A. INJEKSI
1 Aminofillin Injeksi 24 mg/ ml Kt k 30 amp @ 10 ml 15
2 ampisilin serbuk injeksi i.m./ i.v. 1000 mg/ vial kt k 10 Vial 180
3 Aqua pro Injeksi St eril, Bebas Pirogen kt k 10 vial @ 20 ml 2,592 4 At ropin injeksi i.m./ i.v/ s.k. 0,25 mg/ ml (Sulfat ) kt k 30 amp @ 1 ml 18
5 Deksamet ason injeksi i.v. 5 mg/ ml kt k 100 amp @ 1 ml 27
6 Diazepam Injeksi 5mg/ ml kt k 30 amp @ 2 ml 18
7 Difenhidramin injeksi i.m. 10 mg/ ml (HCl) kt k 30 amp @ 1 ml 48
8 Efinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) kt k 30 amp @ 1 ml 6
9 Fenit oin Nat rium Injeksi 50 mg/ ml amp @ 2 ml 36
10 Fenobarbit al Injeksi i.m./ i.v. 50 mg/ ml kt k 30 amp @ 1 ml 12
11 Fit omenadion (Vit amin K1) injeksi 10 mg/ ml kt k 30 amp @ 1 ml 30
12 Furosemid injeksi i.v/ i.m. 10 mg/ ml kt k 25 amp @ 2 ml 36
13 Gent amicin Inj 80 mg/ ml kt k 1 Vial @ 2 ml 1,800 14 Gent amicin Injeksi 40 mg/ ml kt k 5 amp 200
15 Ket orolac injeksi 10 mg kt k 5 amp @ 1 ml 126
16 Ket orolac injeksi 30 mg kt k 6 amp @ 1 ml 60
17 Klorpromazin injeksi 1.m. 25 mg/ ml (HCl) kt k 30 amp @ 2 ml 3
18 Kuinin Dihidroklorida Injeksi 25 % - 2 ml kt k 30 amp 15
19 Lidokain Injeksi 2 % (HCl) +Epinefrin 1:80.000 - 2 ml kt k 30 amp @ 2 ml 300
20 M agnesium Sulfat inj (IV) 40% - 25ml kt k 10 vial 18
21 M et ampiron Injeksi 250 mg kt k 30 amp @ 2 ml 3
22 M et ilergomet rin M aleat injeksi 0,200 mg-1 ml kt k 30 amp 3
23 M et oklorpramid injeksi 5 mg/ ml kt k 10 amp @ 2 ml 90
24 M orfin injeksi 10 mg/ ml kt k 10 amp @ 1 ml 2
25 Oksit et rasiklin HCl injeksi i.m. 50 mg.ml-10 ml kt k 10 vial 9
26 Oksit osin Injeksi 10IU/ ml-1ml kt k 30 amp 360
27 papaverin injeksi 40 mg/ ml kt k 100 amp @ 1 ml 9
28 Pet idin injeksi 50 mg/ ml kt k 10 amp 2
29 Piracet am injeksi 1 g/ 5 ml kt k 10 amp 18
30 Prokain Benzil Penisilin G. injeksi 3 jt IU/ vial kt k 30 vial @ 15 ml 2
31 Ranit idin injeksi 25 mg/ 2 ml kt k 25 amp 36
32 Sefot aksim injeksi 1 gram per vial kt k 1 vial 360
33 Seft riakson serbuk injeksi 750 mg/ vial kt k 1 vial @ 10 ml 360
34 Sianokobalamin (Vit amin B12) injeksi 500 mcg kt k 100 amp @ 1 ml 2
35 Tramadol injeksi 50 mg/ ml kt k 5 amp 90
B. TABLET
36 Asiklovir t ablet 400 mg kt k 5 x 10 t ablet 18.0 37 Albendazol t ablet / t ablet kunyah 400 mg kt k 5 x 6 t ablet 18.0 38 Alopurinol t ablet 100 mg kt k 10 x 10 t ablet 18.0 39 Alprazolam t ablet 0,5 mg kt k 10 x 10 t ablet 18.0 40 Ambroxol t ablet 30 mg kt k 10 x 10 t ablet 180.0 41 Aminofilin t ablet 200 mg bt l 100 t ablet 18.0 42 Amit ript ilin t ablet salut 25 mg (HCl) kt k 10 x 10 t ablet 18.0 43 Amlodipin t ablet 10 mg kt k 5 x 10 t ablet 180.0
OBAT GENERIK
TAHUN ANGGARAN 2012
NO
NAMA OBAT
SATUAN
VOL
DINAS KESEHATAN
Jln. Bung Karno Kompleks Kemutar Telu Center (KTC) Taliwang Kabupaten Sumbawa Barat Telp. (0372) 81833; Fax. (0372) 81833. Email : dinkes_ksb@yahoo.co.id
44 Amlodipin t ablet 5 mg kt k 5 x 10 t ablet 180.0 45 Amoksisilin kaplet 250 mg kt k 10 x 10 kapsul 360.0 46 Amoksisilin kaplet 500 mg kt k 10 x 10 kaplet 2,520.0 Ant asida DOEN I Tablet Kunyah, kombinasi : kt k 10 x 10 t ablet 1,080.0 Alumunium Hidroksida 200 mg
M agnesium Hidroksida 200 mg
48 Ant imigren (Ergot amin Tart rat 1 mg+Kofein 50 mg bt l 100 t ablet 81.0 49 Asam M efenamat kapsul 500 mg kt k 10 x 10 t ablet 720.0 50 Asam Aset ilsalisilat t ablet 100 mg (Aset osal) kt k 10 x 10 t ablet 36.0 51 Bet ahist in M esilat t ablet 6 mg kt k 3 x 10 t ablet 18.0 52 Bromheksin t ablet 8 mg kt k 10 x 10 t ablet 90.0 53 Cet irizine t ablet 10 mg kt k 5 x 10 t ablet 72.0 54 Deksamet ason t ablet 1,5 mg kt k 10 x10 t ablet 540.0 55 Dekst romet orfan t ablet 15 mg (HBr) kt k 10 x10 t ablet 54.0 56 Diazepam t ablet 2 mg kt k 10 x10 t ablet 18.0 57 Diazepam t ablet 5 mg kt k 10 x10 t ablet 36.0 58 Digoksin t ablet 0,25 mg kt k 10 x10 t ablet 72.0 59 Dilt iazem HCl t ablet 30 mg kt k 10 x10 t ablet 36.0 60 Dimenhidrinat t ablet 50 mg bt l 100 t ablet 36.0 61 Domperidon t ablet 10 mg kt k 10 x10 t ablet 36.0 62 Ekst rak Belladona t ablet 10 mg bt l 1000 t ablet 1.0 63 Efedrin t ablet 25 mg (HCl) bt l 250 t ablet 36.0 64 Erit romisin kapsul 250 mg kt k 10 x10 t ablet 36.0 65 Famot idine t ablet 20 mg kt k 5 x 10 t ablet 126.0 66 Fenit oin kapsul 100 mg bt l 250 kapsul 4.0 67 Furosemid t ablet 40 mg kt k 10 x10 t ablet 72.0 Garam Oralit I Serbuk, kombinasi : kt k 100 sachet 90.0 Nat rium 0,52 gram
Nat rium Klorida 0,30 gram Trinat rium Sit rat Dihidrat 0,58 gram Glukosa Anhidrat 2,70 gram
69 Gemfibrozil kapsul 300 mg kt k 10 x10 kapsul 54.0 70 Glibenklamida t ablet 5 mg kt k 10 x10 t ablet 90.0 71 Glimepiride t ablet 1 mg kt k 5 x10 t ablet 180.0 72 Gliseril guaiakolat t ablet 100 mg bt l 1000 t ablet 36.0 73 Griseofulvin t ablet 125 mg kt k 10 x 10 t ablet 9.0 74 Haloperidol t ablet 1,5 mg kt k 10 x10 t ablet 36.0 75 Haloperidol t ablet 5 mg kt k 10 x 10 t ablet 18.0 76 Hyoscine -N-But ilbromide t ablet 10 mg kt k 10 x10 t ablet 36.0 77 Ibuprofen t ablet 400 mg kt k 10 x10 t ablet 180.0 78 Isosorbit Dinit rat t ablet sublingual 5 mg kt k 10 x10 t ablet 54.0 79 Kalsium Lakt at (Kalk) t ablet 500 mg bt l 1000 t ablet 27.0 80 Kapt opril 25 mg kt k 10 x 10 t ablet 90.0 81 Karbamazepin t ablet 200 g kt k 10 x 10 t ablet 18.0 82 Ket okonazol t ablet 200 mg kt k 5 x10 t ablet 216.0 83 Ket oprofen t ablet 100 mg kt k 10 x10 t ablet 18.0 84 Klorfeniramina M aleat (CTM ) t ablet 4 mg bt l 1000 t ablet 54.0 85 Klorokuin t ablet 150 mg bt l 1000 t ablet 1.0 86 Klorpromazin t ablet salut 100 mg (HCl) bt l 250 t ablet 7.2 87 Kodein t ablet 10 mg bt l 250 t ablet 2.0 88 Kot rimoksazol DOEN I (dew asa) kt k 10 x 10 t ablet 360.0
kombinasi :
Sulfamet oksazol 400 mg Trimet oprim 80 mg
89 Lansoprazol kapsul 30 mg kt k 2 x 10 Kapsul 540.0 90 Levofloksasin t ablet 500 mg kt k 5 x 10 t ablet 108.0 91 Loperamid Tablet 2 mg kt k 10 x 10 t ablet 36.0 92 Lorat adin t ablet 10 mg kt k 5 x 10 t ablet 180.0 47
93 M eloksikam t ablet 15 mg kt k 5 x 10 t ablet 108.0 94 M eloksikam t ablet 7,5 mg kt k 5 x 10 t ablet 72.0 95 M et ampiron t ablet 500 mg kt k 10 x 10 t ablet 90.0 96 M et formin HCl t ablet 500 mg kt k 10 x 10 t ablet 180.0 97 M et ilprednisolon t ablet 4 mg kt k 10 x 10 t ablet 108.0 98 M et ilprednisolon t ablet 8 mg kt k 10 x 10 t ablet 18.0 99 M et oklopramide t ablet 10 mg kt k 10 x 10 t ablet 54.0 100 M et ronidazol t ablet 500 mg kt k 10 x 10 t ablet 108.0 101 Nat rium diklofenak t ablet 50 mg kt k 5 x 10 t ablet 108.0 102 Nifedipin t ablet 10 mg kt k 10 x 10 t ablet 36.0 103 Nist at in t ab salut 500.000 IU/ g kt k 10 x 10 t ablet 18.0 104 Ofloxacin t ablet 200 mg kt k 5 x 10 t ablet 108.0 105 Omeprazol kapsul 20 mg kt k 3 x 10 kapsul 60.0 106 Paraset amol t ablet 500 mg kt k 10 x 10 t ablet 2,700.0 107 Piracet am t ablet 800 mg kt k 10 x 10 t ablet 36.0 108 Piridoksin (Vit amin B6) t ablet 25 mg (HCL) bt l 1000 t ablet 36.0 109 Piroksikam t ablet 20 mg kt k 10 x 10 t ablet 36.0 110 Prednison t ablet 5 mg bt l 1000 t ablet 13.0 111 Primakuin t ablet 15 mg bt l 1000 t ablet 10.8 112 Propilt iourasil t ablet 100 mg bt l 100 t ablet 36.0 113 Propanolol t ablet 10 mg (HCl) kt k 10 x 10 t ablet 36.0 114 Propanolol t ablet 40 mg (HCl) bt l 100 t ablet 18.0 115 Ranit idin t ablet 150 mg kt k 10 x 10 t ablet 63.0 116 Salbut amol t ablet 2 mg (Sebagai Sulfat ) kt k 10 x 10 t ablet 270.0 117 Salbut amol t ablet 4 mg (Sebagai Sulfat ) kt k 10 x 10 t ablet 18.0 118 Sefadroksil kapsul 500 mg kt k 10 x 10 kapsul 90.0 119 Sefiksim kapsul 100 mg kt k 3x 10 kapsul 5.4 120 Simet idin t ablet 200 mg kt k 10 x 10 t ablet 54.0 121 Simvast at in t ablet 10 mg kt k 5 x 10 t ablet 180.0 122 Siprofloksasin t ablet 500 mg (Sebagai HCl) kt k 10 x 10 t ablet 180.0 123 Spironolakt on t ablet 100 mg kt k 10 x 10 t ablet 36.0 124 Besi (II) Sulfat 200 mg+Asam Folat 0,25 mg t ablet 1 sase @ 30 t ablet 600.0
(t ablet t ambah darah kombinasi)
125 Terbut alin t ablet 2,5 mg kt k 5 x 10 t ablet 36.0 126 Tiamfenikol kapsul 500 mg kt k 10 x 10 t ablet 360.0 127 Tiamin (Vit amin B1) t ablet 50 mg (HCl/ Nit rat ) bt l 1000 t ablet 18.0 128 Tramadol t ablet 50 mg kt k 5 x 10 t ablet 90.0 129 Triheksilfenidil t ablet 2 mg kt k 10 x 10 t ablet 9.0 130 Verapamil t ablet 80 mg (HCl) kt k 10 x 10 t ablet 9.0 131 Vit amin B Kompleks t ablet bt l 1000 t ablet 18.0 132 Zinc t ablet 20 mg kt k 10 x 10 t ablet 90.0
C. SYRUP
133 Amoksisillin sirup kering 125 mg/ 5 ml bt l 60 ml 2,700.0 134 Ant asida DOEN II suspensi, kombinasi : bt l 60 ml 900.0
Aluminium Hidroksida 200 mg/ 5 ml M agnesium Hidroksida 200 mg/ 5 ml
135 Dekst romet orfan sirup 10 mg/ 5 ml (HBr) bt l 60 ml 540.0 136 Domperidon suspensi 5 mg / 5 ml bt l 60 ml 540.0 137 Ibuprofen suspensi 100 mg / 5 ml bt l 60 ml 450.0 138 Kot rimoksazol suspensi komb : bt l 60 ml 3,600.0
Sulfamet oksazol 200 mg+Trimet oprim 40 mg/ 5ml
139 M et oklopramide sirup 5 mg / 5 ml bt l 60 ml 540.0
140 Paraset amol drops bt l 15 ml 900.0
D. SUPPOSITORIA
145 Ant ihemoroid DOEN kombinasi: kt k 10 suppo 18.0 Bismut subgalat 150 mg
Heksaklorofen 2,5 mg
E. INFUS
146 Dekst ran 70-larut an infus 6 % st eril bt l 500 ml 540.0 147 Glukosa larut an infus 10 % st eril bt l 500 ml 360.0 148 Glukosa larut an infus 40 % st eril kt k 10 amp @ 25 ml 18.0 149 Glukosa larut an infus 5 % st eril bt l 500 ml 5,400.0 150 M et ronidazol infus 500 mg/ 100 ml bt l 100 ml 270.0 151 Nat rium Klorida larut an infus 0,9% bt l 500 ml 9,000.0 152 Ringer Lakt at larut an infus bt l 500 ml 18,000.0
F. CAIRAN / GELLY
153 Povidon Iodida larut an 10% bt l 60 ml 720.0 G. TETES / SALEP / POW DER
154 Asiklovir krim 5 % kt k 25 t ube @ 5 gram 21.6 155 Bet amet ason krim 0,1% (sebagai Valerat ) kt k 25 t ube @ 5 gram 216.0 156 Kloramfenikol salep mat a 1 % t ube 5 g 900.0 157 Kloramfenikol Tet es M at a 0,5 % bt l 5 ml 900.0 158 Kloramfenikol Tet es Telinga 3% bt l 5 ml 900.0 159 Gent amisin Salep Kulit 0,1 % kt k 25 t ube @ 5 gram 14.4 160 Hidrokort ison krim 2,5 % t ube 5 g 5,400.0 161 Ket okonazol krim 2% t ube 15 gram 450.0 162 M ikonazol krim/ salep 2% (Nit rat ) t ube 450.0 163 Oksit et rasiklin HCl salep mat a 1% kt k 25 t ube @ 3,5 gr 36.0 164 Oksit et rasiklin salep kulit 3% kt k 25 t ube @ 5 gram 144.0
165 Salisil bedak 2% kt k 50 gram 2,700.0
166 Tet rakain HCl t et es mat a 0,5% kt k 24 bt l @ 5 ml 3.8
A. INJEKSI
167 Asam Traneksamat Inj 250 mg/ 5 ml box @ 10 amp 40
168 Asam Traneksamat Inj 500 mg/ 5 ml box @ 10 amp 40
169 At racium 50 mg kt k @ 5 amp 15
170 ATS Inj 1500 IU Ampul 90
171 ATS Inj 20000 IU/ amp 4 ml Ampul 18
172 SITICOLIN INJ 250 M G/ 2 M L) kt k @ 5 amp 80
173 Combivent Ampul 72
174 Dobut amin Giullini Injeksi ampul 49
175 Dopamin Giullini Injeksi Kt k @ 5 Ampul 49
176 DIGOXIN Kt k @ 5 Ampul 40
177 ISOSORBID Kt k @ 2 Ampul 42
178 TRIAM SINOLON ASETONID Amp 170
179 Fluxum 0,6 cc Kt k @ 6 Ampul 10
180 Fulmicort Ampul 180
181 HIOSINA-N-BUTILBROM IDA Kt k @ 5 Amp 54
182 Heparin Inj Vial 180
183 Kalsium glukonat Inj 100 mg/ ml Ampul 180
184 LIDOCAIN HCL kt k @ 5 amp 37
185 VIT B1 100 M G, VIT B6 100 M G Amp 900
186 Nicardipin Kt k @ 10 Ampul 6
187 Nimodipin Ampul 37
188 Norefpinefrin Inj (Levosol 8mg) kt k 5 amp 15
189 Omeprazole Inj vial 260
190 Ondanset ron 8 mg/ 2ml kt k 5 amp 18
191 SABU Inj vial 18
193 Warfarin Inj Kt k @ 100 Ampul 2
194 Xilomidon Inj Vial 100
B. TABLET 195 Ant algin 500 mg kt k 10 x 10 t ablet 50
196 Asam Tranexamat 500 mg kt k 10 x 10 t ablet 80
197 Aspar K kt k 10 x 10 t ablet 10
198 Curcuma 200 mg bt l 500 t ablet 30
199 kt k 10 x 10 t ablet 54
200 kt k 10 x 10 t ablet 20
201 ASAM TRANEXAM AT kt k 10 x 10 t ablet 30
202 ASAM TRANEXAM AT kt k 10 x 10 t ablet 30
203 bt l 30 t ablet 60
204 kt k 10 x 20 t ablet 180
C. SYRUP 205 AM OXICILLIN drops 15 ml 500
206 bt l 1,300 207 Bromheksin Hcl bt l @ 60 ml 400
208 KAOLIN 700 M G, PECTIN 66 M G/ 15 M L bt l 60 ml 1,700 209 Tyamfenicol syr bt l 1,510 D. SUPPOSITORIA 210 BISAKODIL box @ 50 suppo 2
211 BISAKODIL box @ 6 suppo 20
212 Kalt ropen Supp 100 mg (Prot offen Supp 100mg) kt k @ 20 supp 9
213 t ube 121
214 PARASETAM OL box @ 12 suppo 15
215 PARASETAM OL box @ 12 suppo 15
216 M ETRONIDAZOL 500 M G, NISTATIN 100.000 IU supp 80
217 DIAZEPAM kt k @ 5 t ube 54
E. INFUS 218 Aminofluid bt l/ 500 ml 36
219 Asam Amino 5 % dan 7 % BTL 20
220 BTL 20
221 Asam Amino 50 g, Vit , Elekt rolit BTL 250 M L 20
222 Aqua 1 L bt l 1 L 20
223 fls 500 ml 450
224 Combivent nebules 100 mcg Kt k @ 20 Vial 350
225 Na 38,5 meq, cl 38,5 meq, glukosa 37,5 g fls 500 ml 450
226 fls 500 ml 450 Ca ++ 3 mEq+ 4meq, Na meq, cl-109 meq, aset at 28
meq
Na 60 meq, K10 M eq, cl 50 meq, lakt at 20 meq glukosa 27 g
Fe Glukonat 250 mg, M n Sulfat 0,2 mg, Cu Sulfat 0,2 mg, Vit C 50 mg, Asam Folat 1 mg, Vit B 12 7,5 M cg
M et ionin 100 mg, Kolin Bit art rat 100 mg, Vit B1 M ononit rat 2 mg, Vit B2 2 mg, Nikot inamid, 6 mg, vit B6 hidroklorida 2 mg, Ca pant ot enat , 3 mg, biot in 0,1 mg, Asam folat 0,4 mg, vit B 12, 0,67 mcg, vit E 3 mg
VIT B1 M ONONITRAT 100 M G, B6 200 M G, Vit B-12 250 M cg
Vit B1 5 mg, Vit B2 2 mg, Vit B6 2,5 mg, Vit B 12 3 mcg, Niasinamid 20 mg, L-Lisin Hcl 200 mg, Dekspant enolol 3 mg/ 5 ml
Na Lauril sulfoaset at 45 mg, Na sit rat 450 mg,Asam sorbat 5 mg, PEG 400 625 mg, Sorbit ol 4,465 mg
As. Amini 50 g, sorbit ol mg, Xylit ol 50 g, vit , elekt rolit per L
227 fls 500 ml 450
228 asam aminio esensial dan non esensial bt l 100
229 M anit ol inf 20% 500 ml bt l 100
F. CAIRAN / GELLY 230 Alkohol 70% 1 L Bot ol 800
231 Formalin Cair 1 L fls 5
232 Jelly ECG fls 40
233 Jelly USG gallon( 5 Lit er ) 36
234 KY Jelly fls(82 gr ) 40
235 Lisol btl 36
236 Pehidrol 3% 1 L Bt l ( 800 ml ) 90
G. TETES / SALEP / POW DER 237 Albot hyl Concent rat e 10 ml bt l 54
238 Daryant ul Kt k @ 10 lembar 52
239 Neomicin sulfat 5 mg, Basit rasin 500 iu bt l 18
240 Pant ocain 0,5% TM Tube 58
I GIGI
241 Cresophen Bot ol 25
242 Cavit on Bot ol 12
243 Aquades St eril Bot ol 18
244 H2O2 Bot ol 18
245 Et il cloride Bot ol 54
246 CHKM Bot ol 5
247 Eugenol Bot ol 5
248 Glass Ionomer pak 10
249 Devit alisasi past a Bot ol 5
