Revisi Rekapan Formularium Per Dokter

FORMULARIUM
RUMAH SAKIT dr. ETTY ASHARTO

TAHUN 2018
NO KELAS TERAPI (KOMPOSISI) NAMA OBAT BENTUK SEDIAAN, KEKUATAN

CATATAN
DAN KEMASAN
ANTASIDA, ANTIREFLUX AGENT, ANTIULCERANTS

Mg(OH)2, Al(OH)3 Antasida Tablet (200 mg, 200 mg) GENERIK
Antasida Syrup 60 ml GENERIK
Mg(OH)2, Al(OH)3, Simeticon Acitral Tablet (200 mg, 200 mg, 20 mg) INTERBAT
Acitral Syrup 100 ml (400 mg, 400 mg, 80 mg) INTERBAT
Magtral F Tablet (400 mg, 400 mg, 80 mg) OTTO
Magtral F Syrup 100 ml (400 mg, 400 mg, 80 mg) OTTO
Dimetilpolisiloksan (simeticon) Disflatyl Tablet 40 mg PHAROS
Ranitidin Ranitidin Tablet 150 mg GENERIK

Ranitidin Injeksi 50 mg / 2 ml GENERIK
Omeprazole Omeprazole Kapsul 20 mg GENERIK

Omevell Kapsul 20 mg NOVELL
Pumpitor Injeksi 40 mg / 10 ml SANBE
Lansoprazole Lansoprazole Kapsul 30 mg GENERIK

Lancid Kapsul 30 mg KALBE
Pantoprazole Pantoprazole Injeksi 40 mg / 10 ml GENERIK

Topazol Injeksi 40 mg / 10 ml LAPI
Pepzol Injeksi 40 mg / 10 ml MAHAKAM
Misoprostol Misoprostol Tablet 200 mcg GENERIK

Gastrul Tablet 200 mcg FAHRENHEIT
Sucralfat Sucralfat Syrup 120 ml ( 500 mg / 5 ml ) GENERIK

Peptovell Syrup 120 ml ( 500 mg / 5 ml ) NOVELL
Episan Syrup 120 ml ( 500 mg / 5 ml ) SANBE
Rebamipide Novepide Tablet 100 mg NOVELL
Lactobacillus sporogenes Lacbon Tablet (Not < 50 million) KIMIA FARMA

Lactobacillus acidophilus, Bifidobacterium longun, Streptococcus
Lacto B Sachet (1x107 CFU) NOVELL
thermophilus, Vit C, B1, B2, B6, Niacin,Protein, Fat
Lactobacillus dll Protexin Infant Sachet COMBIPHAR
Lacbon Granul Sachet KIMIA FARMA
Probiostim Tablet SANBE
Probiokid Sachet SANBE
Interlac Tablet INTERBAT
Hyoscine N Butilbromide Hyoscine N Butilbromide Injeksi 20 mg / ml GENERIK

Scopamin Tablet 10 mg OTTO
Gitas Injeksi 20 mg / ml INTERBAT
Hyoscine N Butilbromide, Paracetamol Gitas Plus Tablet 10 mg, 500 mg INTERBAT
Clidinium, Chlordiazepoxide Braxidin Tablet (2,5 mg, 5 mg) SANBE FARMA

Clidinium, Chlordiazepoxide Clidiaz Tablet( 2,5 mg, 5 mg) NOVELL
Attapulgit, Pectin Diagit Tablet 600 mg, 50 mg INTERBAT
Loperamid Loperamide Tablet 2 mg GENERIK

Loperamid Lodia Tablet 2 mg SANBE FARMA
Kaolin, Pectin Neo Kaolana Syrup 120 ml ( 700 mg, 66 mg ) SANBE FARMA
Zinc Zinc Tablet 20 mg GENERIK

Interzinc Tablet 20 mg INTERBAT
Interzinc Syrup 60 ml ( 20 mg / 5 ml ) INTERBAT
Bisacodyl Bisacodyl Tablet 5 mg GENERIK

Stolax Suppositoria 10 mg SANBE FARMA
Lactulose Lactulose Syrup 60 ml ( 3,335 g / 5 ml ) GENERIK

Opilax Syrup 60 ml ( 3,335 g / 5 ml ) OTTO
Tube (45 mg, 5 mg, 625 mg, 450 mg, 4465
Na lauryl sulfoacetat, Asam sorbat, PEG, Na citrat, Sorbitol Microlax PHAROS
mg)
Phenolftalein, Paraffin cair, Gliserin Laxadine Syrup 60 ml (55 mg, 1200 mg, 378 mg) GALENIUM
Pancreatin, Bromelain, Dimethylpolysiloxane Xepazym Tablet (170 mg, 50 mg, 80 mg) METISKA
Ursodeoxycholic acid Ursodeoxycholic acid Kapsul 250 mg GENERIK

Urlicon Kapsul 250 mg NOVELL
Diosmin, hesperidin Ardium Tablet 450 mg, 50 mg SERVIER
Lithospermi radix extr, Benzocaine, Dibucaine, Diphenhidramine,

Borraginol N Suppositoria TAKEDA
Cetrimide
Lithospermi radix extr, Prednisolone, Lidocaine, Benzocaine, Cetrimide Borraginol S Suppositoria TAKEDA
Borraginol S Salep TAKEDA
Metoklopramide Metoklopramide Tablet 10 mg GENERIK

Metoklopramide Injeksi 10 mg / 2 ml GENERIK
Piralen Tablet 10 mg OTTO
Tomit Injeksi 10 mg / 2 ml INTERBAT
Domperidone Domperidone Tablet 10 mg GENERIK

Domperidone Syrup 60 ml ( 5 mg / 5 ml ) GENERIK
Vometa Oral Drop 12 ml ( 5 mg / ml ) OTTO
Vosedon Syrup 60 ml ( 5 mg / 5 ml ) SANBE
Ondansetron Ondansetron Injeksi 4 mg / 2 ml GENERIK

Ondansetron Tablet 8 mg GENERIK
Invomit Tablet 4 mg INTERBAT
Invomit Injeksi 4 mg / 2 ml INTERBAT
Vometron Tablet 4 mg MAHAKAM
Vometron Injeksi 8 mg / 4 ml MAHAKAM
Vomceran Injeksi 4 mg / 2 ml KALBE
Granisetron Granon Tablet 1 mg DEXA MEDICA
Chlorpromazine Chlorpromazine Tablet 100 mg GENERIK
CARDIOVASCULAR DRUGS
Dobutamine Dobutamin Injeksi 250 mg / 5 ml GENERIK
Dopamine Dopamin Giulini Injeksi 200 mg / 10 ml SOLVAY

Cetadop Injeksi 200 mg / 10 ml DARYA VARIA
Amiodarone Kendaron Tablet 200 mg DARYA VARIA

Tiaryt Tablet 200 mg FAHRENHEIT
Tiaryt Injeksi 150 mg / 3 ml FAHRENHEIT
Amiodaron Injeksi 150 mg / 3 ml GENERIK
Digoxine Digoxin Tablet 0,25 mg GENERIK

Fargoxin Injeksi 0,5 mg / 2 ml FAHRENHEIT
Isosorbide dinitrat Isosorbid dinitrat Tablet 5 mg GENERIK

Isosorbid dinitrat Tablet 10 mg GENERIK
Nosorbid Injeksi 10 mg / 10 ml NOVELL
Isosorbid mononitrat Imocard Tablet 60 mg NOVELL
Glyceril trinitrat Nitrokaf Retard Kapsul 2,5 mg PHARMASOLINDO-KF
Nitroglyserin NTG Injeksi FERRON
Captopril Captopril Tablet 12,5 mg GENERIK

Captopril Tablet 25 mg GENERIK
Ramipril Rampiril Tablet 5 mg GENERIK
Lisinopril Lisinopril Tablet 5 mg GENERIK

Lisinopril Tablet 10 mg GENERIK
Bisoprolol Bisoprolol Tablet 5 mg GENERIK
Concor Tablet 1,25 mg MERCK
Propanolol Propanolol Tablet 10 mg GENERIK

Tablet 40 mg GENERIK
Amlodipin Amlodipin Tablet 5 mg GENERIK

Nifedipin Nifedipin Tablet 10 mg GENERIK

Adalat Tablet OROS 30 mg BAYER
Diltiazem Diltiazem Tablet 30 mg GENERIK

Herbesser CD Kapsul 100 mg TANABE
Nicardipine Nicardipin Injeksi 10 mg / 10 ml GENERIK

Blistra Injeksi 10 mg / 10 ml PHAROS
Irbesartan Irbesartan Tablet 150 mg GENERIK

Irbesartan Tablet 300 mg GENERIK
Irvell Tablet 150 mg NOVELL
Valsartan Valsartan Tablet 80 mg GENERIK

Valsartan Tablet 160 mg GENERIK
Candesartan Candesartan Tablet 8 mg GENERIK

Candesartan Tablet 16 mg GENERIK
Telmisartan Telmisartan Tablet 40 mg GENERIK

Telmisartan Tablet 80 mg GENERIK
Trimetazidine HCL Angintriz MR Tablet 35 mg NOVELL
OTHER ANTIHYPERTENSIVES
Clonidin Clonidin Tablet 0,15 mg GENERIK
DIURETICS
Spironolactone Spironolacton Tablet 25 mg GENERIK
Spironolacton Tablet 100 mg GENERIK
Letonal Tablet 25 mg OTTO
Furosemide Furosemide Tablet 40 mg GENERIK

Furosemide Injeksi 20 mg / 2 ml GENERIK
Roxemid Injeksi 20 mg / 2 ml NOVELL
Hydrochlorothiazide HCT Tablet 25 mg GENERIK
PERIPHERAL VASODILATOR, CEREBRAL ACTIVATORS

Flunarizine Flunarizine Tablet 5 mg GENERIK
Unalium Tablet 5 mg GUARDIAN
Citicoline Citicoline Injeksi 250 mg / 2 ml GENERIK

Citicoline Tablet 500 mg GENERIK
VASOCONSTRICTORS
Norepinephrine bitartrate N-Epi Injeksi 1 mg / ml NOVELL
Norepinephrin Injeksi 1 mg / ml GENERIK
DYSLIPIDAEMIC AGENTS
Simvastatin Simvastatin Tablet 10 mg GENERIK
Simvastatin Tablet 20 mg GENERIK
Gemfibrozil Gemfibrozil Kapsul 300 mg GENERIK
Fenofibrate Trolip Kapsul 100 mg DEXA MEDICA

Trolip Kapsul 300 mg DEXA MEDICA
Fenofibrate Kapsul 100 mg GENERIK
Atorvastatin Atorvastatin Tablet 20 mg GENERIK

Atorvastatin Tablet 40 mg GENERIK
HAEMOSTATICS
Carbazochrome Na Sulfonate Carbazochrome Injeksi 50 mg / 10 ml GENERIK
Crome Injeksi 50 mg / 10 ml FERRON
Asam tranexamat Asam Tranexamat Tablet 500 mg GENERIK

Asam Tranexamat Injeksi 250 mg / 5 ml GENERIK
Plasminex Tablet 500 mg SANBE
Phytonadione Neo K Injeksi 2 mg / ml COMBIPHAR
Menadione Vitamin K Injeksi 10 mg / ml GENERIK

Vitamin K3 Injeksi 10 mg / ml GENERIK
ANTICOAGULANTS, ANTIPLATELET, FIBRINOLYTICS (TROMBOLYTICS)

Asam asetilsalisilat Aspilet Tablet 80 mg DARYA VARIA
Thrombo Aspilet Tablet 80 mg MEDIFARMA
Farmasal Tablet 100 mg FAHRENHEIT
Fondaparinux Na Arixtra Injeksi 2,5 mg / 0,5 ml SANOFI

Diviti Injeksi 2,5 mg / 0,5 ml DEXA MEDICA
Clopidogrel Clopidogrel Tablet 75 mg GENERIK

Plavix Tablet 300 mg SANOFI
Enoxaparin Na Lovenox Injeksi 60 mg / 0,6 ml GLAXO
Beraprost Na Dorner Tablet 20 mcg ASTELLAS
Streptokinase Fibrion Vial 1.5 jt IU DEXA MEDICA
Dabigatran etexilate Pradaxa Tablet 75 mg BOEHRINGER

Pradaxa Tablet 110 mg BOEHRINGER
PHLEBITIS, VARICOSE PREPARATIONS

Diosmin, hesperidin Ardium Tablet (450 mg, 50 mg) SERVIER
Heparin Thrombophob Gel TUNGGAL IDAMAN

HAEMORRHEOLOGICALS
Pentoxifylline Tarontal Injeksi 300 mg / 15 ml BERNOFARM
ANTIASTHMATICS & COPD PREPARATIONS

Salbutamol Salbutamol Tablet 4 mg GENERIK
Salbutamol Tablet 2 mg GENERIK
Ventolin Nebules 2,5 mg GLAXO
Ventolin Inhaler GLAXO
Procaterol Meptin Mini Tablet 25 mcg OTSUKA
Theophyllin Retaphyl SR Tablet 300 mg KIMIA FARMA

Theobron Kapsul 130 mg INTERBAT
Ephedrine Ephedrin HCl Injeksi 50 mg / ml ETHICA

Vasodrin Injeksi 50 mg / ml MAHAKAM
Ipatropium, salbutamol Combivent Nebules ( 0,5 mg, 2,5 mg) BOEHRINGER
Aminophyllin Aminophyllin Tablet 200 mg GENERIK

Aminophyllin Injeksi 24 mg / ml GENERIK
Ketotifen Profilas Syrup 60 ml KALBE
Fluticasone propionate Flixotide Nebules 0,5 mg / 2 ml GLAXO
Salmeterol, Fluticasone Seretide Diskus 250 mcg GLAXO

Diskus 100 mcg GLAXO
Budesonide Pulmicort Respules 0.5 mg/ml ASTRAZENECA
Budesonide, Formoterol Symbicort Turbuhaler (160 mcg, 4.5 mcg) ASTRAZENECA
Fenoterol Berotec Inhalasi BOEHRINGER
Indacaterol Onbrez Breezhaler kapsul 150 mcg NOVARTIS
COUGH & COLD PREPARATIONS

Gliseril Guaiakolat Gliseril Guaiakolat Tablet 100 mg GENERIK
Ambroxol Ambroxol Tablet 30 mg GENERIK

Ambroxol Syrup 60 ml (30 mg / 5 ml) GENERIK
Mucera Tablet 30 mg OTTO
Mucera Drop 15 ml (15 mg / ml) OTTO
Epexol Tablet 30 mg SANBE
Epexol Syrup 100 ml (30 mg / 5 ml) SANBE
Paracetamol, Dextromethorphan, CTM, PPA Anadex Tablet (500 mg, 15 mg, 1 mg, 15 mg) INTERBAT
Syrup (120 mg, 3,5 mg, 0,5 mg, 3,5 mg) / 5
Anadex INTERBAT
ml
Tuzalos Tablet (500 mg, 10 mg, 1 mg, 15 mg) SANBE
Dextrometorphan, GG, PPA, CTM Dextral Forte Kapsul MOLEX AYUS
Bromhexin Bisolvon Injeksi 4mg/2ml BOEHRINGER

Bisolvon Solutio 50 ml BOEHRINGER
Mucohexin Tablet 8 mg SANBE
Mucohexin Syrup 120 ml (4 mg / 5 ml ) SANBE
Codein Codein Tablet 10 mg KIMIA FARMA

Codein Tablet 20 mg KIMIA FARMA
Codein Codikaf Tablet 10 mg PHARMASOLINDO - KF

Codikaf Tablet 20 mg PHARMASOLINDO - KF
Guaifenesin, Extr Thyme, Extr Primulae, Extr Althaea, Extr Droseraea, Syrup 100 ml (37,5 mg, 250 mg, 50 mg, 25
Silex DARYA VARIA
Extr Serpylli, Eucalyptus oil, Anise oil mg, 175 mg, 0,5 mg, 1,25 mg) / 5 ml
Erdosteine Erdostein Kapsul 300 mg GENERIK

Erdostein Syrup 60 ml (175 mg / 5 ml) GENERIK
Vestein Syrup 60 ml (175 mg / 5 ml) KALBE
Vestein Kapsul 300 mg KALBE
Pseudoephedrin Alco Oral Drop 10 ml (7,5 mg / 0,8 ml) INTERBAT
Loratadine, Pseudoephedrin Rhinos SR Kapsul (5 mg, 60 mg IR, 60 mg SR) DEXA MEDICA

Aldisa SR Kapsul (5 mg, 120 mg) SANBE
Tripolidine, Pseudoephedrine Trifed Tablet (2,5 mg, 60 mg) INTERBAT

Trifed Syrup 60 ml (1,25 mg, 30 mg) / 5 ml INTERBAT
Tremenza Tablet (2,5 mg, 30 mg) SANBE
Tremenza Syrup 60 ml (1,25 mg, 30 mg) / 5 ml SANBE
Paracetamol, Pseudoefedrin, CTM, Cofein Demacolin Tablet (500 mg, 7,5 mg, 2 mg, 10 mg) CORONET
N-acetylcysteine Acetyl sistein Kapsul 200 mg GENERIK
NASAL DECOGESTANT
NaCl Breathy Drop 30 ml (6,5 mg / ml) NOVELL
NaCl Breathy Nasal spray 50 mcg / dosis NOVELL
ANXIOLYTICS
Alprazolam Alprazolam Tablet 0,5 mg GENERIK
Frixitas Tablet 0,5 mg NOVELL
Clobazam Clobazam Tablet 10 mg GENERIK

Proclozam Tablet 10 mg MEPRO
Diazepam Valisanbe Tablet 2 mg SANBE

Valisanbe Tablet 5 mg SANBE
Valisanbe Injeksi 10 mg / 2 ml SANBE
Stesolid Rectal tube 5 mg / 2,5 ml ACTAVIS
Amitryptilin Amitryptilin Tablet 25 mg GENERIK
HYPNOTICS, SEDATIF
Midazolam Miloz Injeksi 5 mg / 5 ml NOVELL
ANTIPSYCHOTICS
Haloperidol Haloperidol Tablet 5 mg GENERIK

ANTICONVULSANT
Gabapentin Gabapentin Kapsul 300 mg GENERIK
Gabexal Kapsul 100 mg NOVARTIS
Carbamazepine Bamgetol Tablet 200 mg MERSI
Phenytoin Phenytoin Kapsul 100 mg GENERIK

Phenytoin Injeksi 100 mg / 2 ml GENERIK
Kutoin Kapsul 100 mg MERSI
Kutoin Injeksi 100 mg / 2 ml MERSI
Phenobarbital Phenobarbital Tablet 30 mg GENERIK

Phenobarbital Injeksi 200 mg / 2 ml GENERIK
Sibital Injeksi 200 mg / 2 ml MERSI
Asam Valproat Asam Valproat Syrup GENERIK

Procifer Syrup DEXA MEDICA
Divalproex Sodium Depakote Tablet ER 250 mg ABBOTT
ANTIPARKINSON
Trihexyphenidil Arkine Tablet 2 mg PYRIDAM
Hexymer Tablet 2 mg MERSI
ANTIVERTIGO
Betahistin Betahistin Tablet 6 mg GENERIK
Mertigo Tablet 6 mg DEXA MEDICA
Noverty Tablet 6 mg NOVELL
Dimenhydrinat Dimenhydrinat Tablet 50 mg GENERIK
ANALGESICS (OPIOID)
Tramadol Tramadol Kapsul 50 mg GENERIK
Tramadol Injeksi 100 mg / 2 ml GENERIK
Tramadol, paracetamol Patral Tablet (37.5 mg, 325 mg) MAHAKAM
Fentanyl Fentanyl Injeksi 0,05 mg / ml KIMIA FARMA

Morfin Morfin Injeksi 10 mg / ml KIMIA FARMA
Morfin MST Continus Tablet 10 mg KIMIA FARMA
Pethidin Pethidin Injeksi 50 mg / ml KIMIA FARMA
ANALGESICS (NON OPIOID), ANTIPYRETICS

Paracetamol Paracetamol Tablet 500 mg GENERIK
Paracetamol Syrup 60 ml (120 mg / 5 ml) GENERIK
Paracetamol Infusan 100 ml (10 mg/ml) GENERIK
Sanmol Tablet 500 mg SANBE
Sanmol Syrup 60 ml (120 mg / 5 ml) SANBE
Sanmol Drop 15 ml (60 mg / 0,6 ml) SANBE
Sanmol Forte Syrup 60 ml (250 mg / 5 ml) SANBE
Sanmol Infusan 100 ml (10 mg/ml) SANBE
Sumagesic Tablet 600 mg DARYA VARIA
Propyretic Suppositoria 80 mg COMBIPHAR
Asam salisilat Aspilet Tablet 80 mg DARYA VARIA

Acetosal Tablet 500 mg GENERIK
Ibuprofen Ibuprofen Syrup 60 ml ( 100 mg / 5 ml ) GENERIK

Ibuprofen Syrup 60 ml ( 200 mg / 5 ml ) GENERIK
Ibuprofen Tablet 400 mg GENERIK
Fenris Syrup 60 ml ( 100 mg / 5 ml ) INTERBAT
Iprox Suspensi (100 mg / 5 ml ) NOVELL
Proris Suppositoria 125 mg PHAROS
Bufect Forte Suspensi (200 mg / 5 ml ) SANBE
Paracetamol, Ibuprofen Alaxan-FR Kapsul (325 mg, 200 mg) DARYA VARIA
Metampiron Antalgin Tablet 500 mg GENERIK

Antrain Tablet 500 mg INTERBAT
Antrain Injeksi 500 mg / ml INTERBAT
Metampiron, Diazepam Analsik Tablet (500 mg, 2 mg) SANBE

Asam mefenamat Asam mefenamat Tablet 500 mg GENERIK
Mefinter Tablet 500 mg INTERBAT
Mefinal Tablet 500 mg SANBE
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS

Kalium diclofenac Kalium diklofenak Tablet 50 mg GENERIK
Diflam Tablet 50 mg INTERBAT
Cataflam D 50 Tablet 50 mg NOVARTIS
Cataflam Fast Sachet 50 mg / 900 mg NOVARTIS
Natrium diclofenac Natrium diklofenak Tablet 50 mg GENERIK

Voltaren Gel Gel 20 g NOVARTIS
Flamar Tablet 50 mg SANBE
Flamar Gel 20 g SANBE
Ketoprofen Fetik Suppositoria 100 mg INTERBAT

Kaltrofen Suppositoria 100 mg KALBE
Deksketoprofen Keren Tablet 50 mg NULAB

Keren Injeksi NULAB
Meloxicam Meloxicam Tablet 7,5 mg GENERIK

Meloxicam Tablet 15 mg GENERIK
Moxic Tablet 7,5 mg OTTO
Moxic Tablet 15 mg OTTO
Piroxicam Piroxicam Tablet 10 mg GENERIK

Piroxicam Tablet 20 mg GENERIK
Ketorolac Ketorolac Injeksi 30 mg / ml GENERIK

Toramine Injeksi 30 mg / ml OTTO
Ketorolac Tablet 10mg GENERIK
Celecoxib Celebrex Kapsul 100 mg PFIZER
Etiroxocib Etiroxocib Tablet 60 mg GENERIK

DRUG FOR NEUROPATHIC PAIN
Pregabalin Pregabalin Kapsul 75 mg GENERIK

Provelyn Kapsul 75 mg KALBE
ANTIMIGRAINE
NOOTROPICS, NEUROTONICS
Piracetam Piracetam Tablet 400 mg, 1200 MG GENERIK
Piracetam Injeksi 3 g / 15 ml GENERIK
Mecobalamin Mecobalamin Injeksi 500 mcg / ml GENERIK

Mecobalamin Kapsul 500 mcg GENERIK
Lapibal Kapsul 500 mcg LAPI
Lapibal Injeksi 500 mcg / ml LAPI
HYPERURICEMIA, GOUT PREPARATIONS

Allopurinol Allopurinol Tablet 100 mg GENERIK
Allopurinol Tablet 300 mg GENERIK
MUSCLE RELAXANTS
Atracurium besilate Atracurium Injeksi 25 mg / 2,5 ml GENERIK
Eperisone HCl Eperisone Tablet 50 mg GENERIK

Myobat Tablet 50 mg INTERBAT
OTHER DRUGS ACTING ON MUSCULO-SKELETAL SYSTEM

Glucosamine Glucosamin Tablet 250 mg GENERIK
Glucosamine, Chondroitin, MSM, Vit C, Mn, Mg, Zn Ultimax Joint Tablet MAHAKAM
Na-Risendronat Ristonat Tablet 35 mg PHAPROS
ESTROGEN, PROGESTERON, RELATED SYNTHETIC DRUG

Allysterenol Pregnolin Tablet 5 mg DEXA MEDICA
Norethisterone Norelut Tablet 5 mg DEXA MEDICA
Nomegestrol acetate Lutenyl Tablet 5 mg MERCK
Progesteron Cygest Pessari Suppositoria (200 mg, 400 mg) ACTAVIS
CORTICOSTEROID HORMONE
Dexametason Dexametason Tablet 0,5 mg GENERIK
Dexametason Injeksi 5 mg / ml GENERIK
Etason Injeksi 5 mg / ml OTTO
Indexon Tablet 0,5 mg INTERBAT
Indexon Injeksi 5 mg / ml INTERBAT
Methylprednisolon Methylprednisolon Tablet 4 mg GENERIK

Methylprednisolon Tablet 8 mg GENERIK
Methylprednisolon Injeksi 125 mg GENERIK
Prednicort Tablet 4 mg OTTO
Prednison Prednison Tablet 5 mg GENERIK
Triamcinolon Triamcinolon Tablet 4 mg GENERIK

Ketricin orabase Salep 0,1% 5 g FERRON
Trilac Injeksi 10 mg NOVELL
TROPIC HORMON, RELATED SYNTHETIC DRUGS

Clomiphene citrate Fertin Tablet 50 mg INTERBAT
DEPOT CONTRACEPTIVES
Medroxyprogesterone Depo Progestin Injeksi 150 mg / 3 ml HARSEN
Triclofem Injeksi 150 mg / 3 ml TUNGGAL IDAMAN
Medroxyprogesterone, Estradiol Cyclofem Injeksi (50 mg, 10 mg) / ml TUNGGAL IDAMAN
OTHER CONTRACEPTIVES
IUD Nova T IUD BAYER
AMINOGLYCOSIDES
Gentamicin Gentamycin Injeksi 80 mg / 2 ml GENERIK
Ottogenta Injeksi 80 mg / 2 ml OTTO
Salticin Injeksi 80 mg / 2 ml INTERBAT
CEPHALOSPORINS
Cefepime Cefepime Injeksi 1 g GENERIK
Cefadroxil Cefadroxil Kapsul 500 mg GENERIK

Cefadroxil Syrup 60 ml (125 mg / 5 ml) GENERIK
Opicef Kapsul 500 mg OTTO
Cefat Syrup 60 ml (125 mg / 5 ml) SANBE
Cefixime Cefixime Kapsul 100 mg GENERIK

Cefixime Syrup 30 ml (100 mg / 5 ml) GENERIK
Cefila Kapsul 100 mg LAPI
Anfix Kapsul 100 mg MAHAKAM
Sporetik Syrup 30 ml (100 mg / 5 ml) SANBE
Cefotaxim Cefotaxim Injeksi 1 g GENERIK

Biocef Injeksi 1 g OTTO
Taxegram Injeksi 0,5 g SANBE
Taxegram Injeksi 1 g SANBE
Lapixim Injeksi 1 g LAPI
Fobet Injeksi 1 g MAHAKAM
Rycef Injeksi 1 g INTERBAT
Ceftriaxone Ceftriaxone Injeksi 1 g GENERIK

Bioxon Injeksi 1 g OTTO
Starxon Injeksi 1 g INTERBAT
Terfacef Injeksi 1 g SANBE
Ceftazidime Ceftazidime Injeksi 1 g GENERIK
Cefoperazone Cefoperazone Injeksi 500 mg GENERIK

Cefoperazone, Sulbactam Cefoperazone, Sulbactam Injeksi (500 mg, 500 mg) GENERIK
PENICILLIN
Amoxycillin, Clavulanic Acid Co amoxiclav Tablet (500 mg, 125 mg) GENERIK
Clabat Syrup 60 ml (125 mg, 31,25 mg) / 5 ml INTERBAT
Ampicillin sulbactam Viccilin SX Injeksi 1 g MEIJI
Amoxycillin Amoxycillin Tablet (500 mg) GENERIK

Opimox Syrup 60 ml (125 mg/ 5 ml) OTTO
Amoxsan Drop 15 ml (100 mg / ml) SANBE
Intermoxil Tablet (500 mg) INTERBAT
Cloxacillin Meixam Kapsul 500 mg MEIJI

Meixam Injekasi 1 g MEIJI
OTHER BETA-LACTAM
Meropenem Meropenem Injeksi 0,5 g GENERIK
Meropenem Injeksi 1 g GENERIK
CHLORAMPHENICOL
Thiamphenicol Thiamphenicol Kapsul 500 mg GENERIK
Biothicol Syrup 60 ml (125 mg / 5 ml) SANBE
Thiamycin Kapsul 500 mg INTERBAT
MACROLIDES
Erythromycin Erythromycin Tablet 500 mg GENERIK
Erythromycin Syrup 60 ml (200 mg/ 5 ml) GENERIK
Erysanbe Tablet 500 mg SANBE
Erysanbe Tablet chew 200 mg SANBE
Erysanbe Syrup 60 ml (200 mg/ 5 ml) SANBE
Azithromycin Azithromycin Tablet 500 mg GENERIK

Zycin Kapsul 500mg INTERBAT
QUINOLONES
Ciprofloxacin Ciprofloxacin Tablet 500 mg GENERIK
Ciprofloxacin Infusan 100 ml (2 mg/ml) GENERIK
Tequinol Tablet 500 mg OTTO
Levofloxacin Levofloxacin Tablet 500 mg GENERIK

Levofloxacin Infusan 100 ml (500 mg/ 100 ml) GENERIK
LQ-500 Tablet 500 mg MAHAKAM
LQ-500 Infusan 100 ml (500 mg/ 100 ml) MAHAKAM
Ofloxacin Ofloxacin Tablet 200 mg GENERIK

Ofloxacin Tablet 400 mg GENERIK
Doxycycline Doxycyclin Kapsul 100 mg GENERIK
ANTIBACTERIAL COMBINATION
Trimethoprim, Sulfamethoxazole Cotrimoxazol Tablet (80 mg, 400 mg) GENERIK
Cotrimoxazol Syrup 60 ml (40 mg, 200 mg) / 5 ml GENERIK
Trimoxul Tablet (160 mg, 800 mg) INTERBAT
Trimoxul Syrup 60 ml (40 mg, 200 mg) / 5 ml INTERBAT
Sanprima Tablet (80 mg, 400 mg) SANBE
OTHER ANTIBIOTICS / ANTIAMOEBICS

Clindamycin Clindamycin Kapsul 150 mg GENERIK
Clindamycin Kapsul 300 mg GENERIK
Metronidazole Metronidazole Tablet 500 mg GENERIK

Metronidazole Infusan 100 ml (500 mg/100 ml) GENERIK
Fladex Suppositoria 1 g DEXA MEDICA
Fladex Suppositoria 0,5 g DEXA MEDICA
Trichodazol Infusan 100 ml (500 mg/100 ml) SANBE
Colistin / Polymyxin Colistine Tablet 1.500.000 IU ACTAVIS
Fosfomycin Fosmicyn Injeksi 2 g MEIJI
ANTIFUNGALS
Nystatin Nystatin Drop 12 ml ( 100.000 IU/ml) GENERIK
Nymiko Drop 12 ml ( 100.000 IU/ml) SANBE
Ketokonazole Ketokonazole Tablet 200 mg GENERIK

Ketokonazole Salep 10 g GENERIK
Fluconazole Fluconazole Injeksi 200 mg / 100 ml GENERIK

Fluconazole Kapsul 150 mg GENERIK
ANTIVIRALS
Acyclovir Acyclovir Tablet 200 mg GENERIK
Acyclovir Tablet 400 mg GENERIK
Acyclovir Salep 5 g GENERIK
Valacyclovir Inclovir Tablet 500 mg INTERBAT
Methisoprinol Isprinol Syrup 60 ml (250 mg/5 ml) NOVELL
PREPARATION FOR VAGINAL CONDITIONS

Metronidazole, Nystatin Fladystin Ovula (500 mg, 100.000 IU) DEXA MEDICA
Neo Gynoxa Ovula (500 mg, 100.000 IU) KALBE
Metronidazole Fladex Suppo 1 g DEXA MEDICA

Fladex Suppo 0,5 g DEXA MEDICA
Nystatin Nystatin Vaginal Tablet GENERIK
URINARY ANTISEPTICS
Pipemidic acid Urinter Kapsul 400 mg INTERBAT
DRUG ACTING ON THE UTERUS

Methylergometrin maleat Metvell Tablet 125 mcg NOVELL
Metilat Tablet 125 mcg METISKA
Bledstop Injeksi 0,2 mg / ml CAPRI
Isoxsuprine Proterine Injeksi 0,2 mg / ml NOVELL
Oxytocin Oxytocin Injeksi 10 IU/ml GENERIK

Oxyla Injeksi 10 IU/ml NOVELL
Magnesium Sulfat MgSO4 Injeksi 20% OTSUKA
MgSO4 Injeksi 40% OTSUKA
DRUG ACTING ON THE URINARY SYSTEM & PROSTAT

Tamsulosin HCl Harnal OCAS Tablet 0,4 mg ASTRAZENECA
OTHER DRUGS ACTING ON THE GENITO-URINARY SYSTEM

Essential Ketoacid Prorenal Tablet NOVELL
INSULIN PREPARATIONS
Insulin Aspart Novorapid FlexPen 100 U/ml NOVO
Biphasic Insulin Aspart Novomix FlexPen 100 U/ml NOVO
Insulin Glulisine Apidra FlexPen 100 U/ml SANOFI
Insulin Detemir Levemir FlexPen 100 U/ml NOVO
Insulin Glargine Lantus FlexPen 100 U/ml SANOFI
ANTIDIABETICS AGENTS
Glibenclamid Glibenclamid Tablet 5 mg GENERIK
Metformin Metformin Tablet 500 mg GENERIK

Metformin Tablet 850 mg GENERIK
Metformin Tablet 500 mg XR GENERIK
Forbetes Tablet 500 mg SANBE
Diabemin XR Tablet 500 mg DEXA MEDICA
Glucophage XR Tablet 750 mg MERCK
Glimepiride Glimepiride Tablet 1 mg GENERIK

Glimepiride Tablet 2 mg GENERIK
Pioglithazon Pioglithazon Tablet 15 mg GENERIK

Pioglithazon Tablet 30 mg GENERIK
Deculin Tablet 15 mg DEXA MEDICA
Acarbose Acarbose Tablet 50 mg GENERIK

Acarbose Tablet 100 mg GENERIK
Gliquidone Gliquidone Tablet 30 mg GENERIK
Gliclazide Gliclazide Tablet 80 mg GENERIK
Glibenclamid, Metformin Glucovance Tablet (1,25 mg, 250 mg) MERCK

Glucovance Tablet (2,5 mg, 500 mg) MERCK
Glucovance Tablet (5mg, 500 mg) MERCK
Glimepiride, Metformin Velacom Plus Tablet (1 mg, 500 mg) NOVELL

Velacom Plus Tablet (2 mg, 500 mg) NOVELL
VITAMIN E
Vitamin E Santa E Tablet 400 mg SANBE
VITAMIN B COMPLEX WITH C

Vitamin B1 Vitamin B1 Tablet 50 mg GENERIK
Vitamin B Complex Vitamin B Complex Tablet GENERIK
Vitamin B12 Vitamin B12 Tablet 50 mcg GENERIK
Vitamin C Vitamin C Tablet 50 mg GENERIK

Vitamin C Tablet 250 mg GENERIK
Vitamin C Injeksi 200 mg / 2 ml GENERIK
Vitamin B1, B2 Alinamin F Tablet 5 mg TAKEDA

Furamin Injeksi 25 mg/ 10 ml MEPRO
Vitamin B1, B6, B12 Neurobat Tablet (100 mg, 200 mg, 200 mcg) INTERBAT
Vitamin B1, B6, B12 Neurobat Forte Injeksi (100 mg, 100 mg, 5 mg)/ 3 ml INTERBAT
Vitamin B1, B6, B12 Neurosanbe 5000 Tablet (100 mg, 100 mg, 5000 mcg) SANBE
Vitamin B1, B6, B12, Metampyron Neurosanbe Plus Tablet (50 mg, 100 mg, 100 mcg, 500 mg) SANBE
CALCIUM WITH VITAMIN

Calsium Laktat Calcium Laktat Tablet 500 mg GENERIK
Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20

Ca Phospate, Ca Lactate, Vit C, Vit D3, Vit B6 Lycalvit INTERBAT
mg)
Tablet (200 mg, 100 mg, 25 mg, 100 IU,
Ca Phospate, Ca Lactate, Vit C, Vit D3, Vit B6 Elkana SANBE
20 mg)
Bonistein, Ca Phosphate, Vit K1, Vit D3 Hi-Bone Tablet (15 mg, 250 mg, 0,1 mg, 200 IU) OTTO
Coral Calsium 20 mg 500 mg, Natural Soy Isoflavone 20 mg, Cal-95 Tablet LAPI
Vit. D3 200 IU, Vit. K 25 mcg, Mg 100 mg, Zn 5 mg, Boron 1 mg
VITAMIN &/OR MINERAL

Vit B6, B12, Folic acid, Vit E Cernevit Injeksi KALBE
VITAMIN & MINERAL PEDIATRIC

Fe, Vit B1, B6, B12, Folic acid Feroglobin Syrup 60 ml DARYA VARIA
Fe, Vit B1, B6, B12, Folic acid Feroglobin Drop DARYA VARIA
Curcuminoid, Lysine, Vit B1, Vit B2, Vit B6, Vit B12, Niacinamid,
Likurmin Syrup 60 ml KALBE
Panthothenic acid
Lycalvit Syrup 60 ml INTERBAT
Elkana Syrup 60 ml SANBE
VITAMIN & MINERAL (PRE & POST NATAL) / ANTIANEMICS

Folic acid Folac Tablet 400 mcg OTTO
Folic acid Folavit Tablet 1000 mcg SANBE
Inbion Kapsul INTERBAT

Folamil Genio Tablet DEXA MEDICA
Vitamam 1 Kapsul NOVELL
Osfit DHA Kapsul KALBE
Cod liver 200 mg, Vit.A 120 iu, Vit.D3 17 iu, omega-3 fatty acids, Caloma Plus Kapsul NOVELL
EPA 16 mg, DHA 14 mg, Vit.E 5 mg, Vit.B12 1 mcg, folic acid 0,3mg,
Vit. B6 0,6 mg, Ca 40 mg, Mg 25 mg, Fe 4,76 mg.
Grafola DHA Kapsul METISKA
INFANT NUTRITIONAL PRODUCT
Lactogen Premature Susu NESTLE

Lactogen 1 Susu NESTLE
Lactogen LLF Susu NESTLE
SGM Soya Susu SARI HUSADA
S26 LBW Susu WYETH
ENTERAL/NUTRITIONAL PRODUCT
Nephrisol Susu KALBE
Pan Enteral Susu OTSUKA
PARENTERAL NUTRITIONAL PRODUCT

Glucose, Nitrogen, Amino acid, BCAA Aminofluid Infusan 500 ml (75 g, 4,7 g, 30 g, 30%) OTSUKA
ELECTROLYTES
K-L Aspartat Aspar K Tablet 300 mg TANABE
KCl KSR Tablet 600 mg MERCK

ORAL REHYDRATION
Na, K, Cl, Citrat, Dextrose Pharolit Sachet PHAROS
SUPPLEMENTS & ADJUVANT THERAPY

Astaxantin Astar-C Soft kapsul YARINDO
Curcuma Curcuma Tablet SOHO

Sylmarin, Curcuma Livapro SS Soft capsul NOVELL
Coenzym Q10, alpha lipoic acid, l-carnithin Q-ten com Tablet NOVELL
Ekstrak Daun Katuk Lactamor Kaplet KALBE
Echinacea, Zinc Picolinate, Selenium, Vit.c Imunos Kaplet LAPI

Imunos Syrup 60 ml LAPI
Imunos Plus Kaplet LAPI
Ekstrak Jambu Biji, elektrolit Trolit Sachet KALBE
Asam Amino, L carnitin, Vit B1, B6, B12, E, Selenium Minowell Sachet NOVELL
Sirplus Syrup 60 ml MEPRO

Pronis Syrup 60 ml MAHAKAM
L-ornitin L-Aspartat Hepa-Merz Injeksi COMBIPHAR

Hepa-Merz Sachet COMBIPHAR
Vit B1 50 mg, B2 25 mg, B6 10 mg, B12 5mcg, C 500mg, Becom C Tablet SANBE FARMA
nicotinamide 100mg, Ca pantotenat 20 mg
Ossein-hydroxypatite comp (OHC) Ossoral Tablet 200, 800 mg DEXA MEDICA
Ekstrak Ophiocephalus striatus 500 mg Vip Albumin Kapsul ROYAL MEDICALINK
EYE ANTI INFECTIVE & ANTISEPTICS

Tobramycin Tobro Minidose 0,6 ml CENDO
Bralifex Eye drops 5 ml SANBE
Chloramphenicol Colme Eye Drops INTERBAT
Gentamycin Gentamycin Eye oint CENDO
Oxytetracyclin Oxytetracyclin Eye Oint 5 g GENERIK
Levofloxacin LFX Minidose 0,6 ml CENDO

Cravit Eye drop 5 ml FERRON
EYE ANTISEPTICS WITH CORTICOSTEROID

Tobramycin, Dexamethason Tobroson Minidose 0,6 ml CENDO
Polymyxin, Neomycin, Dexamethason Polydex Minidose 0.6 ml CENDO
Polymixin B sulphate, Neomycin, Dexamethason Xitrol Minidose 0.6 ml CENDO

Xitrol Eye oint CENDO
Polymyxin, Neomycin, Tetrahydrozolin Statrol Minidose 0,6 ml CENDO
Betamethason Vosama Minidose 0,6 ml CENDO
MYDRIATIC DRUGS
Tropicamide Mydriatyl Minidose 0,6 ml CENDO
OPTHALMIC DECONGESTAN, ANESTHETICS, ANTI-INFLAMMATORIES

Tetracain Pantocain 0,5% Eye Drops 5 ml (5 mg / 5 ml) CENDO
Naphazoline Vasacon Minidose 0,6 ml CENDO
Naphazoline, Antazoline Vasacon A Minidose 0,6 ml CENDO
Vitamin A, Oxymetazolin Asthenof Minidose 0,6 ml CENDO
OPTHALMIC LUBRICANTS
Dextran, Hypromellosa Sanbe Tears Eye Drops 5 ml SANBE
HPMC, Dextran Eyefresh Minidose 0,6 ml CENDO
Sodium hyaluronate Hialid Minidose 0,6 ml FERRON
GLAUCOMA PREPARATION
Timolol 0,5 % Timol 0,5% Eye drops 5 ml (5mg/5ml) CENDO
EYE ANALGESIC NON CORTICOSTEROID

Na diklofenac Noncort Minidose 0,6 ml CENDO
OTHER EYE PREPARATIONS

Vit A, Aneurine, Calcium Panthothenat Repithel Eye Oint 5 g (10.000 IU, 0,5 mg, 5 mg) CENDO
Potassium Iodide, Sodium Iodide Vitrolenta Minidose 0,6 ml CENDO
Tear artifisial, Vitamin A Protagent A Minidose 0,6 ml CENDO

Lentikular Lentikular Minidose 0,6 ml CENDO
Acetazolamid Glauzeta Tablet 250 mg SANBE
Kalium Iodide, Natrium Tiosulfat Catarlent Minidose 0.6 ml CENDO
EAR ANTICEPTICS WITH CORTICOSTEROID

Polymixin, Neomycin, Fludrocortison, Lidocain Otopain Ear Drops 8 ml INTERBAT
OTHER EAR PREPARATION

Docusate Forumen Ear Drops 10 ml SANBE
MOUTH / THROAT PREPARATIONS

Hexetidine Hexadol Solution 60 ml (0.1%) OTTO
Minosep Solution 60 ml (0.1%) PROMED
Triamcinolon Ketricin Oint 5 g (0,1%) FERRON
Aloclair Plus Spray 15 ml KALBE
TOPICAL ANTIBIOTICS
Neomycin, Placenta extr Bioplacenton Gel 15 g (0,5%, 100 mg) KALBE
Silver Sulfadiazine Burnazin Cream 35 g (10 mg/ g) DARYA VARIA
Gentamicin Salticin Cream 5 g (0,1%) INTERBAT
Clindamycin Clinium Gel 15 g (1%) INTERBAT
Mupirocin Bactoderm Cream 5 g IKAPHARMINDO
TOPICAL ANTIFUNGAL ANTIPARASITES

Ketokonazol Ketokonazol Cream 5 g (2%) GENERIK
Miconazole Miconazole Cream 10 g (2%) GENERIK
Permethrin Scabimite Cream 10 g (5%) GALENIUM

Nystatin, ZnO Myco-Z Salep 10 g
TOPICAL ANTIVIRAL
Acyclovir Acyclovir Cream 5 g (5%) GENERIK
TOPICAL ANTI INFECTIVES WITH CORTICOSTEROID

Neomycin, Betametason Betason N Cream 5 g (0,5%, 0,1%) KIMIA FARMA
Gentamicin, Betametason Digenta Cream 5 g (0,1%, 0,05%) INTERBAT
TOPICAL CORTICOSTEROID
Hidrokortison Hidrokortison Cream 5 g (1%) GENERIK
Hidrokortison Cream 5 g (2,5%) GENERIK
Desoximethason Desoximethason Oint 10g (0,25%) GENERIK

Inerson Oint 15 g (0,25%) INTERBAT
Betamethasone Betason Cream 10 g (0,05%) KIMIA FARMA
Desonide Desolex Cream 10 g SDM
MEDICATED SURGICAL DRESSING

Framycetin Sofratulle Gauze dressing 10x10 SANOFI
Daryantulle Gauze dressing 10x10 DARYA VARIA
OTHER DERMATOLOGICALS
Radix scutellaria, Phellodendri cortex, Rhizoma captidis MEBO Oint 20 g DOXA MANGGALYA UTAMA
ANAESTHETICS, LOCAL & GENERAL

Ketamine KTM Injeksi 10 ml (100 mg / ml) GUARDIAN
Bupivacaine Regyvel Injeksi 5 mg / ml NOVELL
Propofol Nupovel Injeksi 50 ml ( 20 mg / ml ) NOVELL
Halothane Halothane Liquid 250 ml DEXA MEDICA
Lidocaine Lidocain Injeksi GENERIK

Xylocaine Spray Spray 50 ml (10%) ASTRAZENECA
Lidocaine, Adrenalin Pehacain Injeksi 2 ml (20 mg, 12,5 mcg) PHAPROS
ANTIHISTAMINE, ANTIALLERGICS & ANAFILAKSIS

Loratadine Loratadine Tablet 10 mg GENERIK
Cyproheptadine Heptasan Tablet 4 mg SANBE
Diphenhydramin Diphenhydramin Injeksi 10 mg / ml GENERIK
Cetirizine Cetirizine Tablet 10 mg GENERIK

Intrizin Syrup 60 ml (5 mg / 5 ml) INTERBAT
Intrizin Drop 12 ml (10 mg / ml) INTERBAT
Chlorfeniramin maleat CTM Tablet 4 mg GENERIK
Mebhydrolin Interhistin Tablet 50 mg INTERBAT
Betametason, Dexchlorpheniaramin maleat Ocuson Tablet (0,25 mg, 2 mg) SANBE
Epinefrin (Adrenalin) Epinefrin Injeksi 1 mg / ml GENERIK
INTRAVENOUS & OTHER STERILE SOLUTIONS / KOLOID SOLUTION

Human Albumin Octalbin Infusan 100 ml (25%) KALBE
Plasbumin Infusan 100 ml (20%) DIPA
Gelatin, NaCl, CaCl2 Gelafusin Infusan 500 ml BBRAUN

REKAP PENGGUNAAN (SATUAN)
1 JAN - 31 OKT 2018
5
PHARMASOLINDO-KF
40
3135
78
24
5253
60
90
PHARMASOLINDO - KF
PHARMASOLINDO - KF
60
DOXA MANGGALYA UTAMA
FORMULARIUM
TAHUN 2018
NO KELAS TERAPI (KOMPOSISI) NAMA OBAT BENTUK SEDIAAN, KEKUATAN REKAP PENGGUNAAN (SATUAN)
CATATAN
DAN KEMASAN 1 JAN - 31 OKT 2018



Pumpitor Injeksi 40 mg / 10 ml SANBE 5




Peptovell Syrup 120 ml ( 500 mg / 5 ml ) NOVELL 3







Tube (45 mg, 5 mg, 625 mg, 450 mg, 4465

mg)


Cetrimide



Vomceran Injeksi 4 mg / 2 ml KALBE 6








Concor Tablet 1,25 mg MERCK 40
Concor Tablet 2,5 mg MERCK 72










DIURETICS




VASOCONSTRICTORS




HAEMOSTATICS








HAEMORRHEOLOGICALS








Syrup (120 mg, 3,5 mg, 0,5 mg, 3,5 mg) / 5
Anadex INTERBAT
ml



Silex DARYA VARIA



NASAL DECOGESTANT

ANXIOLYTICS




HYPNOTICS, SEDATIF

ANTIPSYCHOTICS

ANTICONVULSANT



334
ANTIPARKINSON
Trihexyphenidil Arkine Tablet 2 mg PYRIDAM 795

ANTIVERTIGO

Mertigo Tablet 6 mg DEXA MEDICA 482

ANALGESICS (OPIOID)

43





Metampiron Antalgin Tablet 500 mg GENERIK 98



Diflam Tablet 50 mg INTERBAT 49



Keren Injeksi NULAB



10

Gabapentin Gabapentin Kapsul 300 mg GENERIK 343


ANTIMIGRAINE




MUSCLE RELAXANTS









AMINOGLYCOSIDES

CEPHALOSPORINS




PENICILLIN

Amoxsan Drop 15 ml (100 mg / ml) SANBE 30

OTHER BETA-LACTAM

CHLORAMPHENICOL

MACROLIDES


QUINOLONES








ANTIFUNGALS



ANTIVIRALS




URINARY ANTISEPTICS














VITAMIN E




Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20

mg)
Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20
mg)
9
Panthothenic acid
60
Folic acid Folac Tablet 400 mcg OTTO 90


S26 LBW Susu WYETH

ELECTROLYTES
ORAL RKCl KSR Tablet 600 mg MERCK



15








MYDRIATIC DRUGS









TOPICAL ANTIBIOTICS



TOPICAL ANTIVIRAL










US & OTHER STERILE SOLUTIONS / KOLOID SOLUTION

FORMULARIUM
TAHUN 2018

CATATAN
DAN KEMASAN














Tube (45 mg, 5 mg, 625 mg, 450 mg, 4465
mg)


Cetrimide



















DIURETICS




VASOCONSTRICTORS




HAEMOSTATICS







HAEMORRHEOLOGICALS








Syrup (120 mg, 3,5 mg, 0,5 mg, 3,5 mg) / 5
Anadex INTERBAT
ml



Silex DARYA VARIA




NASAL DECOGESTANT

ANXIOLYTICS




HYPNOTICS, SEDATIF

ANTIPSYCHOTICS

ANTICONVULSANT





ANTIPARKINSON

ANTIVERTIGO Hexymer Tablet 2 mg MERSI

ANALGE



ANALGE





NONSTEROIDAL ANTI-INFLAMMATORY DRUGS Mefinal Tablet 500 mg SANBE




Keren Injeksi NULAB




DRUG FEtiroxocib Etiroxocib Tablet 60 mg GENERIK


ANTIMIGRAINE Provelyn Kapsul 75 mg KALBE

NOOTROPICS, NEUROTONICS Unalium Tablet 5 mg GUARDIAN


HYPERURICEMIA, GOUT PREPARATIONS Lapibal Injeksi 500 mcg / ml LAPI

MUSCLE RELAXANTS Allopurinol Tablet 300 mg GENERIK

OTHER DRUGS ACTING ON MUSCULO-SKELETAL SYSTEM Myobat Tablet 50 mg INTERBAT

ESTROG
CORTI Progesteron Cygest Pessari Suppositoria (200 mg, 400 mg) ACTAVIS



TROPIC HORMON, RELATED SYNTHETIC DRUGS Trilac Injeksi 10 mg NOVELL
DEPOT Clomiphene citrate Fertin Tablet 50 mg INTERBAT

OTHERMedroxyprogesterone, Estradiol Cyclofem Injeksi (50 mg, 10 mg) / ml TUNGGAL IDAMAN

AMINOG

CEPHALOSPORINS Salticin Injeksi 80 mg / 2 ml INTERBAT





PENICI Cefoperazone, Sulbactam Cefoperazone, Sulbactam Injeksi (500 mg, 500 mg) GENERIK


OTHER BETA-LACTAM Meixam Injekasi 1 g MEIJI

CHLORAMPHENICOL Meropenem Injeksi 1 g GENERIK

MACROLIDES Thiamycin Kapsul 500 mg INTERBAT


QUINOLONES Zycin Kapsul 500mg INTERBAT


ANTIBADoxycycline Doxycyclin Kapsul 100 mg GENERIK

OTHER ANTIBIOTICS / ANTIAMOEBICS Sanprima Tablet (80 mg, 400 mg) SANBE


ANTIFUFosfomycin Fosmicyn Injeksi 2 g MEIJI



ANTIVIRALS Fluconazole Kapsul 150 mg GENERIK

PREPAR

URINARNystatin Nystatin Vaginal Tablet GENERIK
DRUG APipemidic acid Urinter Kapsul 400 mg INTERBAT



DRUG ACTING ON THE URINARY SYSTEM & PROSTAT MgSO4 Injeksi 40% OTSUKA
OTHERTamsulosin HCl Harnal OCAS Tablet 0,4 mg ASTRAZENECA
INSULI Essential Ketoacid Prorenal Tablet NOVELL

ANTIDI Insulin Glargine Lantus FlexPen 100 U/ml SANOFI






VITAMIN E Velacom Plus Tablet (2 mg, 500 mg) NOVELL
VITAMI Vitamin E Santa E Tablet 400 mg SANBE


CALCIUVitamin B1, B6, B12, Metampyron Neurosanbe Plus Tablet (50 mg, 100 mg, 100 mcg, 500 mg) SANBE
Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20

mg)
Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20
mg)
VITAMI Vit. D3 200 IU, Vit. K 25 mcg, Mg 100 mg, Zn 5 mg, Boron 1 mg
VITAMI Vit B6, B12, Folic acid, Vit E Cernevit Injeksi KALBE
Panthothenic acid
VITAMIN & MINERAL (PRE & POST NATAL) / ANTIANEMICS Elkana Syrup 60 ml SANBE


INFANT NUTRITIONAL PRODUCT Grafola DHA Kapsul METISKA

ENTERAL/NUTRITIONAL PRODUCT S26 LBW Susu WYETH

PARENTERAL NUTRITIONAL PRODUCT Pan Enteral Susu OTSUKA
ELECT Glucose, Nitrogen, Amino acid, BCAA Aminofluid Infusan 500 ml (75 g, 4,7 g, 30 g, 30%) OTSUKA

ORAL REHYDRATION
SUPPLENa, K, Cl, Citrat, Dextrose Pharolit Sachet PHAROS




EYE ANEkstrak Ophiocephalus striatus 500 mg Vip Albumin Kapsul ROYAL MEDICALINK


EYE ANTISEPTICS WITH CORTICOSTEROID Cravit Eye drop 5 ml FERRON

MYDRIABetamethason Vosama Minidose 0,6 ml CENDO
OPTHAL
OPTHAL
GLAUCSodium hyaluronate Hialid Minidose 0,6 ml FERRON
EYE ANTimolol 0,5 % Timol 0,5% Eye drops 5 ml (5mg/5ml) CENDO
OTHERNa diklofenac Noncort Minidose 0,6 ml CENDO

EAR ANKalium Iodide, Natrium Tiosulfat Catarlent Minidose 0.6 ml CENDO
OTHERPolymixin, Neomycin, Fludrocortison, Lidocain Otopain Ear Drops 8 ml INTERBAT
MOUTHDocusate Forumen Ear Drops 10 ml SANBE

TOPICAL ANTIBIOTICS Aloclair Plus Spray 15 ml KALBE
TOPICAMupirocin Bactoderm Cream 5 g IKAPHARMINDO

TOPICANystatin, ZnO Myco-Z Salep 10 g
TOPICAAcyclovir Acyclovir Cream 5 g (5%) GENERIK
TOPICAGentamicin, Betametason Digenta Cream 5 g (0,1%, 0,05%) INTERBAT


MEDICADesonide Desolex Cream 10 g SDM

OTHER DERMATOLOGICALS Daryantulle Gauze dressing 10x10 DARYA VARIA
ANAEST

ANTIHI Lidocaine, Adrenalin Pehacain Injeksi 2 ml (20 mg, 12,5 mcg) PHAPROS

& OTHER STERILE SOLUTIONS

Epinefrin (Adrenalin)
/ KOLOID SOLUTION Epinefrin Injeksi 1 mg / ml GENERIK


REKAP PENGGUNAAN (SATUAN)
1 JAN - 31 OKT 2018
46
5
514
210
59
10
19
6
15
220
4
4
465
FORMULARIUM
TAHUN 2018
NO KELAS TERAPI (KOMPOSISI) NAMA OBAT BENTUK SEDIAAN, KEKUATAN REKAP PENGGUNAAN (SATUAN)
CATATAN
DAN KEMASAN 1 JAN - 31 OKT 2018














Tube (45 mg, 5 mg, 625 mg, 450 mg, 4465

mg)


Cetrimide




















DIURETICS



VASOCONSTRICTORS


HAEMOSTATICS



Asam asetilsalisilat Aspilet Tablet 80 mg DARYA VARIA 55




HAEMORRHEOLOGICALS







Syrup (120 mg, 3,5 mg, 0,5 mg, 3,5 mg) / 5
Anadex INTERBAT
ml



Silex DARYA VARIA




NASAL DECOGESTANT
ANXIOLYTICS


HYPNOTICS, SEDATIF
ANTIPSYCHOTICS
ANTICONVULSANT


ANTIPARKINSON
ANTIVERTIGO
ANALGESICS (OPIOID)
1511








Voltaren Gel Gel 20 g NOVARTIS 105


Keren Injeksi NULAB


Ketorolac Ketorolac Injeksi 30 mg / ml GENERIK 37


Pregabalin Pregabalin Kapsul 75 mg GENERIK 8

ANTIMIGRAINE


MUSCLE RELAXANTS


Glucosamine Glucosamin Tablet 500 mg GENERIK 778



AMINOGLYCOSIDES
CEPHALOSPORINS




PENICILLIN


OTHER BETA-LACTAM
CHLORAMPHENICOL
MACROLIDES

QUINOLONES




ANTIFUNGALS


ANTIVIRALS


URINARY ANTISEPTICS












VITAMIN E




Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20

mg)
Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20
mg)
1853
20


Panthothenic acid



S26 LBW Susu WYETH

ELECTROLYTES

ORAL REHYDRATION










MYDRIATIC DRUGS







TOPICAL ANTIBIOTICS


TOPICAL ANTIVIRAL







FORMULARIUM
TAHUN 2018

CATATAN
DAN KEMASAN














Tube (45 mg, 5 mg, 625 mg, 450 mg, 4465

mg)

Lithospermi radix extr, Benzocaine, Dibucaine, Diphenhidramine, Cetrimide Borraginol N Suppositoria TAKEDA



















DIURETICS



VASOCONSTRICTORS


HAEMOSTATICS






HAEMORRHEOLOGICALS








Anadex Syrup (120 mg, 3,5 mg, 0,5 mg, 3,5 mg) / 5 ml INTERBAT



Guaifenesin, Extr Thyme, Extr Primulae, Extr Althaea, Extr Droseraea, Extr Syrup 100 ml (37,5 mg, 250 mg, 50 mg, 25
Silex DARYA VARIA
Serpylli, Eucalyptus oil, Anise oil mg, 175 mg, 0,5 mg, 1,25 mg) / 5 ml



NASAL DECOGESTANT
ANXIOLYTICS


HYPNOTICS, SEDATIF
ANTIPSYCHOTICS
ANTICONVULSANT



ANTIPARKINSON
ANTIVERTIGO

ANALGESICS (OPIOID)










Keren Injeksi NULAB





ANTIMIGRAINE


MUSCLE RELAXANTS





AMINOGLYCOSIDES
CEPHALOSPORINS




PENICILLIN


OTHER BETA-LACTAM
CHLORAMPHENICOL
MACROLIDES

QUINOLONES




ANTIFUNGALS


ANTIVIRALS


URINARY ANTISEPTICS










VITAMIN E




Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20

mg)
Tablet (200 mg, 100 mg, 25 mg, 100 IU, 20
mg)


Panthothenic acid



S26 LBW Susu WYETH

ELECTROLYTES
ORAL REHYDRATION









MYDRIATIC DRUGS







TOPICAL ANTIBIOTICS

TOPICAL ANTIVIRAL











REKAP
PENGGUNAAN
(SATUAN)
1 JAN - 31
OKT 2018
46
1275
240
316
112
124
9
18
4
3
93
108
9
38
53
9
89
13
6
15
42
243
15
195
1122
ACITRAL TABLET ALDISA SR KAPSUL ANADEX TABLET ANTRAIN TABLET
Row LabelsSum of JML Row LabelsSum of JML Row LabelsSum of JML Row Labels
dr. Dyah Re 1 dr. Ditya Ar 9 dr. Dyah Re 60 dr. Dyah Re
dr. Indra W 5 dr. Dyah Re 6 dr. Meddy 38 dr. Lucia Pu
dr. Retno P 30 dr. Faridat 66 Grand Tota 98 Grand Tota
dr. Wara Pe 46 Grand Tota 81
dr. Yasmine 10
Grand Tota 92
ANTRAIN TABLET ASPAR K TABLET ASPILET CHEWABLE TABLET ARDIUM TABLET
Sum of JML Row LabelsSum of JML Row LabelsSum of JML Row LabelsSum of JML
4 dr. Ditya Ar 3 dr. Bamban 55 dr. Agustin 70
98 dr. Meddy 195 dr. Ditya Ar 11 dr. Dyah Re 35
102 dr. Nugroh 22 dr. Dyah Re 746 Dr. Evi Di 60
dr. Yasmine 150 dr. Indra W 5253 dr. Nur Ais 28
Grand Tota 370 dr. Lucia Pu 1449 dr. Oriza I 5
dr. Meddy 9 dr. Retno P 20
dr. Retno P 248 Grand Tota 218
dr. Retno 14
dr. Retno P 44
dr. Wara Pe 6
Grand Tota 7835
ASTA PLUS ALAXAN FR ADALAT OROS 30 MGAZTERCON TAB 500
Sum of JML Row LabelsSum of JML Row LabelsSum of JML Row LabelsSum of JMRow Labels
dr. Dyah Re 28 Dr. Agung 44 dr. Indra W 78 dr. Agustin
Dr. Evi Di 6 dr. Dyah 10 Grand Tota 78 dr. Dyah Re
Grand Tota 34 dr. Dyah Re 1261 Grand Tota
Dr. Evi Di 125
dr. Nugroh 30
Dr. Nuki Ar 20
dr. Nur Ais 44
dr. Oriza I 10
dr. Rizki O 20
Grand Tota 1564
AZTERCON TAB 500 ANGINTRIZ MR TAB ASTAR-C TAB BECOM-C BEFIXIM (CEFIXIM) K CATAFLAM D 50 MG T
Sum of JMRow LabelsSum of JMRow LabelsSum of JMRow LabelsSum of JMRow LabelsSum of JMRow Labels
6 dr. Dyah Re 2 dr. Dyah Re 15 Dr. Agung 96 Dr. Agung 18
16 dr. Indra W 24 Dr. Evi Di 11 dr. Agustin 4 dr. Agustin 902 dr. Agustin
22 dr. Meddy 1 Grand Tota 26 dr. Ditya Ar 120 Dr. Astri U 12 dr. Dyah
Grand Tota 27 dr. Dyah 5 dr. Bamban 835 dr. Dyah Re
dr. Dyah Re 16 dr. Bamban 15 dr. Evi Di
Dr. Evi Di 5 dr. Dhanny 128 dr. Faridat
Dr. Nela 85 dr. Ditya Ar 2200 dr. Lucia Pu
dr. Nugroh 15 dr. Dyah 44 dr. Nugroh
dr. Nur Ais 96 dr. Dyah Re 2511 Dr. Nuki Ar
dr. Nur Ais 5 Dr. Evi Di 326 dr. Nur Ais
dr. Rizki O 10 dr. Faridat 670 dr. Oriza I
Dr. Romi 95 Dr. Icun Ar 2 dr. Retno P
Dr. Titis K 13 dr. Indra W 256 dr. Yasmine
Dr. Yeremi 14 dr. Irene L 16 drg. Dyah T
drg. Dyah 5 Dr. Nela 4 drg. Virma
Grand Tota 584 dr. Nugroh 610 Grand Tota
Dr. Nuki Ar 83
dr. Nur Ais 241
dr. Nur Ais 32
Dr. Nurhida 140
dr. Oriza I 101
Dr. Puji An 10
dr. Retno P 747
dr. Retno 115
dr. Retno P 205
dr. Rizki O 167
Dr. Romi 346
Dr. Teguh 8
Dr. Titis K 272
dr. Wara Pe 249
Dr. Yeremi 80
Grand Tota 11345
CATAFLAM D 50 MG TCELEBREX 100 MG TACOLISTINE 1.5 JUTA I CATAFLAM FAST SAC COBAZIM 1000 MG KCALOMA PLUS
6 dr. Agustin 10 dr. Agustin 34 dr. Agustin 353 dr. Nur Ais 3 dr. Retno P
26 dr. Bamban 120 dr. Ditya Ar 22 dr. Dyah 42 Grand Tota 3 dr. Retno
16 dr. Dyah 6 dr. Dyah Re 5 dr. Evi Di 139 dr. Retno P
10 dr. Dyah Re 32 Dr. Evi Di 1 Dr. Nuki Ar 2 Grand Tota
385 dr. Irene L 4 dr. Nur Ais 7 dr. Nur Ais 10
317 dr. Lucia Pu 10 Grand Tota 69 dr. Rizki O 3
49 Grand Tota 182 drg. Dyah T 30
10 drg. Dyah 38
10 Grand Tota 617
213
10
20
45
42
155
1314
CALOMA PLUS CEFILA 100 MG CAL-95 CALVIT-D TAB CONCOR TAB 2,5 MGCOXIRON TAB 60 MG
360 dr. Agustin 197 dr. Bamban 20 dr. Bamban 20 dr. Agustin 10 dr. Agustin
10 dr. Dyah Re 78 dr. Ditya Ar 12 dr. Nur Ais 10 dr. Dyah 10 dr. Dyah Re
95 Dr. Evi Di 37 dr. Dyah 15 dr. Retno P 1023 dr. Dyah Re 296 Dr. Evi Di
465 dr. Retno P 96 Grand Tota 47 dr. Retno 100 dr. Evi Di 10 Dr. Fathia
dr. Retno 20 dr. Retno P 105 dr. Indra W 3135 dr. Lucia Pu
dr. Retno P 20 Dr. Romi 10 dr. Lucia Pu 72 Grand Tota
dr. Wara Pe 220 Grand Tota 1268 dr. Meddy 93
Grand Tota 668 dr. Nur Ais 30
dr. Nur Ais 1
dr. Oriza I 13
Dr. Romi 4
dr. Wara Pe 6
Dr. Yeremi 11
Grand Tota 3691
COXIRON TAB 60 MG CONCOR TAB 1.25 M CARTYLO TAB 80 MG COTEN CAP 100MG CAVIPLEX KAP CHOLESTOR TAB 20
86 dr. Bamban 2 dr. Dyah 4 dr. Dyah Re 150 Dr. Agung 5 dr. Agustin
227 dr. Dyah 22 dr. Dyah Re 69 dr. Evi Di 34 dr. Dhanny 10 dr. Dyah Re
20 dr. Dyah Re 398 dr. Indra W 748 Grand Tota 184 dr. Dyah Re 11 Dr. Evi Di
2 dr. Indra W 1644 dr. Lucia Pu 154 Dr. Evi Di 5 Dr. Fathia
3 dr. Irene L 1 dr. Nur Ais 4 Dr. Nuki Ar 10 dr. Indra W
338 dr. Lucia Pu 40 dr. Retno P 20 dr. Nur Ais 250 dr. Lucia Pu
dr. Meddy 3 Grand Tota 999 dr. Nur Ais 10 dr. Meddy
Dr. Muham 1 dr. Retno P 2632 dr. Rizki O
dr. Nur Ais 10 dr. Retno 269 Grand Tota
dr. Wara Pe 4 dr. Retno P 421
Grand Tota 2125 dr. Rizki O 10
dr. Rogatus 5
Dr. Titis K 10
Dr. Yeremi 10
drg. Virma 127
Grand Tota 3785
CHOLESTOR TAB 20 DIAGIT TABLET DIFLAM 50 MG TABLEDISFLATYL TABLET DULCOLAX TABLET DORNER 20 MCG TAB
4 Dr. Agung 72 dr. Agustin 10 dr. Dhanny 6 dr. Agustin 10 dr. Dyah Re
87 dr. Agustin 451 Dr. Evi Di 46 dr. Dyah Re 1 dr. Dhanny 4 dr. Indra W
10 dr. Dhanny 180 dr. Faridat 283 dr. Meddy 46 Dr. Evi Di 15 Grand Tota
1 dr. Ditya Ar 111 Dr. Nuki Ar 4 dr. Nur Ais 168 dr. Indra W 1
529 dr. Dyah 446 dr. Nur Ais 74 Dr. Nurhida 10 Dr. Nuki Ar 6
110 dr. Dyah Re 377 dr. Oriza I 5 dr. Retno P 58 dr. Retno P 8
15 dr. Evi Di 322 Dr. Romi 5 dr. Retno P 5 dr. Retno 4
30 Dr. Fathia 3 dr. Yasmine 42 Grand Tota 294 Dr. Romi 11
786 Dr. Icun Ar 20 drg. Virma 40 Grand Tota 59
dr. Indra W 3 Grand Tota 509
dr. Irene L 34
dr. Lucia Pu 6
Dr. Muham 34
Dr. Nela 10
Dr. Nuki Ar 74
dr. Nur Ais 714
dr. Nur Ais 258
Dr. Nurhida 110
dr. Oriza I 399
Dr. Puji An 24
dr. Retno P 66
dr. Rizki O 294
Dr. Romi 45
Dr. Yeremi 75
Nurhidayat 10
Grand Tota 4138
DORNER 20 MCG TABDESTAVELL TAB DIABEMIN XR 500 M DEPAKOTE TAB 250 ERYSANBE 500 MG TAELKANA TABLET
30 dr. Agustin 100 dr. Dyah 120 dr. Lucia Pu 334 dr. Agustin 101 dr. Agustin
90 Grand Tota 100 dr. Dyah Re 60 Grand Tota 334 dr. Ditya Ar 30 dr. Bamban
120 Dr. Evi Di 10 Dr. Evi Di 12 dr. Dyah Re
dr. Nur Ais 10 dr. Nugroh 30 dr. Indra W
Grand Tota 200 Dr. Teguh 10 dr. Nur Ais
Grand Tota 183 dr. Retno P
dr. Retno
dr. Retno P
Dr. Yeremi
Grand Tota
ELKANA TABLET EYE BRIGHT TAB EPEXOL 30MG TAB ERYSANBE CHEW 200FARMASAL 100 MG TFARSORBID 10 MG TA
7 dr. Dyah Re 7 Dr. Agung 25 dr. Agustin 212 dr. Indra W 60 dr. Indra W
85 dr. Nur Ais 5 dr. Agustin 269 dr. Ditya Ar 84 43370 30 dr. Meddy
21 dr. Yasmine 232 dr. Dhanny 10 dr. Nugroh 68 43384 30 Grand Tota
60 Grand Tota 244 dr. Ditya Ar 2 Dr. Teguh 17 Grand Tota 60
10 dr. Dyah 10 Grand Tota 381
2121 Dr. Evi Di 18
130 dr. Faridat 6
200 Dr. Icun Ar 10
40 dr. Irene L 12
2674 Dr. Muham 10
Dr. Nela 4
Dr. Nuki Ar 95
dr. Nur Ais 711
dr. Nur Ais 389
Dr. Nurhida 432
dr. Oriza I 43
dr. Rizki O 389
Dr. Romi 96
Dr. Yeremi 40
Grand Tota 2571
FARSORBID 10 MG TAFERTIN TABLET FLAMAR 50 MG TABLET FOLAC 400 MCG TABLFOLAMIL GENIO KAP
Sum of JMRow LabelsSum of JMRow Labels Sum of JMRow LabelsSum of JMRow LabelsSum of JM
409 dr. Retno P 10 dr. Bambang W., MS. 105 dr. Bamban 4 dr. Dyah Re 33
12 dr. Retno 5 dr. Dhanny Prasetya 5 dr. Dyah Re 323 dr. Nur Ais 37
421 Grand Tota 15 dr. Ditya Arisanti, Sp.A 10 dr. Lucia Pu 60 dr. Retno P 2063
dr. Dyah Kusuma Rah 33 dr. Nur Ais 2 dr. Retno 150
Dr. Evi Diyah Ambarwa 10 dr. Retno P 145 dr. Retno P 187
dr. Faridatul Jannah, 160 dr. Retno P 30 Grand Tota 2470
Dr. Icun Aria 10 Grand Tota 564
dr. Nur Aisyah 216
dr. Oriza Ika Putra 20
Grand Total 569
FOLAVIT 400 MCG TAFARGOXIN TABLET FARSORBID 5 MG TABFARMADRAL TAB GERDILIUM 10 MG TA
Row LabelsSum of JMRow LabelsSum of JMRow LabelsSum of JMRow LabelsSum of JMRow LabelsSum of JM
dr. Dyah Re 92 dr. Dyah Re 18 dr. Dyah 1 1 dr. Agustin 50
Dr. Evi Di 200 dr. Indra W 30 dr. Dyah Re 92 dr. Ditya Ar 23 dr. Dhanny 10
dr. Lucia Pu 90 Grand Tota 48 dr. Indra W 158 dr. Dyah Re 317 dr. Dyah Re 10
dr. Nur Ais 70 dr. Nur Ais 13 dr. Indra W 33 Dr. Nuki Ar 10
dr. Nur Ais 10 Grand Tota 264 dr. Meddy 26 dr. Oriza I 40
dr. Retno P 340 Grand Tota 400 Dr. Puji An 20
dr. Retno P 10 Dr. Romi 40
dr. Rizki O 30 Grand Tota 180
Dr. Romi 60
Dr. Yeremi 10
Grand Tota 912
GLUCOPHAGE XR 500GLUCOVANCE 1,25 MGLUCOVANCE 2,5 MGGLUCOVANCE 5 MG TGRAFOLA-DHA
30 Dr. Evi Di 20 dr. Agustin 30 dr. Agustin 103 dr. Retno P 70
dr. Dyah 148 Grand Tota 20 Dr. Evi Di 65 dr. Nur Ais 70 Grand Tota 70
dr. Dyah Re 61 dr. Nur Ais 50 Grand Tota 173
dr. Nur Ais 38 dr. Rizki O 10
dr. Oriza I 16 Grand Tota 155
dr. Rizki O 36
Grand Tota 329
GABEXAL 100 MG TA GLAUCON TABLET GITAS PLUS TAB GASTRUL TABLET GCM KAPLET
dr. Agustin 157 dr. Yasmine 40 dr. Agustin 4 Dr. Evi Di 10 dr. Bamban 15
dr. Dyah Re 742 Grand Tota 40 dr. Dhanny 215 dr. Nur Ais 9 Grand Tota 15
dr. Evi Di 96 dr. Ditya Ar 6 dr. Retno P 32
dr. Indra W 25 Dr. Evi Di 110 dr. Retno 4
dr. Lucia Pu 343 Dr. Icun Ar 10 dr. Retno P 3
dr. Rizki O 10 Dr. Nuki Ar 6 Grand Tota 58
dr. Nur Ais 237
Dr. Nurhida 257
dr. Oriza I 20
dr. Rizki O 309
Dr. Romi 142
Nurhidayat 10
Grand Tota 2248
HARNAL OCAS TABLEHEPTASAN TABLET HERBESSER CD 100 MHI-BONE KAPLET HYSTOLAN TABLET
dr. Dyah Re 187 4 dr. Indra W 152 dr. Agustin 24 dr. Retno P 26
Dr. Evi Di 20 dr. Agustin 5 Grand Tota 152 dr. Bamban 1843 dr. Retno P 12
dr. Indra W 41 dr. Dhanny 4 dr. Bamban 10 Grand Tota 38
dr. Meddy 15 dr. Ditya Ar 3591 Dr. Evi Di 6
dr. Nur Ais 23 dr. Dyah 5 dr. Retno P 10
dr. Rizki O 10 Dr. Evi Di 3 Grand Tota 1893
Dr. Romi 4 dr. Nugroh 603
dr. Nur Ais 8
Dr. Nurhida 2
dr. Oriza I 16
dr. Rizki O 85
Dr. Yeremi 1
Grand Tota 5045
HEXYMER TAB 2 MG HERBESSER CD 200 MINBION KAPSUL INDEXON TABLET INTERHISTIN TABLET
dr. Dhanny 20 dr. Indra W 30 dr. Agustin 87 Dr. Agung 124 1
dr. Dyah 60 Grand Tota 30 Dr. Astri U 6 dr. Dhanny 185 dr. Agustin 1006
dr. Dyah Re 270 dr. Dhanny 10 dr. Ditya Ar 42 dr. Dhanny 580
Dr. Evi Di 10 dr. Dyah 5 dr. Dyah 179 dr. Ditya Ar 5
dr. Lucia Pu 795 dr. Dyah Re 262 Dr. Evi Di 14 dr. Dyah 36
dr. Nur Ais 67 Dr. Evi Di 51 Dr. Icun Ar 98 dr. Evi Di 1797
Grand Tota 1222 dr. Indra W 38 dr. Irene L 5 Dr. Icun Ar 12
Dr. Nuki Ar 36 dr. Meddy 3 dr. Irene L 2
dr. Nur Ais 20 Dr. Nela 30 Dr. Nuki Ar 139
Dr. Nurhida 6 Dr. Nuki Ar 30 dr. Nur Ais 515
dr. Oriza I 7 dr. Nur Ais 1294 dr. Nur Ais 40
dr. Retno P 2896 dr. Nur Ais 112 Dr. Nurhida 63
dr. Retno 219 Dr. Nurhida 89 dr. Rizki O 120
dr. Retno P 400 dr. Oriza I 346 Dr. Romi 15
dr. Rizki O 10 dr. Rizki O 2675 Dr. Yeremi 38
Dr. Romi 6 Dr. Romi 761 Grand Tota 4369
Dr. Yeremi 10 Dr. Teguh 18
Novi Lis Se 10 Dr. Yeremi 40
Grand Tota 4079 Dr. Zhafra 6
drg. Dyah T 80
drg. Dyah 150
drg. Virma 26
YAKUB 10
Grand Tota 6317
INTERMOXIL 500 MGINTERZINC 20 MG TAINVOMIT 4 MG TABLEIRVELL 150 MG TABLEIMUNOS TAB
Row LabelsSum of JMRow LabelsSum of JMRow LabelsSum of JMRow LabelsSum of JMRow Labels Sum of JM
Dr. Agung 80 dr. Agustin 29 dr. Dyah 4 dr. Meddy 108 Dr. Agung 5
dr. Bamban 6 dr. Ditya Ar 3 dr. Dyah Re 6 Grand Tota 108 dr. Agustini Raha 17
dr. Ditya Ar 4 Grand Tota 32 Dr. Evi Di 14 dr. Dhanny Prase 49
dr. Dyah 2 dr. Nur Ais 10 dr. Dyah Kusuma 2
dr. Dyah Re 15 dr. Retno P 58 Dr. Evi Diyah Amb 251
Dr. Evi Di 101 dr. Retno 30 dr. Faridatul Jann 10
Dr. Icun Ar 10 dr. Retno P 15 Dr. Icun Aria 5
dr. Irene L 9 Grand Tota 137 dr. Irene Lampita 12
dr. Lucia Pu 30 dr. Lucia Pujiastut 15
Dr. Muham 10 Dr. Muhammad Pr 2
Dr. Nuki Ar 30 Dr. Nela 20
dr. Nur Ais 236 Dr. Nuki Ariyana 47
dr. Nur Ais 20 dr. Nur Aisyah 764
Dr. Nurhida 36 dr. Nur Aisyah2 29
dr. Retno P 135 Dr. Nurhidayati Ag 12
dr. Retno P 30 dr. Oriza Ika Putra 364
dr. Rizki O 20 dr. Retno P., Sp. 126
Dr. Romi 30 dr. Retno Pudjast 6
Dr. Yeremi 8 dr. Retno Pudjiast 38
drg. Dyah T 210 dr. Rizki Okto Ku 60
drg. Dyah 175 Dr. Romi 10
drg. Virma 180 dr. Wara Pertiwi, S 4
Grand Tota 1377 drg. Dyah T. W. 4
Grand Total 1852
IMUNOS PLUS KAP IMURAN TAB 50 MG INCLOVIR 500MG TABINTERLAC TABLET KU INTERLAC SACHET
dr. Dhanny 384 dr. Dyah Re 7 dr. Ditya Ar 24 16 dr. Agustin 23
dr. Ditya Ar 6 Dr. Evi Di 25 dr. Dyah 2 dr. Agustin 413 Dr. Evi Di 10
dr. Dyah 6 Grand Tota 32 dr. Nugroh 71 dr. Ditya Ar 16 dr. Rizki O 19
Dr. Evi Di 46 dr. Nur Ais 15 dr. Dyah 4 Grand Tota 52
dr. Indra W 1 Grand Tota 112 dr. Evi Di 120
dr. Irene L 80 dr. Nur Ais 105
dr. Nur Ais 77 dr. Rizki O 80
dr. Retno P 40 Grand Tota 754
dr. Rizki O 414
Dr. Romi 8
dr. Wara Pe 465
Grand Tota 1527
IMOCARD TABLET KENDARON TABLET KSR TABLET
Row LabelsSum of JMRow LabelsSum of JMRow LabelsSum of JML
dr. Dyah 1 dr. Dhanny 10 4
dr. Dyah Re 5 dr. Dyah Re 8 dr. Agustin 30
dr. Indra W 358 dr. Indra W 595 dr. Ditya Ar 19
dr. Lucia Pu 2 dr. Lucia Pu 9 dr. Dyah 1
dr. Meddy 3 dr. Nur Ais 16 dr. Dyah Re 746
Dr. Muham 1 dr. Nur Ais 1 dr. Indra W 31
dr. Nur Ais 2 Grand Tota 639 dr. Lucia Pu 14
dr. Wara Pe 3 dr. Meddy 3
Grand Tota 375 dr. Nugroh 1
dr. Nur Ais 10
dr. Retno P 7
dr. Rizki O 7
dr. Wara Pe 2
dr. Yasmine 10
Grand Tota 885
LQ 500 MG LANCID KAP MINOWELL SACHET NOVERTY TABLET OMEVELL KAPSUL
DOKTER_ Sum - JML DOKTER_ Sum - JML DOKTER_ Sum - JML DOKTER_ Sum - JML DOKTER_ Sum - JML
dr. Dyah Re 10 dr. Dyah Re 1041 dr. Dyah Re 18 dr. Dyah Re 40 dr. Dyah Re 231
Total Resul 10 dr. Indra W 5 Total Resul 18 dr. Lucia Pu 482 dr. Meddy 1275
dr. Lucia Pu 1 dr. Meddy 53 Total Resul 1506
Total Resul 1047 Total Resul 575
OPICORT TAB 4 MG PROTEXIN PROVELYN 75 MG KAPATRAL TAB Q-TEN COM
dr. Ditya Ar 1576 dr. Ditya Ar 1035 dr. Bamban 8 dr. Bamban 1511 dr. Dyah Re 10
dr. Nugroh 22 dr. Nugroh 1095 dr. Dyah Re 114 dr. Ditya Ar 18 dr. Indra W 2
dr. Yasmine 5 Total Resul 2130 Total Resul 122 dr. Dyah Re 10 dr. Meddy 1122
Total Resul 1603 dr. Lucia Pu 43 Total Resul 1134
Total Resul 1582
ULTIMAX JOINT KAP VESTEIN 300 MG KAPVELACOM PLUS 1/25 VELACOM PLUS 2/50 VOMETRON TAB 4 M
dr. Bamban 778 dr. Ditya Ar 24 dr. Dyah Re 34 dr. Dyah Re 117 dr. Retno P 10
dr. Nugroh 18 dr. Dyah Re 190 dr. Indra W 3 dr. Indra W 1 dr. Retno P 10
dr. Retno P 32 dr. Indra W 3 dr. Meddy 42 dr. Meddy 243 Total Resul 20
Total Resul 828 dr. Wara Pe 15 Total Resul 79 Total Resul 361
Total Resul 232
EPISAN SYR 100 ML NORAGES SYR PEPTOVELL 100ML SYSPORETIK DRY SYR TEMPRA DROP
dr. Ditya Ar 1 dr. Agustin 73 dr. Ditya Ar 13 dr. Ditya Ar 10 dr. Nugroh 14
dr. Dyah Re 9 dr. Dyah 22 dr. Dyah Re 27 dr. Faridat 5 Total Resul 14
dr. Meddy 1 dr. Nur Ais 14 dr. Indra W 14 Total Resul 15
dr. Nugroh 12 Dr. Romi 1 dr. Lucia Pu 3
Total Resul 23 Total Resul 110 dr. Meddy 112
dr. Nugroh 15
dr. Retno P 2
dr. Retno 1
Total Resul 187
VOSEDON SYRUP VESTEIN SYRUP 60 MVOMETRON SYRUP FLADEX 0.5 G SUPP FLADEX 1 G SUPP
dr. Ditya Ar 4 dr. Ditya Ar 1 dr. Agustin 3 dr. Retno P 4 dr. Meddy 3
dr. Nugroh 15 dr. Dyah Re 25 Dr. Evi Di 2 Total Resul 4 dr. Retno P 157
Total Resul 19 dr. Lucia Pu 1 Dr. Nuki Ar 4 dr. Retno 3
dr. Wara Pe 6 dr. Nur Ais 2 dr. Retno P 8
Total Resul 33 dr. Nur Ais 3 Total Resul 171
dr. Oriza I 2
Total Resul 16
FLADYSTIN OVULA NEO GYNOXA OVULABIOCEF 1 G INJEKSI BIOXON 1 G INJEKSI CERNEVIT INJEKSI
dr. Retno P 175 dr. Retno P 93 dr. Ditya Ar 61 dr. Bamban 21 dr. Ditya Ar 4
dr. Retno 19 dr. Retno P 3 dr. Meddy 89 dr. Ditya Ar 56 dr. Dyah Re 107
dr. Retno P 9 Total Resul 96 dr. Retno P 27 dr. Nugroh 6 dr. Indra W 33
Total Resul 203 dr. Retno P 3 dr. Retno P 14 dr. Lucia Pu 9
Total Resul 180 Total Resul 97 dr. Meddy 15
dr. Nugroh 2
dr. Wara Pe 4
Total Resul 174
ESOLA INJ FOBET 1 GR INJEKSI LAPIXIME INJ 1 GR PEPZOL INJ 40 MG PUMPITOR INJ
dr. Dyah Re 1 dr. Ditya Ar 11 dr. Dyah 2 dr. Meddy 316 dr. Lucia Pu 5
Total Resul 1 dr. Meddy 13 dr. Nur Ais 2 Total Resul 316 Total Resul 5
Total Resul 24 dr. Nur Ais 4
Total Resul 8
RYCEF 1 G INJEKSI STARXON INJEKSI TAXEGRAM 500 MG IN
TORAMINE 30 MG INJTAXEGRAM 1 G INJ
dr. Ditya Ar 6 dr. Ditya Ar 22 dr. Ditya Ar 13 dr. Bamban 37 dr. Ditya Ar 32
dr. Nugroh 2 Total Resul 22 dr. Nugroh 22 dr. Dyah Re 2 dr. Nugroh 63
Total Resul 8 Total Resul 35 dr. Retno P 47 Total Resul 95
dr. Retno 5
dr. Retno P 5
dr. Rogatus 7
Dr. Titis K 2
Total Resul 105
TOPAZOL 40 MG INJ TERFACEF INJ VOMETRON INJ 4MGVOMETRON INJ 8MGVOMCERAN INJ 4MG/
dr. Dyah Re 181 dr. Ditya Ar 16 dr. Dyah Re 4 dr. Dyah Re 6 dr. Dyah Re 255
dr. Indra W 9 dr. Nugroh 4 dr. Meddy 9 dr. Indra W 3 dr. Indra W 1
dr. Meddy 230 dr. Retno P 31 Total Resul 13 dr. Meddy 124 dr. Lucia Pu 6
Total Resul 420 dr. Retno 6 Total Resul 133 dr. Meddy 18
Total Resul 57 dr. Retno P 7
Total Resul 287
VOMCERAN INJ 8MGLQ 750 INFUS LQ INFUS 500 MG
DOKTER_ Sum - JML DOKTER_ Sum - JML DOKTER_ Sum - JML
dr. Dyah Re 14 dr. Meddy 6 dr. Dyah Re 6
dr. Indra W 9 Total Resul 6 Total Resul 6
dr. Meddy 4
Total Resul 27

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FORMULARIUM

RUMAH SAKIT dr. ETTY ASHARTO

NO KELAS TERAPI (KOMPOSISI) NAMA OBAT BENTUK SEDIAAN, KEKUATAN

ANTASIDA, ANTIREFLUX AGENT, ANTIULCERANTS

Dimetilpolisiloksan (simeticon) Disflatyl Tablet 40 mg PHAROS

Ranitidin Ranitidin Tablet 150 mg GENERIK

Omeprazole Omeprazole Kapsul 20 mg GENERIK

Lansoprazole Lansoprazole Kapsul 30 mg GENERIK

Pantoprazole Pantoprazole Injeksi 40 mg / 10 ml GENERIK

Misoprostol Misoprostol Tablet 200 mcg GENERIK

Sucralfat Sucralfat Syrup 120 ml ( 500 mg / 5 ml ) GENERIK

Lactobacillus sporogenes Lacbon Tablet (Not < 50 million) KIMIA FARMA

Hyoscine N Butilbromide Hyoscine N Butilbromide Injeksi 20 mg / ml GENERIK

Hyoscine N Butilbromide, Paracetamol Gitas Plus Tablet 10 mg, 500 mg INTERBAT

Clidinium, Chlordiazepoxide Braxidin Tablet (2,5 mg, 5 mg) SANBE FARMA

Attapulgit, Pectin Diagit Tablet 600 mg, 50 mg INTERBAT

Loperamid Loperamide Tablet 2 mg GENERIK

Zinc Zinc Tablet 20 mg GENERIK

Bisacodyl Bisacodyl Tablet 5 mg GENERIK

Lactulose Lactulose Syrup 60 ml ( 3,335 g / 5 ml ) GENERIK

Ursodeoxycholic acid Ursodeoxycholic acid Kapsul 250 mg GENERIK

Diosmin, hesperidin Ardium Tablet 450 mg, 50 mg SERVIER

Lithospermi radix extr, Benzocaine, Dibucaine, Diphenhidramine,

Borraginol S Salep TAKEDA

Metoklopramide Metoklopramide Tablet 10 mg GENERIK

Domperidone Domperidone Tablet 10 mg GENERIK

Ondansetron Ondansetron Injeksi 4 mg / 2 ml GENERIK

Chlorpromazine Chlorpromazine Tablet 100 mg GENERIK

Dopamine Dopamin Giulini Injeksi 200 mg / 10 ml SOLVAY

Amiodarone Kendaron Tablet 200 mg DARYA VARIA

Digoxine Digoxin Tablet 0,25 mg GENERIK

Isosorbide dinitrat Isosorbid dinitrat Tablet 5 mg GENERIK

Isosorbid mononitrat Imocard Tablet 60 mg NOVELL

Glyceril trinitrat Nitrokaf Retard Kapsul 2,5 mg PHARMASOLINDO-KF

Nitroglyserin NTG Injeksi FERRON

Captopril Captopril Tablet 12,5 mg GENERIK

Ramipril Rampiril Tablet 5 mg GENERIK

Lisinopril Lisinopril Tablet 5 mg GENERIK

Propanolol Propanolol Tablet 10 mg GENERIK

Amlodipin Amlodipin Tablet 5 mg GENERIK

Nifedipin Nifedipin Tablet 10 mg GENERIK

Diltiazem Diltiazem Tablet 30 mg GENERIK

Nicardipine Nicardipin Injeksi 10 mg / 10 ml GENERIK

Irbesartan Irbesartan Tablet 150 mg GENERIK

Valsartan Valsartan Tablet 80 mg GENERIK

Candesartan Candesartan Tablet 8 mg GENERIK

Telmisartan Telmisartan Tablet 40 mg GENERIK

Trimetazidine HCL Angintriz MR Tablet 35 mg NOVELL

Furosemide Furosemide Tablet 40 mg GENERIK

Hydrochlorothiazide HCT Tablet 25 mg GENERIK

PERIPHERAL VASODILATOR, CEREBRAL ACTIVATORS

Citicoline Citicoline Injeksi 250 mg / 2 ml GENERIK

Gemfibrozil Gemfibrozil Kapsul 300 mg GENERIK

Fenofibrate Trolip Kapsul 100 mg DEXA MEDICA

Atorvastatin Atorvastatin Tablet 20 mg GENERIK

Asam tranexamat Asam Tranexamat Tablet 500 mg GENERIK

Phytonadione Neo K Injeksi 2 mg / ml COMBIPHAR

Menadione Vitamin K Injeksi 10 mg / ml GENERIK

ANTICOAGULANTS, ANTIPLATELET, FIBRINOLYTICS (TROMBOLYTICS)

Fondaparinux Na Arixtra Injeksi 2,5 mg / 0,5 ml SANOFI

Clopidogrel Clopidogrel Tablet 75 mg GENERIK

Enoxaparin Na Lovenox Injeksi 60 mg / 0,6 ml GLAXO

Beraprost Na Dorner Tablet 20 mcg ASTELLAS