Prime Cure Acute and Chronic Formulary 2023

PLEASE NOTE: Provider Trade Names are not listed on formulary, allowing for any generic substitution below or equal to Mediscor Reference Pricing (MRP).

Abbreviations for CDL (Chronic Disease List) conditions:

ADS – Addison’s Disease; AST – Asthma; BCE – Bronchiectasis; BMD – Bipolar Mood Disorder; CHF – Cardiac Heart Failure; CMY – Cardiomyopathy; COP – Chronic Obstructive Pulmonary Disease; CRD – Chronic Renal Disease; CSD – Crohn’s Disease; DBI – Diabetes Insipidus; DM1 – Diabetes Mellitus Type 1; DM2 – Diabetes Mellitus Type 2; DYS – Dysrhythmias; EPL – Epilepsy; GLC – Glaucoma; HAE – Haemophilia; HYL – Hyperlipidaemia; HYP – Hypertension; UC – Ulcerative Colitis; CAD (IHD) – Coronary Artery Disease (Ischaemic Heart Disease) ; MSS – Multiple Sclerosis; PAR – Parkinson’s disease; RHA – Rheumatoid Arthritis; SCZ – Schizophrenia; SLE – Systemic Lupus Erythematosus; TDH – Hypothyroidism

KEY TO QUANTITIES AND LIMITATIONS

1. “Therapeutic-ChroniLineTM” means the 1st months chronic medication (on formulary) can be obtained from the DSP (Designated Service Provider), there after registration with Mediscor ChroniLineTM is required.

2. “Therapeutic-ChroniLineTM Pre-Auth” means the medication is approved subject to registration with Mediscor ChroniLineTM.

3. “Consumables – Clinic use only” means the medication may only be administrated by a DSP at the rooms. Injectables are consumables. No scripting to patients to collect from DSP pharmacies.

4. “Therapeutic-ChroniLine 30 days/gastroscopy 90 days” means the medication is approved initially for 30 days with Mediscor ChroniLineTM and requires additional medical information for further approval.

5. “Max Rx/5 days every 120 days” means a script filled to a maximum of 5 days medication supply every 120 days can be claimed.

6. “HIV DMP” means Prime Cure’s HIV/AIDS Disease Management Programme.

7. All items marked as either Chronic or PMB, to be supplied by a Registered DSP Chronic Medication Supplier (DSP Pharmacy, approved GP or contracted Courier Pharmacy).

8. All items marked as Acute may be supplied by the General Practitioner (provided the GP is registered with Prime Cure as a dispensing provider), alternatively dispensed by a contracted DSP pharmacy (where GP is non-dispensing only)

9. Benefits for medicine are subject to Mediscor Reference Price (MRP). Should the cost of the item exceed the MRP, the patient will be liable for payment of the difference in cost. If this is the case, please inform the patient that the cost difference will be for his/her own personal account.

10. Medication formulary contact details: Tel: 0861 665 665 OR Email: pcauth@mediscor.co.za or chronicdep@primecure.co.za

Should you wish to export the formulary for your own offline use you are welcome to use the export buttons at the top of the table to export the full list in the format you prefer. If you only need a subset of the list please filter the table using the fields provided and then the export buttons will export only your chosen subset of data.

wdt_ID Category Sub-category Description Active Ingredient Label Name Administer Dosage Form Acute Chronic OTC CDL Conditions Quantities and Limitations
1 Central Nervous System Central nervous system stimulants Central Analeptics NONE LISTED
2 Central Nervous System Central nervous system stimulants Respiratory stimulants Naloxone HCl Inj 0.02 MG/ML INJ SOLN A Consumables - Clinic use only
3 Central Nervous System Central nervous system stimulants Respiratory stimulants Naloxone HCl Inj 0.4 MG/ML INJ SOLN A Consumables - Clinic use only
4 Central Nervous System Central nervous system stimulants Others NONE LISTED
5 Central Nervous System Sedative hypnotics Benzodiazepines Midazolam HCl Inj 5 MG/ML (Base Equivalent) INJ SOLN A Consumables - Clinic use only
6 Central Nervous System Sedative hypnotics Barbiturates Phenobarbitone Tab 30 MG OR TABS C EPL Therapeutic - ChroniLine
7 Central Nervous System Sedative hypnotics Others Zopiclone Tab 7.5 MG OR TABS A Max quantity 30 tabs every 90 days
8 Central Nervous System Anxiolytics Benzodiazepines Alprazolam Tab 0.25 MG OR TABS A Max Rx/5 days every 120 days
9 Central Nervous System Anxiolytics Benzodiazepines Alprazolam Tab 0.5 MG OR TABS A Max Rx/5 days every 120 days
10 Central Nervous System Anxiolytics Benzodiazepines Alprazolam Tab 1 MG OR TABS A Max Rx/5 days every 120 days
11 Central Nervous System Anxiolytics Benzodiazepines Bromazepam Tab 3 MG OR TABS A Max Rx/5 days every 120 days
12 Central Nervous System Anxiolytics Benzodiazepines Bromazepam Tab 6 MG OR TABS A Max Rx/5 days every 120 days
13 Central Nervous System Anxiolytics Benzodiazepines Diazepam Inj 5 MG/ML INJ SOLN A Consumables - Clinic use only
14 Central Nervous System Anxiolytics Benzodiazepines Diazepam Tab 5 MG OR TABS A Max Rx/5 days every 120 days
15 Central Nervous System Anxiolytics Benzodiazepines Diazepam Tab 10 MG OR TABS A Max Rx/5 days every 120 days
16 Central Nervous System Anxiolytics Benzodiazepines Lorazepam Inj 4 MG/ML INJ SOLN A Therapeutic - ChroniLine Pre-Auth
17 Central Nervous System Anxiolytics Benzodiazepines Lorazepam Tab 1 MG OR TABS A Max Rx/5 days every 120 days
18 Central Nervous System Anxiolytics Benzodiazepines Oxazepam Tab 10 MG OR TABS A Max Rx/5 days every 120 days
19 Central Nervous System Anxiolytics Benzodiazepines Oxazepam Tab 15 MG OR TABS A Max Rx/5 days every 120 days
20 Central Nervous System Anxiolytics Benzodiazepines Oxazepam Tab 30 MG OR TABS A Max Rx/5 days every 120 days
21 Central Nervous System Anxiolytics Others Hydroxyzine HCl IM Soln 50 MG/ML IM SOLN A Consumables - Clinic use only
22 Central Nervous System Anxiolytics Others Hydroxyzine HCl Syrup 10 MG/5ML OR SYRP A Max quantity 200ml per annum
23 Central Nervous System Anti-depressants Tricyclic Amitriptyline HCl Tab 10 MG OR TABS C MSS, SCZ Therapeutic - ChroniLine
24 Central Nervous System Anti-depressants Tricyclic Amitriptyline HCl Tab 25 MG OR TABS C MSS, SCZ Therapeutic - ChroniLine
25 Central Nervous System Anti-depressants Tricyclic Imipramine HCl Tab 10 MG OR TABS C MSS, SCZ Therapeutic - ChroniLine
26 Central Nervous System Anti-depressants Tricyclic Imipramine HCl Tab 25 MG OR TABS C MSS, SCZ Therapeutic - ChroniLine
27 Central Nervous System Anti-depressants Non-tricyclic NONE
28 Central Nervous System Anti-depressants Mono-amine oxidase inhibitors NONE LISTED
29 Central Nervous System Anti-depressants Selective serotonin re-uptake inhibitors (SSRIs) Citalopram Hydrobromide Tab 20 MG (Base Equiv) OR TABS C BMD, SCZ Therapeutic - ChroniLine
30 Central Nervous System Anti-depressants Selective serotonin re-uptake inhibitors (SSRIs) Citalopram Hydrobromide Tab 40 MG (Base Equiv) OR TABS C BMD, SCZ Therapeutic - ChroniLine
31 Central Nervous System Anti-depressants Selective serotonin re-uptake inhibitors (SSRIs) Fluoxetine HCl Cap 20 MG OR CAPS C BMD, SCZ Therapeutic - ChroniLine
32 Central Nervous System Anti-depressants Serotonin and noradrenaline re-uptake inhibitors (SNRIs) NONE LISTED
33 Central Nervous System Anti-depressants Noradrenaline (and dopamine) re-uptake inhibitors NONE LISTED
34 Central Nervous System Anti-depressants Tetracyclic NONE LISTED
35 Central Nervous System Anti-depressants Melatonergic specific NONE LISTED
36 Central Nervous System Anti-depressants Lithium Lithium Carbonate Tab 250 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
37 Central Nervous System Anti-depressants Lithium Lithium Carbonate Tab 400 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
38 Central Nervous System Anti-depressants Lithium Lithium Carbonate Tab CR 450 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
39 Central Nervous System Anti-depressants Others NONE LISTED
40 Central Nervous System Anti-psychotics Phenothiazines Chlorpromazine HCl Tab 25 MG OR TABS C SCZ Therapeutic - ChroniLine Pre-Auth
41 Central Nervous System Anti-psychotics Phenothiazines Chlorpromazine HCl Tab 50 MG OR TABS C SCZ Therapeutic - ChroniLine Pre-Auth
42 Central Nervous System Anti-psychotics Phenothiazines Chlorpromazine HCl Tab 100 MG OR TABS C SCZ Therapeutic - ChroniLine Pre-Auth
43 Central Nervous System Anti-psychotics Phenothiazines Fluphenazine Decanoate Inj 25 MG/ML IM SOLN C SCZ Therapeutic - ChroniLine Pre-Auth
44 Central Nervous System Anti-psychotics Butyrophenones Haloperidol Lactate Inj 5 MG/ML INJ SOLN A Therapeutic - ChroniLine Pre-Auth
45 Central Nervous System Anti-psychotics Butyrophenones Haloperidol Lactate Inj 10 MG/ML INJ SOLN A Therapeutic - ChroniLine Pre-Auth
46 Central Nervous System Anti-psychotics Butyrophenones Haloperidol Cap 0.5 MG OR CAPS C SCZ Therapeutic - ChroniLine Pre-Auth
47 Central Nervous System Anti-psychotics Butyrophenones Haloperidol Tab 5 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
48 Central Nervous System Anti-psychotics Butyrophenones Haloperidol Tab 10 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
49 Central Nervous System Anti-psychotics Atypical anti-Psychotics Clozapine Tab 25 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
50 Central Nervous System Anti-psychotics Atypical anti-Psychotics Clozapine Tab 100 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
51 Central Nervous System Anti-psychotics Atypical anti-Psychotics Olanzapine Orally Disintegrating Tab 5 MG TBDP TABS C BMD, SCZ Therapeutic - ChroniLine
52 Central Nervous System Anti-psychotics Atypical anti-Psychotics Olanzapine Orally Disintegrating Tab 10 MG TBDP TABS C BMD, SCZ Therapeutic - ChroniLine
53 Central Nervous System Anti-psychotics Atypical anti-Psychotics Olanzapine Tab 2.5 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
54 Central Nervous System Anti-psychotics Atypical anti-Psychotics Olanzapine Tab 5 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
55 Central Nervous System Anti-psychotics Atypical anti-Psychotics Olanzapine Tab 10 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
56 Central Nervous System Anti-psychotics Atypical anti-Psychotics Quetiapine Fumarate Tab 25 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
57 Central Nervous System Anti-psychotics Atypical anti-Psychotics Quetiapine Fumarate Tab 100 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
58 Central Nervous System Anti-psychotics Atypical anti-Psychotics Quetiapine Fumarate Tab 200 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
59 Central Nervous System Anti-psychotics Atypical anti-Psychotics Quetiapine Fumarate Tab 300 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
60 Central Nervous System Anti-psychotics Atypical anti-Psychotics Risperidone Tab 0.5 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
61 Central Nervous System Anti-psychotics Atypical anti-Psychotics Risperidone Tab 1 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
62 Central Nervous System Anti-psychotics Others Flupentixol Decanoate IM Soln 20 MG/ML IM SOLN C BMD, SCZ Therapeutic - ChroniLine Pre-Auth
63 Central Nervous System Anti-psychotics Others Sulpiride Cap 50 MG OR CAPS C SCZ Therapeutic - ChroniLine Pre-Auth
64 Central Nervous System Anti-psychotics Others Zuclopenthixol Decanoate IM in Oil 200 MG/ML IM SOLN C BMD, SCZ Therapeutic - ChroniLine Pre-Auth
65 Central Nervous System Anti-psychotics Others Zuclopenthixol Dihydrochloride Tab 2 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
66 Central Nervous System Anti-psychotics Others Zuclopenthixol Dihydrochloride Tab 10 MG OR TABS C BMD, SCZ Therapeutic - ChroniLine
67 Central Nervous System Anti-epileptics Anti-epileptics Carbamazepine Susp 100 MG/5ML OR SUSP C BMD, EPL, MSS, SCZ Therapeutic - ChroniLine
68 Central Nervous System Anti-epileptics Anti-epileptics Carbamazepine Tab 200 MG OR TABS C BMD, EPL, MSS, SCZ Therapeutic - ChroniLine
69 Central Nervous System Anti-epileptics Anti-epileptics Carbamazepine Tab SR 12HR 200 MG OR TB12 C BMD, EPL, MSS, SCZ Therapeutic - ChroniLine
70 Central Nervous System Anti-epileptics Anti-epileptics Carbamazepine Tab SR 12HR 400 MG OR TB12 C BMD, EPL, MSS, SCZ Therapeutic - ChroniLine
71 Central Nervous System Anti-epileptics Anti-epileptics Clonazepam Conc for Inj 1 MG/ML INJ SOLN A Consumables - Clinic use only
72 Central Nervous System Anti-epileptics Anti-epileptics Clonazepam Tab 0.5 MG OR TABS C EPL Therapeutic - ChroniLine
73 Central Nervous System Anti-epileptics Anti-epileptics Clonazepam Tab 2 MG OR TABS C EPL Therapeutic - ChroniLine
74 Central Nervous System Anti-epileptics Anti-epileptics Ethosuximide 250mg/5ml syrup OR SYRP C EPL Therapeutic - ChroniLine
75 Central Nervous System Anti-epileptics Anti-epileptics Lamotrigine Tab 25 MG OR TABS C BMD, EPL, SCZ Therapeutic - ChroniLine
76 Central Nervous System Anti-epileptics Anti-epileptics Lamotrigine Tab 50 MG OR TABS C BMD, EPL, SCZ Therapeutic - ChroniLine
77 Central Nervous System Anti-epileptics Anti-epileptics Lamotrigine Tab 100 MG OR TABS C BMD, EPL, SCZ Therapeutic - ChroniLine
78 Central Nervous System Anti-epileptics Anti-epileptics Lamotrigine Tab 200 MG OR TABS C BMD, EPL, SCZ Therapeutic - ChroniLine
79 Central Nervous System Anti-epileptics Anti-epileptics Lamotrigine Tab Chewable Dispersible 2 MG OR TABS C BMD, EPL, SCZ Therapeutic - ChroniLine
80 Central Nervous System Anti-epileptics Anti-epileptics Lamotrigine Tab Chewable Dispersible 5 MG OR TABS C BMD, EPL, SCZ Therapeutic - ChroniLine
81 Central Nervous System Anti-epileptics Anti-epileptics Oxcarbazepine Tab 300 MG OR TABS C EPL Therapeutic - ChroniLine
82 Central Nervous System Anti-epileptics Anti-epileptics Oxcarbazepine Tab 600 MG OR TABS C EPL Therapeutic - ChroniLine
83 Central Nervous System Anti-epileptics Anti-epileptics Phenytoin Sodium Inj 50 MG/ML INJ SOLN A Consumables - Clinic use only
84 Central Nervous System Anti-epileptics Anti-epileptics Phenytoin Sodium Susp 125 MG/5ML OR SUSP C EPL Therapeutic - ChroniLine
85 Central Nervous System Anti-epileptics Anti-epileptics Phenytoin Sodium Prompt Tab 100 MG OR TABS C EPL Therapeutic - ChroniLine
86 Central Nervous System Anti-epileptics Anti-epileptics Topiramate Tab 25 MG OR TABS C EPL Therapeutic - ChroniLine
87 Central Nervous System Anti-epileptics Anti-epileptics Topiramate Tab 50 MG OR TABS C EPL Therapeutic - ChroniLine
88 Central Nervous System Anti-epileptics Anti-epileptics Topiramate Tab 100 MG OR TABS C EPL Therapeutic - ChroniLine
89 Central Nervous System Anti-epileptics Anti-epileptics Topiramate Tab 200 MG OR TABS C EPL Therapeutic - ChroniLine
90 Central Nervous System Anti-epileptics Anti-epileptics Topiramate Sprinkle Cap 15 MG OR CAPS C EPL Therapeutic - ChroniLine
91 Central Nervous System Anti-epileptics Anti-epileptics Valproate Sodium For IV Soln 400 MG IV SOLN A Consumables - Clinic use only
92 Central Nervous System Anti-epileptics Anti-epileptics Valproate Sodium Liqd 200 MG/5ML OR SOLN C BMD, EPL, SCZ Therapeutic - ChroniLine
93 Central Nervous System Anti-epileptics Anti-epileptics Valproate Sodium Syrup 250 MG/5ML (Base Equiv) OR SYRP C BMD, EPL, SCZ Therapeutic - ChroniLine
94 Central Nervous System Anti-epileptics Anti-epileptics Valproate Sodium Tab 100 MG OR TABS C BMD, EPL, SCZ Therapeutic - ChroniLine
95 Central Nervous System Anti-epileptics Anti-epileptics Valproate Sodium Tab CR 200 MG OR TABS C BMD, EPL, SCZ Therapeutic - ChroniLine
96 Central Nervous System Anti-epileptics Anti-epileptics Valproate Sodium Tab CR 300 MG OR TBCR C BMD, EPL, SCZ Therapeutic - ChroniLine
97 Central Nervous System Anti-epileptics Anti-epileptics Valproate Sodium Tab CR 500 MG OR TBCR C BMD, EPL, SCZ Therapeutic - ChroniLine
98 Central Nervous System Anti-epileptics Anti-epileptics Valproic Acid Cap 150 MG OR CAPS C BMD, EPL, SCZ Therapeutic - ChroniLine
99 Central Nervous System Anti-epileptics Anti-epileptics Valproic Acid Cap 300 MG OR CAPS C BMD, EPL, SCZ Therapeutic - ChroniLine
100 Central Nervous System Anti-epileptics Anti-epileptics Valproic Acid Cap Delayed Release 500 MG OR CAPS C BMD, EPL, SCZ Therapeutic - ChroniLine
101 Central Nervous System Anti-Parkinson agents Dopaminergics Amantadine HCl Cap 100 MG OR CAPS C PAR Therapeutic - ChroniLine Pre-Auth
102 Central Nervous System Anti-Parkinson agents Dopaminergics Carbidopa & Levodopa Tab 25-100 MG OR TABS C PAR Therapeutic - ChroniLine
103 Central Nervous System Anti-Parkinson agents Dopaminergics Carbidopa & Levodopa Tab 25-250 MG OR TABS C PAR Therapeutic - ChroniLine
104 Central Nervous System Anti-Parkinson agents Dopaminergics Pramipexole Dihydrochloride Tab 0.125 MG OR TABS C PAR Therapeutic - ChroniLine
105 Central Nervous System Anti-Parkinson agents Dopaminergics Pramipexole Dihydrochloride Tab 0.25 MG OR TABS C PAR Therapeutic - ChroniLine
106 Central Nervous System Anti-Parkinson agents Dopaminergics Ropinirole Hydrochloride Tab 0.25 MG OR TABS C PAR Therapeutic - ChroniLine Pre-Auth
107 Central Nervous System Anti-Parkinson agents Dopaminergics Ropinirole Hydrochloride Tab 0.5 MG OR TABS C PAR Therapeutic - ChroniLine Pre-Auth
108 Central Nervous System Anti-Parkinson agents Dopaminergics Ropinirole Hydrochloride Tab 1 MG OR TABS C PAR Therapeutic - ChroniLine Pre-Auth
109 Central Nervous System Anti-Parkinson agents Dopaminergics Ropinirole Hydrochloride Tab 2 MG OR TABS C PAR Therapeutic - ChroniLine Pre-Auth
110 Central Nervous System Anti-Parkinson agents Dopaminergics Ropinirole Hydrochloride Tab 5 MG OR TABS C PAR Therapeutic - ChroniLine Pre-Auth
111 Central Nervous System Anti-Parkinson agents Anti-cholinergics Biperiden Lactate Inj 5 MG/ML INJ SOLN A Consumables - Clinic use only
112 Central Nervous System Anti-Parkinson agents Anti-cholinergics Biperiden HCl Tab 2 MG OR TABS C PAR Therapeutic - ChroniLine
113 Central Nervous System Anti-Parkinson agents Anti-cholinergics Orphenadrine HCl Tab 50 MG OR TABS C PAR Therapeutic - ChroniLine
114 Central Nervous System Anti-Parkinson agents Anti-cholinergics Trihexyphenidyl HCl Tab 2 MG OR TABS C PAR Therapeutic - ChroniLine
115 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Buclizine-Pyridoxine Tab 25-50 MG OR TABS A Max 30/Rx & 3 Rx/annum (Gender)
116 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Cyclizine HCl Syrup 12.5 MG/5ML OR SYRP A OTC Max 1 package/Rx & 3 Rx/annum
117 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Cyclizine HCl Tab 50 MG OR TABS A OTC Max 1 package/Rx & 3 Rx/annum
118 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Cyclizine HCl Supp 50 MG RE SUPP A Max 1 package/Rx & 3 Rx/annum
119 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Fructose-Dextrose-Phosphoric Acid Oral Soln OR SOLN A Max 200ml/Rx & 3 Rx/annum
120 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Metoclopramide HCl Inj 5 MG/ML INJ SOLN A Consumables - Clinic use only
121 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Metoclopramide HCl Syrup 5 MG/5ML OR SYRP A Max 1 package/Rx & 3 Rx/annum
122 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Metoclopramide HCl Tab 10 MG OR TABS A Max 30/Rx & 3 Rx/annum
123 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Phosphorated Carbohydrate Syrup OR SYRP A Max 200ml/Rx & 3 Rx/annum
124 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Prochlorperazine Inj 12.5 MG/ML IM SOLN A Consumables - Clinic use only
125 Central Nervous System Anti-vertigo and anti-emetic agents Anti-vertigo and anti-emetic agents Prochlorperazine Maleate Tab 5 MG OR TABS A Max 30/Rx & 3 Rx/annum
126 Central Nervous System Anti-migraine agents Anti-migraine agents Clonidine HCl Tab 0.025 MG OR TABS A OTC Max 3 Rx/annum
127 Central Nervous System Anti-migraine agents Anti-migraine agents Clonidine HCl (Migraine) Oral Drops 25 MCG/0.5ML OR SOLN A OTC Max 1 package/Rx & 3 Rx/annum
128 Central Nervous System Alzheimer's disease Alzheimer's disease NONE LISTED
129 Anaesthetics General anaesthetics General anaesthetics NONE LISTED
130 Anaesthetics Local Anaesthetics Local Anaesthetics Bupivacaine HCl Inj 0.5% INJ SOLN A Consumables - Clinic use only
131 Anaesthetics Local Anaesthetics Local Anaesthetics Lidocaine HCl Local Inj 2% INJ SOLN A Consumables - Clinic use only
132 Anaesthetics Local Anaesthetics Local Anaesthetics Lidocaine Inj 2% w/ Epinephrine-1:80000 INJ SOLN A Consumables - Clinic use only
133 Anaesthetics Local Anaesthetics Surface anaesthetics Tetracaine HCl Cream 1% EX CREA A OTC Max 1 Rx/annum
134 Anaesthetics Muscle relaxants Muscle relaxants NONE LISTED
135 Analgesics Narcotic Analgesics Narcotic Analgesics Morphine Sulfate Inj 10 MG/ML INJ SOLN A Consumables - Clinic use only
136 Analgesics Narcotic Analgesics Narcotic Analgesics Morphine Sulfate Inj 15 MG/ML INJ SOLN A Consumables - Clinic use only
137 Analgesics Narcotic Analgesics Narcotic Analgesics Codeine Phosphate Tab 30 MG OR TABS A Therapeutic - ChroniLine Pre-Auth
138 Analgesics Narcotic Analgesics Narcotic Analgesics Morphine Sulfate Tab CR 10 MG OR TABS A Therapeutic - ChroniLine Pre-Auth
139 Analgesics Narcotic Analgesics Narcotic Analgesics Oxycodone HCl Cap 5 MG OR TABS A Therapeutic - ChroniLine Pre-Auth
140 Analgesics Narcotic Analgesics Narcotic Analgesics Pethidine HCl Inj 25 MG/ML INJ SOLN A Consumables - Clinic use only
141 Analgesics Narcotic Analgesics Narcotic Analgesics Pethidine HCl Inj 50 MG/ML INJ SOLN A Consumables - Clinic use only
142 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Aspirin Tab 300 MG OR TABS C CHF, CMY, DYS, CAD, HYL, DM1, DM2, SLE, RHA Therapeutic - ChroniLine
143 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Aspirin Tab 300 MG OR TABS A OTC Max Rx/5 days & 3 Rx/annum
144 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Aspirin Dispersible Tab 300 MG OR TABS C OTC CHF, CMY, DYS, CAD, HYL, DM1, DM2, SLE, RHA Therapeutic - ChroniLine
145 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Aspirin Dispersible Tab 300 MG OR TABS A Max Rx/5 days & 3 Rx/annum
146 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Ibuprofen Susp 100 MG/5ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
147 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Ibuprofen 200 MG OR TABS A OTC Max Rx/5 days & 3 Rx/annum
148 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Mefanamic Acid Susp 50mg/5ml OR SUSP A Max 200ml/Rx & 3 Rx/annum
149 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Mefenamic Acid Cap 250 MG OR CAPS A Max Rx/5 days & 3 Rx/annum
150 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Paracetamol Elixir 120 MG/5ML OR ELIX A OTC Max 200ml/Rx & 3 Rx/annum
151 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Paracetamol Elixir 120 MG/5ML OR ELIX C OTC HAE Therapeutic - ChroniLine
152 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Paracetamol Syrup 120 MG/5ML OR ELIX A OTC Max 200ml/Rx & 3 Rx/annum
153 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Paracetamol Syrup 120 MG/5ML OR ELIX C OTC HAE Therapeutic - ChroniLine
154 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Paracetamol Tab 500 MG OR TABS A OTC Max Rx/5 days & 3 Rx/annum
155 Analgesics Analgesics and antipyretics Analgesic and Antipyretics Paracetamol Tab 500 MG OR TABS C OTC HAE, MSS, RHA, SLE Therapeutic - ChroniLine
156 Analgesics Combinations Combination Analgesics Acetaminophen w/ Codeine Cap 500-8 MG OR CAPS A Max Rx/5 days & 3 Rx/annum
157 Analgesics Combinations Combination Analgesics Acetaminophen w/ Codeine Cap 500-8 MG OR CAPS C HAE, MSS, SLE Therapeutic - ChroniLine
158 Analgesics Combinations Combination Analgesics Paracetamol w/ Codeine Tab 500-10 MG OR TABS A OTC Max Rx/5 days & 3 Rx/annum
159 Analgesics Combinations Combination Analgesics Paracetamol w/ Codeine Tab 500-10 MG OR TABS C HAE, MSS, SLE Therapeutic - ChroniLine
160 Analgesics Combinations Combination Analgesics Paracetamol w/ Codeine Tab 500-8 MG OR TABS A OTC Max Rx/5 days & 3 Rx/annum
161 Analgesics Combinations Combination Analgesics Paracetamol w/ Codeine Tab 500-8 MG OR TABS C HAE, MSS, SLE Therapeutic - ChroniLine
162 Analgesics Combinations Combination Analgesics Paracetamol-Meprobamate-Caff-Cod Tab 320-150-32-8 MG OR TABS A Max Rx/5 days & 3 Rx/annum
163 Analgesics Combinations Combination Analgesics Paracetamol-Promethazine w/ Codeine Syrup 120-6.5-5 MG/5ML OR SYRP A Max 100ml/Rx & 3 Rx/annum
164 Analgesics Others Other Analgesics Tramadol HCl Cap 50 MG OR CAPS A C HAE, MSS Therapeutic - ChroniLine Pre-Auth
165 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Diclofenac Sodium IM Inj Soln 25 MG/ML IM SOLN A Consumables - Clinic use only
166 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Diclofenac Sodium Tab Delayed Release 25 MG OR TBEC A C RHA, SLE Max Rx/5 days & 2 Rx/annum / Therapeutic - ChroniLine
167 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Diclofenac Sodium Tab Delayed Release 50 MG OR TBEC A C RHA, SLE Max Rx/5 days & 2 Rx/annum / Therapeutic - ChroniLine
168 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Ibuprofen Tab 200 MG OR TABS A C OTC RHA, SLE Max Rx/5 days & 2 Rx/annum / Therapeutic - ChroniLine
169 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Ibuprofen Tab 400 MG OR TABS A C OTC RHA, SLE Max Rx/5 days & 2 Rx/annum / Therapeutic - ChroniLine
170 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Indomethacin Cap 25 MG OR CAPS A C RHA, SLE Therapeutic - ChroniLine
171 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Naproxen Tab 250 MG OR TABS A C RHA, SLE Max Rx/5 days & 2 Rx/annum / Therapeutic - ChroniLine
172 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Naproxen Tab 500 MG OR TABS A C RHA, SLE Max Rx/5 days & 2 Rx/annum / Therapeutic - ChroniLine
173 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents COX inhibitors Piroxicam Cap 20 MG OR CAPS A C RHA, SLE Therapeutic - ChroniLine
174 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents Selective COX2 inhibitors Meloxicam Tab 7.5 MG OR TABS C RHA, SLE Therapeutic - ChroniLine Pre-Auth
175 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents Selective COX2 inhibitors Meloxicam Tab 15 MG OR TABS C RHA, SLE Therapeutic - ChroniLine Pre-Auth
176 Musculo-Skeletal Agents Non-steroidal anti-inflammatory agents Specific cyclo-oxygenase-2 inhibitor (COXIB) NONE LISTED
177 Musculo-Skeletal Agents Anti-gout Anti-gout Allopurinol Tab 100 MG OR TABS A Max 6 Rx/annum - Prophylactic
178 Musculo-Skeletal Agents Anti-gout Anti-gout Allopurinol Tab 300 MG OR TABS A Max 6 Rx/annum - Prophylactic
179 Musculo-Skeletal Agents Anti-gout Anti-gout Colchicine Tab 0.5 MG OR TABS A Max 12/Rx & 3 Rx/annum
180 Musculo-Skeletal Agents Anti-gout Anti-gout Colchicine Tab 1 MG OR TABS A Max 12/Rx & 3 Rx/annum
181 Musculo-Skeletal Agents Topical agents Topical agents Diclofenac Diethylammonium Gel 1.3% EX GEL A OTC Max 1 package/annum
182 Musculo-Skeletal Agents Topical agents Topical agents Ibuprofen Gel 5% EX GEL A OTC Max 1 package/annum
183 Musculo-Skeletal Agents Topical agents Topical agents Liniments and rubs - ointment EX GEL A OTC Max 50g package/annum
184 Musculo-Skeletal Agents Topical agents Topical agents Zinc Oxide Oint 15% EX OINT C SLE Therapeutic - ChroniLine
185 Musculo-Skeletal Agents Gold Gold NONE
186 Musculo-Skeletal Agents Centrally acting muscle relaxants Centrally acting muscle relaxants Baclofen Tab 10 MG OR TABS C MSS Therapeutic - ChroniLine Pre-Auth
187 Musculo-Skeletal Agents Centrally acting muscle relaxants Centrally acting muscle relaxants Orphenadrine Citrate Tab 100 MG OR TABS A Max Rx/5 days & 3 Rx/annum
188 Musculo-Skeletal Agents Others Others Sulfasalazine Tab Delayed Release 500 MG OR TBEC C RHA, SLE, CSD, UC Therapeutic - ChroniLine Pre-Auth
189 Musculo-Skeletal Agents Osteoporosis (and other metabolic bone disorders) Bisphosphonates NONE LISTED
190 Musculo-Skeletal Agents Osteoporosis (and other metabolic bone disorders) Selective oestrogen receptor modulators NONE LISTED
191 Musculo-Skeletal Agents Osteoporosis (and other metabolic bone disorders) Calcitonin NONE LISTED
192 Musculo-Skeletal Agents Osteoporosis (and other metabolic bone disorders) Minerals and vitamin D Alfacalcidol Cap 0.25 MCG OR CAPS C CRD Therapeutic - ChroniLine Pre-Auth
193 Musculo-Skeletal Agents Osteoporosis (and other metabolic bone disorders) Minerals and vitamin D Alfacalcidol Cap 1 MCG OR CAPS C CRD Therapeutic - ChroniLine Pre-Auth
194 Musculo-Skeletal Agents Osteoporosis (and other metabolic bone disorders) Minerals and vitamin D Ergocalciferol Tab 50000 Unit OR CAPS C CRD Therapeutic - ChroniLine Pre-Auth
195 Musculo-Skeletal Agents Osteoporosis (and other metabolic bone disorders) Dual action bone agents NONE LISTED
196 Autonomic Sympathomimetics Sympathomimetics Epinephrine HCl Inj 1 MG/ML INJ SOLN A Consumables - Clinic use only
197 Autonomic Sympatholytics Sympatholytics NONE LISTED
198 Autonomic Cholinergics Cholinergics NONE LISTED
199 Autonomic Anti-cholinergics Anti-cholinergics Atropine Sulfate Inj 0.5 MG/ML INJ SOLN A Consumables - Clinic use only
200 Autonomic Anti-cholinergics Anti-cholinergics Atropine Sulfate Inj 1 MG/ML INJ SOLN A Consumables - Clinic use only
201 Autonomic Anti-cholinergics Anti-cholinergics Oxybutynin Chloride Tab 5 MG OR TABS C MSS Therapeutic - ChroniLine
202 Autonomic Others Others NONE
203 Autacoids Anti-Histamines Anti-Histamines Chlorpheniramine Maleate Syrup 2 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
204 Autacoids Anti-Histamines Anti-Histamines Chlorpheniramine Maleate Tab 4 MG OR TABS A OTC Max 30/Rx & 3 Rx/annum
205 Autacoids Anti-Histamines Anti-Histamines Chlorpheniramine,combinations OR TABS A OTC
206 Autacoids Anti-Histamines Anti-Histamines Promethazine HCl Inj 25 MG/ML INJ SOLN A OTC Consumables - Clinic use only
207 Autacoids Anti-Histamines Anti-Histamines Promethazine HCl Syrup 5 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
208 Autacoids Anti-Histamines Anti-Histamines Promethazine HCl Tab 10 MG OR TABS A OTC Max Rx/5 days & 3 Rx/annum
209 Autacoids Anti-Histamines Anti-Histamines Promethazine HCl Tab 25 MG OR TABS A OTC Max Rx/5 days & 3 Rx/annum
210 Autacoids Anti-Histamines Anti-Histamines Diphenhydramine-Pyrilamine Cream 1-1% EX CREA A OTC Max 1 package/Rx & 3 Rx/annum
211 Autacoids Anti-Histamines Anti-Histamines Pyrilamine Maleate Cream 2% EX CREA A OTC Max Rx/5 days & 3 Rx/annum
212 Autacoids Anti-Histamines Anti-Histamines Cetrizine OR TABS A OTC Max Rx/5 days & 3 Rx/annum
213 Autacoids Anti-Histamines Anti-Histamines Mepyramine TOP CREA A OTC Max 1 package/Rx & 3 Rx/annum
214 Autacoids Anti-Histamines Anti-Histamines Chlorpheniramine 2MG/5ML OR SYRP A OTC Max Rx/5 days & 3 Rx/annum
215 Autacoids Serotonin antagonists Serotonin antagonists NONE LISTED
216 Autacoids NK1 antagonists NK1 antagonists NONE LISTED
217 Cardio-Vascular Agents Positive inotropic agents Cardiac glycosides Digoxin Elixir 0.05 MG/ML OR SYRP C CHF, CMY, DYS Therapeutic - ChroniLine Pre-Auth
218 Cardio-Vascular Agents Positive inotropic agents Cardiac glycosides Digoxin Tab 0.25 MG OR TABS C CHF, CMY, DYS Therapeutic - ChroniLine Pre-Auth
219 Cardio-Vascular Agents Positive inotropic agents Cardiac glycosides Digoxin Tab 62.5 MCG (0.0625 MG) OR TABS C CHF, CMY, DYS Therapeutic - ChroniLine Pre-Auth
220 Cardio-Vascular Agents Positive inotropic agents Others NONE LISTED
221 Cardio-Vascular Agents Anti-arrhythmics Anti-arrhythmics Amiodarone HCl Tab 100 MG OR TABS C DYS Therapeutic - ChroniLine Pre-Auth
222 Cardio-Vascular Agents Anti-arrhythmics Anti-arrhythmics Amiodarone HCl Tab 200 MG OR TABS C DYS Therapeutic - ChroniLine Pre-Auth
223 Cardio-Vascular Agents Anti-arrhythmics Anti-arrhythmics Lidocaine HCl IV Inj 10 MG/ML INJ SOLN A Consumables - Clinic use only
224 Cardio-Vascular Agents Anti-arrhythmics Anti-arrhythmics Lidocaine HCl IV Inj 20 MG/ML INJ SOLN A Consumables - Clinic use only
225 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Central acting sympathetic nervous system inhibitors Methyldopa Tab 250 MG OR TABS C HYP Therapeutic - ChroniLine (4th Line and Pregnancy)
226 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Alpha-receptor blockers Doxazosin Mesylate Tab 1 MG OR TABS C HYP Therapeutic - ChroniLine
227 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Alpha-receptor blockers Doxazosin Mesylate Tab 4 MG OR TABS C HYP Therapeutic - ChroniLine
228 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Beta-receptor blockers Atenolol & Chlorthalidone Tab 50-12.5 MG OR TABS C CHF, CMY, CRD, HYP Therapeutic - ChroniLine
229 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Beta-receptor blockers Atenolol & Chlorthalidone Tab 100-25 MG OR TABS C CHF, CMY, CRD, HYP Therapeutic - ChroniLine
230 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Beta-receptor blockers Atenolol Tab 50 MG OR TABS C CAD, CHF,CMY,CRD,DYS,HYP Therapeutic - ChroniLine
231 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Beta-receptor blockers Atenolol Tab 100 MG OR TABS C CAD, CHF,CMY,CRD,DYS,HYP Therapeutic - ChroniLine
232 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Beta-receptor blockers Propranolol HCl Tab 10 MG OR TABS C CAD, CHF,CMY,CRD,DYS,HYP Therapeutic - ChroniLine
233 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Beta-receptor blockers Propranolol HCl Tab 40 MG OR TABS C CAD, CHF,CMY,CRD,DYS,HYP Therapeutic - ChroniLine
234 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Alpha- and beta-receptor blockers Carvedilol Tab 12.5 MG OR TABS C CAD, CHF, CMY, CRD, HYP Therapeutic - ChroniLine
235 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Alpha- and beta-receptor blockers Carvedilol Tab 25 MG OR TABS C CAD, CHF, CMY, CRD, HYP Therapeutic - ChroniLine
236 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Sympathetic nervous blockers Reserpine Tab 0.25 MG OR TABS C HYP Therapeutic - ChroniLine
237 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Direct acting vasodilators Hydralazine HCl Tab 10 MG OR TABS C CHF, CMY, HYP Therapeutic - ChroniLine
238 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Direct acting vasodilators Hydralazine HCl Tab 25 MG OR TABS C CHF, CMY, HYP Therapeutic - ChroniLine
239 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Direct acting vasodilators Hydralazine HCl Tab 50 MG OR TABS C CHF, CMY, HYP Therapeutic - ChroniLine
240 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Calcium channel blockers Amlodipine Besylate Tab 5 MG OR TABS C CAD, CRD, HYP Therapeutic - ChroniLine
241 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Calcium channel blockers Amlodipine Besylate Tab 10 MG OR TABS C CAD, CRD, HYP Therapeutic - ChroniLine
242 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Captopril Tab 25 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
243 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Captopril Tab 50 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
244 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Enalapril Maleate & Hydrochlorothiazide Tab 20-12.5 MG OR TABS C CHF,CMY,CRD,HYP Therapeutic - ChroniLine
245 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Enalapril Maleate Tab 5 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
246 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Enalapril Maleate Tab 10 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
247 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Enalapril Maleate Tab 20 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
248 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Lisinopril & Hydrochlorothiazide Tab 10-12.5 MG OR TABS C CHF,CMY,CRD,HYP Therapeutic - ChroniLine
249 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Lisinopril & Hydrochlorothiazide Tab 20-12.5 MG OR TABS C CHF,CMY,CRD,HYP Therapeutic - ChroniLine
250 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Lisinopril Tab 5 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
251 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Lisinopril Tab 10 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
252 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) ACE inhibitors Lisinopril Tab 20 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
253 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Angiotensin receptor antagonists Losartan Potassium Tab 50 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
254 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Angiotensin receptor antagonists Losartan Potassium Tab 100 MG OR TABS C CAD,CHF,CMY,CRD,HYP Therapeutic - ChroniLine
255 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Angiotensin receptor antagonists Losartan Potassium & Hydrochlorothiazide Tab 50-12.5 MG OR TABS C CHF,CMY,CRD,HYP Therapeutic - ChroniLine
256 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Angiotensin receptor antagonists Losartan Potassium & Hydrochlorothiazide Tab 100-25 MG OR TABS C CHF,CMY,CRD,HYP Therapeutic - ChroniLine
257 Cardio-Vascular Agents Anti-hypertensives (single agents and combinations including diuretic combinations) Others NONE LISTED
258 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Diltiazem HCl Tab 60 MG OR TABS C CAD, CRD, HYP Therapeutic - ChroniLine
259 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Nifedipine Cap 5 MG OR CAPS A Max Rx/60 days only
260 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Nifedipine Cap 10 MG OR CAPS A Max Rx/60 days only
261 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Nifedipine Cap CR 20 MG OR CPCR C CAD, CRD, HYP Therapeutic - ChroniLine
262 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Nifedipine Tab SR 12HR 20 MG OR TB12 C CAD, CRD, HYP Therapeutic - ChroniLine
263 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Nifedipine Tab SR 24HR 30 MG OR TB24 C CAD, CRD, HYP Therapeutic - ChroniLine
264 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Verapamil HCl IV Soln 2.5 MG/ML IV SOLN A Consumables - Clinic use only
265 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Verapamil HCl Tab 40 MG OR TABS C DYS, CAD,CRD, HYP Therapeutic - ChroniLine
266 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Verapamil HCl Tab 80 MG OR TABS C DYS, CAD,CRD, HYP Therapeutic - ChroniLine
267 Cardio-Vascular Agents Anti-anginal agents Calcium channel blockers Verapamil HCl Tab CR 240 MG OR TBCR C DYS, CAD,CRD, HYP Therapeutic - ChroniLine
268 Cardio-Vascular Agents Anti-anginal agents Beta-receptor blockers REFER TO 7.3.3 Beta-receptor blockers
269 Cardio-Vascular Agents Anti-anginal agents Organic nitrates Isosorbide Dinitrate SL Tab 5 MG SL TABS C CAD, CHF, CMY Therapeutic - ChroniLine
270 Cardio-Vascular Agents Anti-anginal agents Organic nitrates Isosorbide Dinitrate Tab 10 MG OR TABS C CAD, CHF, CMY Therapeutic - ChroniLine
271 Cardio-Vascular Agents Anti-anginal agents Organic nitrates Isosorbide Dinitrate Tab 30 MG OR TABS C CAD, CHF, CMY Therapeutic - ChroniLine
272 Cardio-Vascular Agents Anti-anginal agents Organic nitrates Isosorbide Mononitrate Cap CR 50 MG OR CPCR C CAD, CHF, CMY Therapeutic - ChroniLine
273 Cardio-Vascular Agents Anti-anginal agents Organic nitrates Isosorbide Mononitrate Tab 20 MG OR TABS C CAD, CHF, CMY Therapeutic - ChroniLine
274 Cardio-Vascular Agents Anti-anginal agents Organic nitrates Isosorbide Mononitrate Tab SR 24HR 60 MG OR TB24 C CAD, CHF, CMY Therapeutic - ChroniLine
275 Cardio-Vascular Agents Anti-anginal agents Organic nitrates Nitro-glycerine SL Tab 0.5 MG SL TABS C CAD, CHF, CMY Therapeutic - ChroniLine
276 Cardio-Vascular Agents Anti-anginal agents Others NONE LISTED
277 Cardio-Vascular Agents Other vasodilators After-load reducers NONE LISTED
278 Cardio-Vascular Agents Other vasodilators Peripheral vasodilators NONE LISTED
279 Cardio-Vascular Agents Vasoconstrictors Vasoconstrictors NONE LISTED
280 Cardio-Vascular Agents Hypolipidemic agents Fibrates Bezafibrate Tab CR 400 MG OR TBCR C HYL Therapeutic - ChroniLine
281 Cardio-Vascular Agents Hypolipidemic agents HMG-CoA reductase inhibitors (Statins) Atorvastatin Calcium Tab 10 MG (Base Equivalent) OR TABS C HYL Therapeutic - ChroniLine Pre-Auth
282 Cardio-Vascular Agents Hypolipidemic agents HMG-CoA reductase inhibitors (Statins) Atorvastatin Calcium Tab 20 MG (Base Equivalent) OR TABS C HYL Therapeutic - ChroniLine Pre-Auth
283 Cardio-Vascular Agents Hypolipidemic agents HMG-CoA reductase inhibitors (Statins) Atorvastatin Calcium Tab 40 MG (Base Equivalent) OR TABS C HYL Therapeutic - ChroniLine Pre-Auth
284 Cardio-Vascular Agents Hypolipidemic agents HMG-CoA reductase inhibitors (Statins) Simvastatin Tab 10 MG OR TABS C HYL Therapeutic - ChroniLine Pre-Auth
285 Cardio-Vascular Agents Hypolipidemic agents HMG-CoA reductase inhibitors (Statins) Simvastatin Tab 20 MG OR TABS C HYL Therapeutic - ChroniLine Pre-Auth
286 Cardio-Vascular Agents Hypolipidemic agents HMG-CoA reductase inhibitors (Statins) Simvastatin Tab 40 MG OR TABS C HYL Therapeutic - ChroniLine Pre-Auth
287 Cardio-Vascular Agents Hypolipidemic agents Cholesterol absorption inhibitors NONE LISTED
288 Cardio-Vascular Agents Hypolipidemic agents Others NONE LISTED
289 Cardio-Vascular Agents Plasma expanders Plasma expanders NONE LISTED
290 Blood and Haemopoeitic Haemostatics Haemostatics Tranexamic Acid Tab 500 MG OR TABS A Max 20/Rx & 2 Rx/annum
291 Blood and Haemopoeitic Haemostatics Haemostatics Tranexamic Acid Tab 500 MG OR TABS C HAE Therapeutic - ChroniLine
292 Blood and Haemopoeitic Anticoagulants Anticoagulants Warfarin Sodium Tab 5 MG OR TABS C CHF, CMY, DYS, CAD Therapeutic - ChroniLine
293 Blood and Haemopoeitic Fibrinolytics Fibrinolytics NONE LISTED
294 Blood and Haemopoeitic Platelet aggregation inhibitors Platelet aggregation inhibitors Aspirin Dispersible Tab 81 MG OR TBDP C CHF, CMY, DYS, CAD, HYL, DM1, DM2 Therapeutic - ChroniLine
295 Blood and Haemopoeitic Platelet aggregation inhibitors Platelet aggregation inhibitors Aspirin Tab Delayed Release 81 MG OR TBEC C CHF, CMY, DYS, CAD, HYL, DM1, DM3 Therapeutic - ChroniLine
296 Blood and Haemopoeitic Platelet aggregation inhibitors Platelet aggregation inhibitors Aspirin Tab 100 MG OR TABS C CHF, CMY, DYS, CAD, HYL, DM1, DM4 Therapeutic - ChroniLine
297 Blood and Haemopoeitic Platelet aggregation inhibitors Platelet aggregation inhibitors Aspirin Dispersible Tab 300 MG OR TBDP C CHF, CMY, DYS, CAD, HYL, DM1, DM2, SLE, RHA Therapeutic - ChroniLine
298 Blood and Haemopoeitic Sclerosing agents Sclerosing agents NONE LISTED
299 Blood and Haemopoeitic Haematinics Haematinics Erythropoietin and Erythropoiesis Stimulating Agents (ESA) INJ SOLN C CRD Limited to Hospital Risk options only
300 Blood and Haemopoeitic Haematinics Haematinics Ferrous Fumarate-Folic Acid Tab 200-0.1 MG OR TABS A Max 9 Rx/annum (Gender)
301 Blood and Haemopoeitic Haematinics Haematinics Ferrous Lactate Drops 25 MG/ML OR SOLN C CRD Therapeutic - ChroniLine
302 Blood and Haemopoeitic Haematinics Haematinics Ferrous Sulfate Tab 30 MG OR TABS C CRD Therapeutic - ChroniLine
303 Blood and Haemopoeitic Haematinics Haematinics Ferrous Sulfate Tab 75 MG OR TABS C CRD Therapeutic - ChroniLine
304 Blood and Haemopoeitic Haematinics Haematinics Ferrous Sulfate-Copper-Manganese Tab 170-2.5-2.5 MG OR TABS C CRD Therapeutic - ChroniLine
305 Blood and Haemopoeitic Haemoglobin-based oxygen carrier Haemoglobin-based oxygen carrier NONE LISTED
306 Blood and Haemopoeitic Others Others NONE LISTED
307 Alcoholism Alcoholism Alcoholism NONE LISTED
308 Respiratory System Coughs and colds Antitussives and expectorants Aminophylline-Diphenyl-Ammon Cl-Sod Citrate Syrup OR SYRP A Max 200ml/Rx & 3 Rx/annum
309 Respiratory System Coughs and colds Antitussives and expectorants Diphenyl-Cod-Amm Cl-Sod Cit Syrup 12.5-10-125-50 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
310 Respiratory System Coughs and colds Antitussives and expectorants Diphenhyd-Cod-Amm Cl-Sod Cit Syrup 7-2.5-68.5-28 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
311 Respiratory System Coughs and colds Antitussives and expectorants Diphenhydramine w/ Codeine-Ammon Cl Syr 12-7.5-100 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
312 Respiratory System Coughs and colds Antitussives and expectorants Diphenhydramine-AmCl-Sod Citrate Syrup 14.07-137-57 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
313 Respiratory System Coughs and colds Antitussives and expectorants Diphenhydramine-AmCl-Sod Citrate Syrup 14.1-135-55 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
314 Respiratory System Coughs and colds Antitussives and expectorants Diphenhydramine-AmCl-Sod Citrate Syrup 14-136-56 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
315 Respiratory System Coughs and colds Antitussives and expectorants Diphenhydramine-AmCl-Sod Citrate-Men Syr 12.5-125-50-1MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
316 Respiratory System Coughs and colds Antitussives and expectorants Diphenhydramine-AmCl-Sod Citrate-Men Syr 14-137-57-1 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
317 Respiratory System Coughs and colds Antitussives and expectorants Diphenhydramine-Ammonium Chloride Syrup 12.5-125 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
318 Respiratory System Coughs and colds Antitussives and expectorants Diphenhydramine-Pholcodine-GG Syr 15-8-100 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
319 Respiratory System Coughs and colds Antitussives and expectorants DPH-AmCl-Sod Citrate-Men Syr 28.1-273.9-113.7-2.5 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
320 Respiratory System Coughs and colds Antitussives and expectorants Ephedrine w/ DM-Ammonium Cl Syrup 7.5-15-125 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
321 Respiratory System Coughs and colds Antitussives and expectorants Ephedrine-Promethazine-Codeine Syrup 7.2-3.6-9 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
322 Respiratory System Coughs and colds Antitussives and expectorants Guaifenesin Syrup 100 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
323 Respiratory System Coughs and colds Antitussives and expectorants Ipecac-Squill Syrup OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
324 Respiratory System Coughs and colds Antitussives and expectorants Metaproterenol-Bromhexine Syrup 5-4 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
325 Respiratory System Coughs and colds Antitussives and expectorants Pholcodine Syrup 4.052 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
326 Respiratory System Coughs and colds Antitussives and expectorants Pseudoephedrine-Triprolidine w/ COD Syrup 30-1.25-10 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
327 Respiratory System Coughs and colds Antitussives and expectorants Pseudoephed-Triprolidine-DM Syrup 30-1.25-10 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
328 Respiratory System Coughs and colds Antitussives and expectorants Pseudoeph-Triprolidine w/ COD-GG Syr 20-1.25-7.5-100 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
329 Respiratory System Coughs and colds Antitussives and expectorants Pseudoeph-Triprolidine w/ COD-GG Syrup 12-0.6-3-50 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
330 Respiratory System Coughs and colds Antitussives and expectorants Theophylline-Etofylline-Diphenhyd-Ammon Cl-Sod Cit Syrup OR SYRP A Max 200ml/Rx & 3 Rx/annum
331 Respiratory System Coughs and colds Antitussives and expectorants Theophylline-Etofylline-Diphenylpyraline-Ammon Cl Syrup OR SYRP A Max 200ml/Rx & 3 Rx/annum
332 Respiratory System Coughs and colds Decongestant, analgesic combinations Chlorphen-Ephedrine-APAP-Caffeine Tab 2-6-200-20 MG OR TABS A Max 20/Rx & 3 Rx/annum
333 Respiratory System Coughs and colds Decongestant, analgesic combinations Chlorphen-PE w/ APAP-Caffeine Cap 2-5-200-30 MG OR CAPS A Max 20/Rx & 3 Rx/annum
334 Respiratory System Coughs and colds Decongestant, analgesic combinations Chlorphen-PE w/ APAP-Caffeine Syrup 2-2.5-75-7.5 MG/5ML OR SYRP A From 1 year Max 100ml/Rx & 3 Rx/annum
335 Respiratory System Coughs and colds Decongestant, analgesic combinations Chlorphen-PE-APAP-Caff-Vit C Cap 2-5-300-30-75 MG OR CAPS A Max 20/Rx & 3 Rx/annum
336 Respiratory System Coughs and colds Decongestant, analgesic combinations Chlorphen-PE-APAP-Salicylamide-Vit C Cap 2-2-100-75-50 MG OR CAPS A Max 20/Rx & 3 Rx/annum
337 Respiratory System Coughs and colds Decongestant, analgesic combinations Diphenhydramine-Phenyleph-APAP-Vit C Cap 10-5-400-50 MG OR CAPS A Max 20/Rx & 3 Rx/annum
338 Respiratory System Coughs and colds Decongestant, analgesic combinations DM-Phenylpropanolamine-APAP Syrup 15-25-500 MG/20ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
339 Respiratory System Coughs and colds Decongestant, analgesic combinations PE-CPM-APAP-Atropine-Caff-Vit C Cap 5-2-300-0.125-30-75 MG OR CAPS A Max 20/Rx & 3 Rx/annum
340 Respiratory System Coughs and colds Decongestant, analgesic combinations Phenyleph-Chlorphen-DM w/APAP Syrup 2.5-0.5-2-120 MG/5ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
341 Respiratory System Coughs and colds Decongestant, analgesic combinations Phenylpropanolamine w/ Acetaminophen Cap 18-325 MG OR CAPS A Max 24/Rx & 3 Rx/annum
342 Respiratory System Coughs and colds Decongestant, analgesic combinations Phenylprop-Phenyltolox w/ Cod-APAP Tab 25-22-15-300 MG OR TABS A Max 20/Rx & 3 Rx/annum
343 Respiratory System Coughs and colds Decongestant, analgesic combinations Pyrilamine-Phenylephrine-Acetaminophen Tab 5-5-500 MG OR TABS A Max 20/Rx & 3 Rx/annum
344 Respiratory System Coughs and colds Decongestant, analgesic combinations Triprolidine-Pseudoephedrine-APAP Syrup 0.625-15-125 MG/5ML OR SYRP A From 6 months Max 100ml/Rx & 3 Rx/annum
345 Respiratory System Coughs and colds Decongestants Pseudoephedrine HCl Syrup 30 MG/5ML OR SYRP A Max 100ml/Rx & 3 Rx/annum
346 Respiratory System Coughs and colds Decongestants Pseudoephedrine HCl Tab 60 MG OR TABS A Max 20/Rx & 3 Rx/annum
347 Respiratory System Coughs and colds Decongestants Triprolidine & Pseudoephedrine Syrup 1.25-30 MG/5ML OR SYRP A Max 100ml/Rx & 3 Rx/annum
348 Respiratory System Coughs and colds Decongestants Triprolidine & Pseudoephedrine Tab 1.25-30 MG OR TABS A Max 20/Rx & 3 Rx/annum
349 Respiratory System Bronchodilators Sympathomimetics Formoterol Fumarate Inhal Aerosol 12 UG/ACT IN AERP C AST, BCE, COP Therapeutic - ChroniLine
350 Respiratory System Bronchodilators Sympathomimetics Salbutamol (Albuterol) Sulfate Cap For Inhal 200 MCG IN CAPS C AST, BCE, COP Therapeutic - ChroniLine
351 Respiratory System Bronchodilators Sympathomimetics Salbutamol (Albuterol) Sulfate Inhal Aero 108 UG/ACT IN AERO C AST, BCE, COP Therapeutic - ChroniLine
352 Respiratory System Bronchodilators Sympathomimetics Salbutamol (Albuterol) Sulfate Syrup 2 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
353 Respiratory System Bronchodilators Sympathomimetics Salbutamol (Albuterol) Sulfate Tab 2 MG OR TABS A OTC Max 30/Rx & 3 Rx/annum
354 Respiratory System Bronchodilators Sympathomimetics Salbutamol (Albuterol) Sulfate Tab 4 MG OR TABS A OTC Max 30/Rx & 3 Rx/annum
355 Respiratory System Bronchodilators Methylxanthines and combinations Aminophylline Dihydrate Inj 25 MG/ML INJ SOLN A Consumables - Clinic use only
356 Respiratory System Bronchodilators Methylxanthines and combinations Theophylline Syrup 80 MG/15ML OR SYRP A Max 200ml/Rx & 3 Rx/annum
357 Respiratory System Bronchodilators Methylxanthines and combinations Theophylline Syrup 80 MG/15ML OR SYRP C AST, BCE, COP Therapeutic - ChroniLine
358 Respiratory System Bronchodilators Methylxanthines and combinations Theophylline Tab SR 12HR 200 MG OR TB12 C AST, BCE, COP Therapeutic - ChroniLine
359 Respiratory System Bronchodilators Methylxanthines and combinations Theophylline Tab SR 12HR 300 MG OR TB12 C AST, BCE, COP Therapeutic - ChroniLine
360 Respiratory System Bronchodilators Methylxanthines and combinations Theophylline-Etofylline Elixir 80-10 MG/15ML OR ELIX A Max 200ml/Rx & 3 Rx/annum
361 Respiratory System Bronchodilators Anticholinergics Ipratropium Bromide Inhal Aerosol 40 UG/ACT IN AERO C AST, BCE, COP Therapeutic - ChroniLine
362 Respiratory System Bronchodilators Combinations Ipratropium-Albuterol Aerosol 18-103 MCG/ACT (20-120MCG/ACT) IN AERO C AST, BCE, COP Therapeutic - ChroniLine
363 Respiratory System Bronchodilators Combinations Clear Cough A OTC
364 Respiratory System Bronchodilators Combinations Bronchol A OTC
365 Respiratory System Mucolytics Mucolytics Carbocysteine Cap 375 MG OR CAPS A OTC Max 30/Rx & 3 Rx/annum
366 Respiratory System Mucolytics Mucolytics Carbocysteine Syrup 250 MG/5ML OR SYRP A OTC Max 200ml/Rx & 3 Rx/annum
367 Respiratory System Anti-asthmatics Beclomethasone Dipropionate Inhal Aero 42 UG/ACT IN AERO C AST, BCE, COP Therapeutic - ChroniLine
368 Respiratory System Anti-asthmatics Beclomethasone Dipropionate Inhal Aero 84 UG/AC IN AERO C AST, BCE, COP Therapeutic - ChroniLine
369 Respiratory System Anti-asthmatics Beclomethasone Dipropionate Inhal Aero 200 UG/ACT IN AERO C AST, BCE, COP Therapeutic - ChroniLine
370 Respiratory System Anti-asthmatics Budesonide Inhaler Aerosol 100 UG/ACT IN AERO C AST, BCE, COP Therapeutic - ChroniLine
371 Respiratory System Anti-asthmatics Budesonide Inhaler Aerosol 200 UG/ACT IN AERO C AST, BCE, COP Therapeutic - ChroniLine
372 Respiratory System Anti-asthmatics Budesonide Inhal Aero Powd 100 MCG/INH (Breath Activated) IN AERO C AST, BCE, COP Therapeutic - ChroniLine
373 Respiratory System Anti-asthmatics Budesonide Inhal Aero Powd 200 MCG/INH (Breath Activated) IN AERO C AST, BCE, COP Therapeutic - ChroniLine
374 Respiratory System Anti-asthmatics Symbicort Turbu 160/4.5 60 dose IN AERO C AST, BCE, COP Therapeutic - ChroniLine
375 Respiratory System Anti-asthmatics Symbicort turbu 160/4.5 120 dose IN AERO C AST, BCE, COP Therapeutic - ChroniLine
376 Respiratory System Anti-asthmatics Symbicort Inh 320/9MCG 60 dose IN AERO C AST, BCE, COP Therapeutic - ChroniLine
377 Respiratory System Anti-asthmatics Foxair (InhalerAero Powd) IN AERO C AST,COP Therapeutic- Chroniline
378 Respiratory System Anti-asthmatics Duolin Respules Inhalation 1.25mg/500mcg IN AERO A Max 7 per Rx & 2Rx/annum
379 Respiratory System Anti-asthmatics Leukotriene receptor antagonist NONE LISTED
380 Respiratory System Anti-asthmatics Chromones NONE
381 Respiratory System Anti-asthmatics Other anti-asthmatics NONE LISTED
382 Respiratory System Surfactants Surfactants NONE LISTED
383 Respiratory System Others Others NONE LISTED
384 Ear, Nose and Throat Topical nasal preparations Antimicrobial and combinations NONE LISTED
385 Ear, Nose and Throat Topical nasal preparations Glucocorticosteroids Beclomethasone Dipropionate Nasal Soln 0.05% NA SOLN A OTC Max 1/Rx & 4 Rx/annum
386 Ear, Nose and Throat Topical nasal preparations Chromones NONE
387 Ear, Nose and Throat Topical nasal preparations Decongestants Phenylephrine HCl Nasal Soln 0.25% NA SOLN A OTC Max 1 package every 30 days & 3 Rx/annum
388 Ear, Nose and Throat Topical nasal preparations Decongestants Phenylephrine HCl Nasal Soln 1% NA SOLN A OTC Max 1 package every 30 days & 3 Rx/annum
389 Ear, Nose and Throat Topical nasal preparations Decongestants Phenylephrine-Naphazoline Nasal Soln 2.5-0.25 MG/ML NA SOLN A OTC Max 1 package every 30 days & 3 Rx/annum
390 Ear, Nose and Throat Topical nasal preparations Antihistamines NONE LISTED
391 Ear, Nose and Throat Topical nasal preparations Mucolytics NONE
392 Ear, Nose and Throat Topical nasal preparations Others Saline Nasal Spray 0.9% NA SOLN A OTC Max 1 package every 30 days & 3 Rx/annum
393 Ear, Nose and Throat Ear drops and ointments Ear drops and ointments Antipyrine Otic Soln 5% OT SOLN A OTC Max 1 package every 30 days & 3 Rx/annum
394 Ear, Nose and Throat Ear drops and ointments Ear drops and ointments Antipyrine-Benzocaine Otic Soln 5-1% OT SOLN A OTC Max 1 package every 30 days & 3 Rx/annum
395 Ear, Nose and Throat Ear drops and ointments Ear drops and ointments Antipyrine-Benzocaine-Ephedrine-Pot Oxyquinolone Otic Soln OT SOLN A Max 1 package every 30 days & 3 Rx/annum
396 Ear, Nose and Throat Ear drops and ointments Ear drops and ointments Antipyrine-Procaine-Pot Oxyquinoline Otic Soln 5-1-0.1% OT SOLN A Max 1 package every 30 days & 3 Rx/annum
397 Ear, Nose and Throat Ear drops and ointments Ear drops and ointments Cilodex Ear drops DRP SOLN A Max 1 package every 30 days & 2 Rx/annum
398 Ear, Nose and Throat Ear drops and ointments Ear drops and ointments Neomycin-Sodium Propionate Otic Soln 3-50 MG/ML OT SOLN A Max 1 package every 30 days & 3 Rx/annum
399 Ear, Nose and Throat Ear drops and ointments Ear drops and ointments Phenazone,chlorbutol;benzocaine DRP SOLN A OTC Max 1 package every 30 days & 3 Rx/annum
400 Ear, Nose and Throat Mouth and throat preparations Mouth and throat preparations Benzocaine Lozenge 10 MG MT LOZG A OTC Max 20/Rx & 4 Rx/annum
401 Ear, Nose and Throat Mouth and throat preparations Mouth and throat preparations Povidone-Iodine Mouthwash 1% MT SOLN A OTC Max 200ml/annum
402 Ear, Nose and Throat Mouth and throat preparations Mouth and throat preparations Tetracaine HCl Ointment 0.5% MT OINT A OTC Max 1 package/annum
403 Gastro-Intestinal Tract Digestants Digestants NONE LISTED
404 Gastro-Intestinal Tract Appetite suppressants Appetite suppressants NONE LISTED
405 Gastro-Intestinal Tract Anti-Spasmodics Anti-Spasmodics Scopolamine N-Butylbromide Inj 20 MG/ML INJ SOLN A Consumables - Clinic use only
406 Gastro-Intestinal Tract Anti-Spasmodics Anti-Spasmodics Scopolamine N-Butylbromide Syr 5 MG/5ML OR SYRP A OTC Max 100ml/Rx & 3 Rx/annum
407 Gastro-Intestinal Tract Anti-Spasmodics Anti-Spasmodics Scopolamine N-Butylbromide Tab 10 MG OR TABS A OTC Max 20/Rx & 4 Rx/annum
408 Gastro-Intestinal Tract Anti-Spasmodics Anti-Spasmodics Mebeverine HCl Tab 135 MG OR TABS A OTC Max 30/Rx & 4 Rx/annum
409 Gastro-Intestinal Tract Anti-Spasmodics Anti-Spasmodics PB-Hyoscy-Atropine-Scopolamine Tab 15-0.104-0.02-0.006 MG OR TABS A Max 30/Rx & 4 Rx/annum
410 Gastro-Intestinal Tract Acid reducers Antacids Aluminum Hydroxide-Mag Oxide Susp 282-120 MG/15ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
411 Gastro-Intestinal Tract Acid reducers Antacids Cal & Mag Carb-Mag Trisilicate Susp 250-250-500 MG/5ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
412 Gastro-Intestinal Tract Acid reducers Antacids Mag Carb-Mag Trisilicate-Sod Bicarb Susp 250-250-250 MG/5ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
413 Gastro-Intestinal Tract Acid reducers Antacids Mag Carb-Mag Trisilicate-Sod Bicarb Susp 500-500-500 MG/5ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
414 Gastro-Intestinal Tract Acid reducers Antacids and combinations Al & Mg Oxides-Dicycl-Methylcell-Simeth Susp OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
415 Gastro-Intestinal Tract Acid reducers Antacids and combinations Al Hyd-Mag Oxide-Dicyclomine-Dimeth Susp 400-200-5-50MG/10ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
416 Gastro-Intestinal Tract Acid reducers Antacids and combinations Alum Hydrox-Mag Oxide-Dicyclomine Susp 400-200-5 MG/10ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
417 Gastro-Intestinal Tract Acid reducers Antacids and combinations Alum Oxide-Mag Oxide-Dicyclomine Gel 200-200-5 MG/10ML OR GEL A OTC Max 200ml/Rx & 3 Rx/annum
418 Gastro-Intestinal Tract Acid reducers Histamine-2 receptor antagonists Cimetidine Tab 200 MG OR TABS C Therapeutic - ChroniLine - 30 days / Gastroscopy - 90 days
419 Gastro-Intestinal Tract Acid reducers Histamine-2 receptor antagonists Cimetidine Tab 400 MG OR TABS C Therapeutic - ChroniLine - 30 days / Gastroscopy - 90 days
420 Gastro-Intestinal Tract Acid reducers Histamine-2 receptor antagonists Ranitidine HCl Tab 150 MG OR TABS C Therapeutic - ChroniLine - 30 days / Gastroscopy - 90 days
421 Gastro-Intestinal Tract Acid reducers Histamine-2 receptor antagonists Ranitidine HCl Tab 300 MG OR TABS C Therapeutic - ChroniLine - 30 days / Gastroscopy - 90 days
422 Gastro-Intestinal Tract Acid reducers Proton pump inhibitors NONE LISTED
423 Gastro-Intestinal Tract Acid reducers Cytoprotective agents NONE LISTED
424 Gastro-Intestinal Tract Acid reducers Other acid reducers NONE
425 Gastro-Intestinal Tract Motility enhancers Motility enhancers REFER TO 1.8 Anti-Vertigo and anti-emetic agents
426 Gastro-Intestinal Tract Laxatives Laxatives Bisacodyl Tab Delayed Release 5 MG OR TBEC A Max 30/Rx & 2 Rx/annum
427 Gastro-Intestinal Tract Laxatives Laxatives Lactulose Solution 10 G/15ML OR SOLN A OTC Max 200ml/Rx & 2 Rx/annum
428 Gastro-Intestinal Tract Laxatives Laxatives Sennosides Tab 7.5 MG OR TABS A OTC Max 30/Rx & 2 Rx/annum
429 Gastro-Intestinal Tract Laxatives Laxatives Sodium Phosphates - Enema RE ENEM A Max 1 package/Rx & 2 Rx/annum
430 Gastro-Intestinal Tract Antidiarrhoeals Antidiarrhoeals Kaolin-Pectin Susp 1-0.05 GM/5ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
431 Gastro-Intestinal Tract Antidiarrhoeals Antidiarrhoeals Kaolin-Pectin Liquid 3-0.15 GM/15ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
432 Gastro-Intestinal Tract Antidiarrhoeals Antidiarrhoeals Kaolin-Pectin Susp 6-0.45 GM/30ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
433 Gastro-Intestinal Tract Antidiarrhoeals Antidiarrhoeals Kaolin-Pectin w/ Electrolytes Susp 6-0.12 GM/30ML OR SUSP A OTC Max 200ml/Rx & 3 Rx/annum
434 Gastro-Intestinal Tract Antidiarrhoeals Antidiarrhoeals Loperamide HCl Syrup 1 MG/5ML OR SYRP A OTC Max 50ml/Rx & 3 Rx/annum
435 Gastro-Intestinal Tract Antidiarrhoeals Antidiarrhoeals Loperamide HCl Tab 2 MG OR TABS A OTC Max 20/Rx & 3 Rx/annum
436 Gastro-Intestinal Tract Liver, gall bladder and bile Liver, gall bladder and bile NONE LISTED
437 Gastro-Intestinal Tract Suppositories and anal ointments Suppositories and anal ointments Hemorrhoidal Anesthetic Compound - Supp RE SUPP A OTC Max 1 package/Rx & 3 Rx/annum
438 Gastro-Intestinal Tract Suppositories and anal ointments Suppositories and anal ointments Pramoxine HCl Rectal Oint 1% RE OINT A Max 1 package/Rx & 3 Rx/annum
439 Gastro-Intestinal Tract Others Others Budesonide Enema Kit 0.02 MG/ML RE KIT C CSD, UC Therapeutic - ChroniLine Pre-Auth
440 Gastro-Intestinal Tract Others Others Mesalamine Suppos 500 MG RE SUPP C CSD, UC Therapeutic - ChroniLine Pre-Auth
441 Gastro-Intestinal Tract Others Others Mesalamine Suppos 1000 MG RE SUPP C CSD, UC Therapeutic - ChroniLine Pre-Auth
442 Gastro-Intestinal Tract Others Others Mesalamine Enema 2 GM RE ENEM C CSD, UC Therapeutic - ChroniLine Pre-Auth
443 Gastro-Intestinal Tract Others Others Mesalamine Tab CR 500 MG OR TBCR C CSD, UC Therapeutic - ChroniLine Pre-Auth
444 Gastro-Intestinal Tract Others Others Mesalamine Tab Delayed Release 400 MG OR TBEC C CSD, UC Therapeutic - ChroniLine Pre-Auth
445 Gastro-Intestinal Tract Others Others Mesalamine Tab Delayed Release 800 MG OR TBEC C CSD, UC Therapeutic - ChroniLine Pre-Auth
446 Gastro-Intestinal Tract Others Others Mesalamine Tab Delayed Release 1.2 GM OR TBEC C CSD, UC Therapeutic - ChroniLine Pre-Auth
447 Gastro-Intestinal Tract Others Others Olsalazine Sodium Cap 250 MG OR CAPS C CSD, UC Therapeutic - ChroniLine Pre-Auth
448 Gastro-Intestinal Tract Others Others Pantaprazole 20MG OR ECT A OTC
449 Gastro-Intestinal Tract Others Others Sulfasalazine Tab 500 MG OR TABS C CSD, RHA, UC Therapeutic - ChroniLine Pre-Auth
450 Anthelmintics Anthelmintics Anthelmintics Albendazole Susp 100 MG/5ML OR SUSP A Max 1 package/Rx & 2 Rx/annum
451 Anthelmintics Anthelmintics Anthelmintics Mebendazole Susp 20 MG/ML OR SUSP A OTC Max 1 package/Rx & 2 Rx/annum
452 Anthelmintics Anthelmintics Anthelmintics Mebendazole Tab 100 MG OR TABS A OTC Max 1 package/Rx & 2 Rx/annum
453 Anthelmintics Anthelmintics Anthelmintics Praziquantel Tab 600 MG OR TABS A Max 1 package/Rx & 2 Rx/annum
454 Dermatologicals Anti-bacterial antiseptic agents Anti-bacterial antiseptic agents Iodoquinol-Chlorobutanol-Benzocaine Cream 30-10-10 MG/GM EX CREA A OTC Max 1 package/Rx & 2 Rx/annum
455 Dermatologicals Anti-bacterial antiseptic agents Anti-bacterial antiseptic agents Nitrofurazone Oint 0.2% EX OINT A OTC Max 1 package/Rx & 2 Rx/annum
456 Dermatologicals Anti-bacterial antiseptic agents Anti-bacterial antiseptic agents Povidone-Iodine Oint 10% EX OINT A OTC Max 1 package/Rx & 2 Rx/annum
457 Dermatologicals Anti-bacterial antiseptic agents Anti-bacterial antiseptic agents Silver Sulfadiazine Cream 1% EX CREA A OTC Max 1 package/Rx & 2 Rx/annum
458 Dermatologicals Anti-bacterial antiseptic agents Anti-bacterial antiseptic agents Sulfanilamide-Mercurochrome-Peru Balsam-Cod Liver Oil Oint EX OINT A Max 1 package/Rx & 2 Rx/annum
459 Dermatologicals Anti-parasitics Anti-parasitics GH EX EMUL A OTC Max 200ml/Rx & 2 Rx/annum
460 Dermatologicals Anti-parasitics Anti-parasitics Sulfiram Bar 5% EX BAR A OTC Max 2 bars/Rx & 2 Rx/annum
461 Dermatologicals Fungicides Fungicides Clotrimazole Cream 1% EX CREA A OTC Max 1 package/Rx & 2 Rx/annum
462 Dermatologicals Cortico-steroids Cortico-steroids (topical) Betamethasone Valerate Cream 0.1% EX CREA A C SLE Max 1 package/Rx & 2 Rx/annum / Therapeutic - ChroniLine
463 Dermatologicals Cortico-steroids Cortico-steroids (topical) Betamethasone Valerate Oint 0.1% EX OINT A C SLE Max 1 package/Rx & 2 Rx/annum / Therapeutic - ChroniLine
464 Dermatologicals Cortico-steroids Cortico-steroids (topical) Fluocinolone Acetonide Cream 0.025% EX CREA A C SLE Max 1 package/Rx & 2 Rx/annum / Therapeutic - ChroniLine
465 Dermatologicals Cortico-steroids Cortico-steroids (topical) Fluocinolone Acetonide Oint 0.025% EX OINT A C SLE Max 1 package/Rx & 2 Rx/annum / Therapeutic - ChroniLine
466 Dermatologicals Cortico-steroids Cortico-steroids (topical) Hydrocortisone Acetate Cream 1% EX CREA A C OTC SLE Max 1 package/Rx & 2 Rx/annum / Therapeutic - ChroniLine
467 Dermatologicals Cortico-steroids Cortico-steroids (topical) Hydrocortisone Cream 1% EX CREA A C OTC SLE Max 1 package/Rx & 2 Rx/annum / Therapeutic - ChroniLine
468 Dermatologicals Cortico-steroids Cortico-steroids with anti-infective agents Iodoquinol-Chlorobutanol-HC Cream 3-1-0.25% EX CREA A Max 1 package/Rx & 2 Rx/annum
469 Dermatologicals Cortico-steroids Cortico-steroids with anti-infective agents Neomycin-HC Ace Cream 1% EX CREA A Max 1 package/Rx & 2 Rx/annum
470 Dermatologicals Psoriasis Psoriasis Coal Tar Cream 1% EX CREA C Therapeutic - ChroniLine
471 Dermatologicals Psoriasis Psoriasis Coal Tar Liquid EX LIQD C Therapeutic - ChroniLine
472 Dermatologicals Psoriasis Psoriasis Coal Tar Shampoo 5% EX SHAM C Therapeutic - ChroniLine
473 Dermatologicals Acne Acne NONE LISTED
474 Dermatologicals Melanin inhibitors and stimulants Melanin inhibitors and stimulants NONE
475 Dermatologicals Emollients and protectives Emollients and protectives Calamine Phenolated Lotion EX LOTN A OTC Max 100ml/Rx & 3 Rx/annum
476 Dermatologicals Others Others Diphenhydramine-Calamine-Phenol Lotion 1-15-0.4% EX LOTN A Max 100ml/Rx & 3 Rx/annum
477 Ophthalmics Anti-infectives Anti-infectives Chloramphenicol Ophth Oint 1% OP OINT A Max 1 package/Rx & 3 Rx/annum
478 Ophthalmics Anti-infectives Anti-infectives Sulfacetamide Sodium Ophth Oint 10% OP OINT A OTC Max 1 package/Rx & 3 Rx/annum
479 Ophthalmics Anti-infectives Antivirals NONE LISTED
480 Ophthalmics Corticoids Corticoids NONE LISTED
481 Ophthalmics Combinations (Anti-infectives with corticoids) Combinations (Anti-infectives with corticoids) NONE LISTED
482 Ophthalmics Decongestants Oxymetazoline HCl Ophth Soln 0.025% OP SOLN A OTC Max 1 package/Rx & 3 Rx/annum
483 Ophthalmics Decongestants Phenylephrine-Boric Acid Ophth Soln 1.25-20 MG/ML OP SOLN A OTC Max 1 package/Rx & 3 Rx/annum
484 Ophthalmics Mydriatics Mydriatics Atropine Sulfate Ophth Soln 1% OP SOLN A Max 1 package/Rx & 3 Rx/annum
485 Ophthalmics Glaucoma Glaucoma Bimatoprost Ophth Soln 0.01% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
486 Ophthalmics Glaucoma Glaucoma Bimatoprost-Timolol Maleate Ophth Soln 0.03-0.5% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
487 Ophthalmics Glaucoma Glaucoma Brimonidine Tartrate Ophth Soln 0.2% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
488 Ophthalmics Glaucoma Glaucoma Brimonidine Tartrate-Timolol Maleate Ophth Soln 0.2-0.5% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
489 Ophthalmics Glaucoma Glaucoma Brinzolamide-Timolol Ophth Susp 1-0.5% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
490 Ophthalmics Glaucoma Glaucoma Dorzolamide HCl Ophth Soln 2% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
491 Ophthalmics Glaucoma Glaucoma Dorzolamide HCl-Timolol Maleate Ophth Soln 22.3-6.8 MG/ML OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
492 Ophthalmics Glaucoma Glaucoma Latanoprost Ophth Soln 0.005% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
493 Ophthalmics Glaucoma Glaucoma Latanoprost-Timolol Maleate Ophth Soln 0.005-0.5% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
494 Ophthalmics Glaucoma Glaucoma Pilocarpine HCl Ophth Soln 1% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
495 Ophthalmics Glaucoma Glaucoma Pilocarpine HCl Ophth Soln 2% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
496 Ophthalmics Glaucoma Glaucoma Pilocarpine HCl Ophth Soln 4% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
497 Ophthalmics Glaucoma Glaucoma Timolol Maleate Ophth Soln 0.5% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
498 Ophthalmics Glaucoma Glaucoma Travoprost Ophth Soln 0.004% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
499 Ophthalmics Glaucoma Glaucoma Travoprost-Timolol Maleate Ophth Soln 0.004-0.5% OP SOLN C GLC Therapeutic - ChroniLine Pre-Auth
500 Ophthalmics Glaucoma Others Cromolyn Sodium Ophth Soln 2% OP SOLN A OTC Max 1 package/Rx & 3 Rx/annum
501 Urinary System Diuretics Diuretics Amiloride & Hydrochlorothiazide Tab 5-50 MG OR TABS C CHF, CMY, HYP Therapeutic - ChroniLine
502 Urinary System Diuretics Diuretics Furosemide Inj 10 MG/ML INJ SOLN A Consumables - Clinic use only
503 Urinary System Diuretics Diuretics Furosemide Tab 40 MG OR TABS C CHF, CMY, CRD, HYP Therapeutic - ChroniLine
504 Urinary System Diuretics Diuretics Hydrochlorothiazide Tab 12,5 MG OR TABS C CHF, CMY, CRD, HYP Therapeutic - ChroniLine
505 Urinary System Diuretics Diuretics Hydrochlorothiazide Tab 25 MG OR TABS C CHF, CMY, CRD, HYP Therapeutic - ChroniLine
506 Urinary System Diuretics Diuretics Hydrochlorothiazide-Potassium Chloride Tab 50-300 MG OR TABS C CHF, CMY, HYP Therapeutic - ChroniLine
507 Urinary System Diuretics Diuretics Indapamide Tab 2.5 MG OR TABS C CHF, CMY, HYP Therapeutic - ChroniLine
508 Urinary System Diuretics Diuretics Spironolactone Tab 25 MG OR TABS C CHF, CMY, HYP Therapeutic - ChroniLine
509 Urinary System Diuretics Diuretics Triamterene & Hydrochlorothiazide Tab 50-25 MG OR TABS C CHF, CMY, HYP Therapeutic - ChroniLine
510 Urinary System Anti-diuretics Anti-diuretics Desmopressin Acetate Nasal Solution 0.01% (Refridgerated) NA SOLN C DBI, HAE Therapeutic - ChroniLine Pre-Auth
511 Urinary System Anti-diuretics Anti-diuretics Desmopressin Acetate Tab 0.1 MG OR TABS C DBI, HAE Therapeutic - ChroniLine Pre-Auth
512 Urinary System Anti-diuretics Anti-diuretics Desmopressin Acetate Tab 0.2 MG OR TABS C DBI, HAE Therapeutic - ChroniLine Pre-Auth
513 Urinary System Urinary alkalinizers Urinary alkalinizers Potassium Citrate & Citric Acid Soln 20-4% OR SOLN A OTC Max 200ml/Rx & 3 Rx/annum
514 Urinary System Urinary alkalinizers Urinary alkalinizers Potassium Citrate & Citric Acid Soln 45-21 MG/15ML OR SOLN A OTC Max 200ml/Rx & 3 Rx/annum
515 Urinary System Urinary antiseptics Urinary antiseptics NONE LISTED
516 Urinary System Others Others NONE LISTED
517 Genital System Contraceptives Contraceptives NONE LISTED
518 Genital System Vaginal Preparations Vaginal Preparations Aminacrine-Iodoquinol-Boric Acd-Cetylpyridinium Vag Gel VA GEL A Max 1 package/Rx & 3 Rx/annum
519 Genital System Vaginal Preparations Vaginal Preparations Clotrimazole Vaginal Cream 1% VA CREA A OTC Max 1 package/Rx & 3 Rx/annum
520 Genital System Oxytocics Oxytocics Ergonovine Maleate Inj 0.5 MG/ML INJ SOLN A Consumables - Clinic use only
521 Genital System Uterine antispasmodics Uterine antispasmodics NONE LISTED
522 Genital System Sexual dysfunction Others NONE
523 Genital System Sexual dysfunction Erectile dysfunction NONE LISTED
524 Antimicrobials Beta-Lactams Penicillins Amoxicillin & K Clavulanate For Susp 125-31.25 MG/5ML OR SUSR A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
525 Antimicrobials Beta-Lactams Penicillins Amoxicillin & K Clavulanate For Susp 250-62.5 MG/5ML OR SUSR A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
526 Antimicrobials Beta-Lactams Penicillins Amoxicillin & K Clavulanate For Susp 400-57 MG/5ML OR SUSR A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
527 Antimicrobials Beta-Lactams Penicillins Amoxicillin & K Clavulanate Tab 250-125 MG OR TABS A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
528 Antimicrobials Beta-Lactams Penicillins Amoxicillin & K Clavulanate Tab 500-125 MG OR TABS A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
529 Antimicrobials Beta-Lactams Penicillins Amoxicillin Cap 250 MG OR CAPS A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
530 Antimicrobials Beta-Lactams Penicillins Amoxicillin Cap 500 MG OR CAPS A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
531 Antimicrobials Beta-Lactams Penicillins Amoxicillin For Susp 125 MG/5ML OR SUSR A C BCE Max 4 fills/annum
532 Antimicrobials Beta-Lactams Penicillins Amoxicillin For Susp 250 MG/5ML OR SUSR A C BCE Max 4 fills/annum
533 Antimicrobials Beta-Lactams Penicillins Amoxicillin-Floxacillin Cap 250-250 MG OR CAPS A Max 4 fills/annum
534 Antimicrobials Beta-Lactams Penicillins Amoxicillin-Floxacillin For Susp 125-125 MG/5ML OR SUSR A Max 4 fills/annum
535 Antimicrobials Beta-Lactams Penicillins Ampicillin Cap 250 MG OR CAPS A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
536 Antimicrobials Beta-Lactams Penicillins Ampicillin For Susp 125 MG/5ML OR SUSR A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
537 Antimicrobials Beta-Lactams Penicillins Ampicillin-Cloxacillin Cap 250-250 MG OR CAPS A Max 4 fills/annum
538 Antimicrobials Beta-Lactams Penicillins Ampicillin-Cloxacillin For Susp 125-125 MG/5ML OR SUSR A Max 4 fills/annum
539 Antimicrobials Beta-Lactams Penicillins Cloxacillin Sodium Cap 250 MG OR CAPS A Max 4 fills/annum
540 Antimicrobials Beta-Lactams Penicillins Cloxacillin Sodium Cap 500 MG OR CAPS A Max 4 fills/annum
541 Antimicrobials Beta-Lactams Penicillins Floxacillin Sodium Cap 250 MG OR CAPS A Max 4 fills/annum
542 Antimicrobials Beta-Lactams Penicillins Penicillin G Benzathine For Intramuscular Susp 1200000 Unit IM SUSR A Consumables - Clinic use only
543 Antimicrobials Beta-Lactams Penicillins Penicillin G Benzathine For Intramuscular Susp 2400000 Unit IM SUSR A Consumables - Clinic use only
544 Antimicrobials Beta-Lactams Penicillins Penicillin G Procaine Intramuscular Susp 300000 Unit/ML IM SUSP A Consumables - Clinic use only
545 Antimicrobials Beta-Lactams Penicillins Penicillin G Sodium For Inj 1000000 Unit IM SUSR A Consumables - Clinic use only
546 Antimicrobials Beta-Lactams Penicillins Penicillin G Sodium For Inj 5000000 Unit IM SUSR A Consumables - Clinic use only
547 Antimicrobials Beta-Lactams Penicillins Penicillin V Potassium For Soln 125 MG/5ML OR SUSR A Max 4 fills/annum
548 Antimicrobials Beta-Lactams Penicillins Penicillin V Potassium Tab 250 MG OR TABS A Max 4 fills/annum
549 Antimicrobials Beta-Lactams Cephalosporins 1st generatiom Cefazolin Sodium For Inj 1 GM INJ SOLR A Consumables - Clinic use only
550 Antimicrobials Beta-Lactams Cephalosporins 1st generatiom Cephalexin Cap 250 MG OR CAPS A Max 4 fills/annum
551 Antimicrobials Beta-Lactams Cephalosporins 1st generatiom Cephalexin Cap 500 MG OR CAPS A Max 4 fills/annum
552 Antimicrobials Beta-Lactams Cephalosporins 1st generatiom Cephalexin For Susp 125 MG/5ML OR SUSR A Max 4 fills/annum
553 Antimicrobials Beta-Lactams Cephalosporins 1st generatiom Cephalexin For Susp 250 MG/5ML OR SUSR A Max 4 fills/annum
554 Antimicrobials Beta-Lactams Cephalosporins 2nd generation Cefoxitin Sodium For Inj 1 G IV SOLR A Consumables - Clinic use only
555 Antimicrobials Beta-Lactams Cephalosporins 2nd generation Cefuroxime Sodium For Inj 250 MG INJ SOLR A Consumables - Clinic use only
556 Antimicrobials Beta-Lactams Cephalosporins 2nd generation Cefuroxime Sodium For Inj 750 MG INJ SOLR A Consumables - Clinic use only
557 Antimicrobials Beta-Lactams Cephalosporins 3rd generation Cefotaxime Sodium For Inj 500 MG INJ SOLR A Consumables - Clinic use only
558 Antimicrobials Beta-Lactams Cephalosporins 3rd generation Ceftriaxone Sodium For Inj 1 G INJ SOLR A Consumables - Clinic use only
559 Antimicrobials Beta-Lactams Others NONE LISTED
560 Antimicrobials Erythromycin and other macrolides Erythromycin and other macrolides Erythromycin Estolate Cap 250 MG OR CAPS A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
561 Antimicrobials Erythromycin and other macrolides Erythromycin and other macrolides Erythromycin Estolate Susp 125 MG/5ML OR SUSP A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
562 Antimicrobials Erythromycin and other macrolides Erythromycin and other macrolides Erythromycin Estolate Susp 250 MG/5ML OR SUSP A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
563 Antimicrobials Erythromycin and other macrolides Erythromycin and other macrolides Erythromycin Stearate Tab 250 MG OR SUSP A C BCE Max 4 fills/annum / Therapeutic - ChroniLine
564 Antimicrobials Erythromycin and other macrolides Erythromycin and other macrolides Azithromycin Unicorn 500mg OR TABS A C Max 3 days Treatment /2 Rx per annum
565 Antimicrobials Aminoglycosides Aminoglycosides Gentamicin Sulfate Inj 40 MG/ML INJ SOLN A Consumables - Clinic use only
566 Antimicrobials Aminoglycosides Aminoglycosides Streptomycin Sulfate Inj 1000 MG/3ML INJ SOLN A Consumables - Clinic use only
567 Antimicrobials Tetracyclines Tetracyclines Doxycycline Hyclate Cap 100 MG OR CAPS A BCE Max 4 fills/annum / Therapeutic - ChroniLine
568 Antimicrobials Tetracyclines Tetracyclines Oxytetracycline HCl Cap 250 MG OR CAPS A Max 4 fills/annum
569 Antimicrobials Chloramphenicols Chloramphenicols Chloramphenicol Cap 250 MG OR CAPS A Max 4 fills/annum
570 Antimicrobials Chloramphenicols Chloramphenicols Chloramphenicol Susp 125 MG/5ML OR SUSP A Max 4 fills/annum
571 Antimicrobials Sulphonamides and combinations Sulphonamides and combinations Sulfamethoxazole-Trimethoprim IV Soln 400-80 MG/5ML IV SOLN A Consumables - Clinic use only
572 Antimicrobials Sulphonamides and combinations Sulphonamides and combinations Sulfamethoxazole-Trimethoprim Susp 200-40 MG/5ML OR SUSP A Max 4 fills/annum / Therapeutic - ChroniLine
573 Antimicrobials Sulphonamides and combinations Sulphonamides and combinations Sulfamethoxazole-Trimethoprim Tab 400-80 MG OR TABS A Max 4 fills/annum / Therapeutic - ChroniLine
574 Antimicrobials Quinolones Quinolones Ciprofloxacin HCl Tab 250 MG OR TABS A BCE, CSD Max 4 fills/annum
575 Antimicrobials Quinolones Quinolones Ciprofloxacin HCl Tab 500 MG OR TABS A BCE, CSD Max 4 fills/annum
576 Antimicrobials Mycobacteria Tuberculostatics Ethambutol HCl Tab 400mg OR TABS C CDL Therapeutic - ChroniLine Pre-Auth
577 Antimicrobials Mycobacteria Tuberculostatics Isoniazid Tab 100mg OR TABS C CDL Therapeutic - ChroniLine Pre-Auth
578 Antimicrobials Mycobacteria Tuberculostatics Isoniazid Tab 200mg OR TABS C CDL Therapeutic - ChroniLine Pre-Auth
579 Antimicrobials Mycobacteria Tuberculostatics Isoniazid & Rifampin Tab 100-150 MG OR TABS C CDL Therapeutic - ChroniLine Pre-Auth
580 Antimicrobials Mycobacteria Tuberculostatics Isoniazid & Rifampin Tab 150-300 MG OR TABS C CDL Therapeutic - ChroniLine Pre-Auth
581 Antimicrobials Mycobacteria Tuberculostatics Isoniazid & Rifampin Tab Disp 60-30 MG OR TBDP C CDL Therapeutic - ChroniLine Pre-Auth
582 Antimicrobials Mycobacteria Tuberculostatics Isoniazid-Rifampin-Ethamb-Pyrazinamide Tab 75-150-275-400 MG OR TABS C CDL Therapeutic - ChroniLine Pre-Auth
583 Antimicrobials Mycobacteria Anti-leprotics Dapsone Tab 100 MG OR TABS A C CDL Therapeutic - ChroniLine Pre-Auth
584 Antimicrobials Other anti-bacterial agents Other anti-bacterial agents Clindamycin HCl Cap 150 MG OR CAPS A Max 2 fills/annum
585 Antimicrobials Anti-fungal agents Anti-fungal agents Fluconazole Cap 150 MG OR CAPS A Max 2 fills/annum / Therapeutic - ChroniLine
586 Antimicrobials Anti-fungal agents Anti-fungal agents Nystatin Susp 100000 Unit/ML MT SUSP A OTC Max 2 fills/annum
587 Antimicrobials Anti-protozoal agents Anti-protozoal agents Chloroquine Sulfate Cap 200 MG OR CAPS C RHA, SLE Therapeutic - ChroniLine
588 Antimicrobials Anti-protozoal agents Anti-protozoal agents Metronidazole Susp 200 MG/5ML OR SUSP A Max 3 fills/annum
589 Antimicrobials Anti-protozoal agents Anti-protozoal agents Metronidazole Tab 200 MG OR TABS A C CSD Max 3 fills/annum / Therapeutic - ChroniLine
590 Antimicrobials Anti-protozoal agents Anti-protozoal agents Metronidazole Tab 400 MG OR TABS A C CSD Max 3 fills/annum / Therapeutic - ChroniLine
591 Antimicrobials Anti-viral agents Anti-viral agents Acyclovir Cream 5% EX CREA A OTC Max 2 Rx/annum
592 Antimicrobials Anti-viral agents Anti-viral agents Acyclovir Tab 200 MG OR TABS A Max 1 Rx/annum
593 Antimicrobials Anti-viral agents Anti-viral agents Acyclovir Tab 400 MG OR TABS A Max 1 Rx/annum
594 Antimicrobials Anti-viral agents Anti-viral agents Acyclovir Tab Disp 200 MG OR TBDP A Max 1 Rx/annum
595 Antimicrobials Anti-viral agents Anti-viral agents Acyclovir Tab Disp 400 MG OR TBDP A Max 1 Rx/annum
596 Antimicrobials Anti-viral agents Anti-retroviral agents According to HIV Disease Management Programme (DMP)
597 Endocrine System Anti-diabetic agents Rapid acting Insulins Insulin Lispro (Human) Inj 100 Unit/ML (10ml vial) SC SOLN C DM1, DM2 Therapeutic - ChroniLine
598 Endocrine System Anti-diabetic agents Rapid acting Insulins Insulin Aspart Inj 100 Unit/ML (10ml vial) SC SOLN C DM1, DM2 Therapeutic - ChroniLine
599 Endocrine System Anti-diabetic agents Rapid acting Insulins Insulin Glulisine Subcutaneous Inj 100 Unit/ML (10ml vial) SC SOLN C DM1, DM2 Therapeutic - ChroniLine
600 Endocrine System Anti-diabetic agents Short acting Insulins Insulin Regular (Human) Inj 100 Unit/ML SC SOLN C DM1, DM2 Therapeutic - ChroniLine
601 Endocrine System Anti-diabetic agents Intermediate acting Insulins Insulin Isophane (Human) Inj 100 Unit/ML SC SUSP C DM1, DM2 Therapeutic - ChroniLine
602 Endocrine System Anti-diabetic agents Biphasic Insulins Insulin Lispro Prot & Lispro (Human) Inj 100 Unit/ML (75-25) SC SUSP C DM1, DM2 Therapeutic - ChroniLine
603 Endocrine System Anti-diabetic agents Biphasic Insulins Insulin Lispro Prot & Lispro (Human) Inj 100 Unit/ML (50-50) SC SUSP C DM1, DM2 Therapeutic - ChroniLine
604 Endocrine System Anti-diabetic agents Biphasic Insulins Insulin Aspart Prot & Aspart (Human) Inj 100 Unit/ML (70-30) SC SUSP C DM1, DM2 Therapeutic - ChroniLine
605 Endocrine System Anti-diabetic agents Biphasic Insulins Insulin Isophane & Regular (Human) Inj 100 Unit/ML (70-30) SC SUSP C DM1, DM2 Therapeutic - ChroniLine
606 Endocrine System Anti-diabetic agents Oral anti-diabetic agents Gliclazide Tab 80 MG OR TABS C DM2 Therapeutic - ChroniLine
607 Endocrine System Anti-diabetic agents Oral anti-diabetic agents Gliclazide Tab SR 24HR 30 MG OR TABS C DM2 Therapeutic - ChroniLine
608 Endocrine System Anti-diabetic agents Oral anti-diabetic agents Gliclazide Tab SR 24HR 60 MG OR TABS C DM2 Therapeutic - ChroniLine
609 Endocrine System Anti-diabetic agents Oral anti-diabetic agents Metformin HCl Tab 500 MG OR TABS C DM2 Therapeutic - ChroniLine
610 Endocrine System Anti-diabetic agents Oral anti-diabetic agents Metformin HCl Tab 850 MG OR TABS C DM2 Therapeutic - ChroniLine
611 Endocrine System Anti-diabetic agents Oral anti-diabetic agents Metformin HCl Tab 1000 MG OR TABS C DM2 Therapeutic - ChroniLine
612 Endocrine System Anti-diabetic agents GLP-1 agonists NONE LISTED
613 Endocrine System Anti-hypoglycaemic agents Anti-hypoglycaemic agents Glucagon For Inj Kit 1 MG INJ KIT A CDL Therapeutic - ChroniLine Pre-Auth
614 Endocrine System Thyroid Thyroid Levothyroxine Sodium Tab 100 UG OR TABS C TDH Therapeutic - ChroniLine
615 Endocrine System Thyroid Thyroid Levothyroxine Sodium Tab 50 UG OR TABS C TDH Therapeutic - ChroniLine
616 Endocrine System Thyroid Thyroid Levothyroxine Sodium Tab 25 UG OR TABS C TDH Therapeutic - ChroniLine
617 Endocrine System Parathyroid and calcitonin Parathyroid and calcitonin NONE LISTED
618 Endocrine System Corticosteroids Corticosteroids Betamethasone Sodium Phosphate Inj 4 MG/ML INJ SOLN A Consumables - Clinic use only
619 Endocrine System Corticosteroids Corticosteroids Betamethasone Syrup 0.6 MG/5ML OR SYRP A Max 3 fills/annum
620 Endocrine System Corticosteroids Corticosteroids Dexamethasone Sodium Phosphate Inj 4 MG/ML INJ SOLN A Consumables - Clinic use only
621 Endocrine System Corticosteroids Corticosteroids Fludrocortisone Acetate Tab 0.1 MG OR TABS C ADS Therapeutic - ChroniLine Pre-Auth
622 Endocrine System Corticosteroids Corticosteroids Hydrocortisone Sodium Succinate For Inj 100 MG INJ SOLN A Consumables - Clinic use only
623 Endocrine System Corticosteroids Corticosteroids Hydrocortisone Tab 10 MG OR TABS C ADS Therapeutic - ChroniLine Pre-Auth
624 Endocrine System Corticosteroids Corticosteroids Prednisolone Syrup 15 MG/5ML OR SYRP A Max 3 fills/annum
625 Endocrine System Corticosteroids Corticosteroids Prednisolone Tab 5 MG OR TABS A Max 3 fills/annum
626 Endocrine System Corticosteroids Corticosteroids Prednisolone Tab 5 MG OR TABS C ADS, AST, BCE, COP, CSD, UC, RHA, SLE Therapeutic - ChroniLine
627 Endocrine System Corticosteroids Corticosteroids Prednisone Tab 5 MG OR TABS A Max 3 fills/annum
628 Endocrine System Corticosteroids Corticosteroids Prednisone Tab 5 MG OR TABS C ADS, AST, BCE, COP, CSD, UC, RHA, SLE Therapeutic - ChroniLine
629 Endocrine System Sex hormones Androgens and anabolic steroids NONE LISTED
630 Endocrine System Sex hormones Oestrogens Estradiol Valerate Tab 1 MG OR TABS C Therapeutic - ChroniLine Pre-Auth
631 Endocrine System Sex hormones Oestrogens Estradiol Valerate Tab 2 MG OR TABS C Therapeutic - ChroniLine Pre-Auth
632 Endocrine System Sex hormones Oestrogens Estrogens, Conjugated Tab 0.3 MG OR TABS C Therapeutic - ChroniLine Pre-Auth
633 Endocrine System Sex hormones Oestrogens Estrogens, Conjugated Tab 0.625 MG OR TABS C Therapeutic - ChroniLine Pre-Auth
634 Endocrine System Sex hormones Oestrogens Estrogens, Conjugated Tab 1.25 MG OR TABS C Therapeutic - ChroniLine Pre-Auth
635 Endocrine System Sex hormones Progestogens Medroxyprogesterone Acetate Tab 5 MG OR TABS A C Max 15/Rx & 2 fills per annum / Therapeutic - ChroniLine Pre-Auth
636 Endocrine System Sex hormones Progestogens Medroxyprogesterone Acetate Tab 10 MG OR TABS A C Max 15/Rx & 2 fills per annum / Therapeutic - ChroniLine Pre-Auth
637 Endocrine System Sex hormones Combinations Estradiol Val 1 MG & Estradiol-Norethin Tab 1-1 MG OR TABS C HRT Therapeutic - ChroniLine Pre-Auth
638 Endocrine System Sex hormones Combinations Estradiol Val 2 MG & Estradiol-Norethin Tab 2-1 MG OR TABS C HRT Therapeutic - ChroniLine Pre-Auth
639 Endocrine System Tropic hormones Tropic hormones NONE LISTED
640 Endocrine System Hormone inhibitors Hormone inhibitors NONE LISTED
641 Vitamins, Tonics, Minerals and Electrolytes Vitamins Vitamins Niacin Tab CR 500 MG OR TABS C HYL Therapeutic - ChroniLine
642 Vitamins, Tonics, Minerals and Electrolytes Vitamins Vitamins Pyridoxine HCl Tab 25 MG OR TABS C CDL (Only whilst on Isoniazid) Therapeutic - ChroniLine Pre-Auth
643 Vitamins, Tonics, Minerals and Electrolytes Vitamins Vitamin combinations NONE LISTED
644 Vitamins, Tonics, Minerals and Electrolytes Vitamins Calcium Calcium Gluconate Chew Tab 300 MG OR CHEW C CRD, SLE Therapeutic - ChroniLine
645 Vitamins, Tonics, Minerals and Electrolytes Vitamins Calcium Calcium Gluconate Tab 300 MG (Elemental Ca) OR TABS C CRD, SLE Therapeutic - ChroniLine
646 Vitamins, Tonics, Minerals and Electrolytes Vitamins Calcium Calcium Carbonate Chew Tab 1250 MG OR CHEW C CRD, SLE Therapeutic - ChroniLine
647 Vitamins, Tonics, Minerals and Electrolytes Vitamins Prenatal vitamins Folic Acid Tab 5 MG OR TABS A OTC Max 9 Rx/annum (Gender)
648 Vitamins, Tonics, Minerals and Electrolytes Vitamins Prenatal vitamins Folic Acid Tab 5 MG OR TABS C CRD, CSD, MSS, RHA, SLE, UC Therapeutic - ChroniLine
649 Vitamins, Tonics, Minerals and Electrolytes Vitamins Prenatal vitamins Pregi Forte Capsules (nappi code 715465) OR CAPS A OTC Max 9 Rx/annum (Gender)
650 Vitamins, Tonics, Minerals and Electrolytes Vitamins Prenatal vitamins Calcipreg Tablets (nappi code 704600) OR TABS A OTC Max 9 Rx/annum (Gender)
651 Vitamins, Tonics, Minerals and Electrolytes Vitamins Prenatal vitamins Preg-Natal Capsules (nappi code 701693) OR CAPS A OTC Max 9 Rx/annum (Gender)
652 Vitamins, Tonics, Minerals and Electrolytes Vitamins with minerals Vitamins with minerals Calcium Carbonate-Vitamin D Chew Tab 1250 MG-200 Unit OR CHEW C CRD, SLE Therapeutic - ChroniLine
653 Vitamins, Tonics, Minerals and Electrolytes Vitamins with minerals Vitamins with minerals Calcium Carbonate-Vitamin D Tab 1250 MG-400 Unit OR TABS C CRD, SLE Therapeutic - ChroniLine
654 Vitamins, Tonics, Minerals and Electrolytes Vitamins with minerals Vitamins with minerals Calcium-Magnesium w/ Vitamin D Chew Tab 500MG-125MG-250 Unit OR CHEW C CRD, SLE Therapeutic - ChroniLine
655 Vitamins, Tonics, Minerals and Electrolytes Vitamins with minerals Vitamins with minerals Calcium-Magnesium w/ Vitamin D Tab 500 MG-125 MG-250 Unit OR TABS C CRD, SLE Therapeutic - ChroniLine
656 Vitamins, Tonics, Minerals and Electrolytes Tonics Tonics NONE LISTED
657 Vitamins, Tonics, Minerals and Electrolytes Minerals and electrolytes Minerals and electrolytes Magnesium Sulfate Inj 50% INJ SOLN A Consumables - Clinic use only
658 Amino-acids Amino-acids Amino-acids NONE LISTED
659 Special foods Special foods Special foods NONE LISTED
660 Cytostatics Cytostatics Cytostatics Methotrexate Tab 2.5 MG OR TABS C CSD, MSS, RHA, SLE, UC Therapeutic - ChroniLine Pre-Auth
661 Immunological Immunological Immunosuppressants Azathioprine Tab 50 MG OR TABS C CSD, MSS, RHA, SLE, UC Therapeutic - ChroniLine Pre-Auth
662 Immunological Immunological Immunostimulants NONE LISTED
663 Chelating Agents, Ion Exchange Preparations Chelating Agents, Ion Exchange Preparations Chelating agents, ion exchange preparations NONE LISTED
664 Biologicals Biologicals Flu Vaccination High risk members only, as per 2022 flu vaccination policy
665 Biologicals Biologicals Other Biologigals NONE LISTED
666 Diagnostics and Devices Diagnostics and Devices Insulin syringes and needles Insulin Pen Needle - MISC C Therapeutic - ChroniLine Pre-Auth
667 Diagnostics and Devices Diagnostics and Devices Glucometers GlucoCheck Classic Blood Glucose Monitoring Unit - KIT C Therapeutic - ChroniLine Pre-Auth
668 Diagnostics and Devices Diagnostics and Devices Glucometer test strips - TEST C Therapeutic - ChroniLine Pre-Auth
669 Diagnostics and Devices Diagnostics and Devices Glucocheck Lancets - MISC C Therapeutic - ChroniLine Pre-Auth
670 Diagnostics and Devices Diagnostics and Devices Inhaler Devices Drug Application Product - Misc - DEVI C Therapeutic - ChroniLine Pre-Auth
Category Sub-category Description Active Ingredient Label Name Administer Dosage Form Acute Chronic OTC CDL Conditions Quantities and Limitations

Disclaimer:
Please note that the formulary will be reviewed regularly by clinical and pharmaceutical advisors to ensure it complies with the latest industry norms for the treatment of these conditions. Prime Cure reserves the right to change medication on the formulary when important information comes to light that requires us to do so – for instance, new findings regarding safety of medicine.