DAFTAR OBAT STANDAR PROGRAM KESEHATAN KARYAWAN DAN PENSIUNAN BPJS KETENAGAKERJAAN BESERTA KELUARGA

TAHUN 2018

NO. ZAT AKTIF OBAT MERK SEDIAAN

KODE PABRIK
1. ANALGESIK NARKOTIK, ANALGESIK NON NARKOTIKA, ANTIPIRETIK, ANTIINFLAMASI NONSTEROID (AINS) DAN ANTI PIRAI

1.1 ANALGESIK NARKOTIK

1 Fentanil Fentanil Injeksi 0,05 mcg/ml, 10 ml PT. Kimia Farma

Durogesic Patch (12 Mcg, 25 Mcg, 50 Mcg) PT. Johnson & Johnson Indonesia
2 Morfin HCl Morfina HCl Injeksi 10 mg/ml PT. Kimia Farma
MST Continous Tablet 10mg; 15 mg; 30 mg PT. Mahakam Beta Farma
3 Petidin HCl Pethidine Injeksi 50 mg/ml , 2 ml PT. Kimia Farma
4 Sufentanil Sufentanil Injeksi epidural 5mcg/ml PT. Kimia Farma
1.2 ANALGESIK NON NARKOTIKA, ANTIPIRETIK, ANTIINFLAMASI NONSTEROID (AINS)

1 Asam asetilsalisilat Farmasal Tablet 50 mg; 100 mg PT. Pratapa Nirmala Fahrenheit
Aspirin Tablet 500 mg PT. Bayer
2 Asam mefenamat Asam mefenamat Kapsul 250 mg; 500 mg OGB
Mefinal Kapsul 250 mg; 500 mg PT.Sanbe
Ponstan Kapsul 250 mg; 500 mg PT. Pfizer
Pondex Sirup 50 mg/5 ml, 60 ml PT. Dexa Medica
3 Diklofenak, natrium Voltadex Tablet 25 mg; 50 mg ,Gel 20 g PT. Dexa Medica
Voltaren SR Tab. 25 mg; 50 mg , Gel 20 g, SR 75 mg PT. Novartis
4 Diklofenak, kalium Cataflam Tablet 25 mg; 50 mg PT. Novartis
5 Fenilbutason Fenilbutason Tablet Salut 100 mg; 200 mg OGB
Irgapan Tablet Salut 100 mg; 200 mg PT. Dexa Medica
6 Ibuprofen Ibuprofen Tablet 200 mg; 400 mg OGB
Tablet 200 mg, Chewable tab, Sirup
Proris 100mg/5 ml, 60 ml ; Forte syr 50 ml,
Suppositoria 125 mg PT. Pharos
7 Indometasin Indomethacin Kapsul 25 mg; 75 mg OGB
Benocid Kapsul 25 mg; 75 mg PT. Bernofarm
8 Ketoprofen Protofen Tablet 100 mg, Suppositoria 100 mg PT. Kimia Farma
Profenid E Tablet 100 mg, Suppositoria 100 mg PT. Aventis
9 Ketorolak Tromethamine Ketorolac Tablet 10 mg OGB
Remopain Injeksi 10 mg/ml, 30 mg/ml PT.Dexa Medika
Toradol Injeksi 10 mg/ml, 30 mg/ml PT. Roche Indonesia
10 Meloksikam Meloxicam Tablet 7,5 mg; 15 mg OGB
Movi-Cox Tablet 7,5 mg; 15 mg BI
11 Metampiron Antalgin Tablet 500 mg OGB
Drop 10 mg, Sirup, Tablet 500 mg, Injeksi
Novalgin
500 mg/ml PT. Aventis
12 Metamizol Natrium Antrain Tablet 500 mg, Injeksi 1 g/2ml PT. Interbat
13 Nabumetone Goflex Tablet 500 mg PT. Guardian
14 Parasetamol Parasetamol Tablet 500 mg OGB
 Tablet 500 mg, Sirup 120 mg/5 ml, 60 ml;
Dumin 150 ml , Syrup Forte 250 mg/5 ml, 60 ml;
Rectal Tube 125 mg/2.5 ml; 250 mg/ 4 ml
PT. Alpharma

Panadol Tablet 500 mg, Syrup, Syrup F, drops, Suppos

Pt. Glaxo

Sanmol Drop 100 mg/5 ml, Infus 60 ml

PT. Sanbe
Sirup 160 mg/5ml 60 ml, Sirup Forte 250
Tempra
mg/5 ml 60 ml, drop 80 mg/0,8 ml PT. Taisho Pharmaceutical
15 Piroksikam Piroxicam Kapsul 10 mg; 20 mg OGB
Kifadene Kapsul 10 mg; 20 mg PT. Kimia Farma
Feldene Gel 15 gr PT. Pfizer
16 Selekosib Celebrex Kapsul 100 mg; 200 mg PT. Pfizer
17 Tenoksikam Notritis Kapsul 20 mg PT. Sanbe
18 Tinoridin HCl Nonflamin Kapsul 50 mg PT. Takeda
Metampiron 500 mg + Vitamin
19 Neuralgin Tablet 500 mg, tablet RX
Neutotropik PT. Kalbe Farma
Metampiron 250 mg + Aminofenazon
20 Paramidon Injeksi 15 ml
50 mg + Xilokain 15 mg PT. Aditama pharmindo
21 Dexetoprofen Tromethamol Ketesse tab Tablet 25 mg. Injeksi 50 mg/2ml PT. Ferron
Gel 2,5% / 30 gr, Suppositoria 100 mg,
22 Profenid Suprafenid
Tablet 100 mg:200 mg PT. Sanovi Aventis
Tablet 50 mg:100 mg, injeksi 50
23 Tramadol HCl Tramadol
mg/ml;100mg/2ml OGB
Tablet 50 mg:100 mg, suppositoria 100 mg,
Tramal
injeksi 50mg/ml;100mg/3ml PT. Pharos
24 Etoricoxib Arcoxia tablet 60 mg; 90 mg; 120 mg PT. Merck
Tablet tramadol 37,5 mg + paracetamol 325
25 Tramadol + paracetamol Ultracet
mg Janssen

Piroxicam + Methyl Salicylate + L- Salep Piroxicam 5 mg, Methyl Salicylate 102

26 Counterpain PXM
Menthol + Eugenol mg, L- Menthol 54,3 mg, Eugenol 13,7 mg
PT. Taisho
1.3 ANTIPIRAI

1 Allopurinol Allopurinol Tablet 100 mg; 300 mg OGB

Puricemia tablet 300 mg PT. Sanbe Farma
Zyloric Tablet 100 mg; 300 mg PT. Glaxo
2 Kolkisin Recolfar Tablet 500 mcg PT. Pratapa Nirmala Fahrenheit
3 Probenesid Probenid Tablet 500 mg PT. Dexa Medika
Tablet mengandung Glukosamin-HCl 250
Glukosamin-HCl+ Kondroitin Sulfat+
4 Oste mg, Kondroitin Sulfat 200 mg, Vit. C 25 mg,
Vit. C 25 mg+ Mg + Zn + Mn
Mg 5 mg, Zn 2,5 mg, Mn 0,25 mg
PT. Soho

Tablet mengandung Glukosamin-HCl 500mg,

Glukosamin-HCl + Kondroitin Sulfat+
5 Oste Forte Kondroitin Sulfat 400 mg, Vit. C 50 mg, Mg
Vit. C+ Mg + Zn + Mn
10 mg, Zn 2,5 mg, Mn 0,5 mg
PT. Soho
Glucosamine HCI, chondroitin sulfate,
6 Viostin DS Tablet
manganese PT. Pharos
2 ANESTETIK

2.1 ANESTETIK LOKAL

1 Bupivakain HCl Bupicain Injeksi 0,25%, 20 ml Pra

Marcain Injeksi 0,25%, 20 ml AZ
2 Etilklorida Chlor Ethyl Semprotan 100 ml Hen
3 Lidokain Lidokain HCl Injeksi 1%, 2 ml OGB
Lidokain Comp. Injeksi 1%, 2 ml OGB
Pehacain Injeksi 1%, 2 ml PT. Phapros
Lidonest Salep 50 mg/g PT. Merck
4 Lidokain HCl 2%, Adrenalin (1:80.000) Extracaine Injeksi 2 ml PT. Ethica
5 Bupivacaine Buvanest Injeksi 0,5%/100 mg dalam 20 ml PT. Kalbe Farma
2.2 ANESTETIK UMUM dan OKSIGEN

1 Droperidol Dehydrobenz peridol Injeksi 2,5 mg/ml, 2 ml; 5 ml; 10 ml

Jan
2 Enfluran Ethrane Solution 250 ml PT. Abbott
3 Halotan Fluotane Solution 50 ml; 250 ml AZ
4 Isoflurane Isoflurane Inhalasi 100ml; 250ml/larutan PT. Dexa Medika
Forane Inhalasi 100ml; 250ml/larutan

5 Ketamin HCl Ketalar Injeksi 50 mg/ml; 100 mg/ml, 10 ml PT. Pfizer

6 Nitrogen oksida Nitrogen oksida Gas dalam tabung

7 Oksigen Oksigen Gas dalam tabung

8 Midazolam Dormicum Injeksi 5 mg/5 ml; 15 mg/3 ml PT. Roche

Miloz Injeksi 5 mg/5 ml; 15 mg/3 ml PT. Novell
9 Propofol Recofol Injeksi 10mg/ml; 20mg/ml PT. Dexa Medika
10 Tiopental, natrium Penthotal Injeksi 500mg/ml; 1000 mg/ml PT. Abbott
3 ANTIALERGI

3.1. ANTIHISTAMIN

1 Cetirizine Cetirizine Tablet 10 mg OGB

Incidal OD Tablet 10 mg PT. Bayer
Ozen Tablet, SIRUP, DROP PT. Pharos
2 Difenhidramina HCl Duradryl Injeksi 10 mg/ml, 15 ml Dur
3 Desloratadina Aerius Tablet 5 mg PT. Scherinh
Sirup 60 ml PT. Scherinh
4 Feniramin maleat Avil Tablet 50 mg PT. Aventis
Avil Retard Tablet 50 mg PT. Aventis
5 Homoklorsiklizina-HCl Homoclomin Tablet 10 mg PT. Eisai
6 Klorfeniramin maleat CTM Tablet 4 mg OGB
Cohistan Sirup 5mg/5ml, 60 ml BMS
7 Loratadin Loratadin Tablet 10 mg OGB
Rihest Tab. 10 mg; Sir. 5 mg/ 5 ml, 60 ml PT. Otto
Alloris Tablet 10 mg PT. Sanbe Farma
8 Mebhidrolin napadisilat Incitin Tablet 50 mg PT. Bernofarm
Interhistin Sirup 50 mg/5ml, 60 ml PT. Interbat
TELFAST, HD, OD, mengandung 120 mg/ tab; Telfast HD 180
9 Fexofenadine HCl PT. Sanovi
Plus mg, Telfas OD 120
10 Siproheptadin hidroklorida Pronicy Siproheptadin hidroklorida 4 mg PT. Kalbe Farma
3.2. KORTIKOSTEROID

1 Metilprednisolon Metilprednisolon Tablet 4 mg; 8 mg; 16 mg OGB

Lameson Tablet 4 mg; 8 mg; 16 mg PT. Lapi
2 Triamsinolon asetonid Trinolon Tablet 4 mg PT. Kimia Farma
Triamcort Tablet 4 mg PT. Interbat
Trilac Injeksi Triamsinolon asetonid 10 mg; 40 mg PT. Novell Pharma
Betametason 0,25 mg, Tablet (Betametason 0,25 mg +
3 Ocuson
Deksklorfeniramin maleat 2 mg Deksklorfeniramin maleat 2 mg) PT. Sanbe Farma
Sirup 30 ml; 60 ml, tablet (Tablet
Celestamin Betametason 0,25 mg + Deksklorfeniramin
maleat 2 mg) PT. Scheering
4 ANTIKEJANG

4.1 ANTIEPILEPSI

1 Natrium valproat Depakote Tablet 250 mg PT. Abbott

Depakene Sirup 250 mg/ 5 ml, 120 ml PT. Abbott
2 Diazepam Diazepam Tablet. 2 mg; 5 mg OGB
Valium Tablet. 2 mg; 5 mg; Injeksi 10 mg/ml PT. Roche
3 Fenitoin, natrium Kutoin Kapsul 100 mg Mersi
Tab. 50 mg ; 100 mg; Inj. 50 mg/ml, 100
Dilantin
mg/2 ml PT. Pfizer
Tab. 30 mg; 50 mg; 100 mg; Inj. 50 mg/ml, 2
4 Fenobarbital Phenobarbital
ml OGB
Luminal Tab. 30 mg; 50 mg; 100 mg

5 Gabapentin Gabexal Kaps 300 mg PT. Sandoz

Neurontin Kaps 300 mg PT. Pfizer
6 Karbamazepin Carbamazepin Tab. 200 mg OGB
Tegretol Tab. 200 mg, XR, Syrup PT. Novartis
7 Primidon Mysoline Tab. 250 mg PT. Astra Zeneka
8 Valproat, natrium Leptilan Tab. 150 mg; 300 mg PT. Novartis
9 Pregabalin Pregabalin Tablet 75 mg; 150 mg OGB
Lyrica Tablet 50 mg, 75 mg; 150 mg PT.Pfizer
4.2 ANTIKEJANG UMUM

1 Magnesium sulfat Magnesium Sulfat Inj. 20%; 40%, 25 ml OGB

5 ANTIMIGREN/ANTIVERTIGO

5.1 ANTIMIGREN

1 Dihidroergotamin mesilat Dihydergot Tab. 2,5 mg PT. Novartis

2 Ergotamin Ergotamina Tab. 1 mg OGB
3 Ko-dergokrin mesilat Crinadex Tab. 1 mg; 4.5 mg PT. Dexa Medika
Hydergin Tab. 1 mg; 4.5 mg; Inj. 0,3 mg/ml PT. Novartis
4 Ergotamin tartrat + Kafein Ericaf Ergotamin tartrat 1 mg + Kafein 100 mg PT. Tempo
Cafergot Ergotamin tartrat 1 mg + Kafein 100 mg PT. Novartis
5.2 ANTIVERTIGO

1 Betahistin HCl Betaserc Tab. 8 mg PT. Abbots

2 Betahistin mesilat Merislon Tab. 6 mg PT. Eisai
Mertigo Tab. 6 mg PT. Dexa Medika
3 Flunarizine Sibelium Tab. 5 mg; 10 mg PT. Janssen
4 Sinarizin Cinnipirine Tab. 25 mg PT. Kimia Farma
Stugeron Tab. 25 mg PT. Janssen
6 ANTI MIKROBA

6.1. Antibiotik

6.1.1. Golongan Aminoglikosida

1 Amikasin sulfat Mikasin Injeksi, Syrup 250 mg/ ml PT.Kalbe Farma

2 Gentamisin Gentamycin Injeksi 80 mg / 2ml PT.Kimia Farma
Gentamerck Injeksi 80 mg / 2ml PT.Merc
Garamycin Injeksi 80 mg / 2ml PT.Schering
3 Dibekacin sulfat Dibekacin Injeksi 50 mg ; 100 mg PT.Meiji Indonesia
4 Nethylmycin Sulfate Hypobhac Injeksi 150 mg PT.Pharos Indonesia
Hypobhac 200 Injeksi 150 mg PT.Pharos Indonesia
6.1.2. Golongan Sefalosporin

1 Sefadroksil Sefadroksil Kapsul 250 mg ; 500 mg PT.Hexpharm

Syr. 125 mg/5 ml, 60 ml; Forte Syr. 250 mg/5
Lapicef
ml, 60 ml PT.Lapi
2 Sefaleksin monohidrat Sefaleksin Kapsul. 250 mg ; 500 mg OGB
Cefabiotik Kapsul. 250 mg ; 500 mg PT.Bernofarm
Syr. 125 mg/5 ml, 60 ml ; Syr. 250 mg/5 ml,
Cefat
60 ml PT.Sanbe Farma
3 Sefiksim Sefiksim Kapsul 50 mg; 100 mg ; 200 mg PT.Kimia Farma
Kapsul 50 mg; 100 mg ; 200 mg ; Syr. 100
Cefspan
mg/5 ml, 60 ml PT.Kalbe Farma
Starcef kapsul 50 mg, 100 mg, sirup kering PT.Dexa Medika
4 Sefotaksim, natrium Sefotaksim Injeksi 0,5 gr ; 1 gr PT.Kimia Farma
Clacef Injeksi 0,5 gr ; 1 gr PT.Dexa Medika
Taxegram inj Injeksi 0,5 gr ; 1 gr PT. Sanbe
5 Seftazidim Seftazidim Injeksi 1 gr PT.Kimia Farma
Fortum Injeksi 1 gr PT.Glaxo Smith Kline
6 Sefotiam Ceradolan Tablet 200 mg ; Injeksi 1 gr PT.Takeda
7 Seftriakson Seftriakson Injeksi 0,5 gr ; 1 gr PT.Kimia Farma
Cephaflox Injeksi 0,5 gr ; 1 gr PT.Guardian Farma
Starxon Injeksi 0,5 gr ; 1 gr PT.Interbat
8 Sefuroksim Sharox Tablet 500 mg ; Injeksi 750 mg ; Injeksi 1 gr
PT.Fahreinheit

Anbacim Tablet 500 mg ; Injeksi 750 mg ; Injeksi 1 gr

PT.Sanbe Farma
9 Seftditoren Pluoksil Meiact Tablet 100 mg ; tablet 200 mg PT.Meiji Indonesia
10 Sefpirom Nufirom Injeksi 1 gr PT.Guardian Farma
11 Sefepime Exepime Injeksi 1 gram PT. Ferron
6.1.3 Golongan Kloramfenikol
Kapsul 250 mg ; 500 mg ; Syr 125 mg/ 5
1 Kloramfenikol Kloramfenikol ml,60 ml; salep mata 1%; tetes telinga 3%;
tetes mata OGB
Kapsul 250 mg ; Kapsul 500 mg ; Syr 125 mg/
Colsancetine
5 ml ;Injeksi 1000 mg PT.Sanbe Farma
Kapsul 250 mg ; Kapsul 500 mg ; Syr125 mg/
Kemicetine
5 ml; Oint 2% 15 Gr PT.Kalbe Farma
Kapsul 250 mg ; Kapsul 500 mg ; 250 mg/5
2 Tiamfenikol Tiamphenicol
ml OGB
Dexycol Kapsul 250 mg ; Kapsul 500 mg PT.Dexa Medika
 Thiamycin Kapsul 250 mg ; Kapsul 500 mg ; 1000 mg
PT.Interbat
6.1.4 Golongan Lincosamid
1 Klindamisin Clindamycin Kapsul150 mg; Kapsul300 mg OGB
Kapsul 150 mg; Kapsul 300 mg ; Sol 150 mg;
Dalacin C
Sol 300 mg PT.Pfizer
2 Linkomisin HCl Nichomycin Kapsul 250 mg; 500 mg PT. Nicholas
6.1.5 Golongan Makrolid
Kapsul 250 mg; Kapsul500 mg, Syr 200 mg/ 5
1 Eritromisin etilsuksinat Eritromisin
ml,60 ml, Syr 100 mg/2,5 ml, 30 ml OGB
Kapsul 250 mg; Kapsul500 mg, Syr 200 mg/ 5
Erythrocin
ml,60 ml, Syr 100 mg/2,5 ml, 30 ml PT.Abbott
2 Azythromicin Zithrax Kapsul 250 mg; 500 mg PT.Dankos Farma
Zibramax Kaplet 500 mg; Syr 15 ml PT. Pfizer
3 Roksitromisin Biostatik Tablet 150 mg; Tablet 300 mg PT.Pharos Indonesia
4 Spiramisin Spiramisin Kapsul 250 mg; Kapsul 500 mg OGB
Spirabiotik Kapsul 250 mg; Kapsul 500 mg PT.Kimia Farma
Kapsul 250 mg; Kapsul 500 mg, Syr 125 mg/
Spiradan
5ml ; 60ml PT.Dankos Farma
Tablet 250 mg; Tablet 500 mg ; Tablet XL 500
5 Clarithromycin Abbotic
mg; Syr 30 ml ; Syr 60ml; Syr 250mg/ 50 ml
PT.Abbott
6.1.6 Golongan Penisilin
Tablet 250 mg; Tablet 500 mg ; Syr 125 mg ;
1 Amoksisilin anhidrat Amoxycillin
Syr 250 mg ; Injeksi 1000 mg PT.Kimia Farma
Tablet 250 mg; Tablet 500 mg ; Syr 125 mg ;
Amoxsan
Syr 250 mg ; Injeksi 1000 mg PT.Sanbe Farma
Tablet 250 mg; Tablet 500 mg ; Syr 125 mg ;
Amoxil
Syr 250 mg ; Injeksi 1000 mg PT.Glaxo Smith Kline
Kapsul 250 mg; Kapsul 500 mg ;Syr 125
2 Ampisilin Ampicillin
mg/5ml ; Injeksi 0,5 gr, Injeksi 1 gr PT.Kimia Farma
Kapsul250 mg;Kapsul 500 mg ;Syr 125
Ampicil
mg/5ml ; Syr 250 mg PT.Sanbe Farma
Kapsul 250 mg ; Kapsul 500 mg ; Syr 125
Sanpicilin
mg/5ml ;Forte Syr 250 mg; Injeksi 1 gr PT.Sanbe Farma
3 Fenoksimetil penisilin Penicillin V Tablet 250 mg; Tablet 500 mg PT.Kimia Farma
Ospen Tablet 250 mg; Tablet 625 mg PT.Sandoz
4 Flucloxacillin Na Monohydrate Floxapen Kapsul 500 mg PT.Glaxo Smith Kline
5 Prokain benzilpenisilin Prokain Penicilin Injeksi 3 juta IU PT.Kimia Farma
6 Piperacillin 4 g, Tazobactam 500 mg Tazocin Injeksi 4,5 gr PT.Pfizer
7 Sulbenisilin Kedacilin Injeksi 1 gr ; Injeksi 2 gr PT.Takeda
8 Sultamisilin Bactesyn Tablet 375mg PT. Kalbe Farma
Injeksi 0.75g ; Injeksi 1.5g PT. Kalbe Farma
6.1.7 Golongan Penisilin dengan Inhibitor Beta-Laktamase

1 Kombinasi:
Amoksisilin trihidrat, Asam klavulanat
Co-amoxiclav Tablet 250 mg; Tablet 500 mg PT.Kimia Farma
125 mg
Dexyclav Tablet 250 mg; Tablet 500 mg PT.Dexa Medika
Syr 60 ml; Forte Syr 60 ml; Tablet 250mg ;
Clavamox
Tablet 500 mg; Injeksi 500 ; Injeksi 1000 PT.Kalbe Farma
6.1.8 Golongan Kuinolon
Tablet 250 mg; Tablet 500 mg ; Tetes Mata
1 Siprofloksasin Ciprofloxacin
3% OGB
 Quidex Tablet 250 mg;Tablet 500 mg ;Infus 100 ml
PT.Ferron Par
Tablet 250mg ;Tablet500mg; ED 5 ml;Infus
Baquinor
100 ml PT. Sanbe
2 Levofloksasin Levofloksasin Tablet 250 mg ;Tablet 500 mg;Infus
PT.Kimia Farma
Tablet 250 mg ;Tablet 500 mg;Infus 750 ml;
Cravox
Infus 100 ml PT.Lapi Labolatories
Tablet 250mg; Tablet 500 mg; ED 0,5%; 250
Cravit
mg/50 ml; 750mg/150 ml PT.Kalbe Farma
levocin Tablet 500 ; Infus 100 ml ;ED 5 ml
Tablet 200 mg ;Tablet 400 mg;Infus 100
3 Ofloksasin Ofloxacin
ml;Infus 200 ml PT.Kimia Farma
Tablet 250mg; Tablet 500 mg; ED 0,3%; Otic
Tarivid
drop 5ml; Otic drop 10ml
4 Sparfloxacin Resflox Tablet 200 mg PT.Sanbe Farma
5 Gatifloksasin Gatimax Tablet 400 mg PT.Pharos Indonesia
Tequin Tablet 400 mg BMS
6 Moxifloxacin HCl Avelox Tablet 400mg ; Infus 250 mg Bayer
6.1.9 Golongan Tetrasiklin

1 Tetrasiklin HCl Tetracyclin Kapsul 250 mg; Kapsul 500 mg OGB

Super tetra Kapsul 250 mg; Kapsul 500 mg DV
2 Doksisiklin HCl Doxycycline Kapsul 100 mg OGB
Interdoxin Kapsul 100 mg PT.Interbat
3 Oksitetrasiklin HCl Kaloxy Injeksi 50 mg/ml, 10 ml PT.Kalbe Farma
Terramycin Injeksi 50 mg/ml, 10 ml PT.Pfizer
6.1.10 Kombinasi Antibakterial

1 Kombinasi :

Sulfadiazin, Sulfadimidin, Sulfamerazin Trisulfa Tablet 500 mg OGB

Tablet SMZ 400 mg ; TM 80 mg ; Tab. Syr 60
2 Sulfametoksazol + Trimetoprim Cotrimoxazol
ml; SMZ 800 mg; OGB
Tablet SMZ 800 mg ; TM 160 mg (Forte) ;
Kaftrim
Tab. Syr 60 ml PT.Kimia Farma

Tablet Adult SMZ 200 mg ; TM 40 mg ;Tablet

Primadex
Forte SMZ 400 mg ; TM 80 mg Syr. 60 ml
PT.Dexa Medika

Tablet Adult SMZ 200 mg ; TM 40 mg ;Tablet

Bactrim
Forte SMZ 400 mg ; TM 80 mg Syr. 60 ml
PT.Roche Indonesia
6.1.11 Beta-laktam Golongan lain

1 Kombinasi :

Imipenem, Cilastatin Natrium Tienam Injeksi 0,5gr / 120 ml PT.Merck

2 Meropenem Meropex Injeksi 500 mg ; Injeksi 1000 mg PT.Bernofarm
Meronem Injeksi 500 mg ; Injeksi 1000 mg PT. Astra Zaneca
6.1.12 Antibiotik Golongan Lain

1 Fosmicin, natrium Fosmicin Injeksi 1 gr ; Injeksi 2 Gr PT.Meiji Indonesia

6.2 ANTISEPTIK SALURAN KEMIH

1 Asam nalidiksat Asam nalidiksat Tablet 500 mg PT.Kimia Farma

Urineg Tablet 500 mg AP
2 Asam pipemidat Urotractin Kapsul 400 mg PT.Sanbe Farma
Urinter Kapsul 400 mg PT.Interbat
3 Tamsulosin HCl Prostam SR Tablet PT. Novel
6.3 ANTITUBERKULOSIS

1 Etambutol hidroklorid Etambutol Tablet 250 mg; Tablet 500 mg PT.Kimia Farma
Etibi Tablet 250 mg; Tablet 500 mg PT.Roche
Dexabutol Tablet 250 mg; Tablet 500 mg PT.Dexa Medika
2 Isoniazid Isoniazid Tablet 100 mg ;Tablet 300 mg PT.Kimia Farma
3 Pirazinamid Pirazinamid Tablet 500 mg PT.Kimia Farma
Prazina Tablet 500 mg AP
Tablet 300 mg ; Tablet 450 mg ; Tablet 600
4 Rifampisin Rifampisin
Mg ; PT.Kimia Farma
Kaplet 300 mg ;Kaplet 450 mg ; Kaplet600
Rimactane
Mg ; Syr 50 ml ; Syr 100 ml PT.Sandoz
Injeksi 1000 mg ; Injeksi 1500 mg ; Injeksi
5 Streptomycin Sulfat Streptomisin
5000 mg PT.Kimia Farma
6 Isoniazid + Vitamin B6 Inoxin Kaplet 400 mg PT.Dexa Medika
Pehadoxin Tablet 400 mg PT.Pharos Indonesia
TB vit 6 Syr 110 ml ;Syr 225 ml

Pyravit Syr 120 ml

Tablet 75 mg/150 mg ;Tablet 50 mg/75 mg

7 Rifampisin + INH + Pyrazinamide Rimcure Paed
;Tablet 150 mg/ 400 mg PT.Sandoz
Tablet 75 mg/150 mg ;Tablet 50 mg/75 mg
Rimcure 3FDC
;Tablet 150 mg/ 400 mg PT.Sandoz
Tablet 75 mg/50 mg ; Tablet 225 mg/200 mg
8 Rifampisin + INH Rimactazid
; 450 mg/300 mg PT.Sandoz
Tablet 75 mg/50 mg ; Tablet 225 mg/200 mg
Rimactazid paed
; 450 mg/300 mg PT.Sandoz
Rifampisin + INH + Pirazinamide +
9 Rimstar 4-FDC Tablet 150 mg ; 75 mg ; 400 mg ; 275 mg
Ethambutol PT.Sandoz
6.4 ANTILEPRA

1 Dapson Dapsona Tablet 50 mg ; 100 mg INF

6.5 ANTIVIRUS

1 Asiklovir Acyclovir Tablet 200 mg ; 400 mg ; 5% +3% ; 250 mg

OGB
Clinovir Tablet 200 mg ; 400 mg ; 5% +3% ; 250 mg
PT.Pharos Indonesia

Zovirax Tablet 200 mg ; 400 mg ; 5% +3% ; 250 mg

PT.Glaxo Smith Kline
2 Interferon Alfa Intron A Injeksi 3 IU ; 5 IU PT.Schering
3 Ribavirin Virazide Tablet 100 mg AP
4 Ganciclovir Cymevene Tablet 500 mg PT.Roche Indonesia
5 Valacyclovir Valvir Tablet 500 mg PT.Schering
6 Lamivudine 3TC Tablet Tablet 150mg PT.Glaxo Smith Kline
3TC- HBV Tablet 100 mg PT.Glaxo Smith Kline
7 ANTIPARASIT

7.1 ANTELMINTIK

1 Albendazol Albendazol Tablet 400 mg OGB

Helben Tablet 400 mg PT.Merck
2 Levamisole HCL Askamex Tablet 25 mg Kon
Tablet 100 mg ; 500 mg ;Syr 100 mg/5ml ;
3 Mebendazol Mebendazol
30 ml OGB
 Tablet 100 mg ; 500 mg ;Syr 100 mg/5ml ;
Vermox
30 ml Jan
4 Piperazin sitrat Upixon Syr 1 Gr/5ml ; 15 ml PT.Bayer
Tablet 125 mg ; 250 mg ;Syr 25 mg/50 mg ;
5 Pirantel pamoat Pyrantel
10 ml OGB
Tablet 125 mg ; 250 mg ;Syr 25 mg/50 mg ;
Combantrin PT.Pfizer
10 ml
6 Oxantel pamoat + Pyrantel Pamoat Quantrel Tablet 150 mg ;Syr 100 mg / 5 ml ; 10 ml PT.Pfizer
7.2 ANTIFILARIA

1 Dietilkarbamazin sitrat Dietilkarbamazin Tablet 100 mg OGB

Filarzan Tablet 100 mg PT.Merck
7.3 ANTISISTOSOMA

1 Prazikuantel Prazikuantel Tablet 600 mg PT.Pharos Indonesia

7.4 ANTIAMUBA DAN ANTIGIARDIASIS

1 Metronidazol Metronidazol Tablet 250 mg ; 500 mg OGB

Fladex Tablet 250 mg ; 500 mg PT.Dexa Medika
Tablet 250 mg ; 500 mg ;Syr 125 mg/5 ml,60
Flagyl ; 5 ml/100 ml ; 500 mg/100 ml ;Injeksi 0.5
Gr ; 1 Gr PT.Sanofi Aventis
Flagyl IV Infus 500 mg/mL PT Sanofi Aventis
2 Metronidazol + Nistatin Flagystatin ovula Ovulae 500 mg ; 100.000 IU PT.Sanofi Aventis
3 Nimorazol + Kloramfenicol + Nistatin Gynoxa Ovula 250 mg ; 250 mg ; 100.000 IU PT.Kalbe Farma
7.5 ANTIMALARIA

1 Klorokuin difosfat Choloroquin Tablet 250 mg OGB

Avloclor Tablet 250 mg ; 80 mg/5,50 ml AZ
Resochin Tablet 250 mg PT.Bayer
2 Kuinin etilkarbonat Kina Tablet 2 mg OGB
Quinine 2mg ; 25%/2ml PT.Kimia Farma
3 Primakuin Primaquine Tablet 15 mg OGB
Bestaquin Tablet 15 mg Com
4 Sulfadoksin + Pirimetamin Sulfadoxine Tablet 500 mg ; 25 mg OGB
Fansidar Tablet 500 mg ; 25 mg PT.Roche Indonesia
5 artesunat + Amodiaquine Arsuamoon Tablet 50mg ; 150 mg Guillin Pharmaceuticals Co,Ltd
Dihydroartemisinin-Piperaquine
6 Artekinin Tablet 40mg ; 320 mg Cv. Artekan
Phosphate
7 Artemeter + Lumefantrin Coartem Tablet 120 mg Novartis Indonesia
8 Artemeter Artem Ampul 80 mg/mL Multi Mitra Biotech
7.6 ANTIJAMUR

1 Flukonazol Zemyc Kapsul 50 mg ; 150 mg ;Infus 100 ml PT.Pharos Indonesia

Diflucan Kapsul 50 mg ; 150 mg ;Infus 100 ml; ED 5 ml PT. Pfizer

2 Griseofulvin Griseofulvin Tablet 125 mg ; 500 mg OGB

Grivin Tablet 125 mg ; 500 mg PT.Pharos Indonesia
3 Itraconazole Sporacid Kapsul 100 mg PT.Ferron Par
4 Ketokonazol Ketoconazole Tablet 200 mg OGB
Mycoral Tablet 200 mg Yup
5 Klotrimazol Canesten VT, SD Cream 3 gr, 5 gr, 10 gr;Ovula 100 mg Bay
 Tablet 500.000 IU/Gr ; 100.000 IU/
6 Nistatin Nystatin
Gr,Oral,Ovula, Vag Tablet OGB
Tablet 500.000 IU/Gr ; 100.000 IU/ Gr, Susp
Mycostatin
12ml;30 ml; Ovula; Vagina Tablet Sq
Kandistatin Drop 12 ml MF
7 Tinidazol Flatin Tablet 500 mg PT.Pharos Indonesia
Fasigyn Tablet 500 mg PT.Pfizer
8 Miconazole Daktarin Cream 2%/5mg ; 2%/10 mg ; 2%/20 mg Janssen
9 Micafungin Mycamine Injeksi 50 mg Astellas

10 Voriconazole Vfend Tab 200 mg, powder for injection 200 mg

Pfizer
8 OBAT YANG BEKERJA PADA DARAH

8.1 ANTIANEMIA

1 Asam folat Folic acid Tablet 5 mg ; 400 mcg ; 1000 mcg OGB
Folavit Tablet 5 mg ; 400 mcg ; 1000 mcg PT.Sanbe Farma
2 Ferrous sulfat Ferrous sulfat Tablet 300 mg OGB
3 Sianokobalamin Vitamin B12 Tablet 50 mg ;Injeksi 1000 mcg/5ml OGB
4 Fe(OH)3 sucrose complex Venofer Injeksi 100 mg/5ml Combhipar
Asam askorbat + Asam Folat + Ferrous
5 Ferofort Tablet 150 mg ; 1 mg ; 83 mg
Fumarat PT.Kalbe Farma
Besi (II) glukonat + Mangan (II) Sulfat + Biosanbe Kapsul 250 mg ; 0,2 mg ; 0,2 mg ; 50 mg ; 1
Tembaga (II) Sulfat + Asam Askorbat + mg ; 7,5 mcg
6
Asam Folat+ Vit B12 + Sorbitol
PT.Sanbe Farma
Ferrous fumarat + Ca Pantotenat + Dasabion Kapsul 360 mg ; 20 mg ; 1,5 mcg ; 400 IU ; 20
7 Folic Acid + Vit C + Vit B12 +Vit D3 + mg
Sorbitol
PT.Kimia Farma
Beta karoten + Ca Laktat + Ca Folamil Genio Tablet mengandung :Copper Sulfat + Folic
Pantotenat Copper Sulfat + Folic Acid Acid + Fe Fumarat +Nikotinamid + K Iodida +
+ Fe Fumarat + Nikotinamid + K Iodida Na Fluorida +Vit B1 monohidrat + Vit B1 + Vit
8 + Na Fluorida + Vit B1 monohidrat + B12 + Vit B2 + Vit B6 + Vit C + Vit D + DHA
Vit B1 + Vit B12 + Vit B2 + Vit B6 + Vit C
+ Vit D + DHA
PT.Dexa Medika
8.2 OBAT YG MEMPENGARUHI KOAGULASI

1 Fitomenadion Phytomenadion Injeksi 10 mg /ml OGB

Vitamin K Injeksi 10 mg /ml PT.Kimia Farma
Vitadion Injeksi 2 mg/mL PT.Kalbe Farma
2 Protamin sulfat Protamin sulfat Injeksi 10 mg /ml

8.3 HEMOSTATIK

1 Carbazocrome Natriun Sulfonat Adona Tablet 100 mg ; 300 mg ;Injeksi 5mg/ml Tanabe
2 Etamsilat Dicynone 500 mg ; 250 mg/2ml Corsa
8.4 ANTIFIBRINOLISIS
Tablet 250 mg ; 500 mg ;Injeksi 250 mg;
1 Asam traneksamat Kalnex
500mg PT.Kalbe Farma
Kapsul 250mg;500 mg; Injeksi 250 mg; 500
Transamin
mg PT.Otto

Kapsul 250 mg; Tablet 500 mg; Injeksi 50

Tranexid
mg/mL; Injeksi 100 mg/mL
PT.Dexa Medika
9 OBAT KARDIOVASKULER

9.1 ANTIANGINA

1 Diltiazem HCl Diltiazem HCl Tablet 30 mg OGB

 Tablet 30 ; 60 mg ;100 mg;200 mg;90
Herbesser
mg;180 mg;10mg Tan
2 Dipyridamole Persantin Tablet 25 mg ; 50 mg ; 75 mg BI
3 Isosorbid dinitrat Isosorbide Tablet 5 mg ; 10 mg OGB
Farsorbid Tablet 5 mg ; 10 mg PT.Fahreinheit
Tablet 5 mg; 10 mg; 20 mg; R 20 mg; Retard
Cedocard
20 mg; 10 ml DV
Isoket Injeksi 10 mg/10 ml Ph I
4 Nicardipine HCl Perdipine Injeksi 2 mg /2 ml; 10 mg/ 10ml Ast
5 Nitrogliserin Nitrocaf retard Kapsul 5 mg ; 10 mg PT.Kimia Farma
6 Propranolol Propranolol Tablet 10 mg OGB
7 Trimetazidine HCl Trizedon MR Tablet 35 mg PT. Servier
8 Isosorbide 5-mononitrate IMDUR Tablet 60 mg PT. Astra Zaneca
9 Ivabradine Coralan Tablet 5 mg ; 7.5 mg

9.2 ANTIARITMIA

1 Amiodaron HCl Tiaryt Tablet 200 mg; Injeksi 5ml Fah

Cordarone Tablet 200 mg ; 150 mg/3 ml PT.Sanofi Aventis
2 Disopiramid fosfat Norpace Tablet 100 mg PT.Schering
Rytmodan Injeksi 10 mg/ml Av

3 Lidokain HCl Lidokain Injeksi 2%/2ml

OGB
4 Verapamil HCl Verapamil Tablet 80 mg OGB
Corpamil Tablet 80 mg PT.Bernofarm
Isoptin Dragee Tablet 80 mg PT.Abbott
5 Atropin sulfat Atropin Sulfat Injeksi 600 mcg/1 ml OGB
9.3 ANTIHIPERTENSI

1 Amlodipin Tensivask Tablet 5 mg ; 10 mg PT.Dexa Medika

Norvask Tablet 5 mg ; 10 mg PT.Pfizer
2 Atenolol Tenblok Tablet 50 mg ; 100 mg PT.Kimia Farma
Betablok Tablet 50 mg ; 100 mg PT.Kalbe Farma
Tenormin Tablet 50 mg ; 100 mg PT.Astra Zeneca
Bisoprolol
3 Bisoprolol hemifumarat Tablet 2,5 mg ; 5 mg OGB
hemifumarat
Concor Tablet 2,5 mg ; 5 mg PT.Merck
Maintate Tablet 2,5 mg ; 5 mg PT.Tanabbadi
4 Hidroklorotiazid HCT Tablet 25 mg OGB
5 Indapamid Natrilix SR Tablet 1,5 mg; 2,5 mg PT.Servier
6 Kaptopril Captopril Tablet 12,5 mg ; 25 mg ; 50 mg OGB
Captensin Tablet 12,5 mg ; 25 mg ; 50 mg PT.Kalbe Farma
Capoten Tablet 12,5 mg ; 25 mg ; 50 mg Sq
7 Klonidin HCl Klonidin Tablet 0,15 ; 0,075 OGB

Catapres 0,75 mcg;150 mcg;Injeksi 0,75 ml;0,15/ml

BI
8 Lisinopril dihidrat Interpril Tablet 5 mg ; 10 mg PT.Interbat
Nopril Tablet 5 mg ; 10 mg PT.Kimia Farma
9 Losartan Tensaar Tablet 50 mg PT.Kimia Farma
Angioten Tablet 50 mg PT.Kalbe Farma
10 Metildopa Medopa Tablet 125 mg ; 150 mg AP
Dopamet Tablet 125 mg ; 150 mg PT.Alpharma
11 Nifedipin Nifedipine Tablet 5 mg ; 10 mg OGB
Cordalat Tablet 5 mg ; 10 mg PT.Kimia Farma
Adalat Oros Tablet 10 mg ; 20 mg ; 30 mg ;; 60 mg PT.Bayer
12 Perindopril Prexum Tablet 4 mg Ser
13 Reserpin Reserpin Tablet 0,1 mg ; 0,25 mg OGB
Resapin Tablet 0,1 mg ; 0,25 mg PT.Schering
Serpasil Tablet 0,1 mg ; 0,25 mg PT.Biochemie
14 Hidralazin HCl + Reserpin + HCT Ser-ap-es Tablet 0,1 mg ; 0,25 mg PT.Novartis
15 Kandesartan Sileksetil Blopress Tablet 8 mg ; 16 mg PT.Takeda
16 Telmisartan Micardis Tablet 40 mg ; 80 mg Boehringer Ingelheim
17 Irbesartan Irbesartan Tablet 150 mg ; 300 mg OGB
Irvask
Tablet 150 mg ; 300 mg PT.Kalbe Farma
150MG;300MG
Fritens Tablet 150 mg ; 300 mg PT.Dankos Farma
18 Kombinasi EXFORGE 10/160MG Tablet 5/80;5/160;10/160 PT.Novartis Indonesia
19 Olmesartan Olmetec Tablet 20 mg ; 40 mg PT. Pfizer
Olmesartan medoxomil,
20 Olmetec Plus Tablet Plus 20 mg; 40 mg PT. Pfizer
hydrochlorotiazide
21 Ramipril Hyperil Tablet 2,5 mg ; 5 ; 10 mg PT. Ferron
22 Valsartan Valsartan Tablet 80 mg ; 160 mg OGB

Diovan Tablet 80 /12,5mg ; 160/12,5 mg; 160/25mg

PT. Novartis Indonesia
Tablet Per 40/5 mg ; Per 40/10 mg ; Per 80/5
23 Telmisartan + amlodipine Twynsta
mg ; Per 80/10 mg PT. Boehringer Ingelheim
9.4 OBAT GAGAL JANTUNG

1 Digoksin Digoxin Tablet 0,25 mg OGB

Lanoxin Tablet 0,25 mg ; 0,25 mg/ml GSK
9.5 DIURETIK

1 Amilorid HCl Amilorid Tablet 5 mg OGB

2 Furosemid Furosemid Tablet 40 mg ;Injeksi 10 mg/ml OGB
3 Hidroklorotiazid HCT Tablet 25 mg OGB
4 Manitol Manitol Infus 20%/250 ml; 20%/500ml PT.Otsuka
5 Spironolakton Spirolacton Tablet 25 mg ; 100 mg PT.Pharos Indonesia
Aldacton Tablet 25 mg ; 100 mg PT.Pfizer
9.6 PENURUN LIPID

1 Fenofibrat Trolip Kapsul 100 mg ; 300 mg PT.Dexa Medika

Hyperchol Kapsul 100 mg ; 300 mg Ika
Lipanthyl Kapsul 100 mg ;200 mg; 300 mg PT. Solvay Pharmaceuticals
Lipanthyl penta ;Penta 145 mg PT. Solvay Pharmaceuticals
Lipanthyl Supra Supra 160 mg PT. Solvay Pharmaceuticals
2 Gemfibrozil Gemfibrozil Kapsul 300 mg ; 600 mg OGB
 Scantipid Kapsul 300 mg ; 600 mg PT.Tempo Scan Pacific
Lopid Kapsul 300 mg ; 600 mg ; 900 mg PT.Pfizer
3 Kolestiramin anhidrat 4 gr Questran Sachet 5 Gr Sq
4 Pravastatin Pravastatin 20 mg OGB
Cholespar 10 mg; 20 mg; 40 mg PT. Pharos
5 Rosuvastatin Rosuvastatin Tablet 5 mg ; 10 mg ; 20 mg ; 40 mg OGB
Crestor Tablet 5 mg ; 10 mg ; 20 mg ; 40 mg AZ
6 Simvastatin Simvastatin Tablet 5 mg ; 10 mg OGB
Cholestat Tablet 5 mg ; 10 mg PT. Kalbe Farma
7 Atorvastatin Atorvastatin Tablet 5 mg ; 10 mg OGB
LIPITOR Tablet 10 mg ; 20 mg; 40 mg PT.Pfizer
8 Ezetimibe Ezetrol Tablet 10 mg PT. Schering Plough

9.7 ANTIKOAGULANS
Injeksi 20 mg/2ml ; 40 mg/0,4ml ; 60
1 Enoxaparin Na Lovenox
mg/0,6ml PT. Aventis
2 Heparin, natrium Heparin Sodium Injeksi 5000 IU/ml,5 ml BB
3 Warfarin, natrium Simarc-2 Tablet 2 mg PT. Fahreinheit

Arixtra Syringe 2,5 Injeksi mengandung Fondaparinux natrium

4 Fondaparinux natrium
mg/0,5 ml 2,5 mg / 0,5 ml

PT.Glaxo Smith Kline

9.8 TROMBOLITIK

1 Streptokinase Streptase Injeksi 750.000 IU ; 1.500.000 IU Av

9.9 ANTIPLATELET

1 Asam asetilsalisilat Thrombo Aspilets Tablet 80 mg ; 160 mg MdF

Ascardia Tablet 80 mg ; 160 mg PT.Pharos Indonesia
Aspilets Tablet 80 mg ; 160 mg PT.UAP
2 Cilostazol Pletaal Tablet 50 mg ; 100 mg PT.Otsuka
3 Clopidogrel Plavix Tablet 75 mg PT.Sanofi Aventis
4 Rivaroxaban Xarelto Tablet 10 mg ; 15 mg ; 20 mg PT. Bayer
9.10 VASODILATOR PERIFER

1 Naftidrofuryl Oxalate Praxilene Tablet 100 mg ; 200 mg PT.Merck

Tablet 100 mg ; 400 mg ; Injeksi 100
2 Pentoksifilin Pentoksifilin
mg/5ml,5ml OGB
Tablet 250 mg ; 500 mg; Injeksi 250 mg; 500
3 Sitikoline Brainact
mg PT.Dankos Farma
10 ANTISYOK

10.1 ANTISYOK KARDIOGENIK

1 Dobutamin HCl 250 mg Cardiject Injeksi 250 mg/5 ml PT.Dankos Farma

Infus 250 mg/5 ml Dobuject Injeksi 250 mg/5 ml PT.Dexa Medika
2 Dopamin HCl Dopamin Giulini Injeksi 50mg/ml, 5ml ; 200 mg/10 ml SP
3 Epinefrin Epineprin Injeksi 1mg /ml OGB
Adrenalin Bitatras Injeksi 1mg /ml Eth
10.2 ANTISYOK ANAFILAKSIS
1 Deksametason Deksametason Injeksi 5mg/ml OGB
Indexon Injeksi 5mg/ml PT.Interbat
Kalmethason Injeksi 5mg/ml PT.Kalbe Farma
2 Epinefrin Epineprin Injeksi 0.1%/ml, 2 ml OGB
3 Hidrocortison natium suksinat Solu-cortef Injeksi100 mg/2 ml PT.Pfizer
10.3 ANTISYOK AKIBAT ANESTESIA

1 Efedrin Efedrin HCl Injeksi 50 mg/ml OGB

11 PRODUK DARAH DAN PENGGANTI PLASMA

11.1 PRODUK DARAH

1 Albumin serum normal Albumin Human; Injeksi 20% 50 mL; 100 mL PT. Kimia Farma
Octalbin Injeksi 20% 50 mL; 100 mL PT. Kimia Farma
Albapure Injeksi 200 g/L PT. Dexa Medixa
Farmin Injeksi 200 g/L PT. Fahrenheit
lasbumin Injeksi 5%/50 mL PT. Dupa Pharma
Plasbumin 25 Injeksi 25% 20 mL; 50 mL; 100 mL PT. Dupa Pharma
11.2 PENGGANTI PLASMA

1 Dekstran 70 Plasmafusin infus 9 %, 500 ml PT. Fahrenheit

Dextran 70 infus 6 %, 500 ml; 10 %, 500 ml; 5 % 250 ml PT. Otsuka
2 Hydroxyethyl starch Haes Steril infus 6 %, 500 ml; 10 %, 500 ml PT. Fahrenheit
Gelofusin beta infus 10 %, 500 ml PT. BB
3 Polygelin 3,5% Haemaccel infus Polygelin 3,5% PT. Aventis
4 Kombinasi :
Polipeptidase 60 gr + Na. Klorida 6,5
mg + K. Klorida 0,3 gr + Ca Klorida Expafusin infus 500 ml
0,22 mg + Na. Lactat Salin 4,48 gr PT. Kalbe Farma
5 Kombinasi :
Asam amino, elektrolit + Vitamin B6,
Tutofusin Ch Forte infus 500 ml
xylitol, nikotinamid PT. Kalbe Farma
6 Kombinasi

Asam amino, elektrolit + Vitamin B6,

Tutofusin LC infus 500 ml
xylitol, nikotinamid + Sorbitol, vitamin
PT. Kalbe Farma
7 Kombinasi

Na Lactat 28.25 gr, KCI 0,075 gr, CaCI2

Totilac infus 500 ml
Dihidrat 0.05 gr PT. Kalbe Farma
12 OBAT SALURAN CERNA

12.1 ANTASID DAN ANTITUKAK

1 Natrium rabeprazol Pariet Tablet salut 10 mg; 20 mg PT. Eisai

2 Omeprazol Omeprazol Kapsul 20 mg OGB
OMZ Kapsul 20 mg; Injeksi 40 mg PT. Dexa Medica
3 Pantoprazol Pantozol Tablet 40 mg, Inj 40 mg PT. Pharos Indonesia
Pepzol Tablet 40 mg, Injeksi 40 mg PT. Mahakam Beta Farma
4 Sukralfat Inpepsa Sirup 100 ml; 200 ml PT. Fahrenheit
Ulsidex Tablet 500 mg, forte 1000 mg PT. Dexa Medica
5 Kombinasi :
 Al Hidroksida 200 mg;Mg Hidroksida Magasida Tablet kunyah Al Hidroksida 200 mg + Mg PT. Kimia Farma
200 mg;Simetikon 20 mg Hidroksida 200 mg+ Simetikon 20 mg, Sirup
Al Hidroksida 200 mg + Mg Hidroksida 200
mg+ Simetikon 20 mg

Dexanta Tablet kunyah Al Hidroksida 200 mg + Mg PT. Dexa Medica

Hidroksida 200 mg+ Simetikon 20 mg, Sirup
Al Hidroksida 200 mg + Mg Hidroksida 200
mg+ Simetikon 20 mg

6 Kombinasi :

Al Hidroksida 250 mg, Mg Hidroksida Acitral Tablet Al Hidroksida 250 mg+ Mg Hidroksida PT. Interbat
250 mg, Simetikon 50 mg 250 mg+Simetikon 50 mg, Sirup 250 mg+ Mg
Hidroksida 250 mg+Simetikon 50 mg

7 Kombinasi:

Al Hidroksida gel 250 mg, Mg trisilikat Gastrinal Tablet Al Hidroksida gel 250 mg+Mg trisilikat PT. Mepro
250 mg, Dimetilpolisiloksan 50 mg 250 mg+ Dimetilpolisiloksan 50 mg, Sirup Al
Hidroksida gel 250 mg+Mg trisilikat 250 mg+
Dimetilpolisiloksan 50 mg

8 Kombinasi:
Tablet Dimetilpolisiloksan 40 mg+ Silicon
Dimetilpolisiloksan 40 mg Disflatyl
dioksid 2 mg PT. Phapros
Tablet Dimetilpolisiloksan 40 mg+ Silicon
Silicon dioksid 2 mg Polysilane
dioksid 2 mg , Sirup 180 ml PT. Pharos Indonesia
9 Kombinasi :

Eksetazaina 5 mg, Polimigel 244 mg Strocain Tablet Eksetazaina 5 mg+ Polimigel 244 mg
PT. Eisai
10 Rebamipide Rebamipide Tablet 100mg OGB
Mucosta Tablet 100mg PT. Otsuka
11 Esomeprazole NEXIUM Tablet 20 mg; 40 mg, Injeksi 40 mg PT. Astrazenica
12.2 ANTIEMETIK

1 Dimenhidrinat Dimenhydrinat Tablet 50 mg OGB

Dramamin Tablet 50 mg PT. Soho
2 Domperidon Tilidon Tablet 10 mg, Sir PT. Interbat
Vometa Tablet, tablet FT , Syrup 60 ml, drop 5 mg/ml
PT. Dexa Medixa
3 Metoklopramid Metoklorpramida Tablet 5 mg; 10 mg OGB
Tablet 5 mg; 10 mg, sirup 60 ml, injeksi 10
Primperan
mg /2 ml, Supp 10 mg PT. Soho
Tablet 5 mg; 10 mg , Syrup 60 ml, Drop 5
Vomitrol
mg/ml PT. Pharos Indonesia
Tablet 4mg; 8 mg, Injeksi 4 mg/2 ml; 8 mg/4
4 Ondansentron HCl Ondavell PT. Nuvarindo
ml
Vomceran Injeksi 4 mg/2 mL ; 8 mg/4 mL PT. Kalbe Farma
5 Prometazin 5 mg/5 ml Allerzin Sirup 60 ml; 120 ml PT. Sak

6 Sulpirida Dogmatil Kapsul 50 mg; 200 mg, Injeksi 100 mg/2 ml

PT. Soho
7 Kombinasi :
Pyrathiazine chlorotheophylinate 40
Anvomer B6 Tablet 30 mg PT. Dexa Medica
mg
12.3 ANTISPASMODIK

1 Atropin sulfat Atropin sulfat OGB Injeksi 0,25 mg/ml; 0,5 mg OGB
2 Ekstrak beladon Extract Belladona Tablet 10 mg OGB
3 Hiosin N butil bromida Buscopan Tablet10 mg, Injeksi 20 mg/ml

4 Kombinasi :
 Fenilpropiletilamin 30 mg,
Spasmium Tablet 30 mg + 5 mg
Klordiazepoksid HCl 5 mg PT. Soho
5 Kombinasi :
Hiosin N butil bromida 10 mg, Kapsul Hiosin N butil bromida 10 mg+
Gitas Plus
Parasetamol 500 mg Parasetamol 500 mg PT. Interbat
6 Kombinasi :

Metamizol natrium 500 mg, Ekstak Tablet Metamizol natrium 500 mg+ Ekstak
Spasminal
belladon 10 mg, Papaverin HCl 25 mg belladon 10 mg +Papaverin HCl 25 mg
PT. Kalbe Farma
12.4 KATARTIK

1 Bisakodil Dulcolax Tablet 5 mg, supp 10 mg, 5 mg PT. Bhoeringer Ing

2 Laktulosa 3,35 gr / 5 ml Lactulax Sirup 120 ml PT. Ikapharmindo
Duphalac Sirup 120 ml PT. SP
3 Kombinasi:

Fenolftalein 56 mg, Vit. B Kompleks Laxadine Tablet 50 mg, Sirup 60 ml PT. Yuparindo
4 Kombinasi:

Na-laurylsulfoacetat 45 mg, Na-citrate Tube Na-laurylsulfoacetat 45 mg+ Na-citrate

450 mg, Sorbic acid 5 mg, PEG 400 625 Microlax 450 mg,+ Sorbic acid 5 mg, + PEG 400 625
mg, Sorbitol 4,465 mg mg+ Sorbitol 4,465 mg
PT. Pharos Indonesia
12.5 ANTIDIARE

1 Atapulgit New Diatabs Tablet 600 mg PT. Bio

Biodiar Tablet 630 mg PT. Sandoz
2 Dioctahedral smectite Smecta Sachet PT. Bea
3 Garam oralit Garam Oralit Sachet 200 ml OGB
Pharolit Sachet 200 ml PT. Pharos Indonesia
Pedialyte Steril sol 500 ml PT. Abboth
4 Loperamid HCl Lodia Tablet 2 mg PT. Sanbe Farma
Imodium Tablet 2 mg PT. Jassen
5 Nifuroxazide Nifural Sirup PT. Daria Varia
6 Kombinasi :

Atapulgit 300 mg, Pektin 50 mg Nodiar Tablet Atapulgit 300 mg+ Pektin 50 mg PT. Kimia Farma
7 Kombinasi :

Kaolin 700 mg Neo Kaolana Sirup 120 ml PT. Sanbe Farma

Pektin 50 mg Kaopectat Sirup 120 ml PT. Pfizer
8 Lactobasillus sporogenes Lacbon Tablet PT. Kimia Farma
Tablet Lactobacillus reuteri Protectis 108
Rillus
CFU PT. Kimia Farma
9 Bividobacteri Inf. L - Bio Sachet PT. Lapi
10 Zink Sulfat Zn-Diar Tablet 20mg PT. Hexpharm
Zinkid Tablet 20mg, Sirup 10mg/5ml PT. Indofarma
12.6 ANTIKOLITIS

1 Coenzym B12 Cobazim Kapsul 1000 : 1 mg; 3000 : 3 mg PT. Interbat

2 Sulfalazin Sulcolon Tablet 500 mg PT. Ber
12.7 DIGESTIF

1 Kombinasi:
Pankreatin 150 mg, Ekstrak empedu Tablet Pankreatin 150 mg+ Ekstrak empedu
Enzymfort
25 mg 25 mg PT. Kimia Farma
12.8 HEPATOPROTEKTOR

1 Serbuk rhizoma kurkuma 200 mg Curcuma Tablet serbuk rhizoma kurkuma 200 mg PT. Soho
2 Kombinasi :
Kurkuma 2 mg, Vit B1 3 mg, Vit B2 2 Curvit Sirup 60 ml; 120 ml PT. Soho
mg, Vit B6 5 mg, Vit B12 5 mg,
Betakaroten 4 mg, Dekspantenol 3
mg, Kalsium glukonat 300 mg
3 Kombinasi :

Schizandrae fructus extr 135 mg, Curliv Tablet, Sirup Schizandrae fructus extr 135 PT. Soho
Curcuma xanthorrhizae extr 150mg, mg,+ Curcuma xanthorrhizae extr 150mg,
Liquiritiae radix 135 mg, choline +Liquiritiae radix 135 mg, +choline Bitartrate
Bitartrate 150 mg, vit B6 2 mg. 150 mg, +vit B6 2 mg.

4 Fructus Schizandrae (Extract siccum) Hp Pro Tablet 7,5 mg PT. Bio-Life

5 Kombinasi Hepamax Tablet PPC 95% 150 mg, silymarin PT. Kalbe Farma
phytosome 100 mg, Ekstrak schizandra 37.5
mg, d-a tokoferol 5 ui

12.9 ANTIHEMOROID

1 Fluokortolon pivalat Supp Ultraproct N Supp, Cream 10 gram PT. Shering Ploung Ind
2 Kombinasi:
Lidocaine HCl 5%, Al-subacetat 3,5%,
Hydrocortisone acetate 0,25%, Zn- Hemocaine Tube 15 g
oxide 18% PT. Yuparindo
3 Kombinasi:
Graptophyllum pictum 30%, Sophora Ambeven Kapsul Graptophyllum pictum 30%, PT. Medifarma
japonica 15%, Rubia cardiofolia 15%, +Sophora japonica 15%, +Rubia cardiofolia
Coleus atropurpureus 10%, 15%+ Coleus atropurpureus 10%, +
Sanguisorba officinalis 10%, Kaemferia Sanguisorba officinalis 10%, +Kaemferia
angustifolia 10%, Curcuma heyneanae angustifolia 10%+Curcuma heyneanae 10% /
10%/caps caps

Policresulen+ cinchocain Faktu Salep 50 mg+10 mg ; Suppositoria 100 mg+ PT. Pharos
4 2.5 mg
Kombinasi Ardium Tablet Micronized Purified Flavanoid PT. Servier
Fraction 500 mg setara dengan Diosmin
5 90%, flavanoid dalam bentuk hesperidin
10%.

13 OBAT SUSUNAN SYARAF

13.1 PELEMAS OTOT

1 Atrakurium besilat Tracrium Injeksi 25 mg/2,5 ml; 50 mg/5 ml PT. Glaxo Smiet Klien
2 Pankuronium bromida Pavulon Injeksi 2mg/ml PT. Org
3 Suksametonium klorida Succinyl-Asta Siccum Injeksi 100 mg/ml ; 500 mg/ml PT. AM
4 Eperisone HCl MYONAL Tablet 50 mg PT. Eisai

5 Hyaluronic acid / asam hyaluronit Durolane inj 3 ml Injeksi 20 mg/ ml

6 Tizanidine HCI Sirdalud Tablet 2 mg PT. Novartis

7 Baclofen Lioresal Tablet 10 mg PT. Novartis
13.2 OBAT MIASTENIA GRAVIS

1 Neostigmin metilsulfat Prostigmin Injeksi 0,5 mg/ml PT. Combipar

2 Piridostigmin bromida Mestinon Tablet 60 mg PT. Aztra Zenica
3 Immune Globulin IV (human) 10% Gammaras Injeksi Immune Globulin IV (human) 10% PT. Combipar
13.3 ANTIPARKINSON
Tablet 0,5 mg, Injeksi 0,25 mg/ml; 0,5
1 Atropin sulfat Atropin Sulfat
mg/ml; 1 mg/ml OGB
2 Bromocriptine mesilate Parlodel Tablet 2 mg Nov
3 Triheksifenidil HCl Triheksifenidil HCl Tablet 2 mg OGB
Artane Tablet 2 mg Led
4 Kombinasi:
Levodopa 100 mg; Benzerazida HCl 25 Tablet Levodopa 100 mg+ Benzerazida HCl
Madopar
mg 25 mg Ro I
Tablet 0,125 mg; 0,250 mg; 0,375 mg ; 0,750
5 Pramipeksol HCl Sifrol PT. Boehringer Ingelheim
mg
14 PSIKOFARMAKA

14.1 ANTIANSIETAS (TRANSKUILIZER MINOR)

1 Alprazolam Xanax Tablet 0,25 mg; 0,5 mg; 1 mg Pfi

Zypras Tablet 0,25 mg; 0,5 mg; 1 mg pharos
2 Diazepam Diazepam Tablet 2 mg; 5 mg, Injeksi 10 mg/2 ml OGB
Valium Tablet 2 mg; 5 mg, Injeksi 10 mg/2 ml Ro I
3 Klobazam Klobazam Tablet 10 mg OGB
Frisium Tablet 10 mg Av
4 Klordiazepoksid Arsitran Tablet 5 mg; 10 mg Mep
Cetabrium Tablet 5 mg; 10 mg Sh
5 Lorazepam Merlopam Tablet 0,5 mg; 1mg; 2 mg Mersi
Ativan Tablet 0,5 mg; 1mg; 2 mg Wye
6 Bromazepam Lexotan Tablet 1,5 mg; 3 mg; 6 mg Roche
7 Estazolam Esilgan Tablet 1 mg ; 2 mg Takeda
14.2 ANTIDEPRESI

1 Amitriptilin HCl Amitriptilin Tablet 10 mg; 25 mg OGB

2 Clomipramine HCL Anafranil Tablet 25 mg Nov
3 Fluoksetin Nopres Tablet 20 mg Fer
4 Imipramin HCl Tofranil Tablet 25 mg Nov
5 Maprotilin HCl Ludiomil Tablet 10 mg; 25 mg; 50 mg; 75 mg Nov
6 Escitalopram Cipralex Tablet 10mg ; 20 mg PT. Pyridam farma
7 Sertraline HCL Zoloft Tablet 5 mg; 10 mg; 15 mg PT. Pfizer
14.3 ANTIPSIKOTIK / TRANSKUILIZER MAYOR

1 Flufenazin HCl Anatensol Tablet 2,5 mg; 5 mg Sq

Modecate Injeksi 25 mg\ 5 ml Brist
2 Haloperidol Haloperidol Tablet 0,5 mg; 1,5 mg; 5 mg OGB
Serenace Tablet 0,5 mg; 1,5 mg; 5 mg Pfi
Haldol Tablet 0,5 mg; 1,5 mg; 5 mg Jan
3 Klorpromazin HCl Chlorpromazin HCl Tablet 25 mg; 100 mg OGB
Largactil Injeksi 25 mg/5 ml Av
4 Risperidon Neripros Tablet 1 mg; 2 mg; 3 mg Pha
Risperdal Tablet 1 mg; 2 mg; 3 mg Jan
5 Sulpirida Dogmatil Capsul 50 mg; 200 mg, Injeksi 100 mg/2 ml Sh
6 Trifluoperazina Stelazine Kapsul 1 mg; 5 mg SK
7 Klozapin Luften Tablet 25; 100 mg Pharos
8 Aripiprazole Abilify Tablet 5mg; 10mg; 15mg, Injeksi 7.5mg/ml PT. Otsuka
14.4 HIPNOTIK

1 Nitrazepam Dumolid Tablet 10 mg Alp

15 OBAT SISTIM PERNAFASAN

15.1 ANTIINFLUENZA DAN DEKONGESTAN

1 Kombinasi :
Asetaminofen 500 mg; 650 mg
Khlorfeniramin maleat 2 mg,
Penilpropanolamin HCl 12,5 mg
Fludane Kaplet Asetaminofen 500 mg; 650 mg+ Tan
Khlorfeniramin maleat 2 mg+
Penilpropanolamin HCl 12,5 mg
Fludane forte Kaplet Asetaminofen 500 mg; 650 mg+ Tan
Khlorfeniramin maleat 2 mg+
Penilpropanolamin HCl 12,5 mg

2 Kombinasi :

Asetaminofen 120 mg;Khlorfeniramin Nipe Sirup, Drop Asetaminofen 120 mg+ AM

maleat 0,75 mg;Penilpropanolamin Khlorfeniramin maleat 0,75 mg+
HCl 25 mg; Tipepidin hibenzat 3,5 mg Penilpropanolamin HCl 25 mg+ Tipepidin
hibenzat 3,5 mg

3 Kombinasi :
Dekstrometorfan HBr 15 mg, Tuseran forte Kapsul Wes
Phenylephrine HCl 10 mg;
Paracetamol 325 mg

4 Kombinasi:

Fenilpropanolamin HCl 15 mg, Nalgestan Tablet Fenilpropanolamin HCl 15 mg+ Bio

Klorfeniramin maleat 2 mg Klorfeniramin maleat 2 mg

5 Kombinasi :
Pseudoefedrin 30 mg (15 mg), Rhinofed Tablet Pseudoefedrin 30 mg (15 mg) + Dex
Terfenadin 40 mg (20mg) Terfenadin 40 mg (20mg), Sirup 60 ml

6 Kombinasi :

Triprolidin HCl 2,5 mg (1,25 mg) Nasafed Tablet Tripolidin HCl 2,5 mg (1,25 mg)+ MP
Pseudoefedrin HCl 60 mg (30 mg) Sirup
Pseudoefedrin HCl 60 mg (30 mg) Actifed Sirup 60 ml; sirup 120 mL GSK

Tremenza Tablet Tablet Tripolidin HCl 2,5 mg (1,25 PT. Sanbe

mg)+ Pseudoefedrin HCl 60 mg (30 mg),
Sirup 30 mg+1.25 mg/60ml
7 Kombinasi :

Ibuprofen 200 mg, Pseudoefedrin 30 Flurofen Tablet Ibuprofen 200 mg + Pseudoefedrin 30 PT. Kimia Farma
mg mg

8 Xylometazolin HCl Otrivin Nasal Drop 0.01 %; 0.005 % Nov

9 Kombinasi :

Loratadine 5 mg, Pseudoephedrine Rhinos SR Kapsul Loratadine 5 mg, Pseudoephedrine PT. Dexa Medika
HCI lepas segera 60 mg, HCI lepas segera 60 mg, Pseudoephedrine
Pseudoephedrine HCI lepas lambat 60 HCI lepas lambat 60 mg
mg
10 Kombinasi :

Pseudoephedrine HCl Triaminic Sirup 7.5 mg/0.8 mL Novartis / glaxo

Pseudoephedrine HCl +
Triaminic sirup Sirup 7.5 mg/0.8 mL Novartis / glaxo
dextromethorphan HBr
Pseudoephedrine HCl 15 mg,
Triaminic pilek Sirup 15 mg + 1 mg
chlorpheniramine maleate 1 mg Novartis / glaxo
11 Momethasone furoate Nasonex nasal spray semprot hidung 60 MD ; 140 MD PT. Schering Plough
15.2 ANTITUSIF

1 Doveri Doveri Tablet 100 mg; 150 mg; 200 mg PT. Kimia Farma
2 Kodein HCl Kodein Tablet 10 mg; 20 mg OGB
Kapsul 25 mg; 50 mg, Sirup 25 mg/5 ml, 60
3 Noskapin Longatin Alp
ml
Mercotin Drop 10 mg/ml, 20 ml Eis
4 Kombinasi
Kapsul Kodein 30 mg+ Feniltoloksamin 10
Kodein 30 mg, Feniltoloksamin 10 mg Codipront PT. Kimia Farma
mg, Sirup
15.3 EKSPEKTORAN DAN MUKOLITIK

1 Ambroksol HCl Ambroxsol Tablet 30 mg/ 5 ml, Sirup 60 ml OGB

Mucopect Tablet 30 mg/ 5 ml, Sirup 60 ml BI
Transbroncho Tablet 500 mg, Sirup 15 mg/ 5 ml, 100 ml Kal
Mucos Drop 15mg/ml, 20 ml Mep
Mucopect Drop 15mg/ml, 20 ml BI
2 Asetilsistein Fluimucyl Kapsul 200 mg; , Sacchet 100 mg, 200 mg ZS
3 Bromheksin HCl Solvax Tablet 8 mg PA
Mucosolvan Sirup 4 mg/5 ml Kal
Bisolvon Tablet, Sirup, Drop, Injeksi 4 mg/ml, 2 ml BI
4 Karbosistein Solmux Kapsul 500 mg Wes
Rhinathiol Sirup 500 mg/ 5 ml Ph I
5 Erdosteine Vectrine Kapsul 300 mg, Sirup 175 mg/5 ml Int
6 Gliseril guaiakolat Gliseril Guaiakolat Tablet 100 mg OGB
7 Kombinasi :
Desktrometorfan HBr 7,5 mg; Ersylan Sirup 60 ml; 120 ml PT. Kimia Farma
Klorfeniramin maleat 0,5 mg;
Amonium klorida 30 mg; Natrium
sitrat 60 mg; Efedrin HCl 3 mg

15.4 ANTIASMA

1 Aminofilin Aminophilin Tablet 100 mg; 200 mg, injeksi 24 mg/ml OGB

2 Budesonide, Aero 200 Pulmicort Turbuhaller 100 Y AZ

3 Deksametason Deksametason Tablet 0,5 mg OGB
Cortidex Tablet 0,5 mg San
4 Deksametason natrium fosfat Deksametason Injeksi 5 mg/ml OGB
Kalmethason Tablet 0,5 mg, Injeksi 5 mg/ml Kal
5 Efedrin HCl Efedrin HCl Tablet 25 mg OGB
6 Fenoterol BR Berotec Semprot Aero 100 Y BI
Tablet 0,01 mg; 0,02 mg;, Sirup 0,005 mg/5
7 Klenbuterol hidroklorida Spiropent BI
ml, 60 ml
8 Salbutamol Salbutamol Tablet 2 mg; 4 mg OGB
Suprasma Sirup 2 mg/5 ml, 100 ml Dex
Salbuven Sirup 2 mg/5 ml, 100 ml Ph I
Ventolin Nebules 2.5 mg/2.5 ml GSK
9 Teofilin Teofilin Tablet 150 mg OGB
Serbuk Bronsolvan Tablet 125 mg, Sirup 150 mg/15 ml Kal
Euphylin Retard Mite Tablet 250 mg Ph I
Euphylin Retard Tablet 300 mg Ph I
10 Terbutalin sulfat Terasma Tablet 2,5 mg Med
Bricasma Tablet 2,5 mg, Injeksi 0,5 mg/ml AZ
11 Terbutalin sulfat 1,5 mg Terasma Sirup 100 ml Med
Guaifenesin 50 mg Bricasma Sirup 100 ml AZ
12 Kombinasi :

Efedrin HCl 12,5 mg; Teofilin 130 mg Asmadex Tablet Dex

13 Kombinasi
Budesonid 80 mcg / 160 mcg; Turbuhaler 60 dosis 80/4,5 mcg, 60 dosis
Symbicort
Formoterol Fumarat 4,5 mcg 160/4,5 ,cg, 120 dosis 160/4,5 mg AZ
14 Kombinasi

Salbutamol Sulfate, Teofilin Teosal Tablet 1 mg + 150 mg; Sirup 0.5 mg + 50 mg PT. Dexa Medica

15 Kombinasi
inhalasi Salmeterol xinafoate 50 meg,
Salmeterol + fluticasone propionate Seretide Diskus 100 glaxo
fluticasone propi¬onate 100 meg
inhalasi Salmeterol 50 mcg, fluticasone
Seretide Diskus 250 glaxo
propionate 250 mcg.
16 HORMON, HORMON KONTRASEPSI DAN KONTRASEPSI LAIN

16.1 KORTIKOSTEROID

1 Deksametason Deksametason Injeksi 5mg/ml OGB

Indexon Injeksi 5mg/ml PT. Interbat
Kalmethason Injeksi 5mg/ml PT.Hexpharm
2 Kortison Asetat Cortison asetat Injeksi 5mg ml OGB
3 Methilprednisolon Methylpredisolon Tablet 4mg,8mg,16mg ; Injeksi 125mg OGB
Lameson Tablet 4mg,8mg,16mg PT. Lapi
Medixon Tablet 4mg,8mg,16mg ; Injeksi 125mg PT.Ferron
4 Prednisolone Prednison Tablet 5mg OGB
Lupred Tablet 5mg PT.Fahreinheit
5 Triamsinolon asetonid Trinolon Tablet 4mg PT.Interbat
6 Kombinasi

Betametason, deksklorfeniramin Tablet mengandung: Betametason 0.25mg +

Ocuson PT.Sanbe
maleat deksklorfeniramin maleat 2mg
Tablet, Syrup mengandung: Betametason
Celestamin PT. MSD (merck sharp dohme)
0.25mg + deksklorfeniramin maleat 2mg
16.2 ESTROGEN DAN ANTIESTROGEN

1 Estrogen konyugasi Esthero Tablet 0.625mg, 1.25mg PT.Sunti Sephuri

2 Etinil Estradiol Lynoral Tablet 50mcg PT.Organon
3 Klomifen Sitrat Mestrolin Tablet 50mcg PT. Darya Varia
16.3 PROGESTERON

1 Didigresteron Duphaston Tablet 10mg PT.Kimia Farma

2 Hidroksiprogesteron kaproat Prolutan Depo Injeksi 250mg/ml PT.Schering
3 Norestisteron Primolut N Tablet 5mg PT.Schering
16.4 ANDROGEN

1 Testoteron propionat Testoteron Tablet 30mg; Injeksi 50mg/ml PT.Ethica

16.5 HORMON ANTIDIURETIK

1 Vasopresin Pitresin Injeksi 20 IU

16.6 HORMON LAIN

1 Bromokriptin Serocryptin Tablet 2.5mg

Parlodel Tablet 2.5mg PT. Novartis

2 Danazol Danocrine kapsul 100mg, 200mg PT. Sanovi Aventis
16.7 HORMON KONTRASEPSI
1 Etonolgesrel Implanon limas Implan 68mg PT.Organon
2 Levonogestrol Norplan Implan 36mg PT.Djaya Bina Agung
3 Medoksiprogesteron asetat Depo progestin Injeksi 50mg/ml PT. Harsen
Provera Injeksi 50mg/ml PT. Pharmacia
Farlutal Injeksi 50mg/ml PT.Ce
4 kombinasi
Tablet mengandung: levonogestrol
levonogestrol,etinilestradiol Microgynon PT.Schering
150mcg+ etinilestradiol 30mcg
5 Kombinasi
Medoksiprogesteron asetat, Estradiol Injeksi mengandung: Medoksiprogesteron
Cyclofem PT.Tunggal Idaman Abdi
sipionat asetat 50mg + Estradiol sipionat 10mg
6 Kombinasi
Tablet mengandung : norgestrel 0.15mg; +
Norgestrel, etinilestradiol Microdiol PT.Kimia Farma
etinilestradiol 0.03mg
7 Kombinasi
6 Tablet mengandung: levonorgestrel 50mcg
levonogestrel,etinilestradiol Triquilar-ED PT. Schering
+ etinilstradiol 30mcg
5 Tablet mengandung: levonorgestrel 75mcg
+ etinilstradiol 40mcg
10 Tablet mengandung: levonorgestrel
125mcg + etinilstradiol 30mcg
8 Kombinasi
Tablet mengandung: siproteron 2mg +
Siproteron, etinilestradiol Diane 35 PT.Bayer
etinilestradiol 0.035mg
16.8 KONTRASEPSI NON HORMONAL
Copper T Cu 380 A
1 Copper T Cu 380 A Libi Copper T Cu 380 A Libi
Libi PT.Kimia Farma
Nova T pcs PT.Kimia Farma
Copper T Cu 380 A
2 Copper T Cu 380 A Limas Copper T Cu 380 A Limas
Limas PT.Kimia Farma
17 THYROID DAN ANTITHYROID

17.1 THYROID

1 Levothyroxine na Euthyrox Tablet 50mcg, 100mcg PT.Merck

2 Lar.Lugol Lar.Lugol Larutan 30ml PT.Kimia Farma
3 propitiouracil PTU Tablet 50mg, 100mg PT.Kimia Farma
4 L-thyroxine, natrium Thyrax Tablet 100mcg PT.Quamed
17.2 ANTI THYROID

1 Karbimazol Neo Mercazole Tablet 5mg PT.Nicholas

2 Thiamazole Thyrozol Tablet 5mg, 10mg PT.Merck

18 ANTIDIABETIK

18.1. ANTIDIABETIK ORAL

1 Akarbose Glucobay Tablet 50mg, 100mg PT.Bayer

2 Glimepirid Glimepirid Tablet 1mg, 2mg, 3mg PT. Dexa medica
Metrix Tablet 1mg, 2mg, 3mg PT. Kalbe farma
Amaryl Tablet 1mg, 2mg, 3mg PT.Sanovi Aventis
3 Glibenklamid Glibenklamid Tablet 5mg PT.Dexa medica
4 Glikasid Glidabet Tablet 30mg PT.Kalbe Farma
Glicab Tablet 30mg PT.Tempo Scan Pacipic
 Diamicron MR Tablet 80mg PT.Servier
5 Glipizid Minidiab Tablet 5mg, 10mg PT.Kalbe Farma
6 Gliquidon Gliquidon Tablet 30mg PT.Dexa medica
Glurenorm Tablet 30mg PT.Boehringer
7 Metformin HCL Metformin HCL Tablet 500mg, 850mg PT. Dexa medica
Tablet 500mg, 850mg ; Tablet XR 500mg,
Glucophage PT. Merck
750mg
Nevox XR Tablet (lepas lambat) 500mg, 850mg PT. Kalbe Farma
8 Kombinasi
Glucovance Tablet mengandung: Glibenclamide 1.25mg
Glibenclamide, metformin
1.25mg/250mg + metformin 250mg PT.Merck
Glucovance Tablet mengandung: Glibenclamide 2.5mg +
2.5mg/500mg metformin 500mg
Glucovance Tablet mengandung: Glibenclamide 5mg +
5mg/500mg metformin 500mg
9 Pioglitazon Deculin Tablet 15mg, 30mg PT. Dexa medica
Actos Tablet 15mg, 30mg PT.Dexa medica
10 Repaglinid Novonorm Tablet 0.5mg, 1mg, 2mg PT. Dexa medica
11 Linagliptin Trajenta Tablet 5mg PT. Boehringer Ingelheim
12 Sitagliptin Januvia Tablet 50mg, 100mg PT. Merck
13 Vildagliptin Galvus Tablet 50mg PT. Novartis
14 Kombinasi

Tablet mengandung: Sitagliptin 50 mg +

Sitagliptin + metformin HCl Janumet 50/500MG
metformin HCl 500 mg
PT. Merck
Tablet mengandung: Sitagliptin 50 mg +
Janumet50/850MG PT. Merck
metformin HCl 850 mg
Tablet mengandung: Sitagliptin 50 mg +
Janumet50/1000MG PT. Merck
metformin HCl 1000 mg
Tablet mengandung: Glimepiride 1mg +
15 Glimepirid, metformin Amaryl M 1/250
Metformin 250mg PT.Sanofi aventis
Tablet mengandung: Glimepiride 2mg +
Amaryl M 2/500
Metformin 500mg PT.Sanofi aventis
Galvusmet Tablet mengandung: Vidaglaptin 50mg +
16 Vildagliptin, Metformin HCl
50mg/500mg Metformin 500mg
PT.Sanofi aventis
Galvusmet Tablet mengandung: Vidaglaptin 50mg +
50mg/850mg Metformin 850mg PT.Sanofi aventis
Galvusmet Tablet mengandung: Vidaglaptin 50mg +
50mg/1000mg Metformin 1000mg PT.Sanofi aventis
18.2 ANTIDIABETIK PARENTAL

1 Insulin Actrapid HM Injeksi 40 IU/mlx 10ml, 100IU/mlx 10ml PT.Novo Nordisk

Actrapid HM Penfill Penfill, Injeksi 100IU/ml x 3ml PT.Novo Nordisk
Insulin determinan Levemir Flexpen Flexpen, Injeksi 100IU/ml x 3ml PT.Novo Nordisk
Injeksi 100IU/ml x 10ml; Solostar 100IU/ml x
Insulin Glargine Lantus solostar PT. Sanofi aventis
3ml
2 Human monocomponen insulin Monotard HM Injeksi 40 IU/mlx 10ml, 100 IU/ml x 10ml PT.Novo Nordisk
Zinc Susp 30% amorphous dan 70%
crsytaline PT.Novo Nordisk
3 Humulin soluble Human Insulin Humulin Injeksi 40 IU/ml x 10ml, 100 IU/ml x 3ml Eli Lilly
Regular soluble human insulin 30%
Catridge,Injeksi 100 IU/ml x 10ml Eli Lilly
dan
Isophane human insulin susp 70%

18.3 ANTIDIABETIK LAINNYA

Tablet mengandung: Glibenclamide 1.25mg
1 Kombinasi Glucovance
+ metformin 250mg PT. Merck
 Tablet mengandung: Glibenclamide 2.5mg +
Glibenclamide, Metformin
metformin 500mg PT. Merck
Tablet mengandung: Glibenclamide 5mg +
metformin 500mg PT. Merck
2 Pioglitazone Hcl Pionix Tablet 15 mg, 30mg PT.Kalbe Farma
Deculin Tablet 15 mg, 30mg PT.Dexa Medica
Tablet mengandung pioglitazone 15
3 Pioglitazone HCl , Metformin Pionix M mg/metformin 500mg ; pioglitazone 15
mg/metformin 850 mg PT.Kalbe farma

19 OBAT YANG BEKERJA PADA RAHIM

19.1 UTEROTONIN

1 Metilergometrin maleat Metilergometin Tablet 0.125mg OGB

Methergin Tablet 0.125mg; Injeksi 0.2mg/ml PT. Novartis
Pospargin Tablet 0.125mg; Injeksi 0.2mg/ml PT.Kalbe Farma
2 Oksitosin Santocyn Injeksi 10 IU/ml PT.Caprifarmindo
3 Oksitosin sintetik Syntocinon Injeksi 10 IU/ml PT.Novartis
19.2 TOKOLITIK

1 Isoksuprin HCL Isoksuprin Tablet 10mg, 20mg OGB

Hystolan Tablet 10mg, 20mg PT.Dexa Medica
Duvadilan Tablet 10mg, 20mg ; Injeksi 5mg/ml PT.SP
2 Magnesium sulfat Magnesium sulfat Injeksi 20% x25ml , 40% x 25ml OGB
3 Terbutalin Sulfat Terasma Tablet 2.5mg PT.Medikon Pratama
Bricasma Tablet 2.5mg; Injeksi 0.5mg/ml PT.Astra Zeneca
20 OBAT YANG BEKERJA PADA SALURAN KEMIH

20.1 ANALGESIK SALURAN KEMIH

1 Fenozopiridin HCL Pyridium Tablet 100mg PT. Pfizer

20.2 Urolitikum

1 Prazosin HCL Prazosin Tablet 1mg OGB

Minipress Tablet 1mg, 2mg PT.Pfizer
2 Terazosin HCL Hytrin Tablet 1mg, 2mg PT.Abbot
3 Tamsulosin HCL Harnal D Tablet 0.2mg PT. Astellas
Harnal OCAS Tablet 0.4mg PT. Astellas
4 Flavoxate HCl Urispas Tablet 200mg PT. Indo Farma
21 VITAMIN DAN MINERAL

21.1 VITAMIN

1 Asam askorbat Vitamin C Tablet 50 mg OGB

2 D alfatokoferol Dalfarol Kapsul 100-200 IU PT. Darya Varia lab
3 Mekobalamin Kalmeco Kapsul 250 dan 500 mcg PT. Kalbe Farma
Lapibal Kapsul 250;500 mcg, injeksi 500 mcg PT. Lapi
Methycobal Kapsul 250;500 mcg, injeksi 500 mcg PT. EISAI
Tablet Vit. B1 100mg+ Vit. B6 200mg+Vit.
4 Neurotropik vitamin Neurobion
B12 200 mcg PT. Merck
Tablet Vit. B1 100mg+ Vit. B6 200mg+Vit.
Neurosanbe
B12 200 mcg PT. Sanbe farma

5 Ossein hydroksiapatite
6 Piridoksin HCl
7 Vitamin A (Retinol)
50.000 IU
8 Tiamin HCl
9 Vitamin B Komp
10 Glukosamin HCl + Chondroitin Sulfat
11 kombinasi :
Vit A + Vit B1 + Vit B2 + Vit B6 + Vit Obimin AF
B12 + Vit C + Vit D + Niacinamid +
Kalsium pantotenat + Folic acid + Fe
Fumarat + Kalsium laktat + Copper +
Iodine + Natrium fluoride
12 kombinasi :
Vit A + Vit B1 + Vit B2 + Vit B6 + Vit Obipluz
B12 + Vit C + Vit D + Nicotinamide +
Asam folat + Ca. Panthothenate +
Biotin + Fe. Sulfat + Iodine + Ca.
Carbonat + Zn. Sulfat + Mg. Sulfat +
Magnanese Sulfat + Cupric Sulfat +
Natural fish oil + Omega 3 fish oil
13 kombinasi :
Vit. A + Vit. B1 + Vit. B2 + Vit. B6 +
Vit. B12 + Vit. C + Vit D +
Nicotinamide + Ca. Panthothenate
kombinasi :
14
Vit B1 + vit B2 + vit B6 + vit B12 +
nicotinamide + d(+) pantothenol
kombinasi :
15
Vit A + vit B1 + vit B2 + vit B6 + vit Elkana CL
B12 + vit C + vit D + nicotinamide +
Ca pantothenate + choline + inositol +
Ca gluconate + Ca hypophosphite +
Na hypophosphite + l-lysine HCl
kombinasi :
16
Fursultiamine HCl + Vit. B2 5 mg
kombinasi :
17
Tablet Vit. B1 100mg+ Vit. B6 100mg+Vit.
Neurosanbe 5000 B12 5000 mcg, ampul Vit. B1 100mg + Vit. B6
100mg,+Vit. B12 5000 mcg PT. Sanbe farma
Ossopan Tablet 200 ; 800 mg PT. Darya Varia lab
Vitamin B6 Tablet 10 mg OGB
Vitamin A Tablet 10 mg OGB
Vitamin B1 Tablet 100 mg OGB
Vitamin B Comp Tablet OGB
Tablet Glukosamin HCl 250 mg + Chondroitin
Flexor
Sulfat 200 mg PT. Dexa Medica
Tablet Glukosamin HCl 500 mg + Chondroitin
Flexor DS
Sulfat 400 mg PT. Dexa Medica
Tablet mengandung Vit A 6000 IU+ Vit B1 PT. Darya Varia lab
10mg + Vit B2 2,5mg + Vit B6 15 mg + Vit
B12 4 mcg + Vit C 100mg + Vit D 400 U +
Niacinamid 20 mg + Kalsium pantotenat 7,5
mg + Folic acid 1 mg + Fe Fumarat 90 mg +
Kalsium laktat 250 mg + Copper 0,1 mg +
Iodine 0,1 mg + Natrium fluoride 1 mg
Tablet mengandung Vit A 3000 IU + Vit B1 2 PT. Darya Varia lab
mg + Vit B2 2 mg + Vit B6 3 mg + Vit B12 3
mcg + Vit C 100 mg + Vit D 200 IU +
Nicotinamide 20 mg + Asam folat 1000 mcg
+ Ca. Panthothenate 8 mg + Biotin 35 mcg +
Fe. Sulfat 30 mg + Iodine 150 mcg + Ca.
Carbonat 100 mg + Zn. Sulfat 15 mg + Mg.
Sulfat 5 mg + Magnanese Sulfat 1 mg +
Cupric Sulfat 1000 mcg + Natural fish oil 500
mg + Omega 3 fish oil 135 mg
Multivitaplex Tablet mengandung Vit. A 2000 IU + Vit. B1 1 PT. Actavis
mg + Vit. B2 1,2 mg + Vit. B6 80 mcg + Vit.
B12 1 mcg + Vit. C 30 mg + Vit D 200 IU +
Nicotinamide 10 mg + Ca. Panthothenate 2
mg
Becombion Sirup per 5 ml Vit B1 5 mg + vit B2 2 mg + vit PT. Merck
B6 2.5 mg + vit B12 3 mcg + nicotinamide 20
mg + d(+) pantothenol 3 mg
Sirup Per 5 ml Vit A 2,400 iu + vit B1 4 mg + PT. Sanbe Farma
vit B2 1.2 mg + vit B6 1.2 mg + vit B12 4 mcg
+ vit C 60 mg + vit D 400 iu + nicotinamide 16
mg + Ca pantothenate 6 mg + choline 12 mg
+ inositol 12 mg + Ca gluconate 300 mg + Ca
hypophosphite 20 mg + Na hypophosphite
20 mg + l-lysine HCl 200 mg
Alinamin F Ampul 25 mg/10 ml Fursultiamine HCl + Vit. PT. Takeda
B2 5 mg
 Vitamin A + Vitamin B1+ Vitamin B2 + Lysmin
Vitamin B6 + Vitamin B12 + Vitamin C
+ Vitamin D + Niasinamida + [l]-lisin
HCl
18 kombinasi :
Asam 3-metil-2-oksovalerat+Asam 4- Ketosteril
metil-2-oksovalerat +Asam 2-okso-3-
fenilpropionat +Asam 3-metil-2-
oksobutirat +Asam 2-hidroksi-4-
metiltiobutirat +L-lysine monoasetat
+L- treonin+L-triptofan +L-histidin +L-
tirosin +Nitrogen total +Ca
19 kombinasi :
Fe Fumarat +Asam Folat +Vitamin B12 Prenamia
+Vitamin C +Vitamin D3 +Kalsium
Karbonat.
20 kombinasi :
Bonistein (Genistein) +Ca elemental
+Vit K1 +Vit D3
Mekobalamin
21
22 kombinasi :
beta-karoten + Kalsium Laktat + Folamil
Kalsium Pantotenat + Tembaga Sulfat
+ Asam Folat+ Fe Fumarat +
Nikotinamida + Kalium Iodida +
Natrium Fluorida+ Vitamin B1
monohidrat + Vitamin B12 + Vitamin
B2 + Vitamin B6 HCl + Vitamin C+
Vitamin D
kombinasi :
23
Asam folat + beta-karoten + vit B1 + Folamil Genio
vit B2 + nikotinamid + vit B6 +
kalsium pantotenat + kalsium
karbonat + vit B12 + vit D3 + vit K1 +
biotin + copper gluconate + Fe
polymaltose complec (IPC) + DHA dari
ganggang + asam arakidonat
24 Fe(OH)3 sucrose complex
Fe (III) hydroxide polymaltose complex Maltofer
+ Folic acid
25 Kombinasi
Vit A, vit B1, vit B2, vit B6, vit B12, vit
C , vit D, Ca pantothenate,
niacinamide, K iodide, Fe, Mg,
manganese, copper, Zn
26 Kombinasi
Alfa-asam lipoat + vit C + Zn pikolinat Seloxy AA
+ selenium + a karoten
Sirup per 5 ml Vitamin A 5000 iu + Vitamin PT. Armoxindo
B1 3 mg + Vitamin B2 2 mg + Vitamin B6 1
mg + Vitamin B12 5 µg + Vitamin C 50 mg +
Vitamin D 1000 iu + Niasinamida 20 mg + [l]-
lisin HCl 200 mg.
Kaplet mengandung Asam 3-metil-2- PT. FreseniusKabi
oksovalerat 67mg+Asam 4-metil-2-
oksovalerat 101mg+Asam 2-okso-3-
fenilpropionat 68 mg+Asam 3-metil-2-
oksobutirat 86 mg+Asam 2-hidroksi-4-
metiltiobutirat 59 mg+L-lysine monoasetat
105 mg+L- treonin 53 mg+L-triptofan 23
mg+L-histidin 38 mg+L-tirosin
30mg+Nitrogen total 36 mg+Ca 0,05 gr
Kapsul mengandung Fe Fumarat 360 mg, PT. Sanbe farma
+Asam Folat 1,5 mg+Vitamin B12 15 mcg
+Vitamin C 75 mg +Vitamin D3 400 iu
+Kalsium Karbonat 200 mg.
Hi-Bone kaplet mengandung Bonistein (Genistein) 15 PT. Otto Pharmaceutical Industries
mg +Ca elemental 250 mg+Vit K1 0,1 mg+Vit
D3 200 iu
Methycobal Kaps 250 mcg; 500 mcg; Amp 500 mcg/ml PT. Eisai
Kaplet beta-karoten 10000 iu+ Kalsium PT. Dexa Medica
Laktat 250 mg + Kalsium Pantotenat 7,5 mg
+ Tembaga Sulfat 0,1 mg + Asam Folat 1 mg
+ Fe Fumarat 90 mg + Nikotinamida 20 mg +
Kalium Iodida 100 µg + Natrium Fluorida 1
mg + Vitamin B1 monohidrat 10 mg +
Vitamin B12 4 µg + Vitamin B2 2,5 mg +
Vitamin B6 HCl 15 mg + Vitamin C 100 mg +
Vitamin D 400 iu.
Kapsul Asam folat 1 mg + beta-karoten PT. Dexa Medica
10.000 iu + vit B1 3 mg + vit B2 3,4 mg +
nikotinamid 20 mg + vit B6 2 mg + kalsium
pantotenat 7,5 mg + kalsium karbonat 100
mg + vit B12 4 mcg + vit D3 400 iu + vit K1 50
mcg + biotin 30 mcg + copper gluconate 0,1
mg + Fe polymaltose complec (IPC) 30 mg +
DHA dari ganggang 40 mg + asam arakidonat
8 mg.
Venofer Ampul 100 mg/ 5 ml PT. Combiphar
Tablet Ferric hydroxide-polymaltose PT. Combiphar
complex 100 mg + folic acid 0.35 mg.
Theragram M Tablet Vit A 10,000 IU + vit B1 10 mg + vit B2 PT. Thaiso
10 mg + vit B6 5 mg + vit B12 5 mcg + vit C
200 mg + vit D 400 IU + Ca pantothenate 20
mg + niacinamide 100 mg + K iodide 150 mcg
+ Fe 12 mg + Mg 65 mg + manganese 1 mg +
copper 2 mg + Zn 1.5 mg
Tablet Alpha-lipoic acid 100mg + calcium PT. Ferron
ascorbate 500mg + zinc picolinate 50mg +
selenium 50mcg + B-caroten 5000 iu
 kombinasi : Cernevit Injeksi Vit A 3,500 iu+ vit D3 200 iu+ vit E PT. Kalbe Farma
11.2 iu + vit C 125 mg + vit B1 3.51 mg + vit
B2 4.14 mg + vit B3 46 mg + vit B5 17.25 mg
+ vit B6 4.53 mg + vit B12 6 mcg + folic acid
27 414 mcg + biotin 69 mcg + pantothenic acid
17.25 mg + nicotinamide 46 mcg + glycine
250 mg + glycocol ic acid 140 mg + soybean
lecithin 112.5 mg

21.2 MINERAL

1 Kalsium Glukonat Calcium Gluconate Ampul 10%/10 ml OGB

2 Kalsium hidrigen fosfat Dumocalcin Tablet 500 mg PT. Actavis
3 Kalsium Laktat Kalk Tablet 500 mg PT. Graha Farma
Lactas calsicus Tablet 500 mg PT. Bernofarm
Calnic Kapsul 200 mg, sirup 200 mg/5 ml PT. Gracia
Kapsul kalsium laktat 400 mg + vitamin D3
Calnic plus PT. Gracia
200 IU
4 Kalium L-aspartat Aspar-K Tablet 300 mg PT. Tanabe
5 KCL KSR Tablet 600 mg PT. Merck
6 Kombinasi: Cal-95 Tablet Coral kalsium 500 mg + natural soy PT. Lapi
isoflavone 20 mg + vitamin D3 200 iu +
vitamin K1 25 mcg + magnesium 100 mg +
zinc 5 mg + boron 1 mg.
21.3 Preparat osteoporosis

1 Kalsitrol Kolkatriol Kapsul 0,25 mcg PT. Pharos

2 Natrium Risedronat Actonel Tablet 35 mg PT. Sanofi aventis
3 Serum Anti Tetanus ATS Ampul 1500 IU; 10000 IU; 20000 IU PT. Biofarma
22 Vaksin dan Serum

22.1 Vaksin

1 Vaksin rabies untuk manusia Vaksin Rabies Ampul PT. Biofarma

22.2 Serum

1 Immunoglobulin Gamimune-N S/D Ampul 10% PT. Bayer Biological

Human Immunoglobulin Hepatitis Hyper Hep Ampul 500mg/ 5 ml

Human Immunoglobulin Tetagam Ampul 250 IU PT. Dexa Medica

2 Serum Antibisa Ular (ABS) A.B.U I Ampul PT. Biofarma
A.B.U II Ampul PT. Biofarma
3 Serum Anti Difteri ADS Ampul 2000 IU PT. Biofarma
4 Serum Anti Rabies Serum Anti Rabies Ampul PT. Biofarma
5 Serum Anti Tetanus ATS Ampul 1500 IU; 10000 IU; 20000 IU PT. Biofarma
23 Cairan Nutrisi dan Mineral

23.1 Cairan Nutrisi

1 Maltosa Martos Infus PT. Otsuka

2 Nutrisi enteral Aminoleban Oral Infus PT. Otsuka
3 Nutrisi parenteral Aminofusin Hepar Infus 500 ml
Infus 1000 ml Asam amino 50 gram, vitamin,
Aminofusin Ped
elektrolit.
Darrow Solution Infus PT. Otsuka
infus Per 1000 mL Natrium laktat 3,1 gram +
Ringer Laktat NaCl 6 gram + KCl 0,3 gram + CaCl2 0,2 gram PT. Otsuka
+ air untuk injeksi ad 1,000 mL.
 Dextrosa dalam RL Infus PT. Otsuka
RL + Glucosa ( 3 : 1 ) Infus PT. Otsuka
RL + Glucosa ( 4 : 1 ) Infus PT. Otsuka
Sol 2.A Infus

Sol 3.A Infus

Glucosa + NaCl Infus PT. Otsuka

Infus Per Liter NaCl 6 gram + KCl 0,3 Potacol-R
4 gram + CaCl2 0,2 g + Na Laktat 3,1 g +
Maltosa 50 gram.
Infus Per 1 Liter Asam Amino 27,2 g + Pan Amin G
Asam Amino esensial 20,6 g + Asam
5 Amino semi esensial 3,2 g + Asam
Amino non esensial 3,4 g + Sorbitol 50
g
Infus Per Liter NaCl 6 gram + KCl 0,3 gram + PT. Otsuka
CaCl2 0,2 g + Na Laktat 3,1 g + Maltosa 50
gram.
Infus Per 1 Liter Asam Amino 27,2 g + Asam PT. Otsuka
Amino esensial 20,6 g + Asam Amino semi
esensial 3,2 g + Asam Amino non esensial 3,4
g + Sorbitol 50 g

6 Asam amino, elektrolit Aminoleban Infusion Infus PT. Otsuka

Vitamin B6, xylitol, nikotinamid
Infus Per liter Fruktosa 120 g + Triofusin Infus Per liter Fruktosa 120 g + Glukosa 66 g PT. Kalbe Farma
7 Glukosa 66 g + Xylitol 60 g + elektrolit + Xylitol 60 g + elektrolit + vitamin.
+ vitamin.
Triofusin E 1000 Infus PT. Kalbe Farma

Infus Per liter Minyak kedelai 200 g + Infus Per liter Minyak kedelai 200 g + Fosfat
8 Fosfat dari telur 12 g + Gliserol 25 g + Ivelip dari telur 12 g + Gliserol 25 g + Natrium oleat PT. Kalbe Farma
Natrium oleat 0,3 g 0,3 g

9 Kombinasi:
Asam amino, elektrolit, Glukosa, PT. Baxter Kalbe
Clinimix Infus
Kalsium. (Pfrimmer)/Pharmacia.
23.2 Larutan Mineral

1 Glukosa Glukosa 5 % Infus 5%; 10%; 40% PT. Otsuka

Glukosa 10% Infus PT. Otsuka
Otsu-D40 Infus PT. Otsuka
2 Kalium Klorida KCl Infus Kalium Klorida 7,46% PT. Otsuka
3 Larutan elektrolit dan nutrisi Darrow solution Infus OGB
4 Natrium bikarbonat Meylon Infus Na. Bikarbonat 8,4% PT. Otsuka
5 Natrium Klorida Nacl Infus Na.Cl 0,9 % PT. Otsuka
Infus Natrium Laktat 1,55 g + Na.Cl 3 g +
Natrium Laktat + Na.Cl + Kalsium
6 Ringer Lactat Kalsium Klorida dihidrat 0,1 g + Kalium
Klorida dihidrat + Kalium Klorida PT. Otsuka
Klorida 0,15 g
Dextrose Monohidrat + Na.Cl + Na. Infus Dextrose Monohidrat 5 g + Na.Cl 6 g +
7 Asetat amhidrose + Kalium Klorida + Dextrosa dalam RL Na. Asetat amhidrose 2,28 g + Kalium Klorida
Kalsium dihidrat 300 mg + Kalsium dihidrat 200 mg
PT. Otsuka
Eas Pfrimmer Infus PT. Kalbe Farma
8 Glukosa + NaCl D5 + 1/2 NS Infus glukosa 5% + Na.Cl 0,45% PT. Sanbe
D5 + 1/4 NS Infus glukosa 5% + Na.Cl 0,225% PT. Sanbe
Infus Ca 3 mEq+ Na 130 mEq + K 4 mEq + Cl
9 Ca+ Na + K + Cl Asering
109 mEq PT. Otsuka
Infus Ca 3 mEq+ Na 130 mEq + K 4 mEq + Cl
Asering-5
109 mEq PT. Otsuka

10 Na + Cl + Glukosa KA EN 1B Na 38,5 mEq + Cl 38,5 mEq + Glukosa 37,5 g

PT. Otsuka
Na 60 mEq + K 10 mEq + Cl 50 mEq + Glukosa
11 Na + K + Cl + Glukosa + Laktat KA EN 3A
27 g + Laktat 20 mEq PT. Otsuka
Na 50 mEq + K 20 mEq + Cl 50 mEq + Glukosa
KA EN 3B
27 g + Laktat 20 mEq PT. Otsuka
 Na 30 mEq + K 8 mEq + Cl 28 mEq + Glukosa
KA EN 4B
37,5 g + Laktat 10 mEq PT. Otsuka
Na 50 mEq + K 20 mEq + Cl 50 mEq + Glukosa
KA EN MG3
100 g + Laktat 20 mEq PT. Otsuka
Infus Na 30 mEq + Cl 20 mEq + Glukosa 40 g
12 Na + Cl + Laktat + Glukosa KA EN 4A
+ Laktat 10 mEq PT. Otsuka
NaCl, KCl, CaCl2 Dihidrat, MgCl2 Futrolit Infus Per L Na 100 meq + Cl 90 meq + K 18 PT. Sanbe
hexahidrat, Na Asetat Trihidrat, meq + Ca 4 meq + Mg 6 meq + acetate 38
Sorbitol meq + (NaCl 3.624 g + KCl 1.342 g + CaCl2
13 0.294 g + Mg(OH)2 0.61 g + Na acetate 5.172
g + water for inj 1,000 mL). Osmolarity: 525
mOsm. Energy: 200 kCal.

24 Obat Topikal pada Kulit

24.1 Anti jamur

1 Ketoconazol Ketokonazol Salep 2% OGB

Fungoral Salep 2% PT.Kimia Farma
Zoloral Salep PT. Ika Pharmindo
2 Klotrimazol Fungiderm Salep 1%

Canesten Salep 1%

3 Mikonazol nitrat Miconazole Salep 2% OGB

Mycorin Salep 2%; Bedak 2% PT. Galenium
Nazoderm Salep 2%
Salep Asam undesilenat 50 mg + Seng
4 Asam undesilenat + Seng undesilinat Undecyl
undesilanat 200 mg PT. Kimia Farma
Salep Mikonazol nitrat 2% + Hidrokortison
5 Mikonazol nitrat + Hidrokortison Brentan
1% PT. Janssen-Cilag
6 Kotrimazol + deksamethason Baycuten - N Salep Kotrimazol 10mg, Deksametason 2mg
PT. Bayer
7 Terbinafin Termisil Cream 1%, 1g Ferron
24.2 Anti Parasit

1 Gameksan Scabicid Salep 10 mg PT. Kimia Farma

Salep Asam salisilat 2% + Sulfur presipitatum
2 As.salisilat + Sulfur presipitatum 2-4 Salep
4% PT. Kimia Farma
Asam salisilat , Asam laktat Salep Asam salisilat 0.2 gr + Asam laktat 0,05
3 Callusol
,Polidocanol gr + Polidocanol 0,02 g PT.Fahreinheit
24.3 Anti bakteri

1 Framisetin sulfat Sofra-tulle Salep 1% PT. Aventis

2 Gentamisin Sulfat Gentamysin Salep 1mg/gr OGB
Gentamerck Salep 1mg/gr PT. Merck
Garamycin Salep 1mg/gr PT. Schering Plough
3 Kloramfenikol Kemicetine Salep 2% PT. Kalbe Farma
4 Oksitetrasiklin Oxytetracyclin Salep 3% OGB
Terramycin Salep 3% PT. Pfizer
Betametason valerat + Neomisin Salep Betametason valerat 1 mg + Neomisin
5 Betason N
Sulfat sulfat 0,5% PT. Kimia Farma
Fluocinazole acetonide + neomycin Salep Fluocinolone acetonide 0,025 % +
6 Kalcinol - N
sulfat Neomycin sulfat 0,5 % PT. Kalbe Farma
Salep Kloramfenikol 20 mg + Prednisolon 2,5
7 Kloramfenikol + Prednisolon Kloramfecort H
mg + Hidrokortison asetat 25 mg PT. Kimia Farma
8 Perak Sulfadiazin Burnazin Salep 1%

9 Asam fusidat Fusycom Salep 5 gram PT. Combiphar

Betametason valerat + Gentamisin
10 Digenta salep 10 gr PT. Interbat
sulfat
24.4 Anti inflamasi dan anti puritik

1 Betametason valerat Benoson Salep Betametason valerat 0,5 mg PT. Bernopharm

2 Desoximethasone INERSON SALEP Salep 0,25 % PT. Interbat
3 Diflukortolon valerat Nerisona Combi Salep 0,1% PT. Schering Plough
4 Fluocinolon asetonid Cinolon N Salep 0,25 mg PT. Sanbe Farma
5 Hidrokortison asetat Hidrokortison Salep 2,5% OGB
Enkacort Salep 2,5% PT. Kimia Farma
6 Triamsinolon asetonid Kenacort-A Salep 0,1% PT. Taisho Pharmaceutical
Bedak Kalamin 10 % + Zn Oksid 2 % , Lotion
7 Calamin + Zn. Oksid Caladine
Kalamin 10 % + Zn Oksid 2 %
8 Natrium metamizol Norages Injeksi 500 mg/ml PT. Meprofarm
9 Kalium Diklofenak Cataflam fast Tablet 50 mg PT. Novartis
10 Heparin + Asam nicotinic benzylaster Thrombhopop gel Salep Heparin Sodium 200 IU PT. Nordmark
Salep Betamethasone/Betametason
Betametason dipeopionat +
11 Diprogenta dipropionat 0,05%, + Gentamisin sulfat 0,1
Gentamisin sulfat
%. PT. Schering Plough
12 Betametason valerat, neomycin Benoson N Betametason valerat 0,1%
Betamethasone valerate 0.1% + gentamicin
Benoson G
sulfate 0.1%
Betamethasone valerate 0.1% + miconazole
Benoson M
nitrate 2%
13 Klobetasol propionat. DERMOVATE Salep 0,05%

14 Desonide Apolar Salep 0,5 mg/g

Salep Per gram Desonide 0.5 mg + neomycin
15 Desonode, neomycin Apolar - N
sulfate 5 mg
24.5 Obat topikal untuk luka bakar

1 Cantela asiatika Lanakeloid Salep Cantela asiatika 1% + Vit. E 0,2 %

PT. Landson
Fitocassol Salep Cantela asiatika 1% PT. Kimia Farma

Madecassol Salep Cantela asiatika 1% + Vit. E 0,2 %

2 Silver Sulfadiazin Dermazin Salep 1% PT.Pharos

Salep Ekstrak plasenta 10% + Neomisin sulfat
3 Ekstark pasenta + Neomisin Sulfat Bioplacenton PT. Kalbe Farma
0,5%
24.6 DESINFEKTANS & ANTISEPTIK
Hidrogen peroksida
1 Hidrogen peroksida (H202) OGB
(H2O2)
2 Povidon iodida 10% Povidon Iodine Cairan Povidon iodida 10% OGB
Alphadine Cairan Povidon iodida 10% PT.Pharos
Vidisep Cairan Povidon iodida 10% PT. Kimia Farma
Septadine Cairan Povidon iodida 10% Pra
Betadine Cairan Povidon iodida 10% MBF
Isodine Cairan Povidon iodida 10% MBF
24.7 PHLEBITIS
Salep Heparin 5,000 iu + nicotinic acid benzyl
Heparin + asam nikotinat Thrombophob
ester 250 mg PT. TIA
25 Obat topikal pada mata

25.1 Antiinfeksi
Salep Amfoterisin-B 1%, tetes mata
1 Amfoterisin-B Fungicid
Amfoterisin-B 1% PT. Cendo
Tetes mata
2 Gentamisin Gentamycin Salep OGB
Cendogentamycin Tetes mata 0,1 %, 5 ml PT. Cendo
3 Indoksuridin Cendrid Tetes mata 1 mg/ml, 5 ml PT. Cendo
4 Kloramfenikol Kloramfenikol Salep 1% PT. Kimia Farma
Combicetin Salep 1% PT. Combiphar
Cendo fenicol Tetes mata 0,5%

Colme Tetes mata 0,5%

5 Oksitetrasiklin Oxytetracyclin Salep 1% OGB

Terramycin Salep 1% PT. Pfizer
6 Siprofloksasin Ciprofloxacin Tetes mata 0,3 % OGB
7 Sulfasetamid Albuvit Tetes mata 10% PT. Cendo
Cendocetamid Salep mata 10% PT. Cendo
8 Tobramycin Bralifex Tetes mata 0,3% PT. San V
Salep mata Neomisin sulfat 3,5 mg +
9 Neomisin sulfat + Polimiksin B Sulfat Cendostatrol
Polimiksin B sulfat 6000 IU PT. Cendo
Tetes mata
Cendo Hervis eye
10 Acyclovir Salep PT. Cendo
oint
11 Levofloxacin CENDO LFX MD Tetes mata MD
25.2 Kombianasi anti infeksi dan Anti Inflamasi

As borat + Seng sulfat + Eskulin + Tetes mata Asam borat 15 mg + Seng sulfat 1
1 Benzalkonium klorida+ Dinatriun Cendo asthenof mg + Eskulin 0.1 mg + Benzalkonium klorida
edetat 0.1 mg + Dinatrium edetat 1 mg +
PT. Cendo
2 Hidrokortison asetat + Kloramfenikol Cendomycos Salep mata 3,5% PT. Cendo
Tetes mata Hidrokortison asetat 0,5% +
Kloramfenikol 0,2% PT. Cendo
Tetes mata Hydrokortison 5 mg + CTM 2,5
3 Hydrokortison + CTM Cortihist
mg PT. Cendo
Tetes mata Neomisin sulfat 3,5 mg +
Neomisin sulfat + Deksametason +
4 Cendoxitrol Deksametason 0,15 + Polimiksin B Sulfat
Polimiksin B Sulfat
6000 IU PT. Cendo
Neomisin Sulfat + Prednisonoln Tetes mata Neomisin sulfat 0,5% +
5 Cendo P-N-P
alkohol + Fenilfrina HCl Prednisolon alkohol 0,2%
PT. Cendo
Ion Natrium & Kalium dengan
6 Cendo Lyteers 15 ml Tetes mata PT. Cendo
Benzalkonium Cl.
7 Natrium hyaluronate Hialid ED Tetes mata 0,1% PT. Cendo
cendo protagenta 5
8 Polyvinylpyrolidone Tetes mata 20 mg PT. Cendo
ml
9 Sodium / Na Hyaluronate Cendo hyalub tetes mata 5 ml, MD 1mg/ml PT. Cendo
tetes mata Tobramycin 0,3% +
10 Tobramycin + dexamethasone Tobroson dexamethasone 0,1%, minidose Tobramycin
0,3% + dexamethasone 0,1% PT. Cendo
25.3 Anti katarak

1 Pirenoksin Na Catalin Tetes mata0,75 mg PT. Takeda

Tetes mata Kalium iodida 5 mg + Kalium
Kalium iodida + Kalium Chlorida +
2 Cendo catarlent Chlorida 5 mg + Natrium tiosulfat 0,5 mg +
Natrium tiosulfat + Timersol
Timersol 0,02 mg PT. Cendo
25.4 Miotik

1 Pilokarpin HCl Cendocarpine Tetes mata 1%; 2%; 4%

PT. Cendo
Tetes mata 1%; 2%; 4%

25.5 Anti Glaukoma

1 Asetazolamid Acetazolamid Tablet 250 mg OGB
Diamox Tablet 250 mg PT. Pharos
Cendo Glaucon Tablet 250 mg PT. Cendo

2 Pilokarpin HCl Cendocarpine Tetes mata 1%; 2%; 4%

PT. Cendo
3 Timolol maleat Cendo timolol Tetes mata 025%;0,5% PT. Cendo
Ximex Opticom

4 Travaprost Travatan Tetes mata 0,004% PT. Alco

5 Brinzolamid Azopt ED Tetes mata 1% PT. Alco
25.6 Midriatik

1 Atropin sulfat Cendotropin Tetes mata 0,5%; 1% PT. Cendo

2 Homatropin HBr Homatro Tetes mata 2% PT. Cendo
25.7 ANTI ALERGI TOPIKAL

Tetes mata Antazolin-PO4 5 mg + Nafazolin

1 Kombinasi Vasacon A HCl 1 mg + Fenilraksa (II) asetat 0,02 mg +
Asam borat 12 mg PT. Cendo

2 Cromolyn sodium Cendo conver Tetes mata 2%

PT. Cendo
25.8 Anestetik Lokal
Tetes mata 0,5% ; 0,2%, salap mata 0,5%;
Tetrakain Pantocain
0,2% PT. Cendo
salap mata

25.9 Lain-lain

1 Phenylephrine HCl Efrisel Tetes mata 10 % PT. Cendo

Tetes mata Carboxymethyl cellulose sodium
2 Carboxymethyl Cellulose Sodium 5 mg CENFRESH 5 mg, mini dose Carboxymethyl cellulose
sodium 5 m PT. Cendo
3 Brimonidin tartrate Alphagan P ED Tetes mata

26 Obat Telinga, Tenggorokan dan Hidung

26.1 Sediaan Telinga

1 Karbogliserin Karbogliserin Tetes telinga 10% OGB

2 Cloramphenicol Cloramphenicol Tetes telinga 10% OGB
Tetes telinga
CloramphenicolChloramphenicol 10%,
3 Colme ear CloramphenicolChloramphenicol 10% +
lidocaine HCl 4%.
lidocaine HCl 4%. PT. Interbat

Fludrocortisone acetate, polymyxin B Tetes telinga Fludrocortisone acetate 1 mg +

4 sulfate, neomycin sulfate, lidocaine Otopraf polymyxin B sulfate 10000 IU + neomycin
HCl sulfate 5 mg + lidocaine HCl 40 mg
PT.Prafa

Tetes telinga Polymyxin B sulfate 50000 IU +

Polymyxin B sulfate, neomycin sulfate,
5 Otopain neomycin sulfate 25 mg + fludrocortisone
fludrocortisone acetate, lidocaine HCl
acetate 5 mg + lidocaine HCl 200 mg
PT. Merck Sharp & Dohme Indonesia
6 Docusate Na Forumen Tetes telinga 5 mg/ml, 10 ml PT. Sanbe Farma
26.2 Sediaan Mulut dan Tenggorokan

1 Dequalinium Cl degirol Tablet Hisap 0.25 mg PT.Darya varia Lab

SP Troches Tablet Hisap 0.25 mg PT. Meiji

2 Dequalinium Cl, vitamin C Efisol Tablet Hisap 0.25 mg + 25 mg

PT. Novell Pharmaceutical Laboratories
3 Fradiomisin sulfat, gramisidin S HCL FG Troches Tablet Hisap 2.5 mg + 1 mg PT. Meiji
4 Gargarisma DOEN Gargarisma Khan larutan OGB

5 Hexetidine Hexadol larutan 0.10 %

PT. Otto Pharmaceutical Industries
6 Mikonazol nitrat Dactarin Oral Gel Gel 20 mg PT. Janssen-Cilag
7 Povidon iodida Betadine larutan 10 % PT. Mahakam Beta Farma
Isodine larutan 10 % PT. Mahakam Beta Farma
Septadine larutan 10 % PT. Mahakam Beta Farma
8 Triamsinolon asetonid Kenalog in orabase salep 0.10 % PT. Taisho Pharmaceutical
26.3 Sediaan Mulut dan Tenggorokan

1 Oksimetazolin HCl Illiadin kinder tetes hidung 0,25 mg/ml PT. Merck Tbk
Illiadin Spray 0.5mg/ml PT. Merck Tbk
Afrin Spray 0.5mg/ml PT. Bayer Schering Pharma
Afrin tetes hidung 0,25 mg/ml PT. Bayer Schering Pharma
27 Lain-lain

27.1 Obat Susunan Syaraf Pusat

1 Mekobalamin Kalmeco Tablet 250 mg ; 500 mg PT. Kalbe Farma

Lapibal Tablet 250 mg ; 500 mg PT. Lapi Laboratories
Methycobal Kapsul 250 mg ; 500 mg ; Sirup 500 mcg/ml PT. Eisai Indonesia
2 Nimodipine Nimotop Infus 10 mg/ 50 ml PT. Bayer Schering Pharma
3 Pirasetam Pirasetam Tablet 400 mg ; 800 mg ; 1.200 mg OGB
Injeksi 1gr/5 ml ; Infus 200 mg/60ml ;
Benocetam
3g/15ml PT. Bernofarm
Noocephal Syrup 200 mg/5 mL PT. Pyridam Farma Tbk
Tablet 400mg, 800mg dan 1200 mg ; injeksi
Neurotam
1g/5 ml PT. Kalbe Farma

Nootropil Tablet 1200 mg

PT. Glaxo Welcome Indonesia
injeksi 250mg/2 ml; 500 mg/4 ml;
4 Citicoline Brainact 1000mg/8ml, tablet 500 mg ; 1.000 mg,
powder 2gr PT. Kalbe Farma

Simciti Tablet 500 mg

PT. Simex Pharmaceutical Indonesia
5 Donepezil Aricept Tablet 5 mg PT. Eisai Indonesia
Aricept Evess Tablet 10 mg PT. Eisai Indonesia
27.2 Lipotropik

Cholagogues, Cholelitholytics & Hepatic Protectors  

1 Asam ursodeoksikholik Urdafalk Kapsul 250 mg PT. Darya Varia lab

urdahex Kapsul 250 mg PT. Kalbe Farma
28 ANTIDOT DAN OBAT LAIN UNTUK KERACUNAN

28.1 Umum

1 Apomorfin Apomorfin Injeksi 5 mg/ ml OGB

2 Karbon activ Norit Tablet 125 mg PT. Calang
3 Magnesium sulfat Garam inggris Sachet 30 gr OGB
28.2 Khusus

1 Atropin sulfat Atropin Sulfat Injeksi 0.25 mg/ml OGB

Metiltionin klorida
2 Metiltionin klorida (biru metilen) Injeksi 10 mg/ ml
(biru metilen) OGB
3 Natrium bikarbonat Bicnat Tablet 500 mg, Injeksi 8.4% / ml OGB
4 Protamin sulfat Protamin sulfat Injeksi 10 mg/ml OGB
29 Diagnostik

29.1 Bahan kontras Radiologi Angiografi

1 Meglumin amidotrizoat Angiografin Vial 65 % 20 ml ; 50 ml

PT. Bayer Schering Pharma
Natrium ioksaglate, Meglumin
2 Hexabrix-320 Vial 393 mg + 196.5 mg ,50 ml ; 100 ml PT. Guerbet
ioksaglate
29.2 Bahan kontras Radiologi Bronkografi
Injeksi 150 mg I/ml ; 240 mg I/ml ; 300 mg
1 Lopromid Ultravist
I/ml ; 370 mg I/ml PT. Bayer Schering Pharma
Injeksi 300 mg/ ml, 20 ml ; 50 ml ; 100 ml ;
2 Lohekssol Omnipaque
350 mg/ ml, 50 ml ; 100 ml

3 Lopamidol Lopamidol Injeksi 0,408 g/ ml, 10 ml ; 0,612 g/ ml, 20 ml

29.3 Bahan kontras Radiologi Histerosalpingografi

Meglumin natrium
1 Meglumin natrium amidotrizoat Injeksi 76 %, 20 ml
amidotrizoat

29.4 Bahan kontras Radiologi Limfangiografi

Etil ester dari oleum papaveris,

1 Lipiodol Ultra Injeksi 10 mg/ml
teriodisasi (oleum lodatum) PT. Guerbet
2 Patent blue - V Patent blue - V Injeksi 2.5 % / 2 ml PT. Guerbet
29.5 Bahan kontras Radiologi Mielografi

1 Yofendilat Yofendilat Injeksi 3 ml

Injeksi 150 mg I/ml ; 240 mg I/ml ; 300 mg
2 Iopromid Ultravist
I/ml ; 370 mg I/ml PT. Bayer Schering Pharma
Injeksi 300 mg/ ml, 20 ml ; 50 ml ; 100 ml ;
3 Loheksol Omnipaque
350 mg/ ml, 50 ml ; 100 ml PT. Bayer Schering Pharma

4 Lopamidol Lopamidol Injeksi 0,408 g/ ml, 10 ml ; 0,612 g/ ml, 20 ml

PT. Bayer Schering Pharma
29.6 Bahan kontras Radiologi Saaluran Cerna

1 Natrium bikarbonat 1,25 g + Simetikon Bahan kontras DOEN 1,25 gr + 0,042 gr OGB
2 Barium sulfat Barium sulfat Sach 200 gr OGB
suspensi 2.2%, 250/450 ml

suspensi 55%, 2 lt

suspensi 65%, 500 ml

29.7 Bahan kontras Radiologi Urografi

1 Iopamidol Iopamidol Injeksi 0.612 g/ ml, 20 ml ; 0.755 g/ ml, 20 ml

PT. Abbott Indonesia
Meglumin natrium
2 Meglumin natrium amidotrizoat Injeksi 76 %, 20 ml
amidotrizoat OGB
Natrium
3 Natrium amidotrizoat Vial 80 mg OGB
amidotrizoat
Angiografin Vial 65%/ 50 ml PT. Bayer Schering Pharma
Natrium ioksitalamat + Meglumin
4 Telebrix - 38 Vial 5,13 gr ; 10,26 gr PT. Guerbet
ioksitalamat
29.8 Test Fungsi Ginjal
Natrium
1 Natrium aminohipurat Injeksi 200 mg/ml OGB
aminohipurat
2 Kombinasi
 DL-3-metil-2-okso-asam valerat 67 mg, Prorenal Tablet 67 mg+101 mg+68 mg+86 mg+59
4- metil-2 okso asam valerat 101 mg, 2 mg+105 mg+52 mg+23 mg+38 mg+30 mg
- okso-3 fenil-asam propionat 68 mg, 3
metil-2-oksa-asam butirat 86 mg, DL-
2-hidroksi-4-metiltio-asam butirat 59
mg, L-lisin monoasetat 105 mg, L-
treonin 52 mg, L - triptofan 23 mg, L-
histidin 38 mg, L - tirosin 30 mg
PT. Novell Pharmaceutical Laboratories
29.9 Test Fungsi Hati
Natrium
1 Natrium bromsulfoftalein Injeksi 5%
bromsulfoftalein
29.10 Test Lain-lain

1 Fluoressein Fluoressein tetes mata 1 %

tetes mata 2 %

Injeksi 10 %

Injeksi 20 %

29.11 Test Kulit

Tuberkulin protein
1 Tuberkulin protein purified derivative Injeksi
purified derivative

30 Antineoplastik

30.1 Hormon dan Antihormon

1 Anastrozole Arimidex tablet 1 mg PT. AstraZeneca Indonesia Zeneca

2 Exemestan Aromasin tablet 25 mg PT. Pfizer Indonesia
3 Letrozol Femara tablet 2.5 mg PT. Novartis Indonesia

4 Leuprorelin Acetate Tapros 1,88 vial 1.88 mg

PT. Takeda Indonesia
Endrolin vial 3.75 mg PT. Kalbe Farma

Tapros 3,75 vial 3.75 mg

PT. Takeda Indonesia

Tapros 3M vial 11.25 mg

PT. Takeda Indonesia
5 Medroksi Progesteron Asetat Veraplex tablet 500 mg PT. Combiphar
6 Tamoksifen sitrat Tamofen tablet 10 mg ; 20 mg PT. Kalbe Farma
Tamoxifen Ebewe 20 tablet 20 mg PT. Ferron Pharmaceuticals
Tamoplex tablet 10 mg PT. Combiphar
30.2 Sitotoksik

1 Asparaginase Leunase Infus 10.000 KU PT. Lindra Sakti Pharma

2 Bevacizumab Avastin Injeksi 100 mg/4 ml PT. Roche Indonesia
3 Bleomisin Blenamax injeksi 15 mg PT. Combiphar
Bleocin injeksi 15 mg
PT. Kalbe Farma
4 Bicalutamide Casodex Tablet 50 mg ; 150 mg
PT. AstraZeneca Indonesia Zeneca
5 Busulfan Myleran PT. Glaxo Welcome Indonesia
6 Cisplatin Sinplatin vial 10 mg ; 50 mg PT. Actavis Indonesia
Cisplatin vial 10 mg ; 50 mg PT. Kalbe Farma
Cisplatin Ebewe Infus 10 mg/20ml ; 50 mg/100ml PT. Ferron Pharmaceuticals
Platosin, RTUS vial 10mg/10ml ; 50mg/50ml PT. Combiphar

Unistin vial 10mg/20ml ; 50mg/100ml

PT. Novell Pharmaceutical Laboratories
7 Citarabin Alexan vial 100 mg/5 ml ;vial 500 mg/10 ml PT. Ferron Pharmaceuticals
Citarabin PT. Ferron Pharmaceuticals
Citarabin Cytarabin vial 1gr/10ml PT. Tempo RX Farma
8 Capecibatine*) Xeloda Tablet 500 mg PT. Roche Indonesia
9 Carboplatin *) Carboplatin Ebewe Infus 150 mg/ml ; 450 mg/ml PT. Ferron Pharmaceuticals
Actoplatin Infus 150 mg/ml ; 450 mg/ml PT. Actavis Indonesia

Carboplatine Infus 150 mg/ml ; 450 mg/ml

PT. Kalbe Farma

10 Cetuximab*) Erbitux vial 5 mg/ml

PT. Merck Tbk
11 Dakarbazin Dacarbazin Medac Vial 200 mg/ml PT. Dipa Pharmalab Intersains
Dacarbazin DBL Vial 200 mg/ml PT. Tempo RX Farma
12 Dounorubisin Dounorubicin Injeksi 20 mg/4 ml PT. Tempo RX Farma

Daunocin Injeksi 20 mg/4 ml

PT. Novell Pharmaceutical Laboratories
13 Doksorubisin Doxorubicin Actavis Injeksi 10 mg ; 50 mg PT. Actavis Indonesia
Adricin Injeksi 10 mg ; 50 mg PT. Novell Pharmaceutical Laboratories
Doksorubicin Ebewe Injeksi 10 mg ; 50 mg PT. Ferron Pharmaceuticals
Doksorubicin Kalbe Injeksi 10 mg ; 50 mg PT. Kalbe Farma
Doksorubicin RTUS Injeksi 10 mg ; 50 mg PT. Combiphar
14 Docetaxel*) Brexel Injeksi 20 mg ; 80 mg PT. Kalbe Farma
Decotere Injeksi 20 mg ; 80 mg PT. Ferron Pharmaceuticals
Taxotere Injeksi 20 mg ; 80 mg PT. Sanofi Aventis Indonesia
15 Epirubicin*) Epirubicin Ebewe Injeksi 10 mg ; 50 mg PT. Ferron Pharmaceuticals
Epirubicin Kalbe Injeksi 10 mg ; 50 mg PT. Kalbe Farma
16 Etoposid Etoposide Ebewe Injeksi 100 mg/ml, 5 ml PT. Ferron Pharmaceuticals
Etopul Injeksi 100 mg/ml, 5 ml PT. Novell Pharmaceutical Laboratories
Posyd RTUS Injeksi 100 mg/ml, 5 ml PT. Combiphar

17 Fluorourasil 5-Fluorouracil Ebewe Injeksi 250 mg/ml ; 500 mg/ml

PT. Ferron Pharmaceuticals
Curacil Injeksi 250 mg/ml ; 500 mg/ml
PT. Kalbe Farma
Fluracedyl RTUS Injeksi 500 mg/ml PT. Combiphar

18 Gemcitabine*) Cytogem Injeksi 200 mg/ml ; 1 gr/ml

PT. Ferron Pharmaceuticals

Gemzar Injeksi 200 mg/ml ; 1 gr/ml

PT. Elly Lily
19 Goserelin Asetate*) Zoladex Syringe 10.8 mg ; 3.6 mg
PT. AstraZeneca Indonesia Zeneca
20 Hidroksi Urea*) Cytodrok Kapsul 500 mg PT. Combiphar
Hydroxyurea Medac Kapsul 500 mg PT. Dipa Pharmalab Intersains
21 Ifosfamide*) Holoxan Vial 1gr ; 2 gr PT. Transfarma Medica Indah
22 Imatinib Mesylat*) Gilvec Tablet 100 mg
PT. Novartis Indonesia
23 Irinotecan HCL*) Campto Injeksi 40 mg/ml ; 100 mg/ml PT. Pfizer Indonesia
Irnocam Injeksi 40 mg/ml ; 100 mg/ml PT. Ferron Pharmaceuticals
24 Kalsium Folinat Rescuvolin Tablet 15 mg ; Injeksi 50 mg/ml PT. Combiphar
Calcium Folinat
Injeksi 50 mg/ ml
Ebewe PT. Ferron Pharmaceuticals
 Leucovorin Folinat
Injeksi 50 mg/ ml PT. Ferron Pharmaceuticals
Ebewe
Leucovorin Kalbe Injeksi 50 mg/ ml PT. Kalbe Farma
Rescovulin RTUS PT. Combiphar
25 Klorambusil Leukeran Tablet 2 mg PT. Glaxo Welcome Indonesia
26 Lapatinib ditosylate Tykerb Tablet 250 mg
PT. Glaxo Welcome Indonesia
27 Melfalan Alkeran Tablet 2 mg PT. Glaxo Welcome Indonesia
28 Merkaptopurin Puri-Nethol Tablet 50 mg PT. Glaxo Welcome Indonesia
29 Mesna Uromitexan Injeksi 400 mg/ml PT. Transfarma Medica Indah
30 Metotreksat Emthexate RTUS Tablet 2.5 mg ; Injeksi 5 mg/ml ; 50 mg/ml PT. Combiphar
Methotreksat Ebewe Tablet 2.5 mg ; Injeksi 5 mg/ml ; 50 mg/ml PT. Ferron Pharmaceuticals
31 Mitomicin C*) Mitomycin Injeksi 10 mg/ml PT. Indra Sakti Pharma
32 Oxaliplatine*) Eloxatin 50 Sol Injeksi 50 mg/ml PT. Sanofi Aventis Indonesia
Oxaliplatin Actavis Injeksi 50 mg/ml ; 100 mg/ml PT. Actavis Indonesia
Oxaliplatin Ebewe Injeksi 50 mg/ml ; 100 mg/ml PT. Ferron Pharmaceuticals
Oxaliplatin Medac Injeksi 50 mg/ml ; 100 mg/ml PT. Dipa Pharmalab Intersains
Rexta Injeksi 50 mg/ml
PT. Kalbe Farma
33 Paclitaxel*) Antazax PT. Tempo RX Farma
Ebetaxel Injeksi 30 mg/ml ; 100 mg/ml ; 300 mg/ml PT. Ferron Pharmaceuticals
Paxus Injeksi 30 mg/ml ; 100 mg/ml PT. Kalbe Farma
Sindaxel Injeksi 30 mg/ml ; 100 mg/ml ; 300 mg/ml PT. Actavis Indonesia
34 Rituximab*) Mabhtera Injeksi 100 mg/ml ; 500 mg/ml PT. Roche Indonesia

PT. Roche Indonesia

35 Siklosfosfamid Chilophosphamide Tablet 50 mg ; Injeksi 200 mg/ml ; 1 gr/ml

PT. Kalbe Farma
Cyclovid Injeksi 200 mg/ml ; 500 mg/ml ;1 gr/ml
PT. Novell Pharmaceutical Laboratories
Endoxsan Injeksi 200 mg/ml ; 500 mg/ml ;1 gr/ml PT. Transfarma Medica Indah
36 Sorafenib Tosylate Nexavar Tablet 200 mg PT. Bayer Indonesia

37 Trastuzumab*) Herceptin Injeksi 440 mg/ml

PT. Roche Indonesia

38 Vinblastin Vinblastin Injeksi 10 mg/ml

PT. Tempo RX Farma
Vinblastine RTUS Injeksi 10 mg/ml PT. Combiphar
39 Vinkristin Vincristine DBL Injeksi 1mg/ml ; 2 mg/ml PT. Tempo RX Farma
Vincristine Kalbe Injeksi 1mg/ml ; 2 mg/ml PT. Kalbe Farma
Vincristine RTUS Injeksi 1mg/ml ; 2 mg/ml PT. Combiphar
40 Vinorelbine*) Navelbine Injeksi 10 mg/ml ; 50 mg/ml PT. Transfarma Medica Indah
30.3 Antineoplastik lain

1 Disodium Clodronate Tetrahydrate*) Actabone Injeksi 300 mg/ml PT. Actavis Indonesia
Disodium Clodronate Tetrahydrate*) Bonefos Tablet 400 mg ; 800 mg ; injeksi 5 mg/ml PT. Bayer Indonesia
2 Zoledronic Acid*) Zometa Injeksi 4 mg/ml PT. Novartis Indonesia
3 Filgrastrim*) Leucogen Injeksi 300 mcg/ml PT. Kalbe Farma

Leukokine Injeksi 300 mcg/ml

PT. Novell Pharmaceutical Laboratories
Neupogen Syringe 30 MU/ml PT. Roche Indonesia
4 Lenogastrim*) Granocyte 34 Vial 263 mcg/ml
PT. Sanofi Aventis Indonesia

5 Eritripoetin-Alfa*) Epotrex Syringe 2000 IU ; 4000 IU ; 10000 IU

PT. Novell Pharmaceutical Laboratories
Syringe 2.000 IU; 4.000 IU ; 10.000 IU ;
Eprex, 2000 PT. Johnson & Johnson Indonesia
40.000 IU
Hemapo 3000, 10000
Syringe 3.000 IU ; 10.000 IU PT. Kalbe Farma
IU
6 Eritropoetin - Beta*) Recormon PFS 2000, 5000, 30000 dan 10000 IU PT. Roche Indonesia