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NATIONAL
ESSENTIAL DRUGS LIST
OF PAKISTAN
Ministry of Health
Government of Pakistan
Islamabad
NATIONAL
ESSENTIAL DRUGS
CONTENTS
PREFACE…………………………………….……………… vii NATIONAL ESSENTIAL DRUGS LIST
THIRD REVISION
Local Analgesics………………………………. 2 Antimalarial Drugs and Prophylactics . 8 Vaccines for Universal Immunization . 15 Non-steroidal Antiallergic/Decongestants . 17 After the second World War the development and emergence of miracle drugs like antibiotics brought a revolution in the medical care. The obvious effectiveness of these new pharmaceuticals and intensive marketing efforts combined to catalyze wide spread use of modern medicine. A rapidly growing and profitable industry, together with an enthusiastic but largely uninformed audience and an unregulated market, resulted in excess of promotion and consumption alowgwith inflated level of expenditure. However, by 1970s it had become clear that least advantageous nations were not even meeting the basic needs of their people for essential life saving and health promoting drugs. As a result gradually a number of countries started concentrating on the development of a basic list of reliable drugs to meet the most vital basic needs of their people. A World Health Organization (WHO) Committee of Experts met in 1977 to determine the number of drugs, which were actually needed to ensure a reasonable level of health care for as many people as possible. Consequently, the first Model List of Essential Drugs was finalized in the same year. This list is being updated regularly by the WHO and is intended to be used as a guideline and provide basis for member countries to identify their own priorities and make their own selection. Through 1970s and 1980s the WHO started promotion of the concept of Essential Drugs Program in order to redress this imbalance. The program aimed at reduction in the number of drugs purchased/used by the hospitals/institutions to a minimum possible level in order to make best use of limited public funds. Essential drugs as defined by WHO are those that satisfy the health care needs of majority of the population. They should therefore be available at all times in adequate amounts and in the appropriate dosage forms. The National Essential Drugs List (NEDL) of Pakistan was first prepared in 1994 in consultation with relevant experts. The list was previously reviewed in 1995 and 2000. The present list is the third revision containing 452 drugs of different pharmacological classes. The health sector in general and public health sector in particular is expected to seriously consider adopting this list. The provincial health departments can play a pivotal role to encourage the hospitals/institutions for making bulk purchases from within this list. We hope that this list will find more acceptance among health care professionals. EXPLANATORY NOTES
Letters in parentheses following drug names indicate: (P) for Primary, (S) for Secondary and (T) for Tertiary. 1. Classification of drugs for use at various levels of Health PRIMARY: For use at the Primary Health Care Level
including Basic Health Units and Rural Health Centers. SECONDARY: For use at the Secondary Health
TERTIARY: For use at the specialized and sub-
specialized levels for specific expertise diagnostic precision or special equipment required for proper use. II. Drugs subject to international controls under : Single Convention on Narcotic drugs 1961: Convention on Psychotropic Substances 1971; and Convention on Illicit Traffic in Narcotic Drugs and In renal insufficiency, contraindicated or dosage Adverse effects diminish benefit/risk ratio; Limited indications or narrow spectrum of activity; Specific expertise, diagnostic precision, individualization of dosage or special equipment (12) COMPLEMENTARY DRUGS: Choice to be made
IV. 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 ANAESTHETICS
1.1 General Anaesthetics and Oxygen
ether, anaesthetic (P), (S), (T), (3,10) (*only in exceptional cases on the basis of cost effectiveness). 1.2 Local Anaesthetics
1.3 Neuromuscular Blocking Agents.
1.4 Miscellaneous
ANALGESICS, ANTI TIPYRETICS, NON-STEROIDAL
ANTI-INFLAMMATORY DRUGS AND DRUGS
USED TO TREAT GOUT.
2.1 Opioid Analgesics
2.2 Non-Opioid Analgesics and NSAIDS
acetylsalicylic acid (P), (S), (T) 300 mg tab. diclofenac (T) 75 mg / 3 ml inj. (as sodium) ibuprofen (P),(S),(T) 200,400 and 600 mg tab. indomethacin (P),(S),(T) 25 mg cap or tab. 2.3 Local Analgesics
2.4 Drugs used to treat Gout
3: ANTIALLERGICS AND DRUGS USED IN
ANAPHYLAXIS
4: ANTI-EPILEPTICS
ANTI-INFECTIVE DRUGS.
5.1 Anthelmintics
5.2 Antibacterials
300 & 600 mg inj. (as hydrochloride) 250 & 500mg tab. (as potassium salt) 5.3 Anti-Tuberculosis Drugs
5.4 Anti-Fungal Drugs
5.5 Anti-Amoebic Drugs
5.6 Antiviral Drugs
5.7 Antimalarial Drugs and Prophylactics
5.8 Antileishmanial Drugs
6: ANTIMIGRAINE DRUGS
7: ANTIPARKINSONISM DRUGS
8: DRUGS AFFECTING BLOOD
8.1 Antianaemic Drugs
8.2 Drugs Affecting Coagulation
9: BLOOD PRODUCTS AND PLASMA SUBSTITUTES
10: CARDIOVASCULAR DRUGS
100 & 200 mg tab. (as hydrochloride) 11: DERMATOLOGICAL DRUGS (TOPICAL)
betamathosone + neomycin (S), (T) 0.1+0.5% 12: DIURETICS
13: GASTROINTESTINAL DRUGS
14: HORMONES, OTHER ENDOCRINE DRUGS AND
CONTRACEPTIVES
15: IMMUNOLOGICALS
15.1 Diagnostics
15.2 Sera and Immunologicals
15.3 Vaccine for Universal Immunization
dipatheria-tetanus vaccine (P), (S), (T) inj. 15.4 Vaccines for Specific Use.
15.5 Immunosuppressents.
16: MUSCLE RELAXANTS (PERIPHERALLY ACTING) AND
CHOLINESTERASE INHIBITORS
17: OPHTHALMOLOGICAL PREPARATIONS
17.1 Anti-Infective Agents
17.2 Miotics and Antiglaucoma Drugs.
17.3 Mydriatics and Cycloplegics Drugs
17.4 Corticosteroids
17.5 Non-steroidal Antiallergic/Decongestants
17.6 Topical Anaesthetics
17.7 Others
18: OXYTOCICS AND ANTIOXYTOCICS
19: PERITONEAL DIALYSIS SOLUTION
20: PSYCHOTHERAPEUTIC DRUGS

21
: DRUGS ACTING ON THE RESPIRATORY TRACT
22: SOLUTIONS CORRECTING WATER,
ELECTROLYTE AND ACID BASE DISTURBANCES
23: VITAMINS AND MINERALS
24: E.N.T. PREPARATIONS
25: ANTISEPTICS AND DIS-INFECTANTS
25.1 Antiseptics
25.2 Disinfectants
26: DENTAL PREPARATIONS (T)
formocresol (formaldehyde 19% cresol 35% and glycerol 15%) zinc oxide + magnesium oxide in polyacrylic 40% cement. 27: DISPENSARY ITEMS: (P), (S), (T)
28: DRUGS FOR LOCAL PURCHASE
Drugs in the following groups are required occasionally. Therefore drugs in these groups can be made available through local purchase by hospitals. Some of the illustrative drugs in these groups are mentioned below:- 28.1 ANTIDOTES AND OTHER SUBSTANCES USED IN POISONING
0.04 & 0.4 mg inj. (as hydrochloride) 28.2 Antileprosy Drugs
28.3 ANTI-NEOPLASTICS, IMMUNOSUPPRESSIVES AND DRUGS USED
IN PALLIATIVE CARE
28.3.1 Immunosuppressive Drugs
50 mg tablet 200, 500 mg & 1 gm inj. 2.5, 5 & 10 mg tab. 5, 50 & 500 mg inj. 28.4 DIAGNOSTIC AGENTS
29: DRUGS FOR SPECIALIZED CENTERS
29.1 Antiretroviral drugs
acetylsalicylic acid . 2, 9 acyclovir . 8, 16 adrenaline . 3 albendazole . 3 albumin (human) . 9 allopurinol . 2 aluminium hydroxide . 12 aluminium hydroxide + magnesium hydroxide . 12 amikacin . 4 amiloride . 12 aminogluthemide . 24 aminophylline . 18 amiodarone . 9 amitryptyline . 18 amlodipine . 9 amoxicillin . 4 amphotericin . 7 ampicillin . 4 anastrazole . 24 antazoline . 17 anti-D immunoglobulin . 15 antiscorpian sera . 15 antivenom sera . 15 artficial tears . 17 ascorbic acid . 19 asparaginase . 24 atenolol. 9 atracurium . 2 atropine . 2, 16, 23 atropine sulphate . 12 azathioprine . 24 baclomethasone . 18 barium sulphate . 25 BCG (dried) vaccine . 15 benzoic acid + salicylic acid . 11 benzophenones . 11 benzoyl peroxide . 11 benzyl benzoate . 11 benzylpenicillin . 4 betamathosone . 11 betamathosone + neomycin . 11 biperiden . 8 bisacodyl . 12 bleomycin . 24 boroglycerine . 20 bromocriptine . 13 bupivacaine . 1 busulphan . 24 calamine powder . 11 calcium folinate . 24 calcium gluconate . 19 calcium hypochlorite . 21 calcium lactate . 19 captopril . 10 carbamazepine . 3 carbidopa+levodopa . 8 carbimazole . 13 carboplatin . 24 cefatazidime . 4 cefazolin . 4 cefixin . 4 ceftizoxime . 4 ceftriaxone . 5 cefuroxime . 4 cephalexin . 5 cephradine . 5 charcoal, activated . 23 chloral hydrate . 18 chlorambucil . 24 chloramphenicol . 5, 16 chlorhexidine gluconate . 20 chlormethine . 24 chloroquine . 7, 8 chloroxylenol . 21 chlorpheniramine . 3 chlorpromazine . 18 choline salicylate . 2 cimetidine . 12 ciprofloxacin . 5 cisplatin . 24 clindamycin . 5 clofazimine . 24 clomifene . 13 clomipramine . 18 clotrimazole . 11, 20 cloxacillin . 5 coaltar liquid . 11 colchicines . 2 condoms with or without spermicide (nonoxinol) . 13 conjugated estrogen . 13 co-trimoxazole . 5 cromoglycate. 18 cyclizine . 12 cyclophosphamide . 24 cyclosporin . 16 cyproterone acetate . 24 cytarabine . 24 D – 3 . 19 dacarbazine . 24 dactinomycin. 24 dapsone . 24 desferrioxamine . 23 dexamethasone . 3, 13 dextran . 19 dextran 40 . 9 dextromethorphan compound . 18 dextrose . 19 dextrose + saline . 19 diaphragms with spermicide (nonoxinol) . 13 diazepam . 1, 3, 18 diclofenac ……………………………………………………………………….2 didanosine . 26 di-ethylstilboestrol diphosphate sodium . 24 digoxin . 10 diloxanide . 7 diltiazem . 10 dimercaprol . 23 dipatheria-tetanus vaccine . 15 diphtheria antitoxin inj. . 15 dipivefrin . 16 diphtheria-pertussis tetanus vaccine . 15 dobutamine . 10 dopamine . 10 doxorubicin . 24 doxycycline . 5 efavirenz . 26 enalapril . 10 ephedrine hydrochloride . 1 ephedrine nasal drops . 20 epinephrine . 18 ergometrine . 17 ergotamine . 8 erogocalciferol . 19 erythromycin . 5 esmolol . 10 ethambutol . 6 ether . 1 ethosuximide . 3 ethynylestradiol + levonorgestrol . 13 ethynylestradiol + norethisterone . 14 etoposide . 24 factor IX complex . 9 factor VIII concentrate . 9 ferrous salt . 9 flourescine sodium . 17 flumazenil . 23 5-fluorouracil . 25 fluoxetine . 18 fluphenazine . 18 flutamide . 25 folic acid . 9 furosemide . 12 gammabenzene hexachloride . 11 gemfibrozil . 10 gentamicin . 5, 16 gentamycin + hyrocortisone . 20 gentian violet . 11, 20, 22 glibenclamide . 14 glutaraldehyde . 21 glutoral . 21 gonadotrophic hormone . 14 griseofulvin . 7 haloperidol . 18 halothane . 1 heparin . 9 hepatitis B immunoglobulin . 15 hepatitis B vaccine . 15 hexavitamin USP . 19 homatropine . 16 human chorionic . 14 hydralazine . 10 hydrochlorthiazide . 12 hydrocolloid methoxasalen . 11 hydrocortisone . 3, 11, 14 17-hydroxy progesterone caproate . 14 hydrogen peroxide BP . 21, 22 hydroxyurea . 25 hyoscine butylbromide . 12 ibuprofen…………………………………………………………………………2 ichthamol glycerin BPC . 20 ifosfamide . 25 imipramine . 18 immune human serum . 9 indinavir . 26 indomethacin…………………………………………………………………….2 insulin comp. zinc or isophane . 14 insulin regular . 14 intraperitonial dialysis parental solution . 17 intrauterine device copper T . 14 iodinated poppy . 25 iodipamide . 25 iohexol . 25 iophendylate . 25 iothalamate . 25 iron dextran . 9 isoniazid . 6 isoniazid + ethambutol . 6 isoprenaline . 10 isosorbide dinitrate . 10 ispaghulla husk . 13 ketamine . 1 ketoconazole . 7, 16 labetolol . 10 lactulose . 13 lamivudine . 26 levamisole . 4 levobunalol . 16 levonorgesterol . 14 lignocaine . 1, 10 lignocaine + epinephrine . 1 lignocaine hydrochloride . 20 lisinopril . 10 lithium carbonate . 18 lomustine . 25 losartan . 10 magenesium hydroxide . 13 magnesium sulphate . 22, 23 mannitol . 12 measles vaccine . 15 measles-mumps-rubella vaccine . 15 mebendazole . 4 medroxyprogesterone . 25 megesterol acetate . 25 meglumine diatrizoate BP/USP . 25 meglumine diatrizoate+sodium diatrizoate . 26 meglumine iotroxenate . 26 meglumine ioxagalate + sodium ioxagalate . 26 melphalan . 25 meningococcal vaccine . 15 mercaptopurine . 25 mesna . 25 metformin . 14 methionine . 23 methotrexate . 25 methyldopa . 10 metoclopramide . 13 metronidazole . 5, 7 mitomycin . 25 mitozantrone . 25 morphine . 2 nalidixic acid . 6 naloxone . 23 naphazoline . 17 nelfinavir . 26 neomycin . 12 neomycin+bacitracin . 11 neostigmine . 23 nevirapine . 26 niclosamide . 4 nicotinamide . 19 nicotinic acid . 10 nitrofurantoin . 6 nitroglycerin . 10 nitrous oxide . 1 norethisterone . 14 normal saline . 19 nystatin . 6, 7, 12 obidoxime . 23 omeprazole . 13 oral rehydration salt . 13 oxybuprocaine . 17 oxygen . 2 oxytocin . 14 pancuronium . 2 Paracetamol……………………………………………………………………….2 pefloxacin . 6 penicillamine . 23 permethrin . 12 pethidine . 2 pheniramine maleate . 17 phenobarbitone . 3 phenoxymethylpenicillin . 6 phenylepherine . 16 phenytoin . 3, 10 phenytoin sodium . 3 physostigmine . 23 phytomenadione . 9 pilocarpine . 16 platelets human . 9 poliomyelitis vaccine (live attenuated) . 15 polygeline . 9 polymixin B sulphate + bacitracin zinc . 12, 16 polymyxin B sulphate + lignocaine hydrochloride …. . 20 potassium chloride . 13, 19, 22 potassium iodide . 14 pralidoxime . 23 prazosin . 11 prednisolone . 3, 14, 17, 20 primaquine . 8 procainamide . 11 procaine benzylpenicillin . 6 procarbazine . 25 prochlorperazine . 13, 20 procyclidine . 8 promethazine . 3, 13, 20 proparacaine . 17 propofol . 1 propranolol . 11 propyliodone . 26 propylthiouracil . 14 protamine . 23 povidone iodine . 21 prussian blue . 23 pseudoephedrine . 20 pyrantel . 4 pyrazinamide . 6 pyridostigmine . 16 pyridoxine . 19 quinidine . 11 quinine . 8 quinine dihydrochloride . 8 rabies vaccine . 15 resperidone . 18 retinol . 20 rifampicin . 6 rifampicin + isoniazid . 6 rifampicin + isoniazid + pyrazinamide . 6 rifampicin + isoniazid + pyrazinamide + ethambutol . 7 ringer’s lactate . 19 ritonavir . 26 rubella vaccine . 15 salbutamol . 18 salicylic acid . 12, 22 saquinavir . 27 seed oil . 26 selegiline . 8 silver sulphadiazine . 12 soda glycrine BPC . 20 sodium acetrizoate . 26 sodium bicarbonate . 19, 22 sodium calcium edetate . 23 sodium ipodate . 26 sodium nitrite . 23 sodium nitroprusside . 11 sodium stibogluconate . 8 sodium thiosulfate . 12, 23 spironolactone . 12 stavudine . 27 streptomycin . 7 sulfacetamide . 16 sulphadoxine + pyrimethamine . 8 sulphamethoxazole+ trimethoprim . 5 sulphasalazine . 6, 13 suxamethonium . 2 tamoxifen . 25 tetanus antitoxin . 15 tetanus toxid . 15 tetanus vaccine . 15 tetracycline . 16 theophylline . 18 thiamine . 20 thioacetazone . 7 thioacetazone + isoniazid . 7 6-thioguanine . 25 thiopental . 1 thyroxine . 14 tincture benzoin co.BP . 20 tincture iodine . 21 tinidazole . 6 tranexamic acid . 9 trifluperazine . 18 trimethoprim . 6 tropicamide . 16 tuberculin PPD . 14 valproate sodium . 3 valproic acid . 3 vasopressin/ADH . 14 verapamil . 11 vinblastine . 25 vincristine . 25 vinorelbine . 25 warfarin . 9 water for inj. . 19 xylocaine . 20 xylocaine + adrenaline . 20 xylometazoline . 20 yellow fever vaccine . 15 zalcitabine . 27 zidovudine . 27 zinc oxide . 12, 23 zinc sulphate + boric acid . 17

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