Professional Documents
Culture Documents
(FOPI)
2022
PT Pertamina Bina Medika – Indonesia Healthcare Corporation
(PERTAMEDIKA-IHC)
Jl. Kyai Maja No. 43, Kebayoran Baru
Jakarta Selatan 12120
Telp. +62 21 7219001
Fax. +62 21 7247006
www.pertamedika.co.id
SAMBUTAN
DIREKTUR UTAMA
PT PERTAMINA BINA MEDIKA IHC
Dengan diberlakukannya FOPI tahun 2022 ini per tanggal 1 Februari 2022 di lingkungan Rumah
Sakit dibawah pengelolaan Pertamedika IHC, diharapkan mendapatkan nilai tambah (value
creation) dari pengadaan obat sehingga tercapai pemerataan efisiensi dari pembiayaan obat
pada tahun berjalan serta manfaat dapat dinikmati secara bersama-sama baik oleh Rumah Sakit
maupun penjamin dari perusahaan-perusahaan dan asuransi yang telah bekerjasama dengan
PERTAMEDIKA IHC selaku holding RS BUMN.
Kami menyadari masih terdapat beberapa kekurangan pada buku formularium ini untuk itu
masukan serta saran dapat disampaikan melalui tim penyusunan formularium obat
PERTAMEDIKA IHC.
Semoga seluruh Rumah Sakit unit usaha Pertamedika IHC, RS Anak Perusahaan, RS KSO, dan
RS IHC Member di seluruh Indonesia menjadi Rumah Sakit yang unggul kualitas layanannya,
baik pada tingkat Nasional Maupun Global.
i
PERTAMEDIKA
PERTAMINA BINA MEDIKA cB- IHClndon•sla
Corporation
TENTANG PENETAPAN
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) TA HUN 2022
DIREKTUR UTAMA
PT PERTAMINA BINA MEDIKA IHC
ii
PERTAMEDIKA
PERTAMINA BINA MEDIKA
3.
a IHC
Akta Perubahan terakhir Anggaran Dasar PT Pertamina
lndonl'sia 1
Corporation
.art
iii
PERTAMEDIKA
PERTAMINA BINA MEDIKA cB- IHC lndonHia I
Corpor.ation
Ditetapkan di : Jakarta
Pada Tanggal: 30 Desember 2021
PT PERTAMINA BINA MEDIKA
Direktur Utama,
i2;
DR. dr. Fathema Djan Rachmat, Sp.B, Sp.BTKV (K), MPH;,.
iv
PERTAMEDIKA
PERTAMINA BINA MEDIKA
&_
er
IHC
� lndone5ia Healthcare
Corporation
SURAT PERINT AH
No.Print- CY+72 /A00000/2021-S0
TENTANG
TIM NEGOSIASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
PT PERTAMINA BINA MEDIKA IHC
DIREKTUR UTAMA
PT PERTAMINA BINA MEDIKA IHC
MEMER INTAHKAN
Kepada Para Pekerja yang namanya tercantum dalam Lampiran - I Surat Perintah
ini sebagai Tim Negosiasi Obat dan Bahan Medis Habis Pakai (BMHP)
Pertamedika IHC.
Untuk 1. Disamping melaksanakan tugas dan tanggung jawabnya sehari-hari
juga melaksanakan tugas sebagai Tim Negosiasi Obat dan Bahan
Medis Habis Pakai (BMHP) Pertamedika IHC dengan uraian tugas
sebagaimana tercantum dalam Lampiran - II Surat Perintah ini;
2. Melakukan koordinasi tentang BMHP termasuk HNA tahun
sebelumnya dengan unit-unit usaha dan AP Pertamedika IHC;
3. Melaporkan hasil pelaksanaan Surat Perintah ini kepada Direktur
Utama PT Pertamina Bina Medika IHC;
4. Semua biaya yang timbul sehubungan dengan pelaksanaan Surat
Perintah ini menjadi beban perusahaan;
5. Dalam melaksanakan perencanaan, pelaksanaan sampai dengan
pelaporan agar memperhatikan prinsip-prinsip good corporate
governance (GCG);
6. Surat Perintah ini agar dilaksanakan dengan penuh tanggung jawab.
Dengan diberlakukannya Surat Perintah ini, maka Surat Perintah Tim Formularium Obat dan
Bahan Medis Habis Pakai (BMHP) Pertamedika IHC sebelumnya menjadi tidak berlaku. Surat
Perintah ini berlaku sejak tanggal ditetapkan, dengan ketentuan hal-hal yang belum cukup
diatur dalam Surat Perintah ini segala sesuatunya akan tinjau kembali.
v
PERTAMEDIKA
PERTAMINA BINA MEDIKA &_
{T
IHC
� Indonesia Mealthcare
Corporation
-2-
Lampiran- I Surat Perintah
No Print : 0'.!.72 /A00000/2021-SO
Tanggal : 6 Oktober 2021
r· �11,
dr. FathemaOJan Rachmat, Sp.B, Sp.BTKV(K), MPH
I
Tembusan:
vi
PERTAMEDIKA
PERTAMINA BINA MEDIKA &_ IHC
�
� Indonesia Mealthcare
Corporation
-3-
Lampiran- II Surat Perintah
No Print : C/472 /A00000/2021-SO
Tanggal : 6 Oktober 2021
URAIAN TUGAS TIM NEGOSIASI OBAT DAN BAHAN MEDIS HABIS PAKAI (BMHP)
PT PERTAMINA BINA MEDIKA IHC
vii
PERTAMEDIKA
PERTAMINA BINA MEDIKA &_
CT
IHC
� Indonesia Healthcare
Corporation
-4-
4 Sekretaris 1. Bertanggung jawab terhadap pendataan perusahaan principle
dan distributor berdasarkan data yang pernah bekerjasama
dengan seluruh Unit Usaha Pertamedika IHC dalam 2 tahun
terakhir;
2. Membuat time-line dan mendiskusikan kepada ketua tim;
3. Mempersiapkan agenda rapat, kegiatan rapat, materi rapat/
materi negosiasi, membuat notula dan pendokumentasian
seluruh kegiatan rapat;
4. Melakukan komunikasi dengan seluruh Unit Usaha dan AP
Pertamedika IHC atas keputusan-keputusan rapat;
5. Membuat rekap seluruh penawaran yang masuk sehingga
menjadi data yang siap untuk menjadi bahan rapat keputusan/
penentuan pemilihan obat dan BMHP;
6. Menjaga kerahasiaan data terutama harga penawaran;
7. Mencatat principle yang tidak memenuhi kesepakatan sesuai
berita acara untuk disampaikan pada saat rapat;
8. Bersama Ketua dan Wakil Ketua Mencari solusi/ alternatif
pemecahan masalah yang ada di unit usaha dan AP
Pertamedika IHC kaitannya dengan principle dan distributor;
9. Memutakhirkan dan merekap serta menyiapkan data obat dan
BMHP yang masuk untuk kepentingan negosiasi;
10. Menginventarisasi penawaran obat dan BMHP dari principle/
distributor untuk dilakukan negosiasi;
11. Menangani surat masuk, surat keluar dan menginventarisir;
12. Melakukan pendokumentasian data;
13. Melakukan pemilahan email yang masuk dan memberikan
respon terhadap informasi internal/ eksternal kemudian diprint
out dan diserahkan ke ketua tim untuk ditindaklanjuti;
14. Melakukan inventarisasi seluruh email penawaran dari principle
yang masuk;
15. Bertanggung jawab terhadap distribusi informasi baik eksternal
(principle/ Distributor) dan internal (Unit Usaha);
16. Menentukan jam kerja yang disepakati untuk menerima tamu
eksternal (principle) yang diatur secara khusus sehingga setiap
komunikasi dengan principle menggunakan pencatatan yang
terdokumentasi dan tidak menimbulkan antrian dengan tetap
mengedepankan GCG ctan etiKa usaha
17. Melakukan komunikasi dengan pie, principle dan distributor
farmasi peserta negosiasi obat;
18. Memastikan undangan sampai ke principle dan distributor;
19. Mempersiapkan ruangan dan konsumsi untuk rapat (proyektor,
absensi, pengumpulan kartu nama principle dan distributor);
viii
PERTAMEDIKA
PERTAMINA BINA MEDIKA &_
a-
�
IHC Indonesia Healthcare
Corporation
SURAT PERINTAH
No.Print- 0+71 /A00000/2021-SO
TENTANG
TIM PENYUSUNAN FORMULARIUM OBAT PT PERTAMINA BINA MEDIKA IHC
DIREKTUR UTAMA
PT PERTAMINA BINA MEDIKA IHC
M E M E R I N T A HK A N
Kepada Para Pekerja yang namanya tercantum dalam Lampiran - I Surat Perintah
ini sebagai Tim Penyusunan Formularium Obat.
Untuk 1. Disamping melaksanakan tugas dan tanggung jawabnya sehari-hari
juga melaksanakan tugas sebagai Tim Penyusunan Formularium
Obat dengan uraian tugas sebagaimana tercantum dalam Lampiran
- II Surat Perintah ini;
2. Melakukan koordinasi tentang utilisasi obat dengan unit-unit usaha
dan anak perusahaan Pertamedika IHC;
3. Melaporkan hasil pelaksanaan Surat Perintah ini kepada Direktur
Utama PT Pertamina Bina Medika IHC;
4. Semua biaya yang timbul sehubungan dengan pelaksanaan Surat
Perintah ini menjadi beban perusahaan;
5. Dalam melaksanakan perencanaan, pelaksanaan sampai dengan
pelaporan agar memperhatikan prinsip-prinsip good corporate
governance (GCG);
6. Surat Perintah ini agar dilaksanakan dengan penuh tanggung jawab.
Dengan diberlakukannya Surat Perintah ini, maka Surat Perintah Tim Formularium Obat dan
Bahan Medis Habis Pakai (BMHP) Pertamedika IHC sebelumnya menjadi tidak berlaku. Surat
Perintah ini berlaku sejak tanggal ditetapkan, dengan ketentuan hal-hal yang belum cukup
diatur dalam Surat Perintah ini segala sesuatunya akan tinjau kembali.
lff-ttia\
r. dr. Fathema-Bfan Rachmat, Sp.B, Sp.BTKV(K), MPH/
;
ix
PERTAMEDIKA
PERTAMINA BINA MEDIKA &_
{T
IHC
� Indonesia Healthcare
Corporation
-2-
Lampiran- I Surat Perintah
No Print : fY.+72 /A00000/2021-SO
Tanggal : 6 Oktober 2021
�\�
;
•· dr. Fathema Djlm Rachmat, Sp.B, Sp.BTKV(K), MPH/
Tembusan:
x
PERTAMEDIKA
PERTAMINA BINA MEDIKA
c!l_ IHC
�
� Indonesia Healthcar<
Corporation
-3-
'
xi
PERTAMEDIKA
PERTAMINA BINA MEDIKA &_
CT
""J:l::J
IHC
Indonesia Healthcare
Corporation
-4-
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r. dr. Fathema '0jan Rachmat, Sp.B, Sp.BTKV(K), MPH
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xii
DAFTAR ISI
Sambutan Direktur Utama Pertamedika IHC ………………………………………………..……………………………..i
Keputusan Direktur Utama Penetapan FOPI 2022 ………………………………………………………………………ii
Surat Perintah Tim Negosiasi Harga Obat dan BMHP Pertamedika IHC ……………………………………..v
Surat Perintah Tim Penyusunan Obat Formularium Pertamedika IHC ………………………………………..vi
Daftar Isi …………………………………………………………………………………………………………………………………...x
Ketentuan Penggunaan FOPI 2022 ………………… ……………………………………………………………………….xiv
Kriteria Penilaian FOPI …………………………………………………………………………………………………………….xvi
Tata Cara Pemilihan Obat ……………………………………………………………………………………………………….xvii
Template Laporan Utilisasi Obat / BMHP ……………………………………………………………………………….xviii
Daftar Rumah Sakit Dibawah Pengelolaan Pertamedika IHC ………………….………………………………..xix
Daftar Klinik Dibawah Pengelolaan Pertamedika IHC ………………………………………………………………..xx
Indeks Generik ……………………………………………………………………………………………………………………….xxii
Indeks Farmakologik ………………………………………………………………………………………………………………xLii
Isi Formularium Obat Pertamedika IHC (FOPI) 2022 …………………………………………………………………..1
A. Gastrointestinal & Hepatobiliary System ………………………………………………………………………..1
B. Cardiovascular & Hematopoietic System ………………………………………………………………………..6
C. Respiratory System ………………………………………………………………………………………………………13
D. Central Nervous System ……………………………………………………………………………………………….16
E. Musculosceletal System ……………………………………………………………………………………………….25
F. Hormones ……………………………………………………………………………………………………………………26
G. Contraceptive Agents …………………………………………………………………………………………………..27
H. Anti Infective System ……………………………………………………………………………………………………28
I. Oncology ……………………………………………………………………………………………………………………..34
J. Genito Urinary System …………………………………………………………………………………………………38
K. Endocrine & Metabolic System …………………………………………………………………………………….39
L. Allergy & Immune System …………………………………………………………………………………………….42
M. Nutrition ………………………………………………………………………………………………………………………44
N. Eye ………………………………………………………………………………………………………………………………45
O. Ear ……………………………………………………………………………………………………………………………….46
P. Dermatologicals …………………………………………………………………………………………………………..47
Q. Anaesthetics & General ………………………………………………………………………………………………..49
R. Antidotes & Detoxifying Agents ……………………………………………………………………………………50
S. Intravenous & Other Sterile Solutions …………………………………………………………………………..50
T. Vitamins & Minerals …………………………………………………………………………………………………….52
U. Health Suplements & Food …………………………………………………………………………………………..55
V. Dermatological & Personal Care …………………………………………………………………………………..56
xiii
KETENTUAN PENGGUNAAN
FORMULARIUM OBAT PERTAMEDIKA – IHC (FOPI) TH 2022
xv
KRITERIA PENILAIAN FOPI 2022
Expert Judgement
NO KRITERIA KETERANGAN
Requirement
FAKTOR KUALITAS ZAT AKTIF
Membandingkan formularium dengan Fornas karena
Bio Availibility (Zat Aktif) Farmakologi Klinik
1 ditentukan tim yang kompeten
Bio Equivalent Apoteker
CPOB dan Uji Stabilitas dan Uji Kualitas
KETERSEDIAAN (AVAILABILITY)
2 Tingkat kepercayaan tinggi ditunjukkan dengan pilihan Farmakologi Klinik
Produksi Obat Per Tahun
terbanyak oleh dokter Procurement/Logistik
SERVICE
Terms Of Payment Farmakologi Klinik
3 Perjanjanjian Kerjasama dengan Distributor/Pedagang
Delivery Service Financial
Besar Farmasi
Supply Chain
HARGA JUAL
xvi
TATA CARA PEMILIHAN OBAT
TUJUAN
1 Menentukan OE : Kualitas yang terbaik dan harga terendah
2 Mengurangi duplikasi item yang terlalu banyak
TATA CARA
1 Melakukan filterisasi berdasarkan farmakologi (Kelas dan Sub Kelas) dan kandungan obat
2 Melakukan pengelompokkan berdasarkan urutan dosis dan sediaan
3 Mengidentifikasi urutan obat dari harga terendah
4 Melakukan pengecekan apakah obat tersebut ada dalam daftar Fornas ( zat aktif)
5 Melakukan pengecekan apakah obat tersebut ada dalam daftar E-katalog (perbandingan harga)
6 Melihat pertimbangan usulan quantity RKO
7 Obat dengan zat aktif yang belum tersedia akan dimasukkan dengan minimal usulan dari 5 RS
Untuk 1 zat aktif minimal ditentukan 2 item obat per dosis dengan komposisi Paten, Generik atau Me
8
too
9 Untuk obat yang tidak ada subtitusinya diambil seluruh ragam sediaan dosisnya
Memastikan kembali atas faktor utama lainnya sebagai dasar pertimbangan pemilihan : Ketersediaan
10 (Availability), Services (Terms Of Payment dan Delivery Services), serta dukungan Evidence Base
Medicine
TUJUAN
1 Menentukan OE : Kualitas yang terbaik dan harga terendah
2 Mengurangi duplikasi item yang terlalu banyak
TATA CARA
1 Melakukan filterisasi berdasarkan farmakologi (Kelas dan Sub Kelas) dan kandungan obat
2 Melakukan pengelompokkan berdasarkan urutan dosis dan sediaan
3 Mengidentifikasi urutan obat dari harga terendah
4 Melakukan pengecekan apakah obat tersebut ada dalam daftar Fornas ( zat aktif)
5 Melakukan pengecekan apakah obat tersebut ada dalam daftar E-katalog (perbandingan harga)
6 Melihat pertimbangan usulan quantity RKO
7 Obat dengan zat aktif yang belum tersedia akan dimasukkan dengan minimal usulan dari 5 RS
Untuk 1 zat aktif minimal ditentukan 2 item obat per dosis dengan komposisi Paten, Generik atau Me
8
too
9 Untuk obat yang tidak ada subtitusinya diambil seluruh ragam sediaan dosisnya
Memastikan kembali atas faktor utama lainnya sebagai dasar pertimbangan pemilihan : Ketersediaan
10 (Availability), Services (Terms Of Payment dan Delivery Services), serta dukungan Evidence Base
Medicine
xvii
Template Laporan Utilisasi Obat / BMHP
xviii
DAFTAR 75 FASKES UNIT USAHA, ANAK PERUSAHAAN, MEMBER IHC, RS KSO
No Nama Rumah Sakit Alamat Keterangan
1 RS Pusat Pertamina Jl. Kyai Maja No.43, Kebayoran Baru, Jakarta Selatan, DKI Jakarta 1212
2 RS Pertamina Jaya Jl. Jend. Ahmad Yani No.2 Cempaka Putih, Jakarta Pusat, DKI Jakarta 10510
3 RS Pertamina Balikpapan Jl. Jend Sudirman No.1, Balikpapan, Kalimantan Timur 76111
4 RS Pertamina Cirebon Jl. Patra Raya Klayan Cirebon No.1, Klayan, Kec. Gunungjati, Cirebon, Jawa Barat 45151
5 RS Pertamina Pangkalan Brandan JL Wahidin, No. 1, Pangkalan Brandan, Kabupaten Langkat, Sumatera Utara 20857
6 RS Pertamina Plaju Jl. Pengantingan No.1, Komperta, Kec. Plaju, Kota Palembang, Sumatera Selatan 30967
7 RS Pertamina Prabumulih Jl. Kesehatan Raya No.100, Muntang Tapus, Kota Prabumulih, Sumatera Selatan 31122
8 RS Pertamina Tarakan Jl. Mulawarman No.1, Karang Anyar Pantai, Kota Tarakan, Kalimantan Utara Unit Pertamedika
9 RS Pertamina Tanjung Jl. Gas Komperta, Murung Pudak, Kabupaten Tabalong, Kalimantan Selatan 71514
10 RS Pertamina Sorong Jl Ahmad Yani, Kota Sorong, Papua Barat. 98412
11 RS Pertamina Cilacap Kemiren, Tegalkamulyan, Kec. Cilacap Selatan, Kabupaten Cilacap, Jawa Tengah
12 RS Pertamina Balongan Jl. Bumi Patra Raya, Karanganyar, Kabupaten Indramayu, Jawa Barat 45213
13 RS Pertamina Dumai Bukit Datuk, Dumai Selatan, Kota Dumai, Riau 28826
14 RS Pertamina Rantau JL. Cepu, Kp. Pertamina, Rantau, Kabupaten Aceh Tamiang, Aceh 24476
15 Klinik Pertamedika IHC (Grup) JL. Sinabung II, No. 32 AF, Kebayoran Baru, Jakarta Selatan, DKI Jakarta 12120
16 RS Pelni Jl. Ks. Tubun No.92 - 94, Slipi, Jakarta Barat, DKI Jakarta 11410
17 RS Krakatau Medika Jl. Semang Raya No.1, Kota Cilegon, Banten 42434
18 RS Bakti Timah Pangkalpinang Jalan Bukit Baru No. 1, Pangkalpinang, Kabupaten Bangka, Kepulauan Bangka Belitung 33131
19 RS Medika Stania Sungailiat Sungai Liat, Kabupaten Bangka, Kepulauan Bangka Belitung 33215
20 RS Bakti Timah Muntok Sungai Baru, Mentok, Kabupaten Bangka Barat, Kepulauan Bangka Belitung 33351
21 RS Bakti Timah Karimun Jl. Canggai Putri, Tlk. Uma, Tebing, Kabupaten Karimun, Kepulauan Riau 29663
22 RS Pelabuhan Jakarta Jl. Kramat Jaya Raya No.1, Tugu Utara, Koja, Jakarta Utara, DKI Jakarta 14260
23 RS Pelabuhan Cirebon Jl. Sisingamangaraja No.45, Panjunan, Kota Cirebon, Jawa Barat 45112
24 RS Pelabuhan Palembang Jl. Mayor Memet Sastra Wirya No.1, Lawang Kidul, Kota Palembang, Sumatera Selatan
25 RS Port Medical Center Jl. Enggano No.10, RT.8/RW.16, Tj. Priok, Kota Jkt Utara, DKI Jakarta 14310 Anak Perusahan
26 RS PHC Surabaya Jl. Prapat Kurung Selatan No.1, Perak Utara, Kota Surabaya, Jawa Timur 60165 (AP) Pertamedika
27 RS Gatoel Jl. Raden Wijaya No.56, Mergelo, Kec. Prajurit Kulon, Kota Mojokerto, Jawa Timur 61321 IHC
28 RS Toeloengredjo Jl. A.Yani Timur No.25, Pare, Kec. Pare, Kediri, Jawa Timur 64212
29 RS Perkebunan Jember Klinik Jl. Bedadung No.2, Kp. Using, Jemberlor, Kec. Patrang, Kab Jember, Jawa Timur 68118
30 RS Medika Utama Jl. Kusuma Bangsa No.1, Kanigoro, Kec. Kanigoro, Blitar, Jawa Timur 66171
31 RS Lavalette Jl. W.R. Supratman No.10, Kec. Klojen, Kota Malang, Jawa Timur 65111
32 RS Wonolangan Jl. Raya Dringu No.115, Karangdalem, Kec. Dringu, Probolinggo, Jawa Timur 67216
33 RS Djatiroto Jl. PB Sudirman No. 81, Jatiroto, Kabupaten Lumajang, Jawa Timur 67355
34 RS Elizabeth Jl. WR. Supratman No.2, Mulyautama, Kabupaten Situbondo, Jawa Timur 68312
35 RS Kaliwates Jl. Diah Pitaloka No.1, Kaliwates Kidul, Kec. Kaliwates, Kabupaten Jember, Jawa Timur 68131
36 RS Bhakti Husada Dusun Gn. Krikil, Tegalharjo, Kec. Glenmore, Kabupaten Banyuwangi, Jawa Timur 68466
37 RS Universitas Indonesia Jl Prof Bahder Djohan, Kampus UI, Kota Depok, Jawa Barat 16424
38 RS Bintang Amin Jl. Pramuka No.27, Kemiling Permai, Kota Bandar Lampung, Lampung 35151 Kerjasama
39 RS Baiturrahim Jl. Prof. DR. Moh. Yamin No.30, Lb. Bandung, Kec. Jelutung, Kota Jambi, Jambi 36124 Operasional (KSO)
40 RS Umi Rosnati Jl. Sekolah No. 5 Gampoeng, Ateuk Pahlawan, Kec. Baiturrahman, Kota Banda Aceh, Aceh 23241 Pertamedika IHC
41 RSU Pekerja Jl. Tipar Cakung No.46, Sukapura, Kec. Cilincing, Jakarta Utara, DKI Jakarta 14140
42 RS Prima Husada Cipta Medan Jl Stasiun No.92, Belawan, Kota Medan, Sumatera Utara 20411
43 RS Cut Meutia Jl. Kebun Baru, Paya Bujok Seuleumak, Langsa Baro, Kota Langsa, Aceh 24375
44 RS dr. G.L Tobing Tj. Morawa, Kabupaten Deli Serdang, Sumatera Utara 20362
45 RS Bangkatan Jl. Sultan Hasanuddin No.40, Rambung Bar., Binjai Sel., Kota Binjai, Sumatera Utara 20714
46 RS Tanjung Selamat Tebing Tj. Selamat, Padang Tualang, Kabupaten Langkat, Sumatera Utara 20811
47 RS Sri Pamela Jl Jend. Sudirman, Sri Padang, Kec. Tebing Tinggi, Kota Tebing Tinggi, Sumatera Utara 20998
48 RS Sei Dadap Jl. Lintas Sumatera dusun II, Desa, Sei Dadap, Kabupaten Asahan, Sumatera Utara 21226
Jl. Lintas Sumatera, Beringin Jaya, Kec. Torgamba, Kab. Labuhan Batu Selatan, Sumatera Utara
49 RS Sri Torgamba
21464
50 RS Pabatu Kedai Damar, Kec. Tebing Tinggi, Kabupaten Serdang Bedagai, Sumatera Utara 20998
51 RS Laras Jl. Besar Bahapal, Laras, Kabupaten Simalungun, Sumatera Utara 21155
52 RS Balimbingan Balimbingan, Tanah Jawa, Kabupaten Simalungun, Sumatera Utara 21181
53 RS Tandun Talang Danto, Kec. Tapung Hulu, Kabupaten Kampar, Riau 28554
54 RS PTPN VIII Subang Jl. Otto Iskandardinata No.1, Karanganyar, Kabupaten Subang, Jawa Barat 41211
55 RS Parindu Binjai, Tayan Hulu, Kabupaten Sanggau, Kalimantan Barat 78562
56 RS Danau Salak Jl. A. Yani, Desa No.Km. 57,8, Bawahan Selan, Banjar, Kalimantan Selatan 70672
57 RS Pindad Medika Utama Jl. Gatot Subroto No.517, Sukapura, Kec. Kiaracondong, Kota Bandung, Jawa Barat 40285
58 RS Pindad Turen Jl. Semeru No.1, Turen, Kec. Turen, Malang, Jawa Timur 65175 Member
59 RS Bukit Asam Medika Jl. Raya Bukit Asam, Tj. Enim, Kabupaten Muara Enim, Sumatera Selatan 31716 Pertamedika IHC
60 RS LNG Badak Komplek PT Badak NGL, Satimpo, Bontang Sel., Kota Bontang, Kalimantan Timur 75325
61 RS Semen Gresik Jl RA Kartini No 280 Kec. Gresik, Kabupaten Gresik, Jawa Timur 61122
62 RS Semen Padang Jl. By Pass No.Km, RW.7, Pisang, Kec. Pauh, Kota Padang, Sumatera Barat 25161
63 RS Antam Medika Jl. Pemuda No.1A, Jatinegara Kaum, Kec. Pulo Gadung, Jakarta Timur, DKI Jakarta 13210
64 RSI Garam Jl Raya Kalianget No.10, Kalianget Timur, Kabupaten Sumenep, Jawa Timur 69471
65 RS Petrokimia Gresik Jl Padi No 3 Perumahan PT.Petrokimia Gresik, Kabupaten Gresik, Jawa Timur 61119
66 RS Graha Husada Komplek Perum PT Petrokimia Gresik, Jl Padi No.3, Kabupaten Gresik, Jawa Timur 61118
67 RS Petrokimia Driyorejo Gresik Jl. Raya Legundi KM.0,5, Krikilan, Kec. Driyorejo, Kabupaten Gresik, Jawa Timur 61177
68 RS PKT Bontang Jl. Oxigen No.01, Guntung, Bontang Utara, Kota Bontang, Kalimantan Timur 75313
69 RS Prima Sangatta Jl. Yos Sudarso I No.01, Sangatta Utara, Kabupaten Kutai Timur, Kalimantan Timur 75683
70 RS Medika Utama Permata Jl. Imam Bonjol No.1, Klandasan Ulu, Balikpapan Kota, Kota Balikpapan, Kalimantan Timur 76112
71 RS Medika Utama Manggar Jl. Mulawarman No.24, Manggar Baru, Balikpapan, Kalimantan Timur 76116
72 RS Pusri Palembang Komp. PT PUSRI, Jl. May Zen, Kota Palembang, Sumatera Selatan 30118
73 RS Haji Jakarta Jl. Raya Pondok Gede No 4 Kel Pinang Ranti, Kec Makasar, Jakarta Timur DKI Jakarta
74 RS Prima Inti Medika Komplek PT Pupuk Iskandar Muda Jl Singgalang No 1 Kreung Geukuh, Aceh Utara, Aceh
Jl. Jend. Sudirman No 134 Kel Tangkerang Tengah , Kec Marpoyan Damai, Kota Pekan Baru,
75 RS Syafira
Provinsi Riau 28282
xix
DAFTAR KLINIK DIBAWAH PENGELOLAAN PERTAMEDIKA IHC
No Nama Rumah Sakit/Klinik No Nama Rumah Sakit/Klinik
1 Klinik PERTAMEDIKA IHC Bogor 41 Klinik Cut Meutia
2 Klinik PERTAMEDIKA IHC Bekasi 42 Klinik Cut Meutia Cot Girek
3 Klinik PERTAMEDIKA IHC Cinere 43 Klinik Cut Meutia II
4 Klinik PERTAMEDIKA IHC Deli 44 Klinik Esme Jember
5 Klinik PERTAMEDIKA IHC Depok 45 Klinik Esme Mojokerto
6 Klinik PERTAMEDIKA IHC Jatiwaringin 46 Klinik Esme Pare
7 Klinik PERTAMEDIKA IHC Medan Satria 47 KLINIK GUNUNG MELIAU
8 Klinik PERTAMEDIKA IHC Patra Jasa 48 Klinik JICT
9 Klinik PERTAMEDIKA IHC Pondok Ranji 49 Klinik Kebun Ajamu
10 Klinik PERTAMEDIKA IHC Rawamangun 50 Klinik Krakatau Medika Cilegon
11 Klinik PERTAMEDIKA IHC Sinabung 51 Klinik Krakatau Medika Pandeglang
12 Klinik PERTAMEDIKA IHC Yos Sudarso 52 Klinik Krakatau Medika Serang
13 Klinik UKK Kantor Pusat Pertamina 53 Klinik Laras
14 Klinik UKK Oil Centre 54 KLINIK LAWA BARU
15 Klinik UKK Pertamina Corporate University 55 Klinik Medika Meta Utama
16 Klinik UKK Pertamina International EP 56 Klinik Medika Stannia Belinyu
17 Klinik UKK PGN Manhattan 57 Klinik Medika Utama
18 Klinik UKK PHE 58 Klinik Modern Dasa Medika
19 Klinik UKK Pratama PGN 59 Klinik Onsite PT.MTU
20 Klinik UKK SOPODEL TOWER 60 klinik pasir junghuhn
21 Klinik Universitas Pertamina 61 Klinik PHC Banjarmasin
22 Klinik Pertamedika Klandasan 62 Klinik PHC Benowo
23 Klinik Pertamedika Panorama 63 Klinik PHC Kebraon
24 Klinik Pendopo 64 Klinik PHC Pedurungan
25 Klinik Kenten 65 Klinik PHC Tanjung Emas Semarang
26 Klinik Pelabuhan Banten 66 Klinik PHC Tanjung Perak
27 Klinik Pelabuhan Bengkulu 67 Klinik PPK I PT PETROKIMIA GRESIK
28 Klinik Pelabuhan Cirebon 68 Klinik PPK I PT Petrokimia Gresik
29 Klinik Pelabuhan Jambi 69 Klinik Pratama Aek Torop
30 Klinik Pelabuhan Palembang 70 Klinik Pratama Bakti Timah Jakarta
31 Klinik Pelabuhan Panjang 71 Klinik Pratama Bakti Timah Manggar
32 72 Klinik Pratama Bakti Timah Pangkal
Klinik Pelabuhan Pontianak Balam
33 73 Klinik Pratama Bakti Timah
Klinik Pelabuhan Tanjung Priok Pangkalpinang
34 Klinik Pelabuhan Teluk Bayur 74 Klinik Pratama Bakti Timah Prayun
35 75 Klinik Rawat Inap Rolas Medika
Klinik Perkebunan Kalikempit Banjarsari
36 Klinik Permata 76 Klinik Rolas Medika
37 Klinik Cakra Husada 77 Klinik Pratama Batang Toru
38 Klinik Bakti Timah Parit Tiga 78 Klinik Pratama Bukit Asam
39 Klinik Bakti Timah Tanjung Pandan 79 Klinik Pratama Bukit Asam Medika
40 Klinik Bakti Timah Toboali 80 Klinik Pratama Emplasment Lubuk Dalam
xx
DAFTAR KLINIK DIBAWAH PENGELOLAAN PERTAMEDIKA IHC
No Nama Rumah Sakit/Klinik No Nama Rumah Sakit/Klinik
81 Klinik Pratama Emplasment Sei Galuh 120 Klinik Pratama TPK - Koja
82 Klinik Pratama Emplasment Sei Lindai 121 Klinik Prima Inti Medika
83 Klinik Pratama Emplasment Terantam 122 Klinik Prima Medica Nusantara
84 Klinik Pratama Gunung Pamela 123 Klinik Prima Pabatu
85 Klinik Pratama Kandir Medan 124 Klinik PT Cheil Jedang Indonesia
86 125 Klinik PT Multi Bintang Indonesia
Klinik Pratama Krakatau Sampangagung Plant
87 Klinik Pratama l RS LNG Badak 126 Klinik PT Nestlé Indonesia - Gempol DC
88 Klinik Pratama NSM Argosari 127 Klinik Puskesbun Adolina
89 Klinik Pratama NSM Jatiroto 128 Klinik Puskesbun Bahjambih
90 Klinik Pratama NSM Mahakam 129 Klinik Puskesbun Mayang
91 Klinik Pratama Nusa Medika Ajong 130 Klinik Puskesbun Sidamanik
92 Klinik Pratama Nusa Medika Arjasa 131 Klinik Satelit 1 RS PKT
93 Klinik Pratama Nusa Medika Bondoyudo 132 Klinik Satelit 2 RS PKT Bengalon
94 Klinik Pratama Nusa Medika Djombang 133
Baru Klinik Satelit 3 RS PKT
95 Klinik Pratama Nusa Medika Gempolkrep 134 Klinik Satelit Kalimantan
96 Klinik Pratama Nusa Medika HVA 135 Klinik Sehat Pupuk Kaltim
97 Klinik Pratama Nusa Medika Kebun Klaten 136 Klinik SG GKB Gresik
98 Klinik Pratama Nusa Medika Kremboong 137 Klinik SG Pabrik Rembang
99 Klinik Pratama Nusa Medika Lestari 138 Klinik SG Pabrik Tuban
100 Klinik Pratama Nusa Medika Meritjan 139 Klinik SG Pramuka Tuban
101 Klinik Pratama Nusa Medika 140
Modjopanggung Klinik SG Tubanan Gresik
102 Klinik Pratama Nusa Medika Ngadiredjo 141 Klinik SG Veteran Gresik
103 Klinik Pratama Nusa Medika Pesantren 142
Baru Klinik Tinjowan
104 Klinik Pratama Nusa Medika Puri 143 Klinik Utama Nusa Lima
105 Klinik Pratama Nusa Medika Tjoekir 144 Klinik Utama SG Bogorejo Tuban
106 Klinik Pratama Nusa Medika Watoetoelis 145 Klinik Wringinanom
107 Klinik Pratama Nusantara 146 Poliklinik PTPN IV Kebun Timur
108 Klinik Pratama Pelabuhan Jakarta 147 PTPN IV Sosa
109 Klinik Pratama Pindad 148 Puskesbun PTPN IV BP Mandoge
110 Klinik Pratama Rambutan 149 Puskesbun PTPN IV Langkat
111 Klinik Pratama Rantau Prapat 150 Klinik Melati
112 Klinik Pratama Sebelas Medika Probolinggo 151 BPS Polikbun Berangir
113 Klinik Pratama Sebelas Medika Situbondo 152 BPS Polikbun Berangir
114 Klinik Pratama Sei Baruhur 153 Dokkel Kantor Pusat PTPN X
115 Klinik Pratama Sei Dadap 154 DPP dr Bayu Chandra
116 Klinik Pratama Sei Karang 155 DPP dr Mohammad Najib Abdullah
117 Klinik Pratama Sei Mangkei 156 DPP drg Riskyana Dwi Hendra AR
118 Klinik Pratama Sei Silau 157 FKTP Rawat Inap Aek Nabara
119 Klinik Pratama Sri Rokan 158 FKTP Rawat Inap Membang Muda
xxi
INDEKS GENERIK
xxii
INDEKS GENERIK
xxiii
INDEKS GENERIK
xxiv
INDEKS GENERIK
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INDEKS GENERIK
xxvi
INDEKS GENERIK
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INDEKS GENERIK
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INDEKS GENERIK
xxix
INDEKS GENERIK
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INDEKS GENERIK
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INDEKS GENERIK
xxxii
INDEKS GENERIK
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INDEKS GENERIK
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INDEKS GENERIK
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INDEKS GENERIK
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INDEKS GENERIK
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INDEKS GENERIK
xl
INDEKS GENERIK
xli
INDEKS FARMAKOLOGI
KELAS SUB KELAS HAL
01 GASTROINTESTINAL & HEPATOBILIARY SYSTEM
01a. ANTACIDS, ANTIREFLUX AGENTS & ANTIULCERANTS 1
01b. GIT REGULATORS, ANTIFLATULENTS & ANTI-INFLAMMATORIES 2
01c. ANTISPASMODICS 3
01d. ANTIDIARRHEALS 3
01e. LAXATIVES, PURGATIVES 3
01f. DIGESTIVES 4
01g. CHOLAGOGUES, CHOLELITHOLYTICS & HEPATIC PROTECTORS 4
01h. ANORECTAL PREPARATIONS 4
01i. ANTIEMETICS 5
02 CARDIOVASCULAR & HAEMATOPOIETIC SYSTEM
02a. CARDIAC DRUGS 6
02b. ANTI-ANGINAL DRUGS 6
02c. ACE INHIBITORS 7
02d. BETA-BLOCKERS 7
02e. CALCIUM ANTAGONISTS 8
02f. ANGIOTENSIN II ANTAGONISTS 8
02h. DIURETICS. 9
02i. ANTIDIURETICS. 10
02j. PERIPHERAL VASODILATORS & CEREBRAL ACTIVATORS 10
02k. VASOCONSTRICTORS 10
02l. DYSLIPIDEMIC AGENTS 10
02m. HAEMOSTATICS 11
02n. ANTICOAGULANTS, ANTIPLATELETS & FIBRINOLYTICS
(THROMBOLYTICS) 12
02r. HAEMOTOPOIETICS AGENTS 13
02S. OTHER CARDIOVASCULAR DRUGS 13
03 RESPIRATORY SYSTEM
03b. ANTIASTHMATICS & COLD PREPARATIONS 13
03c. COUGH & COLD PREPARATIONS 14
03d. NASAL DECONGESTANT & OTHER NASAL PREPARATIONS 16
03e. OTHER DRUGS ACTING ON THE RESPIRATORY SYSTEM 16
04 CENTRAL NERVOUS SYSTEM
04a. ANXIOLYTICS 16
04b. HYPNOTICS & SEDATIVES 17
04c. ANTIDEPRESSANTS 17
04d. ANTIPSYCHOTICS 18
04e. ANTICONVULSANTS 19
04f. OTHER CNS DRUGS & AGENTS FOR ADHD 20
04g. NEURODEGENERATIVE DISEASE DRUGS 20
04h. ANTIPARKINSONIAN DRUGS 20
04i. ANTIVERTIGO DRUGS 20
04j. ANALGESICS (OPIOID) 20
04k. ANALGESICS (NON-OPIOID) & ANTIPYRETICS 21
04l. NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS) 22
04m. DRUGS FOR NEUROPATHIC PAIN 24
04n. ANTIMIGRAINE PREPARATIONS 24
04p. NOOTROPICS & NEUROTONICS 24
xlii
INDEKS FARMAKOLOGI
KELAS SUB KELAS HAL
05 MUSCULO-SKELETAL SYSTEM
05b. HYPERURICEMIA & GOUT PREPARATIONS 25
05c. MUSCLE RELAXANTS 25
05e. NEUROMUSCULAR DISORDER DRUGS 25
05f. OTHER DRUGS ACTING ON THE MUSCULO-SKELETAL SYSTEM 25
06 HORMONES
06a. ANDROGENTS & RELATED SYNTHETIC DRUGS 26
06b. ESTROGEN, PROGESTERON & PREPARAT SINTETIKNYA 26
06d. CORTICOSTEROID HORMONES 26
06e. TROPHIC HORMONES & RELATED SYNTHETICS DRUGS 27
07 CONTRACEPTIVE AGENTS
07a. ORAL CONTRACEPTIVES 27
07b. DEPOT CONTRACEPTIVES 27
07c. OTHER CONTRACEPTIVES 27
08 ANTI-INFECTIVES SYSTEMIC
08a. AMINOGLYCOSIDES 28
08b. CEPHALOSPORINS 28
08c. PENISILIN 29
08d. OTHER BETA-LACTAMS 30
08e. CHLORAMPHENICOLS 30
08f. MACROLIDES 30
08g. QUINOLONES 31
08h. TETRACYCLINS 31
08j. ANTIBACTERIAL COMBINATION 31
08k. OTHER ANTIBIOTICS 32
08l. ANTI-TB AGENTS 32
08n. ANTIFUNGALS 33
08p. ANTIVIRALS 33
08q. ANTHELMINTIKA 34
08r. ANTI MALARIA 34
08s. ANTIAMUBA 34
09 ONCOLOGY
09a. KEMOTERAPI SITOTOKSIK 34
09b. KEMOTERAPI HORMONAL 37
09d. TARGETED CANCER THERAPY 37
09e. TERAPI SUPORTIF 37
10 GENITO-URINARY SYSTEM
10a. PREPARATIONS FOR VAGINAL CONDITIONS 38
10b.URINARY ANTISEPTICS 38
10c. DRUGS ACTING ON UTERUS 38
10d. DRUGS FOR ERECTILE DYSFUNCTION AND EJACULATORY DISORDERS 38
10e. DRUGS FOR BLADDER & PROSTATE DISORDERS 38
10f. OTHER DRUGS ACTING ON GENITO-URINARY SYSTEM 39
11 ENDOCRINE & METABOLIC SYSTEM
11a. INSULINS PREPARATIONS 39
11b. ORAL ANTIDIABETICS AGENTS 39
11c. THYROID HORMONES 41
11d. ANTITHYROIDS AGENTS 41
11e. ANTIOBESITY GENTS 41
11f. AGENTS AFFECTING BONE METABOLISM 41
xliii
INDEKS FARMAKOLOGI
KELAS SUB KELAS HAL
12 ALLERGY & IMMUNE SYSTEM
12a. ANTIHISTAMINES & ANTIALLERGICS 42
12b. VACCINES, ANTICERA & IMMUNOLOGICALS 42
12c. IMMUNOSUPPRESSANTS 44
13 NUTRITION
13c. PARENTERAL NUTRITIONS 44
13d. ELECTROLYTES 44
14 EYE
14a. EYE ANTI-INFECTIVES & ANTISEPTICS 45
14b. EYE ANTISEPTICS WITH CORTICOSTEROIDS 45
14c. EYE CORTICOSTEROIDS 45
14d. MYDRIATIC DRUGS 45
14e. MIOTIC DRUGS 45
14f. ANTIGLAUCOMA PREPARATIONS 46
14g. OPHTALMIC DECONGESTANTS, ANESTHETICS, ANTI-
INFLAMMATORIES 46
14h. OTHER EYE PREPARATIONS 46
15 EAR
15a. EAR ANTI-INFECTIVES & ANTISEPTICS 46
15b. EAR ANTISEPTICS WITH CORTICOSTEROIDS 46
15d. OTHER EAR PREPARATIONS 47
15e. MOUTH/THROAT PREPARATIONS 47
16 DERMATOLOGICALS
16a. TOPICAL ANTIBIOTICS 47
16b. TOPICAL ANTIFUNGALS & ANTIPARASITES 47
16c. TOPICAL ANTIVIRALS 48
16d.TOPICAL ANTI-INFECTIVES WITH CORTICOSTEROIDS 48
16e. TOPICAL CORTICOSTEROIDS 48
16f. ACNE TREATMENT PREPARATIONS 48
16k. SKIN ANTISEPTICS & DISINFECTANTS 49
16m. OTHER DERMATOLOGICALS 49
17 ANAESTHETICS LOCAL & GENERAL
17a. ANAESTHETICS LOCAL & GENERAL 49
17b. NEUROMUSCULAR BLOCKING AGENTS 50
17c. SURGICAL DRESSINGS & WOUND CARE 50
18 ANTIDOTES & DETOXIFYING AGENTS
18a. ANTIDOTES & DETOXIFYING AGENTS 50
18b. DRUGS USED IN SUBSTANCE DEPENDENCE 50
19 INTRAVENOUS & OTHER STERILE SOLUTIONS
19O. INTRAVENOUS & OTHER STERIL SOLUTIONS 50
30 VITAMINS & MINERALS
30a. VITAMIN A, D & E 52
30b. VITAMIN B-COMPLEX/WITH C 53
30c. VITAMIN C 53
30d. CALCIUM/WITH VITAMINS 53
30e. VITAMINS &/OR MINERALS 54
30g. VITAMINS & MINERALS (PEDIATRIC) 55
30h. VITAMINS & MINERALS (PRE- 7 POST-NATAL)/ANTIANEMICS 55
31 HEALTH SUPPLEMENTS & FOOD
31a. APPETITE ENHANCERS 55
31b. SUPPLEMENTS & ADJUVANT THERAPY 55
40 DERMATOLOGICAL & PERSONAL CARE
40a. EMOLIENTS, CLEANSER & SKIN PROTECTIVES 56
xliv
I
SIFORMULARI UM
OBATPERTAMDI KAIHC
(
FOPI)2022
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
01 GASTROINTESTINAL & HEPATOBILIARY SYSTEM
01a. ANTACIDS, ANTIREFLUX AGENTS & ANTIULCERANTS
Cimetidine CIMETIDINE Tab 200 mg Tablet 200 mg HOLI PHARMA
Esomeprazole ESOMEPRAZOLE Inj 40 mg/ml (OT) Injeksi 40 mg/ml OTTO PHARMACEUTICAL
ESOMEPRAZOLE Tab 20 mg (NP) Tablet 20 mg NOVEL PHARMA
ESOMEPRAZOLE Tab 40 mg (NP) Tablet 40 mg NOVEL PHARMA
GRAXIUM Inj 40 mg/ml Injeksi 40 mg/ml GRACIA PHARMINDO
NEXIUM Inj 40 mg/mL Injeksi 40 mg/ml ASTRA ZENECA
NEXIUM Tab 20 mg Tablet 20 mg ASTRA ZENECA
NEXIUM Tab 40 mg Tablet 40 mg ASTRA ZENECA
Famotidine LEXMODINE Tab 20 mg Tablet 20 mg MOLEX AYUS
Lansoprazole LANSOPRAZOLE Inj 30 mg (FA) Injeksi 30 mg FAHRENHEIT
LANSOPRAZOLE Kaps 30 mg (IF) Kapsul 30 mg INDOFARMA
LANSOPRAZOLE Kaps 30 mg (NP) Kapsul 30 mg NOVEL PHARMA
LOPREZOL Kaps 30 mg Kapsul 30 mg KIMIA FARMA
PROSOGAN FD Tab 30 mg Tablet 30 mg TAKEDA INDONESIA
PROSOGAN Inj 30 mg Injeksi 30 mg TAKEDA INDONESIA
Mg(OH) +Al (OH) Dimeticon ATMACID Syr 60 ml Sirup 60 ml GRAHA FARMA
ANTASIDA DOEN Susp (MT) Suspensi 60 ml MERSIFARMA
ANTASIDA DOEN Tab (MT) Tablet MERSIFARMA
CARSIDA Susp Suspensi SAMPHARINDO PERDANA
CARSIDA Tab Tablet SAMPHARINDO PERDANA
Misoprostol MISOPROSTOL Tab 200 mcg (MB) Tablet 200 mcg MAHAKAM BETA FARMA
MISOPROSTOL Tab 200 mcg (NB) Tablet 200 mcg NULAB PHARMACEUTICAL INDONESIA
NEOPROST Tab 200 mcg Tablet 200 mcg GRACIA PHARMINDO
Omeprazole GASTROFER Inj 40 mg Injeksi 40 mg DEXA MEDICA
OMBERZOL Kaps 20 mg Kapsul 20 mg BERNOFARM
OMEPRAZOLE Inj 40 mg (BE) Injeksi 40 mg BERNOFARM
OMEPRAZOLE Inj 40 mg (DM) Injeksi 40 mg DEXA MEDICA
OMEPRAZOLE Kaps 20 mg (KF) Kapsul 20 mg KIMIA FARMA
OMEPRAZOLE Kaps 20 mg (NP) Kapsul 20 mg NOVEL PHARMA
Pantoprazole PANLOC Inj 40 mg Injeksi 40mg LANDSON PERTIWI AGUNG
PANTOPRAZOLE Inj 40 mg (PR) Injeksi 40 mg PHAPROS
PANTOPRAZOLE SODIUM Inj 40 mg (HJ) Injeksi 40 mg HEXPHARM JAYA
PANTOPRAZOLE Tab 20 mg (MB) Tablet 20 mg MAHAKAM BETA FARMA
PANTOPRAZOLE Tab 40 mg (MB) Tablet 40 mg MAHAKAM BETA FARMA
PANTOPRAZOLE Tab 40 mg (NP) Tablet 40 mg NOVEL PHARMA
PEPZOL Tab 40 mg Tablet 40 mg MAHAKAM BETA FARMA
VOMIZOLE Tab 20 mg Tablet 20 mg DEXA MEDICA
1
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Polymigel STROCAIN P Tab 400 mg Tablet 400 mg EISAI INDONESIA
Rabeprazole - BAROLE Tab 10 mg Tablet 10 mg MEGA LIFESCIENCES
BAROLE Tab 20 mg Tablet 10 mg MEGA LIFESCIENCES
PARIET Tab 10 mg Tablet 10 mg EISAI INDONESIA
PARIET Tab 20 mg Tablet 20 mg EISAI INDONESIA
Ranitidin HCl GASELA Tab 150 mg Tablet 150 mg ERELA
RANITIDINE HCI Inj 50 mg/2 ml (MM) Injeksi 50 mg / 2 ml MEPROFARM
RANITIDINE Inj 25 mg/ml (BE) Injeksi 50 mg/2 ml BERNOFARM
RANITIDINE Tab 150 mg (HJ) Tablet 150 mg HEXPHARM JAYA
RANITIDINE Tab 150 mg (IF) Tablet 150 mg INDOFARMA
RANIVEL Inj 25 mg/ml Injeksi 2 ml NOVEL PHARMA
RANIVEL Syr 75 mg/5 ml Sirup 75 mg / 5 mL NOVEL PHARMA
Rebamipide MUCOSTA Tab 100 mg Tablet 100 mg OTSUKA
REBAMIPIDE Tab 100 mg (IT) Tablet 100 mg INTERBAT
REPIMIDE Tab 100 mg Tablet 100 mg NOVEL PHARMA
Sucralfate NUCRAL Susp 500 mg/5 ml 200 ml Suspensi 500 mg/5 ml 200 ml GUARDIAN PHARMATAMA
SUCRALFATE Susp 500mg/5 ml 100 ml (IF) Suspensi 500 mg INDOFARMA
SUKRALFAT Syr 500 mg/5 ml (CB) Sirup 500 mg/5 ml COMBIPHAR
SUCRALFATE Tab 500 mg (CB) Tablet 500mg COMBIPHAR
SUCRALFATE Tab 500 mg (DM) Tablet 500 mg DEXA MEDICA
ULSIDEX Tab 500 mg Tablet 500 mg DEXA MEDICA
01b. GIT REGULATORS, ANTIFLATULENTS & ANTI-INFLAMMATORIES
Atropine Sulphate ATROPINE Inj 0,25 mg/ml (EI) Injeksi 0,25 mg/ mL ETHICA INDUSTRI FARMASI
Budesonide BUDENOFALK Kaps 3 mg Kapsul 3 mg DARYA VARIA
Cisapride ACPULSIF Tab 5 mg Tablet 5 mg DEXA MEDICA
Domperidone DOMPERIDON Tab 10 mg (IF) Tablet 10 mg INDOFARMA
DOMPERIDONE Tab 10 mg (FA) Tablet 10 mg FAHRENHEIT
DOMPERIDONE Drops 5 mg/5 ml (BE) Drops 5 mg/5 ml BERNOFARM
VOMETA FT Tab 10 mg Tablet FT 10 mg DEXA MEDICA
MIRADON Syr Sirup 5 mg/5 ml SAMPHARINDO PERDANA
VOMETA Syr 5 mg/5 mL Sirup 5 mg/5 ml DEXA MEDICA
VOMETA Drops 5 mg/ml Drops 5 mg/5 ml DEXA MEDICA
Lactobacillus Rhamnosus Lactobacillus AcidophillusLACIDOFIL Kaps Kapsul 2x109 CFU DEXA MEDICA
Bifidobacterium longum,
Streptococcus
Lactobacillus Sp thermophilus), Vit C, Vit LACTO-B Sach Granul 1x109 CFU/g NOVEL PHARMA
B1 , Vit B2 , Vit B6 ,
Niacin, Protein , Fat, Zn
INTERLAC PROBIOTIC Drops Drops 10 8 CFU INTERBAT
LACBON Granul Granul 10000000 KIMIA FARMA
2
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Mesalazine SALOFALK Supp 500 mg Suppositoria 500 mg DARYA VARIA
SALOFALK Tab 500 mg Tablet 500 mg DARYA VARIA
Metoclopramide GAVISTAL Drops 2 mg/ml Drops 2 mg MEPROFARM
METOCLOPRAMIDE Inj 10 mg/2 ml Injeksi 10 mg/2 ml IPHA LABORATORIES
METOCLOPRAMIDE Inj 10 mg/2 ml (IT) Injeksi 10 mg/2 ml INTERBAT
METOCLOPRAMIDE Tab 10 mg (GF) Tablet 10 mg GRAHA FARMA
METOCLOPRAMIDE Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
METOLON Tab 10 mg Tablet 10 mg BERNOFARM
PRIMPEN Syr 5 mg/5 ml Sirup 5 mg/5 ml SAMPHARINDO PERDANA
PRIMPERAN Inj 5 mg/ml Injeksi 10 mg/2 ml SOHO INDUSTRI PHARMASI
SOTATIC Inj 10 mg/2 ml Injeksi 10 mg/2 ml FAHRENHEIT
01c. ANTISPASMODICS
Chlordiazepoxide Clidinium Bromide BRAXIDIN Tab 5 mg/2,5 mg Tablet 5 mg/ 2,5 mg SANBE FARMA
Hyoscine Paracetamol BUSCOPAN Plus Tab 10 mg Tablet 10 mg; 500 mg AVENTIS PHARMA
Hyoscine BUSCOPAN Tab 10 mg Tablet 10 mg AVENTIS PHARMA
GITAS Inj 20 mg/mL Injeksi 20 mg INTERBAT
HYOSCINE Inj 20 mg/mL (OT) Injeksi 20 mg OTTO PHARMACEUTICAL
SPASMOLIT Tab 10 mg Tablet 10 mg MEPROFARM
Mebeverine Hydrochloride DUSPATALIN Tab 135 mg Tablet 135 mg ABBOTT
Timepidium Bromide SESDEN Kaps 30 mg Kapsul 30 mg TANABE
01d. ANTIDIARRHEALS
Attapulgite Pectin MOLAGIT Tab Tablet MOLEX AYUS
Kaolin NEOKAOMINAL Susp Suspensi MOLEX AYUS
Loperamide HCl GRADILEX Tab 2 mg Tablet 2 mg GRAHA FARMA
PRIMODIAR Tab 2 mg Tablet 2 mg SAMPHARINDO PERDANA
Zinc sulfate monohydrate HOLIZINC Syr 60 ml Sirup HOLI PHARMA
HOLIZINC Tab 20 mg Tablet 20 mg HOLI PHARMA
ZINC SULFATE MONOHYDRATE Drops 10 mg/ml (MM) Drops 10mg/ml MEPROFARM
ZINC SULFATE MONOHYDRATE Syr 20 mg/5 ml (BE) Sirup 200 mg / 5 ml BERNOFARM
ZINC SULFATE Syr 20 mg/5 ml (MM) Sirup 20 mg/5 ml MEPROFARM
ZINC Tab 20 mg (IF) Tablet 20 mg INDOFARMA
ZINCPRO Drops 10 mg/ml Drops 10 mg COMBIPHAR
01e. LAXATIVES, PURGATIVES
Bisacodyl BISACODYL Tab 5 mg (NP) Tablet 5 mg NOVEL PHARMA
DULCOLAX Supp Adult 10 mg Suppositoria 10 mg AVENTIS PHARMA
DULCOLAX Supp Infant 5 mg Suppositoria 5 mg AVENTIS PHARMA
DULCOLAX Tab 5 mg Tablet 5 mg AVENTIS PHARMA
STOLAX Supp 10 mg Suppositoria 10 mg SANBE FARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Lactulose EXTRALAC Syr 60 ml Sirup 60 ml KIMIA FARMA
GRAPHALAC Syr 3,335 g Sirup 120 ml GRACIA PHARMINDO
LACTULOSE Syr 3.335 g/5 ml (NP) Sirup 120 ml NOVEL PHARMA
Monobasic Na Posphate Dibasic Sod Phosphate FLEET Enema 133 ml Enema 133 mL COMBIPHAR
PHOSPHO-SODA Syr 45 ml Sirup 45 ml COMBIPHAR
Sodium Citrate; PEG-400;
Na Lauryl Sulfate MICROLAX Gel Rect Tube 45 mg Rectal Tube 45 mg PHAROS INDONESIA
Sorbic Acid; Sorbitol
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Aethylis Aminobenzoas;
Dibucaini
Hydrochloridum
Lithospermi Radix Extractum BORRAGINOL S Supp Suppositoria TAKEDA INDONESIA
;Diphenhydramini;
Hydrochloridum;
Cetrimide
Aethylis Aminobenzoas;
Dibucaini
Hydrochloridum BORRAGINOL N Supp Suppositoria (blank) TAKEDA INDONESIA
;Diphenhydramini;
Hydrochloridum;
Cetrimide
Micronized Purified
ARDIUM Tab 500 mg Tablet 500 mg SERVIER INDONESIA
Flavonoids Fraction
DISOLF EC Tab 490 mg Tablet 490 mg DEXA MEDICA
Policresulen Cinchocaine HCl FAKTU Supp 100 mg Suppositoria 100 mg PHAROS INDONESIA
01i. ANTIEMETICS
Dimenhydrinate DIMENHYDRINATE Tab 50 mg (KF) Tablet 50 mg KIMIA FARMA
DRAMAMINE Tab 50 mg Tablet 50 mg TAISHO PHARMACEUTICAL
MANTINO Tab 50 mg Tablet 50 mg SAMPHARINDO PERDANA
Granisetron GRANISETRON Inj 1 mg (NP) Injeksi 1 mg NOVEL PHARMA
GRANISETRON Inj 3 mg (NP) Injeksi 3 mg / ml NOVEL PHARMA
GRANON Inj 1 mg Injeksi 1 mg DEXA MEDICA
GRANON Tab 1 mg Tablet 1 mg DEXA MEDICA
Ondansetron NARFOZ Syr 4 mg/ 5 ml 60 ml Sirup 4 mg/5 ml PHAROS INDONESIA
ONDANSETRON Syr 4 mg/5 ml (PM) Sirup 4 mg/5 ml PROMEDRAHARDJO FARMASI INDUSTRI
ONDANCETRON Inj 4 mg/2ml (IT) Injeksi 4 mg / 2 ml INTERBAT
ONDANE Inj 4 mg/2 ml Injeksi 4 mg/2 mL GUARDIAN PHARMATAMA
ONDANSETRON Inj 4 mg /2 ml (BE) Injeksi 4 mg/2 mL BERNOFARM
ONDANSETRON Inj 8 mg/4 ml (BE) Injeksi 8 mg/4 ml BERNOFARM
ONDANSETRON Inj 8 mg/4 ml (QL) Injeksi 8 mg / 4 ml QUANTUM LABS
ONDANSETRON Tab 4 mg (LS) Tablet 4 mg LANDSON PERTIWI AGUNG
ONDANSETRON Tab 4 mg (NP) Tablet 4 mg NOVEL PHARMA
ONDANSETRON Tab 8 mg (LS) Tablet 8 mg LANDSON
VOMETRAZ Tab 4 mg Tablet 4 mg DEXA MEDICA
VOMETRAZ Tab 8 mg Tablet 8 mg DEXA MEDICA
Pyrathiazine Theoclat Vit B6 ANVOMER Tab 40 mg Tablet 40 mg DEXA MEDICA
MEDIAMER Tab 40 mg/30 mg Tablet 40 mg/30 mg DARYA VARIA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
02 CARDIOVASCULAR & HAEMATOPOIETIC SYSTEM
02a. CARDIAC DRUGS
Amiodarone HCl AMIODARONE Inj 50 mg/ml (DV) Injeksi 150 mg/ 3 mL DARYA VARIA
AMIODARONE Inj Lq 150 mg/3 ml Injeksi 150 mg/ 3 mL ETHICA INDUSTRI FARMASI
KENDARONE Tab 200 mg Tablet 200 mg DARYA VARIA
TYARIT Tab 200 mg Tablet 200 mg FAHRENHEIT
Digoxin DIGOXIN Tab 0,25 mg (PN) Tablet 0.25 mg FAHRENHEIT
FARGOXIN Inj 0,5 mg/2 ml Injeksi 0.5 mg/2 ml FAHRENHEIT
FARGOXIN Tab 0,25 mg Tablet 0.25 mg FAHRENHEIT
Dobutamine DOBUTAMIN Inj 250 mg/5 ml (DM) Injeksi 250 mg/ 5 ml DEXA MEDICA
DOBUTAMINE HCL Inj 250 mg/5 ml Injeksi 250 mg/ 5 ml ETHICA INDUSTRI FARMASI
DOMINE Inj 250 mg/5 ml Injeksi 250 mg/ 5 ml GUARDIAN PHARMATAMA
Dopamine DOPAMINE HCL Inj 40 mg/ml (DM) Injeksi 200 mg/ 5 ml DEXA MEDICA
INDOP Inj 40 mg/ mL Injeksi 200 mg/ 5 ml FAHRENHEIT
Milrinone INOVAD Inj 10 mg/10 ml Injeksi 10 mg/ 10 mL FAHRENHEIT
Propafenone HCl RYTMONORM Tab 150 mg Tablet 150 mg ABBOTT
02b. ANTI-ANGINAL DRUGS
Diltiazem HCl DILMEN Tab 60 mg Tablet 60 mg SANBE FARMA
DILTIAZEM Tab 30 mg (DM) Tablet 30 mg DEXA MEDICA
DILTIAZEM Tab 30 mg (KF) Tablet 30 mg KIMIA FARMA
HERBESSER CD Kaps 100 mg Kapsul 100 mg TANABE
HERBESSER Inj 50 mg Injeksi 50 mg TANABE
Glyceryl Trinitrat CARNIT Inj 20 mg/10 ml Injeksi 20 mg/10ml NOVEL PHARMA
NTG Inj 10 mg/10 ml Injeksi 10 mg/ 10 mL FERRON PAR PHARMATEUTICALS
NITRAL Tab 500 ug Tablet 500 mcg ACTAVIS
NITROKAF RETARD Forte Tab 5 mg Tablet 5 mg KIMIA FARMA
NITROKAF RETARD Tab 2,5 mg Tablet 2,5 mg KIMIA FARMA
Isosorbide 5-mononitrate CARDISMO Tab 20 mg Tablet 20 mg PHAPROS
MONECTO Tab 20 mg Tablet 20 mg FAHRENHEIT
IMOCARD SR Tab 60 mg Tablet SR 60 mg NOVEL PHARMA
Isosorbide Dinitrate CEDOCARD I.V.Inj 10 mg/mL Injeksi 10 mg/10ml DARYA VARIA
CEDOCARD RETARD Tab 20 mg Tablet 20 mg DARYA VARIA
CEDOCARD Tab 5 mg Tablet 5 mg DARYA VARIA
FARSORBID Tab 5 mg Tablet 5 mg FAHRENHEIT
ISONAT Tab 5 mg Tablet 5 mg KIMIA FARMA
ISONAT Tab 10 mg Tablet 10 mg KIMIA FARMA
ISOSORBID DINITRAT Inj 10 mg/10 ml (FA) Injeksi 10mg/10ml FAHRENHEIT
ISOSORBIDE DINITRAT Tab 5 mg (PN) Tablet 5 mg FAHRENHEIT
ISOSORBIDE DINITRATE Tab 5 mg (IF) Tablet 5 mg INDOFARMA
ISOSORBIDE DINITRATE Tab 10 mg (NP) Tablet 10 mg NOVEL PHARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Ivabradine CORALAN Tab 5 mg Tablet 5 mg SERVIER INDONESIA
Ranolazine RANEXA Tab 375 mg Tablet 375 mg TRANSFARMA MEDICA INDAH
RANEXA Tab 500 mg Tablet 500 mg TRANSFARMA MEDICA INDAH
Trimetazidine ANGINTRIZ MR Tab 35 mg Tablet MR 35 mg NOVEL PHARMA
TRIMETAZIDINE Tab 35 mg (NP) Tablet MR 35 mg NOVEL PHARMA
TRIZEDON MR TAB 35 mg Tablet MR 35 mg SERVIER INDONESIA
02c. ACE INHIBITORS
Captopril CAPTOPRIL Tab 12.5 mg (IF) Tablet 12.5 mg INDOFARMA
CAPTOPRIL Tab 12.5 mg (PR) Tablet 12.5 mg PHAPROS
CAPTOPRIL Tab 25 mg (IF) Tablet 25 mg INDOFARMA
CAPTOPRIL Tab 25 mg (PR) Tablet 25 mg PHAPROS
Imidapril TANAPRESS Tab 10 mg Tablet 10 mg TANABE
Lisinopril INTERPRIL Tab 5 mg Tablet 5 mg INTERBAT
LISINOPRIL Tab 10 mg (DM) Tablet 10 mg DEXA MEDICA
LISINOPRIL Tab 5 mg (DM) Tablet 5 mg DEXA MEDICA
NOPRIL Tab 10 mg Tablet 10 mg KIMIA FARMA
Perindopril Arginine BIOPREXUM Tab 5 mg Tablet 5 mg SERVIER INDONESIA
Ramipril EMERTEN Tab 10 mg Tablet 10 mg NOVEL PHARMA
EMERTEN Tab 2,5 mg Tablet 2,5 mg NOVEL PHARMA
HYPERIL Tab 5 mg Tablet 5 mg FERRON PAR PHARMATEUTICALS
RAMIPRIL Tab 10 mg (NP) Tablet 10 mg NOVEL PHARMA
RAMIPRIL Tab 2,5 mg (DM) Tablet 2,5 mg DEXA MEDICA
RAMIPRIL Tab 5 mg (DM) Tablet 5 mg DEXA MEDICA
RAMIPRIL Tab 5 mg (PR) Tablet 5 mg PHAPROS
Telmisartan Amlodipine TWYNSTA Tab 40 mg/5 mg Tablet 40 mg/ 5 mg BOEHRINGER
TWYNSTA Tab 80 mg/5 mg Tablet 80 mg/5 mg BOEHRINGER
Telmisartan MICARDIS Tab 40 mg Tablet 40 mg BOEHRINGER
MICARDIS Tab 80 mg Tablet 80 mg BOEHRINGER
NUZARTAN Tab 80 mg Tablet 80 mg NUFARINDO
TELMISARTAN Tab 40 mg (DM) Tablet 40 mg DEXA MEDICA
TELMISARTAN Tab 80 mg (DM) Tablet 80 mg DEXA MEDICA
TINOV Tab 40 mg Tablet 40 mg NOVEL PHARMA
02d. BETA-BLOCKERS
Atenolol FARNORMIN Tab 50 mg Tablet 50 mg FAHRENHEIT
Bisoprolol Fumarate Amlodipine CONCOR AM Tab 10/5 mg Tablet 10 mg MERCK BIOPHARMA
CONCOR AM Tab 5/10 mg Tablet 5 mg MERCK BIOPHARMA
CONCOR AM Tab 5/5 mg Tablet 5 mg MERCK BIOPHARMA
Bisoprolol Fumarate Hydrochlorthiazide LODOZ Tab 2.5 mg Tablet 2,5 mg MERCK BIOPHARMA
LODOZ Tab 5 mg Tablet 5 mg MERCK BIOPHARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Bisoprolol Fumarate BETA ONE Tab 2,5 mg Tablet 2,5 mg KALBE FARMA
BISOPROLOL FUMARATE Tab 2.5 mg (NP) Tablet 2,5 mg NOVEL PHARMA
BISOPROLOL Tab 2.5 mg (FA) Tablet 2,5mg FAHRENHEIT
BISOPROLOL Tab 5 mg (DM) Tablet 5 mg DEXA MEDICA
BISOPROLOL Tab 5 mg (NP) Tablet 5 mg NOVEL PHARMA
CONCOR HEART SHAPE Tab 2,5 mg Tablet 2,5 mg MERCK BIOPHARMA
CONCOR HEART SHAPE Tab 5 mg Tablet 5 mg MERCK BIOPHARMA
CONCOR Tab 1.25 mg Tablet 1,25 mg MERCK BIOPHARMA
Carvedilol CARVILOL Tab 6,25 mg Tablet 6,25 mg DARYA VARIA
VBLOC Tab 6,25 mg Tablet 6,25 mg KALBE FARMA
VBLOC Tab 25 mg Tablet 25 mg KALBE FARMA
Metoprolol FAPRESOR Inj 5 mg/5 ml Injeksi 5 mg/5 ml FAHRENHEIT
Nebivolol NEVODIO Tab 5 mg Tablet 5 mg DEXA MEDICA
Propranolol FARMADRAL Tab 10 mg Tablet 10 mg FAHRENHEIT
PROPRANOLOL Tab 10 mg (DM) Tablet 10 mg DEXA MEDICA
PROPRANOLOL Tab 40 mg (DM) Tablet 40 mg DEXA MEDICA
02e. CALCIUM ANTAGONISTS
Amlodipine AMLODIPINE Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
AMLODIPINE Tab 10 mg (PR) Tablet 10 mg PHAPROS
AMLODIPINE Tab 5 mg (IF) Tablet 5 mg INDOFARMA
AMLODIPINE Tab 5 mg (KF) Tablet 5 mg KIMIA FARMA
CARDIPIN Kapl 10 mg Tablet 10 mg SAMPHARINDO PERDANA
PEHAVASK Tab 10 mg Tablet 10 mg PHAPROS
PEHAVASK Tab 5 mg Tablet 5 mg PHAPROS
TENSIVASK Tab 5 mg Tablet 5 mg DEXA MEDICA
Amlodipine Valsartan EXFORGE Tab 10/160 mg Tablet 10/160 mg NOVARTIS INDONESIA
EXFORGE Tab 5/80 mg Tablet 5/80 mg NOVARTIS INDONESIA
Lercanidipine ZANIDIP Tab 10 mg Tablet 10 mg ABBOTT
Nicardipine NICARDIPINE HCL Inj 10 mg/10 ml (NP) Injeksi 10 mg/10 mL NOVEL PHARMA
NICARDIPINE Inj 10 mg/10 ml (FA) Injeksi 10 mg / 10 ml FAHRENHEIT
Nifedipine ADALAT OROS Tab 30 mg Tablet 30 mg BAYER INDONESIA
NIFEDIPIN Tab 10 mg (DM) Tablet 10 mg DEXA MEDICA
NIFEDIPIN Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
Verapamil ISOPTIN SR Tab 240 mg Tablet SR 240 mg ABBOTT
VERAPAMIL Tab 80 mg (KF) Tablet 80 mg KIMIA FARMA
02f. ANGIOTENSIN II ANTAGONISTS
Alfa Methyldopa DOPAMET Tab 250 mg Tablet 250 mg ACTAVIS
Candesartan BLOPRESS Tab 16 mg Tablet 16 mg TAKEDA INDONESIA
CANDEFAR Tab 8 mg Tablet 8 mg FAHRENHEIT
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
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CANDERIN Tab 16 mg Tablet 16 mg DEXA MEDICA
CANDESARTAN CILEXETIL Tab 16 mg (BE) Tablet 16 mg BERNOFARM
CANDESARTAN CILEXETIL Tab 8 mg (BE) Tablet 8 mg BERNOFARM
CANDESARTAN Tab 16 mg (DM) Tablet 16 mg DEXA MEDICA
CANDESARTAN Tab 8 mg (DM) Tablet 8 mg DEXA MEDICA
Clonidine Hcl CATAPRES Inj 0.15 mg/ml Injeksi 0,15 mg BOEHRINGER
CATAPRES Tab 150 mcg Tablet 150 mcg BOEHRINGER
CATAPRES Tab 75 mcg Tablet 75 mcg BOEHRINGER
CLONIDINE Tab 0,15 mg (IF) Tablet 150 mcg INDOFARMA
CLONIDINE Tab 150 mcg (KF) Tablet 150 mcg KIMIA FARMA
Irbesartan Hydrochlorthiazide CO-APROVEL Tab 150 mg/12,5 mg Tablet 150 mg, 12,5 mg AVENTIS PHARMA
Irbesartan APROVEL Tab 150 mg Tablet 150 mg AVENTIS PHARMA
IRBESARTAN Kapl 150 mg (IF) Tablet 150 mg INDOFARMA
IRBESARTAN Kapl 300 mg (IF) Tablet 300 mg INDOFARMA
IRBESARTAN Tab 150 mg (NP) Tablet 150 mg NOVEL PHARMA
IRBESARTAN Tab 300 mg (NP) Tablet 300 mg NOVEL PHARMA
IRTAN Tab 150 mg Tablet 150 mg IKAPHARMINDO PUTRAMAS
IRTAN Tab 300 mg Tablet 300 mg IKAPHARMINDO PUTRAMAS
Losartan LIFEZAR Tab 50 mg Tablet 50 mg DARYA VARIA
LOSARTAN Tab 50 mg (HJ) Tablet 50 mg HEXPHARM JAYA
LOSARTAN Tab 50 mg (NP) Tablet 50 mg NOVEL PHARMA
Olmesartan medoxomil OLMETEC Tab 20 mg Tablet 20 mg PFIZER INDONESIA
Sacubitril Valsartan UPERIO Tab Tablet 24,3 mg NOVARTIS INDONESIA
UPERIO Tab Tablet 48,6 mg NOVARTIS INDONESIA
Valsartan DIOVAN Tab 80 mg Tablet 80 mg SOHO INDUSTRI PHARMASI
VALSARTAN Tab 160 mg (KF) Tablet 160 mg KIMIA FARMA
VALSARTAN Tab 80 mg (DM) Tablet 80 mg DEXA MEDICA
VALSARTAN Tab 80 mg (KF) Tablet 80 mg KIMIA FARMA
VASTAN Tab 160 mg Tablet 160 mg GUARDIAN PHARMATAMA
VASTAN Tab 80 mg Tablet 80 mg GUARDIAN PHARMATAMA
02h. DIURETICS.
Furosemide FARSIX Inj 10 mg/ml Injeksi 10 mg/ml FAHRENHEIT
FUROSEMIDE Inj 10 mg/ml (DM) Injeksi 10 mg/ml DEXA MEDICA
FUROSEMIDE Inj 10 mg/mL (IF) Injeksi 10 mg/ml INDOFARMA
FUROSEMIDE Tab 40 mg (IF) Tablet 40 mg INDOFARMA
FUROSEMIDE Tab 40 mg (KF) Tablet 40 mg KIMIA FARMA
LASIX Inj 10 mg/mL Injeksi 10 mg/ml AVENTIS PHARMA
LASIX Tab 40 mg Tablet 40 mg AVENTIS PHARMA
URESIX Tab 40 mg Tablet 40 mg SANBE FARMA/CAPRIFARMINDO
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Hydrochlortiazid HYDROCHLORTIAZIDE Tab 25 mg (KF) Tablet 25 mg KIMIA FARMA
Spironolactone CARPIATON Tab 25 mg Tablet 25 mg FAHRENHEIT
SPIROLACTON Tab 100 mg (PR) Tablet 100 mg PHAPROS
SPIRONOLACTON Tab 100 mg (DM) Tablet 100 mg DEXA MEDICA
SPIRONOLACTON Tab 25 mg (DM) Tablet 25 mg DEXA MEDICA
SPIRONOLACTONE Tab 25 mg (OT) Tablet 25 mg OTTO PHARMACEUTICAL
Tolvaptan SAMSCA Tab 15 mg Tablet 15 mg OTSUKA
02i. ANTIDIURETICS.
Vasopresin FARPRESIN Inj 20 U/ml Injeksi 20 U/ML FAHRENHEIT
02j. PERIPHERAL VASODILATORS & CEREBRAL ACTIVATORS
Cytidine
Monophosphate; Tablet
Choline Citrate Phosphatidylserine NEULIN PS Tab 147,5 mg 147,5 mg FERRON PAR PHARMATEUTICALS
Cinnarizine STUGERON Tab 25 mg Tablet 25 mg JOHNSON & JOHNSON
Citicholine BRAINACT Inj 250 mg/2 ml Injeksi 250 mg/2 ml KALBE FARMA
BRAINACT Inj 500 mg/4 ml Injeksi 500 mg/4 ml KALBE FARMA
BRAINACT O-DIS Tab 500 mg Tablet 500 mg KALBE FARMA
CITICHOLINE Inj 500 mg/4 ml (HJ) Injeksi 500 mg/4 ml HEXPHARM JAYA
CITICHOLINE Tab 500 mg (HJ) Tablet 500 mg HEXPHARM JAYA
CITICOLIN Inj 250 mg/2 ml (BE) Injeksi 250 mg/2 ml BERNOFARM
CITICOLINE Inj 500 mg/4 ml (MB) Injeksi 500 mg/4 ml MAHAKAM BETA FARMA
CITICOLINE Kapl 1000 mg (MB) Kaplet 1000 mg MAHAKAM BETA FARMA
Nicergoline SEROLIN Tab 10 mg Tablet 10 mg KALBE FARMA
02k. VASOCONSTRICTORS
Epinephrine EPINEPHRINE Inj (PR) Injeksi 1 mg/ml PHAPROS
EPINEPHRINE Inj 1 mg/ml (EI) Injeksi 1 mg/ml ETHICA INDUSTRI FARMASI
Norephineprine N-EPI Inj Injeksi 4 mg / 4 ml NOVEL PHARMA
NOREPHINEPHRINE BITARTATE Inj 4 mg/4 ml (BE) Injeksi 4 mg/4 ml BERNOFARM
NOREPINEPHRINE BITARTRATE MONOHYDRATE Inj 1
Injeksi
mg/ml (NP) 4 mg / 4 ml NOVEL PHARMA
02l. DYSLIPIDEMIC AGENTS
Atorvastatin ATORVASTATIN Tab 10 mg (AM) Tablet 10 mg AMAROX PHARMA GLOBAL
ATORVASTATIN Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
ATORVASTATIN Tab 20 mg (AM)) Tablet 20 mg AMAROX PHARMA GLOBAL
ATORVASTATIN Tab 20 mg (KF) Tablet 20 mg KIMIA FARMA
ATORVASTATIN Tab 40 mg (KF) Tablet 40 mg KIMIA FARMA
LIPIDEF Tab 10 mg Tablet 10 mg KIMIA FARMA
LIPIDEF Tab 20 mg Tablet 20 mg KIMIA FARMA
LIPIDEF Tab 40 mg Tablet 40 mg KIMIA FARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
LIPITOR Tab 10 mg Tablet 10 mg PFIZER INDONESIA
LIPITOR Tab 20 mg Tablet 20 mg PFIZER INDONESIA
LITORCOM Tab 40 mg Tablet 40 mg COMBIPHAR
Cholestyramine SEQUEST Sach Granul 4g NOVEL PHARMA
Ezetimibe Simvastatin VYTORIN Tab Tablet 10 mg TRANSFARMA MEDICA INDAH
EZETROL Tab 10 mg Tablet 10 mg TRANSFARMA MEDICA INDAH
Fenofibrate EVOTHYL Kaps 100 mg Kapsul 100 mg GUARDIAN PHARMATAMA
EVOTHYL Kaps 300 mg Kapsul 300 mg GUARDIAN PHARMATAMA
FENOFIBRATE Kapl 200 mg (ML) Tablet 200 mg MEDIKON
FENOFIBRATE Kaps 100 mg (HJ) Kapsul 100 mg HEXPHARM JAYA
FENOFIBRATE Kaps 300 mg (HJ) Kapsul 300 mg HEXPHARM JAYA
FENOPI FC Kapl Kaplet 160 mg OTTO PHARMACEUTICAL
LIPANTHYL PENTA Tab 145 mg Tablet 145 mg ABBOTT
Gemfibrozil GEMFIBROZIL Kaps 300 mg (PR) Kapsul 300 mg PHAPROS
HYPOFIL Tab 300 mg Tablet 300 mg SANBE FARMA
Pitavastatin LIVALO Tab 2 mg Tablet 2 mg TANABE
Rosuvastatin CRESTOR Tab 20 mg Tablet 20 mg ASTRA ZENECA
CRESTOR Tab 5 mg Tablet 5 mg ASTRA ZENECA
ROSUVASTATIN CAL Tab 40 mg (AM) Tablet 40 mg AMAROX PHARMA GLOBAL
ROSUVASTATIN Tab 10 mg Tablet 10 mg KIMIA FARMA
ROSUVASTATIN Tab 20 mg (IT) Tablet 20 mg INTERBAT
ROVASCOL Tab 10 mg Tablet 10 mg KIMIA FARMA
ROVASCOL Tab 20 mg Tablet 20 mg KIMIA FARMA
Simvastatin SIMVASTATIN Kapl 20 mg (KF) Kaplet 20 mg KIMIA FARMA
SIMVASTATIN Tab 20 mg (HJ) Tablet 20 mg HEXPHARM JAYA
SIMVASTATIN Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
SIMVASTATIN Tab 10 mg (PN) Tablet 10 mg FAHRENHEIT
STATCOL Tab 10 mg Tablet 10 mg KIMIA FARMA
STATCOL Tab 20 mg Tablet 20 mg KIMIA FARMA
02m. HAEMOSTATICS
Asam Traneksamat ASAM TRANEKSAMAT Inj 250 mg (DM) Injeksi 250 mg/5 ml DEXA MEDICA
ASAM TRANEKSAMAT Tab 500 mg (BE) Tablet 500 mg BERNOFARM
KALNEX INJ 500 mg/5 ml Injeksi 500 mg/5 ml KALBE FARMA
KALNEX Kaps 250 mg Kapsul 250 mg KALBE FARMA
NUTRANEX Tab Tablet NULAB PHARMACEUTICAL INDONESIA
TRANEXAMIC ACID Inj 500 mg/5 ml (DM) Injeksi 500 mg/5 ml DEXA MEDICA
TRANEXAMIC ACID Inj 500 mg/5 ml (HJ) Injeksi 500 mg/5 ml HEXPHARM JAYA
Carbazochrome ADONA (AC-17) Inj 50 mg/10 ml Injeksi 50 mg TANABE
ADONA FORTE Tab 30 mg Tablet 30 mg TANABE
CARBAZOCHROME Inj 50 mg/10 ml (NP) Injeksi 50 mg NOVEL PHARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Fibrin Sealant Set BERIPLAST P COMBISET Inj 1 mL Injeksi 1 mL DEXA MEDICA
Phytomenadione PHYTOMENADIONE Inj 2 mg/ml (PR) Injeksi 2 mg PHAPROS
PHYTOMENADIONE Tab 10 mg (PR) Tablet 10 mg PHAPROS
PHYTOMENADIONE Inj 10 mg/ml (PR) Injeksi 10 mg/ml PHAPROS
VITKA INFANT Inj 2 mg/ml Injeksi 2 mg/ml PHAPROS
Somatostatin SOMANOVELL Inj 3 mg Injeksi 3 mg NOVEL PHARMA
02n. ANTICOAGULANTS, ANTIPLATELETS & FIBRINOLYTICS (THROMBOLYTICS)
Tablet Salut
Acetylsalicylic Acid ASPILETS THROMBO Tab 80 mg Selaput 80 mg DARYA VARIA
CARTYLO Tab 80 mg Tablet 80 mg KIMIA FARMA
ASTIKA Tab 100 mg Tablet 100 mg IKAPHARMINDO PUTRAMAS
Alteplase ACTILYSE Inj 50 mg Injeksi 50 mg BOEHRINGER
Antitrombin III KYBERNIN Inj 50 IU/ml Injeksi 50 IU / mL DEXA MEDICA
Beraprost Sodium DORNER Tab 20 µG Tablet 20 mcg ASTELLAS
Cilostazol NALETAL Tab 100 mg Tablet 100 mg GUARDIAN PHARMATAMA
PLETAAL SR Kaps 100 mg Kapsul 100 mg OTSUKA
Clopidogrel CLOPIDOGREL Tab 75 mg (KF) Tablet 75 mg KIMIA FARMA
CLOPIDOGREL Tab 75 mg (PR) Tablet 75 mg PHAPROS
PLAVIX Tab 75 mg Tablet 75 mg AVENTIS PHARMA
TROMBIKAF Tab 75 mg Tablet 75 mg KIMIA FARMA
Collagenase, Fibrinolysin, Profibrinolysin activat PLASMIN Kaps Kapsul LANDSON
Dabigatran Etexylate PRADAXA Kaps 110 mg Kapsul 110 mg BOEHRINGER
Edoxaban LIXIANA Tab 30 mg Tablet 30 mg KALBE FARMA
Enoxaparin Sodium ENOXAPHARIN PFS 0,4 ml (BF) Injeksi 0,4 mL BIOFARMA
ENOXAPHARIN PFS 0,6 ml (BF) Injeksi 0,6 mL BIOFARMA
LOVENOX Inj 0,2 mL Injeksi 0,2 mL AVENTIS PHARMA
LOVENOX Inj 0,4 mL Injeksi 0,4 mL AVENTIS PHARMA
LOVENOX Inj 0,6 mL Injeksi 0,6 mL AVENTIS PHARMA
Eptifibatide INTEGRILIN Inj 75 mg/100 mL Injeksi 75 mg/ 100 mL TRANSFARMA MEDICA INDAH
Fondaparinux Sodium ARIXTRA Inj 2,5 mg/0,5 mL Injeksi 2,5 mg/ 0,5 mL TANABE
VENAX Inj Injeksi 2,5 mg/0.5 ml NOVEL PHARMA
VASOLA Inj Injeksi 2,5 mg/0.5 ml FAHRENHEIT
Heparin Na HEPARINOL Inj 5000 IU/ml Injeksi 5000 IU Usaha Sarana Medika
INVICLOT Inj 5000 IU/mL Injeksi 5000 IU FAHRENHEIT
THROMBOPHOB Gel 20 g Gel 20 g TUNGGAL IDAMAN ABDI
Hidrosmin VENOSMIL Kaps Injeksi KALBE FARMA
Iloprost VENTAVIS Inj Injeksi BAYER INDONESIA
Rivaroksaban NOSTROK Tab 10 mg Tablet 10 mg FAHRENHEIT
XARELTO Tab 10 mg Tablet 10 mg BAYER INDONESIA
12
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
NOSTROK Tab 20 mg Tablet 20 mg FAHRENHEIT
XARELTO Tab 20 mg Tablet 20 mg BAYER INDONESIA
Streptokinase FIBRION Inj 1.500.000 IU Injeksi 1,500,000 IU DEXA MEDICA
Ticagrelor BRILINTA Tab 90 mg Tablet 90 mg ASTRA ZENECA
CLOTAIRE Tab 90 mg Tablet 90 mg FAHRENHEIT
Warfarin Na NOTISIL Tab 2 mg Tablet 2 mg NOVEL PHARMA
SIMARC Tab 2 mg Tablet 2 mg FAHRENHEIT
NOTISIL Tab 5 mg Tablet 5 mg NOVEL PHARMA
02r. HAEMOTOPOIETICS AGENTS
Epoetin beta RECORMON Inj 5000 IU Injeksi 5,000 IU ROCHE
Erythropoetin EPODION Inj 2000 IU/0,5 mL Injeksi 2000 IU DAEWONG
EPODION Inj 3000 IU/0,3 mL Injeksi 3000 IU DAEWONG
EPOTREX Inj 10.000 IU Injeksi 10.000 IU NOVEL PHARMA
EPOTREX Inj 4000 IU Injeksi 4000 IU NOVEL PHARMA
HEMAPO Inj 2000 IU Injeksi 2000 IU KALBE FARMA
HEMAPO Inj 3000 IU Injeksi 3000 IU KALBE FARMA
RENOGEN Inj 3000 IU Injeksi 3000 IU ETANA BIOTECHNOLOGI
RENOGEN Inj 4000 IU Injeksi 4000 IU ETANA BIOTECHNOLOGI
Filgastrim LEUCOGEN PFS 300 mcg Injeksi 300 mcg KALBE FARMA
NEUKINE Inj 300 mcg/ml Injeksi 300 mcg SANBE FARMA
Methoxy polyethylene glycol-epoetin beta MIRCERA Inj 100 mcg Injeksi 100 mcg ROCHE
02S. OTHER CARDIOVASCULAR DRUGS
Vit B1; vit B6; vit B12; vit
Tablet
ATP E BIO ATP Tab 20 mg PHAPROS
Coenzyme Q10 UBI-Q Kaps 100 mg Kapsul 100 mg TANABE
Omega-3; ethyl esters CORMEGA BLISTER Kaps 1 g Kapsul 1g LANDSON PERTIWI AGUNG
Prothrombin Complex Concentrate (Factor II,VII, IX, X) OCTAPLEX Inj 500 IU Injeksi 500 iu SATYA ABADI PHARMA
03 RESPIRATORY SYSTEM
03b. ANTIASTHMATICS & COLD PREPARATIONS
Aminophylline AMINOPHYLLINE Inj 24 mg/ml (PR) Injeksi 24 mg/mL PHAPROS
PHAMINOV Inj 24 mg/ml Injeksi 24 mg/mL PHAPROS
Beclometason Formoterol INNOVAIR INH 100 mcg Inhaler 100 mcg ZAMBON INDONESIA
Budesonide BUDESMA Resp 0,5 mg/ml Inhalasi 0,5 mg DEXA MEDICA
BUDESONIDE Neb 0.5 mg/2 ml (FA) Inhalasi 0,5mg/2ml FAHRENHEIT
Ephedrin HCl EPHEDRIN HCL Inj 50 mg/ml (EI) Injeksi 50 mg/ml ETHICA INDUSTRI FARMASI
EPHEDRIN HCL Inj 50 mg/mL (MB) Injeksi 50 mg/ml MAHAKAM BETA FARMA
Fluticasone propionate FLIXOTIDE Nebules 0,5 mg/2 mL Inhalasi 0,5 mg/ 2 ml GLAXO WELLCOME INDONESIA
Indacaterol ONBREZ INH 300 mcg Inhaler 300 mcg NOVARTIS INDONESIA
13
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Ipratropium Salbutamol MEPROVENT Inhalasi Liq 0,5 mg/2,5 ml Inhalasi 0,5 mg MEPROFARM
Ipratropium IPRATROPIUM BROMIDA Inhalasi (PN) Inhalasi 0,25mg FAHRENHEIT
Ketotifen hydrogen fumarate PROFILAS Tab 1 mg Tablet 1 mg KALBE FARMA
Montelukas MONARIN Tab 10 mg Tablet 10 mg DEXA MEDICA
Procaterol HCl MEPTIN Inh Sol 30 mcg/0,3 ml Inhalasi 30 mcg/0,3 mL OTSUKA
MEPTIN MINI Tab 25 mcg Tablet 25 mcg OTSUKA
PROCATEROL HYDROCHLORIDE HEMIHYDRATE Syr 0.025 mg/5Sirup
ml (MM) 0,025 mg/5 ml MEPROFARM
Salbutamol guafenesin FARTOLIN Syr 2 mg Sirup 2 mg FAHRENHEIT
Ipratoprium COMBIVENT UDV Inj 3.00 mg/2,5 ml Inhalasi 3 mg/2,5 ml BOEHRINGER
Salbutamol DILATAMOL Tab 2 mg Tablet 2 mg BERNOFARM
PRITASMA Tab 4 mg Tablet 4 mg MOLEX AYUS
SALBUTAMOL Syr 2 mg/5 ml (ID) Sirup 2 mg/5 ml IMFARMIND FARMASI INDUSTRI
SALBUTAMOL Tab 2 mg (KF) Tablet 2 mg KIMIA FARMA
SALBUTAMOL Tab 2 mg (PN) Tablet 2 mg FAHRENHEIT
SALBUTAMOL Tab 4 mg (FA) Tablet 4 mg FAHRENHEIT
SALBUTAMOL Tab 4 mg (ID) Tablet 4 mg IMFARMIND FARMASI INDUSTRI
SUPRASMA MDI Inh 100 mcg Inhaler 100 mcg DEXA MEDICA
VELUTINE NEBULES Inh 2,5 mg/4 ml Inhalasi 2,5 mg/4 mL NOVEL PHARMA
VENTOLIN Inh 100 mcg Inhaler 100 mcg GLAXO WELLCOME INDONESIA
VENTOLIN NEBULES 2.5 mcg Inhalasi 2,5 mcg GLAXO WELLCOME INDONESIA
Salmeterol Fluticasone propionat RESPITIDE Inh 25 mg/125 mcg Inhaler 25 mg DEXA MEDICA
SERETIDE DISKUS 50/500 mcg Inhaler 50 mg GLAXO WELLCOME INDONESIA
SERETIDE MDI Inh 25 mg/125 mcg Inhaler 25 mg GLAXO WELLCOME INDONESIA
Terbutaline Sulfate BRICASMA Inj 0.5 mg/ml Injeksi 0,5 mg/ mL ASTRA ZENECA
MOLASMA Tab 2,5 mg Tablet 2,5 mg MOLEX AYUS
NAIRET Inj 0,5 mg/ml Injeksi 0,5 mg OTTO PHARMACEUTICAL
TABAS Syr 1,5 mg/5 ml 100 ml Sirup 1,5 mg/5 mL MEPROFARM
Theophylin Salbutamol TEOSAL Tab Tablet DEXA MEDICA
EUPHYLLIN R.MITE Tab 125 mg Tablet 125 mg PHAROS INDONESIA
EUPHYLLIN RETARD Tab 250 mg Tablet 250 mg PHAROS INDONESIA
RETAPHYL SR Tab 300 mg Tablet SR 300 mg KIMIA FARMA
Tiotropium Br SPIOLTO RESPIMAT Inh 2,5 mcg Inhalasi 2,5 mcg BOEHRINGER
SPIRIVA RESPIMAT Sol Inh 2,5 mcg Inhalasi 2,5 mcg BOEHRINGER
03c. COUGH & COLD PREPARATIONS
Acetaminophen NIPE Drops Drops 1 mg TRANSFARMA MEDICA INDAH
Ambroxol AMBROXOL ELIXIR 30 mg/5 ml (BE) Sirup 30 mg / 5 ml BERNOFARM
AMBROXOL Syr 15 mg/5 ml (PR) Sirup 15 mg / 5 ml PHAPROS
AMBROXOL Tab 30 mg (KF) Tablet 30 mg KIMIA FARMA
AMBROXOL Tab 30 mg (PR) Tablet 30 mg PHAPROS
14
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
EPEXOL Syr 30 mg/5 ml Sirup 30 mg/5 ml SANBE FARMA
MUCOPECT Ped Syr 15 mg/5 ml Sirup 15 mg/5 mL AVENTIS PHARMA
MUCOPECT Tab 30 mg Tablet 30 mg AVENTIS PHARMA
PROMUXOL Drops Drops 15 mg GRACIA PHARMINDO
Bromhexine Hcl BISOLVON Sol 2 mg/ml Larutan 2 mg/ ml AVENTIS PHARMA
FARMAVON Inj 4 mg/2 ml Injeksi 4 mg/2 mL FAHRENHEIT
HUSTAB P Tab 8 mg Tablet 8 mg PHAPROS
LEXAVON Syr 4 mg/5 ml Sirup 4 mg/5 ml MOLEX AYUS
Codein Phenyltoloxamine CODIPRONT Kaps 30 mg Kapsul 30 mg KIMIA FARMA
Phenyltoloxamine;
Kapsul
Guaifenesin CODIPRONT CUM EXP Kaps 30 mg 30 mg KIMIA FARMA
Phenyltoloxamine;
Guaifenesin; Thyme liqd Sirup
extr CODIPRONT CUM EXP Syr KIMIA FARMA
CODEIN Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
CODEIN Tab 15 mg (KF) Tablet 15 mg KIMIA FARMA
CODEIN Tab 20 mg (KF) Tablet 20 mg KIMIA FARMA
CODIKAF Tab 10 mg Tablet 10 mg KIMIA FARMA
CODIKAF Tab 15 mg Tablet 15 mg KIMIA FARMA
Diphenhydramine Hcl Ammonium klorida SANADRYL Syr 12,5 mg 60 ml Sirup 12,5 mg SANBE FARMA
Sodium Citrate;
Menthol, Ammonium Sirup
klorida SANADRYL EXPECTORAN Syr 120 ml 120 ml SANBE FARMA
Erdosteine EDOTIN Kaps 300 mg Kapsul 300 mg FERRON PAR PHARMATEUTICALS
ERDOSTEINE Dry Syr 175 mg/5 ml (NP) Sirup Kering 175 mg /5 ml NOVEL PHARMA
ERDOSTEINE Kaps 300 mg (MB) Kapsul 300 mg MAHAKAM BETA FARMA
ERDOSTEINE Tab 300 mg (NP) Tablet 300 mg NOVEL PHARMA
MUCOTEIN DS 175 mg/5 ml Sirup Kering 175 mg /5 ml COMBIPHAR
Glyceryl guaiacolate GLYCERYL GUAIACOLAT Tab 100 mg (KF) Tablet 100 mg KIMIA FARMA
Levodropropizine LEVOPRONT Syr 60 mg/10 mL Sirup 60 mg/ 10 mL COMBIPHAR
N-Acetylcysteine ACETYLCYSTEIN Kaps 200 mg (IF) Kapsul 200 mg INDOFARMA
ACETYLCYSTEINE Kaps 200 mg (NP) Kapsul 200 mg NOVEL PHARMA
ACETYLCYSTEINE Inf 200 mg/ml (YN) Infus 200 mg/ml YARINDO FARMATAMA
ACYSTEIN Cairan Inh 300 mg/3 ml Inhalasi 300 mg/3 ml BERNOFARM
FLUIMUCIL Inj 10% 300 mg/3 ml Injeksi 300 mg/3 mL ZAMBON INDONESIA
FLUIMUCIL Kaps 200 mg Kapsul 200 mg ZAMBON INDONESIA
FLUIMUCIL Syr 100 mg/5 ml 75 ml Sirup 100 mg/ 5 mL ZAMBON INDONESIA
HIDONAC Inj 20 % 5 g/25 ml Injeksi 5 g/ 25 mL ZAMBON INDONESIA
INCETYL Kaps 200 mg Kapsul 200 mg INDOFARMA
15
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
MEMUCIL Tab 600 mg Tablet 600 mg SIMEX
N-ACETYLCYSTEINE Sol 100 mg/ml (DM) Infus 100 mg DEXA MEDICA
RESFAR Inj 5 g/25 ml Injeksi 5 g/ 25 mL FAHRENHEIT
Oxomemazine Guaifenesin OKSOVELL syr Sirup NOVEL PHARMA
Paracetamol;
Chlorpheniramine; Tablet
Phenylpropanolamine Dekstromethorphan HBr ALPARA Tab 500 mg 500 mg MOLEX AYUS
TUZALOS Tab Tablet 500 mg SANBE FARMA
MOLEXFLU Syr Sirup MOLEX AYUS
Isothipendyl HCl;
Liquorice extr; Glyceryl Sirup
Pipazethate Guaiacolate TRANSPULMIN Syr 100 ml 100 mL TRANSFARMA MEDICA INDAH
Pseudoephedrine Hcl Loratadin ALDISA SR Kaps 60 mg Kapsul 60 mg SANBE FARMA
RHINOS SR Kaps 60 mg Kapsul 60 mg DEXA MEDICA
Pseudoephedrine Hcl Tripolidine GRAFED Tab 30 mg Tablet 30 mg GRACIA PHARMINDO
RHINOFED Tab 30 mg Tablet 30 mg DEXA MEDICA
RHINOFED Syr 15 mg Sirup 15 mg DEXA MEDICA
RHINOS JUNIOR Syr 60 ml Sirup 60 ml DEXA MEDICA
TREMENZA Syr 30 mg/5 ml 60 ml Sirup 30 mg/5 ml SANBE FARMA
03d. NASAL DECONGESTANT & OTHER NASAL PREPARATIONS
Fluticasone propionate AVAMYS Nasal Spray 27,5 mcg/spray Semprot Hidung 27,5 mcg GLAXO WELLCOME INDONESIA
Mometasone Furoate MODEXA Nasal Spray 0.05% Semprot Hidung 0.05% DEXA MEDICA
NASONEX Spray 140 MDS Semprot Hidung 140 MDS TRANSFARMA MEDICA INDAH
Oxymetazoline Hcl ILIADIN Drops 0.025% Tetes Hidung 0.025% PNGH (Protecter & Gamble)
ILIADIN Spray 0,05% 10 ml Semprot Hidung 10 ml PNGH (Protecter & Gamble)
Sea Water NASALIN Nasal Spray 100% Semprot Hidung DEXA MEDICA
STERIMAR BABY Nose Hygiene 50 ml Semprot Hidung 50 ml HYPHENS
Sodium Chloride BREATHY Nasal Drops 6,5 mg 30 ml Tetes Hidung 6,5 mg NOVEL PHARMA
Triamcinolone Acetonide NASACORT AQ Drops 55 mcg/120 Dosis Tetes Hidung 55 mcg AVENTIS PHARMA
03e. OTHER DRUGS ACTING ON THE RESPIRATORY SYSTEM
Beractant SURVANTA Inj 25 mg/ml Injeksi 25 mg/ mL ABBOTT
04 CENTRAL NERVOUS SYSTEM
04a. ANXIOLYTICS
Alprazolam ALPRAZOLAM Tab 0,5 mg (OT) Tablet 0,5 mg OTTO PHARMACEUTICAL
ALPRAZOLAM Tab 0.5 mg (KF) Tablet 0,5 mg KIMIA FARMA
ALPRAZOLAM Tab 1 mg (KF) Tablet 1 mg KIMIA FARMA
XANAX Tab 0,5 mg Tablet 0,5 mg PFIZER INDONESIA
XANAX Tab 1 mg Tablet 1 mg PFIZER INDONESIA
ZOLASTIN tab 1 mg Tablet 1 mg GRACIA PHARMINDO
16
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Clobazam CLOBAZAM Tab 10 mg (DM) Tablet 10 mg DEXA MEDICA
CLOFRITIS Tab 10 mg Tablet 10 mg MERSIFARMA
Diazepam DIAZEPAM ENEMA 5 mg/2,5 ml (NP) Rectal Tube 5 mg/2,5 ml NOVEL PHARMA
STESOLID Rectal Tube 10 mg Rectal Tube 10 mg/2,5 ml ACTAVIS
STESOLID Rectal Tube 5 mg Rectal Tube 5 mg/2,5 ml ACTAVIS
DIAZEPAM Inj 10 mg/2 ml (MM) Injeksi 10 mg/2ml MEPROFARM
DIAZEPAM Tab 2 mg (KF) Tablet 2 mg KIMIA FARMA
DIAZEPAM Tab 2 mg (PN) Tablet 2 mg FAHRENHEIT
VALDIMEX Inj 10 mg/2 ml Injeksi 10 mg/2ml MERSIFARMA
VALISANBE Tab 2 mg Tablet 2 mg SANBE FARMA
VALISANBE Tab 5 mg Tablet 5 mg SANBE FARMA
Lorazepam ATIVAN Tab 1 mg Tablet 1 mg SUNTHI SEPURI
LORAZEPAM Tab 2 mg (SU) Tablet 2 mg SUNTHI SEPURI
MERLOPAM Tab 0.5 mg Tablet 0,5 mg MERSIFARMA
04b. HYPNOTICS & SEDATIVES
Dexmedetomidine Hcl ICUNES Inj Injeksi 100 mcg/ml NOVEL PHARMA
KABIMIDINE Inj 100 mcg/ml Injeksi 100 mcg/ml ETHICA INDUSTRI FARMASI
Estazolam ALENA Tab 1 mg Tablet 1 mg NOVEL PHARMA
ALENA Tab 2 mg Tablet 2 mg NOVEL PHARMA
ESILGAN Tab 1 mg Tablet 1 mg TAKEDA INDONESIA
ESILGAN Tab 2 mg Tablet 2 mg TAKEDA INDONESIA
Midazolam HIPNOZ Inj 5 mg/5 ml Injeksi 5 mg/5 ml PHAROS INDONESIA
MIDANEST Inj 15 mg/3 ml Injeksi 15mg/3 ml GUARDIAN PHARMATAMA
MIDAZOLAM HCL Inj 15 mg/3 ml (EI) Injeksi 15mg/3 ml ETHICA INDUSTRI FARMASI
MIDAZOLAM HCL Inj 5 mg/5 ml (EI) Injeksi 5 mg/5ml ETHICA INDUSTRI FARMASI
MILOZ Inj 15 mg/3 ml Injeksi 15mg/3 ml NOVEL PHARMA
Zolpidem ZOLMIA Tab 5 mg Tablet 5 mg FAHRENHEIT
ZUDEM Tab 10 mg Tablet 10 mg GUARDIAN PHARMATAMA
04c. ANTIDEPRESSANTS
Agomelatine VALDOXAN Tab 25 mg Tablet 25 mg SERVIER INDONESIA
Amitriptyline AMITRIPTYLINE Tab 25 mg (IF) Tablet 25 mg INDOFARMA
AMITRIPTYLINE Tab 25 mg (PN) Tablet 25 mg FAHRENHEIT
Duloxetine CYMBALTA Kaps 60 mg Kapsul 60 mg ELI LILLY
Escitalopram CIPRALEX Tab 10 mg Tablet 10 mg LUNDBEX EXPORT A/S
ELXION Tab 10 mg Tablet 10 mg MERSIFARMA
Fluoxetin FLUOXETINE Kapl 20 mg Kaplet 20 mg DEXA MEDICA
NOPRES Kapl 20 mg Kaplet 20 mg DEXA MEDICA
Fluvoxamine Maleate LUVOX Tab 50 mg Tablet 50 mg ABBOTT
Lithium FRIMANIA Tab 200 mg Tablet 200 mg MERSIFARMA
17
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Maprotiline SANDEPRIL Tab 50 mg Tablet 50 mg MERSIFARMA
Mirtazapine MIRZAP Tab 30 mg Tablet 30 mg NOVEL PHARMA
Sertraline HCl SERTRALINE Tab 50 mg (MM) Tablet 50 mg MEPROFARM
SETRALIN Tab 50 mg Tablet 50mg FAHRENHEIT
Vortioxetine BRINTELLIX Tab 10 mg Tablet 10 mg LUNDBEX EXPORT A/S
04d. ANTIPSYCHOTICS
Aripiprazole ABILIFY DISCMELT Tab 10 mg Tablet 10 mg OTSUKA
ABILIFY MAINTENA Inj 400 mg Injeksi 400 mg OTSUKA
ABILIFY Tab 5 mg Tablet 5 mg OTSUKA
ARIPIPRAZOLE FAST MELTING Tab 15 mg (DM) Tablet 15 mg DEXA MEDICA
ARIPIPRAZOLE Kapl 10 mg (NB) Kaplet 10 mg NULAB PHARMACEUTICAL INDONESIA
AVRAM Tab 10 mg Tablet 10 mg PHAROS INDONESIA
AVRAM Tab 15 mg Tablet 15 mg PHAROS INDONESIA
Brexpiprazole REXULTI Tab 1 mg Tablet 1 mg OTSUKA
Chlorpromazine CEPEZET Inj 50 mg/2 ml Injeksi 50 mg/2ml MERSIFARMA
CEPEZET Tab 100 mg Tablet 100 mg MERSIFARMA
CHLORPROMAZINE Inj 25 mg/ml (PR) Injeksi 25 mg PHAPROS
CHLORPROMAZINE Inj 5 mg/ml (PR) Injeksi 5 mg PHAPROS
CHLORPROMAZINE Tab 100 mg (PR) Tablet 100 mg PHAPROS
CHLORPROMAZINE Tab 25 mg (PR) Tablet 25 mg PHAPROS
Clozapine CLORILEX Tab 100 mg Tablet 100 mg MERSIFARMA
CLORILEX Tab 25 mg Tablet 25 mg MERSIFARMA
CLOZAPINE Tab 100 mg (DM) Tablet 100 mg DEXA MEDICA
CLOZAPINE Tab 100 mg (SU) Tablet 100 mg SUNTHI SEPURI
CLOZAPINE Tab 25 mg (DM) Tablet 25 mg DEXA MEDICA
Flufenazine SIKZONOATE Inj 25 mg/ml Injeksi 25 mg MERSIFARMA
Haloperidol HALOPERIDOL Inj 5 mg/1 ml (DM) Injeksi 5 mg/1 ml DEXA MEDICA
HALOPERIDOL Tab 0,5 mg (PN) Tablet 0,5 mg FAHRENHEIT
HALOPERIDOL Tab 1,5 mg (PN) Tablet 1,5 mg FAHRENHEIT
HALOPERIDOL Tab 5 mg (PN) Tablet 5 mg FAHRENHEIT
LODOMER Drops 2 mg/15 mL Drops 5 mg MERSIFARMA
LODOMER Inj 5 mg/mL Injeksi 5 mg/1 ml MERSIFARMA
LODOMER Tab 2 mg Tablet 2 mg MERSIFARMA
LODOMER Tab 5 mg Tablet 5 mg MERSIFARMA
Olanzapine OLANZAPIN 10 mg (AC) Tablet 10 mg ACTAVIS
OLANZAPIN Tab 5 mg (AC) Tablet 5 mg ACTAVIS
ONZAPIN Tab 10 mg Tablet 10 mg ACTAVIS
ONZAPIN Tab 5 mg Tablet 5 mg ACTAVIS
REMITAL Tab 10 mg Tablet 10 mg PHAROS INDONESIA
18
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Quetiapine fumarate Q-PIN Tab 100 mg Tablet 100 mg AMAROX PHARMA GLOBAL
QUETIAPINE FUMARATE Tab 100 mg (AM) Tablet 100 mg AMAROX PHARMA GLOBAL
QUETIAPINE FUMARATE Tab 200 mg (AM) Tablet 200 mg AMAROX PHARMA GLOBAL
QUETVELL Tab 200 mg Tablet 200 mg NOVEL PHARMA
SEROQUEL XR Tab 200 mg Tablet XR 200 mg ASTRA ZENECA
SEROQUEL XR Tab 50 mg Tablet XR 50 mg ASTRA ZENECA
Risperidone - RISPERIDONE Tab 1 mg (NB) Tablet 1 mg NULAB PHARMACEUTICAL INDONESIA
RISPERIDONE Tab 1 mg (DM) Tablet 1 mg DEXA MEDICA
NOPRENIA ODT 2 mg Tablet 2 mg NOVEL PHARMA
RISPERIDONE Tab 2 mg (DM) Tablet 2 mg DEXA MEDICA
RISPERIDONE Tab 2 mg (NB) Tablet 2 mg NULAB PHARMACEUTICAL INDONESIA
Sulpiride DOGMATIL FORTE Kapl 200 mg Kaplet 200 mg SOHO INDUSTRI PHARMASI
DOGMATIL Kaps 50 mg Kapsul 50 mg SOHO INDUSTRI PHARMASI
Trifluoperazine STELOSI Tab 5 mg Tablet 5 mg MERSIFARMA
TRIFLUOPERAZINE Tab 5 mg (DV) Tablet 5 mg DARYA VARIA
04e. ANTICONVULSANTS
Asam Valproat DEPAKENE Syr 250 mg/5 ml 120 ml Sirup 250 mg/5 ml ABBOTT
SODIUM VALPROATE Syr 250 mg/120 ml (PR) Sirup 250 mg / 5 ml PHAPROS
VALPROIC ACID Syr 250 mg/5 ml 100 ml (IF) Sirup 250 mg/5 ml INDOFARMA
Carbamazepine BAMGETOL Tab 200 mg Tablet 200 mg MERSIFARMA
TEGRETOL CR TAB 200 MG Tablet CR 200 mg NOVARTIS INDONESIA
TEGRETOL Tab 200 mg Tablet 200 mg NOVARTIS INDONESIA
Clonazepam RIKLONA Tab 2 mg Tablet 2 mg MERSIFARMA
Divalproat Na DEPAKOTE ER Tab 250 mg Tablet ER 250 mg ABBOTT
DEPAKOTE ER Tab 500 mg Tablet ER 500 mg ABBOTT
DIVALPROEX SODIUM Kapl 250 mg (NP) Kaplet 250 mg NOVEL PHARMA
DIVALPROEX SODIUM Kapl 250 mg (YN) Kaplet 250 mg YARINDO FARMATAMA
DIVALPROEX SODIUM Kapl 500 mg (YN) Kaplet 500 mg YARINDO FARMATAMA
Lamotrigin LAMICTAL Tab 50 mg Tablet 50 mg GLAXO WELLCOME INDONESIA
LAMIROS Tab 50 mg Tablet 50 mg MERSIFARMA
Levetiracetam ETERLOX Tab 500 mg Tablet 500 mg NOVEL PHARMA
KEPPRA Tab 500 mg Tablet 500 mg GLAXO WELLCOME INDONESIA
Oxcabarzepin PROLEPSI Tab 300 mg Tablet 300 mg MERSIFARMA
Perampanel FYCOMPA Tab 2 mg Tablet 2 mg EISAI INDONESIA
Phenobarbital PHENOBARBITAL Inj 50 mg (PR) Injeksi 50 mg PHAPROS
PHENOBARBITAL Tab 30 mg (KF) Tablet 30 mg KIMIA FARMA
SIBITAL Inj 200 mg/2 ml Injeksi 200 mg/2 ml MERSIFARMA
SIBITAL Tab 50 mg Tablet 50 mg MERSIFARMA
19
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Phenytoin KUTOIN Kaps 100 mg Kapsul 100 mg MERSIFARMA
NA. PHENYTOIN Inj 50 mg/ml (PR) Injeksi 50 mg PHAPROS
PHENYTOIN SODIUM Inj 50 mg/ml (MM) Injeksi 50 mg MEPROFARM
PHENYTOIN Kaps 100 mg (IP) Kapsul 100 mg IKAPHARMINDO PUTRAMAS
Pregabalin LYRICA Kaps 150 mg Kapsul 150 mg PFIZER INDONESIA
NEVALIN Tab 150 mg Tablet 150 mg KIMIA FARMA
NEVALIN Tab 75 mg Tablet 75 mg KIMIA FARMA
PREGABALIN Kaps 150 mg (KF) Kapsul 150 mg KIMIA FARMA
PREGABALIN Kaps 50 mg (AM) Kapsul 50 mg AMAROX PHARMA GLOBAL
PREGABALIN Kaps 75 mg (HJ) Kapsul 75 mg HEXPHARM JAYA
PREGABALIN Kaps 75 mg (KF) Kapsul 75 mg KIMIA FARMA
Topiramate TOPAMAX Tab 25 mg Tablet 25 mg JOHNSON & JOHNSON
04f. OTHER CNS DRUGS & AGENTS FOR ADHD
Methylphenidate Hidroklorida PROHIPER Tab 10 mg Tablet 10 mg MERSIFARMA
04g. NEURODEGENERATIVE DISEASE DRUGS
Donepezil HCl ARICEPT EVESS Tab 10 mg Tablet 10 mg EISAI INDONESIA
ARICEPT EVESS Tab 5 mg Tablet 5 mg EISAI INDONESIA
DONEPEZIL HCL Tab 5 mg (NP) Tablet 5 mg NOVEL PHARMA
DONEPEZIL Tab 5 mg (NB) Tablet 5 mg NULAB PHARMACEUTICAL INDONESIA
Memantine ABIXA Tab 10 mg Tablet 10 mg LUNDBEX EXPORT A/S
04h. ANTIPARKINSONIAN DRUGS
Levodopa Benserazide LEVAZIDE Tab 100 mg Tablet 100 mg PYRIDAM
Cardidoka, Entacapon STALEVO Tab Tablet 100mg IMEDCO / WELLESTA CPI
Pramipexole DiHCl PRAMIPEXOLE Tab 0.125 mg (DM) Tablet 0,125 mg DEXA MEDICA
PRAMIVEX Tab 0,125 mg (NP) Tablet 0,125 mg NOVEL PHARMA
SIFROL Tab 0.125 mg Tablet 0,125 mg BOEHRINGER
Trihexyphenydil ARKINE Kapl 2 mg Kaplet 2 mg PYRIDAM
HEXYMER Tab 2 mg Tablet 2 mg MERSIFARMA
TRIHEXYPHENIDYL Tab 2 mg (IF) Tablet 2 mg INDOFARMA
04i. ANTIVERTIGO DRUGS
Betahistine BETAHISTIN Tab 6 mg (DM) Tablet 6 mg DEXA MEDICA
BETAHISTINE Tab 6 mg (NP) Tablet 6 mg NOVEL PHARMA
LEXIGO Tab 6 mg Tablet 6 mg MOLEX AYUS
VASTIGO Tab 6 mg Tablet 6 mg DEXA MEDICA
MERTIGO SR Tab 12 mg Tablet SR 12 mg DEXA MEDICA
VERTIKAF Tab 24 mg Tablet 24 mg KIMIA FARMA
04j. ANALGESICS (OPIOID)
Fentanyl DUROGESIC Patch 12 mcg Patch 12 mcg JOHNSON & JOHNSON
DUROGESIC Patch 25 mcg Patch 25 mcg JOHNSON & JOHNSON
20
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
ETANYL Inj 0,1 mg/2 mL Injeksi 0,1 mg/2 mL MAHAKAM BETA FARMA
FENTANYL Inj 0,1 mg/2 ml (MB) Injeksi 0,1 mg/2 mL MAHAKAM BETA FARMA
FENTANYL Inj 0,5 mg/10 ml (MB) Injeksi 0,5 mg/10 ml MAHAKAM BETA FARMA
FENTANYL Inj 50 mcg/mL 2 mL (PI) Injeksi 0,5 mg/5 ml PIRAMAL CRITICAL CARE
Morphine Sulfat MORFIKAF Tab 10 mg Tablet 10 mg KIMIA FARMA
MORPHIN HCL Inj 10 mg (KF) Injeksi 10 mg KIMIA FARMA
MORPHIN Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
MST CONTINUS Tab 15 mg Tablet 15 mg MAHAKAM BETA FARMA
MST Tab 10 mg Tablet 10 mg MAHAKAM BETA FARMA
Tramadol DOLGESIC Inj 100 mg/2 ml Injeksi 100 mg/2 ml MERSIFARMA
DOLGESIC Kaps 50 mg Kapsul 50 mg MERSIFARMA
TRAMADOL Inj 100 mg/2 ml (MB) Injeksi 100 mg/2 ml MAHAKAM BETA FARMA
TRAMADOL Inj 100 mg/2 ml (MT) Injeksi 100 mg/2 ml MERSIFARMA
TRAMADOL Kaps 50 mg (FA) Kapsul 50 mg FAHRENHEIT
TRAMADOL Kaps 50 mg (OT) Kapsul 50 mg OTTO PHARMACEUTICAL
TRAMAL Supp 100 mg Suppositoria 100 mg PHAROS INDONESIA
04k. ANALGESICS (NON-OPIOID) & ANTIPYRETICS
Metamizole Diazepam NEURODIAL tab Tablet 500 mg KIMIA FARMA
Metamizole POTENSIK Tab 500 mg Tablet 500 mg PYRIDAM
ANTALGIN Inj 25 % (PR) Injeksi 250 mg PHAPROS
METAMIZOLE SODIUM MONOHYDRATE Inj 500 mg (BE) Injeksi 500 mg BERNOFARM
METAMIZOLE SODIUM Tab 500 mg Tablet 500 mg MERSIFARMA
Paracetamol N Acetilcystein SISTENOL Kapl Kaplet 500 mg DEXA MEDICA
Vit B1, B6, B12 DOLONEUROBION Tab 500 mg Tablet 500 mg PNGH (Protecter & Gamble)
Paracetamol DUMIN Rect Tube 125 mg/2,5 ml Rectal Tube 125 mg/2,5 ml ACTAVIS
DUMIN Rect Tube 250 mg/4 ml Rectal Tube 250 mg/4 mL ACTAVIS
PARACETAMOL Enema 125 mg/2,5 ml (NP) Enema 125 mg/2,5 ml NOVEL PHARMA
ERLAMOL Drops Drops 100 mg ERELA
FARMADOL Tab 500 mg Tablet 500 mg FAHRENHEIT
SANMOL Tab 500 mg Tablet 500 mg SANBE FARMA
PARACETAMOL Tab 500 mg (KF) Tablet 500 mg KIMIA FARMA
PARACETAMOL Tab 500 mg (MT) Tablet 500 mg MERSIFARMA
PARACETAMOL Drops 100 mg/ml (IF) Drops 100 mg INDOFARMA
PARACETAMOL Syr 120 mg/5 ml (MM) Sirup 120 mg / 5 ml MEPROFARM
TEMPRA FORTE Syr 250 mg/5 ml 60 ml Sirup 250 mg/ 5 ml TAISHO PHARMACEUTICAL
TEMPRA Syr 160 mg/5 ml 100 ml Sirup 160 mg/ 5 mL TAISHO PHARMACEUTICAL
XEPAMOL Syr 250 mg Sirup 250 mg METISKA FARMA
PARACETAMOL Inf 1 g/100 ml (BE) Infus 1 g/100 mL BERNOFARM
PARACETAMOL Inf 1 g/100 ml (PR) Infus 1 g / 100 ml PHAPROS
21
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
PYREXIN Supp 160 mg Suppositoria 160 mg MEPROFARM
PYREXIN Supp 80 mg Suppositoria 80 mg MEPROFARM
Tramadol Paracetamol TRAPASIN Tab Tablet 37,5 mg ; 325 mg COMBIPHAR
TRAMPARA Tab 325 mg Tablet 325 mg PHAPROS
ULTRACET Tab 37,5 mg/325 mg Tablet 37,5/325 mg JOHNSON & JOHNSON
04l. NONSTEROIDAL ANTI-INFLAMMATORY AGENTS (NSAIDS)
Asam Mefenamat - ASAM MEFENAMAT Tab 500 mg (HL) Tablet 500 mg HOLI PHARMA
MEFENAMIC ACID Kapl 500 mg (HJ) Kaplet 500 mg HEXPHARM JAYA
MEFINAL Kapl 500 mg Kaplet 500 mg SANBE FARMA
PONDEX Susp 50 mg/5 ml Suspensi 50 mg/ 5 mL DEXA MEDICA
TOPGESIC Tab 500 mg Tablet 500 mg KIMIA FARMA
Celecoxib CELEBREX Kaps 200 mg Kapsul 200 mg PFIZER INDONESIA
CELECOXIB Kaps 200 mg (NP) Kapsul 200 mg NOVEL PHARMA
NUBREX Kaps 200 mg Kapsul 200 mg GUARDIAN PHARMATAMA
CELEXOCIB Kaps 100 mg (FA) Kapsul 100 mg FAHRENHEIT
NUBREX Kaps 100 mg Kapsul 100 mg GUARDIAN PHARMATAMA
Dexketoprofen trometamol DEXKETOPROFEN Inj 50 mg/2 ml (NP) Injeksi 25 mg/ml NOVEL PHARMA
DEXKETOPROFEN TROMETAMOL Inj 25 mg/ml (IT) Injeksi 25 mg/ml INTERBAT
DEXKETOPROFEN Tab 25 mg (NP) Tablet 25 mg NOVEL PHARMA
DEXKETOPROFEN TROMETAMOL TAB 25 MG (IT) Tablet 25 mg INTERBAT
KETESSE Inj 50 mg Injeksi 25 mg/ml FERRON PAR PHARMATEUTICALS
KETESSE Tab 25 mg Tablet 25 mg FERRON PAR PHARMATEUTICALS
Diclofenac Diethylamine DICLOFENAC DIETHYLAMINE Gel 20 g ((NP) Gel 20 g NOVEL PHARMA
DICLOFENAC DIETHYLAMINE Gel 50 g (NP) Gel 50 g NOVEL PHARMA
VOLTAREN EMULGEL 20 g Gel 20 g STERLING PRODUCTS INDONESIA
Diclofenac Kalium CATAFLAM FAST POWD 50 mg Serbuk 50 mg NOVARTIS INDONESIA
CATAFLAM Oral Drops 15 mg/ml 15 ml Drops 15 mg/15 mL NOVARTIS INDONESIA
CATAFLAM Tab 25 mg Tablet 25 mg NOVARTIS INDONESIA
DICLOFENAC K Tab 25 mg (NB) Drops 25 mg NULAB PHARMACEUTICAL INDONESIA
DICLOFENAC POTASSIUM Tab 50 mg (HJ) Tablet 50 mg HEXPHARM JAYA
DICLOFENAC POTASSIUM Tab 50 mg (NP) Tablet 50 mg NOVEL PHARMA
KAMAFLAM Tab 50 mg Tablet 50 mg KIMIA FARMA
DICLOFENAC SODIUM ENTERIC COATED Tab 50 mg
Tablet
Diclofenac Na (DM) 50 mg DEXA MEDICA
KLOTAREN Tab 25 mg Tablet 25 mg KIMIA FARMA
KLOTAREN Tab 50 mg Tablet 50 mg KIMIA FARMA
NATRIUM DIKLOFENAK Tab 25 mg (KF) Tablet 25 mg KIMIA FARMA
NATRIUM DIKLOFENAK Tab 25 mg (PR) Tablet 25 mg PHAPROS
NATRIUM DIKLOFENAK Tab 50 mg (KF) Tablet 50 mg KIMIA FARMA
22
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Etoricoxib ARCOXIA Tab 120 mg Tablet 120 mg TRANSFARMA MEDICA INDAH
ETORICOXIB Tab 120 mg (AM) Tablet 120 mg AMAROX PHARMA GLOBAL
ARCOXIA Tab 60 mg Tablet 60 mg TRANSFARMA MEDICA INDAH
ETORICOXIB Tab 60 mg (AM) Tablet 60 mg AMAROX PHARMA GLOBAL
ORINOX Tab 60 mg Tablet 60 mg DEXA MEDICA
ETORICOXIB Tab 90 mg Tablet 90 mg YARINDO FARMATAMA
ETORIX Tab 90 mg Tablet 90 mg DARYA VARIA
Ibuprofen BUFECT Tab 200 mg Tablet 200 mg SANBE FARMA
IBUPROFEN Tab 200 mg (PN) Tablet 200 mg FAHRENHEIT
IBUPROFEN FC Tab 400 mg (PM) 400 mg
Tablet
PROMEDRAHARDJO FARMASI INDUSTRI
LIFLAMAL 400 Kapl Kaplet 400 mg HOLI PHARMA
IBUPROFEN Susp 100 mg/5 ml (BE) Suspensi 100 mg/ 5 mL BERNOFARM
INSIC Susp Suspensi 100 mg/ 5 mL HOLI PHARMA
INSIC Susp Forte 200 mg/5 ml Suspensi 200 mg/5 ml HOLI PHARMA
PEINLOS Inj 400 mg/4 ml Injeksi 400 mg/4ml FAHRENHEIT
PEINLOS Inj 800 mg/8 ml Injeksi 800 mg/8 ml FAHRENHEIT
PRORIS Supp 125 mg Suppositoria 125 mg PHAROS INDONESIA
Ketoprofen KALTROFEN Gel Gel 2,5% KALBE FARMA
KETOPROFEN Inj 100 mg/2 mL (BE) Injeksi 100 mg/2 ml BERNOFARM
KETOPROFEN Inj 100 mg/2 ml (NP) Injeksi 100 mg/2 ml NOVEL PHARMA
KETOPROFEN Tab 100 mg (NP) Tablet 100 mg NOVEL PHARMA
PROTOFEN Tab 100 mg Tablet 100 mg KIMIA FARMA
KETOPROFEN Tab 50 mg (NP) Tablet 50 mg NOVEL PHARMA
PROFENID Supp Suppositoria 100 mg AVENTIS PHARMA
PROTOFEN Supp 100 mg Suppositoria 100 mg KIMIA FARMA
Ketorolac tromethamine KETOFLAM Inj 30 mg/ml Injeksi 30 mg/ml INDOFARMA
KETOROLAC TROMETAMOL Inj 30 mg/ml (PR) Injeksi 30 mg/ml PHAPROS
REMOPAIN Prefilled Syringe 30 mg/ml Injeksi 30 mg/ml DEXA MEDICA
KETOROLAC Inj 10 mg/ml (PR) Injeksi 10 mg/ml PHAPROS
KETOROLAC Tab 10 mg (NP) Tablet 10 mg NOVEL PHARMA
TERANOL Tab 10 mg Tablet 10 mg GUARDIAN PHARMATAMA
Meloxicam LILOXICAM Tab 15 mg Tablet 15 mg HOLI PHARMA
MELOGRA Tab 7.5 mg Tablet 7,5 mg GRAHA FARMA
MELOXICAM Tab 15 mg (HJ) Tablet 15 mg HEXPHARM JAYA
MELOXICAM Tab 15 MG (OT) Tablet 15 mg OTTO PHARMACEUTICAL
MELOXICAM Tab 7,5 mg (IF) Tablet 7,5 mg INDOFARMA
MELOXICAM Tab 7.5 mg (BE) Tablet 7,5 mg BERNOFARM
Parecoxib DYNASTAT IM/IV Inj 40 mg Injeksi 40 mg PFIZER INDONESIA
23
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Piroxicam INPIROX Kaps 20 mg Kapsul 20 mg INDOFARMA
PIROXICAM Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
PIROXICAM Tab 20 mg (KF) Tablet 20 mg KIMIA FARMA
Sulfasalazine SULFASALAZINE Tab 500 mg (BE) Tablet 500 mg BERNOFARM
SULFITIS Tab 500 mg Tablet 500 mg FAHRENHEIT
Tenoxicam PILOPIL Tab 20 mg Tablet 20 mg GUARDIAN PHARMATAMA
04m. DRUGS FOR NEUROPATHIC PAIN
Gabapentin ALPENTIN Kaps 300 mg Kapsul 300 mg ACTAVIS
GABAPENTIN Kaps 100 mg (AC) Kapsul 100 mg ACTAVIS
GABAPENTIN Kaps 100 mg (KF) Kapsul 100 mg KIMIA FARMA
GABAPENTIN Kaps 300 mg (KF) Kapsul 300 mg KIMIA FARMA
GABAPENTIN Kaps 300 mg (PR) Kapsul 300 mg PHAPROS
SIPENTIN Kaps 300 mg Kapsul 300 mg MERSIFARMA
04n. ANTIMIGRAINE PREPARATIONS
Ergotamine Coffeine ERGOTAMINE COFFEINE Tab (KF) Tablet 1 mg KIMIA FARMA
ERICAF Tab Tablet 1 mg TEMPO RX FARMA
Flunarizine FLUNARIZIN Tab 5 mg (BE) Tablet 5 mg BERNOFARM
FLUNARIZINE Tab 5 mg (NB) Tablet 5 mg NULAB PHARMACEUTICAL INDONESIA
FUNAR Tab 5 mg Tablet 5 mg GRAHA FARMA
FLUNARIZINE Tab 10 mg (NB) Tablet 10 mg NULAB PHARMACEUTICAL INDONESIA
FREGO Tab 10 mg Tablet 10 mg KALBE FARMA
04p. NOOTROPICS & NEUROTONICS
Mecobalamin ICOBAL Kaps 500 mcg Kapsul 500 mcg GRAHA FARMA
METHYCOBAL Kaps 500 mcg Kapsul 500 mcg EISAI INDONESIA
MECOBALAMIN Kaps 500 mcg (NB) Kapsul 500 mcg NULAB PHARMACEUTICAL INDONESIA
MECOBALAMIN Kaps 500 mcg (NP) Kapsul 500 mcg NOVEL PHARMA
MECOBALAMINE Inj 500 mcg/mL (NB) Injeksi 500 mcg /ml NULAB PHARMACEUTICAL INDONESIA
MECOBALAMINE Inj 500 mcg/ml (NP) Injeksi 500 mcg /ml NOVEL PHARMA
METHYCOBAL Inj 500 mcg/mL Injeksi 500 mcg /ml EISAI INDONESIA
LANABAL Inj 500 mcg/ml Injeksi 500 mcg /ml LANDSON PERTIWI AGUNG
Nimodipine NIMODIPINE Inf Infus 0,2 mg NOVEL PHARMA
NIMOTOP Tab 30 mg Tablet 30 mg BAYER INDONESIA
Pentoxifylline TRENTAL Inj 100 mg/5 ml Injeksi 100 mg/5 mL AVENTIS PHARMA
TRENTAL Tab 400 mg Tablet 400 mg AVENTIS PHARMA
Piracetam PIRACETAM Kapl 400 mg (BE) Kaplet 400 mg BERNOFARM
ERLATAM Tab 800 mg Tablet 800 mg ERELA
PIRACETAM Kapl 800 mg (BE) Kaplet 800 mg BERNOFARM
NEUROTAM Tab 1200 mg Tablet 1200 mg KALBE FARMA
PIRACETAM Kapl 1200 mg (BE) Kaplet 1200 mg BERNOFARM
24
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
PIRACETAM Kapl 1200 mg (HJ) Kaplet 1200 mg HEXPHARM JAYA
PIRACETAM Inf 12 g/60 ml (NP) Infus 12 g/60 ml NOVEL PHARMA
PIRACETAM Inj 1 g/5 ml (BE) Injeksi 1 g/5 ml BERNOFARM
PIRACETAM Inj 3 g/15 ml (BE) Injeksi 3 gr/15 ml BERNOFARM
PIRACETAM Inj 3 g/15 ml (QL) Injeksi 3 g / 15 ml QUANTUM LABS
Pyritinol Dihydrochloride Monohydrate ENCEPHABOL FORTE Tab 200 mg Tablet 200 mg MERCK BIOPHARMA
Sulbuthiamine ARCALION Tab 200 mg Tablet 200 mg SERVIER INDONESIA
05 MUSCULO-SKELETAL SYSTEM
05b. HYPERURICEMIA & GOUT PREPARATIONS
Allopurinol ALLOPURINOL Tab 100 mg (HJ) Tablet 100 mg HEXPHARM JAYA
INPURIN Tab 100 mg Tablet 100 mg INDOFARMA
PURINIC Tab 100 mg Tablet 100 mg SAMPHARINDO PERDANA
ZYLORIC Tab 100 mg Tablet 100 mg GLAXO WELLCOME INDONESIA
ALLOPURINOL Tab 300 mg (HJ) Tablet 300 mg HEXPHARM JAYA
ALLURIC Tab 300 mg Tablet 300 mg KALBE FARMA
Colchicine COLCHISIN Tab 0.5 mg (CB) Tablet 0.5 mg COMBIPHAR
RECOLFAR Tab 0,5 mg Tablet 0.5 mg FAHRENHEIT
Febuxostat FEBURIC Tab 80 mg Tablet 80 mg ASTELLAS
FESTARIC Tab 80 mg Tablet 80 mg DEXA MEDICA
05c. MUSCLE RELAXANTS
Atracurium Besilate ATRACURIUM BESYLATE Inj 5 ml Injeksi 50 mg NOVEL PHARMA
ATRACURIUM Inj Lq (EI) Injeksi 25 mg ETHICA INDUSTRI FARMASI
NOTRIXUM Inj 25 mg/ml Injeksi 25 mg/ml NOVEL PHARMA
Baclofen LIORESAL Tab 10 mg Tablet 10 mg NOVARTIS INDONESIA
Eperison Hcl EPERISONE Tab 50 mg (ML) Tablet 50 mg MEDIKON
EPERISONE Tab 50 mg (NP) Tablet 50 mg NOVEL PHARMA
FORRES Tab 50 mg Tablet 50 mg KALBE FARMA
MYONAL Tab 50 mg Tablet 50 mg EISAI INDONESIA
Neostigmine methylsulfate NEOSTIGMINE Inj 0,5 mg/ml (EI) Injeksi 0,5 mg ETHICA INDUSTRI FARMASI
Summagadex BRIDION Inj 200 mg/2 ml Injeksi 200 mg/2ml MSD
Tizanidine HCl SIRDALUD Tab 2 mg Tablet 2 mg NOVARTIS INDONESIA
TIZACOM Tab 2 mg Tablet 2 mg COMBIPHAR
TIZANIDINE Tab 2 mg (NP) Tablet 2 mg NOVEL PHARMA
05e. NEUROMUSCULAR DISORDER DRUGS
Pyridostigmine Bromide MESTINON Tab 60 mg Tablet 60 mg TRANSFARMA MEDICA INDAH
05f. OTHER DRUGS ACTING ON THE MUSCULO-SKELETAL SYSTEM
Diacerein ARTRODAR Kaps 50 mg Kapsul 50 mg COMBIPHAR
Glucosamine HCl GLUCOSAMINE Tab 250 mg (HJ) Tablet 250 mg HEXPHARM JAYA
OSTE Forte Kapl Kaplet 500 mg SOHO INDUSTRI PHARMASI
25
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Metil Salisilat Eugenol , Menthol COUNTERPAIN Cr 15 g Krim 15 gr TAISHO PHARMACEUTICAL
N-Acetyl Glucosamine FITAJOint ROLLER Gel 1mg/g Gel 1 mg/ g COMBIPHAR
Sodium Hyaluronate ADANT DISPO Inj 10 mg/2,5 ml Injeksi 10 mg/2,5 ml MEIJI INDONESIA
HYALGAN Inj 10 mg/ml Injeksi 10 mg COMBIPHAR
OSFLEX Inj 25 mg/2,5 ml Injeksi 25 mg/2,5 ml NOVEL PHARMA
SINOVIAL Inj 16 mg/2 ml Injeksi 16 mg/2 ml DEXA MEDICA
06 HORMONES
06a. ANDROGENTS & RELATED SYNTHETIC DRUGS
Testosteron Propionate SUSTANON Inj 30 mg Injeksi 30 mg SYDNA FARMA/QUAMED
Testosterone Undecanoate NEBIDO Inj 250 mg Injeksi 250 mg BAYER INDONESIA
06b. ESTROGEN, PROGESTERON & PREPARAT SINTETIKNYA
Allylestrenol PRESTRENOL Tab 5 mg Tablet 5 mg INTERBAT
Dienogest NELANDOZ Tab Tablet 2 mg FAHRENHEIT
Drospirenone Estradiol ANGELIQ Tab 2 mg Tablet 2 mg BAYER INDONESIA
Dydrogesterone DUPHASTON Tab 10 mg Tablet 10 mg ABBOTT
Esteriol OVESTIN Tab 1 mg Tablet 1 mg SYDNA FARMA/QUAMED
Estradiol Valerate Norgestrel CYCLO PROGYNOVA Tab 2 mg Tablet 2 mg BAYER INDONESIA
Medroxyprogesterone Acetate PROTHYRA Tab 10 mg Tablet 10 mg SUNTHI SEPURI
PROVERA Tab 10 mg Tablet 10 mg ZUELLIG PHARMA
Norethisterone PRIMOLUT N Tab 5 mg Tablet 5 mg BAYER INDONESIA
Progesteron MICROGEST Kaps 200 mg Kapsul 200 mg LAPI
CYGEST Pessary 200 mg Pessary 200 mg ACTAVIS
CYGEST Pessary 400 mg Pessary 400 mg ACTAVIS
MICROGEST Kaps 100 mg Kapsul 100 mg LAPI
06d. CORTICOSTEROID HORMONES
Dexamethason CORTIDEX Inj 5 mg/ml Injeksi 5 mg/ml SANBE FARMA
DEXAMETHASONE Inj 5 mg/ml (BE) Injeksi 5 mg/ml BERNOFARM
DEXAMETHASONE Inj 5 mg/ml (PR) Injeksi 5 mg/ml PHAPROS
DEXAMETHASONE Tab 0,5 mg (MA) Tablet 0,5 mg MOLEX AYUS
DEXAMETHASONE Tab 0,5 mg (PM) Tablet 0,5 mg PROMEDRAHARDJO FARMASI INDUSTRI
MOLACORT Tab 0,5 mg Tablet 0,5 mg MOLEX AYUS
Hydrocortisone FARTISON Inj 100 mg Injeksi 100 mg FAHRENHEIT
HYDROCORTISONE Inj (PN) Injeksi 100 mg FAHRENHEIT
Methylprednisolone CARMESON Kapl 8 mg Kaplet 8 mg SAMPHARINDO PERDANA
DEPO MEDROL Inj 40 mg Injeksi 40 mg ZUELLIG PHARMA
MEDIXON Inj 125 mg Injeksi 125 mg/ml FERRON PAR PHARMATEUTICALS
METHYL PREDNISOLON Inj 125 mg/ml (PR) Injeksi 125 mg/ml PHAPROS
METHYLPREDNISOLON Inj 125 mg/mL (BE) Injeksi 125 mg/ml BERNOFARM
METHYL PREDNISOLON Inj 500 mg/ml (PR) Injeksi 500 mg PHAPROS
26
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
METHYLPREDNISOLON Tab 8 mg (BE) Tablet 8 mg BERNOFARM
METHYLPREDNISOLONE Tab 8 mg (MB) Tablet 8 mg MAHAKAM BETA FARMA
METHYLPREDNISOLONE Tab 16 mg (HJ) Tablet 16 mg HEXPHARM JAYA
METHYLPREDNISOLONE Tab 4 mg (HJ) Tablet 4 mg HEXPHARM JAYA
METHYLPREDNISOLONE Tab 4 mg (MA) Tablet 4 mg MOLEX AYUS
PHADILON Tab 4 mg (PR) Tablet 4 mg PHAPROS
Prednisone LEXACORT Tab 5 mg Tablet 5 mg MOLEX AYUS
PREDNISON Tab 5 mg (ER) Tablet 5 mg ERELA
PREDNISON Tab 5 mg (PR) Tablet 5 mg PHAPROS
Triamcinolone Acetonide KENACORT Tab 4 mg Tablet 4 mg TAISHO PHARMACEUTICAL
OPICORT Tab 4 mg Tablet 4 mg OTTO PHARMACEUTICAL
TRIAMCINOLONE Tab 4 mg (NP) Tablet 4 mg NOVEL PHARMA
TRIAMCINOLONE ACETONIDE IA/ID Inj 10 mg/ml (NP) Injeksi 10 mg NOVEL PHARMA
TRILAC IA Inj 10 mg/ml Injeksi 10 mg NOVEL PHARMA
TRILAC IM Inj 40 mg/ml Injeksi 40 mg/ mL NOVEL PHARMA
06e. TROPHIC HORMONES & RELATED SYNTHETICS DRUGS
Bromocriptine Mesilate - CRIPSA Tab 2.5 mg Tablet 2,5 mg SANBE FARMA/CAPRIFARMINDO
Choriogonadotropin alfa OVIDREL Prefilled Syringe 250 mcg/0.5 ml Injeksi 250 mcg/ 0,5 mL MERCK BIOPHARMA
Clomiphen Citrate CLOMIFENE CITRATE Tab 50 mg (MM) Tablet 50 mg MEPROFARM
PROFERTIL Tab 50 mg Tablet 50 mg KALBE FARMA
Follitropin alfa GONAL-F Prefilled Syringe 75 IU Injeksi 75 IU MERCK BIOPHARMA
Leuprorelin acetate ENDROLIN Inj Injeksi 3.75 mg KALBE FARMA
TAPROS DPS Inj 11.25 mg Injeksi 11,25 mg TAKEDA INDONESIA
TAPROS DPS Inj 3.75 mg Injeksi 3,75 mg TAKEDA INDONESIA
TAPROS Inj 1,88 mg Injeksi 1,88 mg TAKEDA INDONESIA
Octreotide SANDOSTATIN Inj 20 mg Injeksi 20 mg NOVARTIS INDONESIA
07 CONTRACEPTIVE AGENTS
07a. ORAL CONTRACEPTIVES
Cyproterone Acetate Ethinyl Estradiol DIANE 35 Tab Tablet 2 mg ; 0,035 mg BAYER INDONESIA
Desogestrel DESIRETT Tab 75 mcg Tablet 75 mcg NUFARINDO
Drospirenone Ethinyl Estradiol YAZ Tab Tablet 3 mg BAYER INDONESIA
Levonorgestrel Ethinyl Estradiol Pil KB I Kombinasi Tablet 0,15 mg HARSEN LABORATORIES
MICROLUT Tab Tablet 0,03 mg BAYER INDONESIA
MYCROGYNON Tab Tablet BAYER INDONESIA
07b. DEPOT CONTRACEPTIVES
Medroxyprogesterone Acetate OBAT SUNTIK KB I Tiga Bulanan Injeksi 50 mg HARSEN LABORATORIES
07c. OTHER CONTRACEPTIVES
Copper With Silver Wire With Silver Core NOVA T IUD IUD BAYER INDONESIA
27
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
08 ANTI-INFECTIVES SYSTEMIC
08a. AMINOGLYCOSIDES
Amikasin AMIKACIN Inj Lq 500 mg/2 ml Injeksi 500 mg/2 mL ETHICA INDUSTRI FARMASI
AMIKACIN SULFAT Inj 500 mg/2 ml (PR) Injeksi 500 mg/2 mL PHAPROS
AMIKASIN Inj 250 mg/2 ml (MB) Injeksi 250 mg/ 2 mL MAHAKAM BETA FARMA
GLYBOTIC Inj 250 mg/2 ml Injeksi 250 mg/ 2 mL SANBE FARMA
Dibekacin sulfat DIBEKASIN Inj 100 mg/2 ml Injeksi 100 mg/2 ml MEIJI INDONESIA
Gentamicin Sulfate GENTAMICIN Inj 40 mg/mL (IF) Injeksi 40 mg INDOFARMA
OTTOGENTA Inj 80 mg/2 ml Injeksi 80 mg / 2 ml OTTO PHARMACEUTICAL
Kanamycin Sulphate KANAMYCIN Inj 1 g Injeksi 1g HARSEN LABORATORIES
Netilmycin Sulfat HYPOBHAC 200 Inj 300 mg/1,5 ml Injeksi 300 mg/ 1,5 mL PHAPROS
Procain Benzyl Penicillin PROCAINE PENICILLIN-G MEIJI Inj 3 JT IU Injeksi 3 Jt iu MEIJI INDONESIA
Streptomycin sulphate STREPTOMYCIN SULFAT Inj 1 g (PR) Injeksi 1000 mg PHAPROS
08b. CEPHALOSPORINS
Cefadroxil - LIFADROX Dry Syr Forte 250 mg/5 ml Sirup Kering 250 mg/5 ml HOLI PHARMA
CEFADROXIL Dry Syr 250 mg/5 ML 60 ML (MM) Sirup Kering 250 mg/5 ml MEPROFARM
CEFADROXIL Dry Sry 125 mg/5 ml (BE) Sirup Kering 125 mg/5 ml BERNOFARM
CEFAT Syr 125 mg/ml Sirup Kering 125 mg/5 ml SANBE FARMA
DOXEF DS 125 mg/5 ml Sirup Kering 125 mg / 5 mL KIMIA FARMA
CEFADROXIL Kaps 500 mg (HJ) Kapsul 500 mg HEXPHARM JAYA
CEFADROXIL Kaps 500 mg (IN) Kapsul 500 mg INFION
DOXEF Kaps 500 mg Kapsul 500 mg KIMIA FARMA
LAPICEF Drops 150 mg/ml Drops 150 mg LAPI
Cefazolin CEFAZOLIN Inj 1 g (DM) Injeksi 1g DEXA MEDICA
CEFAZOLIN Inj 1 g (MB) Injeksi 1g MAHAKAM BETA FARMA
Cefditoren pivoxil MEIACT Tab 200 mg Tablet 200 mg MEIJI INDONESIA
Cefepime CEFEPIME Inj 1 g (DM) Injeksi 1g DEXA MEDICA
CEFEPIME Inj 1 g (MB) Injeksi 1g MAHAKAM BETA FARMA
Cefixime CEFIXIME DS 100 mg/ 5 ml 30 ml (HJ) Sirup Kering 100 mg/5 ml HEXPHARM JAYA
INFIX DS 100 mg/5 ml Sirup Kering 100 mg/5 ml INDOFARMA
CEFIXIME Kaps 100 mg (HJ) Kapsul 100 mg HEXPHARM JAYA
CEFIXIME Kaps 100 mg (KF) Kapsul 100 mg KIMIA FARMA
CEFIXIME Kaps 200 mg (BE) Kapsul 200 mg BERNOFARM
CEFIXIME Kaps 200 mg (DM) Kapsul 200 mg DEXA MEDICA
FIXACEP OD Drops 100 mg/30 ml Drops 30 mg FAHRENHEIT
ORACEF Kaps 100 mg Kapsul 100 mg KIMIA FARMA
STARCEF Kaps 200 mg Kapsul 200 mg DEXA MEDICA
Cefoperazon Sulbactam CEFOPERAZONE+SULBACTAM Inj 1 g (BE) Injeksi 1g BERNOFARM
CEFOPERAZONE+SULBACTAM Inj 1 g (HJ) Injeksi 1g HEXPHARM JAYA
28
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
NUBAC Inj Injeksi 1g GUARDIAN PHARMATAMA
SULPERAZON Inj 1 g Injeksi 1g PFIZER INDONESIA
Cefoperazon CEFOPERAZON Inj 1 g (BE) Injeksi 1g BERNOFARM
CEFOPERAZONE Inj 1 g (HP) Injeksi 1g HOLI PHARMA
Cefotaxim CEFOTAXIM Inj 1 g (PR) Injeksi 1g PHAPROS
CEFOTAXIME Inj 1 g (BE) Injeksi 1g BERNOFARM
CEFOTAXIME SODIUM Inj 500 mg (DM) Injeksi 500 mg DEXA MEDICA
LITAXIM Inj 1 g Injeksi 1g HOLI PHARMA
Cefpirome sulfate CEFPIROME Inj 1 g (PR) Injeksi 1g PHAPROS
CEFPIROME SULFATE Inj 1 g (DM) Injeksi 1g DEXA MEDICA
Ceftazidime CEFTAZIDIME Inj 1 g (BE) Injeksi 1g BERNOFARM
CEFTAZIDIME PENTAHYDRATE Inj 1 g (DM) Injeksi 1g DEXA MEDICA
FORTA Inj 1 g Injeksi 1g GUARDIAN PHARMATAMA
Ceftizoxime CEFTIZOXIME Dry Inj 1 g (NP) Injeksi 1g NOVEL PHARMA
CEFTIZOXIME Inj 1 g (BE) Injeksi 1g BERNOFARM
TIZOS Inj 1 g Injeksi 1g DEXA MEDICA
Ceftriaxone CEFTRIAXON Inj 1 g (BE) Injeksi 1g BERNOFARM
CEFTRIAXONE SODIUM Inj 1 g (PR) Injeksi 1g PHAPROS
LIAXON Inj 1 g Injeksi 1g HOLI PHARMA
Cefuroxime ANBACIM Inj 1 g (SB) Injeksi 1g SANBE FARMA
CEFUROXIME Inj 750 mg (MB) Injeksi 750 mg MAHAKAM BETA FARMA
CEFUROXIME SODIUM Inj 750 mg (DM) Injeksi 750 mg DEXA MEDICA
ZINNAT Tab 500 mg Tablet 500 mg GLAXO WELLCOME INDONESIA
08c. PENISILIN
Tablet Salut
Amoxycillin Asam clavulanat ANCLA FC Tab 625 mg Selaput 625 mg MEPROFARM
Tablet Salut
ANCLA FC Tab 625 mg Selaput 625 mg MEPROFARM
CLANEKSI Kapl 625 mg Kaplet 625 mg SANBE FARMA
CO AMOXICLAV Tab 625 mg (IF) Tablet 625 mg INDOFARMA
CO AMOXICLAV Tab 625 mg (MM) Tablet 625 mg MEPROFARM
CO-AMOXICLAV Inj (IT) Injeksi 1g INTERBAT
CLANEKSI Inj 1 g Injeksi 1g SANBE FARMA
CLAMIXIN Dry Syr 125 mg/5 ml 60 ml Sirup Kering 125 mg / 5 mL OTTO PHARMACEUTICAL
CLANEKSI Dry Syr 250 mg/5 ml Sirup Kering 250 mg/5 ml SANBE FARMA
Amoxycillin AMOBIOTIC DS 250 mg/5 ml Sirup Kering 250 mg/5 ml BERNOFARM
HOLIMOX Dry Syr Forte 250 mg/5 ml Sirup Kering 250 mg / 5 ml HOLI PHARMA
AMOXICILLIN Dry Syr 250 mg/5 ml Sirup Kering 250 mg/5 ml MERSIFARMA
AMOXICILLIN Dry Syr 125 mg/5 ml Sirup Kering 125 mg / 5 mL MERSIFARMA
29
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
AMOXSAN Drops 100 mg/ml Drops 100 mg/ml SANBE FARMA
AMOXICILLIN Tab 500 mg (KF) Tablet 500 mg KIMIA FARMA
AMOXICILLIN Kapl 500 mg (QL) Kaplet 500 mg QUANTUM LABS
AMOXSAN Kaps 500 mg Kapsul 500 mg SANBE FARMA
KIMOXYL Tab 500 mg Tablet 500 mg KIMIA FARMA
AMOXYCILLIN Inj 1 g (PR) Sirup Kering 1g PHAPROS
Phenoxymetyl penicilin PHENOXYMETYL PENICILIN Tab 500 mg (PR) Tablet 500 mg PHAPROS
Piperacillin TAZAM Inj Injeksi KALBE FARMA
08d. OTHER BETA-LACTAMS
Doripenem DARYAVEN Inj 500 mg Injeksi 500 mg DARYA VARIA
DORIPENEM IV Inj 500 mg (DV) Injeksi 500 mg DARYA VARIA
Imipenem Cilastatin IMIPENEM - CILASTATIN Inj 1 g (MB) Injeksi 1g MAHAKAM BETA FARMA
IMIPENEM + CILASTATIN Inj 1 g (BE) Injeksi 1g BERNOFARM
IMITATIN Inj Injeksi 1g GUARDIAN PHARMATAMA
Meropenem MEROKAF Inj 1 g Injeksi 1g KIMIA FARMA
TRIPENEM Inj 1 g Injeksi 1g DEXA MEDICA
MEROPENEM Inj 1 g (DM) Injeksi 1g DEXA MEDICA
MEROPENEM Inj 1 g (KF) Injeksi 1g KIMIA FARMA
MEROKAF Inj 500 mg Injeksi 500 mg KIMIA FARMA
MEROPENEM Inj 500 mg (KF) Injeksi 500 mg KIMIA FARMA
08e. CHLORAMPHENICOLS
Chloramphenicol CHLORAMPHENICOL Kaps 250 mg (BE) Kapsul 250 mg BERNOFARM
Thiamphenicol THIAMFILEX Kaps 500 mg Kapsul 500 mg MOLEX AYUS
THIAMPENICOL Kaps 500 mg (BE) Kapsul 500 mg BERNOFARM
THIAMPENICOL Syr 125 mg/5 ml (BE) Sirup 125 mg/5 ml BERNOFARM
08f. MACROLIDES
Azithromycin AZITHROMYCIN Dry Syr 200 mg/5 ml (BE) Sirup Kering 200 mg/5 ml BERNOFARM
ZITHROMAX POS Syr 600 mg/15 ml Sirup 200 mg/5 ml PFIZER INDONESIA
AZITHROMYCIN Inj 500 mg (BE) Injeksi 500 mg BERNOFARM
AZITHROMYCIN Kapl 500 mg (KF) Kaplet 500 mg KIMIA FARMA
ZIBRAMAX Kapl 500 mg Kaplet 500 mg GUARDIAN PHARMATAMA
ZITHROMAX Tab 500 mg Tablet 500 mg PFIZER INDONESIA
ZITHROMAX IV Inj 500 mg Injeksi 500 mg PFIZER INDONESIA
Clarithromycin ABBOTIC Granulle Syr 250 mg/5 ml Sirup Kering 250 mg/ 5 ml ABBOTT
COMTRO Dry Syr 125 mg/5 ml 30 ml Sirup Kering 125 mg/5 ml COMBIPHAR
ABBOTIC XL Tab 500 mg Tablet XL 500 mg ABBOTT
CLARITHROMYCIN Kapl 500 mg (NP) Kaplet 500 mg NOVEL PHARMA
30
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Erythromycin ERYSANBE Kaps 500 mg Kapsul 500 mg SANBE FARMA
ERYTHROMYCIN Kapl 500 mg (PN) Kaplet 500 mg FAHRENHEIT
ERYTHROMYCIN Kaps 250 mg (KF) Kapsul 250 mg KIMIA FARMA
ERYSANBE Syr Sirup 200 mg/5 ml SANBE FARMA
Spiramycin PROVAMED FC Tab 500 mg Tablet 500 mg PROMEDRAHARDJO FARMASI INDUSTRI
SPIRAMYCIN Tab 500 mg (NP) Tablet 500 mg NOVEL PHARMA
08g. QUINOLONES
Ciprofloxacin CIPROFLOXACIN Inf 200 mg / 100 ml Infus 200 mg/ 100 ml IPHA LABORATORIES
CIPROFLOXACIN Inf 200 mg/100 ml (BE) Infus 200 mg/ 100 ml BERNOFARM
CIPROFLOXACIN Tab 500 mg (BE) Tablet 500 mg BERNOFARM
CIPROFLOXACIN Tab 500 mg (HJ) Tablet 500 mg HEXPHARM JAYA
KIFAROX Tab 500 mg Tablet 500 mg KIMIA FARMA
Levofloxacin INACID Tab 500 mg Tablet 500 mg INDOFARMA
LOVEQUIN Kapl 500 mg Kaplet 500 mg
LEVOFLOXACIN HEMIHYDRATE Tab 500 mg (HJ) Tablet 500 mg HEXPHARM JAYA
LEVOFLOXACIN Kapl 500 mg (KF) Kaplet 500 mg KIMIA FARMA
LEVOFLOXACIN Inf 500 mg/100 ml (IL) Infus 500 mg/100 ml IPHA LABORATORIES
LEVONIC Inf 500 mg/100 ml Infus 500 mg/100 ml NICHOLAS
LEVOFLOXACIN HEMIHYDRATE Inf 5 mg/ml (DM) Infus 750 mg/ 150 ml DEXA MEDICA
LEVORES Inf 750 Infus 750 mg/ 150 ml NOVEL PHARMA
Moxifloxacin HCl AVELOX Tab 400 mg Tablet 400 mg BAYER INDONESIA
MOXICIN Tab 400 mg Tablet 400 mg AMAROX PHARMA GLOBAL
MOXIFLOXACIN HCL Kaps 400 mg (AM) Kapsul 400 mg AMAROX PHARMA GLOBAL
MOXIFLOXACIN HCL Inf 400 mg/ 250 ml (BE) Infus 400 mg/ 250 ml BERNOFARM
MOXIFLOXACIN Inf 400 mg/250 ml (DV) Infus 400 mg/ 250 ml DARYA VARIA
MOXIVAR Inf 400 mg/250 ml Infus 400 mg/ 250 ml DARYA VARIA
Ofloxacin OFLOXACIN Tab 200 mg (IF) Tablet 200 mg INDOFARMA
OFLOXACIN Tab 400 mg (NP) Tablet 400 mg NOVEL PHARMA
08h. TETRACYCLINS
Doxycycline INTERDOXIN Kap 100 mg Kapsul 100 mg INTERBAT
Tetracycline TETRASANBE Kaps 250 mg Kapsul 250 mg SANBE FARMA
08j. ANTIBACTERIAL COMBINATION
Sulfamethoxazole Trimethoprim COTRIMOXAZOLE Syr 240 mg/5 ml (BE) Sirup 240 mg/5 ml BERNOFARM
MIRATRIM Susp Suspensi SAMPHARINDO PERDANA
COTRIMOXAZOLE Tab 480 mg (BE) Tablet 480 mg BERNOFARM
INFATRIM F Tab 960 mg Tablet 960 mg MOLEX AYUS
SISOPRIM Tab 400 mg/80 mg Tablet 480 mg PROMEDRAHARDJO FARMASI INDUSTRI
31
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
08k. OTHER ANTIBIOTICS
Clindamycin CLINDAMYCIN Kaps 150 mg (NP) Kapsul 150 mg NOVEL PHARMA
CLINDAMYCIN Kaps 150 MG (PR) Kapsul 150 mg PHAPROS
OPICLAM Kaps 150 mg Kapsul 150 mg OTTO PHARMACEUTICAL
CLINDAMYCIN Kaps 300 mg (IF) Kapsul 300 mg INDOFARMA
CLINDAMYCIN Kaps 300 mg (MM) Kapsul 300 mg MEPROFARM
DAMYCIN Kaps 300 mg Kapsul 300 mg INDOFARMA
Fosfomycin Na FOSFOMYCIN SODIUM Serbuk Inj 1 g (BE) Injeksi 1g BERNOFARM
FOSFOMYCIN SODIUM Serbuk Inj 2 g (BE) Injeksi 2g BERNOFARM
NOVELLMYCIN Inj 2 g Injeksi 2g NOVEL PHARMA
Fosfomycin Trometamol MONURIL POWD Sach 3 g Granul 3g ZAMBON INDONESIA
Lincomycin INCOCYN Kaps 500 mg Kapsul 500 mg INDOFARMA
LINCOMYCIN Kaps 500 mg (IF) Kapsul 500 mg INDOFARMA
LYNCOMYCIN Kaps 500 mg (PR) Kapsul 500 mg PHAPROS
Linezolid LINITERO Tab 600 mg Tablet 600 mg AMAROX PHARMA GLOBAL
ZYVOX Infus 600 mg/300 mL Infus 600 mg PFIZER INDONESIA
Tigecycline TYGACIL Inj 50 mg/5 ml Injeksi 50 mg PFIZER INDONESIA
Vancomycin VANCOMYCIN Inj 500 mg (OT) Injeksi 500 mg OTTO PHARMACEUTICAL
VANCONEX Inj 500 mg Injeksi 500 mg AMAROX PHARMA GLOBAL
08l. ANTI-TB AGENTS
Ethambutol ETHAMBUTOL Tab 500 mg (BE) Tablet 500 mg BERNOFARM
ETHAMBUTOL Tab 500 mg (KF) Tablet 500 mg KIMIA FARMA
Isoniazid Vit B6 INOXIN Tab 400 mg Tablet 400 mg DEXA MEDICA
INHA Tab 400 mg Tablet 400 mg MERSIFARMA
Isoniazid ISONIAZIDE Tab 100 mg (KF) Tablet 100 mg KIMIA FARMA
ISONIAZIDE Tab 300 mg (KF) Tablet 300 mg KIMIA FARMA
Pyrazinamide PYRAZINAMID Tab 500 mg (KF) Tablet 500 mg KIMIA FARMA
PYRAZINAMIDE Tab 500 mg (DM) Tablet 500 mg DEXA MEDICA
TB ZET Tab 500 mg Tablet 500 mg MEPROFARM
Rifampicin Isoniazid PRO TB 2 KID Tab Tablet PHAPROS
PRO TB 2 Tab Tablet PHAPROS
Isoniazid, Pyrazinamid,
Tablet
Ethambutol RIFASTAR Tab PROMOSINDO
Isoniazid; Pyrazinamid PRO TB 3 Tab Tablet 75 mg PHAPROS
Isoniazid; Pyrazinamid;
Tablet
Ethambutol PRO TB 4 Tab 150 mg PHAPROS
Rifampicin MERIMAC Kapl 450 mg Kaplet 450 mg MERSIFARMA
RIFAMPICIN Kapl 450 mg (BE) Kaplet 450 mg BERNOFARM
32
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
RIFAMPICIN Tab 450 mg (KF) Tablet 450 mg KIMIA FARMA
RIFABIOTIC Tab 600 mg Tablet 600 mg BERNOFARM
RIFAMPICIN Kapl 600 mg (BE) Kaplet 600 mg BERNOFARM
RIFAMPICIN Kapl 600 mg (KF) Kaplet 600 mg KIMIA FARMA
08n. ANTIFUNGALS
Anidulafungin ECALTA Inj 100 mg Injeksi 100 mg PFIZER INDONESIA
Fluconazole DIFLUCAN IV Infus 2 mg/mL Infus 200 mg /100 ml PFIZER INDONESIA
FLUCONAZOLE Infus 2 mg/ml (DM) Infus 200 mg /100 ml DEXA MEDICA
FLUCONAZOLE Kaps 150 mg (KF) Kapsul 150 mg KIMIA FARMA
FLUCONAZOLE Kaps 150 mg (NB) Kapsul 150 mg NULAB PHARMACEUTICAL INDONESIA
KIFLUZOL Tab 150 mg Tablet 150 mg KIMIA FARMA
Griseofulvin GRISEOFULVIN Tab 125 mg (KF) Tablet 125 mg KIMIA FARMA
GRISEOFULVIN Tab 500 mg (DV) Tablet 500 mg DARYA VARIA
Itraconazole ITRACONAZOLE Kaps 100 mg (BE) Kapsul 100 mg BERNOFARM
SPORACID Kaps 100 mg Kapsul 100 mg FERRON PAR PHARMATEUTICALS
Ketoconazole FUNGORAL Tab 200 mg Tablet 200 mg KIMIA FARMA
KETOCONAZOLE Tab 200 mg (HJ) Tablet 200 mg HEXPHARM JAYA
KETOKONAZOL Tab 200 mg (DM) Tablet 200 mg DEXA MEDICA
Micafungin MYCAMINE Inj 50 mg Injeksi 50 mg ASTELLAS
Nystatin MYCOSTATIN Syr 30 ml Drops 100,000 IU TAISHO PHARMACEUTICAL
NYNDIA Drops 100.000 IU/ml Drops 100,000 IU GUARDIAN PHARMATAMA
NYSTATIN Drops 100.000 IU/ml (NP) Drops 100.000IU/ml NOVEL PHARMA
NYSTATIN Tab 50000 IU (PR) Tablet 50000 IU PHAPROS
Voriconazole VFEND IV Inj 200 mg Injeksi 200 mg PFIZER INDONESIA
08p. ANTIVIRALS
Acyclovir ACYCLOVIR Tab 200 mg (PR) Tablet 200 mg PHAPROS
ACYCLOVIR Tab 400 mg (HJ) Tablet 400 mg HEXPHARM JAYA
ACYCLOVIR Tab 400 mg (PR) Tablet 400 mg PHAPROS
ZOVIRAX IV Inj 250 mg Injeksi 250 mg GLAXO WELLCOME INDONESIA
Entecavir Monohydrate ENTECAVIR MONOHYDRATE Tab 0.5 mg (HJ) Tablet 0.5 mg HEXPHARM JAYA
TKV Tab 0,5 mg Tablet 0,5 mg KALBE FARMA
TECAVIR Tab 0,5 mg Tablet 0,5 mg KIMIA FARMA
Favipiravir FAVIPIRAVIR Tab 200 mg (KF) Tablet 200 mg KIMIA FARMA
Lamivudine Zidovudine DUVIRAL Tab Tablet 100 mg KIMIA FARMA
HEPLAV Tab 100 mg Tablet 100 mg KIMIA FARMA
HIVIRAL Tab 150 mg Tablet 150 mg KIMIA FARMA
Lopinavir Ritonavir RITOCOM Tab Tablet 200 mg/50 mg AMAROX PHARMA GLOBAL
33
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Methisoprinol BEPRIN Tab 500 mg Tablet 500 mg DEXA MEDICA
ISOPRINOSINE Syr 250 mg/5 ml Sirup 250 mg /5 ml DARYA VARIA
METHISOPRINOL Syr (LS) Sirup 250 mg /5 ml LANDSON
METHISOPRINOL Tab 500 mg (NB) Tablet 500 mg NULAB PHARMACEUTICAL INDONESIA
METHISOPRINOL Tab 500 mg (PR) Tablet 500 mg PHAPROS
Oseltamivir OSELTAMIVIR Kaps 75 mg (IF) Kapsul 75 mg INDOFARMA
OSEVELL Tab 75 mg Tablet 75 mg NOVEL PHARMA
Peg intron alfa - 2A PEGASYS Inj 180 mcg/0,5 ml Injeksi 180 mcg/0,5 ml ROCHE
Remdesivir DESREM Inj 100 mg Injeksi 100 mg INDOFARMA
Tenofovir HEPAMED Kaps 300 mg Kapsul 300 mg DIPA PHARMALAB INTERSAINS
HEPBEST Tab 25 mg Tablet 25 mg INDOFARMA
KIFOVIR Tab 300 mg Tablet 300 mg KIMIA FARMA
Valacyclovir VALACICLOVIR Tab 500 mg (NP) Sirup 500 mg NOVEL PHARMA
VALVIR Tab 500 mg Tablet 500 mg ETHICA INDUSTRI FARMASI
Valganciclovir hydrochloride VALCYTE Kapl 450 mg Kaplet 450 mg ROCHE
08q. ANTHELMINTIKA
Albendazole ALBENDAZOL Tab 400 mg (KF) Tablet 400 mg KIMIA FARMA
VERMIC Susp 200 mg/5 ml Suspensi 200 mg/5 ml INDOFARMA
Ivermectin IVERMECTIN Tab 12 mg (IF) Tablet 12 mg INDOFARMA
Mebendazole VEMORAN Chewable Tab 500 mg Tablet 500 mg PHAROS INDONESIA
Pyrantel Pamoat PYRANTEL Tab 125 mg (KF) Tablet 125 mg KIMIA FARMA
08r. ANTI MALARIA
Primaquine PRIMAQUINE Tab 15 mg Tablet 15 mg PHAPROS
Quinine HCl QUININE Tab 222 mg (KF) Tablet 222 mg KIMIA FARMA
08s. ANTIAMUBA
Metronidazole GRAFAZOL Syr 125 mg/5 ml Sirup 125 mg/5 ml GRAHA FARMA
METRONIDAZOLE BENZOATE Susp 125 mg/ 5 ml (MM) Suspensi 125mg/5 mL MEPROFARM
METRONIDAZOL Infus 500 mg/100 mL (HJ) Infus 500 mg/100 ml HEXPHARM JAYA
METRONIDAZOLE Infus 500 mg/100 ml (BE) Infus 500 mg/100 ml BERNOFARM
VELAZOL Inf 500 mg/100 ml Infus 500 mg/100 ml NOVEL PHARMA
METRONIDAZOLE Tab 500 mg (BE) Tablet 500 mg BERNOFARM
METRONIDAZOLE Tab 500 mg (KF) Tablet 500 mg KIMIA FARMA
MOLAZOL Tab 500 mg Tablet 500 mg MOLEX AYUS
TRICHODAZOL Supp 1 g Suppositoria 1g SANBE FARMA
09 ONCOLOGY
09a. KEMOTERAPI SITOTOKSIK
5 Fluorouracil CURACIL Inj 500 mg Injeksi 500 mg KALBE FARMA
FLUOROURACIL Inj 500 mg Injeksi 500 mg FERRON PAR PHARMATEUTICALS
34
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Abiraterone asetat ABIRONE Tab 250 mg Tablet 250 mg AMAROX PHARMA GLOBAL
ZYTIGA Tab 500 mg Tablet 500 mg JOHNSON & JOHNSON
Afatinib GIOTRIF FCT Tab 40 mg Tablet 40 mg BOEHRINGER
Anagrelide HCL THROMBOREDUCTIN Kaps 0,5 mg Kapsul 0,5 mg COMBIPHAR
Bleomycin BLEOCIN Inj 15 mg Injeksi 15 mg KALBE FARMA
Capecitabine BINECAP Tab 500 mg Tablet 500 mg FERRON PAR PHARMATEUTICALS
XELODA Tab 500 mg Tablet 500 mg ROCHE
Carboplatin - FUPLATIN Inj 150 mg Injeksi 150 mg MEGA LIFESCIENCES
FUPLATIN Inj 450 mg Injeksi 450 mg MEGA LIFESCIENCES
CARBOPLATIN Inj 150 mg/15 ml (FE) Injeksi 150 mg/15 ml FERRON PAR PHARMATEUTICALS
CARBOPLATIN Inj 450 mg/45 ml (FE) Injeksi 450 mg FERRON PAR PHARMATEUTICALS
Cisplatin CISPLATIN Inj 10 mg (FE) Injeksi 10 mg FERRON PAR PHARMATEUTICALS
CISTEEN Inj 10 mg Injeksi 10 mg KIMIA FARMA
CISTEEN Inj 50 mg Injeksi 50 mg KIMIA FARMA
Cyclophosphamide CYCLOPHOSPHAMIDE Inj 1000 mg (KB) Injeksi 1000 mg KALBE FARMA
CYCLOPHOSPHAMIDE Inj 200 mg (KB) Injeksi 200 mg KALBE FARMA
CYCLOVID Inj 200 mg Injeksi 200 mg NOVEL PHARMA
ENDOXAN Inj 1000 mg Injeksi 1000 mg TRANSFARMA MEDICA INDAH
ENDOXAN Inj 500 mg Injeksi 500 mg TRANSFARMA MEDICA INDAH
Dacarbazine DACARBAZINE MEDAC Inj 200 mg Injeksi 200 mg DIPA PHARMALAB INTERSAINS
Docetaxel DOCETAXEL Inj 80 mg (FE) Injeksi 80 mg FERRON PAR PHARMATEUTICALS
DOCETAXEL TRIHYDRATE Inj 20 mg (FE) Injeksi 20 mg FERRON PAR PHARMATEUTICALS
TACEEDO-20 Combipack Inj Injeksi 20 mg KIMIA FARMA
TACEEDO-80 Combipack Inj Injeksi 80 mg KIMIA FARMA
TAXOTERE Inj 20 mg Injeksi 20 mg AVENTIS PHARMA
TAXOTERE Inj 80 mg Injeksi 80 mg AVENTIS PHARMA
Doxorubicin DOXORUBICIN Inj 50 mg (CO) Injeksi 50 mg CKD OTTO Pharmaceuticals
DOXORUBICIN Inj 10 mg (CO) Injeksi 10 mg CKD OTTO Pharmaceuticals
NAPRODOX Inj 10 mg Injeksi 10 mg KIMIA FARMA
NAPRODOX Inj 50 mg/25 ml Injeksi 50 mg KIMIA FARMA
Enzalutamide XTANDI Kaps 40 mg Kapsul 40 mg ASTELLAS
Epirubicin 4-EPEEDOO-10 Inj 10 mg Injeksi 10 mg/ml KIMIA FARMA
4-EPEEDOO-50 Inj 50 mg Injeksi 50 mg KIMIA FARMA
EPIRUBICIN Inj 10 mg/5 mL (SB) Injeksi 10 mg/5 ml SANBE FARMA
EPIRUBICIN Inj 50 mg/25 mL (SB) Injeksi 50 mg/25 ml SANBE FARMA
Eribulin Mesylate HALAVEN Inj Injeksi 0.88 mg EISAI INDONESIA
Erlotinib ERLONIB Tab 100 mg Tablet 100 mg AMAROX PHARMA GLOBAL
ERLONIB Tab 150 mg Tablet 150 mg AMAROX PHARMA GLOBAL
Etoposide ETOPUL Inj 100 mg Injeksi 100 mg NOVEL PHARMA
35
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Fludarabine Phosphate FLUDARA Inj 50 mg Injeksi 50 mg AVENTIS PHARMA
Gemcitabine HCl ABINGEM Inj 1 g Injeksi 1g KIMIA FARMA
ABINGEM Inj 200 mg Injeksi 200 mg KIMIA FARMA
GEMCITABINE Powder Inj 200 mg Injeksi 200 mg CKD OTTO Pharmaceuticals
GEMCITABINE Powder Inj 1 g Injeksi 1g CKD OTTO Pharmaceuticals
GEMZAR Inj 1 g Injeksi 1g ELI LILLY
Hydroxyurea HYDROXYUREA MEDAC Kaps 500 mg Kapsul 500 mg DIPA PHARMALAB INTERSAINS
Ifosfamide HOLOXAN Inj 1 g Injeksi 1g TRANSFARMA MEDICA INDAH
Irinotecan IRITERO Inj 100 mg/5 ml Injeksi 100 mg/5 mL AMAROX PHARMA GLOBAL
IRITERO Inj 40 mg/2 ml Injeksi 40 mg/2 ml AMAROX PHARMA GLOBAL
Melphalan ALKERAN Tab 2 mg Tablet 2 mg GLAXO WELLCOME INDONESIA
Methotrexate FERXATE Tab 2.5 mg Tablet 2.5 mg FERRON PAR PHARMATEUTICALS
KEMOTREXATE Inj 50 mg/2 ml Injeksi 50 mg/2 ml CKD OTTO Pharmaceuticals
METHOTREXATE Inj 50 mg/2 ml Injeksi 50 mg/2 ml SANBE FARMA
RHEUTREX Tab 2.5 mg Tablet 2,5 mg KALBE FARMA
Nimotuzumab THERACIM Inj Injeksi 50 mg KALBE FARMA
Oxaliplatin OXALIPLATIN Powder Inj 100 mg (CO) Injeksi 100 mg CKD OTTO Pharmaceuticals
REXTA Inj 100 mg/20 ml Injeksi 100 mg / 20 ml KALBE FARMA
Paclitaxel FONKOPAC Inj 6 mg/ml 50 ml Injeksi 300 mg FERRON PAR PHARMATEUTICALS
NAPROTAX Inj 100 mg Injeksi 100 mg KIMIA FARMA
NAPROTAX Inj 30 mg Injeksi 30 mg KIMIA FARMA
Pemetrexed ALIMTA Inj 100 mg Injeksi 100 mg ELI LILLY
ALIMTA Inj 500 mg Injeksi 500 mg ELI LILLY
AVITREX Inj 500 mg Injeksi 500 mg KIMIA FARMA
Pertuzumab PERJETA Inj 420 mg/14 ml Injeksi 420 mg ROCHE
Rituximab MABTHERA Inj 100 mg Injeksi 100 mg ROCHE
REDITUX Inj 500 mg Injeksi 500 mg FERRON PAR PHARMATEUTICALS
Sorafenib NEXAVAR Tab 200 mg Tablet 200 mg BAYER INDONESIA
Tamoxifen TAMOFEN Tab 10 mg Tablet 10 mg KALBE FARMA
gimeracil+oteracil
Tegafur TS-ONE ODT Tab 25 mg Tablet 25 mg TAIHO PHARMACEUTICAL CoLtd
potassium
Temozolomide TEMOTERO Kaps 100 mg Kapsul 100 mg AMAROX PHARMA GLOBAL
TEROZA Kaps 20 mg Kapsul 20 mg SOHO INDUSTRI PHARMASI
Vincristine VINCRISTIN Inj 1 mg (KB) Injeksi 1 mg KALBE FARMA
VINCRISTINE Inj 2 mg/2 ml (KB) Injeksi 2 mg / 2 ml KALBE FARMA
Vinorelbine NAVELBINE Inj 10 mg Injeksi 10 mg TRANSFARMA MEDICA INDAH
NAVELBINE Inj 50 mg Injeksi 50 mg TRANSFARMA MEDICA INDAH
VINORELBINE Inj 10 mg/ml (FE) Injeksi 10 mg FERRON PAR PHARMATEUTICALS
36
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
09b. KEMOTERAPI HORMONAL
Anastrozole ARIMIDEX Tab 1 mg Tablet 1 mg ASTRA ZENECA
ATZ Tab 500 mg Tablet 500 mg FAHRENHEIT SYNTHON PHARMA
BRACER Tab 1 MG Tablet 1 mg FERRON PAR PHARMATEUTICALS
Bicalutamide BICASTRA Tab 50 mg Tablet 50 mg FERRON PAR PHARMATEUTICALS
CASODEX Tab 150 mg Tablet 150 mg ASTRA ZENECA
CASODEX Tab 50 mg Tablet 50 mg ASTRA ZENECA
Exemestane AROMASIN Tab 25 mg Tablet 25 mg PFIZER INDONESIA
NATERAN Tab 25 mg Tablet 25 mg FAHRENHEIT
Goserelin acetate ZOLADEX Inj 3.6 mg IMP Injeksi 3,6 mg ASTRA ZENECA
ZOLADEX LA Inj 10.8 mg SDS Injeksi 10,8 mg ASTRA ZENECA
Letrozole FEMARA Tab 2,5 mg Tablet 2,5 mg NOVARTIS INDONESIA
LEBREST Tab 2,5 mg Tablet 2,5 mg FERRON PAR PHARMATEUTICALS
Megestrol Acetat MG-40 Syr Sirup 40 mg LAPI
TRACETATE Tab 160 mg Tablet 160 mg FAHRENHEIT
09d. TARGETED CANCER THERAPY
Bevacizumab AVASTIN Inj 100 mg/4 ml Injeksi 100 mg/ 4 mL ROCHE
Cetuximab ERBITUX Inj 5 mg Injeksi 5 mg MERCK BIOPHARMA
Disodium clodronate tetrahydrate ACTABONE Inj 300 mg Injeksi 300 mg ACTAVIS
Everolimus AFINITOR Tab 10 mg Tablet 10 mg NOVARTIS INDONESIA
Gefitinib GEFITERO Tab 250 mg Tablet 250 mg AMAROX PHARMA GLOBAL
IRESSA Tab 250 mg Tablet 250 mg ASTRA ZENECA
Imatinib GLIVEC Tab 400 mg Tablet 400 mg NOVARTIS INDONESIA
IMATERO Tab 400 mg Tablet 400 mg AMAROX PHARMA GLOBAL
Lapatinib ditosylate TYKERB Tab 250 mg Tablet 250 mg NOVARTIS INDONESIA
Osimertinib TAGRISSO Tab 40 mg Tablet 40 mg ASTRA ZENECA
Pazopanib VOTRIENT Tab 400 mg Tablet 400 mg NOVARTIS INDONESIA
Regorafenib STIVARGA Tab 40 mg Tablet 40 mg BAYER INDONESIA
Sunitinib malate SUTENT Kaps 12,5 mg Kapsul 12,5 mg PFIZER INDONESIA
Trastuzumab HERTRAZ Inj 440 mg Injeksi 440 mg INDOFARMA
KADCYLA Inj 160 mg Injeksi 160 mg ROCHE
VIVITRA Inj 440 mg Tablet 440 mg KIMIA FARMA
09e. TERAPI SUPORTIF
Calcium Folinate CALCIUM FOLINATE Inj 10 mg (FE) Injeksi 10 mg FERRON PAR PHARMATEUTICALS
KALSIUM FOLINAT Inj 50 mg Injeksi 50 mg KALBE FARMA
Leucovorin Calcium NOVORIN Inj 10 mg Injeksi 10 mg NOVEL PHARMA
Netupitant Palonosetron AKYNZEO Kaps 300 mg Kapsul 300 mg MUNDI PHARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
10 GENITO-URINARY SYSTEM
10a. PREPARATIONS FOR VAGINAL CONDITIONS
Clotrimazole CANESTEN SD Vag Tab Tablet vaginal 500 mg BAYER INDONESIA
Metronidazole VAGISTIN Ovula Ovula 500 mg ; 100.000 IU COMBIPHAR
VAGIZOL Ovula Ovula 500 mg KIMIA FARMA
Nystatin NYSTATIN Tab Vag 10.000 IU (PR) Tablet vaginal 10,000 IU PHAPROS
10b.URINARY ANTISEPTICS
Flavoxate HCl URISPAS Tab Tablet 200 mg PROMOSINDO
Phenazopyridine NEXURIN Tab 100 mg Tablet 100 mg NOVEL PHARMA
UROGETIX Kapl 100 mg Kaplet 100 mg TRANSFARMA MEDICA INDAH
Pipemidic acid URINTER Kaps 400 mg Kapsul 400 mg INTERBAT
UROTRACTIN Kaps 400 mg Kapsul 400 mg SANBE FARMA
10c. DRUGS ACTING ON UTERUS
Isoxsuprine HCl DUVADILAN Inj 10 mg/2 ml Injeksi 10 mg/2 ml KIMIA FARMA
DUVADILAN Tab 20 mg Tablet 20 mg KIMIA FARMA
HYSTOLAN Tab 20 mg Tablet 20 mg DEXA MEDICA
Methylergomethrine Maleate BLEDSTOP Tab 125 mcg Tablet 125 mcg SANBE FARMA/CAPRIFARMINDO
METHYLERGOMETRINE Tab 0,125 mg (KF) Tablet 125 mcg KIMIA FARMA
METHYLERGOMETRINE MALEATE Inj 0,2 mg/ml (MM) Injeksi 0,2 mg/ml MEPROFARM
Oxytosin OXYTOCIN HCL Inj 10 IU/ml Injeksi 10 IU NOVEL PHARMA
PROTOCIN Inj 10 IU/ml Injeksi 10 IU MEPROFARM
10d. DRUGS FOR ERECTILE DYSFUNCTION AND EJACULATORY DISORDERS
Sildenafil Citrate SILDENAFIL CITRATE Tab 100 mg (NP) Tablet 100 mg NOVEL PHARMA
SILDENAFIL CITRATE Tab 50 mg (NP) Tablet 50 mg NOVEL PHARMA
VIAGRA Tab 50 mg Tablet 50 mg PFIZER INDONESIA
Tadalafil CIALIS Tab 5 mg Tablet 5 mg ELI LILLY
10e. DRUGS FOR BLADDER & PROSTATE DISORDERS
Dutasteride Tamsulosin DUODART Kap 0,5/0,4 mg Kapsul 0,5mg;0,4mg GLAXO WELLCOME INDONESIA
AVODART Kaps 0,5 mg Kapsul 0,5 mg SMITHKLINE BEECHAM P
DUTASTERIDE Tab 0,5 mg (NP) Tablet 0,5 mg NOVEL PHARMA
Finasteride REPROSID Tab 5 mg Tablet 5 mg HARSEN LABORATORIES
Imidafenacin URITOS Tab 0,1 mg Tablet 0,1 mg EISAI INDONESIA
Mirabegron BETMIGA Tab 50 mg Tablet 50 mg ASTELLAS
Silodosin URIEF Tab 4 mg Tablet 4 mg EISAI INDONESIA
Solifenacin Succinate VESICARE Tab 5 mg Tablet 5 mg ASTELLAS
Tamsulosin Hydrochloride HARNAL OCAS Tab 0,4 mg Tablet 0,4 mg ASTELLAS
PROSTAM SR Tab 0,4 mg Tablet 0,4 mg NOVEL PHARMA
TAMSULOSIN Tab 0,4 mg (NP) Tablet 0,4 mg NOVEL PHARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Terazosin HYTROZ Tab 1 mg Tablet 1 mg DEXA MEDICA
HYTROZ Tab 2 mg Tablet 2 mg DEXA MEDICA
10f. OTHER DRUGS ACTING ON GENITO-URINARY SYSTEM
Agropyron repeans RENALOF Kaps Kapsul SINTESA HEALTH
Amino Acids BINAPRO Kaps Kapsul DIPA PHARMALAB INTERSAINS
Essential ketoacids KETOSTERIL Tab 630 mg Tablet 630 mg FRESENIUS KABI
PRORENAL Tab 630 mg Tablet 630 mg NOVEL PHARMA
11 ENDOCRINE & METABOLIC SYSTEM
11a. INSULINS PREPARATIONS
Human insulin short acting inj 100 UI/ ml, vial
ACTRAPID Inj Injeksi 100 IU NOVO NORDISK
(Human Insulin (Short Acting))
Humulin R Reguler Soluble Human insulin (
HUMULIN R KWIKPEN Inj Injeksi Insulin 300 IU ELI LILLY
Recombinant DNA Origin)
Insulin Aspart NOVORAPID Flexpen 100 IU/mL Injeksi Insulin 100 IU NOVO NORDISK
Insulin Degludec Insulin Aspart RYZODEG Flextouch Injeksi Insulin 100IU NOVO NORDISK
TRESIBA Flextouch 100 IU/mL Injeksi Insulin 100 IU NOVO NORDISK
Insulin determir LEVEMIR Flexpen 100 IU/mL Injeksi Insulin 100 IU NOVO NORDISK
Insulin Glargine Lixisenatide SOLIQUA 100 IU /50 mcg (Peach) Injeksi Insulin 100 IU AVENTIS PHARMA
EZELIN INSULIN GLARGINE 1000 IU/10 ml Injeksi Insulin 100 IU KALBE FARMA
LANTUS Solostar Inj 100 IU Injeksi Insulin 100 IU/mL AVENTIS PHARMA
LANTUS XR 300 IU/mL Injeksi Insulin 300 IU/mL AVENTIS PHARMA
SANSULIN Log G Dispopen Injeksi Insulin 100 IU/mL SANBE FARMA
Insulin Glulisine APIDRA SOLOSTAR Inj 100 IU Injeksi Insulin 100 IU AVENTIS PHARMA
insulin lispro HUMALOG KWIKPEN Injeksi Insulin 100 IU ELI LILLY
Insulin lispro; insulin lispro protamine HUMALOG MIX 25 KWIKPEN Injeksi Insulin 100 IU ELI LILLY
HUMALOG MIX 50 KWIKPEN 100 IU Injeksi Insulin 100 IU ELI LILLY
Liraglutide VICTOZA Penf Inj 18 mg Injeksi Insulin 18 mg NOVO NORDISK
Protamine crystallised
Injeksi Insulin
Premix Insulin Aspart insulin aspart NOVOMIX 30 FLEXPEN 100 IU/ml 100 IU NOVO NORDISK
11b. ORAL ANTIDIABETICS AGENTS
Acarbose ACARBOSE Tab 100 mg (DM) Tablet 100 mg DEXA MEDICA
ACARBOSE Tab 100 mg (PN) Tablet 100 mg FAHRENHEIT
ACARBOSE Tab 50 mg (DM) Tablet 50 mg DEXA MEDICA
ACARBOSE Tab 50 mg (PN) Tablet 50 mg FAHRENHEIT
ECLID Tab 100 mg Tablet 100 mg DEXA MEDICA
GLUCOBAY Tab 50 mg Tablet 50 mg BAYER INDONESIA
Dapagliflozin Metformin XR XIGDUO XR Tab Tablet XR 5mg/500mg ASTRA ZENECA
FORXIGA Tab 10 mg Tablet 10 mg ASTRA ZENECA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Empagliflozin JARDIANCE FCT Tab 10 mg Tablet 10 mg BOEHRINGER
JARDIANCE FCT Tab 25 mg Tablet 25 mg BOEHRINGER
Glibenclamide GLIBENCLAMIDE Tab 5 mg (KF) Tablet 5 mg KIMIA FARMA
GLIBENCLAMIDE Tab 5 mg (PR) Tablet 5 mg PHAPROS
RENABETIC Tab 5 mg Tablet 5 mg FAHRENHEIT
Gliclazide DIAMICRON MR Tab 60 mg Tablet MR 60 mg SERVIER INDONESIA
FONYLIN MR Tab 60 mg Tablet MR 60 mg FERRON PAR PHARMATEUTICALS
GLICLAZIDE Tab 80 mg (DM) Tablet 80 mg DEXA MEDICA
GLUCODEX Tab 80 mg Tablet 80 mg DEXA MEDICA
Glimepiride AMARYL Tab 2 mg Tablet 2 mg AVENTIS PHARMA
DIAVERSA Tab 2 mg Tablet 2 mg DEXA MEDICA
DIAVERSA Tab 3 mg Tablet 3 mg DEXA MEDICA
DIAVERSA Tab 4 mg Tablet 4 mg DEXA MEDICA
GLAMAROL Tab 1 mg Tablet 1 mg GUARDIAN PHARMATAMA
GLIMEPIRIDE Tab 1 mg (DM) Tablet 1 mg DEXA MEDICA
GLIMEPIRIDE Tab 1 mg (HJ) Tablet 1 mg HEXPHARM JAYA
GLIMEPIRIDE Tab 2 mg (KF) Tablet 2 mg KIMIA FARMA
GLIMEPIRIDE Tab 2 mg (PR) Tablet 2 mg PHAPROS
GLIMEPIRIDE Tab 3 mg (DM) Tablet 3 mg DEXA MEDICA
GLIMEPIRIDE Tab 3 mg (KF) Tablet 3 mg KIMIA FARMA
GLIMEPIRIDE Tab 4 mg (HJ) Tablet 4 mg HEXPHARM JAYA
GLIMEPIRIDE Tab 4 mg (KF) Tablet 4 mg KIMIA FARMA
Gliquidone GLIQUIDONE Tab 30 mg (DM) Tablet 30 mg DEXA MEDICA
GLURENORM Tab 30 mg Tablet 30 mg BOEHRINGER
Linagliptin Metformin TRAJENTA DUO FCT Tab 2,5 mg/1000 mg Tablet 2,5 mg/1000 mg BOEHRINGER
TRAJENTA DUO FCT Tab 2,5 mg/500 mg Tablet 2,5 mg/500 mg BOEHRINGER
Linagliptin TRAJENTA FCT Tab 5 mg Tablet 5 mg BOEHRINGER
Metformin Glibenclamide GLUCOVANCE Tab 500/5 mg Tablet 500 mg/5 mg MERCK BIOPHARMA
Kaplet XR
EFOMET XR Kapl 500 mg 500 mg PROMEDRAHARDJO FARMASI INDUSTRI
FORBETES Tab 850 mg Tablet 850 mg SANBE FARMA
GLUCOPHAGE Tab 500 mg Tablet 500 mg MERCK BIOPHARMA
GLUCOTIKA Tab 500 mg Tablet 500 mg IKAPHARMINDO PUTRAMAS
METFORMIN Tab 500 mg (HJ) Tablet 500 mg HEXPHARM JAYA
METFORMIN Tab 500 mg (PR) Tablet 500 mg PHAPROS
METFORMIN Tab 850 mg (BE) Tablet 850 mg BERNOFARM
METFORMIN Tab 850 mg (DM) Tablet 850 mg DEXA MEDICA
METFORMIN XR Kapl 500 mg (PM) Kaplet XR 500 mg PROMEDRAHARDJO FARMASI INDUSTRI
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Pioglitazone - TAZOVELL Tab 30 mg Tablet 30mg NOVEL PHARMA
PIOGLITAZONE Tab 15 mg (MB) Tablet 15 mg MAHAKAM BETA FARMA
PIOGLITAZONE Tab 15 mg (OT) Tablet 15 mg OTTO PHARMACEUTICAL
PIOGLITAZONE Tab 30 mg (MB) Tablet 30 mg MAHAKAM BETA FARMA
PIOGLITAZONE Tab 30 mg (OT) Tablet 30 mg OTTO PHARMACEUTICAL
PIONIX Tab 15 mg Tablet 15 mg KALBE FARMA
Saxagliptin Metformin KOMBIGLYZE-XR Tab Tablet 5 mg/500 mg KALBE FARMA
ONGLYZA Tab 5 mg Tablet 5 mg KALBE FARMA
Sitagliptin Metformin JANUMET XR Tab 100/1000 mg Tablet XR 1000 mg MSD
JANUMET XR Tab 50/500 mg Tablet XR 500 mg MSD
JANUVIA Tab 100 mg Tablet 100 mg MSD
Vildagliptin Metformin GALVUSMET Tab 50/500 mg Tablet 50 mg NOVARTIS INDONESIA
VILDI Tab 50 mg Tablet 50 mg DEXA MEDICA
11c. THYROID HORMONES
Carbimazole NEO MERCAZOLE Tab 5 mg Tablet 5 mg NICHOLAS
Iodine LIPIODOL Inj Injeksi (blank) HYPHENS
Levothyroxine Sodium EUTHYROX Tab 100 mcg Tablet 100 mcg MERCK BIOPHARMA
EUTHYROX Tab 50 mcg Tablet 50 mcg MERCK BIOPHARMA
THYRAX Tab 100 mcg Tablet 100 mcg SYDNA FARMA/QUAMED
11d. ANTITHYROIDS AGENTS
Propiltiourasil PROPYLTHIOURACIL Tab 100 mg (DM) Tablet 100 mg DEXA MEDICA
PROPYLTHIOURACYL Tab 100 mg (IF) Tablet 100 mg INDOFARMA
Thiamazole THYROZOL Tab 10 mg Tablet 10 mg MERCK BIOPHARMA
THYROZOL Tab 5 mg Tablet 5 mg MERCK BIOPHARMA
11e. ANTIOBESITY GENTS
Orlistat XENICAL Tab 120 mg Tablet 120 mg ZUELLIG PHARMA
11f. AGENTS AFFECTING BONE METABOLISM
Alendronate Na ALOVELL Tab 70 mg Tablet 70 mg NOVEL PHARMA
Asam Zoledronat ZOLEDRONIC ACID Inj Injeksi 4 mg ETHICA INDUSTRI FARMASI
ZOMETA Inf 4 mg/100 ml Infus 4 mg/100 ml FERRON PAR PHARMATEUTICALS
Calcitriol CALCITRIOL Kaps 0.25 mcg Kapsul 0.25 mcg PHAPROS
CALCITRIOL Kaps 0.50 mcg Kapsul 0.5 mcg PHAPROS
KOLKATRIOL Kaps 0.25 mcg Kapsul 0,25 mcg PHAPROS
OSCAL Kaps 0,5 mcg Kapsul 0.5 mcg KALBE FARMA
Ibandronic Acid BONEVELL Inj 6 mg Injeksi 6 mg NOVEL PHARMA
Risedronat OSTEONATE OAW Tab 35 mg Tablet 35 mg KALBE FARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
12 ALLERGY & IMMUNE SYSTEM
12a. ANTIHISTAMINES & ANTIALLERGICS
Betamethasone Dexchlorpheniramine
Sirup
maleat CORTAMINE Syr 60 ml 0,25 mg / 5 mL INTERBAT
Cetirizine ALERGINE FT Tab 10 mg Tablet FT 10 mg KIMIA FARMA
ALERGINE Syr 5 mg/5 ml Sirup 5 mg/5 ml KIMIA FARMA
CETIRIZINE Drops 10 mg/ml (IF) Drops 10 mg/ml INDOFARMA
CETIRIZINE Syr 5 mg/5 ml (DM) Sirup 5 mg/5 ml DEXA MEDICA
CETIRIZINE Tab 10 mg (HJ) Tablet 10 mg HEXPHARM JAYA
RYVEL Drops Drops 10 mg/ml NOVEL PHARMA
RYVEL Tab 10 mg Tablet 10 mg NOVEL PHARMA
Chlorpheniramine Maleat CHLORPHENIRAMINE Tab 4 mg (ID) Tablet 4 mg IMFARMIND FARMASI INDUSTRI
KOFIREN Tab 4 mg Tablet 4 mg SAMPHARINDO PERDANA
Desloratadine Pseudoephedrin Sulfate AERIUS Tab 5 mg Tablet 5 mg TRANSFARMA MEDICA INDAH
DESLORATADINE Tab 5 mg Tablet 5 mg BERNOFARM
DESTAVELL Syr 2,5 mg/5 ml 60 ml Sirup 2,5 mg/5 ml NOVEL PHARMA
Dexchlorpheniramine
Sirup
Maleate Betamethasone COLERGIS Syr 60 ml 60 ml DEXA MEDICA
POLARIST Tab Tablet 2 mg BERNOFARM
Diphenhydramine Hcl DIPHENHIDRAMINE HCL Inj 10 mg/ml (IL) Injeksi 10 mg / ml IPHA LABORATORIES
DIPHENHYDRAMINE Inj 10 mg/ml (PR) Injeksi 10 mg / ml PHAPROS
SIDIADRYL Inj 10 mg/ml Injeksi 10 mg / ml BERNOFARM
Fexofenadine HCl TELFAST HD Tab 180 mg Tablet 180 mg AVENTIS PHARMA
TELFAST OD Tab 120 mg Tablet 120 mg AVENTIS PHARMA
Levocetirizine AVOCEL Tab 5 mg Tablet 5 mg PHAROS INDONESIA
Loratadine GRADINE Tab 10 mg Tablet 10 mg GRAHA FARMA
LORATADINE Tab 10 mg (BE) Tablet 10 mg BERNOFARM
LORATADINE Tab 10 mg (HJ) Tablet 10 mg HEXPHARM JAYA
MIRATADIN Syr 5 mg/5 ml Sirup 5 mg/5 ml SAMPHARINDO PERDANA
RAHISTIN Tab 10 mg Tablet 10 mg KIMIA FARMA
Mebhydrolin Napadisilate INTERHISTIN Tab 50 mg Tablet 50 mg INTERBAT
12b. VACCINES, ANTICERA & IMMUNOLOGICALS
2a dan 2b virus influenza VAXIGRIP TETRA NH inj Injeksi 0,5 ml AVENTIS PHARMA
Anti bisa ular Agkistrodon rhodostoma;10 LD50Bunga BIOSAVE (ABU) Inj Injeksi BIOFARMA
Antibisa Brown snake 1.000 unit, Antibisa Tiger sn SERUM ABU II Inj Injeksi BIOFARMA
Antitoksin tetanus serum BIOSAT-1.5 (ATS 1500) Inj Injeksi 1500 IU BIOFARMA
Bacillus Calmette Guerin hidup BCG Inj Injeksi 0,05 mL /20 dosis BIOFARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Inactived Poliovirus
Diphteria toxoid, tetanus
(type 1,2,3); H Influenza INFANRIX IPV HIB Inj 0,5 ml Injeksi 0,5 mL SMITHKLINE BEECHAM P
toxoid, acellular pertusis
type B (Hib)
Inactived Poliovirus
(type 1,2,3); H Influenza Injeksi
type B (Hib); HBsAg HEXAXIM Inj 0,5 mL AVENTIS VACCINE
INFANRIX HEXA Inj Injeksi SMITHKLINE BEECHAM P
BOOSTRIX Inj 0,5 ml Injeksi 0,5 mL SMITHKLINE BEECHAM P
Hemaglutinin A/California/07/2009 X-179 A (H1N1) 7 FLUBIO Inj Injeksi BIOFARMA
Hepatitis A viral protein HAVRIX 1440 Inj 0,5 mL (Adult) Injeksi 1440 Elisa U/0,5 mL SMITHKLINE BEECHAM P
HAVRIX 720 Inj 0,5 mL (Junior) Injeksi 720 Elisa U/0,5 mL SMITHKLINE BEECHAM P
Hepatitis B Immune Globulin (Human) FOVEPTA Inj 200 IU/0.4 ml Injeksi 200 iu / 0,4 ml KIMIA FARMA
HYPERHEP B Inj 0,5 mL Injeksi 220 IU/ mL; 0,5 mL DIPA PHARMALAB INTERSAINS
IVIG Inj (KF) Injeksi KIMIA FARMA
Hepatitis B virus (recombinant) ENGERIX Inj 10 mcg 0,5 mL Injeksi 10 mcg/ 0,5 mL SMITHKLINE BEECHAM P
ENGERIX Inj 20 mcg 1 mL Injeksi 20 mcg/ 1 mL SMITHKLINE BEECHAM P
HBV Inj 10 mcg/0.5 ml Injeksi 10 mcg / 0,5 mL BIOFARMA
VHB Dewasa Inj 20 mcg/ml Injeksi 20 mcg / 1 mL BIOFARMA
HPV Type 6 L1 Protein; HPV Type 11 L1 Protein; HPV CERVARIX Inj 0.5 ml Injeksi 0,5 mL BIOFARMA
GARDASIL Inj HPV Type 6 Injeksi 0,5 mL MSD
Human Bovine Rotavirus Reassortants (G1,G2,G3,G4, ROTATEQ Drops 2 mL Drops 2 ml MSD
Human gammaglobulin GAMARAAS Inj 2,5 g/50 mL Injeksi 2,5 g/ 50 mL COMBIPHAR
Human Tetanus Imunoglobulin TETAGAM P. PFS Inj 250 IU/mL Injeksi 250 IU/ mL DEXA MEDICA
Immune Globulin IV PRIVIGEN Inf 10% 25 ml Infus 25 ml DEXA MEDICA
PRIVIGEN Inf 10% 50 ml Infus 50 ml DEXA MEDICA
Inactivated Hepatitis A Virus AVAXIM Inj 80 IU /0.5 mL Injeksi 80 IU/ 0,5 ml AVENTIS VACCINE
Inactivated rabies virus (wistar pm/wi 38-1503-3m strain)VERORAB
NLT = Inj
2.5 iu Injeksi 0,5 ml AVENTIS PHARMA
Influenza virus surface antigens (4 strains) INFLUVAC TETRA Inj Injeksi ABBOTT
Live measles, mumps & rubella virus vaccine MMR II Inj 0,5 ml Injeksi 0,5 mL MSD
Live, attenuated, recombinant japanese encephalitis
Injeksi
virus IMOJEV Inj 0,5 mL AVENTIS PHARMA
Lyophilized preparation of The Oka/Merck Strain of VARIVAX Inj Tablet 0,5 mL MSD
Mycobacterium tuberculosis 0,4 mcg; Disodium phospatPPD RT23 2 UT Inj Injeksi BIOFARMA
Pneumococcal Conjugate Vaccine PREVENAR 13 PFS Inj 0,5 ml Injeksi 0,5 mL PFIZER INDONESIA
Pneumococus Haemophilus Influenza Protein D-ConjugSYNFLORIX PFS Inj 0,5 ml Injeksi 0,5 mL SMITHKLINE BEECHAM P
Polio INACTIVATED POLIO VACCINE (IPV) Inj Injeksi BIOFARMA
Polisakarida ACYW MENIVAX Inj 0,5 ml Injeksi 0,5 mL BIOFARMA
Purified VI capsular polysaccharide of salmonella TYPHIM VI PREFILLED Inj 0,025 mg/0,5 ml Injeksi 0,025 mg/0,5 mL AVENTIS VACCINE
Rabies Vaccine 1 Dose-WFI SAS Ktk 50 RABIVAX Inj Injeksi INDOFARMA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
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Rotavirus ROTARIX Oral Susp 1,5 ml Larutan Oral 1,5 mL SMITHKLINE BEECHAM P
Toksoid Difteri Murni 2 lf, Toksoid Tetanus Murni JERAP TD (TETANUS DIFTERI) Inj Injeksi BIOFARMA
Toksoid Difteri Murni 20 lf, HBSAg; HIB; Bordella
Injeksi
Toksoid Tetanus Murni Pertussis Antigens PENTabIO (VAKSIN DTP-HB-HIB) Inj 0,5 ml 0,5 mL BIOFARMA
JERAP DIFTERI TETANUS (DT) Inj Injeksi BIOFARMA
Toksoid Tetanus Murni 10 lf Alumunium BIO-TT Inj Injeksi BIOFARMA
JERAP TETANUS (TT) Inj Injeksi BIOFARMA
Toksoid tetanus murni 7,5Lf; Toksoid difteri murni BIO-TD Inj Injeksi 0,5 mL BIOFARMA
Varicella (Live attenuated) vaccine VARICELLA Inj Injeksi BIOFARMA
VARILRIX Inj 0,5 ml Injeksi 0,5 mL SMITHKLINE BEECHAM P
Virus campak dan rubella VAKSIN MEASLES RUBELLA (MR) Inj 5 ml Injeksi 5 mL BIOFARMA
Virus campak strain CAM 70 CAMPAK Inj Injeksi BIOFARMA
Virus polio dilemahkan (strain sabin) POLIO (SABIN) BIVALEN Inj Drops BIOFARMA
12c. IMMUNOSUPPRESSANTS
Adilimumab HUMIRA Inj 40 mg/0.4 ml Injeksi 40 mg/ 0.4 mL ABBOTT
Ciclosporin SANDIMMUN NEORAL Kaps 25 mg Kapsul 25 mg NOVARTIS INDONESIA
SANDIMMUN NEORAL Kaps 50 mg Kapsul 50 mg NOVARTIS INDONESIA
Mycophenolate mofetil - CELMUNOS Kaps 500 mg Kapsul 500 mg SOHO INDUSTRI PHARMASI
KAMYFET Tab 50 mg Tablet 50 mg KALBE FARMA
MYREPT Inj 500 mg Injeksi 500 mg CKD OTTO Pharmaceuticals
Mycophenolate Na MYFORTIC Tab 180 mg Tablet 180 mg NOVARTIS INDONESIA
Tacrolimus PROGRAF Kaps 1 mg Kapsul 1 mg ASTELLAS
13 NUTRITION
13c. PARENTERAL NUTRITIONS
Amino Acids Electrolite, Xylite, vitaminCOMAFUSIN HEPAR Infus Cairan Infus KALBE FARMA
Electrolytes; Glucose;
Cairan Infus
Vitamin BFLUID Infus 500 ml 500 ml OTSUKA
Glucose; Lipid SMOFKABIVEN Infus Cairan Infus 493ml FRESENIUS KABI
AMINOSTERIL INFANT Infus 6% 100 ml Cairan Infus 6% 100 ml FRESENIUS KABI
Fruktosa , Dekstrosa, xylitol Elektrolit, vitamin TRIOMIX E 1000 Infus Cairan Infus KALBE FARMA
Glukosa Asam amino, elektrolit CLINIMIX N9G15E Infus Cairan Infus 1000 mL KALBE FARMA
Lipid Olive oil; Soybean Oil CLINOLEIC Infus 20% 100 mL Cairan Infus 200 g/ L KALBE FARMA
Soy bean oil 6, medium
chain trigliceride 6 g, Cairan Infus
olive oil 5 g, Fish oil 3 g SMOFLipid Infus 100 mL FRESENIUS KABI
N(2)-L-Alanyl-Glutamine GABAXA Inf 20 g/100 mL Infus FAHRENHEIT
13d. ELECTROLYTES
Electrolyte Dextrose PEDIALYTE Soln 500 mL Larutan Oral 500 ml ABBOTT
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Kalium L-Aspartate Mg L- Aspartate RENAPAR Tab 300 mg Tablet 300 mg FAHRENHEIT
ASPAR K Tab 300 mg Tablet 300 mg TANABE
Potassium Chloride KSR Tab 600 mg Tablet 600 mg MERCK BIOPHARMA
KCl; Trinatrium sitrat;
Sodium Chloride ORALIT Sach 200 mg (PR) Granul 200 mg PHAPROS
Glukosa anh
14 EYE
14a. EYE ANTI-INFECTIVES & ANTISEPTICS
Acyclovir HERVIS Eye Oint 3% Salep Mata 0.03 CENDO
Chloramphenicol CHLORAMPHENICOL Salep Mata (KF) Salep Mata KIMIA FARMA
ERLAMYCETIN Salep Mata Salep Mata 10 mg ERELA
FENICOL Eye Drops 0.5% 0.6 ml MD Tetes Mata 0,6 mL CENDO
Ciprofloxacin BAQUINOR Eye Drops 3 mg/ml Tetes Mata 3 mg/ml SANBE FARMA
Dibekacin sulfat DIBEKACIN MEIJI Eye Drops 0,3% 5 ml Tetes Mata 5 mL MEIJI INDONESIA
Gentamicin Sulfate GENOINT Salep Mata 0.3% Salep Mata 3 mg ERELA
GENOINT Tetes Mata 0.3% Tetes Mata 0.3% ERELA
GENTAMYCIN SULFATE Salep Mata 0.3% (ER) Salep Mata 3 mg ERELA
GENTAMYCIN SULFATE Tetes Mata 0.3% (ER) Tetes Mata 3 mg ERELA
Levofloxacin L F X Eye Drops 0,6 mL MD Tetes Mata 0,6 mL CENDO
Moxifloxacin HCl MOLCIN Eye Drops 5 mg/ml Tetes Mata 5 mg/ ml FERRON PAR PHARMATEUTICALS
MOXIFLOXACIN HCL Eye Drops 5 mg/ml (FE) Tetes Mata 5 mg/ml FERRON PAR PHARMATEUTICALS
Natamycin CENDO NATACEN Eye Drops 0,6 ml MD Tetes Mata 0.6 mL CENDO
Ofloxacin FLOXA Eye Drops 3 mg/ml 0,6 ml MD Tetes Mata 3 mg/ 0,6 mL CENDO
Olopatadine PATACEN MD Eye Drops 0,6 ml Tetes Mata 0,6 mL CENDO
Oxytetracycline HCL OKSITETRASIKLIN Eye Oint 1% (KF) Salep Mata 0.01 KIMIA FARMA
14b. EYE ANTISEPTICS WITH CORTICOSTEROIDS
Neomycin sulfate Dexamethasone XITROL Eye Oint 3.5 g Salep Mata 3,5 gr CENDO
Prednisolone P-PRED Eye Drops 0,6 ml MD Tetes Mata 0,6 mL CENDO
Tobramycin Dexamethasone TOBROSON Eye Drops 0,6 ml MD Tetes Mata 0,6 mL CENDO
14c. EYE CORTICOSTEROIDS
Betamethasone Natrium Phosphate VOSAMA Eye Drops 0,6 ml MD Tetes Mata 0,6 mL CENDO
Chloramphenicol Dexamethasone ERLAMYCETINE PLUS Tetes Mata Tetes Mata 5 mg ERELA
Flourometholone OCUFLAM Eye Drops 1 mg/ml Tetes Mata 1 mg SANBE FARMA
POSOP Eye Drops 0,6 mL MD Tetes Mata 0,6 mL CENDO
14d. MYDRIATIC DRUGS
Atropine Sulphate TROPINE Eye Drops 5 mg Tetes Mata 5 mg CENDO
Tropicamide MYDRIATIL Eye Drops 0.5% 0.6 ml MD Tetes Mata 0,6 mL CENDO
MYDRIATIL Eye Drops 1% 0.6 ml MD Tetes Mata 0,6 mL CENDO
14e. MIOTIC DRUGS
Betaxolol HCl TONOR Eye Drops 5 mg Tetes Mata 5 mg CENDO
Phenyleprine HCl EFRISEL Eye Drops 10% 5 ml Tetes Mata 5 mL CENDO
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
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Pilocarpine Hcl CARPINE Eye Drops 1% Tetes Mata 0.01 CENDO
CARPINE Eye Drops 2% Tetes Mata 0.02 CENDO
14f. ANTIGLAUCOMA PREPARATIONS
Acetazolamide GLAUCON Tab 250 mg Tablet 250 mg CENDO
GLAUSETA Tab 250 mg Tablet 250 mg SANBE FARMA
Latanoprost Timolol GLAOPLUS Eye Drops 0,05 mg/ml MD Tetes Mata 0,05 mg CENDO
GLAOPEN Eye Drops 0,05 mg/mL MD Tetes Mata 0,05 mg CENDO
LATANOPROST Tetes Mata 2,5 ml (PN) Tetes Mata 2,5 ml FAHRENHEIT
Tafluprost TAFLOTAN Eye Drops Tetes Mata 2.5ml MEIJI INDONESIA
Timolol hydrogen maleate TIMOL Eye Drops 0.5 % 0.6 ml MD Tetes Mata 0,6 mL CENDO
14g. OPHTALMIC DECONGESTANTS, ANESTHETICS, ANTI-INFLAMMATORIES
Pemirolast Pottasium ALEGYSAL Eye Drops 5 ml Tetes Mata FERRON PAR PHARMATEUTICALS
Tetracaine HCl PANTOCAIN Eye Drops 0.5 % 0.6 ml MD Tetes Mata 0,6 mL CENDO
PANTOCAIN Eye Drops 0.5 % 5 ml Tetes Mata 5 mL CENDO
PANTOCAIN Eye Drops 2 % 5 ml Tetes Mata 5 mL CENDO
Diclofenac Na FLAMAR Eye Drops 1 mg/ml Tetes Mata 1 mg/ml SANBE FARMA
NONCORT Eye Drops 0,6 ml MD Tetes Mata 0,6 mL CENDO
14h. OTHER EYE PREPARATIONS
Carboxymethylcellulose CENFRESH Eye Drops 0.6 ml MD Tetes Mata 0,6 mL CENDO
Ciclosporin IKERVIS Eye Drops Tetes Mata 1 mg/ 1 mL MEIJI INDONESIA
Dextran Hypromellose SANBE TEARS Eye Drops 1 mg/ml Tetes Mata 1 mg SANBE FARMA
Diquafosol DIQUAS Eye Drops Tetes Mata 3%/5ml MEIJI INDONESIA
Glycerin
Hydroxyprophylmethylcellulose, dextran EYEFRESH PLUS Eye Drops MD Tetes Mata 5 mg; 1 mg; 2 mg CENDO
EYEFRESH MILD Eye Drops MD Tetes Mata 5 mg; 1 mg CENDO
Kalium Iodide CATARLENT Eye Drops 15 mL Tetes Mata 15 ml CENDO
Naphazoline HCl VASACON Eye Drops 0.6 ml MD Tetes Mata 0,6 mL CENDO
Polyvinylpyrrolidone, vit A PROTAGENTA Eye Drops 0,6 ml MD Tetes Mata 0,6 mL CENDO
Sodium Chloride KCl LYTEERS Eye Drops 0.6 ml MD Tetes Mata 0,6 mL CENDO
MIRIWASH Sol 500 ml Larutan 500 ml SANBE FARMA
Sodium Hyaluronate HYALUB Eye Drops 1 mg 0,6 ml MD Tetes Mata 1 mg CENDO
15 EAR
15a. EAR ANTI-INFECTIVES & ANTISEPTICS
Chloramphenicol Lidocain HCl COLME Ear Drops 8 ml Tetes Telinga 8 ml INTERBAT
Ciprofloxacin DUOXAL Ear Drops 10 ml Tetes Telinga 10 ml HYPHENS
Gentamicin Sulfate SAGESTAM Ear Drops 3 mg/mL Tetes Telinga 3 mg/ml SANBE FARMA
15b. EAR ANTISEPTICS WITH CORTICOSTEROIDS
Neomycin sulfate, Polymixin Fludrocortisone Acetate,
OTILON Ear Drops 5 mg/mL Tetes Telinga SANBE FARMA
B Sulfate Lidocain HCl
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
15d. OTHER EAR PREPARATIONS
Docusate Sodium FORUMEN Ear Drops 5 mg/ml Tetes Telinga 5 mg SANBE FARMA
15e. MOUTH/THROAT PREPARATIONS
Benzydamine HCL - TANTUM VERDE Gargle 120 ml Larutan Kumur 7.5 mg /5mL SOHO INDUSTRI PHARMASI
Larutan Kumur
Chlorhexidine Glukonate MINOSEP Gargle 0,1% 60 ml 60 ml PROMEDRAHARDJO FARMASI INDUSTRI
Hexetidine HEXADOL Gargle 0,1% 60 mL Injeksi 60 ml OTTO PHARMACEUTICAL
Povidone Iodine BETADINE GARGLE 1% 190 ml Larutan Kumur 190 mL MUNDI PHARMA
Triamcinolone Acetonide KENALOG IN ORABASE Gel 0.1% Gel 0.1% TAISHO PHARMACEUTICAL
KETRICIN IN ORABASE 0.1% 5 g Gel 0.1%, 5 g FERRON PAR PHARMATEUTICALS
16 DERMATOLOGICALS
16a. TOPICAL ANTIBIOTICS
Clindamycin MEDIKLIN Gel 15 g Gel 15 g SURYA DERMATO
Fucidic Acid FUCILEX Cr 2% 5 g Krim 2% 5 g MOLEX AYUS
FULADIC Oint Salep Kulit GUARDIAN PHARMATAMA
FUSYCOM Cr 2% 5 g Krim 2% 5 g COMBIPHAR
Gentamicin Sulfate GENTALEX Cr 0.1% Krim 5g MOLEX AYUS
GENTAMICIN Salep Kulit 0.1% 5 g (IF) Salep Kulit 5g INDOFARMA
GENTAMYCIN Krim 0,1 % 5 g (KF) Krim 5g KIMIA FARMA
Mupirocin BACTODERM Cr 2% Salep Kulit 0.02 IKAPHARMINDO PUTRAMAS
BACTODERM Oint 2% Salep Kulit 2% IKAPHARMINDO PUTRAMAS
MUPIROCIN Cr 2% 5 g (NP) Krim 5g NOVEL PHARMA
MUPIROCIN Ointment 2% (NP) Salep Kulit 2% NOVEL PHARMA
Neomycin sulfate Zn Bacitracin ENBATIC Powder 250 IU Serbuk 250 IU ERELA
ENBATIC Salep Kulit 500 IU Salep Kulit 500 iu ERELA
Oxytetracycline HCL OKSITETRASIKLIN Cr 3% (KF) Krim 3% KIMIA FARMA
Silver Sulfadiazine BURNAZIN Cr 500 g Krim 500 g DARYA VARIA
BURNAZIN PLUS Cr 10 mg/2 mg Krim 10 mg; 2 mg DARYA VARIA
SULFADIAZINE SILVER Cr 35 g (DV) Krim 35 g DARYA VARIA
16b. TOPICAL ANTIFUNGALS & ANTIPARASITES
Ketoconazole FORMYCO Cr Krim 200 mg SANBE FARMA
FUNGORAL Cream 10 g Krim 10 g KIMIA FARMA
KETOCONAZOLE Krim 2% 15 g (KF) Krim 15 g KIMIA FARMA
KETOKONAZOL Cream 2% 10 g (PR) Krim 10 g PHAPROS
KETOMED Soln 60 mL Larutan 60 ml SURYA DERMATO
Miconazole nitrate MICONAZOLE Cr 2% (KF) Krim 2% KIMIA FARMA
MOLADERM Cr 2% 10 g Krim 10 g MOLEX AYUS
MYCORINE POWDER Serbuk GALENIUM PHARMASIA LABORATORIES
Nystatin Zinc Oxide MYCO Z Ointment Salep Kulit 100,000 IU TAISHO PHARMACEUTICAL
47
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Permethrin PEMETRIN Cr 10 g (CB) Krim 10 g COMBIPHAR
PERMETHRINE Cr 5% 15 g (NP) Krim 15 g NOVEL PHARMA
SCABICID Cr Krim 10 g KIMIA FARMA
16c. TOPICAL ANTIVIRALS
Acyclovir ACYCLOVIR Cr 5 % (IF) Krim 5 gr INDOFARMA
16d.TOPICAL ANTI-INFECTIVES WITH CORTICOSTEROIDS
Betamethasone dipropionate Gentamicin sulfate DIPROGENTA Cr 5 g Krim 5g TRANSFARMA MEDICA INDAH
Chloramphenicol Prednisolone CHLORAMFECORT H Cr Krim 20 mg; 2,5 mg KIMIA FARMA
Desoximetasone Neomycin sulfate DENOMIX Cr Krim 0,5 mg ; mg COMBIPHAR
Neomycin sulfate Placenta BIOPLACENTON Cr Krim KALBE FARMA
16e. TOPICAL CORTICOSTEROIDS
Betamethasone BETAMETASON Cr 0,1% (KF) Krim 0,1% KIMIA FARMA
BETAMETASON Cr 0.1% (PR) Krim 0.1% PHAPROS
Betamethasone valerate BETAMETHASONE VALERATE Cr 0.1 % 5 g Krim 5g BERNOFARM
BETASON Cr 0,1% Krim 0.1% KIMIA FARMA
Clobetasol Propionate CLOBETASOL Cr 0,05% (NP) Krim 0,05 %/10 g NOVEL PHARMA
KLODERMA Cr 0.05% 10 g Krim 0,05 %/10 g SURYA DERMATO
Desonide CALACORT Cr 0.5% 0.5%
Krim
GALENIUM PHARMASIA LABORATORIES
DESOLEX Sol 0,05% 10 ml Krim 10 ml SURYA DERMATO
Desoximetasone DESOXIMETHASONE Cr 0.25% 15 g (DM) Krim 0.2%;15 g DEXA MEDICA
DEXOCORT Cr 0,25% 10 g Krim 10 g KIMIA FARMA
ESPERSON Cr 0,25% 15 g Krim 15 gram AVENTIS PHARMA
Fluocinolone acetonide INODERM Cr 0.25% Krim 0.25% MEPROFARM
Hydrocortisone HYDROCORTISONE Cream 2,5 % (IF) Krim 2.5% INDOFARMA
Mometasone Furoate ELOX Cr 5 g Krim 5g GUARDIAN PHARMATAMA
MOFACORT Cr Krim 10 g SURYA DERMATO
MOMETASONE Cr 0,1% 10 g (NP) Krim 0.1% 10 g NOVEL PHARMA
MOMETASONE FUROATE Cr 5 g (NB) Krim 0.1% 5 g NULAB PHARMACEUTICAL INDONESIA
Prednicarbate DERMATOP Cr 0,25% 5 g Krim 5g AVENTIS PHARMA
Triamcinolone Acetonide KENACORT-A Cream Krim TAISHO PHARMACEUTICAL
TRIAMCINOLONE Cr 0,1% (NP) Krim 0.1% NOVEL PHARMA
16f. ACNE TREATMENT PREPARATIONS
Adapalen EVALEN Gel 10 g Gel 10 g FERRON PAR PHARMATEUTICALS
Erythromycin ERYMED Gel 2% 15 g Gel 2%;15 g SURYA DERMATO
Lactobacillus Sp PRODIVA Gel Gel 30 g DARYA VARIA
Nicotinamide NIACEF Gel 4% 15 g Gel 4%;15 g SURYA DERMATO
Tretinoin VITACID Cr 0.05% 20 g Krim 0.05%;20 g SURYA DERMATO
48
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
16k. SKIN ANTISEPTICS & DISINFECTANTS
Ferracrylum HEMOLOK FERACRYLUM Soln 1% 100 mL Larutan 1%;100 mL DEXA MEDICA
Povidone Iodine IODINE POVIDON Soln 10% 30 ml Larutan 10%;30 ml KIMIA FARMA
IODINE POVIDON Soln 10% 300 ml (KF) Larutan 10%;300 ml KIMIA FARMA
IODINE POVIDON Soln 10% 60 ml (KF) Larutan 10%;60 ml KIMIA FARMA
IODINE POVIDONE Soln 10% 1000 ml (KF) Larutan 10%;1000 mL KIMIA FARMA
Tetrachlorodecaoxide OXOFERIN Sol 30 ml Larutan 30 ml PHAROS INDONESIA
16m. OTHER DERMATOLOGICALS
Alium Cepa, Xhantan, Allantoin MEDERMA Gel Proaktif Gel COMBIPHAR
Ethylhexyl Methoxycinnamate; Titanium Dioxide; Oxy PARASOL SPF 33 Cr 20 g Krim 20 g SURYA DERMATO
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
LIDOCAIN HCL Inj 2 % (BE) Injeksi 2% BERNOFARM
LIDOCAINE HCL Inj 2% (PR) Injeksi 2% PHAPROS
XYLOCAINE Jelly 2% 10 g Gel 10 g TANABE
XYLOCAINE PDF Inj 2% 20 mL Injeksi 2%,20 ml TANABE
Lignocaine HCl XYLOCAINE Top Pump Spray 10% 50ml Semprot 10% 50 ml TANABE
Natrium Tiopental THIOPENTAL SODIUM Inj 0.5 g (BE) Injeksi 500 mg BERNOFARM
TIOPOL Inj 500 mg Injeksi 500 mg BERNOFARM
Pethidine PETHIDIN Inj 50 mg/ml 2 ml Injeksi 50 mg/ mL KIMIA FARMA
Propofol FRESOFOL Inj 10 mg Injeksi 10 mg FRESENIUS KABI
PROPOFOL Inj 10 mg Injeksi 10 mg NOVEL PHARMA
Ropivacaine Hcl NAROPIN Inj 7,5 mg/ml Injeksi 7,5 mg/ml TANABE
Sevoflurane SEVOFLURANE Sol Inh 250 ml (MT) Cairan Inhalasi 250ml MERSIFARMA
SEVOFLURANE Sol Inh 250 ml (NP) Cairan Inhalasi 250ml NOVEL PHARMA
17b. NEUROMUSCULAR BLOCKING AGENTS
Rocuronium Bromide NOVERON Inj 50 mg/5 ml Injeksi 50 mg/5 ml NOVEL PHARMA
ROCURONIUM Inj 50 mg/5 ml (DM) Injeksi 50 mg/5 ml DEXA MEDICA
Vecuronium Br ECRON Inj 4 mg Injeksi 4 mg PHAROS INDONESIA
17c. SURGICAL DRESSINGS & WOUND CARE
Framycetin Sulfate DARYANT-TULLE Lembar DARYA VARIA
18 ANTIDOTES & DETOXIFYING AGENTS
18a. ANTIDOTES & DETOXIFYING AGENTS
Calcium Polistiren KALITAKE Sach 5 g Granul 5g DIPA PHARMALAB INTERSAINS
Deferasiroks EXJADE Tab 500 mg Tablet 500 mg NOVARTIS INDONESIA
KALSIROX Tab 250 mg Tablet 250 mg KALBE FARMA
KALSIROX TAB 500 MG Tablet 500 mg KALBE FARMA
Mesna UROMITEXAN Inj 400 mg Injeksi 400 mg TRANSFARMA MEDICA INDAH
18b. DRUGS USED IN SUBSTANCE DEPENDENCE
Naloxone Hcl NOKOBA Inj 0,4 mg/mL Injeksi 0.4 mg/ml FAHRENHEIT
19 INTRAVENOUS & OTHER STERILE SOLUTIONS
19O. INTRAVENOUS & OTHER STERIL SOLUTIONS
Potasium chloride,
Calcium Chloride Dihydrate sodium acetate, sodium ASERING Infus 500 ml Cairan Infus 500 ml OTSUKA
chloride
INFUSAN RING-AS SP Infus 500 ml Cairan Infus 500 ml SANBE FARMA
RINGER ACETATE Inf 500 ml (SR) Cairan Infus 500 ml SATORIA
Potasium chloride,
sodium chloride, sodium INFUSAN RL SP Infus 500 ml Cairan Infus 500 ml SANBE FARMA
lactate
OTSU - RL Infus 500 ml Cairan Infus 500 ml OTSUKA
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
RINGER LAKTAT Infus 500 ml (KF) Cairan Infus 500 ml KIMIA FARMA
RINGER LAKTAT Infus 500 ml (MH) Cairan Infus 500 ml EMJEBE
Dextrose Electrolyte DIANEAL Infus 1.5% Cairan Infus 1.5% KALBE FARMA
DIANEAL Infus 2.5% Cairan Infus 2.5% KALBE FARMA
INFUSAN D2.5 + 1/2NS Infus Cairan Infus 2,5%; 0,45% SANBE FARMA
Sodium Chloride INFUSAN D5 + 1/2 NS SP Infus 500 ml Cairan Infus 5%, 0,45%, 500 ml SANBE FARMA
INFUSAN D5 + 1/4 NS DP Infus Cairan Infus 5%, 0,225%, 500 ml SANBE FARMA
INFUSAN D5 + NS Infus Cairan Infus 5%, 0,9%, 500 ml SANBE FARMA
KA- EN 1B Infus 500 ml Cairan Infus 500 ml OTSUKA
OTSU - D5, 1/2 NS Infus 500 ml Cairan Infus 5%, 0,45%, 500 ml OTSUKA
OTSU - D5, 1/4 NS Infus 500 ml Cairan Infus 5%, 0,225%, 500 ml OTSUKA
OTSU - D5, NS Infus 500 ml Cairan Infus 5%, 0,9%, 500 ml OTSUKA
Sodium Chloride;
Potassium Chloride; KA - EN 3A Infus 500 ml Cairan Infus 500 ml OTSUKA
Sodium Lactate
KA - EN 3B Infus 500 ml Cairan Infus 500 ml OTSUKA
KA - EN MG3 Infus 500 ml Cairan Infus 500 ml OTSUKA
D-5 GLUKOSA Infus 5% (KF) Cairan Infus 5%, 500 ml KIMIA FARMA
D5 Infus 500 ML (MH) Cairan Infus 5%, 500 ml EMJEBE
DEXTROSE Infus 10% 500 ml (SR) Cairan Infus 10%, 500 ml SATORIA
DEXTROSE Infus 5% 100 ml (SR) Cairan Infus 5%, 100 ml SATORIA
DEXTROSE Infus 5% 250 ml (SR) Cairan Infus 5%, 250 ml SATORIA
ECOSOL G10 Infus 500 ml Cairan Infus 10%, 500 ml B BRAUN
ECOSOL G5 Infus 500 ml Cairan Infus 5%, 500 ml B BRAUN
GLUKOSA Infus 10 % (WB) Cairan Infus 10%, 500 ml WIDATRA BHAKTI
OTSU - D40 Infus 25 ml Cairan Infus 40%, 25 ml OTSUKA
OTSU - D5 Infus 100 ml Cairan Infus 5%, 100 ml OTSUKA
Electrolyte Water for Injection SANBE WATER For Irrigation 1000 ml Cairan Infus 1000 mL SANBE FARMA
Acetate; Malate RINGERFUNDIN Infus 500 mL Cairan Infus 500 ml B BRAUN
Gelatin Polysuccinate Electrolyte GELAFUSAL Infus 500 mL Cairan Infus 500 ml DEXA MEDICA
GELOFUSINE ECOFLAC Infus 500 mL Cairan Infus 500 ml B BRAUN
Human Albumin ALBUMINAR Infus 25% 100 ml Cairan Infus 25%, 100 ml DEXA MEDICA
HUMAN ALBUMIN Infus 20% 100 ml (BIOTEST) Cairan Infus 20%, 100 ml KIMIA FARMA
HUMAN ALBUMIN Infus 20% 50 ml Cairan Infus 20%, 50 ml KIMIA FARMA
KEDRIALB Infus 20% 100 ml Cairan Infus 20%, 100 ml BERNOFARM
PLASBUMIN Infus 20%/100 mL Cairan Infus 20%, 100 ml DIPA PHARMALAB INTERSAINS
PLASBUMIN Infus 20%/50 mL Cairan Infus 20%, 50 ml DIPA PHARMALAB INTERSAINS
PLASBUMIN Infus 25%/100 mL Cairan Infus 25%, 100 ml DIPA PHARMALAB INTERSAINS
PLASBUMIN Infus 25%/50 mL Cairan Infus 25%, 50 ml DIPA PHARMALAB INTERSAINS
PLASBUMIN Infus 5%/250 mL Cairan Infus 5%, 250 ml DIPA PHARMALAB INTERSAINS
51
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Hydroxyethyl Starch Electrolyte TERASTARCH Infus Cairan Infus 500 ml KALBE FARMA
NaCl WIDAHES 130 Infus Cairan Infus 500 ml WIDATRA BHAKTI
Maltose 50g/L+electrolyte (Na+130;K+ 4 ; Ca2+ 2,7) HYDROMAL Infus Cairan Infus SANBE FARMA
Mannitol MANNITOL Infus 20 g/ 500 ml (MT) Cairan Infus 20g/500 ml MERSIFARMA
MANNITOL Infus 20% (KB) Cairan Infus 500 ml KALBE FARMA
Meylon MEYLON 8,4% Infus 25 mL Cairan Infus 25 ml OTSUKA
MgSO4 OTSU - MGSO4 20 Infus 25 mL Cairan Infus 20% 25 ML OTSUKA
OTSU - MGSO4 40 Infus 25 mL Cairan Infus 40% 25 ML OTSUKA
Plasma Protein Fraction Human PLASMANATE Infus 250 ml Cairan Infus 250 ml DIPA PHARMALAB INTERSAINS
Potassium Chloride POTASSIUM CHLORIDA Infus 7,46% (SR) Cairan Infus 1865 mg SATORIA
OTSU - KCL 7,46% Infus 25 ml Cairan Infus 25 ml OTSUKA
Sodium Chloride INFUSAN NS IRIGASI Infus 1000 ml Cairan Infus 0.9%;1000 ml SANBE FARMA
NACL Infus 0,9% 500 ml (KF) Cairan Infus 0.9%;500 ml KIMIA FARMA
NATRIUM KLORIDA Infus 0,9% 100 ml (SR) Cairan Infus 0.9%;100 ml SATORIA
NATRIUM KLORIDA Infus 0,9% 25 ml (SR) Cairan Infus 0.9%;25 ml SATORIA
NATRIUM KLORIDA Infus 0,9% 250 ml (SR) Cairan Infus 0.9%;250 ml SATORIA
NATRIUM KLORIDA Infus 0,9% 500 ml (WB) Cairan Infus 0.9%;500 ml WIDATRA BHAKTI
OTSU - NS Infus 0.9% 100 ml Cairan Infus 0.9%;100 ml OTSUKA
OTSU - NS Infus 1000 ml Cairan Infus 0.9%;1000 ml OTSUKA
OTSU - NS Infus 25 ml Cairan Infus 0.9%;25 ml OTSUKA
OTSU - SALIN 3 Infus 500 ml Cairan Infus 3%;500mL OTSUKA
WIDA BES Infus Cairan Infus WIDATRA BHAKTI
WIDA KN-1 Infus Cairan Infus WIDATRA BHAKTI
WIDA KN-2 Infus Cairan Infus WIDATRA BHAKTI
Sorbitol Electrolit FUTROLIT Infus 500 ml Cairan Infus 500 ml SANBE FARMA
TUTOSOL Infus Cairan Infus 500 ml KALBE FARMA
Sterile Water STERIL WATER Infus 1000 ml Cairan Infus 1000 mL OTSUKA
STERILE PURIFIED WATER Inf 500 ml Cairan Infus 500 ml IPHA LABORATORIES
WIDA WI UNICAP Infus 500 ml Cairan Infus 500 ml WIDATRA BHAKTI
Water For Injection - WATER For Injection 25 ml (SR) Cairan Infus 25 ml SATORIA
OTSU - WI Infus 25 ml Cairan Infus 25 ml OTSUKA
WATER For Injection 25 ml (MH) Cairan Infus 25 ml EMJEBE
WATER For Injection 500 ml (IL) Cairan Infus 500 ml IPHA LABORATORIES
30 VITAMINS & MINERALS
30a. VITAMIN A, D & E
Vit D3; Vit A; Vit B1; Bit B2; Folic acid; Lysine; L-
ZAMEL Syr 60 ml Sirup 60 ml NOVEL PHARMA
Vit B12 Glutamine; Zinc; Mineral
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FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Vit B1; Vit B2; Vit E; vit C;
Vit. B1, Vit. B6, Vit B12 Folic acid; Niacin; SURBEX Z Tab Tablet ABBOTT
Pantothenic acid; Zn
NEUROBION FORTE Tab 5000 mcg Tablet 5000 mcg PNGH (Protecter & Gamble)
NEUROBION Inj 5000 mcg Injeksi 5000 mcg PNGH (Protecter & Gamble)
NEUROBION Tab Tablet 100 mcg PNGH (Protecter & Gamble)
NEURODEX Tab Tablet DEXA MEDICA
NEUROSANBE Inj 3 ml Injeksi 3 mL SANBE FARMA
NEUROSANBE Tab 5000 mcg Tablet 100 mcg SANBE FARMA
Vitamin C, Vitamin D3, Zinc, Vitamin B1, B2, B3, B4,
Drops
Vitamin A, Vitamin E B5, B6, B12, Biotin ZAMEL Drops 16 ml NOVEL PHARMA
30b. VITAMIN B-COMPLEX/WITH C
Asam folat ANEMOLAT Tab 1 mg Tablet 1 mg PHAPROS
FOLAVIT Tab 1000 mcg Tablet 1000 mcg SANBE FARMA
FOLIC ACID Tab 1 mg (PR) Tablet 1 mg PHAPROS
FOLIC ACID Tab 400 mcg Tablet
400 mcg PROMEDRAHARDJO FARMASI INDUSTRI
STARFOLAT Tab 400 mcg Tablet 400 mcg DEXA MEDICA
Fursultiamine ALINAMIN F Tab 50 mg Tablet 50 mg TAKEDA INDONESIA
FURAMIN Inj 2,5 mg/mL Injeksi 2,5 mg/ mL MEPROFARM
Pyridoxin HCl PYRIDOXINE (VIT B6) Tab 10 mg (KF) Tablet 10 mg KIMIA FARMA
VITAMIN B6 Tab 10 mg (ID) Tablet 10 mg IMFARMIND FARMASI INDUSTRI
VITAMIN B6 Tab 25 mg (ID) Tablet 25 mg IMFARMIND FARMASI INDUSTRI
Vit B1 , Vit B2 , Vit B6 , Vit Niacinamid ,
Tablet
B12 , Vit C Ca.Pantothenat, vit B3 SURBEX T Tab ABBOTT
30c. VITAMIN C
Ascorbic Acid ASCORBIC ACID Inj 1000 mg/5 ml (MB) Injeksi 1000 mg / 5 mL MAHAKAM BETA FARMA
YES C Kapl 500 mg Tablet 500 mg INFION
ASAM ASCORBAT (VIT.C) Tab 500 mg Tablet 500 mg PHAPROS
EXTRACE LQ Inj 500 mg/5 ml Kapsul 500 mg/ 5 mL ETHICA INDUSTRI FARMASI
LARCE Inj 1000 mg/5 ml Injeksi 1000 mg/5 mL MAHAKAM BETA FARMA
VITAMIN C Inj 100 mg/ml (EI) Injeksi 100 mg/ml ETHICA INDUSTRI FARMASI
VITAMIN C Tab 100 mg (KF) Tablet 100 mg KIMIA FARMA
VITAMIN C Tab 250 mg (KF) Tablet 250 mg KIMIA FARMA
VIVENA 9 Inj Injeksi 217 mg DEXA MEDICA
30d. CALCIUM/WITH VITAMINS
Cholecalciferol (Vitamin
Suspensi 200 mg/5 mL GRACIA PHARMINDO
Calcium Carbonat D3) CALNIC PLUS Susp 200 mg/5 ml
CALCIUM CARBONATE Tab 500 mg (MT) Tablet 500 mg MERSIFARMA
53
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
EPOCALDI Tab Tablet NOVEL PHARMA
OSTEOCAL Tab Tablet NICHOLAS
Calcium Glukonat CALCII GLUCONAS Inj 100 mg/ml (EI) Injeksi 100 mg/ml ETHICA INDUSTRI FARMASI
CALCIUM GLUCONATE Inj 10%/10 ml (DM) Injeksi 100 mg/ml DEXA MEDICA
Calcium Hidrogen Phosphate Cholecalciferol CAVIT D3 Tab 500 mg Tablet 500 mg PNGH (Protecter & Gamble)
Calcium Lactate CALCIUM LACTATE Tab 500 mg (MT) Tablet 500 mg MERSIFARMA
KALSIUM LAKTAT Tab 500 mg (KF) Tablet 500 mg KIMIA FARMA
Cholecalciferol (Vitamin D3) CAMIVIT D3 Kaps 1.000 IU Kapsul 1000 IU LUCAS DJAJA
HID Tab 5000 IU Tablet 5000 IU IMEDCO
PROVE D3 Drops Drops 400 IU KALBE FARMA
PROVE D3 Tab 1.000 IU Tablet 1000 IU KALBE FARMA
Ossein Hydroxyapatite OSSORAL Tab 800 mg Tablet 800 mg DEXA MEDICA
30e. VITAMINS &/OR MINERALS
Coenzym B12 COBAZIM Kaps 1000 mcg Kapsul 1000 mcg INTERBAT
COBAZIM Kaps 3000 mcg Kapsul 3000 mcg INTERBAT
D-alfa-Tocopherol Vit E DALFAROL Kaps 200 IU Kapsul lunak 200 IU DARYA VARIA
LANTUROL Kaps 400 IU Kapsul lunak 400 IU LANDSON
Lutein; Vit E; Vit C; Zinc;
Lycopene Beta Carotene; Selenium LYCOXY Kapl 8 mg Tablet 8 mg DEXA MEDICA
Yeast
Vit C, nicotinamide, ca
pantothenate, choline,
Vit A, Vit B complex, Vit D ELKANA Syr 60 mg/5 ml Sirup 60 mg/5 ml SANBE FARMA
inositol, calcium,
sodium, I-lysine HCl
Vit C, Nicotinamide,
Dexpanthenol, L-lysin Drops
monohydrochloride APIALYS Drops LAPI
Vit B complex VITAMIN B KOMPLEKS Tab 2 mg (KF) Tablet 2 mg KIMIA FARMA
Vit B1 VITAMIN B1 Tab 100 mg (KF) Tablet 100 mg KIMIA FARMA
VITAMIN B1 Tab 50 mg (KF) Tablet 50 mg KIMIA FARMA
Nicotinamide D-
Vit B1 , Vit B2 , Vit B6 , Vit B12Panthenol
, Vit C , Vit A, Vit D , SUPRALYSIN Syr 1,5 mg/5 ml 60 ml Sirup 1.5 mg/5 mL MEPROFARM
Vit C , Lysine HCl
Biotin; Folic acid;
Nicotinamid;
CERNEVIT Inj Injeksi KALBE FARMA
Pantothenic acid; vit D;
retinol dll
Nicotiname; Pantothenic
Kapsul
acid BECOM C Kaps 500 mg 50 mg SANBE FARMA
Vitamin B12 VITAMIN B12 Tab 0.05 mg (KF) Tablet 0.05 mg KIMIA FARMA
54
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Zinc sulfate monohydrate Vitamin C IMUNPED Drops 5 mg/ml Drops 5 mg/ 1 mL DARYA VARIA
IMUNPED Syr 10 mg/5 ml Sirup 10 mg/5 ml DARYA VARIA
30g. VITAMINS & MINERALS (PEDIATRIC)
Fe Folic acid; Vit B complex FERLIN Drops 30 mL Drops 30 ml DARYA VARIA
Biotin; Vit B1; vit B2; Vit
Sirup
Fe gluconate B6; vit B3 SANGOBION KIDS Syr 113 mg PNGH (Protecter & Gamble)
30h. VITAMINS & MINERALS (PRE- 7 POST-NATAL)/ANTIANEMICS
Asam folat FOLAMIL GENIO Kapl Kaplet DEXA MEDICA
Vitamin B1 monohidrat 3
mg, Vitamin B2 sodium
fosfat 3.4 mg, Vitamin B6
Betakaroten HCL 10 mg, Vitamin C 120 HB-VIT Kapl Kaplet SIMEX
mg, Vitamin E 30 IU,
Kalsium pantotenat 5
mg, Nikotinamid 20 mg,
55
FORMULARIUM OBAT PERTAMEDIKA IHC (FOPI) - 2022
KELAS SUB KELAS ZAT AKTIF UTAMA ZAT AKTIF LAIN NAMA OBAT SEDIAAN DOSIS PABRIK
Astaxantin ASTHIN FORCE Kaps 6 mg Kapsul 6 mg SOHO INDUSTRI PHARMASI
Bilberry Dry Extract ,
Retinol ; vit E; Lutein; Kaplet
Betakaroten Selenium; Zinc RETIVIT PLUS Kapl SANBE FARMA
Black Elderberry , Zn
Kaplet
Echinacea Purpurea Extract Picolinate IMBOOST Force Kapl 250 mg SOHO INDUSTRI PHARMASI
IMBOOST FORCE Syr 60 ml Sirup 60 ml SOHO INDUSTRI PHARMASI
NATURA NUSWANTARA
Kapsul
Ekstrak Chana Striata ONOIWA Kaps 1500 mg NIRMALA(NUCLEUS FARMA)
Citrus Sinensis; Curcuma
Granul
Ekstrak ophiocephalus striatusDomesticae VIPALBUMIN Plus Sach 5 g 5g ROYAL MEDICALINK PHARMALAB
VIPALBUMIN Kaps 500 mg Kapsul 500 mg ROYAL MEDICALINK PHARMALAB
glycine, L-cysteine
Injeksi
Glycyrrhizin hydrochloride HISHIPHAGHEN Inj 20 ml DARYA VARIA
Amino Acetic Acid; L-
Injeksi
Cysteine STRONGER NEO-MINOPHAGEN C (SNMC) Inj 40 mg 40 mg DEXA MEDICA
Glycine 400 mg ,L-
Injeksi
Cysteine HCL 20 mg NORPHAGEN Inj FAHRENHEIT
L-Glutathione reduced GLUBIO Kaps Kapsul IMEDCO
Magnesium BIOLECTRA Tab Tablet IKAPHARMINDO PUTRAMAS
Natural Astaxanthin BIOSTHIN Kaps 4 mg Kapsul 4 mg INDOFARMA
Placenta Extract Vit B12 MOLOCO Tab Tablet DARYA VARIA
Pygeum africanum PYGEUM AFRICANUM STARFER Kaps Kapsul SINTESA HEALTH
Radix Salvia
Miltiorrhizae; Radix
Kapsul
Radix Astragali Paeoniae Rubra;
Membranaceus Rhizoma; etc NEUROAID II Kaps 650 mg 650 mg MERSIFARMA
vit B1 ,vit B2 , vit B6 , vit
B12 , niacinamide , vit E ,
Silibinin phospholipids LIVERPRIME Tab Tablet DARYA VARIA
Ca pantothenate, Zn
sulfate
40 DERMATOLOGICAL & PERSONAL CARE
40a. EMOLIENTS, CLEANSER & SKIN PROTECTIVES
Na Cocoyl Isothionate PHYSIOGEL CLEANSER Sol 150 ml Larutan 150 mL ZUELLIG PHARMA
Vitis Vinifera;
Butyrospermum Parkii
Sodium Hyaluronate ATOPICLAIR Cr 40 ml Krim 40 ml TRANSFARMA MEDICA INDAH
Butter; Telmesteine;
Glycyrrhetinic Acid
Sodium L-Ascorbyl Phosphate PROBIO-C SERUM 0,1% 10 ml Larutan 10 ml IKAPHARMINDO PUTRAMAS
56