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Revised item list (Pharmaceuticals) 2016/2017
Page 1
Approved list of Pharmaceutical items
(Formulary revision 2016/2017)
Medical Supplies Division
Revised item list (Pharmaceuticals) 2016/2017
Page 2
Members of the Core Committee – Formulary Revision 2016/2017
(Pharmaceuticals)
1. Dr. Lal Panapitiya, Director/ Medical Supplies Division
2. Dr. Kamal Jayasinghe, Chief Executive Officer/NMRA
3. Dr.A.T.S. Sudarshana, Deputy Director/ Medical Supplies Division
4. Prof. Laal Jayakody, Professor of Pharmacology, University of Colombo
5. Prof. Gita Fernando, Emeritus Professor of Pharmacology, University of Sri Jayawardenapura
6. Prof. Rohini Fernandopulle, Professor of Pharmacology,Kothalawala Defence University
7. Prof. Shalini Sri Ranganathan, Professor in Pharmacology,University of Colombo
8. Prof. Priyadarshani Galappatthy, Professor in Pharmacology, University of Colombo
9. Prof. Athula Kaluarachchi, Professor in Obstetrics & Gynecology, University of Colombo
10. Prof. Raveen Hanwella, Professor of Psychiatry, University of Colombo
11. Prof. Pujitha Wickramasinghe, Professor in Pediatrics, University of Colombo
12. Dr. Ananda Wijewickrama, Consultant Physician, National Institute of Infectious Diseases
13. Dr. Mahanama Gunesekara, Consultant Surgeon, National Hospital of Sri Lanka
14. Dr. Geethika Patabendige, Consultant Clinical Microbiologist, National Hospital of Sri Lanka
15. Dr. Anoma Perera, Consultant Anaesthesiologist, Lady Ridgway Hospital
16. Mr. E.D.Weerarathne, Former Assistant Director, Medical Supplies Division
Revised item list (Pharmaceuticals) 2016/2017
Page 3
Level demarcation
Level 01 – Primary Medical Care Units(Central Dispensaries, Maternity Clinics)
Level 02 – Divisional Hospitals (District Hospitals, Divisional Hospitals)
Level 03 - Base Hospitals
Level 04 – Provincial General Hospitals, Teaching Hospitals, District General Hospitals
Vital, Essential and Non-essential status
V- Vital drugs are potentially lifesaving and crucial for providing basic health services. It should
be available at all times.
E- Those drugs that satisfy the health care needs of the majority of the population; they should
therefore be available at all times in adequate amounts and in appropriate dosage forms, at a
price the community can afford. (Essential drugs are effective against less severe but are
nevertheless significant forms of illness but are not absolutely vital to providing basic health
care).
N- Non essential drugs are used for minor illnesses are of questionable efficacy or have a
comparatively high cost for a marginal therapeutic advantage.
Regular Items
Item this had been approved to be included in the formulary for the use of general practice.
These items will be regularly supplied by MSD.
Complimentary Items
Essential medicines for priority diseases for which specialized diagnostic or monitoring facilities
and/or specialist medical care and /or specialist training are needed. In case of doubt, medicines
may also be listed as complimentary on the basis of consistence higher costs or less attractive in
a variety of settings.
Named patient items
The items issued for a particular patient for a specific indication
Revised item list (Pharmaceuticals) 2016/2017
Page 4
Table of Contents
1. Drugs used in Infections
1.1. Members of the sub committee 06
1.2. Approved item list 07
2. Drugs used in Cardiovascular system
2.1. Members of the sub committee 17
2.2. Approved item list 18
3. Drugs used in Central Nervous System
3.1. Members of the sub committee 25
3.2. Approved item list 26
4. Drugs affecting Nutrition and Blood
4.1. Members of the sub committee 32
4.2. Approved item list 33
5. Drugs used in Respiratory system
5.1. Members of the sub committee 40
5.2. Approved item list 41
6. Vaccines and Immunological products
6.1. Members of the sub committee 46
6.2. Approved item list 47
7. Drugs used in Endocrine system
7.1. Members of the sub committee 50
7.2. Approved item list 51
8. Drugs used in Gastrointestinal system
8.1. Members of the sub committee 48
8.2. Approved item list 49
9. Drugs acting on the Eye
9.1. Members of the sub committee 61
9.2. Approved item list 62
10. Drugs used in the treatment of diseases of Ear, Nose and Oropharynx
10.1. Members of the sub committee 66
10.2. Approved item list 67
Revised item list (Pharmaceuticals) 2016/2017
Page 5
11. Drugs acting on the Skin
11.1. Members of the sub committee 69
11.2. Approved item list 70
12. Drugs used in the Malignant diseases
12.1. Members of the sub committee 74
12.2. Approved item list 75
13. Drugs used in Obstetrics and Gynecology
13.1. Members of the sub committee 82
13.2. Approved item list 83
14. Drugs use in Renal Diseases
14.1. Members of the sub committee 86
14.2. Approved item list 87
15. Drugs used in the treatment of musculoskeletal and Joint Diseases
15.1. Members of the sub committee 93
15.2. Approved item list 94
16. Drugs used in Anaesthesia
16.1. Members of the sub committee 97
16.2. Approved item list 98
17. Antidotes
17.1. Members of the sub committee 103
17.2. Approved item list 104
18. Antiseptics and disinfectants 106
19. Surgical Dressings
19.1. Members of the sub committee 108
19.2. Approved item list 109
Revised item list (Pharmaceuticals) 2016/2017
Page 6
01. Drugs used in Infections
1.1. Members of the sub committee
1. Dr. Lal Panapitiya, Director, Medical Supplies Division
2. Prof. Rohini Fernandopulle, Professor of Pharmacology
3. Prof. Shalini Sri Ranganathan, Professor in Pharmacology, Faculty of Medicine, Uni of
Colombo
4. Dr. Geethika Patabadige, Consultant Clinical Microbiologist, NHSL
5. Dr. Kushlani Jayatilleke, Consultant Microbiologist, SJGH
6. Dr. Kanthi Nanayakkara, Consultant Vaccinologist and Virologist, MRI
7. Dr. Nadeeka Janage, Consultant Virologist, T.H.Kandy
8. Dr. Primali Jayasekara, Consultant Mycologist, MRI
9. Dr. Ananda Wijewickrama, Consultant Physician, National Institute of Infectious Diseases
10. Dr. Ajantha Liyanage, Consultant Physician, T.H.Kalubowila
11. Dr. Surantha Perera, Consultant Peadiatrician, Kethumathie Hospital
12. Dr. Sameera Jayasinghe, Consultant Surgeon, Accident service, NHSL
13. Dr. Nadeeja Samarasinghe, Consultant Surgeon, B.H.Dambadeniya
14. Mr. E.D.Weerarathne, Former Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 7
1.2. Approved item list - Drugs used in Infections
Drugs available for all levels of Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00100101 Amoxicillin capsule 250mg R E
2 00100102 Amoxycillin capsule 500mg R E
3 00100103 Amoxicillin tablet ( soluble ) 125mg R E
4 00100104
Amoxicillin oral suspension 125mg / 5ml, 100ml
bottle R E
5
New
00100403
Phenoxymethyl penicillin oral Solution 125mg
/5ml, 100ml R E
6 00100402 Phenoxymethyl penicillin tablet 250 mg R E
7
New
00100404 Phenoxymethyl penicillin tablet 500 mg R E
8
New
00100805 Flucloxacillin capsule 250mg R E
9 00100801 Flucloxacillin capsule 500mg R E
10
New
00100804
Flucloxacillin oral solution 125mg/5ml, 100ml
bottle R E
11 00101301 Cefalexin capsule 250mg R E
12 00101302 Cefalexin syrup 125 mg / 5ml,100ml bottle R E
13 00101303 Cefalexin dispersible tablet 125mg R N
14 00101304 Cephalexin capsule 500mg C N
15 00102301 Doxycycline hydrochloride capsule 100mg R E
16 00102903
Erythromycin oral suspension 125mg / 5 ml, 100ml
bottle R N
17 00103001 Clarithromycin tablet 250mg R E
18 00103006 Clarithromycin tablet 500mg C E
19 00103002
Clarithromycin lactobionate for IV infusion 500mg
vial R E
20
New
00103903 Trimethoprim tablet 200 mg R E
21
New
00103901 Trimethoprim tablet 100mg R E
22
New
00103902
Trimethoprim oral suspension 50mg / 5ml, 100ml
bottle R E
23 00105201 Metronidazole tablet 200mg R E
24 00105202 Metronidazole tablet 400 mg R E
25
New
00105204
Metronidazole oral suspension 200mg/5ml, 100ml
bottle R E
Revised item list (Pharmaceuticals) 2016/2017
Page 8
26 00105301 Furazolidone tablet 100mg R N
27 00105302
Furazolidone oral suspension 25mg / 5ml,100ml
bottle R N
28 00105501 Nalidixic acid tablet 250mg R N
29 00105502 Nalidixic acid tablet 500mg R E
30 00105901 Nitrofurantoin tablet 50mg R E
31
New
00105903 Nitrofurantoin syrup 25mg/5ml, 300ml bottle R E
32 00106601 Mebendazole tablet 100mg R E
33 00106602 Mebendazole tablet 500mg R N
34 00106901 Diethyl carbamazine citrate tablet 50mg R E
35 00108801 Albendazole tablet 400mg C N
36
New
00108802 Albendazole syrup 200mg/5ml ,30ml bottle C N
37 00106001 Chloroquine phosphate tablet 250mg R E
38 00106101 Primaquine tablets 7.5 mg R E
Drugs available for Level 2,3 & 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 00100201 Benzylpenicillin injection 1 million unit vial R E
2 00100301 Benzathine penicillin injection 1.2 million unit vial R E
3 00100601 Ampicillin Injection 250mg vial R E
4
New
00100603 Ampicillin injection 1g vial
R E
5 00100704 Cloxacillin injection 250 mg vial R E
6 00100705 Cloxacillin injection 500mg vial R E
7 00100802 Flucloxacillin injection 500mg vial R E
8
New
00100803 Flucloxacillin injection 1g vial
R E
9 00105601 Norfloxacin tablet 400 mg R N
10 00107901 Aciclovir tablet 200mg R E
11 00107902 Aciclovir tablet 800mg R N
12
New
00107904
Aciclovir oral suspension 200mg / 5ml, 125ml
bottle R N
Drugs available for Level 3 & 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00100901 Co-amoxyclav tablet 375mg R E
Revised item list (Pharmaceuticals) 2016/2017
Page 9
2 00100902 Co-amoxiclav tablet 625mg R E
3 00100903
Co-Amoxiclav oral suspension 125/31mg, /5ml,
100ml bottle R E
4
New
00100906 Co-Amoxiclav dispersible tablet 125mg R E
5 00100904 Co-amoxyclav injection 500/100mg vial R E
6 00100905 Co-amoxyclav injection 1000/200mg vial R E
7 00101001
Piperacillin 4g with tazobactam injection 500mg
vial C N
8 00101202
Ticarcillin disodium 3g & Clavulanate potassium
200mg injection vial C E
9 00101401 Cefuroxime tablet 125mg R N
10 00101403 Cefuroxime tablet 500mg R E
11 00101404
Cefuroxime oral suspension 125mg /5ml, 100ml
bottle C E
12 00101405 Cefuroxime injection 250mg vial R E
13 00101406 Cefuroxime injection 750mg vial R E
14
New
00101503 Cefotaxime injection 500mg vial R E
15 00101502 Cefotaxime injection 1g vial R E
16 00101601 Ceftazidime Injection 500mg vial R E
17 00101602 Ceftazidime injection 1g vial R E
18 00101703 Ceftriaxone injection 500mg vial R N
19 00101704 Ceftriaxone injection 1g vial R N
20 00102101 Meropenem injection 500mg vial C E
21 00102102 Meropenem injection 1g vial C E
22 00102502
Gentamicin Sulphate injection 80mg / 2ml
ampoule R N
23 00102601 Amikacin injection 250mg / 1ml vial C N
24 00102603 Amikacin injection 500mg / 2ml vial C N
25 00102701 Netilmicin injection 100mg /2ml vial R N
26 00103003 Clarithromycin syrup 125mg /5ml,100ml bottle R E
27 00103201 Clindamycin hydrochloride capsule 150mg C N
28 00103101 Azithromycin tablet 250mg R N
29 00103102
Azithromycin dihydrate oral suspension
200mg/5ml, 15ml bottle R N
30 00103202 Clindamycin hydrochloride capsule 300mg C N
31 00103301 Chloramphenicol capsule 250mg C N
32 00103302 Chloramphenicol injection 500mg vial C N
33 00103401 Sodium Fusidate tablet 250mg C N
34 00103501 Vancomycin hydrochloride injection 500mg vial C E
35 00103502 Vancomycin hydrochloride injection 1g vial C N
36 00103702 Co-trimoxazole tablet 480 mg R E
37 00103801 Sulphadiazine tablet 500mg C N
Revised item list (Pharmaceuticals) 2016/2017
Page 10
38 00104601 Cycloserine capsule 250mg C N
39 00105203 Metronidazole injection 500mg / 100ml bottle R E
40 00105401 Ciprofloxacin tablet 250mg R E
41 00105402 Ciprofloxacin tablet 500 mg R E
42 00105403 Ciprofloxacin injection 200mg / 100ml vial R E
43 00105503
Nalidixicacid oral suspension 300 mg / 5 ml,100ml
bottle R N
44 00106701 Levamisole hydrochloride tablet 40mg R N
45 00106801 Pyrentel pamoate tablet 125mg R E
46 00106802
Pyrantel Pamoate oral suspnsion 50mg/ml,10ml
bottle R E
47 00107101 Fluconazole capsule 50mg C E
48
New
00107103 Fluconazole capsule 200mg C E
49 00107102 Fluconazole injection 200mg / 100ml vial C E
50 00107401 Amphoteracin Injection 50mg Vial R E
51 New
00107403 Liposomal Amphotericin B injection 50mg vial C E
52 00107501 Nystatin tablet 500,000 I.U. R N
53 00107601 Griseofulvin tablet 500mg R E
54
New
00110901 Terbinafine tablet 250mg R N
55 00107701 Zidovudine tablet 300mg C N
56 00107903 Aciclovir injection 250mg vial C E
57 00108201 Oseltamivir capsule 30mg C E
58 00108202 Oseltamivir capsule 45mg C E
59 00108203 Oseltamivir capsule 75mg C E
60
New
00108205 Oseltamivir oral suspension 30mg/5ml, 65ml bottle C E
61
New
00112101 Famciclovir tablet 250mg C N
62
New
00112001
Zanamivir inhaler 5mg /dose Diskhaler device and
rotadisks C N
63 00106201 Quinine sulphate tablet 300 mg R E
64 00106202
Quinine dihydrochloride injection 600mg / 2ml
ampoule R E
Drugs available for Level 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1
00101101 Sulbactam sodium and Cefoperazone sodium (1:1)
for injection 1g vial C N
Revised item list (Pharmaceuticals) 2016/2017
Page 11
2 00101102 Sulbactam sodium and Cefoperazone sodium (1:1)
for injection 2g vial C N
3 00101801 Cefixime dispersible tablet 100mg C N
4 00101802 Cefixime tablet 200mg C N
5 00101901 Cefepime for injection 500mg vial C N
6 00101902 Cefepime for injection 1g vial C N
7 00102001 Imipenem cilastatin sodium infusion 500mg C N
8 00103203 Clindamycin phosphate injection 300mg/2ml C N
9 00103402 Sodium Fusidate injection 500mg vial C N
10 00103601 Teicoplanin injection 200mg vial C N
11 00103602 Teicoplanin injection 400mg vial C N
12 00103703
Co-trimoxazole paediatric oral suspension,50ml
bottle (Sulphamethoxazole 200mg +Trimethoprim
40mg in 5ml)
C E
13 00105701 Ofloxacin tablet 200 mg C E
14 00105702 Ofloxacin tablet, 400 mg C E
15 00105801 Levofloxacin tablet 500mg C E
16 00105802 Levofloxacin injection 500mg vial C N
17 00106401 Pyrimethamine tablet 25 mg C N
18 00106501 Sodium stibogluconte injection 10g/100ml vial C E
19
New
00111401 praziquantel tablet 600mg C N
20 00107201 Itraconazole capsule 100mg C N
21
New
00111901
Itraconazole oral suspension 10mg / ml,150ml
bottle C N
22 00107301 Voriconazole tablet 200mg C N
23 00107302 Voriconazole injection 200mg /10ml, vial C N
24 00107702 Zidovudine Syrup 50mg / 5ml, 100ml bottle C N
25 00108001 Ganciclovir injection for IV use 500mg vial C N
26
New
00111901 Valaciclovir tablet 500mg C N
27 00108101 Valganciclovir tablet 450mg C N
28
New
00108102
Valganciclovir oral suspension 250mg / 5ml,
100ml bottle C N
29
New
00111901 Linezolid tablet 600mg C N
30 00108901 Artemether 20mg with Lumefantrine 120mg tablet C N
31
New
00108902 Artemether injection 80mg / 1ml vial C N
32 00106301 Mefloquine tablet 250mg C N
Drugs available for Level 5 Institutions
No Item Medium Description Item VEN
Revised item list (Pharmaceuticals) 2016/2017
Page 12
Code Category status
1 00107801 Lamivudine 150mg tablet C E
2 00109001 Emtricitabine 200 mg + Tenofovir tablet,300mg C E
3 00109101
Lamivudine 150mg + Zidovudine 300mg +
Nevirapine 200mg tablet C E
4 00109102
Lamivudine 30mg + Zidovudine 60mg +
Nevirapine 50mg tablet C E
5 00109201
Isoniazid 75mg +Rifampicin 150mg + Ethambutol
275mg tablet C E
6 00109301 Isoniazid 75mg + Rifampicin 150mg tablet C E
7 00109401
Isoniazid 75mg +Rifampicin 150mg + Ethambutol
275mg + Pyrazinamide 400mg tablet C E
8 00109501 Nevirapine 200 mg,tablet C E
9 00109502 Nevirapine suspension,50 mg / 5 mL,240ml bottle C E
10 00109601 Abacavir tablet 300mg C E
11 00109701 Lopinavir 100mg + Ritonavir 25mg tablet C E
12 00109702 Lopinavir 200mg + Ritonavir 50mg tablet C N
13 00110001
Efavirenz 600 mg, Emtricitabine 200 mg,Tenofovir
disoproxil (as fumarate) 300 mg tablet C E
14 00110101 Darunavir (as ethanolate)300 mg tablet, C N
15 00110301 Raltegravir (as potassium salt) 400 mg,tablet C N
16 00110401 Zidovudine 300mg + Lamivudine 150mg tablet C E
17 00110402 Lamivudine 30mg + Zidovudine 60mg tablet C E
18 00110501 Efavirenz tablet 600mg C N
19 00110502 Efavirenz 200mg tablet C N
20 00110601 Abacavir sulfate 60mg + Lamivudine 30mg tablet C E
21 00110701 Atazanavir (as sulphate) 300 mg capsule C E
22 00110801 Ritonavir tablet 100mg C E
Drugs to be issued on Named Patient basis
No
Item
Code Medium Description Item level
Item
Categ
ory VEN
1 New
00111101 Moxifloxacin tablet 400mg
4 C N
2 00108301 Linezolid injection 600mg / 300ml 4 C N
3 New
00111801 Flucytosine tablet 250mg
3 C N
4 New
00111802 Flucytosine injection 10mg / ml,250ml bottle
3 C N
5 New
00111601 Caspofungin injection 50mg vial
3 C N
Revised item list (Pharmaceuticals) 2016/2017
Page 13
6 New
00108701 Anidulafungin injection 100mg vial
4 C N
7 New
00111701 Micafungin injection 50mg vial
3 C N
8 New
00108401 Colistimethate sodium injection 1,000,000 IU, vial 3 C N
9 New
00112901 Cidofovir 75mg/ml, 5ml vial 4 C N
10 New
00113001 Foscarnet sodium 24mg /1ml 250ml bottle
4
C N
11 New
00111501
Posaconazole tablet 100mg 4 C N
12 New
00111502 Posaconazole injection 300mg / 16.5ml 4 C N
13 New
00102304 Tigecycline injection 50mg vial 4 C N
Drugs deleted /tailed offed from the Formulary
No
Item
Code Medium Description
Reasons for the
deletion
1 00100401 Phenoxymethylpenicillin tablet 125mg
125mg/5ml oral
solution is included
2 00100602 Ampicillin injection 500mg vial
Replace with
Ampicillin
Injection1g vial
3 00100701 Cloxacillin capsules 250mg
To tail off the item
and replace with
Flucloxacillin
250mg capsule.
4 00100702 Cloxacillin capsule 500mg
To tail off the item
and replace with
Flucloxacillin
500mg capsule.
5 00100703 Cloxacillin syrup 125mg / 5ml,100ml bottle
To tail off the item
and replace with
Flucloxacillin oral
solution.
6 00101201 Ticarcillin sodium 1.5g + Clavulanic acid 100mg
powder for reconstitution for IV use
To tail off gradually
due to Ticarcillin
sodium 1.5g +
Clavulanic acid
100mg is adequate.
7 00101402 Cefuroxime tablet 250mg
Revised item list (Pharmaceuticals) 2016/2017
Page 14
8 00101501 Cefotaxime injection 250mg vial
Replace with
Cefotaxime
Injection 500mg vial
9 00101701 Ceftriaxone injection 250mg
500mg and 1g
strength is adequate.
10 00102401 Tetracycline hydrochloride capsule 250 mg Not required
11 00102501 Gentamicin sulphate injection 20mg / 2ml ampoule
Not used within last
five years
12 00102901 Erythromycin tablet 250mg
To remove and
replace with
Clarythromycin
tablet 250mg
13 00102902 Erythromycin tablet 500mg
To remove and
replace with
Clarythromycin
tablet 500mg
14 00105404
Ciprofloxacin suspension 250 mg / 5 ml,100 ml
bottle
Not used within last
five years
15 00105703 Ofloxacin injection 200mg / 100ml vial
Not used within last
five years
16 00106902 Diethylcarbamazine citrate 100mg tablet
50mg strength is
adequate
17 00107001 Niclosamide chewable tablet 500mg
To substitute with
Praziquantel
18 00107502
Nystatin oral suspension 100,000 I.U. in 1 ml,30ml
bottle
Include miconazole
oral gel
Drugs included to the Formulary
No
Item
Code Medium Description
1
New
00100403
Phenoxymethylpenicillin oral solution 125mg /5ml
100ml
2
New
00100404 Phenoxymethylpenicillin tablet 500 mg
3
New
00100603 Ampicillin injection 1g vial
4
New
00100805 Flucloxacillin capsule 250mg
5
New
00100803 Flucloxacillin injection 1g
6
New
00100804
Flucloxacillin oral solution 125mg / 5ml, 100ml
bottle
7
New
00100906 Co-Amoxiclav dispersible tablet 125mg
8
New
00101503 Cefotaxime injection 500mg vial
Revised item list (Pharmaceuticals) 2016/2017
Page 15
9 New
00103903 Trimethoprim tablet 200 mg
10
New
00103901 Trimethoprim tablet 100mg
11
New
00103902
Trimethoprim oral suspension 50mg / 5ml, 100ml
bottle
12
New
00105204
Metronidazole oral suspension 200mg/5ml, 100ml
bottle
13
New
00105903 Nitrofurantoin syrup 25mg/5ml, 300ml bottle
14 New
00111401
Praziquantel tablet 600mg
15
New
00107103 Fluconazole capsule 200mg
16
New
00107202
Itraconazole oral suspension 10mg / ml,150ml
bottle
17
New
00107403 Liposomal amphotericin B injection 50mg vial
18
New
00110901 Terbinafine tablet 250mg
19
New
00107904 Aciclovir oral suspension 200mg/5ml, 125ml bottle
20
New
00111901 Valaciclovir tablet 500mg
21
New
00108102
Valganciclovir oral suspension 250mg/ 5ml, 100ml
bottle
22
New
00108205 Oseltamivir oral suspension 30mg/5ml, 65ml bottle
23
New
00112101 Famciclovir tablet 250mg
24
New
00112001
Zanamivir inhaler 5mg /dose Diskhaler device and
rotadisks
25
New
00108302 Linezolid tablet 600mg
25
New
00108802 Albendazole syrup 200mg/5ml ,30ml bottle
26
New
00108902 Artemether injection 80mg /1ml vial
Newly suggested drugs will be included if they are registered only
Approved drugs to be Local purchased by Institutions
No
Item
Code Items Medium Description
Revised item list (Pharmaceuticals) 2016/2017
Page 16
1
New
0011130
1
Aztreonam injection 1g vial
2
New
0011110
2
Moxifloxacin injection 400mg/250ml, bottle
Revised item list (Pharmaceuticals) 2016/2017
Page 17
02. Drugs used in Cardiovascular system
2.1. Members of the sub committee
1. Dr. Lal Panapitiya, Director, Medical Supplies Division
2. Prof. Rohini Fernandopulle, Professor in Pharmacology ,KDU
3. Dr. Nimali Fernando, Consultant Cardiologist, NHSL
4. Dr. Gotabhaya Ranasinghe, Resident Cardiologist, NHSL
5. Dr. Chandrika Ponnamperuma, Resident Cardiologist, CSTH
6. Dr. Rohan Gunawardana, Consultant Cardiac Electrophysiologist, NHSL
7. Dr. Chandima Amarasinghe, Consultant Cardiothoracic Surgeon, NHSL
8. Dr. Mahendra Munasinghe, Consultant Cardiothoracic Surgeon, NHSL
9. Dr. Duminda Samarasinghe, Consultant Pediatric Cardiologist, LRH
10. Dr. Shehan Perera, Consultant Pediatric Cardiologist, LRH
11. Dr. Anoma Perera, Consultant Aneasthetist, LRH
12. Dr. Kumuduni Ranathunga, Consultant Aneasthetist, NHSL
13. Dr. Namal Wijesinghe, Consultant Physician, Kothalawala Defence University, Rathmalana
14. Dr. Duminda Samarasinghe, Consultant Pediatric Cardiologist, LRH
15. Dr. Shehan Perera, Consultant Pediatric Cardiologist, LRH
16. Mr. E.D.Weerarathne, former Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 18
2.2. Approved item list : Drugs used in Cardiovascular system
Drugs available for all Levels of Institutions
No Item Code Medium Description Item Category VEN status
1 00200101 Digoxin tablet 0.25mg R E
2 00200201 Hydrochlorothiazide tablet 25mg R E
3 00200301 Furosemide(Frusemide) tablet 40 mg R E
4 00200302
Furosemide(Frusemide) injection 20mg / 2ml,
ampoule R E
5 00200401 Spironolactone tablet 25 mg R E
6 00201001 Atenolol tablet 50 mg R N
7 00201101 Propranolol tablet 10 mg R N
8 00201102 Propranolol tablet 40 mg R N
9 00202201 Methyldopa tablet 250 mg R E
10 00202301 Prazosin hydrochloride tablet 1mg R E
11 00202601 Enalapril maleate tablet 5mg R E
12 00202701 Captopril tablet 25mg C N
13
New
00202702 Captopril tablet 12.5 mg C N
14 00202901 Losartan potassium tablet 50mg R E
15 00203001 Glyceryl trinitrate tablet 0.5 mg R V
16
New
00203203 Isosorbide mononitrate SR tablet 30mg R E
17 00203202 Isosorbide mononitrate SR tablet 60mg R E
18 00203301 Amlodipine besylate tablet 5mg R E
19
New
00203302 Amlodipine Besylate tablet 2.5mg R E
20 00203401 Diltiazem tablet 30mg R E
21 00203501 Nifedipine SR tablet 20mg R N
22 00203701 Verapamil hydrochloride tablet 40mg R E
23 00205404 Aspirin enteric coated tablet 75mg R E
24 00206501 Atorvastatin tablet 10mg R E
25 00206502 Atorvastatin calcium tablet 20mg R E
Drugs available for Level 2,3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 00200601 Adenosine injection 6mg / 2ml, vial R E
2 00200702 Amiodarone injection 150mg / 3ml, ampoule R E
3 00201201 Carvedilol tablet 6.25mg R E
4 00201202 Carvedilol tablet 12.5mg R E
Revised item list (Pharmaceuticals) 2016/2017
Page 19
5 New
00201203 Carvedilol tablet 3.125mg R E
6 00205501 Clopidogrel tablet 75mg R E
7 00205901 Tranexamic acid capsule 500mg R E
8 00205903
Tranexamic acid injection 500mg / 5ml,
ampoule R E
9
New
00406601
Histidine-tryptophan-ketoglutarate (HTK)
solution R N
Drugs available for Level 3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 00200102
Digoxin injection 500 microgram / 2ml,
ampoule R N
2 00200103 Digoxin syrup 50 microgram / 1ml, 60ml bottle R N
3
New
00208601 Metolazone tablet 5mg C N
4
New
00200305 Furosemide (Frusemide) tablet 10 mg R E
5
New
00200306
Furosemide syrup 20mg/5ml suger free,150ml
bottle R E
6 00200303
Furosemide(Frusemide) injection 100mg /
10ml, ampoule R N
7
New
00200403 Spironolactone Syrup 10mg / 5ml 100ml bottle R E
8 00200501 Mannitol 20% I.V.infusion, 250 ml bottle R E
9 00200701 Amiodarone tablet 100mg R E
10 00200901
Lignocaine hydrochloride(Anhydrous)
injection for antiarrhythmic use, 100mg / 5ml,
ampoule
R E
11
New
00201104 Propranolol SR capsules 80mg R E
12
New
00201105 Propranolol SR capsules 160mg R E
13 00201103 Propranolol injection 1mg / 1ml, ampoule C N
14 00201301 Bisoprolol fumarate tablet 5mg R E
15 00201401
Esmolol hydrochloride injection 100mg / 10ml,
vial R E
16 00201501 Labetalol hydrochloride tablet 100mg R E
17 00201502
Labetalol hydrochloride injection 100mg /
20ml, ampoule R E
18
New
00208801 Sotalol tablet 80mg C N
19 00201602
Metoprolol tartrate injection 5mg / 5ml,
ampoule C N
20 00201701 Hydralazine hydrochloride tablet 50mg R E
Revised item list (Pharmaceuticals) 2016/2017
Page 20
21 00201702 Hydralazine hydrochloride injection, 20mg /
1ml ampoule R E
22 00201901 Sildenafil tablet 50mg R E
23
New
00201902 Sildenafil tablet 25mg R E
24 00202001 Sodium nitroprusside injection 50mg vial R E
25 00202101 Bosentan tablet 125mg R E
26
New
00202102 Bosentan tablet 62.5mg R E
27
New
00202703 Captopril syrup 5mg / ml 100ml bottle C N
28 00203002 Glyceryl trinitrate injection 50mg / 10ml, vial R E
29 00203402
Diltiazem tablet 60 mg
R E
30
New
00203403 Diltiazem ER tablet 90mg R E
31 00203601 Nimodipine tablet 30mg. R N
32
New
00203703 Verapamil SR tablet 240mg R N
33 00203702
Verapamil hydrochloride injection 5mg / 2ml,
ampoule R E
34 00203801 Nicorandil tablet 10mg R N
35
New
00208901 Ivabradine tablet 5 mg C N
36 00203901 Dobutamine injection 250mg / 20ml, vial R E
37 00204001 Dopamine injection 200mg / 5ml, ampoule R E
38 00204101
Isoprenaline hydrochloride injection 2mg /
2ml, ampoule R E
39 00204201
Ephedrine sulphate injection 30mg / 1ml,
ampoule R E
40 00204401 Noradrenaline acid tartrate 4mg / 2ml, ampoule R E
41 00204501 Phenylephrine injection 10mg /1ml R N
42 00204601 Heparin injection 25,000 I.U / 5ml vial R E
43
New
00204602
Heparin injection Benzyl alcohol free 25,000
I.U / 5ml vial R E
44 00204701
Enoxaparin injection 40mg / 0.4ml, prefilled
syringe R E
45 00204702
Enoxaparin injection 60mg / 0.6ml, prefilled
Syringe R E
46 00205101 Warfarin sodium tablet 0.5mg R N
47 00205102 Warfarin sodium tablet 1mg R E
48 00205103 Warfarin sodium tablet 3mg R E
49 00205104 Warfarin sodium tablet 5 mg R E
50 00205201 Protamine sulphate injection 50mg / 5ml, vial R E
51 00205601 Dipyridamole tablet 100mg R N
Revised item list (Pharmaceuticals) 2016/2017
Page 21
52 00205801 Streptokinase injection 1.5 million Units vial R V
53
New
00206901 Tenecteplase injection 40mg vial R V
54 00206601 Fenofibrate capsule 200mg C N
55 00206801
Sodium tetradecyl sulphate injection 60 mg /
2ml, ampoule R N
Drugs available for Level 4 Institutions
No Item Code Medium Description Item Category VEN status
1
New
00208701 Indapamide tablet 1.5mg C N
2 00200801 Mexiletine capsule 50mg R N
3 00200802
Mexiletine hydrochloride
injection250mg/10ml, ampoule R N
4 00201601 Metoprolol tablet 50mg C N
5 00202401
Phenoxybenzamine hydrochloride capsule
10mg C N
6 00202402
Phenoxybenzamine hydrochloride injection
100mg / 2ml C N
7 00202501
Phentolamine mesylate injection 10mg / 10ml,
ampoule C N
8
New
00203602
Nimodipine injection 200 microgram / ml,
50ml vial R N
09 00204301 Metaraminol injection 10mg / 1ml, ampoule R N
10 00204801
Tinzaparin sodium injection 3,500 units,
Prefilled syringe C N
11 00204802
Tinzaparin sodium injection 20,000 IU units
vial C N
12 00204901 Epoprostenol sodium injection 500 microgram C N
13 00205001
Fondaparinux sodium, 2.5mg / 0.5ml, solution
for injection C N
14 00205301
Abciximab Intravenous Infusion, 10mg / 5ml
C N
15 00205701
Alteplase(Recombinent tissue type
plasminogen activator) 20mg vial C N
16 00205702
Alteplase(Recombinent tissue type
plasminogen activator) 50mg vial C N
17 00206401
Aprotinin injection 500,000 kallikrein
inactivator units in 50ml vial C N
18 00207001
Papavarine hydrochloride injection, 20mg /
1ml, ampoule C N
19 00207101
Milrinone lactate injection 10mg/10ml,
ampoule C N
20 00207301 Alprostadil injection 500 microgram ampoule C N
Revised item list (Pharmaceuticals) 2016/2017
Page 22
21 00207401 Clonidine hyrochloride injection 150
microgram / 1ml ampoule C N
22 00207501 Cadioplegia infusion(St. Thomas Solution) C E
23 00207002 Papaverine hydrochloride injection 60mg/2ml C N
24 00200903 Flecainide Acetate tablet 50mg C E
25 00200904 Flecainide Acetate injection 10mg/ml, 15ml
ampoule C E
Drugs deleted from the Formulary
No Item Code Medium Description
Reasons for the
deletion
1 00200902
Lignocaine hydrochloride ( Anhydrous
)Injection for antiarrhythmic use 500mg /5ml
ampoule
Not used within
last five years
2 00201801 Minoxidil tablet. 2.5mg Low consumption
3 00201802 Minoxidil tablet. 5mg Low consumption
4 00203201 Isosorbide Mononitrate tablet 20mg
Replaced with
ISMN SR 30mg
tablets
5 00205403 Aspirin enteric coated tablet 150mg
75mg and 300mg
adequate
6 01502401
Prilocaine hydrochloride injection, 3% / 2ml
ampoule
Not used within
last five years
7 00201603 Metoprolol ER tablet 50mg
8 00205401 Aspirin tablet 100mg
75mg and 300mg
adequate
9 00205402 Aspirin tablet 150mg
75mg and 300mg
adequate
Drugs to be issued on Named Patient basis
No Item Code Medium Description
1 00203004
Glyceryl trinitrate spray 400microgram
/Metered dose
Drugs included to the Formulary
No Item Code Items Medium Description
1 New Metolazone tablet 5mg
Revised item list (Pharmaceuticals) 2016/2017
Page 23
00208601
2 New
00200305 Furosemide (Frusemide) tablet 10 mg
3
New
00200306
Furosemide syrup 20mg/5ml, suger free,150ml
bottle
4
New
00200403 Spironolactone syrup, 10mg/5ml, 100ml bottle
5
New
00201104 Propranolol SR tablet 80mg
6
New
00201105 Propranolol SR tablet 160mg
7
New
00201203 Carvedilol tablet 3.125mg
8
New
00208801 Sotalol tablet 80mg
9
New
00201902 Sildenafil tablet 25mg
10
New
00202102 Bosentan tablet 62.5mg
11
New
00202702 Captopril tablet 12.5 mg
12
New
00202703 Captopril syrup 5mg/ml, 100ml bottle
13
New
00203203 Isosorbide mononitrate SR tablet 30mg
14
New
00203302 Amlodipine besylate tablet 2.5mg
15
New
00203403 Diltiazem SR tablet 90mg
16
New
00203602
Nimodipine injection 200 microgram /ml,50ml
vial
17
New
00203703 Verapamil SR tablet 240mg
18
New
00204602
Heparin injection (Benzyl alcohol free)25,000
I.U. / 5ml Vial
19
New
00206901 Tenecteplase injection 40mg
20
New
00406601
Histidine-tryptophan-ketoglutarate (HTK)
solution
21
New
00200903 Flecainide Acetate tablet 50mg
22
New
00200904
Flecainide Acetate injection 10mg/ml, 15ml
ampoule
Newly suggested item will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 24
Aproved drugs to Local Purchased by institutions
No Item Code Items Medium Description Item Category VEN status
1
New
00208701 Indapamide tablet 1.5mg
C N
2
New
00208901 Ivabradine tablet 5 mg
C N
3
New
00209001 Ranolazine SR tablet 500mg
C N
03.Drugs used in Central Nervous System
Revised item list (Pharmaceuticals) 2016/2017
Page 25
3.1. Members of the sub committee
01. Dr. Lal Panapitiya, Director, Medical Supplies Division
02. Prof. Rohini Fernandopulle, Professor in Pharmacology
03. Prof. Raveen Hanwella, Professor of Psychiatry
04. Dr. Swarna Wijethunga, Consultant Pediatric Psychiatrist,
05. Dr. Padma Gunarathne, Consultant Neurologist, NHSL
06. Dr. Sunethra Senanayake, Consultant Neurologist, NHSL
07. Dr. Bimsara Senanayake, Consultant Neurologist, NHSL
08. Dr. Senaka Bandusena, Resident Neurologist, CSTC
09. Dr. Jithangi Wanigasinghe, Consultant Pediatric Neurologist, LRH
10. Dr. Piyara Rathnayake, Consultant Pediatric Neurologist, LRH
11. Mr. E.D.Weerarathne, former assistant Director, MSD
3.2. Approved item list : Drugs used in Central Nervous System
Drugs available for all Levels of Institutions
Revised item list (Pharmaceuticals) 2016/2017
Page 26
No Item Code
Medium Description
Item
Category
VEN
status
1 00300102 Diazepam tablet 5mg R E
2 00300104 Diazepam rectal solution 5mg / 2.5ml tube R E
3 New
00300105 Diazepam rectal solution 10mg / 2.5ml tube R N
4 00300201 Chlordiazepoxide tablet 10mg R N
5 00302202 Amitriptyline tablet 25mg R E
6 00302301 Imipramine tablet 25 mg R E
7 00302701 Fluoxetine hydrochloride capsule 20mg R E
8 00303001 Cinnarizine tablet 25mg R N
9 00303201 Aspirin tablet 300mg R E
10 00303301 Paracetamol tablet 500mg R E
11 00303302 Paracetamol syrup 120mg in 5ml, 60ml bottle R E
12 00303703 Phenytoin sodium tablet 100 mg R E
13 00303801 Carbamazepine tablet 100mg R E
14 00303802 Carbamazepine tablet 200mg R E
15 New
00303805 Carbamazepine modified release tablet 200mg C N
16 00304001 Sodium valproate tablet 100mg R E
17 00304002 Sodium valproate tablet 200mg R E
18 00300801 Haloperidol tablet 1.5mg R E
19 00300803 Haloperidol Injection 5mg / 1ml ampoule R E
20 00301501 Prochlorperazine tablet 5mg R E
21 00301701 Trifluoperazine tablet 5mg R E
22 00301901 Olanzapine tablet 5mg R E
23 00301902 Olanzapine tablet 10mg R E
24 00302001 Risperidone tablet 2mg R E
Drugs available for Level 2,3 & 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 00300103 Diazepam Injection 10mg / 2ml ampoule R E
2 00300301 Lorazepam tablet 1mg R N
3 New
00306801 Alprazolam tablet 0.25 mg R N
4 New
00306802 Alprazolam tablet 0.5mg R N
5 New
00307501
Midazolam nasal spray 0.5mg / metered dose,50
dose unit R N
6 00302101 Lithium carbonate tablet 250mg R E
7 00302402 Clomipramine hydrochloride tablet 25 mg R E
Revised item list (Pharmaceuticals) 2016/2017
Page 27
8 00302801 Sertraline tablet 50mg R E
9 00302901 Venlafaxine extended release capsules 37.5mg R E
10 00302902 Venlafaxine hydrochloride extended release
capsules 75mg R E
11 New
00306901 Aripiprazole tablet 10mg R E
12 00303601 Phenobarbitone tablet 15 mg R N
13 00303602 Phenobarbitone tablet 30 mg R N
14 00303701 Phenytoin sodium tablet 25mg C E
15 00303702 Phenytoin sodium tablet 50mg R E
16 00303901 Clonazepam tablet 0.5mg R E
17 00303902 Clonazepam tablet 2mg R E
18 00304004 Sodium valproate syrup 200mg / 5ml,100ml R E
19 00304901 Benzhexol hydrochloride tablet 2mg R E
20 00305001 Co-careldopa tablet 25mg/100mg R E
21 00305002 Co-careldopa tablet 25/250mg R E
22 New
00305004
Co-careldopa Modified Release tablet 50mg /
200mg C N
23 00305201 Benztropine injection 2mg / 2ml Ampoule R N
24 00305401 Disulfiram tablet 200mg R E
25 00305501 Atomoxetine hydrochloride capsule 10mg C N
26 00300902 Chlorpromazine hydrochloride tablet 50mg R N
27 00301001 Fluphenazine decanoate injection 25mg / 1ml
ampoule R N
28 00301101 Flupenthixol decanoate injection 40mg / 2ml
ampoule R N
29 New
00306701 Quetiapine tablet 25mg C E
30 New
00302003 Risperidone tablet 1mg R E
Drugs available for Level 3 & 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 00300302 Lorazepam injection 4mg / 1ml ampoule. R E
2 00300501 Chloral hydrate crystals R N
3 00300502 Chloral hydrate oral solution, 500mg / 5ml in
200ml bottle R N
4 New
00300505
Chloral betaine tablet 707mg (equal to Chloral
hydrate 414mg) R N
5 00305601 Betahistine tablet 8mg R N
6 00305602 Betahistine tablet 16mg R N
7 00303103 Ondansetron injection 8mg / 4ml, ampoule R E
Revised item list (Pharmaceuticals) 2016/2017
Page 28
8 New
00303104 Ondansetron tablet 4mg R E
9 00303401 Tramadol hydrochloride capsule 50mg R E
10 00303403 Tramadol hydrochloride injection 100mg / 2ml,
ampoule C N
11 00303501 Sumatriptan tablet 50mg C E
12 00303604 Phenobarbitone injection 200mg / 1ml ampoule R E
13 New
00307001 Primidone tablet 250mg R E
14 00303704 Phenytoin sodium injection 250mg / 5ml, ampoule R E
15 00303803 Carbamazepine syrup 100mg / 5ml,300ml bottle R N
16 00304101 Paraldehyde rectal solution, 10ml, single dose unit C N
17 00304201 Clobazam tablet 5mg R E
18 00304202 Clobazam tablet 10mg R E
19 New
00304302 Gabapentin capsule 100mg C N
20 00304301 Gabapentin capsules 300mg C N
21 00304401 Lamotrigine tablet 25mg C E
22 New
00304402 Lamotrigine tablet 50mg C N
23 New
00304403 Lamotrigine tablet 100mg C N
24 New
00305902 Levetiracetam tablet 250mg C N
25 New
00305901 Levetiracetam tablet 500mg C N
26 00304501 Topiramate tablet 25mg C E
27 00304502 Topiramate tablet 50mg C E
28 00304601 Ethosuximide capsule 250mg C N
29 00304801 Vigabatrin 500mg tablets C N
30 00305301 Botulinum Toxin 100U vial C N
31 New
00305302 Botulinum Toxin 50U vial C N
32 00305801 Duloxetine (as hydrochloride) capsule 20 mg R E
33 New
00306301 Donepezil tablet 5mg C E
34 00300802 Haloperidol tablet 5mg R E
35 00300804 Haloperidol oral solution 2mg / 1ml. 100ml bottle C N
36 00301201 Zuclopenthixol acetate injection 50mg / 1ml
ampoule R N
37 00301301 Zuclopenthixol deconate injection 200mg / ml, 1ml
ampoule R N
38 00301801 Clozapine tablet 100mg R E
39 New
00306702 Quetiapine modified release tablet 200mg C E
Revised item list (Pharmaceuticals) 2016/2017
Page 29
40 00000501
Methadone Tablet 5mg R N
41 00000601
Methylphenidate Hydrochloride Tablet 10mg R E
Drugs available for Level 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 New
00306401 Ox-carbazepine tablet 150mg C N
2 New
00303903 Clonazepam oral drops 2.5mg / ml , 10ml bottle C N
3 New
00304005 Sodium valproate modified release tablet 300mg C N
4 New
00306601 Pregabalin capsule 75 mg C N
5 New
00305003 Co-careldopa Modified Release tablet 25mg/100mg C N
6 New
00307201 Amantadine capsule 100mg C N
7 New
00307301 Ropinirole tablet 0.5mg C N
8 New
00307401 Pizotifen tablet 0.5mg C N
9 New
00701801 Methylprednisolone tablet 4mg R E
10 New
00306101 Melatonin tablet 2mg C N
11 New
00402804 Pyridoxine tablet 100mg C N
12 New
00407301 pyridoxal phosphate tablet 50mg C N
13 New
00307101 Tetrabenazine tablet 25mg C N
42 00000701
Dexamphetamine tablet 5mg C N
Drugs deleted /tailed offed from the Formulary
No Item Code Medium Description Reasons for the deletion
1 00302403 Clomipramine hydrochloride tablet 50 mg 25mg strength is adequate
2 00302501 Doxepin hydrochloride capsule 50mg
3 00303603 Phenobarbitone tablet 60mg 15mg and 30mg strength
are adequate
Revised item list (Pharmaceuticals) 2016/2017
Page 30
4 00304701 Flunarizine capsule 5mg
5 00301202 Zuclopenthixol acetate injection 100mg/2ml
ampoule
200mg/ml(SR No
00301301)can be used
Drugs to be issued on Named Patient basis
No
Item Code Medium Description
Item
Category
VEN
status
1 New
00405901 Biotin capsule 5mg
5 N
Drugs included to the Formulary
No Item Code Medium Description
1
New
00300105 Diazepam rectal solution 10mg in 2.5ml tube
2
New
00306801 Alprazolam tablet 0.25 mg
3
New
00306802 Alprazolam tablet 0.5 mg
4
New
00307501
Midazolam nasal spray 0.5mg/metered dose,50 dose
unit
5
New
00300505
Chloral betaine tablet 707mg (equal to Chloral
hydrate 414mg)
6
New
00306901 Aripiprazole tablet 10mg
7
New
00303104 Ondansetron tablet 4mg
8
New
00307001 Primidone tablet 250mg
9
New
00303805 Carbamazepine modified release tablet 200mg
10
New
00306401 Ox-carbazepine tablet 150mg
11
New
00303903 Clonazepam oral drops 2.5mg/ml , 10ml bottle
12
New
00304005 Sodium valproate modified release tablet 300mg
13 New
00304302
Gabapentin capsule 100mg
14
New
00306601 Pregabalin capsule 75 mg
15
New
00304402 Lamotrigine tablet 50mg
16 New Lamotrigine tablet 100mg
Revised item list (Pharmaceuticals) 2016/2017
Page 31
00304403
17 New
00305902 Levetiracetam tablet 250mg
18
New
00305901 Levetiracetam tablet 500mg
19
New
00305003 Co-careldopa Modified Release tablet 25mg/100mg
20
New
00305004
Co-careldopa Modified Release tablet 50mg/200mg
21
New
00307201 Amantadine capsule 100mg
22
New
00307301 Ropinirole tablet 0.5mg
23
New
00305302 Botulinum Toxin 50 IU vial
24
New
00307401 Pizotifen tablet 0.5mg
25
New
00306301 Donepezil tablet 5mg
26
New
00701801 Methylprednisolone tablet 4mg
27
New
00306101 Melatonin tablet 2mg
28
New
00402804 Pyridoxine tablet 100mg
29
New
00407301 Pyridoxal phosphate tablet 50mg
30
New
00307101 Tetrabenazine tablet 25mg
31
New
00306701 Quetiapine tablet 25mg
32
New
00306702 Quetiapine modified release tablet 200mg
33
New
00302003 Risperidone tablet 1mg
Newly suggested drugs will be included if they are registered only
04. Drugs affecting Nutrition and Blood
4.1.Members of the sub committee
Revised item list (Pharmaceuticals) 2016/2017
Page 32
1. Dr. Lal Panapitiya, Director, MSD
2. Prof. Rohini Fernandopulle, Professor in Pharmacology
3. Prof. Pujitha Wickramasinghe, Professor in Pediatrics, LRH
4. Dr. Lalindra Goonarathne, Consultant Hematologist, Faculty of Medicine, University of Colombo
5. Dr. Visaka Rathnamala, Consultant Hematologist, NHSL
6. Dr. Rohan Pulleperuma, Consultant Hematologist, D.G.H. Hambanthota
7. Dr.Chandima Thevarapperuma, Consultant Hematologist, B.H.Panadura
8. Dr.Chamil Marasinghe, Consultant Physician, CSTH, Kalubowila
9. Dr. Ruwangi Dissanayake, Consultant Pediatrician, LRH
10. Mr. E.D.Weerarathne, Formar Assistant Director, MSD
4.2 Approved item list : Drugs affecting Nutrition and Blood
Drugs available for all Levels of Institutions
Revised item list (Pharmaceuticals) 2016/2017
Page 33
No Item Code
Medium Description
Item
Category
VEN
status
1 00400101 Ferrous sulphate tablet 200mg R E
2 New
00400203
Ferrous fumarate tablet 210mg R E
3 New
00400201
Ferrous fumarate chewable tablet 100mg
(33mg iron) R N
4 New
00400306
Iron syrup 50mg/5ml, 100ml bottle R E
5 00400303 Iron drops 50mg/ml, in 15ml dropper bottle R E
6 00400601 Water for Injection 10ml vial R E
7 New
00400602
Water for injection 5ml ampoule R E
8 00400701 Potassium chloride tablet 600mg R E
9 New
01300602
Potassium citrate tablet 10mEq (1080mg per
tablet) R E
11 New
00406501 Phosphate tablet 500 mg R E
12 00400801 Oral rehydration powder sachets 1000ml (1L) R E
13 New
00400802
Oral rehydration powder sachets 200ml R E
14 00401003 Sodium chloride for intravenous infusion
0.9%, 500ml bottle R V
15 00401101 Dextrose for intravenous infusion 5%, 500ml
bottle R V
16 00401103 Dextrose for intravenous infusion 25%, 25ml
ampoule R N
17 00401104 Dextrose for intravenous infusion 50%, 50ml
ampoule R E
18 00401601 Calcium lactate tablet 300mg R E
19 00402501 Vitamin A high potency oral capsule
100,000IU R E
20 00402601 Vitamin B complex tablet R N
21 00402901 Vitamin C tablet 100mg C N
22 00403401 Folic acid tablet 1mg R E
23 00403601 Multivitamin drops 15ml bottle R N
24 New
00406801
Syrup multivitamin + Zinc 200 ml R N
25 00405401 Calcium 500mg + Vitamin D3 250IU tablet R E
26 New
00405402
Calcium carbonate 500mg + Vitamin D 400IU/
5ml R E
27 00405604 Zinc sulfate dispersible tablet 20mg R N
28 00400501 Ferrous fumarate and Folic Acid tablet BP
(182.4 mg + 400 microgram ) R N
Revised item list (Pharmaceuticals) 2016/2017
Page 34
Drugs available for Level 2,3 & 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1
00400702 Potassium chloride injection 15% in 10ml
ampoule R E
2 00400901 Sodium bicarbonate tablet 600mg R E
3
00400903 Sodium bicarbonate 8.4% for intravenous
infusion 50ml ampoule R E
4 00400905 Sodium bicarbonate tablet 500mg R N
5
00401001 Sodium chloride for intravenous infusion 0.9%
,5ml ampoule R N
6
00401102 Dextrose for intravenous infusion 10%, 500ml
bottle C N
7
00401202 Sodium chloride 0.45% & Dextrose 5% for
intravenous infusion 500ml Bottle R E
8
00401301 Compound sodium lactate for intravenous
infusion 500ml bottle R E
9
00401401 Dextran 40,10% w / v in Sodium chloride
0.9% for intravenous infusion, 500ml bottle R E
10
00401501 Tetrastarh solution for intravenous infusion
500ml R N
11
New
00406601
Histidine-tryptophan-Ketoglutarate( H.T.K.)
solution 1000ml bags R E
12 00402701 Vitamin B1 tablet 10mg R N
13 00402801 Pyridoxine tablet 10mg R E
14 00402802 Pyridoxine hydrochloride tablet 25mg R E
15
00403202 Phytomenadione injection 1mg / 0.5ml
ampoule R E
16
00403203 Phytomenadione injection 10mg / 1ml
ampoule R E
17
00403501 Hydroxocobalamine injection 1mg / 1ml
ampoule C N
18 00404801 Desferrioxamine injection 500 mg R E
19 00205901 Tranexamic acid capsule 500mg R E
20
New
00205902 Tranexamic acid tablet 500mg R E
21
00205903 Tranexamic acid injection 500mg / 5ml
ampoule R E
Drugs available for Level 3 & 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 00400401 Iron sucrose injection 100mg / 5ml ampoule C N
2 00401004 Sodium chloride for intravenous infusion 3%, C E
Revised item list (Pharmaceuticals) 2016/2017
Page 35
500ml bottle
3 New
00401006
Sodium chloride for intravenous infusion 3%,
10ml C N
4 New Sodium chloride for intravenous infusion 3%,
20ml C N
5 New
00401005
Sodium chloride for intravenous infusion
0.9% 1000ml (Collapsible bag) R V
6 00401701 Calcium gluconate injection 10% in 10ml
ampoule R E
7 00401801 Calcium carbonate tablet 1.25g C E
8 00401903 Magnesium sulphate injection 50% in 10ml
ampoule R E
9 00402102 Fat emulsion injection 10% in 500ml bottle R N
10 00402103 Fat emulsion injection 20% in 100ml bottle R E
11 00402201 Protein hydrolysate injection 100ml bottle C E
12 00402202 Amino acids solution for intravenous infusion
500ml bottle R E
13 00402301 Peritoneal dialysis solution 1.5% in 1000ml
bottle R E
14 00402702 Thiamine hydrochloride injection 100mg in
2ml ampoule R E
15 00403001 Calcitriol capsule 250mg R E
16 00403101 Alfacalcidol capsule 250ng R E
17 00403201 Phytomenadione tablet 5mg R N
18 New
00406701
Cholecalciferol tablet 400IU R E
19 New
00406702
Cholecalciferol tablet 1000IU R E
20 New
00406703
Cholecalciferol tablet 5000IU R E
21 New
00406704 Cholecalciferol 200,000 I.U ampoule R E
22 00404001 Epoetin injection 2,000 IU vial/pre-filled
syringe C E
23 00404002 Epoetin injection 4,000 IU -5000IU vial/pre-
filled syringe C E
24 New
00404004
Epoetin injection 10,000 IU vial/Pre-filled
syringe C E
25 New
00405801
Eltrombopag tablet 50mg C N
26 00404401 Sodium dihydrogen orthophospate powder C N
27 00404501 Disodium hydrogen orthophospate powder C N
28 00404601 Deferiprone capsule 250mg R E
29 00404602 Deferiprone capsule 500mg R E
30 00404701 Deferasirox tablets 100mg R E
Revised item list (Pharmaceuticals) 2016/2017
Page 36
31 00404702 Deferasirox tablets 400mg R E
32 00405201 Calcium chloride injection BP 10mmol (14.7%
W/V) in 10ml C N
33 00405301 Albumin Solution (human) 20%,50ml bottle C E
34 00405302 Albumin solution ( human ) 5% ,250ml bottle C N
35 00206003 Dried Factor VII fraction 2mg (100 KIU) vial C E
36 00206101 Dried,Factor VIII fraction 200-350 IU vial C E
37 00206105 Dried,Factor VIII fraction 200-350IU vial with
von Willebrand factor C E
38 00206201 Dried,Factor IX fraction 500 IU vial C E
39 00206301 Activated Prothrombin Complex Concentrate
injection 500IU vial C N
40 00206302 Prothrombin Complex Concentrate injection
500IU vial C N
41 New
00404301 Oxymetholone tablets 50mg R N
Drugs available for Level 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 New
00407201 Total Parenteral Nutrition solution C E
2 00404202 Trientine dihydrochloride capsule 300mg C E
Drugs deleted from the Formulary
No Item Code Medium Description Reasons for the deletion
1 00400302 Iron drops 100mg/5ml 15ml bottle Replace with iron syrup
2 00400902 Sodium bicarbonate for intravenous infusion
4.2% in 50 ml bottle
Sodium bicarbonate 8.4% is
adequate.
3 00401002 Sodium chloride for intravenous infusion
0.9%, 100ml pack
500ml and 1000ml are
adequate.
4 00401201 Sodium chloride 0.18% & Dextrose 4% for
intravenous infusion 500ml bottle Not used in last few years
5 00401901 Magnesium sulphate 40% in 25ml injection
ampoule
6 00401904 Magnesium sulphate 50% w/v in 2ml Magnesium sulphate 50%
10ml vial is adequate.
7 00402101 Fat emulsion injection 10% in 100ml bottle Fat emulsion Injection
10%,500ml is adequate.
8 00402803 Pyridoxine hydrochloride tablet 50mg 25mg strength is adequate.
9 00403301 Calciferol tablet 10,000 I.U. Replace with cholecalciferol
10 00403402 Folic acid tablet 5mg 1mg strength is adequate
Revised item list (Pharmaceuticals) 2016/2017
Page 37
11
00405501 Parenteral infusion fluid 500ml(K+
5mmol/L,Mg2+ 1.5mmol/L,Na+ 140
mmol/L,Acetate 27mmol/L,Cl-98mmol/L)
Replace withParenteral
infusion fluid in 500ml
collapsible bag/bottle
12
00405601
Zinc sulfate dispersible tablet 10mg
Deleted as 20mg strength of
Zinc sulfate dispersible
tablet is adequate.
13
00405603 Zinc sulfate oral solution 10mg/5ml in 75ml
bottle
Deleted as 20mg strength of
Zinc sulfate dispersible
tablet is adequate.
14
0400502 Ferrous fumarate and Folic acid BP (182.4
mg + 1mg)
as Ferrous Fumarate and
Folic Acid tablet BP (182.4
mg + 400mcg) is adequate.
15
00400503 Ferrous fumarate and Folic acid tablet BP
(91.2mg + 1mg)
as Ferrous Fumarate and
Folic Acid tablet BP (182.4
mg + 400mcg) is adequate.
Drugs to be issued on Named Patient basis
No Item Code Medium Description
1
New
00400402
Iron sucrose injection 50mg/ml ,10ml vial
2
00404101 Methoxy polyethylene glycol-epoetin beta
injection 100 microgram /0.3ml vial/prefilled
syringe
3
00404102 Methoxy polyethylene glycol-epoetin beta
injection 50 microgram /0.3ml vial/prefilled
syringe
4
New
01209302
Ruxolitinib 5mg
5
New
01209303
Ruxolitinib 15mg
6
New
01209301
Ruxolitinib 20mg
Drugs included to the Formulary
No Item Code Medium Description
1
New
00400203
Ferrous fumarate 210mg
2
New
00400201
Ferrous fumarate chewable tablet 100mg
(33mg iron)
3
New
00400306
Iron syrup 50mg/5ml, 100ml bottle
4
New
00400402
Iron sucrose injection 50mg/ml ,10ml vial
5 New Water for injection 5ml vial
Revised item list (Pharmaceuticals) 2016/2017
Page 38
00400602
6 New
01300602
Potassium citrate tablet 10mEq (1080mg per
tablet)
8
New
00406501 Phosphate tablet 500 mg
9
New
00400802
Oral rehydration powder sachets 200ml
10
New
00401005
Sodium chloride for intravenous infusion
0.9% 1000ml (Collapsible bag)
11
New
00401006
Sodium chloride for intravenous infusion
3%, 10ml
13
New
00406601
Histidine-tryptophan-Ketoglutarate( H.T.K.)
Solution 1000ml bags
14
New
00406701 Cholecalciferol tablet 400 I.U
15
New
00406702 Cholecalciferol tablet 1000 I.U
16
New
00406703 Cholecalciferol tablet 5000 I.U
17
New
00406704 Cholecalciferol 200,000 I.U ampoule
18
New
00406801
Syrup multivitamin + Zinc 200 ml
19
New
00404004
Epoetin injection 10,000 IU vial/Pre-filled
syringe
21
New
00407201 Total Parenteral Nutrition solution
22
New
00405402
Calcium carbonate 500mg + Vitamin D
400IU/ 5ml
23
New
00404301 Oxymetholone tablets 50mg
24
New
00205902 Tranexamic acid tablet 500mg
25
New
01209302
Ruxolitinib 5mg
26
New
01209303
Ruxolitinib 15mg
27
New
01209301
Ruxolitinib 20mg
Newly suggested drugs will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 39
05. Drugs used in Respiratory system
5.1. Members of the sub committee
1. Dr.Lal Panapitiya, Director, Medical Supplies Division
2. Prof. Rohini Fernandopulle, Professor in Pharmacology
3. Dr. Manil Peris, Consultant Respiratory Physician, T.H.Kurunegala
4. Dr. Saman Kularatne, Consultant Respiratory Physician, NHRD, Welisara
Revised item list (Pharmaceuticals) 2016/2017
Page 40
5. Dr. Dushantha Medagedara, Consultant Respiratory Physician, T.H.Kandy
6. Dr. S. Muhunathan, Consultant Respiratory Physician, T.H.Karapitiya
7. Dr. Geethika Patabadige, Consultant Clinical Microbiologist, NHSL
8. Dr. Asanka Rathnayake, Consultant Physician, T.H.Kalubowila
9. Dr. Surantha Perera, Consultant Pediatrician, Kethumathi Hospital, Panadura
10. Mr.E.D. Weerarathne, Former Assistant Director, MSD
5.2. Approved item list: Drugs Used in Respiratory system
Drugs available for all Levels of Institutions
No Item Code
Medium Description
Item Category
VEN
status
1 00500101 Salbutamol tablet 2mg R E
2 00500105 Salbutamol dry powder capsule for breath activated
device, 200 microgram R E
3 00500106 Salbutamol dry powder capsules for breath activated
devise, 400 microgram R E
Revised item list (Pharmaceuticals) 2016/2017
Page 41
4 00500107 Salbutamol aerosol Inhaler 100 microgram/metered
dose, 200 dose unit R E
5 00500108 Salbutamol aerosol Inhaler 200 microgram/metered
dose, 200 dose unit R E
6 00500109 Salbutamol respiratory solution 0.5% in 15ml vial R E
7 00500111 Salbutamol syrup 2mg/5ml, 60ml bottle R E
8 00500201 Salmeterol xinafoate 50 microgram + Fluticasone
propionate 100 microgram dry powder caps R E
9 00500202
Salmeterol Xinafoate 50mcg + Fluticasone
Propionate 250mcg, dry powder capsules for breath
activated device..
R E
10 00500203
Salmeterol xinafoate 50 microgram + Fluticasone
propionate 500 microgram, dry powder capsules for
DP inhaler
R E
11 00500401 Ipratropium Bromide dry powder capsules 40mcg R N
12 00500501 Theophylline slow released tablet 125mg
R E
13 New
00500505
Theophyllin Syrup 25mg /5ml , 60ml bottle R E
14 00500701 Beclometazone dipropionate dry powder capsule100
microgram for breath activated device R E
15 00500702 Beclomethasone dipropionate dry powder capsule
for breath activated device, 200 microgram R E
16 00500703 Beclomethasone dipropionate dry powder capsule
for breath activated device, 400 microgram R E
17 00500704 Beclomethasone dipropionate aerosol Inhaler 50
microgram /metered dose, 200 dose unit R E
18 00500705 Beclamethasone aerosol Inhaler 100 microgram
metered dose, 200 dose Unit R E
19 00500706 Beclamethasone dipropionate aerosol inhaler 250
microgram /metered dose, 200 dose unit R E
20 00501101 Cetirizine hydrochloride tablet 10mg R E
21 00501102 Cetirizine hydrochloride syrup 5mg/5ml, 60ml
bottle R E
22 00501301 Chlorpheniramine maleate tablet 4mg R E
23 00501302 Chlorpheniramine maleate syrup 2mg / 5ml , 60ml
bottle R E
24 00501401 Promethazine hydrochloride tablet 10mg R N
25 00501402 Promethazine hydrochloride tablet 25mg R N
26 00501403 Promethazine hydrochloride syrup 5mg/5ml,60ml
bottle R N
27 00501405 Promethazine hydrochloride Injection 25mg / 1ml
ampoule R N
28 00501502 Adrenaline bitartrate injection 1mg / 1ml ampoule R V
29 00501701 Breath activated device for dry powder capsules R E
30 00501901 Spacer device for infants R E
Revised item list (Pharmaceuticals) 2016/2017
Page 42
31 New
00701704
Prednisolone syrup 5mg / 5ml ,60ml bottle R E
Drugs available for Level 2,3 & 4 Institutions
No Item Code
Medium Description
Item Category
VEN
status
1 00500204
Fluticasone propionate 125 with Salmeterol
xinafoate 25 microgram / metered dose,120 dose
unit
R E
2 00500205
Fluticasone propionate 250 microgram with
Salmeterol xinafoate 25 microgram / metered
dose,120 dose unit
R E
3 New
00500206
Fluticasone propionate 50 microgram with
Salmeterol xinafoate 25mcg / metered dose,120
dose unit
R E
4 00500301 Fluticasone propionate 125 microgram /dose 120
metered doses aerasol inhaler R E
5 00500402 Ipratropium Bromide Respiratory Solution 0.5mg /
2ml vial R E
6 00500403 Ipratropium bromide respiratory solution, 250
microgram / 1ml, 15ml Bottle R E
7 00501304 Chlorpheniramine maleate injection.10mg / 1ml
ampoule R E
Drugs available for Level 3 & 4 Institutions
No Item Code
Medium Description
Item Category
VEN
status
1 00500104 Salbutamol injection 5mg / 5ml ampoule R N
2 New
01001401
Fluticasone propionate nasal spray 50 microgram
/metered dose, 150 dose unit R N
3 New
00500901
Tiotropium bromide dry powder capsule 18
microgram R N
4 New
00502801
Inhalation device for Tiotropium bromide
monohydrate Inhalation powder capsule 18
microgram
R N
5 00500404 Ipratropium bromide 20 microgram /dose 200
metered doses aerosol inhaler R E
6 00500601 Aminophylline injection 250mg / 10ml ampoule R E
7 00500801 Budesonide respiratory suspension 0.5mg in 2ml R E
8 New
00501802
Spacer device,100ml compatible with all metered
dose inhalers R E
9 00502001 Plastic, Baby mask to be compatible with volumetic
spacer R E
Revised item list (Pharmaceuticals) 2016/2017
Page 43
10 New
00701703
Prednisolone tablet 20 mg R N
11 New
00501002
Montelukast tablet 10mg R N
12 New
00501001
Montelukast chewable tablet 5mg R N
Drugs available for level 4 Institutions
No Item Code
Medium Description
Item Category
VEN
status
1 00501601 Beractant 8ml vial (25mg/ml) C E
2 00502101 Caffeine citrate oral solution 25mg / 5ml, vial C N
3 00502102 Caffeine citrate injection 40mg / 2ml, vial C N
4 00502201 Desloratidine tablet 5mg C N
5 New
00000203
Codein syrup 25mg /5ml ,100ml C N
Drugs available for Level 5 Institutions
No Item Code
Medium Description
Item Category
VEN
status
1 00104001 Ethambutol tablet 400mg R N
2 New
00104002
Ethambutol injection 100mg/ml,10ml vial R N
3 00104101 Ethionamide tablet 250mg R E
4 00104201 Isoniazid tablet 100mg R E
5 00104202 Isoniazid syrup 50mg in 5ml ,100ml bottle C N
7 00104301 Pyrazinamide tablet 500mg R E
8 00104401 Rifampicin capsule 150mg R E
9 00104402 Rifampicin injection 600mg vial C N
10 00104403 Rifampicin syrup 100mg in 5ml,120ml bottle R E
11 00104501 Streptomycin Injection 1g vial R E
Drugs deleted from the Formulary
No Item Code Medium Description Reasons for the deletion
1 00501801 Spacer device, 750ml compatible with all metered
dose inhalers for adults
Replace with 'Spacer device,
100ml compatible with all
metered dose inhalers'
Drugs to be issued on Named Patient basis
Revised item list (Pharmaceuticals) 2016/2017
Page 44
No Item Code
Medium Description
Item level
VEN
status
1 New
00104203
Isoniazid injection 50mg/2ml ampoule
5 N
2 00501503
Adrenaline injection for self administration
(1.05ml single dose auto-injector devise)
. 4 N
3 New
00503001
Pentamidine isetionate powder for solution for
Injection 300mg 3 N
4 New
00502601
Tobramycin nebuliser solution 60mg / ml, in 5ml
ampoule 3 N
5 New
00502501
Pirfenidone tablet 200mg
4 N
6 New
00502701
Omalizumab injection 150mg /ml 1ml vial
4 N
7 New Bupropion hydrochloride modified -release tablet
150mg 4 N
8 New
00502901
Talc powder sterile 4g bottle (sclerosing agent) to
decrease malignant pleural effusions, 3 N
9 New
00103704
Co-trimoxazole Injection 480 mg in 5ml ampoule
3 N
10 New
00108401 Colistimethate sodium injection 1,000,000 IU, vial 3 N
11 New
00603701
Infiuenza vaccine 0.5ml prefilled syringe
4 N
Drugs included to the Formulary
No Item Code Medium Description
1
New
00104002
Ethambutol injection 100mg/ml,10ml vial
2 New
00500206
Fluticasone propionate 50 microgram with
Salmeterol xinafoate 25 microgram / metered
dose,120 dose unit
3
New
01001401
Fluticasone propionate nasal spray 50 microgram
/metered dose, 150 dose unit
4
New
00500901
Tiotropium bromide dry powder capsule 18
microgram
5 New
00502801
Inhalation device for Tiotropium bromide
monohydrate Inhalation powder capsule 18
microgram
6
New
00500505
Theophylline syrup 25mg /5ml , 60ml bottle
7
New
00501802
Spacer device,100ml compatible with all metered
dose inhalers
Revised item list (Pharmaceuticals) 2016/2017
Page 45
8 New
00701704
Prednisolone tablet 20mg
9
New
00701704
Prednisolone syrup 5mg / 5ml ,60ml bottle
10
New
00501002
Montelukast tablet 10mg
11
New
00501001
Montelukast chewable tablet 5mg
12
New
00000203
Codeine syrup 25mg /5ml ,100ml
13
New
00502601
Tobramycin nebuliser solution 60mg / ml in 5ml
14
New
00502501
Pirfenidone tablet 200mg
15
New
00502701
Omalizumab injection 150mg /ml 1ml vial
16
New
00306501
Bupropion hydrochloride modified -release tablet
150mg
18
New
00103704
Co-trimoxazole injection 480 mg in 5ml ampoule
19
New
00603701
Infiuenza vaccine 0.5ml prefilled syringe
Newly suggested drugs will be included if they are registered only
06. Vaccines and Immunological products
6.1. Members of the sub committee
1. Dr.Lal Panapitiya, Director, Medical Supplies Division
2. Prof. Shalini Sri Ranganathan, Professor in Pharmacology
3. Prof. Pujitha Wickkramasinghe, Professor in Pediatrics, LRH
4. Dr. Kanthi Nanayakkara, Consultant Vaccinologist and Virologist, MRI
Revised item list (Pharmaceuticals) 2016/2017
Page 46
5. Dr. Prabha Palihawadana, Director, Epidemiology unit
6. Dr. Rajeeva de Silva, Consultant Immunologist, MRI
7. Dr. A. Wijewickkrama, Consultant Physician, National Hospital for Infectious Diseases,
8. Dr. Vishaka Rathnamalala, Consultant Heamatologists, NHSL
9. Mr. E.D.Weerarathne, Former Assistant Director, MSD
6.2.Approved item list: Vaccines and Immunological products
Drugs available for all levels of Institutions
No
Item
Code Medium Description Item Category VEN status
1 00600101
Tetanus toxoid vaccine 0.5ml(single dose)
ampule R E
2 00602301 Antisnake venom serum Injection 10ml R V
Drugs available for level 2,3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
Revised item list (Pharmaceuticals) 2016/2017
Page 47
1 00600201 Anti Rabies vaccine R V
2 00602201 Antitetanus human immunoglob.250IU R E
Drugs available for level 3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 00600301 Hepatitis B vaccine single dose vial C N
2 00600401 Meningococcal vaccine single dose vial C E
3 00603001 Varicella Zoster Immunoglobulin 2ml Ampoule C N
4
00600402 Meningococcal Conjugate Tetravalent vaccine
single dose Vial C N
5 00600501 Pneumococcal vaccine singledose vial C E
6 00600601 Yellow fever vaccine 0.5ml single dose C E
7 00600602 Yellow fever vaccine(10D)vial+diluent C N
8 00601101 Varicella vaccine 0.5ml Vial C N
9 00602401 Anti Rabies serum 1,000I.U./5ml R V
10 00602501 Anti Rabies human immunoglobulin 300I.U. R E
11 00602502 Anti Rabies human immunoglobulin 750IU C N
12 00603201 Human immunoglobulin for IV use, 1g R E
13 00603202 Human Immunoglobulin for IV use 2.5g R E
14 00603205 Human immunoglobulin for IV use 5-6g R E
15 New Human immunoglobulin for subcutaneous use 3 N
Drugs available for level 5 Institution
Revised item list (Pharmaceuticals) 2016/2017
Page 48
No Item Code
Medium Description
Item
Category VEN status
1 00600102 Tetanus Toxoid vaccine,10 dose vial C N
2 00600801 Bacillus Calmette-Guerin vaccine ,20 dose vial C N
3 00600901
Typhoid Vi capsular polysaccharide vaccine,10
dose vial C N
4 00601001
Live Japanese Encephalitis vaccine (LJEV), 5 dose
vial C N
5 00601601 MMR vaccine 10 dose vial C N
6 00601701
Adsorbed Adult Tetanus and Diphtheria vaccine
(aTD),10 dose vial C N
7 00601702
Adsorbed Diphtheria and Tetanus vaccine (DT),10
dose vial C N
8
00601801
Adsorbed Diphtheria Tetanus and Purtussis
vaccine(DPT), 1
0 dose vial
C N
9 00601903 Bivalent Poliomyelitis vaccine Live 10 dose vial C N
10 00602001 DPTHepBHIb (Pentavalent) vaccine10 dose vial C N
11 00600903 Human Papilloma virus recombinant vaccine C N
12 00601905 Inactivated poliovirus vaccine (IPV) 5 dose vial
13 00600302 Hepatitis B vaccine, (10 dose) vial C N
14 00603603 Tuberculin for Mantoux test 5TU/0.1 ml, 1ml vial C N
Drugs to issue on Named Patient basis
No Item Code Medium Description
Ite
m
leve
l
VE
N
stat
us
Remarks
1
New
00603701
Infiuenza vaccine 0.5ml prefilled syringe 3 N For prevention of
seasonal influenza
in patients with
high risk for
morbidity and
mortality
2 New
00603002
Varicella zoster specific Immunoglobulin
(VZIG) (Human) Lyophilized 250mg vial
3 N For post exposure
propylaxis of VZV in
immunocompromized
, pregnant, neonates
3 New
00603801
Cytomegalovirus specific Immunoglobulin
(CMVIg) 50mg /ml
3 N For management of
CMV pneumonitis in
severly
immunocompromised
e.g. bone marrow
transplant patients
4
New
00600303
Hepatitis B specific Immunoglobulin(HBIG)
50units/ml in 10ml vial
3 N For post-exposure
propylaxis of HBV in
Revised item list (Pharmaceuticals) 2016/2017
Page 49
non immune
individuals
5 00602901 Hepatitis B Immunoglobulin 200I.U. 3 N 1
2
006029
01
Vaccines for animal use
No Item Code Medium Description Item Category VEN status
1 00603301 A.R.V. for animal use 10 dose C N
2 00603501
Japanese Encephalitis
vaccine(swine) C N
Other Decisions
No. Item Remarks
01. 00600401- Meningococcal vaccine single
dose vial
00600402 - Meningococcal conjugate
Tetravalent vaccine single dose Vial
To be procured the most economical product from
the two products of SR.No: 00600401 and
SR.NO: 00600402, As per instruction given by
Vaccinologists.
07.Drugs used in Endocrine system
Revised item list (Pharmaceuticals) 2016/2017
Page 50
7.1.Members of the sub committee
1. Dr. Lal Panapitiya, Director, Medical Supplies Division
2. Prof. Rohini Fernandopulle, Professor of Pharmacology
3. Prof. Shyamya de Silva, Professor in Paediatrics , LRH
4. Prof. Athula Kaluarachchi, Professor in Obstetrics and Gynecology
5. Dr. Manilka Sumanathilaka Consultant Endocrinologist, NHSL
6. Dr. Uditha Bulugahapitiya, Consultant Endocrinologist, T.H.Kalubowila
7. Dr.Noel Somasundaram, Consultant Endocrinologist, NHSL
8. Dr. Nayananjalee Karunasena, Consultant Endocrinologist, T.H.Karapitiya
9. Dr. Navoda Athapaththu, Consultant Pediatric Endocrinologist, LRH
10. Dr. K.V.C.Janaka, Consultant Physician, G.H. Sri Jayawardanapura
11. Mr. E.D. Weerarathne, Former Assistant Director, Medical Supplies Division
7.2.Approved item list: Drugs used in diseases of the Endocrine System
Revised item list (Pharmaceuticals) 2016/2017
Page 51
Drugs available for all Levels of Institutions
N
o
Item
Code Medium Description
Item
Category
VEN
status
1 00700301 Gliclazide tablet 40mg R E
2 00700302 Gliclazide tablet 80mg R E
3
New
00700303 Gliclazide modified released tablet 30mg R E
4 00700401 Metformin tablet 500mg R E
5
New
00700403 Metformin S.R. tablet 500mg R N
6
00701101
Thyroxine tablet 50 microgram R E
7
New
00701103 Thyroxine tablet 25 microgram R E
8 00701102 Thyroxine sodium tablet 100 microgram R E
9 00701503 Hydrocortisone hemisucci.inj. 100mg R V
10 00701601 Dexamethasone tablet 0.5 mg R E
11 00701701 Prednisolone tablet 5mg R E
12 01300801 Levonorgestrel 0.15mg + Ethinyl oestradiol 0.03mg tablet R E
13 01301301 levonorgestrel tablet 1.5 mg R E
14 00702601
Medroxyprogesterone acetate Injection, 150mg in 1ml
vial R E
Drugs available for Level 2,3 & 4 Institutions
N
o
Item
Code Medium Description
Item
Category
VEN
status
1 00700601
Bipha.Isoph.Insulin(human) Injection (30/70) 1000 IU /
10ml. R E
2 00700701 InsulinIsophane(human)1,000IU/10ml R E
3 00700801 Insulin soluble(human) Inj.1,000IU/10ml R E
4 00701201 Carbimazole tablet 5mg R E
5
New
00701202 Carbimazole tablet 10mg R E
6 00701602 Dexamethasone Inj. 8mg/2ml R E
7 00704301 Potassium Iodide tablet 5 mg R N
Drugs available for Level 3 & 4 Institutions
N Item Medium Description Item VEN
Revised item list (Pharmaceuticals) 2016/2017
Page 52
o Code Category status
1 00701001 Glucagon Inj. 1 I.U. vial R N
2 00701301 Propylthiouracil tablet 50mg R E
3 00701401 Fludrocortisone tablet 0.1mg R E
4 00701501 Hydrocortisone tablet 5mg R N
5 00701502 Hydrocortisone tablet 10mg R E
6 00701803
Methylprednisolone acetate Injection for
intramuscular/Intra-articular Injection 40mg 1ml Vial R N
7 00701804 Methylprednisolone IV Inj.500mg R E
8 00701805 Methylprednisolone IV Inj. 1gVial R E
9 00704501 Triamcinolone acetonide Inj40mg/ml R N
10 00702701 Testosterone enanthate Inj.250mg/1ml R N
11
New
00706401 Testosterone undecanoate Inj. 250mg/1ml ,4ml vial R N
12 00703001 Tetracosactrin Inj.250 microgram / 1ml R E
13 00703202 Somatropin for injection BP/USP 2 IU-30 IU R E
14 00703302 Desmopresin acetate nasal spray(60m spray) R E
15 00703502 Alendronate sodium tablet 70mg R E
16 00703701 Zoledronic acid Injection4mg/5ml R N
17 New ketoconazole tablet 200mg R N
18 00703801 Bromocriptine tablet 2.5mg R N
19 00703901 Cabergoline tablet 500 microgram R N
20 00701901 Conjugated estrogens tablet 0.325mg R N
21 00701902 Conjugated estrogens tablet 0.625mg R N
22 00702001 Ethinyloestradiol tablet 5 microgram C N
23 00702003 Ethinyloestradiol tablet 20 microgram R N
24 00702101 Dydrogesterone tablet 10mg R N
25 00702201
Oestradiol valerate 2mg, 11 tablets and Oestradiol
valerate 2mg + Cyproterone acetate 1mg, 10 tablets in a
calendar pack
C N
26 00702401 Hydroxyprogesterone Injection 250mg in 1ml ampoule R E
27 00702501 Norethisterone tablet 5mg R E
28 00702801 Clomiphene citrate tablet 50 mg R E
29 00703101 Human Chorionic Gonadortophin 5000 IU R N
30 00703103 Human Chorionic Gonadotrophin 2000 IU C N
31 01207301 Goserelin acetate implant 3.6mg R E
32
New
00706501 Sitagliptin tablet 100mg C N
33
New
00706801 Insulin pen to be used with replaceable insulin cartridge C N
34
New
00706701
Insulin soluble (human) 25% - 30% + Protamine 70% -
75%, 300 IU per 3ml cartridge C N
35
New
00706901 Insulin soluble (Human) 300 IU in 3ml cartridge C N
Revised item list (Pharmaceuticals) 2016/2017
Page 53
36 New
00706802
Needle for insulin pen, size 30-32 gauge, 3mm-5mm
length C N
37
01207402 Octreotide injection 50mcg in 1ml amp R E
Drugs available for Level 4 Institutions
N
o
Item
Code Medium Description
Item
Category
VEN
status
1
New
00705501 Diazoxide tablet 50mg C N
2 00703002 Corticotrophin Injection 200 I.U. in 5ml ampoule R E
3 00703301 Desmopressin tablets 100 microgram R N
4
New
00703305
Desmopressin acetate Injection 4 microgram / ml ,1ml
ampoule C N
5 00703401 Vasopressin Injection 20 I.U. in 1ml ampoule R E
6 00703601 Pamidronate disodium Inj. 30mg R N
7 00704001 Danazol capsule 100mg C N
8
New
00705601 Oxandrolone tablet 10mg C N
9 01207201 Leuprorelin acetate 3.75mg vial with solvent 2ml C N
Drugs deleted /tailed offed from the Formulary
N
o
Item
Code Medium Description
Reasons for the
deletion
1 00700101 Glibenclamide tablet 5mg
To gradually tail off and
to fullfill the
requirement with
Gliclazide
2 00700201 Tolbutamide tablet 500mg
To remove from the list
and replace by
Gliclazide
3 00700402 Metformin tablet S.R. 850mg
To remove from the list
and to be replaced with
metformin 500mg SR
tablet
4 00704401 Methimazole tablet 5mg carbimazole is adequate
5 00703102 Human Chorionic Gonadotrophin 500 IU
To remove from the list
as 5000IU strength is
adequate
6 01207202
Leuprorelin acetate injection 1mg in 0.5ml Goserelin can be used as
an alternatives
Revised item list (Pharmaceuticals) 2016/2017
Page 54
7 00703201 Somatropin Inj. 24 IU(8mg)
Replaced by
‘Somatropin for
injection BP/USP 2 IU-
30 IU’
Drugs to issue on a Named Patient basis
N
o
Item
Code Medium Description
Item
Category
VEN
status
1
New
00705602 Oxandrolone tablet 10mg
3 N
2
New
00705101 Cetrorelix injection 250 microgram
3 N
4
New
00705901 Human Menopausal Gonadotrophin Injection 75 IU
3 N
5 01207403
Octreotide injection (LA) 30mg vial with solvent in 2.5ml
pre-filled syringe 3 N
6 00707101 Follicle - Stimulating Hormone (FSH) Injection 75 IU vial
C N
Drugs included to the Formulary
N
o
Item
Code Medium Description
1
New
00700303 Gliclazide Modified released tablet 30mg
2 New Metformin S.R. tablet 500mg
3
New
00706501 Sitagliptin tablet 100mg
4
New
00706801 Insulin pen to be used with replaceable insulin cartridge
5
New
00706701
Insulin soluble (human) 25% - 30% + Protamine 70% -
75%, 300 IU per 3ml cartridge
6
New
00706901 Insulin soluble (human) 300 IU in 3ml cartridge
7
New
00706802
Needle for insulin pen, size 30-32 Gauge, 3mm-5mm
length
8
New
00701101 Thyroxine tablet 25 microgram
9
New
00701202 Carbimazole tablet 10mg
10
New
00706401 Testosterone undecanoate Inj. 250mg/1ml ,4ml vial
11
New
00703305
Desmopressin acetate Injection 4microgram /ml ,1ml
ampoule
Revised item list (Pharmaceuticals) 2016/2017
Page 55
12 New
00112201 Ketoconazole tablet 200mg
13
New
00705501 Diazoxide tablet 50mg
Revised item list (Pharmaceuticals) 2016/2017
Page 56
08. Drugs used in Gastrointestinal system
08.1.Members of the sub committee
1. Dr. Lal Panapitiya, Director, Medical Supplies Division
2. Prof. Rohini Fernandopulle, Professor in Pharmacology
3. Dr. Ranjith Peris, Consultant Gastroenterologist, NHSL
4. Dr. N.M.M.Nawarathne, Consultant Gastroenterologist, NHSL
5. Dr. Madunil Niriella, Consultant Gastroenterologist, CSTH
6. Dr. Sanjeewa Ariyasinghe, Consultant Gastroenterologist, CSTH
7. Dr. Nilesh Fernandopulle, Consultant Gastroenterologist, T.H.Jaffna
8. Dr. Chamila Ranawaka, Consultant Gastroenterologist, G.H.Rathnapura
9. Dr. Mananjula Senanayake, Consultant Gastroenterologist, G.H.Kurunegala
10. Dr. Sujeeva Kumarasena, Consultant Gastroenterologist, T.H. Galle
11. Dr. Jayani Manchanayake, Consultant Gastroenterologist, CNTH
12. Dr. Shaman Rajindrajith, Consultant Pediatrician, CNTH
13. Dr. Ranjani Edirisooriya, Consultant Pediatrician, G.H. Polonnaruwa
14. Mr. Weerarathne, Former Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 57
08.2.Approved item list: Drugs acting on Gastrointestinal system
Drugs available for all Levels of Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00800401 Domperidone tablet 10mg R E
2 00800402 Domperidone syr. 5mg/5ml,60ml bottle R E
3 00800501 Metoclopramide tablet 10mg R E
4 00800502 Metoclopramide Inj.10mg/2ml ampoule R E
5 00800802 Omeprazole cap. 20mg R E
6 00801201 Bisacodyl tablet 5mg R E
7 00801202 Bisacodyl tablet 10mg R N
8 00801203 Bisacodyl suppository 10mg R N
9 00801302 Lactulose syr.3.0-3.7mg/5ml,120ml bottle R E
10 New
00801304
Lactulose syr.3.0-3.7mg/5ml,500ml bottle R E
Drugs available for Level 2,3 & 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00800201 Hyoscine butylbromide tablet 10mg R N
2 00800601 Famotidine tablet 20mg R N
3 00800801 Omeprazole tablet 10mg R N
4 00800803 Omeprazole sodium Inj. 40mg vial R E
Drugs available for Level 3 & 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00800202 Hyoscine butylbromide injection 20mg /1ml
ampoule R N
2 New
00800406 Domperidone suppository 10mg R E
3 00800404 Domperidone suppository 30mg R E
4 New
00800405 Domperidone suppository 60mg R E
5 00800701 Ranitidine HCl Inj. 50mg/2ml,ampoule R N
6 00800901 Sulphasalazine tablet 500mg R E
7 00801401 Iso-osmotic bowel cleansing preparation
(Macrogols 59g) R E
Revised item list (Pharmaceuticals) 2016/2017
Page 58
8 New
00802601
Sodium biphosphate 1.6g and Sodium phosphate
0.6g enema in 10ml , 120 ml container R E
9 00801601
Ursodeoxycholic acid tablets150mg C N
10 01400701
Penicillamine capsule 250mg R E
11 00704501
Triamcinolone acetonide Injection 40mg / 1ml vial R N
Drugs available for Level 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 New
00800301
Mebeverine hydrochloride tablet 135mg C N
2 New
00802002 Pantoprazole Injection 40mg vial C N
3 00801001 Mesalazine tablet 400mg C E
4 New
00802401
Macrogols (Polyethylene glycol) Sachet 13.125 g C N
5 New
00802801 L Ornithine L Aspartate 5g in 10ml ampoule C N
6 New
00404202
Trientine dihydrochloride capsule 300mg C N
7 New
00108601
Tenofovir tablet 300mg C N
8 00801701 Pancreatic enzyme capsule (protease 600U, lipase
10000U, amylase 8000U) R N
9 00801702 Pancreatic enzyme capsule (protease 1000U, lipase
25000U, amylase 40000U) 4 N
10 New
00802201
Loperamide hydrochloride tablet 2mg R N
11 New
00802501 Terlipressin acetate1mg vial C N
Drugs available for Level 5 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00107801 Lamivudine 150mg tablet C E
Revised item list (Pharmaceuticals) 2016/2017
Page 59
Drugs deleted from the Formulary
No
Item
Code Medium Description Reasons for the deletion
1 00801501 Glycerine suppository 2g slow moving item
2 00801602 Ursodeoxycholic acid suspension 250mg/5ml Ursodeoxycholic acid
tablet 150mg is adequate.
3 00801801 Tincture Ipecac Not used in last five years
4 00801901 Ginger Tincture Not used in last five years
Drugs to issue on Named Patient basis
No
Item
Code Medium Description Item level
VEN
status
1 New
00801002
Mesalazine suppositories 500mg
4 N
2 New
00802301
Budesonide capsule 3mg
3 N
3 New
00802701 Hydrocortisone acetate 10% foam enema 100mg
4 N
4 New
01401701
Infliximab Injection 100mg vial
4 N
5 New
Cholestyramine 4g Sachet
4 N
6 New
00112301 Sofosbuvir 400mg tablet
4 N
7 New
00112401 Ledipasvir 90mg/Sofosbuvir 400mg tablet
4 N
8 New
00108601
Tenofovir tablet 300mg
4 N
9 New
00801604 Rifaximine tablet 550mg
4 N
10 New
00109803 Ribavirin capsule 400mg
4 N
11 New
01206001
Peg Interferon alfa - 2a 180 microgram prefilled
syringe/vial 4 N
12 New
01206002
Peg Interferon alfa - 2a 135 microgram prefilled
syringe/vial 4 N
13 New
00112501
Valpatasvir 100mg / Sofosbuvir 400mg tablet
4 N
14 New
00112601 Daclatasvir tablet 60mg
4 N
15 New
00112701 Tenofovir alafenamide tablet 25mg
4 N
16 New Entacavir tablet 0.5mg 4 N
Revised item list (Pharmaceuticals) 2016/2017
Page 60
00112801
17 00404202 Trientine Dihydrochloride capsule 300mg 4 N
Drugs included to the formulary
No
Item
Code Medium Description
1
New
00800301
Mebeverine hydrochloride tablet 135mg
2
New
00800406 Domperidone suppository 10mg
3
New
00800405 Domperidone suppository 60mg
4
New
00802002 Pantoprazole Injection 40mg
5
New
01401701
Infliximab Injection 100mg vial
6
New
00801304
Lactulose syr.3.0-3.7mg/5ml,500ml bottle
7
New
00802401
Macrogols (Polyethylene glycol) Sachet
8
New
00802601
Sodium biphosphate 1.6g and Sodium Phosphate
0.6g enema in 10ml , 120 ml container
9
New
00802801 L Ornithine L Aspartate 5g in 10ml ampoule
10
New
00404202
Trientine dihydrochloride capsule 300mg
11
New
00112401 Ledipasvir 90mg/Sofosbuvir 400mg tablet
12
New
00802201
Loperamide hydrochloride tablet 2mg
13
New
00802501 Terlipressin acetate1mg vial
Newly suggested drugs will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 61
09. Drugs acting on the Eye
09.1.Members of the sub committee
1. Dr. Lal Panapitiya, Director, MSD
2. Prof. Rohini Fernandopulle, Professor in Pharmacology
3. Dr.Binara Amarasingha - Consultant Ophthalmologist, National Eye Hospital,Colombo
4. Dr.Pradeepa K. Siriwardena - Consultant Ophthalmologist, National Eye Hospital,Colombo
5. Dr.Kapila Banduthilake, Consultant Ophthalmologist, National Eye Hospital, Colombo.
6. Dr.Muditha Kulathunga, Consultant Ophthalmologist, National Eye Hospital, Colombo.
7. Dr.Hiranya Abeysekara - Consultant Pediatric Ophthalmologists, Lady Ridgeway Hospital
8. Dr.H.R.Dayawansa, Consultant Ophthalmologist, B.H.Awissawella
9. Dr. Prasad Pathirana, Consultant Ophthalmologist, Base Hospital, Embilipitiya
10. Dr.Kushlani Goonarathne, Consultant Ophthalmologist, Base Hospital, Elpitiya
11. Mr. E.D.Weerarathne, Formar Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 62
09.2.Approved item list: Drugs acting on the Eye
Drugs available for all Levels of Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00900101 Ciprofloxacin eye drops 0.3%, 5ml vial R E
2 00904003 Chloramphenicol eye ointment 1%, 3.5g tube R E
3 00901401 Tropicamide eye drops 1% ,5ml Vial R E
Drugs available for Levels 3 & 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00900201 Fucidic acid eye drop 1%, 5ml vial R E
2 00900301 Tetracycline eye ointment 1%,3.5g R N
3 00900401 Gentamicin eye drops 0.3%,5ml vial C N
4
New
00904901 Natamycin ophthalmic suspension 5% in 15ml vial R E
5 00900602 Acyclovir eye ointment 3%, 5g tube R E
6 00901001 Prednisolone acetate eye drops 1%,5ml vial R E
7
New
00904501 Olopatadine hydrochloride eye drop 1mg/ml,5ml C N
8 00901101 Fluorometholone eye drops 0.1%w/v,5ml vial C N
9 00901201 Atropine sulphate eye drops 1% in 5ml vial R N
10 00901301
Cyclopentolate hydrochloride eye drops 0.5%, 5ml
vial R E
11 00901302 Cyclopentolate hydrochloride eye drops 1.0% 5ml R E
12 00901501
Tropicamide 0.8% with Phenylephrine
hydrochloride 5% eye drops 5ml vial R E
13 00901702 Timolol maleate eye drops 0.5%, 5ml vial R E
14 00901801 Acetazolamide tablet 250mg R E
15 00901802 Acetazolamide sodium Injection 500mg vial R N
16 00901903 Pilocarpine nitrate Eye Drops 4% in 10ml vial R N
17
New
00902602
Acetylcholine chloride intraocular
solution10mg/ml 2ml vial R N
18 00902101 Fluorescein sodium Injection 10% in 5ml vial R E
19 00902103 Fluorescein powder for Eye Drops R N
20
New
Fluorescein dye impregnated strips -No SR R N
21 00902201
Hydroxypropylmethylcellulose ophthalmic solution
for intraocular use 2%, 5ml prefilled syringe R E
22 00902901
Bimatoprost ophthalmic suspension 30 microgram
/ml,3ml vial C E
23 00903001 Brinzolamide eye drops 1%,in 5ml vial C E
Revised item list (Pharmaceuticals) 2016/2017
Page 63
24 00903201 Nepafenac ophthalmic suspension 0.1%,3ml R E
25 00903601 Carbachol intraoccular solution 0.01%,1ml vial R N
26 00903801
Hydroxyethylcellulose 0.44% + Sodium chloride
0.35% eye drop 10ml vial R N
27 00904101
Moxifloxacin hydrochloride ophthalmic solution
0.5%, 5ml vial R E
28 00903901
Sodium hyaluronate for intraocular use 4mg/0.4ml
vial R N
29 00904302
Tobramycin 0.3% with Dexamethasone 0.1% eye
drops,10ml dropper bottle R E
30 01202901 Bevacizumab injection 100mg / 4ml vial C N
31
New
00904801
Proparacaine hydrochloride ophthalmic solution
0.5% in 15ml R N
32
00704501
Triamcinolone acetonide injection 40mg / 1ml R N
33
New
14560002 Ophthalmic surgical drape 10cm x12cm(4"x4"1/2) R E
34
New
14560003
Ophthalmic surgical drape with pouch size 50cm
x40cm R E
35
New
14560004
Ophthalmic surgical drape with pouch size 40cm
x60cm R E
36
New
14560001 Ophthalmic surgical Drape 6cm x7cm R E
37
New
00905001
Sodium chondroitin sulfate 40mg with Sodium
hyaluronate 30mg Solution in Pre-filled syringe C N
38
New
00905201
Lidocaine hydrochloride ophthalmic gel 2% in 30g
tube C N
39
New
00904401 Trypan blue solution 0.06% w/v C N
Drugs available for Level 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 00901701 Timolol maleate eye drops 0.25%, 5ml vial R N
2 00902001 Balanced salt solution,500ml plastic bottle R E
New
00902002 Balanced salt solution,500ml glass bottle C N
3 00902401 Perflurodecalin 5ml vial C E
4 00902502 Silicone oil 10ml bottle C E
5
New
00905301
Brinzolamide 10 mg/1ml with timolol maleate 5
mg /1 ml eye drop in 5ml dropper bottle R N
6 00903701 Indocyanine green for injection 25mg vial R N
7
New
00904601 Brilliant blue G 0.05% in 1ml vial R N
8 New Cyclosporin eye drop 0.1% w/v, 5ml C N
Revised item list (Pharmaceuticals) 2016/2017
Page 64
00904701
9 00107302 Voricanazole Injection 200mg in 10ml C N
Drugs deleted from the Formulary
No
Item
Code Medium Description Reasons for the deletion
1 00900501 Propamidine eye drops0.1%,10ml vial Not used in last five years
2 00901902 Pilocarpine nitrate eye drops 2% in 10ml vial
Pilocarpine nitrate Eye
Drops 4% is adequate
3 00902701 Latanoprost eye drops 50 microgram /ml,2.5ml vial Bimatoprost is adequate
4 00902801 Travoprost eye drops 40 microgram /ml,2.5ml vial Bimatoprost is adequate
5 00903101 Dorzolamide ophthalmic solution 2%,5ml vial Brinzolamide is adequate
6 01401501 Hyaluronidase Injection 1,500 U vial/ampoule
7 01000601 Betamethasone sodium phosphate for Eye,Ear or
Nasal drops 0.1% in 5ml vial
New SR used for Ear and
nasal only preperation (no
need eye drop)
8 01001101 Tobramycin 0.3% with Dexamethasone 0.1% eye
and ear drops, 10ml dropper bottle
Replaced by SR No.
00904302. (Decided to keep
eye and ear separatly)
9 00902103 Fluorescein powder for Eye Drops
Decided to remove the
'Fluorescein powder' from
the formulary after including
fluorescein dye impregnated
strips.
Drugs included to the Formulary
No
Item
Code Medium Description
1
New
00904901 Natamycin ophthalmic suspension 5% in 15ml vial
2
New
00904501 Olopatadine hydrochloride eye drop 1mg/ml,5ml
3
New
00902602
Acetylcholine chloride intraocular
solution10mg/ml 2ml vial
4
New
Fluorescein dye impregnated strips
5
New
00905301
Brinzolamide 10 mg/1ml with timolol maleate 5
mg /1 ml eye drop in 5ml dropper bottle
6
New
00904302
Tobramycin 0.3% with Dexamethasone 0.1% eye
drops,10ml dropper bottle
7
New
00904601 Brilliant blue G 0.05% in 1ml vial
8 New Cyclosporin eye drop 0.1% w/v, 5ml
Revised item list (Pharmaceuticals) 2016/2017
Page 65
00904701
9 New
00904701
Proparacaine hydrochloride ophthalmic solution
0.5% in 15ml
New
00902001 Balanced salt solution,500ml glass bottle
10
New
14560002 Ophthalmic surgical drape 10cm x12cm(4"x4"1/2)
11
New
14560003
Ophthalmic surgical drape with pouch size 50cm
x40cm
12
New
14560004
Ophthalmic surgical drape with pouch size 40cm
x60cm
13
New
14560001 Ophthalmic surgical drape 6cm x7cm
Newly suggested drugs will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 66
10. Drugs used in the treatment of diseases of Ear, Nose and
Oropharynx
10.1. Members of the sub committee
1. Dr. Lal Panapitiya, Director, MSD
2. Prof. Rohini Fernandopulle, Professor in Pharmacology
3. Dr.Ravi Dayasena, Consultant Otorhinolaryngologists, NHSL
4. Dr.Waruna Jayasinghe, Consultant Otorhinolaryngologists, B.H.Puttalam
5. Dr.Madavika Dayarathna, Consultant Otorhinolaryngologists, DGH Chilaw
6. Dr.Dencil Indika, Consultant Otorhinolaryngologists, B.H.Embilipitiya
7. Dr.A.D.K.S.N.Yasawardana, Consultant Otorhinolaryngologists, LRH
8. Dr.S.M.B.H.Ethulagama, Consultant Otorhinolaryngologists, SBSCH
9. Dr.K.D.R.A .Kirihena, Consultant Otorhinolaryngologists, LRH
10. Mr. E.D.Weerarathne, Formar Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 67
10.2. Approved item list: Drugs Used in the treatment of diseases of Ear, Nose and Oropharynx
Drugs available for all Levels of Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 01000201 Gentamicin sulphate ear drops 0.3% w/v in 10ml
vial R E
Drugs available for Level 3 & 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 01000301 Gentamicin 0.3% with Hydrocortisone 1% ear
drops 10ml vial R N
2 New
01001901
Ciprofloxacin ear drops 0.3% w/v, 5ml dropper
bottle R N
3 01000401 Clotrimazole 1% with Lignocaine 2% ear drops
10ml vial R E
4 01000501 Docusate sodium ear drops 0.5%, 10ml vial R N
5 01000601 Betamethasone sodium phosphate for Eye,Ear or
Nasal drops 0.1% in 5ml vial R E
6 01000701 Xylometazoline hydrochloride nasal drops 0.1% in
10ml Vial R E
7 01000801 Ofloxacin ear drops 0.6% in 5ml vial C E
8 01000901 Oxytetracycline 3% with Hydrocortisone acetate
1% ,ear ointment 15g R N
9 01001001 Tobramycin ear drops 0.3%, 5ml vial R E
10 01001104 Tobramycin 0.3% with Dexamethasone 0.1% ear
drops,10ml dropper bottle R N
11 01001201 Silver nitrate sticks for nasal cautering R N
12 01001301 Beclomethasone diprionate nasal spray 100
microgram /metered dose 200 dose unit R E
13 01001401 Fluticasone propionate nasal spray 50 microgram /
metered dose, 150 dose unit R N
14 01001501 Triamcinolone acetonide oral paste 0.1%,5g tube
R N
15 New
01001502
Triamcinolone acetonide nasal spray 55
microgram / spray, 120 spray unit R N
16 01001601 Clotrimazole mouth paint 1%, 15ml bottle R E
17
01001701 Betamethasone sodium phosphate 0.1% with
Neomycin sulphate 0.5% for Eye,Ear or Nasal
drops 5ml vial
R E
Revised item list (Pharmaceuticals) 2016/2017
Page 68
18 01001801 Miconazole oromucosal gel 40g tube/container. R E
19 01001802 Miconazole oromucosal gel 15g tube/container R E
20 New
01107301 Betamethasone 0.1% with Fusidic acid 2% cream R N
21 01102301 Fusidic acid cream 2% 5g tube C E
22. 00000101
Cocaine Hydrochloride powder C N
Drugs deleted from the Formulary
No
Item
Code Medium Description Reasons for the deletion
1 01001102 Tobramycin 0.3% with Dexamethasone 0.1% eye
and ear drops ,5ml vial
Tobramycin 0.3% with
Dexamethasone 0.05% eye
and ear drops, 10ml vial
(SR No: 01001101) is
adequate.
2 01001101 Tobramycin 0.3% with Dexamethasone 0.1% eye
and ear drops, 10ml dropper bottle
Replaced by SR No.
01001104. (Decided to keep
eye and ear separatly)
3
01105901
Fusidic acid 2% with Hydrocortisone acetate 1%
ointment 15g tube
To replace with
Betamethasone 0.1% with
Fusidic acid 2% cream (SR
01107301)
Drugs included to the Formulary
No
Item
Code Items Medium Description
1
New
01001901
Ciprofloxacin ear drops 0.3% w/v, 5ml dropper
bottle
2
New
01001502
Triamcinolone acetonide nasal spray 55
microgram /spray, 120 spray unit
3
01001104 Tobramycin 0.3% with Dexamethasone 0.1% ear
drops,10ml dropper bottle
4
New
01107301 Betamethasone 0.1% with Fusidic acid 2% cream
Newly suggested drugs will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 69
11. Drugs used on the Skin
11.1. Members of the sub committee
1. Dr. Lal Panapitiya, Director, Medical Supplies Division
2. Prof. Rohini Fernandopulle, Professor in Pharmacology
3. Dr. Sriyanie Samaraweera, Consultant Dermatologist, LRH
4. Dr. Indira Kahawita, Consultant Dermatologist, B.H, Homagama
5. Dr. Nayani Madarasinghe, Consultant Dermatologist, Infectious Diseases Hospital, Angoda
6. Dr. D.M. Amerathunga, Consultant Dermatologist, Anti Leprosy Campaign, Colombo
7. Dr. Chamil Marasinghe, Consultant Physician
8. Mr. E.D.Weerarathne, Formar Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 70
11.2. Approved item list: Drugs used on the Skin
Drugs available for all Levels of Institutions
No Item Code Medium Description Item Category VEN status
1 01101403 Hydrocortisone cream 1% ,5g tube R E
2 01102101 Framycetin skin cream 1%, 20 g tube R E
3 01102802 Miconazole nitrate cream 2%, 15g tube R E
4
01103301 Benzyl benzoate application, 25%w/v, 500ml
bottle R E
5 01103401 Permethrin cream 5%, 15g tube R N
6 01103601 Cetrimide powder 500g tin R E
7
New
01106901 Malathion lotion 0.5% w/v 50ml bottle R N
8 01103901 Sodium chloride crystals R E
9 01104001 Hydrogen peroxide 6%v/v , 450ml bottle R E
10 01104201 Potassium permanganate crystal R E
11 01104901 Sulphur precipitated powder R N
12
New
00103903 Trimethoprim tablet 200mg R E
13 01106001 Creta gallica powder R N
14 01106301 Glycerin Liquid R N
15 0104901 MDT-MB Paediatric R E
16 0104902 MDT-MB Adult R E
17 0105001 MDT-PB Paediatric R E
18 0105002 MDT-PB Adult R E
Drugs available for Level 2,3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 01100101 Paraffin, liquid R E
2 01100102 Paraffin,yellow soft R E
3
New
01100103 White soft paraffin R E
4 01100201 Wax,emulsifying R E
5 01100801 Starch powder R N
6 01101101 Calamine powder R E
7 01101401 Hydrocortisone ointment 1%, 5g tube R E
8 01101602 Betamethasone ointment 0.1%,15g tube R E
11 01101604 Betamethasone cream 0.1%,15g tube R E
Revised item list (Pharmaceuticals) 2016/2017
Page 71
9 01102201 Silver sulphadiazine cream 1%,500g jar R E
10 01102501 Benzoic acid powder R N
11 01102601 Salicylic acid powder R E
12 01102901 Magenta crystals R N
13 01104801 Zinc oxide powder R E
14
New
01107002 Benzoyl peroxide gel 2.5%,20g tube
C N
15
New
01107001 Benzoyl peroxide gel 5%,30g tube
C N
16
01101501 Hydrocortisone 0.5% with clioquinol 3%
cream,15g tube R E
Drugs available for Level 3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 01100301 Urea crystals R N
2 01100401 Coconut oil R E
3 01100501 Coal tar solution R E
4 01100601 Dithranol powder R E
5 01100701 Methoxsalen tablet 10mg R N
6 01100901 Flexible collodion R N
7 01101301 Crotamitone cream 10% 20gm tube R E
8 01101402 Hydrocortisone ointment 1%,15g tube R E
9 01101404 Hydrocortisone cream 1%,15g tube R E
10
01101701 Betamethasone dipropionate lotion 0.05%, 50ml
bottle R E
11 01001801 Miconazole oromucosal gel 15g tube/container R E
12 01101901 Fluocinolone cream 0.025% ,15g tube R E
13 01102001 Clobetasol propionate ointment 0.05%,15g tube R N
14 01102301 Fusidic acid cream 2% 5g tube C E
15 01102401 Mupirocin 2% ointment 5g tube. R E
16 01102402 Mupirocin 2% cream 5g tube R E
17 01102701 Clotrimazole cream 1%,15g tube R N
18
New
01107101 Clindamycin gel 1% w/v 30g tube R N
19 0103001 Thymol crystals R N
20 01103101 Selenium sulphide lotion, 2.5%, 60ml bottle R N
21 01104301 Silver nitrate crystals R N
22
01104602 Povidone iodne solutiotion 7.5%w/v for surgcal
scrub C E
23 01105001 Tretinoin cream 0.025%,15g tube R N
24
01105101 Calcipotriol 50 microgram /gram with
Betamethasone ointment 0.05%, 15g tubes C N
25 01105201 Podophyllin resin R N
Revised item list (Pharmaceuticals) 2016/2017
Page 72
26 01105301 Resorcinol powder R N
27
New
01107201 Adapalene gel 0.1%,45g tube C N
28 01105701 Mometasone furoate cream 0.1%,5g tube C N
29
New
01105702 Mometasone furoate cream 0.1%,15g tube R N
30
New
01107301 Betamethasone 0.1% with Fusidic acid 2% cream R N
31 01106601 Acitretin capsule 10mg R N
32 00104801 Dapsone tablet 50mg R E
33
New
00104803 Dapsone tablet 25mg R E
34 0105102 Clofazimine tablet 100mg R E
35
New
0105103 Clofazimine capsule 50mg R E
36
New
01106801 Tacrolimus ointment 0.1%, 30g tube R N
37
New
01106802 Tacrolimus ointment 0.03%,30g tube R N
38
New
01106804 Pentoxifylline modified release tablet 400mg
C N
39 01106103
Alcohol based hand rub (75%-85%) 500ml bottle R
N
Drugs deleted from the Formulary
No Item Code Medium Description Reasons for the deletion
1 01101001 Magnesium sulphate crystals Not required
2 01103701 Chlorhexidine and Cetrimide solution Not used in last five years
3 01104101 Iodine solution(weak) Not used in last five years
4 01106201 Alcohol 90%v/v Not required
5
01105901 Fusidic acid 2% with Hydrocortisone acetate, 1%
ointment, 15g tube
To replace with Betamethasone
0.1% with Fusidic acid 2%
cream
Drugs issued on Name Patient basis
No Item Code Medium Description Item level VEN status
1
New
01209503 Isotretinoin capsule 20mg
3 N
2 01209502 Isotretinoin capsule 10mg 3 N
3
New Pentoxifylline modified release tablet 400mg
3 N
Revised item list (Pharmaceuticals) 2016/2017
Page 73
01106804
4 New
01106803 Ivermectin tablet 6mg
3 N
5
New
01401702 Etanercept injection 25mg,vial
3 N
Drugs included to the Formulary
No Item Code Medium Description
1
New
01100103 White soft paraffin
2
New
01107101 Clindamycin gel 1% w/v, 30g tube
3
New
01106901 Malathion lotion 0.5% w/v, 50ml bottle
4
New
01107201 Adapalene gel 0.1%,45g tube
5
New
01209503 Isotretinoin capsule 20mg
6
New
00103903
Trimethoprim tablet 200mg
7
New
01105702
Mometasone furoate cream 0.1%,15g tube
8
New
001107301 Betamethasone 0.1% with Fusidic acid 2% cream
9
New
0105103 Clofazimine capsule 50mg
10
New
01106804 Pentoxifylline modified release tablet 400mg
11
New
01106801 Tacrolimus ointment 0.1% ,30g tube
12
New
01106802 Tacrolimus ointment 0.03%,30g tube
13
New
01107002 Benzoyl peroxide gel 2.5%,20g tube
14
New
01107001 Benzoyl peroxide gel 5%,30g tube
Revised item list (Pharmaceuticals) 2016/2017
Page 74
12. Drugs used in Malignant diseases
12.1.Members of the sub committee
1. Dr. Lal Panapitiya, Director, MSD
2. Prof. Asitha de Silva, Chairman, NMRA
3. Prof. LaL Jayakody, Professor of Pharmacology
4. Prof. Rohini Fernandopulle, Professor in Pharmacology
5. Prof. Geetha Fernando, Professor in Pharmacology
6. Prof. Priyadharshanie Galappaththy, Professor in Pharmacology
7. Prof. Shalini Sri Ranganathan, Professor in Pharmacology
8. Dr. Damayanthi Peris, Consultant Clinical Oncologist, NCI, Maharagama
9. Dr.Umagowry Sarawanamuttu, Consultant Clinical Oncologist, T.H.Karapitiya
10. Dr. Prasad Abeysinghe, Consultant Clinical Oncologist, NCI, Maharagama
11. Dr. Mahendra Somathilake, Consultant Pediatric Oncologist, NCI, Maharagama
12. Dr. Priyantha Madawala, Consultant Haematoncologist, NCI, Maharagama
13. Dr. Jaliya Jayasekara, Consultant Clinical Oncologist, G.H.Rathnapura
14. Dr. Janaka Cooray, Consultant Clinical Oncologist, T.H. Jaffna
15. Dr. Thushari Hapuarachchi, Consultant Clinical Oncologist, T.H.Anuradapura
16. Dr. Sachini Rasnayake, Consultant Clinical Oncologist, G.H.Gampaha
11. Dr. Lalindra Goonerathne, Consultant Haematologist, Faculty of Medicine, Uni. of Colombo
17. Dr. Rohan Pulleperuma, Consultant Haematologist, D.G.H. Hambanthota
18. Mr. E.D.Weerarathne, Former Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 75
12.2. Approved item list: Drugs used in Malignant diseases
Drugs available for level 2,3 & 4 Institutions
No Item Code Medium Description
Item
Category
VEN
status
1 00000801 Morphine sulphate tablet 10mg R E
2 00000802 Morphine sulphate tablet 15mg R E
3 00000804
Morphine sulphate controlled release
tablet 10mg R E
4 00000805
Morphine sulphate controlled release
tablet 30mg R E
5 00000806
Morphine sulphate controlled release
tablet 60mg R E
6 00000807
Morphine sulphate injection 15mg
ampoule R E
Drugs available for level 3 & 4 Institutions
No Item Code Medium Description
Item
Category
VEN
status
1 01200101 Busulphan tablet 2mg R N
2 01200201 Chlorambucil tablet 2mg R E
3 01200301 Cyclophosphamide tablet 50mg R E
4 01200303
Cyclophosphamide injection 200mg
vial R E
5
New-
01200304 Cyclophosphamide injection 1g vial R E
6 01200401
Ifosfamide injection 1g vial with Mesna
injection 100mg in 1ml, 3 ampoules in
one set
R E
7
New-
01210101 Mesna injection 200mg in 2ml C N
8 01200501 Melphalan tablet 2mg R N
9 01200601 Lomustine hydrochloride capsule 40mg R N
10 01200801
Bleomycin sulphate injection 15000
units vial R N
11 01200901
Actinomycin D injection 500
microgram vial R N
12 01201001
Daunorubicin hydrochloride injection,
20mg vial R N
13 01201101 Doxorubicin hydrochloride injection, R E
Revised item list (Pharmaceuticals) 2016/2017
Page 76
10mg vial
14 New-
01201103
Doxorubicin injection 2mg/ml, 25ml
vial R E
15 01201201
Epirubicin hydrochloride injection
10mg vial R N
16 01201202
Epirubicin hydrochloride injection,
50mg vial R E
17 01201401 Mitomycin injection 2mg vial R E
18 01201701 Cytarabine injection 100mg vial R N
19 01201702
Cytarabine injection 100mg in 1ml vial
(preservative free) R N
20 01201902
Fluorouracil injection 250mg in 10ml,
vial R E
21 01202001
Gemcitabine hydrochloride injection,
200mg vial R E
22 01202002
Gemcitabine hydrochloride injection 1g
vial R N
23 01202101 Mercaptopurine tablet 50mg R E
24 01202201 Methotrexate tablet 2.5mg R E
25 01202202 Methotrexate injection 50mg vial R E
26 01202203
Methotrexate inj.50mg/2ml (without
preservative) R N
27 01202204 Methotrexate injection 1g vial R E
28
New-
01202206
Methotrexate injection 500mg/5ml R E
29 01202401 Vincristine sulphate injection 1mg vial R N
30 01202501
Vinblastine sulphate injection 10mg
vial R N
31 01202601 Vinorelbine injection 50mg vial R N
32
New-
01202603 Vinorelbine tablet 30mg R E
33 01202701 Etoposide capsule 100mg R E
34 01202702 Etoposide injection 100mg vial R E
35
New-
01202703 Etoposide capsule 50mg R E
36 01202801 Folinic acid tablet 15mg R E
37 01202802 Folinic acid injection,15mg/2ml vial R E
38
New
01202803 Folinic acid injection 50mg/5ml C E
39 01203201 Asparaginase 10,000 Unit vial R N
40 01203301 Dacarbazine injection 200mg ,vial R N
41 01203401 Temozolomide capsule 100mg R N
42 01203402 Temozolomide capsule 250mg R N
43 01203501 Hydroxyurea capsule 500mg R N
Revised item list (Pharmaceuticals) 2016/2017
Page 77
44 01203601 Carboplatin injection 150mg /15ml, vial
with diluent R E
45 01203602 Carboplatin injection 450mg / 45ml vial R E
46 01203701 Cisplatin injection 10mg vial R N
47 01203702 Cisplatin injection 50mg vial R E
48 01203801 Oxaliplatin injection 50mg vial R E
49 01203803 Oxaliplatin injection 100mg vial R E
50 01203901 Procarbazine capsule 50mg R E
51 01204401 Imatinib mesilate capsule100mg R E
52 01204801 Docetaxel injection 20mg vial R E
53 01204802 Docetaxel injection 80mg vial R E
54 01204901 Paclitaxel injection 30mg/5ml vial R E
55 01204904 Paclitaxel injection 260mg / 43.4ml vial R E
56 01204905
Paclitaxel nanoparticle injection 100mg
vial C N
57 01205001 Irinotecan injection 40mg / 2ml R E
58 01205002 Irinotecan injection 100mg / 5ml R E
59 01205901
Interferon alfa injection 3 million unit
vial R E
60 01206401 Thalidomide capsule 100mg R E
61
New-
01206402 Thalidomide capsules 50mg C E
62 01206501 Megestrol acetate tablet 40mg R N
63 01206701 Anastrozole tablet 1mg R E
64 01206802 Tamoxifen tablet 20mg R E
65 01206901 Letrozole tablet 2.5mg R E
66 01207301 Goserelin acetate implant 3.6mg R E
67 01207402
Octreotide injection 50 microgram in
1ml amp R E
69 00303103
Ondansetron injection 8mg / 4ml,
ampoule R E
70 New-
00303102
Ondansetron injection 4mg / 2ml,
ampoule R E
71
New-
00303104 Ondansetron tablet 4mg R E
72
New-
00303105
Ondansetron oral solution 4mg/5ml
,50ml bottle R E
73 00000803 Morphine sulphate tablet 30mg R E
74
New-
00000810
Morphine sulphate syrup, 2mg in 1ml
,100ml bottle R E
75
New-
00701603 Dexamethasone tablet 4mg R E
76
New-
00701604 Dexamethasone tablet 8mg R E
Revised item list (Pharmaceuticals) 2016/2017
Page 78
Drugs available for Level 4 Institutions
No Item Code Medium Description
Item
Category
VEN
status
1
New-
01200102
Busulphan Injection 6mg/ml, 10ml vial C N
2
New-
01200502
Melphalan injection 50mg powder with
solvent R N
3 01201301 Idarubicin hydrochloride capsule 5mg C N
4 01201302
Idarubicin hydrochloride injection 5 mg
vial C N
5 01201601 Capecitabine tablet 500mg R N
6
New-
01201703 Cytarabine injection 1g in 10ml vial C E
7
New-
01210201 Azacitadine injection 100mg vial C E
8 01201904 Fluorouracil injection 1g, 20ml vial R E
9 01202602 Vinorelbine Injection 10mg Vial R N
10 01203001 Bortezomib injection 1mg vial R N
11 01203002 Bortezomib injection 2mg vial R N
12 01203202
Crisantaspase ( Ervinia L-asparaginase
enzyme) injection 10,000 units, bottle C N
13
New-
01203502
Hydroxyurea (Hydroxy carbamide)
tablet 100mg R E
14
New-
01204403
Imatinib capsules 400mg R E
15 01205101 Trastuzumab injection 150mg vial C N
16 01205102 Trastuzumab injection 440mg vial C N
17 01205701 Rituximab injection100mg/10ml vial R E
18 01205702 Rituximab injection 500mg/50ml vial R E
19 01206101
Filgrastim injection 300 microgram in
0.5ml /1ml PFS/vial R E
20 1206201
Filgrastim (Pegylated) injection
6mg/0.6ml -1ml C N
21 1206301 Lenalidomide capsule 5mg R E
22 01206302 Lenalidomide capsule 10mg R E
23 1206502 Megestrol acetate tablet 160mg C N
24 1207001 Bicalutamide tablet 50mg R E
25 01207002 Bicalutamide tablet 150mg R E
26 1207901 Exemestane tablet 25mg R E
27 01208601 Cabazitaxel Injection 60 mg /1.5ml vial C N
28 1208901 Nilotinib capsule 150mg C N
Revised item list (Pharmaceuticals) 2016/2017
Page 79
29 00108601 Tenofovir tablet 300mg C N
30 01208301 Cladribine injection 10mg/10ml vial C N
31
New-
00000809 Morphine sulphate CR tablet 15mg R E
32 00000401
Fentanyl Citrate transdermal patches 50
microgram per hour R N
33
New-
00000402
Fentanyl dermal patches 12 microgram
per hour R N
34
New-
00000403
Fentanyl Dermal patches 25 microgram
per hour R N
35
New-
01210301
BCG suspension for intravesical
chemotherapy 40mg / 1ml vial R N
Drugs to be issued on Named patient basis
No Item Code Medium Description
1 01201102
Doxorubicin con.(Liposoml)injection
20mg/10ml
2 01201501 Mitoxantrone injection 20mg/10ml vial
3 01201801
Fludarabine phosphate injection 50mg
vial
4
New-
01201703 Azacitadine injection 100mg vial
5
New-
01205305
Tegafur 20mg, Gimeracil 5.8mg and
Oteracil potassium 19.6mg per capsule
6
New-
01202102
Mercaptopurine oral suspension
20mg/ml, 100ml bottle
7 01202901 Bevacizumab injection 100mg/4ml,vial
8 01203101 Cetuximab injection 100mg vial
9 01203202
Crisantaspase (L-Asparaginase) 10000
U
10 01204002 Dasatinib tablet 50mg
11 01204003 Dasatinib tablet 20mg
12 01204101 Erlotinib hydrochloride tablet 150mg
13 01204202 Everolimus tablet 10mg
14 01204501 Lapatinib tablet 250mg
15 01204601 Sorafenib tablet 200mg
16 01204701 Sunitinib malate capsule 50mg
17
New -
01204702 Sunitinib malate capsule 12.5mg
Revised item list (Pharmaceuticals) 2016/2017
Page 80
18 01204903 Paclitaxel (protein-bound)injection
100mg vial
19 01204906
Paclitaxel nanoparticle injection 300mg
vial
20 01204905
Paclitaxel nanoparticle injection 100mg
vial
21 01205101 Trastuzumab injection 150mgvial
22 01205102 Trastuzumab injection 440mgvial
23
New-
01206001
Peginterferone alfa 2a injection, 180
microgram / 0.5ml prefilled syringe
24 01206201
Filgrastim (Pegylated) injection
6mg/0.6ml -1ml
25
New-
01207302 Goserelin acetate implant 10.8mg
26 01207401 Octreotide injection 20mg/2.5ml PFS
27 01207601
Pemetrexed disodium injection 100mg
vial
28 01207602
Pemetrexed disodium injection 500mg
vial
29 01207801 Trabectedine injection 1mg
30 01208601 Cabazitaxel Injection 60 mg /1.5ml vial
31 01208901
Nilotinib hydrochloride monohydrate
capsule 150mg
32 01208902
Nilotinib hydrochloride monohydrate
capsule 200mg
33 01209001
Bendamustine hydrochloride injection,
100mg in 20ml vial
34 01209101 Mitotane tablets 500mg
35 01208501 Abiraterone acetate tablet 250mg
36 01208201 Decitabine injection 50mg/20ml vial
37 01204301 Gefitinib tablet 250mg
38 00107802 Lamivudine tablet. 100mg
39 01208101 Pazopanib tablet 200mg
40 01203203 Peg-asparaginase injection 3,750IU
41 01208001
Topotecan hydrochloride injection
2.5mg vial
42 01209501 Tretinoin capsule 10mg
43 01209502 Isotretinoin capsule 10mg
43 01209504 Isotretinoin capsule 20mg
44 00108601 Tenofovir tab. 300mg
45 01208301 Cladribine injection 10mg/10ml vial
46
New
00706101
Thyrotropin alfa (rhTSH) injection 900
microgram vial
Revised item list (Pharmaceuticals) 2016/2017
Page 81
Drugs deleted / tailed off from the Formulary
No Item Code
Medium Description
Reasons for the
deletion
1
01200302 Cyclophosphamide injection 100mg
vial
slow moving item
manage with 200mg
2
01200701 Carmustine capsule 40mg Not used during last
five years
3
01202301 Thioguanine tablet 40mg Not used during last
five years
4
01204001 Dasatinib tablet 70mg
50mg & 20mg
adequate.
5
01205801 Nimotuzumab Injection 50mg in 10ml
Deleted
6
01206601 Stilboesterol tablet 1mg Not used during last
five years
7
01206602 Stilboestrol tablet 5mg Not used during last
five years
8
01207202 Leuprorelin acetate injection 1mg in
0.5ml
Tail off due to
Goserelin use as an
alternatives
9
01207403 Octreotide injection 30mg/2.5ml PFS 20mg/2.5ml and 50mcg
adequate.
10
01207501 Thymosin alpha 1 injection1.6mg vial Not used during last
five years
Revised item list (Pharmaceuticals) 2016/2017
Page 82
13. Drugs used in Obstetrics and Gynecology
13.1. Members of the sub committee
1. Dr. Lal Panapitiya, Director, MSD
2. Prof. Rohini Fernandopulle, Professor in Pharmacology.
3. Prof. Athula Kaluarachchi, Professor in Obstetrician and Gynecology, D.M.H.,
4. Dr. Mangala Dissanayake, Consultant Obstetrician and Gynecologist, Kethumathie Hospital,
Panadura,
5. Dr. Gayan De Silva, Consultant Obstetrician and Gynecologist, B.H. Kuliyapitiya,
6. Dr. Sanath Lanerolle, Consultant Obstetrician and Gynecologist, Castle Street Hospital,
7. Dr. U.P.D. Rathnasiri, Consultant Obstetrician and Gynecologist, Castle Street Hospital,
8. Dr.S.Godakandage, CCP, Family Health Bureau
9. Mr. E.D. Weerarathne, Former Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 83
13.2. Approved item list: Drugs used in Obstetrics and Gynaecology
Drugs available for all Levels of Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 01300801 Levonorgestrel 0.15mg + Ethinyloestradiol 0.03mg tablet R E
2 1301301 levonorgestrel 1.5 mg,tablets R E
3 00702601 Medroxyprogesterone acetate Injection 150mg in 1ml vial R E
Drugs available for Level 2,3 & 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 01300102
Ergometrine maleate injection 500microgram / 1ml
ampoule R E
2 01300201 Oxytocin injection 2 I.U.in 2ml ampoule R N
3 01300202 Oxytocin Injection 5 I.U. in 1ml ampoule R E
4 01300402 Levonorgestrel implants two rod (75mg) C E
5 01300501 Etonogestrel Implant single rod (68mg) R N
6 01301201 Clotrimazole pessaries 100mg R E
7
New
01103602 Cetrimide cream 0.5%, 50g tube C E
Drugs available for Level 3 & 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 01300301 Dinoprostone vaginal tablet 3mg R E
2 01300302 Dinoprostone vaginal gel 1mg in 2.5ml Tube/Unit R N
3 01300401 Levonorgestrel 20 microgram /24h Intra-uterine system C E
4 01300601 Potassium citrate powder R N
5 01300701 Sodium citrate powder R E
6 01301101 Citric acid crystals R N
7 01301401 Misoprostol tablet 200 micrograms C E
8
New
01301403 Misoprostol tablet 25 mcg C N
9 00701901 Conjugated estrogens tablet 0.325mg R N
10 00701902 Conjugated Estrogens tablet 0.625mg R N
11 00702001 Ethinyloestradiol tablet 5 microgram C N
Revised item list (Pharmaceuticals) 2016/2017
Page 84
12 00702003 Ethinyloestradiol tablet 20 microgram R N
13 00702101 Dydrogesterone tablet 10mg R N
14 00702201
Oestradiol valerate 2mg, 11 tablets and Oestradiol valerate
2mg + Cyproterone acetate 1mg, 10 tablets in a calendar
pack
C N
15
New
00706601 Estradiol valerate tablet 1mg R E
16
New
00706602 Estradiol valerate tablet 2mg R E
17
New
01302401
Estrogen vaginal cream 0.01%, 15g tube C E
18 00702401 Hydroxyprogesterone Injection 250mg in 1ml ampoule R E
19
New
00707101 Follicle - Stimulating Hormone (FSH) Injection 1200U vial C N
20 00702501 Norethisterone tablet 5mg R E
21 00702801 Clomiphene citrate tablet 50mg R E
22 00703101 Human Chorionic Gonadotrophin injection 5000 IU R N
23 00703103 Human Chorionic Gonadotrophin injection 2000 IU C N
24 01207301 Goserelin acetate implant 3.6mg R E
25 00602801
Anti D.(Rho)Immunoglobulin injection 300mcg in 1.5ml
vial R E
Drugs available for Level 4 Institutions
No
Item
Code Medium Description
Item
Category
VEN
status
1 01207201 Leuprorelin acetate 3.75mg vial with solvent 2ml C N
Drugs, deleted from the Formulary
No
Item
Code Medium Description Reasons for the deletion
1 01300101
Ergometrine maleate injection 250microgram in 1ml
ampoule
Ergometrine injection
500mcg is adequate
2 01300901 Nystatin pessaries 100,000 IU Slow moving
3 01301202 Clotrimazole pessaries 500mg
Clotrimazole pessaries
100mg is
adequate
4 01301402 Misoprostol Tablet 50 micrograms,
Misoprostol 25mg can be
used use for induction of
labor
5 00704901 Progesterone vaginal gel Not used in last few years
6 00703102 Human Chorionic Gonadotrophin 500 IU
5000IU strength is
adequate
7 01207202 Leuprorelin acetate 1mg in 0.5ml
Goserelin can be used as an
alternatives
Revised item list (Pharmaceuticals) 2016/2017
Page 85
Drugs to be issued on Named Patient basis
No
Item
Code Medium Description Item level
1
New
00707101 Follicle - Stimulating Hormone (FSH) Injection 75 IU vial
4
2
New
00600303
Hepatitis B specific Immunoglobulin(HBIG) 50units/ml in
10ml vial 4
3
New
00603002
Varicella Zoster specific Immunoglobulin(VZIG) (Human)
Lyophillized 250mg vial 4
Drugs included to the Formulary
No
Item
Code Medium Description
1
New
01301403 Misoprostol tablet 25 microgram
2
New
00706601 Estradiol valerate tablet 1mg
3
New
00706602 Estradiol valerate tablet 2mg
4
New
01302401
Estrogen vaginal cream 0.01%, 15g tube
5
New
01103602 Cetrimide cream 0.5%, 50g tube
Revised item list (Pharmaceuticals) 2016/2017
Page 86
14. Drugs used in Renal Diseases
14.1. Members of the sub committee
1. Dr. Lal Panapitiya, Director, MSD
2. Prof. Rohini Fernandopulle, Professor in Pharmacology
3. Prof. Kamani Wanigasooriya, Consultant Physician,
4. Prof. Mandika Wijerathne, Consultant Vascular Surgeon, NHSL
5. Dr. A.L.M.Nazar, Consultant Nephrologist, NHSL
6. Dr. Mathu Selvarajah, Consultant Nephrologist, Colombo North Teaching Hospital, Ragama
7. Dr. A.W.M. Wazil, Teaching Hospital, Kandy
8. Dr. Manjula Wijewardana, Consultant Urologist, NHSL
9. Dr. Ranga Wickramarachchi, Consultant Urologist, G.H.Ampara
10. Dr. Kanchana Edirisinghe, Consultant Urologist, T.H.Kandy
11. Dr. Vindya Gunasekara, Consultant Peadiatrician, LRH
12. Dr. Inoka Perera, Consultant Peadiatrician, Sirimavo Bandaranaka Hospital, Peradeniya
13. Mr. E.D.Weerarathne, Formar Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 87
14.2. Approved item list: Drugs used in Renal diseases
Drugs available for all Levels of Institutions
No Item Code Medium Description Item Category VEN status
1 New
00406501
Phosphate tablet R E
2 New
00701702 Prednisolone tablet 1mg R E
3 New
00103901 Trimethoprim tablet 100mg R E
4 New
00103902
Trimethoprim oral suspension 50mg / 5ml, 100ml
bottle R E
5 New
00105903
Nitrofurantoin oral suspension 25mg/ 5ml, 300ml
bottle R E
6 00105901 Nitrofurantoin tablet 50mg R E
Drugs available for Level 2,3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 00400901 Sodium bicarbonate tablets 600mg R N
Drugs available for Level 3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 00404001 Epoetin injection 2,000 IU vial/PFS C E
2 New
00404003
Epoetin injection 1,000 IU vial/PFS C E
3 00404002 Epoetin injection 4,000IU-5,000IU vial/PFS C E
4 01205401 Cyclosporin capsule 25mg C E
5 01205402 Cyclosporin capsule 50mg C E
6 01205403 Cyclosporin capsule 100mg C E
7 New
01205404
Cyclosporine oral solution 100mg/ml, 50ml bottle C E
8 01205201 Azathioprine tablet 50mg R E
9 00405301 Albumin solution (human)20%,50ml C E
10 00405302 Albumin solution (human) 5%,250ml C N
11 00107403 Liposomal Amphotericin B injection 50mg for
I.V. use C E
12 00402301 Peritoneal dialysis solution 1.5% in 1000ml Bottle R E
13 00405001 Administration set for PD solution R E
14 00405101 PD catheter set R E
Revised item list (Pharmaceuticals) 2016/2017
Page 88
15 New
00405101
PD catheter set , Peadiatric size R E
16 00404401 Sodium dihydrogen orthophospate powder C N
17 00404501 Disodium hydrogen orthophospate powder C N
18 00401801 Calcium carbonate tablet 1.25g C E
19 New
00401802
Calcium carbonate oral suspension 500mg/5ml C E
20 New
Magnesium glycero Phosphate tablet C N
21 New
00400906
Sodium bicarbonate 1.25% Collapsible bag 500ml C N
22 New
00406101
Calcium acetate tablet 1g C E
23 New
00406102
Calcium acetae oral solution 169mg/5ml C E
24 New
00701703 Prednisolone tablet 20mg C E
25 New
00200304 Furosemide tablet 250mg C N
26 New
00405303 Albumin solution (human) 5%, 500ml bottle C E
27 New
00406301 Potassium phosphate injection 50ml C E
28 New
01301501 Tamsulosin capsule 0.2 mg R E
29 New
01301502 Tamsulosin capsule 0.4 mg R E
30 New
01301601 Terazosin tablet 1mg R E
31 New
01301602 Terazosin tablet 2mg C E
32 New
01301603 Terazosin tablet 5mg C E
33 New
01301701
Alfuzosin hydrochloride tablet (extended release)
10mg C N
34 New
01301801
Tolteridone tablet 1 mg R E
35 New
01301802 Tolteridone capsule sustained release 2mg R E
36 New
00207901 Solifenacin tablet 5 mg R E
37 New
00207901 Oxybutynine hydrocloride tablet 5mg R E
38 New
01302001 Oxybutynine hydrocloride tablet 2.5mg R N
39 New
01302002
Oxybutynine hydrocloride oral solution 1mg /
5ml, 100ml bottle C N
Revised item list (Pharmaceuticals) 2016/2017
Page 89
40 New
00706301 Finasteride tablet 5mg R E
41 New
01300603 Potassium citrate oral solution R E
42 New
01300602 Potassium citrate tablet 1080mg R E
43 New
01300702
Sodium citrate oral solution 500mg/334mg per
5ml in 100ml bottle R E
44
New
00401005
Sodium chloride for intravenous infusion 0.9%
1000ml, collapsible bag R E
45 01300601 Potassium citrate powder R N
46 01300701 Sodium citrate powder R E
47 01207101 Flutamide tablet 250mg R E
48 New
00406202
Calcium polystyrene sulphonate powder 17g
powder sachet R E
8 New
00401005
Sodium chloride for intravenous infusion 0.9%
1000ml, collapsible bag R V
Drugs available for Level 4 Institution
No Item Code Medium Description Item Category VEN status
1 01205501 Basiliximab injection 20mg for IV use with
solvent 5ml C N
2 01205601 Tacrolimus capsule 0.5mg C E
3 01205602 Tacrolimus capsule 1mg C E
4 01204201 Everolimus tablet 0.25mg C N
5 01205301 Mycophenolate mofetil capsules 250mg C E
6 01205303 Mycophenolate mofetil capsules 500mg C E
7 New
01205306
Mycophenolate mofetil oral suspension 1g/5ml
in175ml bottle C E
8 00108101 Valganciclovir Tab. 450mg C N
9 00108001 Ganciclovir injection for IV use 500mg C N
10 New
00406901
Magnesium glycinate tablet 400mg (200mg of
elemental magnesium) C N
11 New
01302201
Sevelamer hydrochloride tablet 800mg C
N
12 01207001 Bicalutamide tablet 50mg C N
13 00401007 Sodium chloride for IV use, 0.45%, 500ml R N
14 New
00706201
Dutasteride capsule 0.5 mg
3 E
15 01207201 Leuprorelin acetate 3.75mg vial with solvent 2ml C N
Revised item list (Pharmaceuticals) 2016/2017
Page 90
Drugs deleted from the Formulary
No Item Code Medium Description Reasons for the deletion
1 01205603 Tacrolimus capsule 5mg 1mg & 0.5mg strengths are
enough
2 00603101 Anti-Human Thymocyte equine Immunoglobulin
(Lymphoglobulin)5ml Vial
Not used in last five years
Drugs to be issued on a Named Patient basis
No Item Code Medium Description Item level VEN status
1 01208701 Mycophenolic acid tablet 180mg 4 N
2 01208802 Mycophenolic acid tablet 360mg 4 N
3 00404101 MPG-epoetin 100microgram /0.3ml, injection
PF.Sy 3 N
4 00404102 MPG-epoetin 50microgram /0.3ml, injection
PF.Syr 3 N
5 00603102 Antithymocyte inj. 250mg,5ml, vial 4 N
6 New
01302101 Tadalafil tablet 10mg
3 N
7 New
01207205
Leuprorelin acetate injection 7.5 mg
4 N
8 01208501 Abiraterone acetate tablet 250mg 4 N
Drugs included to the Formulary
No Item Code Medium Description
1
New
00404003
Epoetin injection 1,000 IU vial / PFS
2
New
PD catheter set , Peadiatric size
3
New
00401802
Calcium carbonate oral suspension 500mg/5ml
4
New
01205404
Cyclosporin oral solution 100mg/ml in 50ml
bottle
5
New
00406501
Phosphate tablet
6
New
Magnesium glycero Phosphate tablet -No SR.NO
7
New
00406901
Magnesium glycinate tablet 400mg (200mg of
elemental Magnesium)
8 New Sevelamer hydrochloride tablet 800mg
Revised item list (Pharmaceuticals) 2016/2017
Page 91
01302201
9 New
00400906
Sodium bicarbonate 1.25% collapsible bag 500ml
10
New
00406101
Calcium acetate tablet 1g
11
New
00406102
Calcium acetae oral solution 169mg/5ml
12
New
00701702 Prednisolone tablet 1mg
13
New
00701703 Prednisolone tablet 20mg
14
New
00200304 Furosemide tablet 250mg
15
New
00406202
Calcium polystyrene sulphonate powder 17g
powder sachet
16
New
01205306
Mycophenolate mofetil oral suspension 1g/5ml
in175ml bottle
17
New
00405303 Albumin solution (human) 5%, 500ml bottle
18
New
00406301 Potassium phosphate injection 50ml
19
New
01301501 Tamsulosin capsule 0.2 mg
20
New
01301502 Tamsulosin capsule 0.4 mg
21
New
01301601 Terazosin tablet 1mg
22
New
01301602 Terazosin tablet 2mg
23
New
01301603 Terazosin tablet 5mg
24
New
01301701
Alfuzosin hydrochloride tablet (extended release)
10mg
25
New
01301801
Tolteridone tablet 1 mg
26
New
01301802 Tolteridone capsule sustained release 2mg
27
New
01301901 Solifenacin tablet 5 mg
28
New
00207901 Oxybutynine hydrocloride tablet 5mg
29
New
01302001 Oxybutynine hydrocloride tablet 2.5mg
30
New
01302002
Oxybutynine hydrocloride oral Solution 1mg in
5ml, 100ml bottle
31
New
00706301 Finasteride tablet 5mg
Revised item list (Pharmaceuticals) 2016/2017
Page 92
32 New
01300603 Potassium citrate oral solution
33
New
01300602 Potassium citrate tablet 1080mg
34
New
01300702
Sodium citrate oral solution 500mg/334mg per
5ml in 100ml bottle
35
New
00103901 Trimethoprim tablet 100mg
36
New
00103902
Trimethoprim oral suspension 50mg / 5ml, 100ml
bottle
37
New
00105903
Nitrofurantoin oral suspension 25mg/ 5ml, 300ml
bottle
38
New
00401005
Sodium chloride for intravenous infusion 0.9%
1000ml, collapsible bag
Approved drugs to be Local Purchased by Institutions
No. Item code Item medium description Item catogory VEN
status
Item
level
1. 01302301 Doxazosin tablet 1mg C N 3
2. 01302302 Doxazosin tablet 4mg C N 3
Newly suggested drugs will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 93
15.Drugs used in the treatment of Musculoskeletal and Joint Diseases
15.1. Members of the sub committee
1. Dr. Lal Panapitiya, Director, MSD
2. Prof. Rohini Fernandopulle, Professor in Pharmacology
3. Prof. Saroj Jayasinghe, Consultant Physician, NHSL
4. Dr. V.Swarnakumar, Consultanat Orthopedic Surgeon, NHSL
5. Dr. T.G.J.D.Munidasa, Consultanat Orthopedic Surgeon, NHSL
6. Dr. Saman Jayanetti, Consultant Rheumatologist, NHSL
7. Dr. Duminda Munidasa, Consultant Rheumatologist, Rheumatology & Rehabilitation Hospital,
Ragama
8. Dr. Kalum Deshapriya, Consultant Rheumatologist, T.H.Karapitiya
9. Dr. Kelum De Silva, Consultant Rheumatologist, D.G.H.Kaluthara
10. Dr. Monika De silva, Consultant Rhumatologist , NHSL
11. Dr. Rasika Gunapala, Consultant Pediatrician, LRH
12. Mr. E.D.Weerarathne, Former Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 94
15.2. Approved item list: Drugs Used in treatment of Musculoskeletal and Joint Diseases
Drugs available for all Level of Institution
No Item Code
Medium Description
Item
Category
VEN
status
1 01400101 Methyl salicylate R N
2 01400201 Ibuprofen tablet 200mg R E
3 New
01400204
Ibuprofen tablet 400mg R E
4 01400302 Diclofenac sodium tablet 50mg R E
5 01400307 Diclofenac sodium gel 20g tube C E
6 New
00701702
Prednisolone tablet 1mg R E
Drugs available for Level 2,3 & 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 01400202 Ibuprofen syrup 100mg/5ml, 60ml bottle R E
2 01400301 Diclofenac sodium tablet 25 mg R N
Drugs available for Level 3 & 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 01400304 Diclofenac sodium suppository 25mg R E
2 01400306 Diclofenac sodium suppository 100mg R E
3 New
01402701
Diclofenac 1% w/w + Capsaicin 0.025% w/w
gel 30g tube C N
4 01400401 Indomethacin capsule 25mg R N
5 New
01402201
Naproxane tablet 250mg R N
6 New
01402301
Celecoxib capsule 100mg R N
7 New
01402302
Celecoxib capsule 200mg R N
8 New
01402401
Meloxicam tablet 7.5mg C N
9 01400701 Penicillamine capsule 250mg R N
10 01400801 Hydroxychloroquine sulphate tablet 200mg R E
Revised item list (Pharmaceuticals) 2016/2017
Page 95
11 01400901 Leflunomide 10 mg tablet C E
12 New
01400903
Leflunomide tablet 20 mg C E
13 01401001 Allopurinol tablet 100mg R E
14 01401101 Neostigmine Tab. 15mg R E
15 New
01402501
Febuxostat tablet 40mg R N
16 New
01402601
Colchicine tablet 0.5mg R N
17 01401201 Pyridostigmine bromide tablet 60mg R N
18 01401301 Baclofen tablet 5mg R N
19 01401302 Baclofen tablet 10mg R N
20 New
00302201
Amitriptyline tablet 10mg R N
21 01401601 Mefenamic acid tablet 500mg C N
22 00703502 Alendronate sodium tablet 70mg R E
23 00701803 Methylprednisolone IA Inj.40mg/1ml R N
24 01205201 Azathioprine tablet 50mg R E
25 01202201 Methotrexate tablet 2.5mg R E
26 01202202 Methotrexate injection 50mg vial R E
27 01202203
Methotrexate inj.50mg/2ml(without
preservative) R N
28 01202204 Methotrexate injection 1g vial R E
29 00800901 Sulphasalazine tablet 500mg R E
Drugs available for Level 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
1 New
00305701
Paracetamol 500mg+Codeine 8mg (co-
codamol) tablet C N
2 01205701 Rituximab injection100mg/10ml vial R E
3 01205702 Rituximab injection500mg/50ml vial R E
Drugs deleted from the Formulary
No Item Code Medium Description Reasons for the deletion
1 01401501 Hyaluronidase injection 1,500 U vial/ampoule
Drugs to be issued on Named Patient basis
No Item Code
Medium Description Item level
VEN
status
1 01401801 Zoledronic acid injection 5mg in 100ml bottle 3 N
Revised item list (Pharmaceuticals) 2016/2017
Page 96
2 01401701 Infliximab injection 100mg vial 4 N
3 01401702 Etanercept injection 25 mg 3 N
4 01209201 Golimumab solution for injection 50mg, in
pre-filled syringe 3 N
5 01207701 Tocilizumab 80mg/4ml for infusion 4 N
6 01207702 Tocilizumab 200mg/10ml for IV infusion 4 N
7 01207703 Tocilizumab 400mg/20ml,concentrated solution 4 N
Drugs included to the Formulary
No Item Code Medium Description
1
New
00305701
Paracetamol 500mg+Codeine 8mg (co-
codamol) tablet
2
New
01400204
Ibuprofen tablet 400mg
3
New
01402701
Diclofenac 1% w/w + Capsaicin 0.025% w/w
gel 30g tube
4
New
01402201
Naproxane tablet 250mg
5
New
01402301
Celecoxib Capsule 100mg
6
New
01402302
Celecoxib Capsule 200mg
7
New
01402401 Meloxicam 7.5mg
8
New
01400903
Leflunomide tablet 20 mg
9
New
01402501
Febuxostat tablet 40mg
10
New
01402601
Colchicine tablet 0.5mg
11
New
00302201
Amitriptyline tablet 10mg
12
New
00701702
Prednisolone tablet 1mg
Newly suggested drugs will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 97
16. Drugs used in Anaesthesia
16.1. Members of the sub committee
1. Dr. Lal Panapitiya, Director, MSD
2. Prof. Rohini Fernandopulle, Professor in Pharmacology,
3. Prof. Anuja Abedeera, Professor in Anaesthesiology, Dept. of Surgery, Faculty of Medicine,
University of Colombo,
4. Dr. Ramani Pallemulle, Consultant Anaesthetist, Castle Street Hospital for women, Colombo 08,
5. Dr. Samitha Jayawickrama, Consultant Anaesthetist, Lady Ridgeway Hospital, Colombo,
6. Dr. Vinodini Wanigasekara, Consultant Anaesthetist, NINDT, Maligawaththa,
7. Dr. Anoma Perera, Consultant Anaesthetist, Lady Ridgeway Hospital, Colombo,
8. Dr. Nalin Kithulwatte, Consultant Paediatrician, Lady Ridgeway Hospital, Colombo,
9. Dr. Manjula Hewageegana, Consultant Paediatrician, T.H.Karapitiya
10. Mr. E.D.Weerarathne, Former Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 98
16.2. Approved item list: Drugs used in Anaesthesia
Drugs available for all Level of Institution
No Item Code
Medium Description
Item
Category
VEN
status
1
01500801 Atropine sulphate injection 600 microgram
/1ml ampoule R V
2
New
01500802
Atropine sulphate inj. 0.1mg/ml in 10ml pre-
filled syringe R V
3
01502101 Lignocaine hydrochloride injection 2% , 5ml
single dose vial R E
4 00501502 Adrenaline bitartrate Inj.1mg/1ml ampoule R V
5
New
00501504
Adrenaline solution for injection 1 mg/10 ml
(1:10,000), in pre-filled syringe ampoule R V
Drugs available for Level 2,3 & 4 Institutions
1 Item Code
Medium Description
Item
Category
VEN
status
2
New
01500101
Thiopentone sodium injection 500mg vial R E
3
01500902 Midazolam maleate injection 5mg / 1ml
ampoule R E
4
01501101 Atracurium besylate injection 25mg / 2.5ml
ampoule R E
5
01501401 Suxamethonium chloride injection 100mg /
2ml amp R V
6
New
01501402
Suxamethonium chloride injection 20mg/ml,
10ml pre filed syringe R V
7
01501502 Neostigmine methylsulphate injection 2.5mg /
1ml ampoule R E
8
01501701 Flumazenil injection 500 microgram / 5ml
vial R E
9
01501801 Naloxone injection 400 microgram / 1ml
ampoule R E
10 01502105 Lignocaine anhydrous gel 2% in 30g tubes R E
11
01502201 Lignocaine 2% with Adrenalin 1:80,000
injection 30ml vial R E
12 00001101 Pethidine hydrochloride injection 50mg R E
Revised item list (Pharmaceuticals) 2016/2017
Page 99
ampoule
13 00001102
Pethidine hydrochloride injection 75mg
ampoule R E
14 00401501
Tetrastarch solution for intravenous
infusion,500ml collapsible bag R N
15
New
00407001
Gelatin for intravenous infusion 4% w/v in
500ml collapsible bag R N
Drugs available for Level 3 & 4 Institutions
No. Item Code
Medium Description
Item
Category
VEN
status
1
01500201 Ketamine hydrochloride injection 200mg in
20ml vial R E
2
01500202 Ketamine hydrocloride injection 500mg in
10ml vial R E
3 01500301 Propofol IV infusion 20ml ampoule/vial R E
4 01500302 Propofol IV infusion 50ml ampoule/vial R E
5 01500401 Etomidate injection 20mg in 10ml vial C E
6 01500501 Halothane 250ml bottle R E
7
01500602 Isoflurane for inhalational anaesthesia 250ml
bottle R E
8
01500701 Sevoflurane for inhalational anaesthesia
250ml bottle R E
9 01500901 Midazolam maleate tablet 7.5mg R E
10
01501001 Glycopyrrolate injection 200microgram / 1ml
vial C E
11
01501201 Pancuronium bromide injection 4mg / 2ml
ampoule R E
12 01501301 Vecuronium bromide injection 10mg vial R E
13
New
00207402
Clonidine hydrochloride injection
(preservative free) 0.5mg/1ml ,10ml vial R E
14
01501501 Neostigmine methylsulphate injection 0.5mg /
1ml ampoule R E
15
01501601 Edrophonium chloride injection 10mg / 1ml
ampoule R N
16
New
01502601
Sugammadex injection 100mg / ml,5ml vial R E
17 01501901 Dantroline sodium injection 20mg vial C V
18 01502001
Bupivacaine hydrochloride injection 0.5% in
10ml ampoule with sterile wrap R E
19
01502003
Bupivacaine hydrochloride injection 0.5%
with Glucose 8% in 4ml amp in pre-sterilized
theatre pack for spinal anaesthesia
R E
20 01502102 Lignocaine hydrochloride injection 2% w/v in R E
Revised item list (Pharmaceuticals) 2016/2017
Page 100
20ml vial
21 01502104 Lignocaine spray 10%, 50ml bottle R E
22
01502106 Lignocaine hydrochloride topical solution
4%w/v in 30ml vial R N
23
01502301 Lignocaine 2.5% with Prilocaine cream 2.5%,
5g tube R E
24
01502501 Rocuronium bromide injection 50mg in 5ml
vial R E
25 43412201 Soda lime R E
26 00204201
Ephedrine SulphateInjection 30mg/1ml
ampoule R E
27
New
00204202
Ephedrine sulphate solution for injection 3
mg/ml, in 10ml pre-filled syringe R E
28 00000301
Fentanyl citrate injection 100 microgram /
2ml ampoule. R E
29 00000808
Morphine sulphate injection (preservative
free) 2mg / 2ml ampoule R E
30
New
00303304 Paracetamol suppository 125mg C N
31
New
00303305
Paracetamol suppository 250mg C N
32
New
00303306
Paracetamol suppository 500mg C N
33
New
00303307
Paracetamol 10mg/ml solution for infusion C N
34
New
00401903
Magnesium sulphate injection 50% in 10ml
ampoule R E
35
New
00400704
Potassium chloride oral solution 10% R E
36
New
00405201
Calcium chloride Intravenous infusion, 10%
w/v C E
37
New
00407101
Parenteral infusion fluid in 500ml collapsible
bag/bottle R N
38 00402102 Fat emulsion injection 10% in 500ml bottle R N
39 00402103 Fat emulsion injection 20% in 100ml bottle R E
40 00402201 Protein hydrolysate injection 100ml bottle C E
41
00402202 Amino acids solution for intravenous infusion
500ml bottle R E
42
New
00402203
Amino acids solution 6.25% C E
Drugs available for Level 4 Institutions
No Item Code
Medium Description
Item
Category
VEN
status
Revised item list (Pharmaceuticals) 2016/2017
Page 101
1
New
00001401
Diamorphine hydrochloride injection 5mg
vial C N
2 00001201 Remifentanil injection 1mg / 2ml ampoule. R E
3 00001301 Alfentanil hydrochloride 1mg / 2ml ampoule R N
Drugs deleted from the Formulary
No Item Code Medium Description Reasons for the deletion
1 01500102 Thiopentone sodium injection 1g vial To avoid multy dose vial
2 01502401 Prilocaine hydrochloride 3% in 2ml ampoule
3
00400902 Sodium bicarbonate for intravenous infusion
4.2% in 50 ml bottle
4 00401002
Sodium chloride for intravenous infusion
0.9%, 100ml pack
500ml &1000ml volume are
adequate
5
00401201 Sodium chloride 0.18% & Dextrose 4% for
intravenous infusion 500ml bottle
6
00401901 Magnesium sulphate 40% in 25ml injection
ampoule
7
00401904 Magnesium sulphate injection 50% w/v in
2ml
50%,10ml stength is
adequate
8
00402101 Fat emulsion injection 10% in 100ml bottle 10%,500ml bottle is
adequate
9 00405501
Parenteral infusion fluid 500ml(K+
5mmol/L,Mg2+ 1.5mmol/L,Na+ 140
mmol/L,acetate 27mmol/L,Cl-98mmol/L)
Replace with Parenteral
infusion fluid in 500ml
collapsible bag/bottle (SR
No:00407101)
Drugs included to the Formulary
No Item Code Medium Description
1
New
01500101
Thiopentone sodium injection 500mg vial
2
New
01500802
Atropine Sulphate injection 0.1mg/ml in 10ml
pre-filled syringe
3
New
00207402
Clonidine hydrochloride injection
(preservative free) 0.5mg/1ml ,10ml vial
4
New
01501402
Suxamethonium chloride injection 20mg/ml
in 10ml pre filed syringe
5
New
01502601
Sugammadex injection 100mg/ml,5ml
6
New
00501504
Adrenaline solution for injection 1 mg/10 ml
(1:10,000), in pre-filled syringe
7
New
00204202
Ephedrine sulphate solution for injection 3
mg/ml, in 10ml pre-filled syringe
Revised item list (Pharmaceuticals) 2016/2017
Page 102
8 New
00001401
Diamorphine hydrochloride injection 5mg
vial
9
New
00303304 Paracetamol suppository 125mg
10
New
00303305
Paracetamol suppository 250mg
11
New
00303306
Paracetamol suppository 500mg
12
New
00407001
Gelatin for intravenous infusion 4% w/v in
500ml collapsible bag
13
New
00401903
Magnesium sulphate injection 50% in 10ml
ampoule
14
New
00400704
Potassium chloride oral solution 10%
15
New
00406401
Calcium chloride Intravenous infusion, 10%
w/v
16
New
00407101
Parenteral infusion fluid in 500ml collapsible
bag/bottle
17
New
00402203
Amino acids solution for intravenous infusion
6.25%
Newly suggested drugs will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 103
17.Antidotes
17.1Members of the sub committee
1. Prof. Rohini Fernandopulle, Professor in Pharmacology,
2. Dr. K.V.C.Janaka, Consultant Physician, Sri Jayewardenepura Hospital,
3. Dr. Rajeeve de silva, Consultant Immunologist, MRI,
4. Dr.Rupika Mahalekama, Consultant Anaesthetist, NHSL,
5. Dr. Waruna Gunathilake, Head , National Poison Information Center, NHSL,
6. Mr.E.D.Weerarathne, Former Assistant Director, MSD
Revised item list (Pharmaceuticals) 2016/2017
Page 104
17.2. Approved item list Drugs used as Antidotes
Drugs available for all Level of Institutions
No Item Code Medium Description Item Category VEN status
1 01600101 Charcoal activated 50g Bottle R E
2 01600301 Fuller's earth 60g bottle R E
3 01600401 Methionine tablet 500mg R E
Drugs available for Level 2,3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 01600201 Acetylcysteine 2g in 10ml ampoule R E
2 01601001
Pralidoxime chloride injection 1g / 20ml
ampoule R E
3 01501701 Flumazenil injection 500 microgram / 5ml vial R E
4 01501801
Naloxone injection 400 microgram / 1ml
ampoule R E
Drugs available for Level 3 & 4 Institutions
No Item Code Medium Description Item Category VEN status
1 01600501 Dicobalt edetate injection 300mg 20ml ampoule R E
2 01601101 Dehydrated ethanol (96.8w/w) 5ml ampoule R E
3 01601201 Methylene blue 1% injection 10ml ampoule R E
4
New
01600503
Ascorbic acid injection 100mg / ml, 5ml
ampoule C N
5 01601301 Atropine sulphate injection 15mg /25ml vial R E
6
New
01601501
Physostigmine salicylate injection 1mg/ml, 2ml
vial R E
7
New
01600502 Hydroxocobalamin intravenous infusion 5g vial C N
Drugs available for Level 4 Institutions
No Item Code Medium Description Item Category VEN status
1
New
01600801 Dimercaprol injection 100mg / 2ml ampoule R E
2
New
01601401
Fomepizole intravenous infusion 1.5g/1.5ml
(1g/ml) C E
Revised item list (Pharmaceuticals) 2016/2017
Page 105
Drugs deleted from the Formulary
No Item Code Medium Description Reasons for the deletion
1 01600901
Sodium calcium edetate injection 1g / 5ml
ampoule
Not used in last five years
2 01601103 Ethanol 40% 20ml vial for IV use Not used in last five years
Drugs included to the Formulary
No Item Code Medium Description
1
New
01600503
Ascorbic acid injection 100mg/ml, 5ml
Ampoule
2
New
01601401
Fomepizole intravenous infusion 1.5g/1.5ml
(1g/ml)
3
New
01601501
Physostigmine salicylate injection 1mg/ml, 2ml
vial
4
New
01600502 Hydroxocobalamin intravenous infusion 5g vial
Newly suggested drugs will be included if they are registered only
Revised item list (Pharmaceuticals) 2016/2017
Page 106
18.Antiseptics and Disinfectants
Items available for all Levels of Institutions
No
Item
Code Items Medium Description
1 01104401 Surgical spirit R E
2 01104601 Povidone iodine solution 10%w/v,
500ml bottle R E
3 01104603 Povidone Iodine 5%w/v cream,
15g tube C N
4 01104606 Povidone Iodine ointment 5% w/w,
15g tube
5 01103801 Chlorhexidine
solution20%w/v,500ml bottle R E
6 43400401 Ammonia (strong ) solution R N
7 43400101 Boric acid powder R N
8 43400201 Cresol and soap solution 25L drum R E
9 01106301 Glycerin R N
10 43400301 Tropical chlorinated lime R E
11 43400502 Enzymatic cleaning solution R N
12 43400503 Aldehyde free detergent solution R N
13 43400504 Chlorhexidine gluconate solution
2.5% v/v R N
Items available for Level 2,3 & 4 Institutions
1 01104602
Povidone iodne solutiotion
7.5%w/v for surgcal scrub C E
2 01106103 Alcohol based hand rub (75%-
85%) 500ml bottle R N
3 43400501 Formaldehyde solution R N
4 01101201 Bentonite (as fine powder) R E
5 43412101 Solvent ether, 500ml R N
Items available for Level 3 & 4 Institutions
1 01105501
Ortho-phthaladehyde 0.55%w/v
disinfectant solution R E
2 01105603 Peracetic acid R E
3 43400601 Liquified phenol R N
4 43412201 Soda lime R E
5 01106103 Alcohol based hand rub (75%-
85%) 500ml bottle R N
6 43400502 Enzymatic cleaning solution R N
7 43400503 Aldehyde free detergent solution R N
Revised item list (Pharmaceuticals) 2016/2017
Page 107
8 43400504 Chlorhexidine gluconate solution
2.5% v/v R N
Drugs deleted from the Formulary
No
Item
Code Medium Description
Reasons for the
deletion
1 01104101
Iodine solution(weak) Not used in last five
years
2 01106201 Alcohol 90%v/v
Revised item list (Pharmaceuticals) 2016/2017
Page 108
19. Surgical Dressings
19.1. Members of the sub committee
1. Professor Mandika Wijerathne, Consultant Vascular Surgeon, NHSL,
2. Dr. Kamal Jayasooriya, Consultant General Surgeon, NHSL,
3. Dr. Lalanta Ranasinghe, Consultant General Surgeon, NHSL,
4. Dr. Rasitha Manathunga, Consultant Oncosurgeon, D.G.H.Badulla,
5. Dr. Swarnakumar, Consultant Orthopedic Surgeon, NHSL,
6. Dr. Dilshan Munidasa, Consultant Orthopedic Surgeon, NHSL,
7. Dr. T.Benaragama, Consultant Plastic Surgeon, NHSL,
8. Dr. Nilaksha Kumarasinghe, Consultant Neurosurgeon, NHSL,
9. Dr. M.Munasinghe, Consultant Cardiothoracic Surgeon, NHSL,
10. Dr. Kapila Banduthilaka, Consultant Ophthalmologist, Eye Hospital,
11. Dr. Samitha Jayawikkrama, Consultant Anaesthesiologist, LRH,
12. Mr. G. Nimalsiri, Former Assistant Director (Surgical), MSD,
13. Mr. E.D.Weerarathne, Former Assistant Director (Pharmaceutical), MSD,
Revised item list (Pharmaceuticals) 2016/2017
Page 109
19.2.Approved list of items: Surgical Dressings
Items available for all Level of Institutions
No
Item Code
Medium Description
Item
Categor
y
VEN
status
1 14500101 Gauze absorbent R E
2 14500201 Cotton Wool 500g Roll R E
3
New
14500206 'Interlayered Cotton Wool 2" x 3.5m Roll' R E
4 14500301 Bandage W.O.W. 6.25 cm x 4.5m Roll R E
5
New
14500302 Open Woven Bandage 2.5cm x 5m R E
6
New
14500303 Open Woven Bandage 8 cm x 4.5m R E
7 14500601 Sanitary pads R E
8 14500701 Wadding cellulose 500gm R E
9 14500801 Plaster Adhesive 5cm x 4.5m Roll R E
10 14503001
Synthetic casting material 10.0mm x
3.6mm.Packed individually and labelled
accordingly.
C N
11 14503002 Synthetic casting material 7.5mm x 3.6mm. C N
Items available for Level 2,3 & 4 Institutions
No
Item Code
Medium Description
Item
Categor
y
VEN
status
1
New
14500102
Gauze absorbent 30cmx30cmx8ply R N
2
New
14500103
Gauze Absorbent 23cmx23cmx4ply
R N
3
New
14500104 Gauze absorbent 11cmx11cmx16ply R N
14500105 Gauze Absorbent 11cmx11cmx8ply R N
14500106 Gauze Absorbent 8cmx8cmx8ply R N
14500107 Gauze Absorbent 8cmx8cmx16ply R N
4 14500401 Bandage Crepe 7.5cm x 4.5 m Roll R E
Revised item list (Pharmaceuticals) 2016/2017
Page 110
5 New
14500403 Bandage Crepe 2.5cmx2m Roll R E
6
New
14500404 Bandage Crepe 5cmx3m Roll R E
7
New
14500405 Bandage Crepe 10cmx6m Roll R E
8
New
14500406 Bandage Crepe 15cmx6m Roll R E
9 14500501
Lint plain Lint plain 500 g roll
R E
10 14500802 Plaster Adhesive 7.5cm x 4.5 m Roll R E
11 14500901 Bandage Elastic Adhesive 7.5cm x 4.5m Roll R E
12 14501201 Paraffin Gauze 10cm x 10cm R E
Items available for Level 3 & 4 Institutions
No
Item Code
Medium Description
Item
Categor
y
VEN
status
1 14500202 Interlayered Cotton Wool 3" x 3.5m 50g Roll c N
2 14500203 Interlayered Cotton Wool 4" x 3.5m 100g Roll C N
3 14500204 Interlayered Cotton wool 6" x 3.5m 200g Roll C N
4 14500205 Inter layered cotton wool 6",500g roll C N
5
New
14501104
Bandage Plaster of Paris 3cmx2.7m Roll R E
6 14500902 Bandage Elastic Adhesive 10cm x 4.5m Roll R E
7 14501001 Plaster extension 7.5cm x 4.5m Roll R E
8 14501101 Bandage Plaster of Paris 7.5cm x 2.7m Roll R E
9 14501102 Bandage Plaster of Paris 10cm x 2.7m Roll R E
10 14501103 Bandage Plaster of Paris 15cm x 2.7m Roll R E
11
New
14501501
Fusidic impregnated 1-3% paraffin gauze
dressing, 10cm x 10cm R N
12 14501202 Paraffin Gauze 9cm x 7m,01 piece in a box R E
13 14501301 Gelatine Sponge, 2cm x 6cm x 7mm R E
14 14501302 Gelatine Sponge, 8cm x 12.5cm x 10mm R E
15 14501303 Gelatine Sponge, 5cm x 3cm x 10mm R E
16 14501304 Gellatine Sponge,7cm x 5cm x 10mm R E
17 14501401
Non allergenic surgical tape 1.25cm x 9.1m
Roll C N
18
New
14501601
Latex free hypoallergenic paper tape 1.25cm x
9-10m C N
19
New
14501602
Latex free hypoallergenic paper tape 2.5cm x 9-
10m C N
20
New
14501603
Latex free hypoallergenic paper tape 5cm x 9-
10m C N
Revised item list (Pharmaceuticals) 2016/2017
Page 111
21 New
14501604
Latex free hypoallergenic paper tape 7. 5cm x 9-
10 m C N
22 14503003
Synthetic casting material 12.5mm x
3.6mm.Packed individually and labelled
accordingly.
C N
24
New
14501701
Transparent dressing for catheter fixation 6cm x
7cm R N
25
New
14501702
Transparent dressing for catheter fixation 10cm
x 12cm R N
26
New
14501901
Rdio Opaque Gauze Swab 30cmx30cmx8ply R N
27
New
14501902
Radio Opaque Gauze Swab 23cmx23cmx4ply R N
28
New
14501903
Radio Opaque Gauze Swab 11cmx11cmx16ply R N
29
New
14501904
Radio Opaque Gauze Swab 11cmx11cmx8ply R N
30
New
14501905
Radio Opaque Gauze Swab 8cmx8cmx8ply R N
31
New
14501906
Radio Opaque Gauze Swab 8cmx8cmx16ply R N
32
New
14501801
Dressing semipermiable water proof size -
6cmx7cm R N
33
New
14501802
dressing semipermiable water proof size -
10cmx12cm R N
34
New
14560002
Ophthalmic Surgical Drape 10cm x
12cm,Sterile. R E
35
New
14560003
Ophthalmic Surgical Drape with pouch size
50cm x 40cm, Sterile. R E
36
New
14560004
Ophthalmic Surgical Drape with pouch size
40cm x 60cm, sterile. R E
37 New
14560001 Ophthalmic surgical Drape 6cm x7cm R E
38
New
14540001
Nanocrystal Silver dressing 10cmX10cm C N
39
New
14540002
Nanocrystal Silver dressing 10cmX20cm C N
40
New
14540003
Nanocrystal Silver dressing 20cmX40cm C N
41
New
14540101
Nanocrystal Silver Flexible dressing
10cmX10cm C N
42
New
14540102
Nanocrystal Silver Flexible dressing
10cmX20cm C N
43
New
14540103
Nanocrystal Silver Flexible dressing
20cmX40cm C N
44
New
14540201
Cadexsomer Powder with Iodine 3g C N
Revised item list (Pharmaceuticals) 2016/2017
Page 112
45 New
14540202
Cadexsomer ointment with Iodine 10g C N
46
New
14540301
Hydro gel 25g C N
47
New
14540401
0.5% Chlorhexidine Acetate dressing
10cmX10cm C N
48
New
14540501
Post-Operative water proof dressing with non-
adhesive absorbent pad 6.5cmX5cm C N
49
New
14540502
Post-Operative water proof dressing with non-
adhesive absorbent pad 8.5cmX9.5cm C N
50
New
14540503
Post-Operative water proof dressing with non-
adhesive absorbent pad 15.5cmX8.5cm C N
51
New
14540504
Post-Operative water proof dressing with non-
adhesive absorbent pad20cmX10cm C N
52
New
14540505
Post-Operative water proof dressing with non-
adhesive absorbent pad 25cmX10cm C N
53
New
14540506
Post-Operative water proof dressing with non-
adhesive absorbent pad 30cmX10cm C N
54
New
14540507
Post-Operative water proof dressing with non-
adhesive absorbent pad 35cmX10cm C N
55
New
14540602
Low adherent wound dressing 10cmX10cm C N
56
New
14540601
Low adherent wound dressing 10cmX7m C N
57
New
14540701
Water resistant post-operative spray 40ml C N
58
New
14540702
Water resistant post-operative spray 240ml C N
59
New
14540801
Cellulose ethyl sulphonate wound dressing
5cmx5cm C N
60
New
14540802
Cellulose ethyl sulphonate wound dressing
10cmx10cm C N
61
New
14540803
Cellulose ethyl sulphonate wound dressing
4cmx20cm C N
62 New
14540804
Cellulose ethyl sulphonate wound dressing
15cmx15cm
C N
63
New
14540805
Cellulose ethyl sulphonate wound dressing
2cmx45cm C N
64
New
14540901
Hydrocellularpolyurethane dressing with Silver
5cmX5cm C N
65
New
14540902
Hydrocellular polyurethane dressing with Silver
10cmX10cm C N
66
New
14540903
Hydrocellular polyurethane dressing with Silver
15cmX15cm C N
67 New Hydro surgery system for wound cleaning C N
Revised item list (Pharmaceuticals) 2016/2017
Page 113
22310001
68 New
14530001
Hydro surgery system hand piece,14mm-
0.11mm Nozzle C N
69
New
14530002
Hydro surgery system hand Piece, 14mm-
0.10mm Nozzle C N
70
New
22310002
NPWT Pump - Rechargeable (Negative Pressure
Wound Therapy) C N
71 New
14530101
Negative Pressure Wound Therapy Canister kit
800ml C N
72 New
14530102
Negative Pressure Wound Therapy foam
dressing kit Large 25cmX15cmX3cm C N
73
New
14530103
Negative Pressure Wound Therapy foam
dressing kit - Medium 20cmX12.5cmX3cm C N
74
New
14530104
Negative Pressure Wound Therapy gauze
dressing kit - Medium 20cmX12.5cmX3cm C N
Items included to the Formulary
No Item Code Medium Description
1
New
14500102
Gauze absorbent 30cmx30cmx8ply
2
New
14500103
Gauze Absorbent 23cmx23cmx4ply
3
New
14500104 Gauze absorbent 11cmx11cmx16ply
4 14500105 Gauze Absorbent 11cmx11cmx8ply
5 14500106 Gauze Absorbent 8cmx8cmx8ply
6 14500107 Gauze Absorbent 8cmx8cmx16ply
7
New
14500206 'Interlayered Cotton Wool 2" x 3.5m roll'
8
New
14500302 Open Woven Bandage 2.5cm x 5m
9
New
14500303 Open Woven Bandage 8 cmx4.5m
10
New
14500403
Cotton crepe bandage 2.5 cm width and 2m
lengh
11
New
14500404 Cotton crepe bandage 5cm width and 3m lengh
12
New
14500405 Cotton crepe bandage 10cm width and 6m lengh
13
New
14500406
Cotton crepe bandage 15cm width and 6m
length
Revised item list (Pharmaceuticals) 2016/2017
Page 114
14 New
14501104
Plaster of Paris Bandage (P.O.P. Bandage)
Width: 3 cm Length: 2.7m Roll
15
New
14501501
Fusidic impregnated 1-3% paraffin gauze
dressing, 10cm x 10cm
13
New
14501601
Latex free hypoallergenic 'paper' tape 1.25cm
and longer size for the length is better
16
New
14501602
Latex free hypoallergenic 'paper' tape 2.5cm
and longer size for the length is better
17
New
14501603
Latex free hypoallergenic 'paper' tape 5cm and
longer size for the length is better
18
New
14501604
Latex free hypoallergenic 'paper' tape 7.5cm
width and longer size for the length is better
19
New
14501701
Transparent dressing for catheter fixation 6cm x
7cm
20
New
14501702
Transparent dressing for catheter fixation 10cm
x 12cm
21
New
14501901
Radio Opaque Gauze Swab 30cmx30cmx8ply
22
New
14501902
Radio Opaque Gauze Swab 23cmx23cmx4ply
23
New
14501903
Radio Opaque Gauze Swab 11cmx11cmx16ply
24
New
14501904
Radio Opaque Gauze Swab 11cmx11cmx8ply
25
New
14501905
Radio Opaque Gauze Swab 8cmx8cmx8ply
26
New
14501906
Radio Opaque Gauze Swab 8cmx8cmx16ply
27
New
14501801
Dressing semipermiable water proof size -
6cmx7cm
28
New
14501802
dressing semipermiable water proof size -
10cmx12cm
29
New
14560002
Ophthalmic surgical drape 10cm
x12cm(4"x4"1/2)
30
New
14560003
Ophthalmic surgical drape with pouch size 50cm
x40cm
31
New
14560004
Ophthalmic surgical drape with pouch size 40cm
x60cm
32
New
14560001 Ophthalmic surgical drape 6cm x7cm
33
New
14540001
Nanocrystal Silver dressing 10cmX10cm
34
New
14540002
Nanocrystal Silver dressing 10cmX20cm
35
New
14540003
Nanocrystal Silver dressing 20cmX40cm
36 New Nanocrystal Silver flexible dressing
Revised item list (Pharmaceuticals) 2016/2017
Page 115
14540101 10cmX10cm
37 New
14540102
Nanocrystal Silver flexible dressing
10cmX20cm
38
New
14540103
Nanocrystal Silver flexible dressing
20cmX40cm
39
New
14540201
Cadexsomer powder with Iodine 3g
40
New
14540202
Cadexsomer ointment with Iodine 10g
41
New
14540301
Carboxymethylcellulose 2.3%, Propylene glycol
USP 20.0%, water 77.7%/ ,25g Appli pack.
42
New
14540401
0.5% Chlorhexidine acetate dressing
10cmX10cm
43
New
14540501
Post-operative water proof dressing with non-
adhesive absorbent pad 6.5cmX5cm
44
New
14540502
Post-operative water proof dressing with non-
adhesive absorbent pad 8.5cmX9.5cm
45
New
14540503
Post-operative water proof dressing with non-
adhesive absorbent pad 15.5cmX8.5cm
46 New
14540504
Post-operative water proof dressing with non-
adhesive absorbent pad20cmX10cm
47
New
14540505
Post-operative water proof dressing with non-
adhesive absorbent pad 25cmX10cm
48
New
14540506
Post-operative water proof dressing with non-
adhesive absorbent pad 30cmX10cm
49
New
14540507
Post-operative water proof dressing with non-
adhesive absorbent pad 35cmX10cm
50
New
14540602
Low adherent wound dressing 10cmX10cm
51
New
14540601
Low adherent wound dressing 10cmX7m
52
New
14540701
Water resistant post-operative spray 40ml
53
New
14540702
Water resistant post-operative spray 240ml
54
New
14540801
Cellulose ethyl sulphonate wound dressing
5cmx5cm
55
New
14540802
Cellulose ethyl sulphonate wound dressing
10cmx10cm
56
New
14540803
Cellulose ethyl sulphonate wound dressing
4cmx20cm
57
New
14540804
Cellulose ethyl sulphonate wound dressing
15cmx15cm
58 New
14540805
Cellulose ethyl sulphonate wound dressing
2cmx45cm
Revised item list (Pharmaceuticals) 2016/2017
Page 116
59 New
14540901
Hydrocellular polyurethane dressing with Silver
5cmX5cm
60
New
14540902
Hydrocellular polyurethane dressing with Silver
10cmX10cm
61
New
14540903
Hydrocellular polyurethane dressing with Silver
15cmX15cm
62
New
22310001
Hydro surgery system for wound cleaning
63 New
14530001
Hydro surgery system hand piece
64
New
14530002
Hydro surgery system hand piece
65
New
22310002
NPWT Pump - Rechargeable (Negative Pressure
Wound Therapy)
66 New
14530101
Negative Pressure Wound Therapy Canister kit
800ml
67 New
14530102
Negative Pressure Wound Therapy foam
dressing kit large 25cmX15cmX3cm
68
New
14530103
Negative Pressure Wound Therapy foam
dressing kit - medium 20cmX12.5cmX3cm
69
New
14530104
Negative Pressure Wound Therapy gauze
dressing kit - medium 20cmX12.5cmX3cm