Obat Generik

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1 2 3 4 5
Acetyl cysteine/ N-asetil sistein
1 strip/ blister
tablet/kapsul/kaplet 200 mg
Air untuk injeksi/ Aqua pro injeksi/ Aqua pro
2 ampul/vial/botol
injection 10 ml
Air untuk injeksi/ Aqua pro injeksi/ Aqua pro
3 ampul/vial/botol
injection 20 ml
Akarbose/Acarbose tablet/kapsul/kaplet 100
4 strip/blister
mg

5 Akarbose/Acarbose tablet/kapsul/kaplet 50 mg strip/blister

6 Albendazol/ Albendazole tablet/kapsul/kaplet strip/blister

400 mg
7 Alopurinol/Allopurinol tablet/kapsul/kaplet 100 strip/blister
mg
Alopurinol/Allopurinol tablet/kapsul/kaplet 300
8 strip/blister
mg
9 Alprazolam tablet/kapsul/kaplet 0,5 mg strip/blister
10 Alprazolam tablet/kapsul/kaplet 1 mg strip/blister
Amikasin/Amikacin/Amikacin sulfate injeksi
11 vial/ampul
250 mg/ml
12 Aminofilin tablet/kapsul/kaplet 150 mg botol/kaleng maks 100 tablet
13 Aminofilin/Aminophylline inj 24 mg/ml ampul/vial 10 ml
Aminofilin/Aminophylline tablet/kapsul/kaplet strip/blister/maks botol 100
14
200 mg tablet
15 Amiodaron inj 50 mg/ml (150 mg/ 3 mL) ampul/vial
Amitriptilin/Amitriptyline tablet/kapsul/kaplet 25
16 strip/blister
mg
Amlodipin/ Amlodipine/ Amlodipine besilate
17 strip/blister
tablet/kapsul/kaplet 10 mg

18 Amlodipin/ Amlodipine/ Amlodipine besilate strip/blister

tablet/kapsul/kaplet 5 mg
Amoksisilin/Amoxicillin sirup kering 250 mg/5
19 botol 60 ml
ml
Amoksisilin/Amoxicillin tablet/kapsul/kaplet
20 strip/blister
250 mg
Amoksisilin/Amoxicillin/Amoxicillin trihydrate
21 botol @ 10 mL
100 mg/mL drops/ sirup kering
22 Ampisilin/Ampicillin injeksi 1000 mg (i.v) ampul/vial
Anestetik lokal gigi, kombinasi KDT/FDC
23 mengandung: lidokain 2% + epinefrin ampul/vial
1:80.000, inj 2 mL
Antasida, kombinasi: alumunium hidroksida
24 200 mg + magnesium hidroksida 200 mg, botol 60 ml
susp
Antasida, kombinasi: alumunium hidroksida
25 200 mg + magnesium hidroksida 200 mg, tab strip/ blister
kunyah

Antifungi Salep, Kombinasi: Asam Benzoat

26 pot 30 g
6% + Asam Salisilat 3% / Salep Whitfield

Asam asetilsalisilat (asetosal/acetosal) tablet

27 strip/ blister
sal enterik/kaplet salut enterik 100 mg

Asam Folat/folic acid tablet/kapsul/kaplet 0,4

28 strip/ blister
mg

29 Asam folat/folic acid tablet/kapsul/kaplet 1 mg strip/ blister

Asam traneksamat/Tranexamic acid

30 strip/blister
tablet/kapsul/kaplet salut selaput 500 mg
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Asam traneksamat/Tranexamic acid injeksi

31 ampul/vial
100 mg/ml
Asam traneksamat/Tranexamic acid injeksi 50
32 ampul/vial
mg/ml
Asam ursodeoksikolat/Ursodeoxycholic acid
33 strip/ blister
tablet/kapsul/kaplet 250 mg

34 Asiklovir/Acyclovir/Aciclovir strip/ blister

tablet/kapsul/kaplet 200 mg
35 Asiklovir/Acyclovir/Aciclovir strip/ blister
tablet/kapsul/kaplet 400 mg

Atorvastatin/ Atorvastatin Calcium Trihydrate

36 strip/ blister
tablet salut selaput/kaplet salut selaput 10 mg

Atorvastatin/ Atorvastatin Calcium Trihydrate

37 strip/ blister
tablet salut selaputl/kaplet salut selaput 20 mg

38 Atracurium Besilate/ Atracurium Besylate/ ampul/vial @ 5 mL

Atrakurium injeksi 10mg/mL (i.v)
39 Atracurium Besilate/ Atracurium Besylate/ ampul/vial @2,5 mL
Atrakurium injeksi 10mg/mL (i.v)
Azitromisin/Azithromycin dihydrate tablet salut
40 strip/ blister
selaput/kaplet salut selaput 500 mg
41 Azitromisin/Azithromycin serb inj 500 mg ampul/vial
Azitromisin/Azithromycin sir kering 200 mg/ 5
42 botol @ 15 mL
mL
43 Bedak salisil/Bedak salicyl serbuk 2% kotak/plastik
Betahistin/Betahistine Mesilate/Betahistine
44 strip/ blister
Mesylate tablet/kapsul/kaplet 6 mg
Betametason/Betamethasone Valerate krim
45 tube 5 gram
0,1%
Bisakodil/Bisacodyl tablet salut/kaplet salut 5
46 strip/blister
mg
Bisoprolol/Bisoprolol Fumarate tablet salut
47 strip/ blister
selaput/kaplet salut selaput 5 mg
Bisoprolol/Bisoprolol Fumarate
48 strip/ blister
tablet/kapsul/kaplet 2,5 mg
Bupivakain heavy/Bupivakain heavy, injeksi
49 vial/ampul @4 ml
0.5% + glukosa 8%
50 Bupivakain inj 0,5% ampul/vial
Cefadroxil monohydrate/ Cefadroxil/
51 botol @ 60 mL
Sefadroksil sirup kering 125 mg/5ml
Cefadroxil monohydrate/ Cefadroxil/
52 botol @ 60 mL
Sefadroksil sirup kering 250 mg/5ml
Cefadroxil monohydrate/ Cefadroxil/
53 strip/ blister
Sefadroksil tablet/kapsul/kaplet 250 mg
Cefadroxil monohydrate/ Cefadroxil/
54 strip/ blister
Sefadroksil tablet/kapsul/kaplet 500 mg
Cefalexin monohydrate/ Cefalexin/ Sefaleksin
55 strip/ blister
tablet/kapsul/kaplet 500 mg
Cefazolin sodium/ Sefazolin serbuk injeksi
56 ampul/vial
1.000 mg

57 Cefepime/ Cefepime HCl/ Sefepim serbuk ampul/vial

injeksi 1.000 mg
Cefixime trihydrate/ Cefixime/ Sefiksim sirup/
58 botol
sirup kering 100 mg/ 5 ml
Cefixime trihydrate/ Cefixime/ Sefiksim
59 tablet/kapsul/kaplet/tablet salut selaput/kaplet strip/ blister
salut selaput 200
Cefoperazone sodium/Cefoperazone/
60 ampul/vial
Sefoperazon serb inj 1.000 mg
Cefotaxime sodium/ Cefotaxime/ Sefotaksim
61 ampul/vial
serb inj 1.000 mg
Cefotaxime sodium/ Cefotaxime/ Sefotaksim
62 ampul/vial
serb inj 500 mg
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63 Cefpirome/ Sefpirom serb inj 1000 mg ampul/vial

64 Ceftazidime/ Ceftazidime Pentahydrate/ ampul/vial
Seftazidim serb inj 1.000 mg
Ceftriaxone/ Ceftriaxone Sodium/ Seftriakson
65 ampul/vial
inj 1.000 mg.
Cefuroxime sodium/ Cefuroxime/ Sefuroksim
66 ampul/vial
serbuk injeksi 750 mg
Cetirizine hydrochloride(HCl)/ Cetirizine/
67 botol @ 60 mL
Setirizin sirup 5 mg/5 ml
Cetirizine hydrochloride(HCl)/ Cetirizine/
68 strip/ blister
Setirizin tablet/kapsul/kaplet 10 mg

Chloramphenicol/ Chloramphenicol palmitate/

69 botol 60 ml
Kloramfenikol suspensi 125 mg/ 5 ml

Chloramphenicol/ Kloramfenikol salep mata 1

70 tube @ 5 gram
%
Chloramphenicol/ Kloramfenikol
71 strip/ blister
tablet/kapsul/kaplet 250 mg

Clindamycin hydrochloride (HCl)/ Clindamycin/

72 strip/ blister
Klindamisin tablet/kapsul/kaplet 150 mg

Chlorpromazine Hydrochloride/
73 Chlorpromazine / Klorpromazin injeksi 25 ampul/vial
mg/ml ( i.m.)
Ciprofloxacin hydrochloride (HCl)/
74 Ciprofloxacin Lactate/ Ciprofloxacin/ strip/ blister
Siprofloksasin tablet/kapsul/kaplet 500 mg
Ciprofloxacin hydrochloride(HCl)/ Ciprofloxacin
75 Lactate/ Ciprofloxacin/ Siprofloksasin inf 2 vial/ botol 100 ml
mg/ml

76 Clindamycin hydrochloride (HCl)/ Clindamycin/ strip/ blister

Klindamisin tablet/kapsul/kaplet 300 mg
Clobazam/ Klobazam tablet/kapsul/kaplet 10
77 strip/ blister
mg
Clonidine hydrochloride/ Clonidine/ Klonidin
78 strip/ blister
tablet/kapsul/kaplet 0,15 mg
Clopidogrel bisulfate/ Clopidogrel/ Clopidogrel
79 hydrogen sulfate/ Klopidogrel strip/ blister
tablet/kapsul/kaplet 75 mg
Clozapine/ Klozapin tablet/kapsul/kaplet 100
80 strip/ blister
mg

81 Clozapine/ Klozapin tablet/kapsul/kaplet 25 mg strip/ blister

Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol

(anak) kombinasi tiap 5 ml suspensi:
82 botol 60 mL
sulfametoksazol 200 mg + trimetoprim 40 mg
(susp 240 mg)

Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol

83 (dewasa) kombinasi: sulfametoksazol 400 mg strip/ blister
+ trimetoprim 80 mg (tab/kaptab 480 mg)

Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol

84 forte kombinasi: sulfametoksazol 800 mg + strip/ blister
trimetoprim 160 mg (tab/kaptab 960 mg)

Cyanocobalamin/ Cyanocobalamine/
85 Sianokobalamin (vitamin B12) injeksi 500 ampul/vial
mcg/mL
Cyanocobalamin/ Cyanocobalamine/
86 Sianokobalamin (vitamin B12) strip/ blister
tablet/kapsul/kaplet 50 mcg
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Deferipron tab salut selaput/kaplet salut

87 strip/ blister
selaput 500 mg
Deksametason/ Dexamethasone
88 strip/ blister
tablet/kapsul/kaplet 0,5 mg
Desoksimetason/ Desoximetasone krim 0,25%
89 tube 15 g
(2,5 mg/g)
Desoksimetason/ Desoximetasone salep
90 tube
0,25%
Dexamethason Sodium Phosphate/
91 Deksamethason/ Deksametason injeksi 5 ampul/vial
mg/mL
92 Diazepam injeksi 5 mg/ ml ampul/vial
strip/ blister/ maks botol 100
93 Diazepam tablet/kapsul/kaplet 2 mg
tablet
94 Diazepam tablet/kapsul/kaplet 5 mg strip/ blister

Diclofenac sodium/ Natrium diklofenak tablet

95 strip/ blister
salut enterik/kaplet salut enterik 50 mg

Diclofenac sodium/ Natrium diklofenak tablet

96 strip/ blister
salut enterikl/kaplet salut enterik 25 mg

Dietilkarbamazin/ Diethylcarbamazine
97 strip/ blister
tablet/kapsul/kaplet 100 mg
Difenhidramin/ Diphenhydramine injeksi 10
98 ampul/vial
mg/ml ( i.v./i.m.)

99 Digoksin/ Digoxin tablet/kapsul/kaplet 0,25 mg strip/ blister

Diltiazem/ Diltiazem HCl tablet/kapsul/kaplet

100 strip/ blister
30 mg
strip/ blister/ maks botol 100
101 Dimenhidrinat/ Dimenhydrinate
tablet/kapsul/kaplet 50 mg tablet
Divalproex sodium / Valproat tabet lepas
102 strip/blister/botol
lambat/kaplet lepas lambat 250 mg
Divalproex sodium / Valproat tablet salut strip/blister/maks botol 100
103
enterik/ kaplet salut enterik 250 mg tablet
Dobutamin/ Dobutamin HCl/ Dobutamine HCl
104 ampul/vial
injeksi 50 mg/mL
Doksisiklin/ Doxycycline/ Doxycycline hyclate
105 strip/blister
tablet/kapsul/kaplet 100 mg
Domperidon/ Domperidone maleate/
106 botol
Domperidone drops 5 mg/mL
Domperidon/ Domperidone maleate/
107 botol @60 ml
Domperidone sirup/suspensi 5 mg/5 ml
Domperidon/ Domperidone/ Domperidone
108 strip/ blister
Maleate tablet/kapsul/kaplet 10 mg
Donepezil/ Donepezil HCl tablet salut
109 strip/ blister
selaput/kaplet salut selaput 5 mg
Dopamin / Dopamine hidrochloride injeksi 40
110 ampul/vial
mg/ml
111 Efedrin/ Ephedrine HCl Inj 50 mg/ml ampul/vial
Epinefrin/ Epinephrine (Adrenalin) injeksi 1
112 ampul/vial
mg/mL
Eritromisin/ Erythromycin/ Erythromycin Ethyl
113 botol @60 mL
Succinate sirup kering 200 mg/ 5 ml
Eritromisin/ Erythromycin/ Erythromycin
114 strip/ blister
stearate tablet/kapsul/kaplet 250 mg
Eritromisin/ Erythromycin/ Erythromycin
115 strip/ blister
stearate tablet/kapsul/kaplet 500 mg
Esomeprazole Sodium/ Esomeprazol serbuk
116 ampul/vial
Inj. 40 mg (i.v)
Fenitoin/ Phenytoin Sodium Injeksi 50 mg/ml
117 ampul @ 2 ml
(100 mg/ 2 mL)
Fenitoin/ Phenytoin/ Phenytoin sodium kapsul strip/ blister/ maks botol 100
118
100 mg tablet
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119 Fenofibrat tablet/kapsul/kaplet 100 mg strip/ blister

120 Fenofibrat tablet/kapsul/kaplet 300 mg strip/ blister
121 Fentanil/ Fentanyl injeksi 0,05 mg/ml (i.m/i.v) ampul @ 2 mL

122 Fentanil/ Fentanyl injeksi 0,05 mg/ml (i.m/i.v) ampul/vial, @ 10 mL

Fitomenadion/ Phytomenadion (Vitamin K1)

123 strip/ blister
tablet/kapsul/kaplet 10 mg
Fitomenadion/ Phytomenadione/
124 Phytomenadion (Vitamin K1) injeksi 2 mg/ml ampul/vial
(i.m.)
125 Flukonazol/ Fluconazole injeksi/ infus 2 mg/ml ampul/vial/botol

Fluoksetin/Fluoxetine HCl tablet/kapsul/kaplet

126 strip/ blister
20 mg

127 Furosemid/ Furosemide inj 10 mg/mL (i.v./i.m) ampul/vial

Furosemid/ Furosemide tablet/kapsul/kaplet

128 strip/ blister
40 mg
129 Gabapentin tablet/kapsul/kaplet 300 mg strip/ blister

Garam Oralit kombinasi: Natrium klorida 0,52

130 g + kalium klorida 0,30 g + Trinatrium sitrat sachet
dihidrat 0,58 g + Glukosa Anhidrat 2,70 g, serb

131 Gemfibrozil tablet/kapsul/kaplet 300 mg strip/ blister

Gentamisin/ Gentamycin sulfate salep mata
132 tube
0,3% (3 mg/g)
Gentamisin/ Gentamycin/ Gentamycin sulfate
133 botol 5 mL
tetes mata 0,3%
Glibenklamid/ Glibenclamide
134 strip/ blister
tablet/kapsul/kaplet 5 mg

135 strip/blister
Gliklazid/ Gliclazide tablet/kapsul/kaplet 80 mg
Glimepiride/ Glimepirid tablet/kapsul/kaplet 1
136 strip/ blister
mg
Glimepiride/ Glimepirid tablet/kapsul/kaplet 2
137 strip/ blister
mg
Glimepiride/ Glimepirid tablet/kapsul/kaplet 3
138 strip/ blister
mg
Glimepiride/ Glimepirid tablet/kapsul/kaplet 4
139 strip/ blister
mg
Griseofulvin (micronized) tablet/kapsul/kaplet
140 strip/ blister
125 mg
Griseofulvin (micronized) tablet/kapsul/kaplet
141 strip/ blister
500 mg
142 Haloperidol tablet/kapsul/kaplet 0,5 mg strip/ blister
143 Haloperidol tablet/kapsul/kaplet 1,5 mg strip/ blister
144 Haloperidol tablet/kapsul/kaplet 5 mg strip/ blister
145 Hidrokortison/ Hydrocortisone krim 1% tube @ 5 g
Hidrokortison/ Hydrocortisone/ Hydrocortisone
146 tube @ 5 g
acetate krim 2,5 %
Hidroksi klorokuin/ Hydroxychloroquine sulfate
147 strip/blister
tablet 200 mg
Hiosin butilbromid/Hyoscine
148 butylbromide/Hyoscine N Butylbromide inj 20 ampul/vial
mg/ml
149 Ibuprofen suspensi 100 mg/5 ml maks botol @ 60 ml
150 Ibuprofen suspensi 200 mg/ 5ml maks botol @ 60 ml
151 Ibuprofen tablet/kapsul/kaplet 200 mg strip/ blister
152 Ibuprofen tablet/kapsul/kaplet 400 mg strip/ blister
Ioheksol inj 140-350 mg iodium/ml
153 ampul/vial/botol
(350mg/50ml)
Ioheksol inj 180-300 mg iodium/ml
154 ampul/vial/botol
(300mg/50ml)
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155 Irbesartan tablet/kapsul/kaplet 150 mg strip/ blister

156 Irbesartan tablet/kapsul/kaplet 300 mg strip/ blister
157 Isofluran/ isoflurane inhalasi botol @ 100 mL
158 Isofluran/ isoflurane inhalasi botol @ 250 mL
159 Isosorbid dinitrat inj 1 mg/mL ampul/vial
Isosorbid Dinitrat/ Isosorbide dinitrate
160 strip/ blister
tablet/kaplet 5 mg
Isosorbid dinitrat/ Isosorbide dinitrate
161 strip/blister
tablet/kapsul/kaplet 10 mg
strip/ blister/maks botol 100
162 Kalsitriol kapsul lunak 0,25 mcg
kaps
Kalsium folinat/ Calsium folinate (leukovorin,
163 ampul/vial
Ca) injeksi 10 mg/mL

164 Kalsium glukonat/ Calcium gluconate inj 10% ampul/vial

165 Kalsium Karbonat tablet/kapsul/kaplet 500 mg strip/ blister

Kalsium Laktat/ Calcium lactate (Kalk)

166 strip/ blister
tablet/kapsul/kaplet 500 mg
Kalsium polistirena sulfonat / Calcium
167 sachet
Polystyrene Sulfonate serb 5 g
Kandesartan/ Candesartan/ Candesartan
168 strip/ blister
Cilexetil tablet/kapsul/kaplet 16 mg
Kandesartan/ Candesartan/ Candesartan
169 strip/ blister
Cilexetil tablet/kapsul/kaplet 8 mg
Kaptopril/ Captopril tablet/kapsul/kaplet 12,5
170 strip/ blister
mg

171 Kaptopril/ Captopril tablet/kapsul/kaplet 50 mg strip/ blister

172 Karbamazepin tablet/kapsul/kaplet 200 mg strip/ blister
Ketamin/Ketamine Hydrochloride injeksi 100
173 ampul/vial
mg/mL ( i.v.)
Ketamin/Ketamine Hydrochloride injeksi 50
174 ampul/vial
mg/mL ( i.v.)
175 Ketokonazol/ Ketoconazole krim 2% tube 10 gr
Ketokonazol/ Ketoconazole
176 strip/ blister
tablet/kapsul/kaplet 200 mg
177 Ketoprofen inj 50 mg/mL ampul/vial

Ketorolak/ Ketorolac / Ketorolac trometamol/

178 ampul/vial
Ketorolac tromethamine inj 30 mg/ml (3%)

179 Klobetasol propionat krim 0,05% tube

180 Klorokuin tablet/kaplet 250 mg strip/blister
Klorpromazin/Chlorpromazine
181 Hydrochloride/Chlorpromazine tablet salut strip/blister
selaput/kaplet salut selaput 100 mg
Kolkisin/ colchicine tablet/ kapsul/ kaplet/ 500
182 strip/blister
mcg
Kombinasi: sefoperazon/ cefoperazone
183 sodium 500 mg + sulbaktam/ sulbactam ampul/vial
sodium 500 mg, serb inj 1.000 mg
184 Lactulose/ Laktulosa sir 3,335 g/5 mL botol @ 60 mL
Lansoprazole/ Lansoprazol
185 strip/ blister
tablet/kapsul/kaplet 30 mg
Levofloxacin hemihydrate/ Levofloxacin/
186 vial/ botol/ flexy bag @ 100 ml
Levofloksasin inf 5 mg/mL
Levofloxacin hemihydrate/
Levofloxacin/Levofloksasin tablet salut
187 strip/ blister
selaput/kaplet salut selaput/ kaptab salut
selaput 500 mg
Lidocaine Hydrochloride/ Lidocaine/ Lidocain/
188 ampul/vial
Lidokain injeksi 2%
Lisinopril dihydrate/ Lisinopril/ Lisinopril
189 strip/ blister
tablet/kapsul/kaplet 10 mg
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Lisinopril dihydrate/ Lisinopril/ Lisinopril

190 strip/ blister
tablet/kapsul/kaplet 5 mg
Loratadine/ Loratadin tablet/kapsul/kaplet 10
191 strip/ blister
mg
192 Lorazepam tablet/kapsul/kaplet 2 mg strip/ blister
193 Manitol inf 20% (100 mL) botol @ 100 mL
194 Manitol inf 20% (500 mL) botol @ 500 mL
195 Meropenem serb inj 500 mg ampul/vial
196 Meropenem/ Meropenem Trihydrate serb inj ampul/vial
1.000 mg
Metformin Hydrochloride/ Metformin
197 strip/ blister
tablet/kapsul/kaplet 500 mg
Metformin Hydrochloride/ Metformin
198 strip/ blister
tablet/kapsul/kaplet 850 mg
Methylergometrine Maleate/
199 Methylergometrine/ Metilergometrin inj 0,2 ampul/vial
mg/ml
Methylergometrine Maleate/
200 Methylergometrine/ Metilergometrin strip/ blister
tablet/kapsul/kaplet 0,125 mg
Methylprednisolone Sodium Succinate/
201 Metilprednisolon/ Methylprednisolone inj 125 ampul/vial
mg
Methylprednisolone Sodium Succinate/
202 Metilprednisolon/ Methylprednisolone inj 500 ampul/vial
mg
Metilprednisolon/Methylprednisolone
203 strip/ blister
tablet/kapsul/kaplet 16 mg
Metilprednisolon/Methylprednisolone
204 strip/ blister
tablet/kapsul/kaplet 4 mg
Metilprednisolon/Methylprednisolone
205 strip/ blister
tablet/kapsul/kaplet 8 mg
Metoclopramide hydrochloride (HCl)/
Metoclopramide/
206 ampul/vial
Metoklopramid inj 5 mg/mL

Metoclopramide hydrochloride (HCl)/

207 botol @ 10mL
Metoclopramide/ Metoklopramid drop 2 mg/mL

Metoclopramide hydrochloride (HCl)/

208 Metoclopramide/ Metoklopramid strip/ blister
tablet/kapsul/kaplet 10 mg
209 Metronidazole/ Metronidazol infus 5 mg/ ml botol
Metronidazole/Metronidazol suspensi 125
210 botol 60 mL atau 100 mL
mg/5 mL
Metronidazole/Metronidazol
211 strip/ blister
tablet/kapsul/kaplet 250 mg
Metronidazole/Metronidazol
212 strip/ blister
tablet/kapsul/kaplet 500 mg
Miconazole nitrate/ Miconazole/ Mikonazol
213 tube
krim 2 %
Mometasone furoate/ Mometason furoat krim
214 tube 10 gram
0,1%
Mometasone furoate/ Mometason furoat krim
215 tube 5 gram
0,1%
Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/
216 Moksifloksasin infus 1,6 mg/mL vial/ampul/botol/softbag
(400mg/250ml)
Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/
217 Moksifloksasin tablet salut selaput/kaplet salut strip/ blister
selaput 400 mg
218 Mupirosin krim 2% tube
Naloxone hydrochloride/ Naloxone/ Nalokson
219 ampul/vial
injeksi 0,4 mg/ml
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Nicardipine hydrochloride (HCl)/ Nicardipine/

220 ampul/vial
Nikardipin inj 1 mg/mL

221 Nifedipine/ Nifedipin tablet/kapsul/kaplet 10 mg strip/ blister

Nimodipin/ Nimodipine Infus 0,2 mg/ml

222 ampul/vial/botol
(0,02%)
223 Nistatin/Nystatin suspensi 100.000 IU/mL botol/vial

Norepinephrine bitartate/ Norepinephrine

224 bitartate monohydrate / Norepinephrine/ ampul/vial
Norepinephrine base/ Norepinefrin inj 1 mg/ml

Nystatin/ Nistatin tablet/kapsul/kaplet 500.000

225 strip/blister
IU
226 Obat Anti Tuberculosis FDC Kategori Anak paket
227 Obat Anti Tuberculosis FDC Kategori I paket
228 Obat Anti Tuberculosis FDC Kategori II paket
229 Obat Anti Tuberculosis FDC Kategori Sisipan paket

230 Obat Anti Tuberculosis Kombipak Kategori 1 paket

231 Ofloxacin/ Ofloksasin tablet salut selaput/ strip/ blister

kaplet salut selaput 200 mg
232 Ofloxacin/ Ofloksasin tablet salut selaput/ strip/ blister
kaplet salut selaput 400 mg
233 tube
Oksitetrasiklin/ Oxytetracycline salep mata 1%
Olanzapine/ Olanzapin tablet salut selaput/
234 strip/blister
kaplet salut selaput 10 mg.
Olanzapine/ Olanzapin tablet salut selaput/
235 strip/blister
kaplet salut selaput 5 mg.
Omeprazol/Omeprazole tablet/kapsul/kaplet
236 strip/ blister
20 mg

237 Omeprazol/Omeprazole/ Omeoprazole ampul/vial

Sodium serb injeksi 40 mg
Ondansetron hydrochloride (HCl)/
238 Ondansetron HCl dihydrate /Ondansetron inj 2 ampul/vial
mg/mL
Ondansetron hydrochloride (HCl)/
239 Ondansetron HCl dihydrate /Ondansetron strip/ blister
tablet/kapsul/kaplet 4 mg
Ondansetron hydrochloride (HCl)/
240 Ondansetron HCl dihydrate /Ondansetron strip/ blister
tablet/kapsul/kaplet 8 mg
241 Oxytocin/ Oksitosin inj 10 IU/ml ampul/vial
Paracetamol/ Parasetamol drops 100 mg/ml
242 botol @ 15 mL
(60mg/0,6ml)

243 Paracetamol/ Parasetamol infus 10 mg/mL vial/ flexybag/botol @ 100 ml

244 Paracetamol/ Parasetamol sirup 120 mg / 5 ml botol @ 60 mL

245 Pioglitazone/ pioglitazone hydrochloride (HCl)/ strip/ blister

pioglitazon tablet 15 mg

Pioglitazone/ pioglitazone hydrochloride (HCl)/

246 strip/ blister
Pioglitazon tablet/kapsul/kaplet 30 mg

Pirantel pamoat/ Pyrantel Pamoate

247 strip/ blister
tablet/kapsul/kaplet 125 mg
Pirazinamid/Pyrazinamide tablet/kapsul/kaplet
248 strip/blister
500 mg
249 Povidon iodin lar 100 mg/mL botol @ 30 mL
250 Povidon iodin lar 100 mg/mL botol @ 60 mL
251 Povidon iodin lar 100 mg/mL botol @ 1.000 mL
Pravastatin sodium/ Pravastatin
252 strip/ blister
tablet/kapsul/kaplet 20 mg
 Kemasan Yang
No Nama Zat Aktif (Generik) Industri Farmasi Kemasan Sesuai NIE
Dipersyaratkan

Prednison/Prednisone tablet/kapsul/kaplet 5
253 strip/ blister
mg

Procainebenzylpenicillin/ Prokain
254 ampul/vial
Benzilpenisilin serbuk injeksi 3 juta IU (i.m)

255 Propofol injeksi 1% ampul/vial

Propranolol hydrochloride (HCl)/ Propranolol
256 strip/ blister
tablet/kapsul/kaplet 10 mg
Propranolol hydrochloride (HCl)/ Propranolol
257 strip/ blister
tablet/kapsul/kaplet 40 mg
Propylthiouracil/ Propiltiourasil
258 strip/ blister
tablet/kapsul/kaplet 100 mg
Pyridoxine/ Piridoksin (Vitamin B6)
259 strip/ blister
tablet/kapsul/kaplet 10 mg
260 Ramipril tablet/kapsul/kaplet 5 mg strip/ blister
Ranitidine hydrochloride (HCl)/ Ranitidin
261 ampul/vial
injeksi 25 mg/ml
Ranitidine hydrochloride (HCl)/Ranitidin
262 strip/ blister
tablet/kapsul/kaplet 150 mg

Retinol acetate/ Retinol (vitamin A)/ Vitamin A

263 botol
palmitate kapsul lunak 100.000 IU

Retinol acetate/ Retinol (vitamin A)/ Vitamin A

264 botol
palmitate kapsul lunak 200.000 IU

Rifampicin/ Rifampisin tablet/kapsul/kaplet 450

265 strip/ blister
mg
Rifampicin/ Rifampisin tablet/kapsul/kaplet 600
266 strip/ blister
mg
Risperidone/ Risperidon tablet/kapsul/kaplet 1
267 strip/blister
mg
Risperidone/ Risperidon tablet/kapsul/kaplet 2
268 strip/ blister
mg
Risperidone/ Risperidon tablet/kapsul/kaplet 3
269 strip/blister
mg
Rocuronium bromide/ Rokuronium inj 10
270 ampul/vial
mg/ml (i.v.)
Rosuvastatin calcium/ Rosuvastatin
271 strip/ blister
tablet/kapsul/kaplet 10 mg
Salbutamol sulfate/ Salbutamol
272 strip/ blister
tablet/kapsul/kaplet 2 mg
Salbutamol sulfate/ Salbutamol
273 strip/ blister
tablet/kapsul/kaplet 4 mg

274 Salbutamol/ Salbutamol Sulfate cairan ih 1 ampul/vial/botol

mg/mL
Salep 2-4, kombinasi: asam salisilat 2% +
275 pot 30 gram
belerang edap 4%, salep
Salep 2-4, kombinasi: asam salisilat 2% +
276 pot 15 gram
belerang edap 4%, salep
Sertraline hydrochloride (HCl)/ Sertraline/
277 strip/ blister
Sertralin tablet salut/kaplet salut 50 mg
278 Sevoflurane/ Sevofluran ih botol
279 Simvastatin tablet/kapsul/kaplet/tablet salut strip/ blister
selaput/kaplet salut selaput 10 mg
Simvastatin tablet/kapsul/kaplet/tablet salut
280 strip/ blister
selaput/kaplet salut selaput 20 mg
Sodium bicarbonate/ Natrium Bikarbonat
281 strip/ blister/maks botol 100 tab
tablet/kapsul/kaplet 500 mg
Sodium fusidate/ Natrium fusidat krim 2% (20
282 tube
mg/g)

283 Sodium Valproate/ Valproat/ Valproic acid maks botol @ 120 ml

sirup 250 mg/5 ml
 Kemasan Yang
No Nama Zat Aktif (Generik) Industri Farmasi Kemasan Sesuai NIE
Dipersyaratkan

Spiramycin/ Spiramisin tablet salut

284 selaput/kaplet salut selaput/kaptab salut strip/ blister
selaput 500 mg
Spironolactone/ Spironolakton
285 strip/ blister
tablet/kapsul/kaplet 100 mg
Spironolactone/ Spironolakton
286 strip/ blister
tablet/kapsul/kaplet 25 mg
Streptomycin sulfate/ Streptomycin/
287 ampul/vial
Streptomisin serbuk inj 1000 mg
288 Sucralfate/ Sukralfat susp 500 mg/5 mL botol

289 Sucralfate/ Sukralfat tablet/kapsul/kaplet 500 strip/ blister

mg
Sulfadiazine/ Sulfadiazin tablet/kapsul/kaplet
290 strip/ blister
500 mg
291 Telmisartan tablet/kapsul/kaplet 40 mg strip/ blister
292 Telmisartan tablet/kapsul/kaplet 80 mg strip/blister
Tenofovir Disoproxil Fumarate/ Tenofovir
293 tablet/kapsul/kaplet 300 mg (untuk ARV dan strip/blister/botol
Hepatitis)
Tetrasiklin/ Tetracycline/ Tetracycline
294 strip/ blister
Hydrochloride tablet/kapsul/kaplet 250 mg
Tetrasiklin/ Tetracycline/ Tetracycline
295 strip/ blister
Hydrochloride tablet/kapsul/kaplet 500 mg

296 Tiamin (Vitamin B1) tablet/kapsul/kaplet 50 mg strip/ blister

Trifluoperazine hydrochloride (HCl)/

297 Trifluoperazin tablet salut selaput/kaplet salut strip/ blister
selaput 5 mg
Trihexyphenidyl hydrochloride (HCl)/
298 strip/blister
Triheksifenidil tablet/kapsul/kaplet 2 mg

Valaciclovir hydrochloride (HCl)/ Valasiklovir

299 strip/ blister
tablet/kapsul/kaplet 500 mg

300 Valsartan tablet/kapsul/kaplet 160 mg strip/ blister

301 Valsartan tablet/kapsul/kaplet 80 mg strip/ blister
302 Vancomycin hydrochloride (HCl)/ Vankomisin ampul/vial
injeksi 500 mg
303 strip/ blister
Vitamin B Kompleks/ Vitamin B complex tablet

Warfarin sodium/ Warfarin sodium clathrate/

304 strip/blister
Warfarin tablet/kapsul/kaplet 2 mg

Zinc sulfate/ Zinc sulfate monohydrate/ Zinc/

305 botol
Zink sir 20 mg/5 ml

Zinc sulfate/ Zinc sulfate monohydrate/Zinc/

306 strip/ blister
Zinc tablet dispersible 20 mg
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)

6 7 8 9 10
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
Obat Nama Dagang
Catatan: Apabila ada industri farmasi yang telah memiliki NIE generik maka silahkan diisi pada kolom 11 "telah memiliki NIE generik"

Nama Produk
No Nama Zat Aktif (Generik) Kemasan yang Dipersyaratkan Industri Farmasi Kemasan Sesuai NIE
(Apabila Nama Dagang)

1 2 3 4 5 6
1 Air untuk irigasi inf botol @ 1.000 mL
2 Air untuk irigasi inf botol @ 500 mL
3 Anastrozol tablet salut selaput/kaplet salut selaput 1 mg strip/blister
4 Aripiprazol oral solution 1 mg/ml botol
5 Aripiprazol tab 5 mg strip/blister
6 Asam Asetilsalisilat (asetosal) tablet/kapsul/kaplet 80 mg strip/blister
7 Asam Mefenamat/Mefenamic acid tablet/kapsul/kaplet 250 mg strip/blister
8 Asam Pipemidat tablet/kapsul/kaplet 400 mg strip/blister
9 Asetazolamid tablet/kapsul/kaplet 250 mg strip/blister
10 Asiklovir salep mata 3% tube
11 Atapulgit tablet/kapsul/kaplet 600 mg strip/blister
12 Atapulgit tablet/kapsul/kaplet 630 mg strip/blister
13 Azitromisin/Azithromycin tablet/kaplet/kapsul 250 mg strip/blister
14 Betaksolol tts mata 0,5% botol @ 5 mL
15 Betametason tetes mata 1 mg/ml botol
16 Bikalutamid tablet salut/kaplet salut 150 mg strip/blister
17 Bikalutamid tablet salut/kaplet salut 50 mg strip/blister
18 Bisakodil suppositoria 10 mg strip
19 Bisakodil suppositoria 5 mg strip
20 Chloramphenicol/ Kloramfenikol inj 1000 mg vial/ampul
21 Chloramphenicol/ Kloramfenikol salep 2% tube 15g
22 Deksmedetomidin inj 100 mcg/mL ampul/vial
23 Diazepam enema 10 mg/2,5 mL tube @ 2,5 mL
24 Diazepam enema 5 mg/2,5 mL tube @ 2,5 mL
25 Diclofenac sodium/ Natrium diklofenak tetes mata 1 mg/ml botol 5 mL

Doksisiklin/ Doxycycline/ Doxycycline hyclate

26 strip/blister
tablet/kapsul/kaplet 50 mg
27 Erlotinib tablet salut selaput/kaplet salut selaput 100 mg strip/blister
28 Erlotinib tablet salut selaput/kaplet salut selaput 150 mg strip/blister
29 Flukonazol/ Fluconazole tablet/kapsul/kaplet 50 mg strip/ blister
30 Fluoksetin tablet/kapsul/kaplet 10 mg strip/ blister
31 Fluorometolon tetes mata 0,1% botol
32 Flusinolon asetonid krim 0,025% tube @ 5g
Fondaparinuks inj 2,5 mg/0,5 mL (untuk tromboemboli dan
33 ampul/vial/prefilled syringe
sindrom koroner akut)
34 Gabapentin tablet/kapsul/kaplet 100 mg strip/ blister
35 Gefitinib tablet/kapsul/kaplet 250 mg strip/blister
36 Haloperidol drops 2 mg/mL botol
37 Haloperidol tablet/kapsul/kaplet 2 mg strip/ blister
Imatinib mesilat tablet/kapsul/kaplet 100 mg (untuk LGK/CML
38 strip/blister
dan LLA/ALL, GIST)
Imatinib mesilat tablet/kapsul/kaplet 400 mg (untuk LGK/CML
39 strip/blister
dan LLA/ALL, GIST)
40 Iodiksanol inj 320 mg Iodium/mL (@ 50 mL) ampul/vial/botol
41 Ioheksol inj 140-350 mg Iodium/ml (350mg/100ml) ampul/vial/botol
42 Ioheksol inj 180-300 mg Iodium/ml (300mg/100ml) ampul/vial/botol
43 Ioheksol inj 180-300 mg Iodium/ml (300mg/20ml) ampul/vial/botol
44 Kapesitabin/ Capecitabine tab salut/kaplet salut 500 mg strip/ blister
45 Karvedilol tablet/kapsul/kaplet 25 mg strip/ blister
46 Ketokonazol scalp sol 2% botol
47 Ketoprofen supositoria 100 mg strip
48 Klaritromisin sir kering 125 mg/5 ml botol maks 60 mL
49 Kloramfenikol tts mata 0,5% botol
Kombinasi (DHP): dihidroartemisinin 40 mg + Piperakuin 320
50 strip/ blister
mg tablet/kapsul/kaplet
Kombinasi KDT/FDC mengandung: benserazid 25 mg +
51 strip/blister
levodopa 100 mg, tablet/kapsul/kaplet
Kombinasi KDT/FDC mengandung: parafin + gliserin +
52 botol @ 60 mL
fenolftalein, susp
Kombinasi: Ampisilin 1000 mg + Sulbaktam 500 mg serb inj
53 ampul/vial
1500 mg
Kombinasi: Ampisilin 500 mg + Sulbaktam 250 mg serb inj
54 ampul/vial
750 mg
Kombinasi: ipratropium bromida 0,5 mg + salbutamol 2,5 mg,
55 ampul/vial
cairan ih

56 Kombinasi: Salmeterol 25 mcg + Flutikason propionat 50 mcg aerosol can/canister

57 Lamotrigine/ Lamotrigin tablet/kapsul/kaplet 50 mg strip/blister
58 Letrozole/ Letrozol tablet/kapsul/kaplet 2,5 mg strip/blister
59 Leuprorelin asetat serb inj 3,75 mg ampul/vial
Levofloxacin hemihydrate/ Levofloxacin/Levofloksasin tts mata
60 botol @ 5mL
0,5%

61 Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain gel 2% syringe/syringe plastik

Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain spray

62 botol
topikal 10%
63 Lorazepam tablet/kapsul/kaplet 0,5 mg strip/blister
64 Lorazepam tablet/kapsul/kaplet 1 mg strip/blister
 Nama Produk
No Nama Zat Aktif (Generik) Kemasan yang Dipersyaratkan Industri Farmasi Kemasan Sesuai NIE
(Apabila Nama Dagang)

Magnesium sulfate/ Magnesium sulfate heptahydrate/

65 ampul/vial/botol
Magnesium sulfat injeksi 20%v (i.v.)
Magnesium sulfate/ Magnesium sulfate heptahydrate/
66 ampul/vial/botol
Magnesium sulfat injeksi 40%v (i.v.)
67 Mebendazole/ Mebendazol tablet/kapsul/kaplet 500 mg strip/blister
Medroxyprogesterone Acetate/ Medroksi Progesteron asetat
68 strip/blister
tablet/kapsul/kaplet 10 mg

Medroxyprogesterone Acetate/ Medroksi Progesteron Asetat

69 strip/blister
tablet/kapsul/kaplet 100 mg

70 Metronidazole/ Metronidazol suppositoria 500 mg strip

71 Miconazole nitrate/ Miconazole/ Mikonazol serbuk 2% botol / sachet

72 Mikofenolat mofetil tablet/kapsul/kaplet 500 mg strip/blister

Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/ Moksifloksasin

73 botol
tts mata 0,5%

74 Natamycin/ Natamisin tts mata 5% (50 mg/ml) botol @ 15 mL

75 Natamycin/ Natamisin tts mata 5% (50 mg/ml) catchcover, botol @ 0,6 mL

76 Natrium diklofenak inj 25 mg/mL ampul/vial

77 Natrium fosfat lar oral 45 mL botol

78 Natrium hialuronat tetes mata botol

79 Norethisterone/ Noretisteron tablet/kapsul/kaplet 5 mg strip/ blister
80 Ofloxacin/ Ofloksasin tets telinga 3% Botol @ 5 mL
Olopatadine hydrochloride (HCl)/ Olopatadine/ Olopatadin tts
81 botol
mata 0,1%
82 Oxymetazoline/ Oksimetazolin tetes hidung 0,025% botol @ 10 mL
83 Oxymetazoline/ Oksimetazolin tetes hidung 0,050% botol @ 10 mL
84 Quetiapine fumarate/ Quetiapin tablet SR/kaplet SR 200 mg strip/ blister

Risedronat / Risedronate Sodium Hemipentahydrate /

85 Risedronate sodium tablet salut selaput / kaplet salut selaput strip/ blister
35 mg

86 Ropivacaine hydrochloride (HCl)/ Ropivakain inj 7,5 mg/ml ampul/polyamp/vial

87 Salbutamol/ Salbutamol Sulphate MDI/aerosol 100mcg/dosis canister / botol

88 Sofosbuvir tablet salut selaput / kaplet salut selaput 400 mg strip/blister/botol

89 Temozolomide/ Temozolamid tablet/kapsul/kaplet 100 mg sachet/botol

90 Temozolomide/ Temozolamid tablet/kapsul/kaplet 20 mg sachet/botol
91 Terbutaline sulfate/ Terbutalin injeksi 0,5 mg/ml (s.k./i.v.) ampul/vial
92 Terbutaline sulfate/ Terbutalin sir 1,5 mg/5 mL botol
93 Terbutaline sulfate/ Terbutalin tablet/kapsul/kaplet 2,5 mg strip/ blister
94 Timolol maleate/ Timolol tetes mata 0,25% botol @ 5 mL
95 Timolol maleate/ Timolol tetes mata 0,5% botol @ 5 mL
96 Tobramisin tts mata 0,3% botol @ 5 mL
97 Topiramate/ Topiramat tablet/kapsul/kaplet 25 mg strip/blister
98 Topiramate/ Topiramat tablet/kapsul/kaplet 50 mg strip/blister
99 Tretinoin/ Asam Retinoat krim 0,1 % tube @ 10 gram
100 Tretinoin/ Asam Retinoat krim 0,1 % tube @ 20 gram
101 Triamcinolone acetonide/ Triamsinolon asetonid inj 40 mg/mL ampul/vial
102 Tropikamid tts mata 0,5% botol @ 5 mL
103 Urea krim 10 % pot
104 Urea krim 20% tube
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
7 8 9 10 11
 Harga Reguler Per
Keterangan Lainnya
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE Satuan Terkecil
(Jika ada)
(HNA + PPN)
Obat dengan 1 Penyedia Pemilik NIE
Catatan: Apabila ada industri farmasi yang telah memiliki NIE generik maka silahkan diisi pada kolom 10

No Nama Zat Aktif (Generik)

1 2

1 Adefovir Dipivoksil tablet/kapsul/kaplet 10 mg

2 Afatinib tablet salut selaput/kaplet salut selaput 20 mg

3 Afatinib tablet salut selaput/kaplet salut selaput 30 mg

4 Afatinib tablet salut selaput/kaplet salut selaput 40 mg

5 Air untuk injeksi, cairan inj 25 mL

6 Albendazol susp 200mg/5 ml

7 Alendronat tablet/kapsul/kaplet 70 mg

8 Alprazolam tablet/kapsul/kaplet 0,25 mg (G)

9 Alteplase serb inj 50mg/ Alteplase 50mg/vial

10 Amfoterisin B salep mata 1%

11 Amiodaron tablet/kapsul/kaplet 200 mg

12 Ampisilin injeksi 250 mg (i.m/i.v)

Anti Bakteri salep kombinasi: Basitrasin 500 IU/g + Polimiksin 10.000
13
IU/g
Antihemoroid, kombinasi sup :_x000D_
bismut subgalat _x000D_
14 heksaklorofen _x000D_
lidokain _x000D_
seng oksida
15 Aripiprazol tablet dispersible 10 mg (G)
16 Aripiprazol/ Aripiprazole tablet dispersible 15 mg (G)
17 Artesunat inj 60 mg
18 Asam Fusidat tetes mata 1%
19 Asam Zoledronat/Zoledronic acid inf 4mg/100 ml
20 Atapulgit tablet/kapsul/kaplet 650 mg
21 Atenolol tablet/kapsul/kaplet 100 mg
22 Atenolol tablet/kapsul/kaplet 50 mg
23 Atropin inj 0,25 mg/mL (i.v./s.k.) (G)
24 Atropin tab 0,5 mg (G)
25 Atropine sulfate/ Atropine/ Atropin tetes mata 0,5%
26 Atropine sulfate/ Atropine/ Atropin tetes mata 1%
27 Azatioprin tablet salut selaput/kaplet salut selaput 50 mg
28 Bedakuilin fumarat tab 100 mg
29 Benzatin benzilpenisilin inj 1,2 juta IU/mL (G)
30 Beraprost sodium tablet/kapsul/kaplet 20 mcg
31 Betahistin/ Betahistine Hydrochloride tab 24 mg (G)
32 Betaksolol tts mata 0,5%, catchcover, botol 0,6 mL
No Nama Zat Aktif (Generik)

33 Betamethasone Dipropionate/ Betametason krim 0,05% (0,5mg/g) (G)

34 Bisoprolol tablet/kapsul/kaplet 1,25 mg
35 Bisoprolol tablet/kapsul/kaplet 10 mg
36 Brinzolamid tetes mata 1%
37 Bromokriptin tablet/kapsul/kaplet 2,5 mg
38 Budesonid cairan ih 0,25 mg/mL (G) **)
39 Budesonid cairan ih 0,5 mg/mL (G) **)
40 Budesonid cairan inhalasi 0,25mg/mL, respoules 2 mL **)
41 Budesonid cairan inhalasi 0,5 mg/mL, respoules 2 mL **)
42 Budesonid serb ih 200 mcg/dosis, 100 dosis
43 Budesonid serb ih 200 mcg/dosis, 200 dosis
Cefuroxime axetil/ Cefuroxime/ Sefuroksim tablet salut selaput/kaplet
44
salut selaput 250 mg
Cefuroxime axetil/ Cefuroxime/ Sefuroksim tablet salut selaput/kaplet
45
salut selaput 500 mg (G)
46 Chloramphenicol/ Kloramfenikol tablet/kapsul/kaplet 500 mg
47 Chloramphenicol/ kloramfenikol tts telinga
48 Chloramphenicol/Kloramfenikol tetes mata 1%
Chlorpromazine Hydrochloride/ Chlorpromazine / Klorpromazin injeksi
49
5 mg/ml ( i.m.)
50 Ciclosporin A/ Siklosporin kaps lunak 100 mg
51 Ciclosporin A/ Siklosporin Kaps lunak 50 mg
52 Ciclosporin A/ Siklosporin kapsul lunak 25 mg
53 Cilostazol/ Silostazol tablet/kapsul/kaplet 100 mg (G)
54 Clonazepam/ Klonazepam tablet/kapsul/kaplet 2 mg (G)
55 Clonidine hydrochloride/ Clonidine/ Klonidin injeksi 150 mcg/mL (i.v.)

Clopidogrel bisulfate/ Clopidogrel/ Clopidogrel hydrogen sulfate/

56
Klopidogrel tablet salut selaput/kaplet salut selaput 300 mg

Codeine Phosphate Hemihydrate/ Codeine/ Kodein

57
tablet/kapsul/kaplet 10 mg
Codeine Phosphate Hemihydrate/ Codeine/ Kodein
58
tablet/kapsul/kaplet 15 mg
Codeine Phosphate Hemihydrate/ Codeine/ Kodein
59
tablet/kapsul/kaplet 20 mg
Dabigatran etexilate mesilate/ Dabigatran etexilate/ Dabigatran
60
eteksilat tablet/kapsul/kaplet 110 mg
Dabigatran etexilate mesilate/ Dabigatran etexilate/ Dabigatran
61
eteksilat tablet/kapsul/kaplet 75 mg
62 Deferasiroks tablet dispersible/kaplet dispersible 250 mg
63 Deferasiroks tablet dispersible/kaplet dispersible 500 mg
64 Deferipron sir 100 mg/mL
65 Deferoksamin/ Deferoksamin mesilat injeksi 500 mg
66 Delamanid tablet salut selaput 50 mg
67 desmopresin nasal spray 10 mcg/puff
68 Desogestrel tablet/kapsul/kaplet 75 mcg
69 Dienogest tablet/kapsul/kaplet 2 mg
70 Diflukortolon valerat salep 0,1%
71 Digoksin injeksi 0,25 mg/ml (G)
72 Diltiazem injeksi 50 mg
No Nama Zat Aktif (Generik)

73 Diltiazem injeksi inj 5 mg/mL (G)

74 Diltiazem kapsul lepas lambat 100 mg
75 Diltiazem kapsul lepas lambat 200 mg
76 Dinatrium klodronat/ Clodronate Disodium Tetrahydrate inj/inf 60
mg/mL (G)
Divalproex sodium / Valproat tablet lepas lambat/kapsul lepas lambat
77
500 mg 
78 Dobutamin Injeksi 12,5 mg/ml
79 Dobutamine Hydrochloride/ Dobutamine/ Dobutamin Injeksi 25 mg/ml
80 Doksazosin/Doksazosin Mesilat tablet/kapsul/kaplet 1 mg (G)
81 Doksazosin/Doksazosin Mesilat tablet/kapsul/kaplet 2 mg (G)
82 Dolutegravir tab 50 mg
83 Donepezil tablet dispersible /kaplet dispersible 10 mg
DTPA 2,06-2,5 mg pantetate calsium trisodium/ mL / DTPA-
84 Pentasodium diethylene triamine pentaacetate 10 mg; SnCl2 2 H2O
0,8 mg
85 Dutasterid kaps lunak 0,5 mg (G)
86 efavirenz 200 mg
87 Efavirenz tablet salut selaput/kaplet salut selaput 600 mg (G)
88 Eksemestan tablet salut gula 25 mg
89 enoksaparin sodium inj 10.000 IU/mL
90 Entekavir tab sal selaput 0,5 mg (G)
91 Entekavir tablet salut selaput/kaplet salut selaput 1 mg
92 Estrogen terkonjugasi tablet salut gula/kaplet salut gula 0,625 mg
93 Etil klorida spray 100 mL
94 Everolimus tablet/kapsul/kaplet 0,25 mg
95 Everolimus tablet/kapsul/kaplet 0,5 mg
96 Fenitoin/ Phenytoin sodium tablet/kapsul/kaplet 30 mg
97 Fenobarbital/ Phenobarbital injeksi 50 mg/ml (G)
98 Fenobarbital/ Phenobarbital tablet/kapsul/kaplet 30 mg (G)
Fenoksimetil penisilin/ Phenoxymethyl Penicillin (penisilin V) tab 250
99
mg (G)
Fenoksimetil penisilin/ Phenoxymethyl Penicillin (penisilin V) tab 500
100
mg (G)
101 Fenoterol Hydromide/ Fenoterol HBr aerosol 100 mcg/puff
102 Fenoterol Hydromide/ Fenoterol HBr cairan ih 0,1%
103 Fentanil patch 12,5 mcg/jam
104 Fentanil patch 25 mcg/jam
105 Finasterid tablet/kapsul/kaplet 5 mg (G)
106 Fludarabin tablet salut/kaplet salut 10 mg
107 Flufenazin injeksi 25 mg/mL (i.m )
108 Flukonazol/ Fluconazole tablet/kapsul/kaplet 150 mg (G)
109 Fluorescein Sodium/ Natrium Fluoresein tetes mata 2% (G)
110 Flusinolon Asetonid salep 0,025%
111 Flutikason furoat susp 27,5 mcg/spray
112 Flutikason Propinat MDI/aerosol 50 mcg/dosis
113 Flutikason propionat cairan ih 0,5 mg/dosis
114 Framisetin sulfat tulle 1% (G)
115 Gadobutrol inj 1 mmol/mL, @ 5 mL
116 Gadobutrol inj 1 mmol/mL, @ 7,5 mL
117 Gadoksetat disodium/ gadoxetate disodium 0,25 mmol/mL
No Nama Zat Aktif (Generik)

118 Gansiklovir serb inj 500 mg

119 Gemfibrozil tablet/kapsul/kaplet 600 mg (G)
120 Gentamisin/ Gentamycin injeksi 40 mg/ ml (G)
121 Glibenklamid/ Glibenclamide tablet/kapsul/kaplet 2,5 mg
122 Gliklazid tablet lepas lambat/kaplet lepas lambat 60 mg
123 glikopironium serb ih 50 mcg
124 Glikuidon/ Gliquidone tablet/kapsul/kaplet 30 mg (G)
125 Glipizid tablet/kapsul/kaplet 10 mg
126 Glipizid tablet/kapsul/kaplet 5 mg
127 Gliseril trinitrat tablet/kapsul/kaplet 0,5 mg
128 Gliseril Trinitrat/ Glyceryl trinitrate inj 5 mg/ml
129 Gliseril trinitrat/ Glyceryl trinitrate kapsul lepas lambat 2,5 mg
130 Gliseril trinitrat/ Glyceryl trinitrate kapsul lepas lambat 5 mg
131 Gliserin lar 50% (G)
132 Goserelin asetat serb inj 10,8 mg
133 Goserelin asetat serb inj 3,6 mg
134 Griseofulvin (micronized) tablet/kapsul/kaplet 250 mg
135 Haloperidol inj 50 mg/mL
136 Halotan inhalasi
137 Heparin, Na injeksi 5000 IU/ml (i.v./s.k.) (G)
138 Hidroklorotiazid/ Hydrochlorothiazide tablet/kapsul/kaplet 25 mg (G)
139 Hidrokortison inj 100 mg (G)
140 Hidroksi Urea/ Hydroxy urea tablet/kapsul/kaplet 500 mg
141 Hidromorfon/ Hydromorphone HCl tablet lepas lambat/kaplet lepas
lambat 16 mg
142 Hidromorfon/ Hydromorphone HCl tablet lepas lambat/kaplet lepas
lambat 8 mg
143 Hiosin butilbromid/Hiosin butilbromida tablet/kapsul/kaplet 10 mg (G)
144 Homatropin tts mata 2%
145 Ibandronic Sodium Monohydrate/Asam Ibandronat inj 1 mg/mL (G)
146 Iloprost ih 10 mcg/mL
147 Imidapril tablet/kapsul/kaplet 10 mg
148 Imidapril tablet/kapsul/kaplet 5 mg
149 Indakaterol serbuk ih 150 mcg
150 Indakaterol serbuk ih 300 mcg
151 Iopamidol inj 300-370 mg/mL (300mg, @ 100ml)
152 Iopamidol inj 300-370 mg/mL (300mg, @ 50ml)
153 Iopamidol inj 300-370 mg/mL (370mg, @ 50ml)
154 Iopamidol inj 300-370 mg/mL (370mg, @100ml) (G)
155 Iopromid inf 300 -370 mg Iodium/mL (300 mg, @ 100 ml)
156 Iopromid inf 300 -370 mg Iodium/mL (300 mg, @ 50 ml)
157 Iopromid inf 300 -370 mg Iodium/mL (370 mg, @ 100 ml)
158 Iopromid inf 300 -370 mg Iodium/mL (370 mg, @ 50 ml)
Ipratropium Bromida Anhidrous/ Ipratropium bromida aerosol 20
159
mcg/semprot
160 Ipratropium Bromide/ Ipratropium bromida cairan ih 0,025% (G)
161 Itrakonazol tablet/kapsul/kaplet 100 mg (G)
162 Ivabradin tablet /kapsul/kaplet 5 mg
No Nama Zat Aktif (Generik)

163 Kalium aspartat tablet salut selaput/kaplet salut selaput 300 mg (G)
164 Kalium Klorida tablet lepas lambat/kaplet lepas lambat 600 mg
165 Kalsitriol kapsul lunak 0,5 mcg (G)
166 Kanamisin/ Kanamycin serb inj 1.000 mg (G)
167 Karbimazol/Carbimazole tablet/kapsul/kaplet 5 mg
168 Karbogliserin tetes telinga 10%
169 Karvedilol tablet/kapsul/kaplet 6,25 mg (G)
170 Klaritromisin sir kering 250 mg/5 ml
171 Klaritromisin tablet salut selaput/kaplet salut selaput/kaptab salut
selaput 500 mg (G)
172 Klobetasol propionat salep 0,05% (G)
173 Klorheksidin lar 0,2%
174 Kolestiramin serb 4 g
Kombinasi (LPV/r), tablet:
175 Lopinavir 200 mg
Ritonavir 50 mg

176 Kombinasi (LPV/r): lopinavir 100 mg + ritonavir 25 mg tab sal selaput

Kombinasi :
Benserazid 25 mg
177
Levodopa 100 mg
tablet dispersible/kaplet dispersible
Kombinasi :
Salmeterol 50 mcg
178
Flutikason propionat 100 mcg
ih 100mcg/puff
kombinasi KDT/FDC mengandung:
meglumin amidotrizoat
179
sodium amidotrizoat
inj 76%
kombinasi KDT/FDC, setiap mL mengandung: latanoprost 0,05 mg +
180
timolol 5 mg tetes mata, botol
kombinasi KDT/FDC, setiap mL mengandung: latanoprost 0,05 mg +
181
timolol 5 mg tetes mata, botol 0,6 mL
Kombinasi tab:
Levodopa 100 mg
182 Karbidopa 25 mg
Entekapon 200 mg
tablet/kapsul/kaplet

183 Kombinasi tablet/kaplet: Zidovudin 300 mg + Lamivudin 150 mg (G)

kombinasi, setiap dosis mengandung :

Budesonid 160 mcg
184
Formoterol 4,5 mcg
(inhalasi), 120 dosis
kombinasi, setiap dosis mengandung :
Budesonid 160 mcg
185
Formoterol 4,5 mcg
(inhalasi), 60 dosis
No Nama Zat Aktif (Generik)

kombinasi, setiap dosis mengandung : _x000D_

Budesonid 80 mcg_x000D_
186
Formoterol 4,5 mcg_x000D_
(inhalasi)
Kombinasi, setiap mL mengandung: brinzolamid 1% + timolol 0,5%, tts
187
mata
Kombinasi, setiap mL mengandung: natrium klorida 4,40 mg + kalium
188
klorida 0,80 mg, tts mata
Kombinasi: amoksisilin 1000 mg + klavulanat 200 mg serb inj 1200 mg
189
(G)
Kombinasi: artemether 20 mg + lumefantrin 120 mg
190
tablet/kapsul/kaplet
Kombinasi: ergotamin /ergotamine1 mg + kafein/caffeine 50 mg,
191
tablet/kapsul/kaplet
Kombinasi: medroksi progesteron asetat + estradiol sipionat, inj depot
192
25 mg + 5 mg (G)
Kombinasi: setiap mL mengandung: travoprost 0,004% + timolol 0,5%,
193
tts mata
Kombinasi:
Salmeterol 50 mcg
194
Flutikason propionat 250 mcg
ih 250 mcg/puff
Kombinasi:
Salmeterol 50 mcg
195
Flutikason propionat 500 mcg
ih 500 mcg/puff
Kombipak Azitromisin/ Azithromycin dihydrate 500 mg + Sefiksim/
196 Cefixime trihydrate 200 mg (amplop @ 2 strip (1 strip @ 2 kaptab
azithromycin + 1 strip @ 2 kapsul cefixime)
197 Kuinin inj 25% (G)
198 Lamivudine/ Lamivudin tablet/kapsul/kaplet 100 mg (G)
199 Lamivudine/ Lamivudin tablet/kapsul/kaplet 150 mg (G)
200 Lamotrigine/ Lamotrigin tablet dispersible/kaplet dispersible 25 mg
201 Lansoprazole/ Lansoprazol serbuk inj 30 mg/ml (G)
202 Lapatinib tosilate/ Lapatinib tablet/kapsul/kaplet 250 mg
203 Latanoprost tts mata 0,005% (G)
204 Leflunomide/ Leflunomid tablet salut selaput/kaplet salut selaput 20 mg
205 Lenograstim serb inj 263 mcg
206 Leuprorelin asetat serbuk injeksi 1,88 mg
207 Leuprorelin asetat serbuk injeksi 11,25 mg
208 Levetiracetam/ Levetirasetam tablet/kapsul/kaplet 250 mg (G)
209 Levetiracetam/ Levetirasetam tablet/kapsul/kaplet 500 mg (G)
Levothyroxine Sodium/ Levothyroxine/ Levotiroksin tablet/kaplet/kapsul
210
100 mcg (G)
Levothyroxine Sodium/ Levothyroxine/ Levotiroksin tablet/kapsul/kaplet
211
50 mcg
212 Linestrenol tablet/kapsul/kaplet 0.5 mg (G)
213 Litium karbonat tablet/kapsul/kaplet 200 mg
214 Litium karbonat tablet/kapsul/kaplet 400 mg
215 Low molecule feri sucrose inj 20 mg/mL (100mg/5mL) (G)
No Nama Zat Aktif (Generik)

216 Manitol inf 20% (250 mL)

217 Maprotilin/Maprotiline HCl tablet salut selaput/kaplet salut selaput 50
mg (G)
MDP- Acidum methylene diphosphonicum 10 mg; SnCl2 2 H2O 0,238
218
mg; Acidum ascorbicum 2 mg
219 Melfalan/Melphalan tablet/kapsul/kaplet2 mg
220 Mesalazine/ Mesalazin tablet salut enterik/kaplet salut enterik 250 mg
221 Mesna inj 100 mg/mL
222 Metadon sir 50 mg/5 mL (G)
Metamizol/Antalgin Inj 500 mg/ml atau Metamizole Sodium
223
Monohydrate/Antalgin inj 1000 mg/2ml (G)
224 Methyldopa/Metildopa tablet/kapsul/kaplet 250 mg
225 metilfenidat tab lepas lambat 18 mg
226 metilfenidat tab lepas lambat 36 mg
227 Metilfenidat/Methylfenidat Hydrochloride tablet/kapsul/kaplet 10 mg (G)

228 Metoclopramide hydrochloride (HCl)/ Metoclopramida HCl/

Metoclopramide/ Metoklopramid tablet/kapsul/kaplet 5 mg (G)
Metoclopramide hydrochloride (HCl)/ Metoclopramide/ Metoklopramide
229
sirup 5 mg/ 5 ml (G)
230 Metoprolol tartrate/ Metoprolol tartat inj 1 mg/ml
231 Metronidazole/ Metronidazol ovula 500 mg
MIBI 5 ml, reaction vial / MIBI- Tetra (2-methoxyisobutyl isonitrile)
232 Copper (1) tetrafluoroborate 1 mg; SnCl2 2 H2O 0,1 mg; Sodium
Citrate dihydrate 2,6 mg; L-Cystein 1 mg
233 Midazolam hydrochloride/ Midazolam injeksi 1 mg/ml (i.v.) (G)
234 Midazolam hydrochloride/ Midazolam injeksi 5 mg/ml (i.v.) (G)
Mikafungin serb inj 50 mg / Micafungin serbuk injeksi/serbuk infus 50
235
mg
236 Mikofenolat sodium tablet salut/kaplet salut 180 mg
237 Mikofenolat sodium tablet salut/kaplet salut 360 mg
238 Milrinone inj 1 mg/mL

Mineral Mix (Bismuth Subcitrate Tripottasium, Copper sulfate,

239
Magnesium Chloride Anhydrous, Pottasium Chloride, Zinc Acetate)

240 Morfin Injeksi 10 mg/ml (i.m/s.k/ i.v) (G)

Morphine hydrochloride(HCl)/ Morphine/ Morfin tablet/kapsul/kaplet 10
241
mg (G)
Morphine sulfate/ Morphine/ Morfin tablet lepas lambat/kaplet lepas
242
lambat 10 mg
Morphine sulfate/ Morphine/ Morfin tablet lepas lambat/kaplet lepas
243
lambat 15 mg
244 Nacl 0,9% / Sodium Chloride 90 mg, kemasan 10 mL
245 N-asetil sistein/ N-acetylcysteine ih 100 mg/mL (G)
246 Natrium klorida tetes mata 50 mg/mL
247 Neostigmin injeksi 0,5 mg/ml (G)
248 Nevirapine/ Nevirapin tablet/kapsul/kaplet 200 mg (G)
249 Nifedipine/ Nifedipin tablet lepas lambat/kaplet lepas lambat 20 mg

250 Nifedipine/ Nifedipin tablet lepas lambat/kaplet lepas lambat 30 mg

No Nama Zat Aktif (Generik)

251 Nilotinib hydrochloride (HCl)/ Nilotinib tablet/kapsul/kaplet 150 mg

252 Nilotinib hydrochloride (HCl)/ Nilotinib tablet/kapsul/kaplet 200 mg

253 Nimodipine/Nimodipin tablet salut selaput/kaplet salut selaput 30 mg
254 Nomegestrol asetat tablet/kapsul/kaplet 5 mg
255 Nystatin/ Nistatin vaginal tablet/kaplet 100.000 IU (G)
256 Octreotide/ Oktreotid asetat 0,05 - 6 mg/mL (G)
257 Oksikodon kaps 5 mg
258 Okskarbazpin susp 60 mg/mL
259 Olanzapine/ Olanzapin inj 10 mg/2 mL (10 mg/vial)
Oxytetracycline Hydrochloride/ Oxytetracycline/ Oksitetrasiklin inj 50
260
mg/mL (i.m.)
261 Pegylated interferon alfa-2a inj 135 mcg/0,5 ml
262 Pegylated interferon alfa-2a inj 180 mcg/0,5 ml
263 Perindopril arginine tablet/kapsul/kaplet 5 mg

264 Permethrin/ Permetrin Krim 5% (G)

265 Pethidine hydrochloride/ Petidin inj 50 mg/mL (i.m./i.v.)

Pilocarpine/ Pilocarpine hydrochloride/ Pilokarpin tetes mata 2%,
266
kemasan botol 5 mL
Pilocarpine/ Pilocarpine hydrochloride/ Pilokarpin tetes mata 2%,
267
kemasan catchcover, botol 0,6 mL
268 Pirantel pamoat susp 125 mg/5 ml (G)
269 Pirantel pamoat tablet/kapsul/kaplet 250 mg
270 Polietilen Glikol serb

Pramipexole dihydrochloride monohydrate/ Pramipexole hydrochloride

271
monohydrate/ Pramipeksol tablet/kapsul/kaplet 0,125mg (G)

Pramipexole dihydrochloride monohydrate/Pramipexole/ Pramipeksol

272
tablet lepas lambat/kaplet lepas lambat 0,375mg
Pramipexole dihydrochloride monohydrate/Pramipexole/ Pramipeksol
273
tablet lepas lambat/kaplet lepas lambat 0,750mg
274 Probenesid/ Probenecid tablet/kapsul/kaplet 500 mg
275 Procaterol hydrochloride (HCl)/ Prokaterol cairan ih 30 mcg
276 Procaterol hydrochloride (HCl)/ Prokaterol cairan ih 50 mcg
277 Procaterol hydrochloride (HCl)/ Prokaterol serbuk ih 10 mcg
Pyridostigmin bromide/ Pyridostigmin/ Piridostigmin
278
tablet/kapsul/kaplet 60 mg
279 Quetiapin 100 mg tablet (G)

280 Quetiapine fumarate/ Quetiapin tab SR 300 mg

281 Quetiapine fumarate/ Quetiapin tablet SR/kapsul SR 400 mg

282 Quinine/ Quinine sulfate/ Kuinin tablet/kapsul/kaplet 200 mg (G)
283 Ramipril tablet/kapsul/kaplet 10 mg (G)
284 Ramipril tablet/kapsul/kaplet 2,5 mg (G)
285 Ranibizumab inj 10 mg/mL
286 Ribavirin tab sal selaput 200 mg
287 Rifampicin/ Rifampisin tablet/kapsul/kaplet 300 mg
288 Rifapentin tablet 150 mg
No Nama Zat Aktif (Generik)

289 Rilpivirin tablet 25 mg

290 Risperidon oral solution 1 mg/mL (G)
291 Rivaroxaban/ Rivaroksaban tablet salut/kaplet salut 10 mg
292 Rivaroxaban/ Rivaroksaban tablet salut/kaplet salut 15 mg
293 Rivaroxaban/ Rivaroksaban tablet salut/kaplet salut 20 mg
Ropinirole hydrochloride (HCl)/ Ropinirol tablet lepas lambat/kaplet
294
lepas lambat 2 mg
Ropinirole hydrochloride (HCl)/ Ropinirol tablet lepas lambat/kaplet
295
lepas lambat 4 mg
Ropinirole hydrochloride (HCl)/ Ropinirol tablet lepas lambat/kaplet
296
lepas lambat 8 mg
297 Salbutamol sulfate/ Salbutamol sir 2 mg/5 mL (G)
298 Sodium bicarbonate/ Natrium Bikarbonat inj 8,4% (i.v.)
299 solifenasin tab 10 mg
300 solifenasin tab 5 mg
301 Stavudin tab 30 mg
302 Streptokinase serb inj 1,5 juta IU
303 Sufentanil citrate/Sufentanil injeksi 5 mcg/mL (i.v)
304 Sugammadeks inj 100 mg/ml

305 Sulfadiazine silver/ Perak sulfadiazin krim 1% (tube 35 g) (G)

Sulfasalazine/ Sulfasalazin tablet salut enterik/kaplet salut enterik 500

306
mg (G)
307 Surfaktan susp 25 mg/mL (intratekal)
308 Tacrolimus/ Takrolimus tablet/kapsul/kaplet 0.5 mg
309 Tacrolimus/ Takrolimus tablet/kapsul/kaplet 1 mg
310 Takrolimus/ Tacrolimus kapsul lepas lambat 0,5 mg
311 Takrolimus/ Tacrolimus kapsul lepas lambat 1 mg
312 Tamoxifen citrate/ Tamoksifen tab 10 mg
313 Tamsulosin tablet lepas lambat / kaplet lepas lambat 0,4 mg (G)
314 Tamsulosin tablet/kapsul/kaplet 0,2 mg
315 Telbivudin tablet/kapsul/kaplet 600 mg
316 Tenofovir 300 mg + Lamivudin 300 mg + Dolutegravir 50 mg
317 Terazosin/ Terazosin HCl tablet/kapsul/kaplet 1 mg (G)
318 Terazosin/ Terazosin HCl tablet/kapsul/kaplet 2 mg (G)
Terbinafine hydrochloride (HCl) / Terbinafin tablet/kapsul/kaplet 250
319
mg
320 Terbutaline sulfate/ Terbutalin cairan ih 2,5 mg/mL
321 Terbutaline sulfate/ Terbutalin serbuk ih 0,50 mg/dosis
322 Testosteron Inj 250 mg/ml (vial 1 ml)
323 Testosteron Inj 250 mg/ml (vial 4 ml)
324 Testosterone undecylate/ Testosteron kapsul lunak 40 mg
325 Tetanus toxoid inj
326 Tetracaine/ Tetrakain tetes mata 0,5% (G)
327 Theophylline/ Teofilin tablet lepas lambat/kaplet lepas lambat 300 mg
328 Theophylline/ Teofilin tablet/kapsul/kaplet 150 mg
329 Thiamazole/ Tiamazol tablet/kapsul/kaplet 10 mg
330 Thiamazole/ Tiamazol tablet/kapsul/kaplet 5 mg (G)
Thiopental Sodium with sodium carbonate/ Thiopental sodium/
331
Tiopental inj 500 mg (i.v.) (G)
No Nama Zat Aktif (Generik)

Thiopental Sodium with sodium carbonate/ Thiopental sodium/

332
Tiopental serb inj 1.000 mg (i.v.) (G)
333 Ticagrelor/ Tikagrelor tablet/kapsul/kaplet 90 mg
334 Tobramisin tts mata 0,3%, catchcover, botol 0,6 mL
335 Topiramate/ Topiramat tablet/kapsul/kaplet 100 mg
336 tosilizumab inf 20mg/ml (400 mg/20 mL)
337 tosilizumab inf 20mg/ml (80 mg/4 mL)
338 Travoprost tetes mata 0,004%/ Travoprost cairan mata 0,004%
339 Triamcinolone acetonide/ Triamsinolon asetonid inj 10 mg/mL (G)

Triamsinolon asetonid/Triamcinolone acetonide nasal spray/semprot

340
hidung 55 mcg/puff
341 Tropikamid tts mata 0,5%, catchcover, botol 0,6 mL
342 Tuberkulin protein purified derivative serb inj 2 TU/0,1 mL
Valganciclovir hydrochloride (HCl)/ Valgansiklovir tablet salut/kaplet
343
salut 450 mg
344 Vasopressin injection/ Vasopresin injeksi 20 IU/mL (i.m/s.k.)
Verapamil hydrochloride (HCL)/ Verapamil tablet lepas lambat/kaplet
345
lepas lambat 240 mg
Verapamil hydrochloride (HCL)/ Verapamil tablet/kapsul/kaplet 80 mg
346
(G)
347 Warfarin potassium/ Warfarin tablet/kapsul/kaplet 1 mg (G)
348 Zidovudine/ Zidofudin tablet/kapsul/kaplet 100 mg (G)
349 Zinc sulfate/ Zinc sulfate monohydrate/ Zink/ Zinc drops 10 mg/mL (G)
Obat Multiwinner

No Nama Zat Aktif (Generik) Industri Farmasi

1 2 3
1 Albumin serum normal (human Albumin) inj 20% 100 mL
2 Albumin serum normal (human Albumin) inj 20% 50 mL
Albumin serum normal (human Albumin) inj 25%
3
(250 g/1.000 mL) 100 mL
4 Albumin serum normal (human Albumin) inj 25% 20 mL
5 Albumin serum normal (human Albumin) inj 25% 50 mL
6 Albumin serum normal (human Albumin) inj 5% 250 mL
7 Albumin serum normal (human Albumin) inj 5% 50 mL
Amoksisilin/ Amoxicillin/ Amoxicillin Trihydrate
8
tablet/kapsul/kaplet/kaptab 500 mg (G)
Analog insulin long acting inj 100 IU/mL, vial/cartridge
9
disposible/penfill cartridge
Analog insulin mix insulin inj 100 IU/mL (kemasan vial,
10
cartridge disposible, penfill cartridge)
Analog insulin rapid acting inj 100 IU/mL (cartridge disposible,
11
penfill cartridge)
12 Asam askorbat (vitamin C) tablet/kapsul/kaplet 50 mg
Asam Mefenamat/Mefenamic acid tablet/kapsul/kaplet/kaptab
13
500 mg (G)
14 Asetat Ringer (softbag, flexy bag, plabot)
15 Asparaginase serb inj 10.000 IU
16 Bleomisin serb inj 15 mg
Chlorphenamine Maleate/ Klorfeniramin tablet/kapsul/kaplet 4
17
mg (G)
18 Cisplatin/ Sisplatin inj 1 mg/mL, vial 10 mg
19 Cisplatin/ Sisplatin inj 1 mg/mL, vial 50 mg
Cyclophosphamide monohydrate/ Cyclophosphamide/
20
siklofosfamid serb inj 1.000 mg (i.v.)
Cyclophosphamide monohydrate/ Cyclophosphamide/
21
siklofosfamid serb inj 200 mg (i.v.)
Cyclophosphamide monohydrate/ Cyclophosphamide/
22
siklofosfamid serb inj 500 mg (i.v.)
23 Cytarabine/ Sitarabin inj 100 mg/ml (i.m./i.v/s.k.)
24 Dakarbazin/Dacarbazine serb inj 200 mg
25 Daunorubisin nj 20 mg
26 Dialisis peritoneal, larutan intraperitoneal - Extraneal
27 Doksorubisin /Doxorubicin HCl serbuk inj 50 mg
28 Doksorubisin/ Doxorubicin HCl serb inj 10 mg (i.v.)
29 Dosetaksel inj 20 mg
30 Dosetaksel inj 80 mg
Epirubisin/Epirubicin Hydrochloride injeksi 2 mg/mL, vial 25
31
mL

32 Epirubisin/Epirubicin Hydrochloride injeksi 2 mg/mL, vial 5 mL

Epirubisin/Epirubicin Hydrochloride serb injeksi 50 mg / inj 50

33
mg/25 mL
34 Eritropoetin-alfa inj 10.000 IU
35 Eritropoetin-alfa inj 2.000 IU
36 Eritropoetin-alfa inj 3.000 IU
37 Etoposid inj 20 mg/mL
38 Faktor IX kompleks inj 1.000 IU
39 Faktor IX kompleks inj 500 IU
Faktor koagulasi II, faktor
40 koagulasi VII, faktor koagulasi, faktor IX, faktor koagulasi X,
serb inj 500 IU/20 mL
41 Faktor VIIa (rekombinan) inj 1 mg

42 Faktor VIII (konsentrat) inj 1.000 IU

No Nama Zat Aktif (Generik) Industri Farmasi

43 Faktor VIII (konsentrat) inj 230-340 IU

44 Faktor VIII (konsentrat) inj 250 IU
45 Faktor VIII (konsentrat) inj 480-600 IU
46 Faktor VIII (konsentrat) inj 500 IU
47 Faktor IX kompleks inj 50 IU/mL
48 Filgrastim inj 300 mcg/mL
49 Fludarabin serb inj 50 mg
50 Fluorourasil inj 50 mg/mL (@ 10 mL)
51 Fraksi Protein Plasma inf 5%
Gemsitabin/ Gemcitabine / Gemcitabine HCl serb inj / lar inj
52
1000 mg
Gemsitabin/ Gemcitabine / Gemcitabine HCl serb inj / lar inj
53
200 mg
54 Glukosa larutan infus 10% 500 mL
55 Glukosa larutan infus 5 % 500 mL
56 Glukosa Larutan Infus 5% steril 100 ml
57 Glukosa Larutan Infus 5% steril 250 ml
58 Hepatitis B imunoglobulin (human) inj 220 IU/mL
Human Insulin intermediate acting inj 100 IU/ml, cartridge
59
disposible/penfill cartridge

60 Human insulin intermediate acting inj 100 IU/mL, vial 10 mL

Human insulin mix insulin inj 100 IU/mL (kemasan vial,

61
cartridge disposible, penfill cartridge)
62 Human insulin mix insulin inj 100 IU/mL, vial 10 mL
Human insulin short acting inj 100 IU/ml, cartridge
63
disposible/penfill cartridge
64 Human insulin short acting inj 100 IU/ml, vial 10 mL
65 Human tetanus imunoglobulin inj 250 IU (i.m.)
66 ifosfamid serb inj 1.000 mg
67 Ifosfamid serb inj 2000 mg
68 Ifosfamid serb inj 500 mg
69 Imunoglobulin Intravena inj 50 mg/mL
Irinotekan/ Irininotecan HCl/ Irinotecan HCl trihydrate inf 20
70
mg/mL
Irinotekan/ Irininotecan HCl/ Irinotecan HCl trihydrate inj 20
71
mg/mL

72 Kalium klorida / Potasium klorida injeksi 25 mg 7,46% 25 mL

73 Kaptopril/ Captopril tablet/kapsul/kaplet 25 mg
74 karboplatin/ carboplatin inj/inf 10 mg/mL (vial 15mL)
75 karboplatin/ carboplatin inj/inf 10 mg/mL (vial 45mL)
Kombinasi: ferro fumarat 60 mg + as. Folat 0,4 mg tablet salut
76
gula (tablet tambah darah)
77 Methotrexate/ metotreksat inj 25 mg/mL
N(2)-L-Alanyn-L-Glutamine/ N(2)-L-Alanyn-L-Glutamine 20%
78
(Larutan mengandung Asam Amino)
79 Nacl 0,9% / Sodium Chloride 0,9%, 500 mL
80 Octreotide/ Oktreotid LAR serb inj 20 mg
81 Octreotide/ Oktreotid LAR serb inj 30 mg
82 Oxaliplatin/ oksaliplatin serb inj 100 mg
83 Oxaliplatin/ oksaliplatin serb inj 50 mg
84 Paclitaxel/ paklitaksel inj 6 mg/mL, vial @ 16,7 mL(inj 100 mg)

85 Paclitaxel/ paklitaksel inj 6 mg/mL, vial @ 5 mL (inj 30 mg)

86 Paclitaxel/ paklitaksel inj 6 mg/mL, vial @ 50 mL (inj 300 mg)

87 Paracetamol/ Parasetamol tablet/kapsul/kaplet 500 mg
88 Pemetreksed/Pemetrexed serb inj 500 mg
89 Pengganti plasma golongan gelatin inf
90 Produk untuk Dialisis Peritoneal
No Nama Zat Aktif (Generik) Industri Farmasi

91 Ringer Laktat/ Ringer Lactate, @1000 ml

92 Ringer Laktat/ Ringer Lactate, @500 mL
93 Rituximab/ Rituksimab infus 10 mg/ml (vial @ 10 ml)
94 Rituximab/ Rituksimab infus 10 mg/ml (vial @ 50 ml)
95 Serum anti bisa ular A.B.U. I inj (i.m./i.v)
96 Serum Anti Rabies (SAR) 150 IU/mL, kemasan 2 mL
97 Serum antitetanus (A.T.S) inj 1500 IU/mL (i.m)
98 Setuksimab injeksi 5 mg/mL
99 Trastuzumab serb inj 440 mg
100 Vaksin BCG Kering
101 Vaksin DPT-HB-Hib
Vaksin Hepatitis B Rekombinan Prefilledsyringe (Uniject) @
102
0,5 Ml
103 Vaksin influenza
104 Vaksin Jerap difteri tetanus (DT) cairan inj i.m 40/15 If per mL

105 Vaksin Jerap difteri tetanus (Td) cairan inj i.m 15/4 If per mL
106 Vaksin Meningitis
107 Vaksin MR (Measles and Rubella Vaccine), 10 dosis
Vaksin Pneumococcus 13 (PCV13), @ 2 mL (4 x @0,5 mL
108
dosis)
Vaksin Pneumococcus 13 (PCV13), Prefilled syringe 1 dosis
109
@0,5 mL
110 Vaksin Polio 10 dosis (b-opv)
111 Vaksin Poliomyelitis inaktif (IPV), @2,5 mL (5 dosis)
112 Vaksin Rabies untuk manusia, serb inj 2,5 IU (s.k.)
113 Vaksin Yellow Fever
114 Vinblastin inj 1 mg/mL
115 Vincristine sulfate/ Vinkristin inj 1 mg/ml (vial 1 mL) (i.v.)
116 Vincristine sulfate/ Vinkristin inj 1 mg/ml (vial 2 mL) (i.v.)
Vinorelbine Tartrate / Vinorelbine inj 10 mg/mL, kemasan vial
117
1 mL
Vinorelbine Tartrate / Vinorelbine inj 10 mg/mL, kemasan vial
118
5 mL
Larutan

No Nama Zat Aktif (Generik) Industri Farmasi

1 2 3
AHEP - Larutan mengandung asam amino,
1
kemasan botol 500 mL
Aminofluid 1000 mL - Larutan mengandung
2
asam amino
Aminofluid 500 mL - Larutan mengandung
3
asam amino
Aminofusin Hepar - Larutan mengandung
4
asam amino **)
Aminofusin Paed - Larutan mengandung
5
asam amino
Aminofusn L 600 - Larutan mengandung
6
asam amino
Aminoleban - Larutan mengandung asam
7
amino **)
Aminosteril infant 10% - Larutan
8
mengandung asam amino **)
Aminosteril Infant 6% - Larutan
9
mengandung asam amino
Aminosteril N-Hepa 8% - Larutan
10
mengandung Asam Amino
Amiparen - Larutan mengandung asam
11
amino

12 Benutrion VE - Larutan mengandung Asam

Amino
Clinimic N9G15E - Larutan mengandung
13
asam amino
Clinimic N9G20E - Larutan mengandung
14
asam amino
Clinoleic 20% 100 mL - Larutan
15
mengandung lipid **)
Clinoleic 20% 250 mL - Larutan
16
mengandung lipid **)
Comafusin Hepar - Larutan mengandung
17
asam amino **)
Combiflex Peri - Larutan mengandung asam
18
amino
EAS PFRIMMER - Larutan mengandung
19
Asam Amino
Futrolit - Larutan mengandung
20
karbohidrat+elektrolit
HYDROMAL - Larutan mengandung
21
Karbohidrat+Elektrolit
Infumal - Larutan mengandung karbohidrat
22
**)
INFUSAN D5 (100 ML) - Larutan
23
mengandung karbohidrat **)
INFUSAN D5 (250 ML) - Larutan
24
mengandung karbohidrat
Infusan D5+1/2NS SP - Larutan
25
mengandung Karbohidrat+Elektrolit
Infusan D5+1/4NS SP - Larutan
26
mengandung Karbohidrat+Elektrolit
Infusan D5+NS - Larutan mengandung
27
karbohidrat+elektrolit **)
No Nama Zat Aktif (Generik) Industri Farmasi

Infusan RD SP - Larutan Mengandung

28
Karbohidrat+Elektrolit **)

29 INTRALIPID - Larutan mengandung Lipid

Kabiven Peripheral 1440 mL - Larutan

30
mengandung asam amino
Kabiven Peripheral 1920 mL - Larutan
31
mengandung asam amino
KA-EN 1B - Larutan mengandung elektrolit
32
**)
KA-EN 3A - Larutan mengandung elektrolit
33
**)
KA-EN 3B botol plastik - Larutan
34
mengandung elektrolit **)
KA-EN 3B softbag - Larutan mengandung
35
elektrolit **)
KA-EN MG3 - Larutan mengandung
36
karbohidrat+elektrolit **)
Kalbamin - Larutan mengandung asam
37
amino **)

38 KIDMIN - Larutan mengandung asam amino

Lipofundin MCT/LCT 20% 100 mL - Larutan

39
mengandung lipid **)
Lipofundin MCT/LCT 20% 250 mL - Larutan
40
mengandung lipid **)
Lipomed MCT/LCT 20% 100 mL - Larutan
41
mengandung lipid **)
Lipomed MCT/LCT 20% 250 mL - Larutan
42
mengandung lipid **)
Martos 10 - Larutan mengandung
43
karbohidrat **)
Nephrosteril - Larutan mengandung Asam
44
Amino
Nutriflex Lipid Peri 1250 - Larutan
45
mengandung asam amino
Nutriflex Lipid Special 1250 - Larutan
46
mengandung asam amino
Nutriflex Lipid Special 625 - Larutan
47
mengandung asam amino **)
Olimel N9E - Larutan mengandung Asam
48 amino + Elektrolit + Karbohidrat + Lipid,
kemasan flexybag @ 1.000 mL
49 Omegaven - Larutan mengandung lipid
Otsulip 20% - Larutan mengandung lipid,
50
softbag 250 mL
PAN-AMIN G - Larutan mengandung Asam
51
Amino **)
Precopar - Larutan mengandung asam
52
amino **)
Renosan - Larutan mengandung asam
53
amino **)
Renxamin - Larutan mengandung Asam
54
Amino **)
Ringerfundin - Larutan mengandung
55
elektrolit
No Nama Zat Aktif (Generik) Industri Farmasi

56 Smofkabiven - Larutan mengandung

Karbohidrat+Elektrolit **)
Smoflipid 20% 100 mL - Larutan
57
mengandung lipid **)
58 Totilac - Larutan mengandung elektrolit
Tridex 100 - Larutan mengandung
59
karbohidrat+elektrolit **)
Tridex 27A - Larutan mengandung elektrolit
60
**)
Tridex 27B - Larutan mengandung elektrolit
61
**)
Tridex Plain - Larutan mengandung
62
elektrolit **)
Triofusin 1000 - Larutan mengandung
63
karbohidrat **)
Triofusin 1600 - Larutan mengandung
64
karbohidrat **)
Triofusin 500 - Larutan mengandung
65
karbohidrat **)
Triofusin E 1000 - Larutan mengandung
66
karbohidrat+elektrolit **)
Triomix 1000 - Larutan mengandung
67
karbohidrat+elektrolit **)
Triomix 1600 - Larutan mengandung
68
karbohidrat **)
Triomix 500 - Larutan mengandung
69
karbohidrat **)
Triomix L 1000 Larutan mengandung
70
karbohidrat+elektrolit **)
Tutofusin OPS - Larutan mengandung
71
karbohidrat+elektrolit
Tutosol - Larutan mengandung elektrolit,
72
kemasan flexybag @ 500 mL
Valamin - Larutan mengandung asam
73
amino **)
WIDA 2A - Larutan mengandung
74
karbohidrat+elektrolit
WIDA D5-1/2NS - Larutan mengandung
75
karbohidrat+elektrolit
WIDA D5-1/4NS - Larutan mengandung
76
karbohidrat+elektrolit
WIDA D5NS - Larutan mengandung
77
karbohidrat+elektrolit **)
WIDA HSD - Larutan Mengandung
78
Karbohidrat+Elektrolit
WIDA KDN1 - Larutan mengandung
79
karbohidrat+elektrolit 500 ml
WIDA KDN2 - Larutan mengandung
80
karbohidrat+elektrolit 500 ml
WIDA KN1 - Larutan mengandung elektrolit
81
500 ml
WIDA KN2 - Larutan mengandung elektrolit
82
500 ml
WIDA RD - Larutan Mengandung
83
Karbohidrat+Elektrolit **)
Tambahan Obat

No Nama Zat Aktif (Generik)

1 2
1
2
3
4
5
6
7
dst
 Nama Produk
Industri Farmasi Kemasan Sesuai NIE
(Apabila Nama Dagang)

3 4 5
Nomor Izin Edar (NIE) Tanggal Terbit NIE Masa Berakhir NIE

6 7 8
Harga Reguler Per
Keterangan Lainnya
Satuan Terkecil
(Jika ada)
(HNA + PPN)
9 10