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CORE CHRONIC MEDICATION FORMULARY
This formulary represents drugs covered for chronic use for the 25 Chronic Disease List (CDL) conditions and individual Diagnostic Treatment Pairs (DTP) conditions.
The examples below serve as a guide on the trade names available for the active ingredients listed and not for marketing a specific brand.
Unless stipulated, all active ingredients listed in this formulary are subject to the Metropolitan Health Reference Price (MetRef) in line with scheme rules.
IMPORTANT: Please note that the medication on this list is published on an annual basis. Medication and prices are subject to change based on new clinical information and/or pricing updates which may not be reflected on the list below.
KEY:
Treatment designated as "Accepted treatment" indicates that this is a medicine covered as first line; i.e. without additional clinical information required, according to Metropolitan Health Risk Management Medicine Reimbursement Policies.
For treatment designated as "Motivation required", certain criteria as specified in the Metropolitan Health Risk Management Medicine Reimbursement Policies should be met.
For treatment designated as “Special investigations", the relevant clinical investigation reports as specified in the Metropolitan Health Risk Management Medicine Reimbursement Policy are required.
Abbreviations of dosage form
CAP Capsule ENE Enema OPD Eye drops
CPS Capsule (Inhaler) INH Inhaler SLN Sublingual
CRM Cream INJ Injection SRC Slow release capsule
DRP Drops LOT Lotion SRT Slow release tablet
DSP Dispersible NAS Nasal spray SUP Suppository
SYR Syrup TAB Tablet UNG Ointment
ECT Enteric-coated tablet NOD Nasal drops SUS Suspension
ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
CHRONIC DISEASE LIST CONDITIONS (CDLs) ADDISON'S DISEASE
ICD10: E27.1
Fludrocortisone 0.1mg TAB Florinef acetate Corticosteroids , oral Motivation required; Specialist initiation
Hydrocortisone 10mg TAB Covocort Corticosteroids , oral Accepted treatment
Prednisolone 5mg TAB Prelone Lenisolone Corticosteroids , oral Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids , oral Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
ASTHMA
ICD10: J45.0, J45.1, J45.8, J45.9
Aminophylline 225mg SRT Phyllocontin Xanthines Motivation required
Beclometasone 100mcg INH Beclate 100 Becotide 100 comp Corticosteroids, inhaled Accepted treatment
Beclometasone 200mcg INH Beclate 200 Corticosteroids, inhaled Accepted treatment
Beclometasone 50mcg INH Beclate 50 Becotide complete Corticosteroids, inhaled Accepted treatment
Budesonide 100mcg INH Budeflam 300 dose gentle-haler hfa
Pulmicort Turbohaler 200d Corticosteroids, inhaled Accepted treatment
Budesonide 200mcg INH Budeflam 300 dose gentle-haler hfa
Pulmicort Turbohaler 200d Corticosteroids, inhaled Accepted treatment
Budesonide 200mcg CPS Budeflam DP Caps Inflacor 200 Corticosteroids, inhaled Accepted treatment
Budesonide 100mcg CPS Inflacor 100 Corticosteroids, inhaled Accepted treatment
Budesonide 400mcg CPS Inflacor 400 Corticosteroids, inhaled Accepted treatment
Budesonide 400mcg INH Inflammide 400 Novolizer Complete
Corticosteroids, inhaled Accepted treatment
Budesonide 400mcg INH Inflammide 400 Novolizer refill Corticosteroids, inhaled Accepted treatment
Fenoterol and ipratropium bromide
200mcg INH Duovent HFA 200 dose Beta agonists , short acting Accepted treatment
Formoterol 12mcg CPS Foradil dry powder inhalation Beta agonists, long acting Accepted treatment
Formoterol 12mcg INH Foratec HFA Beta agonists, long acting Accepted treatment
Formoterol and Budesonide combination
80/4.5mcg INH Symbicord turboh 120 dose 160mcg;45mcg
Vannair 120d Formoterol and other drugs fro obstructive airway disease
Accepted treatment
Formoterol and Budesonide combination
160/4.5mg INH Symbicord turboh 120 dose 160: 4.5mcg
Vannair 120d Formoterol and other drugs fro obstructive airway disease
Accepted treatment
Montelukast 10mg TAB Monte-air Sintrine Leukotriene receptor antagonists Motivation required
Montelukast 5mg CHU Monte-air Sintrine Leukotriene receptor antagonists Motivation required
Montelukast 4mg CHU Monte-air Sintrine Leukotriene receptor antagonists Accepted treatment
Montelukast 4mg SAC Monte-air Sintrine Leukotriene receptor antagonists Accepted treatment
Ipratropium bromide 40mcg INH Ipvent anticholinergics Accepted treatment
Ipratropium bromide 20mcg INH Atrovent anticholinergics Accepted treatment
Salbutamol 100mcg INH Asthavent 200 dose Beta agonists , short acting Accepted treatment
Salbutamol 100mcg INH Asthavent 300d ecohaler cfc free Beta agonists , short acting Accepted treatment
Salbutamol 200mcg CAP Asthavent DP Beta agonists , short acting Accepted treatment
Salbutamol 100mcg INH Venteze CFC free Beta agonists , short acting Accepted treatment
Salbutamol 100mcg INH Venteze complete Beta agonists , short acting Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Salbutamol 100mcg INH Ventolin inhaler 200 cfc-free Beta agonists , short acting Accepted treatment
Salmeterol and fluticasone 25/125mcg INH Foxair Sereflo HFA 25/125 Dose 120
Salmeterol and other drugs used in obstructive airway disease
Accepted treatment
Salmeterol and fluticasone 25/250mcg INH Foxair Sereflo HFA 25/250 Dose 120
Salmeterol and other drugs used in obstructive airway disease
Accepted treatment
Salmeterol and fluticasone 25/50mcg INH Foxair Sereflo HFA 25/50 120 Dose
Salmeterol and other drugs used in obstructive airway disease
Accepted treatment
Salmeterol and fluticasone 50/100mcg ACC Foxair Seretide accuhaler 50/100 Salmeterol and other drugs used in obstructive airway disease
Accepted treatment
Salmeterol and fluticasone 50/250mcg ACC Foxair Seretide accuhaler 25/250 120 dose
Salmeterol and other drugs used in obstructive airway disease
Accepted treatment
Salmeterol and fluticasone 50/500mcg ACC Foxair Seretide accuhaler 50/500 Salmeterol and other drugs used in obstructive airway disease
Motivation required
Theophylline 250mg SRT Euphyllin retard Xanthines Motivation required
Theophylline 125mg SRC Microphyllin Xanthines Motivation required
Theophylline 250mg SRC Microphyllin Xanthines Motivation required
Theophylline 250mg SRT Nuelin sa 250 Xanthines Motivation required
Theophylline 300mg SRT Pulmophyllin sr 300 Xanthines Motivation required
Theophylline 200mg SRT SANDOZ Theophyllin Anhydrous SR Xanthines Motivation required
Theophylline 300mg SRT SANDOZ Theophyllin Anhydrous SR Xanthines Motivation required
Theophylline 200mg SRT Theoplus Xanthines Motivation required
Theophylline 300mg SRT Theoplus Xanthines Motivation required
Theophylline 400mg SRT Uniphyl 400 Xanthines Motivation required
Theophylline 600mg SRT Uniphyl 600 Xanthines Motivation required
BIPOLAR MOOD DISORDER (initial diagnosis and treatment to be confirmed by a psychiatrist)
ICD10: F31.0, F31.1, F31.2, F31.3, F31.4, F31.5, F31.6, F31.8, F31.9
Amitriptyline 25mg TAB SANDOZ Amitryptyline Trepiline Heterocyclic antidepressant Accepted treatment
Carbamazepine 200mg TAB CPL-Carbamazepine Degranol Antimanic agent Accepted treatment
Carbamazepine 400mg SRT SANDOZ Cabamazepine CR Tegretol CR Antimanic agent Accepted treatment
Carbamazepine 200mg SRT SANDOZ Carbamazepine CR Tegretol CR Antimanic agent Accepted treatment
Chlorpromazine 100mg TAB Largactil Antipsychotics Accepted treatment
Chlorpromazine 25mg TAB Largactil Antipsychotics Accepted treatment
Chlorpromazine 50mg TAB Largactil Antipsychotics Accepted treatment
Citalopram 20mg TAB Adco-Talomil Arrow Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Citalopram 10mg TAB Austell-Citalopram Selective serotonin receptor inhibitors
Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Citalopram 40mg TAB DRL-Citalopram Depramil Selective serotonin receptor inhibitors
Accepted treatment
Clomipramine 10mg TAB Equinorm Clomidep Heterocyclic antidepressants Accepted treatment
Clomipramine 25mg TAB Equinorm Clomidep Heterocyclic antidepressants Accepted treatment
Clozapine 100mg TAB Cloment Leponex Antipsychotics Accepted treatment
Clozapine 25mg TAB Cloment Leponex Antipsychotics Accepted treatment
Dosulepin 25mg CAP Prothiaden Thaden Heterocyclic antidepressants Accepted treatment
Dosulepin 75mg TAB Thaden Selective serotonin receptor inhibitors
Accepted treatment
Fluoxetine 20mg TAB Lorien Selective serotonin receptor inhibitors
Accepted treatment
Fluoxetine 20mg CAP Nuzak Lilly-fluoxetine Selective serotonin receptor inhibitors
Accepted treatment
Fluoxetine 20mg DSP Prohexal 20t Selective serotonin receptor inhibitors
Accepted treatment
Haloperidol 1.5mg TAB SANDOZ Haloperidol Antipsychotics Accepted treatment
Haloperidol 5mg TAB SANDOZ Haloperidol Serenace Antipsychotics Accepted treatment
Haloperidol 0.5mg CAP Serenace Antipsychotics Accepted treatment
Haloperidol 10mg TAB Serenace Antipsychotics Accepted treatment
Imipramine 25mg TAB Ethipramine Tofranil Heterocyclic antidepressants Accepted treatment
Lamotrigine 100mg TAB Aspen Lamotrigine Arrow lamotrigine Antimanic agent Accepted treatment
Lamotrigine 50mg TAB Dyna-Lamotrigine Austell-Lamotrigine Antimanic agent Accepted treatment
Lamotrigine 200mg TAB Mylan-Lamotrigine Lamitor Antimanic agent Accepted treatment
Lamotrigine 25mg TAB SANDOZ Lamotrigine Austell-Lamotrigine Antimanic agent Accepted treatment
Lithium 250mg TAB Camcolit Antimanic agent Accepted treatment
Lithium 400mg TAB Camcolit Antimanic agent Accepted treatment
Lithium 450mg TAB Quilonum retard Antimanic agent Accepted treatment
Maprotiline 25mg TAB Ludiomil Heterocyclic antidepressants Motivation required
Maprotiline 75mg TAB Ludiomil Heterocyclic antidepressants Motivation required
Olanzapine 2.5mg TAB Olexar Redilanz Antipsychotics Accepted treatment
Olanzapine 5mg TAB Olexar Redilanz Antipsychotics Accepted treatment
Olanzapine 10mg TAB Olexar Redilanz Antipsychotics Accepted treatment
Quetiapine 25mg TAB Quetoser 25 Serez 25 Antipsychotics Accepted treatment
Quetiapine 100mg TAB Truvalin Quetoser Antipsychotics Accepted treatment
Quetiapine 200mg TAB Mylan Quetiapine Dopaquel Antipsychotics Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Quetiapine 300mg TAB Serez Truvalin Antipsychotics Accepted treatment
Quetiapine 200mg TAB Seroquel XR 200 Antipsychotics Accepted treatment
Quetiapine 300mg TAB Seroquel XR 300 Antipsychotics Motivation required
Quetiapine 400mg TAB Seroquel XR 400 Antipsychotics Motivation required
Risperidone 0.5mg TAB Aspen Risperidone Risperlet Antipsychotics Accepted treatment
Risperidone 2mg TAB Aspen Risperidone Risperdal Quicklet Antipsychotics Accepted treatment
Risperidone 3mg TAB Aspen Risperidone Risperidone-Hexal Antipsychotics Accepted treatment
Risperidone 1.0mg TAB DRL-Risperidone Auroperdal Antipsychotics Accepted treatment
Risperidone 1mg/ml SYR Risperdal Antipsychotics Accepted treatment
Risperidone 4mg TAB Risperdal Risponz Antipsychotics Accepted treatment
Sulpiride 200mg TAB Bio-Sulpiride Substituted benzamide Accepted treatment
Sulpiride 50mg CAP Espiride SANDOZ Sulpiride Substituted benzamide Accepted treatment
Trifluoperazine 1mg TAB Stelazine Antipsychotics Motivation required
Trifluoperazine 5mg TAB Stelazine Antipsychotics Motivation required
Valproic acid 150mg CAP Convulex Antimanic agent Accepted treatment
Valproic acid 300mg CAP Convulex Antimanic agent Accepted treatment
Valproic acid 500mg CAP Convulex Antimanic agent Accepted treatment
Valproic acid 200mg SRT Epilim cr 200 Antimanic agent Accepted treatment
Valproic acid 300mg SRT Epilim cr 300 Antimanic agent Accepted treatment
Valproic acid 500mg SRT Epilim cr 500 Antimanic agent Accepted treatment
Zuclopenthixol 10mg TAB Clopixol Antipsychotics Accepted treatment
Zuclopenthixol 2mg TAB Clopixol Antipsychotics Accepted treatment
Zuclopenthixol 200mg/ml INJ Clopixol depot Antipsychotics Motivation required
BRONCHIECTASIS
ICD10: Q33.4, J47
Oral antibiotics will be reimbursed in the treatment of Bronchiectasis. Limited durations authorisation periods may apply.
Aminophylline 100mg TAB Norstan-ted Xanthines Accepted treatment
Aminophylline 200mg TAB Norstan-ted Xanthines Accepted treatment
Aminophylline 225mg SRT Phyllocontin Xanthines Accepted treatment
Beclometasone 100mcg INH Beclate 100 Becotide 100 comp Corticosteroids, inhaled special investigations, Lung Function Test (LFT)
Beclometasone 200mcg INH Beclate 200 Corticosteroids, inhaled special investigations, LFT
Beclometasone 50mcg INH Beclate 50 Becotide complete Corticosteroids, inhaled special investigations, LFT
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Budesonide 100mcg INH Budeflam 300 dose gentle-haler hfa
Pulmicort Turbohaler 200d Corticosteroids, inhaled special investigations, LFT
Budesonide 200mcg INH Budeflam 300 dose gentle-haler hfa
Pulmicort Turbohaler 200d Corticosteroids, inhaled special investigations, LFT
Budesonide 200mcg CPS Budeflam DP Caps Corticosteroids, inhaled special investigations, LFT
Budesonide 100mcg CPS Inflacor 100 Corticosteroids, inhaled special investigations, LFT
Budesonide 200mcg CPS Inflacor 200 Corticosteroids, inhaled special investigations, LFT
Budesonide 400mcg CPS Inflacor 400 Corticosteroids, inhaled special investigations, LFT
Budesonide 400mcg INH Inflammide 400 Novolizer Complete
Corticosteroids, inhaled special investigations, LFT
Budesonide 400mcg INH Inflammide 400 Novolizer refill Corticosteroids, inhaled special investigations, LFT
Fenoterol and ipratropium bromide
200mcg INH Duovent HFA 200 dose Beta agonists, short-acting Accepted treatment
Formoterol 12mcg CPS Foradil dry powder inhalation Beta agonists, long-acting Accepted treatment
Formoterol 12mcg INH Foratec HFA Beta agonists, long-acting Accepted treatment
Formoterol and budesonide combination
80/4.5mg INH Symbicord turboh 120d 80/4.5mg Vannair 120d Formoterol and other drugs used in obstructive airway disease
special investigations, LFT
Formoterol and budesonide combination
160mg/4.5mg INH Symbicord turboh 120d 160/4.5mg Vannair 120d Formoterol and other drugs used in obstructive airway disease
special investigations, LFT
Formoterol and budesonide combination
320/9mcg INH Symbicord turboh 60dose 320:9mcg
Formoterol and other drugs used in obstructive airway disease
special investigations, LFT
Ipratropium bromide 20mcg INH Atrovent 20 HFA MDI 200dose 10ml
Beta agonists, short-acting Accepted treatment
Ipratropium bromide 40mcg INH Ipvent-40 300 dose Beta agonists, short-acting Accepted treatment
Salbutamol 100mcg INH Asthavent 200 dose Beta agonists, short-acting Accepted treatment
Salbutamol 100mcg INH Asthavent 300d ecohaler cfc free Beta agonists, short-acting Accepted treatment
Salbutamol 200mcg CAP Asthavent DP Beta agonists, short-acting Accepted treatment
Salbutamol 100mcg INH Venteze CFC free Venteze complete Beta agonists, short-acting Accepted treatment
Salmeterol and fluticasone combination
25/125mcg INH Foxair Sereflo HFA 25/125 Dose 120
Salmeterol and other drugs used in obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone 25/250mcg INH Foxair Sereflo HFA 25/250 Dose 120
Salmeterol and other drugs used in obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone 25/50mcg INH Foxair Sereflo HFA 25/50 120 Dose
Salmeterol and other drugs used in obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone 50/100mcg ACC Foxair Seretide accuhaler 50/100 Salmeterol and other drugs used in obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone 50/250mcg ACC Foxair Seretide Accuhaler 50/250 Salmeterol and other drugs used in obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone 50/500mcg ACC Foxair Seretide accuhaler 50/500 Salmeterol and other drugs used in obstructive airway disease
special investigations, LFT
Theophylline SYR Alcophyllin Xanthines Accepted treatment
Theophylline 25mg/5ml SYR Nuelin liquid Xanthines Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Theophylline 250mg SRT Euphyllin retard Xanthines Accepted treatment
Theophylline 125mg SRC Microphyllin Xanthines Accepted treatment
Theophylline 250mg SRC Microphyllin Xanthines Accepted treatment
Theophylline 250mg SRT Nuelin sa 250 Xanthines Accepted treatment
Theophylline 300mg SRT Pulmophyllin sr 300 Xanthines Accepted treatment
Theophylline 200mg SRT SANDOZ Theophyllin Anhydrous SR Xanthines Accepted treatment
Theophylline 300mg SRT SANDOZ Theophyllin Anhydrous SR Xanthines Accepted treatment
Theophylline 200mg SRT Theoplus Xanthines Accepted treatment
Theophylline 300mg SRT Theoplus Xanthines Accepted treatment
Theophylline 400mg SRT Uniphyl 400 Xanthines Accepted treatment
Theophylline 600mg SRT Uniphyl 600 Xanthines Accepted treatment
CARDIOMYOPATHY/HEART FAILURE
ICD10: I42.0, I42.1
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Bayer aspirin Aspirin Accepted treatment
Amlodipine 10mg TAB Almadin Amloc Calcium channel blockers Accepted treatment
Amlodipine 5mg TAB Amlodac Amlosyn Calcium channel blockers Accepted treatment
Amlodipine besylate 10mg TAB Austell-Amlodipine Calbloc Calcium channel blockers Accepted treatment
Amlodipine Besylate 5mg TAB Lomanor Ciplavasc Calcium channel blockers Accepted treatment
Amlodipine maleate 10mg TAB Amlate Calcium channel blockers Accepted treatment
Amlodipine maleate 5mg TAB Amlate Calcium channel blockers Accepted treatment
Atenolol 100mg TAB Adco-atenolol B-Block Beta blockers Accepted treatment
Atenolol 50mg TAB Bio-atenolol Gulf Atenolol Beta blockers Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Tenoret Tenchlor Beta blockers and combinations Accepted treatment
Atenolol and other diuretics 50mg/12.5mg TAB Tenoret Tenchlor hs Beta blockers and combinations Accepted treatment
Atenolol and thiazides 100mg/25mg TAB Adco-loten Beta blockers and combinations Accepted treatment
Bisoprolol 5mg TAB Bisoprolol Unicorn Adco-Bisocor Beta blockers Accepted treatment
Bisoprolol 10mg TAB Adco-Bisocor Betacor Beta blockers Accepted treatment
Captopril 25mg TAB Bio-Captopril Capace ACE-inhibitors Accepted treatment
Captopril 12.5mg TAB Capoten hs Captohexal ACE-inhibitors Accepted treatment
Captopril 50mg TAB Captohexal Captomax ACE-inhibitors Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Captopril and diuretics 50mg/25mg TAB Captoretic Zapto-co ACE-inhibitors and combinations Accepted treatment
Carvedilol 12.5mg TAB Aspen-Carvidelol Carloc 12 5 Alpha/beta blockers Accepted treatment
Carvedilol 25mg TAB Aspen-Carvidelol Carloc 25 Alpha/beta blockers Accepted treatment
Carvedilol 6.25mg TAB Aspen-Carvidelol Carloc 6 25 Alpha/beta blockers Accepted treatment
Digoxin 0.0625mg TAB Lanoxin Cardiac glycosides Accepted treatment
Digoxin 0.25mg TAB Lanoxin Cardiac glycosides Accepted treatment
Digoxin 0.05mg/ml SYR Lanoxin paed Cardiac glycosides Accepted treatment
Digoxin 0.25mg TAB Purgoxin Cardiac glycosides Accepted treatment
Diltiazem 180mg TAB Adco-Zildem 180 SR Calcium channel blockers Accepted treatment
Diltiazem 240mg TAB Adco-Zildem 240 SR Calcium channel blockers Accepted treatment
Enalapril 10mg TAB Enap Alapren 10 ACE-inhibitors Accepted treatment
Enalapril 20mg TAB Ciplatec Alapren 20 ACE-inhibitors Accepted treatment
Enalapril 5mg TAB Alapren 5 Ciplatec 5 ACE-inhibitors Accepted treatment
Enalapril 2.5mg TAB Renitec 2 5 ACE-inhibitors Accepted treatment
Enalapril and diuretics 20mg/12.5mg TAB Co-renitec Enap co ACE-inhibitors Accepted treatment
Felodipine 10mg SRT Felodipine-Hexal Calcium channel blockers Accepted treatment
Felodipine 5mg SRT Felodipine-Hexal Plendil Calcium channel blockers Accepted treatment
Felodipine 2.5mg SRT Plendil Calcium channel blockers Accepted treatment
Furosemide 40mg TAB Austell- Furosemide Beurises Diuretics Accepted treatment
Furosemide 10mg/ml SYR Lasix oral Diuretics Motivation required
Hydralazine 10mg TAB Hyperphen Vasodilators Accepted treatment
Hydralazine 50mg TAB SANDOZ Hydralazine Hyperphen Vasodilators Accepted treatment
Hydrochlorothiazide 12.5mg TAB Ridaq Diuretics Accepted treatment
Hydrochlorothiazide 25mg TAB Ridaq Hexazide Diuretics Accepted treatment
Hydrochlorothiazide and potassium
50mg/300mg TAB Urirex-k Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/5mg TAB Adco-retic Betaretic Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
25mg/2.5mg TAB Amiloretic hs Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/25mg TAB Dyazide Renezide Diuretics Accepted treatment
Indapamide 2.5mg TAB Cipla-Indapamide Dapamax Diuretics Accepted treatment
Irbesartan 150mg TAB Iberwin Aprovel Angiotension receptor antagonist Accepted treatment
Irbesartan 300mg TAB Iberwin Aprovel Angiotension receptor antagonist Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Irbesartan and diuretics 150mg/12.5mg TAB Co-Iberwin Coaprovel Angiotensin receptor blockers and combinations
Accepted treatment
Irbesartan and diuretics 300mg/12.5mg TAB Co-Iberwin Coaprovel Angiotensin receptor blockers and combinations
Accepted treatment
Isosorbide dinitrate 40mg TAB Isordil tembid Organic nitrates Accepted treatment
Isosorbide dinitrate 30mg TAB SANDOZ Isosorbide Isordil Organic nitrates Accepted treatment
Isosorbide dinitrate 10mg TAB SANDOZ Isosorbide Dinitrate Isordil Organic nitrates Accepted treatment
Isosorbide dinitrate 5mg TAB SANDOZ Isosorbide Dinitrate Isordil sublingual Organic nitrates Accepted treatment
Lisinopril 10mg TAB Auro-Lisinopril Austell-Lisinopril ACE-inhibitors Accepted treatment
Lisinopril 5mg TAB Auro-Lisinopril Hexal-lisinopril 5 ACE-inhibitors Accepted treatment
Lisinopril 2.5mg TAB Austell-lisinopril ACE-inhibitors Accepted treatment
Lisinopril 20mg TAB Zestril Zetomax ACE-inhibitors Accepted treatment
Lisinopril and diuretics 10mg/12.5mg TAB Auro-Lisinopril Co HEXAL-Lisinopril Co ACE-inhibitors and combinations Accepted treatment
Lisinopril and diuretics 20mg/12.5mg TAB Auro-Lisinopril Co HEXAL-Lisinopril Co ACE-inhibitors and combinations Accepted treatment
Losartan 100mg TAB Cipla Losartan Cozaar Angiotensin receptor blockers Accepted treatment
Losartan 50mg TAB Cipla Losartan Cozaar Angiotensin receptor blockers Accepted treatment
Losartan and diuretics 50mg/12.5mg TAB Zartan Co Losaar plus 50/12.5 Angiotensin receptor blockers and combinations
Accepted treatment
Losartan and diuretics 100mg/25mg TAB Zartan Co Hytenza Angiotensin receptor blockers and combinations
Accepted treatment
Nifedipine 20mg SRT Adco-Nifedpine Nifedalat SR 20mg Calcium channel blockers Accepted treatment
Nifedipine 30mg TAB Adco-Vascard Fedaloc SR Calcium channel blockers Accepted treatment
Nifedipine 60mg TAB Adco-Vascard Fedaloc SR Calcium channel blockers Accepted treatment
Perindopril 4mg TAB Cipla Perindopril Peristar ACE-inhibitors Accepted treatment
Perindopril 8mg TAB Cipla-Perindopril Ciplasyl ACE-inhibitors Accepted treatment
Perindopril 10mg TAB Prexum Coversyl ACE-inhibitors Accepted treatment
Perindopril 5mg TAB Prexum 5 ACE-inhibitors Accepted treatment
Perindopril 5mg/1.25mg TAB Prexum 5 Plus ACE-inhibitors Accepted treatment
Perindopril and diuretics 2mg/0.625mg TAB Acesyl Co Preterax ACE-inhibitors and combinations Accepted treatment
Perindopril and diuretics 4mg/1.25mg TAB Acesyl Co 4/1.25 BiPreterax ACE-inhibitors and combinations Accepted treatment
Perindorpil and Amlodipine 5mg/5mg TAB Coveram 5/5 ACE-inhibitors and Calcium Channel Blockers
Accepted treatment
Perindopril and diuretics 10mg/2.5mg TAB BioPrexum plus ACE-inhibitors and combinations Accepted treatment
Perindorpil and Amlodipine 5mg/10mg TAB Coveram 5/10 ACE-inhibitors and Calcium Channel Blockers
Accepted treatment
Perindorpil and Amlodipine 10mg/5mg TAB Coveram 10/5 ACE-inhibitors and Calcium Channel Blockers
Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Perindorpil and Amlodipine 10mg/10mg TAB Coveram 10/10 ACE-inhibitors and Calcium Channel Blockers
Accepted treatment
Potassium chloride 600mg TAB Plenish k SANDOZ K-600 Potassium supplements Accepted treatment
Propranolol 10mg TAB Indoblok Purbloka Beta blockers Accepted treatment
Propranolol 40mg TAB INdoblok Purbloka Beta blockers Accepted treatment
Quinapril 10mg TAB Accumax Accupril ACE-inhibitors Accepted treatment
Quinapril 20mg TAB Accumax Accupril ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Austell-Ramipril ACE-inhibitors Accepted treatment
Ramipril 5mg CAP Austell-Ramipril ACE-inhibitors Accepted treatment
Ramipril 5mg CAP Apex-Ramipril 5mg ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Apex-Ramipril 10mg ACE-inhibitors Accepted treatment
Ramipril 2.5mg TAB Retace RamiprilHexal ACE-inhibitors Accepted treatment
Ramipril 5mg TAB Apex-Ramipril RamiprilHexal ACE-inhibitors Accepted treatment
Ramipril 2.5mg CAP Ramiwin Rampil ACE-inhibitors Accepted treatment
Ramipril 5mg CAP RamiWin Rampil ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Simayla Ramipril Ran-Ramipril ACE-inhibitors Accepted treatment
Spironolactone 25mg TAB Spiractin SANDOZ Spironolactone Diuretics Accepted treatment
Telimisartan 40mg TAB Pritor Micardis ACE-Inhibitor Accepted treatment
Telimisartan 80mg TAB Pritor Micardis ACE-Inhibitor Accepted treatment
Telimisatan and diuretic 40mg/12.5mg TAB Co-Pritor Co-Micardis ACE-Inhibitor and diuretic Accepted treatment
Telimisatan and diuretic 80mg/12.5mg TAB Co-Pritor Co-Micardis ACE-Inhibitor and diuretic Accepted treatment
Telimisatan and diuretic 80mg/25mg TAB Co-Pritor Co-Micardis ACE-Inhibitor and diuretic Accepted treatment
Trandolapril 0.5mg CAP Mavik (was Gopten) ACE-inhibitors Accepted treatment
Trandolapril 2mg CAP Mavik (was Gopten) ACE-inhibitors Accepted treatment
Valsartan 160mg TAB Migroben Diovan Angiotensin receptor blockers Accepted treatment
Valsartan 80mg TAB Migroben Diovan Angiotensin receptor blockers Accepted treatment
Valsartan and amlodipine 10mg/160mg TAB Exforge Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and amlodipine 5mg/160mg TAB Exforge Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 320/12.5mg TAB Co-Diovan Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 320mg/25mg TAB Co-Diovan Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 160mg/12.5mg TAB Co-Migroben Co-diovan Angiotensin receptor blockers and combinations
Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Valsartan and diuretics 160mg/25mg TAB Co-Migroben Co-Diovan Plus Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 80mg/12.5mg TAB Co-Migroben Co-diovan Angiotensin receptor blockers and combinations
Accepted treatment
Verapamil 240mg SRT Calcicard sr 240 Verahexal 240 sr Calcium channel blockers Accepted treatment
Verapamil 40mg TAB Vasomil Isoptin Calcium channel blockers Accepted treatment
Verapamil 80mg TAB Vasomil Isoptin Calcium channel blockers Accepted treatment
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Warfarin Cipla Warfarin Anticoagulants Accepted treatment
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (Initial diagnosis to be confirmed by lung function test)
ICD10: J43.0, J43.1, J43.2, J43.8, J43.9, J44.0, J44.1, J44.8, J44.9
Aminophylline 100mg TAB Norstan-ted Xanthines Accepted treatment
Aminophylline 200mg TAB Norstan-ted Xanthines Accepted treatment
Aminophylline 225mg SRT Phyllocontin Xanthines Accepted treatment
Beclometasone 200mcg INH Beclate 200 Corticosteroids, inhaled special investigations, LFT
Beclometasone 100mcg INH Becotide 100 comp Beclate 100 Corticosteroids, inhaled special investigations, LFT
Beclometasone 50mcg INH Becotide complete Beclate 50 Corticosteroids, inhaled special investigations, LFT
Budesonide 100mcg INH Budeflam 300 dose gentle-haler hfa
Pulmicort 200d Corticosteroids, inhaled special investigations, LFT
Budesonide 200mcg CPS Budeflam DP Caps Pulmicort 200d Corticosteroids, inhaled special investigations, LFT
Budesonide 100mcg CPS Inflacor 100 Corticosteroids, inhaled special investigations, LFT
Budesonide 400mcg CPS Inflacor 400 Corticosteroids, inhaled special investigations, LFT
Budesonide 200mcg INH Inflammide 200 Novolizer Budeflam 300 dose gentle-haler hfa
Corticosteroids, inhaled special investigations, LFT
Budesonide 400mcg INH Inflammide 400 Novolizer Complete
Corticosteroids, inhaled special investigations, LFT
Budesonide 400mcg INH Inflammide 400 Novolizer refill Corticosteroids, inhaled special investigations, LFT
Fenoterol and ipratropium bromide
200mcg INH Duovent HFA 200 dose Fenoterol and other drugs for obstructive airway disease
Accepted treatment
Formoterol 12mcg CPS Foradil dry powder inhalation Beta agonists, long-acting Accepted treatment
Formoterol 12mcg INH Foratec HFA Beta agonists, long-acting Accepted treatment
Fomoterol and Budesonide combination
160/4.5mg INH Symbicord Turbohaler 120d Vannair 120d Formoterol and other drugs for obstructive airway disease
special investigations, LFT
Fomoterol and Budesonide combination
80/4.5mg INH Symbicord Turbohaler 120d Vannair 120d Formoterol and other drugs for obstructive airway disease
special investigations, LFT
Fomoterol and Budesonide combination
160/4.5mg INH Symbicord Turbohaler 60d Formoterol and other drugs for obstructive airway disease
special investigations, LFT
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Fomoterol and Budesonide combination
320/9mg INH Symbicord Turbohaler 60d Formoterol and other drugs for obstructive airway disease
special investigations, LFT
Ipratropium bromide 20mcg INH Atrovent 20 HFA MDI 200dose 10ml
Anticholinergic agent Accepted treatment
Ipratropium bromide 40mcg INH Ipvent-40 300 dose Anticholinergic agent Accepted treatment
Salbutamol 100mcg INH Asthavent 200 dose Beta agonists, short-acting Accepted treatment
Salbutamol 100mcg INH Asthavent 300d ecohaler cfc free Beta agonists, short-acting Accepted treatment
Salbutamol 200mcg CAP Asthavent DP Beta agonists, short-acting Accepted treatment
Salbutamol 100mcg INH Venteze CFC free Beta agonists, short-acting Accepted treatment
Salbutamol 100mcg INH Venteze complete Beta agonists, short-acting Accepted treatment
Salbutamol 100mcg INH Ventolin inhaler 200 cfc-free Beta agonists, short-acting Accepted treatment
Salmeterol and fluticasone combination
25/125mcg INH Foxair Sereflo HFA 25/125 Dose 120
Salmeterol and other drugs for obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone combination
25/250mcg INH Foxair Sereflo HFA 25/250 Dose 120
Salmeterol and other drugs for obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone combination
25/50mcg INH Foxair Sereflo HFA 25/50 120 Dose
Salmeterol and other drugs for obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone combination
50/100mcg ACC Foxair Seretide accuhaler 50/100 Salmeterol and other drugs for obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone combination
50/250mcg ACC Foxair Seretide Accuhaler 50/250 Salmeterol and other drugs for obstructive airway disease
special investigations, LFT
Salmeterol and fluticasone combination
50/500mcg ACC Foxair Seretide accuhaler 50/500 Salmeterol and other drugs for obstructive airway disease
special investigations, LFT
Theophylline SYR Alcophyllin Xanthines Accepted treatment
Theophylline 25mg/5ml SYR Nuelin liquid Xanthines Accepted treatment
Theophylline 250mg SRT Euphyllin retard Xanthines Accepted treatment
Theophylline 125mg SRC Microphyllin Xanthines Accepted treatment
Theophylline 250mg SRC Microphyllin Xanthines Accepted treatment
Theophylline 250mg SRT Nuelin sa 250 Xanthines Accepted treatment
Theophylline 300mg SRT Pulmophyllin sr 300 Xanthines Accepted treatment
Theophylline 200mg SRT SANDOZ Theophyllin Anhydrous SR Xanthines Accepted treatment
Theophylline 300mg SRT SANDOZ Theophyllin Anhydrous SR Xanthines Accepted treatment
Theophylline 200mg SRT Theoplus Xanthines Accepted treatment
Theophylline 300mg SRT Theoplus Xanthines Accepted treatment
Theophylline 400mg SRT Uniphyl 400 Xanthines Accepted treatment
Theophylline 600mg SRT Uniphyl 600 Xanthines Accepted treatment
Tiotropium Bromide 18mcg CPS Forvent Spiriva Anticholinergic agent Motivation required
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
CHRONIC RENAL FAILURE (initial diagnosis to be confirmed by an appropriate specialist)
ICD10: N03.0, N03.1, N03.2, N03.4, N03.5, N03.6, N03.7, N03.8, N03.9, N11.0, N11.1, N11.8, N11.9, N18.0, N18.1, N18.2, N18.3, N18.4, N18.5, N18.9, I12.0, I13.2, I13.2, O10.2
See "Hypertension" for a list of diuretics and antihypertensive agents
Alfacalcidol 0.25mcg CAP One alpha Alfacalcidol Accepted treatment
Alfacalcidol 1mcg CAP One alpha Alfacalcidol Accepted treatment
Calcium acetate 660mg TAB Phosphorb Phosphate binder Accepted treatment
Calcitriol 0.25mcg CAP Rocaltrol Calcitriol Accepted treatment
Darbepoetin alfa 10mcg INJ Aranesp Darbepoetin alfa special investigations, Specialist initiation
Darbepoetin alfa 150mcg INJ Aranesp Darbepoetin alfa special investigations, Specialist initiation
Darbepoetin alfa 20mcg INJ Aranesp Darbepoetin alfa special investigations, Specialist initiation
Darbepoetin alfa 300mcg INJ Aranesp Darbepoetin alfa special investigations, Specialist initiation
Darbepoetin alfa 30mcg INJ Aranesp Darbepoetin alfa special investigations, Specialist initiation
Darbepoetin alfa 60mcg INJ Aranesp Darbepoetin alfa special investigations, Specialist initiation
Dextriferron 50mg/ml INJ CosmoFer Iron Supplements Special investigations; Specialist initiation
Dextriferron 50mg/2ml INJ CosmoFer Iron Supplements Special investigations; Specialist initiation
Ergocalciferol 1.25mg TAB Calciferol Ergocalciferol Accepted treatment
Erythropoietin 6000iu INJ Eprex Recormon Pre-Filled Erythropoietin special investigations, Specialist initiation
Erythropoietin 40000iu INJ Eprex 1ml Prefilled Erythropoietin special investigations, Specialist initiation
Erythropoietin 10000u/ml INJ Eprex prefill Recormon Pre-Filled Erythropoietin special investigations, Specialist initiation
Erythropoietin 2000u/05ml INJ Eprex prefill Erythropoietin special investigations, Specialist initiation
Erythropoietin 4000u/04ml INJ Eprex prefill Erythropoietin special investigations, Specialist initiation
Erythropoietin 2000iu INJ Recormon Pre-Filled Repotin 1ml Erythropoietin special investigations, Specialist initiation
Erythropoietin 30000iu INJ Recormon Pre-filled Erythropoietin special investigations, Specialist initiation
Erythropoietin 4000iu INJ Recormon Pre-Filled Repotin 1ml Erythropoietin special investigations, Specialist initiation
Erythropoietin 500iu INJ Recormon Pre-Filled Erythropoietin special investigations, Specialist initiation
Erythropoietin 6000iu INJ Recormon Pre-Filled Erythropoietin special investigations, Specialist initiation
Ferrous sulfate TAB Ferrous sulph co Iron Supplements Accepted treatment
Ferrous sulfate 100mg TAB Ferrous sulphate Iron Supplements Accepted treatment
Ferrous sulfate 30mg TAB Ferrous sulphate Iron Supplements Accepted treatment
Ferrous Lactate 25mg DRP Ferro L drops Iron Supplements Motivation required
Folic acid 0.5mg TAB Folic acid Folic acid Accepted treatment
Folic acid CAP Folic acid forte Folic acid Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Folic acid 5mg TAB Be-tabs folic acid Folic acid Accepted treatment
Folic acid 5mg CAP Folic acid Folic acid Accepted treatment
Iron in other combinations 20mg/ml INJ Venofer Iron in other combinations Special investigation; specialist initiation
Iron Sucrose 20mg/ml INJ Zypiron Rautevene Iron Supplement Special investigation; specialist initiation
Iron multivitamins and folic acid
CAP Autrin Iron Supplements Special investigation
Iron vitamin B12 and folic acid
TAB Foliglobin Iron Supplements Special investigation
Erythropoietin 0.05mg/03ml INJ Mircera Erythropoeitin Special investigation; specialist initiation
Erythropoietin 0.075mg/0.3ml INJ Mircera Erythropoeitin Special investigation; specialist initiation
Erythropoietin 0.15mg/0.3ml INJ Mircera Erythropoeitin Special investigation; specialist initiation
Erythropoietin 0.25mg/0.3ml INJ Mircera Erythropoeitin Special investigation; specialist initiation
Erythropoietin 0.2mg/0.3ml INJ Mircera Erythropoeitin Special investigation; specialist initiation
CORONARY ARTERY DISEASE
ICD10: I20.0, I20.1, I20.8, I20.9, I25.0, I25.1, I25.2, I25.3, I25.4, I25.5, I25.6, I25.8, I25.9
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Be-tabs aspirin (white) Disprin Aspirin Accepted treatment
Amlodipine 10mg TAB Amlodac Keysal Calcium channel blockers Accepted treatment
Amlodipine 5mg TAB Klodip Stamlo Calcium channel blockers Accepted treatment
Amlodipine besylate 5mg TAB Austell-Amlodipine Lomanor Calcium channel blockers Accepted treatment
Amlodipine besylate 10mg TAB Calbloc Pharma Dynamics Amlodipine Besylate
Calcium channel blockers Accepted treatment
Amlodipine maleate 10mg TAB Amlate Calcium channel blockers Accepted treatment
Amlodipine maleate 5mg TAB Amlate Calcium channel blockers Accepted treatment
Atenolol 50mg TAB Adco-atenolol B-Block Beta blockers Accepted treatment
Atenolol 100mg TAB Gulf Atenolol 100 Sandoz Atenolol Beta blockers Accepted treatment
Atenolol 25mg TAB Tenopress Tenormin 25 Beta blockers Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Tenchlor Tenoretic Beta blocker and diuretics Accepted treatment
Atenolol and other diuretics 50mg/12.5mg TAB Tenchlor hs Tenoret 50 Beta blocker and diuretics Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Beta blockers Accepted treatment
Bisoprolol 5mg TAB Cardicor Concor Beta blockers Accepted treatment
Bisoprolol 10mg TAB Concor Bilocor Beta blockers Accepted treatment
Carvedilol 12.5mg TAB Carvedilol-Hexal Carvetrend Alpha/beta blockers Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Carvedilol 25mg TAB Carvedilol-Hexal Carvetrend Alpha/beta blockers Accepted treatment
Carvedilol 6.25mg TAB Carvedilol-Hexal Carvetrend Alpha/beta blockers Accepted treatment
Diltiazem 180mg SRC Adco-Zildem 180 SR Calcium channel blockers Accepted treatment
Diltiazem 240mg SRC Adco-Zildem 240 SR Calcium channel blockers Accepted treatment
Dipyridimole 100mg TAB Plato Antithrombotic agent Motivation required
Dipyridimole 200mg SRC Persantin 200 Antithrombotic agent Motivation required
Dipyridimole & Acetylsalicylic acid
200mg/25 CAP Assasantin Antithrombotic agent Motivation required
Felodipine 10mg SRT Felodipine-Hexal Calcium channel blockers Accepted treatment
Felodipine 5mg SRT Felodipine-Hexal Plendil Calcium channel blockers Accepted treatment
Felodipine 2.5mg SRT Plendil Calcium channel blockers Accepted treatment
Glyceryl trinitrate 0.5mg TAB Angised Organic nitrates Accepted treatment
Isosorbide dinitrate 40mg TAB Isordil tembid Organic nitrates Accepted treatment
Isosorbide dinitrate 30mg TAB SANDOZ Isosorbide Isordil Organic nitrates Accepted treatment
Isosorbide dinitrate 10mg TAB SANDOZ Isosorbide Dinitrate Isordil Organic nitrates Accepted treatment
Isosorbide dinitrate 5mg TAB SANDOZ Isosorbide Dinitrate Isordil sublingual Organic nitrates Accepted treatment
Isosorbide mononitrate 20mg TAB Elantan Ismo 20 Organic nitrates Accepted treatment
Isosorbide mononitrate 50mg SRC Elantan la Organic nitrates Accepted treatment
Isosorbide-5-mononitrate 60mg SRT Imdur Monicor SR Organic nitrates Accepted treatment
Nifedipine 60mg SRT Fedaloc Macorel 60 SR Calcium channel blockers Accepted treatment
Nifedipine 60mg SRT Macorel 60 SR Calcium channel blockers Accepted treatment
Nifedipine 30mg SRT Spec Nifedipine SR Macorel 30 SR Calcium channel blockers Accepted treatment
Propranolol 10mg TAB Indoblok Purbloka Beta blockers Accepted treatment
Propranolol 40mg TAB Indoblok Purbloka Beta blockers Accepted treatment
Verapamil 240mg SRT Calcicard sr 240 Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Isoptin sr Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Ravamil sr Calcium channel blockers Accepted treatment
Verapamil 40mg TAB Vasomil Isoptin Calcium channel blockers Accepted treatment
Verapamil 80mg TAB Vasomil Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Verahexal 240 sr Calcium channel blockers Accepted treatment
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
CROHN'S DISEASE
ICD10: K50.0, K50.1, K50.8, K50.9
Azathioprine 50mg TAB Azapress Azathioprine Immunosuppressants Accepted treatment; Specialist initiation
Folic acid 5mg TAB Be-tabs folic acid Folic acid Accepted treatment
Folic acid 5mg CAP Folic acid Folic acid Accepted treatment
Hydrocortisone 10mg TAB Covocort Corticoseriod, oral Accepted treatment
Loperamide 10mg TAB Prodium Imodium Antipropulsives Accepted treatment
Mesalazine 800mg TAB Asacol 5-ASA agents Motivation required
Mesalazine 2g/50ml ENE Asacol 5-ASA agents Motivation required
Mesalazine 400mg TAB Asacol 5-ASA agents Motivation required
Mesalazine 500mg TAB Pentasa 5-ASA agents Motivation required
Methotrexate 2.5mg TAB Methotrexate Emthexate Immunosuppressants Accepted treatment; Specialist initiation
Metronidazole 200mg TAB Bemetrazole Acuzole Antibacterial Accepted treatment
Metronidazole 400mg TAB Adco-Metronidazole Metazol Antibacterial Accepted treatment
Olsalazine 250mg CAP Dipentum 5-ASA agents Motivation required
Prednisolone 5mg TAB Prelone Lenisolone Corticosteroids , oral Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids, oral Accepted treatment
Sulfasalazine 500mg TAB Salazopyrin 5-ASA agents Accepted treatment; Specialist initiation
Sulfasalazine 500mg ECT Salazopyrin e n 5-ASA agents Accepted treatment; Specialist initiation
DIABETES INSIPIDUS
ICD10: E23.2
Carbamazepine 200mg TAB Degranol SANDOZ Carbamazepine Anticonvulsants Motivation required; Specialist initiation
Carbamazepine 400mg SRT SANDOZ Carbamazepine CR Tegretol CR Anticonvulsants Motivation required; Specialist initiation
Carbamazepine 200mg SRT SANDOZ Carbamazepine CR Tegretol CR Anticonvulsants Motivation required; Specialist initiation
Desmopressin 0.1mg TAB Ddavp Vasopressin analogues Motivation required; Specialist initiation
Desmopressin 0.2mg TAB Ddavp Vasopressin analogues Motivation required; Specialist initiation
Desmopressin 0.1mg/ml NOD Ddavp 2 5ml Vasopressin analogues Motivation required; Specialist initiation
Desmopressin 0.1mg/ml NAS Ddavp nasal spray 5ml Vasopressin analogues Motivation required; Specialist initiation
DYSRHYTHMIAS
ICD10: I47.2, I48.0, I48.1, I48.2, I48.3, I48.4, I48.9
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Bayer aspirin Aspirin Accepted treatment
Amiodarone 100mg TAB AryCor Hexarone Antiarrhythmics Motivation required; Specialist initiation
Amiodarone 200mg TAB Hexarone Bio-Amiodarone Antiarrhythmics Motivation required; Specialist initiation
Atenolol 100mg TAB Hexa-blok Ten-bloka Beta blockers Accepted treatment
Atenolol 25mg TAB Tenormin 25 Tenopress Beta blockers Accepted treatment
Bisoprolol 5mg TAB Bilocor Bisoprolol Hexal Beta blockers Accepted treatment
Bisoprolol 10mg TAB Bisohexal 10 Betacor Beta blockers Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Beta blockers Accepted treatment
Digoxin 0.0625mg TAB Lanoxin Cardiac glycosides Accepted treatment
Digoxin 0.25mg TAB Lanoxin Cardiac glycosides Accepted treatment
Digoxin 0.05mg/ml SYR Lanoxin paed Cardiac glycosides Motivation required
Digoxin 0.25mg TAB Purgoxin Cardiac glycosides Accepted treatment
Diltiazem 180mg SRC Adco-Zildem 180 SR Calcium channel blockers Accepted treatment
Diltiazem 240mg SRC Adco-Zildem 240 SR Calcium channel blockers Accepted treatment
Magnesium chloride 535mg TAB Slow-Mag Mag-SR Magnesium supplements Accepted treatment
Potassium chloride 600mg TAB Plenish k SANDOZ K-600 Potassium supplements Accepted treatment
Propranolol 40mg TAB Indoblok Purbloka Beta blockers Accepted treatment
Quinidine 200mg TAB Quinidine sulph Antiarrhythmics Motivation required; Specialist initiation
Verapamil 240mg SRT Calcicard sr 240 Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Isoptin sr Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Ravamil sr Calcium channel blockers Accepted treatment
Verapamil 40mg TAB Vasomil Isoptin Calcium channel blockers Accepted treatment
Verapamil 80mg TAB Vasomil Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Verahexal 240 sr Calcium channel blockers Accepted treatment
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
EPILEPSY
ICD10: G40.0, G40.1, G40.2, G40.3, G40.4, G40.5, G40.6, G40.7, G40.8, G40.9, G41.0, G41.2, G41.8, G41.9
Carbamazepine 100mg/5ml SUS Tegretol s Anticonvulsants Accepted treatment
Carbamazepine 200mg TAB Degranol SANDOZ Carbamazepine Anticonvulsants Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Carbamazepine 400mg SRT SANDOZ Cabamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Carbamazepine 200mg SRT SANDOZ Carbamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Clonazepam 0.5mg TAB Rivotril Benzodiazepine derivatives Motivation required
Clonazepam 2.5mg DRP Rivotril Benzodiazepine derivatives Motivation required
Clonazepam 2mg TAB Rivotril Benzodiazepine derivatives Motivation required
Ethosuximide 250mg/5ml SYR Zarontin Ethosuximide Accepted treatment
Folic acid 0.5mg TAB Folic acid Folic acid Accepted treatment
Folic acid CAP Folic acid forte Folic acid Accepted treatment
Folic acid 5mg TAB Be-tabs folic acid Folic acid Accepted treatment
Folic acid 5mg CAP Folic acid Folic acid Accepted treatment
Gabapentin 100mg CAP Epleptin Ran-Gabapentin Anticonvulsants Motivation required
Gabapentin 300mg CAP Epleptin Anticonvulsants Motivation required
Gabapentin 600mg TAB Neurontin Anticonvulsants Motivation required
Gabapentin 800mg TAB Neurontin Anticonvulsants Motivation required
Gabapentin 400mg CAP Ran-Gabapentin Anticonvulsants Motivation required
Lamotrigine 2mg DSP Lamictin P 2 Anticonvulsants Accepted treatment
Lamotrigine 5mg DSP Lamictin p5 Anticonvulsants Accepted treatment
Lamotrigine 100mg TAB Aspen Lamotrigine Epitec Anticonvulsants Accepted treatment
Lamotrigine 200mg TAB Dyna-Lamotrigine Lamidus Anticonvulsants Accepted treatment
Lamotrigine 25mg TAB Epitec Lamitor Anticonvulsants Accepted treatment
Lamotrigine 50mg TAB Epitec SANDOZ Lamotrigine Anticonvulsants Accepted treatment
Levetiracetam 100mg/ml SOL Keppra Anticonvulsants Motivation required
Levetiracetam 250mg TAB Keppra Redilev Anticonvulsants Motivation required
Levetiracetam 750mg TAB Keppra Redilev Anticonvulsants Motivation required
Levetiracetam 500mg TAB Redilev Anticonvulsants Motivation required
Oxcarbazepine 300mg TAB Trileptal fct Mylan Oxcarbazepine Anticonvulsants Accepted treatment
Oxcarbazepine 600mg TAB Trileptal fct Mylan Oxcarbazepine Anticonvulsants Accepted treatment
Phenobarbital SYR Adco-phenobarb vital Anticonvulsants Accepted treatment
Phenobarbital 30mg TAB Lethyl Sedabarb Anticonvulsants Accepted treatment
Phenytoin 100mg CAP Epanutin Anticonvulsants Accepted treatment
Phenytoin 125mg/5ml SUS Epanutin Anticonvulsants Accepted treatment
Phenytoin 100mg TAB Phenytoin sod Anticonvulsants Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Phenytoin 100mg CAP Epanutin Anticonvulsants Accepted treatment
Topiramate 15mg CAP Topamax sc sprinkle Anticonvulsants Motivation required
Topiramate 200mg TAB Adco-topiramate Piramax Anticonvulsants Motivation required
Topiramate 25mg TAB Adco-topiramate Epitoz Anticonvulsants Motivation required
Topiramate 50mg TAB Epitoz Topalex Anticonvulsants Motivation required
Topiramate 25mg CAP Topamax sc sprinkle Anticonvulsants Motivation required
Topiramate 50mg CAP Topamax sc sprinkle Anticonvulsants Motivation required
Topiramate 100mg TAB Toplep Topalex Anticonvulsants Motivation required
Valproic acid 50mg/ml SYR Convulex Anticonvulsants Accepted treatment
Valproic acid 100mg TAB Epilim 100 crushable Anticonvulsants Accepted treatment
Valproic acid 200mg/5ml SYR Epilim sugar free Anticonvulsants Accepted treatment
Valproic acid 150mg CAP Convulex Anticonvulsants Accepted treatment
Valproic acid 300mg CAP Convulex Anticonvulsants Accepted treatment
Valproic acid 500mg CAP Convulex Anticonvulsants Accepted treatment
Valproic acid 200mg SRT Epilim cr 200 Anticonvulsants Accepted treatment
Valproic acid 300mg SRT Epilim cr 300 Anticonvulsants Accepted treatment
Valproic acid 500mg SRT Epilim cr 500 Anticonvulsants Accepted treatment
GLAUCOMA
ICD10:H40.0, H40.1, H40.2, H40.3, H40.4, H40.5, H40.6, H40.8, H40.8, H40.9, Q15.0
Acetazolamide 250mg TAB Azomid Diamox Carbonic anhydrase inhbitor Motivation required
Betaxolol 5mg/ml OPD Betoptic 5ml Beta blockers Accepted treatment
Betaxolol 0.25% OPD Betoptic s 5ml Beta blockers Accepted treatment
Bimatoprost 0.3mg/3ml OPD Lumigan 3ml Prostaglandin analogues Accepted treatment
Brimonidine 1.5mg/1ml OPD Alphagan 5ml Sympathomimetics Motivation required
Brinzolamide 1% OPD Azoptic 5ml eye suspension Carbonic anhydrase inhbitor Motivation required
Carteolol 2% OPD Teoptic 5ml Beta blockers Accepted treatment
Dorzolamide 2% OPD Trusopt 5ml owi Caronic anhydrase inhibitors Motivation required
Latanoprost 50ug OPD Xalatan 2 5ml Ocuprost Prostaglandin analogues Accepted treatment
Levobunolol 0.50% OPD Betagan 7 5ml Beta blockers Accepted treatment
Metipranolol 3% OPD Beta-opthiole 5ml Beta blockers Accepted treatment
Metipranolol 6% OPD Beta-opthiole 5ml Beta blockers Accepted treatment
Pilocarpine 10mg/ml OPD Isopto carpine 1% 15ml Parasympathomimetics Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Pilocarpine 20mg/ml OPD Isopto carpine 2% 15ml Parasympathomimetics Accepted treatment
Pilocarpine 40mg/ml OPD Isopto carpine 4% 15ml Parasympathomimetics Accepted treatment
Pilocarpine 40mg/g OPD Pilogel gel 5gm Parasympathomimetics Accepted treatment
Timolol 5mg/ml OPD Glaucosan 5ml Beta blockers Accepted treatment
Timolol 1mg/g OPD Nyogel eye gel 5g Beta blockers Accepted treatment
Timolol 2.5mg/ml OPD Timoptol 5ml Beta blockers Accepted treatment
Timolol 5mg/ml OPD Timoptol 5ml Beta blockers Accepted treatment
Timolol 2.5mg/ml OPD Timoptol-xe 2 5ml Beta blockers Accepted treatment
Timolol 5mg/ml OPD Timoptol-xe 2 5ml Beta blockers Accepted treatment
Timolol combinations 10mg/5mg OPD Azarga Beta blockers combination Motivation required
Timolol combinations 0.50% OPD Cosopt 5ml Beta blockers Combination Motivation required
Timolol combinations 2mg/5mg OPD Combigan Beta blockers combination Motivation required
Timolol combinations OPD DuoTrav 2.5ml Beta blockers Combination Motivation required
Timolol combinations 0.3mg/5mg/ml OPD Ganfort Beta blockers Combination Motivation required
Timolol combinations OPD Xalacom 2 5ml Beta blockers Combination Motivation required
Travoprost 40ug/ml OPD Travatan 25ml Prostaglandin analogues Accepted treatment
HAEMOPHILIA
ICD10: D66, D67
Paracetamol will be reimbursed in the treatment of Haemophilia
Coagulation factor VIII 500iu INJ Kogenate fs powder for injection vial
Blood coagulation factor special investigations, Specialist initiation
Coagulation factor VIII 500iu INJ Haemosolvate viii Blood coagulation factor special investigations, Specialist initiation
Coagulation factor IX 1000iu/10ml INJ Octanine F1000 Blood coagulation factor special investigations, Specialist initiation
Coagulation factor IX 250iu/5ml INJ Octanine F250 Blood coagulation factor special investigations, Specialist initiation
Coagulation factor IX 500iu/5ml INJ Octanine F500 Blood coagulation factor special investigations, Specialist initiation
Coagulation Factor II, VII, IX, X
1000iu INJ Haemosolvex Factor IX Blood coagulation factor special investigations, Specialist initiation
Coagulation Factor II, VII, IX, X
300iu INJ Haemosolvex Factor IX Blood coagulation factor special investigations, Specialist initiation
Coagulation Factor II, VII, IX, X
500iu INJ Haemosolvex Factor IX Blood coagulation factor special investigations, Specialist initiation
Desmopressin 0.2mg TAB DDAVP Desmopressin special investigations, Specialist initiation
Desmopressin 0.1mg TAB DDAVP Desmopressin special investigations, Specialist initiation
Phytomenadion 10mg/ml INJ Konakion Vitamin K special investigations, Specialist initiation
Tranexamic acid 500mg TAB Cyklokapron Tranexamic acid Medwich Antifibrinolytics special investigations, Specialist initiation
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
HYPERLIPIDAEMIA
ICD10: E78.0,E78.1, E78.2, E78.3, E78.4, E78.5
Acetylsalicylic acid 81mg ECT Ecotrin Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV 100 disp TAB 100mg
Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Be-tabs aspirin (white) Bayer aspirin Aspirin Accepted treatment
Bezafibrate 400mg TAB Bezachole SR SANDOZ Bezafibrate Fibrates special investigations, lipogram
Bezafibrate 200mg TAB Bezalip Fibrates special investigations, lipogram
Simvastatin 10mg TAB Adco-Simvastatin Arrow Simvastatin Statins special investigations, lipogram
Simvastatin 20mg TAB Aspen Simvastatin Austell-Simvastatin Statins special investigations, lipogram
Simvastatin 40mg TAB Simvacor Michol Statins special investigations, lipogram
Simvastatin 80mg TAB Zysim Michol Statins special investigations, lipogram
Atorvastatin 10mg TAB Lipogen Atolip Statins special investigations, lipogram
Atorvastatin 20mg TAB Aspavor Atorvastatin Winthrop Statins special investigations, lipogram
Atorvastatin 40mg TAB Aspavor Lipogen Statins special investigations, lipogram
Atorvastatin 80mg TAB Atolip Lipogen Statins special investigations, lipogram
Nicotinic acid 100mg TAB Be-tabs nicotinic acid Niciotinic acid derivatives Special investigations, lipogram
HYPERTENSION
ICD10: I10, I11.0, I11.9, I12.0, I12.9, I13.0, I13.1, I13.2, I13.9, I15.0, I15.1, I15.2, I15.8< I15.9, O10.0, O10.1, O10.2, O10.3, O10.4, O10.9, O11
Acetylsalicylic acid 81mg ECT Ecotrin Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Bayer aspirin cardio Disprin CV 100 disp TAB 100mg
Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Gulf aspirin Bayer aspirin Aspirin Accepted treatment
Amlodipine 5mg TAB Keysal Indo-Amlodipine Calcium channel blockers Accepted treatment
Amlodipine 10mg TAB Amtas Calcium channel blockers Accepted treatment
Amlodipine besylate 5mg TAB Calbloc Lomanor Calcium channel blockers Accepted treatment
Amlodipine besylate 10mg TAB Ciplavasc Pharma Dynamics Amlodipine Besylate
Calcium channel blockers Accepted treatment
Amlodipine maleate 10mg TAB Amlate Calcium channel blockers Accepted treatment
Amlodipine maleate 5mg TAB Amlate Calcium channel blockers Accepted treatment
Atenolol 50mg TAB SANDOZ Atenolol Bio-atenolol Beta blockers Accepted treatment
Atenolol 100mg TAB Tenopress Gulf Atenolol 100 Beta blockers Accepted treatment
Atenolol 25mg TAB Tenopress Tenormin 25 Beta blockers Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Tenoret Tenchlor Beta blockers and combinations Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Atenolol and other diuretics 50mg/12.5mg TAB Tenoret Tenchlor hs Beta blockers and combinations Accepted treatment
Atenolol and thiazides 100mg/25mg TAB Adco-loten Beta blockers and combinations Accepted treatment
Bisoprolol 5mg TAB Bisoprolol Unicorn Adco-Bisocor Beta blockers Accepted treatment
Bisoprolol 10mg TAB Cardicor Betacor Beta blockers Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Beta blockers Accepted treatment
Captopril 12.5mg TAB Capoten hs Captohexal ACE-inhibitors Accepted treatment
Captopril 50mg TAB Captomax Captohexal ACE-inhibitors Accepted treatment
Captopril 25mg TAB Zapto Capoten ACE-inhibitors Accepted treatment
Captopril 50mg TAB Zapto Mylan-captopril 50 ACE-inhibitors Accepted treatment
Captopril and diuretics 50mg/25mg TAB Zapto-co Captoretic ACE-inhibitors and combinations Accepted treatment
Carvedilol 6.25mg TAB Carvedilol-Hexal Carloc 6.25 Alpha/beta blockers Accepted treatment
Carvedilol 12.5mg TAB Carvetrend Carloc 12.5 Alpha/beta blockers Accepted treatment
Carvedilol 25mg TAB Vediblok Carvedilol-Hexal Alpha/beta blockers Accepted treatment
Diltiazem 180mg SRC Adco-Zildem 180 SR Calcium channel blockers Accepted treatment
Diltiazem 240mg SRC Adco-Zildem 240 SR Calcium channel blockers Accepted treatment
Doxazosin 1mg TAB Cardugen (Prev Mylan-Doxasozin) Alpha blockers Motivation required
Doxazosin 4mg TAB Cardugen (prev Mylan-Doxasozin) Alpha blockers Motivation required
Doxazosin extended release 4mg TAB Cardura XL Carzin XL Alpha blockers Motivation required
Doxazosin 8mg TAB Cardura xl Alpha blockers Motivation required
Enalapril 5mg TAB Alapren 5 Renitec 5 ACE-inhibitors Accepted treatment
Enalapril 10mg TAB Envas Hr-enalapril 10 ACE-inhibitors Accepted treatment
Enalapril 20mg TAB Pharmapress Renitec 20 ACE-inhibitors Accepted treatment
Enalapril 2.5mg TAB Renitec 2 5 ACE-inhibitors Accepted treatment
Enalapril and diuretics 20mg/12.5mg TAB Co-renitec Enap co ACE-inhibitors and combinations Accepted treatment
Felodipine 10mg SRT Felodipine-Hexal Calcium channel blockers Accepted treatment
Felodipine 5mg SRT Felodipine-Hexal Plendil Calcium channel blockers Accepted treatment
Felodipine 2.5mg SRT Plendil Calcium channel blockers Accepted treatment
Furosemide 10mg/ml SYR Lasix oral Diuretics Motivation required
Furosemide 40mg TAB Puresis SANDOZ Furosemide Diuretics Accepted treatment
Furosemide 20mg TAB Lasix Austell Furosemide Diuretics Accepted treatment
Hydralazine 10mg TAB Hyperphen Vasodilators Accepted treatment
Hydralazine 50mg TAB SANDOZ Hydralazine Hyperphen Vasodilators Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Hydrochlorothiazide 12.5mg TAB Ridaq Diuretics Accepted treatment
Hydrochlorothiazide 25mg TAB Ridaq Hexazide Diuretics Accepted treatment
Hydrochlorothiazide and potassium
50mg/300mg TAB Urirex-k Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/5mg TAB Adco-retic Betaretic Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
25mg/2.5mg TAB Amiloretic hs Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/25mg TAB Dyazide Renezide Diuretics Accepted treatment
Indapamide 2.5mg TAB SANDOZ Indapamide Dapamax Diuretics Accepted treatment
Irbesartan 150mg TAB Iberwin Aprovel Angiotension receptor antagonist Accepted treatment
Irbesartan 300mg TAB Iberwin Aprovel Angiotension receptor antagonist Accepted treatment
Irbesartan and diuretics 150mg/12.5mg TAB Co-Iberwin Coaprovel Angiotensin receptor blockers and combinations
Accepted treatment
Irbesartan and diuretics 300mg/12.5mg TAB Co-Iberwin Coaprovel Angiotensin receptor blockers and combinations
Accepted treatment
Lisinopril 20mg TAB Auro-Lisinopril Hexal-lisinopril 20 ACE-inhibitors Accepted treatment
Lisinopril 2.5mg TAB Austell-lisinopril ACE-inhibitors Accepted treatment
Lisinopril 5mg TAB Zestril Zetomax ACE-inhibitors Accepted treatment
Lisinopril and diuretics 10mg/12.5mg TAB Zestoretic 10 Zetomax-Co ACE-inhibitors and combinations Accepted treatment
Lisinopril and diuretics 20mg/12.5mg TAB Zestozide Zetomax-Co ACE-inhibitors and combinations Accepted treatment
Losartan 100mg TAB Spec Losartan 100 Zartan Angiotensin receptor blockers Accepted treatment
Losartan 50mg TAB Zartan Cipla Losartan Angiotensin receptor blockers Accepted treatment
Losartan and diuretics 50mg/12.5mg TAB Losaar plus 50/12.5 Zartan Co Angiotensin receptor blockers and combinations
Accepted treatment
Losartan and diuretics 100mg/25mg TAB Lozaan Co Zartan Co Angiotensin receptor blockers and combinations
Accepted treatment
Methyldopa (levorotatory) 250mg TAB Hypotone SANDOZ Methyldopa Antiadrenegic agents, centrally acting
Accepted treatment
Methyldopa (levorotatory) 500mg TAB Hypotone Antiadrenegic agents, centrally acting
Accepted treatment
Minoxidil 10mg TAB Loniten Vasodilators Motivation required
Minoxidil 5mg TAB Loniten Vasodilators Motivation required
Nifedipine 30mg SRT Adco-Vascard SR Fedaloc Calcium channel blockers Accepted treatment
Nifedipine 60mg SRT Fedaloc Calcium channel blockers Accepted treatment
Nifedipine 60mg SRT Macorel 60 SR Calcium channel blockers Accepted treatment
Nifedipine 20mg SRT Nifedalat SR Cipalat Retard Calcium channel blockers Accepted treatment
Nifedipine 60mg SRT Spec Nifedipine SR Calcium channel blockers Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Perindopril 10mg TAB Prexum Coversyl ACE-inhibitors Accepted treatment
Perindopril 4mg TAB Vectoryl Acesyl ACE-inhibitors Accepted treatment
Perindopril 8mg TAB Vectoryl Spec-Perindopril ACE-inhibitors Accepted treatment
Perindopril 5mg TAB Prexum 5 ACE-inhibitors Accepted treatment
Perindopril 5mg/1.25mg TAB Prexum 5 Plus ACE-inhibitors Accepted treatment
Perindopril and diuretics 2mg/0.625mg TAB Spec-Perindopril Plus 2 Preterax ACE-inhibitors and combinations Accepted treatment
Perindopril and diuretics 4mg/1.25mg TAB Vectoryl plus Prexum Plus ACE-inhibitors and calcium channel blockers
Accepted treatment
Perindopril and diuretics 10mg/2.5mg TAB BioPrexum plus ACE-inhibitors and combinations Accepted treatment
Perindopril and Amlodipine 5mg/5mg TAB Coveram 5/5 ACE-inhibitors and calcium channel blockers
Accepted treatment
Perindopril and Amlodipine 5mg/10mg TAB Coveram 5/10 ACE-inhibitors and calcium channel blockers
Accepted treatment
Perindopril and Amlodipine 10mg/5mg TAB Coveram 10/5 ACE-inhibitors and calcium channel blockers
Accepted treatment
Perindopril and Amlodipine 10mg/10mg TAB Coveram 10/10 ACE-inhibitors and calcium channel blockers
Accepted treatment
Potassium chloride 600mg TAB Slow-k Plenish k Potassium supplements Accepted treatment
Prazosin 1mg TAB Pratsiol Alpha blockers Motivation required
Prazosin 2mg TAB Pratsiol Alpha blockers Motivation required
Prazosin 5mg TAB Pratsiol Alpha blockers Motivation required
Propranolol 10mg TAB Indoblok Purbloka Beta blockers Accepted treatment
Propranolol 40mg TAB Indoblok Purbloka Beta blockers Accepted treatment
Quinapril 10mg TAB Quinaspen Quinagen ACE-inhibitors Accepted treatment
Quinapril 20mg TAB Quinaspen Quinagen ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Austell-Ramipril ACE-inhibitors Accepted treatment
Ramipril 2.5mg CAP Austell-Ramipril ACE-inhibitors Accepted treatment
Ramipril 5mg CAP Austell-Ramipril ACE-inhibitors Accepted treatment
Ramipril 2.5mg CAP Apex-Ramipril 2.5mg ACE-inhibitors Accepted treatment
Ramipril 5mg CAP Apex-Ramipril 5mg ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Apex-Ramipril 10mg ACE-inhibitors Accepted treatment
Ramipril 5mg TAB Retace RamiprilHexal ACE-inhibitors Accepted treatment
Ramipril 2.5mg CAP Ramiwin ACE-inhibitors Accepted treatment
Ramipril 5mg CAP RamiWin ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Rampil ACE-inhibitors Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Ramipril 2.5mg CAP Rampil ACE-inhibitors Accepted treatment
Ramipril 5mg CAP Rampil ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Ran-Ramipril ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Simayla Ramipril ACE-inhibitors Accepted treatment
Ramipril 10mg CAP Tritace ACE-inhibitors Accepted treatment
Ramipril 2.5mg TAB Tritace Retace ACE-inhibitors Accepted treatment
Reserpine 0.25mg TAB Reserpine Antiadrenegic agents, centrally acting
Accepted treatment
Reserpine and diuretics TAB Brinerdin Antiadrenegic agents, centrally acting
Motivation required
Spironolactone 25mg TAB Spiractin SANDOZ Spironolactone Diuretics Accepted treatment
Telimisartan 40mg TAB Pritor Micardis ACE-Inhibitor Accepted treatment
Telimisartan 80mg TAB Pritor Micardis ACE-Inhibitor Accepted treatment
Telimisatan and diuretic 40mg/12.5mg TAB Co-Pritor Co-Micardis ACE-Inhibitor and diuretic Accepted treatment
Telimisatan and diuretic 80mg/12.5mg TAB Co-Pritor Co-Micardis ACE-Inhibitor and diuretic Accepted treatment
Telimisatan and diuretic 80mg/25mg TAB Co-Pritor Co-Micardis ACE-Inhibitor and diuretic Accepted treatment
Trandolapril 0.5mg CAP Mavik (was Gopten) ACE-inhibitors and combinations Accepted treatment
Trandolapril 2mg CAP Mavik (was Gopten) ACE-inhibitors and combinations Accepted treatment
Valsartan 160mg TAB Zomevek Tareg Angiotensin receptor blockers Accepted treatment
Valsartan 80mg TAB Zomevek Tareg Angiotensin receptor blockers Accepted treatment
Valsartan and amlodipine 10mg/160mg TAB Exforge Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and amlodipine 5mg/160mg TAB Exforge Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 320/12.5mg TAB Co-Diovan Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 320mg/25mg TAB Co-Diovan Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 160mg/25mg TAB Co-Zomevek Co-Tareg Plus Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 80mg/12.5mg TAB Co-Zomevek Co-Tareg Angiotensin receptor blockers and combinations
Accepted treatment
Valsartan and diuretics 160mg/12.5mg TAB Co-Zomevek Co-Tareg Angiotensin receptor blockers and combinations
Accepted treatment
Verapamil 240mg SRT Calcicard sr 240 Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Isoptin sr Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Ravamil sr Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Verahexal 240 sr Calcium channel blockers Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
HYPOTHYROIDISM
ICD10: E01.8, E02, E03.0, E03.1, E03.2, E03.3, E03.4, E03.5, E03.8, E03.9, E89.0
Levothyroxine sodium 0.05mg TAB Eltroxin Thyroid hormones Accepted treatment
Levothyroxine sodium 0.1mg TAB Eltroxin Thyroid hormones Accepted treatment
Levothyroxine sodium 100mcg TAB Euthyrox Thyroid hormones Accepted treatment
Levothyroxine sodium 25mcg TAB Euthyrox Thyroid hormones Accepted treatment
Levothyroxine sodium 50mcg TAB Euthyrox Thyroid hormones Accepted treatment
Liothyronine sodium TAB Diotroxin Thyroid hormones Accepted treatment
Liothyronine sodium 20mcg TAB Tertroxin Thyroid hormones Accepted treatment
INSULIN-DEPENDENT DIABETES
ICD10: E E10.0, E10.1, E10.2, E10.3, E10.4, E10.5, E 10.6, E10.7, E10.8, E10.9, E12.3-E12.9, O24.0, O24.2, O24.3
Insulin (human) INJ Insu Humulin 30/70 3 0ml pre-fill disp
Insu Actraph HM ge 3 0ml Pensets+syringe
Insulin Accepted treatment
Insulin aspart 100U/ml INJ Insu Novomix 30 Flexpen 3ml pf device
Insu Novorapid Insulin Accepted treatment
Insulin detemir 100U/ml INJ Insu Levemir Insulin Accepted treatment
Insulin glargine 100iu/ml INJ Lantus Insulin Accepted treatment
Insulin glulisine 100iu/ml INJ Insu Apidra Insulin Accepted treatment
Insulin lispro 100IU/ml INJ Insu Humalog 10ml Insu humalog mix Insulin Accepted treatment
Diabetes Strips, lancets and neddles
Various Various Accepted treatment
MULTIPLE SCLEROSIS (Specialist initiation of therapy required)
ICD10: G35
Amitriptyline 10mg TAB Trepiline Heterocyclic antidepressant Accepted treatment
Azathioprine 50mg TAB Azamun Imuran Immunosuppressants Accepted treatment; Specialist initiation
Baclofen 10mg TAB Bio-Baclofen Lioresal Muscle relaxants Accepted treatment
Carbamazepine 400mg SRT SANDOZ Cabamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Carbamazepine 200mg TAB SANDOZ Carbamazepine Degranol Anticonvulsants Accepted treatment
Carbamazepine 200mg SRT SANDOZ Carbamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Clomipramine 10mg TAB Equinorm Anafranil Heterocyclic antidepressant Accepted treatment
Cyclophosphamide 50mg TAB Endoxan Immunosuppresant Accepted treatment; Specialist initiation
Folic acid 5mg TAB Be-tabs folic acid Folic acid Accepted treatment
Folic acid 0.5mg TAB Folic acid Folic acid Accepted treatment
Folic acid 5mg CAP Folic acid Folic acid Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Folic acid CAP Folic acid forte Folic acid Accepted treatment
Imipramine 10mg TAB Ethipramine Tofranil Heterocyclic antidepressants Accepted treatment
Imipramine 25mg TAB Ethipramine Tofranil Heterocyclic antidepressants Accepted treatment
Interferon beta-1a 30mcg INJ Avonex powder for injection Interferons Motivation required; Specialist initiation
Interferon beta-1a 22mcg INJ Rebiff 22 Interferons Motivation required; Specialist initiation
Interferon beta-1a 44mcg INJ Rebiff 44 Interferons Motivation required; Specialist initiation
Methotrexate 2.5mg TAB Emthexate Emthexate Immunosuppressants Accepted treatment; Specialist initiation
Orphenadrine (citrate) 100mg TAB Norflex Muscle relaxants Accepted treatment
Oxybutynin 5mg TAB Urihexal Lenditro Anticholinergics, oral Accepted treatment
Prednisolone 5mg TAB Lenisolone Prelone Corticosteroids , oral Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids, oral Accepted treatment
NON-INSULIN-DEPENDENT DIABETES
ICD10: E11.0, E11.1, E11.02, E11.3, E11.4, E11.5, E11.6, E11.7, E11.8, E11.9, E12.0, E12.1, E12.5-E12.9, O24.1-O24.3
Gliclazide 40mg TAB Austell-Gliclazide Suphonylureas Accepted treatment
Gliclazide 80mg TAB Glucomed Diaglucide Suphonylureas Accepted treatment
Gliclazide 60mg TAB Diaglucide MR 60 Diamicron MR 60 Suphonylureas Accepted treatment
Gliclazide 30mg SRT Diaran Dyna-Gliclazide SR Suphonylureas Accepted treatment
Insulin (human) INJ Insu Humulin 30/70 3 0ml pre-fill disp
Insu Actraph HM ge 3 0ml Pensets+syringe
Insulin Accepted treatment
Insulin aspart 100U/ml INJ Insu Novomix 30 Flexpen 3ml pf device
Insu Novorapid Insulin Accepted treatment
Insulin detemir 100U/ml INJ Insu Levemir Insulin Accepted treatment
Insulin glargine 100iu/ml INJ Lantus Insulin Accepted treatment
Insulin glulisine 100iu/ml INJ Insu Apidra Insulin Accepted treatment
Insulin lispro 100IU/ml INJ Insu Humalog 10ml Insu humalog mix Insulin Accepted treatment
Metformin 500mg TAB Arrow Metformin SANDOZ Metformin HCL FC
Biguanides Accepted treatment
Metformin 850mg TAB Auro-Metformin Mylan-metformin Biguanides Accepted treatment
Metformin 1000mg TAB Bigsens Glucophage Biguanides Accepted treatment
Diabetes strips, lancets and needles
Various Various Accepted treatment
PARKINSON'S DISEASE
ICD10: G20, G21.0, G21.1, G21.2, G21.3, G21.4, G21.8, G21.9
Amantadine 100mg CAP Symmetrel Symadin (was Flu-stop) Amantadine derivate Accepted treatment
Bromocriptine 2.5mg TAB Aspen Bromocriptine Dopamine agonists Motivation required
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Biperiden 2mg TAB Akineton Anticholinergics, oral Accepted treatment
Levodopa and Carbidopa 25mg/100mg TAB Carbilev 25/100 Sinemet Dopa and dopa derivatives Accepted treatment
Levodopa and Carbidopa 200mg/50mg TAB Madopar Dopa and dopa derivatives Accepted treatment
Levodopa and Benserazide 100mg/25mg CAP Madopar hbs Dopa and dopa derivatives Accepted treatment
Levodopa and Benserazide 25mg/250mg TAB Sinemet Teva Carbi-Levo Dopa and dopa derivatives Accepted treatment
Levodopa and Carbidopa 50mg/200mg SRT Sinemet cr Dopa and dopa derivatives Accepted treatment
Orphenadrine (chloride) 50mg TAB Disipal Muscle relaxants Accepted treatment
Orphenadrine (citrate) 100mg TAB Norflex Muscle relaxants Accepted treatment
Pramipexole 0.125mg TAB Oxpola Pramex Dopamine agonists Motivation required
Pramipexole 0.25mg TAB Oxpola Pazoram Dopamine agonists Motivation required
Pramipexole 1mg TAB Oxpola Oxpola Dopamine agonists Motivation required
Ropinirole 0.25mg TAB Requip 025 Dopamine agonists Motivation required
Ropinirole 0.5mg TAB Requip 05 Dopamine agonists Motivation required
Ropinirole 1mg TAB Requip 10 Dopamine agonists Motivation required
Ropinirole 2mg TAB Requip 20 Dopamine agonists Motivation required
Ropinirole 5mg TAB Requip 50 Dopamine agonists Motivation required
Selegiline 5mg TAB Parkilyne Monoamine oxidase type B inhibitors
Accepted treatment
Trihexyphenidyl 2mg TAB Benzhexol Anticholinergics, oral Accepted treatment
RHEUMATOID ARTHRITIS (Initial diagnosis to be confirmed by a Rheumatologist)
ICD10:M05.00-M05.39 M05.80-M05.99, M06.00-M06.49, M06.80-M06.99, M08.00-M08.09, M05
Paracetamol will be reimbursed in the treatment of Rheumatoid Arthritis.
Azathioprine 50mg TAB Zaprine Azathioprine 50 PCH Immunosuppressants Accepted treatment; Specialist initiation
Chloroquine 200mg TAB Nivaquine Plasmoquine Aminoquinolines Accepted treatment; Specialist initiation
Chloroquine 250mg TAB SANDOZ Chloroquine phosphate Aminoquinolines Accepted treatment; Specialist initiation
Ciclosprine 100mg/ml SYR Sandimmun Neoral Immunosuppressants Accepted treatment; Specialist initiation
Ciclosprine 100mg/ml CAP Sandimmun Neoral Immunosuppressants Accepted treatment; Specialist initiation
Ciclosprine 25mg CAP Sandimmun Neoral Immunosuppressants Accepted treatment; Specialist initiation
Cyclophosphamide 50mg TAB Endoxan Immunosuppressants Motivation required
Diclofenac 25mg TAB Adco-diclofenac Panamor-25 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 50mg TAB Dynak Panamor at-50 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 100mg CAP Fortfen SR Non-steroidal anti-inflammatory drugs
Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Diclofenac 100mg SRT Panamor-100 sr SANDOZ Diclofenac Sodium SR
Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 75mg SRT Panamor-75 sr Voltaren 75 Non-steroidal anti-inflammatory drugs
Accepted treatment
Folic acid 0.5mg TAB Folic acid Folic acid Accepted treatment
Folic acid CAP Folic acid forte Folic acid Accepted treatment
Folic acid 5mg TAB Be-tabs folic acid Folic acid Accepted treatment
Folic acid 5mg CAP Folic acid Folic acid Accepted treatment
Ibuprofen 400mg TAB Inza Ranfen Non-steroidal anti-inflammatory drugs
Accepted treatment
Ibuprofen 100mg/5ml SUS Brufen for children Ibugesic Non-steroidal anti-inflammatory drugs
Accepted treatment
Ibuprofen 200mg TAB Ibuflam Inza Non-steroidal anti-inflammatory drugs
Accepted treatment
Indomethacin 25mg CAP SANDOZ Idomethacin Arthrexin Non-steroidal anti-inflammatory drugs
Accepted treatment
Leflunomide 10mg TAB Arava Immunosuppressants Motivation required
Leflunomide 20mg TAB Arava Immunosuppressants Motivation required
Mefanamic acid 250mg CAP Fenamin Adco Mefanamic acid Non-steroidal anti-inflammatory drugs
Accepted tretment
Mefanamic acid 500mg CAP Fenamin Adco Mefanamic acid Non-steroidal anti-inflammatory drugs
Accepted treatment
Meloxicam 15mg TAB Loxiflam Arrow Meloxicam Non-steroidal anti-inflammatory drugs
Accepted treatment
Meloxicam 7.5mg TAB SANDOZ Meloxicam Coxflam Non-steroidal anti-inflammatory drugs
Accepted treatment
Methotrexate 2.5mg TAB Emthexate Emthexate Immunosuppressants Accepted treatment
Naproxen 250mg TAB Adco-naproxen Mylan-naproxen Non-steroidal anti-inflammatory drugs
Accepted treatment
Naproxen 500mg TAB Napflam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 10mg CAP Adco-piroxicam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 20mg CAP Adco-piroxicam Xycam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 20mg DSP Pixicam Xycam dispers Non-steroidal anti-inflammatory drugs
Accepted treatment
Prednisolone 5mg TAB Lenisolone Prelone Corticosteroids , oral Motivation required
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids, oral Motivation required
Sulfasalazine 500mg TAB Salazopyrin 5-ASA agents Accepted treatment; Specialist initiation
Sulfasalazine 500mg ECT Salazopyrin e n 5-ASA agents Accepted treatment; Specialist initiation
SCHIZOPHRENIA (Diagnosis and all initiation of treatment to be done by a Psychiatrist)
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
ICD10: F20.0, F20.1, F20.2, F20.3, F20.4, F20.5, F20.6, F20.8, F20.9
Amisulpride 200mg TAB Solian Antipsychotics Accepted treatment
Amisulpride 50mg TAB Solian Antipsychotics Accepted treatment
Amitriptyline 25mg TAB SANDOZ Amitryptyline Trepiline Heterocyclic antidepressant Accepted treatment
Aripiprazole 5mg TAB Abilify Antipsychotics Accepted treatment
Aripiprazole 10mg TAB Abilify Antipsychotics Accepted treatment
Aripiprazole 15mg TAB Abilify Antipsychotics Accepted treatment
Chlorpromazine 100mg TAB Largactil Antipsychotics Accepted treatment
Chlorpromazine 25mg TAB Largactil Antipsychotics Accepted treatment
Chlorpromazine 50mg TAB Largactil Antipsychotics Accepted treatment
Citalopram 20mg TAB Auro-Citalopram Austell-Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Citalopram 10mg TAB Austell-Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Citalopram 40mg TAB Depramil Arrow Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Clomipramine 10mg TAB Equinorm Clomidep Heterocyclic antidepressants Accepted treatment
Clomipramine 25mg TAB Equinorm Clomidep Heterocyclic antidepressants Accepted treatment
Clozapine 100mg TAB Cloment Leponex Antipsychotics Accepted treatment
Clozapine 25mg TAB Cloment Leponex Antipsychotics Accepted treatment
Dothiepin 25mg CAP Prothiaden Thaden Heterocyclic antidepressants Accepted treatment
Dothiepin 75mg TAB Thaden Heterocyclic antidepressants Accepted treatment
Fluoxetine 20mg CAP Nuzak Lilly-fluoxetine Selective serotonin receptor inhibitors
Accepted treatment
Fluoxetine 20mg TAB Lorien Prolax Selective serotonin receptor inhibitors
Accepted treatment
Fluoxetine 20mg DSP Prohexal 20t Selective serotonin receptor inhibitors
Accepted treatment
Flupenthixol 0.5mg TAB Fluanxol Antipsychotics Accepted treatment
Flupenthixol 1mg TAB Fluanxol Antipsychotics Accepted treatment
Haloperidol 1.5mg TAB SANDOZ Haloperidol Antipsychotics Accepted treatment
Haloperidol 5mg TAB SANDOZ Haloperidol Serenace Antipsychotics Accepted treatment
Haloperidol 0.5mg CAP Serenace Antipsychotics Accepted treatment
Haloperidol 10mg TAB Serenace Antipsychotics Accepted treatment
Imipramine 25mg TAB Ethipramine Tofranil Heterocyclic antidepressants Accepted treatment
Olanzapine 10mg TAB Olexar Olawin Antipsychotics Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Olanzapine 5mg TAB Olexar Redilanz Antipsychotics Accepted treatment
Olanzapine 2.5mg TAB Redilanz Zyprexa Antipsychotics Accepted treatment
Paliperidone 3mg TAB Invega Antipsychotics Accepted treatment
Paliperidone 6mg TAB Invega Antipsychotics Accepted treatment
Paliperidone 9mg TAB Invega Antipsychotics Accepted treatment
Paliperidone 75mg, 150mg INJ Xeplion Antipsychotics Motivation required
Pimozide 1mg TAB Orap Antipsychotics Accepted treatment
Pimozide 4mg TAB Orap Antipsychotics Accepted treatment
Quetiapine 25mg TAB Dopaquel Serez Antipsychotics Accepted treatment
Quetiapine 100mg TAB Truvalin Quetoser Antipsychotics Accepted treatment
Quetiapine 200mg TAB Mylan Quetiapine Dopaquel Antipsychotics Accepted treatment
Quetiapine 300mg TAB Serez Truvalin Antipsychotics Motivation required
Quetiapine 200mg SRT Seroquel XR 200 Antipsychotics Motivation required
Quetiapine 300mg SRT Seroquel XR 300 Antipsychotics Motivation required
Quetiapine 400mg SRT Seroquel XR 400 Antipsychotics Motivation required
Risperidone 0.5mg TAB Aspen Risperidone Risperlet Antipsychotics Accepted treatment
Risperidone 2mg TAB Aspen Risperidone Risperdal Quicklet Antipsychotics Accepted treatment
Risperidone 3mg TAB Aspen Risperidone Risperidone-Hexal Antipsychotics Accepted treatment
Risperidone 1.0mg TAB DRL-Risperidone Auroperdal Antipsychotics Accepted treatment
Risperidone 1mg/ml SYR Risperdal Antipsychotics Accepted treatment
Risperidone 4mg TAB Risperdal Risponz Antipsychotics Accepted treatment
Sulpiride 200mg TAB Bio-Sulpiride Substituted benzamide Accepted treatment
Sulpiride 50mg CAP Eglonyl Substituted benzamide Accepted treatment
Sulpiride 50mg CAP Espiride Substituted benzamide Accepted treatment
Sulpiride 50mg CAP SANDOZ Sulpiride Substituted benzamide Accepted treatment
Trifluoperazine 1mg TAB Stelazine Selective serotonin receptor inhibitors
Accepted treatment
Trifluoperazine 5mg TAB Stelazine Selective serotonin receptor inhibitors
Accepted treatment
Ziprasidone 20mg CAP Geodon Antipsychotics Accepted treatment
Ziprasidone 40mg CAP Geodon Antipsychotics Accepted treatment
Ziprasidone 60mg CAP Geodon Antipsychotics Accepted treatment
Ziprasidone 80mg CAP Geodon Antipsychotics Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Zuclopenthixol 10mg TAB Clopixol Antipsychotics Accepted treatment
Zuclopenthixol 2mg TAB Clopixol Antipsychotics Accepted treatment
Zuclopenthixol 200mg/ml INJ Clopixol depot Antipsychotics Motivation required
SYSTEMIC LUPUS ERYTHEMATOSUS (Specialist initiation of therapy required)
ICD10: L93.0, L93.1, L93.2, M32.0, M32.1†I32.8*, M32.1†I39.0*, M32.1†I39.1*, M32.1†I39.2*, M32.1†I39.3*, M32.1†I39.4*, M32.1†I39.8*, M32.1†N08.5*, M32.1†N16.4* , M32.1†J99.1*
Paracetamol will be reimbursed for Systemic Lupus Erythematosus
Azathioprine 50mg TAB Zaprine Azathioprine 50 PCH Immunosuppressants Accepted treatment; Specialist initiation
Betamethasone 0.10% CRE Adco-betamethasone Betamethasone valer Corticosteroids, topical Accepted treatment
Betamethasone 0.05g/100g CRE Betnovate Corticosteroids, topical Accepted treatment
Betamethasone 0.1g/100g OIN Persivate Lenovate Corticosteroids, topical Accepted treatment
Betamethasone 0.1g/100g LOT Betnovate scalp Corticosteroids, topical Accepted treatment
Chloroquine 200mg TAB Nivaquine Plasmoquine Other Accepted treatment; Specialist initiation
Chloroquine 250mg TAB SANDOZ Chloroquine phosphate Other Accepted treatment; Specialist initiation
Clobetasol 0.5mg CRE Dermovate Xenovate Corticosteroids, topical Accepted treatment; Specialist initiation
Clobetasol 0.5mg OIN Dermovate Dovate Corticosteroids, topical Accepted treatment; Specialist initiation
Clobetasone CRE Eumovate Corticosteroids, topical Motivation required
Clobetasone OIN Eumovate Corticosteroids, topical Motivation required
Diclofenac 25mg TAB Adco-diclofenac Panamor-25 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 50mg TAB Dynak Panamor at-50 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 100mg CAP Fortfen SR Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 100mg SRT Panamor-100 sr SANDOZ Diclofenac Sodium SR
Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 75mg SRT Panamor-75 sr Voltaren 75 Non-steroidal anti-inflammatory drugs
Accepted treatment
Fluocinolone acetonide 0.25mg/g CRE CORTODERM (PPF) Synalar Corticosteroids, topical Accepted treatment
Fluocinolone acetonide 0.25mg/g OIN CORTODERM (PPF) Synalar Corticosteroids, topical Accepted treatment
Folic acid 0.5mg TAB Folic acid Folic acid Accepted treatment
Folic acid CAP Folic acid forte Folic acid Accepted treatment
Folic acid 5mg TAB Be-tabs folic acid Folic acid Accepted treatment
Folic acid 5mg CAP Folic acid Folic acid Accepted treatment
Hydrocortisone 0.5g OIN Dilucort Corticosteroids, topical Accepted treatment
Hydrocortisone 5mg/g CRE Dilucort Skincalm Corticosteroids, topical Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Hydrocortisone 10mg/g OIN Mylocort Procutan Corticosteroids, topical Accepted treatment
Hydrocortisone 10mg/g CRE Mylocort Procutan Corticosteroids, topical Accepted treatment
Ibuprofen 400mg TAB Inza Ranfen Non-steroidal anti-inflammatory drugs
Accepted treatment
Ibuprofen 100mg/5ml SUS Brufen for children Ibugesic Non-steroidal anti-inflammatory drugs
Accepted treatment
Ibuprofen 200mg TAB Ranfen Inza Non-steroidal anti-inflammatory drugs
Accepted treatment
Indomethacin 25mg CAP SANDOZ Idomethacin Arthrexin Non-steroidal anti-inflammatory drugs
Accepted treatment
Loperamide 2mg TAB Adco-loperamide Betaperamide Antipropulsives Accepted treatment
Mefanamic acid 250mg CAP Fenamin Adco Mefanamic acid Non-steroidal anti-inflammatory drugs
Accepted tretment
Mefanamic acid 500mg CAP Fenamin Adco Mefanamic acid Non-steroidal anti-inflammatory drugs
Accepted treatment
Meloxicam 15mg TAB Loxiflam Arrow Meloxicam Non-steroidal anti-inflammatory drugs
Accepted treatment
Meloxicam 7.5mg TAB SANDOZ Meloxicam Coxflam Non-steroidal anti-inflammatory drugs
Accepted treatment
Methotrexate 2.5mg TAB Emthexate Emthexate Immunosuppressants Accepted treatment; Specialist initiation
Naproxen 250mg TAB Adco-naproxen Mylan-naproxen Non-steroidal anti-inflammatory drugs
Accepted treatment
Naproxen 500mg TAB Napflam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 10mg CAP Adco-piroxicam Rolab-piroxicam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 20mg CAP Adco-piroxicam Xycam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 20mg DSP Pixicam Xycam dispers Non-steroidal anti-inflammatory drugs
Accepted treatment
Prednisolone 5mg TAB Lenisolone Prelone Corticosteroids , oral Motivation required
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids, oral Motivation required
Salicylic acid PWD Salicylic acid BP Salicylic Acid Accepted treatment
ULCERATIVE COLITIS
ICD10: K51.0, K51.1, K51.2, K51.3, K51.4, K51.5, K51.8, K51.9
Azathioprine 50mg TAB Azapress Imuran Immunosuppressants Accepted treatment; Specialist initiation
Loperamide 2mg TAB Adco-loperamide Betaperamide Antipropulsives Accepted treatment
Hydrocortisone 10mg TAB Covocort Corticosteroids , oral Accepted treatment
Mercaptopurine 50mg TAB Purinethol Immunosuppressants Accepted treatment; Specialist initiation
Mesalazine 800mg TAB Asacol 5-ASA agents Motivation required
Mesalazine 2g/50ml ENE Asacol 5-ASA agents Motivation required
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Mesalazine 400mg TAB Asacol 5-ASA agents Motivation required
Mesalazine 500mg TAB Pentasa 5-ASA agents Motivation required
Methotrexate 2.5mg TAB Emthexate Emthexate Immunosuppressants Accepted treatment
Olsalazine 250mg CAP Dipentum 5-ASA agents Motivation required
Prednisolone 5mg TAB Lenisolone Prelone Corticosteroids , oral Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids, oral Accepted treatment
Sulfasalazine 500mg TAB Salazopyrin 5-ASA agents Accepted treatment; Specialist initiation
Sulfasalazine 500mg ECT Salazopyrin e n 5-ASA agents Accepted treatment; Specialist initiation
DIAGNOSES AND TREATMENT PAIRS (DTP) CONDITIONS ADRENOCORTICAL HYPERSECRETION
ICD 10: E25.0 E25.8 E25.9 E26.0 E26.1 E26.8 E26.9
Hydrochlorothiazide and potassium-sparing agents
50mg/5mg TAB Amiloretic Betaretic Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
25mg/2.5mg TAB Amiloretic hs Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/25mg TAB Dyazide Renezide Diuretics Accepted treatment
Spironolactone 25mg TAB SANDOZ Spironolactone Spiractin Diuretics Accepted treatment
ADRENOCORTICAL INSUFFICIENCY
ICD 10: E27.0 E27.1 E27.2 E27.3 E27.4 E27.5 E27.8 E27.9
Fludrocortisone 0.1mg TAB Florinef acetate Corticosteroids , oral Motivation required
Hydrocortisone 10mg TAB Covocort Corticosteroids , oral Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids , oral Accepted treatment
Prednisolone 5mg TAB Lenisolone Prelone Corticosteroids , oral Accepted treatment
ANAEMIA
ICD 10: D50.0 D51.0 D50.1 D50.8 D50.9 D51.0 D51.1 D51.2 D51.3 D51.8 D51.9 D52.0 D52.1 D52.8 D52.9 D53.0 D53.1 D53.2 D53.8 D53.9 D55.0 D55.1 D55.2 D55.3 D55.8 D55.9 D57.0 D57.1 D57.2 D57.8 D58.0 D58.1 D59.0 D59.1 D59.2 D59.3 D59.4 D59.6 D59.8 D59.9 D60.0 D60.1 D60.8 D60.9 D61.0 D61.1 D61.2 D61.3 D61.8 D61.9 D62 D63.0
Cyanocobalamin 1000mcg/ml INJ Vitamin b12 10ml Iron supplementation, oral special investigations, Full blood count
Cyanocobalamin 1000mcg/ml INJ Vitamin b12 1ml Iron supplementation, oral special investigations, Full blood count
Ferrous fumarate TAB Pregamal Iron Supplements special investigations, Full blood count
Ferrous Lactate 25mg DRP Ferro L drops special investigations, Full blood count
Ferrous sulfate TAB Ferrous sulph co Iron Supplements special investigations, Full blood count
Ferrous sulfate 100mg TAB Ferrous sulphate Iron Supplements special investigations, Full blood count
Ferrous sulfate 30mg TAB Ferrous sulphate Iron Supplements special investigations, Full blood count
Folic acid 0.5mg TAB Folic acid Folic acid Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Folic acid CAP Folic acid forte Folic acid Accepted treatment
Folic acid 5mg TAB Be-tabs folic acid Folic acid Accepted treatment
Folic acid 5mg CAP Folic acid Folic acid Accepted treatment
Iron multivitamins and folic acid
100mg TAB Foliferr Iron multivitamins and folic acid special investigations, Full blood count
Iron Polymaltose 50mg CAP Ferrimed Iron Supplements special investigations, Full blood count
Iron multivitamins and folic acid
CAP Autrin Iron preparations special investigations, Full blood count
Iron vitamin B12 and folic acid
TAB Foliglobin Iron preparations special investigations, Full blood count
ARRHYTHMIAS
ICD 10: I44.0 I44.1 I44.2 I44.3 I44.4 I44.5 I44.6 I44.7 I45.0 I45.0 I45.1 I45.2 I45.3 I45.4 I45.5 I45.6 I45.8 I46.0 I46.9 I47.0 I47.1 I47.2 I47.9 I48 I49.0 I49.1 I49.2 I49.3 I49.4 I49.5 I49.8 I49.9 P29.1
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Bayer aspirin Aspirin Accepted treatment
Amiodarone 100mg TAB AryCor Cordarone x Antiarrhythmics Motivation required; Specialist initiation
Amiodarone 200mg TAB Bio-Amiodarone Hexarone Antiarrhythmics Motivation required; Specialist initiation
Atenolol 100mg TAB Sandoz Atenolol Tenopress Beta blockers Accepted treatment
Atenolol 50mg TAB Sandoz Atenolol Tenopress Beta blockers Accepted treatment
Atenolol 25mg TAB Tenopress Tenormin 25 Beta blockers Accepted treatment
Bisoprolol 10mg TAB Cardicor Bilocor Beta blockers Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Beta blockers Accepted treatment
Bisoprolol 5mg TAB Cardicor Bilocor Beta blockers Accepted treatment
Bisoprolol 10mg TAB Concor Beta blockers Accepted treatment
Diltiazem 180mg SRC Adco-Zildem 180 SR Calcium channel blockers Accepted treatment
Diltiazem 240mg SRC Adco-Zildem 240 SR Calcium channel blockers Accepted treatment
Digoxin 0.0625mg TAB Lanoxin Cardiac glycosides Accepted treatment
Digoxin 0.25mg TAB Lanoxin Cardiac glycosides Accepted treatment
Digoxin 0.05mg/ml SYR Lanoxin paed Cardiac glycosides Motivation required
Digoxin 0.25mg TAB Purgoxin Cardiac glycosides Accepted treatment
Dipyridamole 100mg TAB Plato Antithrombotic agents Motivation required
Magnesium chloride 535mg TAB Slow-Mag Mag-SR Magnesium supplements Accepted treatment
Potassium chloride 600mg TAB Plenish k SANDOZ K-600 Potassium supplements Accepted treatment
Propranolol 10mg TAB Indoblok 10 Purbloka Beta blockers Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Propranolol 40mg TAB Indoblok 40 Purbloka Beta blockers Accepted treatment
Quinidine 200mg TAB Quinidine sulph Antiarrhythmics Motivation required; Specialist initiation
Verapamil 40mg TAB Isoptin Vasomil Calcium channel blockers Accepted treatment
Verapamil 80mg TAB Vasomil Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Calcicard sr 240 Verahexal 240 sr Calcium channel blockers Accepted treatment
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
BENIGN PROSTATIC HYPERTROPHY
ICD 10: N40 N42.3
Doxazosin 1mg TAB Cardugen (Prev Mylan-Doxasozin) Alpha-adrenoreceptor antagonists Accepted treatment
Doxazosin 4mg TAB Cardugen (prev Mylan-Doxasozin) Alpha-adrenoreceptor antagonists Accepted treatment
Doxazosin (extended release)
4mg TAB Cardura XL Carzin XL Alpha-adrenoreceptor antagonists Motivation required
Silodosin 4mg TAB Silodyx 4 Alpha-adrenoreceptor antagonists Accepted treatment
Silodosin 8mg TAB Silodyx 8 Alpha-adrenoreceptor antagonists Accepted treatment
Tamsulosin 0,4mg SRC Prostaflo sr Beniprosin Testosterone-5-alpha reductase inhibitors
Motivation required
COAGULATION DEFECTS
ICD 10: D68.0 D68.1 D68.2 D68.3 D68.4 D68.8 D68.9 D69.1 D69.3 D69.4 D69.5 D69.6 D69.8
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Bayer aspirin Aspirin Accepted treatment
Heparin 5000u/ml INJ Bio-heparin Antithrombotic Motivation required, Special investigations
Heparin 5000u/ml INJ Bio-Heparin 5000 Antithrombotic Motivation required, Special investigations
Heparin 100ml INF Trasylol Antithrombotic Motivation required, Special investigations
Heparin 1000u/ml INJ Heparin sod 1ml-fresenius Antithrombotic Motivation required, Special investigations
Heparin 5000u/ml INJ Heparin sod 1ml-fresenius Antithrombotic Motivation required, Special investigations
Heparin 5000u/ml INJ Heparin sod 5ml-fresenius Antithrombotic Motivation required, Special investigations
Heparin 2500u/ml INJ Heparin sod 5ml-fresenius Antithrombotic Motivation required, Special investigations
Tranexamic acid 500mg TAB Tranexamic acid Medwich Cyklokapron Antifibrinolytics Motivation required, Special investigations
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
COMPLICATIONS OF HYPERTENSION
ICD 10: I27.0 I27.2 I67.4 Q27.1
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Bayer aspirin Aspirin Accepted treatment
Amlodipine 10mg TAB Almadin Gulf Amlodipine Calcium channel blockers Accepted treatment
Amlodipine 5mg TAB Almadin Gulf Amlodipine Calcium channel blockers Accepted treatment
Digoxin 0.0625mg TAB Lanoxin Cardiac glycosides Accepted treatment
Digoxin 0.25mg TAB Lanoxin Purgoxin Cardiac glycosides Accepted treatment
Digoxin 0.05mg/ml SYR Lanoxin paed Cardiac glycosides Accepted treatment
Diltiazem 180mg SRC Adco Zildem 180 SR Calcium channel blockers Accepted treatment
Diltiazem 240mg SRC ADco Zildem 240 SR Calcium channel blockers Accepted treatment
Dipyridamole 200mg SRC Persantin 200 Antithrombotic agents Motivation required
Dipyridamole 100mg TAB Plato Antithrombotic agents Motivation required
Dipyridamole ad acetylsalicylic acid
200mg/25mg CAP Assasantin Retard Antithrombotic agents Accepted treatment
Felodipine 10mg SRT Felodipine-Hexal Calcium channel blockers Accepted treatment
Felodipine 5mg SRT Felodipine-Hexal Plendil Calcium channel blockers Accepted treatment
Furosemide 10mg/ml SYR Lasix oral Diuretics Motivation required;
Furosemide 40mg TAB Mylan-furosemide Beurises Diuretics Accepted treatment
Furosemide 20mg TAB Lasix Austell-Furosemide Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/5mg TAB Adco-retic Spec-Co-Amiloride Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
25mg/2.5mg TAB Amiloretic hs Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/25mg TAB Dyazide Renezide Diuretics Accepted treatment
Hydralazine 10mg TAB Hyperphen Vasodilators Accepted treatment
Hydralazine 50mg TAB Hyperphen Vasodilators Accepted treatment
Indapamide 2.5mg TAB Cipla-Indapamide Daptril Diuretics Accepted treatment
Irbesartan 150mg TAB Iberwin Aprovel Angiotension receptor antagonist Accepted treatment
Irbesartan 300mg TAB Iberwin Aprovel Angiotension receptor antagonist Accepted treatment
Irbesartan and diuretics 150mg/12.5mg TAB Co-Iberwin Coaprovel Angiotensin receptor blockers and combinations
Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Irbesartan and diuretics 300mg/12.5mg TAB Co-Iberwin Coaprovel Angiotensin receptor blockers and combinations
Accepted treatment
Methyldopa (levorotatory) 250mg TAB Hypotone SANDOZ Methyldopa Antiadrenegic agents, centrally acting
Accepted treatment
Methyldopa (levorotatory) 500mg TAB Hypotone Antiadrenegic agents, centrally acting
Accepted treatment
Nifedipine 20mg SRT Cipalat Retard Nifedalat SR Calcium channel blockers Accepted treatment
Nifedipine 30mg SRT Fedaloc Spec Nifedipine SR Calcium channel blockers Accepted treatment
Nifedipine 60mg SRT Fedaloc Spec Nifedipine SR Calcium channel blockers Accepted treatment
Reserpine 0.25mg TAB Reserpine Antiadrenegic agents, centrally acting
Accepted treatment
Spironolactone 100mg TAB Aldactone Diuretics Accepted treatment
Spironolactone 25mg TAB Aldactone SANDOZ Spironolactone Diuretics Accepted treatment
Verapamil 40mg TAB Isoptin Vasomil Calcium channel blockers Accepted treatment
Verapamil 80mg TAB Vasomil Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Calcicard sr 240 Verahexal 240 sr Calcium channel blockers Accepted treatment
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
CONGENITAL IODINE DEFICIENCY
ICD 10: E00.0 E00.1 E00.2 E00.9
Levothyroxine sodium 0.05mg TAB Eltroxin Thyroid hormones Accepted treatment
Levothyroxine sodium 0.1mg TAB Eltroxin Thyroid hormones Accepted treatment
Levothyroxine sodium 100mcg TAB Euthyrox Thyroid hormones Accepted treatment
Levothyroxine sodium 25mcg TAB Euthyrox Thyroid hormones Accepted treatment
Levothyroxine sodium 50mcg TAB Euthyrox Thyroid hormones Accepted treatment
Liothyronine sodium 90mcg TAB Diotroxin Thyroid hormones Accepted treatment
Liothyronine sodium 20mcg TAB Tertroxin Thyroid hormones Accepted treatment
CUSHING'S SYNDROME
ICD 10: E24.0 E24.1 E24.2 E24.3 E24.8 E24.9
Octreotide 0.05mg INJ Sandostatin Growth hormone release inhibitor Motivation required; Specialist initiation
Octreotide 0.1mg INJ Sandostatin Growth hormone release inhibitor Motivation required; Specialist initiation
Octreotide 0.2mg INJ Sandostatin Growth hormone release inhibitor Motivation required; Specialist initiation
Octreotide 10mg INJ Sandostatin LAR prefilled Growth hormone release inhibitor Motivation required; Specialist initiation
Octreotide 20mg INJ Sandostatin LAR prefilled Growth hormone release inhibitor Motivation required; Specialist initiation
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
DELUSIONAL DISORDERS
ICD 10: F22.0 F22.8 F22.9
Amisulpiride 50mg TAB Solian Antipsychotics Accepted treatment
Amisulpiride 200mg TAB Solian Antipsychotics Accepted treatment
Amitriptyline 25mg TAB SANDOZ Amitryptyline Trepiline Heterocyclic antidepressant Accepted treatment
Aripiprazole 5mg TAB Abilify Antipsychotics Motivation required
Aripiprazole 10mg TAB Abilify Antipsychotics Motivation required
Aripiprazole 15mg TAB Abilify Antipsychotics Motivation required
Chlorpromazine 100mg TAB Largactil Antipsychotics Accepted treatment
Chlorpromazine 25mg TAB Largactil Antipsychotics Accepted treatment
Chlorpromazine 50mg TAB Largactil Antipsychotics Accepted treatment
Citalopram 20mg TAB Auro-Citalopram Austell-Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Citalopram 10mg TAB Austell-Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Citalopram 40mg TAB Depramil Arrow Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Clomipramine 10mg TAB Equinorm Clomidep Heterocyclic antidepressants Accepted treatment
Clomipramine 25mg TAB Equinorm Clomidep Heterocyclic antidepressants Accepted treatment
Clozapine 100mg TAB Cloment Leponex Antimanic agent Accepted treatment
Clozapine 25mg TAB Cloment Leponex Antimanic agent Accepted treatment
Dothiepin 25mg CAP Prothiaden Thaden Heterocyclic antidepressants Accepted treatment
Dothiepin 75mg TAB Thaden Heterocyclic antidepressants Accepted treatment
Fluoxetine 20mg CAP Nuzak Lilly-fluoxetine Selective serotonin receptor inhibitors
Accepted treatment
Fluoxetine 20mg TAB Lorien Selective serotonin receptor inhibitors
Accepted treatment
Fluoxetine 20mg DSP Prohexal 20t Selective serotonin receptor inhibitors
Accepted treatment
Flupenthixol 0.5mg TAB Fluanxol Antipsychotics Accepted treatment
Flupenthixol 1mg TAB Fluanxol Antipsychotics Accepted treatment
Haloperidol 1.5mg TAB SANDOZ Haloperidol Antipsychotics Accepted treatment
Haloperidol 5mg TAB SANDOZ Haloperidol Serenace Antipsychotics Accepted treatment
Haloperidol 0.5mg CAP Serenace Antipsychotics Accepted treatment
Haloperidol 10mg TAB Serenace Antipsychotics Accepted treatment
Imipramine 25mg TAB Ethipramine Tofranil Heterocyclic antidepressants Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Lithium 250mg TAB Camcolit Antimanic agent Accepted treatment
Lithium 400mg TAB Camcolit Antimanic agent Accepted treatment
Lithium 450mg TAB Quilonum retard Antimanic agent Accepted treatment
Maprotiline 25mg TAB Ludiomil Heterocyclic antidepressants Motivation required
Maprotiline 75mg TAB Ludiomil Heterocyclic antidepressants Motivation required
Paliperidone 3mg TAB Invega Antipsychotics Motivation required
Paliperidone 6mg TAB Invega Antipsychotics Motivation required
Paliperidone 9mg TAB Invega Antipsychotics Motivation required
Quetiapine 25mg TAB Dopaquel Serez Antipsychotics Accepted treatment
Quetiapine 100mg TAB Truvalin Quetoser Antipsychotics Accepted treatment
Quetiapine 200mg TAB Mylan Quetiapine Dopaquel Antipsychotics Accepted treatment
Quetiapine 300mg TAB Serez Truvalin Antipsychotics Accepted treatment
Quetiapine 200mg TAB Seroquel XR 200 Antipsychotics Motivation required
Quetiapine 300mg TAB Seroquel XR 300 Antipsychotics Motivation required
Quetiapine 400mg TAB Seroquel XR 400 Antipsychotics Motivation required
Risperidone 0.5mg TAB Aspen Risperidone Risperlet Antipsychotics Accepted treatment
Risperidone 2mg TAB Aspen Risperidone Risperdal Quicklet Antipsychotics Accepted treatment
Risperidone 3mg TAB Aspen Risperidone Risperidone-Hexal Antipsychotics Accepted treatment
Risperidone 3mg TAB Auropidone Antipsychotics Accepted treatment
Risperidone 1.0mg TAB DRL-Risperidone Auroperdal Antipsychotics Accepted treatment
Risperidone 1mg/ml SYR Risperdal Antipsychotics Accepted treatment
Risperidone 4mg TAB Risperdal Risponz Antipsychotics Accepted treatment
Risperidone 1mg TAB Risperlet Rispacor Antipsychotics Accepted treatment
Sulpiride 200mg TAB Bio-Sulpiride Substituted benzamide Accepted treatment
Sulpiride 50mg CAP Eglonyl Substituted benzamide Accepted treatment
Sulpiride 50mg CAP Espiride Substituted benzamide Accepted treatment
Sulpiride 50mg CAP SANDOZ Sulpiride Substituted benzamide Accepted treatment
Trifluoperazine 1mg TAB Stelazine Selective serotonin receptor inhibitors
Accepted treatment
Trifluoperazine 5mg TAB Stelazine Selective serotonin receptor inhibitors
Accepted treatment
Ziprasidone 20mg CAP Geodon Antipsychotics Motivation required
Ziprasidone 40mg CAP Geodon Antipsychotics Motivation required
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Ziprasidone 60mg CAP Geodon Antipsychotics Motivation required
Ziprasidone 80mg CAP Geodon Antipsychotics Motivation required
Zuclopenthixol 10mg TAB Clopixol Antipsychotics Accepted treatment
Zuclopenthixol 2mg TAB Clopixol Antipsychotics Accepted treatment
DISSEMINATED BULLOUS SKIN DISEASE
ICD 10: L10.0 L10.1 L10.2 L10.3 L10.4 L10.5 L10.8 L10.9 L12.0 L12.1 L12.2 L12.3 L12.8 L12.9 L13.0 L13.1 L13.8 L13.9 Q81.0 Q81.1 Q81.2 Q81.8 Q81.9
Ciclosporin 100mg CAP Sandimmun Neoral soft gel Immuosuppressants Motivation required
Ciclosporin 25mg CAP Sandimmun Neoral soft gel Immuosuppressants Motivation required
Methotrexate 2.5mg TAB Emthexate Methotrexate Immunosuppressants Accepted treatment
Prednisolone 5mg TAB Lenisolone Prelone Corticosteroids , oral Accepted treatment
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids , oral Accepted treatment
ENDOMETRIOSIS
ICD 10: N80.0 N80.1 N80.2
Cyproterone & Estrogen 2mg TAB Ginette Minerva Hormonal preparations, oral Accepted treatment; specialist initiation
Cyproterone acetate 50mg TAB Cipla-cyproterone acetate Cyproplex Hormonal preparations, oral Accepted treatment; specialist initiation
Cyproterone acetate 2mg TAB Adco-fem Diane-35 Hormonal preparations, oral Accepted treatment; specialist initiation
Danazol 100mg CAP Danogen Ladazol (Ladogar) Antigonadotropins Accepted treatment; specialist initiation
Desogestrel and estrogen TAB Marvelon 150/30 Hormonal preparations, oral Accepted treatment; specialist initiation
Desogestrel and estrogen TAB Mercilon Hormonal preparations, oral Accepted treatment; specialist initiation
Dienogest 2mg TAB Visanne Hormonal preparations, oral Accepted treatment; specialist initiation
Drospirenone and estrogen TAB Yasmin Ruby Hormonal preparations, oral Accepted treatment; specialist initiation
Drospirenone and estrogen TAB Yaz Hormonal preparations, oral Accepted treatment; specialist initiation
Gestodene and estrogen TAB Femodene ed Minulette Hormonal preparations, oral Accepted treatment; specialist initiation
Gestodene and estrogen TAB Melodene Hormonal preparations, oral Accepted treatment; specialist initiation
Gestodene and estrogen TAB Mirelle Minesse Hormonal preparations, oral Accepted treatment; specialist initiation
Gestodene and estrogen TAB Tri-minulet Hormonal preparations, oral Accepted treatment; specialist initiation
Gestodene and estrogen TAB Triodene ed Hormonal preparations, oral Accepted treatment; specialist initiation
Goserelin 10.8mg INJ Zoladex Gonadotropin releasing hormone analogues
Motivation required; Specialist initiation
Goserelin 3.6mg INJ Zoladex Gonadotropin releasing hormone analogues
Motivation required; Specialist initiation
Levonorgestrel and estrogen
TAB Biphasil Hormonal preparations, oral Accepted treatment; specialist initiation
Levonorgestrel and estrogen
TAB Logynon ed Hormonal preparations, oral Accepted treatment; specialist initiation
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Levonorgestrel and estrogen
TAB Triphasil Hormonal preparations, oral Accepted treatment; specialist initiation
Medroxyprogesterone 10mg TAB HEXAL-MPA 10 Provera Hormone replacement therapy Accepted treatment; specialist initiation
Medroxyprogesterone 5mg TAB HEXAL-MPA 5 Provera Hormone replacement therapy Accepted treatment; specialist initiation
Medroxyprogesterone 10mg TAB HEXAL-MPA 10 Provera Hormonal preparations, oral Accepted treatment; specialist initiation
Medroxyprogesterone 5mg TAB HEXAL-MPA 5 Provera Hormonal preparations, oral Accepted treatment; specialist initiation
Norethisterone 5mg TAB Primolut n Hormonal preparations, oral Accepted treatment; specialist initiation
Norethisterone 5mg TAB Primolut n Hormonal preparations, oral Accepted treatment; specialist initiation
Norethisterone and estrogen
0.5mg TAB Trinovum Hormonal preparations, oral Accepted treatment; specialist initiation
HYPERPARATHYROIDISM
ICD 10: E21.0 E21.1 E21.2 E21.3 E21.4 E21.5
Chloroquine 200mg TAB Nivaquine Aminoquinolines Accepted treatment
Chloroquine 200mg CAP Plasmoquine Aminoquinolines Accepted treatment
Chloroquine 250mg TAB SANDOZ Chloroquine phosphate Aminoquinolines Accepted treatment
HYPERTHYROIDISM
ICD 10: E05.0 E05.1 E05.2 E05.3 E05.4 E05.5 E05.8 E05.9
Carbimazole 5mg TAB Neo-mercazole Imidazole derivatives Motivation required
Propranolol 10mg TAB Indoblok 10 Purbloka Beta blockers Accepted treatment
Propranolol 40mg TAB Indoblok 40 Purbloka Beta blockers Accepted treatment
HYPOPARATHYROIDISM
ICD 10: E20.0 E20.1 E20.8 E20.9 E89.2 P71.4
Alfacalcidol 0.25mcg CAP One alpha Vitamin supplement Accepted treatment
Alfacalcidol 1mcg CAP One alpha Vitamin supplement Accepted treatment
Calcium 500mg CHU B-cal Mineral Supplement Accepted treatment
Calcium carbonate 500mg SAC Calcidose vit d oral powder Mineral Supplement Accepted treatment
Calcium carbonate 500mg EFT Calcium-hexal 500 Fizzical 500 Mineral Supplement Accepted treatment
Calcium carbonate 500mg TAB Calsuba calcium Mineral Supplement Accepted treatment
Calcium carbonate 300mg CHU Caltrate 300 Link calcium Mineral Supplement Accepted treatment
Calcium carbonate 600mg EFT Caltrate 600 + D effervescent Mineral Supplement Accepted treatment
Calcium carbonate 600mg TAB Caltrate d Mineral Supplement Accepted treatment
Calcium gluconate 300mg TAB Calcium gluconate (fams) Calcium gluconate chew Mineral Supplement Accepted treatment
Calcium, combinations with other drugs
500mg CHU B-cal-d vitamin & Mineral Supplement Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Calcium, combinations with other drugs
500mg TAB B-cal-d vitamin & Mineral Supplement Accepted treatment
Calcitriol 0.25mg CAP Rocaltrol Vitamin supplement Accepted treatment
Ergocalciferol 50000u TAB Calciferol Vitamin supplement Accepted treatment
Ergocalciferol DRP Calciferol oily Vitamin supplement Accepted treatment
Hydrochlorothiazide 25mg TAB Hexazide Ridaq Diuretics Accepted treatment
Hydrochlorothiazide 12.5mg TAB Ridaq Diuretics Accepted treatment
ISCHAEMIC HEART DISEASE
ICD 10: I21.0 I21.1 I21.2 I21.3 I21.4 I21.9 I22.0 I22.1 I22.8 I22.9 I23.0 I23.1 I23.2 I23.5 I23.6 I23.8 I24.1 I24.8 I24.9 I51.0 I51.1 I51.2 I51.3 I51.5 I51.7
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg TAB Be-tabs aspirin (white) Disprin Aspirin Accepted treatment
Amlodipine 10mg TAB Amlodac Keysal Calcium channel blockers Accepted treatment
Amlodipine 5mg TAB Klodip Stamlo Calcium channel blockers Accepted treatment
Amlodipine besylate 5mg TAB Austell-Amlodipine Lomanor Calcium channel blockers Accepted treatment
Amlodipine besylate 10mg TAB Calbloc Pharma Dynamics Amlodipine Besylate
Calcium channel blockers Accepted treatment
Amlodipine maleate 10mg TAB Amlate Calcium channel blockers Accepted treatment
Amlodipine maleate 5mg TAB Amlate Calcium channel blockers Accepted treatment
Atenolol 50mg TAB Adco-atenolol B-Block Beta blockers Accepted treatment
Atenolol 100mg TAB Gulf Atenolol 100 Sandoz Atenolol Beta blockers Accepted treatment
Atenolol 25mg TAB Tenopress Tenormin 25 Beta blockers Accepted treatment
Atenolol and other diuretics 100mg/25mg TAB Tenchlor Tenoretic Beta blocker and diuretics Accepted treatment
Atenolol and other diuretics 50mg/12.5mg TAB Tenchlor hs Tenoret 50 Beta blocker and diuretics Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Beta blockers Accepted treatment
Bisoprolol 5mg TAB Cardicor Concor Beta blockers Accepted treatment
Bisoprolol 10mg TAB Concor Bilocor Beta blockers Accepted treatment
Carvedilol 12.5mg TAB Carvedilol-Hexal Carvetrend Alpha/beta blockers Accepted treatment
Carvedilol 25mg TAB Carvedilol-Hexal Carvetrend Alpha/beta blockers Accepted treatment
Carvedilol 6.25mg TAB Carvedilol-Hexal Carvetrend Alpha/beta blockers Accepted treatment
Diltiazem 180mg SRC Adco Zildem 180 SR Calcium channel blockers Accepted treatment
Diltiazem 240mg SRC ADco Zildem 240 SR Calcium channel blockers Accepted treatment
Dipyridamole 200mg SRC Persantin 200 Antithrombotic agents Motivation required
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Dipyridamole ad acetylsalicylic acid
200mg/25mg CAP Assasantin Retard Antithrombotic agents Accepted treatment
Dipyridimole 100mg TAB Plato Antithrombotic agent Motivation required
Felodipine 10mg SRT Felodipine-Hexal Calcium channel blockers Accepted treatment
Felodipine 5mg SRT Felodipine-Hexal Plendil Calcium channel blockers Accepted treatment
Glyceryl trinitrate 0.5mg TAB Angised Organic nitrates Accepted treatment
Isosorbide dinitrate 40mg TAB Isordil tembid Organic nitrates Accepted treatment
Isosorbide dinitrate 30mg TAB SANDOZ Isosorbide Isordil Organic nitrates Accepted treatment
Isosorbide dinitrate 10mg TAB SANDOZ Isosorbide Dinitrate Isordil Organic nitrates Accepted treatment
Isosorbide dinitrate 5mg TAB SANDOZ Isosorbide Dinitrate Isordil sublingual Organic nitrates Accepted treatment
Isosorbide mononitrate 20mg TAB Elantan Ismo 20 Organic nitrates Accepted treatment
Isosorbide mononitrate 50mg SRC Elantan la Organic nitrates Accepted treatment
Isosorbide-5-mononitrate 60mg SRT Imdur Monicor SR Organic nitrates Accepted treatment
Nifedipine 60mg SRT Fedaloc Calcium channel blockers Accepted treatment
Nifedipine 60mg SRT Macorel 60 SR Calcium channel blockers Accepted treatment
Nifedipine 20mg SRT Nifedalat SR Cipalat Retard Calcium channel blockers Accepted treatment
Nifedipine 30mg SRT Spec Nifedipine SR Macorel 30 SR Calcium channel blockers Accepted treatment
Nifedipine 60mg SRT Spec Nifedipine SR Calcium channel blockers Accepted treatment
Propranolol 10mg TAB Indoblok Purbloka Beta blockers Accepted treatment
Propranolol 40mg TAB Indoblok Purbloka Beta blockers Accepted treatment
Verapamil 240mg SRT Calcicard sr 240 Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Isoptin sr Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Ravamil sr Calcium channel blockers Accepted treatment
Verapamil 40mg TAB Vasomil Isoptin Calcium channel blockers Accepted treatment
Verapamil 80mg TAB Vasomil Calcium channel blockers Accepted treatment
Verapamil 240mg SRT Verahexal 240 sr Calcium channel blockers Accepted treatment
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
MENOPAUSE
ICD 10: N95.0 N95.1 N95.2 N95.3 N95.8 N95.9
Clonidine 0.025mg TAB Dixarit Menograine Alpha-2 agonists Accepted treatment
Conjugated estrogens 0.3mg TAB Premarin Hormonal preparations, oral Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Conjugated estrogens 0.625mg TAB Premarin Hormonal preparations, oral Accepted treatment
Conjugated estrogens 0.625mg/g VCR Premarin Hormonal preparations, oral Motivation required
Conjugated estrogens 1.25mg TAB Premarin Hormonal preparations, oral Accepted treatment
Estradiol 7.8mg PAD Climara 100 Hormonal preparations, oral Accepted treatment
Estradiol 3.9mg PAD Climara 50 Hormonal preparations, oral Accepted treatment
Estradiol 37.5mcg PAD Estradot Hormonal preparations, oral Accepted treatment
Estradiol 50mcg PAD Estradot Evorel 50 tts Hormonal preparations, oral Accepted treatment
Estradiol 75mcg PAD Estradot Evorel 75 tts Hormonal preparations, oral Accepted treatment
Estradiol 1mg TAB Estrofem Estro-pause 1mg Hormonal preparations, oral Accepted treatment
Estradiol 2mg TAB Estrofem Estro-pause 2mg Hormonal preparations, oral Accepted treatment
Estradiol JEL Femigel pump Hormonal preparations, oral Accepted treatment
Estradiol; combinations TAB Menoflush Hormonal preparations, oral Accepted treatment
Estriol 2mg TAB Synapause-e3 Hormonal preparations, oral Accepted treatment
Medroxyprogesterone 10mg TAB HEXAL-MPA 10 Provera Hormonal preparations, oral Motivation required
Medroxyprogesterone 5mg TAB HEXAL-MPA 5 Provera Hormonal preparations, oral Motivation required
Norethisterone and estrogen
TAB Activelle Hormonal preparations, oral Accepted treatment
Norethisterone and estrogen
50/140 PAD Estalis Hormonal preparations, oral Motivation required
Norethisterone and estrogen
TAB Novofem Hormonal preparations, oral Accepted treatment
Norethisterone and estrogen
TAB Estro-pause n Hormonal preparations, oral Accepted treatment
Norethisterone and estrogen
TAB Estro-pause n forte Hormonal preparations, oral Accepted treatment
Norethisterone and estrogen
TAB Trisequens Hormonal preparations, oral Accepted treatment
Norgestrel and estrogen TAB Postoval Hormonal preparations, oral Accepted treatment
MINERAL & ELECTROLYTE DEFICIENCIES
E87.6
Potassium chloride 600mg TAB Plenish k SANDOZ K-600 Potassium supplements Accepted treatment
MUSCULAR DYSTROPHY
ICD 10: G71.0
See "Hypertension" for a list if diuretics and antihypertensive agents
See "Epilepsy" for a list of anticonvulsants Prednisone 5mg/ml SYR Pulmison paed oral solution Corticosteroids , oral Motivation required
Prednisone 5mg TAB Be-tabs prednisone Panafcort Corticosteroids , oral Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
MYCOBACTERIAL INFECTION (EXCL TB)
ICD 10: A30.0 A30.1 A30.2 A30.3 A30.4 A30.5 A30.8 A30.9 A31.0
Ethambutol 400mg TAB Sandoz ethambutol Antimycobacterial special investigations
Ethionamide 250mg TAB Ethatyl Antimycobacterial Motivation required
Isoniazid 100mg TAB Norstan Isoniazid Antimycobacterial special investigations
Moxifloxacin 400mg TAB Numoxx DRL Moxifloxacin Quinolone antibacterial Motivation required
Pyrazinamide 500mg TAB Pyrazide Sandoz pyrazinamide Antimycobacterial special investigations
Pyridoxine (vit B6) 25mg TAB Be-tabs pyridoxine hcl Pyridoxine Vitamin supplement Accepted treatment
Pyridoxine (vit B6) 25mg TAB Pyridoxine Vitamin B6 Vitamin supplement Accepted treatment
Rifampicin 150mg CAP Rimactane Antimycobacterial special investigations
Rifampicin 450mg TAB Rimactane Antimycobacterial special investigations
Rifampicin 600mg TAB Rimactane Antimycobacterial special investigations
Rifampicin & isoniazid 150/150mg TAB Rifinah Antimycobacterial special investigations
Rifampicin & isoniazid 300mg TAB Rifinah Antimycobacterial special investigations
Rifampicin & isoniazid 60/30mg TAB Rimactazid paed Antimycobacterial special investigations
Rifampicin & isoniazid 60/60mg TAB Rimactazid paed Antimycobacterial special investigations
Rifampicin, isoniazid, pyrazinamide & ethambutol
150/75/400/275mg TAB Rifafour E-275 Rimstar 4-FDC Antimycobacterial special investigations
NEONATAL CARDIAC DYSRHYTHMIA
ICD 10: P29.1
Amiodarone 100mg TAB AryCor Hexarone Antiarrhythmics Motivation required
Amiodarone 200mg TAB AryCor Hexarone Antiarrhythmics Motivation required
Atenolol 50mg TAB Gulf Atenolol Tenopress Beta blockers Accepted treatment
Atenolol 100mg TAB Gulf Atenolol 100 Tenopress Beta blockers Accepted treatment
Atenolol 25mg TAB Tenopress Tenormin 25 Beta blockers Accepted treatment
Bisoprolol 10mg TAB Bilocor Cardicor Beta blockers Accepted treatment
Bisoprolol 5mg TAB Bilocor Cardicor Beta blockers Accepted treatment
Bisoprolol 2.5mg TAB Cardicor Beta blockers Accepted treatment
Digoxin 0.05mg/ml SYR Lanoxin paed Cardiac glycosides Accepted treatment
Nicotinic acid 100mg TAB Be-tabs nicotinic acid Peripheral vasodilator special investigations, Pathology report indicating deficiency
Propranolol 10mg TAB Indoblok 10 Purbloka Beta blockers Accepted treatment
Propranolol 40mg TAB Indoblok 40 Purbloka Beta blockers Accepted treatment
Quinidine 200mg TAB Quinidine sulph Antiarrhythmics Motivation required
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Sotalol 160mg TAB Sotahexal Beta blockers Motivation required
Sotalol 80mg TAB Sotahexal Beta blockers Motivation required
NEONATAL CARDIAC FAILURE
ICD 10: P29.0
Digoxin 0.05mg/ml SYR Lanoxin paed Cardiac glycosides Accepted treatment
Furosemide 10mg/ml SYR Lasix oral Diuretics Motivation required
NEPHRITIC SYNDROME
ICD 10: N01.0 N01.1 N01.2 N01.3 N01.4 N01.5 N01.6 N01.7 N01.8 N01.9 N04.0 N04.1 N04.2 N04.3 N04.4 N04.5 N04.6 N04.7 N04.8 N04.9 N11.8 N11.9 N12
See under "Chronic Renal Failure"
NEPHROGENIC DIABETES INSIPIDUS
ICD 10: N25.1
Carbamazepine 200mg TAB Degranol SANDOZ Carbamazepine Anticonvulsants Accepted treatment
Carbamazepine 400mg SRT SANDOZ Cabamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Carbamazepine 200mg SRT SANDOZ Carbamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Diclofenac 25mg TAB Adco-diclofenac Panamor-25 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 50mg TAB Diclohexal Panamor at-50 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 100mg CAP Fortfen SR Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 100mg SRT Panamor-100 sr SANDOZ Diclofenac Sodium SR
Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 75mg SRT Panamor-75 sr Voltaren 75 Non-steroidal anti-inflammatory drugs
Accepted treatment
Hydrochlorothiazide 25mg TAB Hexazide Ridaq Diuretics Accepted treatment
Hydrochlorothiazide 12.5mg TAB Ridaq Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
50mg/5mg TAB Adco-retic Moduretic Diuretics Accepted treatment
Hydrochlorothiazide and potassium-sparing agents
25mg/2.5mg TAB Amiloretic hs Diuretics Accepted treatment
Ibuprofen 400mg TAB Inza Ranfen Non-steroidal anti-inflammatory drugs
Accepted treatment
Ibuprofen 100mg/5ml SUS Brufen for children Ibugesic Non-steroidal anti-inflammatory drugs
Motivation required
Ibuprofen 200mg TAB Ranfen Inza Non-steroidal anti-inflammatory drugs
Accepted treatment
Indomethacin 25mg CAP SANDOZ Idomethacin Arthrexin Non-steroidal anti-inflammatory drugs
Accepted treatment
Meloxicam 15mg TAB Loxiflam Arrow Meloxicam Non-steroidal anti-inflammatory drugs
Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Meloxicam 7.5mg TAB SANDOZ Meloxicam Coxflam Non-steroidal anti-inflammatory drugs
Accepted treatment
Methotrexate 2.5mg TAB Emthexate Emthexate Immunosuppressants Accepted treatment
Naproxen 250mg TAB Adco-naproxen Mylan-naproxen Non-steroidal anti-inflammatory drugs
Accepted treatment
Naproxen 500mg TAB Napflam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 10mg CAP Adco-piroxicam Rolab-piroxicam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 20mg CAP Adco-piroxicam Xycam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 20mg DSP Pixicam Xycam dispers Non-steroidal anti-inflammatory drugs
Accepted treatment
NEUROLOGICAL ABNORMALITIES OF THE NEWBORN
ICD 10: G80.0 G80.1 G80.2 G80.3 G80.4 G80.8 G80.9
Baclofen 10mg TAB Bio-Baclofen Teva Baclofen Muscle relaxants Accepted treatment
Carbamazepine 100mg/5ml SUS Tegretol s Anticonvulsants Accepted treatment
Carbamazepine 200mg TAB Degranol SANDOZ Carbamazepine Anticonvulsants Accepted treatment
Carbamazepine 400mg SRT SANDOZ Cabamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Phenobarbitone 30mg TAB Lethyl Anticonvulsants Accepted treatment
Valproic acid 50mg/ml SYR Convulex Anticonvulsants Accepted treatment
Valproic acid 100mg TAB Epilim 100 crushable Anticonvulsants Accepted treatment
Valproic acid 200mg/5ml SYR Epilim sugar free Anticonvulsants Accepted treatment
Valproic acid 150mg CAP Convulex Anticonvulsants Accepted treatment
Valproic acid 300mg CAP Convulex Anticonvulsants Accepted treatment
Valproic acid 500mg CAP Convulex Anticonvulsants Accepted treatment
Valproic acid 200mg SRT Epilim cr 200 Anticonvulsants Accepted treatment
Valproic acid 300mg SRT Epilim cr 300 Navalpro Anticonvulsants Accepted treatment
Valproic acid 500mg SRT Epilim cr 500 Navalpro Anticonvulsants Accepted treatment
NUTRITIONAL DEFICIENCIES
ICD 10: E40 E41 E42 E43 E46 E50.0-E50.9 E51.1 E51.2 E51.8 E51.9 E52 E53.0 E53.1 E53.8 E53.9 E54 E55.0 E55.9 E56.1 E56.9 E61.1 E61.7 E63.0
Ascorbic acid (vit C) 100mg TAB Ascorbic acid Ascorbic acid (xpressmed) Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 200mg TAB Ascorbic acid Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 250mg TAB Ascorbic acid Ascorbic acid (xpressmed) Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 50mg TAB Ascorbic acid Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 250mg CHU Ascorbic Acid Vitamin supplement Motivation required, Pathology report indicating deficiency
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Ascorbic acid (vit C) 500mg TAB Ascorbic Acid Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 100mg TAB Ascorbic acid (fams) Vitaforce acerola Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 500mg TAB Be-tabs ascorbic acid Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 300mg TAB Vitaforce Acerola Vital vit c Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 600mg TAB Vital vit c hp Vitamin c Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 150mg TAB Vitamin c (150mg) bio-organics Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 1000mg TAB Vitamin C 1000mg Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 500mg TAB Vitamin c 500 Vitamin supplement Motivation required, Pathology report indicating deficiency
Ascorbic acid (vit C) 500mg CAP Vitamin c 500 Vitamin supplement Motivation required, Pathology report indicating deficiency
Calcitriol 0.25mg CAP Rocaltrol Calcitriol Motivation required, Pathology report indicating deficiency
Ergocalciferol 50000u TAB Calciferol Ergocalciferol Motivation required, Pathology report indicating deficiency
Ergocalciferol DRP Calciferol oily Ergocalciferol Motivation required, Pathology report indicating deficiency
MULTIVITAMINS COMBINATIONS
TAB VIT B CO CHOCOLATE MULTIVITAMINS COMBINATIONS Motivation required, Pathology report indicating deficiency
Nicotinamide 100mg TAB Be-tabs nicotinamide Vitaforce nicotinamide Vitamin supplement Motivation required, Pathology report indicating deficiency
Nicotinic acid 100mg TAB Holland and barrett niacin b3 Vitamin supplement Motivation required, Pathology report indicating deficiency
Nicotinic acid 330mg CAP Niacin (flush free) Vitamin supplement Motivation required, Pathology report indicating deficiency
Nicotinic acid 100mg TAB Niacin(Nicotinic Acid)(Vitamin B3) Be-tabs nicotinic acid Vitamin supplement Motivation required, Pathology report indicating deficiency
Nicotinic acid CAP Vitamin B3 Vitamin supplement Motivation required, Pathology report indicating deficiency
Pyridoxine (vit B6) 25mg TAB Be-tabs pyridoxine hcl Vitamin supplement Motivation required, Pathology report indicating deficiency
Pyridoxine (vit B6) 25mg TAB Pyridoxine Vitamin supplement Motivation required, Pathology report indicating deficiency
Pyridoxine (vit B6) 25mg TAB Pyridoxine Vitamin supplement Motivation required, Pathology report indicating deficiency
Pyridoxine (vit B6) 25mg TAB Vitamin B6 Vitamin supplement Motivation required, Pathology report indicating deficiency
Retinol (vit A) 50000u TAB Arovit Vitamin supplement Motivation required, Pathology report indicating deficiency
Thiamine (vit B1) 100mg TAB Thiamine hcl Vitamin supplement Motivation required, Pathology report indicating deficiency
Tocopherol (vit E) 1000iu CAP Vital vit e Vitamin supplement Motivation required, Pathology report indicating deficiency
Tocopherol (vit E) 400iu CAP Vital vit e Vitamin supplement Motivation required, Pathology report indicating deficiency
Tocopherol (vit E) 50iu CAP Vital vit e Vitamin supplement Motivation required, Pathology report indicating deficiency
Tocopherol (vit E) TAB Vitamin e bio-organics Vitamin supplement Motivation required, Pathology report indicating deficiency
Vitamin B-complex; plain SYR Vitamin b co Vitamin b co syrup Vitamin supplement Motivation required, Pathology report indicating deficiency
Vitamin B-complex; plain TAB Vitamin b co chocolate Vitamin supplement Motivation required, Pathology report indicating deficiency
Vitamin B-complex; plain SYR VITAMIN B CO SYRUP Vitamin b co syrup(fams) Vitamin supplement Motivation required, Pathology report indicating deficiency
Vitamin B-complex; plain TAB Vitamin B Complex Vitamin supplement Motivation required, Pathology report indicating deficiency
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Vitamin B-complex; plain CAP Vitamin b complex Vitamin supplement Motivation required, Pathology report indicating deficiency
Vitamin B-complex; plain INJ Vitamin b complex Vitamin supplement Motivation required, Pathology report indicating deficiency
OTHER DIABETES MELLITUS
E13.0 E13.1 E14.0 E14.1 E15 E16.0 E16.2
Glucagon 1mg INJ Glucagen Hypokit Glycogenolytic hormone Motivation required
OVARIAN DYSFUNCTION
ICD 10: E28.0 E28.1 E28.2 E28.3 E28.8 E28.9 L68.0 N34.2 N83.3 N91.0 N91.1 N91.2 N91.4
Cyproterone & Estrogen 2mg TAB Ginette Minerva Hormonal preparations, oral Motivation required
Cyproterone acetate 50mg TAB Androcur Hormonal preparations, oral Motivation required
Cyproterone acetate 50mg TAB Cipla-cyproterone acetate Hormonal preparations, oral Motivation required
Cyproterone acetate 2mg TAB Diane-35 Ginette Hormonal preparations, oral Motivation required
Desogestrel and estrogen TAB Marvelon 150/30 Hormonal preparations, oral Motivation required
Desogestrel and estrogen TAB Mercilon Hormonal preparations, oral Motivation required
Drospirenone and estrogen TAB Yasmin Ruby Hormonal preparations, oral Motivation required
Drospirenone and estrogen TAB Yaz Hormonal preparations, oral Motivation required
Gestodene and estrogen TAB Femodene ed Minulette Hormonal preparations, oral Motivation required
Gestodene and estrogen TAB Melodene Hormonal preparations, oral Motivation required
Gestodene and estrogen TAB Mirelle Hormonal preparations, oral Motivation required
Gestodene and estrogen TAB Minesse Hormonal preparations, oral Motivation required
Gestodene and estrogen TAB Triodene ed Hormonal preparations, oral Motivation required
Levonorgestrel and estrogen
TAB Biphasil Hormonal preparations, oral Motivation required
Levonorgestrel and estrogen
TAB Logynon ed Hormonal preparations, oral Motivation required
Levonorgestrel and estrogen
TAB Triphasil Hormonal preparations, oral Motivation required
Norethisterone and estrogen
TAB Trinovum Hormonal preparations, oral Motivation required
PEPTIC ULCER DISEASE
ICD 10: K25.0 K25.1 K25.2 K25.4 K25.5 K25.6 K26.0 K26.1 K26.2 K26.4 K26.5 K27.0 K27.1 K27.2 K27.4 K27.5 K27.6 K28.0 K28.1 K28.2 K28.4 K28.5 K28.6 K29.0 K26.6 K26.6
Cimetidine 200mg TAB Bio-cimetidine Cimlok H2-receptor antagonists Accepted treatment
Cimetidine 400mg TAB Bio-cimetidine Cimlok H2-receptor antagonists Accepted treatment
Omeprazole 10mg CAP Altosec Omez Proton Pump Inhibitors Accepted treatment
Omeprazole 20mg CAP Altosec Omez Proton Pump Inhibitors Accepted treatment
Omeprazole 40mg TAB Omez Proton Pump Inhibitors Motivation required
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Ranitidine 75mg TAB Histak 75 Austac-75 H2-receptor antagonists Accepted treatment
Ranitidine 150mg TAB Ranihexal 150 Ranit H2-receptor antagonists Accepted treatment
Ranitidine 300mg TAB Ranihexal 300 Ranit H2-receptor antagonists Accepted treatment
Ranitidine 150mg/10ml SYR Zantac H2-receptor antagonists Motivation required
PERIPHERAL VASCULAR DISEASE
ICD 10: I73.1
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Bayer aspirin Aspirin Accepted treatment
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
PITUITARY HYPERFUNCTION
ICD 10: E22.0 E22.1 E22.2 E22.8 E22.9 E23.7
Bromocriptine 2.5mg TAB Aspen Bromocriptine Dopamine agonists Motivation required
Carbegoline 0.5mg TAB Dostinex Prolactin inhibitors Motivation required; Special investigations
PITUITARY HYPOFUNCTION
ICD 10: E23.7
Conjugated estrogens 0.3mg TAB Premarin Hormone replacement therapy Accepted treatment
Conjugated estrogens 0.625mg TAB Premarin Hormone replacement therapy Accepted treatment
Estradiol 7.8mg PAD Climara 100 Hormone replacement therapy Accepted treatment
Estradiol 3.9mg PAD Climara 50 Hormone replacement therapy Accepted treatment
Estradiol 37.5mcg PAD Estradot Hormone replacement therapy Accepted treatment
Estradiol 50mcg PAD Estradot Evorel 50 tts Hormone replacement therapy Accepted treatment
Estradiol 75mcg PAD Estradot Evorel 75 tts Hormone replacement therapy Accepted treatment
Estradiol 1mg TAB Estrofem Hormone replacement therapy Accepted treatment
Estradiol 2mg TAB Estrofem Hormone replacement therapy Accepted treatment
Estradiol 1mg TAB Estro-pause 1mg Hormone replacement therapy Accepted treatment
Estradiol 2mg TAB Estro-pause 2mg Hormone replacement therapy Accepted treatment
Estradiol JEL Femigel pump Hormone replacement therapy Accepted treatment
Estradiol 1mg TAB Progynova Hormone replacement therapy Accepted treatment
Estradiol 2mg TAB Progynova Hormone replacement therapy Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Hydrocortisone 10mg TAB Covocort Corticosteroids , oral Accepted treatment
Levothyroxine sodium 0.05mg TAB Eltroxin Thyroid hormones Accepted treatment
Levothyroxine sodium 0.1mg TAB Eltroxin Thyroid hormones Accepted treatment
Levothyroxine sodium 100mcg TAB Euthyrox Thyroid hormones Accepted treatment
Levothyroxine sodium 25mcg TAB Euthyrox Thyroid hormones Accepted treatment
Levothyroxine sodium 50mcg TAB Euthyrox Thyroid hormones Accepted treatment
Liothyronine sodium 90mcg TAB Diotroxin Thyroid hormones Accepted treatment
Liothyronine sodium 20mcg TAB Tertroxin Thyroid hormones Accepted treatment
Testosterone cypionate 100mg/ml IMP Depo-testosterone 10ml androgens Motivation required
SCHIZOAFFECTIVE DISORDER
ICD 10: F25.0 F25.1 F25.2 F25.8 F25.9
Amisulpiride 50mg TAB Solian Antipsychotics Accepted treatment
Amisulpiride 200mg TAB Solian Antipsychotics Accepted treatment
Amitriptyline 25mg TAB SANDOZ Amitryptyline Trepiline Heterocyclic antidepressant Accepted treatment
Aripiprazole 5mg TAB Abilify Antipsychotics Motivation required
Aripiprazole 10mg TAB Abilify Antipsychotics Motivation required
Aripiprazole 15mg TAB Abilify Antipsychotics Motivation required
Chlorpromazine 100mg TAB Largactil Antipsychotics Accepted treatment
Chlorpromazine 25mg TAB Largactil Antipsychotics Accepted treatment
Chlorpromazine 50mg TAB Largactil Antipsychotics Accepted treatment
Citalopram 20mg TAB Auro-Citalopram Austell-Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Citalopram 10mg TAB Austell-Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Citalopram 40mg TAB Depramil Arrow Citalopram Selective serotonin receptor inhibitors
Accepted treatment
Clomipramine 10mg TAB Equinorm Clomidep Heterocyclic antidepressants Accepted treatment
Clomipramine 25mg TAB Equinorm Clomidep Heterocyclic antidepressants Accepted treatment
Clozapine 100mg TAB Cloment Leponex Antimanic agent Accepted treatment
Clozapine 25mg TAB Cloment Leponex Antimanic agent Accepted treatment
Dothiepin 25mg CAP Prothiaden Thaden Heterocyclic antidepressants Accepted treatment
Dothiepin 75mg TAB Thaden Heterocyclic antidepressants Accepted treatment
Fluoxetine 20mg CAP Nuzak Lilly-fluoxetine Selective serotonin receptor inhibitors
Accepted treatment
Fluoxetine 20mg TAB Lorien Selective serotonin receptor Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
inhibitors
Fluoxetine 20mg DSP Prohexal 20t Selective serotonin receptor inhibitors
Accepted treatment
Flupenthixol 0.5mg TAB Fluanxol Antipsychotics Accepted treatment
Flupenthixol 1mg TAB Fluanxol Antipsychotics Accepted treatment
Haloperidol 1.5mg TAB SANDOZ Haloperidol Antipsychotics Accepted treatment
Haloperidol 5mg TAB SANDOZ Haloperidol Serenace Antipsychotics Accepted treatment
Haloperidol 0.5mg CAP Serenace Antipsychotics Accepted treatment
Haloperidol 10mg TAB Serenace Antipsychotics Accepted treatment
Imipramine 25mg TAB Ethipramine Tofranil Heterocyclic antidepressants Accepted treatment
Lithium 250mg TAB Camcolit Antimanic agent Accepted treatment
Lithium 400mg TAB Camcolit Antimanic agent Accepted treatment
Lithium 450mg TAB Quilonum retard Antimanic agent Accepted treatment
Maprotiline 25mg TAB Ludiomil Heterocyclic antidepressants Motivation required
Maprotiline 75mg TAB Ludiomil Heterocyclic antidepressants Motivation required
Olanzapine 10mg TAB Olexar Redilanz Antipsychotics Accepted treatment
Olanzapine 5mg TAB Olexar Redilanz Antipsychotics Accepted treatment
Olanzapine 2.5mg TAB Redilanz Zyprexa Antipsychotics Accepted treatment
Paliperidone 3mg TAB Invega Antipsychotics Motivation required
Paliperidone 6mg TAB Invega Antipsychotics Motivation required
Paliperidone 9mg TAB Invega Antipsychotics Motivation required
Quetiapine 25mg TAB Dopaquel Serez Antipsychotics Accepted treatment
Quetiapine 100mg TAB Truvalin Quetoser Antipsychotics Accepted treatment
Quetiapine 200mg TAB Mylan Quetiapine Dopaquel Antipsychotics Accepted treatment
Quetiapine 300mg TAB Serez Truvalin Antipsychotics Accepted treatment
Quetiapine 200mg TAB Seroquel XR 200 Antipsychotics Motivation required
Quetiapine 300mg TAB Seroquel XR 300 Antipsychotics Motivation required
Quetiapine 400mg TAB Seroquel XR 400 Antipsychotics Motivation required
Risperidone 0.5mg TAB Aspen Risperidone Risperlet Antipsychotics Accepted treatment
Risperidone 2mg TAB Aspen Risperidone Risperdal Quicklet Antipsychotics Accepted treatment
Risperidone 3mg TAB Aspen Risperidone Risperidone-Hexal Antipsychotics Accepted treatment
Risperidone 3mg TAB Auropidone Antipsychotics Accepted treatment
Risperidone 1.0mg TAB DRL-Risperidone Auroperdal Antipsychotics Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Risperidone 1mg/ml SYR Risperdal Antipsychotics Accepted treatment
Risperidone 4mg TAB Risperdal Risponz Antipsychotics Accepted treatment
Risperidone 1mg TAB Risperlet Rispacor Antipsychotics Accepted treatment
Sulpiride 200mg TAB Bio-Sulpiride Substituted benzamide Accepted treatment
Sulpiride 50mg CAP Eglonyl Substituted benzamide Accepted treatment
Sulpiride 50mg CAP Espiride Substituted benzamide Accepted treatment
Sulpiride 50mg CAP SANDOZ Sulpiride Substituted benzamide Accepted treatment
Trifluoperazine 1mg TAB Stelazine Selective serotonin receptor inhibitors
Accepted treatment
Trifluoperazine 5mg TAB Stelazine Selective serotonin receptor inhibitors
Accepted treatment
Ziprasidone 20mg CAP Geodon Antipsychotics Motivation required
Ziprasidone 40mg CAP Geodon Antipsychotics Motivation required
Ziprasidone 60mg CAP Geodon Antipsychotics Motivation required
Ziprasidone 80mg CAP Geodon Antipsychotics Motivation required
Zuclopenthixol 10mg TAB Clopixol Antipsychotics Accepted treatment
Zuclopenthixol 2mg TAB Clopixol Antipsychotics Accepted treatment
SPINAL CORD INJURIES
ICD 10: G81.0 G81.1 G81.9 G82.0 G82.1 G82.2 G82.3 G82.4 G82.5 N31.0 N31.1 N31.2 N31.8 N31.9
Paracetamol will be reimbursed in the treatment of Rheumatoid Arthritis.
Amitriptyline 10mg TAB Trepiline Heterocyclic antidepressant Accepted treatment
Amitriptyline 25mg TAB SANDOZ Amitryptyline Trepiline Heterocyclic antidepressant Accepted treatment
Baclofen 10mg TAB Bio-Baclofen Teva Baclofen Muscle relaxants Accepted treatment
Bisacodyl 5mg TAB Dulcolax Laxatives Accepted treatment
Bisacodyl paed SUP Dulcolax Laxatives Accepted treatment
Carbamazepine 200mg TAB Degranol SANDOZ Carbamazepine Anticonvulsants Accepted treatment
Carbamazepine 400mg SRT SANDOZ Cabamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Carbamazepine 200mg SRT SANDOZ Carbamazepine CR Tegretol CR Anticonvulsants Accepted treatment
Diclofenac 25mg TAB Adco-diclofenac Panamor-25 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 50mg TAB Mylan Diclofenac Panamor at-50 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 100mg CAP Fortfen SR Non-steroidal anti-inflammatory drugs
Accepted treatment
Diclofenac 100mg SRT Panamor-100 sr SANDOZ Diclofenac Sodium SR
Non-steroidal anti-inflammatory drugs
Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Diclofenac 75mg SRT Panamor-75 sr Voltaren 75 Non-steroidal anti-inflammatory drugs
Accepted treatment
Diphenoxylate/Atropine 2.5mf/0.025mg TAB Lomotil Antipropulsives Accepted treatment
Gabapentin 300mg CAP Epleptin Anticonvulsants Motivation required
Gabapentin 400mg CAP Ran-Gabapentin Anticonvulsants Motivation required
Glycerol SUP Glycerine Adult Glycerine Infant Laxatives Accepted treatment
Ibuprofen 400mg TAB Inza Ranfen Non-steroidal anti-inflammatory drugs
Accepted treatment
Ibuprofen 100mg/5ml SUS Brufen for children Ibugesic Non-steroidal anti-inflammatory drugs
Accepted treatment
Ibuprofen 200mg TAB Ranfen Inza Non-steroidal anti-inflammatory drugs
Accepted treatment
Imipramine 10mg TAB Ethipramine Tofranil Heterocyclic antidepressants Accepted treatment
Imipramine 25mg TAB Ethipramine Tofranil Heterocyclic antidepressants Accepted treatment
Indomethacin 25mg CAP SANDOZ Idomethacin Arthrexin Non-steroidal anti-inflammatory drugs
Accepted treatment
Ispaghula 3.5g GRA Ispagel Agiobulk Laxatives Accepted treatment
Lactulose 3.3g/5ml SYR Aculax Duphalac Laxatives Accepted treatment
Laurilsulfate; incl. combinations
ENE Microlax 5ml Laxatives Accepted treatment
Loperamide 2mg TAB Adco-loperamide Betaperamide Antipropulsives Accepted treatment
Loperamide 1mg/5ml SYR Gastron Imodium Antipropulsives Accepted treatment
Loperamide 2mg TAB Gastron Antipropulsives Accepted treatment
Lornoxicam 4mg TAB Xefo 4 Non-steroidal anti-inflammatory drugs
Accepted treatment
Lornoxicam 8mg TAB Xefo 8 Non-steroidal anti-inflammatory drugs
Accepted treatment
Macrogol, combinations SAC Movicol Laxatives Accepted treatment
Meloxicam 15mg TAB Loxiflam Arrow Meloxicam Non-steroidal anti-inflammatory drugs
Accepted treatment
Meloxicam 7.5mg TAB SANDOZ Meloxicam Coxflam Non-steroidal anti-inflammatory drugs
Accepted treatment
Methotrexate 2.5mg TAB Emthexate Emthexate Immunosuppressants Accepted treatment
Naproxen 250mg TAB Adco-naproxen Mylan-naproxen Non-steroidal anti-inflammatory drugs
Accepted treatment
Naproxen 500mg TAB Napflam Non-steroidal anti-inflammatory drugs
Accepted treatment
Oxybutynin 5mg TAB Urihexal Lenditro Anticholinergics, oral Accepted treatment
Piroxicam 10mg CAP Adco-piroxicam Rolab-piroxicam Non-steroidal anti-inflammatory drugs
Accepted treatment
Piroxicam 20mg CAP Adco-piroxicam Xycam Non-steroidal anti-inflammatory drugs
Accepted treatment
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Piroxicam 20mg DSP Pixicam Xycam dispers Non-steroidal anti-inflammatory drugs
Accepted treatment
Mineral salts in combination PDR Golytely Laxatives Accepted treatment
Mineral salts in combination POW Go-lytely 68 5775g Laxatives Accepted treatment
Mineral salts in combination SAC Klean-prep Laxatives Accepted treatment
Nalidixic acid 500mg TAB Puromylon Quinolone antibacterial Motivation required
Nalidixic acid SUS Winlomylon susp Quinolone antibacterial Motivation required
Nitrofurantoin 25mg/5ml SUS Furadantin Antibiotics, oral Motivation required
Nitrofurantoin 100mg CAP Macrodantin Antibiotics, oral Motivation required
Nitrofurantoin 50mg CAP Macrodantin Antibiotics, oral Motivation required
Nitroxoline TAB Nicene-n Other antibacterial Motivation required
Orphenadrine (citrate) 100mg TAB Norflex Muscle relaxants Accepted treatment
Senna glycosides TAB Senokot Soflax Laxatives Accepted treatment
Senna glycosides combinations
SAC AgioGel Agiolax Laxatives Accepted treatment
Senna glycosides combinations
GRA Agiolax Laxatives Accepted treatment
Sodium phosphate ENE Fosenema enema 150ml Lenolax(fleet) Laxatives Accepted treatment
Sodium phosphate ENE Lenolax paed enema Laxatives Accepted treatment
Sorbitol PDR Sorbitol Laxatives Accepted treatment
Sterculia GRA Normacol/special Laxatives Accepted treatment
Sterculia; combinations GRA Normacol plus Laxatives Accepted treatment
STROKE
ICD 10: :G93.1 I67.6 I61.0 I61.1 I61.2 I61.3 I61.4 I61.5 I61.6 I61.8 I61.9 I63.1 I63.2 I63.3 I63.4 I63.5 I63.6 I63.8 I63.9 I64 I67.6
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Bayer aspirin Aspirin Accepted treatment
Dipyridamole 200mg CAP Persantin 200 Antithrombotic agents Accepted treatment
Dipyridamole and acetylsalicylic acid
200mg/25mg CAP Asasantin 200/25 retard Antithrombotic agents Accepted treatment
Dipyridamole 100mg TAB Plato Antithrombotic agents Motivation required
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
THALASSEMIA
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
ICD 10: D56.0 D56.1 D56.2 D56.3 D56.4 D56.8 D56.9 D58.2 D74.0 D74.8 D74.9
Ascorbic acid 250mg TAB Be-tabs ascorbic acid Vitamin Supplement Motivation required; Specialist initiation
Deferasirox 125mg DSP Exjade Iron Chelating agents Motivation required; Specialist initiation
Deferasirox 250mg DSP Exjade Iron Chelating agents Motivation required; Specialist initiation
Deferasirox 500mg DSP Exjade Iron Chelating agents Motivation required; Specialist initiation
Deferoxamine 500mg INJ Desferal Iron Chelating agents Motivation required; Specialist initiation
THROMBOEMBOLIC DISEASE
ICD 10: G08 I26.0 I26.9 I67.6 I70.2 I70.00 I70.01 I70.10 I70.11 I70.20 I70.21 I70.80 I70.81 I74.0 I74.1 I74.4 I74.5 I74.8 I80.1 I80.2 I80.3 I80.8 I82.1 I82.2 I82.3 I82.8 K75.1
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Bayer aspirin Aspirin Accepted treatment
Dipyridamole 200mg SRC Persantin 200 retard Antithrombotic agents Accepted treatment
Dipyridamole and acetylsalicylic acid
200mg/25mg CAP Asasantin 200/25 retard Antithrombotic agents Accepted treatment
Dipyridamole 100mg TAB Plato Antithrombotic agents Motivation required
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
TRANSIENT ISCHAEMIC ATTACK
ICD 10: G45.0 G45.1 G45.2 G45.3 G45.4 G45.8 G45.9 I65.0 I65.1 I65.2 I65.3 I65.8 I65.9 I66.0 I66.1 I66.2 I66.3 I66.4 I66.8 I66.9
Acetylsalicylic acid 81mg ECT Ecotrin
Aspirin Accepted treatment
Acetylsalicylic acid 100mg TAB Disprin CV 100 disp TAB 100mg Bayer aspirin cardio Aspirin Accepted treatment
Acetylsalicylic acid 300mg DSP Disprin cv 300 disp Bayer aspirin Aspirin Accepted treatment
Dipyridamole 200mg src Persantin 200 retard Antithrombotic agents Accepted treatment
Dipyridamole and acetylsalicylic acid
200mg/25mg CAP Asasantin 200/25 retard Antithrombotic agents Accepted treatment
Dipyridamole 100mg TAB Plato Antithrombotic agents Motivation required
Warfarin 1mg TAB Cipla Warfarin Anticoagulants Accepted treatment
Warfarin 5mg TAB Cipla Warfarin Aspen Warfarin Anticoagulants Accepted treatment
Warfarin 3mg TAB Cipla-Warfarin Anticoagulants Accepted treatment
TUBERCULOSIS
ICD 10: A15.0-A15.9 A16.0 A16.1 A16.2 A16.3 A16.4 A16.5 A16.7 A16.8 A16.9 A17.8 A17.9 A18.0 A18.8 A18.9 A31.0 A98.0 A37.0 A19.0 A19.1 A19.2 A19.8 A19.9 U50.00 U50.01 U50.9 U50.90 U50.91 U50.10 U50.11 U50.20 U50.21 U50.30 U50.31 U50.40 U50.41 U50.50 U50.51 U50.60 U50.61 U84.3 U50.90 U50.91
Ethambutol 400mg TAB Sandoz ethambutol Antimycobacterial special investigations, Sputum Test
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ACTIVE INGREDIENT STRENGTH DOSAGE
FORM EXAMPLE 1 EXAMPLE 2 CLASS COMMENT
Ethionamide 250mg TAB Ethatyl Antimycobacterial Motivation required, Sputum Test
Isoniazid 100mg TAB Norstan Isoniazid Antimycobacterial special investigations, Sputum Test
Moxifloxacin 400mg TAB Numoxx DRL Moxifloxacin Quinolone antibacterial Motivation required, Sputum Test
Pyrazinamide 500mg TAB Pyrazide Sandoz pyrazinamide Antimycobacterial special investigations, Sputum Test
Pyridoxine (vit B6) 25mg TAB Be-tabs pyridoxine hcl Pyridoxine Vitamin supplement special investigations, Pathology report indicating deficiency
Pyridoxine (vit B6) 25mg TAB Pyridoxine Vitamin B6 Vitamin supplement special investigations, Pathology report indicating deficiency
Rifampicin 150mg CAP Rimactane Antimycobacterial special investigations, Sputum Test
Rifampicin 450mg TAB Rimactane Antimycobacterial special investigations, Sputum Test
Rifampicin 600mg TAB Rimactane Antimycobacterial special investigations, Sputum Test
Rifampicin & isoniazid 150/150mg TAB Rifinah Antimycobacterial special investigations, Sputum Test
Rifampicin & isoniazid 300mg/150mg TAB Rifinah Antimycobacterial special investigations, Sputum Test
Rifampicin & isoniazid 60/30mg TAB Rimactazid paed Antimycobacterial special investigations, Sputum Test
Rifampicin & isoniazid 60/60mg TAB Rimactazid paed Antimycobacterial special investigations, Sputum Test
Rifampicin, isoniazid, pyrazinamide & ethambutol
150/75/400/275mg TAB Rifafour E-275 Antimycobacterial special investigations, Sputum Test
VALVULAR HEART DISEASE
ICD 10: I05.0 I05.1 I05.2 I05.8 I05.9 I09.0 I09.1 I09.2 I09.8 I09.9 I34.0 I34.2 I34.8 I34.9 I35.0 I35.1 I35.1 I35.2 I35.8 I35.9
Note: medicines under "heart failure" will also be reimbursed under this condition.
Benzylpenicillin INJ Bio-Pen 5 M U Antibiotics Accepted treatment
Erythromycin 250mg TAB/CAP Racemin Adco-erythromycin Antibiotics, oral Accepted treatment
Phenoxymethylpenicillin 125mg/5mg SUSP Athlone phoxymethyl peniillin Motivation required
Phenoxymethylpenicillin 250mg/mg SUSP Athlone phoxymethyl peniillin Motivation required