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WHO Model List of Essential Medicines - 12th List, April 2002
(2002; 28 pages) [French] [Spanish] View the PDF document
Table of Contents
View the documentIntroduction
View the documentPromoting rational use
View the documentWHO Model List (Revised April 2002). Core List
View the documentWHO Model List (Revised April 2002). Complementary List
 

WHO Model List (Revised April 2002). Complementary List

Explanatory Notes

The complementary list presents essential medicines for priority diseases which are efficacious, safe and cost-effective but not necessarily affordable, or for which specialised health care facilities or services may be needed.

When the strength of a drug is specified in terms of a selected salt or ester, this Is mentioned in brackets; when it refers to the active moiety, the name of the salt or ester in brackets is preceded by the word “as”. Many drugs included in the list are preceded by a box (*) to indicate that they represent an example of a therapeutic group and that various drugs could serve as alternatives. It is imperative that this is understood when drugs are selected at national level, since choice is then influenced by the comparative cost and availability of equivalent products. Examples of acceptable substitutions include:

* Hydrochlorothiazide: any other thiazide-type diuretic currently in broad clinical use.
* Hydralazine: any other peripheral vasodilator having an antihypertensive effect.
* Senna: any stimulant laxative (either synthetic or of plant origin).

Numbers in parentheses following drug names indicate:

(1) Drugs subject to international control under: (a) the Single Convention on Narcotic Drugs (1961); (b) the Convention on Psychotropic Substances (1971); or (c) the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988).

(2) Specific expertise, diagnostic precision, individualization of dosage or special equipment required for proper use.

(3) Greater potency or efficacy.

(4) In renal insufficiency, contraindicated or dosage adjustments necessary.

(5) To improve compliance.

(6) Special pharmacokinetic properties.

(7) Adverse effects diminish benefit/risk ratio.

(8) Limited indications or narrow spectrum of activity.

(9) For epidural anaesthesia.

(10) Sustained-release preparations are available. A proposal to include such a product in a national list of essential drugs should be supported by adequate documentation.

(11) Monitoring of therapeutic concentrations in plasma can improve safety and efficacy.

Letters in parentheses following the drug names indicate the reasons for the inclusion:

(A) When drugs in the main list cannot be made available.

(B) When drugs in the main list are known to be ineffective or inappropriate for a given individual.

(C) For use in rare disorders or in exceptional circumstances.

(D) Reserve antimicrobials to be used only when there is significant resistance to other drugs on the list.

Drugs are listed in alphabetical order

Section 1: Anaesthetics

1.2 LOCAL ANAESTHETICS

ephedrine (C)

injection, 30 mg

(For use in spinal anaesthesia

(hydrochloride)/ml in

during delivery to prevent hypotension)

1-ml ampoule

Section 2: Analgesics, Antipyretics,
Nonsteroidal Anti-Inflammatory
Drugs (NSAIDs), Medicines Used to
Treat Gout and Disease-Modifying
Agents used in Rheumatic
Disorders (DMARDs)

2.2 OPIOID ANALGESICS

*pethidine (A) (1a, 4)

injection, 50 mg

 

(hydcochloride) in 1-ml ampoule

 

tablet, 50 mg, 100 mg (hydrochloride)

Section 5: Anticonvulsants/Antiepileptics

*clonazepam (B) (1b)

scored tablet, 500 µg

Section 6: Anti-infective Medicines

6.1 ANTHELMINTHICS

6.1.2 ANTIFILARIALS

suramin sodium (B) (2, 7)

powder for injection,

 

1 g in vial

 

6.1.3 ANTISCHISTOSOMALS AND OTHER
ANTITREMATODE MEDICINES

oxamniquine (C) (8)

capsule, 250 mg

 

syrup, 250 mg/5 ml

 

6.2 ANTIBACTERIALS

6.2.1 BETA LACTAM MEDICINES

Restricted indications

 

*amoxicillin +

tablet, 500 mg + 125 mg

 

*clavulanic acid (D)

 

ceftazidime (D)

powder for injection, 250 mg

 

(as pentahydrate) in vial

*ceftriaxone (D)

powder for injection, 250 mg

 

(as sodium salt) in vial

imipenem +

powder for injection, 250 mg

 

cilastatin (D)

(as monohydrate) + 250 mg,

 

(as sodium salt)

 

500 mg (as monohydrate) +

 

500 mg (as sodium salt) in vial

 

6.2.2 OTHER ANTIBACTERIALS

chloramphenicol (C)

oily suspension for injection,

 

0.5 g (as sodium succinate)/ml

 

in 2-ml ampoule

clindamycin (B) (8)

capsule, 150 mg

 

injection, 150 mg

 

(as phosphate)/ml

Restricted indications

 

vancomycin (D)

powder for injection 250 mg (as

 

hydrochloride) in vial

 

6.2.4 ANTITUBERCULOSIS MEDICINES

thioacetazone +

tablet, 50 mg + 100 mg,

 

isoniazid (A) (5, 7)

150 mg + 300 mg

Reserve second-line drugs for the treatment of multidrug-resistant tuberculosis (MDR-TB) should be used in specialized centres adhering to WHO standards for TB control. (D)

amikacin (D)

powder for injection 1000 mg in vial

p-aminosalicylic acid (D)

tablet, 500 mg,

 

granules, 4 g in sachet

capreomycin (D)

powder for injection, 1000 mg in vial

ciprofloxacin (D)

tablet, 250 mg, 500 mg

*cycloserine (D)

capsule or tablet, 250 mg

*ethionamide (D)

tablet, 125 mg, 250 mg

kanamycin (D)

powder for injection, 1000 mg in vial

levofloxacin (D)

tablet, 250 mg, 500 mg

ofloxacin (D)

tablet, 200 mg, 400 mg

 

6.3 ANTIFUNGAL MEDICINES

flucytosine (B) (4, 8)

capsule, 250 mg

 

infusion, 2.5 g in 250 ml

potassium iodide (A)

saturated solution

 

6.5 ANTIPROTOZOAL MEDICINES

6.5.2 ANTILEISHMANIASIS MEDICINES

amphotericin B (B) (4)

powder for injection,

 

50 mg in vial

 

6.5.3 ANTIMALARIAL MEDICINES

 

6.5.3.1 FOR CURATIVE TREATMENT

*doxycycline (B) (for use only in

capsule or tablet,

combination with quinine)

100 mg (hydrochloride)

mefloquine (B)

tablet, 250 mg (as hydrochloride)

*sulfadoxine +

tablet, 500 mg + 25 mg

 

pyrimethamine (B)

 

Restricted indications

 

artemether (D)

injection, 80 mg/ml

 

in 1-ml ampoule

artesunate (D)

tablet, 50 mg

 

6.5.5 ANTITRYPANOSOMAL MEDICINES

(a) AFRICAN TRYPANOSOMIASIS

eflornithine (C)

injection, 200 mg (hydrochloride)/

 

ml in 100-ml bottles

Section 8: Antineoplastic and
Immunosuppressive Medicines and
Medicines Used in Palliative Care

8.1 IMMUNOSUPPRESSIVE MEDICINES

 

Adequate resources and specialist oversight are a prerequisite for the introduction of this class of drugs.

*azathioprine (2)

tablet, 50 mg

 

powder for injection, 100 mg

 

(as sodium salt) in vial

*ciclosporin (2)

capsule, 25 mg

(for organ transplantation)

concentrate for injection

 

50 mg/ml in 1-ml ampoule

8.2 CYTOTOXIC MEDICINES

 

Adequate resources and specialist oversight are a prerequisite for the introduction of this class of drugs.

asparaginase (2)

powder for injection,

 

10 000 IU in vial

bleomycin (2)

powder for injection, 15 mg

 

(as sulfate) in vial

calcium folinate (2)

tablet, 15 mg

 

injection, 3 mg/ml in 10-ml ampoule

chlorambucil (2)

tablet, 2 mg

chlormethine (2)

powder for injection, 10 mg

 

(hydrochloride) in vial

cisplatin (2)

powder for injection,

 

10 mg, 50 mg in vial

cyclophosphamide (2)

tablet, 25 mg

 

powder for injection,

 

500 mg in vial

cytarabine (2)

powder for injection,

 

100 mg in vial

dacarbazine (2)

powder for injection,

 

100 mg in vial

dactinomycin (2)

powder for injection

 

500 µg in vial

daunorubicin (2)

powder for injection,

 

50 mg (as hydrochloride)

*doxorubicin (2)

powder for injection, 10 mg,

 

50 mg (hydrochloride) in vial

etoposide (2)

capsule, 100 mg

 

injection, 20 mg/ml in 5-ml ampoule

fluorouracil (2)

injection, 50 mg/ml

 

in 5-ml ampoule

levamisole (2)

tablet, 50 mg

 

(as hydrochloride)

mercaptopurine (2)

tablet, 50 mg

methotrexate (2)

tablet, 2.5 mg (as sodium salt)

 

powder for injection, 50 mg

 

(as sodium salt) in vial

procarbazine

capsule, 50 mg (as hydrochloride)

vinblastine (2)

powder for injection,

 

10 mg (sulfate) in via]

vincristine (2)

powder for injection,

 

1 mg, 5 mg (sulfate) in vial

 

8.3 HORMONES AND ANTIHORMONES

*prednisolone

tablet, 5 mg

 

powder for injection, 20 mg in vial,

 

25 mg (as sodium phosphate or

 

sodium succinate) in vial

tamoxifen

tablet, 10 mg, 20 mg (as citrate)

 

8.4 MEDICINES USED IN PALLIATIVE CARE

 

The WHO Expert Committee on Essential Drugs recommended that all the drugs mentioned in the WHO Publication Cancer Pain Relief: with a Guide to Opioid Availability, 2nd edition, be considered essential. The drugs are included in the relevant sections of the model list according to their therapeutic use, e.g. analgesics.

Section 10: Medicines affecting the Blood

10.1 ANTIANAEMIA MEDICINES

*iron dextran (B) (5)

injection, equivalent to 50 mg

 

iron/ml in 2-ml ampoule

Section 11: Blood Products and Plasma Substitutes

11.2 PLASMA FRACTIONS FOR SPECIFIC USE

 

All plasma fractions should comply with the WHO Requirements for the Collection, Processing and Quality Control of Blood, Blood Components and Plasma Derivatives (Revised 1992). WHO Expert Committee on Biological Standardization Forty-third report, WHO Technical Report Series, No. 840, 1994, Annex 2.

   

*factor VIII concentrate (C) (2, 8)

dried

*factor IX complex (coagulation

dried

factors II, VII, IX, X) concentrate (C) (2, 8)

 

Section 12: Cardiovascular Medicines

12.2 ANTIARRHYTHMIC MEDICINES

epinephrine (adrenaline) (C)

injection, 1 mg

 

(as hydrochloride)/ml in ampoule

isoprenaline (C)

injection, 20 µg

 

(hydrochloride)/ml in ampoule

*procainamide (B)

injection, 100 mg

 

(hydrochloride)/ml

 

in 10-ml ampoule

*quinidine (A) (7)

tablet, 200 mg (sulfate)

 

12.3 ANTIHYPERTENSIVE MEDICINES

*prazosin (B)

tablet, 500 µg, 1 mg

*sodium nitroprusside (C) (2,8)

powder for infusion,

 

50 mg in ampoule

 

12.5 ANTITHROMBOTIC MEDICINES

streptokinase (C)

powder for injection,

 

100 000 IU, 750 000 IU in vial

Section 13:
Dermatological Medicines (topical)

13.1 ANTIFUNGAL MEDICINES

selenium sulfide (C)

detergent-based

 

suspension, 2%

 

13.7 ULTRAVIOLET-BLOCKING AGENTS

topical sun protection agent with

 

activity against ultraviolet A and

 

ultraviolet B (C)

cream, lotion or gel

Section 14: Diagnostic Agents

14.2 RADIOCONTRAST MEDIA

*meglumine iotroxate (C)

solution, 5 - 8 g iodine

 

in 100-250 ml

Section 16: Diuretics

*mannitol (C)

injectable solution, 10%, 20%

Section 18: Hormones, other Endocrine
Medicines and Contraceptives

18.1 ADRENAL HORMONES AND SYNTHETIC
SUBSTITUTES

fludrocortisone (C)

tablet, 100 µg (acetate)

   

18.2 ANDROGENS

 

testosterone (C) (2)

injection, 200 mg

 

(enantate) in 1-ml ampoule

 

18.3 CONTRACEPTIVES

18.3.1 HORMONAL CONTRACEPTIVES

levonorgestrel (B)

tablet, 30 µg

medroxyprogesterone

depot injection,

acetate (B) (7, 8)

150 mg/ml in 1-ml vial

norethisterone

oily solution, 200 mg/ml in

enantate (B) (7, 8)

1-ml ampoule

 

18.7 PROGESTOGENS

medroxyprogesterone acetate (B)

tablet, 5 mg

Section 20:
Muscle Relaxants (peripherally acting)
and Cholinesterase Inhibitors

vecuronium (C)

powder for injection,

 

10 mg (bromide) in vial

Section 21:
Ophthalmological Preparations

21.5 MYDRIATICS

epinephrine (adrenaline) (A)

solution (eye drops), 2%

 

(as hydrochloride)

Section 25: Medicines acting on
the Respiratory Tract

25.1 ANTIASTHMATIC DRUGS

*cromoglicic acid (B)

inhalation (aerosol),

 

20 mg (sodium salt) per dose

Section 27: Vitamins and Minerals

calcium gluconate (C) (2, 8)

injection, 100 mg/ml

 

in 10-ml ampoule

The following changes in the WHO Model List were approved by the WHO Expert Committee on the Selection and Use of Essential Medicines which met in April 2002. The report of the meeting will be published in the WHO Technical Report Series.

Additions: abacavir (ABC), didanosine (ddl), lamivudine (3TC), stavudine (d4T), efavirenz (EFV or EFZ), indinavir (IDV), ritonavir (RTV, r), lopinavir (LPV), nelfinavir (NFV), saquinavir (SQV), artemether + lumefantrine, amikacin, p-aminosalicylic acid, capreomycin, cycloserine, ethionamide, kanamycin, levofloxacin, ofloxacin

 

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