2008 TUVALU ESSENTIAL MEDICINE LIST

WHO Drug name, strength and dosage form Outer Restrict use Cost $A COMMENTS
Island
1 ANAESTHETICS
1.1 GENERAL ANAESTHETICS
Halothane inhalation 39
Isoflurane inhalation 56
Ketamine 50mg/ml injection 2.1
Nitrous oxide gas inhalation
Oxygen gas inhalation 98(G) Need more G size
Soda lime powder 5.63
Thiopentone 0.5% injection 1.1

1.2 LOCAL ANAESTHETICS

Bupivacaine 0.5% plain injection 1 Bup c Adr -sep
Bupivacaine 0.5% heavy (spinal) injection 1.3
Lignocaine 2%plain injection Yes 1 Lig 1% delete
Lignocaine 2% + adrenaline 1:80,000 dental cart Yes 0.4 Lig c Adr-sep
Lignocaine 10% pump spray Anaesthetist 11.25

1.3 PRE-OPERATIVE MEDICATION

Atropine 1mg/ml injection 0.1
Diazepam 10mg/2ml injection 0.15
Droperidol 10mg/2.5ml injection Anaesthetist 3.38
Diazepam 5mg tablet 0.01
Fentanyl 100mcg/2ml injection 0.73
Midazolam 15mg/3ml injection Anaesthetist 2.4
Morphine 10mg/ml injection 0.34
Pethidine 50mg/ml injection O&G only 0.3
Promethazine 50mg/2ml injection 0.26

ANALGESICS, ANTIPYRETICS, NSAID's,

2 DRUGS TO TREAT GOUT
2.1 NON-OPIOIDS
Allopurinol 100mg tablet 0.02 Colchicine del
Aspirin 300mg tablet Yes 0.01
Ibuprofen 400mg tablet Yes 0.01 Diclof, indo del
Paracetamol 500mg tablet Yes 0.01
Paracetamol 500mg Suppos ICU only 0.95
Paed, ICU use
Paracetamol 250mg Suppos only 0.1
Paracetamol 120mg/5ml elixir 0.42 Phase out to tabs
Probenecid 500mg tablet 0.1 Reduced usage
Del Diclofenac inj
2.2 OPIOID ANALGESICS
Codeine 30mg tablet Yes 0.07
Fentanyl 100mcg/2ml injection 0.73
Morphine SR 10mg tablet
Morphine 10mg/ml injection Yes 0.34
Pethidine 50mg/ml injection O&G only 0.3 Peth 100 deleted
ANTI-ALLERGICS & DRUGS USED IN
3 ANAPHYLAXIS
Adrenaline 1mg/ml injection Yes 0.43

Chlorpheniramine 4mg tablet Yes 0.01 cheaper than prom

Dexamethasone 4mg/ml injection 0.2
Dexamethasone 500mcg tablet 0.07 Delete 4mg, 2mg
Hydrocortisone sodium succinate 100mg injection 0.46
Promethazine 50mg/ml injection Yes 0.26 Del Diphenhyd Inj
Del Cyprohept tab
Promethazine Tablets 10mg Included 2008 ed.
ANTIDOTES & OTHER SUBSTANCES USED IN
4 POISONINGS
4.1 GENERAL
 Charcoal and Sorbitol Soln Yes 2-3 for O/D

4.2 SPECIFIC
Paracetamol
Acetycysteine 200mg/ml injection 10ml OD only 6.8 1 course only
Atropine 1mg/ml injection 0.1
Naloxone 400mcg/ml injection 1.08

5 ANTIEPILEPTICS
Carbamazepine 200mg tablet Indiv patients 0.02
Diazepam 10mg/2ml injection Yes 0.15
Diazepam 5mg tablet Yes 0.01
Phenobarbitone 200mg injection Paed use 1.23 Tabs deleted
Phenytoin 250mg/5ml injection 2.88
Phenytoin 100mg tablet Yes 0.01 Syrup deleted
Others
Sod.Valproate 150mg tablet ineffective 0.11

6 ANTI-INFECTIVE DRUGS
6.1.1 INTESTINAL ANTHELMINTICS
Mebendazole 100mg tablet Yes 0.01 Pyrantal deleted

6.1.2 ANTIFILARIALS
Yes - WHO
Albendazole 400mg tablet campaign Filiariasis
Yes - WHO
Diethylcarbamazine 50mg tablet campaign Filiariasis

6.2 ANTIBACTERIALS
6.2.1 Penicillins
Amoxycillin 250mg tablet Yes 0.02
Resistant cases
Amoxycillin 500mg/Clavulanic acid 125mg tablet only 0.24
Amoxycillin 125mg/5ml Susp 0.56 Replace by tabs
Ampicillin 1g injection 0.18 replace 500mg
Benzathine penicillin 1.2 mega injection 0.16 2.4mega deleted
Benzyl penicillin 600mg injection Yes 0.08
Cloxacillin 500mg injection 0.23
Cloxacillin 250mg tablet Yes 0.02 Replaces fluclox
Phenoxymethylpenicillin 250mg tablet Yes 0.03 Replaces syrup
Procaine penicillin 4mega injection Yes 0.25

6.2.2 Other Antibacterials

STI for
Azithromycin 250mg/500mg tablet Yes chlymydia 0.42 Stat dose
For resistant
Ceftriaxone 1g injection organisms 1.72 1g only;C'clor del
Chloramphenicol 250mg capsule 0.02
Chloramphenicol 1g injection 0.58

Chloramphenicol 125mg/5ml suspension 1.88 Keep as only caps

STI for
Ciprofloxacin 500mg tablet Yes gonorrhoea 0.07 Stat dose
Co-trimoxazole 480mg tablet Yes 0.01 delete syrup
Doxycycline 100mg tablet / capsule Yes 0.02
Erythromycin 250 tablet 0.12 Syrup deleted
Gentamicin 80mg/2ml injection 0.08
Metronidazole 5mg/ml IV solution 100ml 1.3
Metronidazole 200mg tablet Yes 0.01 MTZ Syrup del
Tinidazole 500mg tablet Yes 0.04 Stat dose MTZ
Tc, Nitro deleted
6.2.3 Antileprosy drugs
only
Clofazimine 50mg tablet combipacks Free WHO combipacks only
only
Dapsone 100mg tablet combipacks Free WHO Free from WHO
only Free WHO -
Rifampicin 150mg/300mg capsule combipacks need PB?
6.2.4 Anti-tuberculosis drugs
Yes, indiv
Ethambutol 400mg tablet patients TB 0.05
Yes, indiv
Isoniazid 100mg tablet patients 0.02 300mg deleted
Yes, indiv
Pyrazinamide 4/500mg tablet patients TB 0.05
Yes, indiv
Rifampicin 150mg tablet / capsule patients 0.05 300mg, syrup del
Yes, indiv
Rifampicin 150mg/Isoniazid 75mg tablet patients TB 0.04
Streptomycin 1g injection TB 0.56

6.2.5 Antiviral Drugs

Aciclovir 200mg tablet Severe herpes 0.03
Aciclovir Eye Ointment Herpes of eye 0.56
HIV Drugs - as per Global Fund HIV/AIDS Free Global Fund pays

6.3 ANTIFUNGAL DRUGS

Clotrimazole 500mg Pessary Yes 1.32 stat dose
Clotrimazole Cream 20g Yes 0.34 cheaper
Griseofulvin 500mg tablet 0.04 delete 250mg
Nystatin oral suspension 100,000 units 1.13
Terbinafine del
6.4 ANTIPROTOZOAL DRUGS
6.4.1 Antiamoebic
Where oral not
Metronidazole 5mg/ml IV solution 100ml possible 1.3
Metronidazole 200mg tablet Yes 0.01
Tinidazole 500mg tablet Yes 0.04 Stat dose

6.4.2 Antimalarial Drugs

Chloroquine 150mg base tablet 0.01
Doxycycline 100mg tab/cap 0.02
Fansidar® tablet P.falciparum 0.05
P.vivax
Primaquine 15mg tablet eradication 0.02 for indiv patient

Quinine 300mg/ml injection Cerebral malaria 0.23

Quinine sulphate 300mg tablet 0.05

7 ANTI-MIGRAINE DRUGS
7.1 FOR TREATMENT
Aspirin 300mg tablet Yes 0.01
Chlorpromazine 50mg injection 0.19 Low dose only
Metoclopramide 10mg injection 0.15
Paracetamol 500mg tablet Yes 0.01

7.2 FOR PROPHYLAXIS

Propranolol 10mg tablet Thyroid storm 0.01 40mg deleted
Propranolol Injection or similar Thyroid storm 0.67 ?supplier

ANTINEOPLASTICS &
8 IMMUNOSUPPRESSANTS
8.1 IMMUNOSUPPRESSIVE DRUGS
Dexamethasone 500mcg tablet 0.07 not 2mg,4mg
Prednisolone 5mg tablet 0.01 Not prednisone

8.2 ANTINEOPLASTIC DRUGS

Cyclophosphamide injection Indiv patients 7.68 Drug Comm
5-Fluorouracil 500mg injection Indiv patients 7.34 Drug Comm
Methotrexate 50mg injection Indiv patients 5.56 Drug Comm
Methotrexate 2.5mg tablets Indiv patients 0.13

8.3 HORMONES AND ANTI_HORMONES

Tamoxifen 10/20mg tablet Indiv.patients 0.1
 9 ANTIPARKINSONIAN DRUGS
Benzhexol 2mg tablet 0.01

10 DRUGS AFFECTING THE BLOOD

10.1 ANTI-ANAEMIA DRUGS
Ferrous sulphate 200mg tablet 0.01
Ferrous sulphate/gluconate syrup 5.54/100ml
Ferrous sulphate 200mg + folic acid 0.25mg tablet Yes 0.01
Fe Dextran 5% Inj
Folic acid 5mg tablet 0.01 Small supply
Hydroxocobalamin 1mg injection 0.45

10.2 DRUGS AFFECTING COAGULATION

Heparin sodium 5000iu/ml 5ml injection 1.53
Phytomenadione 1mg in 0.5ml injection Yes 0.3 10mg deleted
Warfarin 1mg tablet 0.04 Keep same brand
Warfarin 3mg tablet 0.06 Delete 2mg
Warfarin 5mg tablet 0.06

11 BLOOD PRODUCTS & PLASMA SUBSTITUTES

Polygeline IV solution 500ml (Haemacel/Gelofusine) 5.93

12 CARDIOVASCULAR DRUGS
12.1 ANTI-ANGINAL DRUGS
Atenolol 50mg tablet 0.02
Glyceryl trinitrate 600mcg tablet Yes 0.06
Isosorbide dinitrate 10mg tablet 0.01 change from 5mg

Nifedipine 20mg SR tablet Yes 0.01 change from 10mg

Propranolol 10mg tablet 0.01 change from 40mg

Verapamil 40mg tablet 0.05

12.2 ANTI ARRHYTHMIC DRUGS

Atenolol 50mg tablet 0.02
Lignocaine 2% injection 10ml 0.42
Propranolol 10mg tablet 0.01
Verapamil 2.5mg/ml injection 2.7
Verapamil 40mg tablet 0.05

12.3 ANTIHYPERTENSIVE DRUGS

Atenolol 50mg tablet 0.02
Enalapril 5mg tablets Indiv patient 0.02
Hydralazine 20mg/ml injection 7.16 Tabs deleted
Hydrochlorothiazide 25mg tablet Indiv patient 0.01 50mg deleted
Methyldopa 250mg tablet Indiv patient 0.05 pregnancy only
Nifedipine 20mg ST tablet Indiv patient 0.01
Prazosin 2mg tablet BPH treatment
Propranolol 10mg tablet Thyroid storm 0.01
Delete Labetalol
12.4 DRUGS USED IN HEART FAILURE
Digoxin 500mcg/2ml injection 1.72
Digoxin 250mcg tablet 0.04 62.5mcg deleted
Enalapril 5mg tablet 0.02
Isosorbide dinitrate 10mg tablet 0.01

12.5 DRUGS USED IN VASCULAR SHOCK

Adrenaline 1mg/ml injection 0.43
Ephedrine 30mg/ml injection 0.19

12.6 ANTITHROMBIC DRUGS

Aspirin 300mg tablet 0.01

Streptokinase 1,500,000 units injection Documented MI 82 Keep 1-2 only

12.9 LIPID LOWERING AGENTS
Simvastatin 20mg tablets Indiv patients Drug Comm

13 DERMATOLOGICAL DRUGS
13.1 ANTFUNGAL DRUGS (TOPICAL)
Compound benzoic + salicylic acid oint (Whitfields) Yes 1.1/50g
Compound benzoic + salicylic acid lotion (Whitfields) Yes 1.15/100ml Rep Sal ac 10%
Clotrimazole cream Yes 0.34

13.2 ANTI-INFECTIVE DRUGS

Neomycin + bacitracin + polymyxin ointment Yes 0.63 Delete CB Oint
Silver sulphadiazine 1% cream Yes 0.67/50g Order 50g packs
Chlorhexidine 1% Cream Yes

13.3 ANTI-INFLAMMATORY & ANTI-PRURITIC DRUGS

Betamethasone 0.1% cream 0.7
Hydrocortisone 1% cream Yes 0.51 Deleted Calamine
Zinc Oxide oint 1.23

13.5 SCABICIDES AND PEDICULOCIDES

Benzyl benzoate 25% lotion Yes 4.42/1L
Permethrin Lotion Child, 3.67/100ml
pregnant
women
13.6 OTHER DERMATOLOGICAL PREPARATIONS
Lubricating Jelly 1.76

14 DIAGNOSTIC AGENTS
OPHTHALMIC DRUGS
Fluorescein ophthalmic strips 64/100
Tropicamide 1% Drops 2.1

14.2 IMMUNOLOGICAL AGENTS

PPD Human Tuberculin 100U/ml 44.84

14.3 OTHER AGENTS

ECG Electrode Gel 3.34
Ultrasound Gel

15 DISINFECTANTS & ANTISEPTICS

Calcium hypochlorite/Milton for solution
Chlorhexidine 1.5% + cetrimide 15% conc. Yes 3.3/500ml
Chlorhexidine 1% cream Yes 3.5/500g
Hydrogen peroxide 3% solution 1.27/100ml
Methylated spirits 70% SVM
Povidine iodine 10% aqueous solution Yes 6.97/500ml

16 DIURETICS
Acetazolamide 250mg tablet Glaucoma 0.04
Frusemide 20mg/2ml injection 0.26
Frusemide 40mg tablet Yes 0.01
Hydrochlorothiazide 25mg tablet Yes 0.01
Mannitol 20% injection 3.25
Spironolactone 25mg tablet 0.04

17 GASTROINTESTINAL DRUGS
17.1 ANTACIDS & OTHER ANTIULCER DRUGS
Magnesium trisilicate compound tablet Yes 0.01
Omeprazole 20mg capsule 0.02 Rep Ranitidine
Ranitidine 50mg injection ICU use only 0.38
17.2 ANTIEMETIC DRUGS
Metoclopramide 10mg/2ml injection 0.09
Metoclopramide 10mg tablet 0.01
Prochlorperazine 12.5mg/ml injection 0.51
Promethazine 50mg injection 0.26
17.3 ANTIHAEMORRHOIDAL DRUGS
Haemorrhoidal ointment Yes 1.23 All else deleted
 17.5 ANTISPASMODIC DRUGS
Hyoscine N Butylbromide 20mg injection 0.16
Hyoscine N Butylbromide 10mg tablet 0.02

17.6 LAXATIVE DRUGS

Bisacodyl 10mg suppository 0.1
Bisacodyl 5mg tablet 0.01 Delete senna
Xray Prep Kits

17.7 DRUGS USED IN DIARRHOEA

Codeine phosphate 30mg tablet Yes 0.07
Oral rehydration salts Yes 0.11

HORMONES, OTHER ENDOCRINE DRUGS &

18 CONTRACEPTIVES
18.1 ADRENAL HORMONES & SYNTHETIC SUBSTITUTES
Dexamethasone 500mcg tablet 0.07
Hydrocortisone sodium succinate 100mg injection 0.46
Prednisolone 5mg tablet 0.01

18.2 CONTRACEPTIVES
18.21 Hormonal contraceptives

Ethinyloestradiol 30mcg + levonorgestrel 150mcg (Microgynon) Yes UNFPA Eugynon deleted

Levonorgestrol 750mcg tablet (Postinor) UNFPA Estigyn deleted
Levonorgestrel 30mcg (Microlut) Yes UNFPA Provera 10mg del
Medroxyprogesterone acetate 150mg/ml injection Yes UNFPA Progest Inj del
Medroxyprogesterone acetate implant (Norplant) UNFPA UNFPA donation

18.22 Intrauterine Devices Premarin donation

Copper-containing IUD UNFPA

18.23 Barrier Methods

Condoms with or without spermicide (nonoxicol) Yes UNFPA

18.4 Insulins and other Antidiabetic Agent

Glibenclamide 5mg tabs Yes 0.01
Glipizide 5mg tablet renal pts 0.03
Insulin soluble 100IU/ml 10ml 12.4
Insulin Isophane 100IU/ml 10ml 12.4 Mixtard if needed
Metformin 500mg tablet Yes 0.02

18.5 OVULATION INDUCERS

Clomiphene 50mg tablet O&G only

18.6 PROGESTERONES
Norethisterone 5mg tablet 0.02

18.7 THYROID HORM & ANTITHYROID DRUGS

Carbimazole 5mg tablet 0.02
Thyroxine 100mcg tablet 0.02

18.8 OTHER
Finasteride 5mg tablet Indiv pat only 1.2 Very expensive

19 IMMUNOLOGICALS
19.1 SERA & IMMUNOGLOBULINS
HBV immunoglobulin 400U/ml

19.2 For universal immunisation

BCG Vaccine Yes Pub Health
DPT Vaccine Yes Pub Health
Hepatitis B Vaccine Yes Pub Health
Measles-Rubella Yes Pub Health
Polio (Sabin) Yes Pub Health
Tetanus Toxoid Adsorbed Yes Pub Health
 MUSCLE RELAXANTS(PERIPHERALLY ACT) &
20 C'ESTERASE INHIBITORS
Atracurium 25mg/2.5ml injection 6.77 small supply only
Neostigmine 2.5mg injection 0.47
Suxamethonium 100mg/2ml injection 0.55 Pancur deleted
Vecuronium 10mg injection 5.56

21 OPTHALMOLOGICAL & ENT PREPARATIONS

21.1 ANTI-INFECTIVE AGENTS
Aciclovir Eye Ointment Ocular herpes 0.56
Chloramphenicol 5% ear drops Yes 0.59
Chloramphenicol 0.5% eye drops Yes 0.38
Chloramphenicol 1% eye ointment Yes 0.3
Gentamicin 0.3% eye drops 0.58
Tetracycline 1% eyeointment Yes 0.18

21.2 ANTI-INFLAMMATORY AGENTS

Dexamethasone 1mg/ml eye drops 1.83

21.3 LOCAL ANAESTHETICS

Amethocaine 0.5% eye drops 2.27

21.4 MIOTICS & ANTIGLAUCOMA DRUGS

Acetazolamide 250mg tablets 0.04
Pilocarpine 2% eye drops 1.28 Timolol - indiv.pat

21.5 MYDRIATICS
Tropicamide 1% eye drops 1.05 Atropine dr del
Phenylephrine 10% Drops/Minims 1.26

22 OXYTOCICS & ANTIOXYTOCICS

22.1 OXYTOCICS
Ergometrine 500mcg + oxytocin 5iu injection Yes 1.84
Oxytocin 10iu injection Yes 0.23
Misoprostol 200mcg tablet O&G only 0.32

22.2 ANTIOXYTOCICS
Nifedipine 20mg SR tablet Yes 0.01
Salbutamol 500mcg/ml injection 0.25

24 PYSCHOTHERAPEUTIC DRUGS
Amitriptylline 25mg tablets 0.01
Chlorpromazine25 mg tablets 0.02 prev.100mg
Chlorpromazine 50mg injection 0.1
Diazepam 5mg tablets Yes 0.01
Fluphenazine Depot 25mg/ml injection Indiv patient 0.99
Haloperidol 5mg injection 0.33

DRUGS ACTING ON THE RESPIRATORY

25 TRACT
Adrenaline 1mg/ml injection Yes 0.43
Aminophylline 250mg/10ml injection 0.72 Del theophylline
Beclomethasone 50/100mcg inhaler 4.42 Del Beconase
Salbutamol 100mcg Inhaler Yes 2.16
Salbutamol 5mg/ml Resp.Soln 30ml 5.75
Salbutamol 500mcg/ml injection 0.1 Delete Fenoterol
Salbutamol 4mg tablet 0.01 Delete over time,
encourage spray
SOLNS CORRECTING WATER, ELECTROLYTE
26 & ACID BASE DISTURB
26.1 ORAL
Oral rehydration salts Yes 0.11
Potassium chloride SR 600mg tablet 0.01 Limit supply
Sod.citrotartrate sachets (Ural)

26.2 PARENTERAL
 Calcium Chloride 10% injection 3.62
Compound solution of sodium lactate (Hartmanns) 1L Yes 1.3
Dextrose 10% injection 10ml O&G only
Dextrose 5% 1L 1.3
Dextrose 50% 50ml Yes 1.5
Dextrose 3% in 1/3 NS 1L 1.4
Gelofusine Plasma Expander 500ml 5.93
Magnesium Sulphate 50% injection Eclampsia 1.33
Mannitol 20% 500ml 3.25
Potassium chloride 1.5g/10ml 0.5
Sodium bicarbonate 8.4% 10ml 0.86
Sodium chloride 0.9% 1L Yes 1.3
Water for injection 10ml Yes 0.07 Keep only 10ml

27 VITAMINS & MINERALS

Hydroxocobalamin 1mg/ml injection (VitB12) 0.45 Del Vit B gp tabs
Multivitamin tablet Yes 0.01 Del Calcium carb
Pyridoxine 50mg tablet 0.02 Deleted Vit C
Phytomenadione 1mg in 0.5ml injection (Vit K1) Yes 0.3 10mg deleted