Pengumuman - LKPP
Transcript of Pengumuman - LKPP
KELOMPOK KERJA KATALOG ELEKTRONIK OBAT TAHUN 2020-2022 LEMBAGA KEBIJAKAN PENGADAAN BARANG/JASA PEMERINTAH
Yth. Pimpinan Industri Farmasi di Tempat
Pengumuman
Berikut disampaikan Daftar Nama Obat yang akan diproses baik secara Tender maupun Negosiasi oleh Kelompok Kerja Pemilihan Katalog Elektronik Obat
Tahun 2020 – 2022 (Terlampir)
Demikian disampaikan, atas perhatian dan kerjasamanya diucapkan terimakasih.
Pokja Katalog Elektronik Obat Tahun 2020-2022
TTD Ketua
Tembusan Yth. : 1. Kepala LKPP
2. Sekretaris Jenderal Kementerian Kesehatan;
3. Deputi Bidang Monitoring Evaluasi dan Pengembangan Sistem Informasi LKPP;
4. Direktur Pengembangan Sistem Katalog LKPP.
Nomor : 01/POKJAOBAT2020/12/2019 30 Desember 2019 Lampiran : 3 Berkas Perihal : Pengumuman
1 Acetyl cysteine/ N-asetil sistein tablet/kapsul/kaplet 200 mg strip/ blister
2 Air untuk injeksi, cairan inj ampul/vial/botol 25 mL
3 Air untuk injeksi/ Aqua pro injeksi/ Aqua pro injection 20 ml ampul/vial/botol
4 Akarbose/Acarbose tablet/kapsul/kaplet 100 mg strip/blister
5 Akarbose/Acarbose tablet/kapsul/kaplet 50 mg strip/blister
6 Albendazol tablet/kapsul/kaplet 400 mg strip/blister
7 Alopurinol tablet/kapsul/kaplet 100 mg strip/blister
8 Alopurinol tablet/kapsul/kaplet 300 mg strip/blister
9 Alprazolam tablet/kapsul/kaplet 0,5 mg strip/blister
10 Alprazolam tablet/kapsul/kaplet 1 mg strip/blister
11 Amikasin/Amikacin/Amikacin sulfate injeksi 250 mg/ml vial/ampul
12 Aminofilin/Aminophylline inj 24 mg/ml ampul/vial 10 ml
13 Aminofilin/Aminophylline tablet/kapsul/kaplet 200 mgstrip/blister/maks botol 100
tablet
14 Amiodaron inj 50 mg/ml (150 mg/ 3 mL) ampul/vial
15Amitriptilin/Amitriptyline tablet salut selaput/kaplet salut selaput 25
mgstrip/blister
16 Amlodipin/Amlodipine tablet/kapsul/kaplet 10 mg strip/blister
17 Amlodipin/Amlodipine tablet/kapsul/kaplet 5 mg strip/blister
18 Amoksisilin/Amoxicillin sirup kering 250 mg/5 ml botol 60 ml
19 Amoksisilin/Amoxicillin tablet/kapsul/kaplet 250 mg strip/blister
20 Ampisilin/Ampicillin serbuk injeksi 1000 mg (i.v) ampul/vial
21 Anestetik lokal gigi kombinasi: lidokain 2% + epinefrin 1:80000, inj 2 mL ampul/vial
22Antasida, kombinasi: alumunium hidroksida 200 mg + magnesium
hidroksida 200 mg, susp botol 60 ml
23Antasida, kombinasi: alumunium hidroksida 200 mg + magnesium
hidroksida 200 mg, tab kunyah strip/ blister
24 Antifungi Salep, Kombinasi: Asam Benzoat 6% + Asam Salisilat 3% pot 30 g
25 Aripiprazol tab discmelt/tab cepat larut/disitegrating tablet 10 mg strip/ blister
26Asam asetilsalisilat (asetosal/acetosal) tablet sal enterik/kaplet salut
enterik 100 mg strip/ blister
27 Asam Folat/folic acid tablet/kapsul/kaplet 0,4 mg strip/ blister
28 Asam folat/folic acid tablet/kapsul/kaplet 1 mg strip/ blister
29Asam traneksamat/Tranexamic acid tablet/kapsul/kaplet salut selaput
500 mgstrip/blister
30 Asam traneksamat/Tranexamic acid injeksi 100 mg/ml ampul/vial
31 Asam traneksamat/Tranexamic acid injeksi 50 mg/ml ampul/vial
32Asam ursodeoksikolat/Ursodeoxycholic acid tablet/kapsul/kaplet 250
mg strip/ blister
33 Asiklovir/Acyclovir tablet/kapsul/kaplet 200 mg strip/ blister
34 Asiklovir/Acyclovir tablet/kapsul/kaplet 400 mg strip/ blister
35 Atorvastatin tablet/kapsul/kaplet salut selaput 10 mg strip/ blister
36 Atorvastatin tablet/kapsul/kaplet salut selaput 20 mg strip/ blister
37 Atracurium Besilate/ Atrakurium injeksi 10mg/mL (i.v) ampul/vial @ 5 mL
Lampiran 1
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DIPERSYARATKAN
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38 Atracurium Besilate/ Atrakurium injeksi 10mg/mL (i.v) ampul/vial @2,5 mL
39Azitromisin/Azithromycin dihydrate tablet salut selaput/kaplet salut
selaput 500 mg strip/ blister
40 Azitromisin/Azithromycin serb inj 500 mg ampul/vial
41 Azitromisin/Azithromycin sir kering 200 mg/ 5 mL maks botol @60 ml
42 Bedak salisil/Bedak salicyl serbuk 2% kotak/plastik
43Betahistin/Betahistine Mesilate/Betahistine Mesylate
tablet/kapsul/kaplet 6 mg strip/ blister
44 Betametason/Betamethasone Valerate krim 0,1% tube 5 gram
45 Bisoprolol/Bisoprolol Fumarate tablet/kapsul/kaplet 2,5 mg strip/ blister
46Bisoprolol/Bisoprolol Fumarate tablet salut selaput/kaplet salut selaput
5 mg strip/ blister
47 Bupivakain heavy/Bupivakain heavy (injeksi 0.50% + glukosa 8%) vial/ampul @4 ml
48 Bupivakain inj 0,5% (P.V) ampul/vial
49Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil sirup kering 125
mg/5mlbotol @ 60 mL
50Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil sirup kering 250
mg/5mlbotol @ 60 mL
51Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil tablet/kapsul/kaplet
250 mg strip/ blister
52Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil tablet/kapsul/kaplet
500 mg strip/ blister
53Cefalexin monohydrate/ Cefalexin/ Sefaleksin tablet/kapsul/kaplet 500
mg strip/ blister
54 Cefazolin sodium/ Sefazolin serbuk injeksi 1000 mg ampul/vial
55 Cefepime/ Sefepim serbuk injeksi 1000 mg ampul/vial
56 Cefixime trihydrate/ Cefixime/ Sefiksim sirup 100 mg/ 5 ml botol
57Cefixime trihydrate/ Cefixime/ Sefiksim tablet salut selaput/kaplet salut
selaput 200 mg strip/ blister
58 Cefoperazone sodium/Cefoperazone/ Sefoperazon serb inj 1.000 mg ampul/vial
59Cefoperazone sodium+ Sulbactam Sodium/ Cefoperazone + Sulbactam/
(Sefoperazon 500 mg + Sulbaktam 500 mg) serb inj 1.000 mgampul/vial
60 Cefotaxime sodium/ Cefotaxime/ Sefotaksim serb inj 1.000 mg ampul/vial
61 Cefotaxime sodium/ Cefotaxime/ Sefotaksim serb inj 500 mg ampul/vial
62 Cefpirome/ Sefpirom serb inj 1000 mg ampul/vial
63 Ceftazidime/ Seftazidim serb inj 1.000 mg ampul/vial
64 Ceftriaxone/Seftriakson serb inj 1.000 mg ampul/vial
65 Cefuroxime sodium/ Cefuroxime/ Sefuroksim serbuk injeksi 750 mg ampul/vial
66 Cetirizine hydrochloride(HCl)/ Cetirizine/ Setirizin sirup 5 mg/5 ml botol @ 60 mL
67Cetirizine hydrochloride(HCl)/ Cetirizine/ Setirizin tablet/kapsul/kaplet
10 mg strip/ blister
68Chloramphenicol/ Chloramphenicol palmitate/ Kloramfenikol suspensi
125 mg/ 5 ml botol 60 ml
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69 Chloramphenicol/ Kloramfenikol salep mata 1 % tube @ 5 gram
70 Chloramphenicol/ Kloramfenikol tablet/kapsul/kaplet 250 mg strip/ blister
71Chlorpromazine Hydrochloride/ Chlorpromazine / Klorpromazin injeksi
25 mg/ml ( i.m.)ampul/vial
72Ciprofloxacin hydrochloride (HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/
Siprofloksasin tablet salut selaput/kaplet salut selaput 500 mg strip/ blister
73Ciprofloxacin hydrochloride(HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/
Siprofloksasin inf 2 mg/ml vial/ botol 100 ml
74Clindamycin hydrochloride/ Clindamycin/ Klindamisin
tablet/kapsul/kaplet 150 mg strip/ blister
75Clindamycin hydrochloride/ Clindamycin/ Klindamisin
tablet/kapsul/kaplet 300 mg strip/ blister
76 Clobazam/ Klobazam tablet/kapsul/kaplet 10 mg strip/ blister
77 Clomifene citrate/ Klomifen sitrat tablet/kapsul/kaplet 50 mg strip/ blister
78Clonidine hydrochloride/ Clonidine/ Klonidin tablet/kapsul/kaplet 0,15
mg strip/ blister
79Clopidogrel bisulfate/ Clopidogrel/ Clopidogrel hydrogen sulfate/
Klopidogrel tablet salut selaput/kaplet salut selaput 75 mg strip/ blister
80 Clozapine/ Klozapin tablet 100 mg strip/ blister
81 Clozapine/ Klozapin tablet 25 mg strip/ blister
82
Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol (anak) kombinasi tiap 5
ml suspensi: sulfametoksazol 200 mg + trimetoprim 40 mg (susp 240
mg)
botol 60 mL
83Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol (dewasa) kombinasi:
sulfametoksazol 400 mg + trimetoprim 80 mg (tab/kaptab 480 mg) strip/ blister
84Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol forte kombinasi:
sulfametoksazol 800 mg + trimetoprim 160 mg (tab/kaptab 960 mg) strip/ blister
85Cyanocobalamin/ Cyanocobalamine/ Sianokobalamin (vitamin B12)
injeksi 500 mcg/mLampul/vial
86Cyanocobalamin/ Cyanocobalamine/ Sianokobalamin (vitamin B12)
tablet/kapsul/kaplet 50 mcg strip/ blister
87 Deferipron tab salut selaput/kaplet salut selaput 500 mg strip/ blister
88 Deksametason/ Dexamethasone tablet/kapsul/kaplet 0,5 mg strip/ blister
89 Desoksimetason/ Desoximetasone krim 0,25% tube 15 g
90Dexamethason Sodium Phosphate/ Deksamethason/ Deksametason
injeksi 5 mg/ml (i.v./i.m.)ampul/vial
91 Diazepam injeksi 5 mg/ ml (i.v. / i.m.) ampul/vial
92 Diazepam tablet/kapsul/kaplet 2 mg strip/ blister/ maks botol
100 tablet
93 Diazepam tablet/kapsul/kaplet 5 mg strip/ blister
94Diclofenac sodium/ Natrium diklofenak tablet salut enterik/kaplet salut
enterik 50 mg strip/ blister
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95Diclofenac sodium/ Natrium diklofenak tablet salut enterikl/kaplet salut
enterik 25 mg strip/ blister
96 Dietilkarbamazin/ Diethylcarbamazine tablet/kapsul/kaplet 100 mg strip/ blister
97 Difenhidramin/ Diphenhydramine injeksi 10 mg/ml ( i.v./i.m.) ampul/vial
98 Digoksin/ Digoxin tablet/kapsul/kaplet 0,25 mg strip/ blister
99 Diltiazem/ Diltiazem HCl tablet/kapsul/kaplet 30 mg strip/ blister
100 Dimenhidrinat tablet/kapsul/kaplet 50 mg strip/ blister/ maks botol
100 tablet
101Divalproex sodium / Valproat tablet salut enterik/ kaplet salut
enterik250 mg
strip/blister/maks botol 100
tablet
102 Dobutamin/ Dobutamin HCl/ Dobutamine HCl injeksi 50 mg/mL ampul/vial
103Domperidon/ Domperidone maleate/ Domperidone sirup/suspensi 5
mg/5 ml botol @60 ml
104 Domperidon/ Domperidone tablet/kapsul/kaplet 10 mg strip/ blister
105 Donepezil/ Donepezil HCl tablet salut selaput/kaplet salut selaput 5 mg strip/ blister
106 Dopamin / Dopamine hidrochloride injeksi 40 mg/ml ampul/vial
107 Efedrin/ Ephedrine HCl Inj 50 mg/ml ampul/vial
108 Epinefrin/ Epinephrine (Adrenalin) injeksi 0,1% (i.v/s.k./i.m) ampul/vial
109Eritromisin/ Erythromycin/ Erythromycin Ethyl Succinate sirup kering
200 mg/ 5 ml strip/ blister
110Eritromisin/ Erythromycin/ Erythromycin stearate tablet/kapsul/kaplet
250 mg strip/ blister
111Eritromisin/ Erythromycin/ Erythromycin stearate tablet/kapsul/kaplet
500 mg strip/ blister
112 Esomeprazole Sodium/ Esomeprazol serbuk Inj. 40 mg (i.v) ampul/vial
113 Fenitoin/ Phenytoin Sodium Injeksi 50 mg/ml (100 mg/ 2 mL) ampul @ 2 ml
114 Fenitoin/ Phenytoin/ Phenytoin sodium kapsul 100 mg strip/ blister/ maks botol
100 tablet
115 Fenofibrat tablet/kapsul/kaplet 100 mg strip/ blister
116 Fenofibrat tablet/kapsul/kaplet 300 mg strip/ blister
117 Fentanil/ Fentanyl injeksi 0,05 mg/ml (i.m/i.v) ampul @ 2 mL
118 Fentanil/ Fentanyl injeksi 0,05 mg/ml (i.m/i.v) ampul/vial, @ 10 mL
119Fitomenadion/ Phytomenadion (Vit.K1) tablet salut gula/kaplet salut
gula 10 mg strip/ blister
120 Fitomenadion/ Phytomenadion (Vitamin K1) injeksi 2 mg/ml (i.m.) ampul/vial
121 Flukonazol/ Fluconazole injeksi 2 mg/ml ampul/vial/botol
122 Fluoksetin/Fluoxetine HCl tablet/kapsul/kaplet 20 mg strip/ blister
123 Furosemid/ Furosemide inj 10mg/ml (i.v./i.m) ampul/vial
124 Furosemid/ Furosemide tablet/kapsul/kaplet 40 mg strip/ blister
125 Gabapentin tablet/kapsul/kaplet 300 mg strip/ blister
126Garam Oralit kombinasi: Natrium klorida 0,52 g + kalium klorida 0,30 g +
Trinatrium sitrat dihidrat 0,58 g + Glukosa Anhidrat 2,70 g, serbsachet
127 Gemfibrozil tablet/kapsul/kaplet 300 mg strip/ blister
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128 Gentamisin/ Gentamycin sulfate salep mata 0,3% (3 mg/g) tube
129 Gentamisin/ Gentamycin/ Gentamycin sulfate tetes mata 0,3% botol 5 mL
130 Glibenklamid/ Glibenclamide tablet/kapsul/kaplet 5 mg strip/ blister
131 Glimepiride tablet/kapsul/kaplet 1 mg strip/ blister
132 Glimepiride tablet/kapsul/kaplet 2 mg strip/ blister
133 Glimepiride tablet/kapsul/kaplet 3 mg strip/ blister
134 Glimepiride tablet/kapsul/kaplet 4 mg strip/ blister
135 Griseofulvin (micronized) tablet/kapsul/kaplet 125 mg strip/ blister
136 Griseofulvin (micronized) tablet/kapsul/kaplet 500 mg strip/ blister
137 Haloperidol tablet/kapsul/kaplet 0,5 mg strip/ blister
138 Haloperidol tablet/kapsul/kaplet 1,5 mg strip/ blister
139 Haloperidol tablet/kapsul/kaplet 5 mg strip/ blister
140 Hidrokortison/ Hydrocortisone krim 1% tube @ 5 g
141 Hidrokortison/ Hydrocortisone krim 2,5 % tube @ 5 g
142Hiosin butilbromid/Hyoscine butylbromide/Hyoscine N Butylbromide inj
20 mg/ml ampul/vial
143 Ibuprofen suspensi 100 mg/5 ml maks botol @ 60 ml
144 ibuprofen suspensi 200 mg/ 5ml maks botol @ 60 ml
145 Ibuprofen tablet/kapsul/kaplet 200 mg strip/ blister
146 Ibuprofen tablet/kapsul/kaplet 400 mg strip/ blister
147 Irbesartan tablet/kapsul/kaplet 150 mg strip/ blister
148 Irbesartan tablet/kapsul/kaplet 300 mg strip/ blister
149 Isosorbid dinitrat inj 1 mg/mL ampul/vial
150 Isosorbid Dinitrat/ Isosorbide dinitrate tablet/kaplet 5 mg strip/ blister
151 Isosorbid dinitrat/ Isosorbide dinitrate tablet/kapsul/kaplet 10 mg strip/blister
152 Kalsitriol kapsul lunak 0,25 mcgstrip/ blister/maks botol 100
kaps
153 Kalsium folinat/ Calsium folinate (leukovorin, Ca) injeksi 10 mg/mL ampul/vial
154 Kalsium glukonat/ Calcium gluconate inj 10% ampul/vial
155 Kalsium Karbonat tablet/kapsul/kaplet 500 mg strip/ blister
156 Kalsium Laktat/ Calcium lactate (Kalk) tablet/kapsul/kaplet 500 mg strip/ blister
157Kandesartan/ Candesartan/ Candesartan Cilexetil tablet/kapsul/kaplet
16 mg strip/ blister
158Kandesartan/ Candesartan/ Candesartan Cilexetil tablet/kapsul/kaplet
8 mg strip/ blister
159 Kaptopril/ Captopril tablet/kaplet 12,5 mg strip/ blister
160 Kaptopril/ Captopril tablet/kaplet 50 mg strip/ blister
161 Karbamazepin tablet/kapsul/kaplet 200 mg strip/ blister
162 Ketamin/Ketamine Hydrochloride injeksi 100 mg/ml ( i.v.) ampul/vial
163 Ketamin/Ketamine Hydrochloride injeksi 50 mg/ml ( i.v.) ampul/vial
164 Ketokonazol/ Ketoconazole krim 2% tube 10 gr
165 Ketokonazol/ Ketoconazole tablet/kapsul/kaplet 200 mg strip/ blister
166 Ketoprofen inj 25 mg/mL ampul/vial
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167Ketorolak/ Ketorolac / Ketorolac trometamol/ Ketorolac Tromethamine
inj 30 mg/ml (3%)ampul/vial
168Kombinasi: ferro fumarat 60 mg + as. Folat 0,4 mg tablet salut gula
(tablet tambah darah) strip/ blister
169Kombinasi: Levonogestrel 150 mcg + etinilestradiol 30 mcg (tab salut
gula)
strip/ blister (harga per
kemasan)
170 Lactulose/ Laktulosa sir 3,335 g/5 mL (G) botol @ 60 mL
171 Lansoprazole/ Lansoprazol tablet/kapsul/kaplet 30 mg strip/ blister
172 Levofloxacin hemihydrate/ Levofloxacin/ Levofloksasin inf 5 mg/mL vial/ botol/ flexy bag @ 100
ml
173Levofloxacin hemihydrate/ Levofloxacin/Levofloksasin tablet salut
selaput/kaplet salut selaput 500 mg strip/ blister
174 Levonorgestrel implan 2 rods, 75 mg (3-4 tahun) pack/ sachet/ set
175 Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain injeksi 2% ampul/vial
176 Lisinopril dihydrate/ Lisinopril/ Lisinopril tablet/kapsul/kaplet 10 mg strip/ blister
177 Lisinopril dihydrate/ Lisinopril/ Lisinopril tablet/kapsul/kaplet 5 mg strip/ blister
178 Loratadine/ Loratadin tablet/kapsul/kaplet 10 mg strip/ blister
179 Manitol inf 20% (100 mL) botol @ 100 mL
180 Manitol inf 20% (250 mL) botol @ 250 mL
181 Manitol inf 20% (500 mL) botol @ 500 mL
182Medroxyprogesterone Acetate/ Medroksi progesteron asetat injeksi
150 mg/3ml (50 mg/mL)ampul/vial
183Medroxyprogesterone Acetate/ Medroksi progesteron asetat injeksi
depo 150 mg/mlampul/vial
184 Meropenem serb inj 1.000 mg ampul/vial
185 Meropenem serb inj 500 mg ampul/vial
186 Metformin Hydrochloride/ Metformin tablet/kapsul/kaplet 500 mg strip/ blister
187 Metformin Hydrochloride/ Metformin tablet/kapsul/kaplet 850 mg strip/ blister
188Methylergometrine Maleate Methylergometrine/ Metilergometrin inj
0,2 mg/mlampul/vial
189Methylergometrine Maleate/ Methylergometrine/ Metilergometrin
tablet/kaplet salut selaput 0,125 mg strip/ blister
190Methylprednisolone Sodium Succinate/ Metilprednisolon/
Methylprednisolone serb inj 125 mgampul/vial
191Methylprednisolone Sodium Succinate/ Metilprednisolon/
Methylprednisolone serb inj 500 mgampul/vial
192 Metilprednisolon/Methylprednisolone tablet/kapsul/kaplet 16 mg strip/ blister
193 Metilprednisolon/Methylprednisolone tablet/kapsul/kaplet 4 mg strip/ blister
194 Metilprednisolon/Methylprednisolone tablet/kapsul/kaplet 8 mg strip/ blister
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195
Metoclopramide hydrochloride (HCl)/ Metoclopramide/
Metoklopramid inj 5 mg/mL ampul/vial
196Metoclopramide hydrochloride (HCl)/ Metoclopramide/ Metoklopramid
drop 2 mg/mLbotol @ 10mL
197Metoclopramide hydrochloride (HCl)/ Metoclopramide/ Metoklopramid
tablet/kapsul/kaplet 10 mg strip/ blister
198 Metronidazole/ Metronidazol infus 5 mg/ ml botol
199 Metronidazole/Metronidazol suspensi 125 mg/5 mL botol 60 mL atau 100 mL
200 Metronidazole/Metronidazol tablet/kapsul/kaplet 250 mg strip/ blister
201 Metronidazole/Metronidazol tablet/kapsul/kaplet 500 mg strip/ blister
202 Miconazole nitrate/ Miconazole/ Mikonazol krim 2 % tube
203 Mometasone furoate/ Mometason furoat krim 0,1% tube 10 gram
204Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/ Moksifloksasin infus
1,6 mg/mL (400mg/250ml) vial/ampul/botol/softbag
205Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/ Moksifloksasin tablet
salut selaput/kaplet salut selaput 400 mg strip/ blister
206 Nicardipine hydrochloride(HCl)/ Nicardipine/ Nikardipin inj 1 mg/mL ampul/vial
207 Nifedipine/ Nifedipin tablet/kapsul/kaplet 10 mg strip/ blister
208 Nimodipin/ Nimodipine Infus 0,2 mg/ml (0,02%) ampul/vial/botol
209 Nistatin/Nystatin suspensi 100.000 IU/mL botol
210Norepinephrine bitartate/ Norepinephrine bitartate monohydrate /
Norepinephrine/ Norepinephrine base/ Norepinefrin inj 1 mg/mlampul/vial
211 Obat Anti Tuberculosis FDC Kategori Anak paket
212 Obat Anti Tuberculosis FDC Kategori I paket
213 Obat Anti Tuberculosis FDC Kategori II paket
214 Obat Anti Tuberculosis FDC Kategori Sisipan paket
215 Obat Anti Tuberculosis Kombipak Kategori 1 paket
216 Ofloxacin/ Ofloksasin tablet/kaplet salut selaput 200 mg strip/ blister
217 Ofloxacin/ Ofloksasin tablet/kaplet salut selaput 400 mg strip/ blister
218 Oksitetrasiklin salep mata 1% tube
219 Olanzapine/ Olanzapin tablet/kaplet/salut selaput 10 mg strip/blister
220 Olanzapine/ Olanzapin tablet/kaplet/salut selaput 5 mg strip/blister
221 Omeprazol/Omeprazole serb injeksi 40 mg ampul/vial
222 Omeprazol/Omeprazole tablet/kapsul/kaplet 20 mg strip/ blister
223Ondansentron hydrochloride/ Ondansentron HCl dihydrate
/Ondansetron inj 2 mg/mlampul/vial
224 Ondansentron hydrochloride/ Ondansetron tablet/kapsul/kaplet 4 mg strip/ blister
225 Ondansentron hydrochloride/ Ondansetron tablet/kapsul/kaplet 8 mg strip/ blister
226 Oxytocin/ Oksitosin inj 10 IU/ml ampul/vial
227 Paracetamol/ Parasetamol drops 100 mg/ml (60mg/0,6ml) botol @ 15 mL
228 Paracetamol/ Parasetamol infus 10 mg/mL vial/ flexybag/botol @ 100
ml
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229 Paracetamol/ Parasetamol sirup 120 mg / 5 ml botol @ 60 mL
230 Pioglitazone/ pioglitazone hydrochloride (HCl)/ pioglitazon tablet 15 mg strip/ blister
231Pioglitazone/ pioglitazone hydrochloride (HCl)/ Pioglitazon
tablet/kapsul/kaplet 30 mg strip/ blister
232 Pirantel pamoat/ Pyrantel Pamoate tablet/kapsul/kaplet 125 mg strip/ blister
233 Pirazinamid/Pyrazinamide tablet/kapsul/kaplet 500 mg strip/blister
234 Povidon iodin lar 100 mg/mL botol 30 mL
235 Povidon iodin lar 100 mg/mL botol @ 60 mL
236 Povidon iodin lar 100 mg/mL botol @ 1.000 mL
237 Pravastatin sodium/ Pravastatin tablet/kapsul/kaplet 20 mg strip/ blister
238 Prednison/Prednisone tablet/kapsul/kaplet 5 mg strip/ blister
239Procainebenzylpenicillin/ Prokain Benzilpenisilin serbuk injeksi 3 juta IU
(i.m)ampul/vial
240 Propofol injeksi 1% (i.v., bolus) ampul/vial
241Propranolol hydrochloride (HCl)/ Propranolol tablet/kapsul/kaplet 10
mg strip/ blister
242Propranolol hydrochloride (HCl)/ Propranolol tablet/kapsul/kaplet 40
mg strip/ blister
243 Propylthiouracil/ Propiltiourasil tablet/kapsul/kaplet 100 mg strip/ blister
244 Pyridoxine/ Piridoksin (Vitamin B6) tab/kap/kapl 10 mg strip/ blister
245 Ramipril tablet/kapsul/kaplet 5 mg strip/ blister
246 Ranitidine hydrochloride (HCl)/ Ranitidin injeksi 25 mg/ml ampul/vial
247 Ranitidine hydrochloride (HCl)/Ranitidin tablet/kapsul/kaplet 150 mg strip/ blister
248 Retinol (vitamin A) kapsul lunak 100.000 IU botol
249 Retinol acetate/ Retinol (vitamin A) kaps lunak 200.000 IU botol
250 Rifampicin/ Rifampisin tablet/kapsul/kaplet 300 mg strip/ blister
251 Rifampicin/ Rifampisin tablet/kapsul/kaplet 450 mg strip/ blister
252 Rifampicin/ Rifampisin tablet/kapsul/kaplet 600 mg strip/ blister
253 Risperidone/ Risperidon tablet/kapsul/kaplet 3 mg strip/blister
254 Rocuronium bromide/ Rokuronium inj 10 mg/ml (i.v.) ampul/vial
255 Rosuvastatin calcium/ Rosuvastatin tablet/kapsul/kaplet 10 mg strip/ blister
256 Salbutamol cairan ih 1 mg/mL ampul/vial/botol
257 Salbutamol sulfate/ Salbutamol tablet/kapsul/kaplet 2 mg strip/ blister
258 Salbutamol sulfate/ Salbutamol tablet/kapsul/kaplet 4 mg strip/ blister
259 Salep 2-4, kombinasi: asam salisilat 2% + belerang edap 4%, salep pot 30 gram
260Sertraline hydrochloride (HCl)/ Sertraline/ Sertralin tablet salut/kaplet
salut 50 mg strip/ blister
261 Sevoflurane/ Sevofluran cairan ih botol
262 Simvastatin tablet salut selaput/kaplet salut selaput 10 mg strip/ blister
263 Simvastatin tablet salut selaput/kaplet salut selaput 20 mg strip/ blister
264 Sodium bicarbonate/ Natrium Bikarbonat tablet/kaosul/kaplet 500 mg strip/ blister/maks botol 100
tab
265 Sodium fusidate/ Natrium fusidat krim 20% (20 mg/g) tube
266 Sodium Valproate/ Valproat sirup 250 mg/5 ml maks botol @ 120 ml
Lampiran 1
DAFTAR NAMA OBAT TENDER GENERIK KATALOG OBAT 2020-2022
NO NAMA ZAT AKTIF (GENERIK) KEMASAN YANG
DIPERSYARATKAN
267 Spiramycin/ Spiramisin tablet salut selaput/kaplet salut selaput 500 mg strip/ blister
268 Spironolactone/ Spironolakton tablet/kapsul/kaplet 100 mg strip/ blister
269 Spironolactone/ Spironolakton tablet/kapsul/kaplet 25 mg strip/ blister
270 Streptomycin sulfate/ Streptomycin/ Streptomisin serbuk inj 1000 mg ampul/vial
271 Sucralfate/ Sukralfat susp 500 mg/5 mL botol
272 Sucralfate/ Sukralfat tablet/kapsul/kaplet 500 mg strip/ blister
273 Sulfadiazine/ Sulfadiazin tablet/kapsul/kaplet 500 mg strip/ blister
274 Telmisartan tablet/kapsul/kaplet 40 mg strip/ blister
275Tetrasiklin/ Tetracycline/ Tetracycline Hydrochloride
tablet/kapsul/kaplet 250 mg strip/ blister
276Tetrasiklin/ Tetracycline/ Tetracycline Hydrochloride
tablet/kapsul/kaplet 500 mg strip/ blister
277 Tiamin (Vitamin B1) tablet/kapsul/kaplet 50 mg strip/ blister
278Trifluoperazinehydrochloride (HCl)/ Trifluoperazin tablet salut
selaput/kaplet salut selaput 5 mg strip/ blister
279Valaciclovir hydrochloride (HCl)/ Valasiklovir tablet/kapsul/kaplet 500
mg strip/ blister
280 Valsartan tablet salut selaput/ kaplet salut selaput80 mg strip/ blister
281 Valsartan tablet/kapsul/kaplet 160 mg strip/ blister
282 Vitamin B Kompleks tablet strip/ blister
283 Warfarin sodium/ Warfarin tablet 2 mg strip/blister
284 Zinc sulfate/ Zinc sulfate monohydrate/ Zinc/ Zink sir 20 mg/5 ml botol
285Zinc sulfate/ Zinc sulfate monohydrate/Zinc/ Zinc tablet dispersible 20
mg strip/ blister
286Chlorpromazine Hydrochloride / Chlorpromazine /Klorpromazin tablet
salut selaput/kaplet salut selaput 100 mg strip/ blister
287Doksisiklin/ Doxycycline/ Doxycycline hyclate tablet/kapsul/kaplet 100
mg strip/ blister
288 Pyridoxine/ Piridoksin (Vitamin B6) tablet/kapsul/kaplet 25 mg strip/ blister
289 Risperidone/ Risperidon tablet/kapsul/kaplet 2 mg strip/ blister
290Tenofovir Disoproxil Fumarate/ Tenofovir tablet salut selaput/kaplet
salut selaput 300 mgstrip/blister
291Trihexyphenidyl hydrochloride (HCl)/ Triheksifenidil
tablet/kapsul/kaplet 2 mgstrip/blister
Lampiran 2
1 Air untuk irigasi inf botol @ 1.000 mL
2 Anastrozol tablet salut selaput/kaplet salut selaput 1 mg strip/blister
3 Aripiprazol oral solution 1 mg/ml botol
4 Asam Asetilsalisilat (asetosal) tablet/kapsul/kaplet 80 mg strip/blister
5 Asam Mefenamat/Mefenamic acid tablet/kapsul/kaplet 250 mg strip/blister
6 Asam Pipemidat tablet/kapsul/kaplet 400 mg strip/blister
7 Asetazolamid tablet/kapsul/kaplet 250 mg strip/blister
8 Asiklovir salep mata 3% tube
9 Atapulgit tablet/kapsul/kaplet 600 mg strip/blister
10 Atapulgit tablet/kapsul/kaplet 630 mg strip/blister
11 Atapulgit tablet/kapsul/kaplet 650 mg strip/blister
12 Atenolol tablet/kapsul/kaplet 50 mg strip/blister
13 Azitromisin/Azithromycin tablet/kaplet/kapsul 250 mg strip/blister
14 Betaksolol tts mata 0,5% botol @ 5 mL
15 Betametason tetes mata 1 mg/ml botol
16 Bikalutamid tablet salut/kaplet salut 150 mg strip/blister
17 Bikalutamid tablet salut/kaplet salut 50 mg strip/blister
18 Bisakodil suppositoria 10 mg strip
19 Bisakodil suppositoria 5 mg strip
20Cefuroxime axetil/ Cefuroxime/ Sefuroksim tablet salut selaput/kaplet salut selaput
500 mg strip/ blister
21 Chloramphenicol/ Kloramfenikol salep 2% tube 15g
22 Chloramphenicol/ Kloramfenikol serb inj 1000 mg vial/ampul
23 Ciprofloxacin Hydrochloride/ Ciprofloxacin/ Siprofloksasin tetes mata 3 mg/ml botol 5 mL
24 Deksmedetomidin Inj 100 mcg/ml ampul/vial
25 Diazepam enema 10 mg/2,5 mL tube @ 2,5 mL
26 Diazepam enema 5 mg/2,5 mL tube @ 2,5 mL
27 Diclofenac sodium/ Natrium diklofenak tetes mata 1 mg/ml botol 5 mL
28 Doksisiklin/ Doxycycline/ Doxycycline hyclate tablet/kapsul/kaplet 50 mg strip/blister
29 Dutasterid kaps lunak 0,5 mg strip/ blister
30 Erlotinib tablet salut selaput/kaplet salut selaput 100 mg strip/blister
31 Erlotinib tablet salut selaput/kaplet salut selaput 150 mg strip/blister
32 Filgrastim inj 300 mcg/mL ampul/vial
33 Finasterid tablet/kapsul/kaplet 5 mg strip/ blister
34 Flukonazol/ Fluconazole kaps 50 mg strip/ blister
35 Fluoksetin tablet/kapsul/kaplet 10 mg strip/ blister
36 Fluorometolon tetes mata 0,1% botol
37 Flusinolon asetonid krim 0,025% tube @ 5g
38 Fondaparinuks inj 2,5 mg/0,5 mL ampul/vial/prefilled syringe
39 Gabapentin tablet/kapsul/kaplet 100 mg strip/ blister
40 Gefitinib tablet/kapsul/kaplet 250 mg strip/blister
41 Haloperidol drops 2 mg/mL botol
42 Haloperidol tablet/kapsul/kaplet 2 mg strip/ blister
43 Ibandronic Sodium Monohydrate/Asam Ibandronat inj 1 mg/mL ampul/vial
44 Imatinib mesilat tablet/kapsul/kaplet 100 mg strip/blister
45 Imatinib mesilat tablet/kapsul/kaplet 400 mg strip/blister
46 Iodiksanol 320 mg Iodium/50 mL ampul/vial/botol
47 Ioheksol inj 140-350 mg iodium/ml (350mg/100ml) ampul/vial/botol
48 Ioheksol inj 140-350 mg iodium/ml (350mg/50ml) ampul/vial/botol
49 Ioheksol inj 180-300 mg iodium/ml (300mg/100ml) ampul/vial/botol
50 Ioheksol inj 180-300 mg iodium/ml (300mg/20ml) ampul/vial/botol
51 Ioheksol inj 180-300 mg iodium/ml (300mg/50ml) ampul/vial/botol
NO NAMA ZAT AKTIF (GENERIK) KEMASAN YANG
DIPERSYARATKAN
DAFTAR NAMA OBAT TENDER DAGANG KATALOG OBAT 2020-2022
Lampiran 2
NO NAMA ZAT AKTIF (GENERIK) KEMASAN YANG
DIPERSYARATKAN
DAFTAR NAMA OBAT TENDER DAGANG KATALOG OBAT 2020-2022
52 Iopamidol 200-300 mg Iodium/mL (300mg/100ml) ampul/vial/botol
53 Iopamidol 200-300 mg Iodium/mL (300mg/50ml) ampul/vial/botol
54 Iopamidol 300-370 mg iodium/ml (370mg/100ml) ampul/vial/botol
55 Iopamidol 300-370 mg iodium/ml (370mg/50ml) ampul/vial/botol
56 Isofluran/ isoflurane cairan inhalasi botol @ 250 mL
57 Kapesitabin/ Capecitabine tab salut/kaplet salut 500 mg strip/ blister
58 Karvedilol tablet/kapsul/kaplet 25 mg strip/ blister
59 Ketokonazol scalp sol 2% botol
60 Ketoprofen supositoria 100 mg strip
61 Klaritromisin sir kering 125 mg/5 ml botol maks 60 mL
62 Kloramfenikol tts mata 0,5% botol
63 Kolkisin tablet/ kapsul/ kaplet/ 500 mcg atau colchicine tablet/kapsul/kaplet 0,5 mg strip/blister
64Kombinasi (DHP): dihidroartemisin 40 mg + Piperakuin 320 mg tablet salut
selaput/kaplet salut selaputstrip/ blister
65 Kombinasi: Ampisilin 1000 mg + Sulbaktam 500 mg serb inj 1500 mg ampul/vial
66 Kombinasi: Ampisilin 500 mg + Sulbaktam 250 mg serb inj 750 mg ampul/vial
67 Kombinasi: benserazid 25 mg + levodopa 100 mg, tablet/kapsul/kaplet strip/blister
68 Kombinasi: Salmeterol 25 mcg + Flutikason propionat 50 mcg aerosol can/canister
69 Latanoprost tts mata 0,005% botol @ 2,5 mL
70 Letrozole/ Letrozol tablet/kapsul/kaplet 2,5 mg strip/blister
71 Leuprorelin asetat serb inj 3,75 mg ampul/vial
72Levofloxacin hemihydrate/ Levofloxacin/Levofloksasin tablet salut selaput/kaplet salut
selaput 250 mgstrip/blister
73 Levofloxacin hemihydrate/ Levofloxacin/Levofloksasin tts mata 0,5% botol @ 5mL
74 Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain gel 2% syringe/syringe plastik
75 Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain spray oral 10% botol
76 Lorazepam tablet/kapsul/kaplet 0,5 mg strip/blister
77 Lorazepam tablet/kapsul/kaplet 1 mg strip/blister
78 Low molecule feri sucrose inj 20 mg/mL (100mg/5mL) ampul/vial
79 Mebendazole/ Mebendazol tablet/kapsul/kaplet 500 mg strip/blister
80Medroxyprogesterone Acetate/ Medroksi Progesteron asetat tablet/kapsul/kaplet 10
mgstrip/blister
81Medroxyprogesterone Acetate/ Medroksi Progesteron Asetat tablet/kapsul/kaplet 100
mgstrip/blister
82 Metronidazole/ Metronidazol suppositoria 500 mg strip
83 Miconazole nitrate/ Miconazole/ Mikonazol serbuk 2% botol / sachet
84 Midazolam hydrochloride/ Midazolam injeksi 1 mg/ml (i.v.) ampul/vial
85 Midazolam hydrochloride/ Midazolam injeksi 5 mg/ml (i.v.) ampul/vial
86 Mikofenolat mofetil tablet/kapsul/kaplet 500 mg strip/blister
87 Mometasone furoate/ Mometason furoat krim 0,1% tube 5 gram
88 Natamycin/ Natamisin tts mata 5% (50 mg/ml) botol @ 15 mL
89 Natamycin/ Natamisin tts mata 5% (50 mg/ml) catchcover, botol @ 0,6 mL
90 Natrium hialuronat tetes mata botol
91 Norethisterone/ Noretisteron tablet/kapsul/kaplet 5 mg strip/ blister
92 Octreotide/ Oktreotid asetat 0,05 - 6 mg/mL ampul/vial
93 Ofloxacin/ Ofloksasin tets telinga 3% Botol @ 5 mL
94 Oxymetazoline/ Oksimetazolin tetes hidung 0,025% botol @ 10 mL
95 Oxymetazoline/ Oksimetazolin tetes hidung 0,050% botol @ 10 mL
96 Permethrin/ Permetrin Krim 5% tube
97 Pirantel pamoat tablet/kapsul/kaplet 250 mg strip/ blister
98 Quetiapine fumarate/ Quetiapin tablet SR/kaplet SR 200 mg strip/ blister
99Risedronat / Risedronate Sodium Hemipentahydrate / Risedronate sodium tablet salut
selaput / kaplet salut selaput 35 mgstrip/ blister
Lampiran 2
NO NAMA ZAT AKTIF (GENERIK) KEMASAN YANG
DIPERSYARATKAN
DAFTAR NAMA OBAT TENDER DAGANG KATALOG OBAT 2020-2022
100 Ropivacaine hydrochloride (HCl)/ Ropivakain inj 7,5 mg/ml ampul/polyamp/vial
101 Salbutamol MDI/aerosol 100mcg/dosis canister / botol
102 Siprofloksasin tts mata 3 mg/mL botol @ 5 mL
103 Sofosbuvir tablet salut selaput / kaplet salut selaput 400 mg strip/blister
104 Terbutaline sulfate/ Terbutalin injeksi 0,5 mg/ml (s.k./i.v.) ampul/vial
105 Terbutaline sulfate/ Terbutalin sir 1,5 mg/5 mL botol
106 Terbutaline sulfate/ Terbutalin tablet/kapsul/kaplet 2,5 mg strip/ blister
107 Timolol maleate/ Timolol tetes mata 0,25% botol @ 5 mL
108 Timolol maleate/ Timolol tetes mata 0,5% botol @ 5 mL
109 Tobramisin tts mata 0,3% botol @ 5 mL
110 Topiramate/ Topiramat tablet/kapsul/kaplet 25 mg strip/blister
111 Topiramate/ Topiramat tablet/kapsul/kaplet 50 mg strip/blister
112 Triamcinolone acetonide/ Triamsinolon asetonid inj 10 mg/mL ampul/vial
113 Triamcinolone acetonide/ Triamsinolon asetonid inj 40 mg/mL ampul/vial
114 Tropikamid tts mata 0,5% botol @ 5 mL
115 Urea krim 10 % pot
116 Zinc sulfate/ Zinc sulfate monohydrate/ Zink/ Zinc sirup 10 mg/mL botol
117Kombinasi: tenofovir 300 mg + lamivudin 300 mg + efavirenz 600 mg,
tablet/kapsul/kaplet
strip/blister/botol maks 100
tablet
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
1 Acetyl cysteine cairan ih/ N-asetil sistein ih 100 mg/mL (G) PT Dexa Medica
2 Adefovir Dipivoksil tablet/kapsul/kaplet 10 mg PT Smith Kline
3 Afatinib tablet salut selaput/kaplet salut selaput 20 mg PT Boehringer Ingelheim Indonesia
4 Afatinib tablet salut selaput/kaplet salut selaput 30 mg PT Boehringer Ingelheim Indonesia
5 Afatinib tablet salut selaput/kaplet salut selaput 40 mg PT Boehringer Ingelheim Indonesia
6 Albendazol susp 200mg/5 ml PT Indofarma
7 Alendronat tablet/kapsul/kaplet 70 mg PT Novell Pharmaceuticals
8 Alprazolam tablet/kapsul/kaplet 0,25 mg (G) PT Dexa Medica
9 Alteplase serb inj 50mg/ Alteplase 50mg/vial PT Boehringer Ingelheim Indonesia
10 Amfoterisin B salep mata 1% PT Cendo
11 Aminofilin tablet/kapsul/kaplet 150 mg PT Harsen
12 Amiodaron tablet/kapsul/kaplet 200 mg PT Novell Pharmaceutical Lab
13 Amoksisilin/Amoxicillin/Amoxicillin trihydrate 100 mg/mL drops/ sirup kering, @ 10 mL (G) PT Meprofarm
14 Ampisilin serbuk injeksi 250 mg (i.m/i.v) PT Meiji Indonesia
15 Anti Bakteri salep kombinasi: Basitrasin 500 IU/g + Polimiksin 10.000 IU/g PT Indofarma
16
Antihemoroid, kombinasi sup :
bismut subgalat
heksaklorofen
lidokain
seng oksida
PT Kimia Farma
17 Aripiprazol tab discmelt/tab cepat larut/disintegrating tablet 15 mg (G) PT Dexa Medica
18 Asam Fusidat tetes mata 1% PT Cendo
19 Asam Zoledronat/Zoledronic acid inf 4mg/100 ml PT Ferron Par
20 Atenolol tablet/kapsul/kaplet 100 mg PT Kalbe Farma
21 Atropin inj 0,25 mg/mL (i.v./i.m./s.k.) (G) PT Ethica
22 Atropine sulfate/ Atropine/ Atropin tetes mata 0,5% PT Cendo
23 Atropine sulfate/ Atropine/ Atropin tetes mata 1% PT Cendo
24 Azatioprin tablet salut selaput/kaplet salut selaput 50 mg PT Glaxo Wellcome Indonesia
25 Beraprost sodium tablet/kapsul/kaplet 20 mcg PT Combiphar
26 Betahistin tab 24 mg (G) PT Yarindo
27 Betaksolol tts mata 0,5%, catchcover, botol 0,6 mL PT Cendo
28 Betamethasone Dipropionate/ Betametason krim 0,05% (0,5mg/g) (G) PT Tempo Scan Pasifik
29 Bisakodil/Bisacodyl tablet salut/kaplet salut 5 mg PT Etercon Pharma
30 Bisoprolol tablet salut selaput/kaplet salut selaput 10 mg PT Merck
31 Bisoprolol tablet/kapsul/kaplet 1,25 mg PT Merck
32 Brinzolamid tetes mata 1% PT Tempo Scan Pasifik
33 Bromokriptin tablet/kapsul/kaplet 2,5 mg PT Sanbe Farma
34 Budesonid cairan ih 0,25 mg/mL (G) **) PT Pratapa Nirmala
35 Budesonid cairan ih 0,5 mg/mL (G) **) PT Pratapa Nirmala
36 Budesonid cairan inhalasi 0,25mg/mL, respoules 2 mL **) PT Astrazeneca
37 Budesonid cairan inhalasi 0,5 mg/mL, respoules 2 mL **) PT Astrazeneca
38 Budesonid serb ih 200 mcg/dosis, 100 dosis PT Astrazeneca
39 Budesonid serb ih 200 mcg/dosis, 200 dosis PT Otsuka
40 Cefuroxime axetil/ Cefuroxime/ Sefuroksim tablet salut selaput/kaplet salut selaput 250 mg PT Glaxo Wellcome Indonesia
41 Chloramphenicol/ Kloramfenikol tablet/kapsul/kaplet 500 mg PT Actavis
42 Chloramphenicol/ kloramfenikol tts telinga PT Erela
43 Chloramphenicol/Kloramfenikol tetes mata 1% PT Cendo
44 CHLORPROMAZINE HYDROCHLORIDE/ Chlorpromazine / Klorpromazin injeksi 5 mg/ml ( i.m.) PT Phapros
45 Ciclosporin A/ Siklosporin kaps lunak 100 mg PT Novartis
46 Ciclosporin A/ Siklosporin Kaps lunak 50 mg PT Novartis
47 Ciclosporin A/ Siklosporin kapsul lunak 25 mg PT Novartis
48 Cilostazol/ Silostazol tablet/kapsul/kaplet 100 mg (G) PT Bernofarm
49 Clonazepam/ Klonazepam tablet salut selaput/kaplet salut selaput 2 mg (G) PT Mersifarma
50 Clonidine hydrochloride/ Clonidine/ Klonidin injeksi 150 mcg/mL (i.v.) PT Boehringer Ingelheim
51Clopidogrel bisulfate/ Clopidogrel/ Clopidogrel hydrogen sulfate/ Klopidogrel tablet salut selaput/kaplet salut selaput
300 mgPT Aventis Pharma
52 CODEINE PHOSPHATE HEMIHYDRATE/ Codeine/ Kodein tablet/kapsul/kaplet 10 mg PT Kimia Farma
53 CODEINE PHOSPHATE HEMIHYDRATE/ Codeine/ Kodein tablet/kapsul/kaplet 15 mg PTKimia Farma
54 CODEINE PHOSPHATE HEMIHYDRATE/ Codeine/ Kodein tablet/kapsul/kaplet 20 mg PT Kimia Farma
55 Dabigatran etexilate mesilate/ Dabigatran etexilate/ Dabigatran eteksilat tablet/kapsul/kaplet 110 mg PT Boehringer Ingelheim Indonesia
56 Dabigatran etexilate mesilate/ Dabigatran etexilate/ Dabigatran eteksilat tablet/kapsul/kaplet 75 mg PT Boehringer Ingelheim Indonesia
57 Deferasiroks tablet dispersible/kaplet dispersible 250 mg PT Dankos
58 Deferasiroks tablet dispersible/kaplet dispersible 500 mg PT Dankos
59 Deferipron sir 100 mg/mL PT Sydna Farma
60 Deferoksamin Mesilat serbuk injeksi 500 mg PT Novartis
61 Delamanid tablet salut selaput 50 mg PT Otsuka
62 Desogestrel tablet/kapsul/kaplet 75 mcg PT Nufarindo
NO NAMA GENERIK INDUSTRI FARMASI
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
NO NAMA GENERIK INDUSTRI FARMASI
63 Desoksimetason/ Desoximetasone salep 0,25% (G) PT Etercon Pharma
64 Dienogest tablet/kapsul/kaplet 2 mg PT Bayer Indonesia
65 Digoksin injeksi 0,25 mg/ml (G) PT Pratapa Nirmala
66 Diltiazem injeksi inj 5mg/mL (G) PT Pratapa Nirmala
67 Diltiazem Kapsul lepas lambat 100 mg PT Mitsubishi Tanabe Pharma Indonesia
68 Diltiazem Kapsul lepas lambat 200 mg PT Mitsubishi Tanabe Pharma Indonesia
69 Diltiazem serbuk injeksi 50 mg PT Mitsubishi Tanabe Pharma Indonesia
70 Dinatrium klodronat inj/inf 60 mg/mL PT Novell
71 Divalproex sodium / Valproat tabet lepas lambat/kaplet lepas lambat 250 mg (G) PT Dexa Medica
72 Divalproex sodium / Valproat tablet lepas lambat/kapsul lepas lambat 500 mg PT Abbott Indonesia
73 Dobutamin Injeksi 12,5 mg/ml PT Combiphar
74 DOBUTAMINE HYDROCHLORIDE/ Dobutamine/ Dobutamin Injeksi 25 mg/ml PT Pratapa Nirmala
75 Doksazosin/Doksazosin Mesilat tablet/kapsul/kaplet 1 mg (G) PT Harsen
76 Doksazosin/Doksazosin Mesilat tablet/kapsul/kaplet 2 mg PT Harsen
77 Domperidon/ Domperidone maleate/ Domperidone drops 5 mg/mL (G) PT Bernofarm
78 Donepezil tablet dispersible /kaplet dispersible 10 mg PT Eisai Indonesia
79DTPA 2,06-2,5 mg pantetate calsium trisodium/ mL / DTPA- Pentasodium diethylene triamine pentaacetate 10 mg;
SnCl2 2 H2O 0,8 mgPT Kimia Farma
80 Eksemestan tablet salut gula 25 mg PT Pfizer Indonesia
81 Enoksaparin sodium inj 20 mg/0,2 mL PT Aventis Pharma
82 Enoksaparin sodium inj 40 mg/0,4 mL PT Aventis Pharma
83 Enoksaparin sodium inj 60 mg/0,6 mL PT Aventis Pharma
84 Entekavir tab sal selaput 0,5 mg (G) PT Hexpharm
85 Entekavir tablet salut selaput/kaplet salut selaput 1 mg PT Taisho
86 Estrogen terkonjugasi tablet salut gula/kaplet salut gula 0,625 mg PT Sunthi Sepuri
87 Etonogestrel implan 68 mg PT Merck Sharp Dohme
88 Everolimus tablet/kapsul/kaplet 0,25 mg PT Novartis
89 Everolimus tablet/kapsul/kaplet 0,5 mg PT Novartis
90 Fenitoin/ Phenytoin sodium tablet/kapsul/kaplet 30 mg PT Harsen
91 Fenobarbital/ Phenobarbital injeksi 50 mg/ml (G) PT Phapros
92 Fenobarbital/ Phenobarbital tablet/kapsul/kaplet 30 mg (G) PT Kimia Farma
93 Fenoksimetil penisilin/ Phenoxymethyl Penicillin (penisilin V) tab 250 mg (G) PT Phapros
94 Fenoksimetil penisilin/ Phenoxymethyl Penicillin (penisilin V) tab 500 mg (G) PT Phapros
95 Fenoterol Hydromide/ Fenoterol HBr aerosol 100 mcg/puff PT Boehringer Ingelheim Indonesia
96 Fenoterol Hydromide/ Fenoterol HBr cairan ih 0,1% PT Boehringer Ingelheim Indonesia
97 Fentanil patch 12,5 mcg/jam PT Kimia Farma
98 Fentanil patch 25 mcg/jam PT Kimia Farma
99 Fentanil patch 50 mcg/jam PT Kimia Farma
100 Fludarabin tablet salut/kaplet salut 10 mg PT Aventis Pharma
101 Flukonazol/ Fluconazole tablet/kapsul/kaplet 150 mg (G) PT Kimia Farma
102 Fluorescein Sodium Natrium Fluoresein tetes mata 2% (G) PT Cendo
103 Flusinolon Asetonid salep 0,025% PT Ikapharmindo Putramas
104 Flutikason furoat susp 27,5 mcg/spray PT Glaxo Wellcome Indonesia
105 Flutikason propionat cairan ih 0,5 mg/dosis PT Glaxo Wellcome Indonesia
106 Framisetin sulfat tulle 1% (G) PT Darya Varia
107 Gadobutrol inj 1 mmol/mL, @ 5 mL PT Bayer Indonesia
108 Gadobutrol inj 1 mmol/mL, @ 7,5 mL PT Bayer Indonesia
109 Gadoksetat disodium 0,25 mmol gadoxetate disodium/mL PT Bayer Indonesia
110 Gansiklovir serb inj 500 mg PT Boehringer Ingelheim
111 Gemfibrozil tablet/kapsul/kaplet 600 mg (G) PT Indofarma
112 Gentamisin/ Gentamycin injeksi 40 mg/ ml (G) PT Indofarma
113 Glibenklamid/ Glibenclamide tablet/kapsul/kaplet 2,5 mg PT Harsen
114 Gliklazid tablet lepas lambat/kaplet lepas lambat 60 mg PT Darya Varia Laboratoria
115 Gliklazid tablet/kapsul/kaplet 80 mg (G) PT Tempo Scan Pasifik
116 Glikuidon/ Gliquidone tablet/kapsul/kaplet 30 mg (G) PT Dexa Medica
117 Glipizid tablet/kapsul/kaplet 10 mg PT Pfizer Indonesia
118 Glipizid tablet/kapsul/kaplet 5 mg PT Pfizer Indonesia
119 Gliseril trinitrat kapsul lepas lambat 2,5 mg PT Kimia Farma
120 Gliseril trinitrat kapsul lepas lambat 5 mg PT Kimia Farma
121 Gliseril trinitrat tablet/kapsul/kaplet 0,5 mg PT Actavis Indonesia
122 Gliseril Trinitrat/ Glyceryl trinitrate inj 5 mg/ml PT Tempo Scan Pasifik
123 Gliserin lar 50% PT Lucas Djaja
124 Goserelin asetat serb inj 10,8 mg PT AstraZeneca
125 Goserelin asetat serb inj 3,6 mg PT AstraZeneca
126 Griseofulvin (micronized) tablet/kapsul/kaplet 250 mg PT Galenium
127 Haloperidol inj 50 mg/mL PT Soho Industri Pharmasi
128 Halotan cairan inhalasi PT Dexa Medica
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
NO NAMA GENERIK INDUSTRI FARMASI
129 Heparin, Na injeksi 5000 IU/ml (i.v./s.k.) PT Pratapa Nirmala
130 Hidroklorotiazid/ Hydrochlorothiazide tablet/kapsul/kaplet 25 mg PT Kimia Farma
131 Hidrokortison serb inj 100 mg PT Pratapa Nirmala
132 Hidroksi Urea/ Hydroxy urea tablet/kapsul/kaplet 500 mg PT Dipa Pharmalab
133 Hidromorfon tablet lepas lambat/kaplet lepas lambat 16 mg PT Kimia Farma
134 Hidromorfon tablet lepas lambat/kaplet lepas lambat 8 mg PT Kimia Farma
135 Hiosin butilbromid/Hiosin butilbromida tablet/kapsul/kaplet 10 mg PT Rama Emerald Multi Sukses
136 Homatropin tts mata 2% PT Cendo
137 Imidapril tablet/kapsul/kaplet 10 mg PT Mitsubishi Tanabe Pharma Indonesia
138 Imidapril tablet/kapsul/kaplet 5 mg PT Mitsubishi Tanabe Pharma Indonesia
139 Indakaterol serbuk ih 150 mcg PT Novartis Indonesia
140 Indakaterol serbuk ih 300 mcg PT Novartis Indonesia
141 Iopromid 300 -370 mg Iodium/mL (300 mg / 100 ml) PT Bayer Indonesia
142 Iopromid 300 -370 mg Iodium/mL (300 mg / 50 ml) PT Bayer Indonesia
143 Iopromid 300 -370 mg Iodium/mL (370 mg / 100 ml) PT Bayer Indonesia
144 Iopromid 300 -370 mg Iodium/mL (370 mg / 50 ml) PT Bayer Indonesia
145 Ipratropium Bromida Anhidrous/ Ipratropium bromida aerosol 20 mcg/semprot PT Boehringer Ingelheim
146 Ipratropium Bromide/ Ipratropium bromida cairan ih 0,025% (G) PT Pratapa Nirmala
147 Isofluran/ isoflurane cairan inhalasi botol 100 ml PT Pratapa Nirmala
148 Itrakonazol tablet/kapsul/kaplet 100 mg (G) PT Bernofarm
149 Ivabradin tablet /kapsul/kaplet 5 mg PT Darya Varia Laboratoria
150 Kalium aspartat tablet salut selaput/kaplet salut selaput 300 mg PT Tempo Scan Pasifik
151 Kalium Klorida tablet lepas lambat/kaplet lepas lambat 600 mg PT Merck
152 Kalsitriol kapsul lunak 0,5 mcg PT Phapros
153 Kalsium polistirena sulfonat / Calcium Polystyrene Sulfonate serb 5 g (G) PT Etercon
154 Karbimazol/Carbimazole tablet/kapsul/kaplet 5 mg PT Nicholas Lab Indonesia
155 Karbogliserin tetes telinga 10% PT Lucas Djaja
156 Karvedilol tablet/kapsul/kaplet 6,25 mg PT Kalbe Farma
157 Klaritromisin sir kering 250 mg/5 ml PT Abbott Indonesia
158 Klaritromisin tablet salut selaput/kaplet salut selaput 500 mg (G) PT Etercon Pharma
159
Kombinasi (LPV/r), tablet salut selaput:
Lopinavir 200 mg
Ritonavir 50 mg
PT Abbott Indonesia
160 Kombinasi (LPV/r): lopinavir 100 mg + ritonavir 25 mg tab sal selaput PT Abbott
161
Kombinasi :
Benserazid 25 mg
Levodopa 100 mg
tablet dispersible/kaplet dispersible
PT Boehringer Ingelheim
162
Kombinasi :
Salmeterol 50 mcg
Flutikason propionat 100 mcg
ih 100mcg/puff
PT Glaxo Wellcome Indonesia
163 Kombinasi tab: Zidovudin 300 mg + Lamivudin 150 mg (G) PT Kimia Farma
164
Kombinasi tab:
Levodopa 100 mg
Karbidopa 25 mg
Entekapon 200 mg
tablet/kapsul/kaplet
PT Novartis
165
kombinasi, setiap dosis mengandung :
Budesonid 160 mcg
Formoterol 4,5 mcg
(inhalasi), 120 dosis
PT AstraZeneca Indonesia
166
kombinasi, setiap dosis mengandung :
Budesonid 160 mcg
Formoterol 4,5 mcg
(inhalasi), 60 dosis
PT AstraZeneca Indonesia
167
kombinasi, setiap dosis mengandung :
Budesonid 80 mcg
Formoterol 4,5 mcg
(inhalasi)
PT AstraZeneca Indonesia
168 Kombinasi, setiap mL mengandung: brinzolamid 1% + timolol 0,5%, tts mata PT Tempo Scan Pasifik
169 Kombinasi, setiap mL mengandung: natrium klorida 4,40 mg + kalium klorida 0,80 mg, tts mata PT Cendo
170 Kombinasi: artemether 20 mg + lumefantrin 120 mg tablet/kapsul/kaplet PT Novartis
171 Kombinasi: ergotamin 1 mg + kafein 50 mg, tablet/kapsul/kaplet PT Kimia Farma
172 Kombinasi: ipratropium bromida 0,5 mg + salbutamol 2,5 mg, cairan ih (G) PT Pratapa Nirmala
173 Kombinasi: medroksi progesteron asetat + estradiol sipionat, inj depot 25 mg + 5 mg (G) PT Triyasa Nagamas Farma
174 Kombinasi: parafin + gliserin + fenolftalein Susp PT Ifars
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
NO NAMA GENERIK INDUSTRI FARMASI
175 Kombinasi: Sefiksim 400 mg + Azitromisin 1000 mg PT Kimia Farma
176 Kombinasi: setiap mL mengandung: travoprost 0,004% + timolol 0,5%, tts mata PT Tempo Scan Pasifik
177
Kombinasi:
Salmeterol 50 mcg
Flutikason propionat 250 mcg
ih 250 mcg/puff
PT Glaxo Wellcome Indonesia
178
Kombinasi:
Salmeterol 50 mcg
Flutikason propionat 500 mcg
ih 500 mcg/puff
PT Glaxo Wellcome Indonesia
179 Lamivudine/ Lamivudin tablet/kapsul/kaplet 100 mg (G) PT Kimia Farma
180 Lamivudine/ Lamivudin tablet/kapsul/kaplet 150 mg (G) PT Kimia Farma
181 Lamotrigine/ Lamotrigin tablet dispersible/kaplet dispersible 25 mg PT Glaxo Wellcome Indonesia
182 Lamotrigine/ Lamotrigin tablet/kapsul/kaplet 50 mg PT Glaxo Wellcome Indonesia
183 Lansoprazole/ Lansoprazol serbuk inj 30 mg/ml (G) PT Pratapa Nirmala
184 Lapatinib tosilate/ Lapatinib tablet/kapsul/kaplet 250 mg PT Novartis
185 Leflunomide/ Leflunamid tablet salut selaput/kaplet salut selaput 20 mg PT Aventis Pharma
186 Lenograstim/ Lenogastrim inj 263 mcg PT Aventis Pharma
187 Leuprorelin asetat serbuk injeksi 1,88 mg PT Takeda Indonesia
188 Leuprorelin asetat serbuk injeksi 11,25 mg PT Takeda Indonesia
189 Levetiracetam/ Levetirasetam tablet/kapsul/kaplet 250 mg (G) PT Actavis
190 Levetiracetam/ Levetirasetam tablet/kapsul/kaplet 500 mg (G) PT Actavis
191 Levothyroxine Sodium/ Levothyroxine/ Levotiroksin tablet/kaplet/kapsul 100 mcg (G) PT Novell
192 Levothyroxine Sodium/ Levothyroxine/ Levotiroksin tablet/kapsul/kaplet 50 mcg PT Merck
193 Linestrenol tablet/kapsul/kaplet 0.5 mg (G) PT Harsen
194 Litium karbonat tablet/kapsul/kaplet 200 mg PT Mersifarma Tirmaku Mercusana
195 Litium karbonat tablet/kapsul/kaplet 400 mg PT Mersifarma Tirmaku Mercusana
196 Lorazepam tablet/kapsul/kaplet 2 mg (G) PT Mersifarma
197 Magnesium sulfate/ Magnesium sulfate heptahydrate/ Magnesium sulfat injeksi 20%v (i.v.) PT Otsuka
198 Magnesium sulfate/ Magnesium sulfate heptahydrate/ Magnesium sulfat injeksi 40%v (i.v.) PT Otsuka
199 Maprotilin/Maprotiline HCl tablet salut selaput/kaplet salut selaput 50 mg (G) PT Mersifarma Tirmaku Mercusana
200 MDP- Acidum methylene diphosphonicum 10 mg; SnCl2 2 H2O 0,238 mg; Acidum ascorbicum 2 mg PT Kimia Farma
201 Melfalan/Melphalan tablet/kapsul/kaplet2 mg PT Glaxo Wellcome Indonesia
202 Mesalazine/ Mesalazin tablet salut enterik/kaplet salut enterik 250 mg PT Darya Varia Laboratoria
203 Mesna inj 100 mg/mL PT Menarini
204 Metadon sir 50 mg/5 mL (G) PT Kimia Farma
205 Metamizol/Antalgin Inj 500 mg/ml atau Metamizole Sodium Monohydrate/Antalgin inj 1000 mg/2ml (G) PT Bernofarm
206 Methyldopa/Metildopa tablet/kapsul/kaplet 250 mg PT Actavis Indonesia
207 Metilfenidat/Methylfenidat Hydrochloride tablet/kapsul/kaplet 10 mg (G) PT Mersifarma Tirmaku Mercusana
208 Metoclopramide hydrochloride (HCl)/ Metoclopramide/ Metoklopramid tablet/kapsul/kaplet 5 mg (G) PT Kimia Farma
209 Metoclopramide hydrochloride (HCl)/ Metoclopramide/ Metoklopramide sirup 5 mg/ 5 ml (G) PT First Medifarma
210 Metoprolol tartrate/ Metoprolol tartat inj 1 mg/ml PT Pratapa Nirmala
211 Metronidazole/ Metronidazol ovula 500 mg PT Kimia Farma
212MIBI 5 ml, reaction vial / MIBI- Tetra (2-methoxyisobutyl isonitrile) Copper (1) tetrafluoroborate 1 mg; SnCl2 2 H2O 0,1
mg; Sodium Citrate dihydrate 2,6 mg; L-Cystein 1 mgPT Kimia Farma
213 Mikafungin serb inj 50 mg / Micafungin serbuk injeksi/serbuk infus 50 mg PT Combiphar
214 Mikofenolat sodium tablet salut/kaplet salut 180 mg PT Novartis
215 Mikofenolat sodium tablet salut/kaplet salut 360 mg PT Novartis
216 Milrinone inj 1 mg/mL PT Pratapa Nirmala
217Mineral Mix (Bismuth Subcitrate Tripottasium, Copper sulfate, Magnesium Chloride Anhydrous, Pottasium Chloride,
Zinc Acetate)PT Indofarma
218 Morfin Injeksi 10 mg/ml (i.m/s.k/ i.v) (G) PT Kimia Farma
219 Morphine hydrochloride(HCl)/ Morphine/ Morfin tablet/kapsul/kaplet 10 mg (G) PT Kimia Farma
220 Morphine sulfate/ Morphine/ Morfin tablet lepas lambat/kaplet lepas lambat 10 mg PT Mahakam Beta Farma
221 Morphine sulfate/ Morphine/ Morfin tablet lepas lambat/kaplet lepas lambat 15 mg PT Mahakam Beta Farma
222 Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/ Moksifloksasin tts mata 0,5% PT Tempo Scan Pasifik
223 Naloxone hydrochloride/ Naloxone/ Nalokson injeksi 0,4 mg/ml (G) PT Ethica
224 Natrium fosfat btl, 133 mL PT Combiphar
225 Natrium fosfat lar oral 45 mL PT Combiphar
226 Neostigmin injeksi 0,5 mg/ml (i.v.) (G) PT Ethica
227 Nevirapine/ Nevirapin tablet/kapsul/kaplet 200 mg (G) PT Kimia Farma
228 Nifedipine/ Nifedipin tablet lepas lambat/kaplet lepas lambat 20 mg PT Bayer Indonesia
229 Nifedipine/ Nifedipin tablet lepas lambat/kaplet lepas lambat 30 mg PT Bayer Indonesia
230 Nilotinib hydrochloride (HCl)/ Nilotinib tablet/kapsul/kaplet 150 mg PT Novartis
231 Nilotinib hydrochloride (HCl)/ Nilotinib tablet/kapsul/kaplet 200 mg PT Novartis
232 Nimodipine/Nimodipin tablet salut selaput/kaplet salut selaput 30 mg PT Bayer Indonesia
233 Nomegestrol asetat tablet/kapsul/kaplet 5 mg PT Merck
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
NO NAMA GENERIK INDUSTRI FARMASI
234 Nystatin/ Nistatin tablet salut gula/kaplet salut gula 500.000 IU (G) PT Phapros
235 Nystatin/ Nistatin vaginal tablet/kaplet 100.000 IU (G) PT Phapros
236 Olanzapine/ Olanzapin inj 10 mg/2 mL (10 mg/vial) PT Bayer Indonesia
237 Olopatadine hydrochloride (HCl)/ Olopatadine/ Olopatadin tts mata 0,1% PT Tempo Scan Pasifik
238 Oxytetracycline Hydrochloride/ Oxytetracycline/ Oksitetrasiklin inj 50 mg/mL (i.m.) (G) PT Bernofarm
239 Pegylated interferon alfa-2a inj 135 mcg/0,5 ml PT Boehringer Ingelheim
240 Pegylated interferon alfa-2a inj 180 mcg/0,5 ml PT Boehringer Ingelheim
241 Perindopril arginine tablet/kapsul/kaplet 5 mg PT Darya Varia Laboratoria
242 Pethidine hydrochloride/ Petidin inj 50 mg/mL (i.m./s.k./i.v.) PT Kimia Farma
243 Pilocarpine/ Pilocarpine hydrochloride/ Pilokarpin tetes mata 2%, kemasan catchcover, botol 0,6 mL PT Cendo
244 Pilocarpine/ Pilocarpine hydrochloride/ Pilokarpin tetes mata 2%, kemasan botol 5 mL PT Cendo
245 Pirantel pamoat susp 125 mg/5 ml (G) PT Holi Farma
246 Polietilen Glikol serb PT Meiji Indonesia
247Pramipexole dihydrochloride monohydrate/ Pramipexole hydrochloride monohydrate/ Pramipeksol tablet/kapsul/kaplet
0,125mg (G)PT Dexa Medica
248 Pramipexole dihydrochloride monohydrate/Pramipexole/ Pramipeksol tablet lepas lambat/kaplet lepas lambat 0,375mg PT Boehringer Ingelheim
249 Pramipexole dihydrochloride monohydrate/Pramipexole/ Pramipeksol tablet lepas lambat/kaplet lepas lambat 0,750mg PT Boehringer Ingelheim
250 Probenesid tablet/kapsul/kaplet 500 mg PT Dexa Medica
251 Procaterol hydrochloride (HCl)/ Prokaterol cairan inh 30 mcg PT Otsuka Indonesia
252 Procaterol hydrochloride (HCl)/ Prokaterol cairan inh 50 mcg PT Otsuka Indonesia
253 Procaterol hydrochloride (HCl)/ Prokaterol serb inh 10 mcg/Procaterol hydrochloride (HCl) serbuk inh 10 mcg/dosis PT Otsuka Indonesia
254 Pyridostigmin bromide/ Pyridostigmin/ Piridostigmin tablet/kapsul/kaplet 60 mg PT Menarini Indria Laboratories
255 Quetiapine fumarate/ Quetiapin tab SR 300 mg PT Astrazeneca
256 Quetiapine fumarate/ Quetiapin tablet SR/kapsul SR 400 mg PT AstraZeneca
257 Quinine/ Quinine sulfate/ Kuinin tablet/kapsul/kaplet 200 mg (G) PT Kimia Farma
258 Ramipril tablet/kapsul/kaplet 10 mg PT Novell Pharmaceutical Lab
259 Ramipril tablet/kapsul/kaplet 2,5 mg PT Dexa Medica
260 Ribavirin tab sal selaput 200 mg PT Boehringer Ingelheim Indonesia
261 Rifapentin tablet 150 mg PT Aventis Farma
262 Rilpivirin tablet 25 mg PT Soho Industri Pharmasi
263 Risperidone/ Risperidon tablet/kapsul/kaplet 1 mg (G) PT Dexa Medica
264 Rivaroxaban/ Rivaroksaban tablet salut/kaplet salut 10 mg PT Bayer Indonesia
265 Rivaroxaban/ Rivaroksaban tablet salut/kaplet salut 15 mg PT Bayer Indonesia
266 Rivaroxaban/ Rivaroksaban tablet salut/kaplet salut 20 mg PT Bayer Indonesia
267 Ropinirole hydrochloride (HCl)/ Ropinirol tablet lepas lambat/kaplet lepas lambat 2 mg PT Glaxo Wellcome Indonesia
268 Ropinirole hydrochloride (HCl)/ Ropinirol tablet lepas lambat/kaplet lepas lambat 4 mg PT Glaxo Wellcome Indonesia
269 Ropinirole hydrochloride (HCl)/ Ropinirol tablet lepas lambat/kaplet lepas lambat 8 mg PT Glaxo Wellcome Indonesia
270 Salbutamol sulfate/ Salbutamol sir 2 mg/5 mL (G) PT Indofarma
271 Simeprevir tablet/kapsul/kaplet 150 mg PT Soho
272 Sodium bicarbonate/ Natrium Bikarbonat inj 8,4% (i.v.) PT Otsuka
273 Streptokinase serb inj 1,5 juta IU PT Dexa Medica
274 Sufentanil citrate/Sufentanil injeksi 5 mcg/ml (i.v) PT Kimia Farma
275 sugammadex+ORG488302/ sugammadeks inj 100 mg/mL PT Merck Sharp Dohme
276 Sulfadiazine silver/ Perak sulfadiazin krim 1% (tube 35 g) (G) PT Darya Varia Laboratoria
277 Sulfasalazine/ Sulfasalazin tablet salut enterik/kaplet salut enterik 500 mg (G) PT Bernofarm
278 Surfaktan susp 25 mg/mL (intratekal) PT Abbott Indonesia
279 Tacrolimus/ Takrolimus tablet/kapsul/kaplet 0.5 mg PT Combiphar
280 Tacrolimus/ Takrolimus tablet/kapsul/kaplet 1 mg PT Combiphar
281 Takrolimus/ Tacrolimus kapsul lepas lambat 0,5 mg PT Combiphar
282 Takrolimus/ Tacrolimus kapsul lepas lambat 1 mg PT Combiphar
283 Tamoxifen citrate/ Tamoksifen tab 10 mg PT Kalbe Farma
284 Tamsulosin tab lepas lambat / kaplet lepas lambat 0,4 mg (G) PT Novell
285 Tamsulosin tablet/kapsul/kaplet 0,2 mg PT Combiphar
286 Telbivudin tablet/kapsul/kaplet 600 mg PT Novartis
287 Telmisartan tablet/kapsul/kaplet 80 mg (G) PT Dexa Medica
288 Temozolomide/ Temozolamid tablet/kapsul/kaplet 100 mg PT Merck Sharp Dohme
289 Temozolomide/ Temozolamid tablet/kapsul/kaplet 20 mg PT Merck Sharp Dohme
290 Terazosin HCl tablet/kapsul/kaplet 1 mg (G) PT Dexa Medica
291 Terazosin HCl tablet/kapsul/kaplet 2 mg (G) PT Dexa Medica
292 Terbinafine hydrochloride (HCl) / Terbinafin tablet/kapsul/kaplet 250 mg PT Interbat
293 Terbutaline sulfate/ Terbutalin cairan ih 2,5 mg/mL PT AstraZeneca Indonesia
294 Terbutaline sulfate/ Terbutalin serbuk ih 0,50 mg/dosis PT AstraZeneca Indonesia
295 Testosteron Inj 250 mg/ml (vial 4 ml) PT Bayer Indonesia
296 Testosterone undecylate/ Testosteron kapsul lunak 40 mg PT Merck Sharp Dohme
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
NO NAMA GENERIK INDUSTRI FARMASI
297 Tetanus toxoid inj PT Biofarma
298 Tetracaine/ Tetrakain tetes mata 0,5% (G) PT Cendo
299 Theophylline/ Teofilin tablet lepas lambat/kaplet lepas lambat 300 mg PT Kimia Farma
300 Theophylline/ Teofilin tablet/kapsul/kaplet 150 mg PT Kalbe Farma
301 Thiamazole/ Tiamazol tablet salut selaput/kaplet salut selaput 10 mg PT Merck
302 Thiamazole/ Tiamazol tablet salut selaput/kaplet salut selaput 5 mg PT Merck
303 Thiopental Sodium with sodium carbonate/ Thiopental sodium/ Tiopental serb inj 1.000 mg (i.v. bolus) (G) PT Bernofarm
304 Thiopental Sodium with sodium carbonate/ Thiopental sodium/ Tiopental serb inj 500 mg (i.v. bolus) (G) PT Bernofarm
305 Ticagrelor/ Tikagrelor tablet/kapsul/kaplet 90 mg PT AstraZeneca
306 Tiotropium Bromide/ Tiotropium serb ih 18mcg + handihaller PT Boehringer Ingelheim
307 Tiotropium Bromide/ Tiotropium serb ih 18mcg, refill PT Boehringer Ingelheim
308 Tiotropium respimat ih 5 mcg/semprot PT Boehringer Ingelheim
309 Tobramisin tts mata 0,3%, catchcover, botol 0,6 mL PT Cendo
310 Topiramate/ Topiramat tablet/kapsul/kaplet 100 mg PT Soho Industri Pharmasi
311 Travoprost tetes mata 0,004%/ Travoprost cairan mata 0,004% PT Tempo Scan Pasifik
312 Tretinoin/ Asam Retinoat krim 0,1 % PT Immortal Pharmaceutical Lab
313 Triamsinolon asetonid/Triamcinolone acetonide nasal spray/semprot hidung 55 mcg/puff PT Aventis Pharma
314 Tropikamid tts mata 0,5%, catchcover, botol 0,6 mL PT Cendo
315 Tuberkulin protein purified derivative serb inj 2 TU/0,1 mL PT Bio Farma
316 Valganciclovir hydrochloride (HCl)/ Valgansiklovir tablet salut/kaplet salut 450 mg PT Boehringer Ingelheim Ingelheim
317 Vancomycin hydrochloride (HCl)/ Vankomisin serbuk injeksi 500 mg (G) PT Pratapa Nirmala
318 Vasopressin injection/ Vasopresin injeksi 20 IU/ml (i.m/s.k.) PT Pratapa Nirmala
319 Verapamil hydrochloride (HCL)/ Verapamil tablet lepas lambat/kaplet lepas lambat 240 mg PT Abbott Indonesia
320 Verapamil hydrochloride (HCL)/ Verapamil tablet/kapsul/kaplet 80 mg (G) PT Kimia Farma
321 Warfarin potassium/ Warfarin tablet/kapsul/kaplet 1 mg (G) PT Eisai Indonesia
322 Zidovudine/ Zidofudin tablet/kapsul/kaplet 100 mg (G) PT Kimia Farma
323 Aminofluid 1000 mL - Larutan mengandung asam amino PT Otsuka Indonesia
324 Aminofluid 500 mL - Larutan mengandung asam amino PT Otsuka Indonesia
325 Aminofusin Hepar - Larutan mengandung asam amino **) PT Kalbe Farma
326 Aminofusin Paed - Larutan mengandung asam amino PT Kalbe Farma
327 Aminofusn L 600 - Larutan mengandung asam amino PT Kalbe
328 Aminoleban - Larutan mengandung asam amino **) PT Otsuka Indonesia
329 Aminosteril infant 10% - Larutan mengandung asam amino **) PT Fresenius Kabi Combiphar
330 Aminosteril Infant 6% - Larutan mengandung asam amino PT Fresenius Kabi Combiphar
331 Aminosteril N-Hepa 8% - Larutan mengandung Asam Amino PT Fresenius Kabi Combiphar
332 Amiparen - Larutan mengandung asam amino PT Otsuka Indonesia
333 Benutrion VE - Larutan mengandung Asam Amino PT Sanbe
334 Clinimic N9G15E - Larutan mengandung asam amino PT Kalbe Farma
335 Clinimic N9G20E - Larutan mengandung asam amino PT Kalbe Farma
336 Clinoleic 20% 100 mL - Larutan mengandung lipid **) PT Kalbe Farma
337 Clinoleic 20% 250 mL - Larutan mengandung lipid **) PT Kalbe Farma
338 Comafusin Hepar - Larutan mengandung asam amino **) PT Finusolprima Farma Internasional
339 Combiflex Peri - Larutan mengandung asam amino PT Phapros
340 DIPEPTIVEN - Larutan mengandung Asam Amino PT Fresenius Kabi Combiphar
341 EAS PFRIMMER - Larutan mengandung Asam Amino PT Finusolprima Farma Internasional
342 Futrolit - Larutan mengandung karbohidrat+elektrolit PT Sanbe Farma
343 HYDROMAL - Larutan mengandung Karbohidrat+Elektrolit PT Sanbe Farma
344 Infumal - Larutan mengandung karbohidrat **) PT Sanbe Farma
345 INFUSAN D5 (100 ML) - Larutan mengandung karbohidrat **) PT Sanbe
346 INFUSAN D5 (250 ML) - Larutan mengandung karbohidrat PT Sanbe
347 Infusan D5+1/2NS SP - Larutan mengandung Karbohidrat+Elektrolit PT Sanbe
348 Infusan D5+1/4NS SP - Larutan mengandung Karbohidrat+Elektrolit PT Sanbe
349 Infusan D5+NS - Larutan mengandung karbohidrat+elektrolit **) PT Sanbe Farma
350 Infusan RD SP - Larutan Mengandung Karbohidrat+Elektrolit **) PT Sanbe
351 INTRALIPID - Larutan mengandung Lipid PT Fresenius Kabi Combiphar
352 Kabiven Peripheral 1440 mL - Larutan mengandung asam amino PT Fresenius Kabi Combiphar
353 Kabiven Peripheral 1920 mL - Larutan mengandung asam amino PT Fresenius Kabi Combiphar
354 KA-EN 1B - Larutan mengandung elektrolit **) PT Otsuka Indonesia
355 KA-EN 3A - Larutan mengandung elektrolik **) PT Otsuka
356 KA-EN 3B botol plastik - Larutan mengandung elektrolik **) PT Otsuka
357 KA-EN 3B softbag - Larutan mengandung elektrolik **) PT Otsuka
358 KA-EN MG3 - Larutan mengandung karbohidrat+elektrolit **) PT Otsuka
359 Kalbamin - Larutan mengandung asam amino **) PT Finusolprima Farma Internasional
360 KIDMIN - Larutan mengandung asam amino PT Otsuka Indonesia
361 Lipofundin MCT/LCT 20% 100 mL - Larutan mengandung lipid **) PT Phapros
362 Lipofundin MCT/LCT 20% 250 mL - Larutan mengandung lipid **) PT Phapros
363 Lipomed MCT/LCT 20% 100 mL - Larutan mengandung lipid **) PT Sanbe Farma
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
NO NAMA GENERIK INDUSTRI FARMASI
364 Lipomed MCT/LCT 20% 250 mL - Larutan mengandung lipid **) PT Sanbe
365 Martos 10 - Larutan mengandung karbohidrat **) PT Otsuka Indonesia
366 Nephrosteril - Larutan mengandung Asam Amino PT Fresenius Kabi Combiphar
367 Nutriflex Lipid Peri 1250 - Larutan mengandung asam amino PT Phapros
368 Nutriflex Lipid Special 1250 - Larutan mengandung asam amino PT Phapros
369 Nutriflex Lipid Special 625 - Larutan mengandung asam amino **) PT Phapros
370 Omegaven - Larutan mengandung lipid PT Fresenius Kabi Combiphar
371 PAN-AMIN G - Larutan mengandung Asam Amino **) PT Otsuka Indonesia
372 Precopar - Larutan mengandung asam amino **) PT Sanbe Farma
373 Renosan - Larutan mengandung asam amino **) PT Sanbe Farma
374 Ringerfundin - Larutan mengandung elektrolit PT Phapros
375 Smofkabiven - Larutan mengandung Karbohidrat+Elektrolit **) PT Fresenius Kabi Combiphar
376 Smoflipid 20% 100 mL - Larutan mengandung lipid **) PT Fresenius Kabi Combiphar
377 Totilac - Larutan mengandung elektrolit PT Kalbe Farma
378 Tridex 100 - Larutan mengandung karbohidrat+elektrolit **) PT Sanbe
379 Tridex 27A - Larutan mengandung elektrolit **) PT Sanbe
380 Tridex 27B - Larutan mengandung elektrolit **) PT Sanbe
381 Tridex Plain - Larutan mengandung elektrolit **) PT Sanbe Farma
382 Triofusin 1000 - Larutan mengandung karbohidrat **) PT Kalbe
383 Triofusin 1600 - Larutan mengandung karbohidrat **) PT Kalbe Farma
384 Triomix 1600 - Larutan mengandung karbohidrat **) PT Finusolprima Farma Internasional
385 Triofusin 500 - Larutan mengandung karbohidrat **) PT Kalbe Farma
386 Triomix 500 - Larutan mengandung karbohidrat **) PT Finusolprima Farma Internasional
387 Triofusin E 1000 - Larutan mengandung karbohidrat+elektrolit **) PT Kalbe Farma
388 Triomix 1000 - Larutan mengandung karbohidrat+elektrolit **) PT Finusolprima Farma Internasional
389 Tutofusin OPS - Larutan mengandung karbohidrat+elektrolit PT Kalbe Farma
390 Valamin - Larutan mengandung asam amino **) PT Sanbe Farma
391 WIDA 2A - Larutan mengandung karbohidrat+elektrolit PT Widatra Bhakti
392 WIDA D5-1/2NS - Larutan mengandung karbohidrat+elektrolit PT Widatra Bhakti
393 WIDA D5-1/4NS - Larutan mengandung karbohidrat+elektrolit PT Widatra Bhakti
394 WIDA D5NS - Larutan mengandung karbohidrat+elektrolit **) PT Widatra Bhakti
395 WIDA HSD - Larutan Mengandung Karbohidrat+Elektrolit PT Widatra
396 WIDA KDN1 - Larutan mengandung karbohidrat+elektrolit 500 ml PT Widatra
397 WIDA KDN2 - Larutan mengandung karbohidrat+elektrolit 500 ml PT Widatra
398 WIDA KN1 - Larutan mengandung elektrolit 500 ml PT Widatra
399 WIDA KN2 - Larutan mengandung elektrolit 500 ml PT Widatra
400 WIDA RD - Larutan Mengandung Karbohidrat+Elektrolit **) PT Widatra
401Albumin serum normal (human
Albumin) inj 20% 100 mLSeluruh industri farmasi
402Albumin serum normal (human
Albumin) inj 20% 50 mLSeluruh industri farmasi
403Albumin serum normal (human
Albumin) inj 25% 100 mLSeluruh industri farmasi
404 Albumin serum normal (human Albumin) inj 25% 20 mL Seluruh industri farmasi
405Albumin serum normal (human
Albumin) inj 25% 50 mLSeluruh industri farmasi
406Albumin serum normal (human
Albumin) inj 5% 250 mLSeluruh industri farmasi
407Albumin serum normal (human
Albumin) inj 5% 50 mLSeluruh industri farmasi
408 Analog insulin long acting inj 100 IU/mL, vial/cartridge disposible/penfill cartridge Seluruh industri farmasi
409 Analog insulin mix insulin inj 100 IU/mL (kemasan vial, cartridge disposible, penfill cartridge) Seluruh industri farmasi
410 Analog insulin rapid acting inj 100 IU/mL (cartridge disposible, penfill cartridge) Seluruh industri farmasi
411 Asparaginase serb inj 10.000 IU Seluruh industri farmasi
412 Bleomisin serb inj 15 mg Seluruh industri farmasi
413 Cisplatin/ Sisplatin serb inj 10 mg Seluruh industri farmasi
414 Cisplatin/ Sisplatin serb inj 50 mg Seluruh industri farmasi
415 CODEINE PHOSPHATE HEMIHYDRATE/ Codeine/ Kodein tablet/kapsul/kaplet 20 mg Seluruh industri farmasi
416 Cyclophosphamide monohydrate/ Cyclophosphamide/ siklofosfamid serb inj 1.000 mg (i.v.) Seluruh industri farmasi
417 Cyclophosphamide monohydrate/ Cyclophosphamide/ siklofosfamid serb inj 200 mg (i.v.) Seluruh industri farmasi
418 Cyclophosphamide monohydrate/ Cyclophosphamide/ siklofosfamid serb inj 500 mg (i.v.) Seluruh industri farmasi
419 Cytarabine/ Sitarabin inj 100 mg/ml (i.m./i.v/s.k.) **) Seluruh industri farmasi
420 Dakarbazin/Dacarbazine serb inj 200 mg Seluruh industri farmasi
421 Daunorubisin serb inj 20 mg Seluruh industri farmasi
422 Dialisa peritoneal, lar intraperitoneal dengan dekstrose 1,5% Seluruh industri farmasi
423 Dialisa peritoneal, lar intraperitoneal dengan dekstrose 2,5% Seluruh industri farmasi
424 Doksorubisin /Doxorubicin HCl serbuk inj 50 mg Seluruh industri farmasi
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
NO NAMA GENERIK INDUSTRI FARMASI
425 Doksorubisin/ Doxorubicin HCl serb inj 10 mg (i.v.) Seluruh industri farmasi
426 Epirubisin/Epirubicin Hydrochloride injeksi 2 mg/mL, vial 5 mL Seluruh industri farmasi
427 Epirubisin/Epirubicin Hydrochloride injeksi 2 mg/mL, vial 25 mL Seluruh industri farmasi
428 Epirubisin/Epirubicin Hydrochloride serb injeksi 50 mg / inj 50 mg/25 mL Seluruh industri farmasi
429 Eritropoetin-alfa inj 10000 IU Seluruh industri farmasi
430 Eritropoetin-alfa inj 2000 IU Seluruh industri farmasi
431 Eritropoetin-alfa inj 3000 IU Seluruh industri farmasi
432 Etoposid inj 20 mg/mL Seluruh industri farmasi
433 Faktor IX kompleks serb inj 1.000 IU + pelarut 10 mL Seluruh industri farmasi
434 Faktor IX kompleks serb inj 500 IU + pelarut 5 mL Seluruh industri farmasi
435Faktor koagulasi II, faktor
koagulasi VII, faktor koagulasi, faktor IX, faktor koagulasi X, serb inj 500 IU/10 mLSeluruh industri farmasi
436 Faktor VIIA serb inj + pelarut untuk injeksi Seluruh industri farmasi
437 Faktor VIII serb inj 1.000 IU Seluruh industri farmasi
438 Faktor VIII serb inj 230-340 IU Seluruh industri farmasi
439 Faktor VIII serb inj 250 IU + pelarut 10 mL Seluruh industri farmasi
440 Faktor VIII serb inj 480-600 IU Seluruh industri farmasi
441 Faktor VIII serb inj 500 IU + pelarut 5 mL Seluruh industri farmasi
442 Faktor IX kompleks inj 50 IU/mL Seluruh industri farmasi
443 Fludarabin serb inj 50 mg Seluruh industri farmasi
444 fluorourasil inj 50 mg/mL (@ 10 mL) Seluruh industri farmasi
445 Fraksi Protein Plasma inf 5% Seluruh industri farmasi
446 Gemsitabin/ Gemcitabine / Gemcitabine HCl serb inj / lar inj 1000 mg Seluruh industri farmasi
447 Gemsitabin/ Gemcitabine / Gemcitabine HCl serb inj / lar inj 200 mg Seluruh industri farmasi
448 Human Insulin intermediate acting inj 100 IU/ml, cartridge disposible/penfill cartridge Seluruh industri farmasi
449 Human insulin intermediate acting inj 100 IU/mL, vial 10 mL Seluruh industri farmasi
450 Human insulin mix insulin inj 100 IU/mL (kemasan vial, cartridge disposible, penfill cartridge) Seluruh industri farmasi
451 Human insulin mix insulin inj 100 IU/mL, vial 10 mL Seluruh industri farmasi
452 Human insulin short acting inj 100 IU/ml, cartridge disposible/penfill cartridge Seluruh industri farmasi
453 Human insulin short acting inj 100 IU/ml, vial 10 mL Seluruh industri farmasi
454 ifosfamid serb inj 1.000 mg Seluruh industri farmasi
455 Ifosfamid serb inj 2000 mg Seluruh industri farmasi
456 Ifosfamid serb inj 500 mg Seluruh industri farmasi
457 Imunoglobullin Intravena inj 250 mg/50 ml Seluruh industri farmasi
458 Irinotekan/ Irininotecan HCl/ Irinotecan HCl trihydrate inf 20 mg/mL Seluruh industri farmasi
459 Irinotekan/ Irininotecan HCl/ Irinotecan HCl trihydrate inj 20 mg/mL Seluruh industri farmasi
460 karboplatin/ carboplatin inj/inf 10 mg/mL (vial 15mL) Seluruh industri farmasi
461 karboplatin/ carboplatin inj/inf 10 mg/mL (vial 45mL) Seluruh industri farmasi
462 Methotrexate/ metotreksat inj 25 mg/mL Seluruh industri farmasi
463 Octreotide/ Oktreotid LAR serb inj 20 mg Seluruh industri farmasi
464 Octreotide/ Oktreotid LAR serb inj 30 mg Seluruh industri farmasi
465 Oxaliplatin/ oksaliplatin serb inj 100 mg Seluruh industri farmasi
466 Oxaliplatin/ oksaliplatin serb inj 50 mg Seluruh industri farmasi
467 Paclitaxel/ paklitaksel inj 6 mg/mL, vial @ 16,7 mL(inj 100 mg) Seluruh industri farmasi
468 Paclitaxel/ paklitaksel inj 6 mg/mL, vial @ 5 mL (inj 30 mg) Seluruh industri farmasi
469 Paclitaxel/ paklitaksel inj 6 mg/mL, vial @ 50 mL (inj 300 mg) Seluruh industri farmasi
470 Pemetreksed serb injeksi 500 mg Seluruh industri farmasi
471 Pengganti plasma golongan gelatin inf Seluruh industri farmasi
472 Ranibizumab inj 10 mg/mL Seluruh industri farmasi
473 Rituximab/ Rituksimab infus 10 mg/ml (vial @ 10 ml) Seluruh industri farmasi
474 Rituximab/ Rituksimab infus 10 mg/ml (vial @ 50 ml) Seluruh industri farmasi
475 Serum anti bisa ular A.B.U. I inj (i.m./i.v) Seluruh industri farmasi
476 Serum antidifteri (A.D.S) inj i.m 20.000 IU/mL (i.m.) Seluruh industri farmasi
477 Serum antitetanus (A.T.S) inj 1500 IU/mL (i.m) Seluruh industri farmasi
478 Setuksimab injeksi 5 mg/mL Seluruh industri farmasi
479 Trastuzumab serb inj 440 mg Seluruh industri farmasi
480 Vaksin Campak inj s.k + pelarut Seluruh industri farmasi
481 Vaksin Hepatitis B Rekombinan Prefilledsyringe (Uniject) @ 0,5 Ml Seluruh industri farmasi
482 Vaksin Polio 10 dosis (b-opv) Seluruh industri farmasi
483 Vaksin Yellow Fever Seluruh industri farmasi
484 Vinblastin inj 1 mg/mL Seluruh industri farmasi
485 Vincristine sulfate/ Vinkristin inj 1 mg/ml (vial 1 mL) (i.v.) Seluruh industri farmasi
486 Vincristine sulfate/ Vinkristin inj 1 mg/ml (vial 2 mL) (i.v.) Seluruh industri farmasi
487 Vinorelbine tartrate/ vinorelbin inj 50 mg/ 5 mL (10 mg/mL) Seluruh industri farmasi
488 Vinorelbine tartrate/ vinorelbin inj 50 mg/ 5 mL (10 mg/mL), kemasan 1 mL Seluruh industri farmasi
Lampiran 3
Daftar Nama Obat Negosiasi Katalog Obat 2020-2022
NO NAMA GENERIK INDUSTRI FARMASI
489 Hepatitis B imunoglobulin (human) inj 220 IU/mL Seluruh industri farmasi
490 Human tetanus imunoglobulin inj 250 IU (i.m.) Seluruh industri farmasi
491 Vaksin influenza Seluruh industri farmasi
492 Vaksin Meningitis Seluruh industri farmasi
493 Amoksisilin/Amoxicillintablet/kapsul/kaplet 500 mg Seluruh industri farmasi
494 Asam askorbat (vitamin C) tablet/kapsul/kaplet 50 mg Seluruh industri farmasi
495 Asam Mefenamat/Mefenamic acid tablet/kapsul/kaplet 500 mg Seluruh industri farmasi
496 Kaptopril/ Captopril tablet/kaplet 25 mg Seluruh industri farmasi
497 CHLORPHENAMINE MALEATE/Klorfeniramin tablet/kapsul/kaplet 4 mg Seluruh industri farmasi
498 Paracetamol/ Parasetamol tablet/kapsul/kaplet 500 mg Seluruh industri farmasi
499 Asetat Ringer (softbag, flexy bag, plabot) Seluruh industri farmasi
500 Glukosa larutan infus 10% 500 mL Seluruh industri farmasi
501 Glukosa larutan infus 5 % 500 mL Seluruh industri farmasi
502 Glukosa Larutan Infus 5% steril 100 ml Seluruh industri farmasi
503 Glukosa Larutan Infus 5% steril 250 ml Seluruh industri farmasi
504 Kalium klorida / Potasium klorida injeksi 25 mg 7,46% 25 mL Seluruh industri farmasi
505 Nacl 0,9% / Sodium Chloride 0,9%, 500 mL Seluruh industri farmasi
506 Ringer Laktat/ Ringer Lactate, @1000 ml Seluruh industri farmasi
507 Ringer Laktat/ Ringer Lactate, @500 mL Seluruh industri farmasi
508 Artesunate injeksi 60 mg/mL (i.v./i.m.) PT Pharma Laboratories
509 Bedaquiline/Bedaquiline fumarate tablet 100 mg PT Soho
510 Efavirens tablet salut selaput/kaplet salut selaput 600 mg (G) PT Kimia Farma
511 Flufenazin injeksi 25 mg/mL (i.m ) PT Mersifarma Tirmaku Mercusana
512 Kanamisin/ Kanamycin serb inj 1000 mg PT Harsen
513 Kombinasi: Elbasvir 50 mg dan Grazoprevir 100 mg Tablet/Kapsul/Kaplet PT MSD
514 Quinine Dihydrochloride/ kuinin inj 25% (i.v) (G) PT Kimia Farma
515 Vaksin DPT-HB-Hib Seluruh industri farmasi
516 Vaksin Jerap difteri tetanus (DT) cairan inj i.m 40/15 If per mL Seluruh industri farmasi
517 Vaksin Jerap difteri tetanus (Td) cairan inj i.m 15/4 If per mL Seluruh industri farmasi
518 Vaksin MR (Measles and Rubella Vaccine), 10 dosis Seluruh industri farmasi
519 Vaksin Pneumococcus 13 (PCV13), Prefilled syringe 1 dosis @0,5 mL Seluruh industri farmasi
520 Vaksin Pneumococcus 13 (PCV13), vial 1 dosis @0,5 mL Seluruh industri farmasi
521 Vaksin Rabies untuk manusia, serb inj 2,5 IU (s.k.) Seluruh industri farmasi