NO PHARMACOLOGICAL GROUP 1 Gastro-intestinal system 1.1 Antacids and other drugs for dyspepsia !"#$% ก (AIR-X DROP*) SIMETHICONE DROP 15 ML(C/L2)(40)กSIMETHICONE 22.00 22.00 Y Y AIR-X TAB(C/L2)(39) ก SIMETHICONE 1.50 1.50 Y Y ANTACID TAB ก ALUMINIUM HYDROXIDE [AL(OH)3] 1.00 1.00 Y Y MAGNESIUM HYDROXIDE 1.00 1.00 Y Y MAGNESIUM TRISILLICATE 1.00 1.00 Y Y ANTACIL GEL [HH] 240 ML ก (93) ALUMINIUM HYDROXIDE [AL(OH)3] 22.00 22.00 Y Y MAGNESIUM HYDROXIDE 22.00 22.00 Y Y CARMINATIVE 180 ML V ก SPIRIT CAMPHOR 16.00 16.00 Y Y STRONGER GINGER TR. 16.00 16.00 Y Y TR.CAPSICUM 16.00 16.00 Y Y TR.CARDAMON 16.00 16.00 Y Y !"#$% ( ALUM TAB(ALUMINIUM HYDROXIDE 500 MG)_I ALUMINIUM HYDROXIDE [AL(OH)3] 1.00 1.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 ALGYCON (ALGINIC +ALUM+MAG) TAB D## ALGINIC ACID 14.00 14.00 N N ALUMINIUM HYDROXIDE [AL(OH)3] 14.00 14.00 N N MAGNESIUM CARBONATE 14.00 14.00 N N KREMIL-S (738)_## AL(OH)3MG CARBONATE 1.50 1.50 N N DICYCLOMINE HCL 1.50 1.50 N N SIMETHICONE 1.50 1.50 N N 1.2 Antispasmodics and other drugs altering gut motili !"#$% ก BUSCOPAN INJ (20 MG / ML)V (C/L2) ก(U) HYOSCINE-N-BUTYL BROMIDE 14.00 14.00 Y Y BUSCOPAN SYR 30 ML L (C/L2) ก HYOSCINE-N-BUTYL BROMIDE 19.00 19.00 Y Y BUSCOPAN TAB(207)(C/L2) ก HYOSCINE-N-BUTYL BROMIDE 2.50 2.50 Y Y !"#$% ( MEBEVERINE 135 MG (DUSPATIN)(N/N) TAB I MEBEVERINE 4.00 4.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (OกPQRก)...CIPRIDE(CISAPRIDE) 5 MG(C/L2) CISAPRIDE 1.50 1.50 Y Y BERCLOMINE SYR 60 ML(B/L3)# DICYCLOMINE HCL 23.00 23.00 Y N COLPERMIN CAP(PEPPERMINT) 187 MG D## PEPPERMINT OIL 11.50 11.50 N N LIBRAX (767)(C/L2)# CHLORDIAZEPOXIDE 1.50 1.50 Y N CLIDINIUM BR 1.50 1.50 Y N SPASURI 100 MG (FLAVOXATE) TAB. (B/L2)# FLAVOXATE HCL 2.50 2.50 Y N 1.3 Ulcer-healing drugs and drugs used in variceal ble !"#$% ก
18 พฤศจิกายน 2561 หนา 1 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- OMEPRAZOLE 20 MG (C/L3)CAP (MIRACID)(868)_ก OMEPRAZOLE 1.50 1.50 Y Y XANIDINE 150 MG TAB (RANITIDINE)(B/L2)ก RANITIDINE 1.00 1.00 Y Y !"#$% ( RANIDINE 50 MG/2ML INJ_I(U) RANITIDINE 6.00 6.00 Y Y OUVWX OMEPRAZOLE* 40 MG (C/L3)INJ...I(U) OMEPRAZOLE 21.00 21.00 Y Y !"#$% 4 CONTROLOC 40 MG[^] >>..>>(B/L3) IV [ PANTOPRAZOLE 364.00 364.00 Y Y ULCEFATE SUSPENSION 60 ML [ SUCRALFATE 172.00 172.00 Y Y ULSANIC 1 GM TAB( B/L2)_[ SUCRALFATE 6.00 6.00 Y Y !"#$% 1 AETHOXYSKLEROL 1% ] POLIDOCANOL 149.00 149.00 Y Y BISMUTH SUBSALICYLATE 524 MG ]D (GASTRO)(D/NBISMUTH SUBSALICYLATE 8.00 8.00 Y Y OCTREOTIDE 100 MCG(SANDOSTATIN)(B/L2) ](U) 184.00 184.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (OUQXก^X) DEXILANT 30 MG [^] CAP $ DEXLANSOPRAZOLE 65.00 65.00 N N CIMETIDINE 200 MG TAB(254)(B/L1)# CIMETIDINE 1.00 1.00 Y N CYTOTEC 200 MCG# (X/L3) MISOPROSTOL 14.00 14.00 Y N MUCOSTA 100 MG TAB (N/L3) D# REBAMIPRIDE 13.50 13.50 Y N PARIET 20 MG >>..>>[^] TAB ## 47.00 47.00 N N PREVACID (OUVWX**) 30 MG IV D# LANSOPRAZOLE 255.00 255.00 Y N PREVACID 15 MG FDTAB(B/L3)## LANSOPRAZOLE 32.00 32.00 N N PREVACID 30 MG FDTAB(B/L3).. ## LANSOPRAZOLE 46.00 46.00 N N SELBEX 50 MG( N/N) ## TEPRENONE 9.00 9.00 N N 1.4 Drugs used in acute diarrhoea !"#$% ก ORS ก ELECTROLYTE 3.00 3.00 Y Y ORS PX`ก(^aabc) ก ELECTROLYTE 3.00 3.00 Y Y !"#$% ( LOPERAMIDE CAP (B/L2) I LOPERAMIDE 1.00 1.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 HIDRASEC (30 MG*/SACHET) decf* PAED.POWDER D $RACECADOTRIL 34.00 34.00 N N HIDRASEC PAED.POWDER(10 MG/SACHET)D## RACECADOTRIL 30.00 30.00 N N LACTEOL FORTE*( INFLORAN BERNA) # LACTOBACILLUS ACIDOPHILUS 18.50 18.50 Y N SMECTA# DIOCTAHEDRAL SMECTITE 15.00 15.00 Y N 1.5 Drugs used in chronic bowel disorders !"#$% 4 SALOFALK 500 MGTAB (B/N) [# MESALAZINE 40.00 40.00 Y Y SALOFALK ENEMA 60 ML [# MESALAZINE 665.00 665.00 Y Y 1.6 Laxatives !"#$% ก
18 พฤศจิกายน 2561 หนา 2 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- (OUPeh`ijkU^ DULCOLAX PXRc)BISACODYL SUPPO 10 MG_ BISACODYL 7.00 7.00 Y Y CASTOR OIL (hlmUcnhQoepf]) 30 ML ก BICALUTAMIDE 18.00 18.00 Y Y CASTOR OIL 18.00 18.00 Y Y GLYCERIN SUPPO ก GLYCERINE 4.00 4.00 Y Y MAG SULFATE SAT 240ML ก MAGNESIUM SULFATE 20.00 20.00 Y Y MOM (MILK OF MAG) 240 ML ก MAGNESIUM HYDROXIDE 26.00 26.00 Y Y MUCILIN 100 GM ก ISOPAGHULA HUSK 61.00 61.00 Y Y MUCILIN qr] #ก ISOPAGHULA HUSK 5.00 5.00 Y N SENOKOT TAB(C/L1) (1192) ก SENNOSIDE A+B STANDARDIZED 2.00 2.00 Y Y OU^oiUO BISACODYL 5 MG TAB (C/N)ก BISACODYL 0.50 0.50 Y Y !"#$% ( DUPHALAC(LACTULOSE) SYR 100 ML(B/L2) I LACTULOSE 67.00 67.00 Y Y !"#$% 4 PEG 15 GM (C/N)[ qr]Qo POLYETHYLENE GLYCOL 8.00 8.00 Y Y SWIFF 90 ML [ DIBASIC SOD. PHOSPHATE 91.00 91.00 Y Y MONOBASIC SOD. PHOSPHATE 91.00 91.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 UNISON PX`ก# SODIUM CHLORIDE 9.00 9.00 Y N UNISON stbdeuf#>>..>> SODIUM CHLORIDE 22.00 22.00 Y N 1.7 Local preparations for anal and rectal disorders !"#$% ( DOPROCT OINT 10 GM I BENZOCAINE 54.00 54.00 Y Y HYDROCORTISONE ACETATE 54.00 54.00 Y Y ZINC OXIDE 54.00 54.00 Y Y DOPROCT SUPPO I BENZOCAINE 6.00 6.00 Y Y HYDROCORTISONE ACETATE 6.00 6.00 Y Y ZINC OXIDE 6.00 6.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 FLAVON 500 MG(DAFLON) D# FLAVONOIDIC FRACTION EQUIV TO DIO 5.00 5.00 Y N 1.8 Drugs affecting intestinal secretions !"#$% 1 COMBIZYM TAB>>..>> ]## AMYLASE 4.50 4.50 N N CELLULASE 4.50 4.50 N N LIPASE 4.50 4.50 N N PANCREATIN 4.50 4.50 N N PROTEASE 4.50 4.50 N N GASZYM TAB ] PANCREATIN 3.00 3.00 Y Y SIMETHICONE 3.00 3.00 Y Y URSOLIN 250 MG CAP (B/N)] # URSODEOXYCHOLIC ACID 10.50 10.50 Y Y URSOLIN SUSPENSION (25 MG./ML.) 30 ML (B/N)] URSODEOXYCHOLIC ACID 60.00 60.00 Y Y
18 พฤศจิกายน 2561 หนา 3 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- )*+,ก!"#$%)*-."ก/-01$*23 HEPA-MERZ 5 G (10 ML) INJ## L-ORNITHINE L-ASPARTATE 298.50 298.50 N N MAGESTO-F TAB (796)# DIASTASE 1.50 1.50 Y N MAMYLASE 1.50 1.50 Y N MENTHOL 1.50 1.50 Y N SODIUM BICARB 1.50 1.50 Y N VITAMIN B1 (THIAMINE) 1.50 1.50 Y N SAMARIN 70# SILYMARIN 4.00 4.00 Y N 2 Cardiovascular system 2.1 Positive inotropic drugs !"#$% ก HAD DIGOXIN 0.25 MG TAB(ws])(C/L1) ก DIGOXIN 1.00 1.00 Y Y HAD LANOXIN 0.5 MG/2 ML INJ ก(Z)(U) DIGOXIN 44.00 44.00 Y Y HAD LANOXIN SYR*(0.05 MG/ML) 60 ML ก DIGOXIN 213.00 213.00 Y Y 2.2 Diuretics !"#$% ก (100 MG) SPIRONOLACTONE (C/L2) ก SPIRONOLACTONE 5.50 5.50 Y Y (500 MG) FUROSEMIDE TAB (C/L2)(754)_ก FUROSEMIDE 3.50 3.50 Y Y ALDACTONE SYRUP(10 MG./ML.) 30 ML ก(C/L2) SPIRONOLACTONE 50.00 50.00 Y Y FUROSEMIDE 20 MG/2ML INJ (LASIX) (C/L2) ก(U) FUROSEMIDE 10.00 10.00 Y Y FUROSEMIDE 250 MG INJ/25ML (LASIX)(C/L2)ก(U) FUROSEMIDE 50.00 50.00 Y Y FUROSEMIDE 40 MG (LASIX)TAB (C/L2)(753) ก FUROSEMIDE 1.00 1.00 Y Y FUROSEMIDE SYRUP (10 MG/ML) 30ML(LASIX) (C/L2) 50.00 50.00 Y Y HCTZ 25 MG (B/D/L3) ก HYDROCHLOROTHIAZIDE 0.50 0.50 Y Y HYDROCHLORTIAZIDE SYR. (10 MG./ML.) 30ML (B/D/HYDROCHLOROTHIAZIDE 50.00 50.00 Y Y MANNITOL 20% 500ML ก MANNITOL 213.00 213.00 Y Y SPIRONOLACTONE 25 MG(C/L2) ก SPIRONOLACTONE 1.75 1.75 Y Y !"#$% ( MODURETIC wjh_I AMILORIDE HCL 1.50 1.50 Y Y HYDROCHLOROTHIAZIDE 1.50 1.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 NATRILIX TAB SR (B/D/L2) ## INDAPAMIDE 9.00 9.00 N N 2.3 Anti-arrhythmic drugs !"#$% ก HAD ADE_NOSINE 6 MG/2 ML(aWcfk]) (C/L2) ก (Z)(U) ADENOSINE 490.00 490.00 Y Y !"#$% 4 HAD ARATAC 200 MG _[(AMIODARONE)(D/L3) AMIODARONE HYDROCHLORIDE 13.00 13.00 Y Y HAD CORDARONE 150 MG/3ML INJ [(Z)(D/L3)(U) AMIODARONE HYDROCHLORIDE 107.00 107.00 Y Y 2.4 Beta-adrenoceptor blocking drugs !"#$% ก
18 พฤศจิกายน 2561 หนา 4 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- (100 MG)*ATENOLOL TAB (D/L3)(1918) ก ATENOLOL 1.50 1.50 Y Y (40 MG) PROPRANOLOL (C/L3)(1087) ก PROPANOLOL 1.00 1.00 Y Y ATENOLOL xy MG (D/L3) (1068)_ก ATENOLOL 1.50 1.50 Y Y METOPROLOL 100 MG_ก(C/D/L3) METOPROLOL TARTRATE 2.00 2.00 Y Y PROPRANOLOL 10 MG (C/L3)(1086) ก PROPANOLOL 1.00 1.00 Y Y !"#$% 4 CARVEDILOL (CARATEN) 25 MG D_(C/L3) [ CARVEDILOL 8.00 8.00 Y Y CARVEDILOL (CARATEN) z.{x MG D_ (C/L3)[ CARVEDILOL 6.50 6.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (NOVACOR 5 MG )BISOPROLOL TAB(C/L3)## BISOPROLOL 4.00 4.00 N N LODOZ 2.5 MG [^]>>..>> TAB## BISOPROLOL 10.00 10.00 N N HYDROCHLOROTHIAZIDE 10.00 10.00 N N 2.5 Drugs affecting the renin-angiotensin system and 2.5.1 Vasodilator antihypertensive drugs !"#$% ก APRESOLINE 25 MG (HYDRALAZINE) TAB ก (97) (C/L HYDRALAZINE 2.50 2.50 Y Y HAD SOD.NITROPUSSIDE 50 MG ก SOD.NITROPUSSIDE 241.00 241.00 Y Y HYDRALAZINE 10 MG TAB_ก HYDRALAZINE 1.50 1.50 Y Y !"#$% 1 PROSTIN VR 0.5MG/1ML (PGE1)INJ ] (AD)(X/L3) ALPROSTADIL 7,343.00 7,343.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 IRBESARTAN 300 MG (APROVEL PXRc)*(C/D/L2) D ## IRBESARTAN 8.00 8.00 N N MINOXIDIL 5 MG D (C/L2)# MINOXIDIL 2.00 2.00 Y N 2.5.2 Centrally acting antihypertensive drugs !"#$% ก ALDOMET(METHYLDOPA) 250 MG TAB_ก(B/L2) METHYLDOPA 2.50 2.50 Y Y 2.5.3 Alpha-adrenoceptor blocking drugs !"#$% ( PRAZOSIN 1 MG(C/L3)I PRAZOSIN HCL 1.00 1.00 Y Y !"#$% 4 4 MG* DOXAZOSIN (C/L3) [ DOXAZOSIN MESYLATE 1.50 1.50 Y Y DOXAZOSIN { MG (C/L3)[ DOXAZOSIN MESYLATE 1.00 1.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 HYPERDIX 1 MG TAB>>..>> D# RILMENIDINE 12.50 12.50 Y N 2.5.4 Angiotensin-converting enzyme inhibitors !"#$% ก (20 MG) ENALAPRIL (D/L2)(446)_ก ENALAPRIL MALEATE 1.50 1.50 Y Y CAPOTEN(CAPTOPRIL) 25 MG TAB.(D/L1) ก(U) CAPTOPRIL 2.00 2.00 Y Y CAPTOPRIL SUSP. (1 MG./ML.) ก 25ML CAPTOPRIL 50.00 50.00 Y Y ENALAPRIL 5 MG (D/L2)(445)_ก ENALAPRIL MALEATE 1.50 1.50 Y Y
18 พฤศจิกายน 2561 หนา 5 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- )*+,ก!"#$%)*-."ก/-01$*23 ({y cก.) ACCUPRIL [^] (QUINAPRIL) (D/L2)# QUINAPRIL 9.00 9.00 Y N (RAMIPRIL)TRITACE 10 MG TAB (D/L2)_ ## RAMIPRIL 10.00 10.00 N N ACCUPRIL 10 MG (QUINAPRIL)(D/L2).. # QUINAPRIL 6.00 6.00 Y N COVERSYL ARGININE 5 MG TAB## PERINDOPRIL ARGININE 13.00 13.00 N N TRITAZIDE>>..>>(RAMIPRIL 5 / HCTZ 25)## HYDROCHLOROTHIAZIDE 5.00 5.00 N N RAMIPRIL 5.00 5.00 N N ZESTRIL 10 MG[^] >>..>>(C/D/L2)# LISINOPRIL 17.50 17.50 Y N 2.5.5 Angiotensin-II receptor antagonist !"#$% ( LOSARTAN 50 MG I(C/D/L2) 2.00 2.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (OกPQRก)...APROVEL 300 MG>>..>>(IRBESARTAN) (C/D/LIRBESARTAN 11.00 11.00 N N (OกPQRก)...CO-DIOVAN 160 MG/25 MG>>..>> (D/L3).. D##HYDROCHLOROTHIAZIDE 9.00 9.00 N N VALSARTAN 9.00 9.00 N N DIOVAN 80 MG CAP>>..>>(C1,D2,3/L2) D## VALSARTAN 6.00 6.00 N N EDARBI 40 MG (AZILSARTAN) D $ AZILSARTAN MEDOXOMIL 23.00 23.00 N N 2.6 Nitrates, calcium-channel blockers and other vasod 2.6.1 Nitrates !"#$% ก (IMDUR PXRc) IMDEX 60 MG (C/L2)ก D ISOSORBIDE-5-MONONITRATE 6.00 6.00 Y Y HAD GLYCERYL TRINITRATE 50 MG/10 ML (C)(N) ก(ZGLYCERYL TRINITRATE 470.00 470.00 Y Y ISMO-20 MG (MONOLIN)_(C/L2) ก ISOSORBIDE-5-MONONITRATE 1.50 1.50 Y Y ISORDIL 5 MG SUBLINGUAL (698) (C/L2) ก ISOSORBIDE DINITRATE 1.50 1.50 Y Y ISOSORBIDE 10 MG TAB (697) (C/L2) ก ISOSORBIDE DINITRATE 1.50 1.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 NITRODERM TTS #i NITROGLYCERIN 43.00 43.00 Y N 2.6.2 Calcium-channel blockers !"#$% ก AMLODIPINE 10 MG (2019)(C/L2) ก AMLODIPINE 2.00 2.00 Y Y DILTIAZEM 120 MG [^] (CASCOR XL)(C/L2) ก DILTIAZEM HCL 6.50 6.50 Y Y ISOPTIN SR 240 MG ก VERAPAMIL 15.00 15.00 Y Y VERAPAMIL 40 MG TAB (C/L2)_ก VERAPAMIL 3.00 3.00 Y Y !"#$% ( DILTIAZEM HCL 30 MG (C/L2) I DILTIAZEM HCL 1.50 1.50 Y Y MADIPLOT 20 MG TAB (R) I MANIDIPINE HCL 4.00 4.00 Y Y !"#$% 4 CARDEPINE 10MG/10 ML* INJ [(C/L2)(U) NICARDEPINE HCL 392.00 392.00 Y Y CARDEPINE 2MG/2ML INJ [ (C/L2)(U) NICARDEPINE HCL 113.00 113.00 Y Y !"#$% 1
18 พฤศจิกายน 2561 หนา 6 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- NIMOTOP 30 MG TAB ] (C/L2) NIMODIPINE 20.00 20.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (OกPQRก)...PLENDIL 10 MG >>..>>[^] (2026)## FELODIPINE 23.50 23.50 N N (OกPQRก)...PLENDIL 5 MG >>..>>[^] (2000) ## FELODIPINE 16.00 16.00 N N CADUET 5/10 MG TAB (AMLO 5:ATROVAS 10)D## AMLODIPINE 15.00 15.00 N N ATORVASTATIN 15.00 15.00 N N FELODIPINE 5 MG TAB (C/L2)# FELODIPINE 2.50 2.50 Y N FELODIPINE STADA 10 MG (C/L2)# FELODIPINE 8.00 8.00 Y N HERBESSER 10 MG [^] INJ ## DILTIAZEM HCL 413.50 413.50 N N HERBESSER 90 SR $ DILTIAZEM HCL 13.00 13.00 N N HERBESSER R 200 $ DILTIAZEM HCL 15.00 15.00 N N NELAPINE 5 MG (ADALAT) (C/L2) (911)[NED] NIFEDIPINE 1.50 1.50 N N NIFEDIPINE T 20 MG ] (C/L2)(U) NIFEDIPINE 3.00 3.00 Y Y 2.6.3 Other vasodilators !"#$% 1 ELONZA 50 MG(B/N) D** ] SILDENAFIL 208.00 0.00 N N VIAGRA SYRUP(2 MG/1 CC) 25 ML ] SILDENAFIL 100.00 100.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 DORNER 20 MCG TAB D (N/N)# BERAPROST 27.00 27.00 Y N VASTAREL MR 35 MG TAB(N/L3) ## TRIMETAZIDINE 10.50 10.50 N N 2.7 Sympathomimetics 2.7.1 Inotropic sympathomimetics !"#$% ก HAD DOPAMINE 250 MG/10 ML(C/L2)_ก(Z)(U) DOPAMINE HCL 25.00 25.00 Y Y !"#$% ( HAD (~Xit•UcWh) DOBU_TAMINE 250 MG /20 ML(กQfr]) DOBUTAMINE 171.00 171.00 Y Y 2.7.2 Vasoconstrictor sympathomimetics !"#$% ก HAD NOREPINEPHRINE 4 MG/4ML INJ (LEVOPHED) ก 155.00 155.00 Y Y NorEPINEPHRINE INJ (LEVOPHED) ก 321.00 321.00 Y Y !"#$% 4 EPHEDRINE INJ 30 MG/ML [ EPHEDRINE 15.00 15.00 Y Y 2.7.3 Drugs used in cardiopulmonary resuscitation !"#$% ก HAD ADRENALINE INJ (1 MG/ML)(C/L3) V ก(Z)(U) EPINEPHINE BITATRATE 8.00 8.00 Y Y 2.8 Anticoagulants !"#$% 4 HAD CLEXANE 40 MG/0.4ML INJ (B/L1) [ ENOXAPARIN 242.00 242.00 Y Y HAD CLEXANE 60 MG/0.6ML (ENOXAPARIN)INJ (B/LENOXAPARIN 305.00 305.00 Y Y HAD HEPARIN IkXQo 25,000 U/ 5 ML (C/L1)_[(U) HEPARIN SOD 226.00 226.00 Y Y
18 พฤศจิกายน 2561 หนา 7 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- HAD WARFARIN 2 MG aWabc (X/L3) ([) WARFARIN SOD. 2.50 2.50 Y Y HAD WARFARIN 3 MG aWÇÉU (X/L3)([) WARFARIN SOD. 3.00 3.00 Y Y HAD WARFARIN 5 MG aWÑcÖt (X/L3)([) WARFARIN SOD. 4.00 4.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 CILOSTAZOL 100 MG TAB [L] (PLETAAL PXRc)(C/L3)##ÑnCILOSTAZOL Ük[^Uk 23.00 23.00 N N ILOPROST-TROMETAMOL 20 MCG (C/N) ##[ILOMEDI ILOPROST TROMETAMOL 1,850.00 1,850.00 N N PLETAAL 100 (SR) MG *(CILOSTAZOL)(C/L3) $ CILOSTAZOL 45.00 45.00 N N 2.9 Antipletelet drugs !"#$% ก ASPIRIN 81 MG : (C/L3)(109) ก ASPIRIN 1.00 1.00 Y Y !"#$% 1 (OกPQRก)...PLAVIX 75 MG>>..>> [^] TAB D ] (U) ## CLOPIDOGREL 88.50 88.50 N N APOLETS*(CLOPIDOGREL) 75 MG [PLAVIX PXRc](B/L2)CLOPIDOGREL 13.00 13.00 N N CLOPIDOGREL 75 MG TAB (B/L2) ] CLOPIDOGREL 4.00 4.00 Y Y TICLOPIDINE 250 MG>>..>>(B/L3) (VILADIL) ] TICLOPIDINE 4.00 4.00 Y Y aáaÑ CLOPIDOGREL 75 MG(PJ)PVÖUoin•^jr] TAB ] 0.00 N Y )*+,ก!"#$%)*-."ก/-01$*23 GRENDIS(TRIFLUSAL) 300 MG D## TRIFLUSAL 25.00 25.00 N N 2.10 Fibrinolytics drugs !"#$% ก HAD STREPTOKINASE 1,500,000 U[STREPTASE PXRc]( C 7,211.00 7,211.00 Y Y !"#$% 1 RT-PA (ALTEPLASE/ACTILYSE) 50 MG INJ [ Z ]] ALTEPLASE 23,013.00 23,013.00 Y Y 2.11 Haemostatics !"#$% ก TRANSAMIN INJ 250 MG/ 5 ML (B/L2) ก TRANEXAMIC ACID 34.00 34.00 Y Y !"#$% 4 TRANSAMIN 250 MG CAP [ (B/L2)% TRANEXAMIC ACID 5.00 5.00 Y Y !"#$% 5 HEMOPHIL-M 250 U INJ (FACTOR VIII)à 3,345.00 3,345.00 Y N HEMOPHIL-M 500 U INJ (FACTOR VIII)[HAEMOCTIN]( 6,221.00 6,221.00 Y N IMMUNINE 600 IU INJ [FACTOR IX](PVÖUoCASE) à (2) 6,994.00 6,994.00 Y N )*+,ก!"#$%)*-."ก/-01$*23 NOVOSEVEN 1 MG INJ (C/N) (AD) $ 25,720.00 25,720.00 Y N 2.12 Lipid-regulating drugs !"#$% ATC ATORVASTATIN 40 MG (PVÖUoARV) (X/L3) D## ATORVASTATIN 0.00 0.00 N Y ATC FENOFIBRATE 100 MG PVÖUo ARV(C/L3) FENOFIBRATE 0.00 0.00 N Y !"#$% ก (40 MG)* SIMVASTATIN (X/L3) ก SIMVASTATIN 2.00 2.00 Y Y
18 พฤศจิกายน 2561 หนา 8 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- (600 MG) HIDIL (GEMFIBROZIL) TAB (C/L3)(2991)ก GEMFIBROZIL 1.50 1.50 Y Y ATC GEMFIBROSIL 600 MG (PVÖUoARV) ก GEMFIBROZIL 0.00 0.00 N Y ATC SIMVASTATIN 10 MG (PVÖUoATC) ก SIMVASTATIN 0.00 0.00 N Y NICOTINIC ACID 50 MG T ก NICOTINIC ACID 0.50 0.50 Y Y SIMVASTATIN 20 MG( X/L3) (2845)V ก SIMVASTATIN 1.50 1.50 Y Y PàcâÇ~i^qRQ 300 cก. (GEMFIBROZIL) CAP (C/L3)(1598GEMFIBROZIL 1.50 1.50 Y Y !"#$% ( QUESTRAN (CHOLESTYRAMINE 4 GM) (B/L1) I CHOLESTYRAMINE 25.00 25.00 Y Y !"#$% 4 (LEXEMIN 300 MG PXRc) FENOFIBRATE [ (C/L3)(3117)#FENOFIBRATE 6.00 6.00 Y N LEXEMIN 100 MG (FENOFIBRATE) (C/L3)[ # FENOFIBRATE 5.00 5.00 Y N !"#$% 1 ATORVASTATIN 40 MG (X/L3) D ](##) 7.00 7.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 $XARATOR {y MG (ATORVASTATIN)(X/L3)D$ ATORVASTATIN 20.00 20.00 N N (OกPQRก dÑb ROSUVT1 wjh)CRESTOR 10 MG>>..>>(X/L3)ROSUVASTATIN 22.00 22.00 N N EZETIMIBE 10 MG (wjh EZETROL PXRc)TAB D (C/L3)##EZETIMIBE 17.00 17.00 N N LIVALO 2 MG TAB (PITAVASTATIN) D$ PITAVASTATIN 28.00 28.00 N N LOPID 900 MG ##>>..>> GEMFIBROZIL 20.50 20.50 N N MEVALOTIN 40 MG TAB (X/L3)D# PRAVASTATIN 41.00 41.00 Y N ROSUVASTATIN 10 MG (VIVACOR*)[CRESTORPXRc](XROSUVASTATIN 22.00 22.00 N N SUPRALIP 145 MG NT TAB D $ FENOFIBRATE 15.00 15.00 N N 3 Respiratory system 3.1 Bronchodilators 3.1.1 Adrenoceptor agonists !"#$% ก (VENTOLIN EVOHALER) SALBUTAMOL MDI [100 MCGSALBUTAMOL 135.00 135.00 Y Y [VENTOLIN SOL*] SALBUTAMOL SOLUTION IkXQo[20SALBUTAMOL 65.00 65.00 Y Y ASMASAL SDU NEB ก(U) SALBUTAMOL 13.00 13.00 Y Y MEPTIN SYR 60 ML (N/N) ก PROCATEROL 41.00 41.00 Y Y SALBUTAMOL 2 MG TAB ก (C/N) SALBUTAMOL 0.50 0.50 Y Y SALBUTAMOL SYR 60 ML(C/N) ก SALBUTAMOL 12.00 12.00 Y Y TERBUTALINE 2.5 MG TAB( B/L2)_ก TERBUTALINE SULFATE 0.50 0.50 Y Y TERBUTALINE INJ 500 MCG/ML( B/L2) V ก(U) TERBUTALINE SULFATE 11.00 11.00 Y Y TERBUTALINE SYR( B/L2) 60 ML(TERBULIN) ก TERBUTALINE SULFATE 16.00 16.00 Y Y !"#$% ( MEPTIN-MINI 25 MCG (N/N) TAB (834)I PROCATEROL 3.50 3.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 BAMBEC 10 MG(N/L3) # BAMBUTEROL 11.00 11.00 Y N 3.1.2 Compound antimuscarinic bronchodilators
18 พฤศจิกายน 2561 หนา 9 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- !"#$% ก (BERODUAL FORTE PXRc*) IPRATERAL NEB (B/L2) ก(U 8.00 8.00 Y Y (OกPQRก)...BERODUAL FORTE>>..>>(B/L2) ก(U) FENOTEROL HBR 20.00 20.00 Y Y IPRATROPIUM BR 20.00 20.00 Y Y BERODUAL INHALER (B/L2) ก 200 DOSE FENOTEROL HBR 307.00 307.00 Y Y IPRATROPIUM BR 307.00 307.00 Y Y !"#$% 4 SPIRIVA COMBOPACK (C/N) D [ 30 DOSE TIOTROPIUM BROMIDE 1,956.00 1,956.00 Y Y SPIRIVA REFILL 30 CAP (C/N) _D [ 30 DOSE TIOTROPIUM BROMIDE 1,871.00 1,871.00 Y Y 3.1.3 Theophylline !"#$% ก AMINOPHYLLINE 100 MG T_ (C/L1)ก AMINOPHYLLINE 0.50 0.50 Y Y AMINOPHYLLINE 250 MG INJ (C/L1)ก AMINOPHYLLINE 9.00 9.00 Y Y MEDIC SYR 60 ML>>ก(^rPahr) GLYCERYL GUAIACOLATE 13.00 13.00 Y Y THEOPHYLLINE 13.00 13.00 Y Y NUELIN S.R. 200 MG TAB( C/L1) (3046)_ก THEOPHYLLINE 3.00 3.00 Y Y NUELIN S.R.250MG TAB( C/L1 ) ก [^rPahrrrก] THEOPHYLLINE 3.00 3.00 Y Y 3.2 Corticosteroids !"#$% ก BUDESONIDE 100 MCG INHALER (BUDECORTPXRc)(B/CBUDESONIDE 218.00 218.00 Y Y BUDESONIDE 200 MCG MDI (INFLAMIDE PXRc) ก 200 DOSE BUDESONIDE 319.00 319.00 Y Y PULMICORT 500 MCG RESPULE ก(U) BUDESONIDE 50.00 50.00 Y Y !"#$% 4 (SERETIDE 25/125 EVO PXRc) EVOFLO*[120 DOSE] [ D FLUTICASONE PROPIONATE 356.00 356.00 Y Y SALMETEROL (AS XINAFOATE) 356.00 356.00 Y Y (OกPQRก)...SERETIDE(C/L2) 25/125 EVO(cfk]áUhกQU])>>..FLUTICASONE PROPIONATE 541.00 541.00 Y Y SALMETEROL (AS XINAFOATE) 541.00 541.00 Y Y FLIXOTIDE EVOHALER 125 MCG [ D 120 DOSE FLUTICASONE PROPIONATE 282.00 282.00 Y Y SERETIDE ACCUHALER(C/L2) 50/250 [ _D 60 DOSE FLUTICASONE PROPIONATE 550.00 550.00 Y Y SALMETEROL (AS XINAFOATE) 550.00 550.00 Y Y SERETIDE(C/L2) "{x/xy" EVO (cfk]rfrh*) [_ D 120 DOSE FLUTICASONE PROPIONATE 467.00 467.00 Y Y SALMETEROL (AS XINAFOATE) 467.00 467.00 Y Y SERETIDE(C/L2) 25/ {xy EVO (cfk]PIbc)120 DOSE [_ D FLUTICASONE PROPIONATE 701.00 701.00 Y Y SALMETEROL (AS XINAFOATE) 701.00 701.00 Y Y SYMBICORT 160/4.5 (C/N)[_ D# 60 DOSE BUDESONIDE 523.00 523.00 Y Y FORMOTEROL 523.00 523.00 Y Y SYMBICORT FORTE ã{y/å (C/N)[ D# 60 DOSE BUDESONIDE 737.00 737.00 Y Y FORMOTEROL 737.00 737.00 Y Y 3.3 Leukotriene receptor antagonists !"#$% 4
18 พฤศจิกายน 2561 หนา 10 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- MONTELUKAST 10 MG (MONTEK) [ D (B/L2 ) MONTELUKAST 9.00 9.00 Y Y SINGULAIR [^] x MG [ebU*][ D## (B/L2) MONTELUKAST 27.00 27.00 N N SINGULAIR 10 MG>>..>>[^] [ D## (B/L2) MONTELUKAST 50.00 50.00 N N 3.4 Antihistamines !"#$% ก ATARAX 10 MG L (HYDROXYZINE)(637)_(C/L2)ก HYDROXYZINE 0.50 0.50 Y Y ATARAX SYR 60 ML (HYDROXYZINE)_(C/L2) ก HYDROXYZINE 13.00 13.00 Y Y BENADRYL 25 MG CAP (B/L2) ก DIPHENHYDRAMINE 1.00 1.00 Y Y CETIRIZINE 10 MG (ZENSIL) TAB(B/L2)_ก CETIRIZINE 1.00 1.00 Y Y CETIRIZINE SYRUP 5 MG/ 5 ML(ZENSIL PXRc) ก CETIRIZINE 21.00 21.00 Y Y CLARITYNE SYRUP 100 ML_ ก $(^rPahrrrก) LORATADINE 176.00 176.00 N N CPM 4 MG TAB[aWÇÉUhth] (316) ก(C/L2) CHLORPHENIRAMINE MALEATE 0.50 0.50 Y Y CPM INJ 10 MG/ML V ก(C/L2)(U) CHLORPHENIRAMINE MALEATE 5.00 5.00 Y Y CPM SYR 60 ML ก CHLORPHENIRAMINE MALEATE 7.00 7.00 Y Y LORATADINE (ALLER-TAB) (B/L2) ก LORATADINE TAB 2.00 2.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 AERIUS SYR 0.5 MG/ 1 ML (C/N) D# DESLORATADINE 226.00 226.00 N N AERIUS TAB 5 MG (C/N) D# DESLORATADINE 25.00 25.00 Y N DIMETAPP ELIXIR# BROMPHENIRAMINE MALEATE 32.00 32.00 Y N PHENYLEPHRINE HCL 32.00 32.00 Y N FEXOFENADINE 60 MG (C/L2)D# FEXOFENADINE HCL 4.00 4.00 Y N KETOTIFEN 1 MG TAB(C/N)# KETOTIFEN 1.50 1.50 Y N TELFAST 60 MG D## FEXOFENADINE HCL 9.00 9.00 N N XYZAL 5 MG (B/N)(LEVOCETIRIZINE) _##D LEVOCETIRIZINE DIHYDROCHLORIDE 20.50 20.50 N N 3.5 Pulmonary surfactants !"#$% 1 CUROSURF 1.5 ML (PORACTANT) ] D PORACTANT ALFA (PHOSPHOLIPID) 13,261.00 13,261.00 Y Y SURVANTA ] (AD)D BERACTANT 19,932.00 19,932.00 Y Y 3.6 Cough preparations !"#$% ก TUSSIS [OUwกbârhlmUXmU] (1415) ก V ANTIMONY 27.00 27.00 Y Y CAMPHORATED OPIUM 27.00 27.00 Y Y LIQUORICE LIQUID EXTRACT 27.00 27.00 Y Y 3.6.1 Cough suppressants !"#$% ก DEXTROMETHORPHAN 15 MG (C/L1)(377) ก DEXTROMETHOPHAN 1.00 1.00 Y Y !"#$% 4 CODEPECT10 MG{CODESIA-Pc`XaWPIWOk}(282) [ CODEINE 2.00 2.00 Y Y GLYCERYL GUAIACOLATE 2.00 2.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23
18 พฤศจิกายน 2561 หนา 11 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- BENADRYL EXP 60 ML_ (149)(B/L2)# AMMONIUM CL 22.00 22.00 Y N DIPHENHYDRAMINE 22.00 22.00 Y N 3.6.2 Expectorant and demulcent cough preparations !"#$% ก GUAIFENESIN SYR 60 ML ก GLYCERYL GUAIACOLATE 12.00 12.00 Y Y !"#$% 1 cowkb] (1908) V (^aibkO)qr]Qo diก^oPÖ^U 9.00 9.00 Y Y di•Uhecfrh 9.00 9.00 Y Y diakUX 9.00 9.00 Y Y cowkb] 9.00 9.00 Y Y aU^abc 9.00 9.00 Y Y enkIcRlhrbrO 9.00 9.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 BISOLVON INJ# BROMHEXINE 39.00 39.00 Y N BROMHEXINE 8 MG TAB (N/L3)(179)# BROMHEXINE 0.50 0.50 Y N BROMHEXINE SYR 60 ML(N/L3) (181)# BROMHEXINE 16.00 16.00 Y N CARBOCYSTEINE 375 MG#(N/N) CARBOCISTEINE 2.00 2.00 Y N CARBOCYSTEINE ÑhRXhlmU 60 ML(FLEMEXPXRc)(528)# CARBOCISTEINE 40.00 40.00 Y N FLEMEX 375 MG TAB(527) $ CARBOCISTEINE 4.00 4.00 N N 3.7 Systemic nasal decongestants !"#$% ก MAXIPHED TAB 60 MG (PSEUDOEPHEDRINE)(C/L2)(809 PSEUDOEPHEDRINE HCL 2.00 2.00 Y Y PSEUDOEPHEDRINE SYR 60 ML ก PSEUDOEPHEDRINE HCL 21.00 21.00 Y Y 4 Central nervous system 4.1 Hypnotics and anxiolytics !"#$% ก (1.0 MG) ATIVAN [LORAZEPAM](D/L3)(115) ก LORAZEPAM 1.00 1.00 Y Y ATIVAN 0.5 MG [LORAZEPAM](D/L3)(114)_ก LORAZEPAM 1.00 1.00 Y Y CHLORDIAZEPOXIDE 10 MG>>..>>ก(D/L3) CHLORDIAZEPOXIDE 1.00 1.00 Y Y DIAZEPAM 2 MG (D/L3)(382) ก DIAZEPAM 1.00 1.00 Y Y DIAZEPAM 5 MG (D/L3)(383) ก DIAZEPAM 1.50 1.50 Y Y DIAZEPAM INJ IM 10 MG(D/L3) V ก(U)[2 ML] DIAZEPAM 10.00 10.00 Y Y HAD CHLORAL HYDRATE (100 MG/ML) 15 MLก CHLORAL HYDRATE 20.00 20.00 Y Y !"#$% ( CLORAZEPATE 5 MG CAP (2899)I CHLORAZEPATE 2.50 2.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 ANPRESS 0.25 MG # (ALPRAZOLAM)(D/L3) ALPRAZOLAM 1.00 1.00 Y N ANPRESS 0.5 MG # (ALPRAZOLAM)(D/L3) ALPRAZOLAM 1.50 1.50 Y N DEANXIT TAB # FLUPENTIXOL 7.00 7.00 Y N MELITRACEN 7.00 7.00 Y N
18 พฤศจิกายน 2561 หนา 12 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- 4.2 Drugs used in psychoses and related disorders 4.2.1 Antipsychotic drugs !"#$% ก (wQกPáQWÜOhOUecXrUOp)...CHLORPROMAZINE 50 MG/2MLCHLORPROMAZINE INJ 5.00 5.00 Y Y CHLORPROMAZINE 100 MG TAB (C/L3)ก CHLORPROMAZINE 1.00 1.00 Y Y CHLORPROMAZINE 25 MG TAB (C/L3) ก CHLORPROMAZINE 1.00 1.00 Y Y FLUPHENAZINE DECANOATE 25 MG ก(PHARNAZINEFLUPHENAZINE DECANOATE 36.00 36.00 Y Y HALDOL DECANOAS 50 MG INJ ก HALOPERIDOL DECANOAS 77.00 77.00 Y Y HALOPERIDOL 0.5 MG TAB(aWIUk) (C/L3) ก HALOPERIDOL 0.50 0.50 Y Y HALOPERIDOL 2 MG TAB(aWPeQèr]) V (C/L3) ก HALOPERIDOL 1.50 1.50 Y Y HALOPERIDOL 5 MG TAB(aWÇÉU) (C/L3) ก HALOPERIDOL 1.50 1.50 Y Y HALOPERIDOL INJ 5MG/1ML(C/L3) ก HALOPERIDOL 11.00 11.00 Y Y HALOX SYR 2 MG/ML 15 ML(HALOPERIDOL ) (C/L3) 37.00 37.00 Y Y PERPHENNAZINE 2 MG(C/L3)_ก PERPHENNAZINE 0.50 0.50 Y Y PERPHENNAZINE 4 MG(C/L3) ก PERPHENNAZINE 1.00 1.00 Y Y PERPHENNAZINE 8 MG (C/L3)ก PERPHENNAZINE 1.50 1.50 Y Y !"#$% ( 2 MG RISPERIDONE (GPO*PXRc)(C/L3) TAB I RISPERIDONE 5.00 5.00 Y Y RISPERIDONE ê MG [ehëÜ]]*(C/L3) TAB I RISPERIDONE 3.00 3.00 Y Y RISPERIDONE SYR 1MG/1ML [30 ML] decf*(C/L3) I RISPERIDONE 195.00 195.00 Y Y !"#$% 4 100 MG CLOZA_PINE (Páíhws]) (B/L3)_[ CLOZAPINE 4.00 4.00 Y Y CLOZAPINE 25 MG (B/L3)[ CLOZAPINE 2.00 2.00 Y Y FLUANXOL DEPOT 40 MG INJ D [ FLUPENTIXOL DECANOATE 221.00 221.00 Y Y RISPERIDAL SYR>>..>> [^]$ (C/L3) 1 MG/1ML 30 ML [ RISPERIDONE 1,196.00 1,196.00 N N TIDAZINE 10 MG TAB (PIWOk) (C/L3) [ THIORIDAZINE 1.00 1.00 Y Y TIDAZINE 25 MG TAB (hlmU•UQ) (C/L3 ). [ THIORIDAZINE 1.50 1.50 Y Y TIDAZINE 50 MG TAB (C/L3) [ THIORIDAZINE 2.00 2.00 Y Y !"#$% 1 (200 MG*) QUETIAPIN TAB (C/L3) ] [NEUTAPIN PXRc] QUETIAPINE 24.00 24.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (ABILIFY PXRc) ARIPIPRAZOLE 10 MG [APALIFE*] D($)ARIPIPRAZOLE 85.00 85.00 N N (OกPQRก)...(QUICK TAB) 2 MG RISPERIDAL>>**>>(C/L3)RISPERIDONE 76.00 76.00 N N (OกPQRก)...(QUICK TAB) RISPERIDAL 0.5 MG>>**>>(C/LRISPERIDONE 25.50 25.50 N N ABILIFY ODT 10 MG>>..>>[^] D($) ARIPIPRAZOLE 194.00 194.00 N N SEROQUEL 100 MG>>..>>[^](QUETIAPINE) (C/L3) ## QUETIAPINE 83.50 83.50 N N 4.2.2 Antimanic drugs !"#$% ก LITHIUM CARBONATE 300MG(D/L3) ก LITHIUM CARBONATE 3.00 3.00 Y Y !"#$% 1
18 พฤศจิกายน 2561 หนา 13 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- (LAMICTALPXRc) LAMOTRIGINE 50 MG TAB (C/N )] D LAMOTRIGINE 14.00 14.00 Y Y LAMICTAL TAB 50 MG>>..>>(LAMOTRIGINE)(C/N )] DLAMOTRIGINE 27.00 27.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (SEROQUELPXRc) QUETIAPINE 100 MG [NEUTAPIN*] (CQUETIAPINE 15.00 15.00 N N 4.3 Antidepressant drugs !"#$% ก AMITRIPTYLINE 10 MG (C/L3) ก AMITRIPTYLINE 1.00 1.00 Y Y AMITRIPTYLINE 25 MG (C/L3) ก AMITRIPTYLINE 1.00 1.00 Y Y FLUOXETIN 20 MG {SSRI}(C/L3) ก FLUOXETINE 1.50 1.50 Y Y IMIPRAMINE 25 MG TAB_(D/L3) ก IMIPRAMINE 1.50 1.50 Y Y NORTRILEN 25 MG (NORTRIPTYLINE)TAB ก (C/L3) NORTRIPTYLINE 2.00 2.00 Y Y NORTRIPTYLINE 10 MG TAB ก (C/L3) NORTRIPTYLINE 1.00 1.00 Y Y !"#$% ( SERTRALINE 50 MG TAB{SSRI} (C/L3) I D SERTRALINE 6.50 6.50 Y Y TOLVON 10 MG (MIANSERIN)TAB_I MIANSERIN HCL 3.00 3.00 Y Y !"#$% 4 (ANAFRANIL PXRc*) CLOMIPRAMINE 25 MG TAB [ CLOMIPRAMINE 4.00 4.00 Y Y ANAFRANIL 25 MG>>..>>(CLOMIPRAMINE) [ CLOMIPRAMINE 9.00 9.00 Y Y TRAZODONE 50 MG{SARI} (C/L3)[ TRAZODONE 2.50 2.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 EFEXOR XR 37.5 MG(VENLAFAXINE){SNRI} CAP (C/ VENLAFAXINE HCL 56.50 56.50 N N LEXAPRO 10 MG TAB (ESCITALOPRAM){SSRI} (C/L3 ESCITALOPRAM 52.50 52.50 N N PRISTIQ 50 MG (DESVENLAFAXINE){SNRI} TAB ##D DESVENLAFAXINE SUCCINATE MONOH 66.00 66.00 N N TIANEPTINE (STABLON)>>..>>{SSRE}## TIANEPTINE 19.00 19.00 N N 4.4 Central nervous system stimulants !"#$% 4 (PVÖUo CASE) RITALIN (R) 10 MG TAB [ (C/L3) METHYLPHENIDATE 6.00 6.00 Y Y METHYLPHENIDATE 10 MG TAB [ (C/L3) METHYLPHENIDATE 4.00 4.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 CONCERTA 27 MG (PVÖUo CASE)*[METHYLPHENIDATE_SR METHYLPHENIDATE 109.00 109.00 N N 4.5 Drugs used in nausea and vertigo 4.5.1 Drugs used in nausea and vomitting !"#$% ก DOMPERIDONE 10 MG TAB (C/L2)(876)ก DOMPERIDONE 1.00 1.00 Y Y DOMPERIDONE SYR 30 ML(C/L2)ก DOMPERIDONE 12.00 12.00 Y Y METOCLOPRAMIDE 10 MG TAB ก (B/L3) METOCLOPAMIDE 0.50 0.50 Y Y METOCLOPRAMIDE INJ V ก (B/L3)(U) METOCLOPAMIDE 10.00 10.00 Y Y !"#$% ( ONDANSETRON 4 MG (B/L2)INJ I ONDANSETRON 73.00 73.00 Y Y ONDANSETRON 8 MG (B/L2)TAB_I ONDANSETRON 11.00 11.00 Y Y
18 พฤศจิกายน 2561 หนา 14 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- )*+,ก!"#$%)*-."ก/-01$*23 ALOXI 0.25 MG/5ML (PALONOSETRON) INJ [SMP]PVÖUoPALONOSETRON 2,481.00 2,481.00 N N NASEA 0.1 MG (RAMOSETRON)TAB (N/N)## RAMOSETRON 411.00 411.00 N N 4.5.2 Drugs used in vestibular disorders !"#$% ก DIMENHYDRINATE 50 MG TAB (B/L2)(415) ก DIMENHYDRINATE 0.50 0.50 Y Y DRAMAMINE INJ (DIMENHYDRINATE) 50MG/1MLก(UDIMENHYDRINATE 10.00 10.00 Y Y !"#$% ( BETAHISTINE(MERISLON PXRc)6 MG TAB (N/N)_I BETAHISTINE MESYLATE 1.50 1.50 Y Y MERISLON ê{ MG TAB (N/N)I ## BETAHISTINE MESYLATE 4.00 4.00 N N )*+,ก!"#$%)*-."ก/-01$*23 (SERMION 30 MG PXRc) NICERGOLINE ## NICERGOLINE 13.00 13.00 N N CINNARIZINE 25 MG (256)(C/N)# CINNARIZINE 1.00 1.00 Y N CO_DERGOCRINE 1 MG (HYDERGINE L) (N/N)# CODERGOCRINE MESYLATE 1.50 1.50 Y N EMBOL 400 MG CAP(N/N)# PIRACETAM 4.00 4.00 Y N MECOBALAMINE 500 MCG TAB(1872) ## MECOBALAMINE 2.00 N N PENTOXIFYLLINE 400 MG(FLEXITAL)(C/L2)# PENTOXIFYLLINE 5.00 5.00 Y N 4.6 Analgesics and antipyretics !"#$% ก (ÑhRXeOX KIT) PARACETAMOL DROP [60 MG/0.6 ML] กPARACETAMOL 13.00 13.00 Y Y IBUPROFEN 200 MG TAB (201)_(B/D/L1) ก IBUPROFEN 1.50 1.50 Y Y IBUPROFEN SYR 60 ML (B/D/L1) ก IBUPROFEN 13.00 13.00 Y Y PARACET SUSP(SARA) 120 MG/5ML (B/L1)(1717)ก PARACETAMOL 11.00 11.00 Y Y PARACETAMOL 325 MG TAB (B/L1) (993)ก PARACETAMOL 0.50 0.50 Y Y PARACETAMOL 500 MG TAB (B/L1) (994) ก V(U) PARACETAMOL 1.00 1.00 Y Y TEMPRA FORTE SYR 250 MG/5ML 60 ML ก PARACETAMOL 30.00 30.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 Analgesic balm 33.00 33.00 Y Y IDARAC 200 MG>>..>> (C/L3)(655)# FLOCTAFENINE 5.00 5.00 Y N 4.7 Analgesics 4.7.1 Opioid analgesics !"#$% 4 [rrกùjûRüP^`k] MORPHINE IR TAB 10 MG [ (C/D) MORPHINE SULFATE 3.00 3.00 Y Y 30 MG* MORPHINE TAB MST [ (C/D) MORPHINE SULFATE 31.00 31.00 Y Y FENTANYL 0.1 MG INJ 2 ML (C/L1)[ FENTANYL CITRATE 39.00 39.00 Y Y FENTANYL 12 MCG/HR TRANSDERMAL (DURAGESICFENTANYL CITRATE 97.00 97.00 Y Y MORPHINE [VWX]* 10 MG/ML INJ [ (C/D)(U) MORPHINE SULFATE 20.00 20.00 Y Y MORPHINE SOL 10 MG/5ML 60 ML [ (C/D) MORPHINE SULFATE 61.00 61.00 Y Y MORPHINE TAB 10 MG MST [ (C/D) MORPHINE SULFATE 19.00 19.00 Y Y PETHIDINE 50 MG (B/D/L1)INJ [ PETHIDINE 20.00 20.00 Y Y
18 พฤศจิกายน 2561 หนา 15 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- TRAMADOL 100 MG/2ML INJ (C/L2)_[(U) TRAMADOL 23.00 23.00 Y Y TRAMADOL(Pc`X) 50 MG CAP (C/L2)_[ TRAMADOL 2.50 2.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 TYLENOL WITH CODEINE [CODENOL]% CODEINE 3.00 3.00 Y N PARACETAMOL 3.00 3.00 Y N 4.7.2 Drugs for neuropathic pain !"#$% 1 (300 MG) GABA_PENTIN CAP (C/L2) ] D GABAPENTIN 4.00 4.00 Y Y GA_BA_PENTIN [600 MG] TAB (C/L2) ] D GABAPENTIN 11.00 11.00 Y Y GABAPENTIN 100 MG CAP (C/L2) ] D GABAPENTIN 4.00 4.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 PREGABALIN 75 MG $ (LYRICA PXRc)(C/N) PREGABALIN 20.00 20.00 N N 4.7.3 Antimigraine drugs 4.7.31 Drugs for acute migraine attack !"#$% 4 ERGOTAMINE 1 MG+CAFFEINE 100 MG TAB [(CAFERGOT CAFFEINE 1.50 1.50 Y Y ERGOTAMINE 1.50 1.50 Y Y 4.7.32 Drugs used in the prophylaxis of migraine !"#$% ( CYPROHEPTADINE 4 MG(B/L2) I CYPROHEPTADINE 0.50 0.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 FLUNARIZINE 5 MG CAP (N) (1208)# FLUNARIZINE 1.50 1.50 Y N PIZOTIFEN TAB>>..>>(N/N)[OU EXP.Pahrrก]# PIZOTIFEN 1.00 1.00 Y N 4.8 Antiepileptics 4.8.1 Drugs used in the control of epilepsy !"#$% ก (SODIUM VALPROATE) VAL_PA_RIN**200 MG ก SOD.VALPROATE 3.00 3.00 Y Y (aUcPeQWÜOcaWPeQèr]) DILANTIN 50 MG INFATAB(D/L1) กPHENYTOIN 8.50 8.50 Y Y CARBAMAZEPINE 200 MG(PANTOL) (D/L1)ก CARBAMAZEPINE 2.00 2.00 Y Y DEPAKIN 200 MG TAB( D/L3) ก$ SOD.VALPROATE 6.00 6.00 N N DEPAKIN 400 MG(D/L3) INJ ก SOD.VALPROATE 586.00 586.00 Y Y DEPAKIN CHRONO 500 MG TAB(D/L3) ก SOD.VALPROATE 15.50 15.50 Y Y DEPAKIN SYR(D/L3) 60 ML ก SOD.VALPROATE 270.00 270.00 Y Y DILANTIN 100 MG SR CAP (D/L1)R_ก PHENYTOIN 5.00 5.00 Y Y PHENOBARBITAL GR 1 (D/L3)ก V PHENOBARBITAL 0.50 0.50 Y Y PHENOBARBITAL GR 1/2 (D/L3) ก PHENOBARBITAL 0.50 0.50 Y Y PHENYTOIN CAP 100 MG(DITOIN)(D/L1) ก PHENYTOIN 1.00 1.00 Y Y OUVWX PHENOBARBITONE 200 MG/ML INJ ก PHENOBARBITAL 138.00 138.00 Y Y !"#$% ( (400 MG) ZEPTOL CR(CARBAMAZEPINE) TAB I CARBAMAZEPINE 9.50 9.50 Y Y
18 พฤศจิกายน 2561 หนา 16 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- CLONAZEPAM 0.5 MG TAB (D/L3) I CLONAZEPAM 1.00 1.00 Y Y CLONAZEPAM 2.0 MG TAB (D/L3) I CLONAZEPAM 2.00 2.00 Y Y ZEPTOL CR 200 MG(CARBAMAZEPINE) TAB I CARBAMAZEPINE 5.50 5.50 Y Y !"#$% 1 (LAMICTALPXRc) LAMOTRIGINE 50 MG TAB (C/N )] D LAMOTRIGINE 14.00 14.00 Y Y (TOPAMAX 100 MG PXRc)TOPIRAMATE 100 MG (C/L3) ]TOPIRAMATE 22.00 22.00 Y Y KEPPRA [OUVWX*] INJ (500 MG/5 ML) ] LEVETIRACETAM 529.00 529.00 Y Y KEPPRA 500 MG>>..>>(LEVETIRACETAM) ](C/L2) D LEVETIRACETAM 54.50 54.50 Y Y KEPPRA ORAL SOL.{300 ML}(100 MG/1 ML) ] LEVETIRACETAM 2,980.00 2,980.00 N Y KEPPRA ORAL SOL.qWqWQo**(100 MG/1 ML) ] LEVETIRACETAM 23.00 23.00 N Y LAMICTAL TAB 50 MG>>..>>(LAMOTRIGINE)(C/N )] DLAMOTRIGINE 27.00 27.00 Y Y TOPAMAX 100 MG>>..>>(C/L3) ] D TOPIRAMATE 48.50 48.50 Y Y TOPAMAX xy MG>>..>>(C/L3)] D TOPIRAMATE 31.50 31.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 PHENOBARB ELIXIR>>..>>20 MG/ÑÑ 60 ML(D/L3)# PHENOBARBITAL 37.00 37.00 Y N 4.8.2 Drugs used in status epilepticus !"#$% ก DILANTIN INJ 250 MG(D/L1) ก(U) PHENYTOIN 377.00 377.00 Y Y 4.9 Drugs used in parkinsonism and related disorders !"#$% TRIVASTAL RETARD 50 MG>>..>> D# PIRIBEDIL 19.50 19.50 Y N !"#$% ก (~káU^†)*VOPAR 250 MG TAB ก*[BENSERAZIDE+LEVODOPA BENSERAZIDE 11.00 11.00 Y Y LEVODOPA 11.00 11.00 Y Y BENZHEXOL 2 MG(TRIHEXYPHENIDYL)(103)(C/L2) ก TRIHEXYPHENIDYL HCL 1.00 1.00 Y Y MADOPAR HBS 125 MG CAP ก D ## BENSERAZIDE 10.50 10.50 N N LEVODOPA 10.50 10.50 N N !"#$% 4 SUPLAC (BROMOCRIPTINE) 2.5 MG(B/L3)_[ BROMOCRIPTINE MESYLATE 10.00 10.00 Y Y !"#$% 5 BOTULINUM [PJ]TOXIN 500*IU (aáaÑ/aáa)TYPE Aà 0.00 Y Y BOTULINUM TOXIN (ÑmU^oP]Rh)TYPE A 500 U à BOTULINUM TOXIN TYPE A 15,951.00 15,951.00 N N BOTULINUM à 2 wif]VWXaRjûRrèÜh 1 U à BOTULINUM TOXIN TYPE A 40.00 40.00 Y N 4.10 Drugs used in substance dependence 4.11 DRUGS USED IN DEMENTIA )*+,ก!"#$%)*-."ก/-01$*23 (EBIXA PXRc) MEMANTINE 10 MG [MEMXA*](B/L3) D##MEMANTINE HYDROCHLORIDE 13.00 13.00 N N ARICEPT EVESS 10 MG TAB>>..>>(C/L3)..D $ DONEPEZIL HCL 146.00 146.00 N N EBIXA 10 MG TAB>>..>>[^] (MEMANTINE HCL) (B/L3 MEMANTINE HYDROCHLORIDE 102.00 102.00 N N EXELON PATCH 10 (9.5 MG/24 H) D $ RIVASTIGMINE 154.00 154.00 N N
18 พฤศจิกายน 2561 หนา 17 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- 5 Infections 5.1 Antibacterial drugs )*+,ก!"#$%)*-."ก/-01$*23 ZYVOX TAB 600 MG (LINEZOLID)à(2)##(PVÖUo CASE) LINEZOLID 1,473.00 1,473.00 N N 5.1.1 Penicillins !"#$% ก AMOXICILLIN 125 MG SYR (B/L1)(78)ก AMOXICILLIN 15.00 15.00 Y Y AMOXICILLIN 250 MG SYR(B/L1) (80)ก AMOXICILLIN 23.00 23.00 Y Y AMOXYCILLIN 250 MG CAP (B/L1)(79)Vก AMOXICILLIN 2.00 2.00 Y Y AMOXYCILLIN 500 MG CAP (B/L1)(81)Vก AMOXICILLIN 2.50 2.50 Y Y AMPICILLIN 1 G INJ (B/L1)ก AMPICILLIN 19.00 19.00 Y Y AMPICILLIN 250 MG INJ (B/L1)ก AMPICILLIN 12.00 12.00 Y Y AMPICILLIN 500 MG INJ (B/L1)ก AMPICILLIN 15.00 15.00 Y Y BENZATHINE PEN 1.2 MU (B/L1) ก BENZATHINE PENICILLIN 73.00 73.00 Y Y CLOXACILLIN 1 G INJ(B/L1)_ก CLOXACILLIN 21.00 21.00 Y Y CLOXACILLIN 500 MG INJ (B/L1)_ก CLOXACILLIN 15.00 15.00 Y Y DICLOXACILLIN 250 MG CAP V (B/L1) ก DICLOXACILLIN 2.00 2.00 Y Y DICLOXACILLIN 500 MG CAP (B/L1)(3461) V ก DICLOXACILLIN 3.00 3.00 Y Y DICLOXACILLIN 62.5 MG/5 ML 60 ML SYR ก (B/L1) DICLOXACILLIN 25.00 25.00 Y Y PEN-V 200,000U SYR 60ML(B/L1)_ก PENICILLIN V 13.00 13.00 Y Y PEN-V 400,000U TAB(B/L1) V ก PENICILLIN V 1.50 1.50 Y Y PGS 1 MU>..>ก PENICILLIN G SODIUM 10.00 10.00 Y Y PGS 5* MU ก PENICILLIN G SODIUM 24.00 24.00 Y Y !"#$% 4 (AMOKSIKLAV 1 GM) AMOXICILLIN 875+CLAVULANIC AMOXICILLIN 15.50 15.50 Y Y CLAVULANATE POTASSIUM 15.50 15.50 Y Y [^rPahrrrก] PENICILLAMINE 250 MG (D/L3) CAP [ PENICILLAMINE 19.00 19.00 Y Y AMOKSIKLAV 2X (457MG)(400+57)SUSP 70 ML [ AMOXICILLIN 227.00 227.00 Y Y CLAVULANATE POTASSIUM 227.00 227.00 Y Y AUGMENTIN 2.2 G.INJ (B/L2)[ AMOXICILLIN 147.00 147.00 Y Y CLAVULANATE POTASSIUM 147.00 147.00 Y Y UNASYN 3 GM INJECTION [ SULTAMICILLIN TOSYLATE 347.00 347.00 Y Y OUVWX AMK 1.2 GM.INJ (AUGMENTIN INJ PXRc) (B/L2)[ AMOXICILLIN 59.00 59.00 Y Y CLAVULANATE POTASSIUM 59.00 59.00 Y Y !"#$% 1 (TAZOCIN 4.5 GM PXRc) PIPERACILLIN 4 GM+TAZOBACTAM PIPERACILLIN SOD 135.00 135.00 Y Y TAZOBACTAM 135.00 135.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 AMK 228 MG(200+28)SUSP 70 ML# [NED] AMOXICILLIN 135.00 135.00 Y N CLAVULANATE POTASSIUM 135.00 135.00 Y N
18 พฤศจิกายน 2561 หนา 18 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- AUGMENTIN SYRUP zyy /°{.å MG/5ML 50 ML ## AMOXICILLIN 610.00 610.00 N N CLAVULANATE POTASSIUM 610.00 610.00 N N UNASYN 750 MG TABLET $ AMPICILLIN 59.00 59.00 N N SULBACTAM SOD 59.00 59.00 N N UNASYN POS SYR>>..>>250 MG/5ML 60ML D## SULTAMICILLIN TOSYLATE 350.00 350.00 N N 5.1.2 Cephalosporins, cephamycins, and other beta-lactam !"#$% ก CEFAZOLIN 1 G INJ (ZEFA)(B/L1)ก(U) CEFAZOLIN 21.00 21.00 Y Y CEPHALOSPORINS GROUP 21.00 21.00 Y Y CEPHALEXIN 125 MG /5 ML SYR 60 ML>>..>>_(B/L1)ก CEPHALEXIN 23.00 23.00 Y Y CEPHALOSPORINS GROUP 23.00 23.00 Y Y CEPHALEXIN 500 MG CAP (B/L1)ก CEPHALEXIN 4.00 4.00 Y Y CEPHALOSPORINS GROUP 4.00 4.00 Y Y !"#$% 4 (250 MG) CEF-3 IM INJECTION (B/L1) ([) CEFTRIAXONE DISODIUM 46.00 46.00 Y Y CEPHALOSPORINS GROUP 46.00 46.00 Y Y (CLAFORAN) CEFOTAXIME 1 GM INJ _(B/L1)[ CEFOTAXIME SOD 35.00 35.00 Y Y CEPHALOSPORINS GROUP 35.00 35.00 Y Y (PIbUกQbUc) CEF-3 IM 1 GM (B/L1)([) CEFTRIAXONE SODIUM 34.00 34.00 Y Y CEPHALOSPORINS GROUP 34.00 34.00 Y Y CEF-3 IV(CEFTRIAXONE SOD) 1 GM (2865) (B/L1)[(U)CEFTRIAXONE SODIUM 19.00 19.00 Y Y CEPHALOSPORINS GROUP 19.00 19.00 Y Y CEF-4* 1 GM INJ (CEFTAZIDIME)_[ZEDIM](B/L1) [ CEFTAZIDIME 24.00 24.00 Y Y CEPHALOSPORINS GROUP 24.00 24.00 Y Y !"#$% 1 (LOCAL) MEROPENEM* 1 GM (B/L2) INJ...] MEROPENAM 178.00 178.00 Y Y CEFOPERAZONE+SULBACTAM( B/ L1) 1.5 GM...] D CEFOPERAZONE SOD 46.00 46.00 Y Y CEPHALOSPORINS GROUP 46.00 46.00 Y Y SULBACTAM SOD 46.00 46.00 Y Y CEFSPAN SUSPENSION (100 MG/5 ML)[CEFIXIME] ] 30CEFIXIME 287.00 287.00 Y Y IMIPENAM 500 MG+CILASTATIN 500 MG (C/L3) ] CILASTATIN 228.00 228.00 Y Y IMIPENAM 228.00 228.00 Y Y INVANZ 1 GM (ERTAPENEM SOD) INJ ] (B/L2) ERTAPENAM SOD 1,144.00 1,144.00 Y Y MERONEM 1 GM (B/L2) INJ ] MEROPENAM 1,269.00 1,269.00 Y Y SULPERAZON 1.5 GM INJ>>..>> ] D# CEFOPERAZONE SOD 627.00 627.00 Y N CEPHALOSPORINS GROUP 627.00 627.00 Y N SULBACTAM SOD 627.00 627.00 Y N TIENAM 500 MG INJ (C/L3) ] D CILASTATIN 713.00 713.00 Y Y IMIPENAM 713.00 713.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23
18 พฤศจิกายน 2561 หนา 19 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- DISTACLOR 250 MG CAP##(B/L1) CEFACLOR 24.50 24.50 N N CEPHALOSPORINS GROUP 24.50 24.50 N N MEIACT 100 MG CAP ##(B/L1) CEFDITOREN 40.00 40.00 N N CEPHALOSPORINS GROUP 40.00 40.00 N N MEIACT GRANULES 50 MG/qr]*(CEFDITOREN) D$(B/CEFDITOREN 24.00 24.00 N N CEPHALOSPORINS GROUP 24.00 24.00 N N OMNICEF 100 MG CAP #(B/L1) CEFDINIR 30.00 30.00 Y N CEPHALOSPORINS GROUP 30.00 30.00 Y N OMNICEF 125 MG SYR #(B/L1) CEFDINIR 282.00 282.00 Y N CEPHALOSPORINS GROUP 282.00 282.00 Y N 5.1.3 Tetracyclines !"#$% ก DOXYCYCLINE 100 MG(D/L1)_ก DOXYCYCLINE 2.00 2.00 Y Y TETRACYCLIN 250 MG ( D/L1) CAP_ก TETRACYCLINE 1.00 1.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 OXYTETRACYCLIN HCL 50 MG/ML*(D/L1)INJ #[10 MLOXYTETRACYCLINE 22.00 22.00 Y N TERRAMYCIN EYE OINT# OXYTETRACYCLINE 26.00 26.00 Y N POLYMIXIN B 26.00 26.00 Y N TYGACIL 50 MG INJ(D/N) (TIGLICYCLINE) D ## TIGLICYCLIN 2,651.00 2,651.00 N N 5.1.4 Aminoglycosides !"#$% ก GENTAMICIN 20 MG/2ML INJ (C/L1)ก GENTAMICIN 7.00 7.00 Y Y GENTAMICIN 80 MG/2ML INJ [wáXaRi](C/L1) ก GENTAMICIN 5.00 5.00 Y Y NEOMYCIN 350 MG TAB (C/L2) ก NEOMYCIN SULFATE 4.50 4.50 Y Y STREPTO_MYCIN 1 G INJ (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk)ก STREPTOMYCIN 19.00 19.00 Y Y TB STREPTOMYCIN 1 G ( D/L1)INJ (~[^]กU^) ก STREPTOMYCIN 0.00 0.00 Y Y !"#$% ( (500 MG/2ML) A_MI_KACIN INJ V I AMIKACIN 40.00 40.00 Y Y A_MI_KACIN {250 MG/2ML} INJ V I AMIKACIN 29.00 29.00 Y Y AMIKIN EYE DROP (50 MG./ML.) OUP•^WOc I AMIKACIN 120.00 120.00 Y Y GEN TA MICIN EYE DROP (14 MG./ML.) (C/L1)OUP•^WOc I 90.00 90.00 Y Y !"#$% 4 KANAMYCIN 1 G INJ (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk) [ KANAMYCIN 17.00 17.00 Y Y TB KANAMYCIN 1 G INJ (~[^]กU^) [ KANAMYCIN 0.00 0.00 Y Y !"#$% 1 NETILMICIN 150 MG/1.5ML ] NETILMICIN SULFATE 300.00 300.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 GENTAMICIN CREAM 15 GM decf (C/L1)# 35.00 35.00 Y N 5.1.5 Macrolides !"#$% ก
18 พฤศจิกายน 2561 หนา 20 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- ERYTHROMYCIN SYR 125 MG (B/L1)ก ERYTHROMYCIN ESTOLATE 20.00 20.00 Y Y ERYTHROMYCIN GROUP 20.00 20.00 Y Y ROXITHROMYCIN êxy MG(N/N) TAB. (1649)_ก ROXITHROMYCIN 1.50 1.50 Y Y !"#$% 1 (ZITHROMAX SYRPXRc)_AZITHROMYCIN SUSPENSIONAZITHROMYCIN 79.00 79.00 Y Y (ZITHROMAX PXRc) AZITHROMYCIN 250 MG CAP*[w[áqp AZITHROMYCIN Q 14.00 14.00 Y Y CLARITHROMYCIN 500 MG (CRIXAN)TAB(C/L2)] CLARITHROMYCIN 21.50 21.50 Y Y KLACID MR 500 MG TAB (C/L2)] ## CLARITHROMYCIN 65.50 65.50 N N KLACID ORAL SUSPENSION [125 MG/5 ML] ] 60 ML(DCLARITHROMYCIN 319.00 319.00 Y Y ZITHROMAX DRY SYR>>..>> (B/L2)] (D) AZITHROMYCIN 251.00 251.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 ERYTHRO LOTION 2% (B/L1)30 ML** ERYTHROMYCIN 40.00 N N ERYTHROMYCIN 250 MG TAB [ESTAB](B/L1)# ERYTHROMYCIN 3.00 3.00 Y N ERYTHROMYCIN GROUP 3.00 3.00 Y N KLACID IV 500 MG(C/L2)# CLARITHROMYCIN 442.00 442.00 Y N MIOTIN SYR 200 MG 60ML(N/N)## MEDICAMYCIN 132.00 132.00 N N ROVAMYCIN 500 MG TAB>>..>>(C/L2)##[i^R¢njOกPQRกàmUSPIRAMYCIN ehfUO 11.50 11.50 N N ZITHROMAX 500 MG IV(B/L2)# AZITHROMYCIN 700.00 700.00 Y N 5.1.6 Quinolones !"#$% ก NORFLOXACIN 100 MG TAB._ก (C/L2) NORFLOXACIN 1.50 1.50 Y Y NORFLOXACIN 400 MG TAB. (1645)_ก (C/L2 ) NORFLOXACIN 2.00 2.00 Y Y !"#$% ( QINOLON 200 MG (C/L2)TAB.( OFLOXACIN )_I OFLOXACIN 8.50 8.50 Y Y !"#$% 4 TB OFLOXACIN 200 MG (C/L2)TAB. (~[^]กU^) [ OFLOXACIN 0.00 0.00 Y Y !"#$% 1 CIPROFLOXACIN 200 MG/100ML(VWX*) INJ(C/L2) ] D(UCIPROFLOXACIN 40.00 40.00 Y Y CIPROFLOXACIN 500 MG TAB(C/L2) ] CIPROFLOXACIN 3.00 3.00 Y Y CIPROX 250 MG TAB (CIPROFLOXACIN)(C/L2)] CIPROFLOXACIN 2.50 2.50 Y Y CRAVIT 500 MG TAB>>..>>(LEVOFLOXACIN)(C/L2) D## LEVOFLOXACIN 81.50 81.50 N N CRAVIT INJ 750 MG (C/L2)(LEVOFLOXACIN) ] LEVOFLOXACIN 1,018.00 1,018.00 Y Y LEVOFLOXACIN 500 MG TAB(C/L2) D ] LEVOFLOXACIN 23.00 23.00 Y Y TB LEVOFLOXACIN 500 MG TAB(C/L2)](~[^]กU^) LEVOFLOXACIN 0.00 0.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 AVELOX 400 MG TAB (MOXIFLOXACIN 400 MG) D(PVÖUo MOXIFLOXACIN HCL 153.00 153.00 N N CRAVIT EYE DROP 5MG/ML D# LEVOFLOXACIN 202.00 202.00 Y N VIGAMOX EYE DROP 0.5% 5 ML D# MOXIFLOXACIN HCL 201.00 201.00 Y N 5.1.7 Some other antibacterials !"#$% ก
18 พฤศจิกายน 2561 หนา 21 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- METRONIDAZOLE 200 MG T(B/L3)(848) ก METRONIDAZOLE 1.00 1.00 Y Y METRONIDAZOLE 500MG/100ML INJ_ ก (B/L3)(U) METRONIDAZOLE 28.00 28.00 Y Y !"#$% ( CLINDAMYCIN* 600 MG/4ML INJ (CLINOTT-P) (B/L1)ICLINDAMYCIN 22.00 22.00 Y Y LINCOCIN 600 MG/2 ML INJ(B/L1) I LINCOMYCIN 10.00 10.00 Y Y OUPc`X* CLINDAMYCIN 300 MG CAP (B/L1)I CLINDAMYCIN 4.00 4.00 Y Y !"#$% 1 COLISTATE 150 MG INJ (COLISTIN) (C/L2) ] COLISTIN 431.00 431.00 Y Y COLISTIN 1 GM SYR>>..>>(C/L2) COLISTIN 21.00 21.00 Y Y FOSMICIN 4 G INJ ] D FOSFOMYCIN 445.00 445.00 Y Y FUCIDIN 250 MG TAB. ] D SODIUM FUSIDATE 69.00 69.00 Y Y VANCOCIN* 500 MG INJ (B/L2)] D VANCOMYCIN HCL 91.00 91.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 TARGOCID 200 MG INJ>>..>>(TEICOPLANIN)( N/N)# TEICOPLANIN 1,473.00 1,473.00 Y N TYGACIL 50 MG INJ(D/N) (TIGLICYCLINE) D ## TIGLICYCLIN 2,651.00 2,651.00 N N 5.1.8 Sulphonamides and trimethoprim !"#$% ก BACTRIM INJ (C/L3) ก SULFAMETHOXAZOLE 34.00 34.00 Y Y TRIMETHOPRIM 34.00 34.00 Y Y CO-TRIMOXAZOL SYR 60 ML(C/L3) ก SULFAMETHOXAZOLE 13.00 13.00 Y Y TRIMETHOPRIM 13.00 13.00 Y Y CO-TRIMOXAZOL(BACTRIM) TAB (C/L3)(136) ก SULFAMETHOXAZOLE 1.00 1.00 Y Y TRIMETHOPRIM 1.00 1.00 Y Y PHARMA CREAM 40 GM ก SILVER SULFADIAZINE 32.00 32.00 Y Y PHARMA CREAM 5 GM ก SILVER SULFADIAZINE 7.00 7.00 Y Y PHARMA CREAM 500 GM ก SILVER SULFADIAZINE 370.00 370.00 Y Y SULFADIAZINE 500 MG TAB_ ก SULFADIAZINE 2.00 2.00 Y Y 5.1.9 Antituberculous drugs !"#$% ก ETHAMBUTOL 500 MG ก (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk) ETHAMBUTOL 4.00 4.00 Y Y INH SUSPENSION (10 MG/ML) 30 MLก 50.00 50.00 Y Y RIFAMPICIN SUSPENSION (20 MG/ML) 30 ML ก RIFAMPICIN 50.00 50.00 Y Y STREPTO_MYCIN 1 G INJ (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk)ก STREPTOMYCIN 19.00 19.00 Y Y TB ETHAMBUTOL 400 MG (B/L2)ก(~[^]กU^) ก ETHAMBUTOL 0.00 0.00 Y Y TB ETHAMBUTOL 500 MG (B/L2)ก(~[^]กU^) ก ETHAMBUTOL 0.00 0.00 Y Y TB INH (~[^]กU^) 100 MG (C/L2) ก ISONIAZID 0.00 0.00 Y Y TB PZA(PYRAZINAMIDE) 500MG ก(~[^]กU^) PYRAZINAMIDE 0.00 0.00 Y Y TB STREPTOMYCIN 1 G ( D/L1)INJ (~[^]กU^) ก STREPTOMYCIN 0.00 0.00 Y Y TB â^wÇc RIFAM 300 MG(C/L1) CAP ก(~[^]กU^) RIFAMPICIN 0.00 0.00 Y Y TB â^wÇc RIFAM 450MG(C/L1) TAB ก(~[^]กU^) RIFAMPICIN 0.00 0.00 Y Y
18 พฤศจิกายน 2561 หนา 22 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- !"#$% ( TB RIFINAH 150 MG * [INH 100+RIFAM150] I ISONIAZID 0.00 0.00 Y Y RIFAMPICIN 0.00 0.00 Y Y TB RIFINAH ãyy MG(INH 150+RIFAM300) I(IkXQo 60 ISONIAZID 0.00 0.00 Y Y RIFAMPICIN 0.00 0.00 Y Y TB RIFINAH[ws]] 300 MG*(INH 150+RIFAM300) I ISONIAZID 0.00 0.00 Y Y RIFAMPICIN 0.00 0.00 Y Y !"#$% 4 KANAMYCIN 1 G INJ (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk) [ KANAMYCIN 17.00 17.00 Y Y TB CYCLOSERINE 250 MG TAB (C/L2)(~[^]กU^) [ CYCLOSERINE 0.00 0.00 Y Y TB ETHIONAMIDE 250 MG TAB (C/L2)(~[^]กU^) [ ETHIONAMIDE 0.00 0.00 Y Y TB KANAMYCIN 1 G INJ (~[^]กU^) [ KANAMYCIN 0.00 0.00 Y Y TB OFLOXACIN 200 MG (C/L2)TAB. (~[^]กU^) [ OFLOXACIN 0.00 0.00 Y Y TB PAS SOD. 1 GM TAB (~[^]กU^) [ PARA-AMINO SALICYLIC ACID 0.00 0.00 Y Y !"#$% 1 CYCLOSERINE 250 MG TAB [ (OU TB)(I^ก,ÑmU^oP]Rh,áกaCYCLOSERINE 57.50 57.50 Y Y ETHAMBUTOL 400 MG ก (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk) ETHAMBUTOL 2.50 2.50 Y Y ETHIONAMIDE 250 MG TAB [ (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUETHIONAMIDE k 33.50 33.50 Y Y INH (ISONIAZID) 100 MG ก (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk) ISONIAZID 1.00 1.00 Y Y PAS SOD. 1 GM TAB [(I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk) PARA-AMINO SALICYLIC ACID 6.00 6.00 Y Y PZA(PYRAZINAMIDE) 500 MG ก (I^ก,ÑmU^oP]Rh,áกa,•fU]XbPYRAZINAMIDE Uk 2.50 2.50 Y Y RIFAMPICIN 300 MG CAP ก (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk) RIFAMPICIN 4.50 4.50 Y Y RIFAMPICIN 450 MG TAB ก (I^ก,ÑmU^oP]Rh,áกa,•fU]XbUk) RIFAMPICIN 6.00 6.00 Y Y TB LEVOFLOXACIN 500 MG TAB(C/L2)](~[^]กU^) LEVOFLOXACIN 0.00 0.00 Y Y 5.1.10 Antileprotic drugs !"#$% ก DAPSONE 100 MG (DDS)(C/L3) ก(~[^]กU^) DAPSONE 0.00 0.00 Y Y DAPSONE 100 MG (DDS)(C/L3)_ก DAPSONE 16.00 16.00 Y Y LAMPRENE 50 MG CAP(C/L3) (OU~[^]กU^) ก CLOFAZIMINE 0.00 0.00 Y Y OU~[^]กU^ LEPROSY MDT-MB ws]Qo ก CLOFAZIMINE 0.00 0.00 Y Y DAPSONE 0.00 0.00 Y Y RIFAMPICIN 0.00 0.00 Y Y 5.2 Antifungal drugs !"#$% ก FLUCONAZOLE 200 MG CAP (C/L1)_ ก FLUCONAZOLE 7.50 7.50 Y Y GRISEOFULVIN 500 MG_(C/N) ก GRISEOFULVIN 3.00 3.00 Y Y KETOCONAZOLE 200 MG TAB (C/L2)V ก KETOCONAZOLE 3.00 3.00 Y Y MYCOSTATIN (NYST ORAL SUSP) 12 ML ก NYSTATIN 35.00 35.00 Y Y !"#$% 4 FUNGIZONE(AMPHO - B) 50 MG INJ_(B/L2)[ AMPHOTERICIN-B 474.00 474.00 Y Y
18 พฤศจิกายน 2561 หนา 23 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- ITRACONAZOLE 100 MG (SPAZOL) CAP (C/L3) [ ITRACONAZOLE 8.50 8.50 Y Y !"#$% 5 (OUVWX)VFEND 200 MG INJ (VORICONAZOLE)(D/L3)##à VORICONAZOLE 6,770.00 6,770.00 N N LIPOSOMAL AMPHOTERICIN B 50 MG INJ à(2) AMPHOTERICIN-B 7,376.00 7,376.00 N N VFEND TAB 200 MG[OUPc`X](VORICONAZOLE)(D/L3)PVÖUo 1,592.00 1,592.00 N N aáaÑ LIPOSOMAL AMPHO B 50 MG INJ (AMBISOME) AMPHOTERICIN-B 0.00 Y Y aáaÑ VFEND [OUPc`X] 50 MG*(VORICONAZOLE)(D/L3) 0.00 Y Y aáaÑ VFEND 200 MG TAB[OUPc`X](VORICONAZOLE)(DVORICONAZOLE 0.00 Y Y aáaÑ VFEND(OUVWX) 200 MG INJ (VORICONAZOLE)(D/VORICONAZOLE 0.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 FLUOMIZIN VAGINAL TABLET##D DEQUALINIUM CHLORIDE 33.00 33.00 N N GYNECON-T VAGINAL TABLET# NYSTATIN 6.00 6.00 Y N 5.3 Antiviral drugs !"#$% ก (800 MG)* ACYCLOVIR TAB[VIZO 800] ก ACYCLOVIR 6.00 6.00 Y Y !"#$% 4 ACYCLOVIR 250 MG(B/L1) INJ [ ACYCLOVIR 211.00 211.00 Y Y 5.3.1 Non-antiretrovirals !"#$% ก (ACYCLOVIR) VILERM 200 MG TAB_ก ACYCLOVIR 4.00 4.00 Y Y LAMIVUDINE SYR 10 MG/ML (3TC)(C/L3) ก D## LAMIVUDINE 73.00 73.00 N N !"#$% 1 GANCICLOVIR 500 MG INJ (C/L3)] D GANCICLOVIR 1,736.00 1,736.00 Y Y !"#$% 5 (OกPQRก)...aáaÑ,aáa PEGINTRON CLEARCLICK PEN 150 0.00 Y Y PEGASYS 180 MCG INJECTION D## à 2 PEGINTERFERON ALPHA-2A 3,525.00 3,525.00 N N RIBAVIRIN 200 MG CAP (REBETOL) (X/L3) # à 2 RIBAVIRIN 0.00 0.00 Y N aáaÑ,aáa PEGASYS 180 MCG INJECTION à 2 0.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 FAMVIR 250 MG TAB (B/L3) # FAMCICLOVIR 159.00 159.00 Y N 5.3.2 Antiretrovirals !"#$% ก TENO-EM (^kc 2 ÑhRX) ÑmU^oP]Rh (TDF 300 MG + FTC 200 25.00 25.00 N N (aWÇÉU^W-GPO)TENOFOVIR 300 MG(TDF) ( B/L3) ก D 16.00 16.00 N N ARVSSO (200 MG *) EFAVIRENZ [aWPeQèr]rfrh] ก EFAVIRENZ 0.00 0.00 Y N ARVSSO (EFAVIRENZ 600 MG)aWPeQèr] ก EFAVIRENZ 0.00 0.00 Y N ARVSSO (NEVIRAPINE 200 MG TAB)aWIUk(NVP) ก (C/LNEVIRAPINE 0.00 0.00 Y N ARVSSO (TENOFOVIR 300 MG)(TDF)aWÇÉU^W ก# tenofovir 0.00 0.00 Y N ARVSSO (ZIDOVUDINE 100 MG)w[áqtQaWIUk(AZT) (C/LZIDOVUDINE 0.00 0.00 Y N ARVSSO (ZILARVIR ) AZT 300+3TC 150 ก LAMIVUDINE 0.00 0.00 Y N
18 พฤศจิกายน 2561 หนา 24 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- ARVSSO (ZILARVIR ) AZT 300+3TC 150 ก ZIDOVUDINE 0.00 0.00 Y N ARVSSO GPO-VIR Z Pc`XaWIUk ก LAMIVUDINE 0.00 0.00 Y N NEVIRAPINE 0.00 0.00 Y N ZIDOVUDINE 0.00 0.00 Y N ARVSSO(LAMIVUDINE 150 MG)Pc`XIUk(3TC) ก LAMIVUDINE 0.00 0.00 Y N ARVSSO(^kc 2 ÑhRX)TENO-EM(TDF 300 MG + FTC 200 EMTRICITABINE 0.00 Y N tenofovir 0.00 Y N ARVSSO(^kc 3 ÑhRX) TEEVIR (TDF 300+EFV 600+ FTC 200 EFAVIRENZ 0.00 Y N EMTRICITABINE 0.00 Y N tenofovir 0.00 Y N ATC (200 MG *) EFAVIRENZ (EFV) ก EFAVIRENZ 0.00 0.00 N Y ATC (^kc 2 ÑhRX) TENO-EM(TDF 300 MG + FTC 200 MGEMTRICITABINE 0.00 N Y TENOFOVIR 0.00 N Y ATC (^kc 3 ÑhRX) TEEVIR(TDF 300+EFV 600+ FTC 200 MG EFAVIRENZ 0.00 0.00 N Y EMTRICITABINE 0.00 0.00 N Y TENOFOVIR 0.00 0.00 N Y ATC AZT 300 MG CAP (C/L3) ก ZIDOVUDINE 0.00 0.00 N Y ATC EFAVIRENZ 600 MG(aWPeQèr])(EFV) ก EFAVIRENZ 0.00 0.00 N Y ATC GPO-VIR Z ก LAMIVUDINE 0.00 0.00 N Y NEVIRAPINE 0.00 0.00 N Y ZIDOVUDINE 0.00 0.00 N Y ATC LAMIVUDINE 150 MG (Pc`X^WaWIUk)(3TC)TAB ก LAMIVUDINE 0.00 0.00 N Y ATC LAMIVUDINE(3TC) SYR 10 MG/ML ก LAMIVUDINE 73.00 73.00 N Y ATC NEVIRAPINE(NVR) 200 MG (aWIUk)TAB ก(C/L3)ก NEVIRAPINE 0.00 0.00 Y Y ATC NEVIRAPINE(NVR) SYR 10 MG/ML 60 MLà (C/L3)NEVIRAPINE 79.00 79.00 N Y ATC TENOFOVIR(TDF) 300 MG(aWÇÉU^W) TAB ก TENOFOVIR 0.00 0.00 N Y ATC ZIDOVUDINE(AZT) 100 MG CAPw[áqtQaWIUk (C/L3ZIDOVUDINE 0.00 0.00 N Y ATC ZIDOVUDINE(AZT) SYR 10 MG/ML 60 ML ก ZIDOVUDINE 61.00 61.00 N Y EFAVIRENZ 600 MG TAB(GPO/aWPeQèr]) CL(C/L3)_ ก## EFAVIRENZ 8.00 8.00 N N LAMIVUDINE 150 MG (3TC) Pc`X^WaWIUk(C/L3) V ก D LAMIVUDINE 8.00 8.00 Y Y TEEVIR (^kc 3 ÑhRX) [ÑmU^oP]Rh]*(TDF 300+EFV 600+ FTCEFAVIRENZ 41.00 41.00 N N EMTRICITABINE 41.00 41.00 N N tenofovir 41.00 41.00 N N !"#$% ( ARVSSO (GPO VIR S 30)Pc`XaWIUk I LAMIVUDINE 0.00 0.00 Y N NEVIRAPINE 0.00 0.00 Y N STAVUDINE 0.00 0.00 Y N ATC GPO VIR S 30 I LAMIVUDINE 0.00 0.00 N Y NEVIRAPINE 0.00 0.00 N Y STAVUDINE 0.00 0.00 N Y
18 พฤศจิกายน 2561 หนา 25 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- ATC RILPIVIRINE 25 MG (EDURANT) TAB I RILPIVIRINE 0.00 N Y NEVIRAPINE 200 MG TAB à (aWIUk) (C/L3) # V NEVIRAPINE 7.50 7.50 Y N !"#$% 4 ARV ATAZANAVIR 300 MG(w[áqpQhlmUP]Rh-wX])(REYATAZ ATAZANAVIR 0.00 Y N ARVSSO (RITONAVIR 100 MG decf *)TAB [NORVIR][ RITONAVIR 0.00 Y N ARVSSO (STAVUDINE 30 MG CAP)w[áqtQaWÇÉU-IUk (D4STAVUDINE 0.00 0.00 Y N ARVSSO KALETRA [ LOPINAVIR 0.00 0.00 Y N RITONAVIR 0.00 0.00 Y N ARVSSO(LOPINAVIR200/RITRONAVIR50)aWPeQèr] [ LOPINAVIR 0.00 0.00 Y N RITONAVIR 0.00 0.00 Y N ATC (RITONAVIR 100 MG decf *)TAB [NORVIR][ RITONAVIR 0.00 N Y ATC ATAZANAVIR 300 MG(w[áqpQhlmUP]Rh-wX])(REYATAZ ATAZANAVIR 0.00 N Y ATC LOPINAVIR 200/RITONAVIR 50 (aWPeQèr])[ LOPINAVIR 0.00 0.00 N Y RITONAVIR 0.00 0.00 N Y ATC STAVUDINE(D4T) 30 MG(w[áqtQaWÇÉU-IUk) CAP [ STAVUDINE 0.00 0.00 N Y !"#$% 1 ARVSS0_RILPIVIRINE 25 MG (EDURANT) TAB ] RILPIVIRINE 0.00 Y Y ARVSSO DDI 125 MG TAB ] DIDANOSINE 0.00 Y N ARVSSO DDI 200 MG TAB ] DIDANOSINE 0.00 Y N ARVSSO_(ABACAVIR 600 + 3TC 300)[KIVEXA] ] ABACAVIR 0.00 Y N LAMIVUDINE 0.00 Y N ARVSSO_ABACAVIR 300 MG TAB (ZIAGENAVIR) ] ABACAVIR 0.00 Y N ATC (ABACAVIR 600 + 3TC 300)[KIVEXA] ] ABACAVIR 0.00 N Y LAMIVUDINE 0.00 N Y ATC ABACAVIR 300 MG TAB (ZIAGENAVIR) ] ABACAVIR 0.00 N Y ATC DDI 125 MG TAB ] DIDANOSINE 0.00 N Y KIVEXA TAB [ABACAVIR 600/3TC 300]] D$(PVÖUoCASEABACAVIR 121.00 121.00 N N LAMIVUDINE 121.00 121.00 N N !"#$% 5 (200 MG *) EFAVIRENZ TAB (C/L3)_ à EFAVIRENZ 6.00 6.00 Y Y ARV [DARUNAVIR 600 MG] (PREZISTA) à2 DARUNAVIR 0.00 Y N GPO VIR S 30 TAB>>..>>à # LAMIVUDINE 9.50 9.50 N N NEVIRAPINE 9.50 9.50 N N STAVUDINE 9.50 9.50 N N GPO VIR Z àV## LAMIVUDINE 11.50 11.50 N N NEVIRAPINE 11.50 11.50 N N ZIDOVUDINE 11.50 11.50 N N LOPINAVIR(C/L3)/RITRONAVIR SYR(OUhlmU)[PVÖUoP[a] LOPINAVIR 757.00 757.00 Y Y RITONAVIR 757.00 757.00 Y Y LOPINAVIR200 MG(C/L3)/RITRONAVIR50 MG_CL(aWPeQèLOPINAVIR r] 17.00 17.00 Y Y
18 พฤศจิกายน 2561 หนา 26 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- LOPINAVIR200 MG(C/L3)/RITRONAVIR50 MG_CL(aWPeQèRITONAVIR r] 17.00 17.00 Y Y NEVIRAPINE SYR. 10MG/ML à 60ML (C/L3)## 79.00 79.00 N N RITONAVIR 100 MG(B/L3) Pc`XaWIUk (NORVIR) à RITONAVIR 53.00 53.00 Y Y STAVUDINE 30 MG CAP(C/L3) w[áqtQaWÇÉU-IUk (D4T) à STAVUDINE 5.00 5.00 Y N VIDEX EC 250 MG (B/L3) à (1) DIDANOSINE 115.00 115.00 Y Y ZIDOVUDINE(AZT) 100 MG CAP V w[áqtQaWIUk(C/L3)à ZIDOVUDINE 4.00 4.00 Y Y ZIDOVUDINE(AZT) SYR 10MG/ML à 60ML## 61.00 61.00 N N )*+,ก!"#$%)*-."ก/-01$*23 VIRACEPT 250 MG # # (NELFINAVIR) NELFINAVIR 23.80 23.80 Y Y 5.4 Antiprotozoal drugs 5.4.1 Antimalarials !"#$% ก CHLOROQUINE 250 MG( 150 MG BASE) ก V(C/L1) CHLOROQUINE 1.00 1.00 Y Y PRIMAQUINE 15 MG TAB (C/L2) ก V PRIMAQUINE 1.50 1.50 Y Y PYRIMETHAMINE 25 MG TAB [OUIUX[^Uk](C/L2) ก PYRIMETHAMINE 1.00 1.00 Y Y QUININE 300 MG (D/L2) ก QUININE 2.50 2.50 Y Y QUININE GR 10 INJ. (D/L2) ก QUININE 13.00 13.00 Y Y !"#$% 4 ARTESUNATE 60 MG/1ML INJ [ ARTESUNATE 156.00 156.00 Y Y ARTESUNATE TABLET 50 MG (^rwQกPáQWÜOh EXP.) [ ARTESUNATE 17.50 17.50 Y Y MEFLOQUINE 250 MG(C/L2) [ MEFLOQUINE 30.00 30.00 Y Y 5.4.2 Other antiprotozoal drugs )*+,ก!"#$%)*-."ก/-01$*23 TINIDAZOLE 500 MG TAB(C/N)# TINIDAZOLE 2.50 2.50 Y N 5.5 Antihelmintics !"#$% ก (wQกPáQWÜOhOUecXrUOp)...PRAZIQUANTEL 600 MGTAB(BPRAZIQUANTEL 15.50 15.50 Y Y ALBENDAZOLE 200 MG TAB (C/L2)ก ALBENDAZOLE 3.50 3.50 Y Y DEC 300 MG(DIETHYLCARBAMAZINE) ก DIETHYLCARBAMAZINE 24.00 24.00 Y Y MEBENDAZOLE 100 MG TAB(C/L2)_ก MEBENDAZOLE 1.50 1.50 Y Y MEBENDAZOLE SUSP 30 ML(C/L2) ก MEBENDAZOLE 13.00 13.00 Y Y NICLOSAMIDE TAB>>..>>(HEXIN)_ก (N/N) NICLOSAMIDE 4.50 4.50 Y Y !"#$% ( IVERMECTIN 6 MG TAB (C/L2) I IVERMECTIN 97.00 97.00 Y Y 5.6 Antiseptics !"#$% ก ALCOHOL 70% (240 ml.) ก ETHYL ALCOHOL 32.00 32.00 Y Y ALCOHOL 70% (450 ML.) ก ETHYL ALCOHOL 42.00 42.00 Y Y ALCOHOL 70% (60 ml.) ก ETHYL ALCOHOL 8.00 8.00 Y Y CHLORHEXIDINE 2% IN ALC. 70% (60 ML.) ก CHLORHEXIDINE GLUCONATE 40.00 40.00 Y Y
18 พฤศจิกายน 2561 หนา 27 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- FORMALIN 450 ML [Qn]OU V ก FORMALDEHYDE 40.00 40.00 Y Y GenTian VIOLET ก GENTIAN VIOLET 9.00 9.00 Y Y HIBITANE 0.5% IN WATER (240 ML.) ก 20.00 20.00 Y Y HIBITANE 5% (1,000 ML.) ก 190.00 190.00 Y Y HIBITANE CONCENTRATE 5% ก CHLORHEXIDINE GLUCONATE 908.00 908.00 Y Y HYDROGEN PEROXIDE 450 ML V ก 32.00 32.00 Y Y POT.PERMANGANATE 10 GM ก POT.PERMANGANATE 10.00 10.00 Y Y POVIDINE SOL 60 ML ก POVIDONE IODINE 15.00 15.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 HIBITANE CREAM 100 GM (HEXIDE CREAM)# CHLORHEXIDINE GLUCONATE 149.00 149.00 Y N HIDINE SCRUB 2% 60 ML# CHLORHEXIDINE GLUCONATE 10.00 10.00 Y N HIDINE SCRUB 4 % 60 ML# CHLORHEXIDINE GLUCONATE 12.00 12.00 Y N HIDINE SCRUB 4% GALLON(PVÖUo]UhsQR•) 900.00 900.00 Y N POVIDINE SCRUB 60 ML# POVIDONE IODINE 12.00 12.00 Y N SAVLON CONC. (10 ML.)# 10.00 10.00 Y Y TRIPLE DYE 30 ML# 18.00 18.00 Y N 6 Endocrine system !"#$% 1 (SYNACTHEN PXRc) TETRACOSACTIDE [0.25 MG/ML] INJ TETRACOSACTIDE 816.00 816.00 Y Y !"#$% 5 SYNACTHEN (0.25 MG/ML) INJ ][i^R¢njwàb]IUX[^Uk..debTETRACOSACTIDE dÑb^ena 504.00 504.00 Y Y 6.1 Drugs used in diabetes 6.1.1 Insulins !"#$% ก HAD HUMULIN-R ก (B/L1) REGULAR INSULIN 85.00 85.00 Y Y HUMULIN-N [INSUGEN N*] ก (B/L1) INSULIN ISOPHANE 121.00 121.00 Y Y INSULATARD HM PENFILL D ก (àpกOU]PIWOk)(B/L1) # NPH INSULIN 154.00 154.00 Y N MIXTARD 70/30 PENFILL (àpกOU]hlmU•UQ)(B/L1) ก D# INSULIN ISOPHANE ( to ) NPH 101.00 101.00 Y N INSULIN SOLUBLE C 30 ) 101.00 101.00 Y N MIXTARD HM INSULIN (INSUGEN 30/70) (B/L1) ก INSULIN ISOPHANE 155.00 155.00 Y Y INSULIN SOLUBLE 155.00 155.00 Y Y !"#$% 1 HAD NOVO MIX 30 PENFILL ](àpกOU]hlmUP]Rh) (B/L1) D# INSULIN ASPART 221.00 221.00 Y N )*+,ก!"#$%)*-."ก/-01$*23 LANTUS SOLO STAR 3 ML (GLARGINE) (B/L1) ] D## INSULIN GLARGINE 654.00 654.00 N N 6.1.2 Oral antidiabetic drugs !"#$% ก (850 MG) METFORMIN TAB (B/L1) (1617) ก METFORMIN 1.00 1.00 Y Y GLIBENCLAMIDE 5 MG>>..>>(B/C)(L3)(1933) V ก GLYBENCLAMIDE 1.00 1.00 Y Y GLIPIZIDE 5 MG (C/L2)ก GLIPIZIDE 1.00 1.00 Y Y
18 พฤศจิกายน 2561 หนา 28 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- METFORMIN 500 MG TAB (B/L1)(839) V ก METFORMIN 1.00 1.00 Y Y !"#$% 1 PIOGLITAZONE 30 MG TAB (C/L2)] D PIOGLITAZONE 3.00 3.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (OกPQRก)...ACTOSMET[^] (15 MG/850MG)>>..>> TAB D##METFORMIN 42.00 42.00 N N PIOGLITAZONE 42.00 42.00 N N BASEN 0.2 MG TABLET (N/L3) D # VOGLIBOSE 6.50 6.50 Y N GLIMEPIRIDE 2 MG (AMARYLPXRc) (C/L2)## GLIMEPIRIDE 5.50 5.50 N N JANUVIA 100 MG ( B/N)TAB (SITAGLIPTIN) _D## SITAGLIPTIN PHOSPHATE 41.00 41.00 N N JARDIANCE 10 MG (EMPAGLIFLOZIN) D$ EMPAGLIFLOZIN 55.00 55.00 N N 6.2 Thyroid and antithyroid drugs 6.2.1 Thyroid hormones !"#$% ก L-THYROXIN 100 MCG(A/L1)(THYROSIT)_ก LEVO-THYROXIN 1.00 1.00 Y Y 6.2.2 Antithyroid drugs !"#$% ก (MMI)METHIMAZOLE 5 MG ก(D/L1) METHIMAZOLE 2.00 2.00 Y Y LUGOL'S SOLUTION 30 ML ก IODINE 30.00 30.00 Y Y POT.IODIDE 30.00 30.00 Y Y PTU 50 MG (D/L2) ก PROPYLTHIOURACIL 1.50 1.50 Y Y 6.3 Corticosteroids !"#$% ก (OUPc`X 4 MG) DEXAMETHASONE T(C/L2)_ก DEXAMETHASONE 2.00 2.00 Y Y DEXAMETHASONE 0.5 MG T(C/L2)_ก DEXAMETHASONE 0.50 0.50 Y Y DEXAMETHASONE 4 MG INJ (C/L2)V ก(U) DEXAMETHASONE 7.00 7.00 Y Y DEXAMETHASONE SYRUP 0.1 MG/ML(C/L2)_ก DEXAMETHASONE 50.00 50.00 Y Y PREDNISOLONE 5 MG TAB (C/L1) (1060) ก PREDNISOLONE ACETATE 1.00 1.00 Y Y SOLU-CORTEF 100 MG/2ML (HYDROCORTISONE) (C/DHYDROCORTISONE ACETATE 63.00 63.00 Y Y !"#$% ( FLUDROCORTISONE 0.1 MG TAB (PVÖUoCASE) I FLUDROCORTISONE 8.00 8.00 Y Y !"#$% 4 KENACORT-A 10 MG/ML 5ML [(C-D1/L2) TRIAMCINOLONE ACETONIDE 73.00 73.00 Y Y KENACORT-A 40 MG 1 ML [(C-D1/L2) TRIAMCINOLONE ACETONIDE 62.00 62.00 Y Y SOLU-MEDROL ê GM (METHYL PREDNISOLONE)(C/NMETHYL PREDNISOLONE 2,913.00 2,913.00 Y Y SOLU-MEDROL 500 MG (METHYL PREDNISOLONE) (CMETHYL PREDNISOLONE 1,678.00 1,678.00 Y Y 6.4 Sex hormones 6.4.1 Female sex hormones !"#$% ก NorethiSTERONE 5 MG (STERON) ก NORETHISTERONE 4.00 4.00 Y Y NORETHISTERONE 4.00 4.00 Y Y
18 พฤศจิกายน 2561 หนา 29 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- NORETHISTERONE 5 MG (STERON) ก (X/L3) NORETHISTERONE 4.00 4.00 Y Y NORETHISTERONE 4.00 4.00 Y Y !"#$% ( PROGYNOVA 2 MG (X/L1)ws]Qo(I) ESTRADIOL 190.00 190.00 Y Y PROLUTON DEPOT 250 MG_(D/L2) I HYDROXYPROGESTERONE CAPROATE 139.00 139.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 ANGELIQ 28 TAB $ DROSPIRENONE 934.00 934.00 N N ESTRADIOL 934.00 934.00 N N CELVISTA 60 MG (RALOXIFENE) (X/L3)## RALOXIFEN HCL 70.00 70.00 N N CLOMIPHEN CITRATE 50 MG**(X/L3) CLOMIPHENE CITRATE 55.00 N N CYCLO PROGYNOVA (X/L1)## ESTRADIOL 184.00 184.00 N N NORGESTREL 184.00 184.00 N N CYCLOFEM INJ**>>..>> ESTRADIOL 109.00 N N MEDOXYPROGESTERONE 109.00 N N DUOTON FORTE T.P INJ (X/L1)# ESTRADIOL 19.00 19.00 Y N PROGESTERONE 19.00 19.00 Y N DUPHASTON 10 MG TAB(N/N)## DEHYDROGESTERONE 23.00 23.00 N N FEMOSTON CONTI 1/5 (X/L1)$ DYDROGESTERONE 696.00 696.00 N N ESTRADIOL 696.00 696.00 N N LIVIAL 1 ws]## TIBOLONE 842.00 842.00 N N OESTROGEL (X/L1)# ESTRADIOL 241.00 241.00 Y N UTROGESTAN 100 MG CAP $ D PROGESTERONE (MICRONIZED) 14.00 14.00 N N VERAPLEX 500 MG(MEDROXYPROGESTERONE)(FA MEDROXYPROGESTERONE ACETATE 91.00 91.00 Y N 6.4.2 Male sex hormones and antagonists )*+,ก!"#$%)*-."ก/-01$*23 ANDRIOL CAPSULE(TESTOSTERONE) 40 MG##(PVÖUo TESTOSTERONE UNDECANOATE 19.00 N N PROVIRONUM 25 MG D# MESTEROLONE 12.00 12.00 Y N TESTOVIRON DEPOT INJ # TESTOSTERONE PROPIONATE 178.00 178.00 Y N 6.5 Hypothalamic and pituitary hormones 6.5.1 Hypothalamic and anterior pituitary hormones !"#$% 1 PREGNYL 5,000 U>>..>>] ** HUMAN CHORIONIC GONADOTROPHIN 737.00 N N 6.5.2 Posterior pituitary hormones and antagonists !"#$% 1 MINIRIN (Öfhàctก) SOLUTION ] 2.5 ML (B/N)(DESMOPRESSIN DESMOPRESSIN ACETATE 1,403.00 1,403.00 Y Y MINIRIN TABLET 0.1 MG (B/N)] DESMOPRESSIN ACETATE 78.50 78.50 Y Y 6.6 Drugs affecting bone metabolism !"#$% 1 MIACALCIC 100 IU INJECTION ] [i^R¢njOUIUX[^Uk/dÑb^enCALCATONIN a (CALCITONIN) 698.00 698.00 Y Y PAMIDRONATE INJ 30 MG/10 ML (AREDIA PXRc)(D/N) ]PAMIDRONATE DISODIUM 1,381.00 1,381.00 Y Y
18 พฤศจิกายน 2561 หนา 30 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- )*+,ก!"#$%)*-."ก/-01$*23 (OกPQRก)...ACTONEL 35 MG>>..>>(C/N) ## RISEDRONATE SODIUM 365.00 365.00 N N ACLASTA 5 MG INJ 100 ML D## [-] ZOLEDRONIC ACID 17,128.00 17,128.00 N N ALENDRONATE 70 MG (ALDREN) (C/L2)...# ALENDRONATE SODIUM 58.00 58.00 Y N ARTRODAR 50 MG CAP (DIACEREIN)(B/L3)$ DIACEREIN 32.00 32.00 N N BONVIVA FCT 150 MG TAB(IBANDRONIC) (C/N) D ## IBANDRONIC ACID 1,535.00 1,535.00 N N FLEXSA SACHET 1500 MG $ GLUCOSAMINE SULFATE 12.00 0.00 N N FLEXSA 500 MG CAP(GLUCOSAMINE) $ GLUCOSAMINE SULFATE 4.50 0.00 N N FOSAMAX PLUS 70 MG (C/L2)##>> ALENDRONATE SODIUM 356.00 356.00 N N COLECALCIFEROL 356.00 356.00 N N HYALGAN INJ.(C/N) ## HYALURONIC ACID 2,362.00 0.00 N N ORTHONASE NASAL SPRAY 200 IU 30 DOSE>>.>> (MIACALCIC CALCATONIN SPRAY (CALCITONIN) 2,533.00 2,533.00 N N RISEDRONATE 35 MG TAB (ACTONELPXRc) ##(C/N) D RISEDRONATE SODIUM 213.00 213.00 N N SYNVISC INJ D ## HYALURONIC ACID 6,161.00 0.00 N N VIARTRIL-S 500 MG CAP ## GLUCOSAMINE SULFATE 13.00 0.00 N N Viartril-s CAP# 6.20 6.20 Y N VIARTRIL-S SACHE ## GLUCOSAMINE SULFATE 44.00 0.00 N N Viartril-s SACHET ## 36.80 36.80 N N ZOMETA RTU INJ (4 MG/100 ML)(D/N)$ ZOLEDRONIC ACID 13,656.00 13,656.00 N N 6.7 Other endocrine drugs 6.7.1 Bromocriptine and other dopaminergic drugs !"#$% 4 SUPLAC (BROMOCRIPTINE) 2.5 MG(B/L3)_[ BROMOCRIPTINE MESYLATE 10.00 10.00 Y Y 6.7.2 Drugs affecting gonadotrophins )*+,ก!"#$%)*-."ก/-01$*23 ECTOPAL 200 MG CAP (DANAZOL)(X/L3)# DANAZOL 26.50 26.50 Y N 7 Obstetrics, gynaecology, and urinary-tract disorde 7.1 Drugs used in obstetrics 7.1.1 Prostaglandins, prostaglandins antagonists and oxy !"#$% ก METHERGIN INJ (METHYLERGOMETRINE 0.2 MG/MLMETHYLERGOMETRINE 10.00 10.00 Y Y SYNTOCINON 10 U/ML (X/L3)INJ_ก(U) OXYTOCIN (SYNTHETIC) 19.00 19.00 Y Y !"#$% 1 NALADOR INJ ] SULPROSTONE 910.00 910.00 Y Y 7.1.2 Myometrial relaxants 7.2 Treatment of vaginal and vulval conditions !"#$% ก CANESTEN 500 MG VAG.SUPPO ก## CLOTRIMAZOLE 169.00 169.00 N N CLOTRIMAZOLE 500 MG VAG.SUPPO (COTREN)ก CLOTRIMAZOLE 18.00 18.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23
18 พฤศจิกายน 2561 หนา 31 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- FLUOMIZIN VAGINAL TABLET##D DEQUALINIUM CHLORIDE 33.00 33.00 N N 7.3 Contraceptives !"#$% ก ENAF(DMPA)150MG/3ML INJ ก MEDOXYPROGESTERONE 14.00 N Y IMPLANON NXT IMPLANT 68 MG ก(ETOPLAN PXRc) ETONOGESTREL 2,180.00 0.00 Y Y MIRENA at•R>>..>>(INTRAUTERINEcW LEVONORGESTREL LEVONORGESTEL 5,476.00 0.00 Y Y !"#$% ( MERCILON 28 TAB.(X/L2) I ** DESOGESTREL 137.00 N N ETHINYLESTRADIOL 137.00 N N )*+,ก!"#$%)*-."ก/-01$*23 SUCEE 21TAB **(X/L3)>>[rrก] CYPROTERONE ACETATE 85.00 N N ETHINYLESTRADIOL 85.00 N N YASMIN 21 TAB [^rPahr]>>..>>(X/L2) $ DROSPIRENONE 282.00 N N ETHINYLESTRADIOL 282.00 N N YAZ 24+4 Pc`X(X/L2) $ DROSPIRENONE 442.00 N N ETHINYLESTRADIOL 442.00 N N 7.4 Drugs for genito-urinary disorders 7.4.1 Drugs for benign prostatics hyperplasia !"#$% 4 4 MG* DOXAZOSIN (C/L3) [ DOXAZOSIN MESYLATE 1.50 1.50 Y Y DOXAZOSIN { MG (C/L3)[ DOXAZOSIN MESYLATE 1.00 1.00 Y Y XATRAL XL.(B/L3)D [ (ALFUZOSIN 10 MG)(##) ALFUZOSIN HCL 32.00 32.00 Y Y !"#$% 1 FINASTERIDE 5 MG [STERCIA](X/L3)D ] FINESTERIDE 5.00 5.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (OกPQRก)...HARNAL OCAS..>>*(TAMSULOSIN) 0.4 MG(BTAMSULOSIN 36.50 36.50 N N CARDURA XL 4 MG $ DOXAZOSIN MESYLATE 24.00 24.00 N N 7.4.2 Drugs for urinary frequency, enuresis, and inconti !"#$% 4 DIUTROPAN 5 MG(B/L2) [ D OXYBUTYNIN HCL 10.00 10.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 DETRUSITOL SR 4 MG CAP(C/L3) D## TOLTERODINE 62.00 62.00 N N SPASMEX 30 MG(TROSPIUM ) D## TROSPIUM CHLORIDE 17.50 17.50 N N VESICARE 5 MG D## SOLIFENAIN 52.50 52.50 N N 7.4.3 Drugs used in alkalinisation of urine !"#$% ก (hlmUda) POT. CIT 240 ML(15 ML K=9.9 MEQ CIT=9.9) ก POT.CITRATE 15.00 15.00 Y Y SCHOL SOL 240 ML ก CITRIC ACID 15.00 15.00 Y Y POT.CITRATE 15.00 15.00 Y Y SODIUM CITRATE 15.00 15.00 Y Y
18 พฤศจิกายน 2561 หนา 32 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- 8 Malignant disease and immunosuppression 8.1 Cytotoxic drugs !"#$% 1 HAD TRETINOIN 10 MG (VESANOID) ] (PVÖUo CASE) TRETINOIN 115.00 115.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 HAD CAMPTO 100 MG INJ (NP)## IRINOTECAN 3,289.00 3,289.00 N N HAD EPIRUBICIN 50 MG/25 ML## EPIRUBICIN 6,061.00 6,061.00 N N HAD IRINOTECAN 100 MG/ 5 ML(PVÖUoCASE)$ IRINOTECAN 3,592.00 3,592.00 N N NAVELBINE (VINORELBINE) 20 MG PVÖUoCASE##SMPVINORELBINE 4,534.00 4,534.00 N N NAVELBINE 30 MG (VINORELBINE) PVÖUoCASE##SMPVINORELBINE 6,712.00 6,712.00 N N TEMOZOLOMIDE 100 MG CAP [^](TEMODAL)PVÖUoCASE TEMOZOLOMIDE 7,265.00 7,265.00 N N TEMOZOLOMIDE 20 MG CAP [^](TEMODAL)PVÖUoCASETEMOZOLOMIDE 1,545.00 1,545.00 N N TS ONE CAP 25 MG PVÖUoCASE (SMP)$ GIMERACIL 374.00 374.00 N N OTERACIL POTASSIUM 374.00 374.00 N N TEGAFUR 374.00 374.00 N N 8.1.1 Alkylating drugs !"#$% 4 HAD ENDOXAN 50 MG (CYCLOPHOSPHAMIDE)TAB_CYCLOPHOSPHAMIDE 9.50 9.50 Y Y HAD ENDOXAN INJ 1 GM [(P) CYCLOPHOSPHAMIDE 503.00 503.00 Y Y HAD MYLERAN 2 MG (BUSULPHAN) TAB [ BUSULPHAN 10.00 10.00 Y Y HAD ALKERAN (MELPHALAN)(IUkกQcA) 2 MG TAB [MELPHALAN 103.00 103.00 Y Y HAD LEUKERAN (CHLORAMBUCIL)(hlmU•UQกQc) 2 MGCHLORAMBUCIL TAB 17.50 17.50 Y Y !"#$% 1 HAD IFOSFAMIDE 1000 MG ](P) IFOSFAMIDE 1,497.00 1,497.00 Y Y HAD IFOSFAMIDE 500 MG ](P) IFOSFAMIDE 774.00 774.00 Y Y 8.1.2 Cytotoxic antibiotics !"#$% 4 COSMEGEN 0.5 MG INJ (DACTINOMYCIN) [(P) ACTINOMYCIN-D (DACTINOMYCIN) 908.00 908.00 Y Y HAD BLEOMYCIN 15 MG [(P) BLEOMYCIN 1,381.00 1,381.00 Y Y HAD DOXORUBICIN 50 MG/25ML (ADRIAMYCIN)_ [_DOXORUBICIN HCL 483.00 483.00 Y Y LIPO-DOX [^] 20 MG/10 ML [(NP)## DOXORUBICIN HCL 19,861.00 19,861.00 N N !"#$% 1 HAD IDARUBICIN 10 MG INJ ](NP) IDARUBICIN 8,665.00 8,665.00 Y Y MITOMYCIN C 2 MG INJ ](P) MITOMYCIN C 351.00 351.00 Y Y MITOXANTRONE 10 MG INJECTION ] MITOXANTRONE 4,640.00 4,640.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 HAD PHARMORUBICIN (EPIRUBICIN) 200 MG## EPIRUBICIN 10,317.00 10,317.00 N N 8.1.3 Antimetabolites !"#$% 4 HAD CYTARABINE 1 G/10 ML*HD (SOLUTION) (NP) [CYTARABINE 1,238.00 1,238.00 Y Y
18 พฤศจิกายน 2561 หนา 33 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- HAD CYTARABINE 100 MG/1 ML (SOLUTION) (NP) [ CYTARABINE 135.00 135.00 Y Y HAD CYTOSAR 100 MG/5 ML* CS(SOLUTION) (NP) [ CYTARABINE 260.00 260.00 Y Y HAD FLUOROURACIL (5-FU) 1 G (P)_[ FLUORO-URACIL 138.00 138.00 Y Y HAD METHOTREXATE 1 GM/10ML INJ [(P)(X/L5) METHOTREXATE 1,161.00 1,161.00 Y Y HAD METHOTREXATE 2.5 MG TAB [(X/L5) METHOTREXATE 8.00 8.00 Y Y HAD METHOTREXATE 50MG/2ML INJ (P)_[(X/L5) METHOTREXATE 264.00 264.00 Y Y HAD PURINETHOL(MERCAPTOPURINE) 50 MG TAB. MERCAPTOPURINE 43.00 43.00 Y Y HAD CYTOSAR 2000 MG/20 ML CS>>..>>(SOLUTION) (CYTARABINE 3,828.00 3,828.00 Y Y !"#$% 1 (XELODA PXRc) CAPECITABINE 500 MG [INTACAPE] ] CAPECITABINE 101.00 101.00 N N HAD THIOGUANINE 40 MG (6 TG)[OUกmUÖ^bU] ] THIOGUANINE 93.00 93.00 Y Y UFUR CAP(TEGAFUR-URACIL) ] TEGAFUR 69.00 69.00 Y Y URACIL 69.00 69.00 Y Y XELODA 500 MG>>..>>(CAPECITABINE)(P)..] CAPECITABINE 171.00 171.00 N N )*+,ก!"#$%)*-."ก/-01$*23 HAD ALIMTA 100 MG INJ >>..>>##(PEMETREXED DI PEMETREXED DISODIUM 10,863.00 10,863.00 N N HAD ALIMTA 500 MG INJ >>..>>##(PEMETREXED DI PEMETREXED DISODIUM 45,964.00 45,964.00 N N 8.1.4 Vinca alkaloids and etoposide !"#$% ก HAD VINBLASTIN 10 MG [(P)[OUกmUÖ^bU] VINBLASTIN 466.00 466.00 Y Y !"#$% 4 HAD ETOPOSIDE 100 MG/ 5 ML (P) [ ETOPOSIDE 258.00 258.00 Y Y HAD VINCRISTIN 1 MG/1 ML INJ (P)_[ VINCRISTINE SULFATE 173.00 173.00 Y Y HAD VINCRISTIN 2 MG INJ (P)_[ VINCRISTINE SULFATE 276.00 276.00 Y Y 8.1.5 Other antineoplastic drugs !"#$% 4 HAD ASPARAGINASE 10000 IU (LEUNASE) [(NP)_[ ASPARAGINASE 1,904.00 1,904.00 Y Y HAD CISPLATIN 50 MG/ 50 ML (P)_[ CISPLATIN 402.00 402.00 Y Y HAD CISPLATIN 50 MG/100 ML (P)_[ CISPLATIN 442.00 442.00 Y Y HAD CARBOPLATIN 150 MG/15 ML (P)_[ CARBOPLATIN 381.00 381.00 Y Y HAD CARBOPLATIN 450 MG/45 ML (P)_[ CARBOPLATIN 1,103.00 1,103.00 Y Y HYDREA 500 MG (w[áqtQ-ÑcÖt*PIWOk) [(D/L5) HYDROXYUREA 32.00 32.00 Y Y !"#$% 1 HAD DACARBAZINE 100 MG ]$ DACARBAZINE 1,503.00 1,503.00 N N HAD DACARBAZINE 500 MG ]$ DACARBAZINE 7,271.00 7,271.00 N N HAD OXALIPATIN [150** MG/30 ML] INJ ] D (NP)$ 4,168.00 4,168.00 N N HAD OXALIPATIN 50 MG/10 ML>>..>> INJ ] D (NP)## OXALIPATIN 9,961.00 9,961.00 N N HADáกa,in•^jr] OXALIPATIN 100 MG/20 ML INJ ] D OXALIPATIN 6,653.00 6,653.00 Y Y PACLITAXEL 300 MG/50 ML + SET.(INTAXEL)] PACLITAXEL 2,415.00 2,415.00 Y Y áกa,in•^jr] HAD OXALIPATIN 50 MG/10 ML INJ ] D OXALIPATIN 3,357.00 3,357.00 Y Y
18 พฤศจิกายน 2561 หนา 34 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- !"#$% 5 (ÑmU^oP]Rh/àfUO•^]/•fU]XbUk) AVASTIN [1.25 MG/SYRINGE*]BEVACIZUMAB 750.00 750.00 N N (OกPQRก)...GLIVEC FCT 400 MG à ÑmU^oP]Rh(IMATINIB)(OCPA IMATINIB 4,087.00 4,087.00 N N AVASTIN 100 MG/4ML INJ [aáaÑ/aáa]*(BEVACIZUMAB BEVACIZUMAB 0.00 Y Y AVASTIN 100 MG/4ML INJ..à2(BEVACIZUMAB)(OCPABEVACIZUMAB 20,070.00 20,070.00 Y Y DOCETAXEL 20 MG INJ>>..>>[^](TAXOTERE)à(2)_(P)##SMP docetaxel 9,754.00 9,754.00 N N DOCETAXEL 80 MG INJ>>..>>[^](TAXOTERE)à(2)_(P)##SMP docetaxel 34,371.00 34,371.00 N N GLIVEC FCT 100 MG à ÑmU^oP]Rh(IMATINIB)$(PVÖUoCASE 1,064.00 1,064.00 N N HERCEPTIN 150 MG..à2 (TRASTUZUMAB)aáaÑ/áกa (TRASTUZUMAP 0.00 Y Y HERCEPTIN 440 MG..à2 (TRASTUZUMAB)aáaÑ/áกa (TRASTUZUMAP 0.00 Y Y TASIGNA 200 MG CAP (NILOTINIB) à2 in•^jr]/áกa. NILOTINIB 0.00 Y N TASIGNA 200 MG CAP (NILOTINIB) à2(ÑnÜk[^Uk/áกa.)(OCPA NILOTINIB 867.00 867.00 N N )*+,ก!"#$%)*-."ก/-01$*23 AFINITOR 10 MG TAB (EVEROLIMUS)[PVÖUoCASE]D$ EVEROLIMUS 5,555.00 5,555.00 N N AVASTIN [RPAP]100 MG/4ML INJ (BEVACIZUMAB)OUi^RBEVACIZUMAB àU[ 0.00 N N ERBITUX 5 MG/ML (100 MG/20 ML)* (CETUXIMAB) [PVÖUo CETUXIMAB 10,731.00 10,731.00 N N HERCEPTIN 150 MG..(TRASTUZUMAB)PVÖUo CASE (OCPATRASTUZUMAP 16,937.00 16,937.00 N N HERCEPTIN 440 MG..(TRASTUZUMAB)PVÖUoCASE (OCPA TRASTUZUMAP 49,561.00 49,561.00 N N NEXAVAR (SORAFENIB) 200 MG TAB (PVÖUo CASE)## 1,593.00 0.00 N N PERJETA 420 MG/14 ML (PERTUZUMAB)PVÖUoCASE##SMPPERTUZUMAB 109,993.00109,993.00 N N STIVARGA 40 MG TAB (REGORAFENIB)(OUPVÖUoCASEREGORAFENIB 2,282.00 2,282.00 N N TARCEVA FCT 100 MG (ERLOTINIB) PVÖUoCASE ERLOTINIB 2,242.00 2,242.00 N N TARCEVA FCT 150 MG (ERLOTINIB) PVÖUoCASE ERLOTINIB 2,242.00 2,242.00 N N ~[^]กU^ RPAP HERCEPTIN 440 MG PVÖUoCASE [w´c]## 0.00 0.00 N N 8.2 Drugs affecting the immune response !"#$% 4 AZATHIOPRINE 50 MG TAB [ AZATHIOPRINE 9.00 9.00 Y Y SANDIMMUN NEORAL 100 MG(CICLOSPORIN) [ D TAB CICLOSPORIN 180.00 180.00 Y Y !"#$% 1 (CELLCEPT PXRc) MYCOPHENOLATE MOFETIL 250 MGMYCOPHENOLATE MOFETIL 23.00 23.00 Y Y BCG MEDAC (IMMUCYST INJ PXRc) ] FREEZE DRIED BCG 6,535.00 6,535.00 Y Y CELLCEPT 250 MG>>..>>] D# MYCOPHENOLATE MOFETIL 63.00 63.00 Y Y !"#$% 5 2.5 GM IVIG in•^jr]/áกa. (5% W/V 50 ML IMMUNOGLOBULIN HUMAN IMMUNOGLOBULIN 0.00 N Y INTRAGLOBIN-F 5 GM/100 ML à[IVIG]* (GAMMARAASHUMAN IMMUNOGLOBULIN 9,411.00 9,411.00 Y Y INTRAGLOBIN-F 5 GM/100 ML(PJ) à(2) in•^jr]/áกa. HUMAN IMMUNOGLOBULIN 0.00 N Y 8.3 Sex hormones and hormone antagonists in malignant )*+,ก!"#$%)*-."ก/-01$*23 ZYTIGA 250 MG TAB(ABIRATERONE)(PVÖUo CASE)##SMP ABIRATERONE ACETATE 750.00 0.00 N N 8.3.1 Progestogens, anti-estrogens and enzyme inhibitors
18 พฤศจิกายน 2561 หนา 35 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- !"#$% 4 TAMOXIFEN 20MG TAB ( D/L3)(P) [ TAMOXIFEN 5.00 5.00 Y Y !"#$% 5 FEMARA 2.5 MG D (P) à(2) LETROZOLE 37.00 37.00 Y Y LETROZOLE (dÑbdh sá.in•^jr]/áกa) 2.5 MG D à(2) LETROZOLE 0.00 N Y )*+,ก!"#$%)*-."ก/-01$*23 ARIMIDEX 1 MG TABLET(ANASTROZOLE)$ ANASTROZOLE 49.00 49.00 N N FASLODEX 250MG/5ML (FULVESTRANT)(PVÖUoCASE)FULVESTRANT 14,981.00 14,981.00 N N MEGESTROL 160 MG(MEGAPLEX,MEGACE) (P)] MEGESTROL ACETATE 128.00 128.00 N N 8.3.2 PROSTATE CANCER !"#$% 1 FLUTAMIDE 250 MG TAB D ] 44.00 44.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 CASODEX 150 MG (BICALUTAMIDE) PVÖUo CASE## BICALUTAMIDE 750.00 750.00 N N XTANDI 40 MG (ENZALUTAMIDE) PVÖUo CASE$ 1,197.00 N N 9 Nutrition and blood 9.1 Whole blood, blood product and drugs used in some !"#$% 5 HEMOPHIL-M 250 U INJ (FACTOR VIII)à 3,345.00 3,345.00 Y N HEMOPHIL-M 500 U INJ (FACTOR VIII)[HAEMOCTIN]( 6,221.00 6,221.00 Y N IMMUNINE 600 IU INJ [FACTOR IX](PVÖUoCASE) à (2) 6,994.00 6,994.00 Y N 9.1.1 Whole blood and blood products 9.1.2 Drugs used in hypoplastic, hemolytic and renal an !"#$% ก FOLIC ACID (554) ก FOLIC ACID 1.00 1.00 Y Y !"#$% ( ANDROLIC(OXYMETHOLONE) 50 MG I OXYMETHOLONE 25.00 25.00 Y Y !"#$% 4 GPO L-1 (DEFERIPRONE) 500 MG TAB V [ DEFERIPRONE 5.00 5.00 Y Y !"#$% 5 DEFERASIROX 250 MG (EXJADE) à(2) DEFERASIROX 156.00 156.00 Y Y EPREX 4000 U INJ (C/N) D à(2) $ RECOMBINANT HUMAN ERYTHROPOIET 1,630.00 1,630.00 N N HYPERCRIT 4000 U (PJ)(~[^]กU^ CAPD aáaÑ) à 2 RECOMBINANT HUMAN ERYTHROPOIET 0.00 N Y HYPERCRIT 4000 U INJ(HEMAXPXRc) D à(2)# RECOMBINANT HUMAN ERYTHROPOIET 404.00 404.00 Y N RECORMON 5000 U D..à(2) $ RECOMBINANT HUMAN ERYTHROPOIET 1,634.00 1,634.00 N N )*+,ก!"#$%)*-."ก/-01$*23 MIR_CERA (EPOETIN BETA 75 MCG/0.3ML) D ## EPOETIN BETA 6,006.00 6,006.00 N N 9.1.3 Drugs used in bone marrow transplantation !"#$% 1 NEUTROMAX 300 MCG INJ (FILGRASTIM)(C/L2)] FILGRASTIM(G-CSF) 1,161.00 1,161.00 Y Y
18 พฤศจิกายน 2561 หนา 36 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- 9.2 Fluids and eletrolytes !"#$% DIANEAL HIGHDOSE 1.5% DEXT/LOW CAL 5L(PVÖUoCASE 969.00 969.00 N N F2 - A # CALCIUM CHLORIDE 148.00 148.00 Y N Glacial acetic acid 148.00 148.00 Y N MAGNESIUM CHLORIDE 148.00 148.00 Y N POTASSIUM CHLORIDE 148.00 148.00 Y N SODIUM CHLORIDE 148.00 148.00 Y N F2 - A (LOW CALCIUM 2.5) (K3) # 148.00 148.00 Y N F2 - A K3 # CALCIUM CHLORIDE 132.00 132.00 Y N Glacial acetic acid 132.00 132.00 Y N MAGNESIUM CHLORIDE 132.00 132.00 Y N POTASSIUM CHLORIDE 132.00 132.00 Y N SODIUM CHLORIDE 132.00 132.00 Y N F2 - B # SODIUM CHLORIDE 88.00 88.00 Y N F2-A Low Cal 2.5 # 138.00 138.00 Y N STERILE DISTILLED WATER 1,000 CC -UPกQWOk 36.00 36.00 Y Y !"#$% ก D 10 N/2 1000 ML ก 41.00 41.00 Y Y D 10 N/5 500 ML ก 36.00 36.00 Y Y D 10 S 1000 ML ก 43.00 43.00 Y Y D 10 W 1000 ML ก 41.00 41.00 Y Y D 10 W 500 ML ก 37.00 37.00 Y Y D 5 N/2 500 ML ก 33.00 33.00 Y Y D 5 N/2* 1000 ML (339)ก 40.00 40.00 Y Y D 5 N/3 500 ML ก 33.00 33.00 Y Y D 5 N/4 500 ML ก 33.00 33.00 Y Y D 5 N/5 500 ML (amU^r]hbrO*)ก 33.00 33.00 Y Y D 5 S 1000 ML ก 40.00 40.00 Y Y D 5 W 100 ML ก 21.00 21.00 Y Y D 5 W 1000 ML ก 40.00 40.00 Y Y D 5 W 500 ML ก 33.00 33.00 Y Y D5W 250 ML ก (250 ML dhIkX 500 ML)[P[cWimUinXPXRc] 35.00 35.00 Y Y DEXTROSE 50% 50 ML ก(U) DEXTROSE 22.00 22.00 Y Y HAD KCL INJ (20 MEQ/10 ML) OUVWX* ก POTASSIUM CHLORIDE 10.00 10.00 Y Y KCL 500 MG (OUPc`X)(6.67 MEQ) TAB ก POTASSIUM CHLORIDE 1.50 1.50 Y Y KCL ELIXIR( 20 MEQ/15 ML) 240 ML ก POTASSIUM CHLORIDE 61.00 61.00 Y Y KCL(POT CHLORIDE 20 MEQ/15 ML) 60ML ก POTASSIUM CHLORIDE 19.00 19.00 Y Y LACTATED RINGER 1000 ML ก CALCIUM CHLORIDE 53.00 53.00 Y Y POTASSIUM CHLORIDE 53.00 53.00 Y Y
18 พฤศจิกายน 2561 หนา 37 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- LACTATED RINGER 1000 ML ก SODIUM CHLORIDE 53.00 53.00 Y Y SODIUM LACTATE 53.00 53.00 Y Y NSS (IV)* 1000 ML (954)ก SODIUM CHLORIDE 39.00 39.00 Y Y NSS 100 ML QbU]àctก/•U ก SODIUM CHLORIDE 31.00 31.00 Y Y NSS 1000 ML [dÑbÆUOhrกIkXกQc] ก SODIUM CHLORIDE 36.00 36.00 Y Y NSS 2000 ML [â•PjWOc,OR,OUdh] ก SODIUM CHLORIDE 71.00 71.00 Y Y NSS 250 ML ก (P[cWimUinX) 34.00 34.00 Y Y NSS 3 ML ก (U) SODIUM CHLORIDE 6.00 6.00 Y Y NSS 3000 ML [OR,5/3a] ก SODIUM CHLORIDE 117.00 117.00 Y Y NSS(IV) 500 ML ก SODIUM CHLORIDE 33.00 33.00 Y Y NSS* 100 ML (955)ก SODIUM CHLORIDE 16.00 16.00 Y Y NSS/2 (0.45%) 1000 CC ก SODIUM CHLORIDE 39.00 39.00 Y Y PERITONEAL SOL 1000 ML ก CALCIUM CHLORIDE 61.00 61.00 Y Y DEXTROSE 61.00 61.00 Y Y MAGNESIUM CHLORIDE 61.00 61.00 Y Y SODIUM CHLORIDE 61.00 61.00 Y Y SOD.BICARB 7.5 % 10 ML ก SODIUM BICARB 14.00 14.00 Y Y SOD.BICARB 7.5% 50 ML ก(U) SODIUM BICARB 28.00 28.00 Y Y SOD.CHLORIDE 3% 500 ML ก SODIUM CHLORIDE 42.00 42.00 Y Y SODAMINT (NAHCO3) TAB 300 MG(1225)ก SODIUM BICARB 0.50 0.50 Y Y STERILE WATER (IV) 1000 CCก STERILE WATER FOR INJECTION 36.00 36.00 Y Y STERILE WATER 10 ML ก STERILE WATER FOR INJECTION 6.00 6.00 Y Y STERILE WATER 100 CC ก STERILE WATER FOR INJECTION 21.00 21.00 Y Y STERILE WATER 5 ML ก STERILE WATER FOR INJECTION 6.00 6.00 Y Y !"#$% ( KALIMATE qr]Qo 5 GM I(U) CALCIUM POLYSTYRENE SULFONATE 22.00 22.00 Y Y !"#$% 4 DIANEAL PD-2 TB 1.5% 2 LIT [ 154.00 154.00 Y Y DIANEAL PD-2 TB 2.5% 2 LIT [ 154.00 154.00 Y Y DIANEAL PD-2 TB 4.25% 2 LIT [ 154.00 154.00 Y Y DIANEAL PD-4 TB 1.5% 2 LIT [ 218.00 218.00 Y Y DIANEAL PD-4 TB 2.5% 2 LIT [ 218.00 218.00 Y Y DIANEAL PD-4 TB 4.25% 2 LIT [ 218.00 218.00 Y Y GE-2 600 ML [ CALCIUM 178.00 178.00 Y Y GLUCOSE 178.00 178.00 Y Y MAGNESIUM 178.00 178.00 Y Y POTASIUM 178.00 178.00 Y Y SODIUM 178.00 178.00 Y Y ZINC 178.00 178.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23
18 พฤศจิกายน 2561 หนา 38 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- ACETAR (ARI) 1000 ML [ACETATED RINGER'S INJ] CALCIUM CHLORIDE 54.00 54.00 Y Y POTASSIUM CHLORIDE 54.00 54.00 Y Y SODIUM ACETATE 54.00 54.00 Y Y SODIUM CHLORIDE 54.00 54.00 Y Y ACETAR-5 1000 ML CALCIUM CHLORIDE 60.00 60.00 Y Y DEXTROSE 60.00 60.00 Y Y POTASSIUM CHLORIDE 60.00 60.00 Y Y SODIUM ACETATE 60.00 60.00 Y Y SODIUM CHLORIDE 60.00 60.00 Y Y ALBUMIN 20 % 50 ML...# HUMAN ALBUMIN 1,201.00 1,201.00 Y N DEXTRAN 40# DEXTRAN 40 500.00 500.00 Y N GLUCOLYTE-2 # GLUCOSE 54.00 54.00 Y N MAGNESIUM SULFATE 54.00 54.00 Y N MONOPOTASIUM PHOSPHATE 54.00 54.00 Y N POTASSIUM CHLORIDE 54.00 54.00 Y N SODIUM ACETATE 54.00 54.00 Y N SODIUM CHLORIDE 54.00 54.00 Y N ZINC SULFATE 54.00 54.00 Y N GLYCEROSTERIL 10% 500ML# GLYCEROL 344.00 344.00 Y N HAEMACEL 500 CC# POLYGELINE 331.00 331.00 Y N SOD.CITRATE 0.3 M SOL.(OUP•^WOc)## SODIUM CITRATE 53.00 53.00 N N VOLUVEN 6% 500 ML# 490.00 490.00 Y N 9.3 Vitamins !"#$% ก (OกPQRก)...KONAKION PX`ก 1 MG/0.5 ML>>..>> INJ (C/L1) VITAMIN K1 (PHYTOMENADIONE) 27.00 27.00 Y Y (OกPQRก)...VIT K (KONAKIAN) 10 MG INJ>>..>>(C/L1) ก( VITAMIN K1 (PHYTOMENADIONE) 6.00 6.00 Y Y **[GPO wàb]OUIUX[^Uk]**_TRIFERDINE 150 ( I+FE+FOLIC FERROUS FUMARAT 1.50 1.50 N Y FOLIC ACID 1.50 1.50 N Y IODINE 1.50 1.50 N Y MTV SYR 60 ML (SYNOVITS) ก FOLIC ACID 19.00 19.00 Y Y NICOTINIC ACID 19.00 19.00 Y Y VITAMIN A (RETINOL) 19.00 19.00 Y Y VITAMIN B1 (THIAMINE) 19.00 19.00 Y Y VITAMIN B12 (CYANOCOBALAMIN) 19.00 19.00 Y Y VITAMIN B2 (RIBOFLAVIN) 19.00 19.00 Y Y VITAMIN C (ASCORBIC ACID) 19.00 19.00 Y Y VITAMIN D 19.00 19.00 Y Y VITAMIN E 19.00 19.00 Y Y VIT A 25000 U CAP ก VITAMIN A (RETINOL) 1.00 1.00 Y Y VIT K1*[PHYTOMENADIONE] 10 MG INJ(KONAKIAN VITAMIN K1 (PHYTOMENADIONE) 17.00 17.00 Y Y
18 พฤศจิกายน 2561 หนา 39 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- VITAMIN D2 (20000 U) CALCIFEROL CAP_ ก_ CALCIFEROL 3.00 3.00 Y Y VITB ("iW") CO TAB (aWabc) (1474) ก NICOTINIC ACID 1.00 1.00 Y Y VITAMIN B1 (THIAMINE) 1.00 1.00 Y Y VITAMIN B2 (RIBOFLAVIN) 1.00 1.00 Y Y VITAMIN B6 (PYRIDOXINE) 1.00 1.00 Y Y VITB1 100 MG TAB (1475)_ก VITAMIN B1 (THIAMINE) 1.00 1.00 Y Y VITB1 INJ OUVWX (100 MG/ML) ก(U) VITAMIN B1 (THIAMINE) 5.00 5.00 Y Y VITB2 100 MG TAB ก VITAMIN B2 (RIBOFLAVIN) 1.50 1.50 Y Y VITB6 TAB 50 MG (1479) ก VITAMIN B6 (PYRIDOXINE) 1.00 1.00 Y Y VITC 100 MG TAB (1480) ก VITAMIN C (ASCORBIC ACID) 1.00 1.00 Y Y kR•UcRhiW ê{ (VITB12) TAB 100 MCG ก VITAMIN B12 (CYANOCOBALAMIN) 1.00 1.00 Y Y !"#$% ( VITB [iW] COMPLEX INJ [VWX] 1 ML** I NICOTINIC ACID 8.00 8.00 Y Y VITAMIN B1 (THIAMINE) 8.00 8.00 Y Y VITAMIN B2 (RIBOFLAVIN) 8.00 8.00 Y Y VITAMIN B6 (PYRIDOXINE) 8.00 8.00 Y Y VITC INJ 500 MG I VITAMIN C (ASCORBIC ACID) 6.00 6.00 Y Y !"#$% 4 VIT D3 (0.25 MCG**) [ALFACALCIDOL] [ ALFACALCIDOL 4.50 4.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 CENTRUM TAB ## MINERAL 5.50 N N MULTIVITAMIN 5.50 N N COD-LIVER-OIL>>..>> (VIT A+D) VITAMIN A (RETINOL) 1.50 N N VITAMIN D 1.50 N N MTV TAB (889) V## MULTIVITAMIN 0.50 N N NEUROBION TAB (3237) $ VITAMIN B1 (THIAMINE) 4.50 N N VITAMIN B12 (CYANOCOBALAMIN) 4.50 N N VITAMIN B6 (PYRIDOXINE) 4.50 N N OBIMIN AZ (3136) ## MULTIMINERAL 3.00 N N MULTIVITAMIN 3.00 N N OMVI INJ# MULTIVITAMIN 201.00 201.00 Y N VITALUX PLUS D$ ASCORBIC ACID 15.50 N N BETA-CAROTENE 15.50 N N CU 15.50 N N LUTEIN 15.50 N N RIBOFLAVIN 15.50 N N SELENIUM SULFIDE 15.50 N N VITAMIN E 15.50 N N ZINC GLUCONATE 15.50 N N VITARAL TAB(1486)_## MULTIVITAMIN 2.00 N N
18 พฤศจิกายน 2561 หนา 40 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- VITB 1-6-12 TAB(1472) # VITAMIN B1 (THIAMINE) 1.00 Y N VITAMIN B12 (CYANOCOBALAMIN) 1.00 Y N VITAMIN B6 (PYRIDOXINE) 1.00 Y N VITE 100 U CAP** VITAMIN E 2.00 N N Z-BEC TAB $ MULTIVITAMIN 5.00 N N 9.4 Intravenous nutrition !"#$% 4 AMINOLEBAN 8 % [ AMINO ACIDS 360.00 360.00 Y Y AMINOVEN INFANT 10% 100 ML [ AMINO ACIDS 280.00 280.00 Y Y AMIPAREN 500 ML 10 % [ AMINO ACIDS 360.00 360.00 Y Y CLINOLEIC 20% 100 ML [>> 381.00 381.00 Y Y CLINOLEIC 20% 250 ML [ CLINOLEIC 504.00 504.00 Y Y INTRALIPID 20 % 250 ML(AD) PVÖUokRanuuW [ SOYBEAN OIL 504.00 504.00 Y Y KIDMIN 200 ML INJ. [# AMINO ACIDS 218.00 218.00 Y N LIPOFUNDIN MCT/LCT 20% 100 ML [[^rPahr] 428.00 428.00 Y Y VAMINOLACT 6.5 % 100 ML [ (^rPahrrrก) AMINO ACIDS 280.00 280.00 Y Y TAURINE 280.00 280.00 Y Y !"#$% 1 (OกPQRก)...KABIVEN 1400 ] SOYBEAN OIL 1,827.00 1,827.00 Y Y (OกPQRก)...KABIVEN 1900 ] NUTRITIONALLY COMPLETE DIET 1,915.00 1,915.00 Y Y OLICLINOMEL N4-550 2 LIT ] GLUCOSE 1,945.00 1,945.00 Y Y LIPID AMINO ACID 1,945.00 1,945.00 Y Y OLICLINOMEL N7 1.5 LIT(PVÖUoCASE) ] GLUCOSE 2,062.00 2,062.00 Y Y LIPID AMINO ACID 2,062.00 2,062.00 Y Y OLICLINOMEL N7-1000 2 LIT ] GLUCOSE 2,062.00 2,062.00 Y Y LIPID AMINO ACID 2,062.00 2,062.00 Y Y SMOFKABIVEN 1600 ] 1477ML (SMP) D 2,121.00 2,121.00 Y Y SMOFKABIVEN PERIPHERAL 1300 ] 1904ML (SMP) D 1,827.00 1,827.00 Y Y SMOFLIPID 20% 100 ML ](SMP) D 442.00 442.00 Y Y 9.5 Minerals !"#$% ก (1000 MG) CAL.CARBONATE (ws]PeQèr]) ก CALCIUM CARBONATE 1.00 1.00 Y Y (OกPQRก)...FER-IN-SOL DROP>>..>>(FERROUS SULPHATEFERROUS SULFATE 49.00 49.00 Y Y CAL.CARBONATE 600 MG (2010)ก CALCIUM CARBONATE 1.00 1.00 Y Y CALTAB-êxyy MG (CAL.CARBONATE)ก CALCIUM CARBONATE 1.50 1.50 Y Y FERROUS SULFATE TAB ก FERROUS SULFATE 0.50 0.50 Y Y FLUORIDE 0.25 MG TAB ก SOD.FLUORIDE 0.50 0.50 Y Y HAD 10% MGSO4 INJ [1AMP=10 ML=1GM](B/L1) ก(U) MAGNESIUM SULFATE 10.00 10.00 Y Y HAD 50% MGSO4 INJ [1AMP=2 ML=1GM](B/L1) ก(U) MAGNESIUM SULFATE 10.00 10.00 Y Y IODINE 0.15 MG TAB>>..>> (AS POTASSIUM IODIDE 0IODINE 1.00 1.00 Y Y
18 พฤศจิกายน 2561 หนา 41 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- ZINC 25 MG TAB ก ZINC 1.50 1.50 Y Y ZINC SUSPENSION (10 MG./ML.) 10 ML ก ZINC 50.00 50.00 Y Y PกQèr NACL (SOD.CHLORIDE ãyy cก)(5 MEQ)TAB ก SODIUM CHLORIDE 1.00 1.00 Y Y !"#$% ( EUROFER-IRON SYRUP 60 ML I IRON (3) HYDROXIDE POLYMALTOSE 60.00 60.00 Y Y !"#$% 4 ADDAMEL N INJ [ MINERAL 310.00 310.00 Y Y DIPOTASSIUM PHOSPHATE 20 ML INJ(=20 MEQ) [ DIBASIC POTASSIUM PHOSPHATE 73.00 73.00 Y Y FE BACK INJ 2%(20 MG/ML)[VENOFERPXRc] [ D IRON SUCROSE 276.00 276.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 AMIYU GRANULE 2.5GM/qr]## AMINO ACIDS 44.00 44.00 N N CDR ORANGE eQrXQo## CALCIUM CARBONATE 137.00 N N VITAMIN B6 (PYRIDOXINE) 137.00 N N VITAMIN C (ASCORBIC ACID) 137.00 N N VITAMIN D 137.00 N N CHELATED ZINC TAB (ûU•p ZINC 15 MG) $ ZINC AMINO ACID CHELATED 4.00 N N FERLI-6 (520) FERROUS FUMARAT 1.00 N N MULTIVITAMIN 1.00 N N KAL-CEE ORANGE(2133) ## CALCIUM CARBONATE 50.00 N N CITRIC ACID 50.00 N N VITAMIN B6 (PYRIDOXINE) 50.00 N N VITAMIN C (ASCORBIC ACID) 50.00 N N VITAMIN D 50.00 N N MAGNESIUM OXIDE 140 MG/CAP##[EQ.84.5 MG OF MAGNESIUM OXIDE 2.50 2.50 N N PEDITRACE INJ# TRACE ELEMENTS 258.00 258.00 Y N 10 Musculoskeletal and joint diseases 10.1 Drugs used in rheumatic diseases and gout 10.1.1 Non-steroidal anti-inflammatory drugs !"#$% ก (325 MG) ASPIRIN GR.5(C/L3)(1850)_ก(U) ASPIRIN 1.50 1.50 Y Y ASPENT (ASPIRIN 300 MG) (108) ก ASPIRIN 1.00 1.00 Y Y ASPIRIN 81 MG : (C/L3)(109) ก ASPIRIN 1.00 1.00 Y Y DICLOFENAC 25 MG TAB (B/D3/L2)(1492)_ก DICLOFENAC 1.00 1.00 Y Y DICLOFENAC INJ (B/D3/L2)(2844) ก(U) DICLOFENAC 5.00 5.00 Y Y IBUPROFEN 200 MG TAB (201)_(B/D/L1) ก IBUPROFEN 1.50 1.50 Y Y IBUPROFEN SYR 60 ML (B/D/L1) ก IBUPROFEN 13.00 13.00 Y Y INDOMETHACIN 25 MG CAP_ (B/D/L2) ก INDOMETHACIN 1.00 1.00 Y Y NAPROXEN 250 MG TAB ก (B/D/L2) NAPROXEN 2.00 2.00 Y Y !"#$% ( PIROXICAM 10 MG CAP(C/D/L2) I PIROXICAM 1.00 1.00 Y Y
18 พฤศจิกายน 2561 หนา 42 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- )*+,ก!"#$%)*-."ก/-01$*23 (400 MG) CELEBREX (C/D(3RD)/L3)$D CELECOXIB 40.00 40.00 N N (60 MG) ARCOXIA [*eกaRi*](ETORICOXIB) D$ ETORICOXIB 36.00 36.00 N N ARCOXIA 90 MG (ETORICOXIB) D$ ETORICOXIB 38.00 38.00 N N BANGKOK GEL (CAPSIKA GEL) _## CAPSICUM 67.00 N N CELEBREX 200 MG (2030) (C/D(3RD)/L3)$ CELECOXIB 22.00 22.00 N N CLINORIL 200 MG( B/D/L3 ) ## SULINDAC 9.50 9.50 N N DIFELENE GEL 30 GM (1673)V DICLOFENAC 22.00 N N DYNASTAT 40 MG INJ ##SMP PARECOXIB SODIUM 246.00 246.00 N N KETOLAC 30 MG INJ(C/D/L2) ##SMP KETOROLAC TROMETHAMINE 196.00 196.00 N N LOXOPROFEN 60 MG(JAPROLOX) D_$(N/N) LOXOPROFEN 8.00 8.00 N N MEFENAMIC ACID 250 MG CAP (C/D/L2)# MEFENAMIC ACID 1.50 1.50 Y N MELOXICAM 7.5 MG TAB(C/D/L2) # MELOXICAM 3.00 3.00 Y N MOBIC 7.5 MG TAB(C/D/L2) $ MELOXICAM 14.00 14.00 N N UNIREN SPRAY ** DICLOFENAC 98.00 N N 10.1.2 Disease-modifying antirhumatic drugs (DMADs) !"#$% ก SULFADIAZINE 500 MG TAB_ ก SULFADIAZINE 2.00 2.00 Y Y !"#$% ( [PLAQUENIL*PXRc 200 MG] HYDROXYCHLOROQUINE HYDROXYCHLOROQUINE SULFATE 7.00 7.00 Y Y PLAQUENIL 200 MG TAB>>..>>(C/L2) I HYDROXYCHLOROQUINE SULFATE 20.50 20.50 Y Y !"#$% 4 [^rPahrrrก] PENICILLAMINE 250 MG (D/L3) CAP [ PENICILLAMINE 19.00 19.00 Y Y SALAZOPYRIN EN-TABS ( B/D/L3)500 MG [ SULFASALAZINE 8.50 8.50 Y Y !"#$% 1 ARAVA 20 MG ] (X/L3) D ] LEFLUNOMIDE 68.00 68.00 Y Y MYOCRISINE 20 MG INJ ] D SOD AUROTHIOMALATE 233.00 233.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 ENBREL INJ 25 MG (B/L2)## ETANERCEPT 5,358.00 5,358.00 N N 10.1.3 Drugs for treatment of gout and hyperuricaemia !"#$% ก ALLOPURINOL 100 MG(C/L2) (55) V ก ALLOPURINOL 1.00 1.00 Y Y COLCHICINE 0.6 MG (C,D/L2)(287) ก COLCHICINE 1.00 1.00 Y Y PROBENECID 500 MG (C/L3)TAB ก PROBENECID 2.50 2.50 Y Y !"#$% 4 BENZBROMARONE 100 MG TAB [ BENZBROMARONE 9.00 9.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 SULFIN 100 MG TAB PVÖUoCASE (SULFINPYRAZONE)SULFINPYRAZONE 27.00 27.00 N N 10.2 Drugs used in neuromuscular disorders 10.2.1 Drugs which enhance neuromuscular transmission
18 พฤศจิกายน 2561 หนา 43 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- !"#$% ก PYRIDOSTIGMINE(MESTINON) 60 MG TAB (C/L2)_ก PYRIDOSTIGMINE 10.50 10.50 Y Y 10.2.2 Skeletal muscle relaxants !"#$% ( (SIRDALUD PXRc) TIZANIDINE 2 MG TAB (C/N). I TIZANIDINE 4.00 4.00 Y Y BACLOFEN 10 MG(C/L2) I BACLOFEN 1.50 1.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 BA_MOLIN PXRc# [ORPHENADRINE+PARACET] TAB (138 ORPHENADRINE 1.00 1.00 Y N PARACETAMOL 1.00 1.00 Y N MYONAL TAB## EPERISONE 9.50 9.50 N N TOLPERISONE 150 MG (N/N) (MYDOCALM) $ TOLPERISONE 6.00 6.00 N N âi~r[UQ†c (BIOCALM) 50 MG TAB (N/N) (175)# TOLPERISONE 1.50 1.50 Y N 11 Eye !"#$% ( GEN TA MICIN EYE DROP (14 MG./ML.) (C/L1)OUP•^WOc I 90.00 90.00 Y Y 11.1 Anti-infective eye preparations 11.1.1 Antibacterials and eye wash solution !"#$% ก CEFAZOLIN EYE DROP (50 MG./ML.)(B/L1)OUP•^WOc ก CEFAZOLIN 90.00 90.00 Y Y CEPHALOSPORINS GROUP 90.00 90.00 Y Y CHLORAMPHENICOL EYE DROP 0.5% [eOrX•U*]ก 5 ML CHLORAMPHENICOL 16.00 16.00 Y Y CHLORAMPHENICOL EYE OINT ก 5GM CHLORAMPHENICOL 18.00 18.00 Y Y OPSAR 120 ML ก BORIC ACID 26.00 26.00 Y Y !"#$% ( AMIKIN EYE DROP (50 MG./ML.) OUP•^WOc I AMIKACIN 120.00 120.00 Y Y GEN TA MICIN EYE DROP (14 MG./ML.) (C/L1)OUP•^WOc I 90.00 90.00 Y Y !"#$% 4 FORTUM EYE DROP (50 MG./ML.) OUP•^WOc [ CEFOTAXIME SOD 350.00 350.00 Y Y FUNGIZONE EYE DROP (3 MG./ML.)(B/L2) OUP•^WOc [ AMPHOTERICIN-B 495.00 495.00 Y Y POLY OPH EYE DROP [ GRAMICIDINE 31.00 31.00 Y Y NEOMYCIN SULFATE 31.00 31.00 Y Y POLYMIXIN B 31.00 31.00 Y Y !"#$% 1 FUCITHALMIC EYE DROP ] FUSIDIC ACID 88.00 88.00 Y Y VANCOMYCIN EYE DROP (50 MG/ ML) OUP•^WOc ] VANCOMYCIN HCL 320.00 320.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 CRAVIT EYE DROP 5MG/ML D# LEVOFLOXACIN 202.00 202.00 Y N TERRAMYCIN EYE OINT# OXYTETRACYCLINE 26.00 26.00 Y N POLYMIXIN B 26.00 26.00 Y N VIGAMOX EYE DROP 0.5% 5 ML D# MOXIFLOXACIN HCL 201.00 201.00 Y N
18 พฤศจิกายน 2561 หนา 44 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- 11.1.2 Antibacterials with corticosteroids !"#$% 4 DEX-OPH 4 ML EYE DROP [ DEXAMETHASONE 24.00 24.00 Y Y NEOMYCIN SULFATE 24.00 24.00 Y Y MAXITROL 3.5 GM EYE OINTMENT[ DEXAMETHASONE 77.00 77.00 Y Y NEOMYCIN SULFATE 77.00 77.00 Y Y POLYMIXIN B 77.00 77.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 EXOPRED EYE DROP 5 ML>>..>>## D(dÑbÑnÜk[^Uk) OFLOXACIN 171.00 171.00 Y N PREDNISOLONE ACETATE 171.00 171.00 Y N MAXITROL EYE DROP# DEXAMETHASONE 130.00 130.00 Y N NEOMYCIN SULFATE 130.00 130.00 Y N POLYMIXIN B 130.00 130.00 Y N 11.1.3 Antifungals 11.1.4 Antivirals !"#$% 4 (i^R¢njâcfcWIr]ÑnÜk[^Uk) ZOVIRAX OPHTAMIC OINT [ ACYCLOVIR 608.00 608.00 Y Y 11.2 Corticosteroids and other anti-inflammatory prepar !"#$% ก HISTA OPH 5 ML (636)_ก ANTAZOLINE HCL 15.00 15.00 Y Y BENZALKONIUM CL 15.00 15.00 Y Y HYDROXYPROPYL METHYLCELLULOSE 15.00 15.00 Y Y TETRAHYDROZOLINE HCL 15.00 15.00 Y Y !"#$% 4 INF OPH [ PREDNISOLONE ACETATE 39.00 39.00 Y Y PRED FORTE EYE DROP [ (ÑnÜk[^Uk) PREDNISOLONE ACETATE 73.00 73.00 Y Y VOLTAREN 5 ML EYE DROP (VOLTA-OPH) [ DICLOFENAC 85.00 85.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 LOTEMAX EYE DROP($) D LOTEPREDNOL ETABONATE 313.00 313.00 N N PATADAY [0.2%] EYE DROP >>..>>D## OLOPATADINE HCL 299.00 299.00 N N ZADITEN E/D 0.025% D#>>[ÑnÜk[^Uk] KETOTIFEN 326.00 326.00 Y N 11.3 Mydriatics and cycloplegics !"#$% 4 10% PHENYLEPHINE EYE DROP [ PHENYLEPHRINE HCL 114.00 114.00 Y Y ISOPTO-ATROPINE 1% EYE [ ATROPINE SULFATE 111.00 111.00 Y Y MYDRIACYL EYE DROP 1% [ TROPICAMIDE 275.00 275.00 Y Y PHENYLEPRHINE EYE DROP 1% (OUP•^WOc) [ PHENYLEPHRINE HCL 160.00 160.00 Y Y PHENYLEPRHINE EYE DROP 2.5% (OUP•^WOc) [ PHENYLEPHRINE HCL 365.00 365.00 Y Y 11.4 Drugs for treatment of glaucoma !"#$%
18 พฤศจิกายน 2561 หนา 45 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- SOD. CHLORIDE 3% EYE DROP (OU•U) SODIUM CHLORIDE 40.00 40.00 Y Y !"#$% ก (OกPQRก)...LUMIGAN EYE DROP>>(BIMATOPROST)(0.03BIMATOPROST 171.00 171.00 Y Y ACETAZOLAMIDE TABLET_ก ACETAZOLAMIDE 3.00 3.00 Y Y GLYCERINE 50% ORAL 240 ML ก 57.00 57.00 Y Y GLYCERINE 50% ORAL 50 ML ก 10.00 10.00 Y Y GLYCERINE 60 ML ก GLYCERINE 10.00 10.00 Y Y P.V.CARPINE 2%** EYE DROP [PILOCARPINE] ก PILOCARPINE HYDROCHLORIDE 84.00 84.00 Y Y TIMODROP EYE SOLUTION ก TIMOLOL MALEATE 67.00 67.00 Y Y !"#$% 4 BRIMONIDINE 0.2% EYE DROP [ ØBRIMONIDINE TARTRATE 159.00 159.00 Y Y XALATAN EYE DROPS [ D LATANOPROST 129.00 129.00 Y Y !"#$% 1 COSOPT EYE SOLUTION D ] DORZOLAMIDE 356.00 356.00 Y Y TIMOLOL MALEATE 356.00 356.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 ALPHAGAN-P EYE DROP(BRIMONIDINE) 0.15% D ## ØBRIMONIDINE TARTRATE 384.00 384.00 N N ARTEOPTIC 2% EYE DROP# CARTEOLOL HCL 270.00 270.00 Y N AZOPT EYE DROP>>..>> D [NED] $ BRINZOLAMIDE 463.00 463.00 N N DUOTRAV EYE DROP D## TIMOLOL MALEATE 627.00 627.00 N N TRAVOPROST 627.00 627.00 N N LUMIGAN [0.01%]*decf*EYE DROP#D>>..>>(BIMATOPROST BIMATOPROST 253.00 253.00 Y N TAFLOTAN EYE DROP [SMP] D$ TAFLUPROST 494.00 494.00 N N TRAVATAN EYE DROP>>..>> _ D# TRAVOPROST 414.00 414.00 Y N XALACOM EYE DROP D## LATANOPROST 560.00 560.00 N N TIMOLOL MALEATE 560.00 560.00 N N 11.5 Local anaesthetics !"#$% ก TETRACAINE 0.5% EYE DROP ก(U) TETRACAINE HCL 91.00 91.00 Y Y !"#$% 1 ABSOLUTE ALCOHOL 5 ML] ETHYL ALCOHOL 184.00 184.00 Y Y 11.6 Tear deficiency, ocular lubricants and astringents !"#$% ก GENTEAL EYE DROP ก D ## HYDROXYPROPYL METHYLCELLULOSE 171.00 171.00 N N LAC-OPH 10 ML EYE DROP ก HYDROXYPROPYL METHYLCELLULOSE 32.00 32.00 Y Y NATEAR EYE DROP ก HYPROMELLOSE 91.00 91.00 Y Y !"#$% ( VIDISIC EYE GEL 10 GM D I CARBOMER 141.00 141.00 Y Y CETRIMIDE 141.00 141.00 Y Y SORBITAL 141.00 141.00 Y Y
18 พฤศจิกายน 2561 หนา 46 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- !"#$% 1 SOLCOSERYL EYE GEL ] DEPROTEINZED CALVE BLOOD EXTRAC 114.00 114.00 Y Y TEARS NAT-FREE ED (กQfr]Qo32) ] D DEXTRAN 70 179.00 179.00 Y Y METHYLCELLULOSE 179.00 179.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 KARY UNI 0.005% OPHTHALMIC SUSP#D PIRENOXINE 66.00 66.00 Y N RESTASIS(CYCLOSPORINE) 0.4 ML EYE DROP $ CICLOSPORIN 1,161.00 1,161.00 N N CYCLOSPORINE 1,161.00 1,161.00 N N SYSTANE ULTRA EYE DROP D## POLYETHYLENE GLYCOL 184.00 184.00 N N PROPYLENE GLYCOL 184.00 184.00 N N VISLUBE EYE DROPS (1 efr[RX 30 eQrX) D($) SOD HYALURONATE 21.00 21.00 N N SODIUM HYALURONATE 21.00 21.00 N N 11.7 Ocular diagnostic and peri-operative preparations !"#$% 4 B.S.S 15 ML [ CALCIUM CHLORIDE 135.00 135.00 Y Y MAGNESIUM CHLORIDE 135.00 135.00 Y Y POTASSIUM CHLORIDE 135.00 135.00 Y Y SODIUM ACETATE 135.00 135.00 Y Y SODIUM CHLORIDE 135.00 135.00 Y Y SODIUM CITRATE 135.00 135.00 Y Y B.S.S. PLUS SOL 500 ML [ CALCIUM CHLORIDE 959.00 959.00 Y Y MAGNESIUM CHLORIDE 959.00 959.00 Y Y POTASSIUM CHLORIDE 959.00 959.00 Y Y SODIUM ACETATE 959.00 959.00 Y Y SODIUM CHLORIDE 959.00 959.00 Y Y SODIUM CITRATE 959.00 959.00 Y Y B.S.S.(OPTOSOL) 500 ML [ CALCIUM CHLORIDE 148.00 148.00 Y Y MAGNESIUM CHLORIDE 148.00 148.00 Y Y POTASSIUM CHLORIDE 148.00 148.00 Y Y SODIUM ACETATE 148.00 148.00 Y Y SODIUM CHLORIDE 148.00 148.00 Y Y SODIUM CITRATE 148.00 148.00 Y Y BBT VISC (OPHTHALIN) 1.5% 0.85 ML [ 2,415.00 2,415.00 Y Y FLUORESCEIN SODIUM 10 % 6 ML[ FLUORESCEIN SOD 356.00 356.00 Y Y MIOSTAT 0.01% [ CARBACHOL 295.00 295.00 Y Y VISCOAT 0.5 ML [ SOD CHONDROITIN SULF - SOD HYALUR 1,931.00 1,931.00 Y Y VISCOAT 0.75 ML (PIbUdecf) [ SOD CHONDROITIN SULF - SOD HYALUR 2,247.00 2,247.00 Y Y 12 Ear, nose, and oropharynx 12.1 Drugs acting on the ear !"#$% ก
18 พฤศจิกายน 2561 หนา 47 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- CHLORAMPHENICOL EAR("eOrXet")DROP 1% ก 10 MLCHLORAMPHENICOL 31.00 31.00 Y Y SOD.BICARB EAR DROP 10ML ก SODIUM BICARB 20.00 20.00 Y Y !"#$% ( CANDID EAR DROP 1% I CLOTRIMAZOLE 73.00 73.00 Y Y !"#$% 5 SOFRADEX E/E DROP 8 ML [[i^R¢njwàb]IUX[^Uk**] DEXAMETHASONE 85.00 85.00 Y Y FRAMYCETINE 85.00 85.00 Y Y GRAMICIDINE 85.00 85.00 Y Y 12.2 Drugs acting on the nose 12.2.1 Drugs used in nasal allergy !"#$% ( (OกPQRก) RHINOCORT AQUA I 120 DOSE>>..>> BUDESONIDE 313.00 313.00 Y Y !"#$% 1 AVAMYS NASAL SPRAY (C)D ] 120 DOSE FLUTICASONE FUROATE 288.00 288.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 NASACORT AQ (C-D1/L2) ## 120 DOSE TRIAMCINOLONE ACETONIDE 282.00 282.00 N N NASONEX NASAL SPRAY## 140 DOSE MOMETASONE FUROATE 660.00 660.00 N N 12.2.2 Topical nasal decongestants !"#$% ก EPHEDRINE 2% ก EPHEDRINE 75.00 75.00 Y Y EPHEDRINE 3% ก EPHEDRINE 75.00 75.00 Y Y EPHEDRINE DROP 0.5% ก EPHEDRINE 12.00 12.00 Y Y EPHEDRINE DROP 1.0% ก EPHEDRINE 12.00 12.00 Y Y !"#$% ( (ILIADINE PXRc) OXYMETAZOLINE HCL 0.05% SPRAY[OXYMETAZOLINE 40.00 40.00 Y Y ILIADINE 0.05% SPRAY [^]>>..>>[ÑhRXÖfh] I OXYMETAZOLINE 111.00 111.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 EPHEDRINE DROP 0.25%# EPHEDRINE 11.00 11.00 Y N 12.3.1 DRUG USED IN TREATMENT OF ORAL ULCER !"#$% ก CHLORHEXIDINE 0.12% MOUTH WASH ก CHLORHEXIDINE GLUCONATE 40.00 40.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 KAMILLOSAN-M SPRAY>>..>>$ CAMOMILE 179.00 N N CHAMAZULENE 179.00 N N ESSENTIAL OILS 179.00 N N KENALOG IN ORABASE 1 GM (GENERLOG) L# TRIAMCINOLONE ACETONIDE 8.00 8.00 Y N 12.3.2 Oropharyngeal antifungal drugs !"#$% ก CANDINAS TROCHE TAB. ก CLOTRIMAZOLE 1.50 1.50 Y Y DAKTARIN ORAL GEL ก MICONAZOLE NITRATE 103.00 103.00 Y Y
18 พฤศจิกายน 2561 หนา 48 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- 12.3.3 ANTISEPTICS FOR ROOT CANAL TREATMENT 12.3.4 DRUGS USED IN PREVENTION AND TREATMENT OF DENTAL PLA !"#$% ก FLUORIDE 0.25 MG TAB ก SOD.FLUORIDE 0.50 0.50 Y Y )*+,ก!"#$%)*-."ก/-01$*23 FLUORIDE MOUTHWASH 0.05% 300 ML## SOD.FLUORIDE 35.00 35.00 N N 12.3.5 OTHER DENTAL PREPARATIONS !"#$% SMW 240 ML DETTOL 10.00 10.00 Y Y EUCALYTUS OIL 10.00 10.00 Y Y MENTHOL 10.00 10.00 Y Y METHYL SALICYLATE 10.00 10.00 Y Y 13 Skin !"#$% ACETIC ACID 1% IN ALC. 95%(240 ML.) ACETIC ACID 60.00 60.00 Y Y ACETIC ACID 3% IN ALC. 95%(240 ML) ACETIC ACID 60.00 60.00 Y Y ETHYL ALCOHOL 60.00 60.00 Y Y !"#$% ก ACETIC ACID 3% (240 ML.) ก ACETIC ACID 10.00 10.00 Y Y ACETIC ACID 5% (450 ML.) ก ACETIC ACID 20.00 20.00 Y Y BURROW'S SOL. (240 ML.) ก ACETIC ACID 20.00 20.00 Y Y ALUMINIUM SUBACETATE 20.00 20.00 Y Y CALCIUM CARBONATE 20.00 20.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 4% MINOXIDIL LOTION 30 ML**(C/L2) MINOXIDIL 160.00 N N ACETIC ACID 1% (240 ML.)# ACETIC ACID 10.00 10.00 Y N D-SHAMPOO (240 ML.) RESORCINOL 36.00 0.00 N N SALICYLIC ACID 36.00 0.00 N N GLYCOLIC A.CREAM 3% 5GM** GLYCOLIC ACID 15.00 N N HQ 3% CREAM 5 GM** HYDROQUINONE 10.00 N N HQ 3% IN TA 0.02%CREAM 5 GM** 16.00 N N KOJIC A. CREAM 1.5% 5GM** KOJIC ACID 15.00 N N LOTIO-P 60 ML** RESORCINOL 30.00 N N SALICYLIC ACID 30.00 N N ZINC OXIDE 30.00 N N SKINOREN 20% CREAM 30 GM D**^ AZELAIC ACID 467.00 N N 13.1 Anti-infective skin preparations 13.1.1 Antibacterial preparations !"#$% ก PHARMA CREAM 5 GM ก SILVER SULFADIAZINE 7.00 7.00 Y Y
18 พฤศจิกายน 2561 หนา 49 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- PHARMA CREAM 500 GM ก SILVER SULFADIAZINE 370.00 370.00 Y Y !"#$% ( BACTROBAN (MUPIROCIN) OINTMENT(5 GM) I MUPIROCIN 48.00 48.00 Y Y FUCIDIN CREAM 2% 5 GM I FUSIDIC ACID 70.00 70.00 Y Y FUCIDIN CREAM 2% eQrXQo 15 GM I 208.00 208.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 BETAMETHASONE-N 5 GM# BETAMETHASONE 13.00 13.00 Y N NEOMYCIN SULFATE 13.00 13.00 Y N CLINDA LOTION 15 ML** CLINDAMYCIN 30.00 N N ERYTHRO LOTION 2% (B/L1)30 ML** ERYTHROMYCIN 40.00 N N 13.1.2 Antifungal preparations !"#$% ก CLOTRIMAZOLE CREAM 40 GM ก CLOTRIMAZOLE 72.00 72.00 Y Y CLOTRIMAZOLE CREAM 500 GM ก V CLOTRIMAZOLE 310.00 310.00 Y Y CLOTRIMAZOLE CREAM •Qni 5 GM ก CLOTRIMAZOLE 9.00 9.00 Y Y SOD.THIOSULFATE 20% 60ML(OUÆUOhrก) ก SOD.THIOSULFATE 10.00 10.00 Y Y VIOFORM + TA CREAM 5 GM ก IODOCHLORHYDROXYQUINOLINE 7.00 7.00 Y Y TRIAMCINOLONE ACETONIDE 7.00 7.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 NIZORAL SHAMPOO 100 ML ** KETOCONAZOLE 201.00 N N SELSUN 120 ML ** SELENIUM SULFIDE 154.00 0.00 N N THYMOL 3%IN ALC. 30ML# CHLOROFORM 10.00 10.00 Y N THYMOL 10.00 10.00 Y N 13.1.3 Parasiticidal preparations !"#$% ก (JACUTIN PXRc) "[^Wc°fUPeU" [1 %_PERMETHRIN_HECINPERMETHRIN 37.00 37.00 Y Y BENZYL BENZO 25% 240ML ก BENZYL BENZOATE 100.00 100.00 Y Y BENZYL BENZO 25% 60ML ก BENZYL BENZOATE 25.00 25.00 Y Y HECIN - F [[*[^WcกmUànXeRX*]] (5 %**PERMETHRIN) 30 GMPERMETHRIN 73.00 73.00 Y N )*+,ก!"#$%)*-."ก/-01$*23 BENZYL BENZO 12.5% 240ML# BENZYL BENZOATE 88.00 88.00 Y N BENZYL BENZO 12.5% 60ML# BENZYL BENZOATE 22.00 22.00 Y N 13.2 Emollient and barrier preparations !"#$% ก VASELINE 5 GM ก WHITE PETROLATUM 6.00 6.00 Y Y ZINC OXIDE PASTE 5 GM ก TALCUM 6.00 6.00 Y Y VASELINE 6.00 6.00 Y Y ZINC OXIDE 6.00 6.00 Y Y !"#$% 4 OLIVE OIL 450 ML ก (amUe^ni[RX^U[Usá.) OLIVE OIL 170.00 170.00 Y Y
18 พฤศจิกายน 2561 หนา 50 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- )*+,ก!"#$%)*-."ก/-01$*23 K-Y JELLY 42 GM# LUBRICANTING JELLY 90.00 90.00 Y N NAPPY-HIPPO CREAM 25 GM# ZINC OXIDE 38.00 38.00 Y N PH5-EUCERIN LOTION (~QÑnÜh)** DEXPANTHENOL 282.00 N N DIAMMONIUM CITRATE 282.00 N N EUCERITE 282.00 N N VIT E 282.00 N N QC JELLY 50 GM ** LUBRICANTING JELLY 34.00 N N SOLCOSERYL JELLY eQrXdeuf 20 GM# DEPROTEINZED CALVE BLOOD EXTRAC 117.00 117.00 Y N 13.3 Topical antipruritics !"#$% ก jUsèÜh[nh CALAMINE LOTION 60 ML ก CALAMINE 13.00 13.00 Y Y ZINC OXIDE 13.00 13.00 Y Y 13.4 Topical corticosteroids !"#$% ก BETAMETHASONE (1/2) 40 GM ก BETAMETHASONE 35.00 35.00 Y Y BETAMETHASONE (1/2) 5 GM ก BETAMETHASONE 7.00 7.00 Y Y BETAMETHASONE (1/2) 500 GM ก BETAMETHASONE 500.00 500.00 Y Y BETAMETHASONE 0.1% CREAM 40 GM ก BETAMETHASONE 64.00 64.00 Y Y BETAMETHASONE 0.1% CREAM 5 GM ก BETAMETHASONE 8.00 8.00 Y Y BETAMETHASONE 500 GM ก BETAMETHASONE 500.00 500.00 Y Y HYDROCORTISONE CREAM 5 GM (C/D/L2) ก HYDROCORTISONE ACETATE 18.00 18.00 Y Y P-TOCORT (CLOBETASOL) 40 GM ก 160.00 160.00 Y Y P-TOCORT (CLOBETASOL) CREAM 500 GM_ก 1,666.00 1,666.00 Y Y P-TOCORT (CLOBETASOL) •Qni 5 GM ก CLOBETASOL PROPIONATE 20.00 20.00 Y Y T.A. LOTION (240 ML.) ก TRIAMCINOLONE ACETONIDE 96.00 96.00 Y Y T.A. LOTION (60 ML.) ก TRIAMCINOLONE ACETONIDE 24.00 24.00 Y Y TA 0.02% CREAM 5 GM (1304)ก TRIAMCINOLONE ACETONIDE 6.00 6.00 Y Y TA 0.1% CREAM 500 GM (1306) ก TRIAMCINOLONE ACETONIDE 230.00 230.00 Y Y TA 0.1% CREAM •Qni 5 GM (1306) ก TRIAMCINOLONE ACETONIDE 10.00 10.00 Y Y TA 0.1% CREAM eQrX 5 GM ก 10.00 10.00 Y Y !"#$% ( TOPICORTE 10 GM I DESOXIMETHASONE 52.00 52.00 Y Y TOPICORTE 300 GM I DESOXIMETHASONE 0.00 0.00 Y N !"#$% 4 BETAMETHASONE+SALICYLIC 3% 15 GM(MECYLIC,EPIKLIN BETAMETHASONE 49.00 49.00 Y Y SALICYLIC ACID 49.00 49.00 Y Y !"#$% 1 ELOMET CREAM 5 GM ] ## MOMETASONE FUROATE 65.00 65.00 N N )*+,ก!"#$%)*-."ก/-01$*23
18 พฤศจิกายน 2561 หนา 51 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- BET-C (VIOFORM IN BET) 5 GM# BETAMETHASONE 17.00 17.00 Y N CLIOQUINOL 17.00 17.00 Y N 13.5 Other Preparations for psoriasis (excluding topica !"#$% ก CCT 5% 150 GM ก COAL TAR 190.00 190.00 Y Y CCT 5% 5 GM ก COAL TAR 8.00 8.00 Y Y LCD 5% + TA 40 GM ก 30.00 30.00 Y Y LCD 5% CREAM 5 GM ก COAL TAR 6.00 6.00 Y Y TAR SHAMPOO (240 ML.)ก 48.00 48.00 Y Y !"#$% 1 DAIVONEX OINT 30 GM ] D# CALCIPOTRIOL 584.00 584.00 Y N NEOTIGASON 10 MG TAB>>(ÑnÜk[^Uk) ] ACITRETIN 36.00 36.00 Y Y NEOTIGASON 25 MG TAB ] ACITRETIN 74.00 74.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 ELIDEL CREAM 1 % 15 GM D ## PIMECROLIMUS 783.00 783.00 N N XAMIOL GEL 15 GM (C) D$ BETAMETHASONE 774.00 774.00 N N CALCIPOTRIOL 774.00 774.00 N N 13.6 Preparations for warts and calluses !"#$% ก 40 % SALICYLIC ACID 5 GM ก SALICYLIC ACID 10.00 10.00 Y Y PODOPHYLLIN SOL IkX_ ก PODOPHYLLIN RESIN IN TR. BENZOIN 329.00 329.00 Y Y SILVER NITRATE ก^ncQo ก SILVER NITRATE 105.00 65.00 Y Y TCA 100% 10 ML ก* TRICHLOROACETIC ACID 90.00 N N TCA 20% 10 ML ก * TRICHLOROACETIC ACID 25.00 N N TCA 30% 10 ML ก * TRICHLOROACETIC ACID 25.00 N N TCA 75% 10 ml. ก * TRICHLOROACETIC ACID 90.00 N N !"#$% ( DUOFILM 15 ML I>>(i^R¢njâcfcWIr]) LACTIC ACID 147.00 147.00 Y Y POLIDOCANOL 147.00 147.00 Y Y SALICYLIC ACID 147.00 147.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (VILERM PXRc) ACYCLOVIR CREAM 1 ก^nc * [COVIR 1 GM ACYCLOVIR 5.00 5.00 Y N ACYCLOVIR CREAM 5 GM [COVIR](VILERM PXRc)# ACYCLOVIR 22.00 22.00 Y N ALDARA CREAM qr]Qo D## IMIQUIMOD 206.00 206.00 N N 14 Immunological products and vaccines !"#$% ก (OกPQRก* dÑbRHESI2 wjh) RHESUMAN INJ (ANTI-D)[625HUMAN ANTI - D IG 6,535.00 6,535.00 Y Y ANTIRABIES SERUM(ERIG) 1000 U/5ML ก RABIES SERUM ATTAINED FROM HORSE 774.00 774.00 Y Y B.C.G DOSEQo ก BACILLUS OF CALMETTE GUERIN 15.00 15.00 Y Y DIPHTERIA ANTITOXIN ก DIPHTERIA ANTITOXIN 4,237.00 4,237.00 Y Y
18 พฤศจิกายน 2561 หนา 52 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- DPT - HB ก DIPHTHERIA TOXOID 10.00 10.00 Y Y HEPATITIS B VACCINE 10.00 10.00 Y Y PERTUSSIS TOXOID 10.00 10.00 Y Y TETANUS TOXOID 10.00 10.00 Y Y DPT (414) ก DIPHTHERIA TOXOID 10.00 10.00 Y Y PERTUSSIS TOXOID 10.00 10.00 Y Y TETANUS TOXOID 10.00 10.00 Y Y DT(DIPTHERIA-TETANUS)-Uก[^^Ɔ ก DIPHTHERIA TOXOID 20.00 20.00 Y Y TETANUS TOXOID 20.00 20.00 Y Y DTi^R¢nj (DIPTHERIA-TETANUS) ก DIPHTHERIA TOXOID 49.00 49.00 Y Y TETANUS TOXOID 49.00 49.00 Y Y ENGERIX-B >>(i^R¢njIUXIr])>>1.0 ML_ ก* HEPATITIS B VACCINE 372.00 N N HEPAVAX-B (1818) ก HEPATITIS B VACCINE 20.00 20.00 Y Y JE VAC กjc. (LIVE VAC) (1852) ก 20.00 20.00 Y Y JE Ir]i^R¢nj(CD J VAC) ก IkXQo* JAPANESE ENCEPHALITIS VACCINE 460.00 N N MMR VAC >>..>> ก * MEASLE VIRUS 172.00 N N MUMPS VIRUS 172.00 N N RUBELLA VIRUS 172.00 N N TAT 1500 U ก V TETANUS ANTITOXIN 30.00 30.00 Y Y TT 0.5 CC(OUamU^r]hbrO) DOSE Qo ก(U) TETANUS TOXOID 27.00 27.00 Y Y TUBERCULIN TEST ก TUBERCULIN PPD 632.00 632.00 Y Y !"#$% ( (HRIG PXRc) HUMAN ANTIRABIES 300 IU [BERIRAB]*(CHUMAN RABIES IMMUNOGLOBULIN 1,945.00 1,945.00 Y Y (HRIG aÆUกUÑUX*) HUMAN ANTIRABIES 750 IU/5ML (CHUMAN RABIES IMMUNOGLOBULIN 1,381.00 1,381.00 Y Y [i^R¢njIUXIr]]..HUMAN ANTIRABIES 300 IU*(HRIG)*[(HUMAN RABIES IMMUNOGLOBULIN 2,180.00 2,180.00 Y Y TETAGAM (HUMAN TETANUS) IG 250 IU/1 ML (C/N) IHUMAN ANTI-TETANUS 632.00 632.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 (OกPQRก-IUX[^Uk)*HAVRIX-720(PX`ก)** HEPATITIS A 688.00 N N BOOSTRIX** DIPHTHERIA TOXOID 639.00 N N PERTUSSIS TOXOID 639.00 N N TETANUS TOXOID 639.00 N N CERVARIX VAC(PAPILLOMAVIRUS TYPE16,18)** PAPILLOMAVIRUS TYPE 16,18 2,058.00 N N GARDASIL 0.5 ML( HUMAN PAPILLOMA 6,11,16,18)_ PAPILLOMAVIRUS TYPE 6,11,16,18 2,445.00 N N HIBERIX INJ **[OUaf]PáQWOh EXP.] HAEMOPHILUS TYPE B CONJUGATE VA 515.00 N N PNEUMOCOCCAL VAC 23 (PNEUMOVAX 23)**(PVÖUoCASEPNEUMOCOCCAL VACCINE 1,094.00 N N PREVNAR 13 (IPD VAC)** PNEUMOCOCAL 13-VALENT CONJUGATE 2,338.00 N N ROTARIX VACCINE** ROTAVIRUS VACCINE 971.00 N N VARITECT 125 IU/ 5ML** HUMAN VARICELLA ZOSTER IG 5,781.00 N N 15 Anaesthesia 15.1 General anaesthesia
18 พฤศจิกายน 2561 หนา 53 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- 15.1.1 Intravenous anaesthesia !"#$% 4 ANEPOL INJ 120 MG (12ML) [ PROPOFOL 103.00 103.00 Y Y DIPRIVAN10MG/ML 20MLINJ [ PROPOFOL 333.00 333.00 Y Y ETOMIDATE LIPURO GA 20 MG/ 10ML [ ETOMIDATE LIPURO 245.00 245.00 Y Y PROPOFOL 1% INJ [FRESOFOL](B/L2)_[ PROPOFOL 235.00 235.00 Y Y THIOPENTAL SOD 1 GM INJ [ THIOPENTAL SOD. 184.00 184.00 Y Y !"#$% 1 KETALAR 50 MG/ML 10 ML(B/L2) ] KETAMINE HCL 195.00 195.00 Y Y 15.1.2 Inhalational anaesthesia !"#$% 4 FORANE INHAL ANESTHE_[ ISOFLURANE 6,319.00 6,319.00 Y Y SEVORANE 250 ML [ SEVOFLURANE 6,454.00 6,454.00 Y Y 15.1.3 Muscle relaxants (Neuromuscular blocking drugs) !"#$% 4 (NIMBEX PXRc) CISATRACURIUM KABI*[2 MG/ML] INJCISATRACURIUM 147.00 147.00 Y Y HAD (TRACRIUM)50 MG INJ [(5.0 ML)*ATRACURIUMATRACURIUM BESYLATE BESYLATE 152.00 152.00 Y Y NIMBEX*(R)*(CISATRACURIUM) 2 MG/ML INJ [ 5 MLCISATRACURIUM 179.00 179.00 Y Y SUCCINYL CHLORIDE 500 MG/10 ML*INJ (SUXAMETHONIUM SUCCINYLCHLORIDE (SUXAMETHONIU 184.00 184.00 Y Y VECURONIUM 10 MG INJ (NORCULON)[ VECURONIUM 250.00 250.00 Y Y OU[QUOกQbUcPhèlr ESMERON INJ (ROCURONIUM 10 MG/ML ROCURONIUM BROMIDE 385.00 385.00 Y Y 15.1.4 Sedative and analgesic peri-operative drugs !"#$% 1 DORMICUM 15 MG TAB>>..>>] (D/L3) MIDAZOLAM 9.00 9.00 Y Y DORMICUM INJ 5 MG 1 ML (MIDAZ)INJ ] (D/L3)(U) MIDAZOLAM 19.00 19.00 Y Y DORMICUM INJ(VWX) 15 MG/3 ML(MIDAZOLAM)] (D/L MIDAZOLAM 71.00 71.00 Y Y 15.1.5 Anticholinesterases and antimuscarinic drugs used !"#$% ก NEOSTIGMINE 2.5 MG/ML 1 ML INJ ก NEOSTIGMINE METHYLSULFATE 25.00 25.00 Y Y 15.2 Local anaesthesia !"#$% ก EMLA CREAM 5% 30 GM ก eQrXQo_$ LIDOCAINE HCL 781.00 N N PRILOCAINE 781.00 N N LIDOCAINE 1% 20 ML V ก LIDOCAINE HCL 24.00 24.00 Y Y LIDOCAINE 2% 20 ML กV LIDOCAINE HCL 25.00 25.00 Y Y XYLOCAINE 1% 1 CC ก LIDOCAINE HCL 5.00 5.00 Y Y XYLOCAINE 4% ก 38.00 38.00 Y Y XYLOCAINE JELLY(DOCAINE) 2% eQrX ก LIDOCAINE HCL 153.00 153.00 Y Y XYLOCAINE SPRAY 10% ก LIDOCAINE HCL 516.00 516.00 Y Y XYLOCAINE VISCOUS 10 ML ก LIDOCAINE HCL 35.00 35.00 Y Y
18 พฤศจิกายน 2561 หนา 54 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- !"#$% ( MARCAINE 0.5% [ 20 CC] I BUPIVACAINE 162.00 162.00 Y Y !"#$% 4 MARCAINE HEAVY 0.5% INJ (4 ML*)_[ BUPIVACAINE 176.00 176.00 Y Y GLUCOSE 176.00 176.00 Y Y MARCAINE ISOBARIC SPINA 4 ML [ BUPIVACAINE 165.00 165.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 CHIROCAINE 0.5% 10 ML# LEVOBUPIVACAINE HCL 239.00 239.00 Y N ETHYLCHLORIDE SPRAY# ETHYL CHLORIDE 347.00 347.00 Y N 16 Antidotes !"#$% PJ 3% SOD.NITRITE 10 ML (CYANIDE AD KIT) (AD)(aáaÑ 0.00 0.00 Y Y PJ ESMOLOL 100 MG INJ (AD)aáaÑ ESMOLOL 0.00 0.00 Y Y !"#$% ก (OกPQRก)...KONAKION PX`ก 1 MG/0.5 ML>>..>> INJ (C/L1) VITAMIN K1 (PHYTOMENADIONE) 27.00 27.00 Y Y (OกPQRก)...VIT K (KONAKIAN) 10 MG INJ>>..>>(C/L1) ก( VITAMIN K1 (PHYTOMENADIONE) 6.00 6.00 Y Y ANEXATE 0.5MG/5 ML(FLUMAZENIL) INJ (C/L2) ] [OUกmFLUMAZENIL UÖ^bU 831.00 831.00 Y Y BENADRYL 25 MG CAP (B/L2) ก DIPHENHYDRAMINE 1.00 1.00 Y Y FLUIMUCIL 300 MG(B/L2)(ACETYLCYSTEINE)INJ_ก ACETYLCYSTEIN 25.00 25.00 Y Y HAD ATROPINE INJ 0.6MG/1ML V ก(Z)(U) ATROPINE SULFATE 5.00 5.00 Y Y HAD CAL.GLUCONATE INJ V ก(U) CALCIUM GLUCONATE 13.00 13.00 Y Y NARCAN 0.4 MG/ML INJ ก (NALOXONE)(AD) NALOXONE 245.00 245.00 Y Y PRALIDOXIME(2-PAM) ก (AD) PRALIDOXIME 874.00 874.00 Y Y SERUM ]tPIWOkeU]âecb ก (AD)(U) ANTIVENUM 775.00 775.00 Y Y SERUM ]t^kc ^oiiá^oaUj ก (AD) ANTIVENUM 1,200.00 1,200.00 Y Y SERUM ]t^kc ^oii~QeR• ก (AD)(U) ANTIVENUM 1,200.00 1,200.00 Y Y SERUM ]tPefU (ÑhRXweb]) ก (AD)(U) ANTIVENUM 775.00 775.00 Y Y SOD.BICARB 7.5 % 10 ML ก SODIUM BICARB 14.00 14.00 Y Y SOD.BICARB 7.5% 50 ML ก(U) SODIUM BICARB 28.00 28.00 Y Y VIT K1*[PHYTOMENADIONE] 10 MG INJ(KONAKIAN VITAMIN K1 (PHYTOMENADIONE) 17.00 17.00 Y Y aáaÑ SERUM wกbÖR¢]tPIWOkeU]âecb(ÑhRXweb]) 10 ML ก (ADANTIVENUM 0.00 0.00 Y Y aáaÑ SERUM wกbÖR¢]t^oiiá^oaUj(ÑhRXweb]) 10 ML ก (AD ANTIVENUM 0.00 0.00 Y Y aáaÑ SERUM wกbÖR¢]tPefU (ÑhRXhlmU) 10 ML ก (AD) ANTIVENUM 0.00 0.00 Y Y !"#$% 4 [^rPahrrrก] PENICILLAMINE 250 MG (D/L3) CAP [ PENICILLAMINE 19.00 19.00 Y Y 20% CALCIUM DISODIUM EDTA* [ [wshกànก¢p-OUamU^r]hb CALCIUM rO DISODIUM EDTA 76.00 76.00 Y Y 25% SOD.THIOSULFATE 50 ML (CYANIDE ANTIDOTE SOD.THIOSULFATE KIT 130.00 130.00 Y Y 3% SOD.NITRITE 10 ML (CYANIDE ANTIDOTE KIT) [(SOD.NITRITE 63.00 63.00 Y Y DESFERAL 500 MG INJ(C/N) [ DESFEROXAMINE 235.00 235.00 Y Y PJ 25% SOD.THIOSULFATE 18 ML (CYANIDE AD KIT) 0.00 0.00 Y Y
18 พฤศจิกายน 2561 หนา 55 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- PJ METHYLENE BLUE INJ (AD)aáaÑ [ 0.00 0.00 Y Y PROTAMINE INJ (C/L2) [ (AD) PROTAMINE SULFATE 278.00 278.00 Y Y !"#$% 1 DANTROLENE INJ 20 MG (AD) ] PVÖUokRanuuW DANTROLENE 5,561.00 5,561.00 Y Y LEUCOVERIN 15 MG TAB (FOLINA PXRc) ] CALCIUM FOLINATE 11.00 11.00 Y Y FOLINIC ACID 11.00 11.00 Y Y LEUCOVORIN INJ [50 MG/5 ML]**{ÑnÜk[^Uk}(C/N) ] CALCIUM FOLINATE 172.00 172.00 Y Y LEUCOVORIN INJ 300 MG [CA FOLINATE](C/N)](P) CALCIUM FOLINATE 644.00 644.00 Y Y MESNA (UROMITEXAN)(P) ] UROMITEXAN 110.00 110.00 Y Y METHYLENE BLUE INJ [en•´กU^] METHYLTHIOMINIUM CHLORIDE 149.00 149.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 FOSRENOL 500 MG (LANTHANUM) TAB D$ LANTHANUM CARBONATE 90.00 90.00 N N GLYCOPYRROLATE INJ(0.2 MG/ML)#(PVÖUokRanuuW) GLYCOPYRROLATE 37.00 37.00 Y N IPECAC SYR 15 ML# IPECAC FLUID EXTRACT 10.00 10.00 Y N ULTRA CA-R-BON TAB (ACTIVATED CHARCOAL)# ACTIVATED CHARCOAL 3.00 3.00 Y N 17 Contrast media & Radiopharmaceuticals 17.1 X - ray contrast media, iodinated 17.1.1 Drugs used in urography and computed tomography 17.1.2 Drugs used in angiography 17.1.3 Drugs used in myelography 17.1.4 Drugs used in cardiovascular catherization 17.2 X - ray contrast media, non - iodinated 17.3 Magnetic resonance imaging contrast media (MRI dia 17.4 Radiopharmaceuticals 18 Miscellaneous !"#$% PROPYLENE GLYCOL 40% 240 ML PROPYLENE GLYCOL 37.00 37.00 Y Y SORBITOL 240 ML SORBITAL 20.00 20.00 Y Y )*+,ก!"#$%)*-."ก/-01$*23 ADAPALENE GEL 0.1% •Qni 5 GM D** ADAPALENE 150.00 N N AMMONIA 1 árhX†# AMMONIA 94.00 94.00 Y N BENZAC GELeQrX 60 GM(BENZOYL PEROXIDE 2.5%)BENZOYL ** PEROXIDE 298.00 N N BERMUDA GRASS 5 ML# 5,240.00 5,240.00 Y N ELECTRODE GEL 250 GM (EKG) # 241.00 N N GRASS MIXED 5 ML# 5,711.00 5,711.00 Y N KETOSTERIL 600 MG TAB D$ 27.50 27.50 N N LACTACYD SOAP 60 ML** LACTIC ACID 48.00 N N LACTOSERUM ATOMIZATE 48.00 N N OILATUM SOAP 100 GM** MINERAL OIL 183.00 N N PH5-EUCERIN WASH LOTION (aitf)** CITRIC ACID 206.00 N N
18 พฤศจิกายน 2561 หนา 56 จาก 57
!"#ก"! %&'()"*+,-".#" !"/"0"# 123ก456 7ก) 302"- PH5-EUCERIN WASH LOTION (aitf)** DIAMMONIUM CITRATE 206.00 N N EUCERITE 206.00 N N ROACCUTANE 20 MG CAP** D ISOTRETINOIN 69.00 N N eQrX ADAPALENE GEL 0.1% 30 GM D** ADAPALENE 682.00 N N 80 4y*1#z2