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NO NAMA OBA T IBUPROFEN T AB 400 MG SIR 200 MG/5 BTL MET AMPIRON T AB 500 MG INJ 500 MG/ML, AMP @2 ML

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Page 1: Form Usulan FORMULARIUM

7/24/2019 Form Usulan FORMULARIUM

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NO NAMA OBAT

IBUPROFEN TAB 400 MG

SIR 200 MG/5 BTL

METAMPIRON TAB 500 MG

INJ 500 MG/ML, AMP @2 ML

Page 2: Form Usulan FORMULARIUM

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NO NAMA OBAT Generik Paten 1

1 Ibuprofen

 Tab. 200mg

 Tab./tab. Sa!t S"a#!t 400 mg

S$%. S!&#. 100 mg/5m, bt@ '0m

S$%. 200mg/5m, bt @ 2m

2 Metampiron Tab. 500 mg

I(). 500mg/m, am# @2m

* Parasetamol

 Tab./+a#. 500 mg

S$%!# 120mg/5m, bt @ '0 m

%-# 100 mg/m, bt @ 15 m

Pa%a&"tam- I(!& 100m

Pa%a&"tam- 500mg (a"t&t"$( 200mg

4 Asam Mefenamat

3a#&. 500 mgS!#&.50 mg/5m. bt @ '0m

5 Tramadol

3a#&. 50 mg

I(). 50 mg/m, am# @ 2m

 T%ama- Pa%a&"tam-

' Ketorolac Tromethanime

 Tab. 10 mg

I(). 10mg/m, am# @ 1m

I(). *0mg/m, Am# @ 1m

1 Diklofenak Natrium

 Tab./tab. Sa!t "(t"%$+ 25 mg

 Tab.50 mg

2 Ketoprefon

 Tab./tab &a!t 50mg

 Tab./tab. Sa!t "(t"%$+ 100mg

I(). 50 mg/m, am# @ 2m

S!##-&&$t-%$a 100 mg

* Meloksikam

 Tab. ,5 mg

 Tab. 15mgI().15mg/1,5 m, am# @ 1,5m

S!##-&$t-%$a 15 mg

1 A-#!%$(-

 Tab. 100 mg

 Tab. *00 mg

2 P%-b"("&$

 Tab. 500 mg

* P$%-+&$+am

 Tab. 10 mg3a#./tab. 20 mg

4 3-+$&$(

 Tab.

1 M$a6-am

I(). 5mg/5m, am# @ 5m

1!  ANTIPI"AI

!  AN#$T#TIK 

!1  %M%M

Page 3: Form Usulan FORMULARIUM

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I(). 15mg/*m, am# @ *m

1 "+&am"ta&-(

I(). 5mg/m 7&bg. Na F-&at8 am#@ 1m

2 $"(9$%am$(

I(). 10mg/m, am# @ 1 m

* E#$("%$( 7a%"(a$(8I(). 0,1: 7&bg. ;<$/b$ta%t%at8, am# @ 1m

4 3-%"($%am$(

 Tab 4 mg 79$%-g%"( Ma"at8

5 L-%ata$("

 Tab./+a#. 10 mg

' S"t$%$6$(" ;<I

 Tab ./tab. Sa!t/+a#&. 10 mg

S$%. 5mg/5m, bt @ '0m

3-mb$(a&$ =

">am"t9a&-(" 0,5 mg"+&-%"($%am$(a ma"at 2 mg

 Tab

1 3a%b- A&-%b"(

 Tab. 0,5g

2 Mag("&$!m S!at

S"%b!+, +tg *0g

* 3a&$!m G!+-(at

I(). 100mg/m, am# @ 10 m4 Nat%$!m T$-&!at

I() 25: am# @ 10 m

1 ""%-+&am$( m"ta(&!-(at

S"%b. I(). 500mg/m, ?$a @ 10m

2 ""%a&$%-+&

 Tab. 250 mg

* ""%$#%-("

 Tab. 500mg

La%. O%a 100mg/m, bt @ 500m4 M"&(a

I(). 400mg, am# @ 4m

5 N--+&-( ;<I

I(). 0,4mg/m, am# @ 2m

' N"-&t$gm$("

I(). 0,5mg/m

1 $a6"#am

 Tab. 5 mgI(). 10 mg/2m

La%. R"+ta 5mg/2,5m, t!b" @ 2,5m

La%. R"+ta 10mg/2,5m, t!b" @ 2,5 m

2 F"($t-$( Na.

3a#&. 100 mg

I(). 100mg/2m, am# @ 2m

I(). 250mg/5m

ANTIA'#"GI DAN ANA(I'AK$I$

)  ANTIDOT DAN OBAT 'AIN %NT%K K#"A*%NAN

)1  %M%M

)!  K+%$%$

,  ANTI#PI'#P$I DAN ANTIKON-%'$I

,1 

ANTI#PI'#P$I DAN ANTIKON-%'$I

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* F"(-ba%b$ta

 Tab. *0 mg

I(). 200mg/2m, ?$a @ 2m

4 Nat%$!m a#%-at

 Tab. Sa!t "(t%$+ 250mg

 Tab. ER 250 mg

 Tab. ER 500 mgS% 250 mg/5 m bt @ 120 m

5 A&am a#%-at

 Tab. *00mg

S$%. 250 mg/5 m

1 3a%bama6"#$(a

 Tab 200 mg

2 Gaba#"(t$(

3a#&. 100 mg

3a#&. *00mg

1 Ab"(a6-

 Tab. 400mg

2 M"b"(a6-

 Tab. 500 mg

* P$%a(t"

 Tab 125 mg 7&"baga$ Pam-at8

S$%.

1 $"t$+a%bama6$(

 Tab. 100 mg 7$9$%-g"( &$t%at8

1 Am-+&$&$$( A(9$%at

 Tab. S-%"/+a#"t 500 mg

S$% 3"%$(g 125 mg/ 5 m, bt '0 m

S"%b I() 1000 mg, ?$a

Am->$$( 500 mg <a?!a($ A$ 125 mg

Am->$$( 125 mg <a?!a($ A$ *1,25 mg b-t-

2 Am#$&$$(

3a#&./+a#. 500 mg

S$% +"%$(g 125/5m, bt @ '0m

S"%b $() 1000 mg/?$a

* F"(-+&$m"t$ P"($&$$( 7P"($$$( 8

 Tab 125mg 7&bg. Ga%am 38

 Tab. 250mg 7&bg. Ga%am 38

 Tab. 500mg 7&bg. Ga%am 38

4 P%-+a$( B"(6$ P"($&$$(

S"%b. I(). *.000.000 UI/m, ?$a@ 1m

5 B"(6at$( P"("&$$(

S"%b. I(). 1.200.000 IU, ?$a@ 20m

S"%b. I(). 2.400.000 IU, ?$a@ 20m

' M"%-#"("m

I(). 500mg, ?$a

I(). 1.000mg, ?$a

<"a6-$(

I(). 1 g%am, ?$a @ 50 m

,!  ANTI N.#"I PADA $A"A(

/  ANTIIN(#K$I

/1 

ANT#'MINTIK DAN ANTI(I'A"IA

/11  ANT#'MINTIK INT#$TITA'

/1!  ANTI(I'A"IA

/! 

ANTIBAKT#"I

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1 T"t%a+&$$( ;<I

3a# 250 mg

3a#&. 500mg

2 O+&$t"t%a&$+$( ;<I

I(). 500mg/m, $a @ 10m

* -+&$&$+$(3a#&. 100mg 7&bg.9$+at/;<I8

1 3-%am"($+-

3a#&. 250 mg

S!&# 125 mg /5 m 7&bg. Pam$tat8, bt @ '0 m

S"%b. I(). 1000 mg 7&bg. Nat%$!m S!+&$(at8, ?$a @ 10m

2 T9$am#9"($- 500mg

 T9$am#9"($- S$%!# 125mg

1 3-t%$m-+&a6- OEN II 7#"$at%$83-mb$(a&$ =

 Tab.

2 3-t%$m-+&a6- 7#"$at%$8

3-mb$(a&$ t$a# 5m &!#&"(&$ =

S$%., bt @ '0m

* 3-t%$m-+&a6- OEN I 7"a&a83-mb$(a&$ =

 Tab.

4 3-t%$m-+&a6- F-%t"

3-mb$(a&$ =

 Tab.

1 E%$t%-m$&$(

3a#&. 250 mg 7&"baga$ &t"a%at8

 Tab. 500mg

S$% 3"%$(g 200 mg/5m 7&bg. Et$ S!+&$(at8, bt @'0m

2 S#$%a&$m$(

 Tab. 500 mg

* 3$(am$&$(

3a#&. 150 mg

3a#&. *00mg

4 R->$t9%-ma$(

 Tab. 150 mg

 Tab. *00mg

5 A6$t9%-m$(

 Tab. 250mg

 Tab 500 mg

S$%. 3"%$(g 200mg/5m, bt @ 15m

S$%. 3"%$(g 200mg/5m, bt @ '0m

/!!  T#T"A$IK'IN

/!&  K'O"AM(#NIKO'

/!)  KOT"IMOK$A0O'

a.  S!am"t-+&a6- 200mg

b.   T%$m"t-#%$m 20mg

a.  S!am"t-+&a6- 200mg

b.   T%$m"t-#%$( 40mg

a. 

S!am"t-+&a6- 400mg

b.   T%$m"t-#%$m C0mg

a.  S!am"t-+&a6- C00mg

b. 

 T%$m"t-#%$m 1'0mg

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1 G"(tam$&$(

I() 40 mg/m 7&bg. S!at8,am#@ 2m

2 St%"#t-m$&$(

S"%b. I(). 1000 mg 7&bg. S!at8, ?$a @ 1m

S"%b. I(). 5000 mg 7&bg. S!at8, ?$a @ 1m

* Am$+a&$( S!atI() 250 mg, ?$a @ 2m

I() 500mg, ?$a @ 2 m

1 S$#%-D-+&a&$(

 Tab. 500 mg

I(. 2mg/m, bt @ 100 m

2 L"?-D->a$(

 Tab. 500mg

I(. 500mg/100m, bt @100m

* OD-+&aa&$(

 Tab 200 mg

 Tab. 400 mg

1 S"a%-+&$ M-(-9$%at

3a#./+a#&. 500 mg

S$%. 3"%$(g 125mg/5m, bt @ '0m

S$%. 3"%$(g 250mg/5m, bt @ '0m

2 S"-ta>$m

S"%b. $(). 1000 mg/?$a

* S"t%$a+&-(

S"%b. I() 1000 mg/?$a

4 <"ta6$$m"

S"%b. I(). 1000mg, ?$a

5 <"!%->$m" a>"t$

 Tab. Sa!t 250 mg

<"!%->$m" 50mg $().

' <"-#"%a6-(" 1g%

<"-#"%a6-(" 0.5 g &!batam 0.5g

C <"#$%-m" 1g

<""#$m" 1g

10 <">$m" &$%!#

<">$m" 100

<">$m" 200

11 <"t%$a6-(" Na 1 g

1 a(+-m$&$( 9$%-+9-%$a

S"%b. I(). 500mg, ?$a2 T"$-#a($(

I() 400 mg

1 S!a&aa6$(

 Tab. 500 mg

2 M"&aa6$("

 Tab. 250 mg

/!,  MAK"O'ID

/!/  AMINOG'IKO$ID

/! 

K%INO'ON

/!2  $#(A'O$(O"IN

/!3 

G'IKOP#PTIDA

/!14 

ANTI BAKT#"I 'AIN

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* Im$(#"("m $(). 500mg, $a&tat$( 500mg

1 R$am#$&$(

 Tab. *00 mg

1 Etamb!t- 9$%-+-%$ Tab. 250 mg

 Tab. 500mg

2 I&-($a6$

 Tab 100 mg

 Tab *00 mg

* P$%a6$(am$

 Tab 500 mg

4 R$am#$&$(

 Tab. *00mg

 Tab. 450mg

 Tab. '00mg

R$am#$&$( S$%!# 100m #"% 5m 7b-t- 120m8

5 3-mb$(a&$ /F$>" -&" <-mb$(at$-(=

 Tab.

' 3-mb$(a&$/F$>" -&" <-mb$(a&$-(=

3a#.

3-mb$(a&$=

 Tab. 3!(a9 25mg

C 3-mb$(a&$ =

 Tab. 3!(a9

1 G%$&"-!?$( = M$%-($6"

 Tab 125 mg

 Tab./+a#. 500mg

2 3"t-+-(a6-

 Tab 200 mg

3%$m 2:, t!b" @5g

3%$m 2:, t!b" @10g

Sam#- 2:, @ m '0

* N$&tat$(

 Tab 500.0000 IU

S!&#. 100.000 IU/m, bt @ 12m

S!&#. 100.000 IU/m, bt @ 15m

 Tab ag$(a 100.000 IU

4 P-$+%"&!"( 7+-("(&a&$ M"ta+%"&- S!-(at M"ta(a8

S!##. ag$(a 0mg

/& 

ANTI IN(#K$I K+%$%$

/&1  ANTI '#P"A

/&! 

ANTIT%B#"KO'O$I$

a.  R$am#$$( 150 mg

b. 

I&-($a6$ 5 mg

.  P%a6$(am$" 400 mg

.  Et9amb!t- 25 mg

a. 

R$am#$&$( 450mgb.  I&-($a6$ *00mg

a.  R$am#$&$( 5mg

b.  I&-($a6$ 50mg

.  P%a6$(am$" 150mg

a. 

R$am#$&$( 5mg

b. 

I&-($a6$ 50mg

/)  ANTI(%NGI

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5 F!-(a6-

3a#&. 150 mg

I() 200mg/100m, ?$a @ 100m

' M$a!(g$( S-$!m

S"%b. I()"+&$ 50mg, ?$a

1 M"t%-($a6- Tab. 500 mg

La%. I(!& 5 mg/m, bt @ 100 m

S$%. S!&#. 125mg/5m, bt @ '0m

O?!a 500mg

3-mb$(a&$ =

O?!a

1 A(t$maa%$a OEN=3-mb$(a&$ =

3a#.

2 3!$($(

 Tab 200 mg

* P%$ma+!$(

 Tab. 15mg 7&bg. F-&at8

4 3-mb$(a&$

 Tab.

5 A%t"m"t9"%

I(). C0mg

' A%t"&!(at"

I(). '0mg

1 P"gat" $(t"%"%-( 2a

I(). 1*5mg/0.5m, #& @ 0.5m

I(). 1C0mg/0.5m, #& @ 0.5m

2 R$ba?$%$(

 Tab. 200mg

* T"b$?!$(

 Tab. '00mg

4 Lam$?!$(

 Tab. 100mg

5 A"-?$% $?$?->$

 Tab. 10mg

1 E%g-tam$(

 Tab. 1mg 7ta%t%at8

2 B"ta9$&t$(" $9$%-+-%$a

 Tab. Cmg

* B"ta9$&t$(" M"&$at

 Tab. 'mg

1 T%$9"+&$"($$ ;<I

/, 

ANTIP"OTO0OA

a. 

M"t%-($a6- 500 mg

b.  N&tat$( 100.000 $!

/,1  ANTIAM%BA DAN ANTIGIA"DIA$I$

a. 

P$%$m"tam$( 25 mg

b.  S!a-+&$( 500 mg

a.  A%t"m"t9"% 20mg

b.  L!m"a(t%$(" 120mg

/,!  ANTIMA'A"IA

// 

ANTI -I"%$

  ANTIMIG"#N DAN ANTI-#"TIGO

2  ANTIPA"KIN$ON

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 Tab. 2mg

2 3-mb$(a&$ =

3a#&.

* P%am$#">-"

 Tab. 0.*5mg Tab. 0,50mg

4 3-mb$(a&$ =

 Tab.

5 R-#$($%-"

 Tab. P%--(g" R""a&" 2mg

 Tab. P%--(g" R""a&" 4mg

 Tab. P%--(g" R""a&" Cmg

1 P%$-&t$gm$("

 Tab. '0mg

1 A&am F-at

 Tab 1 mg

 Tab 400 mg

2

 Tab &a!t mg *00mg

S$%. 15mg/5m, bt @ 100m

%-# 15mg/m, bt @ 15m

* S$a(-+-baam$( 7$t B128

 Tab. 50mg

4 L- M-"!" I%-( 7III8 S!%-&"

I(). 100mg/5m, am# @ 5m

5 L- M-"!a% H"$g9t

I(). 100mg/2m, am# @ 2m

1 F$t-m"(a$-( 7?$tam$( 38

 Tab &a!t 10 mg

I(). 10 mg/m

I(). 2 mg/m

2 ;"#a%$( Nat%$!m

I(). 5.000 IU/m, ?$a @5 m

* Ha%a%$(

 Tab &-%" 2mg 7ga%am Na/38

4 A&am T%a("+&amat

3a#./tab. 500mg

I(). 250mg/5m, am# @ 5m

I(). 500mg/5m, am# @ 5m

5 Na%-#a%$(" a$!m

I(). 500 A>a/m, &%$(g" @0.*m

I(). 500 A>a/m, &%$(g" @0.4m

I(). 500 A>a/m, &%$(g" @0.'m

' E(->a#a%$(" S-$!m

I(). 20mg/0,2m, &%$(g" @0.2m

I(). 20mg/0,4m, &%$(g" @0.4m

a.  L"?--#a 100 mg

b. 

B"(6"%a6$ 25 mg

a.  L"?--#a 100mg

b.  <a%b$-#a 25mg

.  E(t"a#-(" 200mg

3  ANTI MIA$T#NIA G"A-I$

14  OBAT %NT%K DA"A+ DAN 5A"INGAN P#MB#NT%K DA"A

141 

ANTIAN#MI

B"&$ 7II8 S!at. ;2O

14!  ANTIKOAG%'A$I

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I(). 20mg/0,'m, &%$(g" @0.'m

F-(a#a%$(!>

I(). 2.5mg, ?$a @0.5m

C R$?a%->aba(

 Tab. 10mg

ab$gat%a( Et">$at"

3a#&. 5mg3a#&. 110mg

1 ;$%-g"( P"%-+&$a

<a$%a( *: bt @100 m

2 3a$!m P"%ma(ga(at

S"%b. 3tg @ 5 g

* P-?$-( L-$a

La%t 10:, bt @*0m

La%t 10:, bt @'0m

1 Eta+%$$( 7R$?a(-8

La%t, 0,1: bt @200 m

2 Eta(- 0:

Bt @100m

1 Am$-%$ ;<I

 Tab. 2.5mg

2 F!%-&"m$

 Tab. 40mg

I(). 10mg/m, am# @2m

I(). 20mg/m, am# @2m

* ;$%-+-%t$a6$ 7;<T8

 Tab 25 mg

4 Ma($t-

La%. I(!& 20:, b% @500m

5 S#$%-(-a+t-(

 Tab. 25mg

 Tab. 100mg

' 3-mb$(a&$ =

 Tab.

1 T"%a6-&$( ;<I

 Tab. 1mg

 Tab. 2mg

2 ->a&-6$( M"&at"

 Tab. 1mg

 Tab. 2mg

* !ta&t"%$"

3a#&. L!(a+ 0.5mg

4 Tam&!-&$("

 Tab. 0.2mg

 Tab. 0.4mg

1 A&am P$#"m$at

11  ANTI$#PTIK DAN D#$IN(#KTAN

111  ANTI$#PTIK 

11!  D#$IN(#KTAN

1!  DI%"#TIK DAN OBAT %NT%K $A'%"AN K#MI+

1!1 

DI%"#TIK

a.  S#$%-(-a+t-( 25mg

b.   T9$ab!ta6$" 2.5mg

1!! 

OBAT %NT%K +IP#"T"OPI P"O$TAT

1!&  OBAT %NT%K ANTI$#PTIK $A'%"AN K#MI+

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3a#&. 400mg

1 G$b"(+am$

 Tab 5 mg

2 G$a6$" Tab C0 mg

 Tab. *0mg

* G$#$6$"

 Tab 5 mg

4 G$+!$-(

 Tab *0 mg

5 G$m"#$%$"

 Tab. 1mg

 Tab. 2mg

 Tab. *mg Tab. 4mg

1 M"t-%m$(

 Tab 500 mg,

 Tab. C50 mg

1 Aa%b-&"

 Tab. 50mg

 Tab. 100mg

1 P$-g$ta6-("

 Tab. 15mg

 Tab. *0mg

1 B$-at$?" F%at$-( LBS*2**

3a#&. 50mg

3a#&. 100 mg

1 ;!ma( $(&!$(

I(). 100 IU/m, ?$a @ 10m

I(). 100 IU/m, a%t%$g" @*m

I(). 100 IU/m, #"( @*m

2 A(a-g $(&!$(

Ba&a $(&!$( a(a-g

I(). 100 UI/m, &--&t"% #"( @*m

* Ra#$ I(&!$( A(a-g

4 M$> I(&!$( A(a-g

1 B%-m-%$#t$("

 Tab. 2.5mg

2 Et$($"&t%a$-

 Tab. 0,05 mg

* A$"&t%"(-

1& 

+O"MON6 OBAT #NDOK"IN 'AIN6 ANTIDIAB#TIK PA"#NT

1&1  ANTI DIAB#TIK O"A'

1&11 

$%'(ONI' %"#A

1&1! 

BIG%ANID

1&1&  A'(A G'%KO$IDA IN+IBITO"

1&1)  T+IA0O'IDINDION

1&1, 

OBAT DIAB#T#$ GO'ONGAN 'AIN

1&! 

ANTIDIAB#TIK PA"#NT#"A'

a. 

I(). 100 UI/m, &--&ta% #"(@*m

b.  I(). 100 UI/m, a%t%$g" @*m

a.  I(). 100 UI/m, D">#"( @*m

b. 

I(). 100 UI/m, a%t%$g" @*m

1&&  +O"MON K#'AMIN

1&&1  #$T"OG#N

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 Tab

1 N-%"t$&t"%-(

 Tab 5 mg

2 M"%->#%-g"&t"%-("

 Tab 5 mg

1 L!g-

La%, bt @*0m

2 Nat%$!m T$%-+&$(

 Tab. 0.1mg

* P%-#$t$-!%a&$

 Tab. 100mg

4 +a%b$ma6-

 Tab. 5mg

5 T9$ama6-

 Tab. 5mg

1 "+&am"ta&-(

 Tab. 0.5mg

I() 0,5 mg/m, am# @2m

2 M"t$ P%"($&--("

 Tab. 4mg

 Tab. Cmg

 Tab. 1'mg

I(). 125 mg/2m, ?$a @2m

* P%"($&-("

 Tab. 5mg

4 T%$am&$(--( a"t-($

 Tab mg 4

I() 10mg/m, ?$a@5 m

1 $t$a6"m ;<I

 Tab. *0 mg

$t$a6"m ;<I

3a#"t. 1C0mg

$t$a6"m ;<I

I(). 25mg /5m am# @5mg

2 I&-&-%b$t $($t%at

 Tab S!b$(g!a 5 mg

tab S!b$(g!a 10 mg

I(). 10mg/10m, am# @ 10m

* I&-&-%b$t M-(-($t%at

 Tab. 10mg

 Tab. '0 mg &- %""a&"

4 G$&"%$ T%$($t%at

 Tab. 2.5mg

 Tab. 5mg

1 E#$("%$( 7A%"(a$(8

I().0.1:7&bg.;<I/b$ta%t%at8,am#@1m

2 P%-#a(-- ;<I

 Tab 10 mg

* Am$-a%-( ;<I

1&&! 

P"OG#$T#"ON

1&) 

+O"MON TI"OID DAN ANTITI"OID

1&,  KO"TIKO$T#"OID

1)  OBAT KA"DIO-A$K%'#"

1)1 

ANTIANGINA

1)!  ANTIA"ITMIA

Page 13: Form Usulan FORMULARIUM

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 Tab. 200mg

I(). 150mg/*m, am# @ *m

4 $g->$(

0.25mg tab"t

$g->$(

0.5mg/2m $()"+&$

1 3a#t-#%$

 Tab. S-%" 12.5mg

 Tab. S-%" 25mg

 Tab. 50mg

2 L$&$(-#%$

 Tab. 5mg

 Tab. 10mg

* Ram$#%$

 Tab. 1,25mg Tab. 2,5mg

 Tab. 5mg

 Tab. 10mg

4 Im$a#%$

 Tab. 5mg

 Tab. 10mg

5 P"%$(%-#%$ A%g$($("

 Tab. 5mg

1 P%-#%a(-- ;<I.

 Tab. 10mg

 Tab. 40 mg

2 At"(--

 Tab. 50mg

 Tab. 100mg

* B$&-#%--

 Tab. 5mg

1 N$"$#$(

 Tab. 10mg

 Tab. O%-& 20mg

 Tab. O%-& *0mg

2 Am-$#$( B"&at

 Tab. 5mg

 Tab. 10mg

* Am-$#$( Ma"at

 Tab. 5mg

 Tab. 10mg

4 "%a#am$

 Tab. C0mg

5 $t$a6"m

 Tab. 100mg

 Tab. 1C0mg

I(). 25mg/5m, ?$a, @ 5m

I(). 50mg, ?$a, @ 5m

' N$+a%$#$( ;$%-+-%$a

I(). 10mg/10m,am# @10m

N$m-$#$("

1)& 

ANTI+IP#"T#N$I1)&1  A*# IN+IBITO"

1)&!  B#TA B'O*K#"

1)&& 

KA'$I%M ANTAGONI$

Page 14: Form Usulan FORMULARIUM

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 Tab. *0mg

I(. 10mg/50m, bt @ 50m

1 a&a%ta(

 Tab. C0mg

 Tab. 1'0mg

2 I%b"&"%ta( Tab. 150mg

 Tab. *00mg

* T"m$&a%ta(

 Tab. C0mg

4 <a("&a%ta( <$">"t$

 Tab. Cmg

 Tab. 1'mg

5 L-&a%ta(

 Tab. 50mg

1 3-($$( ;<I

 Tab. 0,15MG

I(). 0,15 mg/m, am#@ 1m

2 M"t$-#a

 Tab. 250 mg

* B"%a#%-&t S-$!m

tab. 20mg

4 T"%a6-&$( ;<I

 Tab. 1mg

 Tab. 2mg

5 ->a&-6$( M"&at"

 Tab. 1mg

 Tab. 2mg

1 $g-+&$(

 Tab 0,25 mg

2 B$&-#%--

 Tab. 2,5mg

* <a%?"$-

3a#. ',25mg

4 Ram$#%$

 Tab. 1,25mg

 Tab. 2,5mg

 Tab. 5mg

 Tab. 10 mg

1 A&am A&"t$ Sa$&$at 7A&"t-&a8

 Tab./tab. 3!(a9 C0mg

 Tab./tab. Sa!t "(t"%$+ 100mg

2 <-#$-g%" Tab. 5mg

* <$-&ta6-

 Tab. 50mg

1 St%"#t-+$(a&"

S"%b.$(). 1.500.000 IU, ?$a @1m

2 At"#a&"

1)&)  ANGIOT#N$IN II ANTAGONI$

1)&, 

ANTI+IP#"T#N$I 'AIN

1)) 

GAGA' 5ANT%NG

1),  ANTIT"OMBOTIK 

1)/  T"OMBO'ITIK 

Page 15: Form Usulan FORMULARIUM

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I(). 50mg, ?$a @50m

* B$-at$?" #%-t"$( F%at$-( LBS10** 7LUMBRO3INASE8

 Tab. 40mg

4 Natt-+$(a&" II <-"(6m" 10

1 A&am A&"ta$t Sa$&$at 7A&"t-&a8

 Tab. 500mg

1 -#am$( ;$%-+-%$

I() 40 mg/m, am# @ 5 m

2 -b!tam$( ;<I

I(). 250mg, ?$a @5m

* N-%"#$("#9%$("

I(). 4mg/4m, am# @4m

I(). Cmg/Cm, am# @Cm

1 S$m?a&tat$(

 Tab. S-%"/+a#. 10mg

 Tab. 20mg

2 Pa%a?a&tat$( S-$!m

 Tab 10 mg

 Tab 20 mg

* G$mb%-&$

 Tab. *00mg

4 F"(-b%at"

3a#&. 100 mg

1 P%am$&"t$( S!at

3a&a &t"%$ 1:, "mba% @ 10>10m

3a&a &t"%$ 1:, "mba% @ 5>5m

2 Nat%$!m F!&$at

Sa"# 20mg/g, t!b" @5g

3%$m 20mg/g, t!b" @5g

* P"%a+ S!a$a6$(

3%$m 1:, t!b" @*5mg

3%$m 1:, t!b" @500mg

4 E%t%-m$&$( G"

5 3$(am$&$( g"

1 A(t$!(g$ OEN

3-mb$(a&$ =

Sa"#, #-t @*0g

2 M$+-(a6-

3%$m/&a"# 2: 7N$t%at8, t!b" @10g

1 B"tam"ta&-(

3%$m 0,1: 7&bg. a"%at8, t!b" @5g

3%$m 0,05: 7&bg. a"%at8,t!b" @10g

2 ;$%-+-%t$&-( A&"tat

3%$m 1:, t!b" @5mg

3%$m 2,5:, t!b" @5mg

1)  ANTI P#N.AKIT 5ANT%NG "#MATIK 

1,  OBAT %NT%K $.OK 

1,1  $.OK KA"DIOG#NIK 

1/ 

ANTI+IP#"'IPID#MIA

1  OBAT TOPIKA' %NT%K K%'IT

11 

ANTIBAKT#"I

1!  ANTI(%NGI

a.  A&am B"(6-at ':

b.  A&am Sa$&$at *:

1& 

ANTI IN('AMA$I DAN ANTIP"%"ITIK 

Page 16: Form Usulan FORMULARIUM

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* "&-+&$m"ta&-(

3%$m 0,25:, t!b" @ 10g

3%$m 0,25:, t!b" @ 15g

4 $D!+-%t--( a"%at

Sa"# b"%"ma+ 0,1:, t!b" @10g

1 Sa"# 2 43-mb$(a&$ =

Sa"#, #-t @ *0g

2 P"%m"t9%$(

3%$m 5:, t!b" @ 10g%

* Gam">a(

3%$m t!b" @ 10g%

1 U%"a3%$m 10:, t!b" @20g

3%$m 10:, t!b" @40g

1 P-$+%"&!"( 73-("(&a&$ M"ta+%"&- S!-(at M"ta(a8

La%!ta(, bt @10m

1 N$-t$(am$ g", @15 g%

2 L-&$- 3!m"%"$ m 100

* R"t$(-$ a$

<% 0,05:, 0,1: @10 g%

4 B"(6-$ #"%-+&$" 2,5 : a( 5:, @5 g%

1 B"a+ Sa$&$

S"%b. 2:, +t+ @50g%

L"?"%t%a(

Sa"# 10:, #-t *0g%

2 L$-a$(

<% 2: @ 5g%

* M$(->$$ @m '0

4 P&"!-"%ma $#$

3%$m C0 mL

5 3-mb$(a&$ =

3%$m '0 mL

1 Ga%am O%a$t II

3-mb$(a&$ =

S"%b. 100g !(t!+ 200m a$%, &a9"t @ 100g

2 3a$!m 3-%$a

 Tab. S$a# a%!t '00mg

* 3.L. A&#a%tat"

1) 

ANTI$KABI#$ DAN ANTIP#DIK%'O$I$

a.  A&am Sa$&$at 2:

b.  B""%a(g E(a# 4:

1,  K#"ATO'ITIK DAN K#"ATOP'A$TIK 

1/  KA%$TIK 

ANTI 5#"A7AT 8 A*N#

12  'AIN 9 'AIN

a.  (O

b. 

P&"!-"%ma $#$

12 

'A"%TAN #'#KT"O'IT DAN N%T"I$I

121  O"A'

a. 

Nat%$!m 3-%$a 0,0gb.  3a$!m +-%$a 0,*0g

.   T%$(at%$!m S$t%at $9$%at 0,5Cg

G!+-&a A(9$%at 4g

Page 17: Form Usulan FORMULARIUM

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 Tab. *00mg

4 <a$!m P-&t%"(" S!-(at

S"%b, &a9"t @5g

5 $(+

 Tab. 20mg

S$%. 10mg/m, bt @100m

1 G!+-&a

I(!& 5:, bt- @500m

I(!& 10:, bt- @500m

I(!& 40:, bt- @25m

2 3a$!m 3-%$a

I(). ,4':, ?$a @ 25m

* Nat%$!m 3-%$a

La%. I(!& 0,:, bt @500m

La%. I(!& 0,:, bt @1000m

4 R$(g"% La+tatLa%. I(!&, bt @ 500m

La%. I(!&, bt @ 1000m

5 3-mb$(a&$ =

La%. I(!&, bt @500m

' 3-mb$(a&$ = I(!& #"% L

La%. I(!&, bt/&-tbag @500m

3-mb$(a&$ = I(!& #"% L

La%. I(!&, bt/&-tbag @500m

C Nat%$!m B$+a%b-(at

I(). C,4:, $(!& @25m

La%!ta( N!t%$&$ 3-mb$(a&$

La%. I(!&, bt/&-tbag @500m

10 La%!ta( N!t%$&$ 3-mb$(a&$

La%. I(!&, bt @500m

11 La%!ta( N!t%$&$ OEN

3-mb$(a&$ =

La%. I(!&, bt/&-tbag @500m

12 La%!ta( N!t%$&$ 3-mb$(a&$ =

12! 

PA"#NT#"A'

a.  ">t%-&a 5:

b. 

Nat%$!m 3-%$a 0,:

a.  Na<I 2,*4g

b.  3<I 0,5g

.  Na La+tat 2,24g

.  "+&t%-&a A(9$%at 2g

a. 

Na<I 1,5g

b.  3<I 1,5g

Na La+tat 2,24g

.  "+&t%-&a A(9$%at 2g

a.  G!+-&a 5:

b.  Nat%$!m 3-%$a 0,45:

a.  G!+-&a 2,5:

b. 

Nat%$!m 3-%$a 0,45:

a. 

G!+-&a 5:

b.  Nat%$!m 3-%$a 0,225:

a.  A&am Am$(- 50g/L

b. 

. &-%b$t- 100g/L

.  A&am A&+-%bat 7$tam$( <8 0,4g/L

I(-&$t- 0,5g/L

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La%. I(!&, bt @500m

1* 3-mb$(a&$ =

La%. I(!&, bt @500m

14 3-mb$(a&$ = $(!& #"% L

La%. I(!&, bt @250 m

15 3-mb$(a&$ = $(!& #"% L

La%. I(!&, bt @500 m

1' 3-mb$(a&$ = $(!& #"% L

La%. I(!&, bt/&-tbag @500 m

1 3-mb$(a&$ =

La%. I(!&, bt @500m

1C 3-mb$(a&$ =

La%. I(!&, bt @500m

1 3-mb$(a&$ =

La%. I(!&, bt @500m

20 N!t%$&$ L$#$ M<T/L<T

La%. I(!& 20:, bt @100m

21 La%!ta( N!t%$&$ 3-mb$(a&$

La%. I(!&, !a <9amb"% bag @1000m

22 La%!ta( N!t%$&$ 3-mb$(a&$

La%. I(!&, !a <9amb"% Bag @ 500m

La%. I(!&, !a <9amb"% Bag @ 1000m

2* 3-mb$(a&$ = I(!& P"% L

".  N$+-t$(am$a 7N$a&$(am$a8 0,0'g/L

P$%$-+&$( ;<I. 7$tam$( B'8 0,04g/L

g.  R$b-Da?$( Nat%$!m F-&at 2,5mg/m

9. 

R!t-&$ 7R!t$(8 0,4g/L

$.  M$("%a

a.  A&am Am$(-

b.  K$t-

.  $tam$(

.  M$("%a

a.  A&am Am$(- E&&"(&$a 1Cg

b. 

;$&t$$( 'g

a.  F%!+t-&a '0g

b. 

G!+-&a **g

.  K$t- *0g

a.  Na. 100mE, 3 1CmE

b. 

<a. 4mE, Mg 'mE

.  <I 0mE, A&"tat *CmE

.  S-%b$t- 50g

a.  A&am Am$(- Ra(ta$ <aba(g 3aa% T$(gg$

b.  A&am Am$(- A%-mat$+ 3aa% R"(a9

Na. <I 7t$a+ aa t$%-&$(8

a.  A&am Am$(- 100mg

b. 

N$t%-g"( 15,mg

.  Na. 2 mE

A&"tat 120mE

a.  A&am Am$(- 2,2:

b.  S-%b$t- 15:

a.  A&am Am$(- 40g

b.  G!+-&a E"+t%-$t C0g

a.  A&am Am$(- *:

b. 

G!+-&a ,5:

.  E"+t%-$t (

Page 19: Form Usulan FORMULARIUM

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La%. I(!&, bt @ 500m

24 A&am Am$(- E&"(&$a N-( E&"(&$aI(!& :, bt @ 250m

1 A&"ta6-am$

 Tab. 250mg

1 T"t%a+a$( ;<I

 Tt&. Mata 0,5:, bt@ 5m

1 Am-t"%$&$(

Sa"# mata 1:, t!b" @*,5g

2 G"(tam$&$(

Sa"# mata 0,*:, t!b" @*,5g

 Tt&. Mata 0,*:, bt @5m

* O+&$t"t%a&$+$(

Sa"# mata 1:, t!b" @*,5g

4 Natam$$(

 Tt&. Mata 50 mg/0,' m, t!b" @ 5 > 0,' m

5 M-+&$D-+&a&$(

 Tt&. Mata 0,5:, bt @*m

1 3-mb$(a&$ =

 Tt&. Mata, bt @5m

Sa"# mata, t!b" @ *,5g

2 3-mb$(a&$ =

 Tt&. Mata, bt @5m

* 3%-m$$( Nat%$!m

 Tt&, mata 2:, bt @15m

4 3-mb$(a&$ =

 Tt& mata, bt @5m

5 P%"($&--( A&"tat

 Tt&. Mata 10mg/0,'m, t!b" @ 5 > 0,'m

' 3-mb$(a&$ =

 Tt&. Mata 15mg/m, bt @ 5m

3-mb$(a&$ =

a.  Na 140mE

b. 

3 4 mE

.  <I 10mE

<a *mE

".  A&"tat 2C mE

13  OBAT MATA

131  $I$T#MIK

13! 

TOPIKA'

13!1  AN#$T#TIK 'OKA'

13!! 

ANTIMIK"OBA

13!&  ANTI MIK"OBA DAN ANTI IN('AMA$I

a. 

P-$m$+&$(a S!at '.000 IU

b.  N"-m$&$( S!at 5mg

"+&am"ta&-( Na F-&at 1,*mg

a. 

P--m$+&$(a S!at '.000 IU

b. 

N"-m$&$( S!at *,5mg

.  "+&am"ta&-( Na -&at 1mg

a. 

F%am$&"t$( S!at 5mg

b.  G%am$$$(" 0.05mg

.  "+&am"ta&-( 0.5mg

a. 

;$%-+-%t$&-( 5mg/m

b.  3-%am"($+- 10mg/m

a. 

;$%-+-%t$&-( 0.5:

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 Tt&. Mata *.:, t!b" @ *,5g

C B"tam"ta&-(

 Tt&. Mata 1mg/m, t!b" @ 5 > 0,'m

1 At%-#$( S!at

 Tt&. Mata 0,5:, bt @5m2 ;-mat%-#$( ;$%-b%-m$

 Tt&. Mata 2:, bt @5m

* T%-#$+am$

 Tt&. Mata 1:, bt @5m

1 P$-+a%#$(

 Tt&. Mata 2: 7;<I/N$t%at8, bt @5m

2 T$m--

 Tt&. Mata 0,25: 7Ma"at8, bt @5m

 Tt&. Mata 0,5: 7Ma"at8, bt @5m* Lata(-#%-&t

 Tt&. Mata 0,01:/0.' m, t!b" @5 > 0.'m

 Tt&. Mata 0,005:, bt @2,5m

4 B%$(6-am$"

 Tt&. Mata 1:, bt @5m

5 T%a?-#%-&t

 Tt&. Mata 0,004:, bt @2,5m

1 $(at%$!m E"at

 Tt&. Mata 0,*5:, bt @15m

2 M"t$&"!-&a

La%. 2:, bt @5m

* T"t%a9$%-6-$( ;<I

 Tt&. Mata 0,05:, bt @5m

4 3-mb$(a&$ =

 Tt&. Mata, bt @15m

5 A&$+-?$%

Sa"# mata *:, t!b" @*,5g

1 3-%am"($+-

 Tt&. T"$(ga *:, bt @5m

1 T%$am$(--("

Na&a &#%a 55mg/#!, bt @120 -&$&

2 F!t$a&-(" A"t-($"

I(t%a(a&a &#%a, bt @120 -&$&

1 3a%b-g$&"%$(

 Tt&. T"$(ga 10:, bt @5m

2 O+&$m"ta6-$( ;$%-+-%$

 Tt&. ;$!(g 0,025:, bt @10m

 Tt&. ;$!(g 0,050:, bt @15m

1 M"t$""%g-m"t%$(

b.  3-%am"($+- 0.2:

13!)  MID"IATIK 

13!,  MIOTIK DAN ANTIG'A%KOMA

13!/  'AIN 9'AIN

a. 

Nat%$!m 3-%$a C,''4mg

b.  3a$!m 3-%$a 1,*2mg

!4 

OBAT T#'INGA6 +ID%NG DAN T#NGGO"OKAN

!41  ANTIBAKT#"I TOPIKA'

!4! 

KO"TIKO$T#"OID

!4&  'AIN 9'AIN

!1 

OK$ITO$IK DAN "#'AK$AN %T#"%$

!11  OK$ITO$IK 

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 Tab. Sa!t 0,125mg 7Ma"at8

I(). 0,200mg/m, am# @1m

2 O+&$t-&$(

I(). 10 IU/m, am# @1m

1 Mag("&$!m S!at

I(). 20:, am# @20mI(). 40:, am# @20m

2 I&-+&!#%$( ;<I

 Tab. 20mg

1 3-ba6am

 Tab. 10mg

2 A#%a6-am

 Tab. 0,5mg

 Tab. 1 mg* L-%a6"#am

 Tab. 2mg

1 Am$t%$#t$$(

 Tab. Sa, 25 mg 7;<I8

2 Im$#%am$(a ;<I

 Tab. 25mg

* M"#%-t$$( ;<I

 Tab. 25 mg

 Tab. 50 mg

4 F!->"t$(" ;<I

3a#&. 10 mg

3a#&. 20mg

1 3-m$#%am$(

 Tab. 25 mg 7;<I8

1 ;a-#%"($-

 Tab. 0.5mg

 Tab. 1,5 mg

 Tab. 5mg

I(). 5mg/m, am# @ 1m

I(). 50mg/m, am# @ 1m

2 3-%#%-ma6$(

 Tab. Sa 25 mg

 Tab. Sa!t 100 mg 7;<I8

I(). 25mg/5m 7;<I8, am# @ 5m

* T%$D!-#"%a6$(

 Tab . 5 mg

4 R$&#"%$-("

 Tab. 1mg

 Tab. 2mg

5 <-6a#$("

 Tab. 100mg

' Oa(6a#$("

3a#. Sa!t 5mg

3a#. Sa!t 10mg

I(). 10mg/?$a

!1!  "#'AK$AN %T#"%$

!! 

P$IKO(A"MAKA

!!1  ANTIAN$I#TA$ DAN ANTIIN$OMNIA

!!!  ANTID#P"#$I DAN ANTIMANIA

!!& 

ANTIOB$#$I( KOMP%'$I(

!!)  ANTIP$IKO$I$

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F!"(a6$(

I(). 25mg/m, ?$a @ 1m

C !"t$a#$("

 Tab. 200mg

1 M"t9#9"($at" ;<I

 Tab. 10mg

1 A(ta&$a OEN I

3-mb$(a&$ =

 Tab. +!(a9

3-mb$(a&$ =

 Tab. +!(a9

2 A(ta&$a OEN I

3-mb$(a&$ #"% 5m =

S!&#., bt @ '0m

S!&#., bt @ 100m

* Ra($t$$("

 Tab. 150 mg

I(). 50mg/2m, am# @ 2m

4 S!+%aat

 Tab. 500mg

S!&#. 500mg/5m, bt @100m

5 La(&-#%a6-

3a#&. *0mg

Pa(t-#%a6-" 40 mg

' Om"#%a6-"

3a#&. 20 mg

S"%b. I(). 40mg, ?$a #"a%!t @ 10m

M$&-#%-&t- 200 mg

 Tab"t

1 $m"(9$%$(at

 Tab. 50 mg

2 3-%#%-ma6$(

 Tab. Sa. 25 mg 7;<I8

I(). 5mg/m, am# @ 2m

I(). 25mg/m, am# @ 2m

* M"t-+-#%am$

 Tab. 10mg 7&"baga$ ;<I8 Tab. 4 mg

 Tab. C mg

S$%, bt @'0m

%-#, bt @10m

I(). 5mg/m 7&"baga$ ;<I8, am# @2m

I(). 4 mg/2 mL

I(). C mg/4 mL

  GANGG%AN P#M%$ATAN P#"+ATIAN8+IP#"AKTI-ITA$ :GPP8

!&  OBAT $A'%"AN *#"NA

!&1  ANTA$IDA DAN ANTI%'K%$

a.  A!m$($!m ;$%-+&$a 200mg

b. 

Mag("&$!m ;$%-+&$a 200mg

a.  A!m$($!m ;$%-+&$a 200mg

b. 

Mag("&$!m ;$%-+&$a 200mg

a.  A!m$($!m ;$%-+&$a

b. 

Mag("&$!m ;$%-+&$a

!&!  ANTI#M#TIK 

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4 O(a(&"(t%-(

 Tab. 4 mg

 Tab. Cmg

I(). 4mg/2m, am# @2m

I(). Cmg/4m, am# @4m

5 G%a($&"(t%-(

I(). 1mg a( *mg' -m#"%$-(

S$%. 5mg/m, bt @'0m

 Tab. 5mg

1 A(t$9"m-%-$ OEN

3-mb$(a&$=

S!##. @2g

1 A(t%-#$( S!at

I(). 0,25mg/m, am# @1m

2 ;-$&$( N B!t$ B%-m$

 Tab./+a#. 10mg

 Tab. 10mg

I(). 20mg/m, am# @1m

* T$m"#$$!m

3a#&. *0mg

1 3-mb$(a&$=

 Tab

1 B$&a+-$

 Tab. 5mg

S!##-&$t-%$a 5mg

S!##-&$t-%$a 10mg

2 3-mb$(a&$=

1 Am$(-$(

 Tab. S-%" 200mg

I(). 24mg/m, am# @10m

2 E"%$(

 Tab. 25mg 7;<I8

* Sab!tam-

 Tab. 25mg 7&bg. &!at8

 Tab. 4mg 7&bg. &!at8

S$%. 2mg/m, bt @100m

$.9. 100mg/#!, tbg @200 -&$&

N"b!"&, ?$a @2,5mg

!&&  ANTI+#MO"OID

a.  B$&m!t9 S!bgaat 150mg

b. 

;"+&a+-%-"( 2,5mg

.  L$-+a$(

S"(g O+&$a 120mg

!&) 

ANTI$PA$MODIK 

!&,  OBAT DIA"#

a.  3a-$( 550mg

b. 

P"t$( 20mg

!&/ 

KATA"TIK

a.  F"(-ta"$(

b.  L$. Pa%a(

.  G$&"%$(

S!&#/"m!&, bt @'0m

!)  OBAT $A'%"AN NAPA$

!)1 

ANTI A$MA

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4 T"%b!ta$( S!at

 Tab. 2,5mg

S$%. 1,5mg/5m, bt @'0m

I(). 0,5mg/m, am# @1m

 T!%b!. 0.50mg, tbg @ 200 -&$&

R"&#!"& 2,5mg/m

5 T"-$( Tab. 150mg

 Tab. SR *00mg

' B!"&-($"

I(9. 200mg/#!, tbg @ 100 -&$&

I(9. 200mg/#!, tbg @ 200 -&$&

R"&#!"& 0,25mg/m, %"&# @2m

F"(-t"%- ;B%

I(9. 100mg/#!, tbg @200 -&$&

C 3-mb$(a&$=

N"b!"&, ?$a/am# @2,5m

3-mb$(a&$=

Sam"t"%- K$(a-at" 25mg,

I(9. 50mg/#!, tbg @120 -&$&

Sam"t"%- K$(a-at" 50mg,

F!t$a&-(" P%-#%$-(at 100mg

$&+!&. 100mg/#!, tbg @'0 -&$&

Sam"t"%- K$(a-at" 50mg,

F!t$a&-(" P%-#%$-(at 250mg

$&+!&. 250mg/#!, tbg @'0 -&$&

Sam"t"%- K$(a-at" 50mg,

$&+!&. 500mg/#!, tbg @'0 -&$&

10 F!t$a&-(" P%-#$-(at"

N"b!"& 0,5mg, am# @2m

11 B!"&-($" F-%m-t"%- 7F$>" <-mb$(at$-(8

I(9. C0/4.5 mg, tbg @'0 -&$&

I(9. C0/4.5 mg, tbg @'0 -&$&

12 I#%at%-#$!m

I(9. 20mg/#!, tgb @200 -&$&

1 T$-t%-#$!m

3a#&. 1C mg/-&$& 9a($a"%

3a#&. 1C mg/-&$&, %"

1 "+&t%-m"t-%a(

 Tab. Sa!t 15 mg

S$%. 10mg/5m, bt @'0m

2 3-"$( 7;<I/F-&at8

 Tab. 10mg

 Tab. 15mg

 Tab. 20mg

1 G$&"%$ G!a$a+-at

 Tab. 100mg

2 Obat Bat!+ ;$tam 7O.B.;.8

S$%., bt @100m

S$%., bt @200m

a. 

I#%at%-#$!m B%-m$a 0,5mgb.  Sab!tam- 2,5mg

!)! 

PPOK 

!)& 

ANTIT%$I(

!))  #K$P#KTO"AN

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* 3-mb$(a&$=

S$%., bt@'0mS$%., bt@'0m

1 B"%ata(t

I(). 25mg/m, ?$a @Cm

1 Na"t&t"$("

I(). N"b!$6"% *00mg/*m, am#

1 A&am A&+-%bat 7$tam$( <8

 Tab. 50mg Tab. 250mg

2 3a&$!m La+tat

 Tab. 500mg

*

 Tab. 10mg

I(). 100 mg/m, am# @1m

4

 Tab. 50mg 7;<I N$t%at8

I(). 100mg/m, am# @1m

5 $tam$( B <-m#">

 Tab

' 3-mb$(a&$=

I(). 25mg/10m, am# @10m

3-mb$(a&$=

 Tab./+a#. &a!t &"a#!t

C 3-mb$(a&$=

 Tab

I()., am# @*m

3-mb$(a&$ =

 Tab

<a$t%$-

3a#&. L!(a+ 0,25mg

10 3-mb$(a&$ =

a. 

$"(9$%am$( ;<I 1*,5mg

b.  Am-($!m 3-%$a 1*1,5mg

Na&$t%at 55mg

.  M"(t- 1mg

". 

A+-9- 5:

!),  $%"(AKTAN

!)/  M%KO'ITIK

!, 

-ITAMIN DAN MIN#"A'

P$%$-+&$( ;<I 7$tam$( B'8

 T$am$( ;<I 7$tam$( B18

a.  F!%&!t$am$( ;<I 25mg/m

b. 

G!+-&a 2000mg/m

a.  $t B1 M-(-($t%at" 100mg

b.  $t B' 200mg

.  $t B12

 250mg

a.  $t B1 M-(-($t%at" 100mg

b. 

$t B'100mg

.  $t B12

5000mg

a.  ATP 20 mg

b.  $t. B1 100 mg

.  $t. B' 200 mg

$t. B12 200 mg

".  $t. E *0 mg

a.  L!t"$( * mg

b. 

L-#"(" C mg

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3a#&!

Nat!%a A&ta>a(t9$( ' mg

1 3a&$!m 3a%b-(at

 Tab./tab. 3!(a9 500mg

2 A$% !(t!+ $()"+&$

I()., am# @25m

* A$% !(t!+ $%$ga&$

La%. I(!&, bt @1000m

4 3-mb$(a&$ =

Bt.

5 Nat%$!m P9-&#at

Bt @ 1**m

' 3a&$!m A&"tat

 Tab. ''mg

<a$%a( T%$9-%-a"tat 7T<A8 '0,C0, 100:

C <a$%a( P--$(

1 S$+-&#-%$(

3a#&. L!(a+ 25mg

3a#&. L!(a+ 100mg

2 M-#9"(-at"

3a#. 500mg

* E?"%-$m!&

 Tab. 0,25mg

 Tab. 0,50mg

4 Ta%-$m!&

3a#. 0.5mg

3a#. 1mg

5 M"t-t%"+&at

 Tab. 2,5mg 7&bg. ga%am Na8

1 Tam-+&$"(

 Tab. 20mg 7&bg. &$t%at8

2 M"%-+&$ P%-g"&t"%-( A&"tat

 Tab. 500mg

* A(a&t%-6-"

 Tab. 1mg

4 L"t%-6-

 Tab. 2,5mg

5 E>"m&"ta(

 Tab. 25mg

' L"!#%-%"$( A&"tat

I(). 1.CCmg, ?$a

I(). *,5mg, ?$a

.  $t. E 50 mg

$t. < 250 mg

".  ( 20 mg

B"ta 3a%-t"( 10.000 $!

g.  S""($!m "a&t *0 mg

!/  'AIN 9 'AIN

a.  S-%b$t- 1*,40g

b. 

-!&at S-$!m 0,01g

!  ANTIN#OP'A$TIK6 IM%NO$%P"#$AN DAN T#"API PA'IATI(

!1  IMM%NO$%P"#$AN

!!  ANTI+O"MON

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I(). 11,25mg, ?$a

G-&"%"$( A&"tat

I(). *.'mg/?$a

I(). 10.C mg/?$a

1 A&#a%ag$(a&"

S"%b. I(). 10.000 IU/?$a2 B"-m$&$(

S"%. I(). 15 mg/am# 7&bg. S!at8

* a+a%ba6$(

S"%b. I(). 200mg/20m

4 -+&-%!b$&$(

S"%. I(). 10 mg/?$a 7;<I8, ?$a @5m

S"%. I(). 50 mg/?$a 7;<I8, ?$a @25m

5 Et-#-&$

I(). 20 mg/m, am# @5m

' F!-%-!%a&$I(). 250 mg/?$a, ?$a @1m

I(). 500 mg/?$a, ?$a @10m

3a&$!m F-$(at

I(). 50 mg/m, ?$a @5m

C M"t-t%"+&at

S"%b $(). 5mg/2m 7&bg. Ga%am Na8, ?$a @2m

S"%b. I(). 50mg/2m, ?$a @2m

S$+--&am$

 Tab. Sa!t 50

S"%b. I(). 200mg/?$a

S"%b. I(). 500mg/?$a

S"%b. I(). 1000mg/?$a

10 <$&#at$(

S"%b. I(). 10mg/?$a

S"%b. I(). 50mg/?$a

11 <$ta%ab$(

S"%b. I(). 1000mg, ?$a @10m

12 $(ba&t$(

S"%b. I(). 10mg/?$a, 7&!at8, ?$a @10m

1* $(+%$&t$(

S"%b. I(). 1mg/?$a 7&bg. S!at8, ?$a @1m

&"%. I(). 2mg/?$a, ?$a @2mg

14 <a%b-#at$(

I(). 150mg/?$a, ?$a @15m

I(). 450mg/?$a, ?$a @45m

15 E#$%!b$$(

S"%b. I(). 10mg/?$a, ?$a @5m

S"%b. I(). 50mg/?$a, ?$a

1' M$t-m$$( <

S"%b. I(). 10mg/?$a, ?$a

1 Pa$ta+"

I(). *0mg/?$a, ?$a @5m

I(). 100mg/?$a, ?$a @1','m

I(). 150mg/?$a, ?$a @25m

1C <a#"$tab$("

 Tab. 500 mg

1 ;$%-+&$ U%"a

 Tab. 500mg

!&  $ITOTOK$IK 

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20 I-&am$"

I(). 1000mg/?$a

21 -"ta>"

I(). 20 mg/?$a, ?$a @0,5m

I(). C0 mg/?$a, ?$a @2m

22 G"m$tab$("

I(). 200 mg/?$a, ?$a @5mI(). 1000 mg/?$a, ?$a @25m

2* $(-%"b$("

I(). 10mg, ?$a

24 O>a$#at$("

I(). 50mg, ?$a

I(). 100mg, ?$a

25 I%$(-t"a(

I(). 40mg/2m, am# @2m

I(). 100mg/5m, am# @5m

2' T%a&t!6!mabI(). 440mg/20m, ?$a @20m

2 R$t!>$mab

I(). 100mg/10m, ?$a @10m

I(). 500mg/50m, ?$a @50m

2C $&-$!m <-%-(at" T"t%a9%at"

I(). *00mg/5m, am# @5m

2 A&am -"%-(at

I(). 4mg/5m, ?$a @5m

*0 A&am Iba(%-(at

I(). 'mg/'m, ?$a @'m

*1 La#at$($b $t-&at"

 Tab. Sa!t 250mg

*2 <"t!>$mab

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** E%$t%-#-"t$(Aa

I(). 2000 IU, #& @0,5m

I(). *000 IU/m, #& @1m

*4 E%$t%-#-"t$( B"ta

I(). 2000 IU, #& @0,*m

*5 B$a!tam$"

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*C a!(-%!b$$(

I(). 20mg, ?$a

* M"#9aa(

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40 N$-t$b$(

 Tab. 200mg

41 G"t$($b

 Tab. 250mg

1 F$g%a&t$m

I(). 0.*mg/0.5m, #& @0.5m

2 L"(-g%a&t$m

I(). 2'*mg/m, am# @1m

!) 

G"O7 *O'ON. $TIM%'ATING (AKTO" :G*$(;

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1 M-%(

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2 P"t$$(I(). 50mg/m 7;<I8, am# @2m

* F"(ta($

I(). 0,05mg/m 7&bg. S$t%at8, am# @10m

I(). 0,05mg/m 7&bg. S$t%at8, am# @10m

Pat9 12.5mg/)am

Pat9 25mg/)am

Pat9 50mg/)am

4 S!"(ta($

I(). 5mg/m 7&bg S$t%at8, ?$a @10m

5 3-mb$(a&$=

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1 Fa+t-% III 73-(&"(t%a8

S"%b. I(). 2*0 *40 IU, ?$a

S"%b. I(). 4C0 '00 IU, ?$a

I(). $.?. 250 IU, ?$a

I(). $.?. 500 IU, ?$a

1 Ab!m$( S"%!m N-%ma

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2 Pa&ma P%-t"( F%at$-( 7;!ma(8

La%. I(!& 5:, bt @250m

* ;$%-+&$ Et$ Sta%9 BM 200.000

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4 3--$ ;ES BM1*0.000

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5 3--$ ;ES BM 40.000

La%. I(!& ':, @ 500m

' 3--$ Baa(" E"+t%-$t ;ES 1*0/0.42

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* At%a!%$!m B"&at"

I(). 10mg/m, am# @2.5m

I(). 10mg/m, am# @5m

!2  ANA'G#$IK NA"KOTIK

a.  3-"$( *0mg

b. 

Pa%a&"tam- 500mg

!3  P"OD%K DA"A+ DAN P#NGGANTI P'A$MA

!31 

P"OD%K DA"A+

!3!  P#NGGANTI P'A$MA DAN P'A$MA #K$P#ND#"

&4  "#'AK$AN OTOT P#"I(#" DAN P#NG+AMBAT KO'IN#$T

&1 

IM%NOG'OB%'IN DAN $#"%M

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1 Im!(-g-b!$( A(t$ T"ta(!& 7;!ma( T"ta(!& Im!(-g-b!$(8

I(). 250 IU/am#, am# @1m

2 ;"#at$t$& B Im!(-g-b!$( 7;!ma(8

I(). 0.5 m/&%$(g", &%$(g" @ 0,5m

1 A(t$ B$&a Ua% 7ABU.I8

I()., ?$a @5m

2 A(t$ T"ta(!& 7A.T.S8

I(). 1.500. IU/am#, @1m

I(). 20.000. IU/am#, @4m

* a+&$( Rab$"&

I(). 0,5mg/0,5m, #& @0,5m

&11  IM%NOG'OB%'IN

&1!  $#"%M

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Paten ! Paten !

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