GOVERNMENT OF SOUTHERN SUDAN MINISTRY OF HEALTH …apps.who.int/medicinedocs/documents/s19450en/s19450en.pdf · GOVERNMENT OF SOUTHERN SUDAN MINISTRY OF HEALTH ... numerous contributors

GOVERNMENT OF SOUTHERN SUDANMINISTRY OF HEALTH

Southern SudanEssential Medicine List

2007

Essential Medicines List

CONTENTS

Foreword i

Acknowledgements ii

List of contributors iii

Introduction 1

Criteria for selection of Essential Medicines 3

Explanatory notes 4

Abbreviations 4

Revision Request Form 5

Specifications and Content.. 6

Essential Medicines List 10

Index 24

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FOREWORD

In the Government of Southern Sudan (GOSS) Health Policy, thePrimary Health Care programme is the cornerstone of the delivery ofquality health care to all our people. Medicines are an important aspectin ensuring the delivery of quality health care.

This first list for essential medicines is designed to cover the differentpatterns of diseases countrywide and all the different levels of healthcare. The list will provide a living and working tool to the Ministry ofHealth to ensure efficient and comprehensive supply of medicinesto the people of Southern Sudan.

The Essential Medicines List will complement the treatmentguidelines and other health related documents to standardize medicalcare.

The Ministry of health continues to develop and raise the awarenessand training levels of our health care personnel at all levels. This Listprovides a vital link in that process and it is our hope that our serviceproviders will use it as such for the improvement of service deliveryat all our health facilities.

This List and other guidelines developed by the Ministry will continueto be updated over time to meet any evidence basedrecommendations arising from scientific research, moderndevelopments, innovations, lessons learned or best practices thatwill be suitable to our context and deemed necessary to improve our(Primary) Health Care services.

Dr. Joseph Manytuil WejangMinister of HealthGovernment of Southern Sudan

[i]

ACKNOWLEDGEMENTS

Following the conclusion of the comprehensive peace agreementbetween the government of the Sudan and the Sudan People'sLiberation Movement/Army (SPLM/A) in Kenya on the 9th January,2005, and the subsequent endinq of the war in Southern Sudan, theMinistry of Health, Government of Southern Sudan has a greatchallenge to ensure equitable, sector wide, accelerated and expandedqualitv health care fdr all people in Southern Sudan, with a specialfocus and emphasis on women and children.

Thus the development of the Essential Medicines List is one of theefforts towards this mission, especially at this post-conflict periodwhen there is high demand for knowledge on essential medicinesneeded for the different levels of health facilities in Southern Sudan.This document will also meet the demand to ensure appropriate healthmanagement using recommended essential medicines.

The Ministry of Health, Government of Southern Sudan would like tothank all the UN Agencies, international and national Non-Governmental Organisations in Southern Sudan, as well as thetechnical health personnel from various institutions who playedimportant roles in the development and finalization of the SouthernSudan Essential Medicine List. The Ministry gratefully acknowledgesthe technical guidance and constructive comments provided by thenumerous contributors whose names are listed in this document.Profound gratitude and thanks are also addressed to the agenciesthat supported the Ministry financially to develop and process thisim ortant document.

D . Majok Yak MajokUnder SecretaryMinistry of HealthGovernment of Southern Sudan

[ii]

LIST OF CONTRIBUTORS

Name Institution/Affiliation

Agoth Manyang MOH, GOSSArkangelo Mona MerlinAsare Joseph PsychiatristAtem Nathan Riak................................ MOHBannenberg Wilbert ECTBesrat Hagos WHOBoo Tom · CDCBuddingh Carla MOH/GOSSBuddingh Henk CEASBurslem Fiona . GynaecologistBuwa Dragudi UNFPACollins Andrew . Malaria ConsortiumCometto Giorgio .. WHOCongdon Robert Kijabe HospitalDe Jong Joop University of AmsterdamDeyment Wendy MedairFeleke Teshome Concern WorldwideFranco Jose Ramon MalteserGraaf Peter WHOHaarsager Mary CEASHopkins Adrian .. CBMHughes Skye.. MalteserIsika Aham UNFPAJabe Victoria.... MOHJespersen Janice World ReliefJeylani Mahmoud WHOKeus Kees MSF

[iii]

Lomoro Olivia MOHMonywiir Arop MOHMorch Edith UNICEFMuita Mugo .. CDCMwanika Andrew .. DentistNdzi Jonathan UNFPANeitzert Barbara PSFOchol Duncan WHOOkoro Jones UNICEFOmer Nadia PSFOnsarigo Alice Carter FoundationOuma Cyprian TearfundPartick Abok WHOPatel Vaishalee PharmacistPenny Shareen .. TearfundRichard Igu Keri... MOHRicher Michaleen . WHORuiz Jose Antonio WHORumunu John... MOHSamson P Baba . MOHSeaman Jill .. WHOSharland Roger.. REAPSindani Sebit .. WHOSnider Glena Carter FoundationStanfield Paget Medical EditorSubeck Pius .. MOHThabo Othwonth MOHTornbe Martin Advisor/EDLlZToure Brigitte . UNICEFVentevogel Peter Healthnet TPO

[iv]

INTRODUCTION

The Ministry of Health of Southern Sudan is making every effort tostreamline the pharmaceutical and medical management systemsby formulating policies and policy documents in all relevant fieldsapplicable.

The Ministry is proud to present the first edition of the EssentialMedicines List (EML) for Southern Sudan. The EML has beendeveloped on the basis of the WHO Model List (14th Edition) withfocus on all levels of health care facilities and also to provide anadequate, efficient and comprehensive medicine supply to thepopulation of Southern Sudan.

The purpose of developing the EML is to enhance centralization ofthe activities in the pharmaceutical sector as well as to enable rationalprocurement, supply and usage of medicines in Southern Sudan. Theimplementation of the EML will ensure standardization of medicineusage countrywide taking into consideration the aspects of quality,safety and efficacy of medicines supplied.

The following criteria were considered while developing the EML:

o Common Therapeutic Categories - Catering for the most commondisease states prevailing in the Southern Sudan context.

o Pharmaceutical Specifications - This applies the concept ofEssential medicines as defined by WHO whereby the medicinesare listed according to their international nomenclature (INN) ormore commonly known as generic names. The EML covers themost common dosage forms and formulations.

o Other conditions - Packaging and storage of pharmaceuticals forma critical part of medicines management, therefore cold storagerequirements and dosage forms have been indicated to allow forefficient ordering and logistics management.

1

It is the intent of the Ministry of Health to implement the EML amongother policies and guidelines for high quality medicines managementand rationalization of medicines use in the public sector.

The EML will also serve as a reference document for purposes oflegislation, staff development and management improvement toensure regular safe supply of effective medicines at affordable pricesand of acceptable quality to all sectors of health care.

Therefore all health workers, including physicians, clinical officers,nurses, pharmacists, midwives and dentists, are encouraged tofamiliarize themselves with the national policies and to utilize theEML to optimize the quality of health care provided to the people ofSouthern Sudan.

2

CRITERIA FOR SELECTION OF ESSENTIAL MEDICINES

An advisory committee of various medical and pharmaceuticalbackgrounds contributed to define and establish the EML. Thefollowing criteria were used as the fundamental basis forconsideration and implementation during the selection of medicinesfor the Essential Medicines List (EML) of Southern Sudan:

a) Essential Medicines are those that satisfy the needs of themajority of the population.

b) There should be adequate data supporting their efficacy andsafety.

c) The medicines are essential if they are used routinely and basedon their performance in routine practice.

d) The committee critically assessed whether the medicine shouldbe in the essential list. There were some items that did not satisfythe criteria for inclusion into the Essential Medicines List althoughthey may be needed in special circumstances. These items canbe incorporated into the list at a later stage when the PharmacyPolicy and Act and schedules of medicines have been defined bythe Ministry of Health.

e) It is the opinion of the team that all essential medicines shouldbe non-patented. The main reason for this is that patented brandproducts are often enormously expensive and yet have no addedadvantage over the generic drugs. However where a generic doesnot exist. the branded product will be acceptable.

The Essential Medicines List for Southern Sudan is a result derivedfrom these criteria. The objective is to create awareness of the needfor rational medicine use and it can be utilised by all levels of healthcare in Southern Sudan. Hence the list indicates the medicines thatshould be available at the various levels of health care facilities.

3

Levels of health care facilities

EXPLANATORY NOTES

PHCU Primary Health Care Unit

PHCC Primary Health Care Centre

HospitalsD County HospitalD State Hospital

HOSP

REF Referral Hospitals providing specialised tertiary health care

ABBREVIATIONS

1. « * )} Represents cold chain (items should be stored attemperatures between 2 - 8°C){ {**} } Availability of this item is dependent on the availability of aproper working cold chain.

2. Pharmaceutical Abbreviations:

InjPessSuppTabsBlister/CombiSusp.Caps.Chew ..Solu.FDCMDT

InjectionPessarySuppositoryTabletsBlister packs of combined drugsSuspensionCapsulesChewableSolutionFixed Dose CombinationsMulti Drug Therapy

4

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ESSENTIAL MEDICINES LIST REVISION REQUEST FORM

Facility requesting the change:

PHCU D PHCC D HOSP D REF D

TYPE OF REQUEST:

ADDITION D DELETION D CHANGE D

Generic Name:

Dosage Form & Strength:

Best Known Brand Names & Manufacturers:

1)

2)

For ADDITIONS, what similar acting medicines are now on EssentialMedicines List?

1)

2)

State reasons for addition, deletion or change of item in the EML. ForADDITIONS, please explain advantage of proposed medicine/s over similar-acting medicines listed above.

5

SPECIFICATIONS and CONTENTS

The EML is classified into therapeutic categories as defined by the World HealthOrganization (WHO).

1. Anaesthetics1.1. General Anaesthetics and Oxygen1.2. Local Anaesthetics1.3. Preoperative medication and sedation for short term procedures

2. Analgesics. Antipyretics. Non-steroidal Anti-inflammatory Medicines(NSAIMs) and Medicines to Treat Gout2.1. Non-opioids and non-steroidal anti-inflammatory medicines (NSAIM's)2.2. Opioid analgesics2.3. Medicines to treat Gout

3. Anti-allergics and Medicines Used in Anaphylaxis

4. Antidotes and Other Substances Used in Poisonings4.1. Non-specific4.2. Specific

5. Anti-convulsants / Anti-epileptics

6. Anti-infective Medicines6.1. Antihelminthics

6.1.1. Intestinal anthelminthics6.1.2. Antifilarials6.1.3. Antischistosomals and antitrematode medicines

6.2. Antibacterials6.2.1. Beta Lactam medicines6.2.2. Other anti bacteria Is6.2.3. Antileprosy medicines6.2.4. Antituberculosis medicines

6.3. Antifungal Medicines6.4. Antiviral Medicines

6.4.1. Antiherpes medicines6.4.2. Antiretrovirals

6.4.2.1. Nucleoside reverse transcriptase inhibitors6.4.2.2. Non-nucleoside reverse transcriptase inhibitors6.4.2.3. Protease inhibitors

6.4.3. Fixed Dose Combination Anti-retroviral medicines

6

I


6.5. Antiprotoloal Medicines6.5.1. Antiamoebic and antigiardiasis medicines6.5.2. Antileishmaniasis medicines6.5.3. Antimalarial medicines

6.5.3.1. For a curative treatment6.5.3.2. For Prophylaxis

6.5.4. Antitrypanosomal medicines6.5.4.1. African trypanosomiasis

7. Antimigraine Medicines

8. Antineoplastic and Immunosuppressive medicines8.1. Hormones and anti-hormones8.2. Immunosuppressive medicines8.3. Cytotoxic medicines

9. Antiparkinsonism Medicines

10. Medicines Affecting the Blood10.1. Antianaemia medicines10.2. Medicines affecting coagulation

11. Blood products and Plasma Substitutes11.1. Plasma substitutes11.2. Plasma fractions for specific use

12. Cardiovascular Medicines12.1. Antianginal medicines12.2. Antiarrhythmic medicines12.3. Anti-hypertensive medicines12.4. Medicines used in heart failure12.5. Diuretics12.6. Antithrombotic medicines

13. Dermatological Medicines (Topical)13.1. Antifungal medicines13.2. Anti-infective medicines13.3. Anti-inflammatory and anti-pruritic medicines13.4. Medicines affecting skin differentiation and proliferation13.5. Scabicides and pediculicides

7


14. Diagnostic Agents14.1. Ophthalmic medicines14.2. Radio-contrast media

15. Disinfectants and Antiseptics15.1. Antiseptics15.2. Disinfectants

16. Gastrointestinal Medicines16.1. Antacids and other anti-ulcer medicines16.2. Antiemetic medicines16.3. Laxatives16.4. Medicines used in diarrhoea

16.4.1. Oral Iilehydration16.4.2. Zinc Supplement16.4.2. Antidiarrhoeal (symptomatic) medicines in adults

17. Hormones. Other Endocrine medicines and Contraceptives17.1. Contraceptives

17.1.1. Oral hormonal contraceptives17.1.2. Injectable hormonal contraceptives17.1.3. Intrauterine devices17.1.4. Barrier.methods

17.2. Insulin and other antidiabetic agent17.3. Ovulation inducers17.4. Progestogens17.5. Thyroid hormones and anti-thyroid medicines

18. Immunologicals18.1. Diagnostic agents18.2. Sera and immunoglobulins18.3. Vaccines

18.3.1. For universal immunization18.3.2. For specific groups of individuals

19. Muscle Relaxants (Peripherally-acting) and cholinesterase inhibitors

20. Ophthalmological Preparations20.1. Anti-infective agents20.2. Anti-inflammatory agents20.3. Local anaethetics

8


20.4. Miotics and antiglaucoma medicines20.5. Mydriatics

21 .. Oxytocics and Antioxytocics21.1.0xytocics

22. Peritoneal Dialysis Solution

23. Psychotherapeutic Medicines23.1. Medicines used in psychotic disorders23.2. Medicines used in mood disorders

23.2.1. Medicines used in depressive disorders23.3. Medicines used in generalized anxiety and sleep disorders

24. Medicines Acting on the Respiratory Tract24.1. Antiashtmatic and medicines for chronic obstructive pulmonary

diseases24.2. Antitussive medicines for treatment of cough

25. Solutions correcting water, electrolyte and acid-based disturbances25.1. Parenteral25.2. Miscellaneous

26. Vitamins and minerals

9

ESSENTIAL MEDICINES LIST OF SOUTHERN SUDAN

DESCRIPTION OF DOSAGE PHCU PHCC HOSP REF

ITEM FORM

1. Anaesthetics1.1 General Anaesthetics and Oxygen

Halothane inhalation VolatileLiquid X XKetamine 50mg Injection X XOxygen inhalation (medical gas) Gas X XThiopental 0.5g Powder for Inj. X X

- 1.2. -Local Anaesthetics - - - - - - - -------- - -- - -- fooo-- - --

Bupivacaine 0.5% (hydrochloride) Injection X XLidocaine 1% (hydrochloride) Injection X X XLidocaine 2% + Adrenaline 1:200 000 Injection X X-------------------- ------- - -- - -- - - - --

1.3. Preoperative Medication andSedation for Short.:rerm ProceduresAtropine 1mg Injection X X XDiazepam 5mg/ml Injection X X XMorphine 10mg Injection X X

2. Analgesics, Antipyretics, Non-SteroidalAnti-Inflammatory Medicines (NSAIM's)and Medicines Used to Treat Gout-------------------- ------- - -- - -- --- - --2.1. Non-Opioids and Non-Steroidal

Anti-Inflammatory Medicines(NSAIM's)

Acetylsalicylic acid 500mg Tabs X X X XDiclofenac sodium 50mg Tabs X X XIbuprofen 200mg Tabs X X XParacetamol 125mg. (paediatric) Tabs X X X XParacetamol 120mg/5ml Syrup X X X XParacetamol 500mg. (adult) Tabs X X X X-------------------- ------- - -- - -- fooo-- - --

2.2. Opioid AnalgesicsCodeine 30mg Tabs X X XMorphine 10mg/5ml Oral Solution X XPethidine 50mg. Injection X XTramadol 50mg Caps X XTramadol 50mg/ml Injection X X

-------------------- ------- - -- - -- r--- - --2.3. Medicines to Treat Gout

Allopurinol 300mg Tabs X XColchicine 0.5mg Tabs X XProbenecid 500mg Tabs X XProbenecid 100mg/5ml Injection X X

10


DESCRIPTION OF DOSAGE PHCU PHCC HOSP REFITEM FORM

3. Antiallergics And Medicines Used inAnaphylaxisAdrenaline 1mg (Epinephrine) Injection X X XChlorpheniramine 4mg Tabs X X XDexamethasone 4mg Injection X XHydrocortisone 100mg, (Sodium Succinate) Powder for Inj. X X XPrednisolone 5mg Tabs X X X

4. Antidotes And Other Substances UsedIn Poisonings

4.1. Non-specificCharcoal, activated, 125mg Tabs X X-------------------- ------- - -- - -- f--- - --

4.2. SpecificAtropine 1mg Injection X XCalcium Gluconate 100mg/ml Injection X XNaloxone hydrochloride 400 mcg/ml Injection X X

5. Anticonvulsants / Anti-epilepticsCarbamazepine 200mg Tabs X XMagnesium Sulphate 500mg/ml Injection X XPhenobarbital 30mg Tabs X X XPhenytoin 100mg Tabs X XValproic acid 200mg Tabs X X

6. Anti-infective Medicines-------------------- ------- - -- - -- f--- - --6.1. Anti-helminthics-------------------- ------- - -- - -- f--- - --

6.1.1. Intestinal Anti-helminthicsAlbendazole 400mg Oral Suspension X X XAlbendazole 400mg Chewable Tabs X X XMebendazole 500mg Chewable Tabs X X X XPraziquantel 600mg Tabs X X X-------------------- ------- - -- - -- - - - --

6.1 .2. Anti-filarialsDiethylcarbamazine 50mg Tabs X XIvermectin 3mg Tabs X X XAlbendazole 400mg Tabs.Chew. X X X X-------------------- ------- - -- - -- - - - --

6.1.3. Antischistosomals andAntitrematode MedicinesPraziquantel 600mg Tabs X X X-------------------- ------- - -- - -- f--- - --

11


DESCRIPTION OF DOSAGE PHCU PH CC HOSF REFITEM FORM

6.2. Antibacterials-------------------- ------- - -- - -- - - - --6.2.1. Beta Lactam MedicinesAmoxicillin 125mg/5ml Powder X X X X

for Susp.Amoxicillin 250mg ScoredTabs X X X XAmoxicillin 500mg Tabs X XAmoxicillin 500mg +Clavulanic acid 125mg Tabs X XAmpicillin 1gm Powder for ln], X X XBenzathine Penicillin 2.4 MIU Powder for lnj, X X XBenzyl Penicillin 1MIU Powder for ln]. X X XCeftriaxone 500mg, injection powder Powder for lnj, X X XCloxacillin 250mg Caps X X XCloxacillin 500mg Powder for ln], X XProcaine Benzyl Penicillin (1MIU) Powder for ln], X X X-------------------- ------- - -- - -- - -- - --6,2.2. Other Antibacterials

Azithromycin 250mg Caps X X X XCefixime 400mg Tabs X X XChloramphenicol 1Gm,(Sodium Succinate) Powder for In], X X XChloramphenicol 250mg Caps X X XChloramphenicol 150 mg/5ml(Palmitate) Oral Susp. X X XCiprofloxacin 250mg Scored Tabs, X X X XDoxycycline 100mg Caps X X XErythromycin 250mg Tabs X X XGentamycin 40mg/ml Injection X X XMetronidazole 100mg/5ml Oral Susp. X X X XMetronidazole 200mg Scored Tabs, X X X XMetronidazole 500mg in 100ml Injection X X XNalidixic acid 500mg Tabs X XSulphamethoxazole 100mg+ Trimethoprim 20mg(paediatric) Tabs X X X XSulphamethoxazole 200mg+ Trimethoprim 40mg /5ml suspension Oral Susp, X X X XSulphamethoxazole 400mg+ Trimethoprim 80mg Tabs X X X X

-------------------- ------- - -- - -- - - - --

12

•


DESCRIPTION OF DOSAGE PHCU PHCC HOSF REFITEM FORM

6.2.3. Antileprosy MedicinesMedicines used in the treatment of leprosy should never be used except incombination. Colour coded MDT blister packs containing standard two orthree medicines are supplied by WHO free of charge

Dapsone 25mgDapsone 50mgDapsone 100mgClofazirnine 50mgClofazimine 100mgRifampicin 150mgRifampicin 300mg

6.2.4. Antituberculosis MedicinesEthambutol 100mgEthambutol 400mgIsoniazid 100mgIsoniazid 300mgPyrazinamide 400mgRifampicin 150mgRifampicin 150mg + Isoniazid75mg (2FDC)Rifampicin 150mg + Isoniazid150mg + Pyrazinamide500mg (3FDC)Rifampicin 150mg + Isoniazid75mg + Pyrazinamide400mg(3FDC)Rifampicin 150mg + Isoniazid75mg + Pyrazinamide 400mg.Ethambutol 275mg (4FDC)Streptomycin 1gm

- - - -6.3.- Anti=-fu-ngaIMedicines - - -Clotrimazole 500rhgGriseofulvin 125mgGriseofulvin 500mgNystatin 100000 IU/mlNystatin 100 000 IU

TabsTabs.Tabs.Caps.Caps.TabsTabs

TabsTabs.TabsTabsTabsCaps

Tabs

Tabs

Tabs

Pess XTabsTabsOral Susp.Tabs

TabsPowder for Inj.

6.4. Anti-viral Medicines6.4.1. Anti-herpes MedicinesAcyclovir 200mg Tabs

X

XXXXXXX

X

XXXX

X

X

X

XX

X

XXXXX

XXXXXXX

XXXXXXX

X X

XXXX

XXXX

X X

X X

XX

XX

XXXXX

XXXXX

X

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6.4.2. Anti-retroviral Medicines (ARVs)The National HIV policy recommends a combination of three or four drugssimultaneously. In general the ARVs have numerous adverse effects and patientsreceiving these drugs require careful monitoring by adequately trained healthprofessionals.There is a minimum requirement for anti-retrovirals to be availablefor patient use in a health care facility. The following basic infrastructure must bein place: A fully functional laboratory with trained personnel, a VCT centre withpre and post testing counselling facilities and sufficient medical means to handlethe administration of ARV's and adverse reactions in patients on ARV therapy.-------------------- ----------6.4.2.1 . Nucleoside Reverse

Transcriptase InhibitorAbacavir (ABC) 300mg TabsAbacavir (ABC).100mg/5mlDidanosine (ddl) 25mgDidanosine (ddl)100mgLamivudine (3TC)50mg/5mlLamivudine (3TC)150mgStavudine (d4T) 30mgStavudine (d4T) 40mgStavudin (d4T) 5mg/5mllidovudine (lDV orAZT) 100mglidovudine(ZDV or AZT) 300mgZidovudin(ZDV or AZT). 250mglidovudine(ZDV or AZT) 50 mg/5ml Oral Susp.

/ Syrup

6.4.2.2. Non-NucleosideReverse TranscriptaseInhibitorsEfavirenz (EFV orEFZ) 50mgEfavirenz (EFV or EFl)200mgEfavirenz (EFV or EFl)150mg/5mlNevirapine 200mg(NVP) .Nevirapine 50mg/5ml

Oral Solu.Chewable TabsChewable Tabs

Oral Solu.

TabsCapsCapsOral sol.

Tabs

Tabs

Caps

Tabs/Caps

Tabs/Caps

Oral Sol.*

TabsOral Susp.

xxXX

xxXXX

X

X

X

X

X

X

X

XX

X

XXX

X

XXXX

X

X

X

X

X

X

X

XX

14

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6.4.2.3. Protease InhibitorsIndinavir (I0V) 400mg Tabs* X XRitonavir 100mg Tabs* X XLopinavir 133.3mg+ Ritonavir 33.3mg(LPV/r) Tabs* X XNelfinavir 250mg Tabs* X XNelfinavir 50mg/gm Powder for

Oral Susp.* X XSaquinavir 200mg Tabs* X XSaquinavir 200mg +Ritonavir 33.3mg Tabs* X X-------------------- ------- .•.. -- - -- t--- - --

6.4.3 Fixed Dose CombinationAnti-retroviral MedicinesStavudine + Lamivudine +Nevirapine 30mg + 150mg+ 200mg FOC Tabs X XStavudine +Lamivudine +Nevirapine 40mg + 150mg+ 200mg FOC Tabs X XStavudine + Lamivudine 30mg+ 150mg FOCTabs X XStavudine + Lamivudine 40 mg+150 mg FOC Tabs X X-------------------- ------- - -- - -- t--- - --

6.5. Antiprotozoal medicines-------------------- ------- - -- - -- - - - --6.5.1. Antiamoebic And

Anti-giardiasis MedicinesMetronidazole 200mg Tabs X X X XTinidazole 500mg Tabs X X X-------------------- ------- - -- - -- - - - --

6.5.2. Anti-leishmaniasis MedicinesSodium Stibogluconate100mg/ml Injection X XParomomycin 500mg/mlinjection Injection X XMiltefosine 10mg Caps. X XMiltefosine 50mg Caps. X X

- - - -6:5.3. Ant~malarial-Medicines - - - ------- - -- - -- 1--- - --- - - - - - -6.5.3. 1~ For Curative Treatment ------- - -- - -- t--- - --

Artesunate 50mg +Amodiaquine 153mgtablet Blister/Combi. X X X X

15



Artesunate 50mg Rectal Caps. XArtesunate 200mg Rectal Caps. XArtemether 20mg +Lumefantrine 120mg(Co-artem) Tabs X X XQuinine 300mg/ml Injection X X XQuinine 300mg Tabs X X X-------------------- ------- - -- - -- - -- - --

6.5.3.2. For IntermittentPresumptive TherapySulphadoxine +Pyrimethamine 500mg+ 25mg Tabs X X X X

-------------------- ------- -.- - - -- - - - --6.5.4. Anti-trypanosomal Medicines-------------------- ------- - -- - -- - - - --

6.5.4.1. AfricanTrypanosomiasisEflornithine 200mg Injection X XMelarsoprol 3.6% Injection X XPentamidine 300mg.(isetionate) Powder for Inj. X X X

7. Anti-Migraine MedicinesAcetylsalicylic acid 500mg Tabs X X X XParacetamol 500mg Tabs X X X XErgotamine Tartarate 1mg Tabs X X X

8. Antineoplastic andImmunosuppressive Medicines

8.1. Hormones And Anti-HormonesDexamethasone 4mg Injection X XHydrocortisone 100mg. Powder for Inj. X X XPrednisolone 5mg Tabs X X X

-------------------- ------- - -- - -- - -- - --8.2. Immunosuppressive Medicine

Azathioprine 50mg Tabs X XCiclosporin 25mg Caps X X-------------------- ------- - -- - -- - - - --

8.3. Cytotoxic MedicinesActinomycin-D 500mcg Injection X XBusulphan 2mg Tabs X XCyclophosphamide 200mg Powder for Inj. X XCyclophosphamide 500mg Powder for Inj. X XCyclophosphamide 50mg Tabs X XCytosine Arabinoside(Cytarabine HCI) 100mg Powder for Inj. X XDoxorubicin Hydrochloride 50mg Powder for Inj. X X

16

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Fluorouracil 250mg Injection X XFolinic acid 15mg Tabs X XMethotrexate 50mg Injection X XVincristine Sulphate 1mg Injection X X

9. Anti-Parkinsonism MedicinesBiperiden 2mg Tabs X X

10. Medicines Affecting the Blood

10.1. Anti-Anaemia MedicinesFerrous Sulphate 200mg +Folic acid 0.25mg Tabs X X X XFolic acid 5mg Tabs X X X-------------------- ------- - -- - -- r-- - --10.2. Medicines Affecting CoagulationHeparin sodium 5000 IU/ml Injection X XPhytomenadione 10 mg/ml (Vit. K) Injection X XWarfarin 2mg Tabs XWarfarin 5mg Tabs X

11. Blood products and Plasma Substitutes-------------------- ------- - -- - -- - - - --11.1. Plasma SubstitutesDextran 70 (6%) Parenteral X X

Solution-------------------- ------- - -- - -- 1"""-- - --11.2. Plasma Fractions For Specific UseFactor IX complex (coagulationfactors 11. VII. IX. X) concentrate Powder for Inj. X-------------------- ------- - -- - -- - - - --12. Cardiovascular Medicines

12.1. Anti-Anginal MedicinesGlycerin Trinitrate 500mcg. Sublingual Tabs X X X-------------------- ------- - -- - -- r-- - --12.2. Anti-Arrhythmic MedicinesAtenolol 50mg Tabs X XDigoxin 62.5mcg Tabs X XLidocaine 20mg/ml(Hydrochloride) Injection X XProcainamide 100mg/ml(Hydrochloride) Injection X XVerapamil 2.5mg/ml(Hydrochloride) Injection X XVerapamil 40mg Tabs. X X-------------------- ------- - -- - -- - - - --

12.3. Anti-Hypertensive MedicinesAtenolol 50mg Tabs X XCaptopril 12.5mg Tabs X XHydralazine 25mg Tabs X XHydralazine 20mg Injection X XHydrochlorthiazide 25mg Tabs X X

17

ESSENTIAL MEDICINES LIST OF SOUTHERN SUDAN, ,

DESCRIPTION OF DOSAGE PHCU PHCC HOSF REF

ITEM FORM

Nifedipine 10mg Cap X X

Nifedipine 20mg Tabs X X-------------------- ------- - -- - -- 1--- - --12.4. Medicines Used In Heart Failure

Digoxin 62.5mcg Tabs X XFurosemide 40mg Tabs X X XFurosemide 10mg/ml Injection X X X

-------------------- ------- - -- - -- 1--- - --12.5. Diuretics

Amiloride 5mg(Hydrochloride) Tabs. X X

Furosemide 40mg Tabs X X XFurosemide 10mg/ml Injection X X XHydrochlothiazide 25mg Scored Tabs. X X

Mannitol 10% Injection X XPotassium Chloride, 600mg Tabs X XSpironolactone, 25mg Tabs X X-------------------- ------- - -- - -- - - - --

12.6. Anti-Thrombotic MedicinesAcetylsalicylic acid 100mg Tabs X X

13. Dermatological Medicines (Topical)

13.1. Antifungal MedicinesBenzoic acid 6% +Salicylic acid 3% (Whitfield's) Ointment X X X X

Clotrimazole 1% Cream X X X-------------------- ------- - -- - -- - - - --13.2. Anti-Infective Medicines

Potassium Permanganate 1:10,000 Solution X X X XSilver Sulphadiazine 1% Cream X X X X-------------------- ------- - -- - -- 1--- - --

13.3. Anti-Inflammatory And Anti-pruriticMedicinesBetamethasone 0.1 % Ointment XCalamine lotion Lotion X X X XHydrocortisone 1% Ointment X X X

Salicylic acid 2% Ointment X XZinc oxide, 15% Ointment X X X-------------------- ------- - -- - -- 1--- - --

13.4. Medicines Affecting SkinDifferentiation and ProliferationCoal tar 5% + Salicylic acid 2% Solution X XPodophyllin resin paint, 15% Solution X X-------------------- ------- - -- - -- 1--- - --

13.5. Scabicides And PediculicidesBenzyl Benzoate Lotion 25% Lotion X X X X

14. Diagnostic Agents

14.1. Ophthalmic Medicines

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Fluorescein 1% eye drops (sodium salt) Drops X X_____ Tr:?~c~~~ ~.~o/~e'y~d..':oEs___ Drops X X------- - -- - -- - -- - --

14.2. Radiocontrast MediaBarium sulphate Aqueous Susp. X

15. Disinfectants and Antiseptics

15.1. AntisepticsChlorhexidine 0.3% + Cetrimide3% Solution X X X XChlorhexidine 15% + Cetrimide 1.50/. Solution X X XGentian violet crystals. 25gms Powder X X X XPolyvidone iodine 10% Solution X X X X-------------------- ------- - -- - -- - - - --

15.2. DisinfectantsSodium Dichloroisocyanurate2.5gm (NADCC) Tabs X X

16. Gastrointestinal Medicines

16.1. Antacids And Other Anti-UlcerMedicinesAluminium Hydroxide 500mg Tabs X X X XRanitidine 150mg Tabs X X-------------------- ------- - -- - -- f--- - --

16.2. Anti-emetic MedicinesPromethazine 25mg Tabs X X XPromethazine 25mg/ml Injection X X X-------------------- ------- - -- - -- f--- - --

16.3. LaxativesSenna Tabs X X-------------------- ------- - -- - -- - - - --

16.4. Medicines Used in Diarrhoea-------------------- ------- - -- - -- - - - --16.4.1 . Oral Re-hydration

Oral re-hydration salts(glucose 13.5g/l: Sodiumchloride 2.6g/1: - Potassiumchloride 1.5g/l: - Trisodiumcitrate dihydrate 2.9g/l) Powder for

Oral Solution X X X X-------------------- ------- - -- - -- 1---- - --16.4.2. Zinc Supplement

Zinc Sulphate 20mg Tabs X X X X-------------------- ------- - -- - -- f--- - --16.4.3. Anti-Diarrhoeal

(Symptomatic) Medicinesin AdultsCodeine 30mg Tabs X XLoperamide 2mg Tabs X X

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17. Hormones, Other Endocrine Medicinesand Contraceptives

17.1. Contraceptives-------------------- ------- - -- - -- f--- - --17.1.1. Oral Hormonal

ContraceptivesEthinylestradiol +Levonorgestrel, 30micrograms + 150micrograms Tabs X X XEthinylestradiol +Norethisterone, 35micrograms + 1.0mg Tabs X X XLevonorgestrel 750mg Tabs X X X-------------------- ------- - -- - -- - - - --

17.2.2. Injectable HormonalContraceptivesMedroxyprogesteroneacetate, depot injection,150mg/ml Depot Injection X X X-------------------- ------- - -- - -- f--- - --

17.2.3. Intrauterine DevicesCopper containing device Device X X-------------------- ------- - -- - -- f--- - --

17.2.4. Barrier MethodsMale Condoms X X X XFemale Condoms X X X X-------------------- ------- - -- - -- - -- - --

17.3. Insulin and OtherAnti-Diabetic AgentsGlibenclamide 2.5mg Tabs X XInsulin injection (soluble)1001U/ml Inj.* X XIntermediate - actinginsulin 1001U/ml Inj.* X XLong acting insulin1001U/ml Inj.*Metformin 500mg Tabs X X-------------------- ------- - -- - -- - - - --

17.4. Ovulation InducersClomiphene 50mg Tabs X-------------------- ------- - -- - -- --- - --

17.5. ProgestogensNorethisterone 5mg Tabs X-------------------- ------- - -- - -- f--- - --

17.6. Thyroid Hormones andAnti-Thyroid MedicinesLevothyroxine 50mcg Tabs X

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DESCRIPTION OF DOSAGE PHCU PHCC HOSF REFITEM FORM

18. Immunologicals

18.1. Diagnostic AgentsTuberculin, purified proteinderivative (PPD) Inj.* X X-------------------- ------- - -- - -- - - - --

18.2. Sera And Immunoglobulins-------------------- ------- - -- - -- - - - --Anti-D immunoglobulin(human) 250mcg Inj.* X XAntitetanus immunoglobulin(human) 500lU Inj.* X XAntivenom Serum (Polyvalent) Inj.* X XRabies immunoglobulin 1501U/ml Inj.* X-------------------- ------- - -- - -- - - - --

18.3. Vaccines-------------------- ------- - -- - -- - - - --18.3.1. For Universal Immunization

BCG Vaccine Inj.* X X XDPTVaccine Inj.* X X XHepatitis B Vaccine Inj.* X X XMeasles Vaccine Inj.* X X XPolio Vaccine Oral Drops* X X XTetanus Toxoid Inj.* X X X-------------------- ------- - -- - -- - - - --

18.3.2. For Specific Groupsof Individuals-------------------- ------- - -- - -- '--- - --Meningococcal meningitisVaccine Inj.* X XRabies Vaccine Inj.* X XYellow fever Vaccine Inj.* X X

19. Muscle Relaxants (Peripherally-Acting)and Cholinesterase Inhibitors-------------------- ------- - -- - -- f...-- - --Suxamethonium 50mg (Chloride) in 2ml Injection X

20. Opthalmological Preparations

20.1. Anti-infective AgentsGentamycin 0.3% (sulphate) Eye Drops X XTetracycline 1% Ointment X X X X-------------------- ------- - -- - -- - -- - --

20.2. Anti-inflammatory AgentsPrednisolone 0.5% Eye Drops X XSodium Cromoglycate Eye Drops X X-------------------- ------- - -- - -- ,--- - --

20.3. Local AnaestheticsTetracaine (Amethocaine) 0.5%(Hydrochloride) Eye Drops X X

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20.4. Miotics and Anti-GlaucomaMedicinesAcetazolamide 250mg Tabs X XPilocarpine 2% Eye Drops X X-------------------- ------- - -- - -- - - - --

20.5. MydriaticsAtropine 0.1 % Eye Drops X X-------------------- ------- - -- - -- - - - --

21. Oxytocics and Antioxytocics

21.1. OxytocicsOxytocin 10 IU Inj,* X X XErgometrine 200mcg Injection X X X

22. Peritoneal Dialysis Solutionlntraperitoneal dialysis solution(of Appropriate Composition) Parenteral.,' Solution X

23. Psychotherapeutic Medicines

23.1. Medicines Used in PsychoticDisordersChlorpromazine 100mg Tabs X XChlorpromazine 25mg (hydrochloride) Injection X XHaloperidol 2mg Tabs XHaloperidol 5mg in 1ml Injection X--------------------- ------- - -- - -- 1--- - --

23.2. Medicines Used in Mood Disorders-------------------- ------- - -- - -- 1--- - --23.2.1. Medicines Used in

Depressive DisordersAmitryptiline 25mg Tabs X X-------------------- ------- - -- - -- - -- - --

23.3. Medicines Used in GeneralizedAnxiety and Sleep DisordersDiazepam 2mg Tabs X X XDiazepam 5mg Tabs X X X

24. Medicines Acting on the Respiratory Tract

24.1. Anti-Asthmatic and Medicines forChronic Obstructive PulmonaryDiseases-------------------- ------- - -- - -- - - - --Aminophylline 25mg/ml IV Injection X X XBeclomethasone, 50mcg per dose(Diproprionate) Inhalation X XPrednisolone 5mg Tabs X X X

, Salbutamol 100mcg per dose Inhalation X X XSalbutamol 4mg, Tablet Tabs X X X

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ESSENTIAL MEDICINES LIST OF SOUTHERN SUDAN,

DESCRIPTION OF DOSAGE PHCU PHCC HOSP REF

ITEM FORM

24.2. Medicines Used for Treatment ofCoughDiphenhydramine 14mg!5ml Elixir X X X XGuiaphenesin 50mg/5ml Syrup X X X XDextromethorphan 10mg/5ml Syrup X X X XDiphenhydramine 14mg!5ml +Codeine Phosphate 15mg!5ml Syrup X X X X

25. Solutions Correcting Water ••Electrolyte and Acid-Based Disturbances

25.1. OralOral Rehydration Salts See Section

16.4.1-------------------- ------- - -- - -- - - - --25.2. Parenteral

Dextrose 10%, 500ml ParenteralSolution X X

Dextrose 5%, 500ml ParenteralSolution X X X

Dextrose 50% solution, hypertonic,50ml vial Injection X X XPotassium Chloride 11.2% solution,in 20ml Injection XSodium Chloride 0.9%, 500ml Parenteral

Solution X X XSodium lactate compound solution(Ringer Lactate), 1 litre Parenteral

Solution X X X-------------------- ------- 1---- - -- - - - --

25.2. MiscellaneousWater for Injection, 10ml Injection X X X

26. Vitamins and Minerals

Ascorbic acid 50mg Tabs X X X

Multivitamin Tabs X X X

Nicotinamide 50mg Tabs X X XRetinol 200 000 IU, (Vitamin A) Capsule X X X XPyridoxine 25mg Tabs X X X

Thiamine 50mg Tabs X X X

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Abacavir (ABC) 14Albendazole 11Acetazolamide 22Acetylsalicylic Acid 10.16.18Actinomycin - 0 16Acyclovir 13Adrenaline 10.11Allopurinol 10Aluminium Hydroxide 19Amiloride Hydrochrolide 18Aminophylline ; 22Amitryptiline 22Amodiaquine 15Amoxicillin 12Ampicillin , 12Anti - 0 Human Immunoglobulin1 21Antitetanus Immunoglobulin 21Antivenom Serum Polyvalent 21Artemether 16Artesunate 15.16Ascorbic Acid 23Atenolol 17Atropine 10.11.22Azathioprine 16Azithromycin 12

Barium Sulphate 19BCG Vaccin 21Beclomethasone 22Betamethazone 18Benzathine Penicillin 12Benzoic Acid 18Benzy Penicillin 12Benzyl Benzoate 18Biperiden 17Bupivacaine 10Busulphan 16

Calamine Lotion 18Calcium Gluconate 11

IIDEI

Captopril 17Carbamazepine 11Cefixime 12Ceftriaxone 12Cetrimide 19Charcoal Activated 11

Chloramphenicol 12Chlorhexidine 16Chlorpheniramine 11Chlorpromazine ; 22Ciclosprin 16Ciprofloxacin 12Clavulanic Acid 12Clofazimine 13Clomiphene 20Clotrimazole 13.18Cloxacillin 12Coal Tar 18Codeine Phosphate 10.19.23Colchicine 10Condom 20Copper - containing Device 20Cyclophosphamide 16Cystosine Arabinoside 16

Dapsone 13Dexamethasone 11.16Dextran 17Dextromethorphan 23Dextrose (Glucose) 23Diazepam 10.22Didanosine 14Diclofenac Sodium 10Diethycarbamazine 11Digoxin 17.18Diphenhydramine 23Doxorubicin 16Doxycycline Hydrochloride 12OPT Vaccine 21

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Efavirenz (EFV or EFZ) 14Eflornithine 16Ergometrine Maleate 22Ergotamine Tartrate 16Erythromycin 12Ethambutol 13Ethinylestradiol 20

Factor IX complex 17Ferrous Sulphate +Folic Acid 17Fluorouracil 17Fluorescein 19Folic Acid 17Folinic Acid 17Furosemide 18

Gentamycin 12,21Gentian Violet 19Glibenclamide 20Glyserin trinitrate 17Griseofulvin 13Guiaphenesin 23

Haloperidol 22Halothane 10Heparin sodium 17Hepatitis B vaccine 21Hydralazine 17Hydrochlorothiazide 17,18Hydrocortisone 11,16,18

Ibuprofen 10Indinavir(IDV) 15Insulin 20Intraperitoneal dialysis solution 22Ivermectin 11Isoniazid 13

Ketamine 10Lamivudine(3TC) 14,15

IIDEX

Levonorgestrel 20Levothyroxine 20Lidocaine 10,17Loperamide 19Lopinavir 15Lumefantrine 16

Magnesium Sulphate 11Mannitol 18Measles Vaccine 21Mebendazole 11Medroxyprogesterone 20Melarsoprol 16Meningococcal meningitis Vaccine ..21Metformin 20Methotrexate 17Metronidazole 12,15Miltefosin 15Morphine 10Multivitamin 23

Nalidixic Acid 12Naloxone hydrochloride 11Nelfinavir 15Nevirapine(NVP) 14,15Nicotinamide 23Nifedipine 18Norethisterone 20Nystatin 13

Oral Rehydration salts 19,23Oxygen 10Oxytocin 22Paracetamol 10,16Paromomycin 15Pentamidine 15,16Peritoneal Dialysis Solution 22Pethidine 10Phenobarbital 11Phenytoin sodium 11

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Phytomenadione (Vitamin K) 17Pilocarpine 22Podophyllin resin 18Polio Vaccine 21Potassium Chloride 18.23Potassium permanganate 18Povidone Iodine 19Praziquantel 11Prednisolone 11.16.21.22Probencid 10Procaine Penicillin 12Procainamide 17Promethazine 19Pyrazinamide 13Pyridoxine 23Pyrimethamine 16

Quinine 16

Rabies Immunoglobulin 21Rabies Vaccine 21Ranitidine 19Retinol 23Rifampicin 13Ritonavir (LPV/r) 15

Salbutamol 22Salicylic Acid 18Saquinavir 15Senna 19Silver Sulphadiazine 18Sodium Chloride 23Sodium Cromoglycate 21Sodium Oichloroisocyanurate 19Sodium Lactate Compound 23Sodium Stibogluconate 15Spironolactone 18Stavudine (d4T) 14.15Streptomycin 13

IIDEI

Sulphadoxine 16Sulphamethoxazole 12Suxamethonium 21

Tetanus Toxoid 21Tetracaine 21Tetracycline 21Thiamine 23Thiopental 10Tinidazole 15Tramadol 10Trimethoprim 12Tropicamide 19Tuberculin (PPO) 21

Valproic Acid 11Vincristine sulphate 17Verapamil 17

Wafarin 17Water for Injection 23

Yellow Fever Vaccine 21

Zidovudine (ZOV or AZT) 14Zinc Oxide 18Zinc Sulphate 19

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