HARGA

NO
NO KELAS BENTUK (ga di pake, NAMA
URUT NAMA GENERIK KEKUATAN KET
TERAPI SEDIIAN biar tau aja) DAGANG
OBAT
7. DISPEPSIA tablet kunyah 1,900/strip @10 antasida doen
1. antasida
suspensi 200 mg/mL 8.500/botol antasida doen
serbuk injeksi
3. esomeprazol 40 mg 42,000/ amp ezomeb Blm nemu EBM
(i.v.)
prosogan, lancid,
kapsul 30 mg 9,805/strip 30 kaps/ bulan
prazotec
4. lansoprazol
lansoprazole, 1-3 amp/hari
serbuk injeksi 30 mg 65,000/amp
prosogan maks 3 hari.
kapsul 20 mg 5,500/ strip Pumpitor, Ozid 30 kaps/ bulan
6. omeprazole 1-3 amp/hari
injeksi 40 mg 35,000/ampul Omeprazol, Ozid
maks 3 hari.
tablet 150 mg 2000/strip Acran 30 tab/bulan
8. ranitidin
injeksi 25 mg/mL 5000/ampul Acran injek 2 amp/hari
tablet 500 mg 9,100/strip Ulsidex 6o tab/ bulan
10. sukralfat Suklarfat, BLM nemu
suspensi 500 mg/5 mL 28,000/botol
Inpepsa EBM

FORMULARIUM RS TIPE C
 DAFTAR PUSTAKA

Keputusan Menteri Kesehatan Republik Indonesia Nomor Hk.01.07/Menkes/813/2019 Tentang Formularium Nasional, 1 (2019).

Bown, R. L. (2002). An overview of the pharmacology, efficacy, safety and cost-effectiveness of lansoprazole. International Journal
of Clinical Practice, 56(2), 132–139.

De Groot, N. L., Spiegel, B. M. R., Van Haalen, H. G. M., De Wit, N. J., Siersema, P. D., & Van Oijen, M. G. H. (2013).
Gastroprotective strategies in chronic NSAID users: A cost-effectiveness analysis comparing single-tablet formulations with
individual components. Value in Health, 16(5), 769–777. https://doi.org/10.1016/j.jval.2013.05.002

Vakil, N. (2008). Proton pump inhibitors for dyspepsia. Digestive Diseases, 26(3), 215–217. https://doi.org/10.1159/000121349

Van Marrewijk, C. J., Mujakovic, S., Fransen, G. A., Numans, M. E., de Wit, N. J., Muris, J. W., van Oijen, M. G., Jansen, J. B.,
Grobbee, D. E., Knottnerus, J. A., & Laheij, R. J. (2009). Effect and cost-effectiveness of step-up versus step-down treatment
with antacids, H2-receptor antagonists, and proton pump inhibitors in patients with new onset dyspepsia (DIAMOND study): a
primary-care-based randomised controlled trial. The Lancet, 373(9659), 215–225. https://doi.org/10.1016/S0140-6736(09)60070-
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