FORMULARIUM KLINIK UTAMA SEHATI

1. ANALGESIK, ANTIPIRETIK, ANTIINFLAMASI NON STEROID DAN ANTIPIRAI

1.1 ANALGESIK
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 MEFENTA ASAM MEFENAMAT 500 mg

2 IFEN 400 mg
IBU PROFEN
FARSIFEN SYR 100 mg/5 ml
3 DIVOLTAR NATRIUM DICLOFENAK 50 mg
4 KADITIC KALIUM DICLOFENAK 50 mg
5 FASGO TAB 500 mg
6 FASGO F TAB 650 mg
7 FASIDOL TAB 500 mg
8 FASIDOL F TAB 650 mg
9 DAPYRIN SYR 80 mg/5 ml
10 FASGO SYR PARACETAMOL 160 mg/5 ml
11 FASGO F SYR 250 mg/5 ml
12 FASIDOL SYR 120 mg/5 ml
13 FASIDOL F SYR 160 mg/5 ml
14 PAMOL SYR 120 mg/5 ml
15 PAMOL DROP 60 mg/0,6 ml
16 ANTALGIN ANTALGIN 500 mg

1.2 ANTIPIRAI
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 ALOFAR 100 mg 100 mg
ALLUPURINOL
2 ALOFAR 300 mg 300 mg
3 L CISIN COLCHICINE 0.5 mg

2. ANASTESI
2.1 ANASTESI LOKAL
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 ETHYL CHLORIDE ETHYL CHLORIDE SEMPROT 100 ml
SEMPROT
2 LIDOCAIN INJ LIDOCAIN INJ 2%

3. ANTI HISTAMIN
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 LERZIN 10 mg
CETIRIZINE
LERZIN SYR 5 mg/5 ml
2 WINATIN LORATADINE 10 mg
3 CTM CTM 4 mg
3 POLOPAR PLUS DEXAMETHASONE 0.5 mg
Dexchlorpheniramine 2 mg
maleate
4 DIPHENHIDRAMIN INJ RECODRYL INJ 10 mg/ ml

4. ANTIINFEKSI
4.1 ANTIBAKTERI
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN

1 TOPCILLIN AMOXICILLIN 500 mg

LAPIMOX 125 mg/ 5ml
VIBRAMOX SYR 125 mg/ 5ml

1
 2 GIRABLOG CIPROFLOXACIN 500 mg
3 LIBROCEF CEFADROXIL 500 mg
LOSTACEF SYR 125 mg/5 ml
4 THIANICOL THIAMPHENICOL 500 mg
THIAMICIN KAPS 500 mg
THIAMICIN SYR 125 mg/5 ml
THIAMFILEX SYR 125 mg/5 ml
5 TAXIME TABLET CEFIXIME 200 MG
TAXIME SYR 100 mg/ 5ml
HELIXIME SYR 100 mg/ 5ml
6 MILORIN CLINDAMICIN 300 mg
7 ERYTHRIN SYR ERYTHROMYCIN 200 mg/ 5ml
8 INTERMOXIL (SERBUK AMOXICILLIN (SERBUK INJEK) 1g
INJEK)
9 CEFOTAXIM (SERBUK CEFOTAXIM (SERBUK INJEK) 1g
INJEK)
10 CEFTRIAXONE (SERBUK CEFTRIAXONE (SERBUK INJEK) 1g
INJEK)
11 SUPRABIOTIK TETRASIKLIN 500 mg
12 DOHIXAT DOKSISIKLIN 100 mg
13 LEVOFLOKSASIN LEVOFLOKSASIN 500 mg
14 FLADEX F METRONIDAZOLE 500 mg
15 FARIZOL SYR 125 mg/ 5ml

4.2 ANTIFUNGI
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 SOLINFEC KETOCONAZOL 200 mg
2 NYSTIN DROP NYSTATIN 100.000 IU

4.3 ANTIHERPES
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 ACIFAR SALEP ACYCLOVIR 5%
2 ACIFAR TAB 400 mg

4.4 ANTIPROTOZOA
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 FLADEX F METRONIDAZOLE 500 mg
1 FARIZOL SYR 125 mg/ 5ml

5. ANTI HIPERTENSI
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 HEXAVASK 5 AMLODIPIN 5 mg
2 HEXAVASK 10 10 mg
2 FORTEN 12,5 CAPTOPRIL 12,5 mg
3 FORTEN 25 25 mg
4 FORTEN 50 50 mg
5 BISOVELL BISOPROLOL 5 mg
6 OPIPROL 2,5 mg
7 FARMABES DILTIAZEM 30 mg
8 HIDROKLOROTIAZID HIDROKLOROTIAZID 25 mg
9 IRBESARTAN IRBESARTAN 300 mg
10 CANDOTENS 8 CANDESARTAN 8 mg
11 CANCODOTENS 16 16 mg
12 FARMALAT NIFEDIPIN 10 mg

2
6. ANTIAGREGASI PATELET
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 FARMASAL ASETOSAL 100 mg
2 CLOGIN CLOPIDOGREL 75 mg
3 CLOPIDOGREL 75 mg

7. GAGAL JANTUNG
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 OPIPROL BISOPROLOL 2,5 mg
2 BISOVELL 5 mg
3 FARGOXIN DIGOXIN 0,25 mg
4 FARSIRETIC FUROSEMID 40 mg
5 FORTEN 12,5 CAPTOPRIL 12,5 mg
6 FORTEN 25 25 mg
7 FORTEN 50 50 mg
8 CANDOTENS 8 CANDESARTAN 8 mg
9 CANDOTENS 16 16 mg
10 SPIROLA 25 SPIRONOLACTON 25 mg
11 SPIROLA 100 100 mg
12 FASORBID 5 ISDN 5 mg
13 FASORBID 10 10 mg

8. ANTI DIABETES
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 LATIBET GLIBENCLAMIDE 5 mg
2 GLIMETIC GLIMEPIRIDE 2 mg
3 GLIMEPIRIDE 4 mg
4 DIABIT METFORMIN 500 mg
5 VELACOM METFORMIN 500 mg
GLIMEPIRIDE 2 mg

9. ANTI HIPERLIPIDEMIA
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 TAVORA ATORVASTATIN 20 mg
2 SVT 10 SIMVASTATIN 10 mg
3 SVT 20 20 mg
4 GEMFIBROZIL GEMFIBROZIL 300 mg

10. SALURAN CERNA

10.1 ANTASIDA DAN ANTI ULKUS
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 ANFLAT TAB 400 mg
400 mg
Al (OH)3 100 mg
2 ANFLAT SYR Mg (OH)2 Tiap 5 ml
SIMETICONE :400 mg
400 mg
100 mg
3 GASTRUCID SYR Al (OH)3 325 mg
Mg (OH)2 325 mg
DIMETILPOLISILOKSAN 50 mg
4 RANITIDIN RANITIDIN 150 mg
5 TAMEZOL OMEPRAZOLE 20 mg
6 LANSOPRAZOLE LANSOPRAZOLE 30 mg
7 ULCUMAAG SUCRALFAT 500 mg
8 PROFAT 500 mg/ 5 ml

3
10.2 ANTI EMETIK
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 OMEDRINAT DIMENHIDRINAT 50 mg
2 VESPERUM DOMPERIDON 10 mg
5 mg/ 5ml
3 VOMINA DOMPERIDON 10 mg
5 mg/ 5 ml
4 NORVOM METOCLOPRAMID 10 mg
5 ONDANOSTIN ONDANSETRON

11. ANTI VERTIGO

NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 HISTIGO BETAHISTIN 6 mg
2 NOVERTY

12. OBAT YANG MEMPENGARUHI KOAGULASI

NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 NEXA TAB ASAM TRANEXAMAT 500 mg
2 ASAM TRANEXAMAT inj 500 mg/5 ml
3 INVICLOT HEPARIN 5000 IU

13. ANTI ASTHMA

NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 SALBRON SALBUTAMOL 2 mg
2 BRONCHOSAL 4 mg
3 AMINOPHYLLIN AMINOPHYLLIN 200 mg
4 BRONSOLVAN THEOPHYLLINE 150 mg
5 THEOBRON THEOPHYLLINE 130 mg
6 VENTOLIN NEBUL SALBUTAMOL 2.5 mg

14. OBAT BATUK

NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 FLUCADEX PARACETAMOL 500 mg
DEXTROMETHORPHAN HBr 15 mg
GG 50 mg
PPA 15 mg
CTM 1 mg
2 FLUTAMOL PARACETAMOL 500 mg
GG 50 mg
PPA 15 mg
CTM 2 mg
3 FLUTAMOL SYR PARACETAMOL 125 mg
GG 12,5 mg
PPA 3,5 mg
CTM 0.5 mg
Vit C 25 mg
4 DEXTRAL FORTE DEXTROMETHORPHAN Hbr 15 mg
GG 75 mg
PPA 15 mg
CTM 2 mg
5 IFARSYL DEXTROMETHORPHAN Hbr 15 mg
GG 100 mg
CTM 2 mg
6 IFARSYL PLUS SYR DEXTROMETHORPHAN Hbr 10 mg
GG 32,5 mg
CTM 3 mg
AMMONIUM CHLORIDE 100 mg
7 BROMIFAR BROMHEXIN 8 mg

4
 8 ROVERTON AMBROXOL 30 mg

9 TERNIX PLUS SYR PARACETAMOL 250 mg

PSEUDOEFEDRINE HCI 15 mg
CTM 1 mg
GG 100 mg

16. VITAMIN
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 VITAMIN A
2 VITAMIN B6 PYRIDOXINE 10 mg
3 VITAMIN B12 CYANOCOBALAMIN 50 mcg
4 VITAMIN B COMPLEX THIAMINE 2 mg
RIBOFLAVIN 2 mg
PYRIDOXINE 2 mg
CA PANTHOTENAT 10 mg
NICOTINAMIDUM 20 mg
5 VITAMIN C 25 mg
6 SOFERO Ferro fumarate 90 mg
Manganese sulfate 200 mcg
Copper sulfate 200 mcg
Folic acid 800 mcg
Sorbitol 25 mg
Vitamin B1 5 mg
Vitamin B6 5 mg
Vitamin B12 7,5 mg
Vitamin C 50 mg
7 INBION Fe gluconate 250 mg
Manganese sulfate 200 mcg
Copper sulfate 200 mcg
Vit.C 50 mg
Folic Acid 1 mg
Vit.B12 dengan faktor intrinsik 7.5 mg
Sorbitol 25 mg 25 mg
8 CALCIFAR PLUS Calcium hydrogen phosphate 500 mg
dihydrate
Vitamin D3 200 IU
9 CAVIPLEX Vitamin A 4000 iu
Vitamin D 400 iu
Vitamin B1 3 mg
Vitamin B2 4 mg
Vitamin B6 4 mg
Vitamin B12 12 mcg
Vitamin C 75 mcg
Nikotinamid 20 mg
Ca pantotenat 5 mg
Vitamin E 10 mg
Biotin 0,1 mg
Acid Folic 1 mg
Fe Fumarat 135 mg
Acid Glutamic 50 mg
Ca 100 mg
Mg karbonat 87,5 mg
Zn 15 mg
Cu 0,5 mg
Mn 0,5 mg
Fluor 0,5 mg
Iodium 0,15 mg
10 KALBION Vitamin B1 100 mg
Vitamin B6 100mg

5
 Vitamin B12 5000 mcg
11 NUTRIFAR 5000 Thiamine HCl 100 mg
Pyridoxine HCl 200 mg
Cyanocobalamin 200 mcg
12 MULSANOL SYR DHA 10 mg
L – LYSINE HCl 100 mg
Vit A 1000 iu
Vit D 200 iu
Vit B1 3 mg
Vit B2 2 mg
Vit B6 2 mg
Vit B12 2,5 mcg
Niacinamide 10 mg
CA Pantothenate 3 mg
13 KITAVID SYR Curcuminoid 2 mg
Lysine HCl 250 mg
Vit B1 3 mg
Vit B2 2 mg
Vit B6 5 mg
Vit B12 5 mcg
Niacinamide 5 mg
Pantothenic acid 3 mg
14 LYVIT SYR Vit A 5,000 iu
Vit B1 3 mg
Vit B2 1,5 mg
Vit B6 2,5 mg
Vit B12 5 mcg
Vit C 50 mg
Vit D 1,000 iu
Nicotinamide 20 mg
Panthenol 5 mg
Lysine HCl 200 mg

17. ANTIHEMOROID
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 AMBEVEN Graptophyllum 90 mg
pictum
Sophorae Japonicae 85 mg
Rubia Cordofoliae 10 mg
radix
Curcumae 10mg
Domesticae rhizome
Sanguisorba 20 mg
Officinate radix
Kaempferiae 10 mg
angustifolia radix
Curcumae Heyneanae 25 mg
Rhizome

18. ANTI DIARE

NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 LOPERAMIDE LOPERAMIDE Hcl 2 mg
2 AKITA Attapulgit 600 mg
Pectin 50 mg
3 DIAGIT Attapulgit 600 mg
Pectin 50 mg
4 GUANISTREP SYR Kaolin 986 mg
Pectin 40 mg
19. ANTI SPASMODIK
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN

6
 1 SCOPMA PLUS Hyoscine-N-butylbromide 10 mg
Paracetamol 500 mg
2 SPASMINAL Metamizole Na 500 mg
Belladonna extr 10 mg
Papaverine HCl 25 mg

20. DECONGESTAN
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 PROTIFED SYR Triprolidine HCl 1,25 mg
Pseudoephedrine HCl 30 mg
2 TERNIX SYR Paracetamol 250 mg
Pseudoephedrine HCl 15 mg
CTM 1 mg
3 TRIFED Triprolidine HCl 2,5 mg
Pseudoephedrine HCl 60 mg
4 NEO PROTIFED Triprolidine HCl 2,5 mg
Pseudoephedrine HCl 60 mg
5 DEMACOLIN Paracetamol 500 mg
Pseudoefedrin HCl 7,5 mg
CTM 10 mg
6 MOLEXFLU Paracetamol 500 mg
Phenylpropanolamine HCl 12,5 mg
CTM 2 mg
7 FARNIREX Paracetamol 650 mg
PPA 15 mg
8 DEMACOLIN SYR Paracetamol 120 mg
Pseudoefedrin 7,5 mg
CTM 1 mg

21. PENCAHAR
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 LAXANA BISACODYL 5 mg
2 KOMPOLAX SYR Liquidum parafin 1,5 gram
Phenolphthalein 75 mg
Gliserin 1 gram

22. KORTIKOSTEROID
NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 DEXAMETHASON DEXAMETHASON 0,5 mg
0,75 mg
2 RHEMAFAR METIL PREDNISOLON 4 mg

23. OBAT TOPIKAL

NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN
1 SOLINFEC SALEP KETOCONAZOL 2%
2 ORSADERM BETAMETHASONE 0,1 %
3 SCABIMITE PERMETRIN 5%
4 2-4 SALEP ASAM SALISILAT 2%
BELERANG 4%
5 ERLAMYCETIN TETES CHLORAMPHENICOL BASE 1%
TELINGA
6 RECO TETES MATA CHLORAMPHENICOL 0.5%
7 GENALTEN SALEP GENTAMYCIN SULFATE 0.1 %
8 GENOINT TETES MATA 0,3 %

DAFTAR OBAT TROLI EMERGENCY

NO NAMA OBAT KANDUNGAN DOSIS SEDIAAN

7
 1 KETROBAT Inj Ketorolac 30 mg/ml
2 ANTRAIN Inj Metamizole Na 500 mg/ml
3 ASAM TRANEXAMAT Inj ASAM TRANEXAMAT Inj 50 mg/ml
4 GITAS Inj Hyoscine N Butylbromide 20 mg/ml
5 ATROPIN INJ ATROPIN 0,25 mg/ ml
6 NEUROBAT Inj Vit B1 100 mg
Vit B6 100 mg
Vit B12 5 mg
7 TRAMADOL Inj TRAMADOL 100 mg/2ml
8 RECODRYL Inj DIPHENHIDRAMINE 10 mg/ml
9 DEXAMETHASONE Inj DEXAMETHASONE 5 mg/ml
10 RANITIDIN Inj RANITIDIN 25 mg/ml
11 LIDOCAIN Inj 2%
12 TOMIT Inj METOCLOPRAMIDE 5 mg/ml
13 ONDANSETRON Inj ONDANSETRON Inj 4 mg/ 2ml
8 mg/ 4ml
14 TROMBO ASPILET ASAM ASETILSALISILAT 80 mg
15 CLOPIDOGREL BISULFATE CLOPIDOGREL BISULFATE 75 mg
16 DOPAMIN DOPAMIN 10 mg/ml
17 VASCON NOREPHINEPHRINE 4mg/4ml
18 DOBUTAMIN DOBUTAMIN

DAFTAR SERUM
NO NAMA VAKSIN SEDIAAN
1 ATS AMPUL

DAFTAR OBAT CAIRAN

NO NAMA CAIRAN DOSIS SEDIAAN

1 RL
2 NaCl 0,9 %
3 DEXTROSE
4 AQUA BIDES
5 POVIDION IODINE
6 D5 1/4NS
7 D 5 ½ NS
8 WIDA BES
9 ASERING
10 KN3B
11 DEXTROSE 40% 25 ml
12 H2O2 2%

DAFTAR ALKES DAN BMHP

NO NAMA

8
 1 ABOCAT 18G
2 ABOCAT 20G
3 ABOCAT 22G
4 ABOCAT 24G
5 ABOCAT 26G
6 BD NEEDLE 23G
7 BD NEEDLE 26G
8 BLOOD LANCET
9 ECG /PAC
10 FOLEY CATHETER 16
11 FOLEY CATHETER 18
12 HANDSAPLAST(BOX)
13 HANDSCONE MAXTER S,M,L(BOX)
14 HEPAVIX(BOX)
15 INFUSET ANAK
16 INFUSET DEWASA
17 KAPAS GULUNG
18 KASA GULUNG
19 KERTAS EKG
20 LEOKOPLAST
21 LOMATULLE
22 MASK DISPOSABLE(BOX)
23 MASK NEBUL ANAK
24 MASK NEBUL DEWASA
25 MASK O2 ANAK
26 MASK O2 DEWASA
27 NASAL CANNUL ANAK
28 NASAL CANNUL DEWASA
29 NGT
30 SPUIT 10CC
31 SPUIT 1CC INSULIN
32 SPUIT 3CC
33 SPUIT 5CC
34 TRANFUSI SET
35 UNDERPAD
36 URIN BAG
37 IUD
38 SANOSKIN TULLE