FORMULARIUM

RS. PERMATA CIREBON

NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
ANALGESIK NON NARKOTIK, ANTIPIRETIK, ANTI INFLAMASI
1
NON STEROID DAN ANTI PIRAI
1.1 ANALGESIK NON NARKOTIK, ANTIPIRETIK
1. Asam Mefenamat
Asam Mefenamat Tab/kaps 500 mg
Asam Mefenamat
Pondex DEXA Tab 500 mg
Dentacid KALBE Tab 500 mg
Asam Mefenamat Susp 50 mg/5ml, btl 60 ml
Pondex Syr DEXA Susp 50 mg/5ml, btl 60 m
2. Ketorolac Trometamin
Ketorolac Trometamin Tab 10 mg
Torasic KALB
Xevolac NOVE
Ketorolac Trometamin Inj 10 mg/ml, amp 1 ml

Ketorolac Trometamin Inj 30 mg/ml, amp 1 ml

Remopain DEXA
Torasic KALB
Xevolac NOVE

3. Metampiron

Komb :
Metampiron 500 mg+ Diazepam 2 Tab
mg
4. Parasetamol

Parasetamol Tab 500 mg

Parasetamol Tab 600 mg

Sumagesic DARY
Parasetamol Drop 100 mg/ml, btl 15 ml
Naprex drop DARY
Parasetamol Sir 120 mg/5ml, btl 60 ml
Parasetamol Syr
Praxion Syr PHAR

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Parasetamol Sir 250 mg/5ml, btl 60 ml

Naprex Syr DARY Susp
Inf 1000 mg/100ml, btl 100
Parasetamol ml
Parasetamol Inf DARY
Pyrex Inf NOVE
Tamoliv Inf KALB
Parasetamol Supp 125

Parasetamol Supp 250

5. Tramadol
Tramadol Kaps 50 mg
Tramadol OGB
Tramal PHAR
Tramadol Inj 50mg/ml amp 2 ml
Tramal PHAR
Tramadol Inj 100mg/ml amp 2 ml
Tramal PHAR

6. Antalgin
(Metamizole/Metampyron)
Metamizole Tab 500 mg

Metamizole Inj 250 mg/ml

Metamizole Drop

Metamizole Syr

7. Komb : Parasetamol dan

Acetylsistein
Komb :
Parasetamol 500mg dan Kaplet
Acetylsistein 200mg
Sistenol DEXA

8. Komb :
Parasetamol dan Ibuprofen

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Ibuprofen 250 mg, Paracetamol 325 Kaplet
mg
ALaxan FR DARY

9. Komb :
Parasetamol dan Tramadol
Paracetamol 325mg,
Parasetamol dan Tramadol Tramadol Hydrochloride
37,5mg
Sincronik KALB
Zaldiar PHAROS
10. Komb :
Parasetamol , vit B1, vit B6 dan vit
B12
TAB

11. Komb :
Metamphyron, Belladona, dan
Papaverin
Spasmal DARY

1.2 ANTI INFLAMASI NON STEROID (AINS)

1. Ibuprofen
Ibuprofen Tab 200 mg
Ibuprofen
Proris PHAR
Ibuprofen Tab 400 mg
Ibuprofen
Proris PHAR
Susp 100 mg/5 ml, btl 60
Ibuprofen ml
Proris PHAR
Iprox NOVE

2. Ketoprofen
Ketoprofen Tab 50 mg
Kaltrofen KALB
Pronalges 50 DEXA
Ketoprofen Tab 100 mg

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Kaltrofen KALB
Nazovell NOVE
Pronalges 100 DEXA
Ketoprofen Tab 200 mg
Pronalges CR 200 DEXA
Ketoprofen Inj 50 mg/ml, amp 2 ml
Dexpain NOVE
Kaltrofen KALB
Pronalges DEXA
Ketoprofen Supp 100 mg
Kaltrofen KALB

Pronalges supp DEXA

3. Dexketoprofen Trometamol
Dexketoprofen Trometamol Tab 25 mg
Ketesse FERR
Dexketoprofen Trometamol Inj 25 mg/ml
Dextofen DARY
Dexketoprofen Trometamol Inj 50 mg/ml
Ketesse FERR

4. Natrium Diklofenak
Natrium Diklofenak Tab 25 mg
Natrium Diklofenak NOVELL
Natrium Diklofenak Tab 50 mg
Natrium Diklofenak NOVELL
Tab 50 mg + Vit B1 50 mg +
Diklovit NOVE B6 50 mg + B12 1 mg
Voltadex Dexa Tab 50 mg
Natrium Diklofenak Gel 1% , tube 20 gr
Voltaren Gel

5. Kalium Diklofenak
Kalium Diklofenak Tab 25 mg
Kaflam KALB

Kalium Diklofenak Tab 50 mg

Kaflam KALB

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
6. Meloksikam
Meloksikam Tab 7,5 mg
Mecox 7,5MG FERR
Velcox NOVE
Moxam PHAR
Meloksikam Tab 15 mg
Mecox 15MG FERR
Velcox NOVE
Moxam

7. Celecoxib

8. Eterocoxib

9. Tenoxicam
Tenoxicam Tab 20 mg
Tiflam DEXA

1.3 ANTI PIRAI

1. Allopurinol
Allopurinol Tab 100 mg
Alluric KALB
Allopurinol Tab 300 mg
Alluric KALB
2. Probenesid

3. Piroxicam

Piroxicam Tab 10 mg
Piroxicam Tab 20 mg

4. Asam Hyaluronat

1.3 ANTI INFLAMASI NATURAL

1 Serratiopeptidase

2 ANASTETIK
2.1 ANASTESI UMUM

1. Midazolam

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KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Midazolam Inj 5mg/5ml amp 5 ml
Fortanest 5/5 KALB
Hipnoz PHAR
Miloz NOVE
Sedacum 5 MG DEXA
Midazolam Inj 15mg/3ml amp 3 ml
Fortanest 15/3 KALB
Hipnoz PHAR
Miloz NOVE
Sedacum 15 MG DEXA

2. Propofol 1%

Emulsi untuk injeksi 10

Propofol 1% mg/ml amp 20 ml
Nupovell NOVE
Recofol N DEXA
Trivam PHAR

3. Ketamin
Ketamin Inj 50mg/vial

4. Rocorunium Bromida
Rocorunium Bromida Inj 50 mg/5ml vial 5 ml
Noveron NOVE
Roculax KALBE

5. Atracurium Besylate
Atracurium Besylate 1% amp 2,5 ml
Tramus 1% DEXA
Notrixum NOVE

6. Isoflurane
Isoflurane 250 ml/ Btl
Isoflurane DEXA
Aerranne KALBE

7. Sevoflurane
Sevoflurane
Sevodex DEXA
Sevoflurane Baxter KALBE

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
8. Dexmedetomidine HCL
Dexmedetomidine HCL 100Mcg/ml, 1 vial
Icunes NOVE

2.2 ANASTESI LOKAL

1. Bupivacain HCl 0,5%

Bupivacain HCl 0,5% Inj 5mg/ml amp 4 ml
Bupivacain HCl 0,5% DEXA
Decain DEXA
Regivell NOVE

2. Lidocain HCl 2%
Lidocain HCl 2% Inj 2% amp 2 ml
Lidocain HCl 2%
Lignovell NOVE

3. Lidocain Spray
Lidocain Spray Spray 10% 500mg
Lignovell Spray NOVE

4. Komb : Lidocain dan Prolikain

Komb :
Krim, tube 5 gram
Lidocain dan Prolikain

5. Komb : Lidocain dan epinefrin

Komb :
Injeksi
Lidocain dan epinefrin

3 ANTI ALERGI DAN ANAFILAKSIS

3.1 ANTI ALERGI

1. Cetrizine HCl
Cetrizine HCl Tab/kaps 5 mg
Histrine FT 5MG FERR
Cetrizine HCl Tab/kaps 10 mg
Cetinal KALB
Histrine FT 10MG FERR
Ritez FT DEXA
Ryvell NOVE
Cetrizine HCl Drop 10 mg/ml botol 10 ml
Histrine drop FERR

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Ritez drop DEXA
Cetrizine HCl Sir 5 mg/ml botol 60 ml
Cetinal syr KALB
Histrine syr FERR
Ritez syr DEXA

2. Chlorpeniramin maleat
Chlorpeniramin maleat Tab 4 mg
Chlorpeniramin maleat

3.1. Loratadine
Loratadin
Tab 10 mg
Loratadin OGB

3. Dex Loratadine
Sir 2,5 mg/5 ml botol 60
Dex Loratadine ml
Dex Loratadine

4. Fexofenadine
Fexofenadin Tab 30 mg
Fexofenadin Tab 120 mg
Fexofed KALBE

5. Pesudoefedrin HCl
Pesudoefedrin HCl Drop 7.5 mg
Rhinos Neo Drop DEXA

6. Kombinasi

6.1 Komb : Pesudoefedrin HCl 30 Tab

mg, terfenadin 40 mg
Rhinofed Tab DEXA
Ryvell Plus NOVE
Komb : Pesudoefedrin HCl 15 mg, Syr
terfenadin 20 mg
Rhinofed Syr DEXA
6.2 Komb : Pesudoefedrin HCl 120 Caps
mg, loratadin 5 mg
Rhinos SR DEXA

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

6.3 Komb : Pesudoefedrin HCl 15 Syr

mg, ChlorCTM 1 mg
Rhinos Junior Syr DEXA
6.4 Komb : Betametason 0.25mg, Tab
Dex CTM 2 mg
Colergis DEXA
Komb :
Betametason 0.25mg, Dex CTM 2 Syr
mg
Colergis DEXA
6.5 Komb : Deksamethason
(micronized) 0,5mg dan
Deksklorfeniramin Maleat 2mg

6.6 Komb : Deksamethason

(micronized) 0,5mg dan
Deksklorfeniramin Maleat 2mg

6.7 Komb : Bethamethason 0,25mg

dan Deksklorfeniramin Maleat 2mg

Colergis DEXA Syrup 60ml

6.8 Rupatadin
3.2 ANAFILAKSIS

1. Deksametason
Deksametason Tab 0,5 mg
Deksametason

Deksametason Inj 5mg/ml amp 1 ml

Deksametason

Kalmethason KALB

2. Difenhidramin
Difenhidramin Inj 10 mg/ml amp 1 ml
Difenhidramin
3. Epinefrin (adrenalin)
Inj 0,1% (sbg HCl bitartat)
Epinefrin (Adrenalin) amp 1 ml
Epinefrin (Adrenalin)
4 ANTIDOT DAN OBAT LAIN UNTUK KERACUNAN

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
4.1 ANTIDOT UMUM

1. Kalsium Glukonat
Kalsium Glukonat Inj 100 mg.ml amp 10 ml

4.2 ANTIDOTUM KHUSUS

1. Nalokson HCl
Nalokson HCl In 0,4 mg/ml amp 2 ml

2. Neostigmin
Neostigmin Inj 0,5 mg/ml

3. Efedrin
Efedrin In 50 mg/ml amp 1 ml
Efedrin OGB
5 ANTI EPILEPSI DAN ANTI KONVULSI
5.1 ANTIEPILEPSI DAN ANTIKONVULSI

1. Diazepam
Diazepam Tab 2 mg
Diazepam

Diazepam Tab 5 mg

Diazepam Inj 10 mg/2 ml amp 2 ml

Vodin rectal soln 10 mg/2.5 mL
Diazepam Lar rectal 5 mg/2,5 ml
Vodin rectal soln 5 mg/2.5 mL
Diazepam Lar rectal 10 mg/ 2,5 ml

2. Fenitoin Na

Fenitoin Na Kaps 100 mg

Fenitoin Na Inj 50 mg/ml amp 2 ml

Fenitoin Na

3. Fenobarbital
Fenobarbital Tab 30 mg
Fenobarbital OGB

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Fenobarbital Inj 50 mg/ml amp 2 ml

Fenobarbital Inj 200 mg/2ml amp 2 ml

4. Natrium valproat
Natrium valproat Tab 250 mg

Natrium valproat Tab ER 500 mg

Natrium valproat Sir 250 mg/5 ml btl 120 ml

Vellepsy NOVE
Lepsio DEXA

5. Karbamazepin
Karbamazepin Tab 200 mg

6. Oscarbarzepine

Oscarbarzepine Tab 300mg

Barzepin NOVE
Oscarbarzepine Tab 500mg
Barzepin NOVE

5.2 ANTI NYERI PADA SYARAF

1. Gabapentin
Gabapentin Kaps 300 mg
Epiven NOVE
Ganin 300 FERR
Gapenal 300 DEXA
Nepatic KALB

2. Pregabalin
Pregabalin Kap 50 mg
Glinov NOVE
Pregabalin Kap 75 mg
Glinov NOVE
Leptica 75 DEXA
PGB 75 FERR

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Provelyn KALBE
Pregabalin Kap 150 mg
Leptica 150 DEXA
PGB 150 FERR
Provelyn KALB

6 ANTI INFEKSI
6.1 ANTELMINTIK DAN ANTI FILARIA
6.1.1 ANTELMINTIK INTESTINAL

1. Albendazol
Albendazol Tab 400 mg
Albendazol

2. Mebendazol
Mebendazol Tab 500 mg

3. Pirantel
Pirantel Tab 125 mg

6.1.2 ANTIFILARIA

1. Dietilkarbamazin
Dietilkarbamazin Tab 100 mg
- -
6.2 ANTI BAKTERI
6.2.1 BETA LAKTAM

1. Amoksisilin
Drop 100 mg/ml botol 10
Amoksisilin ml

Amoksisilin Sir kering 125mg/5ml

Amoksisilin
Kalmoxilin KALB Sir kering 125mg/5ml
Amoksisilin Kap 250 mg
Amoksisilin
Amoksisilin Kap 500 mg
Amoksisilin
KALMOXILLIN Kap 500 mg

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Amoksisilin Serb injeksi 1000 mg/vial

Amoksisilin

2. Komb : Amoksisilin dan asam

klavulanat
Komb :
Amoksisilin 500mg dan asam Tab 625 mg
klavulanat 125mg
Clavamox KALBE
Dexyclav DEXA

Komb :
Tiap 5 ml Amoksisilin 125 mg dan Sir kering btl 60 ml
asam klavulanat 31,25 mg
Clavamox KALB
Dexyclav DS Syr DEXA

3. Ampisilin
Ampisilin Serb inj 1000 mg/vial
Ampisilin
Phapin

4. Komb : Ampisilin dan sulbactam

Komb :
Ampisilin 500 mg , sulbactam 250 Serb inj 0,75mg
mg
Bactesyn KALB

Komb :
Ampisilin 1000 mg , sulbactam 500 Serb inj 1,5mg
mg
Bactesyn KALB

5. Fenoksimetil Penicilin

Fenoksimetil penicilin Tab 250 mg

Fenoksimetil penicilin
Fenoksimetil penicilin Tab 500 mg
Fenoksimetil penicilin

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KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
6. Benzatin Penisilin
Serb inj 1.200.000 iu vial
Benzatin penisilin 20 ml
Benzatin penisilin
Serb inj 2.400.000 iu vial
Benzatin penisilin 20 ml
Benzatin penisilin

7. Sulbeniciliin disodium

Sulbenicillin Disodium Serb inj 1 gram.vial

8. Prokain Benzil Penicilin

Serb in 3.000.000 iu/ml

Prokain benzil penisilin vial 1 ml
Prokain benzil penisilin

9. Meropenem

Meropenem Inj 500 mg /vial

Merofen KALBE
Phanem NOVELL
Tripenem 0,5 GR DEXA
Meropenem Inj 1000 mg /vial
Merofen KALBE
Tripenem 1 GR DEXA

10. Doripenem

Doripenem Inj. 500mg /vial

Dorbaz FERRON
DRM DEXA

6.2.2 TETRASIKLIN

1. Tetrasiklin HCl

Tetrasiklin HCl Kaps 250 mg

Tetrasiklin HCl
Tetrasiklin HCl Kaps 500 mg
Tetrasiklin HCl

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KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

2. Oksitetrasiklin HCl

Oksitetrasiklin HCl Inj 50mg/ml vial 10 ml

3. Doksisiklin

Doksisiklin Kaps 100 mg

4. Linkomycin

Linkomisin HCl Kaps 500 mg

5. Fosfomycin

Fosfomycin Inj 1000mg

Novellmycin 1g NOVELL
Fosfomycin Inj 2000mg
Novellmycin 2g NOVELL

6.2.3 KLORAMFENIKOL

1. Kloramfenicol

Kloramfenicol Tab 250 mg

Kloramfenicol
Susp. 125 mg/5ml 60 ml
Kloramfenicol
Serb inj 1000 mg/ml

2. Tiamfenikol

Tiamfenicol Kaps 500 mg

Tiamfenicol

Sir kering 125mg/5ml btl

Tiamfenicol 60 ml

6.2.4 KOTRIMOXAZOL

1. Kotrimoxazol Pediatric

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Sir 5ml : sulfametoxazol
Kotrimoxazol pediatric 200 mg dan trimetorpim
40 mg, btl 60 ml
Kotrimoxazol pediatric
Sulprim DARY
2. Kotrimoxazol Adult

Tab 400 mg/80 mg,

Kotrimoxazol adult sulfametoxazol 400 mg dan
trimetoprim 80 mg
Kotrimoxazol adult
Sulprim DARY
3. Kotrimoxazol forte

KaplKotrimoxazol forte
komb :Sulfametoxazol 800
Kotrimoxazol forte mg dan trimetoprim 160
mg

6.2.5 MAKROLID

1. Eritromisin

Eritromisin Kaps 250 mg

Eritromisin Kapl 500 mg

Eritromisin Sir 200 mg/5 ml btl 60 ml

2. Spiramisin

Spiramisin Tab/kap 500 mg

3. Klindamisin

Klindamisin Kaps 150 mg

Klindamisin
Klindamisin Kaps 300 mg
Anerocid FERRON

4. Klaritromisin

Klaritromisin Kapl 500 mg

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

5. Roxithromisin

Roxithromisin Tab 150 mg

Roxithromisin Tab 300 mg

6. Azithromisin

Azithromisin Tab 250 mg

Azithromisin Tab 500 mg
Zithrax KALBE
Azomax DEXA
Sir kering 200 mg/5ml btl
Azithromisin 15 ml
Azomax DS Syr DEXA

6.2.6 AMINOGLIKOSIDA

1. Gentamisin

Gentamisin Inj 40 mg/ml amp 2 ml

Gentamycin OGB INDO

2. Amikasin sulfat

Amikasin sulfat Inj 250 mg vial 2 ml

Mikasin KALBE
Amikasin Sulfat Inj 500 mg /vial
Amiosin DEXA
Mikasin KALBE
3. Streptomysin

Streptomysin Serb inj 1000 mg

Streptomysin

4. Kanamisin

Kanamisin Serb inj 1000 mg

Kanamycin MEIJ
5. Netilmicin Sulphate

Netilmicin Sulphate Amp Inj 150 mg/1,5 ml

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KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Netilmicin Sulphate Amp Inj 300 mg/1,5 ml

Netilmicin Sulphate Vial Inj 50 mg/1,5 ml

6.2.7 KUINOLON

1. Ciprofloxacin

Ciprofloxacin Tab 500 mg

Ciprofloxacin
Civell NOVELL

Quidex FERRON
Ciprofloxacin Inf. 2 mg/ml btl 100 ml
Ciprofloxacin
Civell NOVELL
Quidex 0,2% FERRON

2. Levofloxacin

Levofloxasin Tab 500 mg

Cravit KALBE
Lekuicin FERRON
Levores NOVELL
Volequin DEXA
Levofloksasin Inf. 500 mg/100 ml
Cravit KALBE
Lekuicin FERRON
Levores NOVELL
Volequin DEXA
Levofloxacin Inf. 750 mg
Cravit KALBE
Velequin DEXA
3. Ofloksasin

Ofloksasin Tab 200 mg

Tarivid KALBE
Ofloksasin Tab 400 mg
Tarivid KALBE
Inf 200 mg/100 ml btl 100
Ofloksasin ml

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KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Tarivid KALBE

4. Moksifloksasin

Moksifloksasin Tab 400 mg

Respira NOVELL
Moksifloksasin Inf 400 mg/250 ml
Molcin FERRON

6.2.8 SEFALOSPORIN

1. Sefadroksil

Sefadroksil Kaps 500 mg

Dexacef forte FERRON

Staforin KALBE
Sir kering 125mg/5ml 60
Sefadroksil ml
Dexacef DS FERRON
Staforin KALBE
Sir kering 250 mg/5ml 60
Sefadroksil ml
Staforin KALBE

2. Sefazolin

Sefazolin Inj 1 gram/vial

Cefazol KALBE

3. Cefixime

Cefixime 100 Kaps 100 mg

Cefixime 100
Cefspan 100 KALBE
Starcef 100 DEXA
Trixim 100 FERRON
Urticef 100 DARYA
Cefixime 200 Kaps 200 mg
Cefspan 200 KALBE
Starcef 200 DEXA
Trixim 100 FERRON

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KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Sir kering 100 mg/5ml
Cefixime botol 30 ml
Cefixime
Cefspan KALBE
Starcef DS DEXA
Trixim DS FERRON
Sir kering 100 mg/5ml
Cefixime botol 60 ml
Cefixime Inj 1 gram/vial
Daryacef DARYA

4. Ceftazidime

Ceftazidime Inj 500mg /vial

Ceftum 0,5G FERRON
Ceftazidime Inj 1000mg /vial
Ceftazidime
Ceftum 1G FERRON
Thidim KALBE
Zitadim DEXA

5. Cefuroxime axetil

Cefuroxim axetil Tab 250 mg

Cefuroxim axetil Tab 500 mg
Celocid DEXA
Cefuroxim Axetil Inj 750
Celocid DEXA

6. Cephalexin

Cephalexin Kaps 500 mg

7. Ceftriaxon

Ceftriaxon Inj 1000 mg / vial

Broadced KALBE
Broadced Hospital Pack KALBE
Ceftriaxon
Cefriex NOVELL
Tricefin DEXA
Trixon

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Brospec DARYA

8. Cefotaxim

Cefotaxim Inj 500 mg/vial

Kalfoxim 0,5 GR KALBE
Cefotaxim Inj 1000 mg/vial
Cefotaxim
Clacef DEXA
Kalfoxim KALBE

9. Cefepime

Cefepime Inj 1000 mg/ vial

Cefinov NOVELL
Daryacef DARYA
Exepime FERRON
Vipime KALBE

10. Cefpirome

Cefpirome Inj. 1000 mg/ vial

Cefpirome

11. Ceftizoxime

Ceftizoxime Inj. 1000 mg/ vial

Ceftiz NOVELL

12. Cefoperazone

Cefoperazone Inj. 1000 mg/ vial

Ceropid NOVELL

13. Cefoperazone dan Sulbactam

Cefoperazone dan Sulbactam Inj. 1000 mg/ vial

Fosular NOVELL

6.2.9 GLIKOPEPTIDA

1. Vankomisin Hidroklorida

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Vankomisin Hidroklorida Inj. 500 mg

Vancodex DEXA

2. Teicoplanin

Teicoplanin Inj. 400 mg/ml

Vellanin NOVE

3. Fosfomycin

Fosfomycin Inj. 1000mg /vial

Novellmycin NOVE
Fosfomycin Inj. 2000mg /vial
Novellmycin NOVE

6.2.10 ANTI BAKTERI LAIN

1. Mesalazine

Mesalazine Tab 250 mg

Salofalk DARYA
Mesalazine Tab 500 mg
Salofalk
Mesalazine Supp 500 mg
Salofalk supp
(5-aminosalicylic acid) 4g/
Mesalazine 60g
Salofalk enema

2. Sulfasalazine

Sulfasalazine Tab 500 mg

3. Bismuth subsalisilat

Bismuth subsalisilat Tab 187,5 mg

4.Fradiomcyin + Gramisidin

6.3 ANTI INFEKSI KHUSUS

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KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
6.3.1 ANTI TUBERKULOSIS

1. Rifampisin
Rifampisin Tab 300 mg
Rifampisin Tab 450 mg
Rifampisin Tab 600 mg

2. Etambutol Hidroklorid

Etambutol Hidroklorid Tab 250 mg

Etambutol Hidroklorid Tab 500 mg

3. Isoniazid

Isoniazid Tab 100 mg

Isoniazid Tab 300 mg

4. Pirazinamid

Pirazinamid Tab 500 mg

5. Komb :
Rifampisin, Isoniazid, Pirazinamid
dan Etambutol

Komb :
Rifampisin 150 mg, Isoniazid 75 mg, Film Coated Captab
Pirazinamid 400 mg, Etambutol 275
mg

6. Komb :
Rifampisin, Isoniazid dan
Pirazinamid

Komb :
Rifampisin 75 mg, Isoniazid 50 mg, Tab kunyah 275
Pirazinamid 150 mg

7. Komb :

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NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Rifampisin dan isoniazid

Komb :
Rifampisin 150 mg, Isoniazid 150 Tab
mg
8. Komb : isoniazid dan vitamin B6

Komb :
Tab
Isoniazid 400 mg, Vitamin B6 10 mg

6.4 ANTIFUNGI

1. Griseofulvin
Griseofulvin Tab 125 mg
Griseofulvin
Griseofulvin Kapl 500 mg
Grivin Forte

2. Ketokonazol
Ketokonazol Tab 200 mg

3. Nistatin
Nistatin Tab vagina 100.000 iu
Nistatin
Nistatin Tab 500.000 iu
Nistatin
Susp 100.000 iu/ml botol
Nistatin 12 ml
Constantia NOVELL
Enystin KALBE
Fungatin FERRON
Susp 10.000 iu/ml botol 15
Nistatin ml

4. Fluconazol
Fluconazol Kaps 50 mg
Flucoral KALBE

Fluconazol Kaps 150 mg

Flucoral KALBE
Fluxar NOVELL
Inj 200 mg/100 ml vial 100
Fluconazol ml

24
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
5. Micafungin sodium
Micafungin Serbuk infus 50mg/vial

6. Polikresulen

Polikresulen
7. Terbinafine HCl
Terbinafin HCl Tab 250 mg

8. Itraconazol

Itraconazol Kaps 100 mg

Sporacid FERRON
Sporax DEXA

6.5 ANTI PROTOZOA

6.5.1 ANTI AMUBA DAN ANTIGIARDIASIS

1. Metronidazol
Metronidazol Tab 250 mg

Metronidazol

Metronidazol Tab 500 mg

Fladex DEXA
Susp. 125 mg/5ml btl 60
Metronidazol ml
Metronidazol Infus 5mg/ml btl 100 ml
Fortagyl DARYA
Metrofusin KALBE
Metronidazol DEXA
Velazol NOVELL
Fladex DEXA
Metronidazol Ovula 500 mg

2. Komb : Metronidazol dan

Nystatin
Komb : Ovula
Metronidazol 500 mg
Nystatin 100.000 iu
Neo Gynoxa Ovula KALBE
Fladystin DEXA

6.5.2 ANTI MALARIA

25
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

1. Komb : Sulfadoxin, dan

Primetamin

Komb :
Tab
Sulfadoxin, dan Primetamin

2. Kuinin

Kuinin Tab salut 222 mg

Kuinin Inj 25% amp 2 ml

3. Primakuin

Primakuin Tab 15 mg

4. Artemeter
Artemeter Inj 80 mg/ml amp 1 ml
6.5.3 ANTIPROTOZOA GOLONGAN LAIN

Pirimetamin

Pirimetamin Tab 25 mg

6.6 ANTI VIRUS

1.Ekstrak Pelargonium Sidoides

Ekstrak Pelargonium Sidoides Tab 20 mg ( Eps 7630 )

Ekstrak Pelargonium Sidoides Sir 250 mg /5ml, Btl 100 ml

2. Methysoprinol

Methysoprinol Sir 250 mg /5 ml, Btl 60 ml

Isoprinosin DARYA

Methysoprinol Tab 500 mg

Isoprinosin DARYA
Methysoprinol
Visoprine

26
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
6.6.1 ANTI HERPES

1. Asiklovir

Asiklovir Tab 200 mg

Asiklovir
Clinovir PHAR
Asiklovir Tab 400 mg
Asiklovir
Clinovir PHAR
2. Valasiklovir

Valasiklovir Kapl 500 mg

7 ANTI MIGREN DAN VERTIGO

1. Betahistin dihidroklorida

Betahistin dihidroklorida Tab 8 mg

2. Betahistin Mesilat

Betahistin Mesilat Tab 6 mg

Mertigo DEXA
Noverty NOVELL
Vesitab KALBE
Betahistin Mesilat Tab 12 mg
Mertigo SR DEXA
Betahistin Dehidrochloride Tab 24 mg

3. Komb : ergotamin dan caffein

Komb : Ergotamin 1 mg dan caffein Tab

100 mg

4. Flunarizine

Flunarizine Tab 5 mg
Gratigo DEXA
FREGO 5 MG TAB KALBE Tab 5 mg
FREGO 10 MG TAB KALBE Tab 10 mg

27
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
5. EGB 761

EGB 761 Tab 80 mg

8 ANTI PARKINSON

1. Triheksifenidil
Triheksifenidil Tab 2 mg

2. Komb :
Levodopa dan Benzerasid
Leparson DEXA
3. Pramipexole HCl
Pramipexol 0,375 mg

Pramipexole 0,75 mg

4 Komb :
Levodopa , carbidopa, entecapone tab

9 ANTI MIASTENIA GRAVIS

1 Pyridostigmine
Pyridostigmin Tab 60 mg

10 OBAT UNTUK DARAH DAN JARINGAN PEMBENTUK DARAH

10.1 ANTI ANEMIA

1 Asam folat
Asam Folat 400 mcg
Osfit DHA KALBE
Asam Folat 1 mg
Asam Folat OGB
Feritrin DEXA

2 Low molecule Iron (III) sucrose

Low molecule Iron (III) sucrose Inj 100 mg/5ml, amp 5 ml

3 Low molecular weight iron

dextran

28
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Low molecular weight iron dextran Inj 100 mg/2ml, amp 2 ml

4 Sianokobalamin
Sianokobalamin Tab 50 mcg

5 Zat besi (fe)

Zat besi (fe)
Zat besi (fe) Inj 50 mg/ml btl 150 ml
Zat besi (fe) Sir 15 mg/5 ml btl 100 ml
Zat besi (fe) Drop 15 mg/ml btl 15 ml

6. Kombinasi

Fe, Vit B1, Vit B6, Vit B12, Folic acid

Ferlin Drop DARYA Drop 10 mL

Ferlin Syrup DARYA Syrup 100 mL
Besi (III)300mg, Asam Folat 1 mg
Feritrin DEXA Tab

Substansi Hati kering 100mg,Vit B1

1,5mg,Vit B2 0,25mg,Vit B6
0,25mg,Vit B12 0,5mg,Vit C 12,5mg,
Kalsium Pantetonat Asam Folat
0,5mg,Fe Glukolat 7,5mg,Tembaga
Sulfat 0,65mg

Vit A, vit B1, vit B2, vit B6, vit B12,

vit C, vit D, niacinamide, Ca
pantothenate, folic acid, Fe
fumarate, Ca lactate, copper, iodine,
Na fluoride

Blister isi 10 tab, Botol isi

Obimin DARYA 30 tab.

10.2 ANTI KOAGULASI

1.Asam Traneksamat

Asam traneksamat Tab 250 mg

Kalnex KALBE
Tranexid DEXA

29
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Asam traneksamat Tab 500 mg

Kalnex KALBE
Tranexid DEXA

Asam traneksamat Inj 250 mg/5ml amp 5 ml

Kalnex KALBE
Tranexid DEXA
Ronex PHAROS
Asam traneksamat Inj 500 mg/5ml amp 5 ml
Kalnex KALBE
Tranexid DEXA
Tramix FERRON
2.Fitomenadion (vitamin K)

Fitomenadion Tab salut 20 mg

Fitomenadion (vitamin K) OGB
Fitomenadion Inj 10 mg amp 1 ml
Fitomenadion (vitamin K) OGB

3.Heparin Natrium
Heparin Natrium Inj 5000 IU/ml, vial 5 ml

4.Warfarin
Warfarin Tab 2 mg
Notisil NOVELL
Warfarin Tab 5 mg
Notisil NOVELL

5.Nadroparine Calcium
Nadroparine Calcium Inj syiringe 0,3 ml
Nadroparine Calcium Inj syiringe 0,4 ml
Nadroparine Calcium Inj syiringe 0,6 ml

6.Enoxaparine Sodium
Inj 20 mg/0,2 ml
Enoxaparine Sodium
Syiringe 0,2 ml

Inj 40 mg/0,4 ml
Enoxaparine Sodium
Syiringe 0,4 ml

30
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Inj 60 mg/0,6 ml
Enoxaparine Sodium
Syiringe 0,6 ml

7.Fondaparinux
Fondaparinux Inj 2,5 mg, vial 0,5 ml

Fondaparinux Inj 7,5 mg vial 0,6 ml

8.Rivaroxaban
Rivaroxaban Tab 10 mg
Rivaroxaban Tab 15 mg
Rivaroxaban Tab 20 mg

9.Dabigatran Etexilate
Dabigatran Etexilate Tab 75 mg

Dabigatran Etexilate Kaps 110 mg

10.Anagrelide Hidroklorida
Anegrelide Hidroklorida Kaps 0,5 mg

10.3 OBAT YANG MEMPENGARUHI KOAGULASI

1.Somatostatin
Somatostatin Serb inj 3000 mcg/vial

2.Octreotide
Octreotide Inj 0,1 mg,a mp 1 ml

3.Protombin compex Serb inj 500 IU/20 ml vial

consentrate 20 ml

10. 4 HEMATOPOETIK

1.Eritropoetin alfa
Eritropoetin alfa Inj 2000 iu

Eritropoetin alfa Inj 3000 iu

Eritropoetin alfa Inj 10.000 iu

Eprex JOHN
Eritropoetin alfa Inj 40.000 iu

31
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

2.Eritropoetin Beta
Eritropoetin Beta Inj 2000 iu

11 ANTISEPTIK DAN DESINFEKTAN

11.1 ANTISEPTIK
1 Hidrogen Peroksida Botol 100 ml cairan 3 %

2 Kalium permanganat Serb kantong 5 gram

Kalium Permanganat OGB
3 Povidon Iodine Lar 10 % botol 30 ml
Povidon Iodine

11.2 DESINFEKTAN

1 Etanol 70% Lar botol 100 ml

12 DIURETIK DAN OBAT UNTUK SALURAN KEMIH

12.1 DIURETIK

1.Furosemid
Furosemid Tab 40 mg
Naclex Tab PHAR
Furosemid Inj 20mg/2mL
Naclex PHAR
Roxemid NOVE

2.Hidroklortiazide
Hidroklortiazide Tab 25 mg
Hidroklortiazid OGB

3.Spironolactone
Spironolactone 25 Tab 25 mg
Spironolactone
Spirola KALB

Spironolactone Tab 100 mg

Spironolactone
Spirola KALB

12.2 OBAT UNTUK HIPERTROFI PROSTAT

32
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
1.Doxasozine Mesylate
Doxasozine Mesylate Tab 1 mg
-
Doxasozine Mesylate Tab 2 mg
-
2.Dutasterid
Dutasterid Kapsul lunak 0,5 mg
-
3.Tamsolusine HCl
Tamsolusine HCl Tab disp 0,2 mg

Tamsolusine HCl Tab lepas lambat 0,4 mg

Prostam NOVE
4.Terazosine HCl
Terazosine HCl Tab 1 mg

Terazosine HCl Tab 2 mg

5.Finasteride
Finasterid Tab 5 mg

12.3 OBAT UNTUK SALURAN KEMIH

1.Asam Pipemidat
Asam pipemidat Tab 400 mg

2.Phenazopyridine
Phenazopyridine Kaps 100 mg
Nexurin NOVE
Flavoxate HCl

13 HORMON, OBAT ENDOKRIN LAIN, ANTIDIABETIK PARENTERAL DAN

KONTRASEPTIK
13.1 ANTI DIABETIK ORAL
13.1.1 SULFONIL UREA

1.Glibenklamid
Glibenklamid Tab 5 mg
Glibenklamid OGB

2.Gliclazid
Gliclazid Tab 80 mg

33
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
3.Glikuidon
Glikuidon Tab 30 mg

4.Glimepiride
Glimepiride Tab 1 mg
Metrix 1 KALBE
Gluvas 1 DEXA

Glimepiride Tab 2 mg
Metrix 2 KALBE
Gluvas 2 DEXA

Glimepiride Tab 3 mg
Metrix 3 KALBE
Gluvas 3 DEXA
Velacom 3 NOVE

Glimepiride Tab 4 mg
Metrix 4 KALBE
Gluvas 4 DEXA
Velacom 4 NOVE

5.Glipizide
Glipizide Tab lepas lambat 5 mg

Glipizide Tab lepas lambat 10 mg

13.1.2 BIGUANID

1.Metformin
Metformin Tab 500 mg
Metformin OGB

Glumin 500 FERRON

Metformin Tab lepas lambat 500 mg

Glumin XR FERR
Nevox XR 500 KALB

Metformin Tab lepas lambat 750 mg

Nevox XR 750 KALB

34
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Metformin Tab 850 mg

13.1.3 ALFA GLUKOSIDA INHIBITOR

1.Acarbose
Acarbose Tab 50 mg
Eclid 50 DEXA
Glubose 50 FERR

Acarbose Tab 100 mg

Eclid 100 DEXA
Glubose 100 FERR

13.1.4 TIAZOLIDINEDION

1.Pioglitazone
Pioglitazone Tab 15 mg
Pionix 15 KALB
Pioglitazone Tab 30 mg
Pionix 30 KALB

13.1.5 DIPEPTIDYL PEPTIDASE 4 (DPP 4) INHIBITOR

Sitagliptin
Sitagliptin Tab 50 mg
Sitagliptin Tab 100 mg
2.Linagliptin
Linagliptin Tab 5 mg

13.1.6 ANTIDIABETIK ORAL KOMBINASI

1.komb : Metformin +
Glibenklamid
Glimepirid 1 mg + Metformin 500 Tab
mg
Velacom Plus FERR
Glimepirid 3 mg + Metformin 500 Tab
mg
Velocom Plus FERR

2.komb : Metformin500 mg dan

Sitagliptin 50 mg

3.Komb : Metformin dan

Pioglitazon

35
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Pionix M KALBE Tab 500 mg
Pionix M KALB Tab 800 mg

4. Komb : Metformin +
Linagliptin

5.Repaglinid Tab 1 mg
Dexanorm DEXA

6 Komb : Glimepirid dan Metformin

13.2 ANTIDIABETIK PARENTERAL

1.Human Insulin

Human insulin Inj 100 iu/ml vial 10 ml

Human insulin Inj 100 iu/ml catridge 3 ml

Human insulin Inj 100 iu/ml penfil 3 ml

2.Analog Insulin

Basal Insulin Inj 100iu/ml pen 3 ml

Rapid insulin analog Inj 100iu/ml pen 3 ml

Mix insuin analog Inj 100iu/ml pen 3 ml

Long Acting Insulin Inj 100iu/ml pen 3 ml

13.3 HORMON KELAMIN

13.3.1 ESTROGEN

1.Etinil estradiol
Etinil estradiol Tab 0,05 mg

2.Komb :
Etinil Estradiol + Drospirenon

36
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Etinil Estradiol + Drospirenon

etinil estradiol dan cyproteron

asetat

Hormon Esterogen, Ekstrak Red

Cover 100mg,Vit B1 10mg,Vit B6
10mg,Vit E 15mg.

13.3.2 PROGESTERON

1.Allysterenol
Allysterenol Tab 5 mg
Premaston KALB *
Pregnolin DEXA *

2.Noretisteron
Noretisteron Tab 5 mg
Norelut DEXA

3.Medroksi Progesteron Asetat

Medroksi
Tab 5 mg
Progesteron Asetat

4.Dydrogesterone
Dydrogesterone Tab 10 mg

5.Progesteron
Progesteron Ov 200 mg

Progesteron Ovu 400 mg

Tab/ovu 100 dan 200 mg

6.Nomegestrol Asetat
Nomegestrol Asetat Tab 5 mg

13.3.3 HORMON REPRODUKSI LAIN

1.Leuprolide Asetat
Endrolin KALB

2.Testosteron

37
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Tostrex gel KALBE GEL 2%

3.Hormon Substitusi: Tab50 mg

Clomiphen citrat
Provula DEXA
4.Hormon Substitusi: Ca
phospat 12 mg, B12 20mg, Extr Tab
Placenta 15 mg
Laktafit DEXA

13.4 HORMON TIROID DAN ANTI TIROID

1.Lugol
Lugol Lar btl 30 ml

2.Natrium Tiroksin
Natrium Tiroksin Tab 0,05 mg
Natrium Tiroksin Tab 0,1 mg

3.Propiltiourasil
Propiltiourasil Tab 100 mg

4.Karbimazol
Karbimazol Tab 5 mg

5.Thiamazol
Thiamazol Tab 5 mg
Thiamazol Tab 10 mg

13.5 KORTIKOSTEROID

1.Deksametason
Deksametason Tab 0,5 mg
Deksametason OGB

2.Metylprednisolon

Metilprednisolone Tab 4 mg
Metilprednisolon 4 OGB
Hexilon 4 mg KALB
Medixon 4mg FERR
Metrison 4 mg DEXA

38
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Toras 4 mg PHAROS

Metilprednisolone Tab 8 mg
Metilprednisolon OGB
Hexilon 8 mg KALB
Medixon 8mg FERR
Metrison 8 mg DEXA
Toras 8 mg PHAROS
Metilprednisolone Tab 16 mg
Hexilon 16 mg KALBE
Medixon 16 mg FERRON
Metrison 16 mg DEXA

Metilprednisolone Inj 125 mg

Metilprednisolone OGB
Hexilon KALB
Medixon 125 mg FERR
Novestrol 125 mg NOVE

Metilprednisolone Inj 500 mg

Metilprednisolone OGB
Hexilon 500 mg KALB
Medixon 500 mg

3.Prednison
Prednison Tab 5 mg

4.Triamcinolon Asetonida
Trimacinolon Asetonida Tab Tab 4 mg
Flamicort DEXA
Trilac NOVE
Ketricin FERR
Triamcinolon Asetonida Injeksi Ampul 10mg/ml
Trilac NOVE Ampul 5 mL
14 OBAT KARDIOVASKULER
14.1 ANTI ANGINA

1 Diltiazem
Diltiazem Tab 30 mg

2 Isosorbid Dinitrat

39
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Isosorbid Dinitrat Tab sublingual 5 mg
Isosorbid Dinitrat 5 OGB
Cedocard 5 DARY

Isosorbid Dinitrat Tab sublingual 10 mg

Isosorbid Dinitrat 10 OGB
Cedocard 10 DARY
Isosorbid Dinitrat Tab sublingual 20 mg
Cedocard Retard 20

Inj 10 mg/10 ml, amp 10

Isosorbid Dinitrat ml
Cedocard DARY
Isorbid PHAR
3 Isosorbid 5 Mononitrat

4 Gliseril Trinitrat
Nitroglycerin Kaps 2,5 mg
Nitroglycerin Kaps 5 mg
Nitroglycerin Tab sublingual 500 mcg

Nitroglycerin Inj 10mg/10ml

NTG (nitroglycerin) FERR
5 Trimetazidine Tab 35mg
Angintriz-MR NOVE

14.2 ANTI ARITMIA

1 Amiodarone
Amiodaron Tab 200 mg
Kendaron DARY
Rexidron NOVE

Amiodaron Inj 150 mg/3 ml, amp 3 ml

Amiodaron DARY
Kendaron DARY
Rexidron NOVE

2 Propanolol HCl
Propanolol Tab 10 mg
Propanolol tab OGB
3 Epinefrin

40
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Epinefrin Inj 0,1% amp 1 ml
Epinefrin OGB

4 Propafenon
Propafenon Tab 150 mg

14.3 ANTI HIPERTENSI

14.3.1 ACE INHIBITOR

1 Kaptopril
Kaptopril Tab 12,5 mg
Kaptopril 12,5 OGB

Kaptopril Tab 25 mg
Kaptopril 25 OGB

Kaptopril Tab 50 mg

2 Lisinopril
Lisinopril Tab 5 mg
Lisinopril OGB
Odace DARY

Lisonopril Tab 10 mg
Lisinopril OGB
Odace DARY

3 Perindopril Arginin
Perindopril Arginin Tab 5 mg

4 Ramipril
Ramipril Tab 1,25 mg

Ramipril Tab 2,5 mg

Prohytens NOVE
Hyperil 2,5 FERR

Ramipril Tab 5 mg
Prohytens NOVE
Hyperil 5 FERR

Ramipril Tab 10 mg

41
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Prohytens NOVE
Hyperil 10 FERR

14.3.2 BETA BLOCKER

1 Propanolol HCl
Propanolol Tab 10 mg
Propanolol OGB
Propanolol Tab 40 mg

2 Atenolol
Atenolol Tab 50 mg
Atenolol Tab 100 mg

3 Bisoprolol
Bisoprolol Tab 5 mg
Beta -One KALB
Bisovell NOVE
B Beta FERR

4 Metoprolol tartrat
Metoprolol tartrat Inj 1mg/ml amp 1 ml

14.3.3 KALSIUM ANTAGONIS

1 Amlodipin
Amlodipin Tab 5 mg
Amlodipin 5 OGB
Amlocor NOVE
Divask KALB
Tensivask DEXA

Theravask 5 DARY

Amlodipin Tab 10 mg
Amlodipin 10 OGB
Amlocor NOVE
Divask KALB
Tensivask DEXA

Theravask 5 DARY

42
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
2 Diltiazem
Diltiazem Kapls 90 mg
Diltiazem Kap 100 mg

Diltiazem Kap 180 mg

Cordila SR DEXA

Diltiazem Kaps 200 mg

Diltiazem Inj 25 mg/5 ml vial 5 ml

3 Nifedipine
Nifedipin Tab 10 mg
Nifedipin Tab oros 20 mg

Nifedipin Tab oros 30 mg

4 Verapamil
Verapamil Tab 80 mg

5 Nikardipin
Nikardipin Inj 10 mg/10 ml
Nicardex DEXA
Nidaven NOVE
Nicafer FERR
Blistra PHAR

6 Nimodipin
Nimodipin Tab 30 mg

Nimodipin Inf 10 mg/50 ml btl 50 ml

Ceremax KALBE

14.3.4 ANGIOTENSIN II ANTAGONIS

1 Candesartan
Candesartan Tab 8 mg
Canderin 8 DEXA
Candotens NOVE

Candesartan Tab 16 mg
Canderin 16 DEXA

43
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Candotens NOVE

2 Irbesartan
Irbesartan Tab 150 mg
Irvask KALBE
Irvell NOVE
Irbesartan Tab 300 mg
Irvask KALBE
Irvell NOVE

3 Olmesartan
Olmesartan Tab 20 mg

Olmesartan Tab 40 mg

4 Telmisartan
Telmisartan Tab 40 mg

Telmisartan Tab 80 mg

5 Valsartan
Valsartan Tab 80 mg

Valsartan Tab 160 mg

6 Losartan
Losartan Tab 50 mg
Angioten KALBE
Lifezar DARY

Losartan Tab 100 mg

Lifezar DARY

14.3.5 ANTIHIPERTENSI LAIN

1 Beraprost sodium
Tab 20 mcg

2 Doxazosin Mesylate
Tab 1 mg
Tab 2 mg

44
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
3 Metildopa
Metildopa Tab 250 mg

4 Klonidin HCl
Klonidin Tab 0,15 mg

Klonidin Inj 0,15mg/ml amp 1 ml

5 Terazosin
Terazosin Tab 1 mg

Terazosin Tab 2 mg

14.3.6 ANTIHIPERTENSI KOMBINASI

1 Komb : Telmisartan dan

amlodipin

Telmisartan 80 mg + amlodipin 10 Tab

mg

Telmisartan 40 mg + amlodipin 5 mg Tab

2 Komb : Irbesartan dan HCT

Irbesartan 300 mg dan HCT 12,5 mg Tab
Co-Irvell NOVE

Irbesartan 150 mg dan HCT 12,5 mg Tab

Co-Irvell NOVE

3 Komb : Ext Apii Herba 92 mg , Ext K

Orthosiphon Folium28 mg

4 Komb : Pyridoxine hydrocloride

(vit B6) 25 mg, cyanocobalamin (vit Soft Kaps
B12) 25 mg, folic acid 500 mcg, d-
alpha tocopherol (vit E) 400 IU.

Cardiomin DARY

45
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

5 Komb : Natural Ubidecarenone

(CoQ10) 30 mg, Synthetic
Levocarnitine fumarate 500 mg,
Folic acid 400 mcg
Metsel DARY

14.4 GAGAL JANTUNG

1 Bisoprolol
Bisoprolol Tab 2,5 mg
Beta-One KALB
Bisoprolol Tab 5 mg
Beta -One KALB
Bisovell NOVE
B-Beta FERR
2 Carvediol
Carvediol Tab 6,25 mg
V-BLOC KALB
Carvediol Tab 25 mg
V-BLOC KALB
3 Digoxin

4 Ivabradine Tab 5 mg

5 Komb : Bisoprolol 5 mg dan HCT

12,5 mg Tab

Bisovell Plus NOVE

14.5 ANTI TROMBOTIK

1 Asam asetil salisilat

Aspilet Chewable DARY Tab 80 mg
Thrombo aspilet DARY
Nosprinal NOVE

2 Cilostazol
Cilostazol Tab 100 mg
Citaz KALBE

Cilostazol Tab 50 mg
Citaz KALBE
Aggravan FERRON

46
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

3 Clopidogrel
Clopidogrel Tab 75 mg
Vaclo DEXA
Clotix FERR
Artepid PHAR
CPG KALB
4 Ticagrelor
Tab 90 mg
5 Trombolisisi oral
DLBS 1033
Disolf DEXA Tab

6 Bioactive protein fraction

DLBS1033 (Lumbrokinase) 490 mg
Degrade FERRON Tab

14.6 TROMBOLITIK

1 Streptokinase
Streptokinase Serb inj 1.500.000 iu
Streptase DEXA

2 Alteplase
Serb inj 50 mg

14.7 ANTI PENYAKIT JANTUNG REMATIK

1 Asam asetil salisilat Tab 500 mg

15 OBAT UNTUK SYOK

1 Dopamin HCl
Dopamin Inj 40 mg/ml amp 5 ml
Dopac KALBE

2 Dobutamin
Dobutamin Inj 250 mg, vial 5 ml
Dominic KALBE
Dobuject DEXA
Dobutell NOVE
Cardiotone PHAR

47
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

3 Nor epinefrin
Nor epinefrin Inj 4mg/4 ml amp 4 ml
Raivas DEXA
N-Epi NOVELL
Arespin PHAROS

16 ANTI HIPERLIPIDEMIA

1 Simavastatin
Simvastatin Tab 10 mg
Cholestat 10 KALB

Simvastatin Tab 20 mg
Cholestat 20 KALB

2 Pravastatin sodium
Pravastatin Tab 10 mg
Novales NOVE
Novales NOVE

3 Atorvastatin Ca
Atorvastatin Tab 10 mg
Truvas 10 KALB
Stator 10 DEXA
Stavinor 10 PHAR

Atorvastatin Tab 20 mg
Truvas 20 KALBE
Stator 20 DEXA
Removchol NOVE

Atorvastatin Tab 40 mg
Truvas 40 KALBE
Removchol NOVE
Stavinor 40 PHAR

4 Gemfibrozil
Gemfibrozil OGB Tab 300 mg

5 Fenofibrat
Fenofibrat Kaps 100 mg

48
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Trolip 100 DEXA

Fenofibrat Kaps 300 mg

Trolip 300 DEXA

6 Rosuvastatin
Rosuvastatin Tab 10 mg
Rosufer 10 FERR

Rosuvastatin Tab 20 mg
Rosufer 20 FERR

7 Komb : Pravastatin Sodium 20 mg Tab

dan Asetosal 80 mg
Novosta NOVE

17 OBAT TOPIKAL UNTUK KULIT

17.1 ANTI BAKTERI

1 Natrium Fusidat
Salep 20 mg/g tube 5 gram
2 Asam Fusidat
Afucid FERR Krim 20 mg/g tube 5 gram

3 Perak Sulfadiazin
Burnazin Krim 1% tube 35 gram
Burnazin Krim 1% tube 500 gram

4 Framisetin Sulfat
DaryanTulle Dus 5 Sachet

5 Mupirocin Sulfat

6 Erythromicyn

7 Gentamycin sulfate
Gentamycin oint Salep 0,1% tube 15 gram

49
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

17.2 ANTI FUNGI

1 Ketokonazole
Ketokonazole Krim 2% tube 10 gram
Ketokonazole Krim 2% tube 15 gram
Ketokonazole Shampoo 60 ml

2 Mikonazol
Krim salep 2% tube 10
Mikonazol gram
Mikonazol OGB
Mikonazol Powder 2% 25 gram

3 Terbenafine
Termisil FERR Krim 1% tube 10 gram

4 Nystatin 100000 IU, Seng oksida

200 mg
Myco Z Taiso Salep tube 10 gram

17.3 ANTI INFLAMASI DAN ANTI

PRURITIK
1 Betametason
Betametason Krim 0,1% tube 5 gram
Betametason Salep 0,05% Tube 5 gram
2 Desoksimetason
Krim 0,25% tube 5 gram5
Dermovel FERRON gram

Dermovell FERRON Krim 0,25% tube 10 gram

3 Hidrokortison asetat
Hidrokortison asetat Krim 2,5% tube 5 gram

Krim 1% tube 5 gram

4 Mometason furoat
Mometason Cream 5 gram

Mometason Cream 10 gram

Dermovel FERR

50
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Mometason Salep 10 gram

5 Desonide

6 Klobetasol Dipropionate
Forderm FERR Krim 0.05% tube 10 gram

7 Komb : Hydroquinon, Tretinoin,

Fluocinolone acetonide

8 Triamcinolone acetonide

17.4 ANTISKABIES DAN

ANTIPEDIKULOSIS

1 Permethrin

2 Komb : asm salisilat dan sulfiur

17.5 KAUSTIK

1 Polikresulen

17.6 PREPARAT TOPIKAL LANINNYA

1 Bedak salisil

2 Urea
Krim tube 40 gram
Lotion tube 50 ml
3 Komb : calcipotril, betametason
dipropionat

4 Asam Retinoat

5 Heparin Na

6 Komb : Conc camomile 7,44 mg,

Eucalyptol 100 mg

51
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

7 Komb : Lidocaine HCl, Prilocaine

HCl

8 Komb : Copyidis rhizoma,

Phellodendri
chinensis cortex, Scutellariae
radix, Minyak wijen, Cera flava

9 Ceramide, cholesterol, free fatty

acids (in optimised 3:1:1 ratio),
glycerine, Na hyaluronate

10 Ceramide, cholesterol, free fatty

acids (in optimised 3:1:1 ratio),
glycerine

11 Komb : Anhydrous lanolin 60 mg,

isopropyl myristate 170 mg, cetyl
alcohol 20 mg, sorbitan
monostearate 80 mg, polysorbate
20 mg, glycerol 100 mg,
dimethicone 50 mg, sorbic acid 1.5
mg

17.7 KOSMETIKA

Neostrata PHA Eye Cream DARY Krim Mata tube 15 gram

Neostrata PHA Facial Cleanser DARY Cleanser 100 gram
Neostrata PHA Face Cream DARY Krim Tube 40 gram
Neostrata AHA Oily Skin Solution DARY Solution 100 ml
Neostrata AHA Skin SMT Cream DARY Krim tube 50 gram
Neostrata Bionic Face Serum DARY
Neostrata Bionic Lotion DARY
Neostrata Bionic Face Cream DARY Krim tube 40 gram
Neostrata Bio Hydrating Cream DARY Krim 40 gram

Neostrata Daytime Protection Cream DARY Krim 40 gram

Neostrata AHA Face Cream Plus DARY Krim 40 gram

Neostrata Gel Plus 15 AHA DARY Gel
Neostrata Lotion Plus 15 AHA DARY Lotion
Neostrata Prosystem 20% DARY
Rejuvenating

52
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Neostrata Prosystem 35% DARY
Rejuvenating
Neostrata Prosystem 50% DARY
Rejuvenating
Neostrata Illuminating Serum DARY Serum 40 ml
Neostrata Pigment Controller DARY
Neostrata Ultra Bright Cleanser DARY Cleanser 200 ml

Neostrata Optimal Pre-peel Cleanser DARY

Neostrata Peel Neutralizer DARY

Neostrata Peel Neutralizer Spray DARY Spray 200 ml
Neostrata Renewal Cream DARY
Neostrata Skin Active Cellular R DARY
Neostrata Skin Active Exfoliatin DARY
Neostrata Skin Active Intensive DARY
Neostrata Skin Active Aminovil DARY
Activator
Neostrata Skin Active Finishing DARY
Complex
Neostrata Skin Active Matrix Support DARY
SPF
Neostrata Sheer Hydration SPF 15 DARY
Neostrata Ultra Daytime Smoothing DARY Cream tube 40 gram
Cream
Neostrata AHA Ultra Smoothing DARY Lotion 200 ml
Lotion
Neostrata AHA Ultra Smoothing DARY Krim tube 40 gram
Cream
Celeteque Acne Spot Corr Gel DARY
Celeteque Back Acne Spray DARY
Celeteque Bright Dark Spot C Gel DARY

Celeteque Bright Eye Tuck + Dark Cir DARY

Celeteque Bright Tri Benefit Cream DARY

Celeteque Acne Clear F Moist DARY

Celeteque Adv Anti-Wrin Col Gel DARY
Celeteque Res Ult Lift Con Serum DARY
Celeteque Adv Anti Wrin SPF 15 DARY
Celeteque Adv Anti Wrin F Moist DARY
Celeteque Hydration F Moist DARY

53
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Celeteque Suncare M Moist SPF 30 DARY
Celeteque Acne Oil Cont Toner DARY
Celeteque Res Inst Wrin Smo Cr DARY

Komb : AstaTROL Hp 0.05%,

Matricaria chamomile Extract 5%
Astaderm Body Lotion SOHO Lotion 120 ml
Astaderm SOHO Krim
Astaderm Eye Serum SOHO
Astaderm Face Serum SOHO

Komb : Multi Lamellar Emultion

(MLE) yang terdiri dari Pseudo-
ceramide, Phytosterol, Asam stearat
dan minyak nabati lainnya,
Squalane & komponen lainnya

Noroid Body Wash SOHO

Komb : Psedoceramide
(Myristoyl/palmiroyl
oxostearamide/arachamide MEA),
Phytosterols, Asam stearat dan
minyak nabati, squalene

Noroid SOHO Krim 80 ml

Komb : Psedoceramide
(Myristoyl/palmiroyl
oxostearamide/arachamide MEA),
Phytosterols, Asam stearat dan
minyak nabati, squalene, Zinc oxide

Noroid Derma Rash SOHO 60 ml

Komb : Multi Lamellar Emultion

(MLE) yang terdiri dari Pseudo-
ceramide, Phytosterol, Asam stearat
dan minyak nabati lainnya,
Squalane & komponen lainnya

Noroid Face Cleanser SOHO 50 ml

Komb : Multi Lamellar Emultion
(MLE) yang terdiri dari Pseudo-
ceramide, Phytosterol, Asam stearat
dan minyak nabati lainnya,
Squalane, Defensamide &
komponen lainnya
Noroid I-Intesive SOHO Krim 50 ml

54
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Komb : Multi Lamellar Emultion

(MLE) yang terdiri dari Pseudo-
ceramide, Phytosterol, Asam stearat
dan minyak nabati lainnya,
Squalane, Defensamide &
komponen lainnya

Noroid I-Intensive SOHO Lotion 50 ml

Komb : Psedoceramide
(Myristoyl/palmiroyl
oxostearamide/arachamide MEA),
Phytosterols, Asam stearat dan
minyak nabati, squalene

Noroid SOHO Lotion 200 ml

18 LARUTAN ELEKTROLIT DAN NUTRISI

18.1 LARUTAN ELEKTROLIT DAN NUTRISI

PARENTERAL

1 Kombinasi Asam Amino

Komb (Per L); Amino acids 27.2 g,

essential amino acids 21.8 g, non-
essential amino acids 7.4 g, sorbitol
50 g
Pan Amin G OTSU Inf 500 ml

Komb (Per L); Asam amino 100 mg,

Xylitol, Vitamin, Mineral (Ni 15,7;
Na 2 mEq; Asetat 120 mEq)

Comafusin Hepar KALB Inf 500 ml

Aminoleban OTSU Inf 500 ml

Komb (Per L); Asam Amino 100 mg,

Nitrogen 15,7 mg; Natrium 2 mEq;
Asetat 120 mEq)

55
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Amiparen OTSU Inf 500 ml

Komb (Per L): L-amino acids 72 g,

Asam Amino Rantai Cabang 45.8%,
Ratio EAA/NEAA 2.6:1; Nitrogen 10

Kidmin OTSU Inf 500 ml

Komb (Per L): Asam amino 5g;

Sorbitol 100; Asam Askorbat 0,4g;
Inositol 0,5g; Nikotinamida 0,06g;
Piridoksin HCl 0,04g; Riboflavin
Natrium Fosfat 2,5mg/ml; Rutosid
0,4g/L; Mineral

Aminovel 600 OTSU Inf 500 ml

Aminofusin L 600 KALB Inf 500 ml

Komb (Per L): Asam amino rantai

cabang kadar tinggi 45%, asam
amino aromatik kadar
rendahmethionine, phenylalanine
dan tryptophan

Aminofusin Hepar KALB Inf 500 ml

Komb (Per L): Asam amino 100g;

Nitrogen 15,7 mg; Natrium 2 mEQ;
Asetat 120mEQ

Kalbamin KALB Inf 500 ml

Komb (Per L): Asam Amino 89,49 g;

EAA 48,15g; NEAA 41,34g; Chlorida
28,62 meq/L; Asetat 124,13 meq/L;
Nitrogen 15,2g; Asam amino rantai
Cabang 15,3%

Renxamin KALB Inf 500 ml

Komb (Per L): Asam amino 5% /

50g, Elektrolit, Vit for Paediatric

Aminofusin Paed KALB Inf 250 ml

Komb (Per L): Asam amino 60 g/L,
Nitrogen 9 g/L
Aminosteril Infant 6% FRES Inf 100 ml
2 Kombinasi Lipid

56
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Komb (Per L): Lipid 20% (Soybean
Oil 20%, Olive Oil 80%), Energi: 2
kCal/L
Clinoleic KALB Inf 100 ml
Clinoleic KALB Inf 250 ml
Clinoleic KALB Inf 500 ml

3 Larutan Nutrisi Kombinasi

Komb (Per L); Na 100 mEQ, K 18
mEQ, Ca 4 mEQ, Mg 6 mEQ, Cl 90
mEQ, Asetat 38 mEQ, Sorbitol 50g
Tutofusin OPS KALB Inf 500 ml
Komb (Per L); Glukosa 7,5%,
Elektrolit+ Zn
Aminofluid KALB Inf 500 ml
Aminofluid KALB Iinf 1000 ml
Komb (Per L); Asam Amino 40g,
Glukosa dan Elektrolit 80g
Clinimix KALB Inf 1000 ml

Komb (Per L): Na 100 mEQ, K

18mEQ, Ca 4 mEQ, Mg 6 mEQ, Cl 90
mEQ, Asetat 38 mEQ, Sorbitol 50 g

Tutofusin OPS KALB Inf 500 ml

Komb (Per L): natrium Laktat

28,25;KCl 0,075g; CaCl2 0,05g

Totilac KALB Inf 250 ml

Komb (Per L): HydroxyEthyl Starch

200/0,5 60g; NaCl 6,9g; KCl 0,3g,
CaCl2 0,22g; Na Laktat 4,48g

Fima Hes 200 KALB Inf 500 ml

4 Kombinasi Karbohidarat

Komb (Per L); Dextrosa 5%, NaCl

0,45%

Otsu D5 1/2 NS OSTU Inf 500 ml

57
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Komb (Per L); NaCl 2,34g; KCl 0,75g;

Na Laktat 2,24g; Dekstrosa Anhidrat
27g

KA-EN 3A OTSU Inf 500 ml

Komb (Per L): NaCl 1,75g; KCl 1,5 g;

Na Laktat 2,24g; Dekstrosa Anhidrat
27 g

KA-EN 3B OTSU Inf 500 ml

Komb(Per L): Dextrose 18,750 g;
NaCl 1,125g; Na 38,5 mEq/L; Cl 38,5
mEq/L

KA-EN 1B OTSU Inf 500 ml

Komb (Per L):Dextrose 37,5 g; NaCl

1,17g; KCl 0,6g; Na 30 mEq/L; Laktat
10 mEq/L; K 8 mEq/L; Cl 28 mEq/L

KA-EN 4A OTSU Inf 500 ml

Komb (Per L): Dextrose 40g; NaCl

1,175g; NaLactat 1,12g; Na 30
mEq/L; Laktat 10 mEq/L; Cl
20mEq/L

KA-EN 4B OTSU Inf 500 ml

Komb (Per L): Fruktosa 60g; Glukosa

33g; Xylitol 30 g
Triofusin 500 KALB Inf 500 ml

6. Mannitol
Mannitol 20% OTSU Inf 250 ml
Mannitol 20% KALB Inf 500 ml

7. Kalium Chlorida
Otsu-KCl 7,46% OTSU Vial 25ml (High Alert)

8. Natrium Bikaronat
Otsu-Meylon 8,4% OTSU Vial 25 ml (High Alert)

9. Magnesium Sulfat
Otsu-MGSO4 OTSU Vial 25 ml (High Alert)

58
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

10. Dekstrosa
Otsu-D40 OTSU Vial 25 ml (High Alert)

11.Natrium Chlorida (NaCl)

Otsu-NS (NaCl 0,9%) OTSU Inf 500 ml
Otsu-NS Piggy Back (NaCl 0,9%) OTSU Inf 100 ml
Otsu-NS
OTSU Vial 25 ml
(NaCl 0,9%)
Otsu-Salin 3
OTSU Inf 500 ml (High Alert)
(NaCl 3%)
Wida-Natrium Chlorida 0,9% WIDA Inf 500 ml

12. Glukosa
Otsu-D10 OTSU Inf 500 ml

13. Maltosa
Martos-10
OTSU Inf 500 ml
(maltosa 10%)

14.Ringer Laktat
Otsu-RL OTSU Inf 500 ml

18.2 LARUTAN ELEKTROLIT DAN NUTRISI

ORAL

1.Garam Oralit

NaCl 0,52 g; KCl 0,3g; Trinatrium

Sitrat Dihidrat 0,58g;Glukosa
Anhidrat 2,7g
Pharolit NOVE Serbuk Sach
2. Zinc
Zinc Tab 20 mg
Zinc OGB PHAP
Zincare KALB Tab 20 mg
Zinc Syr 20 mg/5ml, 60 ml
Orezinc 20 mg/5ml NOVE
DaryaZinc DARY
Zinc Drop 27,5mg/ml,15ml
Darya Zinc DARY
3 Kalium Klorida

59
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Kalium Klorida Tab SR 600mg

4 Kalsium Polistiren Sulfonat

Kalsium polistiren Serbuk Sach 5 gr

5 K,L Aspartat
K,L aspartat Tab 300 mg

6 Kombinasi Elektrolit

Komb (Per 200 ml): Na 75 mEq/L; K

20 mEq/L; Cl 65 mEq/L; Sitrat
10mEq/L; Glukosa mEq/L
Dehidralyte NOVE Btl 200 ml

19 OBAT MATA

19.1 SISTEMIK
1 Asetazolamid
Glaucon CEND Tab 250 mg
2 Gliserin
Gliceryn Larutan 50%
4 Komb. Lutein 6 mg,Ext Bilberry
80 mg,
Ocugard PHAP Caps

19.2 PREPARAT MATA TOPIKAL

1 Tetrakain HCl 5mg
Cendo Pantocain 0,5% TM CEND TM 5 ml

2. Anti Mikroba
1. Acyclovir
Acyclovir 5% Cr PHAP Tube 5%, 5 gram

3.Komb (per Gram) Polymixin B

Sulphate 5000 IU, Chloramphenicol
10 mg

Cendo Fenicol Salep Mata 1% CEND Salep Mata 1%; 3,5 gram

4 Gentamisin

60
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Cendo Gentamycin Salep Mata 3% CEND Eye OINT 3%; 3,5 gram
Cendo Genta 0,3% TM 5 ml CEND TM 0,3%;5ml

5 Levofloksasin

Cravit Opthalmic Sol 0,5% Eye Drops FERR ED 0,5%,5ml

6 Komb (Per gram):

Chloramphenicol 10 mg, Polymyxin
B Sulphate 5000 IU
Cendo Mycetin Salep Mata CEND Eye Oint 3,5 gram

7 Komb (per ml): Polymixin B

Sulphate 10.000 IU, Neomycin 3,5
mg; Dexamethasone Sodium
Phosphat

Cendo Polydex TM 5 ml CEND TM 5 ml

8. Komb (per ml): Polymixin B

Sulphate 10.000 IU; Neomycin 2,5
mg; Gramycidin 0,025 mg

Cendo Polygran TM CEND TM 5 ml

Cendo Polygran MD CEND MD 0, ml

9. Komb (per ml): Dexamethason

1mg; neomycin 3,5 mg; Polymixiin B
Sulphate 10.000 IU
Cendo Xitrol TM CEND TM 5 ml

9. Komb (per ml): prednisolon 5

mg, Neomycin Sulphate 5 mg,
Poymixin B Sulphate 10.000 IU

Cendo Polypred MD CEND MD 0,6 ml

8 Ofloxacin
Tarivid Eye Drop FERR ED 0,3%, 5ml
Cendo Floxa 3 mg/ml MD CEND MD 0,6 ml

9.Tobramycin 3 mg
Cendo Tobro MD CEND MD 0,6 ml

61
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

10. Komb (per ml): tobramycin 3

mg, dexamethason 1 mg
Cendo Tobrosan MD CEND MD 0,6 ml

19.3 ANTI INFLAMASI

1 Betametason
Betametason 0,1% Cream PHAP Tube 5 gram

3 Flourometholone
Flumetholone Eye Drop FERR Eye Drops 5 ml

2 Natrium Diklofenak
Cendo Noncort 1 mg/ml MD CEND MD 0,6 ml

19.2.4 MIDRIATIK

1 . Homatropin HBr 20mg

Cendo Homatro 2% TM CEND TM 5 ml
2. Tropicamide 5 mg dan 10 mg
Cendo Mydriatil 0,5% TM CEND TM 5 mg/ml; 5ml
Cendo Mydriatil 1% TM CEND TM 10 mg/ml; 5 ml
19.4 MIOTIK dan ANTIGLAUKOMA
1.Tafluprost
Taflotan Eye Drops 0015% FERR TM 5ml

2.Timolol
Cendo Timol 0,25% TM CEND 2,5mg/ml; TM 5 ml
Cendo Timol 0,25% MD CEND 2,5mg/ml; MD 0,6ml
Cendo Timol 0,5 % TM CEND 5 mg/ml; TM 5ml

19.5 PREPARAT MATA LAIN

1.Kalium Iodida 5 mg
Cendo Caterlent MD CEND MD 0,6 ml

2. Natrium Iodida 10 mg, Kalium

Iodida 5 mg
Cendo Vitrolenta MD CEND MD 0,6 ml

3. NaCl 4,4 mg; Kalium Clorida 0,8

mg
Cendo Lyteers TM CEND TM 15 ml

62
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

4. Natrium Carboxymetilselulosa
5mg
Cendo Cenfresh TM CEND TM 5 ml
Cendo Cenfresh MD CEND MD 0,6ml

5. Pirenixone
Kary Uni 0,05 mg/ml FERR Eye Drop 5 ml
6. Komb (per ml) HPMC 3 mg dan
Dextran 70 1 mg
Cendo Eyefresh TM 5 ml CEND TM 5 ml

7. Komb (per ml)HPMC 2 mg,

Dextran 70 1 mg

Cendo Eyefresh MD CEND MD 0,6 ml

8. Komb (per ml) HPMC 5 mg;

Dextran 701 mg; Gliserin 2 mg
Cendo Eyefresh Plus MD CEND MD 0,6 ml

20 OBAT TELINGA, HIDUNG DAN

TENGGOROKAN
20.1 ANTI BAKTERI
1.Chloramphenicol
Chloramphenicol PHAP Tab 250 mg

2.Komb (per Gram) Neomisin Sulfat

5 mg,Seng bastitrasina 500IU
NB Top Oint PHAP Tube 5g

3. Ofloxacin
Tarivid Otic Ear Drops KALB ED 3mg/ml; 5 ml

4. Komb (per ml) polymyxin B

sulfate 10.000 IU, Neomycin Sulfate
3.390 IU, bethamethasone Base 1
mg, lidocain HCl 40 mg

Otozambon Ear Drops ZAMB ED 8 ml

20.2 KORTIKOSTEROID
1.Triamcinolon asetonid

63
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Nasacort Nasal Spray AVEN Nasal Spray 55mcg/dose

Ketricin Ora Base 0,1% FERR Tube 5 mg

3. Natrium Hyaluronate
Hialid Opthalmic 0,1% FERR Eye Drops 5ml

20.3 ANTI DEKONGESTAN

1.Tripolidine 2,5mg,Psedoepedrine
Hcl 30mg,Paracetamol 500mg

Noza PHAP Kapl

20.4 PREPARAT TELINGA, HIDUNG DAN

TENGGOROKAN LAINNYA

1 Komb (per ml): Polymicin 1000

IU, Neomysin Sulphate 5mg,
Fludokortison asetate 1mg, Lidocain
HCl 40mg.

Otopraf Ear Drops DARY Ear Drops Btl 10 ml

2.Natrium klorida 6,5mg/ml

Breathy Nasal Drops NOVE Btl 30ml
BNS NOVE Btl 30 ml

5.Eucaliptus oil, cajaput oil, clove

oil, juniper oil, pepparmint oil,
levomenthol methyl salicylate

Vaporin NOVE Soft Gel Cap

6.Tiap 1 ml mengandung 0.3 ml air

laut Adriatik dgn mineral dan usur
alam
Aqua Maris Baby Drops SOHO Botol 15 ml
Aqua Maris Nasal Spray SOHO Botol 30 ml

64
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

7. Per 30 ml laut Adriatik hipertonis

dgn mineral dari bahan alam dan
oligoelemen

Aqua Maris Strong Nasal Spray SOHO Botol 30 ml

21 OKSITOSIK DAN RELAKSAN UTERUS

21.1 OKSITOKSIK

1 Metil ergometrin
Metil Ergometrin Tab 0,125
Metil Ergometrin OGB
Metvell NOVE

Metil Ergometrin Inj 0,2 mg/ml

Metil Ergometrin OGB

Metvell NOVE

2 Oksitosin
Oksitosin Inj 10 iu/ml
Oxyla NOVE

21.2 RELAKSAN UTERUS

1 Isoksuprin HCl
Isoksuprin HCl Tab 20 mg
Hystolan DEXA
Proterine NOVE

Isoksuprin HCl Inj 10 mg/2ml

Proterine NOVE

2 Magnesium Sulfat
MgSo4 OTSU
22 PSIKOFARMAKA
22.1 ANTI ANSIETAS DAN ANTI
INSOMNIA
1 Klobazam
Klobazam Tab 10 mg
Clobazam OGB DEXA
2 Lorazepam
Merlopam MERSI Tab 0,5 mg

65
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
3 Alprazolam
Alprazolam Tab 0,25 mg
Alprazolam 0,25 OGB DEXA
Frixitas 0,25 NOVELL
Zypras 0,25 KALBE

Alprazolam Tab 0,5 mg

Frixitas 0,5 NOVELL
Zypras 0,5 KALBE

Alprazolam Tab 1 mg
Frixitas 1 NOVELL
Zypras 1 KALBE

4 Estazolam
Estazolam Tab 1 mg
Estalin 1 NOVELL

Estazolam Tab 2 mg
Estalin 2 NOVELL

5 Zolpidem
Zolta NOVELL Tab 10 mg

22.2 ANTI DEPRESI DAN ANTIMANIA

1 Amitriptilin
Amitriptilin OGB Tab 10 mg

2 Fluoxetin HCl

Fluoxetin Kap 10 mg
Kalxetin KALBE

Fluoxetin Kap 20 mg
Kalxetin KALBE
Noxetin NOVELL
3 Imipramin HCl
- - -
4 Maprotilin HCl
Sandepril 50 MERSI Tab 50 mg
5 Setraline HCl
Setralin Tab 50 mg

66
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Serlof KALBE
Sernade NOVELL

6 Diazepam
Diazepam Tab 2 mg
Diazepam 2 mg OGB KF
Stesolid 2 ACTAVIS

Diazepam Tab 5 mg
Diazepam 5 mg OGB KF
Stesolid 5 ACTAVIS

22.3 ANTI PSIKOSIS

1 Haloperidol
Haloperidol Tab 0,5 mg
Lodomer MERSI

2 Chlorpromazin
Chlorpromazine Tab 100 mg
Cepezet 100 MERSI

Chlorpromazine Inj 50 mg/2ml

Cepezet MERSI

3 Trifluoperazin
Trifluoperazin DARYA Tab 5 mg

4 Risperidone
Risperidon Tab 1 mg
Noprenia 1 NOVELL
Zofredal KALBE

Risperidon Tab 2 mg
Noprenia 2 NOVELL
Zofredal KALBE

Risperidon Tab 3 mg
Noprenia 3 NOVELL
Zofredal KALBE

5 Clozapin

67
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Clozapin Tab 25 mg
Clozapin 25 OGB MERSI
Clorilex 25 MERSI

Clozapin Tab 100 mg

Clozapin 100 OGB MERSI
Clorilex 100 MERSI

6 Olanzapin
Olanzapin Tab 5 mg
Olandoz 5 SANDOZ

Olanzapin Tab 10 mg
Olanoz 10 SANDOZ

7 Fluphenazin
Fluphenazine Decanoate Inj 25mg/ml amp 1 m
Sikzonoate MERSI

8 Quetiapin

9 Oxcarbazepin
Oxcarbazepin Tab 300 mg
Barzepin NOVELL
10 Mirtazapine
Mirtazapine Tab 30 mg
Mirzap 30 NOVELL

23 OBAT SALURAN CERNA

23.1 ANTASIDA DAN ANTI ULKUS
1 Antasida

Antasida Tab
Antasida OGB
Gastran DARY
Magalat FERR

Antasida Syr
Antasida syr OGB DEXA
Dexanta DEXA
MAgalat FERRON

68
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

2 Ranitidine
Ranitidin Tab 150 mg
Ranitidin OGB PHAP
Rantin KALB

Ranitidin Tab 300 mg

Rantin KALB

Ranitidin Inj 50 mg/2 ml

Ranitidin OGB PHAP
Rantin KALB
Radin DEXA

Ranitidine Sir 75mg/5ml

Ranitidine sir OGB
Ranivell NOVE

3 Famotidine
Famotidine Tab 20 mg
- -
Famotidine Tab 40 mg
- -

4 Omeprazol
Omeprazol Kaps 20 mg
Omeprazol kap OGB PHAP
OMZ FERR
Ozid DARY

Omeprazol Inj 40 mg
Omeprazol inj OGB
Gastrofer DEXA
OMZ FERR
Omevell NOVE
Ozid 20 DARY

5 Lansoprazol
Lansoprazol Kaps 30 mg
Lansiprazol OGB

69
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Lancid KALBE
Lanvell NOVE
Laz DEXA

6 Pantoprazol
Pantoprazol Tab 40 mg
Pantoprazol OGB

Pantoprazol Inj 40 mg
Pantoprazol Inj OGB PHAP
Pranza KALB
Vomizole DEXA

7 Esomeprazol
Esomeprazole Inj 40 mg
E-Some PHAP
Esofer FERR
8 Rebamipid
Rebamipid OGB Tab 100 mg
Becantex PHAROS
9 Sukralfat
Sukralfat Tab 500 mg
- -
Sukralfat OGB Susp 500 mg/5ml
Neciblok KALBE
Peptifat NOVE

23.2 ANTI EMETIK

1 Dimenhidrinat
Dimenhidrinat Tab 50 mg

2 Domperidon
Domperidon Tab 10 mg
Domperidon OGB
Vometa FT DEXA
Vidon FERRON

Domperidon Sir 5 mg/5ml

70
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Domperidon sir OGB HEXP
Monell NOVE
Vidon FERRON
Vometa sir DEXA

Domperidon Drop 5 mg/5ml

Monell drop NOVE
Vidon FERR
Vometa drop DEXA

3 Klorpromazine
Klorpromazin Tab salut 100 mg
Klorpromazin OGB PHAP
Klorpromazin Inj. 25 mg / 1 ml
Klorpromazin OGB PHAP

Klorpromazin Inj. 5 mg / 2ml

Klorpromazin OGB PHAP

4 Ondasentron
Ondasentron Tab 4 mg
Ondasentron 4 OGB NOVE
Narfoz 4 PHAR
Ondavell 4 NOVE
Vomceran 4 KALBE

Ondasentron Tab 8 mg
Ondasentron 8 OGB NOVE
Frazon 8 FERR
Narfoz 8 PHAR
Vomceran 8 KALB

Ondasentron Inj 4 mg
Ondasentron 4 OGB
Frazon FERR
Narfoz PHAR
Ondavell NOVE
Vomceran KALB
Vometraz DEXA

Ondasentron Inj 8 mg
Frazon FERR

71
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Narfoz PHAR
Ondavell NOVE
Vomceran KALB
Vometraz DEXA

5 Metoklopramid
Metoklopramid Tab 10 mg
Metoklopramid OGB PHAP
Metoklopramid Inj 5mg/ml amp 2 ml
Primperan SOHO
6 Granisetron
Granisetron Inj 1mg
Granon 1 DEXA
Grant 1 PHAP
Gramet 1 PHAR
Granovell 1 NOVE
Granisetron INJ 3MG
Granon 3 DEXA
Grant 3 PHAP
Gramet 3 PHAR
Granovell 3 NOVE

7 Cisapride
Cisaprid Tab 5 mg
Acpulsif DEXA
8 Pyratiazina 40 mg, B6 40mg Tab
Anvomer B6 DEXA

23.3 ANTI HEMOROID

1 Hidrosmin
Hidrosmin Tab 200 mg
Venosmil
Hidrosmin Gel
Venosmil
1Komb : Diosmin 450 mg +
Hesperidin 50 mg
Dios PHAP tab
Ardium HD SERV
2Komb :

72
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Ekstrak Graptopily Folium
80%,Citrus Bioflavonoid 20%.
Hemorogard PHAP kap

Flavanoid Fraction

23.4 ANTI SPASMODIK

1 Atropin sulfat
Atropin Sulfat Inj 0,25mg/ml
Atropin Sulfat OGB ETHICA
2 Hiosin N Butil bromid
Hiosin N Butil Bromid Inj 20 mg/ml
Buscopan BOEHR

Hiosin B Butil Bromid Tab 10 mg

Buscopan BOEHR
3 Komb : klinidum bromid dan
chlordiazepoxid
Librax COMB Tab
Braxidin SANB
4 Otilonium Bromid
Spasmomen DEXA Tab 40 mg
5Komb :
Parasetamol dan hiosin N Butil
bromid
Spasmacin KALB TAB

6 komb :

Metamphyron 500 mg Belladona

Extract 5 Mg Papaverin Hcl 30 mg

Spasmal DARY

23.5 OBAT DIARE

1 Activate attapulgit
New Diatab DARY
2 Komb : attapulgit dan pektin

3 Loperamid
Motilex KALB Tab 2 mg

73
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
4 Komb : kaolin dan pektin

23.6 KATARTIK

1 Bisakodil
Bisakodil Tab 5 mg
Dulcolax 5 BOEH

Bisakodil Tab 10 mg
Dulcolax 10 BOEH

Bisakodil Rect supp 5 mg

Dulcolax 5

Bisakodil Rect supp 10 mg

Dulcolax 10 BOEH

2 Lactulose
Solac SOHO Sir 10 g/15 ml btl 120 ml

3 komb : gliserin dan liquid parafin

Laxadin GALE Emulsi, sUSp btl 60 ml

23.7 LAIN-LAIN
1 Asam ursodeokikholat
Asam ursodeoksikholat OGB Kap 250 mg
Urdafalk DARY
Urdahex KALB

2 Curcumin
Curcuma SOHO Tab 200 mg

3 Glichirizin
Storeng Neo Menophagen C DEXA Inj 40 mg, amp 20 ml

4 Komb enzym saluran cerna

Enzyplex DARY Tab

5 Lactobacillus acidophilllus
Lacto B NOVE Sach

74
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

6 Lactobacillus Ruterii
Rillus KALBE Tab

7 Lactobacillus Ramosus
Lacidofil DEXA Kap
8 L-ornitin dan L-aspartat
Lolanin FERR Amp 10 ml

9 Kolestiramin
Sequest NOVE sachet

10 Synbiotic
Hexbio SOHO

11 Coenzym Kap
Cobazim 1000 INTE
Cobazim 3000 INTE
24 OBAT SALURAN NAFAS
24.1 ANTI ASMA
1 Aminofillin
Aminofillin Tab 200 mg
Aminofillin 200 OGB

Aminofillin Inj 24mg/ml amp 10 ml

Aminofillin OGB PHAP
Phaminov PHAP

2 Salbutamol
Salbutamol Tab 2 mg
Salbutamol OGB PHAP
Saltam 2 PHAP

Salbutamol Tab 4 mg
Salbutamol OGB PHAP
Saltam 4 PHAP

Salbutamol Sir 2 mg/5ml

Salbuven PHAR

Salbutamol Inh 100 mcg/puff

Suprasma DEXA

75
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Salbutamol Nebules vial 2,5 mg

Vellutin NOVELL

3 Teofilin
Teofilin Tab 125 mg
Euphyllin Retard Mite PHAR

4 Terbutalin sulfat
Terbutalin Sulfat Tab 2,5 mg

Terbutalin Sulfat Inj 0,5 mg/ml amp 1 ml

Terbutalin Sulfat Turbu 0,50 mg

Terbutalin Sulfat Respules 2,5mg/ml

5 Budesonid
Budesonid Cap
Budenofalk DARYA

Budesonid Inh 200 mch/puff

Budesonid Resp 0,25 mg/ml

Budesonid Resp 1 mg/ml

6 komb :
budesonid formoterol

7 Fenoterol HBr

8 Fluticason propionat
Fluticasone propionat Nebules 0,5mg/2ml
9 Komb :
fluticason propionat dan salmeterol
xinafoate

Fluticason propionat dan salmeterol Inh. 50 mcg

xinafoate

76
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Flutias KALB

Fluticason propionat dan salmeterol Inh. 50 mcg

xinafoate

Flutias KALB

10 Ipratoprium br

11 Komb : ipratorptium dan

salbutamol
Resp 2,5ml

12 Procaterol
Procaterol Tab 25 mcg
Ataroc NOVE

Procaterol Sir, 25 mcg/5ml btl 60 ml

Ataroc NOVE
Vactiv PHAR

13 komb :

Ephedrine Hcl 12.5 mg,

Theophylline Anhydrous 130 mg

Asmasolon DARY Tab

24.2 PPOK

1 Indacaterol
-
2 Tiotropium Bromida
-
24.3 ANTITUSIF

1 Codein HCl
Codein Tab 10 mg
Codein 10 K.FARMA
Codikaf 10 K.FARMA
Codein Tab 15 mg

77
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Codein 15 K.FARMA
Codikaf 15 K.FARMA

2 Dekstromethorpan HBr
Dekstromethorpan HBr Tab 15 mg
Dekstromethorpan OGB *
Dekstromethorpan HBr Sir 10mg/5ml
Dekstromethorpan OGB *

3 Komb : Codein dan

Phenytoloxamine
Komb : Codein dan Kap
Phenytoloxamine
Codipront
Komb : Codein dan Sir
Phenytoloxamine
Codipront

24.4 EKSPEKTORAN
1 Obat batuk hitam
OBH Itrasal Sir 100 ml

2 Gliseryl Guaiacolat

Gliseryl Guaiacolat OGB Tab 100 mg

3 Komb : Codein , Phenytoloxamin,

Guafenesin dan Thyme

Codein , Phenytoloxamin, Cap

Guafenesin dan Thyme

Codipront cum Cap

Codein , Phenytoloxamin, Sir

Guafenesin dan Thyme
Codipront cum Sir

24.5 SURFAKTAN

Alveofact DEXA 45mg/ml

78
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
24.6 MUKOLITIK

1 N asetil systein
N asetil sistein Tab eff 200 mg
Siran DEXA

N asetil sistein Sir 100 mg/5ml

Nytex PHAR

N asetil sistein Cap 200 mg

Nytex PHAR

N asetil sistein Ampul 200mg/ml

Fluimucyl Injeksi 300 mg

2 Erdostein
Erdostein Tab 300 mg
Vestein KALBE
Vectrin DEXA
Vostrin NOVELL

Erdostein Sir 175mg/5 ml

Vestein KALBE
Vectrin DEXA
Vostrin NOVELL

3 Ambroksol HCl
Ambroxol Tab 30 mg
Ambroxol OGB PHAP
Transbroncho KALBE

Ambroxol 15 mg/ml

Limoxin Drops PHAROS

Ambroxol Sir 15 mg/5 mg
Transbroncho KALBE

Ambroxol Sir 30 mg/5ml

Transbroncho KALB

4 Bromheksin

79
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Bromheksin Tab 8 mg

Bromheksin Lar 8 mg/4ml

Bromheksin Inj 4mg/2ml

5 Noscapin
Noscapin Tab 50 mg

24.7 OBAT SALURAN NAFAS LAIN

1.Komb :

Paracetamol 130mg, Syrup

Dekstrofeniramine Maleat
1mg,Tiokol 20mg

Febrinex PHAP

2 Komb : Dextrometorfan HBR

7,5mg,Dexchlorfeniramin maleat
1mg, Phenylephrine HCL 5mg

Dextrofen Sirup PHAP Sirup 60ml

3 Bromhexin Hcl 8 mg,

Dipenhidramin HCL 25 mg,
Paracetamol 400 mg

Hustab Tab PHAP

4 Bromhexin Hcl 4 mg
Hustab Sirup PHAP Syrup 60ml

5 Komb : Parasetamol 125mg,

Pseudoefedrin 7,5, Noscapin 10 mg,
Chlorpeniramin 0,5 mg, Guafenesin
25 mg, Succus Liquiritae 125 mg

Paratusin DARYA Sir

6 Komb :

Guafenesin 50 mg, Chlorpeniramin

1 mg

80
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

Cohistan DARYA Sir

7 Komb : Diphenhidramin 12,5 mg ,

ammoniumChlorid 100 mg,
Potasium Guaiacolsulfonat 30 mg.
Menthol 1mg, ethanol 4%

Benacol KALBE Sir

8 Komb :
Glyceryl Guaiacolate 50 mg, Na
Citrate 180 mg,Diphenhydramine
Hcl 12.5 mg,

PhenylpropanolamineHcl 12.5 mg,

Alcohol 5%
Allerin DARYA Sir 60 ml dan 120 ml
9 Komb :

Paracetamol 325 mg,

Phenylpropanolamine Hcl 12.5 mg,
Ethylephedrine Hcl 12.5 mg,
Chlorpheniramine Maleate 1mg,
Dextromethorphan Hbr 10 mg,
Guaifenesin 50 mg.

Decolsin Tab
Decolsin Sir

10 Komb :
Thyme extr, extr primulae, extr
althaea, extr droserae, extr serpylli,
eucalyptus oil, anise oil.
Silex DARYA Sir

11 komb :

Phenylpropanolamine Hcl 15 Mg,

Paracetamol 250 mg, Salicylamide
150 mg, Chlorpheniramine Maleate
2 mg, Ascorbic Acid 25 mg

Neozep DARYA tab

81
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

12 komb :
Paracetamol 500mg,
Pseudoephedrine Hydrochloride
30mg, ChlorpheniramineMaleate 2
Mg, Guaifenesin 50mg

Stop Cold DARY tab

13 Komb :
Parasetamol 650, ctm 2, ppa 12,5

25 VITAMIN, MINERAL DAN SUPLEMEN

25.1 VITAMIN
1 Asam askorbat
Asam askorbat Tab 25 mg
Vit C OGB
2 Calcitriol

Kolkatriol PHAP
Kolkatriol F PHAP
3 Kalsium laktat

4 Asam Folat

5 Thiamin HCl

6 Piridoksin HCl

7 Sianokobalamin

8 Vitamin B komplek

25.2 IMUNODULATOR
1 Komb :

Echinacea Purpurea 250 mg, Black

elderberry 400 mg, Zn picolenat 10
mg

Imboost Force SOHO Kap

82
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

2 komb : Echinacea Purpurea 250

mg, Black elderberry, Zn picolenat 5
mg

Imboost Force syr SOHO Botol 60 ml dan 120 ml

3 komb : Polineceae, Black

Elderberry,

Zinc Picolinate, Vit.C

Starmuno KALB Kaplet
Starmuno KALB Sirup 60 ml

4 Komb : Echinacea 250 mg,

Phyllantus niruri 50mg, Black
Ederberry 50 mg

Protemun NOVE

5 Arabinoxylan derivative 250MG

Biobran FERR Tab 250mg

6 Komb :

Extract Echinace Purpurea 500 mg

Extract Andrographis Peniculata 200
mgZn Picolenat 10 Mg Selenium 15
mcg

Neobost DARY Cap

Neobost DARY Sir

25.3 ANTI OKSIDAN

1 Natural Astaxantin
Natural astaxantin Tab 4 mg
Astatin 4 NOVE
Asthin Force 4 SOHO

Natural Astaxantin Tab 6 mg

Asthin Force 6 SOHO

Natural Astaxantin Sir 2 mg/5ml

83
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Asthin Force sir

2 Komb : Natural Astaxanthin 4 mg

(AstaREAL L10 40mg), Omega 3
350 mg

Astacor SOHO Soft Cap

3 Komb : Natural Astaxanthin 4 mg

(AstaREAL 200mg), Cinnamon
extract 170mg (Cinnulin PF)

Astadiab SOHO Cap

4 Komb : Natural Astaxanthin 4 mg

(AstaREAL 50 FC 80mg) Extramel
10mg (Melon Extract)

Asthin B-OND SOHO

5 Komb : 3 mg Natural Astaxanthin

(Asta REAL 150 mg), 3 mg Lutein,
0.25mg Zeaxanthin, 2.5mg Zinc,
10g Selenium.

Matoflam SOHO

6 Komb : Astaxantin dan Glisodin

Truxanthin KALBE Kapsul 4 mg

7 Komb : Grape seed, lycopen, Vit

C,E,B kompleks, zinc dan selenium

Noros KALBE Kaplet

8 Komb : pureway C, citrus

bioflavanoid

Prove C KALB Kaplet

Cester SOHO

84
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

9 Komb : Vit c, bit b dan

multivitamin

Zegase KALB Kaplet

10 Komb :Beta-karoten 10.000iu,

Vit C 250mg, Vit E 200iu, Seng
20mg, Selenium 30mcg

Seloxy FERR Kap

11 .Alpha Lipoic Acid 300 mg Biotin

0,03 mg Chromium picolinate 0,2
mg

Alicron FERR kap

12 Alpha Lipoic Acid 100 mg,

calcium ascorbate 500mg,zinc
picolinate 50mg, Selenium 50mcg, B
Carotene 5000iu

Seloxy AA FERR kap

25.4 SUPLEMEN FUNGSI HATI

1 Fucoidan
Fucoidan Kap 50 mg
Fucoidan SOHO
Fucohelix KALB
Fucoidan Kap 100 mg
Fucoidan SOHO
Fucohelix KALB Kap 100 mg
Fucoidan Sir 100 mg/15 ml
Fucoidan SOHO
Fucohelix KALB

2 Komb : Lecithin 150 mg, siliramin

100 mg, scizandra ext 375, vit E 5 iu

Hepamax KALB Kapsul Lunak

85
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

3 Komb : Curcuma longa rhizome

150 mg, silymarin Phytosome 35
mg, Schizandrae feuctus 135 mg,
Liquiritae radix 135 mg, Choline
bitartrate 150mg, Vit B6 2mg

Biokurkem SOHO kap

4 Komb :Curcuma longa rhizome

extract (Curcuminoid complex 95% /
Bio-Curcumin / BCM-95 TM) 150
mg, Silymarin Phytosome 35mg,
Ekstak Schizandrae Fructus 135mg,
LiquiritaeRadix 135mg,
CholineBitartrate 150mg,Vit B6 2mg

Biocurliv SOHO Kap

25.5 VITAMIN FUNGSI SENDI

1 Glukosamin 500 mg, condroitin

400 mg, vit c 50 mg, zn 10 mg, Mn
0,5 mg

Kaloste KALB Kaplet

2 komb : Harpagophytum
procumbens radix 250 mg dan salix
alba cortex 120 mg

Fleximax KALB kapsul

3 Komb : Glukosamin, Kondroitin,

kapsicum, camphor dan metyl
salisilat

Flexamin NOVE Tube 15 dan 30 gram

4 Komb : Glukosamin 1500 mg,

condroitin 1200 mg, omega 3 600
mg, MSM 500 mg, Boswelia serrata
ext, Mn dan Zn

86
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Osmetin Zuper NOVE

5 Komb : Ganistein 15 mg, Ca citrat,

vi d3, vit b6, omega 3
Ostobon NOVE
6 Calcitriol sinteis
Ostovel NOVE Kap 0,025 mg
7 Cholecalciferol
Teorol Tab 400 iu

8 Komb : Glucosamine HCL 250mg ,

Chondroitin SO4 200mg, Vit C
25mg, Mg 0.25mg, Zn 2.5 mg

Oste SOHO

9 Komb : Glucosamine HCL 250mg ,

Chondroitin SO4 200mg, Vit C
25mg, Zn 2.5mg, MSM 350 mg

Osteoflam SOHO

10 Christallyn Glucosamine Sulfat

500 mg

Viatril S SOHO cap

11 Christallyn Glucosamine Sulfat

1500 mg
Viatril S SOHO sachet
25.6 VITAMIN NEUROTROPIK
1Komb :
Vit B1, b6, b12 300 mg

Sohobion inj
2Komb :
Vit b1, b6, b12 5000 mcg
Neurobion F MERC tab
Neurobion F MERC Inj
25.7 SUPLEMEN UNTUK ANAK

87
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
25.7.1 Mengandung Dha
Komb : DHA 75 mg, Epa 7 mg, AA
100 mg
Prolacta for baby NOVE Soft cap

25.7.2 Mengandung Colostrum

1 Komb : Kolostrum bovine 250 mg
dan zinc 3 mg
Vistrum Sir

25.7.3 Vitamin Tumbuh Kembang

1 Komb : Lisin 100 mg, vit a 200 iu,

Vitb, zinc Mg, Fe, Vit e, se
Zamel NOVE Sir

2 Komb : zinc 5 mg, vit d 800 iu

Zamel NOVE Drop

3 Komb : Arachidonic acid (AA) 15

mg, DHA 10 mg, EPA 2 mg, L-
glutamic acid 50 mg, folic acid 100
mcg, biotin 0.2 mg, L-lysine HCl 50
mg, vitamin B1 1.5 mg, vitamin B2
1.5 mg, vitamin B6 1.5 mg, vitamin
B12 2 mcg, vitamin A 2000 iu,
vitamin C 50 mg, vitamin D 200 iu

Pediagrow SOHO Sir 200 ml

4 Komb : Vit A 850 IU, Vit B1 3mg,

Vit B2 2mg, Vit B6 5mg, Vit
BCurcuma, Vit B1, B2, B6, B12
5mcg, Dexpanthenol 3mg, Vit D100
IU, Ca Hypophosphite 500mg,
Arachidonic acid (AA) 15mg, DHA
10mg, Fructooligosaccharides (FOS)
500mg, Minyak Ikan Kod 7.5g,
Ektrak Curcuma 10mg

Curvit CL SOHO Botol 60 ml dan 175 ml

88
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

5 Komb : Polyphenol > 75%

(Oxxynea -PF 400 mg)
Vegefrut SOHO kap

25.7.4 Mengandung Fe
1 Komb : Fe dan Multivit
Ferofort For Kid Sir

25.8 VITAMIN MASA KEHAMILAN DAN

MENYUSUI
25.8.1 Mengandung Asam Folat
1 Asam Folat
Anemolat PHAP Tab 1 mg
Vomilat KALB #

2 Komb : Bcaroten 10 000

IU,AsFolat 1 mg, B2 2.5mg, B6
15mg, B12 4mcg, Vit C100 mg, Vit D Tab
400 IU, B1,10mg,KI 100mg, Fe 90
mg, Cu sulft 0.1mg, Ca 7,5 mg

Folamil DEXA
3 Komb : Asam folat dan Fe
Fumarat
Emineton KALB Kap

4 Komb : Asam folat dan Vitamin

Vitamam 1 NOVE Kap
Vitamam 2 NOVE Kap
Vitamam 3 NOVE Kap

25.8.2 Mengandung Kalsium

1 Ossein hidoxyapatit Tab 800mg
Ossoral 800 DEXA
Ossein Hidroxyapatit Tab 200 mg
Ossoral 200 DEXA

2 Komb : Coral Calsium 800 mg dan

vitamin
Eazycal NOVE

89
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK

25.8.3 Mengandung Fe
1 Komb : Fe dan ascorbic acid
Ferofort KALBE

25.8.4 Mengandung DHA

1 Komb : Bcaroten 10 000

IU,AsFolat 1 mg, B2 2.5mg, B6
15mg, B12 4mcg, Vit C100 mg, Vit D Softcap
400 IU, B1,10mg,KI 100mg, Fe 90
mg, Cu sulft 0.1mg, Ca 7,5 mg IPC
30mg, DHA 40mg, ARA 8mg

Folamil Genio DEXA

2 Komb : Calsium, Vit d3 dan tuna

fish oil

Osfit DHA KALBE

3 Komb :

Prolacta For Mother NOVE

4 Komb : Multivitamin, EPA, DHA

Neo Alora PHAR

5 Komb : Cod liver oil 200 mg, EPA,

DHA, Vit

Caloma Plus NOVE Kap

6 Komb : DHA 75mg, EPA 7 mg,

ARA 100mg

Brivita FERR Soft Cap

7 Komb : Multivitamin & mineral

dg dha dan asam folat

Prenatin DF SOHO Kap

25.8.5 Suplemen pelancar asi

Milmor PHAR
Moloco B-12 DARY

90
NO KLS KODE
KELAS TERAPI OBAT CATATAN
TERAPI PABRIK
Lactamam NOVE
Milmor Plus PHAR
Lactamor KALB

25.9 SUPLEMEN PENINGKAT TROMBOSIT

1 Psidii Extr Folium
Psidii Extr Folium Caps
Psidii Caps DEXA
Psidii Extr Folium Syr
Psidii Syr DEXA

2 Komb : Ektra daun jambu biji

300mg,Extra angkak 300mg

Trombufit NOVE Sach

Trolit KALB Sach

3 Komb :Ektrak Psidium guajava L

0.78 g, Ektrak carica papaya L 2.10
g, Ekstak Phyllanthus urinaria L0.78
g, Ektrak Curcuma aeruginosa Roxb
0.96g, Ektrak Curcuma domestica
1.38 g

Dehaf SOHO Sach

25.1 MULTIVITAMIN INJEKSI
Cernevit KALBE

25.11 NUTRISI OTAK

1 Komb : Choline citrat 147,5 mg,

Cytidine monophospat 121,5 mg
dan Phospatydilserin

Neugain NOVELL

25.12 VITAMIN MATA

1.LUTEIN 3mg, Lycopene Vit C, E,

Beta Carotene

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TERAPI PABRIK
Optimax FERR tab

2.Lutein, Lycopene, Zeaxanthin, Vit

E, Vit C, Zn, Beta caroten, Bilberry
extract

Optimax FERR sir

3.Ekstrak billberry 31%, Ekstrak

French maritimepine 63,4%

Optimax for G FERR kap

4 Komb : Billbery dry extract 80 mg,

betacarotene 5mg, retinol 1600
IU,Vit E 40mg

Matovit SOHO Tab

5 komb : 80mg Ektrak bilberry, 2mg

Natural Astaxanthin (Asta REAL
100mg), 3mg Lutein, 0.25mg
Zeaxanthin, 2.5mg Zinc, 10g
Selenium.

Matovit AX SOHO tab

6 Komb : Billbery dry extract 80mg,

Lutein 2mg, Zeaxanthin 0.67 mg, vit
E 40mg

Matovit Fifty SOHO tab

7 Komb : Bilberry dry extract 40mg,

Beta caroten 2.5 mg, Retinol 800 IU,
Vit E 20 mg

Matovit Sir 60 ml

25.13 SUPLEMEN LAIN-LAIN

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TERAPI PABRIK

1 Ketoisoleusin 67mg,ketoleusin
101mg,ketofenilalanin
68mg,hidroksimetinonin
59mg,ketovalin 86mg,LTriptofan Kapl
23mg,LTreonin 53mg, LHistidin
38mg,LTirosin30mg,LLisin asetat
105mg, kalsium 50mg

Aminefron DEXA

2 Komb: Ubiquinone 60 mg + ALA

200 mg + L-Carnitin 250 mg
Nu Qten NOVE

3 Komb : Evening Primose oil, EPA

dan Vit D3
Epocaldi NOVE

4 Komb : 5000 mg D-Ribose, 500

mg L-Carnitine Fumarate 500mg,
Coenzym Q10 50mg, 200 mg
Magnesium

Enercore SOHO sachet

5 Extract Panax Ginseng G115 100

mg
Ginsana SOHO

26 OBAT PENYAKIT NEUROGENERATIF

1 Donepezil

Donepezil OGB Tab 5 mg

Donepezil Tab 5 mg
Donacept NOVE
Fordesia KALB

27 ANTINEOPLASTIK, IMUNOSUPRESAN DAN TERAPI PALIATIF

-

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28 ANALGESIK NARKOTIK

1 Morfin
Morfin Inj 10 mg/ml
Morfin K.FAR

Morfin Tab 10 mg
MST Continous K.FAR

2 Pethidin
Pethidin Inj 50 mg/ml amp 2 ml
Petthidin K.FAR
3 Fentanil
Fentanyl Inj 0,05mg/ml
Fentanyl K.FAR

Fentanyl Patch 25 mcg

Durogesic

29 PRODUK DARAH PENGGANTI PLASMA

1 Albumin serum
Octalbin KALBE Inj 20 % 50 ml

Human Albumin Behring DEXA

Octalbin KALBE Inj 20 % 100 ml

Human Albumin Behring DEXA

Octalbin KALBE Inj 25% 50 ml

Octalbin KALBE Inj 25% 100 ml
Albuminar DEXA

2 Albumin Oral

1 Ekst Ikan Gabus

Chana HERB cap

Posafit DEXA CAP
30 RELAKSAN OTOT PERIFER DAN PENGHAMBAT KOLINESTERASE

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TERAPI PABRIK

1 Atracurium Besylate

Notrixum NOVE
Tramus DEXA

2 Eperison Tab 50 mg
Perilax DEXA

3 Nocuronium Bromida

Noveron NOVE

31 IMUNOGLOBULIN DAN VAKSIN

Vaksin anti polio

Vaksin Polio
Vaksin anti rabies

Vaksin BCG

Vaksin BCG

Vaksin Campak

Vaksin Campak
Vaksin DT
Infanrix

Vaksin DPT

Tripacel

Vaksin Haemophylus Influenza B

Hyberix
Act- HIB
Vaksin Hepatitis A

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TERAPI PABRIK

Vaksin hepatitis B
Engerix
Euvax-B

Vaksin Hepatitis A dan B

Vaksin HPV

Vaksin IgG Hepatitis B

Imunoglobulin Behring

Vaksin Influenza

Vaksin Kombinasi DPT-HIB

Infanrix HIB

Vaksin komb DPT-HIB-Polio

Pediacel
Infanrix ipv

Vaksin Meningitis

Vaksin MMR

Trimovax

Vaksin Pneumococus

Prevenar
Synflorix
Vaksin PPD

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TERAPI PABRIK
PPD
Vaksin Rotavirus
Rotarix

Vaksin Thypoid
Thypim VI
Vaksin TT
TT
Tetagam
Vaksin Varicella

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