KESESUAIAN OBAT YANG TERSEDIA DALAM FORMULARIUM NASIONAL

PUSKESMAS MADIUN
BULAN APRIL 2023

Sesuai dengan Formularium

No Nama Obat Satuan Keterangan
Sesuai Tidak sesuai
1 ACETYLCYSTEINE TABLET 200 MG TABLET 1
2 ACYCLOVIR CREAM TUBE 1
3 ACYCLOVIR TABLET 400 MG TABLET 1
4 ALBENDAZOLE SIRUP 200 MG/5 ML BOTOL 1
5 ALBENDAZOLE TABLET 400 MG TABLET 1
6 ALLOPURINOL TABLET 100 MG TABLET 1
7 ALLOPURINOL TABLET 300 MG TABLET 1
8 AMBROXOL TABLET 30 MG TABLET 1
9 AMINOPHYLLINE INJEKSI 24 MG/ML AMPUL 1
10 AMITRIPTYLINE TABLET 25 MG TABLET 1
11 AMLODIPINE TABLET 10 MG TABLET 1
12 AMLODIPINE TABLET 5 MG TABLET 1
13 AMOXYCILLIN SIRUP 250 MG/5 ML BOTOL
14 AMOXYCILLIN TABLET 500 MG TABLET 1
15 AMPICILLIN INJEKSI 1 G/VIAL AMPUL 1
16 ANTACIDA SIRUP 400 MG/5 ML BOTOL
17 ANTACIDA TABLET 400 MG TABLET 1
18 ANTI INFLUENZA TABLET TABLET 1
ANTIBAKTERI (BACITRACIN
19 POLYMYXIN) SALEP KULIT 5 Gr
TUBE 1
ANTIFUNGI: ASAM SALICYLICUM 30
20 MG, ASAM BENZOICUM 60 MG
POT 1
21 ASAM MEFENAMAT TABLET 500 MG TABLET 1
ASAM TRANEKSAMAT INJEKSI
22 (50MG/ML)/(250MG/5ML)
AMPUL 1
ASCORBIC ACID (VITAMIN C) TABLET
23 250 MG
TABLET 1
ASCORBIC ACID (VITAMIN C) TABLET
24 50 MG
TABLET 1
25 ASETOSAL 100MG TABLET 1
ATROPINE SULPHATE INJEKSI 0.25
26 MG/ML
AMPUL 1
27 ATTAPULGITE 630 MG TABLET 1
28 BEDAK SALISIL SERBUK 2 % POT 1
29 BETAHISTINE TABLET 6 MG TABLET 1
30 BETAMETHASONE KRIM 0.1% TUBE 1
31 BISACODYL SUPPOSITORIA 10 MG SUPPO 1
32 BISACODYL TABLET 5 MG TABLET
 Sesuai dengan Formularium
No Nama Obat Satuan Keterangan
Sesuai Tidak sesuai
CALCIUM GLUKONAT 10 % INJEKSI (10
33 ML)
AMPUL 1
CALCIUM LACTATE TABLET 500 MG /
34 KALK
TABLET 1
35 CAPTOPRIL TABLET 12.5 MG TABLET 1
36 CAPTOPRIL TABLET 25 MG TABLET 1
37 CEFADROXIL TABLET 500 MG TABLET 1
38 KLORAMFENIKOL SALEP KULIT 2% TUBE
CHLORPHENIRAMINE MALEAT TABLET
39 4 MG
TABLET 1
CHLORPROMAZINE HCL TABLET 100
40 MG
TABLET 1
41 CIPROFLOXACIN TABLET 500 MG TABLET 1
42 CLINDAMYCIN 300 MG TABLET 1
43 CLOZAPINE TABLET 25 MG TABLET 1
44 CODEINE TABLET 10 MG TABLET 1
COTRIMOXAZOLE (DOEN I DEWASA) :
45 Sulfametoxazole 400 mg +
Trimetoprim 80 mg tablet
TABLET 1
COTRIMOXAZOLE SUSPENSI
KOMBINASI: SULFAMETOXAZOLE 200
46 MG + TRIMETROPIN 40 MG/5 ML
BOTOL
47 CURCUMA 20 MG TABLET TABLET 1
48 DEXAMETHASONE 0.5 MG TABLET TABLET 1
49 DEXAMETHASONE INJEKSI 5 MG/ML AMPUL 1
DIAZEPAM INJEKSI 5 MG/ML (i.v./i.m.)
50
AMPUL 1
51 DIAZEPAM RECTAL 5 MG/2,5 ML ENEMA 1
52 DIAZEPAM TABLET 5 MG TABLET 1
53 DIGOXIN 0,25 MG TABLET 1
DIPHENHYDRAMINE INJEKSI 10
54 MG/ML
AMPUL 1
55 DOMPERIDONE TABLET 10 MG TABLET 1
EPINEPHRINE INJEKSI 1 MG/ML
56 (i.v./s.k./i.m.)
AMPUL 1
ERGOTAMINE TARTRATE|CAFFEINE
57 TABLET
TABLET
58 ERITROMISIN 500MG TABLET 1
59 FAVIPIRAVIR 200 MG TABLET TABLET 1
FITOMENADION (VIT. K1) 10 MG
60 TABLET
TABLET 1
FITOMENADION (VITAMIN K) INJEKSI 2
61 MG/ML
AMPUL 1
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No Nama Obat Satuan Keterangan
Sesuai Tidak sesuai
FLUPHENAZINE DECANOATE INJEKSI
62 25 MG/ML (i.m.)/SIKZONOATE
AMPUL 1
63 FUROSEMIDE TABLET 40 MG TABLET 1
GARAM ORALIT KOMBINASI SERBUK
64
PCS 1
65 GENTAMYCIN SALEP KULIT TUBE
GENTAMYCIN SULFAT 0.3 % TETES
66 MATA
BOTOL 1
67 GENTIAN VIOLET BOTOL 1
68 GLIBENCLAMIDE TABLET 5 MG TABLET 1
69 GLIMEPIRIDE TABLET 1 MG TABLET 1
70 GLIMEPIRIDE TABLET 3 MG TABLET 1
71 GUAIFENESIN TABLET 100 MG TABLET
72 HALOPERIDOL TABLET 2 MG TABLET 1
73 HERBA VOMITZ (Syrup 60 ml) BOTOL 1
74 HerbaKOF ) 100 ML BOTOL
75 HIDROKORTISON CREAM 2,5% TUBE 1
HYDROCHLOROTHIAZIDE TABLET 25
76 MG (HCT)
TABLET 1
77 IBUPROFEN SIRUP 200 MG/5 ML BOTOL 1
78 IBUPROFEN TABLET 400 MG TABLET 1
IMUNOMODULATOR KAPSUL
79 (Stimuno)
TABLET 1
ISOSORBIDE DINITRATE TABLET 5 MG
80 (ISDN)
TABLET 1
81 KETOCONAZOLE TABLET 200 MG TABLET 1
82 KETOROLAC 30 MG/1 ML INJEKSI AMPUL 1
83 KLORAMFENICOL KAPSUL 250 MG KAPSUL 1
84 KLORAMFENIKOL SALEP MATA TUBE 1
KLORAMFENIKOL TETES MATA 0.5%
85 (Reco TM)
BOTOL 1
KLORAMFENIKOL TETES TELINGA 1 %
86
BOTOL 1
87 LIDOCAINE INJEKSI 2% AMPUL 1
88 LORATADINE TABLET 10 MG TABLET 1
89 LORAZEPAM 2 MG TABLET TABLET 1
MAGNESIUM SULFAT INJEKSI 20 %
90 (i.v.)
AMPUL 1
MAGNESIUM SULFAT INJEKSI 40 %
91 (i.v.)
AMPUL 1
92 METFORMIN HCL TABLET 500 MG TABLET 1
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No Nama Obat Satuan Keterangan
Sesuai Tidak sesuai
METHYLERGOMETRINE INJEKSI 0.2
93 MG/ML
AMPUL 1
METHYLERGOMETRINE TABLET 0.125
94 MG
TABLET 1
METHYLPREDNISOLONE TABLET 4 MG
95
TABLET 1
96 METRONIDAZOLE TABLET 500 MG TABLET 1
97 MICONAZOLE SALEP 2% TUBE 1
98 MULTIVITAMIN SYRUP BOTOL 1
99 MULTIVITAMIN TABLET MG TABLET 1
NATRIUM DIKLOFENAK TABLET 25 MG
100
TABLET 1
NATRIUM DIKLOFENAK TABLET 50 MG
101
TABLET 1
NYSTATIN OVULA 100000 IU/G(tablet
102 vaginal)
TABLET
103 OBAT BATUK HITAM (OBH) SIRUP BOTOL 1
104 OMEPRAZOLE INJEKSI 40 MG/VIAL AMPUL 1
105 OMEPRAZOLE KAPSUL 20 MG KAPSUL
ONDANSETRON INJEKSI (2 MG/ML)/(4
106 MG/2 ML)
AMPUL 1
OSELTAMIVIR PHOSPHATE TABLET 75
107 MG
TABLET 1
108 OXYTOCIN INJEKSI 10 IU/ML AMPUL 1
109 PARACETAMOL SIRUP 120 MG/5 ML BOTOL 1
110 PARACETAMOL TABLET 500 MG TABLET 1
111 PERMETHRIN KRIM 5 % 10 GR TUBE 1
112 PHENOBARBITAL INJEKSI 50 MG/ML AMPUL 1
PHENOL GLYCEROL (TETES TELINGA)
113 10%
BOTOL 1
PHENYTOIN SODIUM INJEKSI 50
114 MG/ML
AMPUL 1
115 PIRIDOKSIN HCL ( VIT. B6 ) 10 MG TABLET 1
116 PREDNISON 5 MG TAB TABLET 1
117 PROPRANOLOL TABLET 10 MG TABLET 1
118 RANITIDINE TABLET 150 MG TABLET 1
RETINOL PALMITATE TABLET 100000
119 IU (Vitamin A Biru)
KAPSUL
RETINOL PALMITATE TABLET 200000
120 IU (Vitamin A Merah)
KAPSUL 1
121 RINGER LAKTAT 500 ML (RL Infus) BOTOL 1
122 RISPERIDONE TABLET 2 MG TABLET 1
123 SALBUTAMOL TABLET 2 MG TABLET 1
 Sesuai dengan Formularium
No Nama Obat Satuan Keterangan
Sesuai Tidak sesuai
SALEP 2-4 KOMBINASI: ASAM
124 SALISILAT 2% + BELERANG ENDAP 4%
POT 1
SERUM ANTI BISA ULAR POLIVALEN
125 (KUDA) 5 ML (A.B.U.) (i.m./i.v.)
AMPUL 1
SIANOKOBALAMIN (VITAMIN B12)
126 INJEKSI 500 MCG
AMPUL 1
127 SIANOKOBALAMIN TABLET 50 MCG TABLET 1
128 SIMVASTATIN TABLET 20 MG TABLET 1
TABLET TAMBAH DARAH KOMBINASI
129 Fe + ASAM FOLAT
TABLET 1
TETAGAM CAIRAN INJEKSI 250
130 IU/ML(DUS, 1 PREFILLED SYRINGE @ 1
ML)
SYRINGE 1
131 TETRASIKLIN 500MG TABLET 1
132 THIAMINE (VITAMIN B1) 50 MG TABLET 1
133 TRIFLUOPERAZINE TABLET 5 MG TABLET 1
TRIHEXYPHENIDYL TABLET 2 MG (THP
134 2 MG)
TABLET 1
VITAMIN B KOMPLEKS: VITAMIN B1 2
MG, VITAMIN B2 2 MG, VITAMIN B6 2
135 MG, NICOTINAMIDE 20 MG, Ca
PANTOTHENATE 10 MG
TABLET 1
VITAMIN D3 CHOLECALCIFEROL 1000
136 IU TABLET
TABLET 1
137 ZINC SULPHATE TABLET 20 MG TABLET 1
TOTAL 112 13

Petugas Farmasi

Nully Andaretha S, S.Farm., Apt

NIP. 199509172020122007