Tabel DOSP 2016 Final

FORMULARIUM PERTAMINA 2016

KELAS/SUB KELAS/ZAT AKTIF/NAMA DAGANG

SEDIAAN DOSIS STRENGTH PRINCIPAL

01 GASTROINTESTINAL & HEPATOBILIARY SYSTEM

01a ANTACIDS, ANTIREFLUX AGENTS & ANTIULCERANTS

ALLUMINIUM HYDROXYDE, MAGNESIUM HYDROXIDE, DOMETICONE

Antasida DOEN SUSP 200 mg, 200 mg Sanbe Farma

Antasida DOEN TAB 200 mg, 200 mg Sanbe Farma

ALLUMINIUM HYDROXYDE, MAGNESIUM HYDROXYDE, SIMETHICONE

Lambucid SUSP 300 mg Hexpharm Jaya

Dexanta SUSP 200 mg, 200 mg Dexa Medica

Dexanta TAB 200 mg, 200 mg Dexa Medica

Magtral Forte TAB 400 mg Otto Pharmaceutical Industries

FAMOTIDINE

Renapepsa TAB 20 mg Pratapa Nirmala

LANSOPRAZOLE

Lansoprazole CAPS 30 mg Hexpharm Jaya

Lansoprazole CAPS 30 mg Novell Pharmaceutical Laboratories

Sopralan CAPS 30 mg Mersifarma Tm

Prosogan VIAL 30 mg Takeda Indonesia

OMEPRAZOLE

Omeprazole CAPS 20 mg Hexpharm Jaya

Omeprazole CAPS 20 mg Novell Pharmaceutical Laboratories

Omeprazole CAPS 20 mg Pertiwi Agung (Landson)

Ozid Iv "G" INJ 40 mg Darya Varia

Omeprazole INJ 40 mg Dexa Medica

RANITIDINE

Ranitidin Hcl INJ 50 mg / 2 ml Dexa Medica

Ranitidin INJ 50 mg / 2 ml Novell Pharmaceutical Laboratories

Ranitidine TAB 150 mg Dexa Medica

Ranitidine TAB 150 mg Hexpharm Jaya

Ranitidine TAB 150 mg Pertiwi Agung (Landson)

15



SUCRALFATE

Ulcumaag CAPL 500 mg Pyridam Farma Tbk

Sucralfate SUSP 500 mg/5 ml Novell Pharmaceutical Laboratories

Nucral SUSP 500 mg / 5 ml Guardian Pharmatama

Nucral SUSP 500 mg / 5 ml Guardian Pharmatama

Ulsafate SUSP 500 mg / 5 ml Combiphar

Ulsidex TAB 500 mg Dexa Medica

01b GIT REGULATORS, ANTIFLATULENTS & ANTI-INFLAMMATORIES

DOMPERIDONE

Vomistop DROPS 5 mg Gracia Pharmindo

Vidon DROPS 5 mg Ferron Par Pharmaceuticals

Vosedon SUSP 5 mg/5 ml Sanbe Farma

Vomina SYR 5 mg/ 5 ml Hexpharm Jaya

Domperidone TAB 10 mg Dexa Medica

Domperidone TAB 10 mg Hexpharm Jaya

Domperidone TAB 10 mg Novell Pharmaceutical Laboratories

LACTOBACILLUS ACIDOPHILUS 1X107 CFU/GR,BIFIDOBACTERIUM BIFIDUM 1X107 CFU/GR,BIFIDOBACTERIUM LONGUM 1X107 CFU/GR,VITAMIN B2 0.5 MG,VITAMIN B6 0.7 MG,NIACINAMID 5.5 MG,ZINC 10 MG

Jovial POWD 1 x 107,1 x 107,1 x 107,0.5 mg,0.7 mg,5.5 mg,10 mg

Galenium Pharmasia Laboratories

LACTOBACILLUS ACIDOPHILUS ROSELLE 52, LACTOBACILLUS RHAMOSUS ROSELL 11

Lacidofil CAPS 2 milyard cfu Dexa Medica

MESALAZIN

Salofalk RECT TUBE

4 gr Darya Varia

Salofalk SUPP 500 mg Darya Varia

Salofalk TAB 500 mg Darya Varia

METOCLOPRAMIDE

Sotatic INJ 10 mg/2 ml Pratapa Nirmala

Primperan ORAL DROPS

Soho Industri Pharmasi

Sotatic SYR 5 mg/ 5 ml Pratapa Nirmala

16



METOCLORPAMIDE

Sotatic TAB 10 mg Pratapa Nirmala

SULFASALAZINE

Silfasalazin TAB 500 mg Pratapa Nirmala

01c ANTISPASMODICS

HYOSCINE N - BUTYLBROMIDE

Hyoscine INJ 20mg Otto Pharmaceutical Industries (Div2)

Scopamin TAB 10 mg Otto Pharmaceutical Industries

HYOSCINE N - BUTYLBROMIDE, PARACETAMOL

Scopamin Plus CAPL 10 mg Otto Pharmaceutical Industries

TIMEPIDIUM BROMIDE

Sesden CAPS 30 mg Tanabe Indonesia

01d ANTIDIARRHEALS

ATTAPULGITE

Biodiar TAB 630 mg Sandoz Indonesia

KAOLIN, PECTIN

Neokaolana SUSP 70 mg ; 50 mg Sanbe Farma

LOPERAMIDE

Normudal TAB 2mg Combiphar

ZINC

Daryazinc DROPS 27.5 mg/ml Darya Varia

Daryazinc SYR 55 mg/ 5 ml Darya Varia

01e LAXATIVES, PURGATIVES

BISACODYL

Dulcolax SUPP 5 mg Boehringer Ingelheim Indonesia

Dulcolax Sup Ad SUPP 10 mg Boehringer Ingelheim Indonesia

Bisacodyl TAB 5 mg Novell Pharmaceutical Laboratories

Dulcolax TAB 5 mg Boehringer Ingelheim Indonesia

LACTULOSE

Graphalac SYR 3,335 gram/5 ml Gracia Pharmindo

Pralax SYR 3.335 g / 5 ml Pratapa Nirmala

17



PHENOLPHTALEIN, PARAFFIN LIQ, GLYCERIN

Laxadine SYR 56 mg, 1200 mg, 736 mg


SODIUM PICOSULFATE

Laxoberon DROPS 7.5 mg Boehringer Ingelheim Indonesia

01g CHOLAGOGUES, CHOLELITHOLYTICS & HEPATIC PROTECTORS

URSODEOXYCHOLIC ACID

Ursodeoxycholic Acid CAPS 250 mg Novell Pharmaceutical Laboratories

Estazor TAB 250 mg Pratapa Nirmala

01h ANORECTAL PREPARATIONS

LIDOCAINE HCL, ALUMUNIUM SUBACETATE, HIDROCORTISONE ACETATE, ZINC OXIDE

Haemocaine OINT 5%, 3.50%, 0.25%, 18%


LITHOSPERMI RADIX EXTRACTUM; AETHYLIS AMINOBENZOAS; DIBUCAINI HYDROCHLORIDUM ;DIPHENHYDRAMINI; HYDROCHLORIDUM; CETRIMIDE

Borraginol N OINT 0,09 mg; 10 mg; 0,25 mg; 0,25 mg; 1,25 mg

Takeda Indonesia

Borraginol N SUPP 0,18 mg; 20 mg; 0,5 mg; 0,5 mg ; 2,5 mg

Takeda Indonesia

LITHOSPERMI RADIX EXTRACTUM; AETHYLIS AMINOBENZOAS; DIBUCAINI HYDROCHLORIDUM ;DIPHENHYDRAMINI; HYDROCHLORIDUM; CETRIMIDE+Prednisolon

Borraginol S OINT Takeda Indonesia

Borraginol S SUPP Takeda Indonesia

01i ANTIEMETICS

ONDANSETRON

Ondansetron Hcl INJ 4 mg / 2 ml Dexa Medica

Ondansetron INJ 4 mg / 2 ml Novell Pharmaceutical Laboratories

Cedantron SYR 4 mg Ethica Industri Farmasi

Ondansetron TAB 4 mg Novell Pharmaceutical Laboratories

PYRATHIAZINE CHLORTEOFILINAT, VIT B6

Anvomer B6 TAB 40 mg, 37.5 mg Dexa Medica

PYRATHIAZINE THEOCLATE, PYRIDOXINE HCL

Vomil B6 TAB Guardian Pharmatama

18



02 CARDIOVASCULAR & HAEMATOPOIETIC SYSTEM

02a CARDIAC DRUGS

AMIODARON

Amiodaron Hcl Iv INJ 150 mg / 3 ml Darya Varia

Kendaron G TAB 200 mg Darya Varia

DIGOXIN

Fargoxin INJ 0.25 mg Pratapa Nirmala

Digoxin TAB 0,25 mg Pratapa Nirmala

Fargoxin TAB 0,25 mg Pratapa Nirmala

DOBUTAMINE

Dobutamine Hcl INJ 250 mg Pertiwi Agung (Landson)

Dobutamine Hcl INJ 50 mg Novell Pharmaceutical Laboratories

DOPAMIN

Indop VIAL 40 mg Pratapa Nirmala

02b ANTI-ANGINAL DRUGS

GLYCERYL TRINITRAT

Nitrokaf Retard Forte TAB 5 mg Kimia Farma

Nitrokaf Retard TAB 2.5 mg Kimia Farma

ISOSORBIDE DINITRATE

Cedocard G INJ 10 mg Darya Varia

Farsorbid INJ 10 mg Pratapa Nirmala

Farsorbid TAB 5 mg Pratapa Nirmala

Cedocard Retard TAB 20 mg Darya Varia

Farsorbid TAB 10 mg Pratapa Nirmala

Isosorbid Dinitrat TAB 5 mg Pratapa Nirmala

Cedocard 10 Mg TAB 10 mg Darya Varia

ISOSORBIDE MONONITRATE

Monecto TAB 20 mg Pratapa Nirmala

Imdur TAB 60 mg Astrazeneca Indonesia

02c ACE INHIBITORS

CAPTOPRIL

Captopril TAB 25 mg Pertiwi Agung (Landson)

19



Dexacap TAB 12.5 mg Dexa Medica

Captopril TAB 25 mg Hexpharm Jaya

Forten TAB 12.5 mg Hexpharm Jaya

LISINOPRIL

Lisinopril TAB 5 mg Novell Pharmaceutical Laboratories

Lisinopril TAB 5 mg Dexa Medica

Lisinopril TAB 10 mg Novell Pharmaceutical Laboratories

Lisinopril TAB 10 mg Dexa Medica

RAMIPRIL

Ramipril TAB 10 mg Novell Pharmaceutical Laboratories

Tenapril TAB 10 mg Dexa Medica

Vivace TAB 5 mg Actavis Indonesia

Vivace TAB 2.5 mg Actavis Indonesia

Ramipril TAB 5 mg Novell Pharmaceutical Laboratories

Cardace TAB 2.5 mg Sanofi Aventis Indonesia

02d BETA-BLOCKERS

ATENOLOL

Betablok TAB 100 mg Hexpharm Jaya

Farnormin TAB 50 mg Pratapa Nirmala

BISOPROLOL

Betaone TAB 2.5 mg Kalbe Farma

Concor TAB 10 mg Merck Tbk

Concor TAB 1.25 mg Merck Tbk

Bisoprolol TAB 5 mg Hexpharm Jaya

Bisoprolol TAB 5 mg Novell Pharmaceutical Laboratories

CARVEDILOL

Vbloc TAB 6.25 mg Kalbe Farma

Vbloc TAB 25 mg Kalbe Farma

PROPANOLOL

Farmadral TAB 10 mg Pratapa Nirmala

02e CALCIUM ANTAGONISTS

20



AMLODIPINE

Amlodipine TAB 10 mg Pertiwi Agung (Landson)

Amlodipine TAB 10mg Otto Pharmaceutical Industries (Div2)

Amlodipine TAB 10 mg Hexpharm Jaya

Amlodipine TAB 5 mg Hexpharm Jaya

Amlodipine TAB 5 mg Pertiwi Agung (Landson)

Amlodipine TAB 5mg Otto Pharmaceutical Industries (Div2)

DILTIAZEM

Herbesser INJ 50 Tanabe Indonesia

Cordila Sr TAB 180 mg Dexa Medica

Dilmen TAB 60 mg Sanbe Farma

Diltiazem TAB 30 mg Sanbe Farma

Diltiazem TAB 30 mg Dexa Medica

LOSARTAN

Lifezar 50 Mg G) TAB 50 mg Darya Varia

NICARDIPINE

Carsive INJ 10 mg/ 5 ml Pertiwi Agung (Landson)

NIFEDIPIN

Nifedipin TAB 10 mg Dexa Medica

VERAPAMIL

Verapamil 8 TAB 80 mg Kimia Farma

02f ANGIOTENSIN II ANTAGONISTS

IRBESARTAN

Irbesartan TAB 150 mg Pertiwi Agung (Landson)

Irbesartan TAB 300 mg Pertiwi Agung (Landson)

Irbesartan TAB 300 mg Novell Pharmaceutical Laboratories

Irbesartan TAB 150 mg Otto Pharmaceutical Industries (Div2)

Irbesartan TAB 150 mg Novell Pharmaceutical Laboratories

LOSARTAN

Losartan TAB 50 mg Hexpharm Jaya

VALSARTAN

21



Valesco CAPL 40 mg Dipa Pharmalab Intersains (Escolab)

Varten TAB 80 mg Actavis Indonesia

Varten TAB 160 mg Actavis Indonesia

02g OTHER ANTI HYPERTENSIVES

20% MGSO4 INJ

Otsu - Mgso4 20 INJ 0.2 Otsuka (Cairan)

40% MGSO4 INJ.

Otsu - Mgso4 40 INJ 0.4 Otsuka (Cairan)

CLONIDINE

Clonidine TAB 150 mcg Kimia Farma

Catapres VIAL 150 mcg Boehringer Ingelheim Indonesia

MANITOL INJ

Infusan M20 INF Sanbe Farma

Otsu - Manitol 20 INF Otsuka (Cairan)

02h DIURETICS

FUROSEMIDE

Farsik INJ 10 mg Pratapa Nirmala

Edemin INJ 10 mg Ikapharmindo Putramas

Furosemide TAB 40 mg Pratapa Nirmala

Furosemide TAB 40 mg Kimia Farma

SPIRONOLACTONE

Spironolactone CAPL 25 mg Dexa Medica

Spironolactone TAB 100 mg Otto Pharmaceutical Industries (Div2)

Spironolactone TAB 25 mg Otto Pharmaceutical Industries (Div2)

Spironolactone TAB 100 mg Dexa Medica

02j PERIPHERAL VASODILATORS & CEREBRAL ACTIVATORS

CO-DERGOCRINE MESYLATE

Exergin TAB 4.5 mg Guardian Pharmatama

02k VASOCONSTRICTORS

EPHEDRINE

Ephedrin Hcl INJ 50 mg Ethica Industri Farmasi

22



Ephedrine TAB 25 mg Kimia Farma

EPINEPHRINE

Epinephrine INJ 1 mg/ ml Ethica Industri Farmasi

NOREPINEPHRINE

Raivas INJ 4mg/4ml Dexa Medica

02l DYSLIPIDEMIC AGENTS

ATORVASTATIN

Avesco CAPL 10 mg Dipa Pharmalab Intersains (Escolab)

Actalipid TAB 40 mg Actavis Indonesia

Actalipid TAB 20 mg Actavis Indonesia

Atorvastatin TAB 20 mg Novell Pharmaceutical Laboratories

FENOFIBRATE

Fenofibrate CAPS 100 mg Hexpharm Jaya

Yosenob CAPS 300 mg Nufarindo

Hyperchol CAPS 100 mg Ikapharmindo Putramas

Fenofibrate CAPS 300 mg Hexpharm Jaya

Zumafib CAPS 300 mg Sandoz Indonesia

GEMFIBROZIL

Lipira CAPL 600 mg Combiphar

PRAVASTATIN

Pravastatin TAB 20 mg Novell Pharmaceutical Laboratories

SIMVASTATIN

Simvastatin TAB 10 mg Pertiwi Agung (Landson)

Simvastatin TAB 10 mg Hexpharm Jaya

Simvastatin TAB 20 mg Hexpharm Jaya

Esvat TAB 20 mg Dexa Medica

02m HAEMOSTATICS

antihaemophilic factor VIII 500 IU

Antihaemophilic Factor Viii INJ 500 iu Ikapharmindo Putramas

ASAM TRANEKSAMAT

Tranexamic CAPS 250 mg Harsen Laboratories

23



Tranec INJ 250 mg/5 ml Gracia Pharmindo

Asam Traneksamat INJ 100 mg/ 5 ml Novell Pharmaceutical Laboratories

Asam Traneksamat INJ 100 mg/ 5 ml Hexpharm Jaya

Nexa TAB 500 mg Hexpharm Jaya

FACTOR VII A RECOMBINAN

Novoseven VIAL 1mg Novo Nordisk Indonesia

VITAMIN K1

Prohem INJ Pratapa Nirmala

02n ANTICOAGULANTS, ANTIPLATELETS & FIBRINOLYTICS (THROMBOLYTICS)

ACETYL SALYCILIC ACID

Cardio Aspirin TAB 100 mg Bayer Indonesia

Aspilet Chewable TAB 80 mg Darya Varia

Thrombo Aspilet TAB 80 mg Darya Varia

BERAPROST SODIUM

Dorner TAB 20mg Astellas Pharma Indonesia

CILOSTAZOL

Fibrozol TAB 50 mg Sanbe Farma

Naletal TAB 100 mg Guardian Pharmatama

Naletal TAB 50 mg Guardian Pharmatama

CLOPIDOGREL

Placta TAB 75 mg Actavis Indonesia

Clopidogrel TAB 75 mg Dexa Medica

Clopidogrel TAB 75 mg Hexpharm Jaya

ENOXAPARINE

Lovenox INJ 0.6 ml Aventis Pharma



FONDAFARINUX

Arixtra PFS 7,5 mg Glaxo Wellcome Indonesia

Arixtra PFS 2,5 mg Glaxo Wellcome Indonesia

HEPARIN

Inviclot VIAL 5000iu Pratapa Nirmala

24



PHYTONADIONE

Neo - K INJ 2 mg Combiphar

STREPTOKINASE

Streptase VIAL 1.500.000 iu Dexa Medica

WARFARIN

Simarc TAB 2 mg Pratapa Nirmala

Warfarin TAB 1mg Eisai Indonesia

02r HAEMOTOPOIETICS AGENTS

ERITROPOIETIN

Epotrex INJ 2000iu Novell Pharmaceutical Laboratories

Epotrex INJ 4000iu Novell Pharmaceutical Laboratories

03 RESPIRATORY SYSTEM

03b ANTIASTHMATICS & COPD PREPARATIONS

BUDESONIDE

Obucort Swinghaler INH 200 mg / puff Otsuka Dvc Non Cairan

Pulmicort RESP 0.5 mg Astrazeneca Indonesia

Budenofalk TAB 3 mg Darya Varia

Pulmicort TURB 200mg Astrazeneca Indonesia

BUDESONIDE, FORMOTEROL

Symbicort Turb 80/60 TURB 80 mg Astrazeneca Indonesia

PROCATEROL

Meptin Swinghaler INH 10 mg Otsuka Dvc Non Cairan

Meptin Inhalation Solution NEBULES 50 mg Otsuka Dvc Non Cairan

Meptin SYR 5 mg Otsuka Dvc Non Cairan

Meptin TAB 50 mg Otsuka Dvc Non Cairan

SALBUTAMOL

Suprasma Inhaler INH 100 mcg Dexa Medica

Fartolin Inhalasi INH 5 mg/5 ml Pratapa Nirmala

Ventolin Nebules NEBULES 0,5 mg Glaxo Wellcome Indonesia

Ventolin Rotacaps ROTACAPS

200 mg Glaxo Wellcome Indonesia

Salbutamol TAB 2 mg Pratapa Nirmala

25



Salbutamol TAB 4 mg Pratapa Nirmala

SALBUTAMOL APPARATUS

Ventolin Rotahaler ROTAHALER

Glaxo Wellcome Indonesia

SALBUTAMOL, GUAIAFENESIN

Salbron Expect SYR 2 mg / 5 ml Hexpharm Jaya

SALBUTAMOL, IPRATROPIUM

Combivent INJ 2.5 mg/2.5 ml Boehringer Ingelheim Indonesia

Farbivent INJ 250 mg Pratapa Nirmala

SALMETEROL, FLUSTICASONE PROPIONATE

Seretide Diskus DPI 50 mg Glaxo Wellcome Indonesia

SALMETEROL, FLUTICASONE

Flutias INH 25mg, 125mg Kalbe Farma

Flutias INH 25mg, 50mg Kalbe Farma

TEOFILIN

Bronsolvan SYR 150 mg / 15 ml Hexpharm Jaya

Bronsolvan TAB 150 mg Hexpharm Jaya

TERBUTALINE SULFATE

Nairet INJ 0,5 mg Otto Pharmaceutical Industries

Bricasma Resp RESP 2.5 mcg Astrazeneca Indonesia

Forasma SYR 1.5 mg / 5 ml Guardian Pharmatama

Nairet TAB 2.5 mg Otto Pharmaceutical Industries

Forasma TAB 2.5 mg Guardian Pharmatama

Bricasma Turb TURB 0.5mg Astrazeneca Indonesia

TIOTROPIUM BR

Spiriva + Hh CAPS 18 mg Boehringer Ingelheim Indonesia

Spiriva CAPS 18 mg Boehringer Ingelheim Indonesia

03c COUGH & COLD PREPARATIONS

AMBROXOL

Epexol DROPS 15 mg/5 ml Sanbe Farma

Mucera DROPS 15 mg/5 ml Otto Pharmaceutical Industries

Epexol SYR 15 mg/5 ml Sanbe Farma

26



Transmuco SYR 15 mg/5 ml Hexpharm Jaya

Ambroxol SYR 15 mg/5 ml Sanbe Farma

Transmuco TAB 30 mg Hexpharm Jaya

Epexol TAB 30 mg Sanbe Farma

Ambroxol TAB 30 mg Novell Pharmaceutical Laboratories

BROMHEXINE

Bisolvon DROPS 4 mg / 2 ml Boehringer Ingelheim Indonesia

Farmavon INJ 4 mg / 2 ml Pratapa Nirmala

Dexolut TAB 8 mg Dexa Medica

BROMHEXINE, GUAIPHENESIN

Bisolvon Kids SYR 4 mg / 5 ml Boehringer Ingelheim Indonesia

Nufadipect SYR 4 mg / 5 ml Nufarindo

Nufadipect TAB 8 mg Nufarindo

CODEINE

Codein TAB 10 mg Kimia Farma

CODEINE ANHIDRATE, FENILTOLOKSAMIN,GUAIAFENESIN,EXTRACT THYMI CAIR

Codipront Cum Exp SYR 11,11 mg/5 ml Kimia Farma

DEXTROMETHORPHAN HBR ; PHENYLPROPANOLAM, PARACETAMOL

Tuzalos TAB 500 mg ; 10 mg Sanbe Farma

DEXTROMETHORPHAN HBR, PHENYLEPHRINE HCL; KLORFENIRAMIN MALEAT; NH4CL; NA CITRAT

Dextrosin SYR 12.5 mg/ 5 ml Otto Pharmaceutical Industries

DIPHENHYDRAMINE HCL

Sanadryl SYR 12.5 mg Sanbe Farma

DIPHENHYDRAMINE HCL, AMMONIUM CHLORIDA, DEXTROMETRORPHAN HBR, PHENYLEPHRINE HCL, NATRIUM CITRATE, PARACETAMOL

Neladryl Dmp SYR 13,5 mg, 131.5 mg, 8 mg, 6 mg, 55 mg, 125 mg


ISOPENDHYL HCL 1 MG, ACETAMINOPHEN 120 MG, PHENYLEPHRINE HCL 1 MG

Nipe Drop DROPS 1 mg Transfarma Medica Indah

LORATADINE, PSEUDOEPHEDRINE SULFATE

Aldisa Sr CAPS 5 mg; 120 mg Sanbe Farma

27



N-ACETYLCYSTEINE

Acetylcysteine CAPS 200 mg Novell Pharmaceutical Laboratories

Fluimucil Syrup DRY SYRUP

100 mg/ 5 ml Zambon Indonesia

Fluimucil Granule 200 GRANULE 200 mg Zambon Indonesia

Fluimucil Pediatric 100 GRANULE 100 mg Zambon Indonesia

Fluimucil 10 % INJ 300 mg / 3 ml Zambon Indonesia

N-Ace Nebu NEBULES 300 mg / 3 ml Pratapa Nirmala

Acetin 600 TAB 600 mg Sanbe Farma

PARACETAMOL, EZETIMIBE,CTM,PPA HCL,DMP HBR

Farapon TAB 250 mg Pratapa Nirmala

PARACETAMOL, GLYCERYL GUALACOLATE, CTM, PHENYLPROPANOLAMINE

Combiflu CAPL 500 mg Combiphar

PARACETAMOL, PSEUDOEPHEDRINE HCL, CHLORPHENIRAMINE MALEATE

Corhinza CAPL 500 mg Hexpharm Jaya

PARACETAMOL; CHLORPHENIRAMINE MALEAT, PHENYLEPHRINE; DEXTROMETHORPHAN HBR

Fludexin SYR 120 mg; 2 mg Dexa Medica

PSEUDOEPHEDRINE HCL, TERFENADINE

Rhinofed TAB 30 mg Dexa Medica

SALBUTAMOL, GUAIAFENESIN

Fartolin Expectorant SYR 1.2 mg/5 ml Pratapa Nirmala

03d NASAL DECONGESTANT & OTHER NASAL PREPARATIONS

MOMETASONE FUROATE

Nasonex SPRAY 60 mds Merck Sharp Dohme Pharma, Tbk

04 CENTRAL NERVOUS SYSTEM

04a ANXIOLYTICS

ALPRAZOLAM

Alprazolam TAB 0,25 mg Dexa Medica

Alprazolam TAB 0,5 mg Dexa Medica

Alprazolam TAB 0,5 mg Otto Pharmaceutical Industries (Div2)

Alprazolam TAB 1 mg Dexa Medica

28



CLOBAZAM

Clobazam TAB 10 mg Dexa Medica

DIAZEPAM

Valisanbe INJ 10 mg / 2ml Sanbe Farma

Valdimex INJ 10 mg/ 2 ml Mersifarma Tm

Trazep RECT TUBE

5 mg Pratapa Nirmala

Trazep RECT TUBE


Valisanbe TAB 2 mg Sanbe Farma

Valisanbe TAB 5 mg Sanbe Farma

04b HYPNOTICS & SEDATIVES

ESTAZOLAM

Elgran TAB 1 mg Guardian Pharmatama

04c ANTIDEPRESSANTS

AMITRIPTYLINE HCL

Trilin TAB 25 mg Harsen Laboratories

FLUOXETINE

Kalxetin CAPS 10 mg Kalbe Farma

Nopres TAB 20 mg Dexa Medica

SERTRALINE

Fatral TAB 50 mg Pratapa Nirmala

04d ANTIPSYCHOTICS

ARIPIPRAZOLE

Abilify TAB 5 mg Otsuka Dvc Non Cairan

CHLORPROMAZINE

Cepezet INJ 50 mg/2 ml Mersifarma Tm

CHLORPROMAZINE, PARACETAMOL

Promactil TAB 100 mg Combiphar

CLOZAPINE

Nuzip TAB 25 mg Guardian Pharmatama

Clozer TAB 100 mg Dexa Medica

HALOPERIDOL

29



Lodomer DROPS 2 mg Mersifarma Tm

Lodomer INJ 5 mg Mersifarma Tm

Haloperidol TAB 0,5 mg Pratapa Nirmala

Haloperidol TAB 1,5 mg Pratapa Nirmala

Lodomer TAB 2 mg Mersifarma Tm

OLANZAPINE

Onzapin TAB 5 mg Actavis Indonesia

RISPERIDONE

Risperidone TAB 2 mg Dexa Medica

Risperidone TAB 1 mg Dexa Medica

SULPIRIDE

Dogmatil TAB 50mg Soho Industri Pharmasi

04e ANTICONVULSANTS

CARBAMAZEPINE

Bamgetol TAB 200 mg Mersifarma Tm

Tegretol TAB 100 mg Novartis Indonesia

GABAPENTIN

Gabexal CAPS 100 mg Sandoz Indonesia

Alpentin CAPS 300 mg Actavis Indonesia

LAMOTRIGINE

Lamictal TAB 50 mg Glaxo Wellcome Indonesia

OXCARBAZEPINE

Prolepsi TAB 300 mg Mersifarma Tm

PHENOBARBITAL

Sibital INJ 200 mg Mersifarma Tm

Sibital TAB 50 mg Mersifarma Tm

PHENYTOIN

Ikaphen CAPS 100 mg Ikapharmindo Putramas

Phenytoin Natrium INJ 50 mg Novell Pharmaceutical Laboratories

PREGABALIN

Pgb CAPS 75 mg Ferron Par Pharmaceuticals

Pregabalin CAPS 150 mg Dexa Medica

30



TOPIRAMATE

Topamax TAB 25 mg Soho Industri Pharmasi

VALPROIC ACID

Valproic Acid SYR 250 mg/5 ml Novell Pharmaceutical Laboratories

04f OTHER CNS DRUGS & AGENTS FOR ADHD

METHYLPHENIDATE HCL

Ritalin La CAPS 20 mg Novartis Indonesia

Ritalin TAB 10 mg Novartis Indonesia

04g NEURODEGENERATIVE DISEASE DRUGS

DONEPEZIL

Donepezil Hcl TAB 5 mg Novell Pharmaceutical Laboratories

GALANTAMINE

Reminyl CAPS 8 mg Soho Industri Pharmasi

04h ANTIPARKINSONIAN DRUGS

LEVODOPA, BENSERAZIDE

Leparson TAB 100 mg Dexa Medica

PRAMIPEXOLE DIHCL

Sifrol TAB 0.125 mg Boehringer Ingelheim Indonesia

Sifrol TAB 0.25 mg Boehringer Ingelheim Indonesia

TRIHEXYPHENIDYL

Parkinal TAB 2 mg Harsen Laboratories

04i ANTIVERTIGO DRUGS

BETAHISTINE

Vastigo TAB 6 mg Dexa Medica

Betahistine TAB 6 mg Novell Pharmaceutical Laboratories

04j ANALGESICS (OPIOID)

MORFIN

Morfina INJ 10 mg Kimia Farma

PETHIDINE

Clopedin INJ 50 mg Kimia Farma

TRAMADOL

31



Tramadol CAPS 50 mg Hexpharm Jaya

Tramadol CAPS 50 mg Pratapa Nirmala

Tramadol INJ 100 mg / 2 ml Novell Pharmaceutical Laboratories

Tramadol INJ 50 mg/ml Sanbe Farma

04k ANALGESICS (NON-OPIOID) & ANTIPYRETICS

PARACETAMOL

Moretic DROPS 60 mg/0,6 ml Gracia Pharmindo

Paracetamol INF 1000 mg Novell Pharmaceutical Laboratories

Paracetamol INF 1000 mg Darya Varia

Propyretic SUPP 240 mg Combiphar



Sanmol SYR 120 mg/5 ml Sanbe Farma

Naprex SYR 250 mg/ 5 ml Darya Varia

Paracetamol TAB 500 mg Sanbe Farma

Farmadol TAB 500 mg Pratapa Nirmala

Sanmol TAB 500 mg Sanbe Farma

PARACETAMOL, N-ACETYLCYSTEINE

Sistenol CAPL 500 mg Dexa Medica

04l NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDs)

ASAM MEFENAMAT

Asam Mefenamat CAPL 500 mg Hexpharm Jaya

Mefenamic Acid CAPL 500 mg Pertiwi Agung (Landson)

Ponstelax CAPL 500 mg Combiphar

Pondex SUSP 50mg/5ml Dexa Medica

IBUPROFEN

Profen SYR 100 mg/5 ml Guardian Pharmatama

Ibuprofen TAB 400 mg Pratapa Nirmala

Ostarin TAB 200 mg Otto Pharmaceutical Industries

Dofen TAB 400 mg Dexa Medica

Ibuprofen TAB 200 mg Pratapa Nirmala

32



INDOMETACIN FANESIL

Dialon CAPS 100 mg Eisai Indonesia

KALIUM DICLOFENAC

Kalium Diklofenak TAB 50 mg Hexpharm Jaya

Kaflam TAB 25 mg Kalbe Farma

KETOPROFEN

Ketoprofen INJ 100 mg/ ml Hexpharm Jaya

Profenid SUPP 100 mg Aventis Pharma

Ketoprofen TAB 100 mg Dexa Medica

Ketoprofen TAB 50 mg Novell Pharmaceutical Laboratories

Ketoprofen TAB 100 mg Novell Pharmaceutical Laboratories

Remapro TAB 50 mg Mersifarma Tm

MELOXICAM

Meloxicam TAB 15 mg Hexpharm Jaya

Meloxicam TAB 7.5 mg Hexpharm Jaya

Meloxicam TAB 7.5 mg Novell Pharmaceutical Laboratories

Meloxicam TAB 15 mg Novell Pharmaceutical Laboratories

NATRIUM DIKLOFENAK

Divoltar TAB 50 mg Hexpharm Jaya

Voltadex TAB 50 mg Dexa Medica

PIROXICAM

Piroxicam CAPS 20 mg Sanbe Farma

Piroxicam TAB 10 mg Novell Pharmaceutical Laboratories

04n ANTIMIGRAINE PREPARATIONS

ERGOTAMINE, COFFEIN

Ergotamine Coffeine TAB 1 mg Kimia Farma

FLUNARIZINE

Silum TAB 5 mg Mersifarma Tm

Bartolium TAB 5 mg Nufarindo

Bartolium TAB 10 mg Nufarindo

04p NOOTROPICS & NEUROTONICS

33



CITICOLINE

Citicoline CAPL 500 mg Dexa Medica

Citicoline CAPL 500 mg Novell Pharmaceutical Laboratories

Citicoline CAPL 1000 mg Novell Pharmaceutical Laboratories

Neulin INJ 500 mg/4 ml Ferron Par Pharmaceuticals

Neulin INJ 250 mg/2 ml Ferron Par Pharmaceuticals

Neurolin VIAL 1000 mg/8 ml Pratapa Nirmala

CITICOLINE SODIUM

Citicoline INJ 250 mg/2 ml Mersifarma Tm



MECOBALAMIN

Mecobalamin INJ 500 mg Novell Pharmaceutical Laboratories

NIMODIPINE

Nimotop INF 0.0002 Bayer Indonesia

PIRACETAM

Piracetam CAPL 1200 mg Dexa Medica

Piracetam CAPL 800 mg Hexpharm Jaya

Piracetam CAPL 1200 mg Hexpharm Jaya

Piracetam CAPL 800 mg Dexa Medica

Piracetam INF 12 gr Novell Pharmaceutical Laboratories

Piracetam INF 200 mg Dexa Medica

Piracetam INJ 1 g / 5 ml Novell Pharmaceutical Laboratories

Piracetam INJ 1 g / 5 ml Dexa Medica

Mersitropil SYR 500 mg/ 5 ml Mersifarma Tm

05 MUSCULO-SKELETAL SYSTEM

05b HYPERURICEMIA & GOUT PREPARATIONS

ALLOPURINOL

Alodan TAB 300 mg Hexpharm Jaya

Sinoric TAB 300 mg Mersifarma Tm

COLCHICINE

34



Recolfar TAB 5 mg Pratapa Nirmala

05c MUSCLE RELAXANTS

EPERISONE HCL

Eperisone Hcl TAB 50 mg Novell Pharmaceutical Laboratories

Permyo TAB 50 mg Ferron Par Pharmaceuticals

ROCURONIUM BROMIDE

Noveron INJ 50 mg Novell Pharmaceutical Laboratories

Esmeron INJ 50 mg/ 5ml Merck Sharp Dohme Pharma, Tbk

TIZANIDINE

Tizacom TAB 2 mg Combiphar

05e NEUROMUSCULAR DISORDER DRUGS

NEOSTIGMINE METHYSULFATE

Neostigmin Hameln INJ 0,5 mg Combiphar

Prostigmin INJ 0,5 mg Transfarma Medica Indah

PYRIDOSTIGMINE BR

Mestinon TAB 60 mg Transfarma Medica Indah

05f OTHER DRUGS ACTING ON THE MUSCULO-SKELETAL SYSTEM

HYALURONIC ACID

Bionect Cream CREAM 0.002 Combiphar

Bionect GAUZE PADS

0.0005 Combiphar

Sinovial INJ 16mg/2ml Dexa Medica

06 HORMONES

06a ANDROGENTS & RELATED SYNTHETIC DRUGS

DANAZOL

Azol CAPS 200 mg Merck Tbk

Danocrine TAB 200 mg Sanofi Aventis Indonesia

06b OESTROGENTS & PROGESTERONES & RELATED SYNTHETICS DRUGS

ALLYLESTRENOL

Nobor TAB 5 mg Guardian Pharmatama

CLOMIPHENE CITRATE

35



Clomiphene Citrate TAB 50 mg Novell Pharmaceutical Laboratories

DROSPIRENONE, ETHYNIL ESTRADIOL

Angeliq TAB 2 mg Bayer Indonesia

ESTRADIOL VALERATE, NORGESTREL

Cyclo Progynova TAB 2 mg Bayer Indonesia

MEDROXYPROGESTERONE ACETATE

Provera TAB 10mg Pfizer Indonesia

Provera TAB 100mg Pfizer Indonesia

NOMEGESTROL ACETATE

Lutenyl TAB 5 mg Merck Tbk

NORETHISTERONE

Norestil TAB 5 mg Guardian Pharmatama

06d CORTICOSTEROID HORMONES

DEXAMETHASONE

Dexamethasone INJ 5 mg/ml Sanbe Farma

Dexamethasone TAB 0.5 mg Sanbe Farma

Kalmethasone TAB 0.5 mg Kalbe Farma

METHYL PREDNISOLONE

Methyl Prednisolone INJ 125 mg / 2 ml Dexa Medica

Methylpresnisolone INJ 125 mg / 2 ml Otto Pharmaceutical Industries (Div2)

Methylprednisolone TAB 16 mg Dexa Medica

Gamesolone TAB 8 mg Galenium Pharmasia Laboratories

Methyl Prednisolone TAB 8 mg Dexa Medica

Methylprednisolone TAB 4 mg Hexpharm Jaya

Methyl Prednisolone TAB 4 mg Dexa Medica

TRIAMCINOLONE

Flamicort INJ 40mg Dexa Medica

Triamcinolone TAB 4 mg Novell Pharmaceutical Laboratories

Triamcinolone TAB 4 mg Dexa Medica

07 CONTRACEPTIVE AGENTS

07a ORAL CONTRACEPTIVES

36



DESOGESTREL

Cerazette TAB 75 mcg Merck Sharp Dohme Pharma, Tbk

DESOGESTREL, ETHYNILESTRADIOL

Marvelon Gold TAB 0.15mg Merck Sharp Dohme Pharma, Tbk

Mercilon Gold TAB 0.15mg Merck Sharp Dohme Pharma, Tbk

DROSPIRENONE, ETHYNIL ESTRADIOL

Yasmin TAB 3 mg Bayer Indonesia

ESTRADIOL VALERATE, DIENOGEST

Qlaira TAB 3 mg Bayer Indonesia

LEVONORGESTREL, ETHINYL ESTRADIOL

Microgynon TAB 150 mg Bayer Indonesia

LYNESTRENOL

Exluton TAB 0.5mg Merck Sharp Dohme Pharma, Tbk

07b DEPOT CONTRACEPTIVES

MEDROXYPROGESTERONE ACETATE

Depo Progestin 150 Mg INJ 150 mg Harsen Laboratories

Depo Progestin 50 Mg INJ 50 mg Harsen Laboratories

MEDROXYPROGESTERONE ACETATE, ESTRADIOL

Gestin F1 INJ 50 mg Harsen Laboratories

08 ANTI-INFECTIVES SYSTEMIC

08a AMINOGLYCOSIDES

AMIKACIN

Amikacin INJ 250 mg/12.5% Dexa Medica

Amikacin INJ 500 mg/25% Dexa Medica

GENTAMYCIN

Gentanal INJ 80 mg Harsen Laboratories

GENTAMYCIN SULFATE

Sagestam INJ 40 mg Sanbe Farma

KANAMYCIN SULFATE

Kanamycin INJ 1 gr Meiji Indonesia

08b CEPHALOSPORINS

37



CEFACLOR

Cloracef Ds Forte SYR 250 mg / 5 ml Ethica Industri Farmasi

Cloracef TAB 500 mg Ethica Industri Farmasi

CEFADROXIL

Cefadroxil CAPS 500 mg Dexa Medica

Cefadroxil CAPS 500 mg Hexpharm Jaya

Renasistin Od DROPS 150 mg Pratapa Nirmala

Cefadroxil DRY SYRUP

250 mg/5 ml Novell Pharmaceutical Laboratories

Cefadroxil SYR 125 mg/ 5 ml Hexpharm Jaya

CEFEPIME

Cefepime INJ 1 gr Darya Varia

Cefepime INJ 1 gr Novell Pharmaceutical Laboratories

CEFIXIME

Cefixime CAPS 100 mg Dexa Medica

Cefixime CAPS 100 mg Novell Pharmaceutical Laboratories

Cefixime CAPS 200 mg Dexa Medica

Cefixime CAPS 200 mg Novell Pharmaceutical Laboratories

Fixacep Od DROPS 30 mg /ml Pratapa Nirmala

Cefixime SYR 100 mg/ 5ml Dexa Medica

Cefixime SYR 100 mg/ 5ml Hexpharm Jaya

CEFOPERAZONE

Ceropid INJ 1000 mg Novell Pharmaceutical Laboratories

CEFOPERAZONE, SULBACTAM

Cefoperazone INJ 500 mg Novell Pharmaceutical Laboratories

CEFOTAXIME

Cefotaxime INJ 1 gr Dexa Medica

Cefotaxime INJ 1 gr Sanbe Farma

Cefotaxime INJ 1 gr Hexpharm Jaya

CEFPIROME

Cefpirome INJ 1 gr Dexa Medica

38



CEFPIROME SULFATE

Cefpirome Sulfate INJ 1 gr Novell Pharmaceutical Laboratories

CEFTAZIDIME

Ceftazidime INJ 1 gr Hexpharm Jaya

CEFTRIAXONE

Ceftriaxone INJ 1 gr Hexpharm Jaya

Ceftriaxone INJ 1 gr Dexa Medica

CEFUROXIME

Zinnat TAB 500 mg Glaxo Wellcome Indonesia

CEFUROXIME AXETIL

Anbacim INJ 1 gr Sanbe Farma

08c PENICILLINS

AMOXYCILLIN

Amoxicillin CAPL 500 mg Hexpharm Jaya

Amoxicillin CAPS 250 mg Sanbe Farma

Amoxicillin INJ 1gr Sanbe Farma

Amoxicillin SYR 125 mg/5 ml Hexpharm Jaya

Topcillin SYR 250 mg/5 ml Hexpharm Jaya

Novax Fds SYR 250 mg/5 ml Gracia Pharmindo

Amoxicillin SYR 125 mg/5 ml Sanbe Farma

Dexymox TAB 500 mg Dexa Medica

AMOXYCILLIN TRHYDRATE

Mokbios TAB 500 mg Mersifarma Tm

PROCAINE BENZYLPENICILLIN

Procaine Penicillin-G vial 3.000.000iu Meiji Indonesia

08d OTHER BETA-LACTAMS

MEROPENEM

Meropenem INJ 1 gr Hexpharm Jaya

Meropenem INJ 0.5 gr Dexa Medica

Meropenem INJ 1 gr Pratapa Nirmala

08e CHLORAMPHENICOLS

CHLORAMPHENICOL

39



Kalmicetine CAPS 250 mg Kalbe Farma

Chloramphenicol SYR 125 mg/ml Kimia Farma

Chloramphenikol TAB 250 mg Kimia Farma

THIAMPHENICOL

Fulsatrak CAPS 250 mg Harsen Laboratories

Biothicol CAPS 250 mg Sanbe Farma

Fosicol Fds SYR 250 mg/5 ml Gracia Pharmindo

Fulsatrak SYR 125 mg/5 ml Harsen Laboratories

08f MACROLIDES

AZITHROMYCIN

Azithromycin CAPL 500 mg Novell Pharmaceutical Laboratories

Zibramax SYR 200 mg/5 ml Guardian Pharmatama

Azithromycin TAB 250 mg Ethica Industri Farmasi

Azithromycin TAB 500 mg Kimia Farma

CLARITHROMYCIN

Clarolid CAPL 500 mg Guardian Pharmatama

Comtro SYR 125 mg/5ml Combiphar

Comtro TAB 250 mg Combiphar

CLINDAMYCIN

Clindamycine CAPS 150 mg Dexa Medica

Clindamycin CAPS 150 mg Novell Pharmaceutical Laboratories

Clindamycine CAPS 300 mg Dexa Medica

Clindamycine CAPS 300 mg Sanbe Farma

ERYTHROMYCIN

Erythromycin SYR 200 mg/5 ml Kimia Farma

Erythromycin TAB 250 mg Kimia Farma

Erythromycine TAB 500 mg Pratapa Nirmala

ROXITHROMYCIN

Uplores SYR 150 mg Sanbe Farma

Rokdisit TAB 150 mg Harsen Laboratories

SPIRAMYCIN

40



Spiramycin TAB 500 mg Novell Pharmaceutical Laboratories

08g QUINOLONES

CIPROFLOXACIN

Ciprofloxacin CAPL 500 mg Novell Pharmaceutical Laboratories

Ciprofloxacin INF 200 mg Hexpharm Jaya

Ciprofloxacin INF 200 mg Dexa Medica

Ciprofloxacin TAB 500 mg Hexpharm Jaya

Ciprofloxacin TAB 500 mg Sanbe Farma

LEVOFLOXACIN

Levofloxacin INF 500 mg Novell Pharmaceutical Laboratories

Levofloxacin INF 500 mg Hexpharm Jaya

Levofloxacin INF 750 mg Hexpharm Jaya

Levofloxacin TAB 500 mg Novell Pharmaceutical Laboratories

Levofloxacin TAB 500 mg Kimia Farma

MOXIFLOXACIN

Maxiflon CAPL 400 mg Guardian Pharmatama

OFLOXACINE

Ofloxacine INF 0.002 Dexa Medica

Ofloxacin TAB 200 mg Novell Pharmaceutical Laboratories

Ofloxacin TAB 400 mg Novell Pharmaceutical Laboratories

08h TETRACYCLINS

DOXYCYCLINE

Doxycycline CAPS 100 mg Sanbe Farma

Doxycycline CAPS 100 mg Dexa Medica

08j ANTIBACTERIAL COMBINATIONS

AMOXYCILLIN, ASAM CLAVULANAT

Claneksi CAPL 500 mg Sanbe Farma

Claneksi INJ 1gr Sanbe Farma

Claneksi SYR 125 mg/5ml Sanbe Farma

Claneksi SYR 250 mg / 5 ml Sanbe Farma

41



TRIMETHOPRIM, SULFAMETHOXAZOLE

Bactoprim Forte CAPL 160 mg Combiphar

Cotrimoxazole SYR 40 mg Kimia Farma

Bactoprim Combi SYR 40 mg Combiphar

Decatrim Forte TAB 160 mg Harsen Laboratories

08k OTHER ANTIBIOTICS

FOSFOMYCIN

Novellmycin INJ 1 gr Novell Pharmaceutical Laboratories

Novellmycin INJ 2 gr Novell Pharmaceutical Laboratories

08l ANTI-TB AGENTS

INH, PYRIDOXINE HCL

Pyravit SYR 100 mg, 10 mg Galenium Pharmasia Laboratories

ISONIAZID, PYRIDOXIN

Inoxin TAB 400 mg Dexa Medica

RIFAMPICIN

Rifampicin CAPL 450 mg Sanbe Farma

Rifampicin CAPL 600 mg Sanbe Farma

Rimactane CAPS 300 mg Sandoz Indonesia

RIFAMPICIN, INH

Rimactazid TAB 75 mg Sandoz Indonesia

Rimactazid TAB 450 mg Sandoz Indonesia

RIFAMPICIN, INH ; PYR

Rimcure TAB 75 mg Sandoz Indonesia

RIFAMPICIN, INH ; PYR ; ETH

Rimstar 4Fdc TAB 150 mg Sandoz Indonesia

08n ANTIFUNGALS

FLUCONAZOLE

Fluconazole CAPS 150 mg Kimia Farma

Fluconazole INF 2 mg Novell Pharmaceutical Laboratories

ITRACONAZOLE

Sporax Kapsul CAPS 100 mg Dexa Medica

42



KETOCONAZOLE

Ketoconazole TAB 200 mg Hexpharm Jaya

Ketoconazole TAB 200 mg Kimia Farma

NYSTATIN

Nyndia DROPS 100.000 iu Guardian Pharmatama

Nymiko SUSP 100.000 iu Sanbe Farma

Decastatin TAB 500000 iu Harsen Laboratories

08p ANTIVIRALS

ACYCLOVIR

Zovirax Iv INJ 250 mg Glaxo Wellcome Indonesia

Acyclovir TAB 200 mg Kimia Farma

Acyclovir TAB 200 mg Pratapa Nirmala

Acyclovir TAB 400 mg Kimia Farma

Acyclovir TAB 400 mg Pratapa Nirmala

LAMIVUDINE

3 Tc Hbv TAB 100 mg Glaxo Wellcome Indonesia

OSELTAMIVIR

Tamiflu CAPS 75 mg Roche Indonesia

VALACYCLOVIR

Valvir CAPL 500 mg Ethica Industri Farmasi

08q ANTHELMINTICS

ALBENDAZOL

Albendazol TAB 400 mg Kimia Farma

PYRANTEL PAMOAT

Pantrin CAPL 250 mg Harsen Laboratories

Pantrin SYR 250 mg Harsen Laboratories

Pyrantel TAB 125 mg Pratapa Nirmala

Pyrantel TAB 125 mg Kimia Farma

08r ANTIMALARIALS

SULFADOXINE, PYRIMETHAMINE

Fansidar TAB 500 mg Roche Indonesia

08s ANTI AMOEBICS

43



METRONIDAZOLE

Metrolet CAPL 250 mg Harsen Laboratories

Metronidazole INF 500 mg Ethica Industri Farmasi

Metronidazole INF 500 mg Darya Varia

Metronidazole INF 500 mg Hexpharm Jaya

Ronazol SUSP 125 mg/5 ml Gracia Pharmindo

Metronidazole TAB 500 mg Kimia Farma

Metronidazole TAB 500 mg Sanbe Farma

09 ONCOLOGY

09a CYTOTOXIC CHEMOTHERAPY

5-FLUOROURACIL

5-Flourouracil INJ 250 mg Kalbe Farma

ANAGRELIDE HCL

Tromboreductine CAPS 0.5 mg Combiphar

ANASTRAZOLE

Arimidex TAB 1 mg Astrazeneca Indonesia

BEVACIZUMAB

Avastin INJ 100 mg Roche Indonesia

BICALUTAMIDE

Casodex TAB 50 mg Astrazeneca Indonesia

Casodex TAB 150 mg Astrazeneca Indonesia

BLEOMYCIN

Bleocin INJ 15mg Kalbe Farma

Bleomycin INJ 15 u/10 ml Sanbe Farma

CABAZITAXEL

Jevtana INJ 60 mg Sanofi Aventis Indonesia

CARBOPLATIN

Carboplatin INJ 450mg Kalbe Farma

Carboplatin INJ 150mg Kalbe Farma

CEPECITABINE

Xeloda CAPS 500 mg Roche Indonesia

CISPLATIN

44



Cisteen INJ 10 mg / 60 -75 mg/m2

Kimia Farma

Cisplatin INJ 50mg Kalbe Farma

Cisteen INJ 50 mg / 60 -75 mg/m2

Kimia Farma

Cisplatin INJ 10mg Kalbe Farma

CYCLOPHOSPHAMIDE

Cyclovid INJ 1000 mg Novell Pharmaceutical Laboratories



DAUNORUBICIN

Daunocin INJ 20 mg Novell Pharmaceutical Laboratories

DOCETAXEL

Brexel Tm INJ 80mg Kalbe Farma

Taceedo INJ 80 mg/2 ml Kimia Farma

Docetaxel INJ 20 mg/0,5 ml Sanbe Farma

Taceedo INJ 20 mg/0,5 ml Kimia Farma

Brexel Tm INJ 20mg Kalbe Farma

Docetaxel INJ 80 mg/2 ml Sanbe Farma

DOXORUBICIN

Doxorubicin INJ 50mg Kalbe Farma

Doxorubicin Hcl INJ 50 mg/25 ml Sanbe Farma

Doxorubicin Hcl INJ 10 mg/5 ml Sanbe Farma

Doxorubicin INJ 10 mg Kalbe Farma

EPIRUBICIN

Epirubicin Hcl INJ 10 mg/5 ml Sanbe Farma

Epirubicin INJ 50mg Kalbe Farma

Epirubicin Hcl INJ 50 mg/25 ml Sanbe Farma

Epirubicin INJ 10 mg Kalbe Farma

ERLOTINIB

Tarceva TAB 150 mg Roche Indonesia

Tarceva TAB 100 mg Roche Indonesia

45



ETOPOSIDE

Etopul INJ 100 mg Novell Pharmaceutical Laboratories

FLUDARABINE PHOSPHATE

Fludara INJ 50 mg Sanofi Aventis Indonesia

Fludara TAB 10 mg Sanofi Aventis Indonesia

GEMCITABINE

Gemcikal INJ 1000 mg Kalbe Farma

Gemcikal INJ 200 mg Kalbe Farma

GOSERELIN

Zoladex INJ 10.8 mg Astrazeneca Indonesia

Zoladex INJ 3.6 mg Astrazeneca Indonesia

HYDROXYDE UREA

Cytodrox CAPS 500 mg Combiphar

IFOSFAMIDE

Holoxan INJ 2000 mg Transfarma Medica Indah

Holoxan INJ 1000 mg Transfarma Medica Indah

IRINOTECAN HCL

Irinotecan Hcl INJ 40 mg/2 ml Sanbe Farma

Irinotecan Hcl INJ 100 mg/5 ml Sanbe Farma

LEUCOVORIN

Leucovorin INJ 50 mg Kalbe Farma

METHOTREXATE

Methotrexate Ebewe INJ 5 mg Sandoz Indonesia

Methotrexate INJ 50 mg/2 ml Sanbe Farma

Methotrexate INJ 50 mg/2 ml Kalbe Farma

Methotrextat TAB 2.5 mg Ferron Par Pharmaceuticals

OXALIPLATIN

Eloxatine INJ 100 mg/20 ml Sanofi Aventis Indonesia

Oxaliplatin INJ 50 mg/10 ml Sanbe Farma

PACLITAXEL

Paclitaxel INJ 100 mg/16,7 ml Kalbe Farma

Paclitaxel INJ 30 mg/ 5 ml Kalbe Farma

46



PEMETREXED

Alimta VIAL 100 mg Eli Lilly Division Of Metro Drug Indonesia.

Alimta VIAL 500 mg Eli Lilly Division Of Metro Drug Indonesia.

TRASTUZUMAB

Herceptin INJ 440 mg Roche Indonesia

VINCRISTINE

Vincristine INJ 2 mg/2 ml Kalbe Farma

Vincristine INJ 1 mg/1 ml Kalbe Farma

VINORELBINE

Navelbine INJ 10 mg Transfarma Medica Indah

Navelbine INJ 50 mg Transfarma Medica Indah

09b HORMONAL CHEMOTHERAPY

EXEMESTANE

Aromasin TAB 25mg Pfizer Indonesia

LETROZOLE

Letraz TAB 2.5mg Kalbe Farma

LEUPRORELINE ACETATE DEPOT

Tapros INJ 1,88 mg Takeda Indonesia

Tapros INJ 11,25 mg Takeda Indonesia

LEUPRORELINE ACETATE DEPOT, MANITOL 75 MG, CARBOXYMETHYLCELLULOSE SODIUM 7.5 MG, POLYSORBATE 80 1.5 MG, WATER FOR INJECTION 1.5 ML

Divalin INJ 3.75 mg Darya Varia

MEGESTROL ACETAT

Tracetate SYR 40mg/ml Pratapa Nirmala

TAMOXIFEN

Tamofen TAB 10 mg Kalbe Farma

Tamoxifen TAB 20 mg Ferron Par Pharmaceuticals

09c IMMUNOLOGICAL CHEMOTHERAPHY

GEFITINIB

Iressa TAB 250 mg Astrazeneca Indonesia

09d TARGETED CANCER THERAPY

LEUCOVORIN

47



Novorin INJ 10mg Novell Pharmaceutical Laboratories

RITUXIMAB

Mabthera INJ 100 mg Roche Indonesia

Mabthera INJ 500 mg Roche Indonesia

10 GENITO-URINARY SYSTEM

10a PREPARATIONS FOR VAGINAL CONDITIONS

METRONIDAZOLE

Flagyl OVULA 1 gr Aventis Pharma

Fladex OVULA 500mg Dexa Medica

Flagyl OVULA 0.5 gr Aventis Pharma

METRONIDAZOLE, NYSTATIN

Vagistin OVULA 500 mg Combiphar

Trichodazol Plus OVULA 500 mg / 1000 iu Sanbe Farma

NYSTATIN

Decastatin Vaginal OVULA 100000 iu Harsen Laboratories

10b URINARY ANTISEPTICS

PIPEMIDIC ACID

Urotractin CAPS 400 mg Sanbe Farma

10c DRUGS ACTING ON THE UTERUS

ISOXSUPRINE HCL

Duvadilan INJ 10 mg/ 2 ml Kimia Farma

Hystolan TAB 20 mg Dexa Medica

METHYL ERGOMETRINE

Methylergometrine Maleate INJ 0.2 mg Ethica Industri Farmasi

MISOPROSTOL

Cytostol TAB 200 mg Combiphar

OXYTOSIN

Oxytocin "S" INJ 10 iu Ethica Industri Farmasi

SYNTHETIC OXYTOCIN

Syntocinon INJ 10 iu Novartis Indonesia

10e DRUGS FOR BLADDER & PROSTATE DISORDERS

FINASTERIDE

48



Reprosid TAB 5 mg Harsen Laboratories

TAMSULOSIN

Prostam Sr TAB 0,4 mg Novell Pharmaceutical Laboratories

TERAZOSIN HCL

Hytroz TAB 1 mg Dexa Medica

10f OTHER DRUGS ACTING ON GENITO-URINARY SYSTEM

SOLIFENACIN

Vesicare TAB 5mg Astellas Pharma Indonesia

11 ENDOCRINE & METABOLIC SYSTEMS

11a INSULINS PREPARATIONS

INSULIN ASPART

Novorapid Flexpen (Include Pen)

INJ 100 iu/ml Novo Nordisk Indonesia

Novorapid Vial INJ 100 iu/ml Novo Nordisk Indonesia

INSULIN DETEMIR

Levemir Flexpen (Include Pen)


INSULIN GLARGINE

Lantus Solostar Pen INJ 100 iu/ml Aventis Pharma

INSULIN GLULISINE

Apidra Solostar Pen INJ 100 iu/ml Aventis Pharma

NPH HUMAN INSULIN (RDNA ORIGIN)

Humulin N Kwikpen CATRIDGES

100 iu/ml Eli Lilly Division Of Metro Drug Indonesia.

PROTAMINATED INSULIN ASPART

Novomix Flexpen (Include Pen)


RECOMBINANT HUMAN INSULIN (AS INACTIVE CRESOL STABILIZED INSULIN SOLUTION)

Sansulin R CATRIDGES

100 iu/ml Sanbe Farma

RECOMBINANT HUMAN INSULIN (AS ISOPHANE CRESOL AND PHENOL STABILIZED INSULIN SUSPENSION)

Sansulin N CATRIDGES


49



RECOMBINANT HUMAN INSULIN (REGULAR SOLUBLE HUMAN INSULIN 30% & ISOPHANE HUMAN INSULIN SUSPENSION 70%)

Sansulin M30 CATRIDGES


REGULAR INSULIN HUMAN INJECTION (RDNA ORIGIN)

Humulin R Kwikpen CATRIDGES

100 iu/ml Eli Lilly Division Of Metro Drug Indonesia.

Humulin R INJ 100 iu/ml Eli Lilly Division Of Metro Drug Indonesia.

11b ORAL ANTIDIABETICS AGENTS

ACARBOSE

Eclid TAB 50 mg Dexa Medica

Eclid TAB 100 mg Dexa Medica

Acrios TAB 50 mg Actavis Indonesia

Acrios TAB 100 mg Actavis Indonesia

GLIBENCLAMIDE

Glibenclamide TAB 5 mg Pratapa Nirmala

Harmida TAB 2,5 mg Harsen Laboratories

Harmida TAB 5 mg Harsen Laboratories

GLICLAZIDE

Glidabet TAB 80 mg Hexpharm Jaya

Glucodex TAB 80 mg Dexa Medica

GLIMEPIRIDE

Glimepiride TAB 3 mg Hexpharm Jaya


Diaversa TAB 4 mg Dexa Medica

Versibet TAB 3 mg Harsen Laboratories

Glimepiride TAB 4 mg Kimia Farma


Glimepiride TAB 2 mg Otto Pharmaceutical Industries (Div2)


Glimepiride TAB 1 mg Kimia Farma



50



Glimepiride TAB 3 mg Otto Pharmaceutical Industries (Div2)

GLIPIZIDE GITS

Glucotrol Xl TAB 10mg Pfizer Indonesia

GLIQUIDONE

Lodem TAB 30 mg Dexa Medica

METFORMIN

Metformin TAB 850 mg Dexa Medica

Diabemin Fc TAB 500 mg Dexa Medica

Heskopaq 500 TAB 500 mg Harsen Laboratories

Heskopaq 850 TAB 850 mg Harsen Laboratories

Diabit TAB 500 mg Hexpharm Jaya

METFORMIN XR

Metformin Xr TAB 500 mg Otto Pharmaceutical Industries (Div2)

PIOGLITAZONE

Prabetic TAB 15 mg Pratapa Nirmala

Prabetic TAB 30 mg Pratapa Nirmala

REPAGLINIDE

Dexanorm TAB 1 mg Dexa Medica

11c THYROID HORMONES

LEVOTHYROXINE

Euthyrox TAB 50 mcg Merck Tbk

Euthyrox TAB 100 mcg Merck Tbk

11d ANTITHYROIDS AGENTS

THIAMAZOLE

Thyrozol TAB 10 mg Merck Tbk

Thyrozol TAB 5 mg Merck Tbk

11f AGENTS AFFECTING BONE METABOLISM

CALCITRIOL

Oscal CAPS 0.5 mcg Kalbe Farma

Ostriol CAPS 0.25 mcg Pratapa Nirmala

12 VITAMINS & MINERALS

51



12b VITAMIN B-COMPLEX/WITH C

B12; B1; B6

Sohobion 5000 INJ 5000 mg, 100mg, 100mg

Ethica Industri Farmasi

VIT B COMP

Neurodex TAB Dexa Medica

VIT C, VIT B COMPLEK

Farmabex Plus TAB 750 mg Pratapa Nirmala

12c VITAMIN C

VITAMIN C, ZINC

Imunped DROPS 40 mg Darya Varia

Imunped SYR 100 mg Darya Varia

12d CALCIUM/WITH VITAMINS

CALCIUM 800 MG VITAMIN D-300 IU

Calporosis D CAPL 800 mg Mersifarma Tm

KALSIUM

Kalsium Laktat CAPL 500 mg Pertiwi Agung (Landson)

12e VITAMINS &/OR MINERALS

VIT A,VIT D,VIT B1,VIT B2,VIT B6,VIT B12, NICOTINAMIDE,CA LACTATE,FE FUMARATE ,K IODIDE ,FOLIC ACID

Prenase CAPL 2000 iu Nufarindo

VIT.D

D-Vit SYR 400 iu Gracia Pharmindo

12g VITAMINS & MINERALS (PEDIATRIC)

CALCIUM, VITAMIN DAN MINERAL

Elkana SUSP 60 mg / 5 ml Sanbe Farma

VIT A 5.000 IU, B1, B2, B6, C, D 400 IU, NICOTINAMIDE, PANTOTHE

San B Plex Drops DROPS 15 ml Sanbe Farma

12h VITAMINS & MINERALS (PRE- 7 POST-NATAL)/ANTIANEMICS

BETA CAROTENE, VIT B1, VIT B2, NICOTINAMIDE, VIT B6, CA PANTOTHENATE, VIT B12, VIT C, FOLIC ACID, K IODIDE, FE (III) FUMARATE, COPPER (II) SULFATE, CA LACTATE, NA FLUORIDE

52



Folamil CAPL 10,000 iu, 10 mg, 2,5 mg, 20 mg, 4 mg, 100 mg, 400 iu, 90 mg, 0,1 mg, 250 mg, 1 mg

Dexa Medica

FE DEXTRAN

Cosmofer INJ 100 mg/ 2 ml Pratapa Nirmala

FE FUMARATE, FOLIC ACIDVIT.B 12VIT.CVIT.DCA-CARBONATE

Bionemi CAPS 360 mg Gracia Pharmindo

FE GLUCONATE, FOLIC ACID, MAGNESIUM SULFATE, COPPER SULFAT, VIT B12, VIT C, SORBITOL

Emibion CAPS 250 mg Guardian Pharmatama

FOLIC ACID

Starfolat TAB 400 mcg Dexa Medica

Nufolic TAB 400 mcg Nufarindo

VIT A 6000 UNITS, VIT D 400 UNITS, VIT C 100 MG, VIT B1 10 MG, VIT B2 2.5 MG, VIT B6 15 MG, VIT B12 : 4 MCG, NIACINAMIDE: 20 MG, CALCIUM PANTHOTHENATE: 7.5 MG, FOLIC ACID: 1 MG, FERROUS FUMERATE: 90 MG, CALCIUM LACTATE: 250 MG, COPPER: 0.1 MG, IODIUM 0.1

Obimin Tab adam folat : 1 mg, Ferrous Fumerate: 90 MG

Darya Varia

13 NUTRITIONS

13c PARENTERAL NUTRITION

AMINO ACID

Aminofusin Paed INF 0.05 Kalbe Farma

Aminoleban INF Otsuka (Cairan)

Pan Amin G INF Otsuka (Cairan)

Kalbamin INF 0.1 Kalbe Farma

AMINO ACID + BCAA + EAA/NEAA

Kidmin INF Otsuka (Cairan)

AMINO ACID 27.2 G/L+ BCAA 27.5 %+ SORBITOL 50 G/L; OSMOLARITY 507 MOSM/L; CALORIE 308 KCAL/L

Renxamin INF 0.09 Kalbe Farma

AMINO ACID, NIL

Aminosteril N Hepa 8% INF 8% Fresenius Kabi Indonesia

53



Aminosteril Infant 6% INF 6% Fresenius Kabi Indonesia

BCAA, LOLA, XYLITOL, VITAMIN, ELEKTROLIT

Comafusin Hepar INF 0.5 Kalbe Farma

FRUKTOSA, GLUKOSA, XYLITOL

Triofusin 500 INF 500 kkal/l Kalbe Farma

FRUKTOSA, GLUKOSA, XYLITOL, ELEKTROLIT

Triofusin E1000 INF 1,000 kkal/l Kalbe Farma

HUMAN ALBUMIN

Albuminar INF 25 gr Dexa Medica

Human Albumin INF 0.2 Dexa Medica

Albumin INJ 0.2 Kimia Farma

Albumin INJ 0.2 Kimia Farma

MALTOSE 100G/L;OSMOLARITY 278 MOSM/L; CALORIE 400 KCAL/L

Infumal 10% Sp INF Sanbe Farma

Infumal 10% Dp INF Sanbe Farma

N(2) L-ALANYL -L-GLUTAMINE, NIL

Dipeptiven INF max daily dose : 2 gr amino acids/kg/body wt

Fresenius Kabi Indonesia

13d ELECTROLYTES

ELECTROLYTE (NA+ 60 ; K+ 10 ;CL- 50 ; LACTATE 20) MEQ/L;GLUCOSE 27G/L;OSMOLARITY 290 MOSM/L; CALORIE 108 KCAL/L

Tridex 27A INF Sanbe Farma

K L-ASPARTATE

Aspar K TAB 300 Tanabe Indonesia

K L-ASPARTATE, MG ASPARTATE

Renapar TAB 300 mg Pratapa Nirmala

14 EYE

14a EYE ANTI-INFECTIVES & ANTISEPTICS

ACYCLOVIR

Hervis EYE OINT 0.03 Cendo Pharmaceutical Industries

CHLORAMPHENICOL

54



Fenicol EYE DROPS

5 mg Cendo Pharmaceutical Industries

Fenicol Eo EYE OINT 10 mg Cendo Pharmaceutical Industries

CIPROFLOXACIN

Ulcori EYE DROPS

3 mg/ml Cendo Pharmaceutical Industries

Baquinor Ed EYE DROPS

3 mg/ml Sanbe Farma

CLORAMPHENICOL

Decacetine EYE DROPS

5 mg Harsen Laboratories

GATIFLOXACIN

Giflox EYE DROPS


Gaforin Ed EYE DROPS

3 mg/ml Sanbe Farma

GENTAMYCIN

Sagestam Ed EYE DROPS

3 mg/ml Sanbe Farma

Genta EYE DROPS


Sagestam Eo EYE OINT 3 mg/g Sanbe Farma

LEVOFLOXACIN

Levocin Ed EYE DROPS

5 mg/ml Sanbe Farma

Lfx EYE DROPS


NEOMYCIN SULFATE 3.5 MG, POLYMYXIN B SULFATE 16,250 IU, PHENYLEPHRINE HCL 1.2 MG

Polifrisin Ed EYE DROPS

Sanbe Farma

OFLOXACINE

Floxa EYE DROPS


POLYMIXIN B SULPHATE, NEOMYCIN SULPHATE,GRAMICIDIN

Polygran EYE DROPS

10000 iu, 2,5 mg, 0.025 mg

Cendo Pharmaceutical Industries

14b EYE ANTISEPTICS WITH CORTICOSTEROIDS

55



DEXAMETHASONE, NEOMYCIN SULFATE, POLYMIXIN B SULFATE

Dexamethason,Neomycin,Polimixyin

EYE DROPS


FRAMYCETIN SULPHATE5 MG, GRAMICIDIN 0.05 MG,DEXAMETHASONE 0.5 MG

Blecidex Ed EYE DROPS

Sanbe Farma

NEOMYCIN SULFATE 3.5 MG, POLYMYXIN B SULPHATE6,000 IU, DEXAMETHASONE 1 MG

Polidemisin Ed EYE DROPS

Sanbe Farma

Polidemisin Eo EYE OINT Sanbe Farma

PREDNISOLONE, POLYMYXIN B SULFATE NEOMYCIN SULFFATE

Polypred EYE DROPS

5 mg, 10000 iu, 5 mg Cendo Pharmaceutical Industries

TOBRAMYCIN 3 MG,DEXAMETHASONE 1 MG

Bralifex Plus Ed EYE DROPS

3 mg,1 mg Sanbe Farma

14c EYE CORTICOSTEROIDS

BETAMETHASONE NATRIUM PHOSPHATE

Vosama EYE DROPS


PREDNISOLONE DISODIUM PHOSPHATE, SODIUM SULPHACETAMIDE

Cetapred EYE DROPS

3,5 mg; 100 mg Cendo Pharmaceutical Industries

14d MYDRIATIC DRUGS

ATROPINE SULPHATE

Tropine EYE DROPS


14e MIOTIC DRUGS

PILOCARPINE HCL

Miokar Ed EYE DROPS

10 mg/ml Sanbe Farma

14f ANTIGLAUCOMA PREPARATIONS

BETAXOLOL HCL

Tonor EYE DROPS


Optibet Ed EYE DROPS

5 mg/ml Sanbe Farma

56



LATANOPROST

Glaopen EYE DROPS

0,05 mg Cendo Pharmaceutical Industries

TIMOLOL MALEAT

Timilol Maleat 0.25% EYE DROPS

2.5 mg/ml Pratapa Nirmala

Timilol Maleat 0.5% EYE DROPS

5 mg/ml Pratapa Nirmala

14g OPHTALMIC DECONGESTANTS, ANESTHETICS, ANTI-INFLAMMATORIES

DICLOFENAC NA

Flamar Ed EYE DROPS

1 mg/ml Sanbe Farma

PEMIROLAST POTASSIUM

Alegysal EYE DROPS

0.1% Ferron Par Pharmaceuticals

PER ML: NAPHAZOLINE HCL 0.25 MG, PHENIRAMINE MALEATE 3 MG

Flamergi EYE DROPS

Sanbe Farma

14h OPHTALMIC LUBRICANTS

GLYCERIN ANHYDROUS

Ophtalgon EYE DROPS


HIYDROXIPROPYL,METHYLCELLULOSE,DEXTRAN

Hidroxipropil,Methylcellulose,Dextran

EYE DROPS


PER ML: DEXTRAN 70 1 MG, HYPROMELLOSE 3 MG

Sanbe Tears EYE DROPS

Sanbe Farma

14i OTHER EYE PREPARATIONS

EACH ML CONTAINS:SODIUM CHLORIDE 6.40 MG, POTASSIUM CHLORIDE 0.75 MG, CALCIUM CHLORIDE DIHYDRATE 0.48 MG, MAGNESIUM CHLORIDE HEXAHYDRATE 0.30 MG, SODIUM ACETATE TRIHYDRATE 3.90 MG, SODIUM CITRATE DIHYDRATE 1.70 MG, WATER FOR INJECTION AD 1.00 ML

Miriwash INF Sanbe Farma

NAPHAZOLINE HCL, ANTAZOLINE HCL

Vasacon A EYE DROPS

1 mg; 2,5 mg Cendo Pharmaceutical Industries

15 EAR & MOUTH/THROAT

57



15a EAR ANTI-INFECTIVES & ANTISEPTICS

CHLORAMPHENICOL

Decacetine EAR DROPS

30 mg Harsen Laboratories

GENTAMYCIN

Sagestam Tt EAR DROPS

3 mg/ml Sanbe Farma

OFLOXACINE

Akilen Tt EAR DROPS

3 mg/ml Sanbe Farma

15b EAR ANTISEPTICS WITH CORTICOSTEROIDS

FLUODROCORTISONE ACETATEPOLYMIXIN B SULFATNEOMYCIN SULFATLIDOCAINE HCL

Otopraf EAR DROPS

1 mg,10.000 iu,5 mg,40 mg

Darya Varia

POLYMYXIN B SULFATE 10,000 IU, NEOMYCIN SULFATE 5 MG, FLUDROCORTISONE ACETATE 1 MG, LIDOCAINE HCL 40 MG

Otilon Tt EAR DROPS

Sanbe Farma

15e MOUTH/THROAT PREPARATIONS

BENZYDAMINE HCL

Benzydamine GARGLE 7.5 mg Soho Industri Pharmasi Div Npp

HEXETIDINE

Hexadol GARGLE 0.1 %, Otto Pharmaceutical Industries

TRIAMCINOLONE

Triamcinolone CREAM IOB

0.001 Novell Pharmaceutical Laboratories

16 DERMATOLOGICALS

16a TOPICAL ANTIBIOTICS

FUCIDIC ACID

Fusycom CREAM 0.05 Combiphar

GENTAMYCIN

Gentamisin Sulfat CREAM 0,1% Kimia Farma

GENTAMYCIN SULFATE

Sagestam Cream CREAM 0.001 Sanbe Farma

OXYTETRACYCLIN

58



Oksitetrasiklin CREAM 0.03 Kimia Farma

SILVER SULFADIAZIN

Burnazin CREAM 0.01 Darya Varia

Burnazin CREAM 0.01 Darya Varia

16b TOPICAL ANTIFUNGALS & ANTIPARASITES

KETOCONAZOLE

Ketoconazole CREAM 5 gr Otto Pharmaceutical Industries (Div2)

Ketoconazole CREAM 0.02 Novell Pharmaceutical Laboratories

Fungasol-Ss SOLN 0.02 Guardian Pharmatama

MICONAZOLE

Mycorine Cream CREAM 0.02 Galenium Pharmasia Laboratories

Fungares CREAM 0.02 Guardian Pharmatama

Mycorine Powder POWD 0.02 Galenium Pharmasia Laboratories

TERBINAFINE

Termisil CREAM 0.01 Ferron Par Pharmaceuticals

16c TOPICAL ANTIVIRALS

ACYCLOVIR

Acyclovir Cream CREAM 0.05 Kimia Farma

Poviral CREAM 0.05 Hexpharm Jaya

16d TOPICAL ANTI-INFECTIVES WITH CORTICOSTEROIDS

BETAMETHASONE VALERATE, NEOMICYNE SULFAT

Oviskin N CREAM 0.001 Hexpharm Jaya

FLUOCINOLONE ACETONIDE 0.025%, NEOMYCIN S 0.5%

Cinolon N CREAM 0.00025 Sanbe Farma

GENTAMYCIN SULFATE, FLUOCINOLONE ACETONIDE

Genolon CREAM Guardian Pharmatama

PREDNISOLONE, CHLORAMPHENICOL

Chloramfecort H CREAM 2,5 mg Kimia Farma

16e TOPICAL CORTICOSTEROIDS

BETAMETHASONE

Betametason 0,1% CREAM 0,1% Kimia Farma

59



BETAMETHASONE DIPROPIONATE

Oviskin CREAM 0.0005 Hexpharm Jaya

BETAMETHASONE DIPROPIONATE, SALYCICLIC ACID

Dprosalic Oint OINT 0.64mg Merck Sharp Dohme Pharma, Tbk

CLOBETASOL PROPIONATE

Forderm CREAM 0.0005 Ferron Par Pharmaceuticals

DESOXIMETASONE

Desoximetasone CREAM 0,25 Dexa Medica

FLUOCINOLONE ACETONIDE

Gentasolon Cream CREAM 0,025%,0,25mg Ikapharmindo Putramas

HYDROCORTISONE

Hydrocortisone CREAM 0.01 Hexpharm Jaya

MOMETASONE FUROATE

Mesonta OINT 1 mg Galenium Pharmasia Laboratories

16k SKIN ANTISEPTICS & DISINFECTANTS

IODINE POVIDON

Iodine Povidon 10% SOLN 0.1 Kimia Farma

Iodine Povidon 10% SOLN 0.1 Kimia Farma

POVIDONE IODINE

Dinasept DROPS 100 mg Harsen Laboratories

16l MEDICATED SURGICAL DRESSINGS

FRAMYCETINE SULFATE

Daryanttule SHEET 0.01 Darya Varia

17 ANAESTHETICS LOCAL & GENERAL

17 ANAESTHETICS LOCAL & GENERAL

ATRACURIUM BESYLATE

Notrixum INJ 25 mg Novell Pharmaceutical Laboratories

Notrixum INJ 50 mg Novell Pharmaceutical Laboratories

Atracurium Hamln INJ 10 mg Combiphar

BUPIVACAINE

Regivell INJ 5 mg/ml Novell Pharmaceutical Laboratories

60



Bupivacaine INJ 5 mg/ml Dexa Medica

HALOTAN

Halothane SOLN 250ml Dexa Medica

ISOFLURANE

Aerrane INH 250 ml Kalbe Farma

KETAMINE

Ketamine Hameln INJ 50 mg Combiphar

Ktmeksi INJ 100 mg/ml Guardian Pharmatama

LIDOCAINE

Xylocain GEL 2 % 10 gr Astrazeneca Indonesia

Kifacain INJ 20 mg Kimia Farma

Xylocain Hvy INJ 2% 2ml Astrazeneca Indonesia

Topsy OINT 0.025 Galenium Pharmasia Laboratories

Xylocain SPRAY 0.1 Astrazeneca Indonesia

MIDAZOLAM

Dormicum INJ 15mg/3ml Roche Indonesia

Anesfar INJ 15mg/3ml Pratapa Nirmala

Sedacum INJ 15mg/3ml Dexa Medica

PROPOFOL

Proanes 1% INJ 200 mg/20 ml Sanbe Farma

Recofol N INJ 10mg Dexa Medica

SEVOFLURANE

Sevodex SOLN 250 ml Dexa Medica

18 ALLERGY & IMMUNE SYSTEMS

18a ANTIHISTAMINES & ANTIALLERGICS

BETAMETHASONE, DEXCHLORPHENIRAMINE MALEATE

Celestamine SYR 0.25 mg/5 ml Merck Sharp Dohme Pharma, Tbk

Gratamin TAB 0.25 mg, 2 mg Gracia Pharmindo

Ocuson TAB 0.25 mg, 2 mg Sanbe Farma

CETIRIZINE

Estin DROPS 10 mg/ml Gracia Pharmindo

61



Cerini SYR 5 mg / 5 ml Sanbe Farma

Estin SYR 5 mg / 5 ml Gracia Pharmindo

Cetirizine TAB 10 mg Novell Pharmaceutical Laboratories

Cetirizine TAB 10 mg Dexa Medica

DEXCHLORPHENIRAMINE MALEATE, DEXAMETHASONE

Proxona TAB 2 mg Harsen Laboratories

DIPHENHIDRAMINE

Decadryl VIAL 10 mg Harsen Laboratories

LORATADINE

Allohex SYR 5 mg/5ml Hexpharm Jaya

Loratadine TAB 10 mg Novell Pharmaceutical Laboratories

Loratadine TAB 10 mg Pertiwi Agung (Landson)

18b VACCINES, ANTISERA & IMMUNOLOGICALS

DIPHTERIA TOXOID, TETANUS TOXOID,ACELLULAR PERTUSIS

Infanrix INJ 0,5 ml Glaxo Wellcome Indonesia

HAEMOPHILUS INFLUENZAE

Acthib INJ 10 mcg / 0.5 ml Aventis Pharma

HEPATITIS B SURFACE ANTIGEN (HBSAG)

Euvax B INJ Aventis Pharma

Euvax B INJ 20 mcg / 1.0 ml Aventis Pharma

HUMAN TETANUS IMMUNOGLOBULIN

Tetagam P INJ 250 iu Dexa Medica

INACTIVATED POLIO VIRUS TYPE 1, 2, 3

Imovax Polio INJ Aventis Pharma

INFLUENZA VACCINE

Fluarix*** INJ 0,5 ml Glaxo Wellcome Indonesia

PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT

Prevenar INJ 0.5 ml Pfizer Indonesia

RABIES VACCINE25 U/0.5 ML

Verorab Reguler INJ 25 iu/dose Aventis Pharma

ROTAVIRUS VACCINE

62



Rotarix SOLN 1,5 ml Glaxo Wellcome Indonesia

TETANUS TOXOID, REDUCED DIPHTHERIA TOXOID AND ACELLULAR PERTUSIS

Boostrix INJ 0,5 ml Glaxo Wellcome Indonesia

VARICELLA (LIVE ATTENUATED) VACCINE

Varilrix INJ 0,5 ml Glaxo Wellcome Indonesia

18c IMMUNOSUPPRESSANTS

CICLOSPORIN

Sandimmun Neoral SOFT CAPS

25 mg Novartis Indonesia

Sandimmun Neoral SOFT CAPS

50 mg Novartis Indonesia

HUMAN GAMMAGLOBULIN

Gammaraas INJ 2,5g Combiphar

MYCOPHENOLATE MOFETIL

Cellcept TAB 500 mg Roche Indonesia

MYCOPHENOLATE NA

Myfortic TAB 180 mg Novartis Indonesia

19 ANTIDOTES & DETOXIFYING AGENTS

19 ANTIDOTES & DETOXIFYING AGENTS

ATROPINE SULPHATE

Atropine INJ 0.25 mg Ethica Industri Farmasi

HYDROXYETHYL STARCH 6%; BM 130KD; DS 0.4, NIL

Voluven INF 50 ml/kg body wt/day

Fresenius Kabi Indonesia

MESNA

Uromitexan INJ 400 mg Transfarma Medica Indah

N-ACETYLCYSTEINE

Hidonac 20 % INJ 5 g / 25 ml Zambon Indonesia

NALOXONE HCL

Nokoba INJ 0.4 mg / ml Pratapa Nirmala

20 INTRAVENOUS & OTHER STERIL SOLUTIONS

20 INTRAVENOUS & OTHER STERIL SOLUTIONS

0,9 % SODIUM CHLORIDE

63



Otsu - Ns INF 0.9 nacl inj. Otsuka (Cairan)

Otsu - Ns INJ Otsuka (Cairan)

0.90 G, 154 MMOL/L, 154 MMOL/L, 1 L, 0,9 % SODIUM CHLORIDE

Ecosol Nacl INF 0.90 g, 154 mmol/l, 154 mmol/l, 1 l

Bbraun Medical Indonesia





10% DEXTRAN 40 IN RL INJ.

Otsutran - 40 INF 10%,40 Otsuka (Cairan)

10% DEXTROSE

Otsu - D10 INF 0.1 Otsuka (Cairan)

2.5% DEXT IN 0.45% NACL INJ.

Otsu - D2.5, 1/2Ns INF 2.5%,4.5% Otsuka (Cairan)

3% SODIUM CHLORIDE INJ.

Otsu Salin-3 INF 0.03 Otsuka (Cairan)

40% DEXTROSE

Otsu - D40 INJ 0.4 Otsuka (Cairan)

5% DEXT IN 0.45% NACL INJ.

Otsu - D5, 1/2 Ns INF 5%,0.45% Otsuka (Cairan)

5% DEXT IN 0.9 NACL INJ.

Otsu - D5, Ns INF 5%,0.9 Otsuka (Cairan)

5% DEXT IN 2.225% NACL INJ.

Otsu - D5, 1/4 Ns INF 5%,2.225% Otsuka (Cairan)

5% DEXT IN RINGER INJ.

Otsu - Rd 5 INF 0.05 Otsuka (Cairan)

5% DEXTROSE


5% DEXTROSE IN LACTATED RINGER

Otsu - Rl D5 INF 0.05 Otsuka (Cairan)

6% DEXTRAN 70 IN NORMAL SALINE INJ.

Otsutran - 70 INF 6%,70 Otsuka (Cairan)

64



7.46% KCL INJ.

Otsu - Kcl 7.46 INJ 0.0746 Otsuka (Cairan)

ASETAT & MALAT (CRISTALOID BALANCED ISOTONIC), NA : 142, K : 4,5 CA: 2,5, MG : 0,85 CL : 103

Ringerfundin INF Bbraun Medical Indonesia

DEXTROSE


DEXTROSE 25 G/L+ELECTROLYTE (NA+ 77 ; CL- 77 ) MEQ/L;OSMOLARITY 293 MOSM/L; CALORIE 100 KCAL/L

Infusan D2.5 + 1/2Ns INF Sanbe Farma


Infusan D5 + Ns INF Sanbe Farma

DEXTROSE 50 G/L+ELECTROLYTE (NA+ 38.5 ; CL- 38.5 ) MEQ/L;OSMOLARITY 355 MOSM/L; CALORIE 200 KCAL/L

Infusan D5 + 1/4 Ns Dp INF Sanbe Farma

Infusan D5 + 1/4 Ns Sp INF Sanbe Farma


Infusan D5 + 1/2 Ns Sp INF Sanbe Farma

DEXTROSE 50G/L;OSMOLARITY 278 MOSM/L; CALORIE 200 KCAL/L

Infusan D5 Dp INF Sanbe Farma

Infusan D5 Sp INF Sanbe Farma

ELECTROLYTE (NA+ 130; K+ 4 ; CA2+ 2,7; CL- 109;LACTATE 28 ) MEQ/L; OSMOLARITY 273 MOSM/L

Infusan Rl Dp INF Sanbe Farma

Infusan Rl Sp INF Sanbe Farma

ELECTROLYTE (NA+ 131; K+ 4; CA2+ 2,7 ; CL- 109; ACETATE 28) MEQ/L;OSMOLARITY 273 MOSM/L

Infusan Ring As Sp INF Sanbe Farma

Infusan Ring As Dp INF Sanbe Farma

ELECTROLYTE (NA+ 147; K+ 4; CA2+ 4,4; CL- 156) MEQ/L+ GLUCOSE 50 G/L;OSMOLARITY 586 MOSM/L; CALORIE 200 KCAL/L

Infusan R + D Dp INF Sanbe Farma

Infusan R + D Sp INF Sanbe Farma

65



ELECTROLYTE (NA+ 154 ; CL- 154) MEQ/L;OSMOLARITY 308 MOSM/L

Infusan Ns Irigasi INF Sanbe Farma

ELECTROLYTE( NA+ 154 ; CL- 154) MEQ/L; OSMOLARITY 308 MOSM/L

Infusan Ns Sp INF Sanbe Farma

Infusan Ns Dp INF Sanbe Farma

Infusan Ns 250 INF Sanbe Farma

Infusan Ns 100 INF Sanbe Farma

ELECTROLYTE, ACETATE RINGER

Asering INF Otsuka (Cairan)

ELECTROLYTE, ACETATE RINGER, 5% DEXTROSE

Asering - 5 INF Otsuka (Cairan)

ELECTROLYTE, GLUCOSE

Ka - En 1B INF Otsuka (Cairan)

Ka - En Mg3 INF Otsuka (Cairan)

Ka - En 3A INF Otsuka (Cairan)


Ka - En 4A INF Otsuka (Cairan)


GELATIN POLYSUCCINATE

Gelafusal INF 20 gr Dexa Medica

GLUCOSE MONOHYDRATE FOR PARENTAL USE, GLUCOSE MONOHYDRATE FOR PARENTAL USE 5.5 G

Ecosol G10 INF 5.5 gr Bbraun Medical Indonesia

Ecosol G5 INF 5.5 gr Bbraun Medical Indonesia

HES

Fimahes INF 6%, 200 kd Kalbe Farma

HES:BM=130.000/0.4+(NA+ 154 ;CL- 154) MEQ/L; OSMOLARITY: 308 MOSM/L; PH 4.0- 5.5

Sanbe Hest 130 INF Sanbe Farma

HES:BM=200.000/0.5+(NA+ 154 ;CL- 154) MEQ/L; OSMOLARITY: 308 MOSM/L; PH ± 5

Sanbe Hest 200 INF Sanbe Farma

MALTOSE 10%

Martos - 10 INF Otsuka (Cairan)

66



NACL 219,66 G;KCL 5,64 G;CACL2.2H2O 90 MG;MGCL2 7.54 MG;ACETAT ACID GLASIAL 4.69 G

Acentrat INF Sanbe Farma

NAHCO3 50 G

Bicarlis INF Sanbe Farma

NORMAL SALINE

Otsu - Ns 500 INF Otsuka (Cairan)

Otsu - Ns 100 INF Otsuka (Cairan)

RINGER LACTATE

Otsu - Rl INF Otsuka (Cairan)

RINGER SOLUTION

Otsu - Rs INF Otsuka (Cairan)

SORBITOL 50 G/L+ELECTROLYTE (NA 100; CL-90; K18; CA2+4; MG2+ 20; ACETATE+ 38) MEQ/L;OSMOLARITY 525 MOSM/L; CALORIE 200 KCAL/L

Futrolit INF Sanbe Farma

SORBITOL, ELEKTROLIT

Tutofusin Ops INF 50 gr Kalbe Farma

STERILE WATER

Sterile Water INF 1000 ml Otsuka (Cairan)

SUCCINYLATED GELATIN (GELATIN MODIFIKASI/MFG), NATRIUM KLORIDA, NATRIUM HIDROKSIDA, AQUA PRO INJECTION

Gelofusine INF 40 gr, 7.01 gr, 1.36 gr, 969 gr


WATER FOR INJ.

Sanbe Water For Irrigation Usp

INF 1000 ml Sanbe Farma

Otsu - Wi INJ 25 ml Otsuka (Cairan)

67

Documents

Tabel DOSP 2016 Final