BUKU FORMULARIUM

OBAT

KLINIK .....................

TAHUN 2023
KLINIK .........................................

DAFTAR NAMA OBAT SESUAI FORMULARIUM TAHUN 2023

DI KLINIK ....................................

NO NAMA OBAT SATUAN

1 2 3
I. ANALGETIK
ANTIPIRETIK
ANTIINFLAMASI
a. Asam Mefenamat 500mg Tablet

b. Ibuprofen 400mg Tablet

c. Ibuprofen 200mg Tablet

d. Ibuprofen Syr (100mg/5ml) Botol

e. Metampyron, vitamin B1+vitamin B16 Tablet

f. Parasetamol 500mg Tablet

g. Parasetamol Sirup Botol

II. ANTI INFLAMASI, ANTI REUMATIK

a. Diclofenac Potassium 50mg Tablet

b. Diclofenac Sodium 50 mg Tablet

c. Meloxicam 15 mg Tablet

III. ANTI GOUT

Allupurinol 300 mg Tablet

 IV. ANTI INFLUENZA

a. Paracetamol + Phenylpropanolamyne Hcl +

Dextromethopran HBr+ Ctm Kapsul

b. Paracetamol + Phenylpropanolamyne Hcl + Ctm Kapsul

c. Pseudoephedrin HCL 2,5 mg+ Chlorphenamine Kapsul

d. Pseudoephedrin HCL 60 mg+ Triprolidine HCL 2,5

mg Tablet

V. MUKOLITIK

Ambroxol Tablet

VI. OBAT BATUK

a. Dipenhydramine HCL+ Dextrometrophan Hbr+

Ammonium Chloride+Phenyleprine+ GG Tablet

b. Dextromethrophan+ Guaifenesin+ CHlorpenamine

Meleate Tablet

c. OBH Sirup Botol

d. Dipenhydramine HCL+ Dextrometrophan Hbr+

Ammonium Chloride+Phenyleprine+ GG sirup Botol

VII. OBAT ASMA

Salbutamol 4mg Tablet

VIII.
OBAT SLAURAN CERNA / ANTASIDA DAN
ANTI ULKUS
a. Magnesium Hydroxide 250 mg +Auminium Tablet
 Hydrokisda 250 mg+ simeticone 50 mg

b. Omeprazole Kapsul

IX. ANTI DIARE

Attalpugite Tablet

X. PENCAHAR

Bysacodil Tablet

XI. ANTI SPASMODIK Kapsul

Hycosine – N butylbromide

XII. ANT I EMETIKA

Domperidone Tablet

XIII. ANTIHIPERTENSI

a. Amlodipine 10 mg Tablet

b. Amlodipine 5 mg Tablet

XIV. ANTI DIABETES

a. Glibenclamide 5 mg Tablet

b. Metformine 500mg Kapsul

c. Metformine 850 mg Kapsul

 XV. OBAT DISLIPEDIMIA
a. Simvastatin 10 mg Tablet

b. Evothyl 100 mg Tablet

c. Gemfibrozil 300 mg Tablet

XVI. OBAT SALEP KULIT

a. Betamhetasone cream Tube

b. Gentamycine sulfate 5mg Tube

c. Neomycin sulfate,Bovine placenta Extract gel Tube

d. Ketoconazole cream Tube

e. Heparin sodium gel 15mg Tube

f. Chlorampenicol+ Hydrocortison cream 5 mg Tube

g. Hydrocortison cream Tube

h. Chlorampenicol cream Tube

i. Acyclovir cream Tube

j. Diclofenac sodium cream Tube

k. Flucinolone acetonide+ Neomycine sulfate Tube

l. Miconazole cream Tube

m. Lespain cream

XVII. MULTIVITAMIN+ MINERAL

a. Cyanocobalamin 5mcg+ Thyamin HCL Tablet

 b. Curcuma + multivitamin sirup Tablet

c. Multivitamin, mineral Ginseng & royal jeli Tablet

d. Vitamin B1 dan B12 Tablet

e. Thiamine mononitrate, Pridoxine,Cyanocobalamin

Tablet

f. Kalsium laktat Tablet

g. Mecobalamin 500mg Tablet

XVIII ANTIBIOTIK
.
a. Amoxillin 500mg Kapsul

b. Amoxilin sirup Botol

c. Ciprofloxacin 500 Kapsul

d. Cefixime 100mg Kapsul

e. Cefixime sirup Botol

f. Cefadroxil 500mg Kapsul

g. Cefadroxil sirup Botol

XIX. ANTI VIRUS

Acyclovir 400mg Tablet

XX. ANTI HISTAMIN

a. Dexamethasone, Dexchlorpheriamine meleate Tablet

b. Cetirizine Tablet
 c. Chlopheniramine maleate 4mg Tablet

XXI. KORTIKOSTEROID

a. Methylprednisolone 4mg Tablet

b. Dexhametasone 0,5 mg Tablet

XXII. KARDIOVASKULER

ISDN 5mg Tablet

XXIII OBAT MATA DAN TETES TELINGA

.
a. Erlamycetin salep mata Tube

b. Gentamycin sulfate salep mata Tube

c. Reco tetes mata Botol

d. Polimiksin B sulfat+ Neomycine Dexhametason tetes

mata Botol

e. Tetrahydozoline Hydrochloride HCl tetes mata Botol

f. Phenol Glycerol Botol

XIV. ANTI SEPTIKA

a. H2O2 Botol

b. Rivanol 100ml Botol

XXV. CAIRAN INFUS

a. Ringer Laktat Kolf

 b. Nacl Kolf

c. Glucose 5 % Kolf

XVI. OBAT INJEKSI

Pehacain injeksi Ampul

XVII. ANASTESI LOKAL

Cloretyl spray Botol

VIII. ALKES HABIS PAKAI

a. Sarung Tangan M pcs

b. Sarung Tangan S pcs

c. Sarung Tangan L pcs

d. Easy touch Glukosa set

e. Easy touch Kolesterol set

f. Easy touch urine acid set

g. Kasa steril 16x16 Roll

h. Leucoplas 2,5 x 4,5 Roll

i. Kasa gulung 4 yard x 5 cm Roll

j. Kasa gulung 4 yard x 10 cm Roll

k. Ultrafix 5 x1 Roll

l. Abocate no.22
XIX. REAGEN LAB KLINIK
a. Diluent Mindray 500 ml Botol

b. Lyse Mindray Botol

XXX. BAHAN GIGI

Fuji IX GP 1-1 # Extra A3 Kit

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Pada Tanggal : .................

KEPALA KLINIK ........................

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