FORM PENGGUNAAN OBAT DI RUMAH SAKIT

Nama Rumah Sakit : RSIA DEDARI

Kelas RS :
Tipe RS : C
Jenis RS : Khusus
Kabupaten/ Kota : Kupang
Propinsi : NTT
Kapemilikan : Swasta
Tahun : 2015

No Nama Obat Kelas Terapi Bentuk Sediaan Penjamin

(JKN/ NON JKN

Aminofusiaon Paed 250 ML

Elkana Suspensi Vitamin
Amoxan 500 mg antibiotik
Cefadroxil 500mg antibiotik
Cefat antibiotik
Cefixime 100mg
Ceptik 100
Floragin kapsul
Glisodin 30 kapsul
Inbion capsul 100 tab
Inlacta DHA
Intermoxil 500mg cap

Lansoprazole 30mg

Neurosanbe
Nulacta plus
Prenamia
Promavit Sof Capsul 30,s
Protop Capsul 14 Cap
Renax caps
Thiampenicol 500mg

Utrogestan 100mg
Utrogestan 200 mg
VipAlbumin

albothyl 10 ml
albothyl 5ml
Chioram Phenicol Salep Mata
Cinolon - N
Cinolon cream
Dermatix Ultra 7gr
Flamar gel
FLAMYCORT
Formyco Cream
Gentamicyn salep kulit
Hydrocortisone 2.5% Krim

ketoconazole zalf

nymiko
Oxytetracyclin salep mata
Oxytetracycline sk

sagestam cr
Sanoskin Melladara plus
Sanoskin Oxy
Stretchmark Care Cream
topcord
Transfulmin BB 20gram
Transfulmin krim BB 10gr
transpulmin Krim 20g

Nopres 20 mg
Sikzonoate inj 25mg
Clozapine 25 mg
Hexymer 2Mg
Risperidone 2 mg

Alco
Amoxan paed 27
Apialys Drop 10mL
Pamol 15 ml
Paracetamol drops 100m/ml
Ritez

San-B plex
Sanmol DROP
Tiris
vometa
VOMETA SUSPENSI

Ciprofloxacin Inf
Clinimix Infus
D5 1/4 NS wida
Dex 40%
Dext 10%
Dext 10% 1/5 NS

Dext 10% OTSU

Dext 5 % 1/2 NS
Dext 5 % otsu
Dext 5% 1/4 NS
Dext 5% sanbe
Dext D5% 1/2 NS
diazol inf 500

Futrolit 24s
Infus NS

Infuset Macro B-braunt

KA-N3B

Metrofusin inf
Metronidazole inf 500mg
MGSO4 20
MGSO4 40
NACL
NACL 500 ML

Paracetamol Infus
Ringer Lactat (bpjs)
Ringer lactat umum

Sanmol Infus
starquin inf
Trichodozal Inf

Widahes 130 500 ml

Acran inj @ 5
Alinamin F Inj

ampicillin inj
Andalan 1 bulan
Andalan 3 bulan

Aqua Pro Inj 20ml

Aqua Pro Injeksi 25 ml
ASAM TRANEKSAMAT inj.
Atropin Sulfat 0,25mg
Baquinor injeksi

Bledstop inj (BPJS)

Bledstop inj (UMUM)

Bunascan Spinal 0,5% Inj

Bupivacaine spinal 20mg/40ml

Cefarin inj
Cefotaxim inj
Ceftriaxon inj

Cernevit Inj
Ciprofloxaci inj

Combivent 2,5 ml udv 20s

Cortidex Inj
damaben inj
Degrani inj 1
Degrani inj 3
Dexametason Inj 5mg
Duvadilan Inj
ENDROLIN inj
Ephedrin HCI 50mg
ephineprine inj

Farpain inj
Fendex inj
Fenitoin Inj
Fentanyl 2 ml inj
Furosimed inj
Gardasil inj 0,5 ml

Gastrofer inj 40 mg

Gentamicin 40 mg inj

Ketamin inj 100g

ketorolac 30 mg/ml askes

Kutoin inj
lactopain inj

Lapibal inj
lapixime inj

Lidocain inj
METHYL ERGOMETRIN INJ.
METHYLPREDNISOLON 500 MG INJEKSI
Methylprednisolone 125 mg inj
Metolon 2 ml

Neo K inj

Neurosanbe inj
ODR 4mg
Omeprazole inj 40mg
Ondansentron inj 4mg
Oxytoxin s inj

Pantoprazol 40mg
Pantopump inj
Pethidin HCL inj 50 mg
Phenytoin Sodium
piracetam 3g/15 ml inj

Pumpitor inj
Ranitidin 50mg/2ml
Ranitidin inj

Sagestam Inj

sancorbin
Sanexon Inj
Sankorbin inj
Sanpicillin inj
Santocyn inj (BPJS)
Santocyn inj (UMUM)
SIDIADRYL inj 150/15 ml
Stesolid 10 mg inj

Taxegram Inj

Tramadol inj
Trovensis inj
Uresix inj

Vaksin TT
Valisanbe 2 mg Injeksi

L-BIO
Acyclovir salep
Burnazin zalf
Ichtiol Saleb
Salep ANTIFUNGI DOEN

Acitral liquid 120 ml

Ambroxol syr
Amoxan dry syrup
Amoxillin syr kering 60ml
Anabion syr
Anadex syr
Antasida syr
Apialys syr
Bufec syr
Bufect Forte
Bysolvon solotion syr
Calnic Syr
Cefadroxil dry
Cefadroxil syr (ED)
Cefat Forte syr
Cefat Syrup
Clabat dry syrup 60ml
Claneksi Dry Syrup
Cotrimoxazole Susp
Damaben syr
Dexanta
Divens syr
Domperidon Syr
Elkana CL emulsi 120 ml
Elkana Cl Emulsi 200ml
Epexol syr
Episan Suspensi
Intermoxil Forte Syr 60 ml
Intermoxil Syr
InterZinc Syr 60ml
Komix Herbal 15 ml
Lapicef 250 mg syr
Lapimox 125 Sirup Kering
Laserin Madu 60ml
Likurmin syr
L-ZINC syr
OB Herbal 60ml
OB Herbal Dewasa 100ml
OB Herbal Junior 60ml
OBH Batuk Flu Ank Orange
OBH Comby Plus 60ml
OBH itrasal
Pamol Syrup 60 cc
Paracetamol syrup
Safe Care Aromat
Sanadryl 60ml DMP
Sanadryl sirup 60 ml
Sanadryl syr 120 ml
Sanadryl syr DMP 60ml
Sanbe Kids
Sanmag Suspensi
Sanmol Syrup
Sanprima Syrup
Sedrofen Syr
Softaman 1L
Solvita syr
Sporetik dry syr
Trimoxsul syr 50ml
ULSAFATE SUSPENSI
Vosedon suspensi
Woods Lozenger sugar free lemon
Woods Lozenges Licorice

Dulcolac 10mg
DULCOLAX 5 mg
Fetik Suppo
Kaltrofen Supp
Nebacetine Poder
Pamol 250mg Supp
Pamol 125 mg Sup
Pronalges 100Mg Supp@10
Propyretik supp 80mg
Protofen Supp
Stesolid 10 mg rectal
Stesolid 5 mg rectal
Trichodazol Plus

Abilify 10 mg
Abilify 15 mg
Abilify 5
Acarbose 100mg
Aclam 500
Acran tab
Acyclovir tab.
Alinamin F
Allopurinol 100mg
Alprazolam 0,5mg
Ambroxol 30mg Tab
Amiclav 5x6 s
Amitriptyline 25 Mg
Amlodipin 10 mg
Amlodipin 5 mg
Amoxicillin 500mg
Analsik tab
Analtram Kaplet 3 X 10"s
Antalgin
Antasida doen tab
Antiza
Anvomer
Anxibloc Tab
Apazol 0,5 mg
Artrilox tab 15mg
Asam Mefenamat 500mg
Asam Traneksamat tab.
Aspilet Tab
Baquinor Forte
Becom - C
Bionemi
Bledstop tab (BPJS)
Bledstop tab(UMUM)
Blesifen
Bodrex
Cal - 95 salut selaput 30s
Calnic 400mg
Calsium Lactate Tab
Captopril 12,5mg
Captopril 25mg
Cataflam fast
Cataflam tab 50 mg
Cetirizin 10mg
Chlcrpherniramin 4mg
Chlorpromazine 100mg
Ciprec 500
Ciprofloxasin 500 Mg
Clamixin Tab.
Clanexi 500 mg
Clavamox
Clindamycin 150Mg
Clindamycin 300Mg
Clobazam 10 mg
Clofritis 10 Mg
Clopidogrel 75 mg
Clozapine 100mg
Clozer
Codein 10mg
Cortidex Tablet
Cotrimoksazole 480mg
Cotrimoxazole ped
CTM 4mg
Cytostol tab
Damaben
Degirol tab
Demacolin
Depacote 250mg
Dexacap
DexaharsenTab 0.75 MG
Dexamethason 0,5mg tab
Dexazol tab
Dextamin TAB.
Diazepam 2 MG
Diazepam 5 MG
Diflucan 150mg
Diltiazem 30Mg
Dismeno 100mg
DMP 15 mg Tab@ 1000
Domperidone Tab 10Mg
Duvadilan Tab
Elizac 20
Elkana
Entrostop tablet
Epatin
Epexol 30 mg tab
Ephedrin tablet
Erysanbe 500 mg capl
Erythromycin
Ester Kap
Fendex 25 tab
Folamil Genio 30cap
Folavicap 400Mg
Folavit
Formyco
Fridep 50 Mg
Frimania 200mg
Frimania 400mg
Frisium 10 mg
fucohelix
Furosemide Tab
Gastridin TabLet 100tab
Genoclom 50mg
GG 100mg
Gitas Plus
Glimepiride 2mg
Govotil 2 mg
Govotil 5 2x20s
Griseufulvin 125
Haloperidol 1,5 mg
Haloperidol 5 mg
Hufamag Plus
Hydrocrotiasida .
Hystolan
Ibuprofen 200mg Tab
Imox
Imunos Plus
Inclarin Tab
Indexon tab
Infelon
Interhistin
Interpec Tab 30mg
ISDN 5 Ml
Isosorbid Dinitrat 5mg
Kalxetin
ketoconazole tab 200mg
Kuldon Sariawan
Lactamor tab
Laktafit
Lapibal 500 mg tab
Lapibion
Lapicef
Lapiflox
Lapimox 500
Lapistan
Levofloxacin
Liproqy Kapsul
Lisinopril 10 mg
Lisinopril 5 mg
Livron B-Plex
Lodia
longatin 25 mg
Loratadin 5 x 10 tab
Ludiomil 25 mg
Lynoral
Mefinal 250 mg
Mefinal 500 mg
Mefinter 250mg
Mefinter 500mg
Meloxicam 15 mg
meloxicam 7.5mg
Metformin 500mg tab
Methergin Tablet
Methylergometrin 0.125 mg
Methylprednisolon tab
Metoclorpramide 10mg
Metronidazol tab
MissoPrasos
Movix 15mg
Movix 7,5mg
Mucohexin
Myobat
Natrium Diklofenak 25 mg
Natrium Diklofenak 50Mg
Neurosanbe 5000
New Diatabs
Nifedipin 10 mg
Nobor
nonemi
Norit Carbo Ativatus
Nudep - 50mg
Ocuson Tab
Omeprazole 20mg
Opus
Orphen Tab
Oskadon
Paracetamol Tab
Paratusin Tablet
Persidal 2
Piracetam1200
Piroxicam 20 mg
Plasminex
Preabor
PREDNISON 5 MG
Premaston
Profertil
Prohiper Tab
Propanolol HCL 40 Mg
Propylthiouracil 100Mg
Ranitidin 150mg tab
Regumen
Retaphyl SR Tab
Revolan 800mg
Rhinofed Tab
Rhinos SR
Rizodal 2 mg
Roksicap 500mg
Salbutamol 2mg
Salbutamol 4 mg
Sandepril 50
Sanexon tab
Sanmol Tab
Sanprima
Santa - E
Simvastatin 10mg tab
Sincronik
Spasminal
Spironolactone TAB 100mg
Spironolactone tab 25mg
Sporetik tab
Stobleb Caps
Thiamycin 500 MG
Tilidon tab
Tofedex
Topgesi 500
Tramadol 50mg tb (askes)
Tramadol tab
Tremenza
Trichodazole 500mg
Trimoxsul Tab
Trovensis 4 mg tab
Ulsafate
Urdafalk tab
Uresix 40mg Tab
Urinter
Valacyclovir 500mg Tab @ 30Tablet
Valisanbe 2mg
Valisanbe 5mg
Vastigo
Vicee lemon
Vicee Orange
Vitalong C
Vitamin B Complex
Vitamin B6
Vitamin C
Vosedon tab
Zinc Tab
Zofredal 2mg
Zophrena
Zorel 200 mg
Zorel 400mg

centabion gel 20 gr
Kesesuaian dengan Jumlah penggunaan (satuan terkecil)
FORNAS (ya/tidak) RI RJ Total