RENCANA KEBUTUHAN OBAT (RKO)

PUSKESMAS …………….
TAHUN 2021

RATA-RATA
SATUAN STOK AWAL (31 PEMAKAIAN
NO. NAMA OBAT KEMASAN DESEMBER 2019) PERBULAN
TAHUN 2019
a b c d e
OBAT RUTIN
1 Persediaan Bahan Habis Pakai
Persediaan Peralatan Kesehatan/
Perbekalan Kesehatan
1 Abbocath jarum infus 18 pieces 18 2
2 Abbocath jarum infus 20 pieces
3 Abbocath jarum infus 22 pieces
4 Abbocath jarum infus 24 pieces
5 Abbocath jarum infus 26 pieces
6 Alat Puyer Set
7 Alat suntik 0.05 cc pieces
8 Alat suntik 0.5 cc pieces
9 Alat suntik 1 cc pieces
10 Alat suntik 3 cc pieces
11 Alat suntik 5 cc pieces
12 Alat suntik 10 cc pieces
13 Alat suntik 20 cc pieces
14 Bisturi pieces
15 Blood Set Set
16 Catgut benang bedah no 2/0-3/0 pieces
17 Catgut benang bedah no 3/0 Roll
18 foley Catheter pieces
20 Hand Scond pieces
21 Infus set anak pieces
22 Infus set dewasa pieces
23 Jarum Hecting Kulit pieces
24 Jarum Hecting Otot pieces
25 Kaca Sediaan pieces
26 Kapas pembalut 250 mg Bungkus
27 Kasa Hidrofil 36 m x 80 cm Roll
28 Kasa Hidrofil Steril Kotak
29 Kasa Pembalut Hidrofil 4 x 10 cm Roll
30 KasaPembalut Hidrofil 4 x 5 Roll
31 Kertas Puyer pieces
32 Masker pieces
33 Nelaton catheter pieces
34 Pembalut gips Roll
35 Plester 5 yard x 2 inch Roll
36 Plester kertas / MICROPORE pieces
37 Pot Sputum pot
38 Safety Box pieces
39 Sarung Tangan Panjang Steril pieces
40 Silk ( Benang sutera ) no 3/0 pieces
41 Underpad pieces
42 Urine Bag ( Non Seteril ) pieces
43 Wing needle pieces
44 Lidi button pieces
45 Masker N95 8210 pieces
46 Masker nebulizer Anak pieces
47 Masker nebulizer dewasa pieces
48 NGT pieces
49 Oxigen nasal canule anak dan dewasa Paket
50 Plastik klip 7 x 10 (Kecil) pieces
51 Plastik klip 8 x 13 (Besar) pieces
52 Pot Urine pieces
53 Pot Fesses pieces
54 Disposible Lancet pieces
55 Pen Lancet pieces
56 Catgut Chromic SMI 2/0 pieces
57 Catgut Chromic SMI 3/0 pieces
58 Catgut Plain SMI 2/0 pieces
59 Catgut Plain SMI 3/0 pieces
2 Persediaan Bahan/ Material
Bahan Obat-obatan
A ANTIBIOTIKA
1 Amoksilin kapsul 250 mg Kapsul
2 Amoksilin tab 500 mg Tablet
3 Amoksisilin s kering 125 mg / 5 cc 60 Ml Botol

4 Amoksisilin s kering 250 mg / 5 cc 60 Ml Botol

5 Asiklovir tab 200 gr Tablet

6 Asiklovir tab 400mg Tablet
7 Azitromisin 500 mg Tablet
8 Benzatin Benzil penisilin Vial
9 Cefixim 100 mg kapsul kapsul
10 Cefixime DS 100 mg/ 5ml Botol
11 Doksisiklin kapsul 100 mg Kapsul
12 Erytromisin sirup 60 Ml 200mg/5ml Botol
13 Erytromycin 250 mg Tablet
14 Erytromycin 500 mg Tablet
15 Fenoksimetil Penisilin tablet 250 mg Tablet
16 Fenoksimetil Penisilin tablet 500 mg Tablet
17 Flukonazol kapsul 150 mg Kapsul
18 Griseofulvin tablet 125 mg micronized Tablet

19 Ketokonazol tablet 200 mg Tablet

20 Klindamisin Kapsul 150 mg Kapsul
21 Klindamisin Kapsul 300 mg Kapsul
22 Kloramfenikol kapsul 250 mg Kapsul
23 Kloramfenikol sirup 60 Ml Botol
24 Kotrimoksazol Suspensi 60 Ml Botol
40mg/5ml
25 Kotrimoksazol Tablet Dewasa Tablet
26 Kotrimoksazol Tablet paed Tablet
27 Lincomysin 500 mg Kapsul
28 Metronidazol tablet 500 mg Tablet
29 Nistatin drop / Mycostatin, candistin, Botol
Nymiko
30 Nistatin tablet salut gula 500.000 IU/g Tablet

31 Nistatin tablet vagina 100.000 IU/g Tablet

32 Sefadoksil 500 mg Kapsul
33 Sefadoksil syrup 125ml/5ml Botol
34 Sefadoksil syrup 250ml/5ml Botol
35 Seftriaxsone 1 gr inj Vial
36 Siproploksasin tab 500 mg Tablet
37 Streptomycin inj 1 gram Vial
38 Tetrasiklin Kapsul 250 mg Kapsul
39 Tetrasiklin Kapsul 500 mg Kapsul
40 Tiamfenikol kap 500 mg Kapsul
B ANALGETIKA-ANTIPIRETIK-
ANTIINFLAMASI
1 Alopurinol tablet 100 mg Tablet
2 Alopurinol tablet 300 mg Tablet
3 Antalgin ( Metampiron ) inj 250 mg/ 5 cc Ampul

4 Asam Mefenamat 250 Kapsul

5 Asam Mefenamat 500 Tablet
6 Asetosal Tablet 80 mg (Aspilet) Tablet
7 Ibuprofen Supp Supp
8 Ibuprofen Suspensi 200mg/5ml Botol
9 Ibuprofen tablet 200 mg Tablet
10 Ibuprofen tablet 400 mg Tablet
11 Kalium Diclofenak 50 mg Tablet
12 Ketoprofen Inj Ampul
13 Meloksixam tablet 15 mg Tablet
14 Natrium Diclofenac tab 50 mg Tablet
15 Parasetamol 100 mg Tablet
16 Parasetamol Drop 15 ml Botol
17 Parasetamol sirup 120 mg / 5ml (60 Ml) Botol

18 Parasetamol tablet 500 mg Tablet

19 Tramadol tablet 50 mg Tablet
C DIGESTIVA
1 Antasida DOEN komb Tablet
2 Antasida sirup 60 Ml Botol
3 Lacto B Sachet
4 Mesoprostol 200 mg Tablet
5 Natrium Bikarbonat tablet 500 mg Tablet
6 Omeprazole 20 mg tablet Kapsul
7 Ranitidin inj 25 mg/2ml Ampul
8 Ranitidin tablet 150 mg Tablet
9 Sucraflat sirup Botol
10 Vitazym tab Tablet
D ANTISPASMODIK
1 Chlordiazepoxide (Braxidin) Tablet
2 Ekstrak Belladon tablet 10 mg Tablet
3 Hyoscine-N-Butilbromida/Buscopan
tablet Tablet
4 Buscopan Inj Ampul
5 Papaverin tablet Tablet
6 Spasminal Tablet
E LAKSATIVA
1 Bisacodil Tablet 10 mg Tablet
2 Bisacodil Tablet 5 mg Suppositoria Suppos
3 Laktulosa Syr 3,335g/5ml / Laktulak Botol
syrup
F ANTIDIARE & ELEKTROLIT
1 Anti Diare Anak Tablet
2 Anti Diare Dewasa Tablet
3 Garam Oralit 200 ml air Sachet
4 Norit Tablet
G ANTIEMESIS
1 Dimenhidrinat tab 50 mg Tablet
2 Domperidon 10 mg tablet Tablet
3 Domperidon suspensi 5 mg/ml Botol
4 Metoclopramid Inj Ampul
5 Metoclopramid Syrup Botol
6 Metoclopramid 10 mg Tab Tablet
7 Ondansetron injeksi Ampul
8 Ondansetron tablet 4 mg Tablet
H OBAT METABOLISME
(VITAMIN&MINERAL)
1 Asam Askorbat (VIT C) Tablet 25 mg Tablet
2 Asam folat 1 mg Tablet
3 Kalsium laktat (Kalk) tablet 500 mg Tablet
4 Multivitamin anak 60 Ml Botol
5 Multivitamin dewasa Tablet
6 Neurobion 5000 injeksi Ampul
7 Phitonadione pead injeksi Ampul
8 Piracetam 800 mg Tablet
9 Piridoksin HCl (Vit B6) tablet 10 mg Tablet
10 Sianokobalamin inj 500 mcg/ml-1ml Ampul
11 Sianokobalamin tab b12 Tablet
12 Tiamin HCL (Vit B1) inj 100 mg/ml-1ml Ampul

13 Tiamin HCL (Vit B1) tablet 50 mg Tablet

14 Vitamin B Komplek Inj ampul
15 Vit B kompleks tab Tablet
I ANTI ASMA
1 Aminofilin inj 24 mg / cc Ampul
2 Aminofilin tab 200 mg Tablet
3 Bisolvon drop Botol
4 Bricasma Inj Ampul
5 Efedrin HCl tablet 25 mg Tablet
6 Salbutamol tablet 4 mg Tablet
7 Salbutamol inhalasi ( Ventolin ) Nebule
J ANTITUSIVE & EKSPEKTORAN
1 Ambroksol sirup 60 ml Botol
2 Ambroksol tablet Tablet
3 Bromhexin tablet 8 mg Tablet
4 Dektrometorfan Tablet Tablet
5 Dektrometorfan sirup 10 mg/5 ml-60 Ml Botol

6 Gliseril Guayakolat tablet 100 mg Tablet

7 Kodein fosfat tablet 10 mg Tablet
8 Obat batuk anak 60 Ml / bromhexin Botol
sirup
9 Obat batuk Hitam (OBH) Cairan -100 ml Botol

10 Asetilsistein 200 mg Tablet

K ANTI ANEMIA
1 Tambah darah komb : Besi + as folat Tablet
L HEMOSTATIK
1 Asam Traneksamat 250mg/5ml Ampul
2 Asam Traneksamat 500 MG Tablet
3 Fitomenadion (Vit K1) inj 10 mg / ml- Ampul
1ml
4 Fitomenadion (Vit K1) tablet gula 10 mg
Tablet
M ANTIALERGI/IMUNOLOGIKUM
1 Anti Histamin/Loratadin Tablet
2 Cetirizin sirup 5 mg/5ml 60 ml Botol
3 Deksametason inj 5 mg/ml 1 ml Ampul
4 Deksametason Tablet 0,5 mg Tablet
5 Difenhidramin inj 10 mg/5 ml-1 ml Ampul
6 Klorfeniramin maleat (CTM) tablet 4 mg
Tablet
7 Methylprednisolon 4 mg tablet Tablet
8 Prednison tab 5 mg Tablet
N ANTIKONVULSI/ANTIPARKINSON
1 Alprazolam tablet 0,5 mg Tablet
2 Amitriptilin HCl tab 25 mg Tablet
3 Fenitoin Na inj 50 mg/ml-2ml Ampul
4 Fenitoin Natrium kapsul 100 mg Kapsul
5 Flufenazin inj ampul
6 Karbamazepin tablet 200 mg Tablet
7 Triheksifenidil Tablet 2 mg Tablet
8 Depakote 250 mg Tablet
O ANTIDEPRESAN
1 Diazepam inj 5 mg/ml -2 ml Ampul
2 Diazepam tablet 2 mg Tablet
3 Fenobarbital inj 50 mg/ml-2ml Ampul
4 Fenobarbital tablet 30 mg Tablet
5 Haloperidol 5 mg Tab Tablet
6 Haloperidol injeksi ampul
7 Klorpromazin HCl inj 5 mg/2cc Ampul
8 Klorpromazin HCl 100 mg Tablet
9 Risperidone 2 mg Tablet
10 Stesolid Rectal Supp
11 Clozapine 100 mg Tablet
12 Olanzapin 5 mg Tablet
P ANTIMIGREN
1 Antimigren DOEN tab Tablet
2 Betahistin Mesilat tab 6 mg Tablet
Q ANTIDIABETIKUM
1 Glibenklamid tablet 5 mg Tablet
2 Glimepirida 1 mg Tablet
3 Metformin Tablet
R OBAT KULIT & OBAT LUAR
1 Antibakteri DOEN salep komb Tube
2 Antifungi DOEN kombinasi salep Tube
3 Asiklovir krim 5 % 5 gr Pot
4 Betametason krim 0,1 % Tube
5 Burnazin cream Tube
6 Chloramfecort Krim Tube
7 Gentamisin salep kulit Tube
8 Gentian violet lar 1 % Tube
9 GOM Botol
10 Hidrokortison krim 2,5 % botol
11 Kassa Penutup luka/lomatule Tube
12 Ketokonazol (cream)10 gr Pieces
13 Kloramfenikol Krim / Bufacetin Salep Tube
2%
14 Mikonazol krim Tube
15 Obat Luka Bakar Tube
16 Oksitetrasiklin 3% salep kulit Tube
17 Polikresulen ( Albothyl ) Botol
18 Salep 2-4 Pot
19 Salisil bedak 2 % Kotak
20 Scabiecid cream Tube
21 Trombophop salep Tube
S OBAT TELINGA
1 Fenol Glicerol Cair Botol
2 Kloramfenikol tetes telinga 3 % Botol
T OBAT MATA
1 Atropin sulfat tetes mata 0,5 % Botol
2 Cendoxitrol Tetes Mata Botol
3 Gentamisin tetes mata Botol
4 Kloramfenikol salep mata 1 % Tube
5 Kloramfenikol tetes mata Botol
0.5%/Decacetin
6 Obat edema kornea tetes mata/Optalgon
Botol
7 Ofloxacin tetes mata Botol
8 Oksitetrasiklin salep mata Tube
9 Sulfasetamida Na tetes mata Botol
10 Tetracain Hcl 0,5 % Tetes Mata Botol
11 Timolol 0,5 % Tetes mata Botol
U ANTIHAEMORRHOID
1 Anti Hemmorhoid DOEN supp Supp
2 Anti Hemoroid kapsul Kapsul
V KARDIOVASKULUS/ ANTIHIPERTENSI

1 Amlodipin 5 mg Tablet
2 Aspar K Tablet
3 Bisoprolol 5 mg Tablet
4 Digoksin tablet 0,25 mg Tablet
5 Isorbid dinitrat tablet sublingual 5 mg Tablet

6 Kaptopril 25 mg Tablet
7 Kaptopril 12.5mg Tablet
8 Metildopa/dopamet Tablet
9 Nifedipin 10 mg tab Tablet
10 Nifedipin 20 mg tab Tablet
11 Propanolol HCl tablet 10 mg Tablet
12 Reserpin tab 0,25 mg Tablet
13 Tensi Gard Tablet
W DIURETIKUM
1 Furosemid tablet 40 mg Tablet
2 Hidroklortiazid (HCT) tablet 25 mg Tablet
3 Nefrolit kapsul Kapsul
4 Glaukon Tablet
X OKSITOSIKUM
1 Metilergometrin maleat inj 0,200 mg - ampul
ml
2 Metilergometrin maleat tab salut 0,125 Tablet
mg
3 Oksitoksin in 10 IU/ml- 1 ml ampul
4 Syntocinon ampul
Y ANTILIPIDEMIKUM
1 Simvastatin Tablet 10 mg Tablet
2 Simvastatin Tablet 20 mg Tablet
Z HORMON
1 Propiltiourasil tablet 100 mg Tablet
AA SYOK ANAFILAKTIK
1 Epinefrin / adrenalin inj 0,1 % - 1ml ampul
AB ANTELMINTIK
1 Pirantel tablet 125 Tablet
AC PELARUT & INFUS
1 Aqua pro inj steril @ 25 cc Botol
2 Cairan infus pengganti plasma/gelofusin
Botol
3 Dekstran 70 lar infus 6 % Botol
4 Glukosa lar infus 10 % Botol
5 Glukosa lar infus 40 % Botol
6 Glukosa lar infus 5 % Botol
7 KN - 3B SOL/KK Botol
8 Magnesium sulfat inj 25 ml -20 % Ampul
9 Magnesium sulfat inj 25 ml -40 % ampul
10 Manitol 20 % Botol
11 Metronidazole infus 500 mg/100ml Botol
12 Natrium Klorida Lar.infus 0,9 % steril Botol
13 Parasetamol Infus Botol
14 Ringer Laktat Larutan Infus Steril Botol
15 Siproploksasin infus Botol
AD ANTISEPTIKA & DESINFEKTAN
1 Bayclin Botol
2 Etakridin ( rivanol ) lar 0,1 % 300 cc Botol
3 Etanol 70 %1000 ml Botol
4 Etanol 70 %100 ml Botol
5 Lisol 5 % Botol
6 Povidon Iodine 10 % 60 ml Botol
7 Povidon Iodine 10 % 300 ml Botol
AE KB
1 Depo progestin/suntik KB Botol
AF ANTI INFLUENZA
1 Obat batuk pilek anak 60 ml Botol
(Paracetamol, Fenileprin Hidroklorida,
CTM, Kalium sulfoguaiakolat)

AG SERUM
1 Serum anti tetanus inj 1.500 IU/amp Vial
2 Serum anti tetanus inj 20.000 IU/vial Vial
 3 Serum antibisa ular Polivalen inj 5 ml Vial
AH LAIN-LAIN
1 Atropin sulfat inj 0,25 mg / ml-1ml ampul
2 Atropin Sulfat Tablet 0,5 mg Tablet
3 Calsium gluconas inj ampul
4 Lidokain Jelly Tube
5 Jelly USG Botol
6 Natrium tiosulfat inj ampul
7 Nalokson Inj 0,4 mg/ml Botol
8 Oxycan Botol
OBAT PROGRAM
AI ANTI MALARIA
1 Artemeter injeksi ampul
2 Arterakine tablet Tablet
3 Artesunate injeksi ampul
4 Kuinin Dihidroklorida injeksi 25%-2 ml ampul

AJ GIZI
1 Zinc suspensi 100 ml Botol
2 Mineral Mix Sachet
3 Pan Entral Sachet
4 Retinol ( vit A ) kapsul 100.000 unit Kapsul
5 Retinol ( vit A ) kapsul 200.000 unit Kapsul
6 Taburia Sachet
7 Formal 100 Sachet
AK FILARIASIS
1 Anti Filaria Tablet ( Dietyl Karbamazepin Tablet
)
2 Albendazol tab 400 mg Tablet
3 Albendazol Sirup 200mg/5ml Botol
AL ANTI LEPRA
1 MB Dewasa Blister
2 MB Anak Blister
3 PB Dewasa Blister
4 PB Anak Blister
AM OBAT TBC
1 INH 100 mg Tablet
2 Obat Anti Tuberkulosis FDC Kat 1 & 3 Paket
3 Obat Anti Tuberkulosis FDC Kat 2 Paket
4 Obat Anti Tuberkulosis Kategori Anak Paket

5 Obat Anti Tuberkulosis Sisipan Paket

AN HEPATITIS
1 Vaksin HBIg / Hyperhep B Vial
AO VAKSIN
1 Vaksin BCG Vial
2 Vaksin Campak/MR Vial
3 Vaksin DT Vial
 4 Vaksin HB COM DPT Vial
5 Vaksin HB UNIJECT ampul
6 Vaksin Polio Vial
7 Vaksin TT Vial
8 Vaksin TD Vial
9 Vaksin DPT HB HIB Vial
10 Polio IVP Vial
AP DENTAL
1 Air Raksa Dental Use Botol
2 Bonding Set
3 Carpul pieces
4 Celluloid strip pieces
5 Composite Set
6 Dentorit Botol
7 Descotan Forte (gigi) Botol
8 Devitalisasi Pasta (Non arsen) Botol
9 Etil klorida semprot 100 cc Botol
10 Etching/Extra gel Set
11 Eugenol Cairan Botol
12 Glass Ionomer Cement (GC IX) Botol
13 Jarum Citoject pieces
14 Kalsium Hidroksida pasta pieces
15 Lidokain inj komb ampul
16 Lining Cement pieces
17 Mata Bor pieces
18 Monoklorkamfer mentol cairan Botol
19 Mummifying Pasta Botol
20 Poles pieces
21 Semen seng fosfat serbuk cairan/Glas pieces
lonomer lineng semen
22 Serat pembeku darah pot
23 Silver amalgam serbuk 65-75 % Set
24 Spray pelumas handpiece Botol
25 Sulfa Stopping Fletcher(Fletcher) Set
26 Tissu steril pembersih alat gigi Botol
27 Topikal anestesi Botol
28 Trikresol formalin Botol
AQ Bahan Kimia
1 Hidrogen Peroksida (H2O2) Botol
2 Oil Imersi Botol
3 Oil Imersi Botol
4 Reagen Ziehl Neelsen Paket
5 Alkohol Swab ampul
6 PPD 2 TU Vial
7 Test Pack pieces
8 Stik Kolesterol pieces
9 Stik Asam Urat pieces
10 Stik Glukosa pieces
 11 VIKIA HIV Pieces
12 DI Anti HIV 1/2 Tes
13 Intec HIV III Tes
14 SD Bioline HIV Kit.1 Tes
15 Oncoprobe HIV.3 Tes
16 SD Bioline Shypilis Tes
17 RPR Shypilis Tes
18 SD HbsAg Tes
19 Iodina Tes 10 ml Kit
AR OBAT PENGADAAN BARU
DINES
1 Golongan Darah Anti A Botol
2 Golongan Darah Anti B Botol
3 Golongan Darah Anti AB Botol
4 Golongan Darah Anti D Botol
5 Guedel Airway 80 mm pieces
6 Guedel Airway 40 mm pieces
7 Stik Hemoglobin pieces
8 Glimepirida 2 mg Tablet
9 Clozapine 25 mg Tablet
10 Protein Urine Test pieces
11 RPR Shypilis Component Set
12 Gentamicin injeksi 40 mg/ml ampul
13 Amlodipin 10 mg Tablet
14 Antiosteoarthritis Tablet
15 Vitamin Neurotropik Tablet
16 Ampicillin inj Vial
17 Krim Natrium Diklofenac Tube
18 Kartu Golongan Darah pieces
19 Azythromycin Cefixime (kombipak) Tablet
20 Pyrimethamine 25 mg Tablet
21 Clobazam 10 mg Tablet
22 Olanzapin 10 mg Tablet
23 Serum Anti Defteri Vial
24 Fase Awal Tablet
25 Fase Lanjutan Tablet
26 OAT Kombipak Kat.1 Paket
27 Diazepam 5mg tablet
28 foley Catheter 2w no.16 pieces
29 foley Catheter 2w no.24 pieces
30 olanzapin inj ampul
31 Bisoprolol 2,5 mg tablet
32 micro brush box
33 xylocain botol
34 Endoprost botol
35 Vaksin rabies Vial
36 DBS Colection test
37 Antiseptic gell Botol
38 Braket Handwash Pieces
39 masker 1860 Pieces
40 masker 1860s Pieces
41 masker 1870t Pieces
42 campak vial
43 surgeon cap pieces
44 shoes cover pieces
45 SD HbsAg (p2p) Paket
46 Susu Ibu Hamil Kotak
47 Tabung EDTA pieces
48 Vacutainer no.21 pieces
49 Vacutainer no.22 pieces
50 Sarung Tangan (M) pieces
51 Syring Needle 3 ml pieces
52 Vaginal Specullum pieces
53 Steril Cotton Swab pieces
54 guidal size 50 mm pieces
55 Handscoon steril 6.5 pieces
56 Handscoon steril 7.5 pieces
57 Handscoon steril 8 pieces
58 simple mask paed pieces
59 sterilization packaging 150 mmx200 m pieces
60 sterilization packaging 200 mmx200 m pieces
61 sterilization packaging 75 mmx200 m pieces
62 cefotaxime 1gr inj pieces
63 Piracetam 200 mg/ml inj pieces
64 povidon iodne 10% 300ml pieces
65 INH 300mg pieces
66 KHB Diagnostar kit.2 pieces
67 Lansoprazole Kapsul
 OBAT (RKO)
……….
1

RENCANA RENCANA RENCANA REALISASI

KEBUTUHAN PENGADAAN PENGADAAN PENGADAAN
TAHUN 2021 TAHUN 2021 TAHUN 2020 TAHUN 2019

f=e x 18 g=f - d h i

36
 Menyetujui,
Kepala UPT Puskesmas ……………

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