RS.

UMUM PEKERJA

FORMULARIUM

TAHUN 2018
 KATA PENGANTAR

Puji syukur kita panjatkan kepada Tuhan Yang Maha Esa yang telah
memberikan nikmat yang tiada putus – putusnya sehingga penyusunan Formularium
Obat Rumah Sakit Umum Pekerja Tahun 2018 ini terselesaikan dengan baik dan
lancar.
Formularium yang telah disusun ini merupakan perwujudan kesepakatan
dalam pemilihan obat yang dibutuhkan informasi mengenai obat yang digunakan
untuk pasien di Rumah Sakit Umum Pekerja. Oleh karena itu, ketaatan dan
kedisiplinan penulisan resep obat – obatan yang ada di dalam Formulariun Obat
Rumah sakit adalah standar kepatuhan terhadap kesepakatan yang telah dibuat.
Atas kerja sama yang baik selama ini dari seluruh anggota KFT serta semua
pihak yang telah memberikan bantuan hingga penerbitan Formularium Obat yang
dapat terlaksana, kami mengucapkan terima kasih yang sebesar – besarnya. Dan
dengan selalu terbuka untuk pengkajian ulang dan revisi demi kesempurnaan
Formularium Obat Rumah Sakit. Semoga dengan terbitnya formularium obat ini
mutu pelayanan di Rumah Sakit Umum Pekerja akan lebih meningkat.

Jakarta, Desember 2018

Ketua Komite farmasi dan Terapi

dr. Martua Silalahi, Sp.JP

i
 DAFTAR ISI

KATA PENGENTAR..........................................................................................................................i
DAFTAR ISI...........................................................................................................................................ii
SISTEM PERNAPASAN..................................................................................................................1
ANTI INFEKSI (SISTEMIK)............................................................................................................3
SISTEM GASTROINTESTINAL DAN HEPATOBILIER...................................................8
SISTEM KARDIOVASKULAR & HEMATONIK..................................................................11
SISTEM SARAF PUSAT...............................................................................................................14
SISTEM MUSKULOSKELETAL.................................................................................................17
HORMONES.......................................................................................................................................17
KONTRASEPSI..................................................................................................................................18
SISTEM KEMIH KELAMIN...........................................................................................................19
SISTEM ENDOKRIN DAN METABOLIK...............................................................................20
PREPARAT MATA...........................................................................................................................21
TELINGA;MULUT & TENGGOROKAN..................................................................................22
DERMATOLOGICALS (KULIT)..................................................................................................23
ANASTETIK LOKAL&UMUM.......................................................................................................25
ALLERGI&IMMUNE SYSTEM....................................................................................................25
VAKSIN ANTISERUM & IMMUNOLOGIKAL.......................................................................26
VITAMINS & MINERALS...............................................................................................................27
LARUTAN INTRAVENA & LARUTAN STERIL LAIN.......................................................29
PENUTUP..............................................................................................................................................31
DAFTAR PUSTAKA..........................................................................................................................32

ii
NO KOMPOSISI SEDIAAN NAMA OBAT PABRIK

1 SISTEM PERNAPASAN
1.1 PREPARAT ANTI ASMA & BRONCODILATOR (1A)
Aminophyllin Inj 200mg AMINOPHYLLIN Indofarma

Procatertol HCl syr 25mcg MEPTIN Otsuka

Ipratropium Br;Salbutamol 2.5mg COMBIVENT Boehringer

Sulfat

Ephedrine nebu 25mg EPHEDRINE OGB

Salbutamol Sulfat kap;syr LASAL Lapi

2mg;4mg

nebu 0.1mg VENTOLIN Glaxo

Budesonid/fFormoterol inh 1mg PULMICORT Astra Zenaca

inh 160/4.5mcg SYNBICORT Astra Zenaca

Salmeterol;fluticasone inh SERETIDE 50 Glaxo

propionate 25mcg;50mcg

inh SERETIDE 125 Glaxo

25mcg;125mcg

SERETIDE DISKUS Glaxo

100

SERETIDE DISKUS Glaxo

250

SERETIDE DISKUS Glaxo

500

1
1.2 BATUK PILEK (1B)
Triprolidine Hcl,Pseudoefedrin 1,25mg;30mg LAPIFED Lapi

;60ml

2.5mg;60mg

Pseudoefedrin,Loratadine 120mg;5mg ALDISA SR Sanbe

Ambroxol 30mg;30ml AMBROXOL KF

15mg/20ml MUCOS Mepro
15mg/5ml MUCOPECT

Difenhidramin,ammonium,potas 12,5mg;100m SANADRYL Sanbe

sium G,sodium citrate g;30mg50mg EXPCTORANT

SANADRYL DMP Sanbe

Pct;Pseudoefedrin HCL;CTM 150mg;10mg;

;Amoniumklorida;Succus 0.3mg;16,7m OBH INDOPLUS
liquiritiae g75mg

Bromhexine HCL 8mg;4mg/5ml MUCOHEXIME Sanbe

Bromhexin, Ethyl alkohol 100ml BISOLVON Boehringer

ELIXIR;EXTRA;FLU

Codein 10mg;20mg CODEIN Kimia Farma

Codein anhidrat;feniltoloksamin 11,11 CODIPRONT syr KF

mg;3,67 mg

Codein anhidrat;feniltoloksamin 11,11 CODIPRONT syr KF

mg;3,67 mg exp

2
 Pct;CTM Dexa
;DMP;Phenylpranolamin HCl 500mg;1mg; TUZALOS
Medika
,DMP 15mg;10mg

500mg;1mg; MOLEXFLU Molex Ayu

15mg;10mg

n-Asetylsistein 200mg FLUIMUCYL Zambon

Gliseril Guaikolat GLISERIL KF

30mg GUAIKOLAT

Erdostein

Loratadine & Pseudoefedrin 5mg;60 mg RHINOS SR Dexa

Erdostein 30mg VECTRIN Dexa

1.3 DEKONGESTAN NASAL&PREPARAT NASAL LAIN (1c)

Natrium klorida/nacl 6.5mg/ml BREATHY Novell

2 ANTI INFEKSI (SISTEMIK)

2.1 AMINOGLIKOSIDA (2A)
Gentamicine 40mg/ml;0,1% 5gr GENTAMICIN KF
SULFATE

25mg/2ml HYPOBHAC Phapros

Nitilmicin Sulfate 25MG/2ML

100mg/1,5ml HYPOBHAC
100MG/1.5ML

200mg/1,5ml0 HYPOBHAC
200MG/1.5ML

3
 2.2 SEFALOSPORIN (2B)
Cefadroxyl 500mg;125mg/m CEFADROXYL Indofarma
l&250mg/ml

500mg CEFAD Sanbe

500mg LOSTACEF Ifars

Cefepime 1gr CEFEPIME Novell

Cefixime 100mg;200mg;1 CEFIXIME Indofarma

00mg/ml

100mg;200mg SPORETIK Sanbe

Cefoperazine 1gr CEFOPERAZINE Novell

Cefotaxime 1gr CEFOTAXIME Berno

1gr LAPIXIME Lapi

Ceftazidime 1gr CEFTAZIDIME Novell

Ceftizoxime

Ceftriaxone 1gr CEFTRIAXONE Sanbe

1gr TERFACEF Sanbe

2.3 PENISILLIN (2C)

Amoxicillin 1gr;500mg;125mg AMOXICILLIN Berno
/ml; 250mg/ml

500mg;100mg/15 AMOXAN Sanbe

ml

4
 Amoxicillin;Clavulanic acid 1gr AMPICILLIN Sanbe
500mg CO.AMOXICLAV Berno

2.4 BETALACTAM&GOLONGAN LAIN (2D)

Meropenem 0.5mg MEROPENEM Novell

2.5 CHLORAMFENICOL (2E)

Chloramfenicol 250mg CHLORAMFENIC KF
OL

1 Gr COLSANTENTINE Sanbe

Thiamphenicol 500mg THIAMPHENICOL Phapros

1gr KALMICETIN Kalbe

2.6 MAKROLID (2F)

Azitromycin 500mg AZITROMYCIN Bernofarm

Erythrmycin 500mg;200mg ERYTROMYCIN OGB

Spiramicin

2.7 KUINOLON (2G)

Ciprofloxacin 500mg CIPROFLOXACIN Indofarma

Levofloxacin 500mg;100mg/ml LEVOFLOXACIN Novell

Ofloxacine 200mg;400mg OFLOXACINE OGB

2.8 TETRASIKLIN (2H)

Doxycycline 500mg DOXYCYCLINE OGB
5
2.9 SULFONAMIDE (2I)
Fluconazole 150mg FLUCONAZOLE KF

Ketoconazole 200mg KETOCONAZOLE Indofarma

Nystatin + Metronidazole 100.000iu PROVAGIN Phapros

2.10 KOMBINASI ANTI BAKTERI (2J)

Sulfamethoxazole;Trimethopr 500mg COTRIMOXSAZ Berno
im OLE

2.11 ANTIBIOTIK GOLONGAN LAIN (2K)

Clindamycin 150mg;300mg CLINDAMYCIN Berno

Lincomycin 500mg LINCOMYCIN Berno

500mg NOLIPO Sanbe

2.12 OBAT ANTI TUBERKULOSIS (2L)

Ethambutol 500mg ETHAMBUTOL Indofarma

Isoniazid (INH) 300mg ISONIAZID kimia Farma

Pyrazinamide 500mg PYRAZINAMIDE Indo Farma

Rifampicin 500mg RIFAMPICIN Indo Farma

Rifampicin;INH;Pyrazinamide 150mg;75mg;400 RIFASTAR Indofarma

;Ethambutol mg;275mg 4FDC

6
2.13 ANTI JAMUR (2M)
Ketoconazole 200mg;10gr KETOCONAZOLE

Fluconazole 50mg FLUCONAZOLE Kimia Farma

Griseofulvin 500mg GRISEOVULVIN Darya Varia

GELOFUSIN

Nystatin 500.000iu NYSTATIN Phapros

PROVAGIN

2.14 ANTIVIRUS (2N)

Acyclovir 400mg;5gr ACYCLOVIR Indofarma

Methisoprinol 500mg MAXPRINAL Mepro

2.15 ANTILMINTIK (2O)

Pyrantel pamoat 250mg;10ml COMBANTRIN Combiphar

2.16 ANTIMALARIA (2P)

Primaquen
Pyrimethamine PRIMET Kimia Farma
2.17 ANTI AMUBA (2Q)
Metronidazole 500mg METRONIDAZOL Berno
E

PROVAGIN Mepro

7
3 SISTEM GASTROINTESTINAL DAN HEPATOBILIER
3.1 ANTASIDA, OBAT ANTIREFLUKS & ANTIULSERASI (3A)
Al. Hidroxida;Mg. Hidroxida ANTASIDA Indofarma
200mg;200mg DOEN Generik

Lansoprazole 30mg LANSOPRAZOLE Gracia

Al. Hidroxida;Mg. 300mg;300mg;50 LAGESIL Lapi

Trisilikat;Simetikon mg

Omeprazole 20mg;1gr OMEPRAZOLE Novell

20mg;1gr PUMPITOR Sanbe

Pantoprazole 40mg PANTOPRAZOLE OGB

40mg PANTOZOLE Pharoz

Sukralfat 500 mg EPISAN Sanbe

Ranitidine 150mg;25mg RANITIDINE Hexpharm J

150mg ACRAN Sanbe

3.2 PREPARAT ANTIFLATULEN & ANTIEMETIK (3B)

Piratiasina klortiafilinat;Vit B6 40mg;30mg MEDIAMER B6 Dexa

Domperidone 10mg;5mg/ml DOMERIDONE Novapharin

10mg;5mg/ml DOM Lapi

Metokloramide 5mg SOTATIC Fahrenheit

8
 Ondansetron 4mg;8mg ONDANSENTRON Pharoz

3.3 OBAT GASTROINTESTINAL LAIN (3C)

Ethamsylate 125mg/ml DICYNONE Corsa

Hiosin-N-Butil ramida 10mg;20mg/ml SCOPAMIN Otto

Hiosin-N-Butil Bramida 10mg SCOPMA

3.4 ANTISPASMODIK (3D)

Klordiazepoksid;Klidinium
Bromida

Papaverin HCL PAPAVERIN

40mg HCL Generik

3.5 ANTIDIARE (3E)

Attapulgit;Pectin 631 mg NEW DIATABS Medifarma

Loperamide 2mg DIADIUM Lapi

2mg LODIA

Nacl, Kcl, Glukosa, Trisodium ORALIT IndoFarma

22,5mEq;10mEq;1
Natrium;Kalium;Klorida;Sitrat; 7,5 mEq;15 PEDIALYTE Abbott
Dekstrosa;kalori mEq;12,5mg;50/5
00ml

Zink HBr ZINK

20mg DISPERSIBLE

20mg/ml ZIRCUM KID Indofarma

9
 Bisakodil 5mg;10mg DULCOLAX Boeringer

3.6 LAKSATIF & PENCAHAR (3F)

Bisakodil supositoria 5mg;10mg DULCOLAX Boeringer

Fenolftaleine;parafin 55mg;1200mg;378 LAXADINE Galenium

cair;gliserin;jeli mg;jeli 9,4mg/5ml

Na-laurilsulat;asam
sorbat;polietilenglikol; Na- MICROLAC Pharos
sitrat ;Sorbitol

3.8 DIGESTIVA,PENCERNAAN (3G)

Lactobasilus L-BIO Lapi
LACTO B Novell
LACBON

Amylase;desoxycholic;protea
se;lipase;dim- VITAZYM Kalbe
polysiloxane;niacinamide;cap
antotenat;vit b.com

3.9 KOLAGOGUM,KOLELITOLITIK&HEPATOPROTEKTOR (3H)

Ursodeoksilat 250 mg URDAFALK Darya Varia

Flavoksat Hidroklorida 200mg 100mg URISPAS Sanbe

Ursodeoksilat 250 mg URSOLIC Guardian

Pipemidic Acid URINTER

10
 Ppc,nicotinamide,vit
E(B1,B2,B6,B12) LESICHOL Landson

Multivitamin D dengan
kombinasi HP-PRO Bio Life

Methisoprinol 500mg MAXPRINOL Simex

3.1 PREPARAT ANOREKTAL (3I)

Ketoprofen 100mg PRONALGES Dexa

4 SISTEM KARDIOVASKULAR & HEMATONIK

4.1 OBAT JANTUNG (4A)
Amiodarone HCL 150mg/ml CORDARONE Sanofi

Digoxin 0,25mg DIGOXIN Indofarma

DOBUTAMINE
Dobutamine 25mg/ml GIULINI Berno

DOPAMINE
Dopamine 200mg GIULINI Kimia farma

40mg INDOP Fahrenheit

4.2 OBAT ANTI ANGINA (4B)

ISOSORBID
Isosorbid dinitrat 5mg DINITRAT Indofarma

Nitrocaf retard 2.5mg:5mg NITROCAF Kimia Farma

Amiodarone 200mg;150/3ml CORDARONE Sanofi

Diltiazem 50mg HERBESSER Tanabe

11
4.3 ACE INHIBITORS (4C)
Captopril 12,5mg;25mg CAPTOPRIL Indofarma

4.4 BETA-BLOKERS (4D)

Bisoprolol 10mg Indofarma

4.5 CALCIUM ANTAGONISTS (4E)

Amlodipine 5mg;10mg AMLODIPINE Berno
5mg;10mg SIMVASK Simex

Nifedipine 10mg NIFEDIPINE Berno

Nicardipine 10mg/10ml PERDIPINE Combifant

4.6 ANGIOTENSIN II ANTAGONISTS(4F)

Valsartan 80MG;160MG VALSARTAN Dexa
Candesartan 8mg:16mg CANDESARTAN

4.7 ANTI HIPERTENSI GOL.LAIN (4G)

Clonidine HCl 0.15mg CATAPRES Boehringer

4.8 DIURETIK (4H)

Furosemide FUROSEMIDE OGB

Hydrochlorthiazide 25mg HCT OGB

Manitol MANITOL Kalbe

SPIRONOLACTO
Spironolactone 25mg;100mg NE OBG

12
 4.9 VASODILATOR PERIFER & AKTIVATOR SEREBRAL (4I)
500mg;125;250mg
Citicoline /ml CITICHOLINE Hexpharm

Isoxuprine HCL 20mg DUVADILAN Kimia farma

4.10 VASOCONTRICTOR (4J)

1mg/ml NOREPHINEPR Phapros
Norephrineprine INE

4.11 OBAT DISLIPIDEMIA (K)

Atorvastatin Ca 10mg ATORVASTATIN Hexpharm

Simvastatin 10mg;20mg SIMVASTATIN Bernofarm

20mg FASTOR Lapi

4.12 HAEMOSTATICS (4L)

CARBAZOCHR
OM SODIUM
Carbazochrom sodium sulfat 50mg SULFAT

50mg/ml CROME

Ethamycilate 125mg DICYNONE Corsa

ASAM
Asam tranexamat 500mg;5mg/ml TRANEXAMAT Berno

500mg;5mg/ml KALNEX Kalbe

Phytomenadion 2mg/ml NEO K Combiphar

13
4.13 ANTIKOAGULAN,ANTI PALTELET &FIBRINOLITIK/TROMBOLITIK (4M)
Acetosal 80mg ASPILET Kimia Farma

Cilostazol 100mg PLETAAL Otsuka

Clopidogrel 75mg CLOPIDOGREL OGB

75mg SIMCLOVIC Simex

Heparin sodium 5000iu INVICLOT Fahrenheit

5 SISTEM SARAF PUSAT

5.1 ANSIOLITIK (5A)
Alprazolam 0.5mg;1mg ALPRAZOLAM Kimia farma

Diazepam 0.5mg DIAZEPAM Kimia farma

2mg;5mg STESOLID Acta

Amitripillin 25mg AMITRIPILLIN Dexa

5.2 ANTIDEPRESAN (5B)

Fluoxetine HCL 20mg KALMICETIN Kalbe

5.3 ANTIPSIKOTIK (5C)

Chlorpromazine 25mg;100mg CPZ OGB

5.4 ANTI KONVULSAN (5D)

Diphenylhydanton;Phenobarb 30mg;2mg/ml PHENOLBARBI OGB
ital TAL

14
 Valproic acid 250mg/ml DEPAKENE Abbout

Gabapentin 300mg GABAPENTIN Pharos

Phenytoin Na 100mg;2ml PHENYTOIN OGB

5.5 ANTI PARKINSON (5E)

TRIHEXYPHEN
Trihexyphenidyl HCL 2mg IDYL HCL Indofarma

5.6 ANTI VERTIGO (5F)

Betahistine mesylate 6 mg BETAHISTIN Indofarma
6 mg HISTIGO Ifars
Flunarizine
Sinarizine 25mg PERIFAS Otto

5.7 ANALGETIK OPIAT (5G)

Tramadol HCL TRAMADOL
50mg HCL Mahakam

50mg TUGESAL Mepro

Tramadol HCL;PCT 37.5mg;325mg ANALTRAM Lapi

37.5mg;325mg PATRAL Mahakam

Fentanyl 50mcg FENTANYL KF

5.8 ANALGETIK NON OPIAT & ANTIPIRETIK (5H)

Paracetamol 125mg;250mg DUMIN Actavis
500mg;120mg;60
mg SANMOL Sanbe

15
 Ibuprofen 400mg IBUPROFEN OGB

Paracetamol;n-acetylcystein 500mg;200mg SISTENOL Dexa

5.9 ANTI INFLAMSI NON STEROID (OAINS) (5I)

KALIUM
Diclofenat K 25mg;50mg DIKLOFENAC Hexpharm

KAFLAM

Natrium
Diclofenac Na 25mg;50mg diklofenac Hexpharm

GLUCOSAMIN
Glucosamine 500mg E Indofarma

Ketoprofen 50mg;100mg KETOPROFEN Novell

100mg PROFENID Sanofi
100mg PRONALGES Dexa

Ketorolac tromethamine 30mg KETOROLAC OGB

Meloxicam 7.5mg;15mg MELOXICAM OGB

Piroxicam 10mg;20mg PIROXICAM OGB

ASAM
Asam mefenamat 500mg MEFENAMAT Hexpharm

500mg LAPISTAN Lapi

500mg MEFINAL Sanbe

Methampyron, VitB1,B6,B12 500mg Neuralgin RX Kalbe

16
 Metamizole Na 500mg/ml SANTAGESIK Sanbe

5.1 NYERI NEUROPATIK (5J)

Gabapentin 300mg GABAPENTIN Pharos

5.11 NOOTROPIK&NEUROTONIK (5K)

MECOBALAMI
Mecobalamin 500mg N Hexpharm

LAPIBAL

Piracetam 400;800;1200mg PIRACETAM OGB

6 SISTEM MUSKULOSKELETAL
6.1 OBAT HIPERURISEMIA & GOUT (6A)
Allopurinol 100mg;300mg ALLOPURINOL Berno

6.2 RELAKSAN OTOT (6B)

Eperisone HCL 10mg;50mg EPSONAL Fahrenheit

6.3 ENZIM ANTI INFLAMASI (6C)

Serratiopeptidase;pancreatin

6.4 OBAT GANGGUAN NEUROMUSKULAR (6D)

Neostigmine methylsulfat 0.5mg/ml PROSTIGMIN Combi

7 HORMONES
7.1 ESTROGEN & PROGESTERON, ACETATE;ESTRADIOL CYPIONATE (7A)
Allylestrenol 5mg PROGESTON Mepro

Clomiphen citrat 50mg CLOFERTIL Mepro

50mg PROFERTIL Kalbe
17
 Norethisteron 5mg PRIMOLUT N Schering

Dydrogesterone 10mg DUPHASTON Solvay

Medroxyprogesterone Tunggal
acetate;estradiol 0.5ml CYCLOFEM idaman

DEPO
150mg/3ml PROGESTIN Harsen

7.2 HORMON KORTIKOSTEROID (7B)

BETAMETHAS
Betamethasone 5gr ONE Kimia farma

DEXAMETHAS
Dexamethasone 0.5mg ONE Errita

0.5mg DANASONE Hexapharm

0.75mg DEXAHARSEN Dexa

METHYLPRED
Methylprednisolone 4;8;16mg NISOLONE Hexpharm

4mg LAMESON Lapi

TRIAMCINOLO
Triamcinolone 4mg NE OGB

8 KONTRASEPSI
8.1 KONTRASEPSI ORAL (8A)
Levonorgester;ethinylestradiol 150mg;30mg MICROGYNON Bayer

18
 8.2 KONTRASEPSI SUNTIK (8B)
Medroxyprogesterone Tunggal
acetate;estradiol 0.5ml CYCLOFEM idaman

DEPO
Depo Progestine 150mg/3ml PROGESTIN Harsen

Tunggal
Medroxyprogesterone 150mg/3ml TRICLOFEM idaman

8.3 KONTRASEPSI LAIN (8C)

IUD BENTUK T COPER T

9 SISTEM KEMIH KELAMIN

9.1 PREPARAT UNTUK MASALAH VAGINA (9A)
Metronidazole Nistatin 500mg METRONIDAZ Dexa
OLE

FLAGYL Sanofi
PROVAGIN Mepro
9.2 ANTISEPTIK SALURAN KEMIH (9B)
Phenazopyridine HCL 100mg URISPAS Sanbe

Pipemidic acid 400mg URINTER Interbat

Extrac folia ortho;strobilantus 24;4;5;200mg NEPHROLIT Hexpharm

9.3 OBAT YANG BEKERJA PADA UTERUS (9C)

Isoxsuprine 20mg;10mg DUVADILAN Kimia farma
20mg HYSTOLAN

19
 METHYL
ERGOMETRIN
Methyl ergometrine 0.125mg E KF

0.125mg;0.2mg/
ml MYOTONIC Mepro

Oxytocin 1ml SYNTOCINON Novartis

1ml OXYLA Novell

9.4 OBAT PENYAKIT SALURAN KEMIH & PROSTAT (9D)

Ursodeoksilat 250mg URDAFALK Darya varia

Tamsulosin 0.2mg;0,4mg HARNAL Boehringer

HARNAL OCAS

10 SISTEM ENDOKRIN DAN

METABOLIK 10.1 INSULIN (10A)
Insulin asprt ACTRAPID Novo nordisk

10.2 OBAT ANTIDIABETES (10B)

Acarbose 50mg ACARBOSE Dexa

Glimepiride 1;2;3;4mg GLIMEPIRIDE Berno

2mg AMADIAB Lapi

Gliquidone 30mg GLIQUIDONE Berno

Metformin 500;850mg METFORMIN Berno

500mg GLUCOPHAGE Merck

Glibenclamide 5mg GLIBENCLAMIDE Indofarma

20
10.2 OBAT METABOLISME TULANG (10C)
Calcium Lactate 500mg NOVAKAL Berlico
CALCIUM
LACTATE

11 PREPARAT MATA
11.1 ANTIINFEKSI & ANTISEPTIKA MATA (11A)
CENDO
Chloramfenicol eye 8ml;3.5gr FENYCOL Cendo

ERLAMYCETIN
8ml3.5gr E Cendo

Levofloxacin 5ml CENDO LFX Cendo

Neomycin sulfate;polymicin b CENDO

sulfate 5ml STATROL Cendo

Garamycin;neomycin CENDO
sulfat;polymicin 5ml;3.5mg POLYGRAN Cendo

Ofloxacin 5ml;0.6ml CENDO FLOXA Cendo

11.2 ANTISEPTIK MATA DENGAN KORTIKOSTEROID (11B)

CENDO
Dexamethasone 5ml XITROL Cendo

Dexamethasone;polymixin;neo CENDO
mycin 5ml;0.6ml POLYDEX Cendo

CENDO
Fluorometholon 5ml;0.6ml POLYNEL Cendo

21
11.3 ANTIGLAUKOMA (11C)
CENDO TIMOL
Timolol maleat 5ml;0.6ml 0.25%;0.5% Cendo

CENDO
5ml;0.6ml HYALUB Cendo

11.4 ANTIGLAUKOMA (11D)

CENDO TIMOL
Timolol maleat 5ml;0.6ml 0.25%;0.5% Cendo

11.4 OBAT DEKONGESTAN;ANASTESI ANTIINFLAMSI MATA (11E)

Antazolina PO4;nafazolin CENDO
HCL;ECT 5ml;0.6ml VASACON-A Cendo

CENDO
5ml;0.6ml GLAOPEN Cendo

11.5 ANTI CATARAK (11F)

CENDO
Potasium hyalurat 5ml;0.6ml CATARLENT Cendo

11.6 PELUMAS MATA (11G)

CENDO
Hydroxypropul methylcelulose 5ml;0.6ml CENFRES Cendo

CENDO
5ml;0.6ml PROTAGENTA Cendo

12 TELINGA;MULUT & TENGGOROKAN

12.1 ANTIINFEKSI&ANTISEPTIK TELINGA (12A)
ERLAMYCETIN
Chloramphenicol;lidocain HCL 5ml TT Eryla

5ml OTOPAIN TT Interbat

22
 Chloramphenicol5%;polymyxin
;nipagin1% 5ml OTOLIN TT Kalbe

TARIVID OTIC
Ofloxacin 3mg TT Kalbe

12.2 PREPARAT MULUT TENGGOROKAN (12B)

Nacl 6.5mg BREATHY TH Novell

Povidone iodine 0.10% BETADINE

TRIAMCINOLO
Triamcinolone 4mg NE Indofarma

KENALOG

13 DERMATOLOGICALS (KULIT)
13.1 ANTIBIOTIK TOPIKAL (13A)
Chloramphenicol 15gr KALMICETIN Kalbe

Fucidin acid 20gr FULADIC Bayer

Gentamycin 5gr GENTAMYCIN OGB

Silversulfadiazin 10mg BURNAZIN Darya

BIOPLACENTO
10gr N

13.2 ANTIJAMUR&ANTIPARASIT TOPIKAL (13B)

Nystatin;zno 20gr MYCO-Z Taiso

23
13.3 ANTIINFEKSI TOPIKAL DGN KORTIKOSTEROID (13C)
Bacitracin;neomycin sulphate 4gr NEBACETIN Pharos

Betamethasone
valerate;neomycin BETASON-N Kimia farma

13.4 KORTIKOSTEROID TOPIKAL (13D)

Clobetasol propionate

Flucinolin acetat
0.025mg,neomisin sulfat 0.5% 10gr FASOLON Coronet

HYDROCORTI
Hydrocortisone 10gr SONE OGB

Triamcinolon acetonide 5gr BUFACOM Bufa aneka

Mometasone 10gr ELOX Guardian

13.5 PREPARAT AKNE (13E)

Clidamycin

13.6 OBAT KULIT LAIN (13G)

Miconazole MYCONAZOLE

Ketoconazole FUNGASOL Guardian

KETOCONAZO
LE OGB

24
 14 ANASTETIK LOKAL&UMUM
14.1 ANASTETIK LOCAL (14A)
Bupivacaine hcl 5mg/ml BUNASCON Novell
BUPIVACAINE

Lidocain 20mg/ml LIDOCAIN Phapros

20mg;0.0125mg/
Lidocaine&ephineprine hcl ml PEHACAIN Phapros

14.2 ANASTETIK UMUM (14B)

ATROPIN
Atropin 0.25mg/ml SULFAT OGB

Isoflurane 250ml TERREL Fahrenheit

Ketamin 100mg/ml KTM Guardian

Midazolam 5mg/ml SEDACUM Dexa

5mg/ml FORTANES Kalbe

Neostigmin metil so4 0.5mg/ml PROSTIGMIN Meda

Propofol 10mg/ml RECOFOL Dexa

10mg/ml PROANES Sanbe

15 ALLERGI&IMMUNE SYSTEM
15.1 ANTIHISTAMIN & ANTIALERGI (15A)
Cetirizine 10mg CETIRIZINE Hexpharm
10mg/ml TIRIZ Lapi

25
 Chlorpeniramine maleate 4mg CTM KF
4mg ALLERON

Dexchlorpheniramine
maleate;dexamethasone 2mg;0.5mg DEXTAFEN Phapros

DIPHENHYDRA
Diphenhydramine hcl 12.5mg MINE HCL OGB

12.5mg SIDIADRYL Berno

Loratadine 10mg LORATADINE OGB

Pseudoephedrine;terfenadine 60mg;25mg;60ml LAPIFED Lapi

RHINOFED Dexa

Pseudoephedrine;loratadine 5mg RHINOS SR Dexa

16 VAKSIN;ANTISERUM & IMMUNOLOGIKAL

16.1 HAEMOPHILUS TYPE B CONJUGATE VACCINE*MENINGITIS (16A)
Tetanus-diptheria Toxoid Td Vaccine Bio Farma
HEPATITIS B

r-dna hepatitis B voceine REKOMBINAN Bio Farma

0,5 ml;1ml (anak)

(strain Sabin) tipe 1 ≥ 106.0 PENTABIO/DTP Bio Farma

CCID50* -HB

ANTIDOTUM&ZAT DETOKSIFIKSI UNTUK TERAPI KETERGANTUNGAN ZAT

16.2
(16B)
Naloxone hcl

26
 17 VITAMINS&MINERALS
17.1 VITAMIN A,D,E (17A)
D-alpha-tocopherol LANTUROL

Axerophtoli acetas 200.000ui;20.0 VITAMIN A Kimia farma

00ui

17.2 VITAMIB B.COMPLEK&VITAMIN C (17B)

Fursulthiamin hcl 25mg/10ml ALINAMIN Takeda
FURAMIN

Folic acid 400mcg FOLIC ACID OGB

400mcg FOLAS Otto
400mcg FOLDA Simex
400mcg FOLAMEF

Folic acid Kombinasi PROMAVIT

FOLAMIL
GENIO

FOLAMIL

VITAMIN B
Vitamin B.complek COMPLEK IFI

Vit.Bcom;Vit C ENERVONCE Medifarma

BECOM C Sanbe

Vit B1;B6:b12 NEUROSENBE Sanbe

NEUROBION Merck
NEURODEX Dexa

27
17.3 VITAMIN C (17C)
25mg;50MG;10
Vitamin C 0MG VITAMIN C Mega farma

SANKORBIN Sanbe

17.4 KALCIUM DENGAN VIT.D (17D)

Calcium; Vit D3;mg BIO CAL 95 Simex

Calcium lactate 500mg NOVAKAL Berlico

Calcium;Vit D3 600;400ui CDR FORTOS Bayer

17.5 VITAMIN & MINERAL (17E)

Cod liver oil plus HP-PRO

Curcumainoid;lysine CURCUMA Soho

Vita;B1;B12;B6;VitC;Fe;Folic
acid BECOM-Z Sanbe

Fe;VitC;VitBcomp SANGOBIAN Merc

ETABION
INBION
17.6 VITAMIN & MINERAL PEDIATRIK (17F)
Lysine hcl;Ca;Vit B.com 60ml VITAGROW MBF

Vit A;VitB1;VitB12;nic;VitC 100ml;10ml APIALYS Lapi

Echinacea;curcumain;colestrum ELKANA Sanbe

60ml TIALYSIN
60ml LYSCAVIT
100ml BEVITA Gracia
100ml D-VIT Gracia
28
 Vitamin Athiamine;
riboflavin;pyridoxine 60ml ZAMEL Novell

17.7 NUTRITION (17G)

HUMAN
Human Insulin 100ml INSULIN Kimia Farma

Protein;karbohidrat;lemak;vitami PROLACTA
n;mineral FOR MAM Novell

17.8 PRODUK NUTRISI PARENTERAL (17H)

Asam amino acid;carbohydrat 500ml AMINOVEL Otsuka

Amino acid;glucosa 500ml AMINOFLUID Otsuka

Amino acid;Na;CL 500ml AMINOLEBAN Otsuka

17.8 SUPLEMEN & TERAPI PENUNJANG (17J)

Vitamin K 10mg/1ml VITAMIN K Kimia farma

18 LARUTAN INTRAVENA & LARUTAN STERIL LAIN

18.1 ELECTROLYT (18A)
Dextrose 500ml D5%
25ml D10%
D40%

KCL 25ml KCL Otsuka

300mg KSR Merc

KL-aspatate ASPAR Tanabe

ASPAR-K

29
Kombinasi NA, CL, GLUCOSA 500ml KAEN 1B Otsuka

500ml KAEN 3A Otsuka

Kombinasi NA, K, CL,

LACTATE, GLUKOSA 500ml KAEN 3B Otsuka

MgSO4 25ml MEYLON Otsuka

500ml;100ml;25
Sodium Chlorida ml NaCL Otsuka

Kombinasi NA, K, CA, CL,

ASETAT 500ml ASERING Otsuka

Kombinasi NA LACTATE, RINGER

NACL, KCL, CACL2 500ml LACTAT Otsuka

30
 PENUTUP

Formularium yang disusun oleh Komite Farmasi dan Terapi merupakan

pemilihan dan penggunaan obat yang paling bermanfaat bagi yang pasien dan akan
mendorong penggunaan obat yang rasional di Rumah Sakit Umum Pekerja. Adanya
formularium di Rumah Sakit diharapkan dapat menyederhanakan penyediaan obat,
membatasi penggunaan obat yang tidak perlu dan meningkatkan efisiansi biaya
pengobatan.
Diharapkan dengan tersusunnya Formulariun di Rumah Sakit, akan
memberikan sumbangan terhadap peningkatan mutu pelayanan kesehatan di
Rumah Sakit.

31
 DARTAR PUSTAKA

1. Aslam M, Tan CK, Prayitno A, “Farmasi Klinik”. (Clinical Pharmacy)

Menuju Pengobatan Rasional dan Penghargaan Pilihab Pasien, Elex Media
komputindo, Jakarta, 2003.
2. ISO INDONESIA VOLUME 44 – 2009 s/d 2010, Penerbit Ikatan
Sarjana Farmasi Indonesia.
3. MIMS Indonesia 2013 issue 2, Master Index of Medical
specialitities Established since 1968.

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