KEKUATAN

NO. NAMA OBAT KANDUNGAN SEDIAAN SATUAN PERESEPAN MAKSIMAL

SEDIAAN

Analgesik, Antipiretik, Antiinflamasi Non Steroid, Antipirai

1. Analgesik Non Narkotik

1 Antrain Metamizol Injeksi 2 ml 4 ampul selama dirawat

2 Gratheos Diklofenac Sodium Tablet Salut Enterik 50 mg 30 tab/bulan

Tablet
Laflanac Diklofenac Sodium 25 mg

3 Propyretic Paracetamol Suppositoria 240 mg -

Propyretic Paracetamol Suppositoria 80 mg

untuk nyeri akut : 14 tabs/kasus,

4 Farsifen Ibuprofen Tablet 400 mg
untuk nyeri kronis : 60 tabs/bulan

Farsifen Ibuprofen Tablet 200 mg

Fenris Ibuprofen Sirup 100 mg/ml

5 Pamol Paracetamol Tablet 500 mg 30 tab/bulan

Hufagesic Paracetamol sirup 120/5 mg/ml

6 Erphamol Paracetamol Tablet 650 mg 2 btl/kasus

7 Voltadex Natrium Diklofenak Gel 10 mg/g

8 Grafamic 500mg Asam mefenamat Tablet 500 mg 30 tabs/bulan

9 Ketrobat ketorolac Injeksi 30 mg/ml 2-3 amp/hari, maks 2 hari.

10 Fenamin Asam mefenamat Tablet 500 Mg 30 tabs/bulan

11 Meloxicam Meloxicam Tablet 15 mg -

Meloxicam meloxicam Tablet 7.5 mg -

14 Apetic forte Paracetamol Sirup 250/5 mg/ml 2 btl/kasus

15 Sanmol Paracetamol Injeksi 1000/100 mg/ml 3 btl/kasus

-
16 Apetic Paracetamol Sirup 120/5 mg/ml

2 amp/hari, maks 3 hari dalam 1

17 Tramal Tramadol Injeksi 50 mg/ml
bulan

Tramal Tramadol Injeksi 100 mg/ml

18 Tradosik Tramadol Kapsul 50 mg -

19 Analtram Tramadol;Paracetamol Tablet 3.75/325 mg

 20 Antrain Metamizol Tablet 500 mg

21 Cataflam Kalium Diklofenak Tablet 50 mg

22 Lacosib Etoricoxib Tablet 60 mg

2. Antipirai

1 allopurinol 100 mg Allopurinol Tablet 10000 mg 30 tab/bulan

3. Antispasmodik

-
1 Atropin Anti spasmodik Injeksi 0,25 mg/mL

Voxamed Flavoxate Tablet 200 mg

4. Analgesik Non Narkotik, Anti Alergi dan Obat untuk Anafilaksis

Paracetamol; pseudoephedrine;
1 Antiza Tablet mg/ml
klorfeniramin maleat

Paracetamol; pseudoephedrine;
2 Hufagrip Flu Sirup mg
klorfeniramin maleat

Anestetik

1 Lidokain Injeksi 20 mg/mL -

1. Anestetik Lokal, Antialergi dan Obat untuk Anafilaksis

2 Pehacain Lidokain; epinefrin Injeksi 20; 0,0125 mg/ml -

Anti Alergi dan Obat untuk Anafilaksis

Urtikaria akut:
1 tab/hari, maks 5
1 Alloris Loratadine Tablet 10 mg
hari, dilakukan di
Faskes Tk. 1

2 Epinephrine Injeksi 1 mg -

Urtikaria akut : 1 tab/hari Urtikaria

3 Tiriz Setirizin Tablet Salut Selaput 10 mg
Kronik : maksimal 30 tab/bulan

4 Tiriz drop Setirizin drop mg/ml

5 Intrizin Setirizin HCl Sirup 5/5 mg/ml 1 btl/kasus

Urtikaria Akut : 1 tab/hari, maks 5

6 Lodia Loperamid HCl Tablet Salut Selaput 2 mg
hari dilakukan di Faskes Tk.1

Dipenhidramin
7 Dipenhidramin hidroklirida Injeksi 10 mg/ml 30 mg/hari
hidroklirida

8 Alleron chlorpheniramine maleate Tablet 4 Mg -

9 Bestalin 25 mg Hydroxyzine Tablet 25 mg

Antiinfeksi

1. Antibakteri Lain

1 Lostacef Sefadroksil Kaplet 500 mg 5 hari

Lapicef Sefadroksil capsul 500 mg

2 Lapicef Sefadroksil Sirup Kering 125 mg/mL 1 btl/kasus

3 Lapicef Sefadroksil Sirup Kering 250 mg/mL -

4 Zycin Azitromisin Tablet Salut Selaput 500 mg 3 hari

5 Azithromycin Azithromycin Tablet 500 mg

2. Antibakteri Lain

1 Baquinor Siprofloksasin Tetes Mata 200/100 mg/ml 4 btl/hari

 2 Floxigra 500mg Siprofloksasin Kaplet Salut Selaput 500 mg -

1 Cefila Sefiksim Capsul 100 mg 10 hari

3 Cefila Sefiksim Capsul 200 mg

4 Lapiflox Siprofloksasin Kaplet Salut Selaput 500 mg -

Amoksisilin dan Asam klavulanat

5 Aclam 500 mg Kaplet 500/125 mg 10 hari
125 mg

6 Intermoxil Amoksisilin Sirup Kering 125/5 mg/ml 1 btl/kasus

Untuk Infeksi akibat bakteri

8 Trichodazole Metronidazol Tablet Salut Selaput 500 mg anaerob , dapat diberikan
maksimum 2 minggu/kasus

9 Metrofusin Metronidazol Injeksi 500/100 mg/ml 3 btl/hari

10 Cravox Levofloksasin Kaplet Salut Selaput 500 mg Maksimal 10 hari

11 Hufanoxil Amoksisilin Sirup Kering 125/5 mg/ml 1 btl/kasus

12 Hufanoxil Amoksisilin Kaplet 500 mg 10 hari

Lapimox Amoksisilin Kaplet 500 mg

Lapimox Amoksisilin Sirup 125/5 mg/ml

Lapimox Amoksisilin Sirup 250/5 mg/ml

13 Cefixime Cefixime Tablet Salut Selaput 200 mg 10 hari

Kombinasi KDT/FDC mengandung :

16 Clabat 500mg Tablet Salut Film 500;125 mg 10
Amoxicilin dan asam klavulanat

17 Clindamycin Clindamycin Capsul 300 mg 11

18 Clinmas Clindamycin Capsul 300 mg 12

19 Clinmas Clindamycin Capsul 150 mg 13

3. Anti Bakteri Lain, Anti Inflamasi dan Anti Pruritik

Betamethasone dipropionate;
1 Digenta Krim 0,5; 1 mg/g -
gentamisin sulfat

4. Anti Fungi Sistemik

Interzol Ketoconazole Tablet Salut Film 200 mg

5. Anti Infeksi Khusus

5.1. Antiseptik Saluran Kemih

1 Furosemid Furosemid Injeksi 10 mg/ml 28 kapsul/kasus

6. Antimikroba

1 Genoint salep mata Gentamyisin sulfate Krim mg/g -

7. Antiprotozoa

1 Siclidon Doksisiklin, antiprotozoa Kapsul 100 mg -

Obat Topikal untuk Mata

1. Antimikroba

Dexamethasone; Neomycin Sulfate;

1 Cendo Xitrol Minidose Tetes Mata 1; 3,5; 10000si mg/ml -
Polymyxin B sulphate

3 Cendo polygrant Salep Mata 3 mg/g -

4 Genoint tm Gentamisin sulfat Salep Mata 3 mg/g -

Cendo Polygrant tm

2. Lain-lain
 Sodium Chloride; Potassium
2 Cendo Lyteers tm Tetes Mata 4,4; 0,8 mg/ml
Chloride

Cendo vernacel minidus

Cendo pantocaine tm

Obat Topikal Untuk Telinga

1. Antibakteri

Polimiksin B sulfat; neomisin sulfat;

1 Otilon Tetes Telinga 1,25; 25; 5; 200 mg -
fludrokortison asetat; lidocain

2. Lain-lain

1 Forumen TT Docusate Na Tetes Telinga 5 mg/ml -

Obat Topikal untuk Kulit

1. Antibakteri

1 Burnazin Cream Silver sulfadiazine Krim 10 mg/g -

Bactoderm Mupirocin Krim 5

Rogencin Gentamycin Krim

Gentamycin sk Krim

Fusifar Fusidic acid Krim

Fusifar Fusidic acid Ointment

2. Antibakteri, Anti Inflamasi, dan Antipruritik

Fluocinolone acetonide; neomycin

2 Fasolon Krim 0,25;5 mg/g -
sulfate

The Cort krim

Myco-z

3. Antifungi

1 Mycoral Ketoconazole Krim 20 mg/g -

2 Cotristen Cotristen Krim

4. Anti Inflamasi dan Antipruritik

1 Inerson Desoximethasone Krim 0,0125 mg/g

2 Hydrocrtisone Cream 1% Krim 5/5 mg/g -

-
3 Nestacort Hydrocrtisone Cream 2.5% Krim 12,5/5 mg/g

4 Cinolon Fluocinolone acetonide Krim 0,25 mg/g -

5. Antimikroba

1 Kalmicetin Kloramfenikol Ointment 20 mg

6. Antivirus, Anti herpes

1 Acifar cream Asiklovir Krim 500 mg -

7. Lain-lain

1 Kenalog Triamcinolon acetonide Krim 1 mg/g -

3 Sanoskin Meladerm O2; olive oil Gel - - -

4 Apolar Desonide Krim 0,005 mg/g -

 Caladine lotion

Caladine powder

Boraginol N

Boraginol S

Estesia

Faktu

Flet Enema

Microlac

Antineoplastik, Imunosupresan, dan Obat terapi paliatif

1 Indexon Dexamethasone Tablet 0,5 mg -

2 Indexon Dexamethasone Injeksi 5 mg/mL -

Dexamethasone;
4 Grafachlor Kaplet 0,5 ; 2 mg -
dexchlorpherinamine maleat

Dexamethasone;
5 Hufabetmin Sirup 0,5 ; 2/5 mg/ml -
dexchlorpherinamine maleat

6 Lameson Metilprednisolon Tablet 8 mg -

7 Rhemafar Metilprednisolon Kaplet 4 mg -

8 Lameson Metilprednisolon Tablet 4 mg -

Kontrasepsi Oral

1 Tablet mg -

Antivertigo

1 Vastigo Betahistin masilat Kaplet 6 mg 20 ab/bulan

Frego Flunarizine 5 mg 21

Antivirus, Antiherpes

1 Acifar 400 Asiklovir Kaplet 400 mg -

2 Inclovir Valacyclovir Tablet 500 mg -

Antiepilepsi – Antikonvulsi

1 Stesolid Diazepam Suppositoria 5/2,5 mg/ml 2 tube/hari, bila kejang

2 Valdimex Diazepam injeksi 2 Mg/ml

3 Nozevap Diazepam Suppositoria 5 Mg/ml

Obat untuk Syok Kardiogenik dan Sepsis

1 Epinef Injeksi mg/ml -

2 Ceftri Injeksi mg/ml -

Obat Kardiovaskular
1.
Antiangina

1 Amlodipin Amlodipin Tablet 10 mg 30 tab/bulan

2 Amlodipin Amlodipin Tablet 5 mg 30 tab/bulan

3 Captopril Captopril Tablet 25 mg 30 tab/bulan

Obat untuk Saluran Napas

1. Ekspektoran

1 L-Acys Acetylcestein capsul 200 mg -

 2
L-Acys effervescent Acetylcestein tablet 600 mg

3 Acetylcestein Acetylcestein tablet 200 mg

2. Mukolitik

1 Bisolvon Solution Bromhexine HCl Solution 2 mg/ml

2 Hufaxol Ambroxol HCl Kaplet 30 mg

3 Hufaxol Ambroxol HCl Sirup 30 mg/ml

Erdobat Erdostein sirup mg/ml

Lactrin Erdobat capsul mg

3. Dekongestan

1 Alco Drop Pseudoefedrine Sirup 7,5/0,8 mg/ml -

2 Aldisa sr Pseudoefedrine; Loratadine Capsul 120/10 mg -

Crofed Pseudoefedrine; triprolidine Tablet mg

4. Antiasma

1 Ventolin Nebules Salbutamol sulfat Injeksi 2,5 mg/ml hari pertama maksimal 8 vial/hari

2 Grafalin Salbutamol Tablet 2 mg -

3 Grafalin Salbutamol Tablet 4 mg

5. Lain-lain

Paracetamol; Dextromethorphan
1 Antiza tab HBr; Phenylpropanolamine HCl; Kaplet 500; 15; 12,; 1 mg -
Chlorpheniramine maleate

Dextrometorpan HBr; guaiafenesin;

2 Dexyl Sirup 5; 5; 50; 197/5 mg/ml -
klorfeniramin maleat; na sitrat

Dextrometorpan HBr; guaiafenesin;

3 Grantusif Tablet 15;100;1 mg -
klorfeniramin maleat

Obat untuk Diare

1 Guanistrep Kaolin; pectin Suspensi 986; 40/5 mg/ml -

2 Coro- sorb Activated attapulgit; Tablet 600 mg -

Obat untuk Relaksasi Otot

1 Myonep Eperisone HCl Tablet Salut Gula 50 mg -

Obat untuk Saluran Cerna

1. Antasida dan Anti Ulkus

1 Ranitidin Ranitidin Injeksi 25 mg/ml 2 ampul/hari

2 Omeprazol Omeprazol Kapsul 20 mg 30 kapsul/bulan

3 Pantoprazole Pantoprazol Serbuk Injeksi 40 mg 1 ampul/hari, maks 3 hari

Esola Esomeprazol Serbuk Injeksi 40 mg

Laproton Lansoprazol Capsul 30 mg

Esola Esomeprazol Kaplet 20 mg

4 Acitral Mg(OH)2; Al(OH)3; Simethicone Suspensi 200; 200; 20 mg/ml -

5 Trianta Mg(OH)2; Al(OH)3; Simethicone Tablet Kunyah 300; 300; 60 mg

6 Gastridin tab Ranitidin Tablet Salut Film 150 mg 30 tab/bulan

7 Hufadin Ranitidin Tablet Salut Selaput 150 mg 30 tab/bulan

2. Antiemetik

1 Trovensis Ondansetron HCl Tablet 4 mg

Trovensis Ondansetron HCl Tablet 8 mg

Odr Ondansentron HCl injeksi 2 mg/ml

Odr Ondansentron HCl injeksi 8 mg/ml

Odr Ondansentron HCl Tablet 4 mg/ml

2 Ondansetron Ondansentron HCl Kaplet Salut Selaput 4 mg

3 Hufadon Domperidon Suspensi 5/5 mg/ml -

5 Hufadon Domperidon Tablet 10 mg -

3. Lain-lain

Na Klorida; Kalium klorida;

1 Pharolit trinatrium sitrat dihidrat; glukosa Serbuk Kering 0,52; 0,30; 0,58; 2,7 g -
anhidrat

4. Anti Spasmodik

1 Scopma Plus Hyoscine butylbromide; paracetamil Kaplet 10;500 mg -

2 Gitas Hyoscine butylbromide Injeksi 20 mg/ml -

3 Gitas Plus Hyoscine butylbromide; paracetamil Kaplet Salut Selaput 10;500 mg -

Obat yang Memengaruhi Sistem Imun

1.
Serum dan Imunoglobulin

1 Tetagam Human Tetanus imunoglobulin Injeksi 250 IU -

2.
vaksin

1 Verorab Vaksin Vaksin rabies Injeksi 2,5 IU -

2 Typhim vi Vaksin Typhoid Injeksi

3 Imojev Vaksin Japanes escephalitis Injeksi

4 Avaxim Vaksin hepatitis A Injeksi 80/160

5 Bio tt Vaksin tetanus Injeksi

6 Bio td Vaksin tetanus dipteri Injeksi

7 Q Denga Vaksin Demama berdarah Injeksi

8 Engerix B Vaksin hepatitis B Injeksi 20 mcg

9 Gardazil 9 Vaksin HPV Injeksi

10 Boostrix Tetanus, dipteri , partusis Injeksi

11 Prevenar 13 pneumonia Injeksi

Psikofarmaka
1.
Antiansietas

1 Valdimex Diazepam Injeksi 5 mg/ml -

2 Valdimex Diazepam Tablet 5 mg

3 valisanbe Diazepam Tablet 5 mg

4 Alprazolam Tablet 1 mg

5 Atarax Alprazolam Tablet 1 mg

6 frixitas Alprazolam Tablet 0.5 mg

7 Merlopam Lorazepam Tablet 2 mg

8 clofritis Clobazam Tablet 10 mg

9 zolta Zolpidem Tablet 10 mg

 10 Concerta Methylphenidate Tablet 18 mg

11
Concerta Methylphenidate Tablet 36 mg

Calmlet Alprazolam Tablet 1 mg

Prohiper Methylphenidate Tablet 10 mg

Riklona Clonazepam Tablet 2 mg

Vitamin dan Mineral

1 Neurobion Tiamin; Piridoksin; kobalamin Injeksi 100; 100; 5000 mg; mcg -

Vitamin a; vitamin d; vitamin b1;

vitamin b2; vitamin b6; vitamin b12;
0,1; 0,01; 3; 4; 4; 12; 75;
vitamin c; nikotinamid; ca
20; 5; 10; 0,1; 1; 135;
3 Caviplex pantotenat; vitamin e; biotin; acid Kaplet Salut Gula mg -
50; 100; 87,5; 15; 0,5;
folic; fe fumarat; acid glutamic; Ca;
0,5; 0,5; 0,15
Mg karbonat; Zn; Cu; Mn; fluor;
Iodium

Vitamin B1; Vitamin B2; Vitamin

50; 25; 10; 5; 500; 100;
4 megazing B6; Vitamin B12; Vitamin C; Kaplet Salut Selaput mg -
18,4
Nicotinamine; Asam Pantotenat

Retinol; cholecalciferol;
alphatocopherol; ascorbic acid; 3500; 220; 11,2; 125;
5 Prove vit thiamine; iboflavin; pyridoxine; Serbuk Injeksi 3,51; 4,14; 4,53; 0,006; iu; mg -
cyanocobalamine; folic acid; 0,414; 17,25; 0,069; 46
pantothenic; biotin; nicotinamide

Echinacea purpurea extract, Zinc

6 Imunos Sirup 500;5;15 mg;mcg
picolinate, Selenium.

Echinacea (EFLA 894), Zinc

7 Imunos picolinate 10 mg, Ascorbic Acid, Kaplet 500;10;50;15 mg;mcg
Selenium

8 Farbion Vit.B1, Vit.B6, Vit.B12. Tablet 100;200;200 mg;mcg

9 Lapibal Mecobalamin capsul 500 mcg

10 L-Vit D Vitamin D3 tablet 1000 mg

Antiseptik dan Disinfektan

1 Medika Povidone 10% Povidon Iodin Cairan 100 mg/ml -

Lain-lain

1 Otsu D5 500 ml Dextrose anhydrate Injeksi mg/ml -

2 Otsu D10 500 ml Dextrose anhydrate Injeksi

4 Otsu Dextrose 40% Dextrose anhydrate Injeksi 400 mg/ml -

5 Otsu Ns 100 ml Natrium klorida Injeksi 0,9/100 g/ml -

6 Otsu Ns 25 ml Natrium klorida Injeksi 0,9 % -

7 Otsu Ns 500 ml Natrium klorida Injeksi 0,9/100 g/ml -

8 Otsu RL 500 ml Na laktat; NaCl; KCl; CaCl; aqua Injeksi - mg/ml -

9 Otsu-WI Aqua untuk injeksi Injeksi - - -