABLET
2 CATAFLAM 25 MG
5 3 CATAFLAM 50 MG TABLET
4 CATAFLAM DROPS 15 ML
5 CATAFLAM FAST 50 MG POWDER
6 X-FLAM 50 MG TABLET
Ketoprofen
1 KALTROFEN 100 MG TABLET
2 KALTROFEN 50 MG TABLET
3 KETOPROFEN 100 MG TABLET
6
4 KETOPROFEN 100 MG/ML INJECTION
5 KETOPROFEN 50 MG TABLET
6 PRONALGES Tab 100 mg
7 PRONALGES Tab 50 mg
Ketorolac
7 1 KETOROLAC 10 MG TABLET
2 KETOROLAC 10 MG/ML INJECTION
Diclofenac Na 50 mg, thiamine nitrate 50 mg, pyridoxol HCl 50 mg, vit B12 1 mg
8
1 NEUROFENAC PLUS TABLET
Metamizole 300 mg, vit B1 100 mg, vit B6 50 mg, vit B12 100 mcg, tocoferol 30 IU
9
1 ARSINAL TAB TABLET
Meloxicam
1 MELOXICAM 15 MG TABLET
10

Page 1
 10 2 MELOXICAM 7.5 MG TABLET
3 ARTRILOX TAB 7.5 MG
4 MECOX Tab 15 mg
Piroxicam
11 1 PIROXICAM 10 MG
2 PIROXICAM 20 MG TABLET
Metamizol
12
1 NOVALGIN SANOFI AVENTIS SYRUP
Nattokinase
13 1 TROBESCO CAPSULE
1.2 Antiepilepsi-Antikonvulsi
Na valproate
1 1 IKALEP SYRUP
2 VALEPTIK SYRUP
Oxcarbazepine
2
1 TRILEPTAL FCT 300 MG
Pregabalin
3 1 PROVELYN 150 MG TABLET
2 PROVELYN 75 MG TABLET
1.3 Psikofarmaka
1.3.1 Anti Ansietas dan Anti Insomnia
Estazolam
1
1 ESILGAN 2 MG

1.3.2 Anti Spasmodik

Chlordiazepoxide, Clidinium Br
1
1 BRAXIDIN TABLET
Valethamate Br
2
1 EPIDOSIN INJECTION
1.3.3 Anti Depresi dan Anti Mania
Buspirone
1
1 XIETY 10 MG TABLET
Escitalopram
2
1 CIPRALEX 10 MG TABLET
Imipramina HCl
3
1 TOFRANIL 25 MG TABLET
1.3.4 Anti Psikotik
Aripiprazole
1
1 ABILIFY 5 MG TABLET
Sulpiride
2
1 DOGMATIL FORTE TABLET

1.3.5 Hipnotik Sedatif dan Lain-lain

Codein 30 mg, Phenyltoloxamine 10 mg
1
1 CODIPRONT 30 MG

1.4 Anti Migren

Caffeine
1
1 COFFEINUM (PER GRAM) POWDER
Flunarizine
1 FLUNARIZINE 5 MG TABLET
2
2 FREGO 10 MG TABLET
3 FREGO 5 MG TABLET
1.5 Peripheral Vasodilators & Cerebral Activators
Co-dergocrine mesylate
1
1 XEPADERGIN 1 MG TABLET
2. OBAT KARDIOVASKULAR

2.1 Anti Hipertensi

2.1.1 Angiotensin Reseptor Blocker

Losartan
1 LOSARTAN 50 MG TABLET, SUGAR COATED
1 2 DIOVAN 40 MG TABLET
3 DIOVAN 80 MG TABLET
4 LIFEZAR 50 MG TABLET, FILM COATED
2.1.2 Beta Blocker

Page 2
 Carvedilol
1
1 V-BLOC 6.25 MG TABLET
2.2 Anti Aritmia
Propafenone HCl
1
1 RYTMONORM 150 MG TABLET
3. OBAT SALURAN PERNAFASAN

3.1 Anti Tusif

Dextromethorphan HBr 10 mg, Diphenhydramine HCl 12.5 mg, Ammon Cl 100 mg, Na citrate 50 mg,
Menthol 1 mg
1
1 SANADRYL DMP 120 ML SYRUP
2 SANADRYL DMP 60 ML SYRUP
Levopropazin
2
1 LEVOPRONT SYRUP 120 ML
3.2 Ekspektoran, Mukolitik
Ambroxol
1 INTERPEC 15 ELIXIR SYRUP
2 INTERPEC 30 MG TABLET
1 3 INTERPEC Eliksir 30 mg/5 mL x 60 mL
4 MUCERA 15 ML DROPS
5 AMBROXOL 15mg/5mL 60 ML SYRUP
6 AMBROXOL 30 MG TABLET
Bromhexine HCl
1 BISOLVON (Per ML) SOLUTION 50 ML INHALATION
2 2 FARMAVON 125 ML SYRUP
3 FARMAVON 4MG/ 2ML INJECTION
4 FARMAVON 8 MG TABLET
Erdosteine
3
1 VECTRINE 300 MG CAPSULE
Glyceril Guaiacolate 50 mg, Cholrfeniramin maleat 1 mg
4
1 COHISTAN EXPECTORAN 60 ML SYRUP
Glyceryl guaiacolate 75 mg, salbutamol sulfate 2 mg
5
1 LASAL EKSPECTORANT 100 ML SYRUP
Glyceril Guaiacolate
6
1 GLYSERIL GUAIAKOLATE 100 MG TABLET
N-acetylcysteine
7
1 FLUIMUCIL 75 ML POWDER, FOR ORAL SOLUTION
S-Carboxy-methyl-cysteine
8
1 RHINATHIOL 375 MG CAPSULE
Succus liquiritiae 500 mg, Ammon Cl 300 mg, SASA 300 mg /15 mL
9 1 OBH KACA 100 ML SYRUP
2 OBH PLASTIK 100 ML SYRUP
Tripolidine HCl 1.25 mg, Pseudoephedrine HCl 15 mg, Glyceril Guaiacolate 100 mg/5 mL
10
1 LAPIFED EXPECTORANT 60 ML SYRUP
Triprolidine HCl 1.25 mg, pseudoephedrine HCl 30 mg
11
1 LAPIFED 60 ML SYRUP
3.3 Anti Asma
Acefilin piperazin
1
1 ETAPHYLLINE 500 MG/5 ML AMP INJECTION
Anhydrous theophylline
2
1 EUPHYLLIN RETARD 250 MG
Salbutamol Sulfat 0.5 mg,Theophylline 50 mg / 5 mL
3
1 TEOSAL TABLET
Procaterol HCl
1 ATAROC 25 MCG TABLET
4 2 MEPTIN 25 MCG TABLET
3 MEPTIN 50 MCG TABLET
4 MEPTIN 60 ML SYRUP
salbutamol
5
1 VELUTINE NEBULES 2.5 MG
Salbutamol Sulfat 1 mg,Theophylline 150 mg
6
1 TEOSAL 100 ML SYRUP
Salbutamol Sulfat 2 mg, Gliseril Guaiacolat 75 mg / 5mL
7
1 VENTOLIN EXPECTORAN 100 ML SYRUP

3.4 Lain - lain

Isothipendyl 2 mg, acetaminophen 120 mg, phenylephrine HCl 5 mg
1

Page 3
 1
1 NIPE 100 ML SYRUP
Isothipendyl HCl 1 mg, acetaminophen 120 mg, phenylephrine HCl 1 mg
2
1 NIPE PEDIATRIC DROPS
Loratadine 5 mg, pseudoephedrine HCl 60 mg
3
1 RHINOS SR Kaps
Noscapine 10 mg, Chlorpheniramine Maleate 2 mg, glyceryl Guaiacolate 25 mg, Paracetamol 125 mg,
Succus liquid 125 mg, Pseudoephedrine HCl 7.5 mg / 5 mL
4
1 PARATUSIN TABLET
2 PARATUSIN 60 ML SYRUP
Tripolidine HCl 2.5 mg, Pseudoephedrine HCl 60 mg
5
1 TREMENZA TAB TABLET
Paracetamol 150 mg, phenylpropanolamine HCl 3.5 mg, chlorpheniramine maleate 0.5 mg,
6 dextromethorphan HBr 5 mg
1 FLUTAMOL P SYRUP 60 ML
Pseudoephedrine 30 mg, Terfenadine 40 mg
7
1 RHINOFED TABLET
Pseudoephedrine HCl
8 1 ALCO ORAL DROPS 15 ML
2 RHINOS NEO 9.375 MG/ML DROPS
Pseudoephedrine HCl 30 mg, Brompheniramine maleate 2 mg / 5 mL
9
1 ALCO PLUS SYRUP
Pseudoephedrine HCl 30 mg, Brompheniramine maleate 2 mg, Dextromethorphan HBr 10 mg / 5 mL
10
1 ALCO PLUS DMP SYRUP
4. OBAT SALURAN CERNA

4.1 Antasida
Al 200 mg, Mg hidroksida 200 mg, Simetikon 20 mg
1 1 ACITRAL LIQUID
2 ACITRAL TABLET
4.2 Obat Diare
Atapulgit 600 mg, Pectin 50 mg
1
1 ARCAPEC TABLET
Dioktahedral smectite
2
1 SMECTA SACHET
Ekstrak psidii folium
3
1 PSIDII 500 MG CAPSULE
Mesalazine
4
1 SALOFALK 500 MG TABLET
Monascus purpureus, Psidii folium, vits, electrolytes, Zn
5
1 TROLIT POWDER
Rice starch, maltodextrin, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium infantis,
6 Lactobacillus salivarius, Bifidobacterium lactis, Bifidobacterium longum, Lactobacillus lactis
1 L - BIO POWDER
Na 22.5 mEq, K 10 mEq, Cl 17.5 mEq, Citrate, 15 mEq, Dextrose 25 g/L
7
1 PEDIALYTE 500 ML SOLUTION
8 Lactobacillus Reuteri Protectis
1 INTERLAC OIL DROP

4.3 Katartik/Laksan

1 Na Lauril Sulfoasetat 45 mg, Na citrate 450 mg, Sorbic acid 5 mg, Sorbitol 4.465, PEG-400 625 mg
1 MICROLAX PHAROS ENEMA
Na picosulfate
2
1 LAXOBERON DROPS
4.4 Obat Tukak Peptik
Misoprostol
1
1 INVITEC 200 MCG TABLET
Pantoprazole
1 PANTOPRAZOLE 20 MG TABLET
2 PANTOPRAZOLE 40 MG INJECTION
3 PANTOPRAZOLE 40 MG TABLET
2
4 PANTOPUMP 40 MG INJECTION
5 PANTOZOL 40 MG INJECTION
6 PEPZOL 20 MG TABLET
7 PEPZOL 40 MG TABLET
Rebamipide
3
1 REBAMIPIDE 100 MG TABLET
Ranitidine
4

Page 4
 4
1 RANIVEL 60 ML SYRUP
Simetidin
5
1 CIMETIDINE 200 MG TABLET

4.5 Anti Spasmodik

4.5.1 Anti Spasmodik
Eperison HCl
1 1 EPERISONE HCL 50 MG TABLET
2 MYONEP 50 MG TABLET
Hyoscine-N-butylbromide 10 mg, Paracetamol 500 mg
2
1 BUSCOPAN PLUS FCT TABLET
Tizanidine HCl
3
1 MYORES 2 MG TAB
Mebeverine HCl
4
1 IRBOSYD 135 MG TABLET
4.5.2 Obat sterilisasi usus
Colistin sulfate (Polymixin E Sulphate)
1
1 COLISTINE ACTAVIS 1500000 IU TABLET
4.5.3 Anti Hemorrhoide
Citrus Bioflavonoid 500 mg, diosmin 450 mg, Hesperidin 50 mg
1
1 CIFLON CAPLET
Fluocortolone pivalate 1 mg, Lidocaine HClg 40 mg
2
1 ULTRAPROCT N SUPPOSITORY

4.5.4 Cholestasis Hepatitis

Fructus Schizandrae (extr. Siccum)
1
1 HP PRO 7.5 MG CAPSULE
4.5.5 Lain-lain
Somastostatin
1
1 SOMATOSTATIN INJEKSI
4.6 Anti Emetik
Granisetron
1
1 GRAVOMIT 3MG/3ML INJECTION
Ondansetron
2 1 NARFOZ 60 ML SYRUP
2 NARFOZ SYRUP 30 ML
4.7 Digestan
Amylase, protease, lipase 240 IU, DHA 30 mg, dimethylpolysiloxane 25 mg, vit B1 10 mg, vit B2 5
1 mg, vit B6 5 mg, vit B12 5 mcg, niacinamide 10 mg, Ca pantothenate 5 mg
1 VITAZYM TABLET
5. OBAT GINJAL DAN SALURAN KEMIH
5.1 Diuretik
Solifenacin suksinat
1
1 VESICARE 5 MG
5.2 Lain - lain
Essential ketoacids
1
1 KETOSTERIL TABLET
α-ketoisoleucine Ca salt 67 mg, α-ketoleucine Ca salt 101 mg, α-ketophenylalanine Ca salt 68 mg, α-ketovaline Ca salt 86 mg, α-hydroxym
2
1 RENOSTERIL CAPLET
Tobbest Busindo
3
1 RENALOF 325 MG CAP
5.3 PDE-5 Inhibitor
Sildenafil Citrate
1
1 SILDENAFIL CITRATE 50 MG TABLET
6. ANTI ALERGI

6.1 Anti Histamin

Cetirisin
1 INTRIZIN 15 ML DROPS
1
2 HISTRINE FT 5 MG TABLET
3 CETIRIZIN 10mg/mL 12 ML DROPS
Cyproheptadine HCl
2
1 HEPTASAN 4 MG TABLET, COATED
Desloratadine
3
1 AERIUS 5 MG TABLET
Desloratadine, pseudoefedrine
4

Page 5
 4
1 AERIUS D-12 TABLET
Hydroxyzine HCl
5
1 BESTALIN 25 MG TABLET
Dimenhidrinat, vit B6
6
1 DRAMASINE TABLET
Dexamethasone (micronized) 500 mcg, dexchlorpheniramine maleate 2 mg
7
1 DEXTAMINE 60 ML SYRUP
Mebhydrolin napadisylate
8
1 INTERHISTIN 50 MG TABLET
Oxatomide
9
1 OXTIN 30 MG TABLET
6.2 Kortikosteroid
Triamsinolon acetonid
1 TRIAMCINOLONE 4 MG TABLET
1
2 TRIAMCORT 4 MG TABLET
3 TRILAC 4 MG TABLET
7. CAIRAN UNTUK KESEIMBANGAN AIR, ELEKTROLIT, DIALISIS DAN NUTRISI
7.1 Larutan Keseimbangan Cairan Elektrolit
K I-aspartate 300mg, Mg L-aspartate 100 mg
1
1 RENAPAR TABLET
Sodium Bicarbonate
2
1 BICARBONAT SOLUTION 5 L
8. HORMON
8.1 Estrogen
Estradiol valerate 2 mg 11 tab ; estradiol valerate 2 mg dan norgestrel 0,5 mg
1
1 CYCLO PROGYNOVA TABLET
8.2 Kontraseptik, Oral Fertilitas dan Hormon lain
Clomiphene citrate
1
1 PROFERTIL 50 MG TABLET
8.3 Progestin
Allylestrenol
1 1 PREMASTON 5 MG TABLET
2 ALLYLESTRENOL 5 MG TABLET
8.4 Progesteron
Progesteron
1
1 UTROGESTAN 100 MG CAPLET
9. VITAMIN, MINERAL DAN METABOLITROPIKUM
9.1 Vitamin - Mineral
9.1.1 Vitamin
Asam Folat 400 mcg, Vitamin B6 30 mg
1
1 VOMILAT TABLET
Ascorbic acid
2 1 EXTRACE 100 MG/ML INJECTION
2 ULVICE 1000 MG INJECTION
D-alpha- Tokoferol/ Vit E
3
1 DALFAROL 200 CAPSULE, SOFT GELATIN
retinol (vitamin A)
4
1 VITAMIN A 6000 UNT TABLET
Thiamine
5
1 THIAMIN 100 MG / ML INJECTION
Vit B1 100 mg, vit B6 100 mg, vit B12 5,000 mcg.
6
1 MERSIBION 5000 CAPLET
Vit B1 100 mg, vit B6 200 mg, vit B12 200 mcg
7 1 FARBION 5000 3 ML INJECTION
2 GRAHABION TABLET
9.1.2 Mineral

1 Dibasic Ca phosphate 200 mg, Ca lactate 100 mg, vit B6 20 mg, vit C 25 mg, vit D3 100 IU/tab
1 ELKANA TABLET, COATED

Vitamin A 2400 iu, vitamin B1 4 mg, vitamin B2 1.2 mg, vitamin B6 1.2 mg, vitamin B12 4 mcg,
2 vitamin C 60 mg, vitamin D 400 iu, nicotinamide 16 mg, Ca pantothenate 6 mg, choline 12 mg,
inositol 12 mg, Ca gluconate 300 mg, Ca hypophosphite 20 mg, l-lysine HCl 200 mg
1 ELKANA 60 ML SYRUP

Page 6
 Vit A 2,400 IU, vit D 400 IU, cod liver oil 8 mg, DHA 10 mg, arachidonic acid (AA) 15 mg, curcuma
3 extr 12 mg, vit B1 4 mg, vit B2 1.2 mg, vit B6 1.2 mg, vit B12 4 mcg, nicotinamide 16 mg, choline 12
mg, inositol 12 mg, L-lysine HCl 100 mg, Ca 33.1 mg, Na 5.2 mg, GOS 500 mg
1 ELKANA CL EMULSI 120 ML
Fe carbonyl 83 mg, ascorbic acid 150 mg, folic acid 1 mg, vit B1 3 mg, vit B2 3 mg, vit B6 5 mg, vit
4 B12 10 mcg, niacinamide 30 mg, Ca pantothenate 15 mg, Zn 15 mg, lysine HCl 50 mg
1 FEROFORT CAPLET
9.1.3 Multivitamin + Mineral, Antioksidan
Alpha-lipoic acid 100mg, calcium ascorbate 500mg, zinc picolinate 50mg, selenium 50mcg, B-caroten
1 5000 iu
1 SELOXY AA CAPLET
Beta-karoten 6 mg, Vitamin C 50 mg, Vitamin E 10 mg, Seng 15 mg, Tembaga 1,5 mg, Selenium 30
2 mcg.
1 OPTIMAX 100 ML SYRUP
Lutein 3 mg, lycopene 2 mg, vitamin E 25 mg, vitamin C 100 mg, zinc 10 mg, beta carotene 6.000 iu,
3 bilberry ekstrak 80 mg.
1 OPTIMAX CAPLET
Ca 150 mg, Mg 75 mg, Zn 3 mg, vit D3 1.9 mcg
4
1 OSTEOCARE 100 ML SYRUP
Ca 200 mg, vit D3 100 IU, tuna fish oil 200 mg
5
1 OSFIT DHA CAPSULE, COATED, SOFT GELATIN
0.6 mL Vit A 2,000 ju, vit C 30 mg, vit D 400 iu, vit B, 1 mg, A B21.2 mg, vit B6 I mg, Vit B12 2
6 Meg, nicotinamide 10 mg, pantothenol 5 mg, lysine HCI 25 mg.
1 APIALYS 10 ML DROPS
Vit A 5,000 IU, vit B1 3 mg, vit B2 2 mg, vit B6 6 mg, vit B12 5 mcg, vit C 50 mg, vit D 400 IU,
nicotinamide 20 mg, lysine HCl 250 mg, [d]- pantothenol 5 mg, l- glutamic acid 25 mg. Per 0.6 mL Vit
7 A 2,000 IU, vit C 30 mg, vit D 400 IU, vit B1 1 mg, vit B2 1.2 mg, vit B6 1 mg, vit B12 2 mcg,
nicotinamide 10 mg, pantothenol 5 mg, lysine HCl 25 mg.
1 APIALYS 100 ML SYRUP
ATP 20 mg, vit B1 100 mg, vit B6 200 mg, vit B12 200 mcg, vit E 30 mg.
8
1 BIO ATP TABLET
Co-enzyme Q10 100 mg, L-carnitine 500 mg, vit E 100 IU, soya bean oil 323.1 mg
9
1 BIOQUINONE CAPSULE
Colostrum bovine 300 mg, DHA 200 mg, cod liver oil 10 mg, lysine HCl 200 mg, vit A 2,000 iu, vit D
200 iu, vit B1 0.6 mg, vit B2 0.15 mg, vit B6 0.6 mg, vit B12 1.5 mcg, nicotinamide 5 mg,
10 dexpanthenol 2.5 mg, zinc picolinate 5 mg.
1 BIOSTRUM SYRUP
2 BRAINVIT 60 ML SYRUP
Ekstr biji anggur 50 mg, lycopene 5 mg, vit E 30 IU, vit C 100 mg, vit B1 15 mg, vit B2 15 mg, vit B6
25 mg, vit B12 15 mcg, folic acid 0.4 mg, niacinamide 100 mg, Zn 25 mg, biotin 150 mcg, selenium
11
60 mcg
1 NOROS CAPSULE
Fe fumarate 360 mg, folic acid 1.5 mg, vit B12 15 mcg, vit C 75 mg, vit D3 400 iu, Ca carbonate 200
12 mg
1 PRENAMIA CAPSULE
Fe gluconate 250 mg, manganese sulfate 200 mcg, copper sulfate 200 mcg, vit C 50 mg, folic acid 1
13 mg, vit B12 w/ intrinsic factor 7.5 mcg, sorbitol 25 mg
1 INBION TABLET
Fish oil 10/50 EPA/DHA 500 mg, vit E 5 mg
14
1 INLACTA 5000 DHA CAPSULE
Vit E 30 iu, vit C 750 mg, vit B1 15 mg, vit B2 15 mg, vit B6 20 mg, vit B12 12 mcg, folic acid 400
15 mcg, pantothenic acid 20 mg, Zn 22.5 mg, niacin 100 mg
1 BECOM-ZET CAPLET
Vit A 850 IU, vit B1 3 mg, vit B2 2 mg, vit B6 5 mg, vit B12 5 mcg, dexpanthenol 3 mg, vit D 100 IU,
Ca hypophosphite 500 mg, arachidonic acid (AA) 15 mg, DHA 10 mg, fructooligosaccharides (FOS)
16
500 mg, cod liver oil 7.5 mg, curcuma extr 10 mg
1 CURVIT CL 175 ML EMULSION
Vit B1 3 mg, vit B2 2 mg, vit B6 5 mg, vit B12 5 mcg, β-carotene 4 mg, (caplet: β-carotene 10% 400
17 mcg), Ca pantothenate/dexpanthenol 3 mg, Ca gluconate 300 mg, curcuminoid 2 mg
1 CURVIT SYRUP
Sodium Fe EDTA 115.4 mg [equivalent with Fe elemental 15 mg (free form fish-odour of Fe)]
18 1 FERRIZ 100 ML SYRUP
2 FERRIZ 15 ML DROPS
Bilberry dry extr 40 mg, retinol 800 IU, β-carotene 2.5 mg, vit E 20 mg.
19
1 MATOVIT 60 ML SYRUP

Page 7
 Thiamine nitrate 60 mg, Ca pantothenate 60 mg, medicinal yeast 100 mg, cystine 20 mg, keratin 20
20 mg, p-aminobenzoic acid 20 mg.
1 PANTOGAR CAPSULE
9.1.4 Suplemen & Adjuvan Terapi
MLC 601
1
1 NEUROAID TABLET
Monoammonium glycyrrhizinate (as glycyrrhizin) 40 mg, amino acetic acid 400 mg, L-cysteine HCl
2 20 mg.
1 STRONGER NEO-MINOPHAGEN C (SNMC) INJECTION
Polysaccharide
3
1 BIOBRAN 250 MG TABLET
9.1.5 Lain - lain
Curcuma longa rhizome extr (curcuminoid complex 95%/Bio-Curcumin/BCM-95) 150 mg, silymarin
phytosome 35 mg, Schizandrae fructus extr 135 mg, Liquiritiae radix 135 mg, choline bitartrate 150
1
mg, vit B6 2 mg
1 BIO CURLIV CAPLET
Curcuma xanthorrhiza extr.
2
1 CURCUMA TABLET
Echinacea purpurea 250 mg, propolis bee 125 mg, Zn picolinate 5 mg.
3
1 OPINACEA 60 ML SYRUP
9.2 Metabolitropikum
9.2.1 Glikotropikum, Nootropik, Neurotonik

1 Choline citrate 147.5 mg, cytidine monophosphate 121.5 mg, phosphatidyl serine 20% 125 mg
1 NEULIN PS
Citicoline
1 NEULIN 1000 MG INJECTION
2 NEULIN 500 MG INJECTABLE
2 3 CITICHOLINE 1000 MG CAPLET
4 CITICHOLINE 1000 MG INJECTION
5 CITICHOLINE 250 MG/2ML INJECTION
6 CITICHOLINE 500 MG/4ML INJECTION
Mecobalamina
1 LANABAL 500 MCG INJECTABLE
3 2 LANABAL KAPSUL 500 MCG
3 MECOBALAMIN 500 MCG CAPSULE
4 MECOBALAMIN 500 MCG INJECTION
Pirasetam
1 PIRACETAM 1200 MG TABLET
2 PIRACETAM 3000 MG/15 ML INJECTION
3 PIRACETAM 400 MG TABLET
4 PIRACETAM 800 MG CAPLET
5 FEPIRAM 12GR INFUSION
6 FEPIRAM 3GR INJ
4
7 FEPIRAM Kapl Salut Selaput 1.200 mg
8 LATROPIL 500 MG/5 ML SYRUP
9 NEUROTAM 100 ML SYRUP
10 NOOCEPHAL 400 MG CAPSULE
11 NOOCHEPAL 100 ML SYRUP
12 PIRACETAM 1000 MG/5ML INJECTION
13 PIRACETAM 12 GRAM INFUSION
Ekstrak Ginkgo Biloba
5
1 GINKO FORCE 50 MG TABLET
9.3 Lain - Lain
Ca citrate 500 mg, vit D3 200 IU, vit K1 20 mcg, Mg 100 mg, Zn 5 mg.
1 1 OSSOVIT KAPLET
2 OSSOVIT 100 ML SYRUP
Collagenase, Fibrinolysine, Profibrinolysin activator
2
1 PLASMIN 250 MG
Alendronate Na
3 1 ALOVEL 70 MG
2 ALOVELL 10 MG TABLET
Astaxanthine
4
1 ASTRIA 4 MG
Ca 200 mg, Vit D2 200 iu
5 1 CALNIC PLUS CAPLET
2 CALNIC PLUS 100 ML SYRUP

Page 8
 Glucosamine
1 GLUCOSAMINE 250 MG TABLET
6
2 CARTOS TUB TABLET, EFFERVESCENT
3 MEDIFLEX 30 GM CREAM
Glucosamine 500 mg, chondroitin sulfate 400 mg, vit C 50 mg, vit E 50 mg, manganese 2.5 mg, Mg
20 mg, selenium 50 mcg, Zn 5 mg. OA Plus Glucosamine 250 mg, chondroitin sulfate 200 mg, vit C
7 30 mg, vit E 25 mg, manganese 10 mg, Mg 10 mg, selenium 25 mcg, Zn 2.5 mg,
methylsulfonylmethane 300 mg, boron 0.25 mg, collagen II 20 mg
1 OA FORTE CAPLET
Pure lecithin (PPC 95%) 175 mg (300 mg for Lesichol-300 & 600 mg for Lesichol-600), vit B1 6 mg,
8 vit B2 6 mg, vit B6 6 mg, vit B12 6 mcg, vit E 10 mg, nicotinamide 30 mg.
1 LESICHOL KAPSUL LUNAK 300 MG
N-acetyl glucosamine 1 mg, mint conc 332 mg, lavender oil 2 mg, nano vit E 1 mg
9
1 FITAJOINT ROLLER GEL 35 G
Placenta extr 15 mg, vit B12 20 mcg, tribasic Ca phosphate 12 mg
10
1 MILMOR TABLET
Risedronate Na
1 OSTEONATE OAW 35 MG CAPLET
11
2 OSTEONATE OD KALBE 5 MG TABLET
3 RISTONAT 35 MG TABLET
Sucralose (powd), natural sugar (syr)
1 SIRPLUS RASA JERUK 100 ML SYRUP
12
2 SIRPLUS RASA MELON 100 ML SYRUP
3 SIRPLUS STROBERI (per ML) 100 ML SYRUP
Sodium hyaluronate
13
1 ADANT DISPO 10 MG/ML X 2.5 ML INJECTION
9.4 Neurodegenerative disease
Memantine HCl
1
1 ABIXA 10 MG
10. ANTI INFEKSI

10.1 Anti Bakteri Sistemik

10.1.1 Golongan Penisilin
Amoksisilin
1 1 INTERMOXIL 1 GM INJECTION
2 AMOXICILLIN 1 GM INJECTION
Cloxacillin Na
2
1 MEIXAM 500 MG CAPSULE
Ampisilin
3
1 AMPICILLIN 500 MG TABLET
Amoksisilin, asam klavulanat
1 CLABAT 500 MG TABLET
4 2 CLABAT SIRUP 60 ML
3 CLABAT SIRUP FORTE 60 ML
4 CO-AMOXYCLAV 625 MG TABLET
10.1.2 Derivat Aminoglikosida
Amikasin sulfat
1
1 MIKAJECT 500 MG INJECTION
Netilmicin sulfate
2 1 HYPOBACH 100 1 VIL INJECTION
2 HYPOBHAC 200 INJEKSI
10.1.3 Golongan Sefalosporin
10.1.3.A Generasi IV
Cefditoren Pivoxil
1
1 MEIACT 200 TABLET
Imipenem Cilastatin
2 1 IMIPENEM CILASTATIN 1 GM INJECTION
2 TIMIPEN INJEKSI
10.1.4 Golongan Makrolida
Spiramicin
1 1 SPIRAMYCIN 500 MG TABLET
2 SPIRANTER 500 MG TABLET
10.1.5 Lain-lain
Doripenem
1
1 DORIPENEM 500 MG INJECTION
Fosfomycin Na
2
1 FOSMICIN 1 GRAM INJECTION
Thiamfenicol

3
Page 9
 1 THIAMFENICOL 500 MG
3 2 THIAMYCIN 500 MG CAPSULE
3 THIAMYCIN SYRUP
4 BIOTHICOL FORTE DS
Metronidazole 500 mg, nystatin 100,000 IU
4
1 NEO GYNOXA OVULA
10.2 Anti Fungi Sistemik
Itrakonazol
1 1 ITRACONAZOLE 100 MG TABLET
2 SPYROCON CAPSULE
10.3 Anti Tuberkulosis
INH 400 mg, vit B6 10 mg
1
1 SUPRAZID FORTE TABLET
10.4 Antiseptik, Desinfektan
Tetra chlorodeca-oxygen anion complex
1
1 OXOFERIN 30 ML SOLUTION
Enzymatic Instrument Cleaner
2 1 ALKAZYME SACHET 25 MG
2 HELIZYME (PER LITER) 1 L
50% Troclosene Sodium (NaDCC)
3
1 PRESEPT 5 GM TABLET
Ethanol 46%
4
1 SOFTAMAN 500 ML

11. IMUNOSUPRESAN & IMUNOMODULATOR

11.1 Anti Virus
Methisoprinol
1 METHISOPRINOL 500 MG TABLET
1
2 ISOPRINOSINE TABLET
3 ISPRINOL 60 ML SYRUP
12. OBAT YANG MEMPENGARUHI SISTEM IMUN
12.1 Vaksin, Toksoid

Adsorbed diphtheria toxoid not <30 IU, adsorbed tetanus toxoid not <40 IU, pertussis toxoid 25 mcg,
filamentous haemagglutinin 25 mcg, pertactin 8 mcg, inactivated poliovirus type 1 (Mahoney) 40 D-
1
antigen units, type 2 (MEF-1) 8 D-antigen units & type 3 (Saukett) 32 D-antigen units, Haemophilus
influenzae type b polysaccharide 10 mcg (conjugated to tetanus toxoid approx 30 mcg)
1 INFANRIX HIB GSK 0,5 ML INJECTION
Haemagglutinin of influenza virus antigen of strain A/H1N1 15 mcg, strain A/H3N2 15 mcg, strain B
2 15 mcg, thimerosal 4 mcg
1 FLU BIO 0,5 ML INJECTION
HbsAg
3 1 ENGERIX B (DEWASA) 0.20 MCG INJECTION
2 ENGERIX B 0.5 ML INJECTABLE
Inactivated HAV (HM 175 strain) adsorbed into Al(OH)3
4 1 HAVRIX 1440 ADULT
2 HAVRIX 720 JUNIOR INJECTABLE
Live attenuated human rotavirus vaccine RIX4414 strain not <106 CCID50
5
1 ROTARIX ORAL SUSPENSI
Measles virus >1,000 CCID50, mumps virus >5,000 CCID50, rubella virus >1,000 CCID50 (all
6 attenuated).
1 TRIMOVAX MERIEUX VIAL 0.5 ML
Pneumococcal polysaccharide (serotype 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, & 23F) & nontypeable
7 Haemophilus influenzae protein D conjugate vaccine, adsorbed
1 SYNFLORIX PFS INJECTABLE
Quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine
8
1 GARDASIL 0.5 ML INJECTION
HBsAg
9
1 VAKSIN HEPATITIS B (KARYAWAN)
Vaksin Thyphim
10
1 VAKSIN THYPHIM INJECTION
12.2 Imunostimulan
Polinacea extr 100 mg, phyllanthus niruri extr 25 mg, Zinc Picolinate 5 mg
1
1 KIDIMUN SYRUP
Echinaceae 250 mg, Zn picolinate 10 mg
2 1 IMBOOST 60 ML SYRUP
2 IMBOOST TABLET
Echinacea purpurea 250 mg, black elderberry extr 400 mg, Zn picolinate 10 mg
3

Page 10
 3 1 IMBOOST FORCE Kapl Salut Selaput
2 IMBOOST FORCE Sir 60 mL
Polinacea 200 mg, Black Elderberry 400 mg, Zinc Picolinate 5 mg, Vitamin C 100 mg, Picolinate 5 mg
4 1 IMUNOS 60 ML SYRUP
2 IMUNOS KAPLET
Pink rock rose/Cistus extract 60%/ECCE 60
5
1 IMULOZ 30 MG TABLET
13. OBAT YANG MEMPENGARUHI DARAH
13.1 Anti Koagulan, Anti Trombotik dan Fibrinolitik
Cilostazol
1
1 PLETAAL 50 MG TABLET
Fulsurtiamin
2
1 ALINAMIN 5 MG TABLET
Fulsurtiamin 50 mg, vitamin B2 5 mg
1 ALINAMIN-F 10 ML INJECTION
3 2 ALINAMIN-F TABLET
Ginkgo biloba extr (EGb761) 80 mg
1 TEBOKAN SPESIAL 80 MG TABLET
Heparin Na
4 1 THROMBOGEL 200 IU GEL
2 THROMBOPHOP 20 GM GEL
Heparin Na 5,000 IU, nicotinic acid benzyl ester 250 mg
5
1 THROMBOPHOB 15 GM OINTMENT
13.2 Hemostatika, Hemorheologik dan Hematopoetik
13.2.1 Hemostatika
Asam Traneksamat
1
1 KALNEX 250 MG TABLET
Carbazochrom sodium sulfonate
1 CARBAZOCHROME INJECTION
2
2 CROME 10 MG TABLET
3 CROME 50 MG INJECTION
Ethamsylate
3
1 DICYNONE 250MG / 2ML INJECTION
13.3 Produk dan Substituen Plasma, Plasma Expander

1 Hydroxyethyl starch (HES) 200/0.5 60 g, NaCl 6.9 g, KCl 0.3 g, Ca chloride 0.22 g, Na lactate 4.48 g
1 FIMA HES-200 Lar Infus 6% x 500 mL
14. OBAT MIOMETRIUM
14.1 Relaksan Uterus
Isoxsuprine HCl
1
1 HYSTOLAN 20 MG TABLET
15. OBAT PENYAKIT KULIT
15.1 Anti Akne
Azelaic Acid
1
1 ZELFACE 20 % (per gram) 10 GM CREAM
Clindamycin phosphat
1 MEDIKLIN (per GR) 15 GM GEL
2
2 MEDIKLIN (per ML) 30 ML SOL
3 CLINIKA 1%(per gram) 10 GM GEL
Adapalene
3
1 EVALEN 0,1% (per Gram) 10 GM GEL
Benzoil Peroxida
4
1 BENZOLAC 2,5 % (PER GRAM) 5 GM
Benzoil Peroxida 5%, Clindamycin phosphat 1.2%
5
1 BENZOLAC CL 5 % (PER GRAM) 10 GM GEL
Asam Salisilat 0.2%, Sulfur Resocin 0.5%
6
1 RESSAL GALENIUM LOTION
Collagen 3%, Hydrolastin 2%
7
1 BIOLASTIN LAP 30 GM CREAM
Niacinamide, lauryl polyglucose
8
1 PAPULEX CLEANSING GEL (per ml) 150 ML
Nicotinamide
9
1 NIACEF 4% (per Gram) 15 GM GEL
Precipitated sulfur
10
1 ACNE FELDIN (per ml) 110 ML LOTION

Page 11
 Retinoic acid
11 1 VITACID 0.025% (per gram) 15 G CREAM
2 VITACID 0.05% (per ml) 50 ML SOL
Cetrimide 5 mg, resorcinol 5 mg, sulfur 50 mg
12
1 BIO ACNE (PER GRAM) 10 GM CREAM
15.2 Anti Inflamasi
Clobetasol propionate
1 KLODERMA (per gram) 10 GM CREAM
1 2 KLODERMA (PER GRAM) 10 GM OINTMENT
3 KLODERMA (per gram) 5 G CREAM
4 KLODERMA 5 GM OINTMENT
Alklometason Dipropionat
2
1 CLODERM (per gram) 10 GM CREAM
Desonid
1 DESOLEX 0,05% ( Per GRAM) 10 GM CREAM
3 2 DESOLEX 0,05% (per gram) 10 GM OINTMENT
3 DESOLEX 0,05% (PER ML) 10 ML LOTION
4 DESOLEX 0.05% ( per Ml) 30 ML LOTION
Flutikason Propionat
4 1 MEDICORT 0.05% (Per Gram) 10 GM CREAM
2 MEDICORT CREAM 0.05 % (per GM) 5 GM
Hydroquinone
5
1 MEDIQUIN (PER GRAM) 15 GM CREAM
Hidroquinon 4%, Tretinoin 0.05%, Fluocinolon Acetonide 0.01%
6
1 REFAQUIN (per gram) 15 GM CREAM
mometason furoat
7
1 ELOCON 0.1 % (PER ML) 10 ML LOTION
Triamcinolone acetonide
1 KENACORT - A (PER GRAM) 10 GM
8
2 KETRICIN 0.1 % (oral base) 5 GM OINTMENT
3 TRIAMCORT - A (per gram) salep kulit 10 GM CREAM
15.3 Perangsang Jaringan Granulasi
Ekstrak Placenta 10%, Neomisin Sulfat 0,5%
1
1 BIOPLACENTON 15 GM GEL
15.4 Anti Bakteri
Erythromycin
1 ERYMED ( per Ml) 30 ML SOL
1
2 ERYMED (PER GRAM) 20 G CREAM
3 ERYMED 15 GM (PER GRAM) GEL
Fluocinolone acetonide 0.025%, gentamicin sulfate 0.1%
2 1 GENTASOLON 5 GM CREAM
2 GENTASOLON CREAM (PER GRAM) 10 GM CREAM
Gentamicin sulfate
1 GENTAMICIN 5 gr (Per Gram) 0.1 %WW OINTMENT
3
2 IKAGEN (per GR) 10 GM CREAM
3 IKAGEN (Per GR) 10 GM OINTMENT
Betametason valera 0.1%, Neomisin sulfat 0.5%
4
1 BETASON-N KRIM 5 GM
Nadifloksasin
5
1 ACUATIM (per GM) 10 GM CREAM
Oksi Tetrasiklin
6
1 OKSITETRASIKLIN 3 % 5 GM OINTMENT
15.5 Anti Fungi
Ketoconazol
1
1 ERAZOL (per Ml) 30 ML LOTION
Miconazole
2
1 DAKTARIN ORAL GEL 10 GR
Miconazole nitrate 2%, Hydrocortisone 1%
3
1 THECORT ( per Gram) 5 GM CREAM
Mupirocin
4 1 BACTODERM 2% (PER GRAM) 10 G CREAM
2 BACTODERM 2% (PER GRAM) 5 G CREAM
Nystatin 100,000 u, Zn oxide 200 mg
5
1 MYCO-Z OINTMENT
Selenium Sulfida
6
1 TOPISEL 30 ML LOTION
Terbinafine HCl
7
1 INTERBI (per Gram) 5 GM CREAM

Page 12
 Tiokonazol
8
1 TROSYD 1 % 10 GM CREAM
15.6 Anti Skabies
Lindane 1%, Usnic Acid 1%
1
1 SCABICID 1 TUB CREAM
15.7 Anti Virus
Asiklovir
1 1 ZOTER CREAM
2 ACYCLOVIR 5 %WW CREAM
Tromantadine HCl
2
1 VIRU-MERZ GEL 5 GM
15.8 Anti Histamin
Doxepin HCl
1
1 SAGALON 5% (Per gram) 10 GM CREAM
15.9 Anestesi
Lidocaine 25 mg, Prilocaine 25 mg
1 1 EMLA 5% (per gram) 5 GM CREAM
2 TOPSY 5 GM CREAM
15.10 Estetika
15.10.1 Sunblock
2-ethyl hexyl p-methoxycinnamate, Oxybenzone, 3-(4-methylbenzylidene) camphor, Butylmethoxy
dibenzoylmethane, Aloe Vera dan Vitamin E
1 1 PARASOL SPF 30 (per ml) 120 ML LOTION
2 PARASOL CREAM 20 GRAM (per Gram)
3 PARASOL SPF 33 (PER GRAM) 20 GM CREAM
15.10.2 Pelembab
Aqua, Paraffinum liquidum, Glyceryn, Petrolatum, Cetearyl alcohol, Dimethicon, Squalene, Ceteth-20,
1 Glyceryl stearat SE, Stearic acid, Laureth-3, Glyceryl stearate, Methylparaben, Dichlorobenzyl alcohol
1 QV CREAM (per Gram) 100 GM
Ceramides, phytosterol, tryglycerides, phospolipids, squalene
2 1 TOPICARE CLEANSING GEL (per ml) 90 ML
2 TOPICARE CREAM (PER GRAM) 50 GM
Dexpanthenol
3 1 BEPANTHEN (PER GRAM) 20 GM OINTMENT
2 PASQUAM (PER GRAM) 20 GM CREAM
Hypoallergenic ambiphilic cream base
4
1 BIOCREAM (PER GRAM) 20 GM CREAM
Pseudoceramide, phytosterols, stearic acid, vegetable oil, squalane
5
1 NOROID PER ML 200 ML LOTION
15.10.3 Pemutih
Ascorbyl glucoside, Aloe barbadensis
1
1 PROBIO-C 10 ML LOTION
Purifed water, Glycerin, Lactic acid, Cyclomethicone, Cetyl alcohol, Kojic acid, Rumex occidentalis
2 extract, Triethanolamine, Stearic acid, Tocopheryl acetate, Propylene glycol, Xanthan gum, Disodium
EDTA, Critic acid, Diazolodinyl urea, BHT, Methylparaben, Propylparaben
1 MELANOX ES (per gram) 15 GM CREAM
15.10.4 Anti Aging
Purified water, triethanolamine, carbomer, glycerin, hydrolyzed collagen, dimethyl dimethyl hydantoin,
1 tetrasodium EDTA, Haematococcus pluvialis extr
1 ASTHIN FORCE GEL ( per GM ) 30 GM
15.10.5 Oil Control
15.10.5.A Pembersih dan Face Tonic
Sulfonated Surfactant Blend 63 mg/g
1
1 AV FACIAL WASH 60 ML
15.11 Penumbuh Rambut
Minoxidil
1 1 REGROU 2% 30 ML SOL
2 REGROU FORTE 5% 30 ML LOTION
15.12 Lain - lain
Conc camomile 7.44 mg, eucalyptol 100 mg
1 1 TRANSPULMIN BB (per GM) 20 GM
2 TRANSPULMIN BB BALSEM 10 GM
Cross-linked CMC 2.3%, propylene glycol 20%, purified water 77.7%
2
1 INTRASITE GEL 15G (per GM)
Lactic Acid 1 g, Lacto Serum 0.9 g
3
1 LACTACYD FH PINK 60 ML SOLUTION

Page 13
 Lactic acid 1 g, lactoserum 0.93 g.
4
1 LACTACYD BABY 60 ML
Salicylic acid
5
1 ASAM SALISILAT (per 100 mg)
Trichloroacetic Acid
1 TCA (PER ML) 80 % 10 ML TINCTURE
6
2 TCA 40 % 10 ML TINCTURE
3 TCA 90% 10 ML TINCTURE
15.13 Dermatologica
Centella asiatica extr
1
1 TEKASOL 1 % (per gr) 10 GM OINTMENT
DMS conc containing physiological lipids
2
1 PHYSIOGEL (per ML) 200 ML LOTION
Pimecrolimus
3
1 ELIDEL 1% (per gram) 10 G CREAM
Purified water, PEG-4, Allium cepa extr, xanthan gum, allantoin
4
1 MEDERMA 20 GM GEL
Radix Scutellariae 0.87 g, phellodendri cortex 0.87 g, rhizoma coptidis 0.87 g
5 1 MEBO 20 GM OINTMENT
2 MEBO 40 GM OINTMENT
Tacrolimus
6 1 PROTOPIC 0,1 OINTMENT (per GM) 10 GM
1 PROTOPIC 0.03 OINTMENT (per GM) 10 GM
16. OBAT PENYAKIT MATA
16.1 Anti Alergi
Naphazoline Hydrochloride 0,25 mg, Pheniramine Maleate 3 mg
1
1 CENDO VERNACEL MINIDOSE EYE DROP
Cromolyn sodium
2 1 CENDO CONVER 2 % MINIDOSE EYE DROP
2 CENDO CONVER 2% TM 15 ML
16.2 Anti Infeksi
Dexamethasone 1mg, neomycin sulphate 3.5mg, polymixin B sulphate 10.000SI
1 1 CENDO XITROL 5 ML EYE DROP
2 CENDO XITROL MINIDOSE (per ampul) EYE DROP
Flourometholone, neomycin
2
1 CENDO POLYNEL MINIDOSE EYE DROP
Hidrokortison Asetat 5 mg, Kloramfenikol 2 mg / g
3 1 CENDO MYCOS 1 TUB EYE OINTMENT
2 CENDO MYCOS MINIDOSE
Ofloxacin 3 mg
4
1 FLOXA TETES MATA 5 ML
Tobramycin 3.0mg, dexamethasone 1.0mg
5 1 CENDO TOBROSON EYE DROPS 5 ML
2 CENDO TOBROSON MINIDOSE EYE DROP
16.3 Midriatik
Phenylephrine / Fenilefrin HCl.
1 1 CENDO EFRISEL 10 % ED 5 ML
2 CENDO EFRISEL 10 % MINIDOSE EYE DROP
Pirenoxine sodium
2
1 KARY UNI 1MG/5ML EYE DROP
Tropikamida
3
1 CENDO MYDRIATIL 1 % EYE DROPS 5 ML
16.4 Lain - lain
HPMC 3.00mg, Dextran 70 1.00mg
1
1 CENDO EYEFRESH MILD MINIDOSE EYE DROP
Polyethilen Glycol 5 mg, Na Hyaluronate 1.5 mg, NaCl 50 mg / mL
2
1 SILOXAN 5 ML
Potassium Iodide 5 mg. Sodium Iodide 10 mg.
3
1 VITROLENTA EYE DROP MD
Sodium hyaluronat, sodium chloride
4
1 CENDO SILOXAN MINIDOSE EYE DROP
vitamin A 1000IU, aneurin hydrocloride 0.5mg, calcium pantothenate 5.0mg
5
1 CENDO REPHITEL 0.6 ML MINI DOSE
17. OBAT PENYAKIT TELINGA, HIDUNG, TENGGOROKAN
17.1 Lain - lain
Benzidamine HCl
1
1 TANTUM VERDE 60 ML SOLUTION, MOUTHWASH

Page 14
 Natrium Dokusat
2
1 FORUMEN EAR DROPS 10 ML
Mometason Furoat
3
1 NASONEX 60 SPR AEROSOL, SPRAY
Pelargonium sidoides
4
1 KALOBA 20 MG TABLET
Perhidrol
5
1 PERHIDROL 3% LIQUID
Physiological sea water 31.82 mL (isotonic)
6 1 STERIMAR BABY NASAL SPRAY 50 ML AEROSOL, SPRAY
2 STERIMAR NASAL SPRAY 50 ML AEROSOL, SPRAY
Polymyxin B sulfate 50,000 iu, Fludrocortisone acetate 5 mg, neomycin sulfate 25 mg, Lidocaine HCl
7 200 mg/ 5 mL
1 OTOPAIN 8 ML DROPS
18. ANTIDOTUM
18.1 Antidotum Kimia
Lanthanum carbonate
1
1 FOSRENOL 500 MG TABLET, CHEWABLE

19. KONTRAS RADIOLOGI

1
XOLMETRAS 50 ML
20. SEDIAAN OBAT LAIN - LAIN
Asam Sitrat
1.
1 ACIDUM CITRICUM

2. 1 BABY OIL 125 ML

2 BABY OIL 50 ML
Natrium Klorida
3. 1 NaCL TAB
2 NATRIUM KHLORIDA (NACL) POWDER
Parafin
4.
1 PARAFIN CAIR ( GENERIK )
5.
1 PRONTOSON (per ML) 350 ML LIQUID
Podophyllin 25 %
6.
1 TINCTURE PODOPHYLLIN 25 % (PER ML)
Vaselin Album
7.
1 VASELIN ALBUM (per g)
Met-Glu-His-Phe-Pro-Gly-Pro (50 mcg), Nipagin (q.s), dan Aqua Bidest (ad 0.05 ml)
8
SEMAX 0,1 % SOLUTION
Formalin
9
FORMALIN 10 % ( per ML )
Alkohol
ALKOHOL 70 % (per ml) 1000 ML SOLUTION
10
ALKOHOL 70 % + GLYSERIN
ALKOHOL 96% (per Ml)
Garam Inggris
11 GARAM INGGRIS
GARAM INGGRIS 30 G
Hydrogen peroxide and Peroxyacetic acid
12
RENALIN ( Per ML)

Direktur Utama
Rumah Sakit Universitas Gadjah Mada,

Prof. dr. Arif Faisal, Sp.Rad (K), DHSM

NIP 194810251977031003

Page 15