USULAN OBAT GENERIK BULAN JANUARI-MARET TAHUN

NO NAMA OBAT BENTUK USULAN PENERIMAAN Keterangan

SEDIAAN
1 Acarbose 100 mg TABLET 3,999 5,700 TIDAK SESUAI
2 Acarbose 50mg TABLET 7,200 11,600 TIDAK SESUAI
3 Acetazolamide 250mg TABLET
4 Acetyl cysteine 200mg TABLET 10,398 35,300 TIDAK SESUAI
Air untuk irigasi lar infus
5 FLAS TIDAK SESUAI
1000 ml 129 180
6 Alopurinol tablet 100 mg TABLET 3,300 1,300 TIDAK SESUAI

7 Alopurinol tablet 300 mg TABLET TIDAK SESUAI

3,000 2,900
8 Alprazolam tablet 0,5 mg TABLET
3,600
10 Alprazolam tablet 1 mg TABLET 699
9 Ambroksol 30mg TABLET 7,800 22,400
11 Ambroksol sirup 15mg/5ml BOTOL
99 230
Amikasin injeksi 500
12 VIAL
mg/ml 24
13 Amikasin injeksi 250 mg/ml VIAL
2
14 Aminofilin injeksi 24 mg/ml AMPUL
120 576
Aminofilin tablet scored
15 TABLET
200 mg 999 600
16 Amiodaron injeksi 150 AMPUL SESUAI
mg/3 ml 114 144
17 Amiodaron tablet TABLET
18 Amitriptilin tablet TABLET 798
19 Amlodipin tablet 10 mg TABLET 38,700 48,600
20 Amlodipin tablet 5 mg TABLET 35,400 56,100
21 Amoksisilin forte sirup BOTOL 18 28
22 Amoksisilin inj VIAL 9 10
23 Amoksisilin sirup BOTOL 33 132
27 Amoksisilin tablet TABLET 3,798 3,200
24 Ampisilin inj VIAL 360
26 Antalgin 500 mg TABLET -
25 Antalgin inj AMPUL -
28 Antasida suspensi BOTOL 129
29 Antasida tablet TABLET 1,698
30 Antihemorhoid supp SUPP 90
32 Aqua b idestilata 25 ml BOTOL 9,840
31 Asam Asetilsalisilat TABLET
(asetosal) tablet -

Asam Askorbat (Vitamin C)

33 TABLET
tablet 50 mg
399
34 Asam Folat tablet 1 mg TABLET 1,599
35 Asam Mefenamat tablet TABLET
17,700
Asam pipemidat kapsul
36 TABLET
400 mg -
Asam traneksamat 500 mg
37 tab TABLET
2,298
Asam traneksamat injeksi
38 AMPUL
100 mg/ml 1,020
Asam traneksamat injeksi
39 AMPUL
50 mg/ml 120
Asam Ursodeoksikolat 250
40 TABLET
mg 3,840
41 Asetazolamid 500mg TABLET -
42 Asiklovir krim 5% TUBE 24
43 Asiklovir tablet 200 mg TABLET 99
44 Asiklovir tablet 400 mg TABLET 999
45 Atorvastatin 10 mg TABLET 1,080
46 Atorvastatin 20 mg TABLET 6,870
47 Atorvastatin 40 mg TABLET 2,310
48 Atracurium Besylate inj AMPUL 99
49 Atropin Sulfat inj AMPUL -
Azitromisin sir kering 200
50 BOTOL
mg/ 5 mL -
51 Azitromisin tablet 500 mg TABLET
759
52 Bacitracin Polymycin B SK TUBE
-
Benzatin Benzil Penisilin
53 VIAL
1,2 juta IU 9
54 Betahistin mesilat TABLET 3,699
55 Betametason krim 0,1% TUBE 24
56 Bisoprolol tablet 5 mg TABLET 21,699
57 Bupivakain heavy inj AMPUL 60
58 Deksametason injeksi AMPUL 1,110
Deksametason tablet 0,5
59 TABLET
mg 3,999
Desoksimetason krim
60 TUBE
0,25% 114
61 Diazepam inj 5mg/ml AMPUL 210
62 Diazepam tablet 2 mg TABLET 1,398
63 Diazepam tablet 5 mg TABLET 699
64 Difenhidramin injeksi AMPUL 180
65 Digoksin tablet 0,25 mg TABLET 9,399
66 Diltiazem HCl tablet 30 mg TABLET
-
67 Dimenhidrinat tablet 50 TABLET
mg 198
Dobutamin injeksi 50
68 AMPUL
mg/mL 48
69 Doksisiklin TABLET 300
70 Domperidon drop 5 mg/mL FLAS
18
71 Domperidon sirup BOTOL 99
72 Domperidon tablet 10 mg TABLET
7,800
73 Dopamin injeksi 40 mg/ml AMPUL
3
74 Efedrin Inj 50 mg/ml AMPUL 90
75 Eperison HCl tab 50mg TABLET 5,100
76 Epinefrin inj AMPUL 300
77 Eritromisin kapsul TABLET 600
78 Eritromisin sirup BOTOL 99
79 Etambutol tablet TABLET 99
80 Etil Klorida Spray FLAS -
81 Famotidin 20mg TABLET -
82 Famotidin 40 mg TABLET -
83 Fenitoin injeksi 50 mg/ml AMPUL
138
84 Fenitoin kapsul AMPUL 9,900
85 Fenobarbital injeksi VIAL -
86 Fenobarbital tab 100mg TABLET 99
87 Fenofibrat kaps 100 mg TABLET 30
88 Fenofibrat kaps 300 mg TABLET 999
89 Fentanil injeksi 10 ml AMPUL 54
90 Fentanil injeksi 2 ml AMPUL 39
91 Flukonazol injeksi AMPUL 72
92 Flukonazol tablet TABLET 360
93 Flunarizine 5 mg TABLET 798
94 Fosfomycin Na vial 1G VIAL -
95 Furosemid injeksi AMPUL 6,300
96 Furosemid tablet 40 mg TABLET 40,998
97 Gabapentin 300 mg TABLET 7,998
98 Garam Inggris PACK -
99 Gemfibrozil kapsul TABLET 600
100 Gemfibrozil tablet 600 mg TABLET
99
101 Gentamisin injeksi 40 mg/ AMPUL
ml 399
102 Gentamisin salep kulit TUBE 168
103 Glibenklamid tablet 5 mg TABLET
-
104 Gliklazid tab 30 mg TABLET 30
105 Gliklazid tab 80 mg TABLET 198
106 Glikuidon tab 30 mg TABLET 1,698
107 Glimepiride tablet 1 mg TABLET 3,099
108 Glimepiride tablet 2 mg TABLET 5,400
109 Glimepiride tablet 3 mg TABLET 1,800
110 Glimepiride tablet 4 mg TABLET 4,899
111 Gliseril Guayakolat 100 mg TABLET
6,798
112 Glucosamin 250 TABLET 3,660
Glukosa larutan infus 10 %
113 FLAS
steril 99
Glukosa larutan infus 40 %
114 steril FLAS
579
Glukosa larutan infus 5 %
115 FLAS
steril 1,380
116 Granisetron 1mg Inj AMPUL 6
117 Griseofulvin tablet 125 mg TABLET
-
118 Haloperidol tablet 0,5 mg TABLET
600
119 Hidroklortiazid TABLET 5,898
120 Hidrokortison krim 2,5 % TUBE
24
121 Hidroksi Progesteron -
122 Ibuprofen injeksi ampul -
Ibuprofen suspensi 200
123 BOTOL
mg/5 ml 165
124 Ibuprofen tablet 200 mg TABLET 1,299
125 Ibuprofen tablet 400 mg TABLET 6,099
126 Iohexol 350/50 BOTOL 75
127 Irbesartan tab 150 mg TABLET -
128 Irbesartan tab 300 mg TABLET -
129 Isofluran 250 ml BOTOL -
130 Isofluran inhalasi BOTOL -
131 Isoniazid tablet 100 mg TABLET -
132 Isoniazid tablet 300 mg TABLET 99
 Isosorbid dinitrat inj
133 AMPUL
1mg/ml 153
134 Isosorbid Dinitrat tablet TABLET 39,399
135 Itraconazol TABLET 210
Kalium Diklofenak tablet
136 TABLET
50 mg 1,299
137 Kalium Klorida 7 % inj FLAS 240
138 Kalsium Glukonat injeksi AMPUL
24
139 Kalsium Laktat (Kalk) tablet TABLET
6,900
140 Kandesartan tab 16 mg TABLET 32,160
141 Kandesartan tab 8 mg TABLET 47,520
142 Kaptopril tablet 12,5 mg TABLET
1,899
143 Kaptopril tablet 25 mg TABLET 99
Karbamazepin tablet 200
144 TABLET
mg 3,000
145 Karbon aktif TABLET -
146 Ketokonazol krim 2% TUBE 39
147 Ketokonazol tablet 200 mg TABLET
150
Ketoprofen supositoria 100
148 SUPP
mg -
149 Ketorolac injeksi 10 mg/ml VIAL
9
150 Ketorolac injeksi 30 mg/ml VIAL
3,498
151 Ketorolac tablet 30 mg TABLET 99
152 Kina Tablet TABLET -
Klindamisin kapsul/kaplet
153 TABLET
300 mg 2,949
154 Klobazam tab 10 mg TABLET 1,800
155 Klonidin tablet 0,15 mg TABLET 8,799
156 Klopidogrel tab 75 mg TABLET 57,120
157 Kloralhidrat -
158 Kloramfenikol salep mata TUBE
84
Klorfeniramin maleat
159 (CTM) TABLET
7,599
160 Klorheksidine 24
161 Klorpromazin 25 mg tab TABLET 198
162 Kodein tablet 10 mg TABLET 7,398
163 Kodein tablet 15 mg TABLET 99
164 Kodein tablet 20 mg TABLET 999
165 Kolistin Sulfat TABLET 99
166 Komb. Amoksisilin + Asam TABLET
Klavulanat 480
167 Kotrimoksazol forte TABLET 3,099
168 Kotrimoksazol tab TABLET 2,298
169 Laktulosa syr BOTOL 69
172 Lansoprazol injeksi AMPUL 357
171 Lansoprazol kaps 30 mg TABLET 13,599
173 Larutan C 1:1 FLAS 120
174 Larutan C 1:2 FLAS 198
175 Larutan C 1:4 FLAS 339
176 Larutan C 1:5 FLAS 18
178 Levofloksasin inf 5 mg/mL BOTOL
915
Levofloksasin tablet 500
177 mg TABLET
2,349
Levonorgesterol tab
179 TABLET
0,15mg -
180 Lidokain injeksi 2% (HCL) AMPUL
1,398
Lidokain injeksi 2% (HCl) +
181 Epinefrin AMPUL
99
182 Lidokain spray 10% FLAS -
183 Linkomisin 500 mg TABLET 99
184 Lisinopril tablet 10 mg TABLET 5,598
185 Lisinopril tablet 5 mg TABLET 6,999
186 Loperamid tablet 2 mg TABLET 198
187 Loratadin tablet 10 mg TABLET 2,349
188 Manitol infus 20%, 500 mL FLAS
45
189 Manitol otsu 250 ml 24
190 Maprotilin HCl tab 50 mg TABLET
-
191 Mebendazol tablet 500 mg TABLET
-
346 Mecobalamin 500 mg TABLET 4,800
192 Mecobalamin inj 500 mg VIAL
180
193 medroksi progesteron TABLET -
194 Meloksikam 15 mg TABLET 3,699
351 Meloksikam 7,5 mg TABLET 699
170 Meropenem inj 1 g VIAL 348
195 Metamizol tab 500 mg 198
Metformin HCl tablet 500
196 TABLET
mg 36,498
 Metformin HCl tablet 850
197 TABLET
mg -
348 Metilergometrin Maleat inj AMPUL
99
Metilergometrin Maleat
198 TABLET
tab 0,125 mg 300
Metilprednisolon inj 125
199 VIAL
mg/2 mL 957
200 Metilprednisolon inj 500 VIAL
mg/8 mL -
Metilprednisolon tablet 16
201 TABLET
mg 1,998
Metilprednisolon tablet 4
202 mg TABLET
7,599
Metilprednisolon tablet 8
203 mg TABLET
4,599
Metoklopramid 10 mg
204 TABLET
tablet 198
205 Metoklopramide inj AMPUL 2,868
Metoklopramide tablet 5
206 mg TABLET
600
207 Metotreksat inj i.v/i.m./i.t. AMPUL
25 mg/ml 2
208 Metotreksat tablet 2,5 mg TABLET
-
209 Metronidazol infus 500 BOTOL
mg/100 ml 897
210 Metronidazol ovula 500 mg OVULA
-
211 Metronidazol supositoria SUPP
500 mg -
Metronidazol suspensi
212 BOTOL
125mg/5ml -
Metronidazol tablet 500
213 TABLET
mg 1,899
214 MgSO4 20 % inj FLAS 120
215 MgSO4 40 % inj FLAS -
Mikonazol krim/salep 2 %
216 TUBE
(Nitrat) 48
Mometason furoat krim
217 TUBE
0,1% 285
218 Morfin HCL inj 10 mg/ml AMPUL 78
219 Morfin tab 10mg TABLET -
Moxifloxacin infus
220 BOTOL
400mg/250ml 6
221 Moxifloxacin tab 400mg TABLET -
222 Na Cl 0,9% 1000 ml FLAS 819
223 Nabic Tablet 4,398
224 Nacl 0,9% 500 ml FLAS 12,840
225 Nacl 100 ml FLAS 405
354 Nacl 3 % FLAS 18
N-asetil sistein inj. nebules
226 AMPUL
100 mg 3
227 Natrium Bikarbonat injeksi FLAS
i.v 8,4% 120
Natrium Diklofenak tablet
228 TABLET
25 mg 948
Natrium Diklofenak tablet
229 50 mg TABLET
8,649
230 Natrium tiosulfat TABLET -
Nifedipin tablet/kapsul 10
231 TABLET
mg 498
232 Nikardipin inj AMPUL 645
233 Nistatin drop FLAS 78
Nistatin tablet salut
234 500.000 IU/ g TABLET
-
Nistatin vaginal tablet
235 TABLET
100.000 IU/ g 798
236 Norephineprin ampul AMPUL
1mg/ml 603
237 OBH BOTOL 90
238 Ofloxacin tablet 200 mg TABLET -
239 Ofloxacin tablet 400 mg TABLET -
240 Oksitetrasiklin krim sk TUBE 24
241 Oksitetrasiklin salap mata TUBE
24
242 Oksitosin injeksi 10 IU/ml AMPUL
300
Omeprazol injeksi 40 mg/
243 VIAL
10 ml 3,576
Omeprazol kapsul/kaplet
244 TABLET
20 mg 11,850
Ondansetron inj 4 mg/ 2
245 AMPUL
mL 3,219
Ondansetron inj 8 mg /4
246 TABLET
mL 810
247 Ondansetron tab 4 mg TABLET 2,340
248 Ondansetron tablet 8 mg TABLET
600
249 Oralit PACK 99
250 Pantoprazole inj 40 mg 270
251 Parasetamol drop FLAS 24
252 Parasetamol infus BOTOL 1,350
353 Parasetamol sirup BOTOL 168
253 Parasetamol tablet 500 mg TABLET
28,200
254 Pentoxyfilin TABLET -
255 Perak sulfadiazin krim 1% TUBE
36
256 Petidin injeksi AMPUL 9
257 Pioglitazon tab 15 mg TABLET 3,930
258 Pioglitazon tab 30 mg TABLET 390
259 Pirasetam 1200 mg TABLET 210
260 Pirasetam inj 3 g VIAL 189
261 Pirazinamid tablet 500 mg TABLET
198
Povidon Iodida larutan 10%
262 BOTOL
30 ml 3
263 PPD 2/5 TU VIAL 1
264 Pravastatin tablet 20 mg TABLET 99
265 Prednison TABLET -
266 Prednison ampul AMPUL -
267 Primakuin TABLET 99
268 Prokain Benzilpenisilin inj VIAL
-
269 Propiltiourasil tablet 100 TABLET
mg 498
Propranolol tablet 10 mg
270 TABLET
(HCl) 6,399
271 Propranolol tablet 40 mg TABLET
(HCl) 198
272 Ramipril tablet 10 mg TABLET 1,560
273 Ramipril tablet 2,5 mg TABLET 4,599
274 Ramipril tablet 5 mg TABLET 7,998
275 Ranitidin injeksi 25 mg/ml AMPUL
5,199
276 Ranitidin tablet 150 mg TABLET 8,898
277 Rifampisin tablet 300 mg TABLET
99
278 Rifampisin tablet 450 mg TABLET
-
279 Rifampisin tablet 600 mg TABLET
198
280 Ringer Dekstrose 5 % FLAS 198
281 Ringer Laktat larutan infus FLAS
2,559
282 Risperidon tablet 1 mg TABLET 99
283 Salbutamol syr 2mg/5ml BOTOL
-
284 Salbutamol tablet 2 mg TABLET 2,700
285 Salbutamol tablet 4 mg TABLET 7,500
286 Sefadroksil kapsul/kaplet TABLET
500 mg 6,129
Sefadroksil sir kering 250
287 BOTOL
mg/5 mL 48
Sefadroksil sirup kering 125
288 mg/5ml BOTOL
57
Sefazolin serbuk injeksi 1
289 VIAL
g/vial 66
290 Sefepim inj 1 g VIAL 132
Sefiksim kapsul/kaplet 100
291 TABLET
mg 18,810
Sefiksim sirup kering 100
292 BOTOL
mg/ 5 ml 171
Sefoperazon , Na
293 Sulbactam Inj VIAL
2
294 Sefoperazon inj 1 g VIAL 714
295 Sefotaksim injeksi 1 g VIAL 48
296 Sefpirom inj VIAL 138
297 Seftazidim injeksi 1 g VIAL 30
298 Seftizoksim inj 1 gram VIAL 174
299 Seftriakson injeksi 1 g/vial VIAL
5,628
300 Sefuroksim inj VIAL 111
352 Serum antitetanus (A.T.S) VIAL
-
301 Setirizin drop FLAS 27
347 Setirizin sirup 5 mg/5 ml BOTOL
99
302 Setirizin tablet 10 mg TABLET 4,638
303 Sevofluran ih, btl BOTOL -
304 Sildenafil citrate TABLET 78
305 Silostazol TABLET 498
306 Simvastatin tablet 10 mg TABLET
330
307 Simvastatin tablet 20 mg TABLET
6,999
308 Siprofloksasin infus 2% BOTOL 687
 Siprofloksasin tablet 500
309 TABLET
mg 6,000
310 Sitikolin 500 mg tab TABLET 5,160
311 Sitikolin inj 250mg/2ml AMPUL 2,028
312 Sitikolin Inj 500mg/4ml AMPUL 189
313 Spiramisin tablet 500 mg TABLET
48
314 Spironolakton tablet 100 TABLET
mg -
315 Spironolakton tablet 25 mg TABLET
38,499
Streptomisin injeksi i.v
316 1000 mg/ml VIAL
54
Sukralfat susp 500 mg/5
317 BOTOL
mL 375
318 Sukralfat tab 500 mg TABLET -
319 Sulfas Ferrosus TABLET 2,199
320 Sulfasalazine 500mg TABLET 399
321 Tenofovir tab 300 mg TABLET 99
322 Tetrasiklin tablet 500 mg TABLET
120
323 Tramadol injeksi 50 mg/ml AMPUL
183
349 Tramadol tablet TABLET 798
324 Triamsinolon asetonid inj VIAL
40mg -
325 Triheksilfenidil 2 mg TABLET 2,898
326 Vaksin Hepatitis B 1 ml VIAL 9
327 Valasiklovir tablet TABLET -
328 Valproat sirup 250 mg/5 ml BOTOL
126
329 Valsartan tab 160 mg TABLET 30
330 Valsartan tab 80 mg TABLET 4,320
331 Vancomisin inj 500 mg VIAL -
332 Vitamin B Kompleks tablet TABLET
7,899
333 Vitamin B1 TABLET 4,098
350 Vitamin B12 tab TABLET 999
334 Vitamin B6 TABLET 3,399
335 Vitamin C inj AMPUL 99
336 Vitamin C Tab 100 mg TABLET -
337 Vitamin K inj 10 mg/ml AMPUL 300
338 Vitamin K inj 2 mg AMPUL 150
339 Vitamin K tab TABLET 99
340 Warfarin 1 mg tablet TABLET 99
341 Zinc sir 20 mg/5 Ml BOTOL 30
342 Zinc tablet dispersible20 TABLET
mg 198
343
344
345
-MARET TAHUN 2020