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WHO Drug Information Vol. 19, No. 3, 2005 (2005; 72 pages)  Table of Contents
WHO Model List of Essential Medicines
Core List (revised March 2005)
Explanatory Notes
The core list presents a list of minimum medicine needs for a basic health care system, listing the most efficacious, safe and cost-effective medicines for priority conditions. Priority conditions are selected on the basis of current and estimated future public health relevance, and potential for safe and cost-effective treatment.
The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities, and/or specialist medical care, and/or specialist training are needed. In case of doubt medicines may also be listed as complementary on the basis of consistent higher costs or less attractive cost-effectiveness in a variety of settings.
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".
The square box symbol (•) is primarily intended to indicate similar clinical performance within a pharmacological class. The listed medicine should be the example of the class for which there is the best evidence for effectiveness and safety. In some cases, this may be the first medicine that is licensed for marketing; in other instances, subsequently licensed compounds may be safer or more effective. Where there is no difference in terms of efficacy and safety data, the listed medicine should be the one that is generally available at the lowest price, based on international drug price information sources. Therapeutic equivalence is only indicated on the basis of reviews of efficacy and safety and when consistent with WHO clinical guidelines. National lists should not use a similar symbol and should be specific in their final selection, which would depend on local availability and price.
Drugs are listed in alphabetical order, within sections.
1: Anaesthetics
1.1 General anaesthetics and oxygen
• halothane |
inhalation |
ketamine |
injection, 50 mg (as hydrochloride)/ml in 10-ml vial |
nitrous oxide |
inhalation |
oxygen |
inhalation (medicinal gas) |
• thiopental |
powder for injection, 0.5 g, 1.0 g (sodium salt) in ampoule |
1.2 Local anaesthetics
• bupivacaine |
injection, 0.25%, 0.5% (hydrochloride) in vial injection for spinal anaesthesia, 0.5% (hydrochloride) in 4-ml ampoule to be mixed with 7.5% glucose solution |
• lidocaine |
injection, 1%, 2% (hydrochloride) in vial
injection for spinal anaesthesia, 5% (hydrochloride) in 2-ml ampoule to be mixed with 7.5% glucose solution topical forms, 2-4% (hydrochloride) |
lidocaine + epinephrine (adrenaline) |
injection 1%, 2% (hydrochloride)+ epinephrine 1:200 000 in vial; dental cartridge 2% (hydrochloride) + epinephrine 1:80 000 |
Complementary List
ephedrine |
injection, 30 mg (hydrochloride)/ml in 1-ml ampoule (For use in spinal anaesthesia during delivery, to prevent hypotension) |
1.3 Preoperative medication and sedation for short-term procedures
atropine |
injection, 1 mg (sulfate) in 1-ml ampoule |
• diazepam |
injection, 5 mg/ml in 2-ml ampoule; tablet, 5 mg |
morphine |
injection, 10 mg (sulfate or hydrochloride) in 1-ml ampoule |
promethazine |
elixir or syrup, 5 mg (hydrochloride)/5ml |
2. Analgesics, antipyretics, non-steroidal anti-inflammatory medicines (NSAIMs), medicines to treat gout and disease modifying agents in rheumatoid disorders (DMARDs)
2.1 Non-opioids and non-steroidal anti-inflammatory medicines (NSAIMs)
acetylsalicylic acid |
tablet, 100-500 mg; |
| |
suppository, 50-150 mg |
ibuprofen |
tablet, 200 mg, 400 mg |
paracetamol* |
tablet, 100-500 mg; |
| |
suppository, 100 mg; |
| |
syrup, 125 mg/5ml |
* not recommended for anti-inflammatory use due to lack of proven benefit to that effect.
2.2 Opioid analgesics
codeine |
tablet, 30 mg (phosphate) |
morphine |
injection, 10 mg in 1-ml |
| |
ampoule (sulfate or hydrochloride); |
| |
oral solution, 10 mg (hydrochloride or sulfate)/5 ml; |
| |
tablet, 10 mg (sulfate) |
2.3 Medicines used to treat gout
allopurinol |
tablet, 100 mg |
2.4 Disease modifying agents used in rheumatoid disorders (DMARDs)
chloroquine |
tablet, 100 mg, 150 mg (as phosphate or sulfate) |
Complementary List
azathioprine |
tablet, 50 mg |
methotrexate |
tablet, 2.5 mg (as sodium salt) |
penicillamine |
capsule or tablet, 250 mg |
sulfasalazine |
tablet, 500 mg |
3. Antiallergics and medicines used in anaphylaxis
• chlorphenamine tablet, 4 mg (hydrogen maleate); |
|
| |
injection, 10 mg (hydrogen maleate) in 1-ml ampoule |
dexamethasone |
injection, 4 mg dexamethasone phosphate (as disodium salt) in 1-ml ampoule |
epinephrine (adrenaline) |
injection, 1 mg (as hydro-chloride or hydrogen tartrate) in 1-ml ampoule |
hydrocortisone |
powder for injection, 100 mg (as sodium succinate) in vial |
• prednisolone* |
tablet, 5 mg, 25 mg |
* there is no evidence for complete clinical similarity between prednisolone and dexamethasone at high doses.
4. Antidotes and other substances used in poisonings
Section 4 will be reviewed at the next meeting of the Expert Committee on the Selection and Use of Essential Medicines.
4.1 Non-specific
charcoal, activated |
powder |
4.2 Specific
acetylcysteine |
injection, 200 mg/ml in 10-ml ampoule |
atropine |
injection, 1 mg (sulfate) in 1-ml ampoule |
calcium gluconate |
injection, 100 mg/ml in 10-ml ampoule |
deferoxamine |
powder for injection, 500 mg (mesilate) in vial |
dimercaprol |
injection in oil, 50 mg/ml in 2-ml ampoule |
DL-methionine |
tablet, 250 mg |
methylthioninium chloride (methylene blue) |
injection, 10 mg/ml in 10-ml ampoule |
naloxone |
injection, 400 micrograms (hydrochloride) in 1-ml ampoule |
penicillamine |
capsule or tablet, 250 mg |
potassium ferric hexacyanoferrate(II)-2H2O (Prussian blue) |
powder for oral administration |
sodium calcium edetate |
injection, 200 mg/ml in 5-ml ampoule |
sodium nitrite |
injection, 30 mg/ml in 10-ml ampoule |
sodium thiosulfate |
injection, 250 mg/ml in 50-ml ampoule |
5. Anticonvulsants/anti-epileptics
carbamazepine |
scored tablet, 100 mg, 200 mg |
• diazepam |
injection, 5 mg/ml in 2-ml ampoule (intravenous or rectal) |
magnesium sulfate* |
injection, 500 mg/ml in 2-ml ampoule; 500mg/ml in 10-ml ampoule |
* for use in eclampsia and severe pre-eclampsia and not for other convulsant disorders.
phenobarbital |
tablet, 15-100 mg; |
| |
elixir, 15 mg/5ml |
phenytoin |
capsule or tablet, 25 mg, 50 mg, 100 mg (sodium salt); |
| |
injection, 50 mg/ml in 5-ml vial (sodium salt) |
valproic acid |
enteric coated tablet, 200 mg, 500 mg (sodium salt) |
Complementary List
ethosuximide |
capsule, 250 mg; |
| |
syrup, 250 mg/5ml |
6. Anti-infective medicines
6.1 Anthelminthics
6.1.1 Intestinal anthelminthics
albendazole |
chewable tablet, 400 mg |
levamisole |
tablet, 50 mg; 150 mg (as hydrochloride) |
• mebendazole |
chewable tablet, 100 mg, 500 mg |
niclosamide* |
chewable tablet, 500 mg |
* niclosamide is listed for use when praziquantel treatment fails
praziquantel |
tablet, 150 mg, 600 mg |
pyrantel |
chewable tablet 250 mg (as embonate); oral suspension, 50 mg (as embonate)/ml |
6.1.2 Antifilarials
ivermectin |
scored tablet, 3 mg, 6 mg |
Complementary List
diethylcarbamazine |
tablet, 50 mg, 100 mg (dihydrogen citrate) |
suramin sodium |
powder for injection, 1 g in vial |
6.1.3 Antischistosomals and antitrematode medicine
praziquantel |
tablet, 600 mg |
triclabendazole |
tablet, 250 mg |
Complementary List
oxamniquine* |
capsule, 250 mg; syrup, 250 mg/5ml |
* oxamniquine is listed for use when praziquantel treatment fails.
6.2 Antibacterials
6.2.1 Beta Lactam medicines
Applications for cefalexin and cefazolin are anticipated for the next meeting of the Expert Committee.
amoxicillin |
capsule or tablet, 250 mg, 500 mg (anhydrous); |
| |
powder for oral suspension, 125 mg (anhydrous)/5 ml |
amoxicillin + clavulanic acid |
tablet, 500 mg + 125 mg |
ampicillin |
powder for injection, 500 mg, 1 g (as sodium salt) in vial |
benzathine benzylpenicillin |
powder for injection, 1.44 g benzylpenicillin (=2.4 million IU) in 5-ml vial |
benzylpenicillin |
powder for injection, 600 mg (= 1 million IU), 3 g (= 5 million IU) (sodium or potassium salt) in vial |
cefixime* |
capsule 400mg |
* only listed for single dose treatment of uncomplicated ano-genital gonorrhoea
• cloxacillin capsule, |
500 mg, 1 g (as sodium salt); |
| |
powder for oral solution, 125 mg (as sodium salt)/5 ml; |
| |
powder for injection, 500 mg (as sodium salt) in vial |
phenoxymethylpenicillin |
tablet, 250 mg (as potassium salt); |
| |
powder for oral suspension, 250 mg (as potassium salt)/5 ml |
procaine benzylpenicillin |
powder for injection, 1 g (=1 million IU), 3 g (=3 million IU) in vial |
Complementary List
ceftazidime |
powder for injection, 250 mg (as pentahydrate) in vial |
• ceftriaxone |
powder for injection, 250 mg, 1 g (as sodium salt) in vial |
imipenem* + cilastatin* |
powder for injection 250 mg (as monohydrate) + 250 mg (as sodium salt), 500 mg (as monohydrate) + 500 mg (as sodium salt) in vial |
* only listed for the treatment of life-threatening hospital-based infection due to suspected or proven multidrug resistant infection.
6.2.2 Other antibacterials
azithromycin* |
capsule, 250 mg or 500 mg;
suspension 200 mg/5 ml |
* only listed for single dose treatment of genital C. trachomatis and of trachoma
chloramphenicol |
capsule, 250 mg; |
| |
oral suspension, 150 mg (as palmitate)/5 ml; |
| |
powder for injection, 1 g (sodium succinate) in vial; |
| |
oily suspension for injection 0.5 g (as sodium succinate)/ml in 2-ml ampoule |
• ciprofloxacin* |
tablet 250 mg (as hydrochloride) |
* final selection depends on indication for use.
doxycycline* |
capsule or tablet, 100 mg (hydrochloride) |
* final selection depends on indication for use.
• erythromycin |
capsule or tablet, 250 mg (as stearate or ethyl succinate); |
| |
powder for oral suspension, 125 mg (as stearate or ethyl succinate); |
| |
powder for injection, 500 mg (as lactobionate) in vial |
• gentamicin* |
injection, 10 mg, 40 mg (as sulfate)/ml in 2-ml vial |
* final selection depends on indication for use.
• metronidazole |
tablet, 200-500 mg; |
| |
injection, 500 mg in 100-ml vial; |
| |
suppository, 500 mg, 1 g; |
| |
oral suspension, 200 mg (as benzoate)/5 ml |
nitrofurantoin |
tablet, 100 mg |
spectinomycin |
powder for injection, 2 g (as hydrochloride) in vial |
sulfamethoxazole + trimethoprim |
tablet, 100 mg + 20 mg, 400 mg + 80 mg; |
| |
oral suspension, 200 mg + 40 mg/5 ml; |
| |
injection, 80 mg + 16 mg/ml in 5-ml and 10-ml ampoules |
trimethoprim |
tablet, 100 mg, 200 mg |
Complementary List
clindamycin |
capsule, 150 mg; injection, 150 mg (as phosphate)/ml |
sulfadiazine |
tablet, 500 mg; |
| |
injection, 250 mg (sodium salt) in 4-ml ampoule |
vancomycin |
powder for injection, 250 mg (as hydrochloride) in vial |
6.2.3 Antileprosy medicines
Medicines used in the treatment of leprosy should never be used except in combination. Combination therapy is essential to prevent the emergence of drug resistance. Colour-coded blister packs (Multi Drug Therapy blister packs) containing standard two medicine (paucibacillary leprosy) or three medicine (multibacillary leprosy) combinations for adult and childhood leprosy should be used. MDT blister packs can be supplied free of charge through WHO.
clofazimine |
capsule, 50 mg, 100 mg |
dapsone |
tablet, 25 mg, 50 mg, 100 mg |
rifampicin |
capsule or tablet, 150 mg, 300 mg |
6.2.4 Antituberculosis medicines
ethambutol |
tablet, 100 mg-400 mg (hydrochloride) |
isoniazid |
tablet, 100-300 mg |
isoniazid + ethambutol |
tablet, 150 mg + 400 mg |
pyrazinamide |
tablet, 400 mg |
rifampicin |
capsule or tablet, 150 mg, 300 mg |
rifampicin + |
tablet, 60 mg + 30 mg; |
isoniazid |
150 mg + 75 mg; 300 mg + 150 mg; 60 mg + 60 mg (For intermittent use three times weekly); 150 mg + 150 mg (For intermittent use three times weekly) |
rifampicin + isoniazid + pyrazinamide |
tablet, 60 mg + 30 mg + 150 mg; |
| |
150 mg + 75 mg + 400 mg |
| |
150 mg + 150 mg + 500 mg (For intermittent use three times weekly) |
rifampicin + isoniazid + pyrazinamide + ethambutol |
tablet, 150 mg + 75 mg + 400 mg + 275 mg |
streptomycin |
powder for injection, 1 g (as sulfate) in vial |
Complementary List
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. These medicines will be reviewed at the next meeting of the Expert Committee.
amikacin |
powder for injection, 1000 mg in vial |
p-aminosalicylic acid |
tablet, 500 mg; |
| |
granules, 4 g in sachet |
capreomycin |
powder for injection, 1000 mg in vial |
ciprofloxacin |
tablet, 250 mg, 500 mg |
cycloserine |
capsule or tablet, 250 mg |
ethionamide |
tablet, 125 mg, 250 mg |
kanamycin |
powder for injection, 1000 mg in vial |
levofloxacin |
tablet, 250 mg, 500 mg |
ofloxacin |
tablet, 200 mg, 400 mg |
6.3 Antifungal medicines
clotrimazole |
vaginal tablet, 100 mg, 500 mg, |
| |
vaginal cream 1%, 10% |
• fluconazole |
capsule 50 mg; |
| |
injection 2 mg/ml in vial; |
| |
oral suspension 50 mg/5-ml |
griseofulvin |
capsule or tablet, 125 mg, 250 mg |
nystatin |
tablet, 100 000, 500 000 IU; |
| |
lozenge 100 000 IU; |
| |
pessary, 100 000 IU |
Complementary List
amphotericin B |
powder for injection, 50 mg in vial |
flucytosine |
capsule, 250 mg; |
| |
infusion, 2.5 g in 250 ml |
potassium iodide |
saturated solution |
6.4 Antiviral medicines
6.4.1 Antiherpes medicines
• aciclovir |
tablet, 200 mg; powder for injection 250 mg (as sodium salt) in vial |
6.4.2 Antiretrovirals
Adequate resources and specialist oversight are prerequisites for the introduction of this class of drugs. The antiretroviral drugs do not cure HIV infection, they only temporarily suppress viral replication and improve symptoms. They have various adverse effects and patients receiving these drugs require careful monitoring by adequately trained health professionals. For these reasons, continued rigorous promotion of measures to prevent new infections is essential and the need for this has not been diminished in any way by the addition of antiretroviral drugs to the Model List. Adequate resources and trained health professionals are a prerequisite for the introduction of this class of drugs. Effective therapy requires commencement of three or four drugs simultaneously, and alternative regimens are necessary to meet specific requirements at start-up, to substitute for first-line regimens in the case of toxicity, or to replace failing regimens. In order to simplify treatment, facilitate storage and distribution, and improve patient adherence to the treatment plan, the Committee recommends and endorses the use of fixed-dose combinations and the development of appropriate new fixed-dose combinations. These include modified dosage forms, non-refrigerated formulations and paediatric formulations with assured pharmaceutical quality and interchange-ability with the single products as approved by the relevant drug regulatory authority.
6.4.2.1 Nucleoside reverse transcriptase inhibitors
abacavir (ABC) |
tablet, 300 mg (as sulphate), |
| |
oral solution, 100 mg (as sulphate)/5ml |
didanosine (ddI) |
buffered chewable, dispersible tablet, 25mg, 50mg, 100mg, 150mg, 200mg
buffered powder for oral solution, 100 mg, 167 mg, 250 mg packets |
| |
unbuffered enteric coated capsule, 125 mg, 200 mg, 250 mg, 400 mg |
lamivudine (3TC) |
tablet, 150mg, |
| |
oral solution 50 mg/5ml |
stavudine (d4T) |
capsule 15mg, 20 mg, 30 mg, 40 mg, |
| |
powder for oral solution, 5 mg/5ml |
zidovudine (ZDV or AZT) |
tablet, 300 mg capsule 100 mg, 250 mg |
| |
oral solution or syrup, 50 mg/5ml |
| |
solution for IV infusion injection, 10 mg/ml in 20-ml vial |
6.4.2.2 Non-nucleoside reverse transcriptase inhibitors
efavirenz (EFV or EFZ) |
capsule, 50 mg, 100 mg, 200 mg |
| |
oral solution, 150 mg/5ml |
nevirapine (NVP) |
tablet 200 mg; |
| |
oral suspension 50 mg/5-ml |
6.4.2.3 Protease inhibitors
Selection of two or three protease inhibitors from the Model List will need to be determined by each country after consideration of local treatment guidelines and experience, as well as the comparative costs of available products. Ritonavir is recommended for use in combination with indinavir, lopinavir and saquinavir as a booster, and not as a drug in its own right.
indinavir (IDV) |
capsule, 200 mg, 333 mg, 400 mg (as sulfate) |
ritonavir |
capsule, 100 mg, |
| |
oral solution 400 mg/5ml |
lopinavir + ritonavir (LPV/r) |
capsule, 133.3 mg + 33.3 mg, |
| |
oral solution, 400 mg + 100 mg/5ml |
nelfinavir (NFV) |
tablet, 250 mg (as mesilate), |
| |
oral powder 50 mg/g |
saquinavir (SQV) |
capsule, 200 mg |
6.5 Antiprotozoal medicines
6.5.1 Antiamoebic and antigiardiasis medicines
diloxanide |
tablet, 500 mg (furoate) |
• metronidazole |
tablet, 200-500 mg; |
| |
injection, 500 mg in 100-ml vial; |
| |
oral suspension 200 mg (as benzoate)/5 ml |
6.5.2 Antileishmaniasis medicines
• meglumine antimoniate |
injection, 30%, equivalent to approximately 8.1% antimony in 5-ml ampoule |
Complementary List
amphotericin B |
powder for injection, 50 mg in vial |
pentamidine |
powder for injection, 200 mg, 300 mg (isetionate) in vial |
6.5.3 Antimalarial medicines
6.5.3.1 For curative treatment
Medicines for the treatment of P. falciparum malaria cases should be used in combination.
amodiaquine* |
tablet, 153 mg or 200 mg (base) |
* amodiaquine should preferably be used as part of combination therapy.
artemether + lumefantrine* |
tablet, 20 mg + 120 mg |
* recommended for use in areas with significant drug resistance and not in pregnancy or in children below 10 kg
chloroquine |
tablet 100 mg, 150 mg (as phosphate or sulfate); |
| |
syrup, 50 mg (as phosphate or sulfate)/5 ml; |
| |
injection 40 mg (as hydrochloride, phosphate or sulfate)/ml in 5-ml ampoule |
primaquine |
tablet, 7.5 mg, 15 mg (as diphosphate) |
quinine |
tablet, 300 mg (as bisulfate or sulfate); |
| |
injection, 300 mg (as dihydrochloride)/ml in 2-ml ampoule |
Complementary List
artemether |
injection, 80 mg/ml in 1-ml ampoule |
artesunate |
tablet, 50 mg |
doxycycline |
capsule or tablet, 100 mg (hydrochloride) (for use only in combination with quinine) |
mefloquine |
tablet, 250 mg (as hydrochloride) |
sulfadoxine + pyrimethamine |
tablet, 500 mg + 25 mg |
6.5.3.2 For prophylaxis
chloroquine |
tablet, 150 mg (as phosphate or sulfate); |
| |
syrup, 50 mg (as phosphate or sulfate)/5 ml |
doxycycline |
capsule or tablet, 100 mg (hydrochloride) |
mefloquine |
tablet, 250 mg (as hydrochloride) |
proguanil |
tablet, 100 mg (hydrochloride) |
| |
(for use only in combination with chloroquine) |
6.5.4 Anti-pneumocystosis and antitoxoplasmosis medicines
pyrimethamine |
tablet, 25 mg |
sulfamethoxazole + trimethoprim |
injection 80 mg + 16 mg/ml in 5-ml ampoule |
| |
80 mg + 16 mg/ml in 10-ml ampoule |
Complementary List
pentamidine |
tablet 200 mg, 300 mg |
6.5.5. Antitrypanosomal medicines
6.5.5.1 African trypanosomiasis
melarsoprol |
injection, 3.6% solution |
suramin sodium |
powder for injection, 1 g in vial |
Complementary List
eflornithine |
injection, 200 mg (hydrochloride)/ml in 100-ml bottles |
pentamidine |
powder for injection, 200 mg, 300 mg (isetionate) in vial |
6.5.5.2 American tripanosomiasis
benznidazole |
tablet, 100 mg |
nifurtimox |
tablet, 30 mg; 120 mg; 250 mg |
7. Antimigraine medicines
7.1 For treatment of acute attack
acetylsalicylic acid |
tablet, 300-500 mg |
paracetamol |
tablet, 300-500 mg |
7.2 For prophylaxis
• propranolol |
tablet, 20 mg, 40 mg (hydrochloride) |
8. Antineoplastic, immuno-suppressives and medicines used in palliative care
8.1 Immunosuppressive medicines
Complementary List
azathioprine |
tablet, 50 mg; |
| |
powder for injection, 100 mg (as sodium salt) in vial |
ciclosporin |
capsule, 25 mg; |
| |
concentrate for injection 50 mg/ml in 1-ml ampoule for organ transplantation |
8.2 Cytotoxic medicines
Complementary List
asparaginase |
powder for injection, 10 000 IU in vial |
bleomycin |
powder for injection, 15 mg (as sulfate) in vial |
calcium folinate |
tablet, 15 mg; |
| |
injection, 3 mg/ml in 10-ml ampoule |
chlorambucil |
tablet 2 mg |
chlormethine |
powder for injection, 10 mg (hydrochloride) in vial |
cisplatin |
powder for injection, 10 mg, 50 mg in vial |
cyclophosphamide |
tablet, 25 mg; |
| |
powder for injection, 500 mg in vial |
cytarabine |
powder for injection, 100 mg in vial |
dacarbazine |
powder for injection, 100 mg in vial |
dactinomycin |
powder for injection, 500 micrograms in vial |
daunorubicin |
powder for injection, 50 mg (as hydrochloride) |
doxorubicin |
powder for injection, 10 mg, 50 mg (hydrochloride) in vial |
etoposide |
capsule, 100 mg; |
| |
injection, 20 mg/ml in 5-ml ampoule |
fluorouracil |
injection, 50 mg/ml in 5-ml ampoule |
levamisole |
tablet, 50 mg (as hydrochloride) |
mercaptopurine |
tablet, 50 mg |
methotrexate |
tablet, 2.5 mg (as sodium salt); |
| |
powder for injection, 50 mg (as sodium salt) in vial |
procarbazine |
capsule, 50 mg (as hydrochloride) |
vinblastine |
powder for injection, 10 mg (sulfate) in vial |
vincristine |
powder for injection, 1 mg, 5 mg (sulfate) in vial |
8.3 Hormones and antihormones
Complementary List
dexamethasone |
injection, 4 mg |
dexamethasone phosphate (as disodium salt) |
in 1-ml ampoule |
hydrocortisone |
powder for injection, 100 mg (as sodium succinate) in vial |
• prednisolone* |
tablet, 5 mg, 25 mg |
* there is no evidence for complete clinical similarity between prednisolone and dexamethasone at high doses.
tamoxifen |
tablet, 10 mg, 20 mg (as citrate) |
8.4 Medicines used in palliative care
The WHO Expert Committee on the Selection and Use of Essential Medicines recommended that all the drugs mentioned in the WHO publication Cancer Pain Relief: with a Guide to Opioid Availability, second edition, be considered essential. The drugs are included in the relevant sections of the Model List, according to their therapeutic use, e.g. analgesics.
9. Antiparkinsonism medicines
biperiden |
tablet, 2 mg (hydrochloride); |
| |
injection, 5 mg (lactate) in 1-ml ampoule |
levodopa + carbidopa |
tablet, 100 mg + 10 mg; |
| |
250 mg + 25 mg |
10. Medicines affecting the blood
10.1 Antianaemia medicines
ferrous salt |
tablet, equivalent to 60 mg iron; |
| |
oral solution equivalent to 25 mg iron (as sulfate)/ml |
ferrous salt + folic acid |
tablet equivalent to 60 mg iron + 400 micrograms folic acid (nutritional supplement for use during pregnancy.) |
folic acid |
tablet 1 mg, 5 mg |
hydroxocobalamin |
injection, 1 mg in 1-ml ampoule |
10.2 Medicines affecting coagulation
heparin sodium |
injection, 1000 IU/ml, 5000 IU/ml, 20,000 IU/ml in 1-ml ampoule |
phytomenadione |
injection, 10 mg/ml in 5-ml ampoule; |
| |
tablet, 10 mg |
protamine sulfate |
injection, 10 mg/ml in 5-ml ampoule |
• warfarin |
tablet, 1 mg, 2 mg and 5 mg (sodium salt) |
11. Blood products and plasma substitutes
11.1 Plasma substitutes
• dextran 70* |
injectable solution, 6% |
* polygeline, injectable solution, 3.5% is considered as equivalent
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 Technical Report Series, No. 840, 1994, Annex 2).
Complementary List
• factor VIII concentrate |
dried |
• factor IX complex |
dried |
(coagulation factors, II, VII, IX, X) concentrate |
|
12. Cardiovascular medicines
12.1 Antianginal medicines
• atenolol |
tablet, 50 mg, 100 mg |
glyceryl trinitrate |
tablet (sublingual), 500 micrograms |
• isosorbide dinitrate |
tablet (sublingual), 5 mg |
verapamil |
tablet, 40 mg, 80 mg (hydrochloride) |
12.2 Antiarrhythmic medicines
This subsection will be reviewed at the next meeting of the Expert Committee when it is anticipated that applications for amiodarone and sotalol will be received.
• atenolol |
tablet, 50 mg, 100 mg |
digoxin |
tablet, 62.5 micrograms, 250 micrograms; |
| |
oral solution 50 micrograms/ml; |
| |
injection 250 micrograms/ml in 2-ml ampoule |
epinephrine (adrenaline) |
injection, 1 mg (as hydrochloride)/ml in ampoule |
lidocaine |
injection, 20 mg (hydrochloride)/ml in 5-ml ampoule |
verapamil |
tablet, 40 mg, 80 mg (hydrochloride); |
| |
injection, 2.5 mg (hydrochloride)/ml in 2-ml ampoule |
Complementary List
• procainamide |
injection, 100 mg (hydrochloride)/ml in 10-ml ampoule |
• quinidine |
tablet, 200 mg (sulfate) |
12.3 Antihypertensive medicines
• amlodipine |
tablet, 5mg |
• atenolol |
tablet, 50 mg, 100 mg |
• enalapril |
tablet, 2.5 mg |
hydralazine* |
tablet, 25 mg, 50 mg (hydrochloride); |
| |
powder for injection, 20 mg (hydrochloride) in ampoule |
* hydralazine is listed for use in the acute management of severe pregnancy-induced hypertension only. Its use in the treatment of essential hypertension is not recommended in view of the availability of more evidence of efficacy and safety of other medicines.
• hydrochlorothiazide |
scored tablet, 25 mg |
methyldopa* |
tablet, 250 mg |
* methyldopa is listed for use in the management of pregnancy-induced hypertension only. Its use in the treatment of essential hypertension is not recommended in view of the availability of more evidence of efficacy and safety of other medicines.
Complementary List
sodium nitroprusside |
powder for infusion, 50 mg in ampoule |
12.4 Medicines used in heart failure
This subsection will be reviewed at the next meeting of the Expert Committee.
digoxin |
tablet, 62.5 micrograms, 250 micrograms; |
| |
oral solution, 50 micrograms/ml; |
| |
injection, 250 micrograms/ml in 2-ml ampoule |
• enalapril |
tablet, 2.5 mg |
• furosemide |
tablet, 40 mg; |
| |
injection, 10 mg/ml in 2-ml ampoule |
• hydrochlorothiazide |
scored tablet, 25 mg |
Complementary List
dopamine |
injection, 40 mg (hydrochloride) in 5-ml vial |
12.5 Antithrombotic medicines
acetylsalicylic acid |
tablet, 100 mg |
Complementary List
streptokinase |
powder for injection, 1.5 million IU in vial |
12.6 Lipid-lowering agents
The WHO Expert Committee on the Selection and Use of Essential Medicines recognizes the value of lipid-lowering drugs in treating patients with hyperlipidaemia. HMG-CoA reductase inhibitors, often referred to as "statins", are a family of potent and effective lipid-lowering drugs with a good tolerability profile. Several of these drugs have been shown to reduce the incidence of fatal and non-fatal myocardial infarction, stroke and mortality (all causes), as well as the need for coronary by-pass surgery. All remain very costly but may be cost effective for secondary prevention of cardiovascular disease as well as for primary prevention in some very high-risk patients. Since no single drug has been shown to be significantly more effective or less expensive than others in the group, none is included in the Model List; the choice of drug for use in patients at highest risk should be decided at the national level.
13. Dermatological medicines (topical)
13.1 Antifungal medicines
benzoic acid + salicylic acid |
ointment or cream, 6% + 3% |
• miconazole |
ointment or cream, 2% (nitrate) |
sodium thiosulfate |
solution, 15% |
Complementary List
selenium sulfide |
detergent-based suspension, 2% |
13.2 Anti-infective medicines
• methylrosanilinium |
aqueous solution, 0.5%; |
chloride (gentian violet) |
tincture, 0.5% |
neomycin sulfate + bacitracin |
ointment, 5 mg neomycin sulfate + 500 IU bacitracin zinc/g |
potassium permanganate |
aqueous solution 1:10 000 |
silver sulfadiazine |
cream, 1%, in 500-g container |
13.3 Anti-inflammatory and antipruritic medicines
• betamethasone |
ointment or cream, 0.1% (as valerate) |
• calamine lotion |
lotion |
• hydrocortisone |
ointment or cream, 1% (acetate) |
13.4 Astringent medicines
aluminium diacetate |
solution, 13% for dilution |
13.5 Medicines affecting skin differentiation and proliferation
benzoyl peroxide |
lotion or cream, 5% |
coal tar |
solution, 5% |
dithranol |
ointment, 0.1%-2% |
fluorouracil |
ointment, 5% |
• podophyllum resin |
solution, 10-25% |
salicylic acid |
solution 5% |
urea |
ointment or cream, 10% |
13.6 Scabicides and pediculicides
• benzyl benzoate |
lotion, 25% |
permethrin |
cream 5%;
lotion 1% |
14. Diagnostic Agents
14.1 Ophthalmic medicines
fluorescein |
eye drops, 1% (sodium salt) |
• tropicamide |
eye drops, 0.5% |
14.2 Radiocontrast media
• amidotrizoate |
injection, 140-420 mg iodine (as sodium or meglumine salt)/ml in 20-ml ampoule |
barium sulfate |
aqueous suspension |
• iohexol |
injection 140-350 mg iodine/ml in 5-ml, 10-ml and 20-ml ampoule |
• iopanoic acid |
tablet, 500 mg |
• propyliodone |
oily suspension, 500-600 mg/ml in 20-ml ampoule |
| |
For administration only into the bronchial tree. |
Complementary List
• meglumine iotroxate |
solution, 5-8 g iodine in 100-250 ml |
15. Disinfectants and antiseptics
15.1 Antiseptics
• chlorhexidine |
solution, 5% |
| |
(digluconate) for dilution |
• ethanol |
solution, 70% (denatured) |
• polyvidone iodine |
solution, 10% |
15.2 Disinfectants
• chlorine base compound |
powder (0.1% available chlorine) for solution |
• chloroxylenol |
solution, 4.8% |
glutaral |
solution, 2% |
16. Diuretics
amiloride |
tablet, 5 mg (hydrochloride) |
• furosemide |
tablet, 40 mg; |
| |
injection, 10 mg/ml in 2-ml ampoule |
• hydrochlorothiazide |
scored tablet, 25 mg |
mannitol |
injectable solution, 10%, 20% |
spironolactone |
tablet, 25 mg |
17. Gastrointestinal medicines
17.1 Antacids and other antiulcer medicines
aluminium hydroxide |
tablet, 500 mg; |
| |
oral suspension, 320 mg/5 ml |
• ranitidine |
tablet, 150 mg (as hydrochloride); |
| |
oral solution 75 mg/5-ml; |
| |
injection, 25 mg/ml in 2-ml ampoule |
magnesium hydroxide |
oral suspension, equivalent to 550 mg magnesium oxide/10 ml |
17.2 Antiemetic medicines
metoclopramide |
tablet, 10 mg (hydrochloride); |
| |
injection, 5 mg (hydrochloride)/ml in 2-ml ampoule |
promethazine |
tablet, 10 mg, 25 mg (hydrochloride); |
| |
elixir or syrup, 5 mg (hydrochloride)/5 ml; |
| |
injection, 25 mg (hydrochloride)/ml in 2-ml ampoule |
17.3 Anti-inflammatory medicines
• sulfasalazine |
tablet, 500 mg; |
| |
suppository 500 mg; |
| |
retention enema |
Complementary List
• hydrocortisone |
suppository 25 mg (acetate); |
| |
retention enema
(the • only applies to hydrocortisone retention enema) |
17.4 Laxatives
• senna |
tablet, 7.5 mg (sennosides) (or traditional dosage forms) |
17.5 Medicines used in diarrhoea
17.5.1 Oral rehydration
oral rehydration salts * (for glucose-electrolyte solution)
glucose: |
75 mEq |
sodium: |
75 mEq or mmol/l |
chloride: |
65 mEq or mmol/l |
potassium: |
20 mEq or mmol/l |
citrate: |
10 mmol/l |
osmolarity: |
245 mOsm/l |
glucose: |
13.5 g/l |
sodium chloride: |
2.6 g/l |
potassium chloride: |
1.5 g/l |
trisodium citrate dihydrate+: |
2.9 g/l |
+ trisodium citrate dihydrate may be replaced by sodium hydrogen carbonate (sodium bicarbonate) 2.5 g/l. However, as the stability of this latter formulation is very poor under tropical conditions, it is only recommended when manufactured for immediate use.
* in cases of cholera a higher concentration of sodium may be required.
17.5.2 Medicines for diarrhoea in children
zinc sulfate* |
tablet or syrup in 10 mg per unit dosage forms |
* in acute diarrhoea zinc sulphate should be used as an adjunct to oral rehydration salts.
17.5.3 Antidiarrhoeal (symptomatic) medicines in adults
codeine* |
tablet, 30 mg (phosphate) |
* the therapeutic efficacy of this item has been questioned and its continued inclusion on the list will be reviewed at the next meeting of the Expert Committee.
18. Hormones, other endocrine medicines and contraceptives
18.1 Adrenal hormones and synthetic substitutes
Addison's disease is a rare condition; adrenal hormones are already included in section 3.
18.2 Androgens
Complementary List
testosterone |
injection, 200 mg (enantate) in 1-ml ampoule |
18.3 Contraceptives
This subsection will be reviewed at the next meeting of the Expert Committee.
18.3.1 Oral hormonal contraceptives
• ethinylestradiol + levonorgestrel |
tablet, 30 micrograms + 150 micrograms |
• ethinylestradiol + norethisterone |
tablet, 35 micrograms + 1.0 mg |
levonorgestrel |
tablet, 30 micrograms,
750 micrograms (pack of two), 1.5 mg |
18.3.2 Injectable hormonal contraceptives
medroxyprogesterone |
depot injection, acetate 150 mg/ml in 1-ml vial |
norethisterone enantate |
oily solution, 200 mg/ml in 1-ml ampoule |
18.3.3 Intrauterine devices
copper-containing device
18.3.4 Barrier methods
condoms
diaphragms
18.4 Estrogens
• ethinylestradiol* |
tablet, 10 micrograms, 50 micrograms |
* the public health relevance and/or comparative efficacy and/or safety of this item has been questioned and its continued inclusion on the list will be reviewed at the next meeting of the Expert Committee.
18.5 Insulins and other antidiabetic agents
glibenclamide |
tablet, 2.5 mg, 5 mg |
insulin injection |
injection, 40 IU/ml in 10-ml vial, (soluble) |
| |
100 IU/ml in 10-ml vial |
intermediate-acting insulin |
injection, 40 IU/ml in 10 ml vial; |
| |
100 IU/ml in 10 ml vial |
| |
(as compound insulin zinc suspension or isophane insulin) |
metformin |
tablet, 500 mg (hydrochloride) |
18.6 Ovulation inducers
Complementary List
clomifene |
tablet, 50 mg (citrate) |
18.7 Progestogens
norethisterone* |
tablet, 5 mg |
* the public health relevance and/or comparative efficacy and/or safety of this item has been questioned and its continued inclusion on the list will be reviewed at the next meeting of the Expert Committee.
Complementary List
medroxyprogesterone acetate* |
tablet, 5 mg |
* the public health relevance and/or comparative efficacy and/or safety of this item has been questioned and its continued inclusion on the list will be reviewed at the next meeting of the Expert Committee.
18.8 Thyroid hormones and antithyroid medicines
levothyroxine |
tablet, 50 micrograms, 100 micrograms (sodium salt) |
potassium iodide |
tablet, 60 mg |
• propylthiouracil |
tablet, 50 mg |
19. Immunologicals
19.1 Diagnostic agents
All tuberculins should comply with the WHO Requirements for Tuberculins (Revised 1985). WHO Expert Committee on Biological Standardization Thirty-sixth report, (WHO Technical Report Series, No. 745, 1987, Annex 1).
tuberculin, purified protein |
injection derivative (PPD) |
19.2 Sera and immunoglobulins
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).
anti-D immunoglobulin |
injection, 250 micrograms (human) in single-dose vial |
antitetanus immunoglobulin |
injection, 500 IU in vial (human) |
antivenom serum* |
injection |
* exact type to be defined locally
diphtheria antitoxin |
injection, 10 000 IU, 20 000 IU in vial |
• rabies immunoglobulin |
injection, 150 IU/ml in vial |
19.3 Vaccines
All vaccines should comply with the WHO Requirements for Biological Substances.
19.3.1 For universal immunization
BCG vaccine
diphtheria vaccine
hepatitis B vaccine
measles vaccine
pertussis vaccine
poliomyelitis vaccine
tetanus vaccine
19.3.2 For specific groups of individuals
influenza vaccine
meningococcal meningitis vaccine
mumps vaccine
rabies vaccine (inactivated: prepared in cell culture)
rubella vaccine
typhoid vaccine
yellow fever vaccine
20. Muscle relaxants (peripherally-acting) and cholinesterase inhibitors
• alcuronium* |
injection, 5 mg (chloride)/ml in 2-ml ampoule |
* It is likely that alcuronium will be replaced and that similar products, including atracurium and/or pancuronium, will be added at the next meeting of the Expert Committee.
neostigmine |
tablet, 15 mg (bromide); |
| |
injection, 500 micrograms in 1-ml ampoule; |
| |
2.5 mg (metilsulfate) in 1-ml ampoule |
suxamethonium |
injection, 50 mg (chloride)/ml in 2-ml ampoule; |
| |
powder for injection (chloride), in vial |
Complementary List
pyridostigmine |
tablet, 60 mg (bromide); |
| |
injection, 1 mg in 1-ml ampoule |
• vecuronium |
powder for injection, 10 mg (bromide) in vial |
21. Ophthalmalogical preparations
This section will be reviewed at the next meeting of the Expert Committee.
21.1 Anti-infective agents
• gentamicin * |
solution (eye drops), 0.3% (sulfate) |
* final selection depends on indication for use.
• idoxuridine |
solution (eye drops), 0.1%; |
| |
eye ointment, 0.2% |
• tetracycline |
eye ointment, 1% (hydrochloride) |
21.2 Anti-inflammatory agents
• prednisolone |
solution (eye drops), 0.5% (sodium phosphate) |
21.3 Local anaesthetics
• tetracaine |
solution (eye drops), 0.5% (hydrochloride) |
21.4 Miotics and antiglaucoma medicines
acetazolamide |
tablet, 250 mg |
• pilocarpine |
solution (eye drops), 2%, 4% (hydrochloride or nitrate) |
• timolol |
solution (eye drops), 0.25%, 0.5% (as maleate) |
21.5 Mydriatics
atropine |
solution (eye drops), 0.1%; 0.5%, 1% (sulfate) |
Complementary List
epinephrine (adrenaline) |
solution (eye drops), 2% (as hydrochloride) |
22. Oxytocics and antioxytocics
22.1 Oxytocics
• ergometrine |
injection, 200 micrograms (hydrogen maleate) in 1-ml ampoule |
oxytocin |
injection, 10 IU in 1-ml ampoule |
Complementary List
misoprostol |
vaginal tablet, 25 micrograms |
mifepristone*- |
tablet 200 mg - |
misoprostol * |
tablet 200 micrograms |
* requires close medical supervision.
Where permitted under national law and where culturally acceptable. |
22.2 Antioxytocics
nifedipine |
immediate release capsule, 10 mg |
23. Peritoneal dialysis solution
Complementary List
intraperitoneal dialysis solution |
parenteral |
(of appropriate composition) |
solution |
24. Psychotherapeutic medicines
24.1 Medicines used in psychotic disorders
• chlorpromazine |
tablet, 100 mg (hydrochloride); |
| |
syrup, 25 mg (hydrochloride)/5ml; |
| |
injection, 25 mg (hydrochloride)/ml in 2-ml ampoule |
• fluphenazine |
injection, 25 mg (decanoate or enantate) in 1-ml ampoule |
• haloperidol |
tablet, 2 mg, 5 mg; |
| |
injection, 5 mg in 1-ml ampoule |
24.2 Medicines used in mood disorders
24.2.1 Medicines used in depressive disorders
• amitriptyline |
tablet, 25 mg (hydrochloride) |
24.2.2 Medicines used in bipolar disorders
carbamazepine |
scored tablet, 100 mg, 200 mg |
lithium carbonate |
capsule or tablet, 300 mg |
valproic acid |
enteric coated tablet, 200 mg, 500 mg (sodium salt) |
24.3 Medicines used in generalized anxiety and sleep disorders
• diazepam |
scored tablet, 2 mg, 5 mg |
24.4 Medicines used for obsessive compulsive disorders and panic attacks
clomipramine |
capsules, 10 mg, 25 mg (hydrochloride) |
24.5 Medicines used in substance dependence programmes
Complementary List
• methadone* |
oral solution 5 mg/5ml, 10 mg/5ml, concentrate for oral solution |
| |
5 mg/ml, 10 mg/ml (hydrochloride) |
* the square box is added to include buprenorphine. The medicines should only be used within an established support programme.
25. Medicines acting on the respiratory tract
25.1 Antiasthmatic and medicines for chronic obstructive pulmonary disease
• beclometasone |
inhalation (aerosol), |
| |
50 micrograms per dose (dipropionate); |
| |
250 micrograms (dipropionate) per dose |
epinephrine (adrenaline) |
injection, 1 mg (as hydrochloride or hydrogen tartrate) in 1-ml ampoule |
ipratropium bromide |
inhalation (aerosol), |
| |
20 micrograms/metered dose |
• salbutamol |
tablet, 2 mg, 4 mg (as sulfate); |
| |
inhalation (aerosol), 100 micrograms (as sulfate) per dose; |
| |
syrup, 2 mg/5 ml; |
| |
injection, 50 micrograms (as sulfate)/ml in 5-ml ampoule; |
| |
respirator solution for use in nebulizers, 5 mg (as sulfate)/ml |
26. Solutions correcting water, electrolyte and acid-base disturbances
26.1 Oral
oral rehydration salts |
see section 17.5.1 (for glucose-electrolyte solution) |
potassium chloride |
powder for solution |
26.2 Parenteral
glucose |
injectable solution, 5%, 10% isotonic; 50% hypertonic |
glucose with sodium chloride |
injectable solution, 4% glucose, 0.18% sodium chloride (equivalent to Na+ 30 mmol/l, Cl- 30 mmol/l) |
potassium chloride |
solution, 11.2% in 20-ml ampoule, (equivalent to K+ 1.5 mmol/ml, Cl- 1.5 mmol/ml) |
sodium chloride |
injectable solution, 0.9% isotonic (equivalent to Na+ 154 mmol/l, Cl- 154 mmol/l |
sodium hydrogen |
injectable solution, 1.4% carbonate |
| |
isotonic (equivalent to Na+ 167 mmol/l, HCO3- 167 mmol/l); |
| |
solution, 8.4% in 10-ml ampoule (equivalent to Na+ 1000 mmol/l, HCO3-1000 mmol/l) |
• sodium lactate, compound solution |
injectable solution |
26.3 Miscellaneous
water for injection |
2-ml, 5-ml, 10-ml ampoules |
27. Vitamins and minerals
ascorbic acid |
tablet, 50 mg |
• ergocalciferol |
capsule or tablet, 1.25 mg (50 000 IU); |
| |
oral solution, 250 micrograms/ml (10 000 IU/ml) |
iodine |
iodized oil, 1 ml (480 mg iodine), |
| |
0.5 ml (240 mg iodine) in ampoule (oral or injectable); |
| |
0.57 ml (308 mg iodine) in dispenser bottle; |
| |
capsule, 200 mg |
• nicotinamide |
tablet, 50 mg |
pyridoxine |
tablet, 25 mg (hydrochloride) |
retinol |
sugar-coated tablet, 10 000 IU (as palmitate) (5.5 mg); |
| |
capsule, 200 000 IU (as palmitate) (110 mg); |
| |
oral oily solution 100 000 IU (as palmitate)/ml in multidose dispenser; |
| |
water-miscible injection 100 000 IU (as palmitate) (55 mg) in 2-ml ampoule |
riboflavin |
tablet, 5 mg |
sodium fluoride |
in any appropriate topical formulation |
thiamine |
tablet, 50 mg (hydrochloride) |
Complementary List
calcium gluconate |
injection, 100 mg/ml in 10-ml ampoule |
 |
 |
|
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