chronic medication core formulary effective 1 january …
TRANSCRIPT
1
CHRONIC MEDICATION CORE FORMULARY Effective 1 January 2011
• This formulary represents drugs covered for chronic use for 25 Chronic Disease List (CDL) conditions and individual Diagnosis and Treatment Pairs (DTP) conditions where applicable for each scheme.
• Reimbursement of medicines for non-CDL and non-DTP conditions is subject to Fund Rules and Qualsa Medicine Reimbursement Policy.
• Unless stipulated, all active ingredients listed in this formulary are subject to the Qualsa Maximum Price (QMP).
• The examples below serve as a guide on the trade names available for the active ingredients listed and not for marketing a specific brand. Any product within the QMP category may be used, however a co-payment may be attracted if the product selected is above the generic reference threshold.
• The dispensing pharmacist may make a generic substitution to assist members in avoiding a co-payment.
• Treatment designated as “Accepted treatment” indicates that this is a medicine covered as first line, according to the Qualsa Medicine Reimbursement Policy.
• For treatment designated as “Motivation required”, certain criteria as specified in the Qualsa Medicine Reimbursement Policy should be met.
• For treatment designated as “special investigation”, the relevant clinical investigation reports as specified in the Qualsa Medicine Reimbursement Policy are required.
Abbreviations of dosage form CAP Capsule ENE Enema OPD Eye drops SYR Syrup CPS Capsule (Inhaler) INH Inhaler SLN Sublingual TAB Tablet CRM Cream INJ Injection SRC Slow release capsule UNG Ointment DRP Drops LOT Lotion SRT Slow release tablet DSP Dispersable NAS Nasal spray SUP Suppository ECT Enteric-coated tablet NOD Nasal drops SUS Suspension
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Addison's disease
Corticosteroids, oral
Fludrocortisone acetate 0.1mg TAB Florinef acetate Motivation required
Hydrocortisone 10mg TAB Covocort Accepted treatment
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Trolic Accepted treatment
2
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Asthma
Beta agonists, short-acting
Salbutamol 100mcg INH Venteze Asthavent Accepted treatment
Salbutamol 2.5mg SLN Ventolin nebules Motivation required
Salbutamol 200mcg CPS Asthavent Accepted treatment
Salbutamol 200mcg CPS Ventodisks Accepted treatment
Salbutamol 400mcg CPS Ventodisks Motivation required
Fenoterol INH Berotec HFA Accepted treatment
Fenoterol and ipratropium bromide
50mcg/20mcg INH Duovent HFA Motivation required
Beta agonists, long-acting
Formoterol 12mcg CPS Foratec DP caps Accepted treatment
Formoterol 9mcg INH Oxis Accepted treatment
Salmeterol 25mcg INH Serevent Accepted treatment
Salmeterol 50mcg INH Serevent Accepted treatment
Corticosteroids, inhaled
Beclometasone 100mcg INH Beclate Accepted treatment
Beclometasone 200mcg INH Beclate Accepted treatment
Beclometasone 50mcg INH Beclate Accepted treatment
Budesonide 100mcg INH/CPS Inflacor Budeflam Inflammide Accepted treatment
Budesonide 200mcg INH/CPS Inflacor Budeflam Inflammide Accepted treatment
Budesonide 400mcg INH/CPS Inflacor Inflammide Novoliser Accepted treatment
Corticosteroids, oral
Prednisolone 15mg/5ml SYR Preflam Motivation required
Prednisone 5mg/ml SYR Pulmison paed Motivation required
Corticosteroids and beta agonists, long-acting
Budesonide and formoterol 160mcg/4.5mcg INH Symbicord Motivation required
Budesonide and formoterol 320mcg/9mcg INH Symbicord Motivation required
Budesonide and formoterol 80mcg/4.5mcg INH Symbicord Motivation required
Salmeterol and fluticasone 25mcg/125mcg INH Sereflo Seretide Accepted treatment
Salmeterol and fluticasone 25mcg/250mcg INH Sereflo Seretide Accepted treatment
Salmeterol and fluticasone 25mcg/50mcg INH Sereflo Seretide Accepted treatment
Salmeterol and fluticasone 50mcg/100mcg INH Foxair Seretide Accepted treatment
Salmeterol and fluticasone 50mcg/250mcg INH Foxair Seretide Accepted treatment
3
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Salmeterol and fluticasone 50mcg/500mcg INH Foxair Seretide Accepted treatment
Xanthines
Aminophylline 225mg SRT Phyllocontin Accepted treatment
Theophylline SYR Alcophyllin Nuelin liquid Motivation required
Theophylline 200mg SRT Sandoz Theophylline Accepted treatment
Theophylline 250mg SRT Nuelin SA Accepted treatment
Theophylline 300mg SRT Sandoz Theophylline Accepted treatment
Theophylline 400mg SRT Uniphyl Accepted treatment
Theophylline 600mg SRT Uniphyl Accepted treatment
Bipolar mood disorder
Heterocyclic antidepressants
Amitriptyline 25mg TAB Trepiline Sandoz-amitriptyline Accepted treatment
Dothiepin (dosulepin) 25mg CAP Thaden Sandoz-dothiepin Accepted treatment
Dothiepin (dosulepin) 75mg TAB Thaden Sandoz-dothiepin Accepted treatment
Imipramine 25mg TAB Ethipramine Accepted treatment
Maprotiline 25mg TAB Ludiomil Motivation required
Maprotiline 75mg TAB Ludiomil Motivation required
Selective serotonin receptor inhibitors
Citalopram 10mg TAB Austell-citalopram Accepted treatment
Citalopram 20mg TAB Austell-citalopram Citalopram-Winthrop Sandoz-citalopram Accepted treatment
Citalopram 40mg TAB Austell-citalopram Citalopram-Winthrop Depramil Accepted treatment
Fluoxetine 20mg CAP/TAB A-lennon fluoxetine Zydus-fluoxetine Ranflocs Accepted treatment
Fluoxetine 40mg DSP Prohexal T Motivation required
Other
Sulpiride 200mg TAB Bio-sulpiride Motivation required
Sulpiride 25mg SYR Eglonyl Motivation required
Sulpiride 50mg CAP Espiride Sandoz Sulpiride Motivation required
Mood stabilisers
Lithium 250mg TAB Camcolit Accepted treatment
Lithium 400mg TAB Camcolit Accepted treatment
Lithium 450mg TAB Quilonum Retard Accepted treatment
Carbamazepine 200mg TAB/SRT Sandoz Carbamazepine CR Degranol CPL-carbamazepine Accepted treatment
Carbamazepine 400mg SRT Sandoz Carbamazepine CR Accepted treatment
Lamotrigine 100mg TAB Aspen-lamotrigine Lamitor Dyna-Lamotrigine Accepted treatment
4
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Lamotrigine 200mg TAB Lamidus Austell-lamotrigine Dyna-Lamotrigine Accepted treatment
Lamotrigine 25mg TAB Aspen-lamotrigine Lamitor Dyna-Lamotrigine Accepted treatment
Lamotrigine 50mg TAB Aspen-lamotrigine Lamitor Dyna-Lamotrigine Accepted treatment
Valproic acid 150mg CAP/SRT Convulex Epilim Accepted treatment
Valproic acid 200mg SRT Epilim Accepted treatment
Valproic acid 300mg CAP Convulex Accepted treatment
Valproic acid 500mg CAP/SRT Convulex Epilim Accepted treatment
Valprioc acid 200mg/5ml SYR Epilim Motivation required
Antipsychotics
Chlorpromazine 100mg TAB Largactil Accepted treatment
Chlorpromazine 25mg TAB Largactil Accepted treatment
Chlorpromazine 50mg TAB Largactil Accepted treatment
Haloperidol 0.5mg CAP Serenace Accepted treatment
Haloperidol 1.5mg TAB Sandoz Haloperidol Accepted treatment
Haloperidol 10mg TAB Serenace Accepted treatment
Haloperidol 5mg TAB Serenace Sandoz Haloperidol Accepted treatment
Trifluoperazine 1mg TAB Stelazine Accepted treatment
Trifluoperazine 5mg TAB Stelazine Accepted treatment
Zuclopenthixole 10mg TAB Clopixol Motivation required
Zuclopenthixole 2mg TAB Clopixol Motivation required
Bronchiectasis
Antibiotic treatment will be reimbursed subject to Qualsa Medicine Policy and specific organism sensitivity.
Cardiomyopathy/Heart failure
Aspirin
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Be-tabs aspirin Aspirin (Resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Anticoagulants
Warfarin 1mg TAB Cipla-warfarin Accepted treatment
Warfarin 3mg TAB Cipla-warfarin Accepted treatment
Warfarin 5mg TAB Cipla-warfarin Lennon warfarin Accepted treatment
5
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Diuretics
Furosemide 10mg/ml SYR Lasix Oral Motivation required
Furosemide 40mg TAB Diuresix Mylan-furosemide Beuresis Accepted treatment
Hydrochlorothiazide 12.5mg TAB Ridaq Accepted treatment
Hydrochlorothiazide 25mg TAB Hexazide Ridaq Accepted treatment
Hydrochlorothiazide and amiloride
25mg/2.5mg TAB Amiloretic HS Accepted treatment
Hydrochlorothiazide and amiloride
50mg/5mg TAB Amiloretic Spec-Co-Amiloride Betaretic Accepted treatment
Indapamide 2.5mg TAB Cipla-Indapamide Daptril Mylan-indapamide Accepted treatment
Spironolactone 100mg TAB Spiractin Accepted treatment
Spironolactone 25mg TAB Spiractin Sandoz Spironolactone Accepted treatment
Triamterine and hydrochlorothiazide
50mg/25mg TAB Renezide Accepted treatment
Hydrochlorothiazide and potassium
50mg/300mg TAB Urirex K Accepted treatment
Potassium supplements
Potassium chloride 600mg TAB Plenish-K Sandoz K-600 Accepted treatment
ACE-inhibitors and combinations
Captopril 12.5mg TAB Captohexal Accepted treatment
Captopril 25mg TAB Captohexal Mylan-captopril Bio-captopril Accepted treatment
Captopril 50mg TAB Captohexal Mylan-captopril Zapto Accepted treatment
Enalapril 10mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 2.5mg TAB Renitec Accepted treatment
Enalapril 20mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 5mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Lisinopril 10mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 2.5mg TAB Austell-lisinopril Accepted treatment
Lisinopril 20mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 5mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Perindopril 4mg TAB Prexum Vectoryl Cipla-perindopril Accepted treatment
Perindopril 8mg TAB Vectoryl Cipla-perindopril Accepted treatment
Perindopril 10mg TAB Prexum Coversyl Accepted treatment
Ramipril 1.25mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 10mg CAP Austell-ramipril Ran-ramipril Rampil Motivation required
Ramipril 2.5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
6
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Trandolapril 0.5mg CAP Mavik Accepted treatment
Trandolapril 2mg CAP Mavik Accepted treatment
Captopril and diuretic 50mg/25mg TAB Captoretic Zapto-Co Capozide Accepted treatment
Enalapril and diuretic 12.5mg TAB Enap Co Pharmapress Co Accepted treatment
Lisinopril and diuretic 10mg/12.5mg TAB Lisoretic Lisozide Hexal-lisinopril Co Accepted treatment
Lisinopril and diuretic 20mg/12.5mg TAB Lisoretic Zestozide Hexal-lisinopril Co Accepted treatment
Perindopril and indapamide 4mg/1.5mg TAB Prexum Plus Vectoryl Plus Accepted treatment
Angiotensin receptor blockers and combinations
Losartan 50mg TAB Lepitrin Cipla-losartan Los-arb Accepted treatment
Losartan 100mg TAB Zartan Cipla-losartan Accepted treatment
Valsartan 160mg TAB Tareg Motivation required
Valsartan 320mg TAB Diovan Motivation required
Valsartan 40mg TAB Diovan Motivation required
Valsartan 80mg TAB Tareg Motivation required
Losartan and diuretic 100mg/25mg TAB Fortzaar Accepted treatment
Losartan and diuretic 50mg/12.5mg TAB Cozaar Comp Accepted treatment
Valsartan and diuretic 160mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretic 160mg/25mg TAB Co-diovan Plus Motivation required
Valsartan and diuretic 320mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretic 320mg/50mg TAB Co-diovan Motivation required
Valsartan and diuretic 80mg/12.5mg TAB Co-tareg Motivation required
Calcium channel blockers
Amlodipine 10mg TAB Almadin Ciplavasc Amlate Accepted treatment
Amlodipine 5mg TAB Almadin Ciplavasc Amlate Accepted treatment
Felodipine 10mg SRT Felodipine-hexal Accepted treatment
Felodipine 5mg SRT Felodipine-hexal Accepted treatment
Beta blockers and combinations
Atenolol 100mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 25mg TAB Tenopress Accepted treatment
Atenolol 50mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Bisoprolol 10mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Propranolol 10mg TAB Indoblok Prodorol Purbloka Accepted treatment
7
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Propranolol 40mg TAB Indoblok Prodorol Purbloka Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Sandoz Co-tenidone Tenchlor Adco-loten Accepted treatment
Atenolol and other diuretics 50mg/12.5mg TAB Sandoz Co-tenidone Tenchlor HS Accepted treatment
Alpha/beta blockers
Carvedilol 12.5mg TAB Carloc Carvetrend Vediblok Accepted treatment
Carvedilol 25mg TAB Carloc Carvetrend Vediblok Accepted treatment
Carvedilol 6.25mg TAB Carloc Carvetrend Vediblok Accepted treatment
Vasodilators
Hydralazine 10mg TAB Hyperphen Accepted treatment
Hydralazine 25mg TAB Sandoz Hydralazine Accepted treatment
Hydralazine 50mg TAB Hyperphen Sandoz Hydralazine Accepted treatment
Cardiac glycosides
Digoxin 0.05mg/ml SYR Lanoxin Paed Accepted treatment
Digoxin 0.0625mg TAB Lanoxin Accepted treatment
Digoxin 0.25mg TAB Lanoxin Purgoxin Accepted treatment
Organic nitrates
Isosorbide dinitrate 10mg TAB Sandoz Isosorbide dinitrate Accepted treatment
Isosorbide dinitrate 30mg TAB Sandoz Isosorbide Accepted treatment
Isosorbide dinitrate 40mg TAB Isordil Tembid Accepted treatment
Isosorbide dinitrate 5mg TAB Sandoz Isosorbide dinitrate Accepted treatment
Chronic obstructive pulmonary disease
Beta agonists, short-acting
Salbutamol 100mcg INH Venteze Asthavent Accepted treatment
Salbutamol 2.5mg SLN Ventolin nebules Motivation required
Salbutamol 200mcg CPS Asthavent Accepted treatment
Salbutamol 200mcg CPS Ventodisks Accepted treatment
Salbutamol 400mcg CPS Ventodisks Motivation required
Fenoterol INH Berotec HFA Accepted treatment
Ipratropium bromide and salbutamol
20mcg/100mcg INH Combivent Motivation required
Anticholinergics, inhaled
Ipratropium bromide 40mcg INH Ipvent Accepted treatment
Corticosteroids, inhaled
Beclometasone 100mcg INH Beclate Special investigations
8
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Beclometasone 200mcg INH Beclate Special investigations
Beclometasone 50mcg INH Beclate Special investigations
Budesonide 100mcg INH/CPS Inflacor Budeflam Inflammide Special investigations
Budesonide 200mcg INH/CPS Inflacor Budeflam Inflammide Special investigations
Budesonide 400mcg INH/CPS Inflacor Inflammide Novoliser Special investigations
Corticosteroids and beta agonists, long-acting
Salmeterol and fluticasone 25mcg/125mcg INH Sereflo Seretide Special investigations
Salmeterol and fluticasone 25mcg/250mcg INH Sereflo Seretide Special investigations
Salmeterol and fluticasone 25mcg/50mcg INH Sereflo Seretide Special investigations
Salmeterol and fluticasone 50mcg/100mcg INH Foxair Seretide Special investigations
Salmeterol and fluticasone 50mcg/250mcg INH Foxair Seretide Special investigations
Salmeterol and fluticasone 50mcg/500mcg INH Foxair Seretide Special investigations
Xanthines
Aminophylline 100mg TAB Norstan-ted Accepted treatment
Aminophylline 200mg TAB Norstan-ted Accepted treatment
Aminophylline 225mg SRT Phyllocontin Accepted treatment
Theophylline SYR Alcophyllin Nuelin liquid Accepted treatment
Theophylline 200mg SRT Sandoz Theophylline Accepted treatment
Theophylline 250mg SRT Nuelin SA Accepted treatment
Theophylline 300mg SRT Sandoz Theophylline Accepted treatment
Theophylline 400mg SRT Uniphyl Accepted treatment
Theophylline 600mg SRT Uniphyl Accepted treatment
Chronic renal failure
Diuretics
Furosemide 10mg/ml SYR Lasix Oral Motivation required
Furosemide 40mg TAB Diuresix Mylan-furosemide Beuresis Accepted treatment
Hydrochlorothiazide 12.5mg TAB Ridaq Accepted treatment
Hydrochlorothiazide 25mg TAB Hexazide Ridaq Accepted treatment
Hydrochlorothiazide and amiloride
25mg/2.5mg TAB Amiloretic HS Accepted treatment
Hydrochlorothiazide and amiloride
50mg/5mg TAB Amiloretic Spec-Co-Amiloride Betaretic Accepted treatment
Indapamide 2.5mg TAB Cipla-Indapamide Daptril Mylan-indapamide Accepted treatment
Spironolactone 100mg TAB Spiractin Accepted treatment
Triamterine and hydrochlorothiazide
50mg/25mg TAB Renezide Accepted treatment
9
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Hydrochlorothiazide and potassium
50mg/300mg TAB Urirex K Accepted treatment
Potassium supplements
Potassium chloride 600mg TAB Plenish-K Sandoz K-600 Accepted treatment
ACE inhibitors and combinations
Captopril 12.5mg TAB Captohexal Accepted treatment
Captopril 25mg TAB Captohexal Mylan-captopril Bio-captopril Accepted treatment
Captopril 50mg TAB Captohexal Mylan-captopril Zapto Accepted treatment
Enalapril 10mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 2.5mg TAB Renitec Accepted treatment
Enalapril 20mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 5mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Lisinopril 10mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 2.5mg TAB Austell-lisinopril Accepted treatment
Lisinopril 20mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 5mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Perindopril 4mg TAB Prexum Vectoryl Cipla-perindopril Accepted treatment
Perindopril 8mg TAB Vectoryl Cipla-perindopril Accepted treatment
Perindopril 10mg TAB Prexum Coversyl Accepted treatment
Ramipril 1.25mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 10mg CAP Austell-ramipril Ran-ramipril Rampil Motivation required
Ramipril 2.5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Trandolapril 0.5mg CAP Mavik Accepted treatment
Trandolapril 2mg CAP Mavik Accepted treatment
Captopril and diuretic 50mg/25mg TAB Captoretic Zapto-Co Capozide Accepted treatment
Enalapril and diuretic 12.5mg TAB Enap Co Pharmapress Co Accepted treatment
Lisinopril and diuretic 10mg/12.5mg TAB Lisoretic Lisozide Hexal-lisinopril Co Accepted treatment
Lisinopril and diuretic 20mg/12.5mg TAB Lisoretic Zestozide Hexal-lisinopril Co Accepted treatment
Perindopril and indapamide 4mg/1.5mg TAB Prexum Plus Vectoryl Plus Accepted treatment
Angiotensin receptor blockers and combinations
Losartan 50mg TAB Lepitrin Cipla-losartan Los-arb Accepted treatment
Losartan 100mg TAB Zartan Cipla-losartan Accepted treatment
Valsartan 160mg TAB Tareg Motivation required
10
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Valsartan 320mg TAB Diovan Motivation required
Valsartan 40mg TAB Diovan Motivation required
Valsartan 80mg TAB Tareg Motivation required
Losartan and diuretic 100mg/25mg TAB Fortzaar Accepted treatment
Losartan and diuretic 50mg/12.5mg TAB Cozaar Comp Accepted treatment
Valsartan and diuretic 160mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretic 160mg/25mg TAB Co-diovan Plus Motivation required
Valsartan and diuretic 320mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretic 320mg/50mg TAB Co-diovan Motivation required
Valsartan and diuretic 80mg/12.5mg TAB Co-tareg Motivation required
Calcium channel blockers
Amlodipine 10mg TAB Almadin Ciplavasc Amlate Accepted treatment
Amlodipine 5mg TAB Almadin Ciplavasc Amlate Accepted treatment
Diltiazem 240mg SRT Zildem SR Accepted treatment
Diltiazem 180mg SRT Zildem SR Accepted treatment
Diltiazem 60mg TAB Zildem Accepted treatment
Diltiazem 90mg TAB Zildem Accepted treatment
Felodipine 10mg SRT Felodipine-hexal Accepted treatment
Felodipine 5mg SRT Felodipine-hexal Accepted treatment
Nifedipine 20mg SRT Nifedalat SR Cipalat Retard Accepted treatment
Nifedipine 30mg SRT Adco-Vascard SR Fedaloc Accepted treatment
Nifedipine 60mg SRT Fedaloc Macorel Motivation required
Verapamil 240mg SRT Verahexal Calcicard Ravamil Accepted treatment
Beta blockers and combinations
Atenolol 100mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 25mg TAB Tenopress Accepted treatment
Atenolol 50mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Bisoprolol 10mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Propranolol 10mg TAB Indoblok Prodorol Purbloka Accepted treatment
Propranolol 40mg TAB Indoblok Prodorol Purbloka Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Sandoz Co-tenidone Tenchlor Adco-loten Accepted treatment
Atenolol and other diuretics 50mg/12.5mg TAB Sandoz Co-tenidone Tenchlor HS Accepted treatment
11
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Erythropoietin and supplements
Alfacalcidol 0.25mg CAP One alpha Special investigations
Alfacalcidol 1mg CAP One alpha Special investigations
Calcium carbonate TAB Titralac Special investigations
Erythropoietin INJ Repotin Recormon Eprex Special investigations
Iron in other combinations INJ Venofer Cosmofer Special investigations
Iron supplementation subject to Qualsa Medicine Reimbursement Policy.
Coronary artery disease
Aspirin
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Be-tabs aspirin Aspirin (Resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Calcium channel blockers
Amlodipine 10mg TAB Almadin Ciplavasc Amlate Accepted treatment
Amlodipine 5mg TAB Almadin Ciplavasc Amlate Accepted treatment
Diltiazem 240mg SRT Zildem SR Accepted treatment
Diltiazem 180mg SRT Zildem SR Accepted treatment
Diltiazem 60mg TAB Zildem Accepted treatment
Diltiazem 90mg TAB Zildem Accepted treatment
Felodipine 10mg SRT Felodipine-hexal Accepted treatment
Felodipine 5mg SRT Felodipine-hexal Accepted treatment
Nifedipine 20mg SRT Nifedalat SR Cipalat Retard Accepted treatment
Nifedipine 30mg SRT Adco-Vascard SR Fedaloc Accepted treatment
Nifedipine 60mg SRT Fedaloc Macorel Motivation required
Verapamil 240mg SRT Verahexal Calcicard Ravamil Accepted treatment
Verapamil 40mg TAB Vasomil Accepted treatment
Verapamil 80mg TAB Vasomil Accepted treatment
Beta blockers
Atenolol 100mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 25mg TAB Tenopress Accepted treatment
Atenolol 50mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
12
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Bisoprolol 10mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Propranolol 10mg TAB Indoblok Prodorol Purbloka Accepted treatment
Propranolol 40mg TAB Indoblok Prodorol Purbloka Accepted treatment
Alpha/beta blockers
Carvedilol 12.5mg TAB Carloc Carvetrend Vediblok Accepted treatment
Carvedilol 25mg TAB Carloc Carvetrend Vediblok Accepted treatment
Carvedilol 6.25mg TAB Carloc Carvetrend Vediblok Accepted treatment
Organic nitrates
Glyceryl trinitrate 0.5mg TAB Angised Accepted treatment
Isosorbide dinitrate 10mg TAB Sandoz Isosorbide dinitrate Accepted treatment
Isosorbide dinitrate 30mg TAB Sandoz Isosorbide Accepted treatment
Isosorbide dinitrate 40mg TAB Isordil Tembid Accepted treatment
Isosorbide dinitrate 5mg TAB Sandoz Isosorbide dinitrate Accepted treatment
Isosorbide mononitrate 20mg TAB Elantan Accepted treatment
Isosorbide mononitrate 50mg SRC Elantan LA Accepted treatment
Isosorbide mononitrate 60mg SRT Monicor Imdur Accepted treatment
Crohn's disease
Corticosteroids, topical
Budesonide ENE Entocord Motivation required
Corticosteroids, oral
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Trolic Accepted treatment
5-ASA agents
Mesalazine 2g/50ml ENE Asacol Motivation required
Mesalazine 400mg TAB Asacol Motivation required
Mesalazine 800mg TAB Asacol Motivation required
Mesalazine 500mg TAB/SUP Asacol Pentasa Motivation required
Olsalazine 250mg CAP Dipentum Motivation required
Sulphasalazine 500mg TAB Salazopyrin Accepted treatment
Immunosuppressants
Azathioprine 50mg TAB Zaprine Azathioprine 50 PCH Azapress Accepted treatment
Methotrexate 2.5mg TAB Methotrexate Emthexate Accepted treatment
13
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Diabetes insipidus
Vasopressin analogues
Desmopressin 0.1mg TAB DDAVP Motivation required
Desmopressin 0.1mg/ml NAS/NOD DDAVP nasal spray 5ml DDAVP 2.5ml Motivation required
Desmopressin 0.2mg TAB DDAVP Motivation required
Diabetes mellitus type I
Insulin
Insulin (human) INJ Humulin Actraphane Protaphane Accepted treatment
Insulin aspart INJ Novorapid Novomix Accepted treatment
Insulin glulisine INJ Apidra Accepted treatment
Insulin lispro INJ Humalog Humalog Mix Accepted treatment
Insulin glargine (analogue) INJ Lantus Accepted treatment
Insulin determir (analogue) INJ Levemir Accepted treatment
Diabetes mellitus type II
Suphonylureas
Glibenclamide 5mg TAB Sandoz Glibenclamide Diacare Glycomin Accepted treatment
Gliclazide 40mg TAB Austell-gliclazide Accepted treatment
Gliclazide 80mg TAB Austell-gliclazide Mylan-gliclazide Sandoz Gliclazide Accepted treatment
Insulin
Insulin (human) INJ Humulin Actraphane Protaphane Accepted treatment
Insulin aspart INJ Novorapid Novomix Accepted treatment
Insulin glulisine INJ Apidra Accepted treatment
Insulin lispro INJ Humalog Humalog Mix Accepted treatment
Insulin glargine (analogue) INJ Lantus Accepted treatment
Insulin determir (analogue) INJ Levemir Accepted treatment
Biguanides
Metformin 1000mg TAB Glucophage Bigsens Metored Accepted treatment
Metformin 500mg TAB Austell-metformin Bigsens Forminal Accepted treatment
Metformin 850mg TAB Austell-metformin Bigsens Forminal Accepted treatment
Metformin 500mg XR TAB Glucophage XR Accepted treatment
Thiazolidinediones
Pioglitazone 15mg TAB Cipla-pioglitazone Motivation required
Pioglitazone 30mg TAB Cipla-pioglitazone Motivation required
14
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Dysrhythmias
Aspirin
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Be-tabs aspirin Aspirin (Resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Anticoagulants
Warfarin 1mg TAB Cipla-warfarin Accepted treatment
Warfarin 3mg TAB Cipla-warfarin Accepted treatment
Warfarin 5mg TAB Cipla-warfarin Lennon warfarin Accepted treatment
Calcium channel blockers
Diltiazem 240mg SRT Zildem SR Accepted treatment
Diltiazem 180mg SRT Zildem SR Accepted treatment
Verapamil 240mg SRT Verahexal Calcicard Ravamil Accepted treatment
Verapamil 40mg TAB Vasomil Accepted treatment
Verapamil 80mg TAB Vasomil Accepted treatment
Beta blockers
Atenolol 100mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 25mg TAB Tenopress Accepted treatment
Atenolol 50mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Bisoprolol 10mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Propranolol 10mg TAB Indoblok Prodorol Purbloka Accepted treatment
Propranolol 40mg TAB Indoblok Prodorol Purbloka Accepted treatment
Sotalol 160mg TAB Sotahexal Motivation required
Sotalol 80mg TAB Sotahexal Motivation required
Cardiac glycosides
Digoxin 0.05mg/ml SYR Lanoxin Paed Accepted treatment
Digoxin 0.0625mg TAB Lanoxin Accepted treatment
Digoxin 0.25mg TAB Lanoxin Purgoxin Accepted treatment
Antiarrhythmics
Amiodarone 100mg TAB Arycor Hexarone Accepted treatment
15
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Amiodarone 200mg TAB Arycor Hexarone Bio-Amiodarone Accepted treatment
Disopyramide 100mg CAP Rythmodan Motivation required
Disopyramide 250mg TAB Rythmodan Motivation required
Flecainide 100mg TAB Tambocor Motivation required
Propafenone 150mg TAB Rhythmol Motivation required
Propafenone 300mg TAB Rhythmol Motivation required
Quinidine sulphate 200mg TAB Quinidine Motivation required
Epilepsy
Anticonvulsants
Carbamazepine 100mg/5ml SUS Tegretol S Accepted treatment
Carbamazepine 200mg TAB/SRT Sandoz Carbamazepine CR Degranol CPL-carbamazepine Accepted treatment
Carbamazepine 400mg SRT Sandoz Carbamazepine CR Accepted treatment
Ethosuxamide 250mg/5ml SYR Zarontin Accepted treatment
Gabapentin 100mg CAP Neurexal Epleptin Ran-gabapentin Motivation required
Gabapentin 300mg CAP Neurexal Epleptin Ran-gabapentin Motivation required
Gabapentin 400mg CAP Neurexal Epleptin Ran-gabapentin Motivation required
Gabapentin 600mg TAB Neurontin Motivation required
Gabapentin 800mg TAB Neurontin Motivation required
Lamotrigine 100mg TAB Aspen-lamotrigine Lamitor Dyna-Lamotrigine Accepted treatment
Lamotrigine 200mg TAB Lamidus Austell-lamotrigine Dyna-Lamotrigine Accepted treatment
Lamotrigine 25mg TAB Aspen-lamotrigine Lamitor Dyna-Lamotrigine Accepted treatment
Lamotrigine 50mg TAB Aspen-lamotrigine Lamitor Dyna-Lamotrigine Accepted treatment
Phenobarbital 30mg TAB Sedabard Lethyl Accepted treatment
Phenobarbital SYR Adco-phenobarb vital Accepted treatment
Phenytoin 100mg TAB/CAP Phenytoin sod Epanutin Accepted treatment
Phenytoin 125mg/5ml SUS Epanutin Accepted treatment
Topiramate 15mg CAP Topamax cs Motivation required
Topiramate 100mg TAB Toplep Adco-topiramate Sandoz-topiramate Motivation required
Topiramate 200mg TAB Toplep Adco-topiramate Sandoz-topiramate Motivation required
Topiramate 25mg TAB Toplep Adco-topiramate Sandoz-topiramate Motivation required
Topiramate 50mg TAB Toplep Adco-topiramate Sandoz-topiramate Motivation required
Valproic acid 100mg TAB Epilim Accepted treatment
Valproic acid 150mg CAP/SRT Convulex Epilim Accepted treatment
Valproic acid 200mg SRT Epilim Accepted treatment
16
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Valproic acid 200mg/5ml SYR Epilim Accepted treatment
Valproic acid 300mg CAP Convulex Accepted treatment
Valproic acid 500mg CAP/SRT Convulex Epilim Accepted treatment
Valproic acid 50mg/ml SYR Convulex Accepted treatment
Benzodiazepine derivatives
Clonazepam 0.5mg TAB Rivotril Motivation required
Clonazepam 2.5mg DRP Rivotril Motivation required
Clonazepam 2mg TAB Rivotril Motivation required
Glaucoma
Beta blockers
Betoxalol 0.25% OPD Betoptic S 5ml Accepted treatment
Betoxalol 5mg/ml OPD Betoptic 5ml Accepted treatment
Carteolol 2% OPD Teoptic 5ml Accepted treatment
Levobunolol 5% OPD Betagan 7.5ml Accepted treatment
Metipranolol 3% OPD Beta-opthiole 5ml Accepted treatment
Metipranolol 6% OPD Beta-opthiole 5ml Accepted treatment
Timolol 1mg/g OPD Nyogel Accepted treatment
Timolol 2.5mg/ml OPD Timoptol Accepted treatment
Timolol 5mg/ml OPD Glaucosan Timoptol Accepted treatment
Parasympathomimetics
Pilocarpine 10mg/ml OPD Isopto-carpine Accepted treatment
Pilocarpine 20mg/ml OPD Isopto-carpine Accepted treatment
Pilocarpine 40mg/ml OPD Isopto-carpine Accepted treatment
Sympathomimetics
Brimonidine OPD Alphagan Purite Motivation required
Dipivefrine 1% OPD Propine Motivation required
Carbonic anhydrase inhibitors
Acetazolamide 250mg TAB Azomid Motivation required
Brinzolamide 1% OPD Azoptic 5ml eye suspension Motivation required
Dorzolamide 2% OPD Trusopt Motivation required
Prostaglandin analogues
Bimatoprost 0.3mg/3ml OPD Lumigan Accepted treatment
Latanoprost OPD Xalatan 2.5ml Accepted treatment
Travoprost 4% OPD Travatan Accepted treatment
17
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Beta blockers, combinations
Timolol and dordolamide OPD Cosopt Motivation required
Timolol and latanoprost OPD Xalacom Motivation required
Timolol and travoprost OPD DuoTrav Motivation required
Haemophilia
Analgesics and antipyretics
Paracetamol 120mg/5ml SYR Feverpain Napamol Painblok Accepted treatment
Paracetamol 500mg TAB Napamol Gencetamol Antalgic Accepted treatment
Antifibrinolytics
Tranexamic acid 500mg TAB Cyklokapron Special investigations
Hyperlipidaemia
Aspirin
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Be-tabs aspirin Aspirin (Resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Fibrates
Bezafibrate 200mg TAB Bezalip Special investigations
Bezafibrate 400mg TAB Sandoz bezafibrate Bezachole SR Dyna-Bezafibrate SR Special investigations
Statins
Simvastatin 10mg TAB Arrow-simvastatin Zocor Michol Special investigations
Simvastatin 20mg TAB Arrow-simvastatin Zocor Michol Special investigations
Simvastatin 40mg TAB Arrow-simvastatin Zocor Michol Special investigations
Simvastatin 80mg TAB Zysim Cipla-simvastatin Michol Special investigations
Hypertension
Aspirin
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Be-tabs aspirin Aspirin (Resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Diuretics
Furosemide 10mg/ml SYR Lasix Oral Motivation required
18
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Furosemide 40mg TAB Diuresix Mylan-furosemide Beuresis Accepted treatment
Hydrochlorothiazide 12.5mg TAB Ridaq Accepted treatment
Hydrochlorothiazide 25mg TAB Hexazide Ridaq Accepted treatment
Hydrochlorothiazide and amiloride
25mg/2.5mg TAB Amiloretic HS Accepted treatment
Hydrochlorothiazide and amiloride
50mg/5mg TAB Amiloretic Spec-Co-Amiloride Betaretic Accepted treatment
Indapamide 2.5mg TAB Cipla-Indapamide Daptril Mylan-indapamide Accepted treatment
Spironolactone 100mg TAB Spiractin Accepted treatment
Spironolactone 25mg TAB Spiractin Sandoz Spironolactone Accepted treatment
Triamterine and hydrochlorothiazide
50mg/25mg TAB Renezide Accepted treatment
Hydrochlorothiazide and potassium
50mg/300mg TAB Urirex K Accepted treatment
Potassium supplements
Potassium chloride 600mg TAB Plenish-K Sandoz K-600 Accepted treatment
ACE-inhibitors and combinations
Captopril 12.5mg TAB Captohexal Accepted treatment
Captopril 25mg TAB Captohexal Mylan-captopril Bio-captopril Accepted treatment
Captopril 50mg TAB Captohexal Mylan-captopril Zapto Accepted treatment
Enalapril 10mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 2.5mg TAB Renitec Accepted treatment
Enalapril 20mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 5mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Lisinopril 10mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 2.5mg TAB Austell-lisinopril Accepted treatment
Lisinopril 20mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 5mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Perindopril 4mg TAB Prexum Vectoryl Cipla-perindopril Accepted treatment
Perindopril 8mg TAB Vectoryl Cipla-perindopril Accepted treatment
Ramipril 1.25mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 10mg CAP Austell-ramipril Ran-ramipril Rampil Accepted treatment
Ramipril 2.5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Trandolapril 0.5mg CAP Mavik Accepted treatment
Trandolapril 2mg CAP Mavik Accepted treatment
Captopril and diuretic 50mg/25mg TAB Captoretic Zapto-Co Capozide Accepted treatment
19
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Enalapril and diuretic 12.5mg TAB Enap Co Pharmapress Co Accepted treatment
Lisinopril and diuretic 10mg/12.5mg TAB Lisoretic Lisozide Hexal-lisinopril Co Accepted treatment
Lisinopril and diuretic 20mg/12.5mg TAB Lisoretic Zestozide Hexal-lisinopril Co Accepted treatment
Perindopril and indapamide 4mg/1.5mg TAB Prexum Plus Vectoryl Plus Accepted treatment
Angiotensin receptor blockers and combinations
Losartan 50mg TAB Lepitrin Cipla-losartan Los-arb Accepted treatment
Losartan 100mg TAB Zartan Cipla-losartan Accepted treatment
Valsartan 160mg TAB Tareg Motivation required
Valsartan 320mg TAB Diovan Motivation required
Valsartan 40mg TAB Diovan Motivation required
Valsartan 80mg TAB Tareg Motivation required
Losartan and diuretic 100mg/25mg TAB Fortzaar Accepted treatment
Losartan and diuretic 50mg/12.5mg TAB Cozaar Comp Accepted treatment
Valsartan and diuretic 160mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretic 160mg/25mg TAB Co-diovan Plus Motivation required
Valsartan and diuretic 320mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretic 320mg/50mg TAB Co-diovan Motivation required
Valsartan and diuretic 80mg/12.5mg TAB Co-tareg Motivation required
Calcium channel blockers
Amlodipine 10mg TAB Almadin Ciplavasc Amlate Accepted treatment
Amlodipine 5mg TAB Almadin Ciplavasc Amlate Accepted treatment
Diltiazem 240mg SRT Zildem SR Accepted treatment
Diltiazem 180mg SRT Zildem SR Accepted treatment
Diltiazem 60mg TAB Zildem Accepted treatment
Diltiazem 90mg TAB Zildem Accepted treatment
Felodipine 10mg SRT Felodipine-hexal Accepted treatment
Felodipine 2.5mg SRT Plendil Accepted treatment
Felodipine 5mg SRT Felodipine-hexal Accepted treatment
Nifedipine 20mg SRT Nifedalat SR Cipalat Retard Accepted treatment
Nifedipine 30mg SRT Adco-Vascard SR Fedaloc Accepted treatment
Nifedipine 60mg SRT Fedaloc Macorel Motivation required
Verapamil 240mg SRT Verahexal Calcicard Ravamil Accepted treatment
Beta blockers and combinations
Atenolol 100mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
20
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Atenolol 25mg TAB Tenopress Accepted treatment
Atenolol 50mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Bisoprolol 10mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Propranolol 10mg TAB Indoblok Prodorol Purbloka Accepted treatment
Propranolol 40mg TAB Indoblok Prodorol Purbloka Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Sandoz Co-tenidone Tenchlor Adco-loten Accepted treatment
Atenolol and other diuretics 50mg/12.5mg TAB Sandoz Co-tenidone Tenchlor HS Accepted treatment
Alpha/beta blockers
Carvedilol 12.5mg TAB Carloc Carvetrend Vediblok Accepted treatment
Carvedilol 25mg TAB Carloc Carvetrend Vediblok Accepted treatment
Carvedilol 6.25mg TAB Carloc Carvetrend Vediblok Accepted treatment
Alpha blockers
Doxazosin 1mg TAB Adco-doxazosin Cardugen Accepted treatment
Doxazosin 2mg TAB Adco-doxazosin Accepted treatment
Doxazosin 4mg TAB Adco-doxazosin Cardugen Accepted treatment
Doxazosin (Extended release)
4mg TAB Cardura XL Motivation required
Doxazosin (Extended release)
8mg TAB Cardura XL Motivation required
Prazosin 1mg TAB Pratsiol Accepted treatment
Prazosin 2mg TAB Pratsiol Accepted treatment
Prazosin 5mg TAB Pratsiol Accepted treatment
Vasodilators
Hydralazine 10mg TAB Hyperphen Accepted treatment
Hydralazine 25mg TAB Sandoz Hydralazine Accepted treatment
Hydralazine 50mg TAB Hyperphen Sandoz Hydralazine Accepted treatment
Minoxidil 10mg TAB Loniten Motivation required
Minoxidil 5mg TAB Loniten Motivation required
Antiadrenegic agents, centrally acting
Methyldopa 250mg TAB Hypotone Sandoz Methyldopa Mylan-methyldopa Accepted treatment
Methyldopa 500mg TAB Hypotone Accepted treatment
Reserpine 0.25mg TAB Reserpine Accepted treatment
Reserpine and diuretics TAB Brinerdin Motivation required
21
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Hypothyroidism
Thyroid hormones
Levothyroxine 100mcg TAB Eltroxin Euthyrox Accepted treatment
Levothyroxine 50mcg TAB Eltroxin Euthyrox Accepted treatment
Levothyroxine 25mcg TAB Euthyrox Accepted treatment
Liothyronine 20mcg TAB Tertroxin Accepted treatment
Thyroxine and liothyronine 90mcg/10mcg TAB Diotroxin Accepted treatment
Multiple sclerosis
Heterocyclic antidepressants
Amitriptyline 10mg TAB Trepiline Accepted treatment
Amitriptyline 25mg TAB Trepiline Sandoz-amitriptyline Accepted treatment
Imipramine 10mg TAB Ethipramine Accepted treatment
Imipramine 25mg TAB Ethipramine Accepted treatment
Anticonvulsants
Carbamazepine 200mg TAB/SRT Sandoz Carbamazepine CR Degranol CPL-carbamazepine Accepted treatment
Carbamazepine 400mg SRT Sandoz Carbamazepine CR Accepted treatment
Immunosuppressants
Azathioprine 50mg TAB Zaprine Azathioprine 50 PCH Azapress Accepted treatment
Cyclophosphamide 50mg TAB Endoxan Motivation required
Methotrexate 2.5mg TAB Methotrexate Emthexate Accepted treatment
Muscle relaxants
Baclofen 10mg TAB Bio-baclofen Accepted treatment
Baclofen 25mg TAB Lioresal Motivation required
Orphenadrine 50mg TAB Disipal Accepted Treatment
Orphenadrine 100mg TAB Norflex Accepted treatment
Corticosteroids, oral
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Trolic Accepted treatment
Anticholinergics, oral
Oxybutynin 5mg TAB Lenditro Mylan-oxybutynin Urihexal Accepted treatment
Parkinson's disease
Dopa and dopa derivatives
Carbidopa and levodopa 25mg/100mg TAB Carbilev Accepted treatment
Carbidopa and levodopa 25mg/250mg TAB Carbilev Accepted treatment
22
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Carbidopa and levodopa 50mg/200mg SRT Sinemet CR Accepted treatment
Levodopa and benserazide 100mg/25mg CAP Madopar HBS Accepted treatment
Levodopa and benserazide 200mg/50mg TAB Madopar Accepted treatment
Anticholinergics, oral
Biperiden 2mg TAB Akineton Accepted treatment
Orphenadrine 100mg TAB Norflex Accepted treatment
Orphenadrine 50mg TAB Disipal Accepted treatment
Adamantine derivatives
Amantadine 100mg CAP Symadin Accepted treatment
Dopamine agonists
Bromocriptine 2.5mg TAB Aspen-Bromocriptine Motivation required
Pramipexole 0.125mg TAB Pexola Motivation required
Pramipexole 0.25mg TAB Pexola Motivation required
Pramipexole 1mg TAB Pexola Motivation required
Ropinirole 0.25mg TAB Requip Motivation required
Ropinirole 0.5mg TAB Requip Motivation required
Ropinirole 1mg TAB Requip Motivation required
Ropinirole 2mg TAB Requip Requip XL Motivation required
Ropinirole 4mg TAB Requip XL Motivation required
Ropinirole 5mg TAB Requip Motivation required
Ropinirole 8mg TAB Requip XL Motivation required
Monoamine oxidase type B inhibitors
Selegiline 5mg TAB Parkilyne Accepted treatment
Rheumatoid arthritis
Immunosuppressants
Azathioprine 50mg TAB Zaprine Azathioprine 50 PCH Azapress Accepted treatment
Leflunomide 10mg TAB Arava Motivation required
Leflunomide 20mg TAB Arava Motivation required
Methotrexate 2.5mg TAB Methotrexate Emthexate Accepted treatment
Sulphasalazine 500mg TAB Salazopyrin Accepted treatment
Other
Chloroquine 150mg TAB Daramal Accepted treatment
Chloroquine 200mg TAB/CAP Nivaquine Plasmoquine Accepted treatment
23
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Corticosteroids, oral
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Trolic Accepted treatment
Non-steroidal anti-inflammatory drugs
Diclofenac 100mg SRT/CAP Fortfen SR Sandoz Diclofenac sodium
SR Difen SR Accepted treatment
Diclofenac 25mg TAB Mylan-diclofenac sodium Diclohexal A-lennon diclofenac Accepted treatment
Diclofenac 50mg TAB Mylan-diclofenac sodium Diclohexal A-lennon diclofenac Accepted treatment
Diclofenac 75mg CAP/TAB Panamor SR Veltex CR Accepted treatment
Ibuprofen 100mg/5ml SUS Ibumax Ibugesic Advil paediatric suspension Accepted treatment
Ibuprofen 200mg TAB Ranfen Ibunate Betaprofen Accepted treatment
Ibuprofen 400mg TAB Ranfen Adco-ibuprofen Betaprofen 400 FC Accepted treatment
Ibuprofen 600mg TAB Sandoz Ibuprofen Accepted treatment
Indomethacin 100mg SUP Arthrexin Motivation required
Indomethacin 25mg CAP Betacin Gulf-indomethacin Adco-indomethacin Accepted treatment
Indomethacin 50mg CAP Arthrexin Accepted treatment
Ketoprofen 200mg SRT Ketoflam Accepted treatment
Meloxicam 15mg TAB Zydus-meloxicam Flexocam Loxiflam Accepted treatment
Meloxicam 7.5mg TAB Zydus-meloxicam Flexocam Loxiflam Accepted treatment
Naproxen 250mg TAB/ECT Mylan-naproxen Napflam Naprel Accepted treatment
Naproxen 500mg TAB Napflam Accepted treatment
Naproxen 500mg SUP Nafasol Motivation required
Piroxicam 10mg CAP Adco-piroxicam Accepted treatment
Piroxicam 20mg CAP/DSP Xycam Roxifen Pyrocaps Accepted treatment
Analgesics and antipyretics
Paracetamol 120mg/5ml SYR Feverpain Napamol Painblok Accepted treatment
Paracetamol 500mg TAB Napamol Gencetamol Antalgic Accepted treatment
Paracetamol combinations excl. psycholeptics
500mg/10mg TAB Napacod Accepted treatment
Schizophrenia
Heterocyclic antidepressants
Amitriptyline 25mg TAB Trepiline Sandoz-amitriptyline Accepted treatment
Dothiepin (dosulepin) 25mg CAP Thaden Sandoz-dothiepin Accepted treatment
Dothiepin (dosulepin) 75mg TAB Thaden Sandoz-dothiepin Accepted treatment
Imipramine 25mg TAB Ethipramine Accepted treatment
24
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Maprotiline 25mg TAB Ludiomil Motivation required
Maprotiline 75mg TAB Ludiomil Motivation required
Selective serotonin receptor inhibitors
Citalopram 10mg TAB Austell-citalopram Accepted treatment
Citalopram 20mg TAB Austell-citalopram Citalopram-Winthrop Sandoz-citalopram Accepted treatment
Citalopram 40mg TAB Austell-citalopram Citalopram-Winthrop Depramil Accepted treatment
Fluoxetine 20mg CAP/TAB A-lennon fluoxetine Zydus-fluoxetine Ranflocs Accepted treatment
Fluoxetine 40mg DSP Prohexal T Motivation required
Other
Sulpiride 200mg TAB Bio-sulpiride Motivation required
Sulpiride 25mg SYR Eglonyl Motivation required
Sulpiride 50mg CAP Espiride Sandoz Sulpiride Motivation required
Mood stabilisers
Lithium 250mg TAB Camcolit Accepted treatment
Lithium 400mg TAB Camcolit Accepted treatment
Lithium 450mg TAB Quilonum Retard Accepted treatment
Antipsychotics
Chlorpromazine 100mg TAB Largactil Accepted treatment
Chlorpromazine 25mg TAB Largactil Accepted treatment
Chlorpromazine 50mg TAB Largactil Accepted treatment
Clozapine 100mg TAB Cloment Accepted treatment
Clozapine 25mg TAB Cloment Accepted treatment
Haloperidol 0.5mg CAP Serenace Accepted treatment
Haloperidol 1.5mg TAB Serenace Sandoz Haloperidol Accepted treatment
Haloperidol 10mg TAB Serenace Accepted treatment
Haloperidol 5mg TAB Serenace Sandoz Haloperidol Accepted treatment
Risperidone 0.5mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 1mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 2mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 3mg TAB DRL-Risperidone Risperidone-Hexal Perizal Motivation required
Risperidone 4mg TAB Aspen Risperidone Risponz Motivation required
Trifluoperazine 1mg TAB Stelazine Accepted treatment
Trifluoperazine 5mg TAB Stelazine Accepted treatment
Zuclopenthixole 10mg TAB Clopixol Motivation required
25
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Zuclopenthixole 2mg TAB Clopixol Motivation required
Systemic lupus erythematosus
Immunosuppressants
Methotrexate 2.5mg TAB Methotrexate Emthexate Accepted treatment
Other
Chloroquine 150mg TAB Daramal Accepted treatment
Chloroquine 200mg TAB/CAP Nivaquine Plasmoquine Accepted treatment
Aspirin
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Be-tabs aspirin Aspirin (Resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Corticosteroids, oral
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Trolic Accepted treatment
Non-steroidal anti-inflammatory drugs
Diclofenac 100mg SRT/CAP Fortfen SR Sandoz Diclofenac sodium
SR Difen SR Accepted treatment
Diclofenac 25mg TAB Mylan-diclofenac sodium Diclohexal A-lennon diclofenac Accepted treatment
Diclofenac 50mg TAB Mylan-diclofenac sodium Diclohexal A-lennon diclofenac Accepted treatment
Diclofenac 75mg CAP/TAB Panamor SR Veltex CR Accepted treatment
Ibuprofen 100mg/5ml SUS Ibumax Ibugesic Advil paediatric suspension Accepted treatment
Ibuprofen 200mg TAB Ranfen Ibunate Betaprofen Accepted treatment
Ibuprofen 400mg TAB Ranfen Adco-ibuprofen Betaprofen 400 FC Accepted treatment
Ibuprofen 600mg TAB Sandoz Ibuprofen Accepted treatment
Ibuprofen 800mg TAB Brufen Retard Motivation required
Indomethacin 100mg SUP Arthrexin Motivation required
Indomethacin 25mg CAP Betacin Gulf-indomethacin Adco-indomethacin Accepted treatment
Indomethacin 50mg CAP Arthrexin Accepted treatment
Ketoprofen 200mg SRT Ketoflam Accepted treatment
Meloxicam 15mg TAB Zydus-meloxicam Flexocam Loxiflam Accepted treatment
Meloxicam 7.5mg TAB Zydus-meloxicam Flexocam Loxiflam Accepted treatment
Naproxen 250mg TAB/ECT Mylan-naproxen Napflam Naprel Accepted treatment
26
INGREDIENT STRENGTH DOSAGE FORM EXAMPLE 1 EXAMPLE 2 EXAMPLE 3 COMMENT
Naproxen 500mg TAB Napflam Accepted treatment
Naproxen 500mg SUP Nafasol Motivation required
Piroxicam 10mg CAP Adco-piroxicam Accepted treatment
Piroxicam 20mg CAP/DSP Xycam Roxifen Pyrocaps Accepted treatment
Corticosteroids, topical
Clobetasol 0.05% LOT Dermovate scalp Motivation required
Clobetasol 0.5mg CRM/UNG Dovate Xenovate Motivation required
Clobetasone CRM/UNG Eumovate Accepted treatment
Flucinolone 0.025mg/g CRM/UNG Cortoderm Accepted treatment
Betamethasone 0.10% CRM/UNG Persivate Repivate Vari-betamethasone Accepted treatment
Hydrocortisone 0.5mg UNG Dilucort Accepted treatment
Hydrocortisone 10mg/g CRM/UNG Vari-hydrocortisone Biocort (STX) Mylocort Accepted treatment
Hydrocortisone 5mg/g CRM/LOT Dilucort Link mezzoderm Accepted treatment
Ulcerative colitis
Corticosteroids, topical
Budesonide ENE Entocord Motivation required
Corticosteroids, oral
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Trolic Accepted treatment
5-ASA agents
Mesalazine 2g/50ml ENE Asacol Motivation required
Mesalazine 400mg TAB Asacol Motivation required
Mesalazine 800mg TAB Asacol Motivation required
Mesalazine 500mg TAB/SUP Asacol Pentasa Motivation required
Olsalazine 250mg CAP Dipentum Motivation required
Sulphasalazine 500mg TAB Salazopyrin Accepted treatment
Immunosuppressants
Azathioprine 50mg TAB Zaprine Azathioprine 50 PCH Azapress Accepted treatment
27
DIAGNOSIS AND TREATMENT PAIRS (DTP) CONDITIONS
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Adrenocortical Hypersecretion
Diuretics
Spironolactone 100mg TAB Spiractin Accepted treatment
Spironolactone 25mg TAB Spiractin Sandoz Spironolactone Accepted treatment
Adrenocortical Insufficiency
Corticosteroids Oral
Hydrocortisone 10mg TAB Covocort Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Accepted treatment
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Fludrocortisone 0.1mg TAB Florinef acetate Motivation required
Anaemia
Iron supplementation, oral
Ferrous salts TAB / CAP Ferrous Sulphate Special investigations
Iron and folic acid TAB / CAP Pregmal Autrin Fero-folic Special investigations
Vitamin B
Folic acid 0.5mg TAB Folic acid Special investigations
Folic acid 5mg TAB / CAP Be-tabs folic acid Special investigations
Cyanocobalamin INJ Vitamin B12 Special investigations
Arrhythmias
Aspirin
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Be-tabs aspirin Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment in children
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Antiarrythmics
Amiodarone 100mg TAB Arycor Hexarone Accepted treatment
Amiodarone 200mg TAB Arycor Hexarone Accepted treatment
Quinidine 200mg TAB Quinadine Motivation required
28
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Disopyramide 100mg CAP Rythmodan Motivation required
Propafenone 150mg TAB Rhythmol Motivation required
Flecainide 100mg TAB Tambocor Motivation required
Betablockers
Atenolol 100mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 50mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 25mg TAB Tenopress Accepted treatment
Bisoprolol 10mg TAB Cardicor Bilocor Adco-Bisocor Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Adco-Bisocor Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Propranolol 10mg TAB Indoblock Prodolol Purbloka Accepted treatment
Propronalol 40mg TAB Indoblock Prodolol Purbloka Accepted treatment
Sotalol 160mg TAB Sotahexal Motivation required
Sotalol 80mg TAB Sotahexal Motivation required
Cardiac Glycosides
Digoxin 0.05mg/ml SYR Lanoxin Paed Accepted treatment
Digoxin 0.0625mg TAB Lanoxin Accepted treatment
Digoxin 0.25mg TAB Lanoxin Purgoxin Accepted treatment
Calcium Channel Blockers
Diltiazem 180mg SRC Zildem SR Accepted treatment
Diltiazem 240mg SRC Zildem SR Accepted treatment
Diltiazem 90mg TAB Zildem Accepted treatment
Diltiazem 60mg TAB Zildem Accepted treatment
Verapamil 240mg SRT Verahexal Calcicard Ravamil Accepted treatment
Verapamil 80mg TAB Vasomil Accepted treatment
Verapamil 40mg TAB Vasomil Accepted treatment
Anticoagulants
Warfarin 5mg TAB Cipla-Warfarin Lennon warfarin Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Accepted treatment
Warfarin 1mg TAB Cipla-Warfarin Accepted treatment
Benign Prostatic Hypertrophy
Doxazosin 1mg TAB Adco-Doxazosin Cardugen Accepted treatment
Doxazosin 2mg TAB Adco-Doxazosin Accepted treatment
29
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Doxazosin 4mg TAB Adco-Doxazosin Cardugen Accepted treatment
Doxazosin (Extended Release)
4mg TAB Carzin XL Cardura XL Motivation required
Doxazosin (Extended Release)
8mg TAB Cardura XL Motivation required
Prazosin 1mg TAB Pratsiol Accepted treatment
Prazosin 2mg TAB Pratsiol Accepted treatment
Prazosin 5mg TAB Pratsiol Accepted treatment
Tamsulosin 0.4mg SRC Uromax Tamsul Flomax sr Motivation required
Finasteride 5mg TAB Fincar Finpro Proscar Motivation required
Dutasteride 0.5mg CAP Avodart Motivation required
Chronic Renal Failure
Ace Inhibitor and Combinations
Captopril 12.5mg TAB Captohexal Accepted treatment
Captopril 25mg TAB Captohexal Mylan Captopril Bio-Captopril Accepted treatment
Captopril 50mg TAB Captohexal Mylan Captopril Zapto Accepted treatment
Captopril and diuretics 50mg/25mg TAB Captoretic Zapto Co Capozide Accepted treatment
Enalapril 2.5mg TAB Renitec Accepted treatment
Enalapril 5mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 10mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 20mg TAB Alapren Ciplatec Pharmaperss Accepted treatment
Enalaprin and diuretics 20mg/12.5mg TAB Enap Co Pharmapress Co Accepted treatment
Lisinopril 20mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 10mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 5mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 2.5mg TAB Austell-lisinopril Accepted treatment
Lisinopril and diuretics 10mg/12.5mg TAB Lisoretic Lisozide Hexal-lisinopril Co Accepted treatment
Lisinopril and diuretics 20mg/12.5mg TAB Lisoretic Zestozide Hexal-lisinopril Co Accepted treatment
Perindopril 4mg TAB Prexum Vectoryl Cipla-Perindopril Accepted treatment
Perindopril 8mg TAB Vectoryl Cipla-Perindopril Accepted treatment
Perindopril 10mg TAB Prexum Coversyl Accepted treatment
Perindopril and diuretics 4mg/1.25mg TAB Prexum Plus Vectoryl Plus Accepted treatment
Ramipril 1.25mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 2.5mg TAB/CAP Austell-ramipril Ran-ramipril Rampil Accepted treatment
Ramipril 5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
30
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Ramipril 10mg TAB/CAP Austell-ramipril Ran-ramipril Rampil Accepted treatment
Trandolapril 0.5mg CAP Mavik Accepted treatment
Trandolapril 2mg CAP Mavik Accepted treatment
Angiotensin Receptor Blockers
Losartan 100mg TAB Zartan Cipla-Losartan Accepted treatment
Losartan 50mg TAB Lepitrin Cipla-Losartan Los-arb Accepted treatment
Losartan and diuretics 100mg/12.5mg TAB Fortzaar Accepted treatment
Losartan and diuretics 50mg/12.5mg TAB Cozaar Comp Accepted treatment
Valsartan 320mg TAB Diovan Motivation required
Valsartan 160mg TAB Tareg Motivation required
Valsartan 80mg TAB Tareg Motivation required
Valsartan 40mg TAB Diovan Motivation required
Valsartan and diuretics 320mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretics 320mg/50mg TAB Co-diovan Motivation required
Valsartan and diuretics 160mg/25mg TAB Co-diovan Plus Motivation required
Valsartan and diuretics 160mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretics 80mg/12.5mg TAB Co-tareg Motivation required
Beta Blockers and Combinations
Atenolol 100mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 50mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 25mg TAB Tenopress Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Sandoz Co-tenidone Tenchlor Adco-loten Accepted treatment
Atenolol and other diuretics 50mg/12.5mg TAB Sandoz Co-tenidone Tenchlor HS Accepted treatment
Atenolol and thiazides 100mg/25mg TAB Adco-loten Accepted treatment
Bisoprolol 10mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Calcium Channel Blockers
Amlodipine 10mg TAB Almadin Ciplavasc Amlate Accepted treatment
Amlodipine 5mg TAB Almadin Ciplavasc Amlate Accepted treatment
Diltiazem 240mg SRC Zildem SR Accepted treatment
Diltiazem 180mg SRC Zildem SR Accepted treatment
Diltiazem 90mg TAB Zildem Accepted treatment
Diltiazem 60mg TAB Zildem Accepted treatment
31
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Felodipine 10mg SRT Felodipine-hexal Accepted treatment
Felodipine 5mg SRT Felodipine-hexal Accepted treatment
Nifedipine 60mg TAB Fedaloc Macorel Accepted treatment
Nifedipine 30mg TAB Fedaloc Accepted treatment
Nifedipine 30mg SRT Adco-Vascard SR Fedaloc Accepted treatment
Nifedipine 20mg SRT Nifedalat SR Cipalat retard Accepted treatment
Diuretics
Hydrochlorothiazide 12.5mg TAB Ridaq Accepted treatment
Hydrochlorothiazide 25mg TAB Hexazide Ridaq Accepted treatment
Hydrochlorothiazide and potassium
50mg/300mg TAB Urirek-k Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
25mg/2.5mg TAB Amiloretic hs Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/25mg TAB Dyazide Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/5mg TAB Amiloretic Accepted treatment
Indapamide 2.5mg TAB Cipla-Indapamide Daptril Mylan-indapamide Accepted treatment
Furosemide 40mg TAB/CAP Diuresix Mylan-Furosemide Accepted treatment
Furosemide 10mg/ml SYR Lasix Oral Motivation required in adults
Erythropoetin and Supplements
Alfacalcidol 0.25mcg TAB One Alpha Special investigation
Alfacalcidol 1mcg TAB One Alpha Special investigation
Ferrous fumarate TAB Pregamal Special investigation
Ferrous sulfate 30mg TAB Ferrous sulfate Special investigation
Ferrous sulfate 100mg TAB Ferrous sulfate Special investigation
Folic acid 0.5mg TAB
Folic acid Special investigation
Folic acid 5mg TAB Be-tabs folic acid Special investigation
Iron multivitamins and folic acid
100mg TAB Autrin Ferograd Special investigation
Iron multivitamins and folic acid
100mg TAB Foliferr Special investigation
Erythropoetin INJ Repotin Recormon Eprex Special investigation
Darbepoetin INJ Aranesp Special investigation
Iron in other combinations INJ Ferofolic Special investigation
Calcium carbonate 300mg CHU Caltrate 300 Special investigation
Calcium carbonate 500mg CHU Virtual care Calcium Special investigation
32
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Calcium carbonate 500mg EFT Sandoz Calcium Forte Fizzical Special investigation
Calcium carbonate 500mg TAB Caltrate d Special investigation
Potassium Supplement
Potassium chloride 600mg TAB Plenish-K Accepted treatment
Hormone inhibitors
Cinacalcet 30mg TAB Senispar Motivation required
Cinacalcet 60mg TAB Senispar Motivation required
Complications of Hypertension
Calcium Channel Blockers
Amlodipine 10mg TAB Almadin Ciplavasc Amlate Accepted treatment
Amlodipine 5mg TAB Almadin Ciplavasc Amlate Accepted treatment
Diltiazem 240mg SRC Zildem SR Accepted treatment
Diltiazem 180mg SRC Zildem SR Accepted treatment
Diltiazem 90mg TAB Zildem Accepted treatment
Diltiazem 60mg TAB Zildem Accepted treatment
Verapamil 240mg SRT Verahexal Calcicard Ravamil Accepted treatment
Verapamil 80mg TAB Vasomil Accepted treatment
Verapamil 40mg TAB Vasomil Accepted treatment
Felodipine 10mg SRT Felodipine -hexal Accepted treatment
Nifedipine 60mg TAB Fedaloc Macorel Accepted treatment
Nifedipine 30mg TAB Fedaloc Accepted treatment
Nifedipine 30mg SRT Adco-Vascard SR Fedaloc Accepted treatment
Nifedipine 20mg SRT Nifedalat SR Cipalat Retard Accepted treatment
Cardiac Glycosides
Digoxin 0.05mg/ml SYR Lanoxin Paed Accepted treatment
Digoxin 0.0625mg TAB Lanoxin Accepted treatment
Digoxin 0.25mg TAB Lanoxin Accepted treatment
Diuretics
Hydrochlorothiazide and potassium-sparing agents
TAB Aldazide Accepted treatment
Furosemide 40mg TAB/CAP Diuresix Mylan-furosemide Beuresis Accepted treatment
Furosemide 10mg/ml SYR Lasix Oral Motivation required in adults
Indapamide 2.5mg TAB Cipla-Indapamide Daptril Mylan-indapamide Accepted treatment
Spironolactone 25mg TAB Spiractin Sandoz Spironolactone Accepted treatment
33
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Spironolactone 100mg TAB Spiractin Accepted treatment
Anticoagulants
Dypiridamole 100mg TAB Plato Accepted treatment
Dypiridamole 200mg SRC Persantin retard Accepted treatment
Dypiridamole 200mg/25mg CAP Asasantin Retard Accepted treatment
Dypiridamole 25mg TAB Plato Accepted treatment
Warfarin 5mg TAB Cipla-Warfarin Lennon warfarin Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Accepted treatment
Warfarin 1mg TAB Cipla-Warfarin Accepted treatment
Vasodilators
Sildenafil 20mg TAB Revatio Motivation required
Cushing’s syndrome
Growth hormone release inhibitor
Ketoconazole 200mg TAB Ketazol Nizoral Motivation required
Octreotide 0.05mg INJ Sandostatin Motivation required
Octreotide 0.1mg INJ Sandostatin Motivation required
Octreotide 0.2mg INJ Sandostatin Motivation required
Octreotide 10mg INJ Sandostatin LAR pre-filled Motivation required
Octreotide 20mg INJ Sandostatin LAR pre-filled Motivation required
Delusional disorders
Heterocyclic antidepressants
Amitriptyline 25mg TAB Trepiline Sandoz-Amitryptyline Accepted treatment
Dothiepin (dosulepin) 25mg CAP Thaden Sandoz-Dothiepen Accepted treatment
Dothiepin (dosulepin) 75mg TAB Thaden Sandoz-Dothiepen Accepted treatment
Imipramine 25mg TAB Ethipramine Tofranil Accepted treatment
Maprotiline 25mg TAB Ludiomil Motivation required
Maprotiline 75mg TAB Ludiomil Motivation required
Selective serotonin receptor inhibitors
Citalopram 10mg TAB Austell-Citalopram Accepted treatment
Citalopram 20mg TAB Austell-Citalopram Citalopram-Winthrop Sandoz-Citalopram Accepted treatment
Citalopram 40mg TAB Austell-Citalopram Citalopram-Winthrop Depramil Accepted treatment
Fluoxetine 20mg CAP / TAB A-lennon fluoxetine Zydus Fluoxetine Ranflocs Accepted treatment
Fluoxetine 40mg DSP Prohexal T Motivation required
34
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Other antidepressants
Sulpiride 200mg TAB Bio-Sulpiride Motivation required
Sulpiride 25mg SYR Eglonyl Motivation required
Sulpiride 50mg CAP Espiride Accepted treatment
Antipsychotics
Amisulpiride 200mg TAB Solian Motivation required
Amisulpiride 50mg TAB Solian Motivation required
Chlorpromazine 100mg TAB Largactil Accepted treatment
Chlorpromazine 25mg TAB Largactil Accepted treatment
Chlorpromazine 50mg TAB Largactil Accepted treatment
Clozapine 100mg TAB Cloment Accepted treatment
Clozapine 25mg TAB Cloment Accepted treatment
Haloperidol 0.5mg CAP Serenace Accepted treatment
Haloperidol 1.5mg TAB Serenace Sandoz Haloperidol Accepted treatment
Haloperidol 10mg TAB Serenace Accepted treatment
Haloperidol 5mg TAB Serenace Sandoz Haloperidol Accepted treatment
Risperidone 0.5mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 1mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 2mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 3mg TAB DRL-Risperidone Risperidone-Hexal Perizal Motivation required
Risperidone 4mg TAB Aspen Risperidone Risponz Motivation required
Trifluoperazine 1mg TAB Stelazine Accepted treatment
Trifluoperazine 5mg TAB Stelazine Accepted treatment
Zuclopenthixole 10mg TAB Clopixal Motivation required
Zuclopenthixole 2mg TAB Clopixal Motivation required
Endometriosis
Hormonal preparations, oral
Cyproterone 2mg TAB Diva -35 Ginette Minerva Motivation required
Cyproterone 50mg TAB Cipla-Cyproterone Acetate Cyproplex Androcur Motivation required
Desogestrel and estrogen TAB Mercilon Marvelon Motivation required
Drospirenone and estrogen TAB Yasmin Yaz Motivation required
Gestodene and estrogen TAB Minulette Melodene Femodene ed Motivation required
Levonorgestrel and estrogen TAB Biphasil Triphasil Motivation required
Medroxyprogesterone 5mg TAB Hexal-PMA Provera Accepted treatment
35
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Norethisterone 5mg TAB Primulot n Accepted treatment
Norethisterone and estrogen TAB Trinovum Motivation required
Norgestimate & oestrogen TAB Tricilest Motivation required
Antigonadotropins
Danazol 100mg CAP Danogen Ladazol Motivation required
Danazol 200mg CAP Danogen Ladazol Motivation required
Gonadotrophin Releasing Hormones and analogues
Goserelin 3.6mg INJ Zoladex Motivation required
Nafarelin 2 mg/mL NAS Synarel Motivation required
Leuprorelin 11.25mg INJ Lucrin Depot Motivation required
Hyperparathyroidism
Aminoquinolines
Chloroquine 150mg TAB Daramal Accepted treatment
Chloroquine 200mg TAB/CAP Nivaquine Plasmoquine Accepted treatment
Calcitonin
Calcitonin 200iu NAS Miacalcic nasal spray Motivation required
Calcitonin 100iu INJ Miacalcic Motivation required
Hormone inhibitors
Cinacalcet 30mg TAB Sensipar Motivation required
Cinacalcet 60mg TAB Sensipar Motivation required
Hyperthyroidism
Imidazole derivatives
Carbimazole 5mg TAB Neo-mercazole Motivation required
Beta blockers
Propranolol 10mg TAB Indoblok Prodorol Purbloka Accepted treatment
Propranolol 40mg TAB Indoblok Prodorol Purbloka Accepted treatment
Hypoparathyroidism
Calcium supplementation
Calcium TAB/EFT B-cal Accepted treatment
Calcium and vitamin D TAB B-cal d Caltrate d Accepted treatment
Idiopathic thrombocytopaenic purpura
Corticosteroids –Oral
Betamethasone 0.5mg TAB Betanoid Celestone Motivation required
36
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Accepted treatment
Alkylating agents
Cyclophosphamide 50mg TAB Endoxan Motivation required
Immunosuppressive agents
Azathioprine 50mg TAB Zaprine Azathioprine 50 PCH Azapress Accepted treatment
Methotrexate 2.5mg TAB Methotrexate Accepted treatment
Ischaemic Heart Disease
Aspirin
Acetylsalicylic acid 100mg TAB Bayer Aspirin Cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf Aspirin Be-Tabs Aspirin Aspirin (Resmed) Accepted treatment in children
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Anticoagulants
Warfarin 5mg TAB Cipla-Warfarin Lennon Warfarin Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Accepted treatment
Warfarin 1mg TAB Cipla-Warfarin Accepted treatment
Dypiridamole 100mg TAB Plato Accepted treatment
Dypiridamole 200mg SRC Persantin Accepted treatment
Dypiridamole 200mg/25mg CAP Asasantin Retard Accepted treatment
Dypiridamole 25mg TAB Plato Accepted treatment
Menopause
Hormone replacement therapy
Conjugated estrogen TAB Premarin Accepted treatment
Drospirenone and estrogen 1mg/2mg TAB Angeliq Accepted treatment
Dydrogesterone and estrogen
TAB Femoston conti Accepted treatment
Estradiol PAD/TAB/IMP Evorel Vagifem Accepted treatment
Estriol 2mg TAB Synapause e3 Accepted treatment
Medrogestone and estrogen TAB Premelle Accepted treatment
Medroxyprogesterone TAB Hexal PMA Provera Accepted treatment
Norethisterone and estrogen PAD/TAB Trinovum Accepted treatment
Norgestral and estrogen TAB Tricilest Accepted treatment
37
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Alpha-2 agonists
Clonidine 0.025mg TAB Dixarit Menograine Accepted treatment
Mycobacterial Infections (Excluding TB)
Pulmonary Disease & Others
Rifampicin 600mg TAB Rimactane Special Investigations
Rifampicin 100mg/5ml SUS R-Cin rifampicin Special Investigations
Ethambutol 400mg TAB Sandoz Ethambutol Special Investigations
Clarithromycin 250mg TAB Clacee Special Investigations
Clarithromycin 500mg TAB Clacee Clarihexal Special Investigations
Clarithromycin 250mg/5ml SUS Clarihexal Ran-Clarithromycin Special Investigations
Clarithromycin 125mg/5ml SUS Clarihexal Ran-Clarithromycin Special Investigations
Tetracycline 250mg TABS/CAPS Be-oxytet Oxypan Special Investigations
Neonatal Cardiac Dysrhythmia
Antiarrhythmics
Amiodarone 100mg TAB Arycor Cordarone X Motivation required
Amiodarone 150mg/3ml INJ Cordarone X Motivation required
Quinidine 200mg TAB Quinidine Sulphate Motivation required
Disopyramide 100mg CAP Rhythmodan Motivation required
Propafenone 150mg TAB Rythmol Motivation required
Flecainide 100mg TAB Rythmol Motivation required
Beta blockers
Propranolol 10mg TAB Indoblok Prodorol Purbloka Accepted treatment
Sotalol 80mg TAB Sotahexal Motivation required
Atenolol 25mg TAB Tenopress Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Cardiac Glycosides
Digoxin 0.05mg/ml SYR Lanoxin Paed Accepted treatment
Neonatal Cardiac Failure
Cardiac Glycosides
Digoxin 0.05mg/ml SYR Lanoxin Paed Accepted treatment
Diuretics
Furosemide 10mg/ml SYR Lasix Oral Accepted treatment
38
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Nephritic Syndrome
Calcium Channel Blockers
Amlodipine 10mg TAB Almadin Ciplavasc Amlate Accepted treatment
Amlodipine 5mg TAB Almadin Ciplavasc Amlate Accepted treatment
Diltiazem 240mg SRC Zildem SR Accepted treatment
Diltiazem 180mg SRC Zildem SR Accepted treatment
Diltiazem 90mg TAB Zildem Accepted treatment
Diltiazem 60mg TAB Zildem Accepted treatment
Felodipine 10mg SRT Felodipine-hexal Accepted treatment
Felodipine 5mg SRT Felodipine-hexal Accepted treatment
Nifedipine 60mg SRT Fedaloc Motivation required
Nifedipine 30mg SRT Adco-Vascard SR Fedaloc Accepted treatment
Nifedipine 20mg SRT Nifedalat SR Cipalat Retard Accepted treatment
Diuretics
Hydrochlorothiazide 12.5mg TAB Ridaq Accepted treatment
Hydrochlorothiazide 25mg TAB Hexazide Ridaq Accepted treatment
Hydrochlorothiazide and potassium
50mg/300mg TAB Urirex K Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
25mg/2.5mg TAB Amiloretic hs Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/25mg TAB Dyazide Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/5mg TAB Amiloretic Accepted treatment
Indapamide 2.5mg TAB Cipla-Indapamide Daptril Accepted treatment
Furosemide 40mg TAB/CAP Diuresix Mylan-Furosemide Beuresis Accepted treatment
Furosemide 10mg/ml SYR Lasix Oral Motivation required in adults
Beta Blocker and Combinations
Atenolol 100mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 50mg TAB Tenopress Sandoz Atenolol B-block Accepted treatment
Atenolol 25mg TAB Tenopress Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Sandoz Co-tenidone Accepted treatment
Atenolol and other diuretics 50mg/12.5mg TAB Sandoz Co-tenidone Accepted treatment
Atenolol and thiazides 100mg/25mg TAB Sandoz Co-tenidone Tenchlor Adco-loten Accepted treatment
Bisoprolol 10mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Adco-bisocor Accepted treatment
39
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Bisoprolol 2.5mg TAB Cardicor Accepted treatment
Ace Inhibitor And Combinations
Captopril 12.5mg TAB Captohexal Accepted treatment
Captopril 25mg TAB Captohexal Mylan-captopril Bio-Captopril Accepted treatment
Captopril 50mg TAB Captohexal Mylan-captopril Zapto Accepted treatment
Captopril and diuretics 50mg/25mg TAB Captoretic Zapto-Co Capozide Accepted treatment
Enalapril 2.5mg TAB Renitec Accepted treatment
Enalapril 5mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 10mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalapril 20mg TAB Alapren Ciplatec Pharmapress Accepted treatment
Enalaprin and diuretics 20mg/12.5mg TAB Enap-Co Pharmapress co Accepted treatment
Lisinopril 20mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 10mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 5mg TAB Sinopren Simayla-lisinopril Zemax Accepted treatment
Lisinopril 2.5mg TAB Austell-lisinopril Accepted treatment
Lisinopril and diuretics 10mg/12.5mg TAB Lisoretic Lisozide Hexal-lisinopril Co Accepted treatment
Lisinopril and diuretics 20mg/12.5mg TAB Lisoretic Zestozide Hexal-lisinopril Co Accepted treatment
Perindopril 4mg TAB Prexum Vectoryl Cipla-Perindopril Accepted treatment
Perindopril 8mg TAB Vectoryl Cipla-perindopril Accepted treatment
Perindopril 10mg TAB Prexum Coversyl Accepted treatment
Perindopril and diuretics 4mg/1.25mg TAB Prexum plus Coversyl Plus Accepted treatment
Ramipril 1.25mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 2.5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 5mg TAB/CAP Austell-ramipril Ramiwin Rampil Accepted treatment
Ramipril 10mg TAB/CAP Austell-ramipril Ran-ramipril Rampil Accepted treatment
Trandolapril 0.5mg CAP Mavik Accepted treatment
Trandolapril 2mg CAP Mavik Accepted treatment
Angiotensin receptor blockers and combinations
Losartan 100mg TAB Zartan Cipla-Losartan Accepted treatment
Losartan 50mg TAB Lepitrin Cipla-Losartan Los-Arb Accepted treatment
Losartan and diuretics 100mg/12.5mg TAB Fortzaar Accepted treatment
Losartan and diuretics 50mg/12.5mg TAB Cozaar-comp Accepted treatment
Valsartan 320mg TAB Diovan Motivation required
40
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Valsartan 160mg TAB Tareg Motivation required
Valsartan 80mg TAB Tareg Motivation required
Valsartan 40mg TAB Diovan Motivation required
Valsartan and diuretics 320mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretics 320mg/25mg TAB Co-diovan Motivation required
Valsartan and diuretics 160mg/25mg TAB Co-diovan plus Motivation required
Valsartan and diuretics 160mg/12.5mg TAB Co-diovan Motivation required
Valsartan and diuretics 80mg/12.5mg TAB Co-tareg Motivation required
Potassium Supplements
Potassium chloride 600mg TAB Plenish-k Accepted treatment
Nephrogenic Diabetes Insipidus
Thiazide diuretic
Hydrochlorothiazide 25mg TAB Hexazide Ridaq Accepted treatment
Hydrochlorothiazide 12.5mg TAB Ridaq Accepted treatment
Neurological abnormalities of the newborn- Spasticity
Muscle relaxants
Baclofen 10mg TAB Bio-baclofen Teva-baclofen Lioresal Accepted treatment
Dantrolene 20mg/70ml INJ Dantrium Motivation required
Diabetes Mellitus – Complications (Neurological)
Tricyclic antidepressants
Amitryptiline 10mg TAB Trepiline Accepted treatment
Amitryptiline 25mg TAB Trepiline Sandoz Amitriptyline Accepted treatment
Anti-convulsants
Carbamazepine 200mg TAB Degranol CPL-carbamazepine Accepted treatment
Ovarian dysfunction Hormonal preparations, oral
Cyproterone 2mg TAB Diva -35 Ginette Minerva Motivation required
Cyproterone 50mg TAB Cipla-Cyproterone Acetate Cyproplex Androcur Motivation required
Desogestrel and estrogen TAB Mercilon Marvelon Motivation required
Drospirenone and estrogen TAB Yasmin Yaz Motivation required
Gestodene and estrogen TAB Minulette Melodene Femodene ed Motivation required
Levonorgestrel and estrogen TAB Biphasil Triphasil Motivation required
Norethisterone and estrogen TAB Trinovum Motivation required
41
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Norgestimate & oestrogen TAB Tricilest Motivation required
Pemphigus and other disseminated bullous skin disease
Immuosuppressants
Azathioprine 50mg TAB Zaprine Azapress Azathioprine 50 PCH Accepted treatment
Methotrexate 2.5mg TAB Methotrexate Accepted treatment
Ciclosporin 25mg CAP Sandimmun neural soft gel Motivation required
Ciclosporin 100mg CAP Sandimmun neural soft gel Motivation required
Corticosteroids oral
Prednisone 5mg CAP Be-tabs prednisone Panafcort Trolic Accepted treatment
Prednisolone 5mg TAB Lenisolone Capsoid Accepted treatment
Alkylating agents
Cyclophosphamide 50mg TAB Endoxan Motivation required
Peptic Ulcer Disease
H2-receptor antagonists
Cimetidine 200mg TAB Bio-Cimetidine Cimlok Lenamet Accepted treatment
Cimetidine 400mg TAB Bio-Cimetidine Cimlok Lenamet Accepted treatment
Ranitidine 150mg TAB Ranihexal Ranit Histak Accepted treatment
Ranitidine 300mg TAB Ranihexal Ranit Histak Accepted treatment
Ranitidine 150mg/10ml SYR Zantac Motivation required
Proton Pump Inhibitors
Omeprazole 10mg CAP Omez Altosec DRL-omeprazole Accepted treatment
Omeprazole 20mg CAP Nozer Altosec Omez Accepted treatment
Omeprazole 40mg TAB/CAP Omez Losec mups DRL-omeprazole Accepted treatment
Pantoprazole 20mg TAB Topzole Pantoloc Controloc Motivation required
Pantoprazole 40mg TAB Topzole Pantoloc Controloc Motivation required
Esomeprazole 20mg TAB Nexiam Motivation required
Esomeprazole 40mg TAB Nexiam Motivation required
Lansoprazole 15mg TAB/CAP Lansoloc Lancap Aspen Lansoprazole Motivation required
Lansoprazole 30mg TAB/CAP Lansoloc Lancap Aspen Lansoprazole Motivation required
Rabeprazole 10mg TAB Pariet Motivation required
Rabeprazole 20mg TAB Pariet Motivation required
42
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Peripheral vascular disease
Aspirin
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf Aspirin Be-tabs aspirin Aspirin (Resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment in children
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Anticoagulants
Warfarin 1mg TAB Cipla-warfarin Accepted treatment
Warfarin 3mg TAB Cipla-warfarin Accepted treatment
Warfarin 5mg TAB Cipla-warfarin Lennon warfarin Accepted treatment
Pituitary hyperfunction
Dopamine Agonists
Bromocriptine 2.5mg TAB Aspen Bromocriptine Special investigations
Carbergoline 0.5mg TAB Dostinex Special investigations & motivation
Growth Hormone Release Inhibitors
Octreotide 0.05mg/ml INJ Sandostatin Special investigations
Pituitary hypofunction
Thyroid Hormones
Levothyroxine 100mcg TAB Eltroxin Euthyrox Accepted treatment
Levothyroxine 50mcg TAB Eltroxin Euthyrox Accepted treatment
Levothyroxine 25mcg TAB Euthyrox Accepted treatment
Liothyronine 20mcg TAB Tertroxin Accepted treatment
Thyroxine and liothyronine 90mcg/10mcg TAB Diotroxin Accepted treatment
Growth Hormone
Humatrope 6mg INJ Isopto homotropine Motivation required
Sex Hormones
Depo- Testosterone 100mg/ml INJ Depot testosterone Motivation required
Conjugated oestrogens 0.625 mg TAB Premarin Accepted treatment
Conjugated oestrogens 0.3mg TAB Premarin Accepted treatment
Glucocorticoids,oral
Hydrocortisone 10mg TAB Covocort Accepted treatment
43
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Schizo-affective disorder
Heterocyclic antidepressants
Amitriptyline 25mg TAB Trepiline Accepted treatment
Dothiepin (dosulepin) 25mg CAP Thaden Sandoz -dothiepin Accepted treatment
Dothiepin (dosulepin) 75mg TAB Thaden Sandoz-dothiepin Accepted treatment
Imipramine 25mg TAB Ethipramine Accepted treatment
Maprotiline 25mg TAB Ludiomil Motivation required
Maprotiline 75mg TAB Ludiomil Motivation required
Selective serotonin receptor inhibitors
Citalopram 10mg TAB Austell-citalopram Accepted treatment
Citalopram 20mg TAB Austell-citalopram Citalopram-Winthrop Sandoz-citalopram Accepted treatment
Citalopram 40mg TAB Austell-citalopram Citalopram-Winthrop Depramil Accepted treatment
Fluoxetine 20mg CAP / TAB A-lennon fluoxetine Zydus-fluoxetine Ranflocs Accepted treatment
Fluoxetine 40mg DSP Prohexal T Motivation required
Other
Sulpiride 200mg TAB Bio-Sulpiride Motivation required
Sulpiride 25mg SYR Eglonyl Motivation required
Sulpiride 50mg CAP Espiride Sandoz Sulpiride Accepted treatment
Monoamine oxidase type A inhibitors
Moclobemide 150mg TAB Depnil Motivation required
Moclobemide 300mg TAB Depnil Motivation required
Mood stabilisers
Lithium 250mg TAB Camcolit Accepted treatment
Lithium 400mg TAB Camcolit Accepted treatment
Lithium 450mg TAB Quinolum Retard Accepted treatment
Antipsychotics
Amisulpiride 200mg TAB Solian Motivation required
Amisulpiride 50mg TAB Solian Motivation required
Chlorpromazine 100mg TAB Largactil Accepted treatment
Chlorpromazine 25mg TAB Largactil Accepted treatment
Chlorpromazine 50mg TAB Largactil Accepted treatment
Clozapine 100mg TAB Cloment Accepted treatment
Clozapine 25mg TAB Cloment Accepted treatment
44
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Haloperidol 0.5mg CAP Serenace Accepted treatment
Haloperidol 1.5mg TAB Serenace Sandoz Haloperidol Accepted treatment
Haloperidol 10mg TAB Serenace Accepted treatment
Haloperidol 5mg TAB Serenace Sandoz Haloperidol Accepted treatment
Risperidone 0.5mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 1mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 2mg TAB DRL-Risperidone Risperidone-Hexal Mylan-Risperidone Motivation required
Risperidone 3mg TAB DRL-Risperidone Risperidone-Hexal Perizal Motivation required
Risperidone 4mg TAB Aspen Risperidone Risponz Motivation required
Trifluoperazine 1mg TAB Stelazine Accepted treatment
Trifluoperazine 5mg TAB Stelazine Accepted treatment
Zuclopenthixole 10mg TAB Clopixol Motivation required
Zuclopenthixole 2mg TAB Clopixol Motivation required
Spinal cord injuries
Antipropulsives
Loperamide 2mg TAB/CAP Adco loperamide Gastron Imodium Accepted treatment
Loperamide 1mg/5ml SYR Adco loperamide Imodium Accepted treatment
Laxatives
Bisacodyl 5mg TAB Dulcolax Accepted treatment
Glycerol SYR / SUP Glycerine Accepted treatment
Ispaghula and combinations GRA / SAC Fybogel Agiolax Accepted treatment
Lactulose 3.3g/5ml SYR Duphalac Aculax Adco-liquilax Accepted treatment
Lactulose SAC Duphalac dry Laxette dry Accepted treatment
Senna glycosides and combinations
TAB / GRA Senokot Soflax Accepted treatment
Heterocyclic Antidepressants
Amitriptyline 10mg TAB Trepiline Accepted treatment
Amitriptyline 25mg TAB Trepiline Sandoz-amitriptyline Accepted treatment
Muscle Relaxants
Baclofen 10mg TAB Bio-baclofen Accepted treatment
Baclofen 25mg TAB Lioresal Motivation required
Orphenadrine 100mg TAB Norflex Accepted treatment
Antibiotics, oral
Nitrofurantoin 50mg CAP Macrodantin Accepted treatment
45
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Nitrofurantoin 100mg CAP Macrodantin Accepted treatment
Stroke
Aspirin
Acetylsalicylic acid 100mg TAB Bayer Aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf Aspirin Be-tabs aspirin Aspirin (resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment in children
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Anticoagulants
Warfarin 1mg TAB Cipla-warfarin Accepted treatment
Warfarin 3mg TAB Cipla-warfarin Accepted treatment
Warfarin 5mg TAB Cipla-warfarin Lennon warfarin Accepted treatment
Thalassemia
Supplemments
Folic acid 0.5mg TAB Folic Acid Accepted treatment
Chelating agents
Deferasirox 125mg DSP Exjade Special investigation
Deferasirox 250mg DSP Exjade Special investigation
Deferasirox 500mg DSP Exjade Special Investigation
Deferoxamine 500mg INJ Desferal Special investigation
Thromboembolic disease
Aspirin
Acetylsalicylic acid 100mg TAB Bayer Aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf Aspirin Be-tabs aspirin Aspirin (resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment in children
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Anticoagulants
Warfarin 1mg TAB Cipla-warfarin Accepted treatment
Warfarin 3mg TAB Cipla-warfarin Accepted treatment
Warfarin 5mg TAB Cipla-warfarin Lennon warfarin Accepted treatment
46
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Transient Ischaemic Attack
Aspirin
Acetylsalicylic acid 100mg TAB Bayer Aspirin cardio Disprin CV Myoprin Accepted treatment
Acetylsalicylic acid 125mg TAB Lo-Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf Aspirin Be-tabs aspirin Aspirin (resmed) Accepted treatment
Acetylsalicylic acid 60mg TAB Genpharma Children Aspirin Accepted treatment in children
Acetylsalicylic acid 81mg ECT Ecotrin Accepted treatment
Anticoagulants
Warfarin 1mg TAB Cipla-warfarin Accepted treatment
Warfarin 3mg TAB Cipla-warfarin Accepted treatment
Warfarin 5mg TAB Cipla-warfarin Lennon warfarin Accepted treatment
Tuberculosis
Drugs
Ethambutol 400mg TAB Sandoz ethambutol Special investigations
Isoniazid 100mg TAB Be-tabs Isoniazid Special investigations (also prophylaxis)
Pyrazinamide 500mg TAB Sandoz Pyrazinamide Special investigations
Rifampicin 450mg TAB Rimactane Special investigations
Rifampicin 600mg TAB Rimactane Special investigations
Rifampicin 150mg CAP Rimactane Special investigations
Rifampicin 300mg CAP Rimactane Special investigations
Rifampicin 100mg/5ml SUS R-cin Special investigations
Rifampicin & isoniazid 150/75mg TAB Rimactazid Special investigations
Rifampicin & isoniazid 300/150mg TAB Rimactazid Special investigations
Rifampicin & isoniazid 60/30mg TAB Rimactazid Paed Special investigations
Rifampicin, isoniazid & pyrazinamide
60/30/150mg TAB Rimcure Paed 3 FDC Special investigations
Rifampicin, isoniazid, pyrazinamide & ethambutol
150/75/400/275mg TAB Rifafour E- 275 Rimstar 4 -FDC Special investigations
Streptomycin 1g/3ml INJ Bio-strep Special investigations
Pyridoxine 25mg TAB Pyridoxine Be-tabs Pyridoxine Accepted treatment
Pyrazinamide 500mg TAB Sandoz Pyrazinamide Special investigations
Ethambutol 400mg TAB Sandoz ethambutol Special investigations
Ethionamide 250mg TAB Ethatyl Special investigations
Ofloxacin 200mg TAB Zanocin Tafloc Special investigations
47
INGREDIENT STRENGTH DOSAGE FORM Example 1 Example 2 Example 3 COMMENT
Ofloxacin 400mg TAB Zanocin Tafloc Special investigations
Ciprofloxacin 250mg TAB Ciplox Special investigations
Ciprofloxacin 500mg TAB Ciplox Special investigations
Kanamycin 1g/3ml INJ Bio-kanamycin Special investigations
Amikacin 100mg INJ Amikacin-fresenius Special investigations
Amikacin 250mg INJ Amikacin-fresenius Special investigations
Amikacin 500mg INJ Amikacin-fresenius Special investigations
Amikacin 1000mg INJ Amikacin-fresenius Special investigations
Terizidone 250mg CAP Terivalidin Special investigations
Cycloserine 250mg CAP Aspen Cycloserine Special investigations
Tuberculoid Leprosy
Rifampicin 450mg TAB Rimactane Special Investigation
Rifampicin 600mg TAB Rimactane Special Investigation
Rifampicin 150mg CAP Rimactane Special Investigation
Rifampicin 300mg CAP Rimactane Special Investigation
Rifampicin 450mg TAB Rimactane Special Investigation
Dapsone 100mg TAB Dapsone Special Investigation
Valvular heart disease
Antibiotics
Benzylpenicillin INJ Bio-pen Accepted treatment
Phenoxymethylpenicillin 250mg TAB Betapen Pen VK Accepted treatment
Erythromycin 250mg CAP Adco-erythromycin Betamycin Accepted treatment